February 16, 2011

Mr. Jeff Hiserman, P.T., CET
Susquehanna Health
Physical Therapy Services
1100 Grampian Boulevard
Williamsport, PA 17701-1995

Dear Mr. Hiserman:

Thank you for your August 24, 2010, letter to the Occupational Safety and Health Administration's (OSHA's) Directorate of Enforcement Programs (DEP). You requested information regarding OSHA's occupational injury and illness recordkeeping regulation at 29 CFR 1904. Specifically, you requested information on examples of "hot therapy" as used in Section 1904.7(b)(5)(ii)(e). Following a telephone conversation with a member of my staff, you indicated that you preferred a written response. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question not delineated within your original correspondence.

Section 1904.7(a) requires an employer to consider an injury or illness to meet the general recording criteria if it results in "medical treatment beyond first aid." For purposes of Part 1904, medical treatment means "the management and care of a patient to combat disease or disorder." This section of the recordkeeping regulation also states that first aid, as defined by Part 1904.7(b)(5)(ii), does not fall within the definition of medical treatment. OSHA also explained in the January 19, 2001, preamble to the final rule revising the Part 1904 regulation that the list of first aid treatments included in Section 1904.7(b)(5)(ii) is comprehensive. This means that any treatment not included on the list is not considered first aid for purposes of Part 1904. See, 66 Fed. Reg. 5984.

Section 1904.7(b)(5)(ii)(e) provides that the definition of "first aid" includes using "hot or cold therapy." OSHA stated in the 2001 preamble to the final rule that hot and cold treatment is first aid regardless of the number of times it is applied, where it is applied, or the injury or illness to which it is applied. See, 66 Fed. Reg. 5990. It is OSHA's judgment that hot and cold treatment is simple to apply, does not require special training, and is rarely used as the only treatment for any significant injury or illness. Examples of heat therapy include compresses, soaking, and non-prescription skin creams/lotions for local relief. On the other hand, please be aware that whirlpool treatments and ultrasound therapies are both considered forms of physical therapy, and are therefore medical treatment for purposes of OSHA recordkeeping.

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA requirements are set by statute, standards, and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at www.osha.gov. If you have any further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.

Sincerely,



Thomas Galassi, Director
Directorate of Enforcement Programs