CAL/OSHA issues Interim Guidelines for Protecting Workers From Exposure to Coronavirus

Cal/OSHA's regulations require protection for workers exposed to airborne infectious diseases such as the 2019 novel coronavirus (COVID-19), first identified in Wuhan City, China in December 2019. Cal/OSHA covers virtually all employees in the state, including those employed by state and local government. There are some limited exceptions to Cal/OSHA jurisdiction, such as federal employees and offshore maritime workers.

Cal/OSHA has issued Interim Guidance for Protecting Health Care Workers and General Industry Workers from Exposure to Coronavirus

Cal/OSHA has a sector/industry-specific standard, which specifically addresses aerosol transmissible diseases covering workers with an elevated risk of contracting aerosol transmitted diseases (i.e., health care and other related industries) and a general industry standard covering all other industries. The following is the general scope of the regulations and recent recommendations for protecting employees.

Health Care Industry and the Aerosol Transmissible Diseases Standard

The Aerosol Transmissible Diseases, or ATD, standard contains the requirements for protecting workers who have an occupational exposure to diseases and pathogens transmitted by aerosols. Since coronavirus is an airborne infectious disease, it's covered by the ATD standard. The ATD Standard applies to employers whose workers have "an elevated risk of contracting a disease" caused by aerosol pathogens. The extent that employers are covered depends on the nature of the occupational exposure. Health care workers are covered because it is "reasonably anticipated" that they will have an "elevated risk of exposure" since they will be treating and working with individuals with confirmed and suspected cases of coronavirus. Some health care employers must comply with the full ATD standard, while some employers are only considered to be "Referring" employers and their requirements are somewhat less stringent.

Full Standard Employers

The ATD applies to health care facilities (i.e. hospitals, skilled nursing facilities, clinics, health care facilities), certain laboratories, public health services, police services, and other /services where workers are reasonably anticipated to be exposed to an aerosol transmissible diseases. The ATD standard also covers correctional facilities, homeless shelters, drug treatment facilities and other locations when Cal/OSHA advises them in writing they must comply with the ATD Standard.

Referring Employers

Referring employers are required to establish a limited set of written procedures, instead of the Exposure Control Plan under the full 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: (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; and (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 non-medical transport in the course of referral.

Referring employers must establish the following six infection control procedures in writing and make them available to the employees at the worksite: (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.

Cal/OSHA Interim Guidelines for General Industry on COVID-19

Cal/OSHA recommends that employers who are not covered by the ATD Standard follow the recommendations from the Centers for Disease Control and Prevention. These guidelines contain infection prevention measures which include the following: Actively encouraging sick employees to stay home; sending employees with acute respiratory illness symptoms home immediately; providing information and training to employees on proper hygiene and avoiding contact with potentially contaminated materials; performing routine environmental cleaning of shared workplace equipment and furniture, and advising employees to check CDC's Travelers Health Notices prior to travel.

The CDC guidelines also contain recommendations for creating an infectious disease outbreak response plan to be followed in the event of outbreak. These response plans include allowing flexible worksites, telecommuting and flexible work hours to increase physical distance among employees, and postponing or cancelling large work-related meetings or events.

Additional Cal/OSHA Regulations for Workplaces Where There Is Significant Risk of Exposure

There are additional regulations which may apply as well.

1. Injury and Illness Prevention Program

All employers must have an program to protect employees from workplace hazards and are required to determine coronavirus infection is a hazard in their workplace. If it is a workplace hazard, then employers must: (1) Implement measures to prevent or reduce infection hazards, such as implementing the CDC recommended actions listed above, and (2) provide training to employees on their coronavirus infection prevention methods

2. Washing Facilities

Regardless of coronavirus risk, all employers must provide washing facilities that have an adequate supply of suitable cleansing agents, water and single-use towels or blowers.

3. Personal Protective Equipment

Employers are required to conduct a hazard assessment to determine if hazards exist in the workplace which necessitate the use of personal protective equipment. If an employer identifies coronavirus as workplace hazard, they must select and provide exposed employees with properly fitting equipment that will effectively protect employees. It should be noted that surgical and other non-respirator face masks do not protect persons from airborne infectious disease and cannot be relied upon for novel pathogens. They do not prevent inhalation of virus particles because they do not seal to the person's face and are not tested to the filtration efficiencies of respirators.

4. Control of Harmful Exposures

Employers must protect employees from inhalation to harmful exposures that can cause injury. Coronavirus is a harmful exposure if there is an increased risk of infection at the workplace. Employers must implement engineering controls where feasible, and administrative controls where practical, or provide respiratory protection. The CDC recommendations provide some useful administrative controls.

We recommend that all employers provide training to its employees as soon as possible and take steps to make sure the recommendations in the Interim Guideline are being implemented. The Interim Guidelines also contain links to many other helpful resources. The CDC and other health agencies are providing frequent updates and employers should monitor these websites for updates. 