Cal/OSHA has adopted first-in-the-nation standards covering "aerosol transmissible diseases," a category that includes diseases like H1N1 influenza and Severe Acute Respiratory Syndrome (SARS) that are carried by droplets, as well as diseases spread by small airborne solids, such as anthrax spores.

The applicability provisions for the new rule are lengthy, and employers may be fully covered by the standard, partially covered, or conditionally exempt. To find out where you fall, use the checklist below.

Am I covered by the new standard? If you can answer "yes" to any of the following, you are covered under the new standard.

My workplace is a:

1. Hospital
2. Skilled nursing facility
3. Clinic, medical office, or other outpatient medical facility that is not conditionally exempt (see below)
4. Facility where high hazard procedures, including (but are not limited to) sputum induction, bronchoscopy, aerosolized administration of pentamidine or other medications, pulmonary function testing, autopsy, and clinical, surgical and laboratory procedures that may aerosolize pathogens, are performed
5. Home health care agency
6. Long term health care facility or hospice
7. Medical outreach services agency
8. Paramedic and emergency medical services provider
9. Medical transport service

My workplace is designated to receive persons arriving from the scene of an uncontrolled release of hazardous substances involving biological agents.

My agency provide police services during transport or detention of persons reasonably anticipated to be cases or suspected cases of aerosol transmissible diseases.

My agency provides police services in conjunction with health care or public health operations.

I work for a public health service agency, such as a communicable disease contact tracing or screening program that is reasonably anticipated to be provided to cases or suspected cases of aerosol transmissible diseases.

I work for a public health service agency that renders assistance in health care facilities or in connection with the provision of health care.

I work in one of the following types of facilities, services or operations:

1. A correctional facility, or other facility that houses inmates or detainees
2. A homeless shelter
3. A drug treatment program

I work for a pathology laboratory, medical examiners' facility, coroners' office, mortuary, or similar facility

I work for a laboratory that performs procedures with materials that contain or are reasonably anticipated to contain aerosol transmissible pathogens—laboratory (ATP-L) or zoonotic aerosol transmissible pathogens.

My workplace has been determined in writing by the Chief of the Division of Occupational Safety and Health, to be subject to this standard.

My workforce performs maintenance, renovation, service, or repair operations involving air handling systems or equipment or building areas that may reasonably be anticipated to be contaminated with aerosol transmissible pathogens (ATPs) or ATPs-L, including:

1. Areas in which Airborne Infectious Disease (AirID) cases and suspected cases are treated or housed.
2. Air handling systems that serve airborne infection isolation rooms or areas (AIIRs).
3. Equipment such as laboratory hoods, biosafety cabinets, and ventilation systems that are used to contain infectious aerosols.

My employer conducts hazardous waste and emergency response operations, as defined in Section 5192.

Am I conditionally exempt from this standard? If you can answer "yes" to any of the following questions, your workplace is not covered by this standard.

I work for an outpatient dental clinic or office that meets the following conditions:

1. We do not perform dental procedures on patients identified to them as ATD cases or suspected ATD cases.
2. Our Injury and Illness Prevention Program includes a written procedure for screening patients for ATDs that is consistent with current guidelines issued by the Centers for Disease Control and Prevention (CDC) for infection control in dental settings, and this procedure is followed before performing any dental procedure on a patient to determine whether the patient may present an ATD exposure risk.
3. Employees have been trained in the screening procedure in accordance with Section 3203, Cal/OSHA's Injury and Illness Prevention Programs Standard.
4. Aerosol generating dental procedures are not performed on a patient identified through the screening procedure as presenting a possible ATD exposure risk unless a licensed physician determines that the patient does not currently have an ATD.

I work for an outpatient medical specialty practice whose policy is not to diagnose or treat ATDs and which meets all of the following conditions:

1. Our practice does not perform aerosol-generating procedures on cases or suspected cases of ATD
2. Our Injury and Illness Prevention Program includes written screening procedures to identify potential ATD cases, and then refer those patients for further evaluation to an appropriate medical provider;
3. Our employees have been trained in the screening procedure in accordance with Section 3203, Cal/OSHA's Injury and Illness Prevention Programs Standard.

Which parts of the new standard do I have to comply with? Of employers who are covered by the standard, referring employers and laboratories that do not perform high hazard procedures only have to comply with certain provisions of the standard.

Am I a referring employer? If you can answer "yes" to all of the following questions, you are a "referring employer" and must only comply with the provisions listed. Do you:

1. Screen persons for airborne infectious diseases (AirID).
2. Refer any person identified as a case or suspected case of AirID.
3. Not intend to provide further medical services to AirID cases and suspected cases beyond first aid, initial treatment or screening and referral.
4. Not provide transport, housing, or airborne infection isolation (as defined in subsection (b)) to any person identified as an AirID case or suspected case, unless the transport provided is only non-medical transport in the course of a referral.

A referring employer is required only to comply with the provisions of subsections (a) Scope and Application, (c), Referring Employers, including all parts of Section 5199 referred to in subsection (c), and subsection (j), Recordkeeping.

Am I a partially exempt laboratory? If you can answer "yes" to the following condition, your laboratory is only required to comply with part of the new standard.

1. Employees in my laboratory do not have direct contact with cases or;
2. suspected cases of ATD or with potentially infected cadavers.

These laboratories are only required to comply with the provisions of subsections (a), Scope and Application, (f), Laboratories, all provisions of Section 5199 referred to in subsection (f), subsection (i), Training, and subsection (j), Recordkeeping.

If I am covered by the standard, but I am neither a referring employer nor a partially exempt laboratory, what parts of the standard do I have to comply with? Such workplaces must comply with subsections (a), Scope and Application, (d), Aerosol Transmissible Diseases Exposure Control Plan, (e), Engineering and Work Practice Controls and Personal Protective Equipment, (f), Laboratories, (g), Respiratory Protection, (h), Medical Services, (i), Training, and (j), Recordkeeping.