California Issues Monkeypox Guidance for Employers

By Alka Ramchandani-Raj, Eric Compere, Melissa Peters, and Krystal Weaver © Littler September 21, 2022

​On Sept. 15, California's Division of Occupational Safety and Health (Cal/OSHA) published guidance on protecting workers from monkeypox. The guidance applies to workplaces covered by the Aerosol Transmissible Disease (ATD) standard, which includes healthcare facilities, medical transport, police, and public health services and others.

Of greater impact is the preamble to the guidance, which states that employers not covered under that standard (Section 5199) must protect their employees under their Injury and Illness Prevention Programs (IIPP) required under Title 8 section 3203 and sanitation requirements set forth under section 3362.

While silent on specific steps non-ATD employers must take, the guidance signals that Cal/OSHA will consider monkeypox a new workplace hazard, subject to an employer's duty to assess, correct and train employees on hazards. Employers should take any reported monkeypox case in their workplace seriously and contact a workplace safety specialist. Further, employers with public-facing employees should be prepared to document hazard assessments and sanitation efforts should Cal/OSHA make moves to utilize IIPP enforcement as a means to address the health hazard.

The guidance does not impose new obligations on employers, but provides guidance for employers already covered by the ATD. The guidance notes that monkeypox is primarily spread by "close or direct contact, but can also become airborne."

The guidance reminds employers already covered by the ATD of their obligations to:

  • Implement a written program to prevent or reduce the transmission of aerosol transmissible diseases, including monkeypox.
  • Provide and ensure the use of respiratory protection for employees that may be exposed to monkeypox.
  • Ensure that personal protective equipment (PPE) is provided and used by employees exposed to known or suspected cases of monkeypox, including when handling linens or surfaces that may be contaminated.
  • Implement written procedures to address exposure incidents.
  • Report exposure incidents to the local health officer.

Employers should keep in mind that there are different requirements for referring employers, laboratories and other facilities. In most cases, this means that employers should revisit their ATD programs to ensure that their engineering controls, work practice controls, referral procedures, etc., are able to address occupational exposure to monkeypox.

Additionally, employers subject to Cal/OSHA's ATD standard should develop practices to ensure compliance with its requirement to maintain an employee's pay, rights, and other benefits during removal due to work-related monkeypox exposure.

Employers, especially healthcare employers, should be cognizant to avoid discrimination—including discriminating against individuals who are disabled or perceived as disabled—because they are exhibiting symptoms suggestive of having contracted monkeypox, or individuals belonging to certain protected classes where the virus is most prevalent.

Employers are advised to consult with their attorney for more information or questions on how to help reduce the chances of exposure to monkeypox, and what steps to take should an employee become infected.

Alka Ramchandani-Raj and Melissa K. Peters are attorneys with Littler in Walnut Creek, Calif. Eric L. Compere is an attorney with Littler in Los Angeles. Krystal N. Weaver is an attorney with Littler in San Diego. © 2022. All rights reserved. Reprinted with permission. 



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