# Presentation: 099276

## 	    OSHA INJURY AND ILLNESS RECORDKEEPING	

## WARNING:  DO NOT MIXOSHA RECORDABILITY AND WORKERS’ COMPENSATION 

- Workers’ Compensation determinations do NOT impact OSHA recordability.
- 	Some cases may be OSHA recordable and   compensable.
- 	Some cases may be compensable, but not  OSHA recordable.
- 	Some cases may be OSHA recordable, but not compensable.

## Organization of the Rule

- Subpart C - Forms and recording criteria
- Subpart D - Other requirements
- Subpart E - Reporting to the government
- Subpart G - Definitions

## Recording Criteria

- Subpart C - Recordkeeping Forms and Recording Criteria
- 1904.4    Recording criteria
- 1904.5    Work-relatedness
- 1904.6    New case
- 1904.7    General recording criteria
- 1904.8    Needlesticks and sharps
- 1904.9    Medical removal
- 1904.10  Hearing loss
- 1904.11  Tuberculosis
- 1904.29  Forms

## 1904.4 – Recording Criteria

- Covered employers must record each fatality,
- injury or illness that:
- Is work-related, and
- Is a new case, and
- Meets one or more of the criteria contained in sections 1904.7 through 1904.11

## 	    OSHA INJURY AND ILLNESS RECORDKEEPING	

**	****	****	****5 STEP PROCESS**

## YES

- experience an
- injury or illness?

- Does the injury or illness meet
- the general criteria or the
- application to specific cases?

**Record the **
**Injury or illness.**

***YES***

***YES***

***YES***

***YES***

## 			  	Definition

- Did the employee
- experience an
- injury or illness?

**	****	****	****  ****	**Definition
- 	An injury OR illness is _an abnormal condition or disorder_.  Injuries 	include cases such as, but not limited to, a cut, fracture, sprain, or 	amputation.  Illnesses include both acute and chronic illnesses, such 	as, but not limited to, a skin disease, respiratory disorder, or 	poisoning.

## 	A worker reports to nurses station with complaint of painful wrists.  Employee given 2 AdvilTM and returned to job.

- Did the employee
- experience an
- injury or illness?

**Stop Here **
**OR **
**Go On To The Next Step?**

**Scenario A:**
- 	A worker reports to nurses station with complaint of painful wrists.  Employee given 2 AdvilTM and returned to job.

**Answer:****	****Go on to the next step.**

**Why:****	****Painful wrists was the injury experienced.**

**Notes:**
Do you want Answer and Why to be seen together or enter separate?

- 	There is a chlorine gas leak at XYZ establishment and the two (2) employees in the area are rushed to the hospital.  They are told to stay home the next day as a precautionary measure.

**Step 1:**
- Did the employee
- experience an
- injury or illness?

**Stop Here **
**OR **
**Go On To The Next Step?**

**Answer:****	****It depends ! !  We need more information.**

**Why:****  ****We need to know if either employee exhibited signs or symptoms ****	****of an injury/illness.  If yes, then go to the next step.  If no, STOP.  We have an event or exposure only.**

## YES

- experience an
- injury or illness?

***YES***

## 		 Determination of work-relatedness

- Is the injury or
- illness work-related?

**	****	**** **Determination of work-relatedness
- You must consider an injury or illness to be work-related if an identifiable event
- or exposure (i.e., discernable cause) in the work environment either caused or
- contributed to the resulting condition or significantly aggravated a pre-existing
- injury or illness.  Work-relatedness is presumed for injuries and illnesses
- resulting from events or exposures in the work environment unless an
- exception specifically applies.

## 1904.5 – Work Environment

- The _work_ _environment_ is defined as the establishment and other locations where one or more employees are working or present as a condition of employment
- The work environment includes not only physical locations, but also the equipment or materials used by employees during the course of their work

## 	The following situations are not work-related:

- 1.     There is **no** _discernable cause__. _ Injury/illness did not result from event/exposure at work

- The injury or illness involves signs or symptoms that surface at work but result solely from a  non-work related event or exposure that occurs outside the work environment.

- The injury or illness results solely from voluntary participation in a wellness program or in a medical, fitness, or recreational activity such as blood donation, physical examination, flu shot,  exercise class, racquetball, or baseball.

- The injury or illness is solely the result of an employee eating, drinking, or preparing food or drink for personal consumption (whether bought on the employer’s premises or brought in). For example, if the employee is injured by choking on a sandwich while in the employer’s establishment, the case would not be considered work-related.

- At the time of the injury or illness, the employee was present in the work environment as a member of the general public rather than as an employee.

**Note****:  **If the employee is made ill by ingesting food contaminated by
-             workplace contaminants (such as lead), or gets food poisoning
-             from food supplied by the employer, the case would be
-             considered work-related.

## 	The following situations also are not work-related:

- The injury or illness is solely the result of personal grooming, self medication for a non-work-related condition, or is intentionally self-inflicted.

- The injury or illness is caused by a motor vehicle accident and occurs on a company parking lot or company access road while the employee is commuting to or from work.

- The illness is a mental illness.  Mental illness will not be considered work-related unless the employee voluntarily provides the employer with an opinion from a physician or other licensed health care professional with appropriate training and experience (psychiatrist, psychologist, psychiatric nurse practitioner, etc.) stating that the employee has a mental illness that is work-related.

- The illness is the common cold or flu (Note: contagious diseases such as tuberculosis, brucellosis, hepatitis A, or plague are considered work-related if the employee is infected at work).

**	****The following situations also **_**are not work-related**_**:**

## 1904.5 – Work Relationship Pre-Existing Conditions

- A “Pre-existing” condition -  an injury or illness that resulted solely from a non work- related event or exposure that occurred outside of the work environment
- A pre-existing injury or illness is significantly  aggravated when the following cases would not have occurred but for an event or exposure in the work environment:
- Death
- Loss of Consciousness
- Days Away, Days Restricted or Job Transfer
- Medical Treatment

## Why?:	Exception #4 -  The injury or illness results solely from voluntary 	participation in a  wellness program or in a medical, fitness, or recreational activity such as blood donation,  physical examination, flu shot,  exercise class, racquetball, or baseball. 

**OR**
**Go On To The Next Step?**

**Why?:****	****Exception #4 -  **The injury or illness results solely from voluntary 	participation in a  wellness program or in a medical, fitness, or recreational activity such as blood donation,  physical examination, flu shot,  exercise class, racquetball, or baseball.** **

**Step 2:**
- Is the injury or
- illness work-related?

**Scenario A:**
- 	Employee gives blood at voluntary employer sponsored blood drive and passes out – losses consciousness.

**Answer:****	****Stop Here**

## 	Employee sprains ankle in company parking lot on their way in to work. 

- 	Employee sprains ankle in company parking lot on their way in to work.

**Step 2:**
- Is the injury or
- illness work-related?

**Stop Here**
**OR**
**Go On To The Next Step?**

**Why?:****	****There is no exception that applies****.**

**Answer:****	****Go on**

## Why?:	Exception #6 - The injury or illness is solely the result of an employee doing personal tasks (unrelated to their employment) at the establishment 	outside of the employee’s assigned working hours.

- 	Employee slips and falls in hallway, breaking arm while working on daughter’s science project on Saturday, employee’s day off.

**Step 2:**
- Is the injury or
- illness work-related?

**Stop Here**
**OR**
**Go On To The Next Step?**

**Why?:****	****Exception #6 - **The injury or illness is solely the result of an employee doing personal tasks (unrelated to their employment) at the establishment 	outside of the employee’s assigned working hours.

**Answer:****	****Stop**

## YES

- experience an
- injury or illness?

***YES***

***YES***

## Step 3:

- Is the injury or
- illness a new case?

**	****	**** ****	****Determination of a new case**
**	****Consider an injury or illness a “new case” if the employee has **
**	****not previously experienced a recorded injury or illness of the **
**	****same type that affects the same part of the body, **
**	****	****	****	****OR the**** **
**	****employee previously experienced a recorded injury or illness of **
**	****the same type that affected the same part of body but had **
**	****recovered completely (all signs and symptoms had disappeared) **
**	****from the previous injury or illness and an event or exposure in **
**	****the work environment caused the signs or symptoms to reappear.**

## Scenario A:  Five (5) weeks ago, employee sprained wrist at work and received support, prescription medication, and “light duty.”  Two weeks ago employee was  back on normal job. Today (5 weeks after the injury) employee complains of pain in same wrist after moving boxes.

- Is the injury or
- illness a new case?

**Stop Here**
**OR**
**Go On to the Next Step?**

**Scenario A:  **Five (5) weeks ago, employee sprained wrist at work and received support, prescription medication, and “light duty.”  Two weeks ago employee was  back on normal job. Today (5 weeks after the injury) employee complains of pain in same wrist after moving boxes.

**Why?:****	**Employee was back at normal job and no criteria for recordability was in existence at that time.

**Answer:****	****Go on**

## Scenario B:  Five (5) weeks ago employee sprained wrist at work and received support, prescription medication, and “light duty”.  Two weeks ago employee was back on normal job.   Today (5 weeks after the injury) employee complains of pain in same wrist after moving boxes.  Employee continues to take prescription medications for pain throughout this period of time.  

**Step 3:**
- Is the injury or
- illness a new case?

**Stop Here**
**OR**
**Go On to the Next Step?**

**Why?:****	**Update the previously recorded injury or illness entry if necessary.

**Answer:****	****Stop**

## Scenario C:  Employee fractures foot at work. Every six months or so it bothers him and he is placed on light duty for a day or two. 

**Step 3:**
- Is the injury or
- illness a new case?

**Stop Here**
**OR**
**Go On to the Next Step?**

**Why?:****	**Was the employee completely recovered.  If no stop.  If yes, was there a new event or exposure in the work environment.

**Answer:****	**It depends.  We need more information

## YES

- experience an
- injury or illness?

- Does the injury or illness meet
- the general criteria or the
- application to specific cases?

***YES***

***YES***

***YES***

## Step 4:

**Step 4:**
- Does the injury or illness
-  meet the general criteria
- or the application
- to specific cases?

**	****	****	**** ****General Recording Criteria**
**	**You must consider an injury or illness to meet the general recording
- 	criteria, and therefore to be recordable, if it results in any of
- 	the following: death, days away from work, restricted work or
- 	transfer to another job, medical treatment beyond first aid, or loss
- 	of consciousness.  You must also consider a case to meet the general
- 	recording criteria if it involves a significant injury or illness diagnosed
- 	by a physician or other licensed health care professional, even if it
- 	does not result in death, days away from work, restricted work or
- 	job transfer, medical treatment beyond first aid, or loss of
- 	consciousness.

## 		    DAY COUNTS

- Count the number of calendar days the employee was away from work or restricted/transferred (include weekend days, holidays, vacation days, etc.)
- May cap day count at 180 days away from work and/or days of restricted/job transfer
- May stop day count if employee leaves company for a reason unrelated to the injury or illness. Must estimate day count when employee leaves company due to reasons related to the injury and illness

## 		Restricted Work Activity 

- Restriction/transfer limited to day of injury/illness onset _not_ recordable-includes employee being sent home during shift.
- Production of _fewer_  goods or services _not_ considered RWA
- Vague restrictions from physician or PLHCP (e.g., “light duty” or “take it easy for a week”) are to be recorded as RWA if no further information is obtain.
- A case is not recordable if the employee experiences minor musculoskeletal discomfort, a health care professional determines that the employee is fully able to perform all of his or her routine job functions, and the employer assigns a work restriction to that employee for the purpose of preventing a more serious condition from developing. Once a case becomes recordable under section 1904.7 general recording criteria, the discomfort is no longer minor.

## 1904.7 – Job Transfer

- Injured or ill employee assigned to job other than regular job for part of the day
- Do not include day of injury/illness onset
-  record job transfer day (s) in RWA column
- Stop count when transfer permanent-- _BUT MUST COUNT AT LEAST ONE DAY_

## Medical Treatment VS First Aid

**Medical Treatment **_**VS**_** First Aid**

- Medical treatment DOES NOT include:

- 1.	Visits to a physician or other licensed health care professional solely for observation or counseling only

- 2.	Diagnostic procedures such as x-rays and blood tests, including administration of prescription medications used solely for diagnostic purposes (e.g., eye drops to dilate pupils)

- 3.	First Aid

## Medical Treatment VS First Aid – cont’d.

- Using eye patches is First Aid

- -	Drilling a nail is First Aid

**Medical Treatment **_**VS**_** First Aid – cont’d****.**

- Removing foreign bodies from the eye using  only irrigation or a cotton swab is First Aid

- Removing splinters or foreign material from areas other than the eye by irrigation, tweezers, cotton swabs or other simple means is First Aid

- Using finger guards is First Aid

- Using massages is First Aid

- First Aid list in regulation is comprehensive.  Any other procedure is medical treatment.

- -	Drinking fluids for relief of heat stress is First Aid

## Medical Treatment VS First Aid – cont’d.

**Medical Treatment **_**VS**_** First Aid – cont’d.**

- 1 dose prescription med is Medical Treatment

- Over the Counter non-prescription med at non-prescription strength is First Aid
- 	OTC med at prescription strength is Medical Treatment
- 	Ibuprofen (such as AdvilTM)                     -      Greater than 467 mg
- 	Diphenhydramine (such as BenadrylTM)    –      Greater than 50 mg
- 	Naproxen Sodium (such as AleveTM)         –      Greater than 220 mg
- 	Ketoprofen (such as Orudus KTTM)           –      Greater than 25 mg

- Any number of hot-cold treatments  is First Aid

- Using wound coverings such as Band-Aids; Butterfly bandage/Steri-Strip (the only kind of wound closures)  are First Aid

- Cleaning, flushing or soaking wounds on the surface of the skin  is First Aid

- Administering **tetanus** immunizations is First Aid

- Using any non-rigid means of support, as elastic bandages, wraps, back belts, etc. is First Aid

## Significant diagnosed Injury or Illness that is automatically recordable if work related:

**1.****	****Fracture **

**2.****	****Punctured ear drum**

**3.****	****Cancer**

**4.****	****Chronic irreversible disease  (e.g., silicosis)**

## YES

- experience an
- injury or illness?

- Does the injury or illness meet
- the general criteria or the
- application to specific cases?

**Record the **
**Injury or illness.**

***YES***

***YES***

***YES***

***YES***

## Determining Case SeverityCase Scenarios

- 	Employee has a work-related injury or illness, sees doctor, told she can only work on light duty for the next two weeks.  Normally scheduled for five day workweeks.  How many days of restricted work activity should be entered on the OSHA Log?

## Determining Case RecordabilityCase Scenarios 

- If a physician recommends medical treatment, but the employee does not follow the recommendation, is the case recordable?
- If an injured employee has repeated sessions of hot or cold therapy, does this case involve medical treatment?
- Wound closures : Steri-Strips and butterfly bandages are now considered to be first aid.  Does this mean that staples, surgical glue, or other wound closures are also first aid?

## Determining Case RecordabilityCase Scenarios

- Employee receives prescription medication in her eye to facilitate examination.  Is this considered medical treatment?
- Employees exposed to slight release of non toxic chemical.  Several feel “light headed”, receive simple administration of oxygen and return to work.  Are these cases recordable?
- Employee’s ankle is injured at work; a slight hairline fracture is detected in a positive X-ray diagnosis.  No medical treatment is provided. Is this case recordable?

## 1904.8 – Bloodborne Pathogens

- Record all work-related needlesticks and cuts from sharp objects that are contaminated with another person’s blood or other potentially infectious material (includes human bodily fluids, tissues and organs; other materials infected with HIV or HBV such as laboratory cultures)
- Record splashes or other exposures to blood or other potentially infectious material if it results in diagnosis of a bloodborne disease or meets the general recording criteria

## Relationship to Bloodborne Pathogen Standard

- Employers _**may elect**_ to use the OSHA 300 and 301 forms to meet the sharps injury log requirements, _**provided two conditions are met**_:
- The **employer must enter the ****type and brand of the device**** on either the 300 or 301 form**.
- The **employer must maintain the records in a way that ****segregates sharps**** injuries from other types of work-related injuries and illnesses, or ****allows sharps injuries to be easily separated**.

## 1904.9 – Medical Removal

- If an employee is medically removed under the medical surveillance requirements of an OSHA standard, you must record the case
- The case is recorded as either one involving days away from work or days of restricted work activity
- If the case involves voluntary removal below the removal levels required by the standard, the case need not be recorded

## 	Conditions For Hearing Loss Recordability  				1904.10

- OSHA’s recordkeeping rule requires the employer to record all work-
- related hearing loss cases that meet BOTH of the following conditions
- on the same audiometric test for either ear:

- The employee has experienced a Standard Threshold Shift (STS) – 10dB or greater from the most current baseline.
- The employee’s total hearing level is 25 dB or more above
- 	audiometric zero (averaged at 2000, 3000, & 4000 Hz) in the
- 	same ear(s) as the STS.

## No

- Use this **‘decision tree’** to determine whether the results of a audiometric exam given on or after January 1, 2003 reveal a recordable STS.

- Note:   In all cases, use the most current baseline to determine recordability as you would to calculate
- a STS under the hearing conservation provisions of the noise standard (§1910.95).  If an STS  occurs in only one ear, you may only revise the baseline audiogram for that ear.
- * The audiogram may be adjusted for presbycusis (aging) as set out in 1910.95.
- * A separate hearing loss column on the OSHA 300 Log beginning in Calendar year 2004.

**No**

**No**

**No**

**Yes**

**Yes**

**Yes**

- .

## 1904.11 - Tuberculosis

- Record a case where an employee is exposed at work to someone with a known case of active tuberculosis, and subsequently develops a TB infection
- A case is not recordable when:
- The worker is living in a household with a person who is diagnosed with active TB
- The Public Health Department has identified the worker as a contact of an individual with active TB
- A medical investigation shows the employee’s infection was caused by exposure away from work

## Record all work-related MSD cases that meet any of the general recording criteria.

- Depending upon the nature of the event or exposure that causes the case you should record these cases as an injury or an “all other illness”

-  Musculoskeletal Disorders

## 1904.29 - Forms

- OSHA Form 300, *Log of Work-Related Injuries and Illnesses*
- OSHA Form 300A, *Summary of Work-Related Injuries and Illnesses*
- OSHA Form 301, *Injury and Illness Incident Report*

## Slide 46

## Slide 47

## 1904.29 - Forms

- Employers must enter each recordable case on the forms within 7 calendar days of receiving information that a recordable case occurred
- An equivalent form has the same information, is as readable and understandable, and uses the same instructions as the OSHA form it replaces
- Forms can be kept on a computer as long as they can be produced when they are needed (i.e., meet the access provisions of 1904.35 and 1904.40)

## 1904.29 – Privacy Protection

- Do not enter the name of an employee on the OSHA Form 300 for “privacy concern cases”
- Enter “privacy case” in the name column
- Keep a separate confidential list of the case numbers and employee names

## 1904.29 – Privacy Protection

- Privacy concern cases are:
- An injury or illness to an intimate body part or reproductive system
- An injury or illness resulting from sexual assault
- Mental illness
- HIV infection, hepatitis, tuberculosis
- Needlestick and sharps injuries that are contaminated with another person’s blood or other potentially infectious material
- Employee voluntarily requests to keep name off for other illness cases

## 1904.29 – Privacy Protection

- Employer may use discretion in describing the case if employee can be identified
- If you give the forms to people not authorized by the rule, you must remove the names first
- Exceptions for:
- Auditor/consultant,
- Workers’ compensation or other insurance
- Public health authority or law enforcement agency

## Subpart D - Other Requirements

- 1904.30  Multiple business establishments
- 1904.31  Covered employees
- 1904.32  Annual summary
- 1904.33  Retention and updating
- 1904.34  Change of ownership
- 1904.35  Employee involvement
- 1904.36  Discrimination
- 	1904.38  Variances

## 1904.30 – MultipleBusiness Establishments

- Keep a separate OSHA Form 300 for each establishment that is expected to be in operation for more than a year
- May keep one OSHA Form 300 for all short-term establishments
- Each employee must be linked with one establishment

## 1904.30 – Multiple Business Establishments

- Employer may keep records at a central location if:
- Information about the injury or illness can be
- transmitted to the central location within 7 days; and
- The records can be produced at the establishment
- within time frames in 1904.35 and 1904.40

## Different locations?

- If an employee _normally reports to an establishment_ and is injured there, the case goes on that establishment’s log.

- If an employee is injured or made ill while visiting or working at another of the employer’s establishments, then the injury or illness must be recorded on the 300 log of the establishment at which the injury or illness occurred (e.g., agency engineer)

- Cases for _employees injured at another employers establishment_ go on the log of the employee’s home establishment (e.g., traveling person)

## 1904.31 – Covered Employees

- Employees on payroll
- Employees not on payroll who are supervised on a day-to-day basis
- Temporary help agencies should not record the cases experienced by temp workers who are supervised by the using firm

## 1904.32 – Annual Summary

- Federal establishments certification
- The senior establishment management official
- The head of the Agency for which the senior establishment management official works, or
- Any management official who is in the direct chain of command between the senior establishment management official and the head of the agency head
- Must post for 3-month period from February 1 to April 30 of the year following the year covered by the summary

## 1904.32 – Annual Summary

- Review OSHA Form 300 for completeness and accuracy, correct deficiencies
- Complete OSHA Form 300A
- Certify summary
- Post summary

## Slide 59

## 1904.33 – Retentionand Updating

- Retain forms for 5 years following the year that they cover
- Update the OSHA Form 300 during that period
- Need not update the OSHA Form 300A or OSHA Form 301

## 1904.35 – Employee Involvement

- You must inform each employee of how to report an injury or illness
- Must set up a way for employees to report work-related injuries and illnesses promptly; and
- Must tell each employee how to report work-related injuries and illnesses to you

## 1904.35 – Employee Involvement

- Must provide limited access to injury and illness records to employees, former employees and their personal and authorized representatives
- Provide copy of OSHA Form 300 by end of next business day
- Provide copy of OSHA Form 301 to employee, former employee or *personal* representative by end of next business day
- Provide copies of OSHA Form 301 to *authorized *representative within 7 calendar days.  Provide only “Information about the case” section of form

## Part 1960 references the Executive Order which prohibits discrimination

- Against an employee for reporting a work-related fatality, injury or illness
- Protects the employee who files a safety and health complaint, asks for access to the Part 1904 records

## Subpart E - Reporting Information to the Government

- 1904.39 Fatality and  catastrophe reporting
- 1904.40 Access for Government representatives

## 1904.39 – Fatality/Catastrophe Reporting

- Report orally within 8 hours any work-related fatality or incident involving 3 or more in-patient hospitalizations
- Do not need to report highway or public street motor vehicle accidents (outside of a construction work zone)
- Do not need to report commercial airplane, train, subway or bus accidents

## 1904.40 – Providing Records to Government Representatives

- Must provide copies of the records within 4 business hours
- Use the business hours of the establishment where the records are located

## For More Help

- OSHA’s Recordkeeping Page-
- www.osha.gov/recordkeeping/index.html
- OSHA Regional Recordkeeping Coordinators

## QUESTIONS