Under OSHA’s General Duty Clause, employers must provide a workplace free from recognized hazards likely to cause serious injury or death. OSHA regulations require PPE and respiratory protection where necessitated by the hazards at the workplace. Infectious diseases represent a recognized hazard at many workplaces across the United States (particularly in healthcare) and employers must implement appropriate procedures to protect employees.
For the past 50 years, employers have leaned heavily on guidance from the federal Centers for Disease Control and Prevention (“CDC”) to ensure that they had sufficient means of abatement in place. Federal OSHA has long deferred to CDC recommendations when it comes to workplace health protocols—from COVID-19 to tuberculosis to seasonal flu. Employers across industries have looked to guidance from the National Institute of Occupational Safety and Health, a division of the CDC, as a resource for occupational safety and health best practices and recommended exposure levels for chemicals.
Under the Trump Administration, the NIOSH workforce has been mostly eliminated. NIOSH may lack capacity to conduct research and make chemical exposure recommendations in the future. HHS director Robert F. Kennedy Jr. further has made public efforts to intervene in the CDC’s scientific recommendations, particularly with regard to virology and the efficacy of vaccines and treatments.
Important Questions on the Horizon
Whether it is COVID, tuberculosis, monkeypox, or a new global pandemic, employers will need to move forward in a new environment.
- In light of recent developments at the CDC and dismantling of NIOSH, how do employers respond to an infectious disease outbreak at work?
- Should employers treat the CDC as a reliable partner for employee health and compliance purposes?
- Will following CDC recommendations protect employees and ensure OSHA compliance?
- Should employers rely on NIOSH for occupational health levels going forward?
CDC: Concerns as to Staffing, Science, and Stability
The CDC has shed nearly one-quarter of its workforce since early 2025, with thousands of employees laid off or having resigned. Sources report that up to 85% of NIOSH employees have left the agency in 2025. The agency has been rocked by internal turmoil, including the ouster of Director Susan Monarez and a wave of policy reversals. The CDC has published guidance that has raised questions in the scientific community, though the agency has focused on childhood vaccines and over-the-counter medications with unproven links to autism. With this new focus, scientific projects on potential occupational exposures to infectious disease may have been disrupted or abandoned. Notably, the CDC reversed its COVID-19 vaccine guidance in October 2025 and general vaccine guidance in December 2025, shifting from universal recommendations to “consult your provider” language.
OSHA’s Position: CDC as a Reference, Not a Rule
OSHA does not mandate adherence to CDC guidance, but it often uses the CDC or NIOSH as a benchmark for what constitutes “reasonable” or “recognized” safety controls to protect employees from hazards, particularly in health care. In enforcement actions, CDC recommendations can serve as evidence of industry standards and recognized hazards to support a General Duty Clause Violations. But if those recommendations are unstable, politically influenced, or scientifically questionable, their value in employee health and OSHA compliance defense diminishes. Employers are ultimately accountable for protecting workers and must decide how much faith to place in these recommendations going forward.
What Should Employers Do?
On infectious diseases, employers will need to track guidance on pressing issues, as guidance and alternative source guidance may change abruptly. They should also track alternative sources of information. Four Western states formed the West Coast Health Alliance, focusing on providing evidence-based recommendations, initially regarding immunizations. This may be a helpful resource in the event of a controversial infectious disease issue. The New England Journal of Medicine (NEJM) is partnering with the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota to create an alternative to the CDC’s Morbidity and Mortality Weekly Report (MMWR). The new initiative will involve a rapid digital alert system, published for free through a new section of NEJM Evidence, to disseminate essential public health data on outbreaks and other critical issues. This may provide additional data and information in the future.
NIOSH has been at the cutting edge of industrial hygiene research and recommendations for occupational exposure limits that may be lower than those covered by the OSHA standards. In the absence of NIOSH recommendations, employers would be wise to track developments from American Conference of Governmental Industrial Hygienists (ACGIH) TLVs, in the absence of future NIOSH guidance.
Document the Rationale
If you follow CDC or NIOSH guidance, you should make an effort to inquire whether it is consistent with scientific and guidance and document why the guidance should be valid in your context. If you deviate, show that what alternative authoritative source you are relying on, and why it is evidence-based.
For OSHA compliance, employers must treat CDC guidance treat as one input—not necessarily the final word. The burden of proof is shifting: it may no longer be enough to say, “we followed CDC guidance.” You must ensure that your infectious disease protocols are defensible and effective.
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