The Labor Department will soon begin penalizing health care employers who fail to protect workers from exposure to AIDS and other blood-borne diseases, department sources said yesterday.

The decision means that the federal government will for the first time subject hospitals and other medical facilities to legal sanctions, such as fines, for failure to enact safeguards protecting workers against transmission of acquired immune deficiency syndrome.

Under the policy, the sources said, the Labor Department's Occupational Health and Safety Administration plans to mount an enforcement campaign to ensure that hospitals and other facilities follow established safety guidelines, such as those issued by the federal Centers for Disease Control.

Facilities that fail to follow these guidelines, which include urging workers to wear special protective clothing and take other safety measures, could face fines ranging up to $10,000 per violation under OSHA rules.

"We believe we need to begin enforcing our existing guidelines," said a Labor source who insisted on anonymity. "We don't think that the {adherence to} the guidelines by employers is consistent enough."

However, OSHA's decision is likely to disappoint unions representing health care workers, who had been pressing the agency to use emergency rules to quickly draft and implement new safety standards for AIDS and hepatitis B.

OSHA has decided to eschew that approach and instead use existing federal rules to make sure employers protect workers from blood-borne diseases like AIDS. Several union officials expressed concern yesterday that OSHA, which has come under heavy criticism in Congress in recent years for poor oversight, would not be vigorous in enforcing its rules. The union officials also said existing OSHA rules do not specifically address the AIDS problem and only generally deal with hazardous substances in the work place.

OSHA chief John A. Pendergrass will formally disclose the new policy on blood-borne diseases at a House hearing this morning, sources said. The announcement follows ten months of intensive debate within the Labor Department.

As part of the new policy, OSHA will initiate the formal process of devising explicit rules on AIDS and hepatitis B, a process that is likely to take several years to complete. In the meantime, in addition to the enforcement campaign using existing rules, the agency will undertake, along with the Department of Health and Human Services, an education campaign to inform health workers about how to prevent the spread of these diseases.

Public health officials have long said the risk of health care workers contracting the AIDS virus through exposure to blood in health facilities is extremely slim, with nine cases of such transmission reported. However, concerns about the issue have risen in recent months with several new cases and reports of orderlies, nurses and doctors refusing to work with AIDS patients.

The reports have underscored the need for workers to follow the nonbinding recommendations of such agencies as the Centers for Disease Control, health officials have said. The CDC guidelines call for workers to wear gloves, masks and other protective clothing when coming in contact with blood, as well as procedures to prevent accidental needle wounds.

Several unions representing health care workers have been pressing OSHA since late last year to enact enforceable standards for employers, arguing that many hospitals do not rigorously follow the guidelines.

The unions petitioned OSHA to take the unusual step of adopting an emergency standard outlining specific requirements to prevent workplace transmission of AIDS and hepatitis B, of which there are many more reported cases of transmission in hospitals. However, the agency has decided to reject this petition, and instead adopt normal rule-making procedures, which union officials fear could get bogged down in delay.

The agency took this route in part because it feared hospitals would successfully challenge the emergency rules in court, Labor sources said. Agency officials also believe that they could accomplish the same goal by using OSHA rules currently in place requiring, for instance, employers to protect workers from recognizable hazards in the workplace.

The CDC guidelines would serve as the basis for enforcing these rules, the sources said, and OSHA inspectors could investigate and take action against facilities that fail to comply.

Jordan Barab, health and safety coordinator of the American Federation of State, County and Municipal Employees, expressed concern yesterday that OSHA lacks the manpower or will to enforce the present guidelines . "Theoretically they could have been doing this already," he said. "This is not as good as having something down on paper."

A spokeswoman for the American Hospital Association said that hospitals fully support the CDC guidelines, but she questioned the need for the government to adopt "strict regulations or to go in with fines."