Retention and access to accident-related medical X-rays

May 14, 1981

MEMORANDUM FOR: Area Directors
District Supervisors
SUBJECT: National Office Letter Dated April 24, 1981

The attached letter includes an important exclusion to 1910.1020. The exclusion for retention of actual X-rays which relate only to safety accidents was made due to the medical community's demonstration of this retention as an excessive burden. X-rays do deteriorate over time, and are normally processed for silver reclamation after a limited period of time.
As noted, interpretations of the above X-rays, and all other X-rays, must still be retained.
Our interpretation of employee access is that employees may not use 1910.1020 as a basis for obtaining medical records when no toxic substance exposure is involved. However, once this exposure (past, present, or future) is established, the employee has access to all records in the medical file, including those normally associated with safety hazards.
KENNETH W. GERECKE
Assistant Regional Administrator
April 24, 1981
A. J. Marinaro, P. A.
Business Manager
Industrial Clinic North, Inc.
[Recipient address omitted]
Dear Mr. Marinaro:
This is in response to your inquiry regarding the preservation of medical records pursuant to OSHA's Access to Employee Exposure and Medical Records Standard (29 CFR 1910.1020).
Under this standard, each employer must assure that all employee medical records of employees exposed to toxic substances or harmful physical agents are preserved and maintained for at least the duration of the employee's employment, plus 30 years.
29 CFR 1910.1020 does not apply to:

1. Working conditions where employees are only exposed to safety hazards (e.g., trips, falls, cuts); or
2. First-aid treatment (one-time treatment and subsequent observation of minor scratches, cuts, burns, splinters, and so forth, which do not ordinarily require medical care) even though provided by a physician or registered professional personnel.
3. X-rays of bones taken only as a result of a safety hazard (e.g., trip, fall) and when the accident is clearly unrelated to exposures to toxic substances and harmful physical agents. The evaluation of this relationship must be made by an examining physician to whom the employer has supplied:
   a. A description of the affected employee's duties as they relate to the employee's exposure to toxic substances and harmful physical agents; and
   b. The employee's exposure level or anticipated exposure level to any toxic substance or harmful physical agent (if applicable).

Whenever such X-rays are destroyed, however, the X-ray report or physician's interpretation of the X-ray must nevertheless be retained as a portion of the worker's medical record for the length of employment plus 30 years.
Other than the above, for employees exposed to toxic substances or harmful physical agents, OSHA does not exclude any medical records (including any other type of X-ray) concerning on-the-job accidents or injuries from being preserved under this standard. Such information may have later significance in assessing occupational health issues.
The preamble accompanying the final standard (Federal Register, Vol. 45, pp. 35263-4) explains that occupational exposure to toxic substances and harmful physical agents can result in practically every form of apparent "non-occupational" health problem, including cuts, falls, bruises, dizziness or headaches. I have enclosed a copy of 29 CFR 1910.1020 and the accompanying preamble for further clarification of this requirement.
I hope this information is helpful to you. If I can be of further assistance, please feel free to contact me again.
Sincerely,
Bruce Hillenbrand
Acting Director,
Federal Compliance and State Programs
[Corrected 3/7/2006]