OSHA – a four letter word


  In this article I am going to talk about OSHA and the top 10 fines that were levied against medical practices for 2011.  I know, I know, this subject matter can be more boring than listening to Al Gore and Charlie Brown’s teacher discuss the finer points of theU.S.tax code but this information can help prevent nasty fines for your facility.

  As you may well know, maintaining compliance within the Blood Borne Pathogens (BBP) standard continues to be the most troubling aspect of OSHA (76% of fines).  Let’s not also forget about the ever enjoyable hazard Communication requirements, record keeping forms, recordkeeping summaries, personal protective equipment, respiratory protection, and electrical wiring requirements.

  So without further ado, here are the top 10 most cited areas you will want to address:

(Note: this list is specific to medical practices, NOT hospitals)

  1. Failure to implement and maintain an Exposure Control Plan under the BBP standard
  2. Failure to train under the BBP standard
  3. Failure to engineer out hazards/ensure hand washing under the BBP standard
  4. Poor housekeeping under the BBP standard
  5. Failure to implement and maintain a written Hazard Communication Program
  6. Failure to make the Hepatitis B vaccination available under the BBP standard
  7. Failure to prepare Exposure Determinations under the BBP standard
  8. Failure to use Personal Protective Equipment (PPE) under the BBP standard
  9. Failure to provide post exposure Hepatitis B vaccination under the BBP standard
  10. Failure to train employees under the Hazard Communication standard


 So what do you need to do?   First, know this.  With OSHA it can seem impossible at times to be in compliance, but the worst thing you can do is give the impression you aren’t serious about this.  If an OSHA inspector comes in and you can prove that due diligence is being done, the fine may be lowered or written off altogether.  However negligence makes them mad and OSHA inspectors aren’t typically gifted with a sense of humor.



  Audit – You need to audit your practice and focus on the areas where non-compliance is most likely to occur, perhaps the list above or any other areas you may feel uncertain about.  Create an “audit policy” for your practice that states when internal and/or external audits are to be done.  Include how they are done, what is covered, who does them, etc.

Logs – review how your practice reports injuries.  Do you have your OSHA 300 logs and workers compensation records?  Are there any patterns to previous injuries that need to be addressed?  If any injuries occurred was the risk that caused the injury mitigated if possible?

Training, training, training – Did I mention training?  It’s very important to have a training schedule for OSHA, especially pertaining to the BBP standard.  Always document any training you give or receive and have the employees sign off.   In fact, I would recommend writing a formal policy regarding OSHA training (frequency, duration, internal or external, specific subject matter, etc.)

MSDS – do you have everything labeled?  Do you need more labels?  Call the manufacturer.

Common sense – It would be a good idea to conduct an occasional walk-through putting yourself in an inspectors shoes.  Do you see any smoking guns?  Any obvious areas you may have overlooked?

Document – document everything.  Having written history of your actions offers a better defense and jogs the memory.

  In conclusion, not all hazards can be eliminated and there is no such thing as 100% OSHA compliance.  Taking the above steps and knowing the areas where medical practices tend to struggle will help minimize your exposure and potential risk.   Always try to put yourself in an inspector’s shoes.

  On a side note:  As if OSHA wasn’t enough of a headache, HIPAA compliance is now in full force, fully funded, and on their way.  According to the Health and Human Services inspections will be done in a similar fashion as OSHA and (as of June 2012) have begun……more on this soon.


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