By Conn Maciel Carey’s COVID-19 Task Force
Today’s topic is cleaning and disinfecting…when cleaning/disinfecting is required and what needs to be cleaned/disinfected.
In patient care areas, resident rooms, and for medical devices and equipment, the employer must follow standard practices for cleaning and disinfection of surfaces and equipment in accordance with CDC’s “COVID-19 Infection Prevention and Control Recommendations” and CDC’s “Guidelines for Environmental Infection Control,” both of which the ETS incorporates by reference. Under the ETS and CDC Guidance, cleaning refers to removal of dirt and germs using soap and water or other cleaning agents while disinfecting means using an EPA-registered, hospital-grade disinfectant included on EPA’s “List N” in accordance with manufacturers’ instructions.
Most healthcare settings have been following this CDC Guidance throughout the pandemic, so OSHA’s incorporation of these requirements into the ETS likely requires nothing new to be done when cleaning and disinfecting. Some of the more fundamental requirements in CDC’s Guidance include:
- Dedicated medical equipment should be used when caring for patients with suspected or confirmed SARS-CoV-2 infection;
- All non-dedicated, non-disposable medical equipment used for patient care should be cleaned and disinfected according to manufacturer’s instructions and facility policies;
- Environmental cleaning and disinfection procedures should be followed consistently and correctly;
- Routine cleaning and disinfection procedures (e.g., using cleaners and water to pre-clean surfaces prior to applying an EPA-registered, hospital-grade disinfectant to frequently touched surfaces or objects for appropriate contact times as indicated on the product’s label) are appropriate for SARS-CoV-2 in healthcare settings, including those patient-care areas in which aerosol generating procedures are performed;
- Management of laundry, food service utensils, and medical waste should also be performed in accordance with routine procedures.
In all other areas of the facility not covered above, the employer must:
- clean high-touch surfaces and equipment at least once a day, following manufacturers’ instructions for application of cleaners; and
- when the employer is aware that a person who is COVID-19 positive has been in the workplace within the last 24 hours, clean and disinfect any areas, materials, and equipment under the employer’s control that have likely been contaminated by the person who is COVID-19 positive (e.g., rooms they occupied, items they touched).
As part of the hazard assessment required by the ETS, employers should identify high-touch surfaces and equipment in their workplaces to which the daily cleaning requirement will apply. The standard defines high-touch surfaces and equipment to mean any surface or piece of equipment that is repeatedly touched by more than one person. Examples include doorknobs, light switches, countertops, handles, desks, tables, phones, keyboards, tools, toilets, faucets, sinks, credit card terminals, and touchscreen enabled devices (e.g., tablets).
As to the cleaning and disinfecting requirement triggered when an employer becomes aware that a COVID-19 positive individual has been in the workplace within the last 24 hours, employers must clean and disinfect any areas, materials, and equipment under the employer’s control that have likely been contaminated by the person who is COVID-19 positive (e.g., rooms they occupied, items they touched). In making determinations about which areas, materials, and equipment have likely been contaminated, OSHA expects employers will be informed by relevant CDC guidance, the specifics of any notice received about the COVID-19 positive person in the workplace, such as when and where they were present, the person’s job duties (if the COVID-19 positive is an employee), and any additional relevant information included on the COVID-19 logs.
This cleaning and disinfecting must be done in accordance with the CDC’s “Cleaning and Disinfecting Guidance,” which includes closing off areas used by the sick person and waiting at least several hours before cleaning and disinfecting. This also includes opening outside doors and windows or using other methods to increase air circulation when feasible, using products from EPA’s “List N,” and wearing a facemask and gloves when conducting the cleaning. If a person who is COVID-19 positive has occupied the space, all potentially-contaminated surfaces, regardless of touch frequency, need to be cleaned and disinfected. Only after the space has been cleaned and disinfected can it be reopened for use.
With respect to who should conduct cleaning and disinfection duties, OSHA’s ETS FAQs state that employers can satisfy their cleaning and disinfection obligations through a variety of means. This may include contracting with a cleaning service or requiring employees to perform cleaning and disinfection duties. Employers should note that if they are relying on employees to clean and disinfect, the employer must provide the necessary supplies to employees at no cost and must ensure employees have sufficient time during their work shift to perform these cleaning and disinfection duties.
Additionally, the ETS requires employers to provide alcohol-based hand rub that is at least 60% alcohol or provide readily accessible hand washing facilities.
Please contact any of the OSHA attorneys in Conn Maciel Carey’s national OSHA Practice if you need help determining when and/or what to clean/disinfect. Also, check out our articles about other sections of the ETS, including:
Look for another blog soon!