November 5, 2020

OSHA's Respiratory Protection Guidance for Long-Term Care Facilities Emphasizes Source Control

New respiratory protection guidance issued on Oct. 30 by OSHA focuses on the use of respirators to help protect workers in nursing homes, assisted living facilities, and other long-term care facilities from occupational exposure to SARS-CoV-2. The guidance recommends “source control” measures for everyone in healthcare facilities due to the potential for asymptomatic and pre-symptomatic transmission of COVID-19. OSHA’s new guidance defines source control as “the use of a [product or device] to cover a person’s mouth and nose to reduce the spread of respiratory secretions and aerosols when that person is breathing, talking, sneezing, or coughing.” The agency urges healthcare providers to wear source control products or devices at all times inside long-term care facilities.

OSHA outlines several source control products and devices, some of which are also considered personal protective equipment. The guidance discusses cloth face coverings and facemasks, which are not considered PPE for the wearer but can assist in source control. According to OSHA, FDA-cleared or authorized surgical masks are preferred over cloth face coverings for healthcare workers because they provide both source control and protection for the wearer against exposure to splashes and sprays of infectious material from others. The guidance also covers respirators, including FDA-cleared or authorized surgical N95 filtering facepiece respirators, and urges employers to reassess their engineering and administrative controls to identify changes that could avoid overreliance on respirators and other PPE.

OSHA’s new guidance is available as a PDF.