The March 17, 2021 letter involved an employee with non-occupational asthma and rhinitis who developed fragrance sensitivity. The employee took daily medication and used a prescribed rescue inhaler. Starting in June 2018, workplace fragrance exposures triggered asthma symptoms and occasional work absences. The employer asked whether inhaler use after these exposures is recordable, given that the underlying condition and the prescription both predated the workplace exposure.
OSHA said the case should have been recorded. Under 29 CFR 1904.5(a), an illness is work-related if the workplace exposure 'caused or contributed to the resulting condition or significantly aggravated a pre-existing injury or illness' — the work exposure need only be 'one of the discernible causes; it need not be the sole or predominant cause.' Under 1904.5(b)(4)(iv), a pre-existing condition is significantly aggravated when a workplace exposure results in medical treatment where none was needed for that exposure before. The fact that the rescue inhaler prescription treats a non-work-related condition is irrelevant.
On the treatment side, OSHA stated that 'the use of a rescue inhaler to treat a work-related illness is not included on the list of first aid treatments in section 1904.7(b)(5).' It is therefore medical treatment beyond first aid, satisfying a recording criterion.
There is an important limit on repeat cases: under 1904.5(b)(4)(iv) and the new-case rules in 1904.6(a), 'significant aggravation of a non-work-related pre-existing condition only needs to be recorded once on the OSHA 300 log.' Once recorded, subsequent exposures and inhaler use do not need to be recorded again unless a change in medical treatment is necessitated to treat a work-related exposure, and employers must evaluate whether the employee had fully recovered from the earlier recorded illness.