OSHA’s guidance and regulations concerning the obligations of an employer to provide first aid and emergency medical treatment to its employees are well settled, but it’s so essential that it’s worth a refresher. So, let’s take a closer look at OSHA’s mandatory requirements and views on voluntary medical services.
OSHA’s standard for general industry, which includes foundry operations, is set forth in section 1910.151, and its standard for the construction industry is in section 1926.50. The basic principles are largely the same, but the construction standard is more detailed and contains additional requirements.

Both standards provide that in the absence of an infirmary, clinic, or hospital located close to the workplace, someone at the worksite must be adequately trained to render first aid. Under the general industry standard, the medical service provider must be located in “near proximity” to the workplace. Under the construction standard, the medical service provider must be “reasonably accessible” to the construction site and the person who is trained on first aid must be certified. The fundamental purpose of these standards is to ensure that adequate first aid is available for the benefit of an injured employee, either on site or in very close proximity to the workplace, during the critical minutes between the occurrence of an injury and the availability of physician or hospital care for the injured employee.

The terms “near proximity” and “reasonably accessible” to the workplace are stated generally and not defined. Therefore, this standard is performance-based rather than prescriptive and each employer must assess its compliance on a case-by-case basis. To make this assessment, employers must weigh how close is close enough. While OSHA states employers must take into account the attendant and relevant circumstances, OSHA has consistently interpreted “near proximity” to mean emergency care must be available for injured employees within 3-4 minutes from workplaces where serious accidents are more likely to occur. OSHA recognizes, however, that a longer response time of up to 15 minutes may be reasonable in other types of workplaces, such as offices, where the likelihood of serious work-related injuries is remote.

To comply with the “near proximity” requirement, employers may rely on the reasonable availability of fire department paramedics or EMS responders to come to the site. OSHA takes the view that fire department paramedics or EMS responders is equivalent to an “infirmary, clinic, or hospital” for purposes of compliance, but they must be able to get to the workplace within 3-4 minutes if it’s a manufacturing facility or 15 minutes if it’s an office.

Over the years, OSHA has issued numerous citations to employers not in compliance with these tight timeframes, and those citations have been upheld by the Occupational Safety and Health Review Commission. Therefore, if the employer’s workplace is not located in near proximity to an outside medical provider, the employer must ensure at least one member of the workforce on each shift has been adequately trained in first aid. For most employers, this is an effective and feasible method to protect employees and ensure compliance with OSHA’s requirements.

The standard provides first aid supplies must be readily available and adequate. Although OSHA does not define “adequate,” OSHA gives an example of the minimal contents of a generic first aid kit as described in American National Standard (“ANSI”) Z308.1 “Minimum Requirements for Workplace First-aid Kits.” The ANSI standard was updated several times, most recently in 2015, and identifies two classes of first aid kits: Class A kits offer the basic products to treat the common injuries encountered in the workplace, such as wounds, minor burns, temperature extremes, and eye injuries; and Class B kits include a broader range and quantity of supplies to address injuries encountered in higher risk work environments. For larger and more complex operations, employers should consider the need for additional first aid kits at the worksite and additional types of first aid equipment and supplies. The locations where the first aid supplies are maintained should be properly labeled with first aid signage and employees must be trained on how to access first aid supplies.

The bloodborne pathogens standard goes hand-in-hand with the first aid standard. Under the bloodborne pathogens standard, employers must train all employees who have occupational exposure to blood or other potentially infectious materials, including any employees who are assigned medical or first aid duties. The term “occupational exposure” is defined as “reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee’s duties.” Thus, if an employee is trained in first aid and identified by the employer as responsible for rendering medical assistance, that employee is covered by the bloodborne pathogens standard.

On a voluntary basis, OSHA recommends, but does not require, every workplace to include one or more employees who are trained in cardiopulmonary resuscitation (CPR) and using automated external defibrillators (AEDs). Employees who complete training from recognized organizations, such as the American Red Cross or American Heart Association, may receive a limited certification for a period of time, and employees should be re-trained when the certification expires.

OSHA’s standards focus on minimal first aid requirements to ensure employees receive prompt treatment for injuries or illnesses that occur in the workplace. OSHA recommends employers take additional voluntary steps to provide greater protection to employees. Each employer must assess the scope of first aid and medical capability based on the workplace conditions and risks and the proximity of the workplace to local medical providers.    

Darren Hunter is a partner and EHS practitioner in the Chicago law firm of Rooney Rippie & Ratnaswamy LLP.  This column does not constitute legal advice or the formation or proposal of an attorney-client relationship to or with any person or entity.  Darren can be contacted at darren.hunter@r3law.com or at 312-447-2818.

Click here to see this story as it appears in the October 2018 issue of Modern Casting.