Document jZqRNYZpYgOaVy9yVKBMeqB5

guidelines tor Reporting Occupational Injuries and Illnesses to the National Safety Council, Using OSHA Recordkeeping Requirements PLAINTIFF'S EXHIBIT DUP-1366 The purpose of these guidelines is to promote uniform recording, classification, and reporting to the National Safety Council of occupational injuries and illnesses, using the Recordkeeping Requirements under the Occupational Safety and Health Act of 1970. Based upon past experience, guidelines are necessary to provide the uniformity and consistency necessary for NSC statistics, contests, and award programs. The recordkcepjng require ments as written in the Code of Federal Regulations, as well as the burden placed on the employer to record those cases where there is doubt, make it impossible to devise a set of guidelines that will result in perfectly uniform recordkeeping. However, perfection is not possible under any recordkeeping system, as there will always be cases that fall into a gray area and are subject to varying interpretations. Hopefully, though, these guidelines can reduce the number of such cases and increase the consistency and uniformity of reporting using the OSHA recordkeeping system. It must be stressed that these guidelines are not a replacement dot the present. OSHA Rt cordkccpinc Rct/tnrcmrnrs nor are they meant to change them Rather, these guide lines arc a clarification cf and an adjunct to the lequircmcnts. As such,, the guidelines should be usee in conjunction with such federal publications as Rmndkeeping Rcqmremenfi Under the Occupational Si.let\ and Health. -I,/,,; 1070 (Re used IW'p),' U S Depaitmeiit of I.al'o,-. Oceup.ita ..11 S.ifetv mu! IL.ilth Admiuis; r,,: :i , ao.J W'hr.t iim r.mpha. i. \, < ,/s to Know about OSH A Recora\ccpnig, LI. S Department of Labor, Bureau-of Labor Statistics. Report 412 (Re vised), 1973.** Using these guidelines, partici pants would prepare reports for NSC by simply copying totals from the OSHA No. 102 Summary Form or tallying cases from the OSHA No. 100 Log. How the guidelines are organiied Three decisions must be made in recording a case. First, it must be determined if the case is workrelated. Second, it must be decided whether the case meets the criteria for recordnbiiity If a case is record able. a third decision must be made to determine the proper injury or illness classification. These guide lines consist'of three sections that correspond to these three decisions: Section I--Work-related cases; Section II--Rccordability; Section III--Classification by extent of injury or illness. The fust section deals with the concept of u-tii k-i elated in juries and illnesses.-and _ the determination ol wli.it eases occur m the work envimnment. The second section dis cusses which work-related injuries and illnesses tue to be refolded and k I)e;'.is!iiu.i.' I ihor, Ov-up.i- liensi S.,letv ui:.! Health AdnimiMia- lion. VS ashmgiun. UC 20110 "U. S. Department of Labor, rim can ot Labor. Washington, DC 20212. 64 Reprinted with permission from National Safety Coucil presents information useful in dis tinguishing between first aid and medical treatment. The third section covers classification by extent of injury or illness: Deaths; Lost Workday Cases Involv ing Days Away From Work; Lost Workday Cases With Days of Restricted Work Activity; Non-Fatal Cases Without Lost Workdays. Definitions of these classifications and points to be considered in mak ing the distinctions between them are included. In using these guidelines, re member that the final decision of whether to record a case and how to classify a recordable case rests with the employer. When the em ployer is in doubt about recordability or the extent of injury or illness, the case should be recorded and classified to the higher extent of injury or illness. Section I--Work-Related Cases Cases that are work-related and meet the criteria discussed in Sec tion II should be recorded. No detailed definition of work-related is contained in any of the OSHA publications or in the law- itself. The broad concept is that any injury or illness "occurring in the w-ork environment" is work-telalcd. The OSHA Form 100, The Log. provides the following definition: As of Jan 1. 1977. NSC members wiil be asked to record their oc cupat onai injury and illr ess cases using the OSHA fleco Jkeepmg System instead of the American Natio nal Standard Z1 6. ) for use in NSC progroms. It ts intended thot these guidelines would be put i ito use by NSC members at thot ime as on aid in using the OSH4 Recordkeeping Sy stem. July 1976, NATIONAL SAFETY NEWS (1/77) Appendix C. Page 1 DU 053751 DUP 1013648 WORK ENVIRONMENT is comprised of the physical location, equipment, materials processed or used, and (lie kinds of operations performed by an employee in the per formance of his work, whether on or of! the employer's premises. T here arc no slated exclusions of place or circumstance. Therefore, injuries or illnesses occurring in such places as the employee park ing lot, lunch room or rest room, or during rest or lunch period on the employer's premises can be work-related. The final determina tion of whether any ease is workrelated must be made by the em ployer. Responsibility or fault docs not enter into the decision of whether a case is work-related. In doubtful situations, a ease should bo recorded. Section II--Recordability Recordable Cases Work-related cases arc recordable that involve any of the following: Deaths -- All occupational deaths regardless of the time between injury and death or length of illness. Injuries--All occupational injuries resulting in any of the following: 1) Lost Workdays (either Days Away From Work or Days of Restricted Activity); 2) Medical ticatment other than first aid, 3) Loss of consciousness; 4) Restriction of work or mo tion; 5) Transfer. Temporary or per manent transfer to another job; 6) Termination of the injured or ill employees. Illnesses--All occupational illnesses including, hut not limned to. the following categories and examples:1 1 ) Occntmtional Skin Diseases or Disorders -- Examples Contact dermatitis, ce/ema. or rush caused by primary irritants and sensitizers or poisonous plants; oil acne; chrome ulccis; chemical hums or inflammations; etc. I Direct contact causing tissue damage only, rcsult- mg from a thermal or chemical burn, is classified as an injury, not an illness case.) 2) Dust Diseases of the Langs (Pneumoconioses)--Examples: Sili cosis, asbcsloMs, coal worker's pneumoconiosis, byssinosis, and other pneumoconioses. 3) Respiratory< Conditions Dae to Toxic Agents--Examples: Pneu monitis, pharyngitis, rhinitis or acute congestion due to chemicals, dusts, gases, or fumes; farmer's lung; etc. 4) Poisoning (Systemic Effects of Toxic Materials) -- Examples: Poi soning by lead, mercury, cadmium, arsenic, or other metals, poisoning by carbon monoxide, hydrogen sul fide or other gases; poisoning by benzol, carbon tetrachloride, or other organic solvents; poisoning-by insecticide sprays such as parathion, lead arsenate; poisoning by other chemicals such as formaldehyde, plastics and resins, etc.; 5) Disorders Due to Physical Agents (Other Than Toxic Mate rials)--Examples: Heatstroke, sun stroke, heat exhaustion and other effects of ~ environmental heat; freezing, frostbite and effects of exposure toTow temperatures; cais son disease; effects of ionizing radiation (isotopes, X-rays, radium); effects of "nonionizing radiation (welding flash, ultraviolet rays, microwaves, sunburn), etc.; 6) Disorders Associated With Re peated Trauina--Examples: Noiseinduccd hearing loss; synovitis, tenosynovitis, and bursitis; Ray naud's phenomena; and other con ditions due to repented motion, vibration, or pressure. 7) All Other Occupational Ill nesses--Examples: Anthrax, brucel losis. infectious hepatitis, malignant and benign tumors, food poisoning, histoplasmosis, coccidioidomycosis, etc. NOTE: Conditions resulting from animal bites, such as insect or snake bites, or from one-time exposure to chemi cals are consideicd to he in juries" ` A discussion of what constitutes Days Away From Work, Days of Restricted Work Activity. Tempo ral y Transfcis, Permanent Trans fers. and Terminations is contained in Section III--Classification. Loss of consciousness of the employee for any period of lime is self explanatory. Restriction of mo tion is not defined .specifically in the OSIIA publications or in the law. Each ease must be judged in dividually lo determine if there is more than a trivial amount of re stricted motion, such as would occur when a small adhesive bandage was placed on the second joint of the finger. It should be noted here that damage to prosthcscs (such as false teeth) is not in and of itself grounds for recordability unless ac companied by other damage to the body that meets the recordability criteria. The distinction between medical treatment and first aid is probably the most difficult of the recordability criteria to interpret. Medical treat ment and first aid are defined in the same paragraph of the OSH A 100 Log as follows: MEDICAL TREATMENT includes treatment (other than first aid) administered hy a physician or hy registered pro fessional personnel under the standing orders of a physician. Medical treatment does NOT include first aid treatmen' lone time treatment and subsequent observation of minor scratches, cuts, burns, splinters, and so forth, which do not ordinarily require medical care) even though provided by a physician or registered professional per sonnel. The important point to be stressed is that the decision as to whether a case involves medical treatment should be made on the basis of whether the case normally would require medical treatment. The decision cannot he made on the basis of who treats the case. First aid can he administered by a physician and medical treatment by someone other than a physician It is not po-sihlc to list all types of medical procedures and treatmen is ami rm that basis (done de termine if first aid or medical ircatment was involved. For example, whirlpool treatments, heat treat ments, application of hot or cold compresses, or elastic bandages arc noi in anil of themselves either first aid or medical treatment. DVJP 1013649 July 1976, NATIONAL SAFETY NEWS (1 '77' `\pnendix C. Paee 2 ES DU 053752 yn aOKiiaaiu: a.- ..;;, m iaiairt'r.ft'aiiiiriliiiBi^i. ! aiiijisaijHliBII m What follows is a discussion of Diagnostic procedures and preven tive procedures and treatments, both of which arc not in and of them selves medical treatment. Next is a discussion of Treatments that are almost always medical treatment, and comments on Medical treatment and first aid for certain types of injuries. Diagnostic procedures Hospitalization for observation, where no medical treatment is rendered other than first aid, is not considered medical treatment. How ever, if the employee misses any part of his next scheduled shift, the ease would become recordable be cause of lost workdays. Visits to a physician or nurse for observation only or for a routine change of dressing arc not medical treatment. X-ray examination for fractures is considered diagnostic procedure and as such is not medical treat ment or first aid. Where the X-ray is negative, the ease is not record able. unless the injury required other medical treatment or met one of the other criteria for rccordability. Physical examination yielding few or no findings, and not substantiat ing subjective complaints in ques tionable cases, is not medical treat ment. Reactions to or side cfTccts of diagnostic procedures, which arc necessitated hv a work-related in jury or illness and which meet the criteria for rcco. viability. should be recorded. Preventive procedures and treatments Tetanus shots--Either initial tet anus shots or boosters, arc con sidered preventive in nature and arc not in and of themselves con sidered uudic.i! treatment. However, treatment o', a icaution to a tetanus shot administered because of an injury mild he consideicd meti cal treatment, and would make the case recordable Prescription medication -- Anv use of presciiption medication noimally constitutes medical treatment. How ever, it should he consideicd first aid when a single dose or applica tion of a prescription medication is given on tne fust visit mutely for relief of pain 01 a-, pievemive tre.it- ment for a minor injury. This situa tion can occur tit facilities having dispensaries slocked with prescrip tion medications frequently used for , preventive treatment and relief of pain and attended by a physician or nurse operating under the standing orders of a physician. The admin istration of nonprescription medica tion in similar circumstances would be considered first aid. Ointments nnd salves--The appli cation of ointments and salves to prevent the drying or cracking of skin at the site of a minor injury can be considered first aid. Antiseptics and dressings -- The application of antiseptics to minor injuries, which do not themselves require medical treatment, can be considered first aid. Changing lt7ic bandage or dressing on an injury, which did not require medical treat ment. because the bandage or dress ing has become dirty, is considered to be first aid. Preventive medication -- Reac tion to preventive medication (not administered because of an occupa tional injury or illness) administered in plant (such as flu shots) would not constitute Ti recordable ease. Off-tlie-job cases -- In-plant treat ment of ofT-lhe-job injuries and ill nesses is not recordable. Treatments that art almost always medical treatment Sutures--The suturing of any wound. Fractures --Treatment of fractures. Casts -- Application of a cast or other professional means of im mobilizing an injured part of the body. Infections--Treatment of infection arising out of an injury. Bruises-- Treatment of a bruise by drainage oL blood. -- - Debridement -- Surgical debride ment, that is, the removal of dead or damaged skin. Abrasions ----Treatment of abra sions that occur to greater than full skin depth. Prescriptions -- Administration of preset iption medicines are usually meilual treatment. (Sec also Pre 56 ventive procedures and treatments.) Burns -- The treatment of second and third degree burns is almost always medical treatment. Medical treatment and first aid for certain types of injuries Cuts nnd lacerations-- First aid treatment is limited to cleaning wound, soaking, applying antiseptic and nonpresetiption medi cation and bandaging oil first visit. Follow-up visits limited to observa tion including chancing dressing and bandage. Additional cleaning and application of antiseptic permis sible as first aid where it is required by work duties that are likely to soil the bandage. The application of butterfly closures for cosmetic purposes only can be considered first aid. Medical treatment includes the application of butterfly closures for noncosmctic purposes, sutures (stitches), surgical debridement (cutting away dead skin), treat ment of infection, or other pro fessional treatment. Abrasions-- First aid treatment for abrasions is the same as for cuts and lacera tions except ointments can be added on follow-up visits 10 picvcnt drying and cracking of skin. Medicai ucatmcnt includes care ful examination for removal of im bedded foreign material, multiple soakincs. whirlpool treatment, tica.tment of infection, or other profes sional treatment. Any ease involv ing more than a. minor, spot-type injury. Treatment of abrasions occurring to greater than full skin depth is considered medical treat ment. Bruises-- Fitst aid treatment is limited to a single soaking or application of cold comp:,".'v. Follow-up si-itc limited only ns obsei v ation. Medical lieatment includes nniitiple soakiugs. di .lining of collected blood, or other extended care beyond observation. Splinters and puncture wounds-- First aiil !ieminent is limited to cleaning the wound, removal of foreign ohjecifs) by tweezers or other simple techniques, app'm... lion of antiseptics anti nonpiesctip- July 1976. NATIONAL SAFETY NEWS rt/"'n ^isnentfis c Par? a DU 053753 DUP 1013650 tion medications, anil bandaging on first visit, Follow-up visits arc limited to observation including changing bandage. Additional clean ing and application of antiseptic permissible as liist aid svhcrc it is required by work duties that arc likely to soil the bandage. Mctlicul treatment consists of re moval of foreign object(s) by physi cian due to depth of imbedment, size or shape of object(s) or loca tion of wound. Treatment for infec tion, treatment of a reaction to tetanus booster, or other profession al treatment is considered medical treatment. Hums, thermal and chemical (re sulting in destruction of tissue by direct contact)-- First aid treatment is limited to cleaning or flushing the surface, soaking, applying cold compresses, antiseptics and/or non-prescription medications and bandaging on first visit. Follow-up visits restricted to observation, changing bandages or additional cleaning. Most first de gree burns arc amenable to first aid treatment. Medical treatment includes a scries of treatments including soaks, whirlpool, and surgical debridement (cutting away dead skin). Most second and trtird degree burns re quire medical treatment. Sprains and strains-- First aid treatment is limited to soaking, application of cold com presses, and use of clastic bandage on first visit. Follow-up visits for observation, possibly including rcapplying bandage, arc first aid. Medical treatment includes a series of hot and cold soaks, use of whirlpools, diathermy treatment, or other professional treatment. Eye injuries-- First aid treatment is limited to iiligation, removal of foieign ma terial not imbedded in eye. and application of nonprescription medi cations. Precautionary visit (special examination) to physician is con sidered as first aid if treatment is limited to above items. Follow-up visits for observation only. Medical treatment cases involve removal of imbedded foieign ob jects, use of picsviipnon mcc.icn- July 1916, NATIONAL SAFETY NEWS i | i~"t) Anrendix 0. Pace 4 lions, or other professional treat ment. Inhalation of toxic or corrosive gases-- First aid treatment is limited to removal of the employee to fresh air or the one-time administration of oxygen for several minutes. Medical treatment consists of any professional treatment beyond that mentioned under first aid and all eases involving loss of conscious ness. Section III--Classification by Extent of Injury or Illness There arc_four classes, based on extent of injury, used in the OSHA recordkeeping system as defined below. An injury or illness should be classified according to its most severe consequence. For example, a case might first become recordable as a Non-Fatal Case Without Lost Workdays. Subsequently, the injured or ill employees may lose workdays because of the injury or illness. The ease then becomes a Lost WorkdayCase and should be counted under that classification. Because a par ticular injury or illness should be counted in only one of the four classifications, this case would be removed from the total of Nonfatnl Cases Without Lost Workdays when the employer becomes aware of the lost workdays. There is an additional category for those eases where injury or ill ness resulted in termination or permanent transfer. Any ease in volving tcrmTnnlion or permanent transfer must also be classified by extent of injury or illness. Any ease that results in death is counted in that classification only. Any lost workdays, transfers, or terminations, which have been recorded prior :o the occurrence of death, should be lined out on the OSHA l.in; and not included in the totals fur those classifications when summaries are" made or reported to the National Safety Council. Deaths Any work-related injury or ill ness that results in Ihe death of the employee, regardless of the length of time between injury and death, or the length of illness is recordable. Lost Workday Cases Involving Days Away From Work Cases that result in one or more Days Away From Work arc re cordable. Days Away From Work arc those workdays (consecutive or not) on which the employee would have worked but could not because of occupational injury or illness. The number of lost workdays should not include the day of injury or onset of illness or any days on which the employee would not have worked even though able to work. Weekends -- For example, if an employee, who is scheduled to work Monday through Friday, Is injured on Friday and returns to work on Monday, the ease docs not involve any Days Away From Work even if the employee was unable to work on Friday. Saturday, or Sunday, If this same employee had been scheduled to work, on Saturday, even if that Saturday constituted overtime, the Saturday would be counted in the Days Away From Work, and the ease would be clas sified as a Lost Workday Case with Days Away From Work. Irregular shifts -- For employees not having a regularly scheduled shift, i.e., certain truck drivers, con struction workers, farm labor, casual labor, pan-time employees, cie.. it may be necessary to estimate the number of lost workdays. Estimates of the number of days that the em ployee would have worked should take into account the prior work history of the employee and days worked by fellow employees, not ill or injured, working in the same department 01 occupation as the til or injuied employee. Doubtful eases -- In some eases an injuied oi ill employee will miss one or more scheduled days or sbilts beside the day of minty o: on set of illness, hut it will be un certain whether the employee w-as truly unable to work on the days missed. Such eases may arise when a physician judges that the em ployee is able to work but the employee decides thu: be is not. In such cases, the employer should not rely solely on the physician's opin ion. He should make the final judg ment himsell. based on all the 67 r DUP 1013651 DU 053754 L-gatvEiiS'mttrnim BSBHiMiM 'tviJj-SBiji. '!&& tued hiltiSaW M aiBimaak evidence nt his disposal. Again, the rule should be "when in doubt, record the ease." Full shifts only -- Days Away From Work should include only those full days or shifts that arc missed by the employee. The loss of a part of a day or shift would be counted under Days of Restricted Work Activity as defined below. Restricted days -- A Lost Work day Case Involving Days Away From Work may also result in Days of Restricted Activity. Such a ease will be recorded as only one ease, but will have days recorded under both categories of recordable days. Lost Workday Cases With Days of Restricted Work Activity Only These arc eases that result in one or more days of Restricted Work Activity but do not result in any Days Away From Work. Although the OSHA Log and the OSHA Summary contain a separate classi fication for Days of Restricted Work Activity, the Summary docs, not provide a separate column for en tering the number of such eases. This number can be arrived at by subtracting the number of Cases Involving Days Away From Work (Column No 4 on the OSHA 102 Sur*->iary) front the number of Total Lost Workday Cases (Column No. 3). Days of Restricted Work Activity include those days (conse cutive or not, but excluding the day of injury or onset of illness) on, which one of the following occurred: 1) Temporary assignment -- The employee was assigned to another job on a temporary basis. Even if the employee normally shifts from job to job within an occupational classification, if any switch or trans fer is occasioned by a work-related injury or illness, the ease involves Days of Restricted Work Activity. Such days arc meant to cover aU days on which the employee was unable to contribute a full day's work on all parts of his peimaucnt job. In cases where an employee is not woiking at his regular job and is injured or becomes ill and is transfer! cd back to Ins original job, which he can perform without limitation, there are no Days of Re stricted Work Activity. 2) Loss ol part of shift -- The employee worked at a permanent job less than his full shift or normal day. Loss of a full day or shift would constitute a Lost Workday Away From Work. 3) Restricted work activity--The employee worked at a permanently assigned job but could not perform all duties normally connected with it. All days (excluding the day of injury or onset of illness), for which the employee was scheduled to work, and could not perform all or any part of his normal assignment during all or any part of the work day or shift, should be considered Days of Restricted Work Activity, Estimating days lost -- As in de termining whether or not a ease involves Days Away From Work, there may be eases where the cVnploycr must estimate the number of days for those employees working irregular or unusual shifts. Again, the final determination as to whether a ease involves Days of Restricted Work Activity must be made by the employer, considering ail evidence, and recording the case if there is any doubt. Precautionary transfers -- If an employee is transferred to another job as a precautionary measure while his ease is .being diagnosed, the case should be included under Lost Workday Cases with Days of Restricted Work Activity only if the transfer proves necessary (that is, the diagnosis indicates that such a transfer was indeed necessary). When lo slop counting--The num ber of Days of Restricted Work Activity can end for a particular ease in the following ways: The employee is able to re turn to bis regularly scheduled job ami is able to_ perform all of it1, duties for a full clay or shift. The employee is permanently transferred to another permanent job (which would be recorded un der Permanent Transfers anti Termi nations). If this happens, even though the employee could not per form his original job any longer, the Davs of Restricted Work Ac tivity will slop._ The employee is terminated or leaves the job. (Terminations would also be recorded under Per manent Transfers and Termina tions.) If the employee continues on his regular job for a long period of time, even though lie cannot per form all parts of it, the jub can be considered lo be redefined after a reasonable period of time and the Days of Restricted Work Activity will stop. It is not practical to con tinue to count Lost Workdays for the rest of the work life of such employees. Non-Fatal Cases Without lost Workdays This classification would include those eases that arc recordable (as defined in Section II) but do not result in Death or Lost Workdays (either Days Away From Work or Dais of Restricted Work Activity) as discussed above. These arc pri marily cases involving medical treatment only. Restriction of motion -- One of the criteria for recordability, as opposed to classification, is any restriction of motion. As some re strictions of motion may not affect the employee's ability to perform all the duties normally connected with his job, it is possible to record a ease because of restriction of motion as a Non-fatal Case Without Lost Workdays. Date of Recordability Injury -- An injury should be charged to the date on which it occurred, not the date when it is reported or brought to the atten tion of the employer. If the extent of injury chances, such as a ease oiiginnlly recorded as a Non-fatal Case Without Lost Workdays which subsequently results in Lost Work days, die date of rccordahiiu\ docs not change. Illness--For occupational illnesses, the ease is dunged to the date on wiiidi 'the illness is diagnosed or brought to the attention of the employer. As with injuries, as out lined above, any changes in the outcome of the ease would not change the. date against which the illness is charged,--End. 6B July J97B, RATIONAL SAfW JtfWS (1/77) Appendix C, Page 5 DU 053755 DUP 1013652