Recording skin conditions, heat illness, and blisters

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.

June 21, 1993

Mr. James A. Werneke
Hoechst Celanese Corporation
Environment, Health & Safety Department
[Recipient address omitted]
Dear Mr. Werneke:

Thank you for your facsimile dated April 23, requesting interpretations of several OSHA injury and illness recordkeeping issues. I will restate each of your questions and follow with my response. Whenever possible, I will refer to the Recordkeeping Guidelines for Occupational Injuries and Illnesses by citing the appropriate Q&A and page numbers.

Q1 Attached is an accident investigation concerning an issue which we have recorded, but do not feel it was work related. Please review and provide your opinion concerning recordability.

A1 Work relationship is established under the OSHA recordkeeping system when an injury or illness results from an event or exposure in the work environment. The general rule is that all injuries and illnesses which result from events or exposures on the employer's premises are presumed to be work related. Furthermore, if it seems likely that an event or exposure in the work environment either caused or contributed to the case, the case is considered work related. It is sufficient for an exposure to only be a contributing and/or aggravating factor to establish work relationship for OSHA recordkeeping purposes. (Q&A C-7 on page 34, Q&A B-17 on page 32). Simply stated, unless the illness was caused solely by a non-work-related event or exposure off-premises, the case is presumed to be work related.

For OSHA recordkeeping purposes, an occupational illness is defined as any abnormal condition or disorder resulting from a non-instantaneous event or exposure in the work environment. Furthermore, non-instantaneous has been interpreted to mean any amount of time longer than a snap of the fingers.

After review of the circumstances outlined in the accident investigation, the case is presumed to be work related because it arose on company premises and it is likely that something (chemical exposure) in the work environment either caused or contributed to the abnormal condition (blister). Based on the information provided, the case is recordable.

Q2 An employee experiences a dermatitis from wearing goggles which are a requirement for the job. There was no incident. Is this OSHA recordable? If so, what classification?

A2 The case should be recorded as a column 7a illness, occupational skin diseases or disorders. The skin contact with the goggles (or chemical on the goggles) is the "event or exposure" which caused or contributed to the employee's dermatitis.

Q3 An employee experiences a "Heat Rash". The NIOSH book on occupational diseases (p499) states: "The physical disabilities caused by excessive heat exposure are in order of increasing severity, - heat rash, heat cramps, heat exhaustion, and heat stroke" a) Are all of these recordable? b) Are "prickly heat" and "heat rash" the same thing? c) Does treatment and/or early recognition with precautionary measures affect the recordability?

A3 For OSHA recordkeeping purposes, an occupational illness is defined as any abnormal condition or disorder resulting from a non-instantaneous event or exposure in the work environment. a) All occupational illnesses must be recorded. If any one of these conditions is diagnosed and determined to be work related, it must be recorded. b) As defined by Blakiston's Pocket Medical Dictionary (fourth addition), the terms are synonymous. c) For occupational illnesses, treatment is not a determining factor for recordability. All occupational illnesses must be recorded, regardless of treatment provided. If the event or exposure is determined to be instantaneous, and the case is evaluated as an injury, then medical treatment becomes a determining factor. For injury cases, treatment is not considered "preventative or precautionary". Treatment that is, or should have been provided, is either first aid or medical treatment (Q&A F-5, page 44).

Q4 Are all types of blisters recordable? a) Does this include chemical, heat, sun, friction, etc. or is there any difference? b) Does the size of the blister determine recordability? (i.e. a few small pinhead size vs. area smaller than a "dime". c) Does the treatment effect classification? d) Does "time" involved to result in a blister become a factor in classification?

A4 Any work related blister, larger than pin-head size, must be recorded. a) This includes all categories mentioned. b) All blisters greater than pin-head size must be recorded. c) Whether the event or exposure was instantaneous or non-instantaneous determines classification (see question Q1 above). If the case is determined to be an injury, pin-head sized blisters that receive medical treatment must be recorded. d) See answer 4c above.

Q5 The BLS Guidelines (Bluebook) states that all occupational illnesses are recordable. Appendix C in the book lists selected illnesses, but otherwise it seems to be very general and subject to interpretation. Concerning this issue: a) What is the distinction between illness and injury? b) Can precautionary measures used as preventive be used to control a potential condition making the result no more than a first aid case? c) If an instantaneous event is an injury, than what is the time factor involved which could/would change it to an illness? d) Are there incidents which could be classified as an injury or an illness?

A5 a) Injuries result from instantaneous events or exposures while illnesses result from non-instantaneous events or exposures. Furthermore, non-instantaneous has been interpreted to mean any amount of time longer than a snap of the fingers. b) Preventative medicine or job transfer without the existence of an injury does not constitute a recordable case (Q&A B-7, page 30). There must be an injury present for a case to be recorded on the Log. The employer must be careful, however, not to define "preventative" to include treatment or job transfer/modification when given to stop an existing condition from becoming worse. Once a person is symptomatic, treatments and job transfers are not considered preventative. c) See answer 5a above. d) Similar conditions can be classified as either an injury or an illness, depending upon the length of exposure. For example, hearing loss can be caused by an instantaneous event (e.g. an explosion) and be classified as an injury or by non-instantaneous exposure to noise and be classified as an illnesses.

I hope you find this information useful. If you have any further questions, please contact my staff at Area Code (202) 219-6463.

Sincerely,
Stephen A. Newell
Director
Office of Statistics