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OSHA requirements are set by statute, standards and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at https://www.osha.gov.
May 21, 1996
The Honorable Bob Graham
United States Senate
Washington, D.C. 20510-0903
Dear Senator Graham:
Thank you for giving me the opportunity to address the concerns of your constituent, John H. Michels regarding OSHA's regulations pertaining to the application of butterfly bandages. Let me assure you OSHA does not regulate, in any manner, who may apply butterfly bandages, nor under what circumstances or how they should be applied.
The quote referenced by Mr. Michels from the March 1996 issue of "Reason" appears to be a misrepresentation of OSHA's occupational injury and illness recordkeeping requirements. Each year, certain employers are required to maintain records of occupational injuries and illnesses which occur to their employees. As stated in Section 8(c)(2) of the OSH Act, "the Secretary, shall issue regulations requiring employers to maintain accurate records of, and to make periodic reports on, work-related deaths, injuries and illnesses other than minor injuries requiring only first aid treatment and which do not involve medical treatment, loss of consciousness, restriction of work or motion, or transfer to another job." In 1971, OSHA issued regulation 29 CFR Part 1904, Recording and Reporting Occupational Injuries and Illnesses which states that occupational injuries involving medical treatment must be recorded on the OSHA Log and Summary of Occupational Injuries and Illnesses.
In 1986, OSHA published the Recordkeeping Guidelines for Occupational Injuries and Illnesses (enclosed) to provide employers with supplemental instructions to the recordkeeping forms. On page 43 of the Recordkeeping Guidelines, OSHA provides guidance for recording lacerations which entail the use of wound closures such as adhesive dressings, sutures, butterfly, and Steri-Strips(TM). Wound closures are considered medical treatment for OSHA injury and illness recordkeeping purposes and thus constitute a recording criteria. On the other hand, wound coverings, such as Band-Aid bandages(TM), are always considered first aid treatment for recordkeeping purposes. On page 42 of the Recordkeeping Guidelines, OSHA states "medical treatment can be provided to employees by lay persons; i.e., someone other than a physician or registered medical personnel." Furthermore, Q&A F-3 on page 44 of the Recordkeeping Guidelines states "The regulations have been interpreted to mean that medical treatment may be administered by medical or nonmedical personnel. The treatment is the main factor to consider in distinguishing medical treatment from first aid, not the person who is administering it. In distinguishing between medical treatment and first aid, Congress intended to focus on the seriousness of the injury. Doctors or medical personnel often provide first aid treatment for minor injuries; nonmedical personnel often provide medical treatment for certain injuries that are relatively serious in nature." Clearly, OSHA does not limit the use of these wound closures in any way.
I hope this information will help you answer your constituent's concerns. If Mr. Michels would like to further discuss these issues, or needs any further assistance, please have him contact the OSHA Division of Recordkeeping Requirements by phone at (202) 219-6463 or by writing:
OSHA Office of Statistics Room N-3507, Frances Perkins Building 200 Constitution Avenue, NW Washington, D.C. 20210
Joseph A. Dear