February 10, 1994

Mr. F.A. Zamzami
Industrial Security Manager
Petromin - Mobil Yanbu Refinery
Post Office Box 30078
Yanbu AlSinaiyah, Saudi Arabia

Dear Mr. Zamzami:

Thank you for your letter dated January 9, requesting interpretations on several OSHA injury and illness recordkeeping issues. I will address your questions in the order as presented in your letter. Whenever possible, I will refer to the enclosed Recordkeeping Guidelines for Occupational Injuries and Illnesses by citing the appropriate page and Q&A numbers.

A.I. Occupational hearing loss, when caused by a non- instantaneous event or exposure should be classified as an illness, specifically as a Disorder associated with repeated trauma (column 7f). I am enclosing a copy of the Hearing Conservation Amendment to give you guidance on procedures for protecting employees from occupational hearing loss. If you have any questions regarding this information, please contact the OSHA Office of Health Compliance Assistance at Area Code (202)-219-8036.

- Work related stress/anxiety/depression & psychosis should be classified as All other occupational illnesses (column 7g) (page 41, Q&A E-14).

- Abnormal conditions caused by worker exposure to heavy metals should be classified as Poisoning (column 7d).

- Allergic conditions aggravated by the work environment can be classified under several categories (columns 7a, 7c, 7e, and 7g) depending upon the source of the allergic condition. For guidance on specific conditions, please reference the Sentinel Health Event List (SHEO) found in Appendix C on page 69 of the Recordkeeping Guidelines.

II. For OSHA recordkeeping purposes, diagnosis is synonymous with recognition. Recordable occupational illnesses do not necessarily have to be diagnosed by a physician or other medical personnel. Employers, employees, and others may be able to detect some illnesses without the benefit of specialized medical training (page 39, Section E).

- The distinction between medical treatment and first aid treatment is found on pages 42 and 43 of the Recordkeeping Guidelines. The definitions outlined on these pages must be used to determine whether an injury case that does not involve death, loss of consciousness, restriction of work or motion, or job transfer is recordable. Please keep in mind that these criteria apply only to minor injuries. All work related non-minor injuries are recordable by definition (page 42, section F).

- The use of antibiotic drugs must be evaluated in terms of whether they are prescription or non-prescription. Any use of non-prescription drugs is considered first aid treatment. The use of prescription drugs (except a single dose administered on the first visit for minor injury or discomfort) is considered medical treatment. Once a prescription is written, it is considered medical treatment regardless of whether the prescription is filled or taken by the employee. This includes prescriptions written on a take as needed basis.

- If it seems likely that an event or exposure in the work environment either caused or contributed to a case or aggravated an existing condition, the case is considered work related. If a backache is known to result from some non-work related activity outside the work environment and merely surfaces at work, then the employer need not record the case (page 32, Q&A B-17). Please keep in mind that all back cases should be analyzed and classified as injuries if recordable. This generalization was made to keep recordkeeping determinations as simple and equitable as possible (page 38, Q&A D-4).

B. For OSHA injury and illness recordkeeping purposes, the term "lost workday case" is used to designate cases involving days away from work and/or days of restricted work activity beyond the date of injury or onset of illness (page 47, section B). OSHA does not use the term "lost time cases". However, other organizations have used this term synonymously with OSHA's definition of a lost workday case or to mean cases involving days away only, depending on the organization's definition.

- Time off to obtain medical treatment is not considered restricted work activity. The emphasis on determining restricted work activity is the employee's ability to perform all or any part of his or her normal assignment during all or any part of his or her normal workday or shift. An employee's normal job duties has been interpreted to mean anything the employee would be expected to do throughout the calendar year. If an employee is able to perform all normal work duties during all normal workdays or shifts following the day of injury or onset of illness, then absence from work for visits to the doctor's office or clinic to receive medical treatment should not be recorded as a lost workday case and your case scenario would be recorded as a non-fatal injury case without lost workdays (column 6) (page 50, Q&A B-19).

- Your case scenario involving the broken right hand with light duty work should be recorded as an injury involving restricted work activity.

- Your case scenario involving the broken leg with light duty work should be recorded as an injury involving restricted work activity.

- As stated above, the emphasis on determining restricted work activity is the employee's ability to perform all or any part of his or her normal assignment during all or any part of his or her normal workday or shift. If an employee is able to perform all normal work duties during all normal workdays or shifts following the day of injury or onset of illness, then absence from work for observation at a hospital should not be recorded as a lost workday case and your case scenario would be recorded as a non-fatal case without lost workdays (page 50, Q&A B-19).

- Your case scenario involving second degree burns on both legs with light duty work should be recorded as a case involving restricted work activity.

- OSHA does not use the term "light duty". However, it seems that most companies define the term "light duty" to be a subset of restricted work activity. Cases involving the assignment of light duty should be evaluated using the OSHA recordkeeping definition for restricted work activity.

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

Sincerely,



Bob Whitmore
Chief
Division of Recordkeeping Requirements