Medical and Dental Offices

What are the hazards associated with medical and dental offices?

The hazards associated with working in medical and dental offices can include working with chemicals (i.e., flammables, sterilants, carcinogens), hazardous drugs (i.e., antineoplastic drugs), compressed gases, infectious agents and biological hazards (i.e., bloodborne pathogens, flu), physical agents (i.e., radiation), ergonomics, and workplace violence.

What can I do to protect myself?

Whether dealing with chemical or biological hazards, plan your work in advance to include how to respond to deviations in procedures (e.g., chemical fume hood failure, glove tear, unexpected chemical reaction, etc.) so that you are not injured or made ill. 

Only individuals trained in the safe handling of antineoplastic drugs should be involved in their use. Annual retraining in the hazards of antineoplastic drugs is recommended, including the procedures to follow in the event of a spill.

Before beginning any task, ask yourself if you will be subjecting any part of your body to a hazard for which PPE is recommended or required. Before using any chemical, information on the label and accompanying information (e.g., safety data sheets) should be consulted in order to identify any personal protective equipment necessary to prevent direct contact through inhalation, splash or spatter to eyes, nose or mouth, or skin contact.

Protection of employees against workplace violence is the responsibility of employers. The best protection employers can offer is to establish a zero-tolerance policy toward workplace violence against or by their employees. 

What resources are available to assist employers?

Safety and Health Programs

These example programs on hazard communication, respiratory protection, hazardous chemical program, chemical hygiene plan, bloodborne pathogens exposure control plan and PPE and hazard analysis can assist the employer in the development of their programs. Other example safety and health programs are available for employers to download and adapt to their specific conditions.

Training and Outreach Services

Presentations on a variety of safety and health topics associated with medical and dental offices are available to assist employers in training their employees. These include: bloodborne pathogens; hazard communication, respiratory protection and personal protective equipment. Other example presentations are available along with pre-recorded webinars which can be accessed at any time. 

In addition, the education, training and technical assistance bureau provides free online safety and health training and outreach services (i.e., speaker's bureau requests, safety booths) upon request. 

Lastly, the NCDOL Library offers free safety and health videos (including streaming video services) and related research assistance on consensus standards (i.e., ANSI, NFPA, NEC).

Safety and Health Topics

Safety and health topic pages on bloodborne pathogens, compressed gases, flammable liquids, formaldehyde, hazard communication, personal protective equipment, eyewash stations and emergency showers,  recording and reporting, medical services and first aid, tuberculosis, hierarchy of controls, chemical hazards and toxic substances. laboratory safety, radiation, ionizing and non-Ionizing, compressed gases, antineoplastic agents, workplace violence and respiratory protection can provide more resource information.

Consultation Services

The consultative services bureau provides free and confidential onsite consultation regarding worksite safety and health hazards.

Which standards apply?

OSH has adopted the following standards that are applicable to medical and dental offices in North Carolina. This is not all inclusive. 

Note: Please also check the standards information and activity webpage to see if there has been any recent or upcoming regulatory activity on this topic.

General Industry

• 29 CFR 1910.22 - walking - working surfaces, general requirements
• 29 CFR 1910.37 - maintenance, safeguards, and operational features for exit routes
• 29 CFR 1910.132 - personal protective equipment, general requirements
• 29 CFR 1910.133 - eye and face protection
• 29 CFR 1910.134 - respiratory protection
• 29 CFR 1910.141 – sanitation
• 29 CFR 1910.151 - medical services and first aid
• 29 CFR 1910.1000 - air contaminants
• 29 CFR 1910.1030 - bloodborne pathogens
• 29 CFR 1910.1048 - formaldehyde
• 29 CFR 1910.1096 - ionizing radiation
• 29 CFR 1910.1200 - hazard communication
• 29 CFR 1910.1450 - occupational exposure to hazardous chemicals in laboratories

North Carolina General Statute

• NCGS 95-156 - handling of dangerous antineoplastic agents

North Carolina Administrative Code

• 13 NCAC 07G .0101 - handling of antineoplastic agents

Recordkeeping

• Refer to Recording and Reporting

General Duty Clause

• NCGS 95-129(1) - General Duty Clause of the Occupational Safety and Health Act of North Carolina

Other Applicable Standards

The Which OSHA Standards Apply webpage can help identify other standards that may also be applicable to your worksite.

Where can I learn more?

Compliance Documents

• Compliance Directive: CPL 02-01-050 - Personal Protective Equipment in General Industry, establishes the NCDOL OSH Division general enforcement and guidance policy for its standards addressing personal protective equipment.
• Compliance Directive: CPL 02-02-052 - Enforcement Procedure for Occupational Exposure to Formaldehyde, establishes the NCDOL OSH Division general enforcement and guidance policy for its standards addressing personal protective equipment.
• Compliance Directive: CPL 02-02-069 - Enforcement Procedures for the Bloodborne Pathogens Standard, establishes policies and provides clarification to ensure uniform inspection procedures are followed when conducting inspections to enforce the Occupational Exposure for Bloodborne Pathogens Standard.
• Compliance Directive: CPL 02-02-078 - Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis, provides general enforcement policies and procedures to be followed when conducting inspections and issuing citations related to occupational exposure to tuberculosis (TB).
• Compliance Directive: CPL 02-02-079 - Inspection Procedures for the Hazard Communication Standard (HCS 2012), applies to enforcement procedures related to the requirements of the hazard communication standard.
• Standards Notice 72: Security of Compressed Gas Cylinders at Compressed Gas Supplier and Distribution Facilities, provides information about securing compressed gas cylinders at compressed gas supplier and distribution facilities.
• Operational Procedure Notice 143: Suitable Facilities for Drenching or Flushing the Eyes or Body, provides guidance when determining what is considered a suitable facility for drenching or flushing the eyes or body.
• OSHA Technical Manual (TED 01-00-015) provides technical information about workplace hazards and controls to OSHA’s Compliance Safety and Health Officers.
• Field Operations Manual (FOM) Chapter XV - Industrial Hygiene Compliance provides guidance on industrial hygiene procedures.
• CFR 108 - Occupational Exposure to Hazardous Chemicals in Laboratories provides the promulgation of the rule.

Brochures

• Medical and Dental Offices Brochure is a guide to compliance with NC safety and health standards for medical and dental offices. 

Industry Guides

• Industry Guide 49 - OSHA General Industry Standards Requiring Programs, Inspections, Procedures, Records and/or Training, provides requirements for standards related to medical and dental offices.

Technical Assistance

• Inquiries about workplace safety and health requirements can be submitted to Ask OSH online or by phone at 919-707-7876.