The Occupational Safety & Health Administration (OSHA)--a division of the United States Department of Labor--manages employment hazards that affect physicians' offices. The division encourages the reduction of occupational health hazards by providing guidelines for safe work environments. The Occupation Safety & Health Act enforces regulations for managing bloodborne pathogens, radiation and the disposal of sharp instruments in medical facilities. Six OSHA regulations affect physicians' offices. A seventh regulation pertains to offices that offer radiation services.
Congress established the Occupational Safety & Health (OSH) Act of 1970 to protect employees, reduce employment related injuries and provide guidelines for reporting employer failures to ensure a safe work environment. The Act encourages technical enhancements to prevent exposure to hazardous materials and provides a framework for the destruction of sharp medical instruments. In 1991, the Bloodborne Pathogens Standard was released to enforce the establishment of exposure reports and planning procedures.
Bloodborne Pathogen Regulation
Congress enforced the Needlestick Safety and Prevention Act to encourage usage of newer technologies in preventing the spread of bloodborne pathogens. Bloodborne pathogen coverage includes hepatitis B and hepatitis C viruses and the human immunodeficiency virus (HIV). OSHA establishes several guidelines for implementation including an annually updated written exposure plan, use of safer needles and sharp instruments and the proper containment of regulated waste.
Hazard Communication Regulation
OSHA requires a hazardous materials communication plan. Employees must be informed if a medical facility houses hazardous materials--disinfectants, sterilants, anesthetic agents or alcohol. Listing the types of materials in an open area is suitable. Material data sheets should be accessible. The information provided in the sheet must instruct employees on how to handle spills, exposure and other emergencies.
Ionizing Radiation Regulation
The ionizing radiation regulation is applicable to medical offices that provide x-ray services. Equipment must be located in areas of the office that limit employee exposure. Equipment and areas must be clearly marked with signage. In addition, offices must supply personal radiation monitors and survey the different radiation types utilized.
Some general regulations that apply to most businesses affect physicians' offices. Exit routes should be clearly marked and accessible by all employees. In addition, an easily accessible evacuation diagram should be present. Electrical equipment--faxes, computers, microwaves, centrifuges and so on--should be placed in a safe location. Currently, medical and dental offices are exempt from reporting illnesses and injuries. However, state laws may require that a physician’s office keep a running log of on-site illnesses and injuries.
Complaints and Penalties
According to Modern Medicine, “In 2002,...OSHA conducted 48 inspections of physician offices. All but three were in response to complaints. The most-often cited violation involved bloodborne pathogens, followed by injury and illness prevention program, formaldehyde, hazard communication, portable fire extinguishers, and electrical equipment.” Physicians should ensure they establish a plan that limits the exposure to bloodborne pathogens as well as implement an illness and injury prevention plan. OSHA violations are punishable with fines up to $7,000. Repeat violations draw penalties up to $70,000.
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