Standard Interpretations - (Archived) Table of Contents|
| Standard Number:||1904|
|NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.|
July 20, 1992
Mr. Charles R. Payne
Dear Mr. Payne:
Thank you for your letters dated June 1 and February 13 requesting interpretations on several OSHA injury and illness recordkeeping issues. Please excuse the lengthy delay in our response. I will first address your question regarding the proper recording of CTD cases involving positive EMG results, and then address the remaining questions by first restating the question, then answering it. Whenever possible, I will reference the Recordkeeping Guidelines for Occupational Injuries and Illnesses by stating the page and Q & A number(s) when relevant.
Cumulative Trauma Disorders are to be recorded if they result in either physical findings or subjective symptoms combined with resulting action. There must be either:
1. At least one physical finding (e.g. positive Tinel's, Phalen's, or Finkelstein's test; or swelling, redness, or deformity; or loss of motion)
2. At least one subjective symptom (e.g. pain, numbness, tingling, aching, stiffness, or burning) and at least one of the following:
a. medical treatment (as defined in the recordkeeping guidelines) or
b. lost workdays (days away from work and/or days of restricted work activity) or
c. transfer/rotation to another job.
It is my understanding that positive EMG results are normally associated with patients who have experienced subjective symptoms and quite often physical signs such as swelling or deformity. Nonetheless, in the absence of other criteria, a positive EMG test would represent a physical finding analogous to a positive Tinel's test, and would therefore represent a recordable CTD case.
Cases and Issues
1. An employee with a chronic back condition aggravates that condition as the result of a new workplace event or exposure. The employee's physician recommends that he continue to take the same medication that he had been using for his back condition at the time of the incident. The employee did not require any additional treatment, nor did the injury result in lost workdays or job transfer/rotation. Does OSHA require the recording of such cases?
A. Work related injuries that require "medical treatment" are recordable cases. As stated on page 43 of the Guidelines, the use of prescription medications (except a single dose administered on first visit for minor injury or discomfort) is medical treatment. Because the physician recommended continued use of the prescription medication to treat the injury, this case should be entered on the OSHA Log as a new case.
2. On January 25, an employee receives "medical treatment" for a condition resulting from an occupational injury. The employee did not report the injury at the time it occurred and is not exactly certain when it happened. He believes it may have occurred "about two weeks ago", but there are no witnesses who can corroborate the date of the employee's injury. What date should be recorded as the "Date of Injury or Onset of Illness"? What criteria should be used to make such determination?
A. If the exact date of injury is unknown, or there is no identifiable event or exposure to which the employee can attribute his or her injury, then a "good faith" estimate of the date should be entered in Column B of the Log. In the above case, a date counting back two weeks should be used.
3. A lathe operator seeks medical attention after being struck in the eye by a metal shaving. Examination of the eye reveals a superficial (i.e. non-embedded) foreign body. Attempts to remove the particle by irrigation are unsuccessful, but it is easily removed with a moist cotton swab. The employee did not require any additional treatment, nor did the injury result in lost workdays or job transfer/rotation. Does OSHA require the recording of such cases? If so, what is the basis for such requirement?
A. This case is not recordable. The removal of non-embedded material from the eye by means of cotton swab is considered first aid treatment.
4. Shortly after a new epoxy is introduced into the production process, several employees complain of nausea, headaches, vertigo, minor eye and throat irritation. As a preventative measure, some employees are given respirators and others are transferred to other work. Industrial hygiene monitoring reveals that exposure levels for the epoxy's constituents are well below permissible limits. Employee complaints cease after modifications to the facility's ventilation system and a change in the epoxy's consistency. Would the employee's complaints merely be considered subjective symptoms, or are such facts sufficient to establish a "recognized or diagnosed" occupational illness?
A. Many subjective complaints such as nausea and headaches are symptomatic of a wide range of occupational diseases. (page 42, Q & A E-16) In the situation described above there is a clear relationship between the occupational exposure to the epoxy and the employees' symptoms. These cases should be considered occupational illnesses due to the non- instantaneous nature of the exposure. Under the current injury and illness recordkeeping requirements, all occupational illnesses must be recorded on the OSHA Log. (page 40, Q & A E-1)
5. An employee suffering from a lower back strain is seen by a physician, who issues a prescription for a muscle relaxant. The employee cannot recall a specific incident or event that may have caused the strain, but attributes his condition to the repetitive bending required by his job. Should such a case be recorded as an occupational injury or as an illness? It is my understanding that back cases should always be classified as injuries, regardless of whether the employee's condition resulted from a specific instantaneous incident or event. Likewise, it is my understanding that cases involving carpal tunnel syndrome should always be recorded as occupational illnesses. Please confirm whether such understandings are consistent with OSHA's official position and enforcement practices.
A. Back cases should always be classified as injuries and are recordable if they meet the injury criteria. This generalization was made to keep recordkeeping determinations as simple and equitable as possible. (page 38 Q & A D-4) Work related cases involving carpal tunnel syndrome almost always result from repetitious movement and those cases should be classified as occupational illnesses. (page 38, Q & A D-5) However, carpal tunnel syndrome may also be caused by an instantaneous blow to the wrist. These cases should be evaluated as injuries. Except for backs, each individual case should be evaluated using the instantaneous/non-instantaneous criteria for distinguishing between injuries and illnesses.
6. An employer installs a computer software system at each of its establishments for purpose of maintaining information pertaining to occupational injuries and illnesses that occur at the establishment. Data stored in the system can be instantaneously retrieved in formats equivalent to either the OSHA 200 log or the OSHA 101 form. The system permits such forms to be viewed on a screen or can generate a hard-copy of same. Under such circumstances, would OSHA require the employer to maintain hard-copies of the OSHA 200 log and OSHA 101 forms at each of its establishments? It is my understanding that neither BLS Guidelines nor the Code of Federal Regulations contain any provisions requiring to maintain hard-copies of such records.
Part 1904.4 of the Code of Federal Regulations specifies that each establishment "shall have available for inspection " a supplementary record of injury or illness for each occupational injury or illness for that establishment. Likewise, BLS guidelines provide only that "a supplementary record must be prepared" for each recordable case (p. 16). Moreover, BLS guidelines explicitly indicate that OSHA records may be kept on microfiche or magnetic tape, provided such information is always available during working hours and is retrievable upon demand in a format equivalent to the OSHA forms (p. 13). Such information seems to suggest that an establishment is not required to maintain hard copies of the OSHA 200 log or OSHA 101 forms if it maintains such information on a computer system, or other electronic data storage and retrieval device, so long as such information is always available during working hours and is instantaneously retrievable in formats equivalent to the OSHA 200 log and OSHA 101 form. Please confirm whether such understanding is consistent with OSHA's official position and enforcement practices.
A. It is possible to maintain the Log by means of data processing equipment if two conditions are met: (1) sufficient information must be available to complete the Log within 6 workdays of receipt of information that a recordable case has occurred; and (2) a copy of the Log current to within 45 calendar days must be present at all times in the establishment. (page 21, section C) As long as the information contained on the Log is immediately retrievable upon request at the site location, the second condition is satisfied. It would not be necessary to keep a hard copy of the Log at the site.
[This document was edited on 06/28/00 to strike information that no longer reflects current OSHA policy. See the 04/03/98 Letter of Interpretation to Frank White]
Injury vs. Illness
Case #1. Prior to his shift, an employee who works as a welder reports to the company medical department, complaining of symptoms later diagnosed as weld flash. The employee cannot recall any specific event that may have caused the irritation, but believes that his condition may have gradually developed over the course of time as the result of exposure to welding arcs.
Case #2. An employee who works as an engineer seeks medical attention for symptoms diagnosed as weld flash. The employee spends the vast majority of his time working in an office setting and believes that his condition is related to the fact that he was instantaneously exposed to a welding arc when he turned his head while walking through the plant.
Although the medical diagnosis was the same in both cases, it is my understanding that the first case should be recorded as an occupational illness, while the latter case should be categorized as an occupational injury.
A. Your interpretation is correct. Case #1 should be evaluated as an illness and Case #2 as an injury for OSHA recordkeeping purposes. Please see question # 5 for evaluating back and carpal tunnel syndrome cases.
I hope you find this information useful. If you have any further questions, please contact my staff at Area Code (202) 523-1463.
Standard Interpretations - (Archived) Table of Contents|