[MCOH-EH] [EXTERNAL] Re: [External] Source patient lab ordering for bloodborne pathogen exposures

[Swift, Melanie D., M.D., M.P.H.]

There are multiple models for this, because OHS programs have variability in how they are funded and whom they can serve. As Tom notes, some are able to extend services to non-employees, but others cannot due to legal or financial restrictions. If the individual is someone else’s employee, their employer may or may not manage BBF exposures under Worker’s Comp, which can influence where employees go for follow-up testing and PEP monitoring, even though the initial time-sensitive care  needs to be rendered on site. And of course their employer still has responsibilities under the BBP standard regardless of where the worker receives care, unless your hospital has contractually agreed to take on those responsibilities.

The Emergency Department may be a good partner who can provide BBF evaluations for non-employees, because they also are set up to manage nonoccupational BBF exposures, and in many instances already provide after hours support for employee BBF exposures.

hope this helps!
Melanie
________________________________
From: MCOH-EH <mcoh-eh-bounces at mylist.net> on behalf of Winters, Tom (BIDMC - Occupational Health) <twinters at bidmc.harvard.edu>
Sent: Saturday, October 18, 2025 7:48:57 AM
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Cc: mcoh-eh at mylist.net <mcoh-eh at mylist.net>
Subject: [EXTERNAL] Re: [MCOH-EH] [External] Source patient lab ordering for bloodborne pathogen exposures

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Great question Rob. At multiple teaching hospitals where I support these programs, we do risk assessment , start PEP if needed, their employer continues with their occ health clinic or medical department continues meds and completes medical surveillance.

Tom Winters


> On Oct 17, 2025, at 11:26 PM, Rob <rl3mped at gmail.com> wrote:
>
> I am curious how other systems are managing BBPE when it involves non-employed individuals such as visitors, non-affiliated workers (including EMS/first responders) and patients.
> Are your occupational health teams responsible for obtaining and reporting labs from source patients?
> Who is managing the post exposure evaluation, testing and treatment for the affected individuals?
>
> Thank you,
>
> Rob Pedowitz, D.O.
>
>
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