Abstract：
The COVID-19 pandemic spurred some regulators in the USA to require occupational health and safety programs to prevent COVID-19 transmission in workplaces. The objective of this study was to describe such state and federal regulations enacted between January 2020 and January 2022. Regulations, including emergency temporary standards (ETS) and permanent standards, were identified through a search of Nexis Uni and Bloomberg Law and review of US OSHA websites and the Federal Register. Full texts were reviewed for regulatory scope, hazard and exposure definitions, determination of exposure or risk levels, and control strategies. Four state (California, Michigan, Virginia, and Oregon) and two federal regulations were identified. All regulations described respiratory aerosols as the primary source of SARS-CoV-2 and recognized person-to-person transmission by droplet, airborne, and contact routes. Only the US OSHA ETS for healthcare explicitly stated that inhalation of respiratory particles was the most likely method of COVID-19 transmission. The Virginia, Michigan, and Oregon regulations described different categories of risk defined by exposure frequency and duration or specific workplace activities. California described exposure as places and times when employees come into contact or congregate with other people. The US OSHA ETS for healthcare described exposure as involving close contact with suspected or confirmed COVID-19 patients. While all of the state regulations required strategies from across the hierarchy, only the Virginia regulations specifically incorporated the hierarchy of controls. Only the California and Virginia regulations explicitly linked control strategies to the transmission route, while Virginia demarcated control strategies by risk level. Oregon linked risk level to occupancy levels and physical distancing requirements and referred to the use of a layered approach for transmission control. The US OSHA ETS for healthcare defined droplet and airborne precautions but made no mention of the hierarchy of controls or risk levels. Respirators were discussed in most of the regulations. The first Michigan regulation explicitly required respirators appropriate to exposure risk. The California regulations noted that respirators protect the wearer while face coverings protect people around the wearer. These regulations offer insights for a permanent US OSHA infectious disease regulation, such as the need to consider a range of transmission modes including near- and far-range aerosol inhalation, endemic and novel pathogens, workplaces beyond healthcare settings, factors that contribute to exposure and risk, the hierarchy of controls, the role of vaccination, and the importance of written exposure assessment and infection prevention plans.
摘要：
COVID-19大流行促使美国一些监管机构要求开展职业健康和安全计划，以防止COVID-19在工作场所传播。这项研究的目的是描述2020年1月至2022年1月之间颁布的州和联邦法规。条例,包括紧急临时标准（ETS）和永久标准，通过搜索NexisUni和BloombergLaw以及审查美国OSHA网站和联邦公报来确定。审查了全文的监管范围，危害和暴露定义，确定暴露或风险水平，和控制策略。四个州（加利福尼亚州，密歇根州,弗吉尼亚,和俄勒冈州），并确定了两项联邦法规。所有法规都将呼吸道气溶胶描述为SARS-CoV-2的主要来源，并通过液滴在人与人之间传播。机载，联系路线。只有美国用于医疗保健的OSHAETS明确指出，吸入呼吸颗粒是最可能传播COVID-19的方法。弗吉尼亚,密歇根州,和俄勒冈州的法规描述了由暴露频率和持续时间或特定工作场所活动定义的不同类别的风险。加州将暴露描述为员工与其他人接触或聚集的地点和时间。美国医疗保健OSHAETS将暴露描述为涉及与疑似或确诊的COVID-19患者的密切接触。虽然所有的州法规都需要来自各个阶层的策略，只有弗吉尼亚州的法规专门纳入了控制的层次结构。只有加利福尼亚州和弗吉尼亚州的法规明确将控制策略与传播路线联系起来，而弗吉尼亚州则按风险等级划分控制策略。俄勒冈州将风险水平与占用水平和物理距离要求联系起来，并提到使用分层方法进行传输控制。用于医疗保健的美国OSHAETS定义了液滴和空中预防措施，但没有提及控制或风险级别的层次结构。在大多数法规中都讨论了呼吸器。密歇根州的第一项法规明确要求呼吸器适合暴露风险。加州法规指出，呼吸器保护佩戴者，而面罩保护佩戴者周围的人。这些法规为永久的美国OSHA传染病法规提供了见解，例如需要考虑一系列传输模式，包括近距离和远距离雾化吸入，地方性和新型病原体，医疗环境之外的工作场所，导致暴露和风险的因素，控制的层次结构，疫苗接种的作用，以及书面暴露评估和感染预防计划的重要性。
