OSHA For Healthcare 29 USC 651-678 Occupational Safety and Health Act of 1970 Provides the authority for the US Department of Labor to develop and enforce

OSHA For Healthcare

29 USC 651-678Occupational Safety and Health Act of 1970

Provides the authority for the US Department of Labor to develop and enforce standards regarding the health and safety of the workplace.

29 USC 654

SEC. 5. DUTIES

(a) Each employer –

(1)shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees;

(2)shall comply with occupational safety and health standards promulgated under this Act.

OSHA “General Duty Clause”

(b)Each employee shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his own actions and conduct.

“General Duty Clause”

Regulations are located in Title 29 of the Code of Federal Regulations (29 CFR)

Some key regulations in 29 CRF are:29 CFR 1903 – Inspections, Posting Requirements, and Citations29 CFR 1904 – Recordkeeping and Reporting29 CFR 1910 – General Industry29 CFR 1926 - Construction

OSHA Regulations

Required PostingsInformation about OSHA and basic employee rights under the act.

– A poster is available for the Department of Labor for this purpose.

An annual summary of occupational illness and injuries from the previous year

OSHA Posting Requirements

Each establishment must maintain records of occupational injuries and illnesses. TOP

Required Forms:

OSHA 300 – Annual log and summary

OSHA 300A – Calendar year summary

Must be posted from February 1 until April 30

OSHA 301 – Additional details on the injuries recorded on the OSHA 300 log

OSHA Recordkeeping

The length of time records must be maintained varies.The OSHA “300” records must be maintained for a five year period.Other records may have to be maintained for much longer periods of time.

– i.e. Employee exposure records must be maintained for the length of employment plus 30 years

OSHA Recordkeeping

Injuries must be evaluated to determine whether or not they are recordable under the OSHA regulations.

Worker’s Compensation Injuries and OSHA recordability do not always align so be sure to evaluate every injury to be sure it is properly classified.

OSHA Recordability

Certain injuries require direct reporting to OSHA and The Rules are changing!

Starting January 1, 2015An employer is required to report a fatality, in-patient hospitalization, amputation, or loss of an eye if the event is reported to employer or employer’s agent(s).

OSHA Injury Reporting

Employers are required to report a fatality within 8 hours of the death, for all fatalities occurring within 30 days of the incident.

Employers are required to report each in-patient hospitalization within 24 hours of the hospitalization, for all hospitalizations occurring within 24 hours of the work-related incident.


Employers required to report each amputation within 24 hours of the amputation, for all amputations occurring within 24 hours of the work-related incident.

Employers required to report each loss of an eye within 24 hours of the loss of an eye, for all losses of an eye occurring within 24 hours of the work-related incident.


29 CFR contains numerous subparts which have specific requirements for reducing risk to workers.

Many of these regulations have application in the healthcare setting.

Note: 29 CFR 1926 contains regulations related to construction which may apply during renovation and construction at healthcare facilities.

OSHA 29 CFR 1910 Overview

1910.1200 - Hazard Communication TOP

Recently updated to incorporate the

Globally Harmonized System– Formal hazard communication plan– Inventory of hazardous chemicals– Ensure training, labeling, and SDS maintenance– Training at the time of initial assignment, when a

new hazard is introduced into the worksite, and when transferred to a new department

OSHA 29 CFR 1910 Subpart ZToxic and Hazardous Substances

1910.1030 - Bloodborne pathogens. TOP

– Formal Exposure control plan– Categorize exposure potential– Hepatitis B Vaccine– Engineering controls– PPE


OSHA eTool: https://www.osha.gov/SLTC/etools/hospital/hazards/bbp/bbp.html

1910.1001 - Asbestos.– Asbestos-containing materials (ACM) are materials that

contain at least 1% asbestos– All construction projects performed where asbestos may

be disturbed should be monitored– Building owner must determine the presence, amount,

location, and type of asbestos in the facility, and can be held accountable for subcontractor activities


1910.1025 – Lead– Buildings constructed prior to 1980 may have lead in the

paint or pipes. Radiology and nuclear medicine areas also have lead present.

– Develop a proactive lead management program.


1910.1047 - Ethylene oxide.– Assess all areas where EtO may be used and determine

potential for exposure. This usually means air sampling.– Use engineering controls and work practices to eliminate

or reduce employee exposure at or below the permissible exposure limits (PEL)

– Medical surveillance program


1910.1048 - Formaldehyde.– Determine potential exposure in areas where chemicals

containing 0.1% or greater formaldehyde are used.– Conduct exposure monitoring– Engineering and workplace controls should be

maintained to keep employee exposure as low as possible.

– An eyewash unit and drench shower shall be provide where formaldehyde is used


1910.1052 - Methylene Chloride.

1910.1096 - Ionizing Radiation

1910.1450 - Occupational Exposure To Hazardous Chemicals In Laboratories

Chemical Hygiene Plan


Pharmacy eTool

Other chemicals that may need to be considered:– Xylene (PEL=100ppm, TLV=100ppm)

– Glutaraldehyde (PEL=N/A, TLV=0.05ppm ceiling)

– OPA (o-phthalaldehyde) may pose similar occupational hazards to those of glutaraldehyde

– Anesthetic Gases


Other chemicals that may need to be considered:– Methyl Methacrylate (PEL=100ppm, TLV=50ppm)

– Mercury (PEL=0.1 mg/m3, TLV=0.025 mg/m3)

– Hazardous Drugs: See OSHA Technical Manual Section VI: Chapter 2 regarding a Hazardous Drug Safety and Health Plan


OSHA 29 CFR 1910 Subpart K Medical and First Aid

1910.151 Medical Services And First Aid. TOP"Where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use.“

– Proper installation– Maintenance

1910.134 - Respiratory Protection.– Formal Respiratory Protection Program– Must include procedures for selection and use, medical

evaluation, fit testing, use, cleaning, training.– Medical evaluation– Fit testing– The respiratory protection program should be evaluated

as often as necessary to ensure effectiveness

OSHA 29 CFR 1910 Subpart IPersonal Protective Equipment TOP

1910.133 - Eye and face protection

1910.136 - Foot protection.

1910.137 - Electrical protective devices

1910.138 - Hand Protection

OSHA 29 CFR 1910 Subpart IPersonal Protective Equipment

1910.95 - Occupational Noise Exposure.– If noise exposures are 85dBA for an eight hour time

weighted average this standard applies. This may occur in certain mechanical areas or during lawn care. Some clinical areas may approach these levels as well.

– Hearing Conservation ProgramAudiometric testing

Noise control

OSHA 29 CFR 1910 Subpart G Occupational noise exposure.

1910.146 - Permit-required Confined Spaces

Confined Space– Large enough and so configured so that an employee can

enter and perform work.– Has limited or restricted means of entry or exit.– Is not designed for continuous occupancy.

OSHA 29 CFR 1910 Subpart JGeneral Environmental Controls

Permit Required Confined Space– Hazardous atmosphere (or potential to contain a

hazardous atmosphere)– Contains a material that may engulf an entrant– Has an internal configuration such that an entrant may

become trapped by inwardly converging walls or a floor that slopes downward and tapers to a smaller cross-section.

– Any other recognized serious safety or health hazard (e.g., electrical).


1910.147 - The control of hazardous energy (lockout/tagout)– Establish a formal program servicing or maintenance on

machinery or equipment where the unexpected energizing, startup or release of stored energy could occur and cause injury

– Lockout and tagout devices shall be provided by the employer for isolating, securing, or blocking of machines or equipment from energy sources


1910.183 – Helicopters

1910.178 - Powered Industrial Trucks– Formal program must be established for training and

permitting operators– Classroom and practical training must be provided.

Refresher training every three years.– Regular equipment inspection

OSHA 29 CFR 1910 Subpart N Materials Handling and Storage

1910 Subpart O - Machinery and Machine Guarding

1910.212 - General Requirements For All Machines

1910.213 - Woodworking Machinery Requirements

1910.215 - Abrasive Wheel Machinery

1910 Subpart P - Hand and Portable Powered Tools and Other Hand-Held Equipment

1910.242 - Hand and portable powered tools and equipment, general

1910.243 - Guarding of portable powered tools

OSHA 29 CFR 1910 Subpart O and P

1910.304 - Wiring Design And Protection. 1910.305 - Wiring Methods, Components, And Equipment

For General Use. 1910.306 - Specific Purpose Equipment And Installations. 1910.307 - Hazardous (Classified) Locations. 1910.332 - Training 1910.333 - Selection And Use Of Work Practices 1910.334 - Use Of Equipment. 1910.335 - Safeguards For Personnel Protection.

OSHA 29 CFR 1910 Subpart S Electrical TOP

Risk Assessment

GHS Pictograms: https://www.osha.gov/Publications/OSHA3491QuickCardPictogram.pdf

Chemical Hygiene Plan: https://www.osha.gov/Publications/laboratory/OSHAfactsheet-laboratory-safety-chemical-hygiene-plan.pdf

Hazardous Drugs: https://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html#3

OSHA eTool Index: https://www.osha.gov/dts/osta/oshasoft/

Some Helpful Links

Documents

OSHA For Healthcare 29 USC 651-678 Occupational Safety and Health Act of 1970 Provides the authority for the US Department of Labor to develop and enforce