American Dental Association v. Martin

Due in part to growing public concern over the spread of HIV, the Occupational Safety and Health Administration (OSHA) (defendant) proposed a rule to limit healthcare workers’ exposure to bloodborne pathogens, primarily HIV and Hepatitis B, while at work. OSHA had found that two or three healthcare workers contracted HIV from work each year, for a total of 24 United States workers in the previous 10 years. OSHA had also found that many healthcare workers did not get vaccinated against Hepatitis B, approximately 20,000 healthcare workers contracted Hepatitis B from work each year, and about 200 of those workers died each year. OSHA noted that some workers became Hepatitis B carriers and then infected people outside the workplace. The proposed rule included requirements for work-area safety, types of personal protective gear, work practices, and cleaning procedures. The proposed rule also required healthcare employers to offer the Hepatitis B vaccine to their employees for free. Most of the rule’s proposed requirements were already recommended by the Centers for Disease Control (CDC). OSHA estimated it would cost the healthcare industry $813 million to implement the rule. After accepting public comments, OSHA enacted the rule, and numerous employers implemented it quickly. However, the American Dental Association and the Home Health Services and Staffing Association (the associations) (plaintiffs) sued, challenging the validity of the rule. The associations argued, among other things, that the rule actually cost much more than $813 million and that the increased medical costs would reduce medical access and cause some patients to lose their lives. The associations had not provided OSHA with any evidence for these arguments during the rulemaking process.