Incidents of workplace violence are on the rise and frontline workers do not feel safe at work, according to a recent survey commissioned by the security management company, Verkada. The survey was conducted on a nationally representative sample of 1,000 Americans who work on-location in critical sectors such as healthcare, hospitality, and retail that have regular contact with patients, customers, clients, or guests.

One in three workers said they have felt unsafe at work in the past year and 58% feel the threat of physical harm at work is increasing. 40% of respondents said they feel more concerned about their personal safety at work than they did a year ago.

69% of healthcare workers expressed concern about aggressive and erratic behavior by patients and 59% said they regularly worry about being physically assaulted at work. 54% of healthcare workers said they are likely to resign in the next 12 months if physical safety at work does not improve. The findings tie in with a recent National Nurses United survey where half of nurses reported an increase in workplace violence in the past year.

Employers were also surveyed, 76% of whom said they had experienced a security incident in the last year, with healthcare one of the worst industries with 4 out of 5 employers reporting a security incident in the past 12 months. 43% of employers said employee safety was a barrier to hiring and retaining workers, and 42% of healthcare employees said safety issues at work were contributing to the ongoing labor shortage. 46% of frontline workers said active shooter scenarios were one of the top concerns. Only one-third of respondents said they have received training on how to respond to these scenarios.

“Our research reveals a disconcerting picture for the frontline workforce driving our economy,” said Brandon Davito, senior VP of product and operations at Verkada. “Our nurses, teachers, cashiers and so many other workers who serve in critical roles interacting with the public are worried about their safety every time they show up to work. As employers, policymakers, and public safety leaders, we need to address these alarming trends and ensure that the safety of our people is the top priority.”

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OSHA training is the training on safety and health that employers are required to provide for members of their workforces. Training requirements vary according to the nature of each business’s activities and the OSHA standards that apply. For example, in the healthcare industry, OSHA training will likely include some or all the following subjects:

• Emergency Action Plans
• Fire Prevention Plans
• Occupational Noise Exposure
• Hazardous Materials
• Personal Protective Equipment
• Bloodborne Pathogens
• Ionizing Radiation
• Hazard Communication
• Walking and Working Surfaces
• Safe Patient Handling

Similar to the HIPAA training requirements, it is necessary for training on some standards to be provided to all members of the workforce, and for training on other standards to be provided to just the members of the workforce exposed to certain hazards.

For example, all Medicare and Medicaid providers are required to comply with CMS’ Emergency Preparedness Requirement. To comply with the OSHA training requirements for emergency action plans qualifying providers should train employees on:

(1) The procedures for reporting a fire or other emergency.

(2) The procedures for emergency evacuation.

(3) The procedures to be followed by employees who remain to maintain critical activities.

(4) Procedures to account for all employees after evacuation.

(5) Procedures to be followed by employees performing rescue or medical duties.

(6) The name or job title of every employee who may be contacted by employees who need more information about the plan or an explanation of their duties under the plan.

Conversely, only members of the workforce who conduct or assist with X-rays, CT scans, CAT scans, PET scans, and procedures involving fluoroscopy – or who use ionizing radiation to sterilize medical equipment – will likely require training on the ionizing radiation standard (1910.1096).

What is the Required Frequency of OSHA Training?

When training is required by an OSHA standard, it is most often the case that training is required prior to a member of the workforce performing a role in which they are exposed to a hazard, with refresher training provided at the employer’s discretion.

However, some standards require more frequent training. For example, the bloodborne pathogens standard (1910.1030) requires employees to receive training “At the time of initial assignment to tasks where occupational exposure may take place and at least annually thereafter.”

Additionally, state OSHA plans and other regulatory authorities may require more frequent training. For example, CMS requires members of the workforce to receive emergency preparedness training every two years – or annually if the healthcare facility provides long-term care.

What is OSHA 10 and 30-Hour Training?

OSHA 10 and 30-hour training – also known as Outreach Training – are two types of training programs offered by OSHA-authorized training organizations. The 10-hour training program is intended for “entry level workers” and includes the basics of hazard recognition and avoidance, workers’ rights, employers’ responsibilities, and how to file a complaint.

The 30-hour training program is more advanced and intended for workers with responsibility for safety and health in the workplace. The program has more depth and variety than the 10-hour program; and, although not standard-specific, is recommended for anybody that will ultimately be responsible for providing OSHA training to colleagues.

Although participation in either Outreach Training Program is voluntary, some states have passed legislation requiring workers in the construction industry to have a 10-hour or 30-hour construction “card” (certificate of completion) before being employed by a construction project. In several cases, the card has to be renewed by retaking training every five years.

Conclusion: Make Sure You Know the OSHA Training Requirements

If a safety or health hazard exists in your workplace, it is likely there is an OSHA standard on how to mitigate the risk of an injury or illness from the hazard. There is also likely to be an OSHA training requirement in the standard. Therefore, it is important that employers are not only aware of the standard but also of the training requirement.

If you are unsure about which standards applicable to your business have an OSHA training requirement, or you need help with the provision of training, OSHA provides multiple sources of information on its website and also offers a free and confidential on-site consultation program for small and medium-sized businesses.

Alternatively, you can find out more about OSHA compliance for the healthcare industry in our OSHA compliance checklist or seek independent advice from a compliance expert. Businesses can be issued with citations and fines for failing to provide safety and health training to employees when required, so it is important you know the OSHA training requirements – and comply with them.

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A Peoria, AZ-based dentist has been ordered to pay $20,000 in back wages to an employee who was terminated for making allegations of unsafe work practices at the practice.

The Occupational Safety and Health Act (OSH Act) has whistleblower provisions that protect employees from retaliation after raising concerns about workplace health and safety issues and reporting injuries sustained in the workplace.  Employers are not permitted to take unfavorable employment actions against employees, such as demoting, denying overtime or promotion, disciplining, intimidating, making threats, or firing employees that raise safety concerns with their employers or report safety and health complaints to the Occupational Safety and Health Administration (OSHA).

In March 2020, a dental assistant at the practice of Dr. Monzer K. Al-Dadah LLC and Dr. Al-Dadah filed a complaint with OSHA about unsafe working practices related to COVID-19. The employee complained about the risk of contracting COVID-19 and refused a work assignment due to fears of contracting COVID-19. The worker also discussed workplace safety issues with coworkers. Dr. Al-Dadah made attempts to identify the individual who submitted the complaint, then terminated the dental assistant, who had worked at the practice for more than 20 years. The dental assistant then filed a complaint with OSHA about the termination and an investigation was launched.

OSHA determined that the dental assistant’s employer had violated the whistleblower protections of the OSH Act and a lawsuit was filed in April 2022. The Department of Labor has now obtained a judgment in federal court requiring back wages to be paid to the employee due to the unlawful termination. “Employees must be able to exercise their legal rights regarding workplace safety freely and without fear of retaliation by their employer,” said OSHA Assistant Regional Administrator Denise Keller in Chicago. “The outcome in this case reflects the Department of Labor’s commitment to protect workers’ rights.”

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There are several categories of workers not covered by OSHA. Additionally, some members of a workforce are only covered in specific roles, while others are only covered in specific states or industries. This article looks at when workers are not covered by OSHA, specifically those in the following areas:

• Volunteers & Temporary Workers
• Self Employed Workers
• Family Members of Farm Employers
• Industries Regulated by Another Agency
• State and Local Government Employees

Volunteers & Temporary Workers

Volunteers are generally not covered by OSHA – but there are exceptions. Volunteer firefighters may be covered by OSHA if they are remunerated for time spent serving the community, covered by workers’ compensation, or regarded as public employees by the state or local government with jurisdiction over the location they volunteer in.

There are also some special cases in which an agency has adopted an OSHA standard as one of its own and included volunteers in the coverage. For example, when the Environmental Protection Agency adopted OSHA’s Hazardous Waste and Emergency Response standard, the Agency applied the standard to both paid and uncompensated workers.

Temporary workers that are paid by either an employer or a staffing agency are classified as employees and covered by OSHA. It is important to note that, regardless of who the payer is, if a temporary worker is assigned a job by a staffing agency, both the employer and staffing agency are accountable for the safety and health of the employee.

One final comment about volunteers and temporary workers not covered by OSHA is that if a workforce consists of both paid employees and volunteers, the workplace must comply with OSHA standards. Therefore, if a volunteer suffers an injury in a workplace accident that could have happened to a paid employee, the employer could still be cited and fined by OSHA.

Self Employed Workers

One significant category of workers not covered by OSHA includes the self-employed – independent contractors, freelancers, or anyone else who works for themselves. Self-employed individuals are, by definition, their own employers and do not have employees of their own. As such, OSHA’s standards, which were designed to protect employees from unsafe working conditions, do not usually apply.

However, there are exceptions. In the same way as an employer has to provide a safe working environment for volunteers when other members of the workforce are paid employees, employers must provide a safe working environment to self-employed individuals when self-employed individuals work on the premises.

Complications can arise when one self-employed individual subcontracts another self-employed individual to work with them or on their premises. In such cases, OSHA standards should not apply because both individuals are self-employed. However, depending on the nature of the work and state regulations, some OSHA standards may be applicable.

Family Members of Farm Employees

The applicability of OSHA standards to farms is a nuanced issue, particularly where family members of farm employees are concerned. Generally, farms with fewer than eleven employees are not covered by OSHA, and OSHA considers immediate family – parents and their children, stepchildren, foster children, and spouses – to be excluded from the count of employees.

However, this doesn’t mean that farms are devoid of all responsibility for the safety of their family members working there. Farms are encouraged to follow best practices in agricultural safety and health, and OSHA provides resources and guidelines to aid in this. Furthermore, certain regulations, such as those pertaining to labor camps, accidents, and hazardous substances, may still apply.

Again, there are exceptions to this category of workers not covered by OSHA. If a temporary labor camp is set up on a farm, or an employee (including family members of farm employees) has a fatal accident or sustains an injury that results in hospitalization, amputation, or the loss of an eye, temporary compliance with OSHA’s standards and reporting requirements applies.

Industries Regulated by Another Agency

Some specific industries and workplaces are regulated by other federal agencies. In such cases, businesses in these industries and their workplaces are not covered by OSHA. Examples of this group include:

Most mining and milling operations fall under the Mine Safety and Health Administration (MSHA). However, OSHA standards may apply for some product types and post-mining processes (see Appendix B of the MSHA and OSHA Memorandum)

The working conditions of flight crews when an aircraft is in flight. These are overseen by the Federal Aviation Administration (FAA). However, FAA oversight does not apply to cabin crews in respect of noise, hazard communication, and bloodborne pathogens.

The safety and health of seamen aboard vessels is regulated by the Department of Transportation’s Coast Guard agency. However, OSHA has the authority to enforce standards relating to discrimination and whistleblowing according to a 1983 Memorandum.

Workers in the publicly owned energy sector that may be exposed to ionizing radiation are covered by safety standards regulated by the Nuclear Regulatory Commission and the Department of Energy. All privately owned businesses in the energy sector are subject to OSHA standards.

State and Local Government Employees

While federal government employees are protected by OSHA, the situation differs for state and local government employees – including those in public schools and universities. OSHA only covers these employees in certain states with an OSHA-approved state plan. In other states, the safety and health of public sector employees fall under the jurisdiction of the state’s health and safety agencies.

In 28 states and territories, the safety and health standards for state and local government employees are overseen by OSHA-approved state plans. Where state plans only apply to state and local government employees, federal OSHA standards apply to private employment activities. State plans are required to have standards and enforcement programs at least as effective as OSHA’s.

Who is Not Covered by OSHA? Conclusion

While it may seem like a large number of workers are not covered by OSHA, it is important to note the agency’s influence is vast, covering most private sector workers and federal employees throughout the United States. Additionally, many workers not directly covered by OSHA are protected indirectly by OSHA, by other health and safety agencies, or by a state plan.

Consequently, most private and public employers need to understand their compliance requirements and ensure measures are implemented to comply with applicable OSHA standards. Employers who are unsure of their compliance requirements should review our OSHA compliance checklist and speak with a compliance expert or seek advice directly from the nearest OSHA office.

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OSHA compliance for dental offices most often consists of compliance with all applicable common OSHA standards and compliance with any further OSHA standards specifically relevant to the business and the nature of services provided. Common OSHA standards applicable to dental offices include:

• 22 General Requirements
• 25 Stairways
• 35 Means of Egress
• 38 Emergency Action Plan
• 95 Noise Exposure
• 1910 Subpart H Hazardous Materials
• 1910 Subpart I Personal Protective Equipment
• 1910 Subpart J General Environmental Controls
• 151 Medical and First Aid
• 1910 Subpart L Fire Protection
• 1910 Subpart O Machinery and Machine Guarding
• 303 General Electrical Requirements
• 1096 Ionization Radiation
• 1200 Hazard Communication
• 1910 Subpart Z Toxic and Hazardous Substances
• 29 USC 654 OSHA General Duty Clause
• 29 CFR 1904 OSHA Reporting Requirements

Although there are no specific OSHA standards for dental offices, dental office employers with one or more employees must comply with the Occupational Safety and Health Act.

The Act requires each employer: (1) to furnish each of his/her employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees (the General Duty clause); and (2) to comply with the applicable occupational safety and health standards promulgated under the Act.

The Challenge of OSHA Compliance for Dental Offices

The challenge of OSHA compliance for dental offices is working out which OSHA standards are applicable, and which are not. For example, under the “Hazardous Substances” standards, most dentists will have to comply with the “Bloodborne Pathogens” standard, but some will also have to comply with the “Beryllium”, “Crystalline Silica”, and “Nitrous Oxide” standards.

It can also be a challenge to determine who is responsible for OSHA compliance in shared buildings. For example, while it might be simple to dismiss the “Stairways” standard if a dental office is on the ground floor of a shared building, it may be more complicated to establish responsibility for compliance with the “Means of Egress” standard in a multi-tenanted building.

Complying with the OSHA General Duty Clause

Complying with the OSHA General Duty clause can also be a challenge of OSHA compliance for dental offices due to the issue of ergonomics. Ergonomics is a hot topic in dentistry due to the positions dental practitioners and assistants adopt during treatment and the potential for work-related musculoskeletal disorders – one of the most common causes of injury in dentistry.

In 2000, OSHA published an ergonomics standard, but this was subsequently repealed by a Senate Resolution due to the cost of compliance and pushback from workers’ compensation insurance companies. OSHA subsequently published guidance on preventing musculoskeletal disorders in the workplace which – although not mandatory – can be enforced under the General Duty clause.

Complying with Recordkeeping & Training Requirements

There are few recordkeeping requirements to comply with due to dental offices being a partially exempt low-hazard industry. Therefore, although it is not necessary to maintain OSHA 300 and 301 logs or submit Form 300A annually, it is necessary to record and report any workplace incident that results in an employee fatality, in-patient hospitalization, amputation, or loss of an eye.

The OSHA training requirements vary by standard. Some standards (i.e., the “Personal Protective Equipment” standard) require that employees are trained in how to use the equipment the first time it is provided for them. Other standards (i.e., the “Bloodborne Pathogens” standard require annual training. Note: annual training on some standards may be required by other agencies. For example, annual emergency action plan training is a condition of participation in Medicare.

Conclusion: Help with OSHA Compliance for Dental Offices

There are multiple sources where employers can get help with OSHA compliance for dental offices. A good place to start if your current level of information is limited is our OSHA compliance checklist which provides further information about the Occupational Safety and Health Act and general compliance information for organizations in the healthcare industry.

Thereafter, dental offices can obtain more specific help from OSHA’s “Quick Start Assistant” or from a professional compliance advisor. Finally, OSHA compliance for dental offices is not something that can be ignored. Penalties can be issued by OSHA inspectors when employers “should have known” about the OSHA compliance requirements.

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There are six OSHA violation types. The Occupational Safety and Health Administration has the authority to issue fines for five of the violation types, while the sixth type of OSHA violation (a “de minimis” violation) will only result in a fine if it escalates into one of the other five violation types. The six OSHA violation types are:

• Serious
• Other-than Serious
• Willful or Repeated
• Posting Violation
• Failure to Abate Violation
• De Minimis Violation

The Six OSHA Violation Types in Greater Detail

A safer workplace is the cornerstone of a productive and successful business. The Occupational Safety and Health Administration (OSHA) plays a pivotal role in achieving this goal by setting and enforcing standards for safe and healthy working conditions. A significant part of OSHA’s role involves identifying and addressing violations of these standards.

Serious Violations

Citations for serious violations are issued when a workplace hazard could cause an accident or illness that would most likely result in death or serious physical injury – or has done so already – and the employer knew or should have known about the hazard.

Other-Than-Serious Violations

Other-than-serious violations are hazards that are related to workplace safety and health but probably wouldn’t cause death or serious physical injury. This OSHA violation type should be remediated quickly to prevent citations for repeated violations.

Willful or Repeated Violations

Willful and repeated violations are the most serious of the OSHA violation types because they demonstrate the knowing failure of an employer to comply with OSHA standards. Naturally, this type of violation attracts the highest financial penalties.

Posting Violations

When an employer is cited for unsafe or unhealthy working conditions, a notice must be posted at or near the hazard to warn employees. The failure to post a notice and display it for a minimum of three working days can attract a penalty for a posting violation.

Failure to Abate Violations

When OSHA inspectors issue a citation for a workplace hazard, the citation usually has a deadline for when the hazard must be rectified or “abated”. The failure to abate the violation within the deadline is a violation of OSHA that can also attract a penalty.

De Minimis Violations

De minimis violations are technical violations of OSHA that are unlikely to result in an injury or illness. Although financial penalties are not issued for de minimis violations, OSHA inspectors make a note of them in case they escalate into one of the more serious OSHA violation types.

Penalties for OSHA Violations

From 1970 until 2016, the penalties for OSHA violation penalties were not much of a deterrent for employers that willfully or repeatedly violated OSHA. The penalty structure was changed in 2016 and is now adjusted for inflation each year. The current (2023) penalties are OSHA violations are as follows:

* Note: For a repeated other-than-serious violation or posting violation that otherwise would have no initial penalty, a penalty of $414 is imposed for the first repeated violation, $1,116 for the second repeated violation, and $2,232 for a third repetition.

It is also important to be aware that in U.S. states and territories where OSHA State Plans exist, each authority can set its own penalty structures and minimum and maximum penalty levels. The penalties must be at least as effective as those of the federal OSHA.

OSHA Violation Types: Conclusion

Due to the change in the OSHA penalty structure, it can be financially worthwhile for employers to ensure they comply with all applicable OSHA standards. To find out more about which standards may apply to your business, review our OSHA compliance checklist, speak with an OSHA compliance expert, or contact OSHA directly.

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The Occupational Safety and Health Administration (OSHA) is responsible for the regulation and enforcement of safety and health standards in most private and public workplaces in the United States. Key areas that OSHA regulates include:

• Safety Standards
• Hazard Communications
• Recordkeeping and Reporting
• Training and Education
• Inspections and Enforcement
• Emergency Preparedness and Response
• Whistleblower Protections

Overview of OSHA Regulation

OSHA is best known for setting and enforcing workplace safety and health standards. These standards include rules and regulations concerning the use of personal protective equipment (PPE), fall protection, and the safe handling of hazardous materials.

The agency requires employers to inform and train employees about hazards in the workplace, safe handling procedures, and emergency protocols. This includes the use of Safety Data Sheets (SDSs) and the proper labeling of hazardous substances.

With regard to recordkeeping and reporting, employers must maintain records of work-related injuries and illnesses, submit annual summaries of the injuries and illnesses, and report serious incidents such as fatalities and injuries resulting in hospitalization.

OSHA provides training programs and educational resources to enhance employer and employee knowledge of occupational safety and health. These include outreach programs that recognize exemplary safety and health programs that result in fewer days lost to injury and illness than the national average.

Enforcement, Emergency Preparedness, and Whistleblower Protections

OSHA is most often alerted to potential non-compliance with safety and health standards via injury reports, worker complaints, and referrals from state and federal agencies. OSHA conducts workplace inspections according to a “system of priorities” to ascertain adherence to its standards. If violations are identified, OSHA has the authority to issue citations and fines.

Outside of its regulatory responsibilities for individual organizations, OSHA develops, regulates, and orchestrates safety and health practices for multiple response organizations in emergency situations. Response organizations can sometimes be overwhelmed in large-scale events such as extreme weather events, and OSHA has the authority to take control of emergency response if required.

Finally, OSHA’s Whistleblower Protection Program enforces the whistleblower provisions of more than 20 statutes. In addition to protecting whistleblowers against retaliation for reporting safety and health violations, the Program protects employees who report issues relating to consumer products, the environment, health insurance reform, food safety, and motor vehicle safety.

What does OSHA Regulate? Conclusion

OSHA regulates many aspects of workplace safety and health – not only in the private sector but in some public sector workplaces as well. Because it is important for businesses to understand which standards may apply to their activities, we have compiled an OSHA compliance checklist that provides more information about OSHA and the OSHA requirements for employers.

Businesses that require further information – or who need help to comply with OSHA’s safety and health standards – should reach out to OSHA via the agency’s website or seek independent compliance advice.

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The government agency OSHA was created in 1971 as a result of the passage of the Occupational Safety and Health Act in 1970. OSHA’s mission is to improve working conditions for the majority of the country’s workforce by setting and enforcing standards, and by providing training, education, and assistance to employers. Key milestones in OSHA’s history include:

• 1970: OSHA is established under the Nixon administration.
• 1971: OSHA’s first safety and health standards are adopted.
• 1972: OSHA starts its on-site consultation program.
• 1972: the first OSHA State Plans are approved.
• 1978: The Field Sanitation Standards are introduced.
• 1983: The Hazard Communication Standard is published.
• 2002: Exit Routes, Emergency Action Plans, and Fire Prevention Plans Standard.
• 2010: OSHA establishes the Severe Violator Enforcement Program to focus on employers who have demonstrated indifference to their OSH Act obligations.
• 2016: The Final Rule to Improve Tracking of Workplace Injuries and Illnesses is published, requiring electronic submission of Form 300A.

The Background to OSHA

Although OSHA was created in 1971, it was not an entirely new department within the Department of Labor. The agency absorbed many of the functions of the former Bureau of Labor Standards, which had promoted industrial safety and health since 1922, and which was responsible for the Fair Labor Standards Act of 1938 which set minimum wage and maximum hours standards nationwide.

Additionally, the agency did not have to start developing safety and health standards from scratch. Many industries already had federal safety and health regulations; and, where gaps existed for certain industries, many states had set up their own commissions and set their own state standards – several prior to the creation of the former Bureau of Labor Standards.

The Early Days of OSHA

When the first safety and health standards were published, they were no more than adaptations of standards already in place at organizations such as the American National Standards Institute and the National Fire Protection Administration. OSHA’s first original standard came sometime later and responded to a well-known health issue by limiting worker exposure to asbestos.

Throughout the 1980s and 1990s, OSHA published hundreds of safety and health standards, plus standards that allowed employees to access toxic exposure records and standards that reduced occupational exposure to bloodborne pathogens such as AIDS and Hepatitis B. The agency also extended its training and outreach programs and refined its inspection targeting system.

OSHA in the 21^st Century

Since the turn of the century, OSHA has continued to publish new standards – or update existing standards – in response to evolving hazards to health and safety in the workplace. The agency’s Training Institute, Voluntary Protection, and On-Site Training programs have grown and a new Safety & Health Achievement Recognition Program recognizes businesses with exemplary safety and health programs that result in fewer days lost to injury and illness than the national average.

With regards to OSHA inspections and enforcement actions, the agency conducts more than 30,000 inspections each year – the majority attributable to worker complaints, injuries and fatalities, and referrals from state and federal agencies. Enforcement actions that result in a financial penalty of $40,000 or above are now listed on the agency’s website, and the maximum amount OSHA can issue as a fine is now increased annually. The maximum fine for 2023 is $156,259 per violation.

What Year was OSHA Created? Conclusion

Businesses covered by OSHA should not be concerned about what year was OSHA created and why, but rather how they can comply with the standards that apply to their activities now. To help better understand safety and health compliance obligations, we have compiled an OSHA compliance checklist which officers with a responsibility for workplace safety and health are invited to review. Thereafter, if questions remain about what standards apply or how best to comply with them, it is advisable to seek professional compliance advice.

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