A dental office fails to provide the hepatitis B vaccination series to a clinical employee at no cost, and an employee's exposure incident goes unreported. Which body's requirements have been violated?

Correct answer: B. OSHA (Occupational Safety and Health Administration)

• A. The FDA regulates devices, drugs, and sterilization equipment clearance — not employer duties toward staff.
• B. CORRECT. The OSHA BLOODBORNE PATHOGENS STANDARD (29 CFR 1910.1030) is ENFORCEABLE LAW. It requires the employer to offer the hepatitis B vaccine series free of charge to all employees with occupational exposure within 10 working days of assignment, to maintain a written exposure control plan, to record and evaluate exposure incidents, and to provide post-exposure follow-up. Failure on any of these points is a citable violation carrying fines.
• C. HIPAA governs the privacy and security of protected health INFORMATION. It has nothing to do with employee vaccination or exposure reporting.
• D. The CDC issues GUIDELINES and RECOMMENDATIONS — including the 2003 Guidelines for Infection Control in Dental Health-Care Settings — but CDC guidance is not itself law. OSHA and state boards are the enforcement bodies; they frequently adopt CDC recommendations as the standard of care.

Note: Sort this family of questions by asking WHO is being protected. Protecting the EMPLOYEE = OSHA. Protecting the PATIENT from cross-infection = CDC guidelines and the state dental board. Protecting patient INFORMATION = HIPAA. Glove washing/reuse violates CDC guidance (and is a standard-of-care/board issue); a dentist's own HIV status is protected health information and is generally not required to be disclosed if standard precautions are followed.