Multi-Employer and Related Worksites | Bloodborne Pathogens

There are a number of different types of multi-employer worksites. This paragraph addresses a few typical situations but does not address all the circumstances that occur. In addition, this paragraph deals with situations in which employees are sent out to sites that are not multi-employer worksites. Where these guidelines do not address a particular question, see CPL 2-0.124, Multi-Employer Citation Policy.

Employment agencies

An employment agency refers job applicants to potential employers but does not put these workers on the payroll or otherwise establish an employment relationship with them; thus, the employment agency is not the employer of these workers. These agencies shall not be cited for violations affecting the workers they refer. The company that uses these workers, e.g., a hospital, is the employer of these workers and shall be cited for all violations affecting them.

Personnel services

Personnel services firms employ medical care staff and service employees who are assigned to work at hospitals and other healthcare facilities that contract with the firm. Typically, the employees are on the payroll of the personnel services firm, but the healthcare facility exercises day-to-day supervision over them. In these circumstances, due to the concerns expressed by the court in American Dental Association v. Martin, 984 F.2d 823, 829-30 (7th Cir. 1993) (dictum about medical personnel services) the personnel services firm should be cited for violations of the bloodborne pathogens standard only in the following categories: (1) hepatitis B vaccinations; (2) post-exposure evaluation and follow-up; (3) recordkeeping under paragraph (h) of the standard; (4) generic training; (5) violations occurring at the healthcare facility about which the personnel services firm actually knew and where the firm failed to take reasonable steps to have the host employer (the employer using the workers, e.g., a hospital) correct the violation (see FIRM multi-employer worksite guidelines); and (6) pervasive serious violations occurring at the healthcare facility about which the personnel service firm could have known with the exercise of reasonable diligence.

When the host employer exercises day-to-day supervision over the personnel service workers, they are the employees of the host employer, as well as of the personnel service, and thus the host employer must comply with all provisions of the standard with respect to these workers. With respect to Hepatitis B vaccination, post-exposure evaluation and follow-up, recordkeeping, and generic training, the host employer’s obligation is to take reasonable measures to assure that the personnel service firm has complied with these provisions.

Home health services

The American Dental Association v. Martin decision upheld the bloodborne pathogens standard but restricted its application in the home health services industry. These are companies whose employees provide home health services in private homes. The court held that OSHA had not adequately considered feasibility problems for such employers, where employees work at sites that the employer does not control. As a result, OSHA may not cite those employers for site-dependent provisions of the standard when the hazard is site-specific.

In implementing this decision, OSHA determined that the employer will not be held responsible for the following site-specific violations: housekeeping requirements, such as the maintenance of a clean and sanitary worksite and the handling and disposal of regulated waste; ensuring the use of personal protective equipment; and ensuring that specific work practices are followed (e.g., handwashing with running water) and ensuring the use of engineering controls.

The employer will be held responsible for all non-site-specific requirements of the standard, including the non-site specific requirements of the exposure control plan, hepatitis B vaccinations, post exposure evaluation and follow-up, recordkeeping, and the generic training requirements. OSHA will also cite employers for failure to supply appropriate personal protective equipment to employees.

Physicians and healthcare professionals who have established an independent practice

In applying the provisions of the standard in situations involving physicians, the status of the physician is important. Physicians may be employers or employees. Physicians who are unincorporated sole proprietors or partners in a bona fide partnership are employers for purposes of the OSH Act and may be cited if they employ at least one employee (such as a technician or secretary). Such physician-employers may be cited if they create or control bloodborne pathogens hazards that expose employees at hospitals or other sites where they have staff privileges in accordance with the multi-employer worksite guidelines of CPL 2-0.124, Multi-Employer Citation Policy. Because physicians in these situations are not themselves employees, citations may not be based on the exposure of such physicians to the hazards of bloodborne diseases.

Physicians may be employed by a hospital or other healthcare facility or may be members of a professional corporation and conduct some of their activities at host employer sites where they have staff privileges. In general, professional corporations are the employers of their physician-members and must comply with the hepatitis B vaccination, post-exposure-evaluation and follow up, recordkeeping, and generic training provisions with respect to these physicians when they work at host employer sites. The host employer is not responsible for these provisions with respect to physicians with staff privileges, but in appropriate circumstances, may be cited under other provisions of the standard in accordance with the multi-employer work-site guidelines of CPL 2-0.124, Multi-Employer Citation Policy. The professional corporation may also be cited under other provisions of the standard for the exposure of its physicians and other workers at a host employer site in accordance with the multi-employer worksite guidelines of CPL 2-0.124, Multi-Employer Citation Policy.

Independent contractors

These are companies that provide a service, such as radiology or housekeeping, to host employers. They provide supervisory personnel, as well as rank-and-file workers, to carry out the service. These companies and the host employers are responsible for complying with all provisions of the standard in accordance with the multi-employer worksite guidelines of CPL 2-0.124, Multi-Employer Citation Policy.

Employer Responsibilities and Rights | OSHA

Employers have certain responsibilities and rights under the Occupational Safety and Health Act of 1970. The checklists which follow provide a review of many of these. Employer responsibilities and rights in states with their own occupational safety and health programs are generally the same as in federal OSHA states.

Responsibilities

As an employer, you must:

• Meet your general duty responsibility to provide a workplace free from recognized hazards that are causing or are likely to cause death or serious physical harm to employees, and comply with standards, rules and regulations issued under the Act.

• Be familiar with mandatory OSHA standards and make copies available to employees for review upon request.

• Inform all employees about OSHA.

• Examine workplace conditions to make sure they conform to applicable standards.

• Minimize or reduce hazards.

• Make sure employees have and use safe tools and equipment (including appropriate personal protective equipment), and that such equipment is properly maintained.

• Use color codes, posters, labels or signs when needed to warn employees of potential hazards.

• Establish or update operating procedures and communicate them so that employees follow safety and health requirements.

• Provide training required by OSHA standards (e.g., hazard communication, lead, etc.).

• Provide medical examinations when required by OSHA standards.

• Report to the nearest OSHA office within 8 hours any fatal accident or one which results in the hospitalization of three or more employees.

• Keep OSHA-required records of work-related injuries and illnesses, and post a copy of the totals from the last page of the OSHA 300 on the OSHA 300A Summary and post it from February 1 through April 30.(This applies to employers with 11 or more employees.)

• Post, at a prominent location within the workplace, the OSHA poster (OSHA 2203 or OSHA 3165) informing employees of their rights and responsibilities. (In states operating OSHA-approved job safety and health programs, you may post your state's equivalent poster.)

• Provide employees, former employees and their representatives access to the Log and Summary of Occupational Injuries and Illnesses (OSHA 200 or OSHA 300/300A) at a reasonable time and in a reasonable manner.

• Provide access to employee medical records and exposure records to employees or their authorized representatives.

• Cooperate with the OSHA compliance officer by furnishing names of authorized employee representatives who may be asked to accompany the compliance officer during an inspection. (If none, the compliance officer will consult with a reasonable number of employees concerning safety and health in the workplace.)

• Not discriminate against employees who properly exercise their rights under the Act.

• Post OSHA citations at or near the worksite involved. Each citation, or copy thereof, must remain posted until the violation has been abated, or for three working days, whichever is longer.

• Abate cited violations within the prescribed period.

Rights

As an employer, you have the right to:

• Seek advice and off-site consultation as needed by writing, calling or visiting the nearest OSHA Office. (OSHA will not inspect merely because an employer requests assistance.)

• Be active in your industry association's involvement in job safety and health.

• Request and receive proper identification of the OSHA compliance officer prior to inspection.

• Be advised by the compliance officer of the reason for an inspection.

• Have an opening and closing conference with the compliance officer.

• Accompany the compliance officer on the inspection.

• File a Notice of Contest with the OSHA area director within 15 working days of receipt of a notice of citation and proposed penalty.

• Apply to OSHA for a temporary variance from a standard if unable to comply because of the unavailability of materials, equipment or personnel needed to make necessary changes within the required time.

• Apply to OSHA for a permanent variance from a standard if you can furnish proof that your facilities or method of operation provide employee protection at least as effective as that required by the standard.

• Take an active role in developing safety and health standards through participation in OSHA Standards Advisory Committees, through nationally recognized standards-setting organizations and through evidence and views presented in writing or at hearings.

• Be assured of the confidentiality of any trade secrets observed by an OSHA compliance officer during an inspection.

• Submit a written request to NIOSH for information on whether any substance in your workplace has potentially toxic effects in the concentrations being used.