OSHA Inspection: WASHINGTON HOSPITAL CENTER

Issued

May 17, 1990

Abate by

Oct 17, 1990

Penalty

Initial $640 · Current $400 Reduced

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970:  The
employer did not furnish employment and a place of employment which were
free from recognized hazards that were causing or likely to cause death
or serious physical harm to employees in that employees were exposed to:
a) Washington Hospital Center - Employees were exposed to serious injury
from carrying, lifting and/or transferring patients, equipmentand
laundry. Such as the following departments:
1) Nursing Department employees in the manual lifting and transferring
of patients were exposed to an increased risk of biomechanical stress
musculoskeletal injuries. The OSHA 200 logs for injury and illness
for the years 1988 and 1989 showed a pattern of back injuries, a
variety of sprains and strains to the torso and limbs which were
caused by or aggravated by the physical exertions of nursing tasks.
4/5/90.
2) Laundry Department employees engaged in the manual lifting of laundry
sorting and other tasks were exposed to musculoskeletal injuries to
the back, torso and limbs which were caused or aggravated by the
requirements and exertions of their jobs. The OSHA 200 logs for
1988 and 1989 revealed a significant pattern of biomechanical stress
related injuries.
3) Environmental Service employees engaged in housekeeping and
disinfecting/sanitation tasks in the hospital requiring excessive
exertions such as related to cleaning operatios were exposed to
increasing numbers of injuries to the back and torso. This pattern
was established by the hospitals's OSHA 200 logs for 1988 and 1989.
4) Receiving and Store employees were exposed to significant
musculoskeletal injuries involving the moving and handling of
equipment and supplies. The OSHA 200 logs for 1988 and 1989 showed
a pattern of back, torso and limb injuries which were caused by
and/or aggravated by the physical nature of their tasks.
5) Radiology Department employees involved in the lifting and handling
of patients were exposed to musculoskeletal injuries which were
increasing significantly as evidenced by the trends documented on
the OSHA 200 logs for 1988 and 1989.
Among the feasible and acceptable abatement methods to correct or reduce
the prevalence of these hazards would be the implementation of a
comprehensive back injury and cumulative trauma program including at a
minimum the following elements:
1) A formal written policy endorsed by the Hospital Administrator which
outlines the authority and specific responsibilities of the staff in
the implementation, compliance and enforcement of the various
provisions included in the injury prevention program.
2) Investigation and analysis of back injury and musculoskeletal
injury cases as a means of evaluating specific activities where the
greatest number of incidences are occurring.
3) Detailed ergonomic evaluations of those tasks which were associated
with those tasks which can be modified through the use of mechanical
lifting devices or changes in lifting methods including if necessary,
the use of multiple personnel. Lifting devices and aids should be
readily available and easily accessed in all areas.
4) Official procedures, guidelines describing specific techniques for
the various routine lifting tasks equipment and supplies handling
performed in the designated departments.
5) Baselines assessments of the lifting skills and abilities of new
hires prior to assignment should be performed.
6) Mandatory inservice back injury, musculoskeletal disorder prevention
training for all employees involved in patient lifting, handling or
transferring and moving of equipment and supplies. Training sessions
should include at a minimum:
a) A review of the prevention policy
b) A discussion of the general rules of body mechanics and associated
musculoskeletal disorders resulting from overexertions.
c) Hands on demonstrations of lifting and transfer techniques.
d) Discussion of the benefits of exercise in injury-reduction.
e) A review of procedures to be followed by employees subsequent to
back or cumulative trauma injuries; medical and rehabilitation
services; and return-to-work program.
7) Internal monitoring of stall compliance with policy and procedures of
the prevention program.
Step 1 - Effective administrative protection, such as employee training,
baseline health surveillance, job rotation, etc., shall be provided
as an interim protective measure until feasible engineering or
permanent administrative controls can be implemented which will
reduce employee exposure to the hazard of musculoskeletal injuries.
Step 2 - Submit to the Area Director a written, detailed plan of
abatement outlining a schedule for the implementation of engineering
or administrative measures to control employee injury due to manual
lifting tasks. Engineering controls to reduce musculoskeletal
stresses include, but are not limited to, job redesign, reduction of
horizontal and vertical load distances from the body, reduction of
the lifting frequency or weight, and use of mechanical lifting aids.
This plan shall include at a minimum, target dates for the following
actions which must be consistent with the dates required by this
citation.
1) Evaluation of the conditions, location and manual lifting
activities that the employees are performing at the onset of
musculoskeletal injuries.
2) Evaluation of applicable control measure(s).
3) Procurement, installation and operation of selected control
ALL PROPOSED CONTROL MEASURES SHALL BE APPROVED FOR EACH PARTICULAR
USE BY A PERSON TRAINED IN THE EVALUATION OF WORKPLACE CONDITIONS
WHICH CAUSE MUSCULOSKELETAL DISORDERS.  THIRTY (30) DAY PROGRESS
REPORTS ARE REQUIRED DURING THE ABATEMENT PERIOD.
Step 3 - Develop a rehabilitation program for injuried workers.  The
program is expected to include exercise, building stamina, training
in safe lifting techniques and work conditioning.

Issued

May 17, 1990

Abate by

May 24, 1990

Penalty

Initial $400 · Current $400

Issued

May 17, 1990

Abate by

May 24, 1990

Issued

May 17, 1990

Abate by

Aug 11, 1990

Penalty

Initial $640 · Current $640

Issued

May 17, 1990

Abate by

May 18, 1990

Issued

May 17, 1990

Abate by

May 24, 1990

Issued

May 17, 1990

Abate by

Jun 7, 1990

Issued

May 17, 1990

Abate by

May 18, 1990

Penalty

Initial $320

Issued

May 17, 1990

Abate by

May 24, 1990

Penalty

Initial $640

Issued

May 17, 1990

Abate by

Jul 22, 1990

Penalty

Initial $810 · Current $530 Reduced

Issued

May 17, 1990

Abate by

May 18, 1990

Issued

May 17, 1990

Abate by

May 24, 1990

Penalty

Initial $1,000 · Current $700 Reduced

Issued

May 17, 1990

Abate by

May 24, 1990

Issued

May 17, 1990

Abate by

May 24, 1990

Issued

May 17, 1990

Abate by

May 18, 1990