October 13, 1992

Mr. David F. Coble, CSP
Vice President - Safety
ELB
605 Eastowne Drive
Chapel Hill, North Carolina 27514

Dear Mr. Coble:

Thank you for your letter dated August 6 requesting interpretations on several injury and illness recordkeeping issues. Please excuse the delay in our response. I will respond by restating each question and then answering it. I will cite the Recordkeeping Guidelines for Occupational Injuries and Illnesses by page and Q & A number(s) whenever possible.

Q1: If an employee voluntarily receives a flu shot at his place of work and has a reaction to the medication, is this a recordable occupational illness/injury?

A1: Work relationship is established under the OSHA recordkeeping system when the injury or illness results from an event or exposure within the work environment (page 32). Since the employee received the vaccination on premises, work relationship is presumed. Unless the employee was there as a member of the general public, work relationship is established (Q & A C-8, page 34). This case should be evaluated as an injury because the original exposure (the flu shot) was an instantaneous event (page 37). The case should be recorded if the employee's condition resulted in loss of consciousness, medical treatment beyond first aid, restriction of work or motion, or transfer to another job (page 42 and Q & A F-17, page 45).

[This document was edited on 06/28/00 to strike information that no longer reflects current OSHA policy. See the 09/20/96 Letter of Interpretation to Larry M. Kreh]

Q2: If an employee voluntarily participates as a blood donor in the workplace as part of a community service Red Cross blood drive and loses consciousness, is this considered a recordable work related case? Injury or illness?

A2: This case should be evaluated the same as the case outlined in Question 1. The case would be a recordable injury or illness depending on the nature of the event or exposure causing the case.

[This document was edited on 06/28/00 to strike information that no longer reflects current OSHA policy.]

Q3: If an employee and his physician state that the employee's high blood pressure and resulting headaches are related to undetectable amounts of various chemicals in the workplace, is this sufficient information to record as an occupational illness/injury? If the employee has a long term high blood pressure problem, whether at work or off, does this affect the case classification?

A3: Any work related abnormal condition resulting from a non-instantaneous event or exposure must be recorded on the OSHA Log as an occupational illness (page 37). If it seems likely that an event or exposure in the work environment either caused or contributed to the case, the case is recordable (Q & A E-6, page 40 and B-17, page 32). In the above scenario, the exposure to the chemicals seems to be non-instantaneous, thus the case should be evaluated as an illness. Because the employee's doctor believes the chemical exposure within the workplace is likely to have caused the symptoms, work relationship is established. The resulting high blood pressure and headaches are abnormal conditions, so the case should be recorded. An employee's physical defect or preexisting physical condition does not affect the determination of recordability (B-14, page 31).

Q4: If an employee and his physician state that the employee's loss of sense of smell is related to a chemical exposure in the workplace but MSDS and other information, tests, etc., do not substantiate the claim, is this still a work related occupational illness?

A4: When an employer has conflicting medical information regarding the work relationship of a case, he/she must make a good faith effort to decide which information is correct (Q & A B-18, page 32). In the above situation, the most convincing information is the opinion of the physician. If the physician believes that the condition is likely to have been caused by a workplace exposure, work relationship is established and the case should be recorded.

Q5: My client has several employees with known allergies to various common substances such as fungi, pollen, dust, etc. Their outside physicians have prescribed many of them to have a periodic injection to keep the symptoms under control. Since many employees do not want to self-inject their serum, because the injections really should be supervised by medical personnel in the case there is a severe reaction, and for convenience to employees, plant medical personnel give the injections to many employees. Their medication is kept in a refrigerator and the employees have appointments to come in and get their injections. If an employee does have a reaction to the injection, is this a work related illness or injury that must be recorded on the OSHA 200 log?

A5: This case should be evaluated using the same criteria as questions 1 and 2. If the case involves loss of consciousness, medical treatment, restriction of work or motion, or transfer to another job, the case should be recorded.

Q6: Similar to above, but the employees use an inhaler or take oral medication. If the employee forgets to take the medication and has a reaction to some unknown substance while at work, does this qualify as an occupational illness?

A6: If there was a non-instantaneous exposure within the work environment that caused or was likely to have caused the reaction, then the case would be a work related illness. If, however, it was merely symptoms surfacing at the workplace, where the symptoms are the result of a nonwork-related event or exposure off premises, the case would not be work related (Q & A C-8, page 34).

Q7: If an employee has a known allergy and carries emergency medication (either oral or injectable), is an allergy attack considered to be an occupational illness if it occurs while the employee is at work and the medication has to be used?

A7: Exposures that cause allergic reactions are often of the non-instantaneous nature. Such cases should be evaluated as illness cases. If it was merely symptoms surfacing at the workplace, where the symptoms are the result of a nonwork-related event or exposure off premises, the case would not be work related (Q & A C-8, page 34). If, however, a non-instantaneous exposure within the work environment caused or contributed to the employee's allergic reaction, the case should be recorded as an illness. If the exposure is determined to have been instantaneous (such as a bee sting), then the case should be evaluated as an injury. An employee's preexisting physical condition does not affect the determination of recordability (Q & A B-14, page 31).

Q8: If a supervisor requests a transfer due to stress of his current job and he gets the transfer, is this a recordable case?

A8: Yes. Cases involving work related stress should be classified as "All other occupational illnesses" in column 7(g) of the Log. If the transfer is not a permanent assignment, days spent in that job should be counted as days of restricted work activity. The count of days of restricted work activity ceases once the transfer is made permanent (Q & A B-9, page 49).

Q9: An employee who is very muscular regularly has muscle spasms while doing his routine job on the premises, and also has the spasms routinely off the job. Is this a recordable case if medical treatment is required?

A9: Work relationship is presumed when the employee is on the employer's premises. The presumption does not apply with symptoms that merely surface on the employer's premises (Q & A C-8, page 34). If there is something within the work environment that causes or contributes to the employee's muscle spasms, then the condition would be work related. Particularly stressful activity is not required (Q & A B-16, page 32). Muscle spasms are generally caused by a non-instantaneous event or exposure (such as overuse of the muscle). In these situations, the illness criteria should be applied.

Q10: An employee suffers an ulcer and appears to be affected by a restructuring of the business (layoffs, forced retirements). Is this recordable?

A10: Yes. If it seems likely that an event or exposure within the work environment either caused or contributed to the case, then work relationship is established (Q & A B-17, page 32). The case should be evaluated as an illness (non-instantaneous exposure of stress) with a resulting abnormal condition (ulcer), and be recorded in column 7(g), all other occupational illnesses.

Q11: A cafeteria is in a building owned by a company. The cafeteria is leased to a third party to operate and is open to both the employees and the public. The company who owns the building subsidizes the cost of operating the cafeteria. If an injury occurs to an employee of the company while in the cafeteria and medical treatment is needed, is this case recordable?

A11: No. When an employee is injured on premises, work relationship is presumed (Q & A C-4, page 33). However, this presumption would not apply if the employee is there as a member of the general public and not as an employee (Q & A C-8, page 34).

Q12: An onshore drilling rig supervisor is on duty 24 hours, but may or may not actually be working during the 24 hours. He may be on call part of that time. What is considered work related duty for this employee?

A12: An injury or illness occurring to an employee when he is in "on call" status would not be presumed work related. The employee would be considered in a "home away from home" status (Q & A C-19, page 36). Conversely, when the employee is in work status, an injury or illness would be presumed work related.

Q13: During an oil rig fire (within the U.S. territorial waters), 4 employees die. Two employees were on duty while the other 2 were in their bunks off duty sleeping. Is this 2 or 4 recordable fatalities?

A13: This is two recordable fatalities. Once the employee has reached the offshore location and is in an "off time" status, that employee has established a home away from home. Hours spent at the location during "off time" would not be considered work related exposure hours.

Technically, a fatality or event involving the hospitalization of five or more employees that are in "off time" status need not be reported to the local OSHA Area Office as required by 29 CFR 1904.8. However, we strongly encourage that such occurences are reported regardless of the employee's "home away from home" status.

Q14: Please explain if pressure patches on eyes are recordable or if a patch over an eye to prevent light from entering is recordable? Is the use of an eye patch recordable?

A14: The use of a normal eye patch is considered to be first aid. However, if the employee is unable to perform all of his/her normal job duties because of the patch, the case should be recorded based on restricted work activity. The use of a pressure eye patch is medical treatment.

Q15: Would a second 25 dB shift in hearing in the same ear due to cumulative noise be another recordable illness?

A15: Yes. A new case must be recorded for each work related cumulative 25 dB shift.

Q16: An employee is diagnosed with carpal tunnel syndrome due to off the job factors. The employee's work makes the wrist hurt but does not aggravate the condition and he continues with his normal and full duties. The employee is continually receiving treatment. Is this case a recordable illness because the wrist hurts? Is making the wrist hurt aggravating the condition?

A16: As found on page 14 of the enclosed Ergonomics Program Management Guidelines For Meatpacking Plants, for upper body cumulative trauma disorders, if a subjective symptom (such as pain) is coupled with medical treatment, the case must be recorded. A case is work related if something within the work environment either caused or contributed to the onset of symptoms, or aggravated existing symptoms to the point that they meet OSHA recordability criteria. Making the wrist hurt establishes the subjective symptom of pain.

Q17: Please explain when a chemical inhalation becomes an illness. Is it after one breath, several breaths, several minutes of exposure?

A17: For OSHA recordkeeping purposes, instantaneous is defined as a snap of the fingers. If an employee is exposed to a chemical inhalation for several breaths, the exposure is non-instantaneous. Please remember that exposures are not recordable cases. There must be a work related injury or illness to have a recordable case.

Q18: Please explain if a chemical burn that results after one drop of a corrosive but appears several hours after exposure would be an injury or illness?

A18: The original exposure to the chemical is an instantaneous event (the splash or drop) and should be evaluated as an injury.

Q19: Are sleep disorders as the result of shift changes a recordable illness?

A19: Yes, if the sleep disorder is recognized as a work related abnormal condition or disorder.

Q20: An employee has arthritis. Is pain and treatment of that pain with prescriptions due to job related activities a recordable case?

A20: Preexisting physical conditions do not enter into the recordability determination process (Q & A B-14, page 31). If there is something within the work environment that contributed to or aggravated the employee's condition, then work relationship is established.

I hope you find this information useful. If you have any further questions, please contact my staff at Area Code (202) 219-6463.

Sincerely,

Stephen A. Newell Director
Office of Statistics