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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 http://www.osha.gov.
September 2, 1997
Dana J. Windhorst, MD, MPH
Director, Central Plains Clinic Occupational Medicine
1100 East 21st Street
Sioux Falls, SD 57105
Dear Dr. Windhorst:
Thank you for your letter of July 2, 1997 requesting interpretations for various scenarios. Please excuse the delay in our response. I will cite the Recordkeeping Guidelines for Occupational Injuries and Illnesses by page and Q&A number(s) whenever possible.
1. Does a physician's act of writing a formal prescription for a non-prescription medication (for instance, so that the medication can be dispensed from the pharmacy and the workers' compensation carrier billed, so that the employee does not have to pay cash for it over the counter somewhere) make the medication a "prescription medication," thereby making an otherwise non-recordable injury recordable? An example might be a prescription for regular aspirin, two tablets four times daily.
A physician's writing a formal prescription for a non-prescription medication (Example: a prescription for regular aspirin, two tablets four times daily) does not make it a "prescription medication." Non-prescription medications are regarded as first aid treatment for OSHA injury and illness recordkeeping purposes (See p 43, Recordkeeping Guidelines).
2. If the answer to question #1 is "no," does the injury become reportable if the physician recommends, or writes a prescription for, a dose of a non-prescription medication that exceeds the FDA-recommend prescription dose of that medication? An example would be a prescription, or recommendation, for ibuprofen 200 mg (the OTC form), 4 tablets three times daily for a total of 2400 mg, where the FDA-recommended OTC dose is 1200 mg/day. A corollary question would be, "with over-the-counter medications, or medications available without a prescription, does the dosage recommended or prescribed by the physician affect the question of OSHA recordability?"
The physician's writing a prescription for a dose of a non-prescription medication that exceeds the FDA-recommended non-prescription dose of that medication (Example: ibuprofen 200 mg, an OTC form, 4 tablets three times daily for a total of 2400 mg, where the FDA-recommended OTC dose is 1200 mg/day) also does not make it a "prescription medication."
Any use of nonprescription medications is considered first aid for OSHA recordkeeping purposes, even when used at prescription strengths (See page 43, Recordkeeping Guidelines).
3. If the answer to both forms of question #2 is "no," does prescribing a larger pill of the same medication (ie, a prescription-requiring 800 mg tablet of ibuprofen), rather than the OTC form (four tablets of the 200 mg OTC ibuprofen) result in OSHA recordability, given that the total dose of ibuprofen is the same in both cases?
Yes. The physician's writing a prescription for multiple doses of prescription medication (Example: an 800 mg tablet of ibuprofen, which is a prescription drug) does result in OSHA recordability.
I hope you find this information useful. If you have any further questions, please contact us at Area Code: (202) 219-6463.
Division of Recordkeeping Requirements