From HealthLeaders,  Nov. 18, 2009
Total OSHA fines and inspections decreased across all types of healthcare facilities in FY 2009.
Medical and dental practices and hospitals saw the greatest decreases in fines, 30%-40% from the previous year, according to OSHA’s Statistics and Data Web page . Nursing care facilities and laboratories showed less dramatic decreases at 12%-14%.
Nursing facilities ($321,327) and hospital settings ($196,400) ranked first and second respectively in total fines by type of facility, accounting for nearly three-quarters of OSHA fines issued in healthcare . Next came medical ($52,214) and dental ($47,549) practices at approximately 7% each of total OSHA healthcare fines.
Even though this is the second straight year healthcare violations have seen a decline, the trend is not likely to continue. OSHA under President Obama has an increased budget, including 130 new inspectors, according to remarks made earlier this summer by acting Assistant Secretary of Labor for Occupational Safety and Health Jordan Barab to the American Society of Safety Engineers. “The law says that employers are responsible for workplace safety and health, and there’s a new sheriff in town to enforce the law,” said Barab.
In addition to more enforcers, there is also better ammunition. OSHA officially posted its revised field operations manual (FOM) last week and the consensus of opinion among safety professionals is that the FOM gives inspectors more latitude in issuing violations, especially in the areas of defining recognizable hazards with regard to the general duty clause, focusing on hazard assessments, and providing more guidance on issuing willful violations.
Also in effect this year is a new recordkeeping national emphasis program (NEP) to find employers who are underreporting injuries and illness in traditionally high-hazard work settings. Nursing care facilities are included in the scope of the NEP.
Finally there are some issues on the legislative horizon pointing particularly to healthcare. A survey by the Association of Occupational Health Professionals in Healthcare found that healthcare workers were most concerned about bloodborne infections from needles, injuries for handing and lifting patients, and protection from airborne diseases. While the bloodborne pathogens standard has been on the books for awhile—indeed this hazard continues as the leading source for violations in all healthcare settings—there is movement for federal standards on the other two.
Both the House and the Senate have bills calling for OSHA to produce a safe patient handling and lifting standard.
Meanwhile, this fall, California introduced an aerosol transmissible disease standard that required employers to provide protection from hazards, such as tuberculosis, SARS, and pandemic influenza.
With the full effect of H1N1 on the healthcare workface yet to be assessed, and given California’s position as the bellwether for federal OSHA standards—it led the way for the eventual bloodborne pathogens standard in 1991—it seems likely that healthcare will be facing additional compliance matters in the next few years with potential for increases in citations and fines.