An analysis of OSHA inspections assessing contaminant exposures in general medical and surgical hospitals

Our plain-English summary of An analysis of OSHA inspections assessing contaminant exposures in general medical and surgical hospitals, by J.L. Knight, D.K. Sleeth, R.R. Larson, et al (Workplace Health & Safety, 2013).

The study

• Authors: J.L. Knight, D.K. Sleeth, R.R. Larson, L.F. Pahler
• Journal: Workplace Health & Safety
• Published: 2013;61(4):153-60
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This study analyzed data from the Occupational Safety and Health Administration's (OSHA) Chemical Exposure Health Database to assess contaminant exposures in general medical and surgical hospitals. Seventy-five inspections conducted in these hospitals from 2005 through 2009 were identified. Five categories of inspections were conducted, the three most common being complaint-based, planned, and referral-based inspections. Complaint-based inspections comprised the majority of inspections-55 (73%) of the 75 conducted. The overall violation rate for all inspection types was 68%. This finding was compared to the violation rates of planned inspections (100%), referral-based inspections (83%), and complaint-based inspections (62%). Asbestos was the hazardous substance most commonly sampled and cited by OSHA in hospitals, with 127 samples collected during 24 inspections; 31% of the total 75 inspections resulting in one or more violations were due to asbestos.

Copyright 2013, SLACK Incorporated.

In plain English

This descriptive study reviewed records in the Occupational Safety and Health Administration's (OSHA) Chemical Exposure Health Database for federal OSHA inspections of general medical and surgical hospitals from 2005 through 2009. The authors found 75 inspections at 69 hospitals. Most (55, or 73%) were prompted by complaints. In all, 68% of inspections led to at least one violation, including all 11 planned inspections. Asbestos was the substance sampled most often, with 127 samples during 24 inspections. Only 2 of those samples were personal samples taken from workers. Most (76%) were bulk samples, which cannot be compared with the permissible exposure limit. Only personal samples were used to judge exceedance, and neither of the two personal asbestos samples exceeded that limit. Asbestos was also the hazard cited most often, appearing in 16 (31%) of the 51 inspections with violations. The authors suggested that the concern may have been how asbestos-containing material in hospitals was managed, rather than measured exposures. They noted that the database covered only federal inspections in which samples were taken, and that it gave a selective snapshot rather than a full picture of exposures in these hospitals.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive study of existing OSHA inspection and sampling records
• Who was studied: 75 federal OSHA inspections of general medical and surgical hospitals (SIC code 8062) at 69 hospitals in the United States, January 2005 through December 2009. Six hospitals were inspected twice on different days. Specialty hospitals and other health care facilities were excluded.
• Exposure: Hazardous substances sampled by OSHA inspectors (personal, area, wipe and bulk samples), chiefly asbestos, formaldehyde and lead. The article does not name an asbestos fiber type.
• Main results:
  • Of the 75 inspections, 55 (73%) were complaint-based. The rest were planned 11 (15%), referral 6 (8%), unprogrammed 2 (3%) and accident 1 (1%).
  • 51 of 75 inspections (68%) resulted in one or more violations. All 11 planned inspections (100%) had a violation, compared with 34 of 55 complaint-based inspections (62%).
  • 5 of 75 inspections (7%) had a personal sample from a worker exceeding the permissible exposure limit. Only the 38 inspections with personal samples could be assessed for this.
  • Asbestos was the most commonly cited hazard: it was listed as a violation in 16 (31%) of the 51 inspections that had one or more violations.
  • Of 127 asbestos samples collected during 24 inspections, only 2 (1.6%) were personal samples.
  • 76% of asbestos samples were bulk samples, which cannot be used to judge whether the exposure limit was exceeded.
  • Exceedance of the exposure limit was judged only from personal samples. Table 3 reports zero asbestos exceedances, which means neither of the two personal asbestos samples exceeded the limit. The other asbestos samples could not be assessed this way.
  • Across the combined 296 samples of asbestos, formaldehyde and lead, the authors reported only three exceedances of exposure limits, all of them formaldehyde. Exceedance could be judged only for the personal samples among these.
  • Asbestos was cited in only one of the 11 planned inspections.
  • The authors suggested that, because asbestos was mostly bulk sampled, the asbestos citations may reflect how asbestos-containing material in hospitals was managed rather than measured exposures.
• The authors' conclusion: The authors concluded that between 2005 and 2009 asbestos was the most commonly sampled substance during hospital OSHA inspections, followed by formaldehyde and lead. They also concluded that asbestos was the most commonly cited hazard.
• Limitations the authors state:
  • The study used online summary reports, not full inspection reports, which might hold more detail (reason for sampling, source of exposure, number of employees exposed).
  • The database is not a complete list of OSHA inspections. Inspections in which no samples were collected are not included.
  • Only federal OSHA inspections are included, not inspections by state-operated programs.
  • Inspectors did not sample all hospitals or all employees, so the data are a selective snapshot and do not fully characterize exposures.

Topics

Medical terms in this study, explained in our Lexicon: OSHA.

Related studies

• Occurrence, behaviour, and human exposure pathways and health risks of toxic geogenic contaminants in serpentinitic ultramafic geological environments (SUGEs): A medical geology perspective — W. Gwenzi (2020)
• Silicosis among foundry workers. Implication for the need to revise the OSHA standard — K.D. Rosenman, M.J. Reilly, et al. (1996)
• Corporate corruption of medical literature: asbestos studies concealed by W.R. Grace & Co — D. Egilman, W. Wallace, et al. (1998)
• Weight of evidence analysis for assessing the genotoxic potential of carbon nanotubes — P. Møller, N.R. Jacobsen (2017)
• An analysis of violations of Osha's (1987) occupational exposure to benzene standard — P.R. Williams (2014)
• OSHA and elongate mineral particles — D.T. Crane (2018)

Browse return to medical research.