CAL/OSHA Issues Interim Guidance for Protecting Workers from Exposure to Coronavirus

03.03.2020

Cal/OSHA’s regulations require protection for workers exposed to airborne infectious diseases such as the 2019 novel (new) coronavirus (2019-nCoV), first identified in Wuhan City, China in December 2019.  While the interim guidance is primarily directed at providing information to employers and workers in the healthcare industry for preventing exposure to the virus, the guidance extends beyond the healthcare industry.  The Aerosol Transmissible Diseases (ATD) standard (Title 8, California Code of Regulations, § 5199) contains the requirements for protecting employees from diseases and pathogens transmitted by aerosols.  2019-nCoV is an airborne infectious disease (AirID) covered by the ATD standard.  The ATD standard addresses employers who must comply with all elements of the ATD standard which are referred to as “full standard” employers in this article and “referring” employers who only have to comply with portions of the ATD standard.

Full Standard Employers

Employers in the following categories are presumed to have employees with some extent of occupational exposure: health care facilities, laboratories, public health services, police services and other locations where employees are reasonably anticipated to be exposed to confirmed or suspected cases of aerosol transmissible diseases.  Health care facilities and other facilities where they diagnose, treat, and house patients are obvious employers who must comply with all elements of the ATD standard but there are many other employers that are less obvious which must also comply with all elements of the ATD standard such as the following:

• Paramedic and emergency medical services including those provided by firefighters and emergency responders;
• Police services provided during transport or detention or persons reasonably anticipated to be cases or suspected cases of aerosol transmitted diseases or other police services; provided in conjunction with health care or public health operations;
• Correctional facilities and other facilities that house inmates or detainees;
• Maintenance, renovation, service or repair operations involving air handling systems or equipment or building areas that may reasonably be anticipated to be contaminated with aerosol transmissible pathogens including areas where suspected cases of airborne infectious disease cases are treated or housed, isolation rooms and/or laboratory hoods and ventilation systems.

The ATD standard requires covered employers to protect employees from AirIDs such as 2019-nCoV through the effective use of the following:

1. Written ATD exposure plan and procedure;
2. Training;
3. Engineering and work practice controls;
4. Personal protective equipment;
5. Medical services including vaccination and infection determination and treatment;
6. Laboratory operation requirements.

The requirements are too detailed to discussed in detail and can be found at Title 8, California Code of Regulations, § 5199.  Cal/OSHA has published “The California Workplace Guide to Aerosol Transmissible Diseases” which provides a guide to compliance with the ATD standard.  

Referring Employers

Referring employers are required to establish a limited set of written procedures instead of the Exposure Control Plan covered under the full ATD standard.  This category of employers includes most primary care offices and clinics, many community-based clinics, long-term health care facilities, school nurses, drug treatment facilities, homeless shelters and jails.  Employees working at such facilities may have direct contact with individuals confirmed or suspected to have an AirID and are therefore at increased risk for infection but not to the same extent as employees in a medical treating facility.

Employers whose employees have occupational exposure but do not provide diagnosis, treatment, transport, housing, isolation or management to patients with known or suspected AirIDs may qualify as referring employers if they meet all of the following conditions:

1. Screen persons for AirID.
2. Refer any person identified as a case or suspected case of AirID to an appropriate facility for care.
3. Do not intend to provide further medical services to AirID cases and suspected cases beyond first aid, initial treatment or screening, and referral.
4. Do not provide transport, housing, or airborne infection isolation to anyone identified as an AirID case or suspected case unless the transport provided is only non-medical transport in the course of referral.

Referring employers must establish the following six (6) infection control procedures in writing and make them available to employees at the work site: (1) Designate one person as the administrator to have overall responsibility for ATD infection control procedures, (2) Develop source control procedures, (3) Develop procedures for screening and referring patients exhibiting symptoms of AirIDs to appropriate facilities treatment, (4) Develop procedures to communicate between employees and “upstream” and “downstream” employers with regard to the patient, (5) Develop procedures to reduce the risk of transmission and (6) Provide the same medical services to employees as full standard employers provide.

Even if an employer is not a “full standard” employer or a “referring” employer they must still identify, evaluate, and correct hazards in their workplaces using their Injury and Illness Prevention Program, in accordance with Title 8, California Code of Regulations Section 3203.  The following is a list of resources from the Cal/OSHA website.

• Infection Control Recommendations
• CDC Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with 2019 Novel Coronavirus (2019-nCoV) – U.S. Centers for Disease Control and Prevention (CDC)
• Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus – U.S. Centers for Disease Control and Prevention (CDC)
• California Department of Public Health letters:
• All Facilities Letter 20-09, Health Update and Interim Guidance – 2019 Novel Coronavirus (nCoV), January 23, 2020
• All Facilities Letter 20-10, Healthcare Facility Resources for the 2019 Novel Coronavirus (2019-nCoV), January 27, 2020
• All Facilities Letter 20-11, Updated 2019 Novel Coronavirus Information (2019-nCoV), Including Patient Under Investigation (PUI) Guidance from the Centers for Disease Control and Prevention (CDC), January 31, 2020
• CDC Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with 2019 Novel Coronavirus (2019-nCoV).
• CDC webpage on 2019 Novel Coronavirus.
• CDPH webpage on Novel Coronavirus 2019.
• Federal OSHA webpage on 2019 Novel Coronavirus.
• World Health Organization webpage on Novel 2019 Coronavirus.

Should you have questions or need further information please contact Jonathan S. Vick at (562) 653-3200.

This AALRR publication is intended for informational purposes only and should not be relied upon in reaching a conclusion in a particular area of law. Applicability of the legal principles discussed may differ substantially in individual situations. Receipt of this or any other AALRR publication does not create an attorney-client relationship. The Firm is not responsible for inadvertent errors that may occur in the publishing process.
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