Medical Safety
Medical Safety References 

Table of Contents

Federal Laws and Regulations

MEDCOM Regulations

DOD Directives

Technical Bulletin-Medical

DOD Instructions

DOD Manuals

APHC Fact Sheets & Technical Information Papers

APHC Technical Guides

Army Regulations

Subjects Specific to the EC/PE

DA Pamphlets

Standards and Guidelines


Federal Law and Regulations

 Centers for Medicare and Medicaid Services 

 CMS Waiver for OR Humidity Levels

 Department of Transportation 

 Environmental Protection Agency 

 Food and Drug Administration 

Guidelines for Public Access Defibrillation Programs in Federal Facilities

 GSA Customer Guide to Real Property

 OSHA General Industry Regulations (Standards - 29 CFR)  

 Worker Safety in Hospitals 

 Prudent Practices in the Laboratory 

The Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules 

 United States Access Board


Department of Defense Directive

4715.1E - Environment, Safety, and Occupational Health (ESOH)


Department of Defense Instructions

6050.05 - DoD Hazard Communication (HAZCOM) Program

6055.01 - DoD Safety and Occupational Health (SOH) Program

6055.05 - Occupational and Environmental Health (OEH)

 6055.08 - Occupational Ionizing Radiation Protection Program 

6055.11 - Protecting Personnel from Electromagnetic Fields 

6055.12 - Hearing Conservation Program (HCP)

6055.15 - DoD Laser Protection Program

  6055.17 – DoD Installation Emergency Management Program


Department of Defense Manuals

 UFC 4-510-01 Design: Military Medical Facilities

Army Regulations

11-34 - The Army Respiratory Protection Program

40-3 - Medical, Dental, and Veterinary Care

40-5 - Preventive Medicine

40-61 - Medical Logistics Policies

40-68 - Clinical Quality Management

190-51 - Security of Unclassified Army Property (Sensitive and Nonsensitive)

200-1 - Environmental Protection and Enhancement

385-10 - The Army Safety Program

420-1 - Army Facilities Management

600-63 - Army Health Promotion


DA Pamphlets 

40-11 - Preventive Medicine

40-21 - Ergonomics Program

40-501 - Hearing Conservation Program

40-503 - Industrial Hygiene Program

40-506 - The Army Vision Conservation and Readiness Program

385-10 - Army Safety Program

385-24 - The Army Radiation Safety Program

385-25 - Occupational Dosimetry and Dose Recording for Exposure to Ionizing Radiation

385-69 - Safety Standards for Microbiological and Biomedical Laboratories


 Army Techniques Publication (ATP)  

ATP 5-19 Risk Management


MEDCOM Regulations

40-35, Management of Regulated Medical Waste (AKO Users)

385-2, Army Medical Command Safety Program (AKO Users)



Technical Bulletins-Medical

245 - Warning Tag for Medical Oxygen Equipment (DD Form 1191)

507 - Heat Stress Control and Heat Casualty Management

508 - Prevention and Management of Cold-Weather Injuries

510 - Guidelines for the Evaluation and Control of Occupational Exposure to Waste Anesthetic Gases

515 - Occupational Health and Industrial Hygiene Guidance for the Management, Use and Disposal of Hazardous Drugs

521 - Occupational and Environmental Health Management and Control of Diagnostic, Therapeutic and Medical Research X-Ray Systems and Facilities

523 - Control of Hazards to Health from Microwave and Radio Frequency Radiation and Ultrasound

524 - Control of Hazards to Health from Laser Radiation

525 - Control of Hazards to Health from Ionizing Radiation Used by Army Medical Dept

530 - Occupational and Environmental Health Food Sanitation

561 - Pest Surveillance

750-1 - Operating Guide for Medical Equipment Maintenance


APHC Fact Sheets & Technical Information Papers (TIPs) 

Biological Safety Cabinets: Certification

  Biological Safety Cabinets: Types

 Emergency Response to Hazardous Substance Spills and Releases in Army Military Treatment Facilities

 Hand Drying at Medical Treatment Facilities

Radio Frequency Identification

 TIP: Managing Confined Spaces in Army Healthcare Facilities



TIP: Procedures for Cleaning Up Hazardous Drug Spills and Leaks 

TIP: Administrative Controls for Management of Hazardous Drugs

TIP: Waste Management of Hazardous Drugs 


APHC Technical Guides

 TG 195 Safety and Health Guidance for Mortuary Affairs Operations: Infectious Materials
and CBRN Handling
 (AKO access)

 TG 195A Safety and Health Guidance for Mortuary Affairs Operations: Infectious Materials


Subjects Specific to the Environment of Care/Physical Environment 


Guidance to help healthcare organizations implement strategies to prevent injuries and illnesses using a multi-component prevention plan.

       ASSE:  Body of Knowledge 

CDC:  Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program

FGI Design Guide for the Built Environment of Behavioral Health Facilities

FDA Personal Protective Equipment for Infection Control

IOM:  Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel Update 2010

MHS:  Military Health System

NAP:  Keeping Patients Safe: Transforming the Work Environment of Nurses

NAP: Safe Work in the 21st Century: Education and Training Needs for the Next Decade's Occupational Safety and Health Personnel

NAP:  To Err is Human: Building a Safer Health System

NAP: The Use and Effectiveness of Powered Air Purifying Respirators in Health Care: Workshop Summary

NIOSH:  Does It Really Work? How to Evaluate Safety and Health Changes in the Workplace

NIOSH:  Exposure to Stress: Occupational Hazards in Hospitals

OSHA: Hospital Respiratory Protection Program Toolkit

OSHA:  Personal Protective Equipment

TJC:  Implementing Hospital Respiratory Protection Programs: Strategies from the Field

TJC:  Keeping Your Hospital Property Smoke-Free

VHA:  Patient Safety Center Safe Bariatric Patient Handling Toolkit



Guidance to assist healthcare organizations in assessing the vulnerabilities of their facilities and implementing appropriate physical security measures.


 IAEMSC Active Shooter Planning and response in a Healthcare Setting

 Mayo Clinic: Diversion of Drugs Within Health Care Facilities, a Multiple-Victim Crime: Patterns of Diversion, Scope, Consequences, Detection, and Prevention

  National Center for Missing and Exploited Children: For Healthcare Professionals: Guidelines on Prevention of and Response to Infant Abductions, 9th ed. and Self-Assessment

NIOSH Guidance for Protecting Building Environments from Airborne Chemical, Biological, or Radiological Attacks 

 NIOSH Violence: Occupational Hazards in Hospitals

 Omnicell Diversion: Your Guide to Identification and Prevention

OSHA Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers

TJC:  Preventing Violent and Criminal Events

TJC: Security/Emergency Management Resources - Violence, Security, Active Shooter 


Hazardous Materials and Waste

Guidance to help healthcare organizations prevent occupational exposures to hazardous gases and vapors, radioactive materials and hazardous energy sources, hazardous drugs and chemicals, blood and other potentially infectious materials.

CDC Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition

DLIS Hazardous Materials Information Resource System

EPA Medical Waste Publications

 EPA Pharmaceuticals Standards and Guidelines 

 NAP Prudent Practices in the Laboratory: Handling and Management of Chemical Hazards, Updated Version

NIOSH Control of Smoke from Laser/Electric Surgical Procedures

NIOSH Personal Protective Equipment for Health Care Workers Who Work with Hazardous Drugs

NIOSH Pocket Guide to Chemical Hazards

NIOSH Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings

NIOSH Waste Anesthetic Gases - Occupational Hazards in Hospitals 

OSHA Best Practices for the Safe Use of Glutaraldehyde in Healthcare

OSHA Hazard Communication Guidelines for Compliance

OSHA Model Plans and Programs for the OSHA Bloodborne Pathogens and Hazard Communications Standards

OSHA Permissible Exposure Limits - Annotated Tables


Fire Safety

Guidance to assist healthcare organizations in protecting occupants from fire, smoke, and panic and maintaining fire protection systems, equipment, and means of egress.

FDA Preventing Surgical Fires

 ECRI Surgical Fire Prevention

 NFPA Health Care Interpretations Task Force (HITF) 

OSHA How to Plan for Workplace Emergencies and Evacuations


Medical Equipment

Guidance to help healthcare organizations manage medical equipment risks from equipment failure and biological contamination.

 AACN Strategies for Managing Alarm Fatigue 

 AAMI/ECRI: Executive Insights on Healthcare Technology Safety

 AHRQ: Multifaceted Initiative to Reduce "Alarm Fatigue" on Cardiac Unit Reduces Alarms and Increases Nurse and Patient Satisfaction 

ECRI Alarm Safety Resource Site

FDA Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment

FDA Practice Hospital Bed Safety



Guidance to help healthcare organizations manage risks from utilities system disruptions and biological contamination.

 ASHRAE Guideline 12-2000 Legionellosis 

 Guidelines for Control of Legionella in Ornamental Water Features 

CDC Legionella

OSHA Control of Hazardous Energy Lockout/Tagout

OSHA Controlling Electrical Hazards

OSHA Hand and Power Tools

OSHA Preventing Mold-Related Problems in the Indoor Workplace


Emergency Management

Emergency Management is another chapter related to the Physical Environment.
Organizations need to plan to respond to the effects of potential emergencies.

Listed below is guidance to help healthcare organizations manage emergencies by assessing threats, developing a comprehensive emergency response plan, and evaluating the effectiveness of emergency response strategies.

 AHRQ Hospital Evacuation Decision Guide 

AHRQ Hospital Assessment and Recovery Guide 

ATSDR Managing Hazardous Materials Incidents

 Hospital Incident Command System 2014 HICS Revision 

CDC Agents, Diseases, and Other Threats (A to Z)

DOT 2012 Emergency Response Guidebook

HHS: Incorporating Active Shooter Incident Planning into Healthcare Facility Emergency Operations Plan

NIOSH Guidance on Emergency Responder Personal Protective Equipment (PPE) for Response to CBRN Terrorism Incidents

NIOSH Protecting Emergency Responders, Volume 3

NIOSH Recommendations for the Selection and Use of Respirators and Protective Clothing for Protection Against Biological Agents

OSHA Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous Substances

OSHA Best Practices for Protecting EMS Responders During Treatment and Transport of Victims of Hazardous Substance Releases

OSHA Fire and Explosion Planning Matrix

OSHA Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers

TJC Emergency Management Resources - Vulnerable Populations

ACEP EMS and Disaster Preparedness

CDC Planning Resources for Hospitals and Healthcare Systems

Infection Control

The infection prevention and control chapter helps healthcare organizations reduce the number of health care-associated infections linked to failures in the environment of care.

Listed below is guidance to help healthcare organizations implement infection control measures to prevent the transmission of infectious agents.

CDC Vaccine Storage and Handling Toolkit 

CDC Guidelines for Environmental Infection Control in Healthcare Facilities

CDC Guidelines for Preventing Transmission of mycobacterium tuberculosis in Healthcare Settings

CDC Healthcare-Associated Infections (HAI)

EPA's Registered Sterilizers, Tuberculocides, and Antimicrobial Products Against Certain Human Public Health Bacteria and Viruses

 FDA FDA-Cleared Sterilants and High Level Disinfectants with General Claims for Processing Reusable Medical and Dental Devices - March 2015

NIOSH Environmental Control for Tuberculosis: Basic Upper-Room Ultraviolet Germicidal Irradiation Guidelines for Healthcare Settings

 HLAC Accreditation Standards for Processing Reusable Textiles for Use in Healthcare Facilities



Standards and Guidelines

Authoritative standards and guidelines are developed by technical or professional societies or by national and international standards-setting organizations.

Compliance is voluntary; however, many government regulators now accept adherence to authoritative standards and guidelines as sufficient for meeting their regulatory requirements especially in the absence of laws.

Listed below are recognized standards-producing organizations.

Standards and guidelines may be purchased through the individual organizations

 ACGIH TLV®/BEI® Guidelines

 Air-Conditioning, Heating, and Refrigeration Institute Standards

American National Standards Institute

American Society of Heating, Refrigerating and Air-Conditioning Engineers Standards

Association for the Advancement of Medical Instrumentation’s Standards and Recommended Practices

 American Society of Mechanical Engineers

American Society for Testing and Materials Standards

 ASHRAE Interpretations for Standard 170-2008

 ASIS Online

Association for Professionals in Infection Control and Epidemiology Standards

 CDC Vaccine Storage and Handling Toolkit

Compressed Gas Association’s American National Standards

ECRI Institute

Facility Guidelines Institute: Guidelines for Design and Construction of Health Care Facilities

 FGI Resources

 Health Physics Society

 IES Illuminating Engineering Society of North America Standards

Institute of Electrical and Electronic Engineers

 International Association of Healthcare Security and Safety

International Electrotechnical Commission

Joint Commission Resources  

 National Fire Protection Association Codes and Standards 

United States Pharmacopeia–National Formulary (USP–NF)

 Underwriters Laboratory Standards for Safety