OSHA Recordkeeping Handbook - Msabc.net

§1904.7However, as discussed above, OSHA believes thatmore extensive treatment, including the administrationof fluids by intravenous injections (IV), are medicaltreatment, and more serious cases of heat disordersinvolving them must be entered into therecords. In addition, any diagnosis by a physician orother licensed health care professional of heat syncope(fainting due to heat) is recordable under paragraph1904.7(b)(6), Loss of Consciousness.Burns: ...[B]urns will be treated just as other typesof injury are, i.e., minor burn injuries will not berecordable, while more serious burns will be recordedbecause they will involve medical treatment. Forexample, a small second degree burn to the forearmthat is treated with nothing more than a bandage isnot recordable. A larger or more severe seconddegree burn that is treated with prescription creamsor antibiotics, or results in restricted work, job transfer,or days away from work is recordable. The vastmajority of first degree burns and minor seconddegree burns will not be recorded because they willnot meet the recording criteria, including medicaltreatment. However, more serious first and seconddegree burns that receive medical treatment will berecorded, and third degree burns should always berecorded because they require medical treatment….OSHA agrees...that certain treatments and interventionsrequire the professional judgment of ahealth care professional. The Agency believes thatthese matters are best left to state agencies andlicensing boards, and the final rule’s definition ofhealth care professional (see Subpart G) makes thisclear….OSHA’s reporting requirements do not in any wayinterfere with or have any impact on state workerscompensation reporting requirements. Employersare required to record certain injuries and illnessesunder the OSHA recordkeeping regulation and toobserve certain other requirements under workers’compensation law. The two laws have separate functions:workers’ compensation is designed to compensateinjured or ill workers, while the OSH Act isdesigned to prevent injuries and illnesses and to createa body of information to improve understandingof their causes. Thus, certain injuries and illnessesmay be reportable under state workers’ compensationlaw but not under the OSHA recordkeeping rule,and certain injuries and illnesses may be reportableunder the OSHA rule but not under one or moreworkers’ compensation statutes….In response, OSHA notes that the list is part of adefinition that sets mandatory recording and report-ing requirements and is a part of the regulation itself.Including the first aid list as a non-mandatory appendixwould provide additional flexibility for futureupdates, but doing so would not meet the purposesfor which the list is intended. The list is mandatory,and making it non-mandatory would only introduceadditional confusion about what is or is not to beentered into the records….Paragraph 1904.7(b)(6) Loss of ConsciousnessThe final rule, like the former rule, requires theemployer to record any work-related injury or illnessresulting in a loss of consciousness. The recording ofoccupational injuries and illnesses resulting in loss ofconsciousness is clearly required by Sections 8(c)and 24 of the OSH Act. The new rule differs from theformer rule only in clearly applying the loss of consciousnesscriterion to illnesses as well as injuries.Since the former rule required the recording of all illnesses,illnesses involving loss of consciousnesswere recordable, and thus OSHA expects that thisclarification will not change recording practices.Thus, any time a worker becomes unconscious as aresult of a workplace exposure to chemicals, heat, anoxygen deficient environment, a blow to the head, orsome other workplace hazard that causes loss of consciousness,the employer must record the case….OSHA agrees …that, in order to be a recordableevent, a loss of consciousness must be the result of aworkplace event or exposure. Loss of consciousnessis no different, in this respect, from any other injuryor illness. The exceptions to the presumption ofwork-relationship at Section 1904.5(b)(2)(ii) allow theemployer to exclude cases that “involve signs orsymptoms that surface at work but result solely froma non-work-related event or exposure that occursoutside the work environment.” This exception allowsthe employer to exclude cases where a loss of consciousnessis due solely to a personal health condition,such as epilepsy, diabetes, or narcolepsy….The final rule does not contain an exception forloss of consciousness associated with phobias orfirst aid treatment. OSHA notes, however, that theexception at paragraph 1904.5(b)(2)(iii) allows theemployer to rebut the presumption of work relationshipif “the injury or illness results solely from voluntaryparticipation in a wellness program or in a medical,fitness, or recreational activity such as blooddonation, physical, flu shot, exercise class, racquetball,or baseball.” This exception would eliminate therecording of fainting episodes involving voluntaryvaccination programs, blood donations and the like.64OSHA RECORDKEEPINGHANDBOOK