For each hospital area, OSHA highlights some of the specific OSHA requirements, as well as recognized controls, that are likely relevant to this particular area. Recognized controls may be required by specific OSHA requirements (such as requirements for the use of respirators, other PPE, and/or work practice, administrative, or engineering controls), but even if not, these controls may be required by OSHA's general duty clause, 29 U.S.C. 654(a)(1), which requires each employer to "furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees."
OSHA's focus on particular hazards, requirements and controls in a particular hospital area does not signify that the hazards, requirements and controls discussed are the only applicable hazards, requirements and controls for this area. To this end, the fact that OSHA highlights hazards, requirements, and controls in one area, but does not highlight them in another area, does not signify that the hazards, requirements, and controls highlighted in the other area are not applicable to both areas. Employers need to conduct a thorough worksite hazard analysis to determine the full range of hazards to which employees are exposed and the full range of controls that will protect workers from those hazards.
The codes require that walkway surfaces and circulation path surfaces of the means of egress be “slip-resistant,” but no method of measurement, quantitative threshold, nor general principles to help the specifier, end-user and code official were previously provided. Given the Code’s lack of criteria for the term “slip-resistant,” materials are sometimes inappropriately and loosely specified causing accidents to occur on walkway surfaces and in circulation paths of the means of egress. This can be especially dangerous for emergency responders who are entering a building for the first time, potentially under conditions with water and limited visibility (smoke).
The published national standard, ANSI A326.3, clearly defines “slip resistant” criteria for walkway hard surface flooring including flooring used in circulation paths of the means of egress in case of fire. The proposed reference standard, ANSI A326.3, sets forth a quantitative minimum threshold, means of measurement, and general principles regarding slip resistance for hard walkway surface flooring and is widely specified for ceramic tile, VCT, LVT, polished concrete, terrazzo, and natural stone. This provides clarity, safety, defined measurements, measurement method and transparency.
Hospital-wide Hazards » Slips/Trips/Falls
Hazard
Wet floors, spills, and clutter can lead to slips/trips/falls and other possible injuries.
Requirements under OSHA's Walking-Working Surfaces Standard, 29 CFR 1910.22
Keep floors clean and dry. [29 CFR 1910.22(a)(2)]
Keep aisles and passageways clear and in good repair, with no obstruction across or in aisles that could create a hazard. [29 CFR 1910.22(a)]
Other OSHA Requirements
Follow Bloodborne Pathogens Standard spill clean-up requirements for spills containing blood or other potentially infectious materials (OPIM) [29 CFR 1910.1030].
Recognized Controls and Work Practices
Ensure that spills are reported and cleaned up immediately.
Use no-skid waxes and surfaces coated with grit to create non-slip surfaces especially slippery areas such as toilet and shower areas.
Use waterproof footgear to decrease slip/fall hazards.
Use only properly maintained ladders to reach items. Do not use stools, chairs, or boxes as substitutes for ladders.
Re-lay or stretch carpets that bulge or have become bunched to prevent tripping hazards.
Ensure that aisles and passageways are sufficiently wide for easy movement and are also kept clear at all times. Ensure that temporary electrical cords that cross aisles are taped or anchored to the floor.
Eliminate cluttered or obstructed work areas.
Use prudent housekeeping procedures, such as cleaning only one side of a passageway at a time, and provide good lighting for all halls and stairwells, to help reduce injuries.
Provide adequate lighting especially during night hours. You can use flashlights or low-level lighting when entering patient rooms.
Instruct workers to use the handrails on stairs, to avoid undue speed, and to maintain an unobstructed view of the stairs ahead of them, even if that means requesting help to manage a bulky load.
Eliminate uneven floor surfaces.
Promote safe work in cramped working spaces. Avoid awkward positions, and use equipment that makes lifts less awkward.
Additional Information
29 CFR 1910.22, General requirements (Walking/Working Surfaces). OSHA Standard.
Inspection Guidance for Inpatient Healthcare Settings. (June 25, 2015). OSHA memorandum establishing guidance for inspections conducted in inpatient healthcare settings.
Small Business Safety and Health Handbook. OSHA Publication 2209, (2022).
1910
Part Number Title:
Occupational Safety and Health Standards
Subpart:
1910 Subpart D
Subpart Title:
Walking-Working Surfaces
Standard Number:
Title:
General requirements.
GPO Source:
Surface conditions. The employer must ensure:
All places of employment, passageways, storerooms, service rooms, and walking-working surfaces are kept in a clean, orderly, and sanitary condition.
The floor of each workroom is maintained in a clean and, to the extent feasible, in a dry condition. When wet processes are used, drainage must be maintained and, to the extent feasible, dry standing places, such as false floors, platforms, and mats must be provided.
1910.22(a)(3)
Walking-working surfaces are maintained free of hazards such as sharp or protruding objects, loose boards, corrosion, leaks, spills, snow, and ice.
Loads. The employer must ensure that each walking-working surface can support the maximum intended load for that surface.
Access and egress. The employer must provide, and ensure each employee uses, a safe means of access and egress to and from walking-working surfaces.
Inspection, maintenance, and repair. The employer must ensure:
Walking-working surfaces are inspected, regularly and as necessary, and maintained in a safe condition;
Hazardous conditions on walking-working surfaces are corrected or repaired before an employee uses the walking-working surface again. If the correction or repair cannot be made immediately, the hazard must be guarded to prevent employees from using the walking-working surface until the hazard is corrected or repaired; and
1910.22(d)(3)
When any correction or repair involves the structural integrity of the walking-working surface, a qualified person performs or supervises the correction or repair.
https://www.cdc.gov/niosh/docs/2011-123/pdfs/2011-123.pdf
