Last Update: 03/26/2020
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- Cal/OSHA’s Aerosol Transmissible Diseases (ATD) Standard
- Personal Protective Equipment
- Laboratory Operation Requirements
Cal/OSHA’s published Interim Guidance for Healthcare Workers on 2019 Novel Coronavirus Disease seems to be in the process of being revised and currently is not available on the Cal/OSHA website. The summary below is based on the last published version of the interim guidance.
Cal/OSHA’s regulations require protection for workers in healthcare settings exposed to airborne infectious diseases such as the 2019 novel coronavirus disease (COVID-19)
- Cal/OSHA’s Aerosol Transmissible Diseases Standard (ATD Standard) requires airborne and contact precautions for patients with suspected or confirmed COVID-19.
- Personal Protective Equipment PPE for COVID-19 must include, at minimum, N95 respirators or higher, isolation gowns, eye protection, and gloves.
- A Powered Air-Purifying Respirator (PAPR) with high efficiency particulate air filters must be worn during aerosol generating procedures on suspected or confirmed COVID-19 cases.
- Laboratories handling COVID-19 causing pathogens or suspect pathogens must follow the CDC Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with 2019 Novel Coronavirus (2019-nCoV).
Cal/OSHA requires employers covered by the Aerosol Transmissible Diseases (ATD) Standard (California Code of Regulations, title 8, section 5199) to protect employees from airborne infectious diseases such as COVID-19 and pathogens transmitted by aerosols. The ATD Standard applies to:
- Hospitals, skilled nursing facilities, clinics, medical offices, outpatient medical facilities, home health care, long-term health care facilities, hospices, medical outreach services, medical transport and emergency medical services
- Certain laboratories, public health services and police services that are reasonably anticipated to expose employees to an aerosol transmissible disease.
- Correctional facilities, homeless shelters, and drug treatment programs.
- Any other locations when Cal/OSHA informs employers in writing that they must comply with the ATD Standard.
Personal protective equipment (PPE) for workers providing care to suspected and confirmed COVID-19 cases includes gloves, gowns or coveralls, eye protection, and respiratory protection.
Respirators must be labeled as certified by NIOSH and must have filters that remove at least 95 percent of airborne particles (N95) or more.
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. Surgical and face masks must not be used instead of an approved respirator such as an N95 mask.
Employers must provide and ensure employees use PPE and respiratory protection when employees:
- Enter or work in an airborne isolation room or area with a case or suspected case.
- Are present during procedures or services on a case or suspected case.
- Repair, replace, or maintain air systems or equipment that may contain pathogens.
- Decontaminate an area that is or was occupied by a case or suspected case.
- Are present during aerosol generating procedures on cadavers of cases or suspected cases.
- Transport a case or suspected case within a facility or within a vehicle when the patient is not masked.
- Are working with viable virus in the laboratory.
With some exceptions, employers must provide a powered air-purifying respirator (PAPR) with high efficiency particulate air filters to employees who perform high hazard procedures on COVID-19 cases or suspected cases. Such procedures include but are not limited to intubation, caring for patients on positive-pressure ventilation, and suctioning of the airway. Emergency medical services employees can use N100, R100, or P100 respirators instead of PAPRs.
Laboratory operations capable of aerosolizing infectious pathogens must have a biosafety plan and a qualified biosafety officer. Additionally, employers with laboratory operations in which employees have direct contact with cases or suspected cases must comply with all other applicable parts of the ATD Standard.
Laboratories handling COVID-19 causing pathogens or suspect pathogens must follow the CDC Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with 2019 Novel Coronavirus (2019-nCoV), which includes, but is not limited to the following:
- Wear appropriate personal protective equipment including disposable gloves, laboratory coat/gown, respiratory, and eye protection.
- Perform procedures that may generate fine-particulate aerosols (e.g., vortexing or sonication of specimens in an open tube) in a Class II Biological Safety Cabinet (see title 8 section 5154.2 for further information on biological safety cabinets).
- Use appropriate physical containment devices (e.g., centrifuge safety buckets; sealed rotors) for centrifugation.
- Use work practices that minimize the risk of exposure for procedures done outside a biological safety cabinet.
- Decontaminate work surfaces and equipment with appropriate disinfectants after specimens are processed.
- Autoclave disposable waste.
Virus isolation in cell culture and initial characterization of viral agents recovered in cultures of COVID-19 specimens are NOT recommended at this time, except at a biosafety level 3 facility.
See the CDC & CDPH guidelines below for more specific guidance.
- Cal/OSHA Interim Guidelines for General Industry on 2019 Novel Coronavirus Disease (COVID-19)
- Cal-OSHA Interim Guidance for Healthcare Workers on 2019 Novel Coronavirus Disease (COVID-19)
- Cal/OSHA’s ATD standard
- CDC Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with 2019 Novel Coronavirus (2019-nCoV)