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Bloodborne remains No. 1, but asbestos jump is notable

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March 1, 2009

OSHA’s top violations in 2008

Bloodborne remains No. 1, but asbestos jump is notable

Although bloodborne pathogens violations continue to be the top employee safety issue in general medical hospitals—a status earned for at least the past nine years—the real surprise in OSHA’s annual top 10 list of most-cited standards concerns asbestos problems.

Overall, there were 328 citations for all OSHA standards, stemming from 150 inspections at hospitals in 2008. The total of $204,184 in fines is up $60,000 from 2007, making the average fine $622.42 per citation. The total number of inspections was down from 168 in 2007.

The figures come from states overseen by federal OSHA only, and cover the period from October 1, 2007–September 30, 2008. (See “Top cited OSHA standards at medical and surgical hospitals” on p. 7.)

Single site shoulders one-third of total fines

One asbestos case that came to a close in 2008 at Niagara Falls (NY) Memorial Medical Center, accounted for $70,000—or about one-third—of the total OSHA hospital fines for the year.

“The Niagara case kind of drove the penalties up a little,” says Dionne Williams, senior industrial hygienist in OSHA’s office of health enforcement. “In terms of numbers of inspections, we did a little bit fewer in 2008. But I don’t think the number was extremely unusual.”

Discounting the Niagara case and its 18 resulting citations, OSHA hospital fines went down on a per-citation basis in 2008. The average fine was $432.85, almost one-third less, when leaving Niagara out of the equation.

Niagara’s case and other asbestos in construction (1926.1101) citations accounted for the second-most cited standard in 2008, even though the standard didn’t make the top 10 in 2007. Interestingly, hazard communication (1910.1200), the third-most cited standard in 2007, dropped to 12th this year.

That’s probably an anomaly, Williams says, because the nature of hospital work involves many hazards.

Constant staff turnover and belt-tightening in healthcare sometimes make it hard to keep up with hazard communication requirements.

Watch for prefilled syringes

When it comes to the ever-present challenge of bloodborne pathogens compliance, Williams suggests safety managers review recent OSHA materials and new equipment choices regarding needles and syringes.

Some hospitals have experienced a rise in needlestick injuries because staff members use prefilled syringes for injected medication, Williams says. Although pharmaceutical companies distribute some drugs in such devices to help nurses administer more precise doses to patients, they often are less safe than syringes that can be filled and offer safety controls.

“When [a facility] orders things, they need to make sure they’re ordering either [safety] devices or the kind that can be adjusted so employees can put on their own safety needles,” Williams says. “When a manufacturer attaches an unprotected needle, you eliminate the potential for the employee to be protected ... You can still get needlesticks if you have a prefilled syringe.”

Prepping for programmed inspections

Although it’s difficult to predict when an employee complaint will result in an OSHA inspection, it is possible to prepare for potential visits from the agency.

State and regional emphasis programs—in which the OSHA authority governing your facility’s area takes a single issue and uses it to randomly inspect a certain number of hospitals—are often announced in press releases on your state OSHA Web site if you’re in one of the 25 states governed by separate OSHA agencies.

Hospitals under federal OSHA can go to www.osha.gov/dep/local_emphasis_programs.html to see what emphasis programs are under way or planned in their region.

For example, at presstime OSHA’s Region III—which includes the District of Columbia, Delaware, Maryland, Pennsylvania, Virginia, and West Virginia—had a bloodborne pathogens emphasis program under way in the communities of Philadelphia, Erie, PA, and Allentown, PA.

Emphasis programs sometimes can be cut short, Williams says, when it appears the issue is being properly addressed at the hospital’s OSHA targets for random inspections. In those cases, a state or regional agency typically decides to devote its resources to on-the-job safety problems elsewhere.




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