Why are so many dental offices being inspected by OSHA? Understanding a Local Emphasis Program.

by Olivia Wann

OSHA is here!  Help!  Are you practicing in Tennessee and have experienced a recent unannounced OSHA inspection?  You are not alone.

Week to week, dental practices are reaching out to us explaining that a Tennessee OSHA inspector stopped in for a random audit.  Quite a number of practices experienced citations, although such citations only amounted to a few hundred dollars.  What is this all about?

It’s part of a Local Emphasis Program (LEP).  Tennessee has its own state-run OSHA program (TOSHA) unlike some states that simply follow federal OSHA.  State run programs are often stricter and have a unique focus.  For example, TOSHA has a stricter Chemical Right-To-Know and Bloodborne Pathogens standards. 

In 2017, TOSHA implemented the Local Emphasis Program (LEP) specifically targeting dental offices to address the Bloodborne Pathogens Standard and the Hazard Communication Standard.

TOSHA studied data collected over a 10-year period (years 2004 and 2014) and identified several hundred serious hazards after inspecting 30 dental offices with an average of 10 serious hazards per office.  As a result, TOSHA launched the Local Emphasis Program to target dental offices.  And here we are…

Personally, I find it interesting that TOSHA targets dental offices and not nursing homes and hospitals where injuries are known to take place.  Other industries and hazards targeted by TOSHA include construction and high-noise workplaces.

Common dental OSHA violations include:

• Failure to provide appropriate training, particularly on the bloodborne pathogens standard and hazard communication
• Inadequate personal protective equipment, including failure to provide proper gloves, masks, or eyewear.
• Missing or inaccessible safety data sheets (SDS) for hazardous chemicals
• Improper handling of sharps and medical waste

Based on our experience, TOSHA is specifically addressing multi-site injections as previously noted in prior blogs and articles we have shared. 

For example, in the Exposure Control Plan, detail more information on how recapping the needle takes place such as:

For recapping: The end-user of the device, a DDS or RDH, uses the one-handed scoop technique, preferably a mechanical device designed for holding the needle cap to facilitate one-handed recapping, or an engineered sharps injury protection device.

For disposal: In most situations, the end-user of the sharp will dispose of the sharp in a sharps container as soon as possible. In limited circumstances where the end user cannot immediately dispose of the sharp due to patient-treatment needs, the dental assistant will immediately dispose of the sharp. 

Another source of violations of recent eyewash stations. What has been considered compliant for years and years is no longer passing the grade.  According to Tennessee OSHA Consultative Services,  faucet-mounted eyewash attachment that requires multiple actions—such as turning on the faucet and pulling a pin—is typically non-compliant because it delays access and may not provide uninterrupted flow or appropriate water temperature. Such units are considered supplemental only and do not replace the need for a fully ANSI-compliant eyewash or eye/face wash station.

What happens after OSHA issues a citation?  The employer must post it, review it to either correct the violation and certify abatement, request an informal conference with the Area Director within 15 days to discuss it or formally contest it.  Failure to act means the citation and penalty become final.

Never feel reluctant to question a citation to assure that the violation is actually lining up to what was observed versus what the law is. You made find TOSHA’s FAQ sheet helpful: https://www.tn.gov/content/dam/tn/workforce/documents/Employees/SafetyHealth/DentalOfficeFAQFinal.pdf

Modern Practice Solutions has been dedicated to keeping dental offices aligned with OSHA for the last 26 years. Whether it’s training, policy development or mock audits, we are here to support your practice.