Answer Library / Recordkeeping OSHA letter · 2018-08-09

Is using the cold-therapy-only setting on a therapeutic device first aid under OSHA recordkeeping?

Quick answer

Yes. OSHA determined that using only the cold therapy component of a dual-modality device (with no compression) is first aid, because 'hot or cold therapy' is on the first aid list (29 CFR 1904.7(b)(5)(ii)(E)). But if the device's air compression component is used — with or without cold therapy — the case must be recorded, because compression therapy is not on the list.

CoolSystems, Inc. (Game Ready) asked OSHA whether the cold-therapy-only setting on its therapeutic device is first aid under 29 CFR Part 1904. The device is a dual-modality care system: cold water flows through a hose onto one side of a wrap, while air flows to the other side for compression. The components operate independently, allowing 'pressure off' cold therapy without compression.

In its August 9, 2018 response, OSHA determined that 'applying only the cold therapy component of your device (with no compression) is first-aid for injury and illness recordkeeping purposes.' Section 1904.7(b)(5)(ii) requires recording work-related injuries resulting in medical treatment beyond first aid, and the regulation specifically lists 'using hot or cold therapy' as first aid under subparagraph (E). Section 1904.7(b)(5)(iii) establishes that the first aid list is comprehensive.

The critical distinction is that air compression therapy is not included on the first aid list. Because the list is exhaustive, OSHA concluded that 'when the air compression component of your device is used, either with or without cold therapy, to treat a work-related injury or illness, the case must be recorded on the OSHA 300 log.'

29 CFR 190429 CFR 1904.7(b)(5)(ii)29 CFR 1904.7(b)(5)(ii)(E)29 CFR 1904.7(b)(5)(iii)
Source: OSHA Standard Interpretation letter, 2018-08-09 — read the official letter on osha.gov →
Interpretation letters explain how OSHA applies its rules to specific situations. Always verify current requirements — regulations and enforcement policies change.

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