OSHA issued a compliance directive effective November 20, 2009 to ensure uniform procedures when conducting inspections to identify and minimize or eliminate high to very high risk occupational exposures to the 2009 H1N1 influenza A virus.  The directive applies to frontline healthcare and emergency medical workers at high risk of infection.  The directive closely follows the Centers for Disease Control (CDC) guidance.

In response to complaints, OSHA inspectors will ensure that healthcare employers implement a hierarchy of controls, and encourage vaccination and other work practices recommended by the CDC. Where respirators are required to be used, the OSHA Respiratory Protection standard must be followed, including worker training and fit testing. The directive also applies to institutional settings where some workers may have similar exposures, such as schools and correctional facilities.

The CDC recommends the use of respiratory protection that is at least as protective as a fit-tested disposable N95 respirator for healthcare personnel who are in close contact (within 6 feet) with patients who have suspected or confirmed 2009 H1N1 influenza.

Where respirators are not commercially available, an employer will be considered to be in compliance if the employer can show a good faith effort has been made to acquire respirators.

Employers with employees at high or very high exposure risk to 2009 H1N1 illness are responsible for recording occupational cases of 2009 H1N1 illness in the OSHA 300 recordkeeping forms if all of the following requirements are met: (1) the case is a confirmed case of 2009 H1N1 illness as defined by CDC; (2) the case is work-related as defined by 1904.5; and (3) the case involves one or more of the recording criteria set forth in 1904.7 (e.g., medical treatment, days away from work).Where OSHA inspectors determine that a facility has not violated any OSHA requirements but that additional measures could enhance the protection of employees, OSHA may provide the employer with a hazard alert letter outlining suggested measures to further protect workers.

For purposes of OSHA injury and illness recordkeeping, illnesses due to the 2009 H1N1 influenza are not considered a common cold or seasonal flu. The work-relatedness exception for the common cold or flu at 29 CFR 1904.5(b)(2)(viii) does not apply to these cases.