Ethics for Case ManagersPage 10 of 12

8. Ethics and OSHA

[Unless otherwise cited, all material in this module is from OSHA, 2016.]

On December 29, 1970, President Nixon signed the Occupational Safety and Health Act of 1970 (OSH Act) into law, establishing OSHA. Congress created OSHA to ensure safe and healthful conditions for working men and women by setting and enforcing standards and providing training, outreach, education and compliance assistance.

Under OSHA, employers are responsible for providing that safe and healthful workplace. The combined efforts of employers, workers, safety and health professionals, unions and advocates, OSHA and its state partners have reduced work-related deaths and injuries by more than 65% since 1970. At that time, it was estimated that about 38 workers were killed on the job every day. In 2010 that number had fallen to 12 per day. The rate of reported serious workplace injuries and illnesses has also fallen dramatically.

Not only does a safer workplace help individual workers and their families, it saves money for employers in workers’ compensation costs and indirect costs for lost work days, training and replacement, and accident investigations.

Who Does OSHA Cover?

The OSH Act covers most private sector employers and their workers, in addition to some public sector employers and workers in the 50 states and certain territories and jurisdictions under federal authority.

OSHA covers most private sector employers and workers in all 50 states, the District of Columbia, and other U.S. jurisdictions either directly through Federal OSHA or through an OSHA-approved state plan.

State plans are OSHA-approved job safety and health programs operated by individual states instead of Federal OSHA. The OSH Act encourages states to develop and operate their own job safety and health programs and precludes state enforcement of OSHA standards unless the state has an approved program. OSHA approves and monitors all state plans and provides as much as fifty percent of the funding for each program. State-run safety and health programs must be at least as effective as the Federal OSHA program.

Federal OSHA provides coverage to certain workers specifically excluded from a state’s plan, for example, those in some states who work in
maritime industries or on military bases.

Any interested person or group, including individual workers, with a complaint concerning the operation or administration of a state program may submit a complaint to the appropriate federal OSHA regional administrator (regional offices are listed at the end of this guide). This is called a Complaint About State Program Administration (CASPA). The complainant’s name will be kept confidential. The OSHA regional administrator will investigate all such complaints, and where complaints are found to be valid, may require appropriate corrective action on the part of the state.

State and Local Government Workers

Workers at state and local government agencies are not covered by Federal OSHA, but have OSH Act protections if they work in those states that have an OSHA-approved state program. OSHA rules also permit states and territories to develop plans that cover only public sector (state and local government) workers.

Federal Government Workers

OSHA’s protection applies to all federal agencies. Federal agency heads are responsible for providing safe and healthful working conditions for their workers. Although OSHA does not fine federal agencies, it does monitor these agencies and conducts federal workplace inspections in response to workers’ reports of hazards.

Federal agencies must have a safety and health program that meets the same standards as private employers. Under a 1998 amendment, the OSH Act covers the U.S. Postal Service the same as any private sector employer.

Not Covered under the OSH Act are:

  • The self-employed;
  • Immediate family members of farm employers; and
  • Workplace hazards regulated by another federal agency (for example, the Mine Safety and Health Administration, the Department of Energy, or the Coast Guard) (OSHA, 2016).

Rights and Responsibilities Under OSHA Law

Employers MUST provide their workers with a workplace that has no serious hazards and must follow all OSHA safety and health standards.

Employers have the responsibility to provide a safe workplace. Employers must find and correct safety and health problems. OSHA further requires that employers must first try to eliminate or reduce hazards by making feasible changes in working conditions rather than relying on personal protective equipment such as masks, gloves, or earplugs. Switching to safer chemicals, enclosing processes to trap harmful fumes, or using ventilation systems to clean the air are examples of effective ways to eliminate or reduce risks (OSHA, 2016).

Employers must also:

  • Prominently display the official OSHA Job Safety and Health. It’s the Law poster that describes rights and responsibilities under the OSH Act.
  • Inform workers about chemical hazards through training, labels, alarms, color-coded systems, chemical information sheets, and other methods.
  • Provide safety training to workers in a language and vocabulary they can understand.
  • Keep accurate records of work-related injuries and illnesses.
  • Perform tests in the workplace, such as air sampling, required by some OSHA standards.
  • Provide required personal protective equipment at no cost to workers.*
  • Provide hearing exams or other medical tests required by OSHA standards.
  • Post OSHA citations and injury and illness data where workers can see them.
  • Notify OSHA within 8 hours of a workplace fatality or within 24 hours of any work-related inpatient hospitalization, amputation or loss of an eye (800 321 OSHA [6742]).
  • Not retaliate against workers for using their rights under the law, including their right to report a work-related injury or illness.

* Employers must pay for most types of required personal protective equipment.
Source: OSHA, 2016.

Under OSHA law, workers are entitled to working conditions that do not pose a risk of serious harm.

Workers have the right to:

  • File a confidential complaint with OSHA to have their workplace inspected.
  • Receive information and training about hazards, methods to prevent harm, and the OSHA standards that apply to their workplace. The training must be done in a language and vocabulary workers can understand.
  • Receive copies of records of work-related injuries and illnesses that occur in their workplace.
  • Receive copies of the results from tests and monitoring done to find and measure hazards in their workplace.
  • Receive copies of their workplace medical records.
  • Participate in an OSHA inspection and speak in private with the inspector.
  • File a complaint with OSHA if they have been retaliated against by their employer as the result of requesting an inspection or using any of their other rights under the OSH Act.
  • File a complaint if punished or retaliated against for acting as a “whistleblower” under the 21 additional federal laws for which OSHA has jurisdiction (OSHA, 2016).

OSHA Standards

OSHA’s Construction, General Industry, Maritime and Agriculture standards protect workers from a wide range of serious hazards. Examples of OSHA standards include requirements for employers to:

  • Provide fall protection;
  • Prevent trenching cave-ins;
  • Prevent exposure to some infectious diseases;
  • Ensure the safety of workers who enter confined spaces;
  • Prevent exposure to harmful chemicals;
  • Put guards on dangerous machines;
  • Provide respirators or other safety equipment; and
  • Provide training for certain dangerous jobs in a language and vocabulary workers can understand.

Employers must also comply with the General Duty Clause of the OSH Act. This clause requires employers to keep their workplaces free of serious
recognized hazards and is generally cited when no specific OSHA standard applies to the hazard.

OSHA has the authority to issue new or revised occupational safety and health standards. The OSHA standards-setting process involves many steps and provides many opportunities for public engagement. OSHA can begin standards-setting procedures on its own initiative or in response
to recommendations or petitions from other parties (OSHA, 2016).

Enforcement: OSHA Inspection Activities

Inspections are initiated without advance notice, conducted using on-site or telephone and facsimile investigations, performed by highly trained compliance officers and scheduled based on the following priorities:

  • Imminent danger;
  • Catastrophes—fatalities or hospitalizations;
  • Worker complaints and referrals;
  • Targeted inspections—particular hazards, high injury rates; and
  • Follow-up inspections.

Current workers or their representatives may file a written complaint and ask OSHA to inspect their workplace if they believe there is a serious hazard or that their employer is not following OSHA standards. Workers and their representatives have the right to ask for an inspection without OSHA telling their employer who filed the complaint. It is a violation of the OSH Act for an employer to fire, demote, transfer or in any way retaliate against a worker for filing a complaint or using other OSHA rights (OSHA, 2016).

When an inspector finds violations of OSHA standards or serious hazards, OSHA may issue citations and fines. A citation includes methods an employer may use to fix a problem and the date by which the corrective actions must be completed. Employers have the right to contest any part of the citation, including whether a violation actually exists. Workers only have the right to challenge the deadline by which a problem must be resolved. Appeals of citations are heard by the independent Occupational Safety and Health Review Commission (OSHRC) (OSHA, 2016).

General Reporting and Recordkeeping Requirements

OSHA’s Reporting Requirements

All employers must report to OSHA:

  • The death of any worker from a work-related incident within 8 hours of learning about it;
  • All work-related inpatient hospitalizations, amputations and losses of an eye within 24 hours.

In addition, employers must report all fatal heart attacks that occur at work. Deaths from motor vehicle accidents on public streets (except those in a construction work zone) and in accidents on commercial airplanes, trains, subways or buses do not need to be reported.

These reports may be made by telephone or in person to the nearest OSHA area office listed at or by calling OSHA’s toll-free number, 800 321 OSHA (6742) (OSHA, 2016).

OSHA’s Recordkeeping Requirements

OSHA requires certain covered employers in high-hazard industries to prepare and maintain records of serious work-related injuries and illnesses. Tracking and investigating workplace injuries and illnesses play an important role in preventing future injuries and illnesses.

Employers with more than ten employees and whose establishments are not classified as a partially exempt industry must record serious work-related injuries and illnesses using OSHA Forms 300, 300A and 301.

A list of partially exempt industries, including establishments in specific low hazard retail, service, finance, insurance or real estate industries is available at from the OSHA website. Employers who are required to keep Form 300, the Injury and Illness log, must also post Form 300A, the Summary of Work-Related Injuries and Illnesses, in the workplace every year from February 1 to April 30.

OSHA is responsible for administering the recordkeeping system established by the OSH Act. OSHA’s recordkeeping regulations provide specific recording and reporting requirements which comprise the framework for the nationwide occupational safety and health recordkeeping system (OSHA, 2016).

OSHA’s Whistleblower Program

To help ensure that workers are free to participate in safety and health activities, Section 11(c) of the OSH Act prohibits any person from discharging or in any manner retaliating against any worker for exercising rights under the OSH Act. These rights include raising safety and health concerns with an employer, reporting a work-related injury or illness, filing a complaint with OSHA, seeking an OSHA inspection, participating in an OSHA inspection and participating or testifying in any proceeding related to an OSHA inspection system (OSHA, 2016).

Protection from retaliation means that an employer cannot retaliate by taking “adverse action” against workers, such as:

  • Firing or laying off;
  • Blacklisting;
  • Demoting;
  • Denying overtime or promotion;
  • Disciplining;
  • Denying of benefits;
  • Failing to hire or rehire;
  • Intimidation;
  • Making threats;
  • Reassignment affecting prospects for promotion; or
  • Reducing pay or hours system (OSHA, 2016).

If a worker believes an employer has retaliated against them for exercising their safety and health rights, they should contact their local OSHA office right away. A retaliation complaint must be filed with OSHA within 30 calendar days from the date the retaliatory decision has been both made and communicated to the worker. No form is needed, but workers must call OSHA within 30 days of the alleged retaliation (at 1-800-321-OSHA [6742]) system (OSHA, 2016).

OSHA provides extensive resources on its website, including training requirements, standards for various industries, support available to employers and employees.

OSHA and the Healthcare Industry

Healthcare workers face a number of serious safety and health hazards. They include bloodborne pathogens and biologic hazards, potential chemical and drug exposures, waste anesthetic gas exposures, respiratory hazards, ergonomic hazards from lifting and repetitive tasks, laser hazards, workplace violence, hazards associated with laboratories, and radioactive material and x-ray hazards. Some of the potential chemical exposures include formaldehyde, used for preservation of specimens for pathology; ethylene oxide, glutaraldehyde, and paracetic acid used for sterilization; and numerous other chemicals used in healthcare laboratories (OSHA, n.d.).

More workers are injured in the healthcare and social assistance industry sector than any other. This industry has one of the highest rates of work related injuries and illnesses. In 2010, the healthcare and social assistance industry reported more injury and illness cases than any other private industry sector (653,900 cases). That is 152,000 more cases than the next industry sector: manufacturing. In 2010, the incidence rate for work related nonfatal injuries and illnesses in health care and social assistance was 139.9; the incidence rate for nonfatal injury and illnesses in all private industry was 107.7 (OSHA, n.d.).

Nursing aides, orderlies, and attendants had the highest rates of musculoskeletal disorders of all occupations in 2010. The incidence rate of work related musculoskeletal disorders for these occupations was 249 per 10,000 workers. This compares to the average rate for all workers in 2010 of 34 (OSHA, n.d.).

The OSHA website provides considerable material regarding workplace safety in the healthcare setting at:


Under normal circumstances, an individual must give written consent to disclose his or her health information. However, a covered entity’s employees or business associates may disclose protected health information to a public health authority (such as federal OSHA or a state agency operating under a federal OSHA-approved state plan, both of which are hereinafter referred to as “OSHA”) that is authorized to investigate a covered entity’s conduct, to an attorney retained to deal with a case involving such conduct, or to a health care accrediting organization. These disclosures are permitted as long as the employee believes in good faith that the conditions he is reporting are unlawful or endanger employees, among other things.

Employees who are crime victims may also disclose protected health information to a law enforcement official if the information is about the suspected perpetrator and the information is limited to that listed in the privacy regulation at 45 CFR § 164.512(f)(2)(i). Also, an employee may report a serious and imminent threat to the health and safety of a person if the recipient of the report is reasonably able to prevent or diminish the threat. Such recipients include law enforcement officials, OSHA, and union officials (OSHA, 2018).

Employees are protected from retaliation for making disclosures authorized by HIPAA in connection with an occupational safety or health complaint. They may file whistleblower complaints with OSHA under Section 11(c) of the Occupational Safety and Health Act (OSH Act). The whistleblower complaint must be filed within 30 days of the retaliation (OSHA, 2018).

OSHA is charged with regulating health and safety in the workplace, and is considered both a public health authority and a health oversight agency under HIPAA. The agency sometimes has to use and disclose protected health information to conduct investigations, litigate cases, and engage in other activities. Although OSHA is not a “covered entity” under HIPAA and is not bound by the use and disclosure requirements included in the privacy regulation, it complies with applicable laws and regulations protecting privacy, such as the Privacy Act, 5 U.S.C. § 552a (OSHA, 2018).

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