Safety and Health Program for Healthcare

In North Carolina, employers are required to post a copy of the "Wage and Hour Notice to Employees" and the "OSH Notice to Employees", North Carolina Workplace Labor Laws Posters, in a conspicuous place where all employees have access to it. The posters are in English, with Spanish on the reverse side. You can order these Workplace Labor Law Posters for free from the NCDOL Website.

Resources:

NC Department of Labor: Workplace Labor Law Posters 

Other State and Federal Labor Law Posters: State and Federal Labor Law Posters

All employers have a North American Industry Classification System (NAICS) code that identifies by industry the type of work being performed, goods being produced or services being provided. For this reason, some small businesses may have more that one NAICS code for their establishment. Many compliance documents and OSHA standards will reference an employer's NAICS code to identify industries that are exempt from a standard, or the reverse, that it only applies to specific industries. 

All employers covered by the Occupational Safety and Health Act (OSH Act) are covered by Recordkeeping standards. However, many small employers are exempted unless OSHA or the Bureau of Labor Statistics (BLS) informs you in writing that you must keep records per 29 CFR 1904.41 - Electronic submission of Employer Identification Number (EIN) or injury and illness records to OSHA or 29 CFR 1904.42 - Requests from the Bureau of Labor Statistics for data, respectively.

Do you meet these exemptions?

• 29 CFR 1904.1 - Partial exemption for employers with 10 or fewer employees, states "If your company had ten or fewer employees at all times during the last calendar year, you do not need to keep OSHA injury and illness records".
• 29 CFR 1904.2 - Partial exemption for establishments in certain industries, states "If your company had more than ten employees at any time during the last calendar year, you must keep OSHA injury and illness records unless your establishment is classified as a partially exempt industry."

Note: The above exemptions do not apply to Public Sector employers in North Carolina. Reference NCGS 95-148, Operational Procedure Notice 128 and Standards Notice 75. 

If you do meet either of the above exemptions, you do not need to comply the Recordkeeping standards for maintaining the OSHA logs, however, as required by 29 CFR 1904.39 - Reporting fatalities, hospitalizations, amputations, and losses of an eye as a result of work-related incidents to OSHA, all employers covered by the OSH Act must report to OSHA any workplace incident that results in a fatality, the hospitalization of one or more employees, an amputation or loss of an eye. 

If you do not meet either exemption, then you will need to maintain the OSHA 300 Log, OSHA Form 300A, and OSHA Form 301. Note: In North Carolina, most employers use the NC Industrial Commission's worker's compensation Form 19 in lieu of the OSHA Form 301.  To learn more about recordkeeping requirements, go to our webpage on "29 CFR Part 1904 - Recordkeeping Standards".

Resources:

Safety and Health Topic Page: Recording and Reporting

Federal OSHA Forms: OSHA 300 Log, OSHA Form 300A, and OSHA Form 301

Presentation: Recordkeeping and Reporting

NC Department of Labor: Training Calendar

Most employers need an Emergency Action Plan (EAP). The standard, 29 CFR 1910.38 - Emergency Action Plan, states that "An employer must have an emergency action plan whenever an OSHA standard in this part requires one." To determine if it applies to you, go to "Do you need an emergency action plan?"

If it does, the standard also states "An emergency action plan must be in writing, kept in the workplace, and available to employees for review. However, an employer with 10 or fewer employees may communicate the plan orally to employees." 

Lastly, the standard requires training on the EAP. "An employer must designate and train employees to assist in a safe and orderly evacuation of other employees." and "An employer must review the EAP with each employee covered by the plan when the plan is developed or an employee is initially assigned to a job, when the employee's responsibilities under the plan  change, and when the plan is changed." 

In addition, you will need to comply with other parts of Subpart E - Exit Routes and Emergency Planning. To learn more about the requirements for exit routes (i.e., exit discharge, lighting, markings, unobstructed), go to the webpage on Does "Subpart E - Exit Routes and Emergency Planning" Apply to You?

Resources:

Safety and Health Topic Page: Emergency Action Plans

Example Program: Emergency Action Plan

Presentation: Exit Routes, Emergency Action and Fire Prevention Plans

NC Department of Labor: Training Calendar

Many employers need a Fire Prevention Plan (FPP). The standard, 29 CFR 1910.39 - Fire Prevention Plan, states that "An employer must have a fire prevention plan whenever an OSHA standard in this part requires one." To determine if it applies to you, go to "Do you need a fire prevention plan?"

If it does, the standard also states "A fire prevention plan must be in writing, be kept in the workplace, and be made available to employees for review. However, an employer with 10 or fewer employees may communicate the plan orally to employees."

The standard also requires training on the FPP. "An employer must inform employees upon initial assignment to a job of the fire hazards to which they are exposed. An employer must also review with each employee those parts of the fire prevention plan necessary for self-protection." 

In addition, you will need to comply with other parts of Subpart E - Exit Routes and Emergency Planning. To learn more about the requirements for exit routes (i.e., exit discharge, lighting, markings, unobstructed), go to the webpage on 'Does "Subpart E - Exit Routes and Emergency Planning" Apply to You?'

Resources:

Safety and Health Topic Page: Fire Prevention Plans

Example Program: Fire Prevention Plan

Presentation: Exit Routes, Emergency Action and Fire Prevention Plans

NC Department of Labor: Training Calendar

Most employers have a physical location with walking and working surfaces. Subpart D - Walking -Working Surfaces covers any horizontal or vertical surface on or through which an employee walks, works, or gains access to a work area or workplace location including ladders, step bolts, manhole steps, scaffolds, stairways, dockboards and areas where there are fall hazards. The standard, 29 CFR 1910.22 - General Requirements, states that "The employer must ensure that walking-working surfaces are inspected, regularly and as necessary, and maintained in a safe condition." 

To learn more about the requirements for walking and working surfaces, go to Does "Subpart D - Walking-Working Surfaces" Apply to You?

Resources:

Safety and Health Topic Page: Walking and Working Surfaces

Presentation: Walking and Working Surfaces

NC Department of Labor: Training Calendar

Most employers have a physical work location where employees are located. The 29 CFR 1910.141 - Sanitation standard includes requirements for housekeeping, potable water, bathrooms, showers, vermin control, food handling, and waste disposal. It states "Every enclosed workplace shall be so constructed, equipped, and maintained, so far as reasonably practicable, as to prevent the entrance or harborage of rodents, insects, and other vermin. A continuing and effective extermination program shall be instituted where their presence is detected."

Resources:

Safety and Health Topic Page: Sanitation

NC Department of Labor: Training Calendar 

Many employers need to provide personal protective equipment (PPE) to their employees. The standard, 29 CFR 1910.132 - PPE, General Requirements, states that "Protective equipment, including personal protective equipment for eyes, face, head, and extremities, protective clothing, respiratory devices, and protective shields and barriers, shall be provided, used, and maintained in a sanitary and reliable condition wherever it is necessary by reason of hazards of processes or environment, chemical hazards, radiological hazards, or mechanical irritants encountered in a manner capable of causing injury or impairment in the function of any part of the body through absorption, inhalation or physical contact." 

To determine if it applies to you, this standard requires that the employer conduct a PPE hazard assessment. It states " The employer shall assess the workplace to determine if hazards are present, or are likely to be present, which necessitate the use of personal protective equipment (PPE)." and "The employer shall verify that the required workplace hazard assessment has been performed through a written certification that identifies the workplace evaluated; the person certifying that the evaluation has been performed; the date(s) of the hazard assessment; and, which identifies the document as a certification of hazard assessment."

If this standard applies, it requires training on the PPE. "The employer shall provide training to each employee who is required by this section to use PPE." and "Each affected employee shall demonstrate an understanding of the training and the ability to use PPE properly, before being allowed to perform work requiring the use of PPE." and "When the employer has reason to believe that any affected employee who has already been trained does not have the understanding and skill required by this section, the employer shall retrain each such employee."

If, through the hazard assessment, you determine that your employees need PPE, then Subpart I  - Personal Protective Equipment applies. Go to "Does  Subpart I - Personal Protective Equipment Apply to you?" to learn more about the other PPE standard requirements (i.e., hand protection, respirators, eye protection, hearing protection). 

Resources:

Safety and Health Topic Page: Personal Protective Equipment, Respiratory Protection, Noise

Example Program: PPE Hazard Assessment, Respiratory Protection Program, Hearing Conservation Program

Presentation: Personal Protective Equipment, Respiratory Protection, Noise Exposure

NC Department of Labor: Training Calendar

If your workplace has hazards that could cause serious injuries, 29 CFR 1910.151 - Medical Services and First Aid, states "That in the absence of an infirmary, clinic, or hospital in near proximity to the workplace, a person or persons shall be adequately trained to render first aid." 

Near proximity means that emergency care must be available within no more than 3-4 minutes from the workplace. In workplaces where serious accidents such as those involving falls, suffocation, electrocution, or amputation are possible, emergency medical services must be available within 3-4 minutes, if there is no employee on the site who is trained to render first aid. 

To learn more about the requirements for medical services and first aid, go to Does "Subpart K - Medical and First Aid" Apply to You?

If you have designated an employee to provide first aid as a collateral job duty, they are covered under 29 CFR 1910.1030 - Bloodborne Pathogens. This standard states "Each employer having an employee(s) with occupational exposure as defined by paragraph (b) of this section shall establish a written Exposure Control Plan designed to eliminate or minimize employee exposure." It also requires training, as it states "The employer shall train each employee with occupational exposure in accordance with the requirements of this section. Such training must be provided at no cost to the employee and during working hours. The employer shall institute a training program and ensure employee participation in the program." To learn more about the requirements for bloodborne pathogens, go to "Does your employees have exposure to blood or OPIM?"

Resources:

Safety and Health Topic Page: Medical Services and First Aid, Bloodborne Pathogens

Example Program: Exposure Control Plan

Presentation: First Aid, Bloodborne Pathogens

NC Department of Labor: Training Calendar

Many employers will have noise exposures due to tools and equipment. 29 CFR 1910.95 - Occupational Noise Exposure, states "The employer shall administer a continuing, effective hearing conservation program, as described in paragraphs (c) through (o) of this section, whenever employee noise exposures equal or exceed an 8-hour time-weighted average sound level (TWA) of 85 decibels measured on the A scale (slow response) or, equivalently, a dose of fifty percent. For purposes of the hearing conservation program, employee noise exposures shall be computed in accordance with appendix A and Table G-16a, and without regard to any attenuation provided by the use of personal protective equipment."; "When information indicates that any employee's exposure may equal or exceed an 8-hour time-weighted average of 85 decibels, the employer shall develop and implement a monitoring program."; and "The employer shall establish and maintain an audiometric testing program as provided in this paragraph by making audiometric testing available to all employees whose exposures equal or exceed an 8-hour time-weighted average of 85 decibels."

In addition, the standard requires training as it states "The employer shall train each employee who is exposed to noise at or above an 8-hour time weighted average of 85 decibels in accordance with the requirements of this section. The employer shall institute a training program and ensure employee participation in the program." and requires maintaining records, "Record retention. The employer shall retain records required in this paragraph (m) for at least the following periods."

To learn more about the requirements for noise exposures, go to "Do you have occupational noise exposure?"

Resources:

Safety and Health Topic Page: Noise

Example Program: Hearing Conservation Program

Presentation: Noise Exposure 

NC Department of Labor: Training Calendar

Most employers have a physical work location. Subpart S - Electrical provides the electrical standards that address the practical safeguarding of employees in the workplace including electric equipment and installations used to provide electric power and light for employee workplaces (i.e., temporary wiring, flexible cords, lighting fixtures), specific purpose equipment and installations (i.e., X-ray equipment, electric welders, cranes), hazardous (classified) locations (i.e., body shops, service stations),  and special systems (over 600 volts). If you have a physical work location, go to Does "Subpart S - Electrical" Apply to You? to learn more about these requirements for your worksite.

If you have employees that work on or near electrical hazards, 29 CFR 1910.332 - Training, states "Employees shall be trained in and familiar with the safety-related work practices required by 29 CFR 1910.331 through 1910.335 that pertain to their respective job assignments." 29 CFR 1910.333 - Selection and Use of Work Practices,  states "Safety-related work practices shall be employed to prevent electric shock or other injuries resulting from either direct or indirect electrical contacts, when work is performed near or on equipment or circuits which are or may be energized. The specific safety-related work practices shall be consistent with the nature and extent of the associated electrical hazards." and "Procedures. The employer shall maintain a written copy of the procedures outlined in paragraph (b)(2) and shall make it available for inspection by employees and by the Assistant Secretary of Labor and his or her authorized representatives."

Additionally, 29 CFR 1910.335 - Safeguards for Personnel Protection, states "Employees working in areas where there are potential electrical hazards shall be provided with, and shall use, electrical protective equipment that is appropriate for the specific parts of the body to be protected and for the work to be performed." and "Protective equipment shall be maintained in a safe, reliable condition and shall be periodically inspected or tested, as required by 29 CFR 1910.137 - Electrical Protective Equipment." To learn more about these requirements, go to "Do you have employees that work on or near exposed energized parts?"

Resources:

Safety and Health Topic Page: Electrical Safety

Example Program: Electrical Safety-related Work Practices Policy

Presentation: Electrical Safety 

NC Department of Labor: Training Calendar

Many small employers use ladders. 29 CFR 1910.23 - Ladders, states "Ladders are inspected before initial use in each work shift, and more frequently as necessary, to identify any visible defects that could cause employee injury;"; "Any ladder with structural or other defects is immediately tagged "Dangerous: Do Not Use" or with similar language in accordance with 29 CFR 1910.145 (Specifications for accident prevention signs and tags) and removed from service until repaired in accordance with 29 CFR 1910.22(d) - General Requirements, or replaced."

In addition, 29 CFR 1910.30 - Training Requirements, states "The employer must train each employee on or before May 17, 2017 in the proper care, inspection, storage, and use of equipment covered by this subpart before an employee uses the equipment."

To learn more about requirements for ladders, go to "Do you have ladders?"

Resources:

Safety and Health Topic Page: Walking and Working Surfaces

Presentation: Walking and Working Surfaces

NC Department of Labor: Training Calendar

Many employers need a Hazard Communication (HazCom) Program. The standard, 29 CFR 1910.1200 - Hazard Communication, "Applies to any chemical which is known to be present in the workplace in such a manner that employees may be exposed under normal conditions of use or in a foreseeable emergency." To determine if it applies to you, go to "Do you have employees that may be exposed to any chemical under normal conditions or in foreseeable emergencies?"

If it does, the standard also requires "All employers to provide information to their employees about the hazardous chemicals to which they are exposed, by means of a hazard communication program, labels and other forms of warning, safety data sheets, and information and training."

Lastly, the standard requires training on HazCom. "Employers shall provide employees with effective information and training on hazardous chemicals in their work area at the time of their initial assignment, and whenever a new chemical hazard the employees have not previously been trained about is introduced into their work area."

Resources:

Safety and Health Topic Page: Hazard Communication

Example Program: Hazard Communication Program

Presentation: Hazard Communication

NC Department of Labor: Training Calendar

Many small employers may have exposures to hazardous substances that require the use of respirators. 29 CFR 1910.134 - Respiratory Protection, states "A respirator shall be provided to each employee when such equipment is necessary to protect the health of such employee. The employer shall provide the respirators which are applicable and suitable for the purpose intended. The employer shall be responsible for the establishment and maintenance of a respiratory protection program, which shall include the requirements outlined in paragraph (c) of this section. The program shall cover each employee required by this section to use a respirator." and "Respiratory protection program. This paragraph requires the employer to develop and implement a written respiratory protection program with required worksite-specific procedures and elements for required respirator use. The program must be administered by a suitably trained program administrator. In addition, certain program elements may be required for voluntary use to prevent potential hazards associated with the use of the respirator." 

It also has requirements for a medical evaluation, fit-testing, training, inspections and recordkeeping. It states "The employer shall provide a medical evaluation to determine the employee's ability to use a respirator, before the employee is fit tested or required to use the respirator in the workplace. The employer may discontinue an employee's medical evaluations when the employee is no longer required to use a respirator."; "Obtain a written recommendation regarding the employee's ability to use the respirator from the PLHCP."; "This paragraph requires that, before an employee may be required to use any respirator with a negative or positive pressure tight-fitting facepiece, the employee must be fit tested with the same make, model, style, and size of respirator that will be used. This paragraph specifies the kinds of fit tests allowed, the procedures for conducting them, and how the results of the fit tests must be used."; "All respirators used in routine situations shall be inspected before each use and during cleaning."; "This paragraph requires the employer to provide effective training to employees who are required to use respirators. The training must be comprehensive, understandable, and recur annually, and more often if necessary. This paragraph also requires the employer to provide the basic information on respirators in appendix D of this section to employees who wear respirators when not required by this section or by the employer to do so." and "This section requires the employer to establish and retain written information regarding medical evaluations, fit testing, and the respirator program. This information will facilitate employee involvement in the respirator program, assist the employer in auditing the adequacy of the program, and provide a record for compliance determinations by OSHA."   

To learn more about other respiratory protection requirements, go to "Do you have airborne contaminants?"

Resources:

Safety and Health Topic Page: Respiratory Protection

Example Program: Respiratory Protection Program

Presentation: Respiratory Protection

NC Department of Labor: Training Calendar

Many small employers have compressed gas cylinders, use flammable liquids, and/or have dipping and coating operations. Subpart H - Hazardous Materials, provides requirements for compressed gases, flammable liquids, LP gases, and dipping and coating operations. 

If you have gas cylinders, flammables, or dipping and coating operations, go to Does "Subpart H - Hazardous Materials" Apply to You? to learn more about these requirements. Note: Subpart H also provides the requirements for HAZWOPER, anhydrous ammonia, blasting and process safety management which normally do not fall under a small employer. However, if they do apply to you,  Does "Subpart H - Hazardous Materials" Apply to You? will provide additional information regarding their requirements. 

Resources:

Safety and Health Topic Page: Flammable Liquids, Compressed Gases, Hazardous Waste Operations and Emergency Response, Ammonia/Ammonia Refrigeration, Dipping and Coating

NC Department of Labor: Training Calendar

Many employers need to have fire protection measures for their employees. 29 CFR 1910.157 - Portable Fire Extinguishers, states "Where the employer has established and implemented a written fire safety policy which requires the immediate and total evacuation of employees from the workplace upon the sounding of a fire alarm signal and which includes an emergency action plan and a fire prevention plan which meet the requirements of 29 CFR 1910.38 and 29 CFR 1910.39 respectively, and when extinguishers are not available in the workplace, the employer is exempt from all requirements of this section unless a specific standard in part 1910 requires that a portable fire extinguisher be provided."; "The employer shall provide portable fire extinguishers and shall mount, locate and identify them so that they are readily accessible to employees without subjecting the employees to possible injury."; "The employer shall assure that portable fire extinguishers are subjected to an annual maintenance check. Stored pressure extinguishers do not require an internal examination. The employer shall record the annual maintenance date and retain this record for one year after the last entry or the life of the shell, whichever is less. The record shall be available to the Assistant Secretary upon request.";  "Where the employer has provided portable fire extinguishers for employee use in the workplace, the employer shall also provide an educational program to familiarize employees with the general principles of fire extinguisher use and the hazards involved with incipient stage fire fighting."; and "The employer shall provide employees who have been designated to use fire fighting equipment as part of an emergency action plan with training in the use of the appropriate equipment."

To learn more about these requirements and other fire protection measures, go to Does "Subpart L - Fire Protection" Apply to You?

Resources:

Safety and Health Topic Page: Portable Fire Extinguishers, Fire Protection and Prevention 

Example Program: Fire Prevention Plan, Emergency Action Plan

Presentation: Exit Routes, Emergency Action and Fire Prevention Plans

NC Department of Labor: Training Calendar

Many employers use accident prevention signs and tags. 29 CFR 1910.145 - Specifications for accident prevention signs and tags provides sign and tag application and use for hazards such as danger, biohazard, slow moving vehicle, and caution. Sign refers to a surface on prepared for the warning of, or safety instructions of, industrial workers or members of the public who may be exposed to hazards. Tag means a device usually made of card, paper, pasteboard, plastic or other material used to identify a hazardous condition.

In addition, employers may need to mark physical hazards to prevent injury to employees. 29 CFR 1910.144 - Safety Color Code for Marking Physical Hazards provides the color codes to be used for fire (red), danger (red), stop (red); physical hazards (yellow) and caution (yellow). 

Resources:

NC Department of Labor: Training Calendar

Many small employers have potential exposures to hazardous substances such as silica, asbestos, benzene, beryllium, isocyanates, lead and other similar hazardous substances. Subpart Z - Toxic and Hazardous Substances, provides the requirements for these substances and many include training, programs, PPE, medical surveillance, and recordkeeping requirements. To learn more about these requirements, go to Does "Subpart Z - Toxic and Hazardous Substances" Apply to You?

Resources:

Safety and Health Topic Page:  Chemical Hazards and Toxic Substances, Organic Solvents, Hierarchy of Controls 

NC Department of Labor: Training Calendar

Many small employers may work at another employer's worksite. On multi-employer worksites (in all industry sectors), more than one employer may be citable for a hazardous condition that violates an OSHA standard. A two-step process is followed in determining whether more than one employer will be cited.

• Step One - The first step is to determine whether the employer is a creating, exposing, correcting, or controlling employer. Note: Only exposing employers can be cited for General Duty Clause violations.
• Step Two - If the employer falls into one of these categories, it has obligations with respect to OSHA requirements.

Definitions:

Creating Employer - The employer that caused a hazardous condition that violates an OSHA standard.

Exposing Employer -  An employer whose own employees are exposed to the hazard.

Correcting Employer - An employer who is engaged in a common undertaking, on the same worksite, as the exposing employer and is responsible for correcting a hazard. This usually occurs where an employer is given the responsibility of installing and/or maintaining particular safety/health equipment or devices.

Controlling Employer - An employer who has general supervisory authority over the worksite, including the power to correct safety and health violations itself or require others to correct them.

Resources:

Safety and Health Topic Page:  Multi-Employer Worksites

Presentation: Multi-Employer Worksites 

NC Department of Labor: Training Calendar

The Occupational Safety and Health (OSH) Division provides many free resources to assist an employer in understanding and meeting the OSHA requirements. 

Consultative Services  

The Consultative Services Bureau helps small employers in meeting the requirements of the OSHA standards. In the private sector, consultation is limited to employers who have 500 or fewer employees nationwide, and In the public sector, priority is given to smaller municipal, county and state agencies. Services are provided free of charge. In addition, records maintained by the Consultative Services Bureau are kept confidential and are not shared with other NCDOL bureaus.

Standard Inquiries

If you have questions regarding the OSHA standards or North Carolina state-specific standards, please submit an inquiry about safety and health requirements to Ask OSH through the online form, by email to ask.osh@labor.nc.gov, or by phone at 919-707-7876.

Training and Outreach

The Education, Training and Technical Assistance bureau provides free online safety and health training (i.e., webinars) and outreach services (i.e., speaker's bureau requests, safety booths) upon request. The bureau also provides free 10- and 30-hour in general industry and construction across the state at community colleges and also provides individual topic on-site training. 

Also reference the Training Requirements document provides the standards within general industry (Part 1910) and recordkeeping (Part 1904) that have training requirements. It also includes the North Carolina State-Specific standards for general industry that require training. 

Which OSHA Standards Apply

The Which OSHA Standards Apply webpages guides an employer through the standards for Recordkeeping, General Industry, Construction, Agriculture, Maritime and North Carolina State-Specific standards to help the employer identify the standards that apply to them. Printable version for general industry.

Programs, Presentations and Publications

Example safety and health programs and presentations (pre-recorded webinars) along with publications are available to assist the employer in meeting standards requirements. Also reference the Programs, Plans and Procedures document for general industry standards that require programs, plans and procedures and the Inspections document for general industry standards that require inspections.  

Safety and Health Topics 

The safety and health topic pages provides information on various topics including applicable standards, related compliance documents and other resources available.   

Compliance Enforcement Procedures 

OSH enforcement procedures provide guidance to compliance personnel, to ensure responsibilities are carried out in an effective, efficient and consistent manner. 

Library Services

The NCDOL Library also offers a free safety and health streaming video service and provides research assistance on consensus standards (i.e., ANSI, NFPA, NEC).