What is an OSHA PEL in Healthcare?
An OSHA PEL in healthcare is the Permissible Exposure Limit allowed by the Occupational Safety and Health Administration (OSHA) for hazardous substances found in healthcare environments. Most commonly, an OSHA PEL in healthcare will limit employee exposure to hazards such as:
- Ethylene Oxide
- Formaldehyde
- Glutaraldehyde
- Ionizing Radiation
- Laboratory Chemicals
- Antineoplastic Drugs
OSHA sets PELs to protect employees against the health effects of exposure to hazardous substances. Most OSHA PELs in healthcare apply limits to the amount or concentration of a hazardous substance an employee can be exposed to over a period of time.
Typically, an OSHA PEL in healthcare is based on a Time Weighted Average (TWA) for an eight-hour workday or a forty hour work week. Once the exposure limit has been reached, an employee must not be exposed to the hazard for the rest of the day/week.
For some PELs, OSHA also applies Short Term Exposure Limits (STELs) for a higher level of exposure to a hazardous substance than allowed by a TWA for a shorter period of time. For example, the OSHA PEL for exposure to formaldehyde (OSHA §1910.1048(c)) states:
1910.1048(c)(1)
TWA: The employer shall assure that no employee is exposed to an airborne concentration of formaldehyde which exceeds 0.75 parts formaldehyde per million parts of air (0.75 ppm) as an 8-hour TWA.
1910.1048(c)(2)
STEL: The employer shall assure that no employee is exposed to an airborne concentration of formaldehyde which exceeds two parts formaldehyde per million parts of air (2 ppm) as a 15-minute STEL.
Potential Changes to OSHA Permissible Exposure Limits
The current list of OSHA PELs for hazardous substances and laboratory chemicals can be found in Annotated Tables Z-1, Z-2, and Z-3. The OSHA PEL for ionizing radiation can be found in OSHA §1910.1096. OSHA defers to NIOSH guidelines for occupational exposure to antineoplastic drugs due to the number of neoplastic drugs and the different levels of risk between unopened, intact tablets and capsules and injectable drugs – which usually require extensive preparation.
However, in the preamble to the Annotated Tables, OSHA acknowledges many of its PELs are out of date because they were adopted after the creation of the Administration in 1971 and have not been updated since. Although the current list is the list against which OSHA compliance is assessed, OSHA advises businesses to refer to Cal/OSHA’s more stringent PELs and NIOSH’s “Pocket Guide to Chemical Hazards” and apply the lowest permissible exposure limit.
The reason why there may be changes to OSHA’s PELs is that the Administration has been looking at ways to keep pace with changes to chemical structures and the hazards that exist because of the changes. Acknowledging that the one-chemical-at-a-time approach is not effective, OSHA has proposed adopting a method similar to the EU’s REACH program which moves the burden of developing PELs for hazardous substances from the government to the manufacturer.
How to Comply with an OSHA PEL in Healthcare
The purpose of an OSHA PEL in healthcare is to keep employees safe. If a highly trained employee develops an illness or health condition due to over-exposure to a hazardous substance, the highly trained employee will no longer be able to provide a service for an employer.
Therefore, it is advisable to conduct a risk assessment for all hazardous substances that employees may be exposed to and, where a risk of exposure exists, implement engineering controls, conduct regular air monitoring, and provide PPE and employee training to comply with the OSHA PEL.
Healthcare organizations can be fined – and have been fined – for violating OSHA permissible exposure limits in healthcare; although, over the past year, more healthcare organizations have been cited for failing to communicate hazards than exceeding permissible exposure limits.
If your organization has concerns it is failing to comply with an OSHA PEL in healthcare, or needs help organizing a training or hazard communication program, you should speak with an OSHA compliance expert or approach OSHA directly to see if you qualify for a free onsite consultation.
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HIPAA and Part 2 Harmonized: What Health Care Organizations Need to Know – The National Law Review
HIPAA and Part 2 Harmonized: What Health Care Organizations Need to Know The National Law Review
HIPAA and Part 2 Harmonized: What Health Care Organizations Need to Know – The National Law Review
HIPAA and Part 2 Harmonized: What Health Care Organizations Need to Know The National Law Review
HIPAA and Part 2 Harmonized: What Health Care Organizations Need to Know – Foley & Lardner LLP
HIPAA and Part 2 Harmonized: What Health Care Organizations Need to Know Foley & Lardner LLP
CMS: Providers may now text patient info, orders to care teams – FierceHealthcare
CMS: Providers may now text patient info, orders to care teams FierceHealthcare
CMS Updates Policy to Allow Texting Patient Information and Patient Orders – HIPAA Journal
CMS Updates Policy to Allow Texting Patient Information and Patient Orders
The Centers for Medicare and Medicaid Services (CMS) at the Department of Health and Human Services (HHS) has updated its policy on texting patient information between members of the care team and texting patient orders. Clinical teams are now permitted to text patient information provided they use a HIPAA-compliant texting platform to do so, and provided they are in compliance with the Conditions of Participation (CoPs). The CMS also permits the texting of patient orders.
In January 2018, the CMS issued a QSO-19-10-Hospital, CAHs Revised memorandum – Texting of Patient Information among Healthcare Providers in Hospitals and Critical Access Hospitals (CAHs) – acknowledging that many hospitals had adopted a secure text messaging platform for communicating among hospital and CAH team members; however, the CMS stated that texting patient orders from a provider to a member of the care team was not compliant with the CoPs due to concerns about privacy, record retention, and the confidentiality, security, and integrity of systems at the time. When the memorandum was written, most hospitals did not have the capability to use secure text messaging platforms to incorporate messages into electronic health records (EHRs). Improvements in technology over the past 6 years, such as the use of encryption, ensure that sensitive health information can be transmitted and stored securely and advances in technology, especially the application interface capabilities of text messaging platforms, allow data to be transferred into EHRs.
While texting patient orders is now permitted, Computerized Provider Order Entry (CPOE) is the preferred method of order entry by a provider. If an order is entered via CPOE and immediately downloaded into the hospital’s or CAH’s EHR system, it is permitted under the CoPs because the order is dated, timed, authenticated, and promptly placed in the medical record. However, providers must utilize and maintain systems/platforms that are secure and encrypted. They must ensure the integrity of author identification and minimize risks to patient privacy and confidentiality, as required by HIPAA.
In addition, procedures and processes should be implemented that routinely assess the security and integrity of the texting systems/platforms to avoid negative outcomes that could compromise the care of patients. Any provider that opts to incorporate texting patient information or orders into the EHR should ensure that the platform is compliant with the requirements of the HITECH Act and HIPAA.
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OSHA Recordkeeping and Reporting Requirements Explained in Two Webinars
The Occupational Safety and Health Administration (OSHA) is hosting two webinars in February that explain the OSHA recordkeeping and reporting requirements. The first, this Wednesday, will explain the process for submitting workplace injury and illness data through OSHA’s online Injury Tracking Application.
The second webinar, on February 28, will be an overview of the OSHA recordkeeping and reporting requirements that will include information about the most common recordkeeping and reporting mistakes made by employers and provide tips on how employers can effectively audit their recordkeeping program.
What Are the OSHA Recordkeeping and Reporting Requirements?
The OSHA recordkeeping and reporting requirements are covered in §1904 of the OSHA Standards. This standard requires all qualifying employers to maintain a log (Form 300) of serious work-related injuries and illnesses (as defined in §1904.4) and post a summary of the log (Form 300A) in a conspicuous place in the workplace by February 1 of the following year.
In addition, the information on the summary Form 300A must be submitted to OSHA. Since 2017, all qualifying employers under Federal OSHA have had to submit the information via OSHA’s Injury Tracking Application which allows information to be uploaded manually, via a CSV file, or via an API. The 2024 deadline for submitting data to OSHA is March 2, 2024.
Who is Required to Comply with the OSHA Requirements?
Since January 2024, all employers with 250 or more employees are required to maintain a log of serious workplace injuries and illnesses and submit a summary to OSHA each year. Employers with 20-249 employees in certain industries with traditionally high rates of workplace injuries and illnesses are subject to the same OSHA recordkeeping and reporting requirements.
However, all employers under OSHA jurisdiction of any size and of any activity must report workplace fatalities (within 8 hours) and any injuries that result in an in-patient hospitalization, an amputation, or the loss of an eye (within 24 hours). Employers that fail to comply with any of the OSHA recordkeeping and reporting requirements can be fined up to $16,131 per violation.
How the Webinars Should Help
According to OSHA, the administrative burden of complying with the annual reporting requirements should be less than one hour per year. However, many employers have reported that the process of calculating the required injury and illness incidence rates, transferring the data to Form 300A, and uploading the information via the Injury Tracking Application can take longer.
OSHA hopes to reduce the administrative burden by explaining in its webinars how best to use the Injury Tracking Application to upload 2023 data and how to avoid the most common recordkeeping and reporting mistakes that can extend the time it takes to upload the data or require the data to be resubmitted.
OSHA Webinar Information
February 14, 9-10:15 a.m. EST: This presentation will explain the process for electronically submitting 2023 workplace injury and illness data through OSHA’s online Injury Tracking Application.
February 28, 9-10:15 a.m. EST: This presentation will be an overview of OSHA’s recordkeeping requirements and address common mistakes made by employers, incentive and disincentive programs, and tips on how an employer can effectively audit their recordkeeping program.
Employers interested in learning more about the OSHA recordkeeping and reporting requirements can register for both free webinars via this link.
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