Occupational Health and Employee Safety
Domain 6 covers employee health and safety programs: injury and illness recording, exposure management, respiratory protection, tuberculosis screening, immunizations, ergonomics, hearing conservation, and workplace violence. Expect questions on OSHA recordkeeping, post-exposure prophylaxis, fit testing, and confidentiality of medical records.
Core rules
- The OSHA 300 log records work-related injuries and illnesses meeting recording criteria; sharps injuries are also tracked on the sharps injury log. Medical records are confidential and kept separately from personnel files.
- Bloodborne pathogen exposure: wash the site, report immediately, evaluate the source and exposed worker, offer post-exposure prophylaxis per protocol, and document. Do not discipline the worker for reporting.
- Respirator use requires medical evaluation, fit testing, training, and maintenance. N95s require fit testing; surgical masks do not provide the same protection.
- TB screening and immunization programs follow risk assessment and public health guidance. Workers with communicable conditions are managed confidentially.
- Ergonomics and safe patient handling programs reduce musculoskeletal injuries; hearing conservation includes noise monitoring, audiograms, and hearing protection.
Worked example
A nurse sustains a needlestick from a used insulin needle. The correct response is to wash with soap and water, report immediately, complete the exposure report, test the source patient under applicable consent and legal rules, and evaluate the nurse for post-exposure prophylaxis. The event goes on the OSHA sharps injury log and may be recorded on the 300 log if criteria are met. The nurse's confidentiality is protected.
Traps
Do not delay reporting to see if anything happens. Do not put medical information in the general personnel file. Do not assume a surgical mask meets respiratory protection for TB.