NEW CALIFORNIA STATE LAW :: COMPLIANCE MANDATORY
Primary Care Physicians & ClinicsClick here to download a summary sheet for primary care physicians and clinics from the Division of Occupational Safety and Health [DOSH].
ATD Standard TextClick here to download a copy of the approved ATD Standard text.
THE NEW AEROSOL TRANSMISSIBLE DISEASE LAW EFFECTIVE AUGUST 5TH, 2009
The new Aerosol Transmissible Disease [ATD] Standard requirements, affecting all medical facilities regardless of size, location or specialty, went into effect on August 5th, 2009. Compliance is mandatory. ATD will affect all medical facilities regardless of size, location or specialty.
What’s at risk?
- Cal/OSHA fines from $25,000 & up
- Workers comp premium increases
- Criminal homicide charges should an employee die from an ATD
- Attorney fees and / or civil fines if sued for wrongful death
Affected employers include medical facilities of all sizes:
- Doctors
- Clinics
- Health care environments
- Pathology laboratories & x-ray facilities
- Hospitals, emergency clinics
- Alternative medicine
- Pharmacies
- Ambulances, paramedics, fire and police services
- Public health services
- Homeless Shelters
- Drug treatment programs
- Coroners & mortuaries
- Maintenance of medical facilities
- Correctional facilities
CALL HRI FOR A FREE CONSULTATION
We will help you limit your exposure and minimize employee claims and expenses.
STATISTICS TO DATE:
According to the CDPH, the numbers of reported Hospitalized, ICU, and Fatal Cases of Pandemic (H1N1) 2009 Influenza Virus Infections in California, as of November 7th, 2009, are:
- 5,380 hospitalizations, ICU cases, and deaths
- 297 deaths
For the latest statistics and information, visit the California Department of Public Health Novel Influenza A (H1N1) Virus - Data and Statistics page.
ADDITIONAL FLU RESOURCES RESOURCES
For more information about HINI and other transmissible illnesses, visit these organizations:
- The California Influenza Surveillance Project (CISP)
- The CDC Influenza Home Page
- The Nation Institute of Allergy and Infectious Diseases (NIAID)
- The World Health Organization
ATD FAQs
As a direct result of the experiences with Severe Acute Respiratory
Syndrome (SARS), Avian Influenza, and the Novel Influenza H1N1, Cal /
OHSA Standards Board has adopted an Aerosol Transmissible Standard on
May 21, 2009 with an effective date of August 5, 2009. This is a very
important milestone in occupational health standards development, as
it is the first standard of its kind to explicitly acknowledge that inhalation
exposure is likely to be the predominant mechanism for transmission of
a variety of lower respiratory infections. Its particular importance
is underscored by its adoption in the context of the current swine flu
pandemic.
2. What kinds of businesses are exempt from the regulation?
3. How does an employer know which ATDs are covered?
4. I am a small medical office of less than 10 employees. How can I conform to the new standard?
5. As an employer, what are my requirements to protect my employees?
6. With the need for a mask to be worn, what is the need for a "Respirator Protection Program"?
7. As an employer, what liabilities can I face?
1. What kinds of businesses
are required to comply with the new "Aerosol Transmissible Disease" (ATD)
standard?
A. California businesses of any employee size including:
- Hospitals;
- Skilled nursing facilities;
- Clinics, medical offices, and other outpatient facilities;
- High hazard procedure facilities;
- Home health care;
- Long term health care facilities and hospices;
- Medical outreach services;
- Paramedic and emergency medical services; and
- Medical transport; and
- Homeless shelters and drug treatment programs.
2. What kinds of businesses are
exempt from the regulation?
A. Outpatient dental
clinics are not required to comply with the ATD standard IF they
meet ALL of the
following conditions:
- Dental procedures are not performed on patients identified to them as ATD cases or suspected cases;
- The business’ Injury & Illness Prevention Program (IIPP) includes a written procedure for screening patients of ATDs that is consistent with the current CDC guidelines for infection control in dental settings AND this procedure is followed before any procedure is performed;
- Employees have been trained in the screening procedure; and
- Aerosol-generating dental procedures are not performed on a patient identified through the screening procedure as presenting possible ATD exposure risk UNLESS a licensed physician determines that the patient does not currently have an ATD.
3. How does an employer know
which ATDs are covered?
A. All ATDs covered by
the Standard are listed in Appendix A
of the Standard. Currently, there are
over 70 ATDs listed including:
- Hepatitis B, C, & D;
- Tuberculosis;
- Pneumonia;
- SARS;
- Herpes
- Influenza virus;
- Measles;
- Mumps; and
- Salmonella.
4. I am a small medical office
of less than 10 employees. How can I conform to the new standard?
A. While some older medial offices will be expensive to
upgrade to meet the engineering controls of the standard, employees MUST be
protected with a written Injury & Illness Prevention Program (IIPP), which
among other requirements, include a written "Aerosol Transmissible Diseases
Exposure Control Plan."
An Administrator must be assigned to the program, as well as a back-up Administrator.
The Plan must be available to employees at the worksite.
One of the most difficult parts of the standard is protecting your employees’
exposure to ATD. While this may be somewhat done with the right Personal Protective
Equipment, it is important to know that Cal / OSHA requires an employer to
first provide "Engineering Controls" and/or "Administrative
Controls" in
lieu of "Personal Protective Equipment." "Engineering controls" may
include isolation rooms for ATD patients, separate specialized air filtration
systems. Some "Engineering Controls" do not have to be in place until
September 2010. Unfortunately, the initial employee making contact with the
suspected or diagnosed ATD patient may be the receptionist. In that case, if
the receptionist cannot be protected from the ATD patient, they will have to
be provided with the required "Personal Protective Equipment."
5. As an employer, what are my
requirements to protect my employees?
A. As
an employer, you must develop various written safety plans by law, including
your Injury & Illness Prevention Program (IIPP), amongst others. As part of your IIPP, you will be required to have three very important and integral "Programs" which would include a "Respirator Protection Program," "Aerosol Transmissible Diseases Exposure Control Plan," and "Personal Protective Equipment" section
dealing with other required safety equipment such as gloves, aprons, non-respirator
type masks and safety glasses/splash proof goggles or shields.
Under those various "Programs," you are required to provide a certain level of documentable training at various times throughout the employee’s employment, including when they are hired. Under the "Aerosol Transmissible Diseases Exposure Control Plan," you will be required to provide a certain level of vaccinations and medical testing at times throughout the employee’s employment and especially is they are exposed to one of the ATDs.
As with all of the "Plans," record keeping and documentation is
required and essential.
6. With the need for a mask to
be worn, what is the need for a "Respirator Protection Program"?
A. While some medical offices have been using "surgical masks" for
years, the new regulation will require a certain type of mask to be used. This
mask is commonly referred to as an "N95 mask." This mask is considered
by Cal / OSHA as a "respirator," thus requiring employers to have
a "Respirator
Protection Program" in place. One of the most important parts of a "Respirator
Protection Program" is the "Fit-Test," which
is required initially and annually (two years for employees who are not exposed
to high hazard procedures).
7. As an employer, what liabilities
can I face?
A. Based upon previous enforcement
of the Bloodborne Pathogen Standard by Cal / OSHA, it is expected that if an
employer were cited for not having an ATD Program, it would be cited as a "serious
violation" with a fine not exceeding $25,000.00. This would not include
other fines for violations found such as not having an Injury & Illness Prevention
Program, which is a maximum fine of $5,000.00. Fines can be "stacked," so
they can add up quickly. These fines are based on whether and injury occurs
or not. If it could be proved that an employee died from the failure of the
employer to not protect the employee’s safety, the fines would go up significantly
and the owner of the practice could face criminal homicide charges. These fines
do not include any attorney fees or civil fines should an employer be sued
for wrongful death, etc.
In summary, there are many written safety plans required by Cal / OSHA for the medical industry. Employees are exposed to chemical, ergonomic injuries, transmissible disease and bloodborne pathogen exposures on a daily basis. Employers need to maintain effective and business specific safety plans to protect themselves from both civil and criminal lawsuits.
The "Aerosol Transmissible Disease" Standard is 48 pages in length (as compared to the Bloodborne Pathogen Standard of 27 pages) and is now being considered as a model for federal OSHA and Canadian OSHA to implement in the near future. With the increased exposure to the H1N1 virus, now is the time to start preparing for this regulation.
HRI AT THE FOREFRONT
We are leading the human resources industry in helping clients meet the "Aerosol Transmissible Disease Standard." Because no two offices or facilities are the same, we are providing FREE on-site appointments to discuss ATD requirements in detail, and determine what is needed to ensure compliance with this new law.
Additionally we can provide and assist employers with all Cal / OSHA-required safety programs for the medical industry.
We are at the forefront of the issues as they arise for our clients. We have expertise in employer issues and stay on top of developing laws, trends, and regulations, allowing you to focus on running your practice. Please call 925.556.4044 to set up your FREE appointment
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