Prior to 1970, workplace safety was some- what ad hoc — employers responded to state regulations, workers compensation costs, liability concerns, and contract
language. In 1970, the federal Occupational
Safety and Health Act (OSH Act or the Act)
was passed and the Occupational Safety and
Health Administration (OSHA)1 was created. 2
The Act allows a state agency to supersede OSHA if the state agency has regulations
more stringent than OSHA. 3 Employers
should be aware of which agency is the authorized enforcement agency and the details of
For editorial purposes we will refer to
OSHA and OSHA regulations. The first step
for the organization is to determine which
agency enforces safety practices in your state.
We will focus on the federal regulations,
but each organization should build a reference collection of applicable federal and/or
The healthcare scene
As modern medicine developed, so
did modern safety practices and especially infection controls. Workplace
safety became a political issue and
was formalized into law in 1970. The
next wave of regulation came during
the AIDS/HIV crisis, when universal
precautions and related practices were
formalized into law.
The AIDS/HIV crisis created a
new concern — working in healthcare
can have lethal consequences. There
was a necessary and quick improvement in medical safety practices,
and these practices were quickly
codified into the blood-borne
With more than 40 years since the
passage of the OSH Act and about 30 years
since universal precautions were codified,
every health organization should be in
a best practices state of operations. Time
pressures, resource pressures, and just the
daily rush of practice operations may put
safety on a back burner. Constant efforts
should be made to review and refresh
by Dale Sanders, DO, DHA; and Tom Ealey
Safety is the law:
Occupational safety compliance
» Safety management and compliance are multi-faceted, and all facets are important.
» The enforcing agency (state or federal) can examine the entire safety culture and operation.
» Policies based on legal requirements must be written for ease of communications and training.
» Employees have a right to be whistleblowers, without fear of retaliation.
» There are significant negative consequences from safety failures for both employee and employer.
Dale Sanders ( firstname.lastname@example.org) is a professor at Alma College in Alma,
Michigan and Director of the Health Care Administration program.
Tom Ealey ( email@example.com) is a professor at Alma College in Alma,
Michigan, and has decades of experience in healthcare consulting and
administration, including regulatory compliance and risk management.