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Clinical Services
Physical Therapy

Click on the area for more specific information. Glove Box Mechanical Lift Adjustable Therapy Table Floor Mat/Whirlpool Area Floor Plug Hydroculator Hazardous Chemicals Ultra-Sound Device Hydrotherapy Tub Parifin Wax Machine Non-Slip Mat

Common safety and health topics:


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Bloodborne Pathogens


Bloodborne pathogens are pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV) [29 CFR 1910.1030(b)].

Potential Hazard

  • Exposure to infectious diseases during physical therapy treatment of patients through exposure to blood or other potentially infectious body fluids (OPIM). OPIM include human body fluids such as semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, and any body fluid that is visibly contaminated with blood.
Possible Solutions
  • Universal precautions shall be observed to prevent contact with blood or other potentially infectious materials [29 CFR 1910.1030(d)(1)].

    • Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials [29 CFR 1910.1030(d)(1)].
  • The Physical Therapist shall wear

    • Personal Protective Equipment such as gloves when providing treatment for patients if exposure to blood or OPIM is anticipated, (e.g., wounds or non-intact skin are present that might open up during treatment) [29 CFR 1910.1030(d)(3)(ix)].

    • Masks, Eye Protection, and Face Shields whenever splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, or mouth contamination can be reasonably anticipated [29 CFR 1910.1030(d)(3)(x)].

Book For additional information, see Healthcare Wide Hazards - Bloodborne Pathogens and (Lack of) Universal Precautions.

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Ergonomics

Potential Hazard

Exposure of physical therapy staff to potential work related musculoskeletal disorders (i.e., strain and sprain injuries to back and shoulders areas) from constant lifting and reaching for patients during treatment procedures and transfers.

Good work practice recommends employers address ergonomic stressors in the physical therapy department and provide engineering controls and work practice techniques to help minimize stressors such as:

  • Emphasize and teach the use of proper lifting techniques using good body mechanics.

    • Take time to stop and think (evaluate the lift).

    • Bend your knees, use arm and leg muscles, keep your back straight.

    • Use smooth and steady lifting motions.

    • Avoid lifting/reaching or working above shoulder height.

    • Avoid awkward postures, such as twisting while lifting.

    • Lift items close to the body.

    • Avoid sitting or standing for long periods of time (take a break).

    • Provide sufficient staff to handle lifts (i.e., get help).
  • Use mechanical aids to reduce the need to lift patients. Some examples include the use of:
    • Mechanical Lift Equipment When lifting patients who cannot support their own weight into/out of whirlpools or tubs.

    • Sliding Boards A slick board used under patients to help reduce friction during transfers (e.g., to and from wheelchairs and treatment tables).
  • Use adjustable equipment such as tubs and therapy tables. Therapists can then adjust the equipment to fit their individual height and comfort levels.
Book For additional information, see Healthcare Wide Hazards - Ergonomics.

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Slips/Trips/Falls

Potential Hazard

Physical Therapists use different modalities of treatment in caring for patients. Some of these treatments involve:

  • Ice, (e.g., ice machine and ice bags), or moist hot packs, (e.g., packs stored in hot water in a machine called a hydroculator).

  • Whirlpools.

  • Workout equipment, (e.g., treadmills).
There is a potential slip and fall hazard if water is spilled on the floor or if electrical or other cords run across pathways.

Possible Solutions


OSHA requires safe clean-up of spills and walkways free of obstructions:
  • Floors shall be kept clean and dry [29 CFR 1910.22(a)(2)].

  • Non-slip mats and other dry standing places should be provided where practicable [29 CFR 1910.22(a)(2)]. Use non-slip floor mats in whirlpool areas that tend to be slippery.

  • Aisles and passageways shall be kept clear and in good repair, with no obstruction across or in aisles that may create a hazard [29 CFR 1910.22(b)(1)]. Provide floor plugs for equipment, so power cords do not run across pathways.
Good work practices include:
  • Placing a table to the side of the hydroculator (the machine that stores the moist heat packs) and providing towels to rest the hot packs on to absorb the dripping water from the hot packs.
Book For additional information, see Healthcare Wide Hazards - Slips/Trips/Falls.
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Hazardous Chemicals

Potential Hazard

Exposure to possible hazardous chemicals found and used in the PT area.
  • Cleaning chemicals such as glutaraldehyde used to disinfect whirlpools or tubs.

  • Gel used for ultrasound procedures.;

  • Prescription medications, creams, or ointments rubbed into skin of patient by therapist during physical therapy treatment.
Possible Solutions
  • Use less-toxic products if feasible and available, or use other processes for sterilization.

  • Rooms in which glutaraldehyde is to be used should be well ventilated and large enough to ensure adequate dilution of vapor, with a minimum air exchange rate of 10 air changes per hour.

    • Use increased dilution ventilation in whirlpool rooms and x-ray rooms, along with the careful application of the glutaraldehyde with a long-handled brush rather than a spray applicator.

  • Follow procedures for safe administration of medications and creams. Therapists should wear gloves while applying certain medications to patients (e.g., if skin contact with the medication is indicated only for the patient).

  • Implement a written program that meets the requirements of the Hazard Communication Standard to provide for worker training, warning labels, and access to Material Safety Data Sheets (MSDS) for all hazardous chemicals/medications used by physical therapists.
Book For additional information, see Healthcare Wide Hazards - Hazardous Chemicals.

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Equipment Hazards

Potential Hazard

Physical Therapists use different types of electrical treatment equipment, such as the hydroculator and ultrasound devices, that could be hazardous:
  • If water and electrical energies mix, it may result in a possible shock hazard.

  • If equipment is used improperly, excessive occupational exposure to ultrasound may occur.
A safety and health program that routinely monitors the condition of equipment and addresses work practices of therapists.
  • Visual inspection of cords; do not use if frayed or damaged.

  • Employee visual inspection of equipment before using.

    • If something doesn't look right, don't use the machine; call for assistance.

  • Ensure that all electrical service near sources of water is properly grounded [29 CFR 1910.304(g)(6)(vi)].
Work Practices
  • Proper technique must be used when administering ultrasound and electrical stimulation treatments to avoid excessive exposure of therapist's hand.

    • Improper technique could result in hand weakness.

    • Physical therapist should use the handle rather than the head of the ultrasound device when administering treatments.
Book For additional information, see Healthcare Wide Hazards - Electrical.

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Legionnaires' Disease
Potential Hazard

Exposure to Legionnaires' Disease
by breathing aerosolized water that contains the legionella bacteria. This could occur in:

  • The shower or whirlpool area, or areas that have a spray nozzle.

  • Cooling towers, evaporative condensers, fluid coolers, and domestic hot-water systems.
These are water sources that may provide optimal conditions for growth of the legionella bacteria.

Possible Solutions


Book For additional information, see Healthcare Wide Hazards - Legionnaires' Disease.
  • Legionnaires' Disease. OSHA eTool. This eTool was designed to assist industrial hygienists in the assessment of worksites for potential Legionnaires' disease. It provides information on disease recognition, investigation procedures to identify probable water sources, and control strategies.
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