California Adopts First-in-Nation Airborne Disease Standards

January 1, 0001


On May 21, 2009, the California Occupational Safety and Health Standards Board adopted two ground-breaking regulations aimed at protecting workers in healthcare, emergency services, and various other workplaces against infection from airborne diseases and those transmissible by animals. Originally prompted by the resurgence of tuberculosis in the 1980’s, the rulemaking process was recently revived following expressions of concern by healthcare workers regarding exposure to Severe Acute Respiratory Syndrome (“SARS”), pandemic flu and other long-standing diseases like tuberculosis (“TB”) as well as emerging diseases. The new regulations -- Sections 5199 and 5199.1 of the General Industry Safety Orders -- are comprehensive and require covered employers to create procedures for preventing and handling exposure to airborne diseases, including those spread by animals. There are no comparable federal standards.

Section 5199 applies to a variety of employers where employees are at increased risk of exposure to people who are capable of transmitting infection. These employers include (among others) health care facilities such as hospitals and skilled nursing facilities, health service providers such as paramedics, correctional facilities, homeless shelters, and laboratories that use materials that may contain aerosol transmissible pathogens. These employers are required to implement a written Aerosol Transmissible Disease (“ATP”) Exposure Control Plan (the “Plan”) particular to the workplace that minimizes employee exposure to ATPs. The Plan must incorporate procedures for, among other things:

  • identifying and isolating or transferring individuals with airborne infectious diseases;
  • providing respiratory protection to employees who may be exposed;
  • providing medical services to exposed employees;
  • reporting cases of exposure;
  • providing seasonal influenza vaccine to employees with occupational exposure; and
  • providing training on occupational exposure to employees.

Employers that may have operational exposure to airborne diseases and refer suspected cases to other facilities must implement procedures for screening cases and reducing the risk of transmission to employees, including providing for respiratory protection and vaccination for employees.

Section 5199.1 applies to workplaces with employee exposure to animals such as farms, slaughterhouses, veterinary facilities, zoos, and laboratories potentially containing zoonotic aerosol transmissible pathogens (“zoonotic ATPs”). (The regulations do not apply to restaurants if they are only exposed to animal products that have passed USDA or CDFA inspection.) These employers are required to implement procedures to prevent employee exposure to zoonotic ATPs, including through sanitation, investigation of occupational injuries and illnesses, training, and use of protective equipment. The regulation incorporates a graduated system of controls based on the level of disease hazard and type of operations.

These regulations are detailed and require employers to create comprehensive plans for dealing with the risk of exposure to airborne diseases such as flu, TB, SARS, and others. Employers are well advised to review the regulations carefully to determine whether they are covered by these regulations and, if so, to take steps to comply with them.