OSHA has published a hazard information
bulletin (HIB) to provide guidance to people who
reside in high or moderate risk areas in the United
States and who are exposed to ticks during the course
of their work and thus at risk of contracting Lyme
disease.* Examples of outdoor work which may be
associated with increased risk of exposure to infected
ticks include: construction work, landscaping,
forestry, brush clearing, land surveying, farming,
railroad work, oil field work, utility line work,
and park/wildlife management.
The Centers for Disease Control and Prevention
(CDC) has developed a national Lyme disease
risk map1 in which CDC identified areas of the U.S.
as minimal or no risk, low risk, moderate risk, or
high risk for predicted Lyme disease. Areas at high
or moderate risk include many counties in the Northeast
U.S., some areas around the Great Lakes, and
an area in Northern California. It is important
that state and local health department authorities be
consulted to determine risk in any given area, since
risk can vary even within a county, and perhaps from
year to year.
Lyme disease is caused by Borrelia burgdorferi,
a bacterium carried in the gut of certain ticks. When
these infected ticks attach to the human body (often
in armpits, groin, scalp, or other hairy, hidden body
areas), they slowly feed, and within 36-48 hours they
may transmit B. burgdorferi to their human host.
Young ticks are especially abundant and are seeking
hosts in late spring and early summer, although adult
ticks can transmit infection as well.
Note: This map demonstrates an approximate distribution of
predicted Lyme disease risk in the United States. The true
relative risk in any given county compared with other
counties might differ from that shown here and might change
from year to year.1
High risk
Moderate risk
Low risk
Minimal or no risk
National Lyme disease risk map with four
categories of risk
Although a majority of people with Lyme disease
develop a “bulls-eye” rash, 20-40% of persons
who have the disease do not have a rash. Other signs
and symptoms may be non-specific and similar to
flu symptoms (e.g., fever, lymph node swelling, neck
stiffness, generalized fatigue, headaches, migrating
joint aches, or muscle aches). Diagnosis is based on
a history of known exposure and development of
clinical signs and symptoms, with blood testing
providing valuable supportive information. Most
cases of Lyme disease can be successfully treated
with antibiotics. It is very important that Lyme disease
be diagnosed and treated with antibiotics, since
untreated Lyme disease may result in symptoms (i.e.,
arthritis, muscle pain, heart disease, brain and nerve
disorders) that are severe, chronic, and disabling.
This fact sheet is informational in content and advisory in
nature.
It is not a new standard or regulation and creates no legal
obligation.
Lyme Disease
facts
U.S. Department of Labor
Occupational Safety and Health Adminsitration
* See OSHA HIB 00-04 online at www.osha.gov or by
calling your nearest OSHA office listed in the blue pages of
your telepone directory.
1 “Recommendations for the Use of Lyme Disease Vaccine;
Recommendations of the Advisory Committee on Immunization
Practices (ACIP).” MMWR 6/4/1999, 48 (RR-7). www.cdc.gov.
The Directorate of Technical Support issues Hazard Information
Bulletins (HIBs) in accordance with OSHA Instruction CPL 2.65
to provide
relevant information regarding unrecognized or misunderstood
health and safety hazards, as well as potential hazards associated
with
particular materials, devices, techniques, and engineering controls.
An HIB is not a new standard or regulation, and it creates no
legal
obligations. It is advisory in nature, informational in content,
and is intended for use by employers seeking to provide a safe
and healthful
workplace. The Occupational Safety and Health Act requires employers
to comply with hazard-specific safety and health standards.
In
addition, employers must provide their employees with a workplace
free from recognized hazards likely to cause death or serious
physical
harm under Section 5(a)(1), the General Duty Clause of the Act.
Employers can be cited for violating the General Duty Clause
if there is a
recognized hazard and they do not take steps to prevent or abate
the hazard. However, failure to implement HIB recommendations
is not, in
itself, a violation of the General Duty Clause. Citations can
only be based on standards, regulations, and the General Duty
Clause.
Prevention of Lyme Disease
First line of defense is decreasing the probability
of tick bites.1 Ticks can be vectors of other
infections, in addition to Lyme disease.
- Avoidance of tick habitat (brushy, overgrown
grassy, and woody areas) particularly in spring
and early summer when young ticks feed.
- Removal of leaves, tall grass, and brush from
areas around work areas or residential areas to
decrease tick as well as host (deer and rodent)
habitat.
- Application of tick-toxic chemicals to surrounding
work or residential areas in accordance
with federal, state, and local regulations and
community standards.
Personal Protection
- Wearing light-colored clothing (to more easily see
ticks).
- Wearing long-sleeved shirts, tucking pant legs into
socks or boots (delays ticks from reaching skin so
they can be more easily found before attaching).
- Wearing high boots or closed shoes covering
entire foot.
- Wearing a hat.
- Using appropriate insect repellants on non-facial
skin and permethrin on clothes (kills ticks) in
accordance with Environmental Protection
Agency guidelines.
- Showering and washing/drying clothes at high
temperature after outdoor exposure.
- Doing a careful body check for ticks, prompt
removal with tweezers and skin cleansing with
antiseptic.
.
Workers at risk should be advised of the signs
and symptoms of Lyme disease, as well as the
primary and secondary preventive measures for this
disease. Those who are at increased risk for Lyme
disease should obtain medical advice regarding the
applicability of the Lyme disease vaccine; those who
have symptoms of suspected tick-borne infection
should seek medical attention early. More detailed
information regarding various aspects of Lyme
disease prevention can be found on the CDC web
site (www.cdc.gov).
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