Berger,J. B. Thomas Hospital, MA - NFPA · Thomas L. Qualey, Jr., Aberley, Inc.,Jennings, ... ~...

Report of the Committee on

Health Care Facilities

Technical Committee on Health Care Facilities

MarvinJ. Fmcher, Cha/rman Brookdale Hospital Medical Center, NY

Douglas S. Erlckson, V/c~ Chairman American Hospital Assn., IL

Burton R. Klein, S~retar) National Fire Protection Assn., MA

(Nonvoting)

Saul Aronow, Technology in Medidne, MA Constance Bobik, B&E Fire Safety Equipment, Inc., FL Bruce M. BurneR, Rockville, MD W'dllam H. L. Dornette, Kensington, MD Leo G. Fox'weB, Hartford Insurance Group, CT

Rep. American Insurance Service Group, Inc. Thomas W. Gardner, Gage-Babcock & Assoc., VA

Rep. American Health Care Assn. Martin Gromman, Ram Trac Corp., NY W'dlinm T. Guy, Jr., The Elizabeth General Medical Center, NJ

Rep. NFPA Health Care Section Gerald A, Hoeltge, Caeveland Clinic Foundation, OH

Rep. College of American Pathologists Stanley D. Kahn, Forest Electric Corp., NY

Rep. National Electrical Contractors Assn. Ode Richard Keil,Joint Commission on Accreditation of Healthcare Organizations, IL James W. Kerr, Winter Park, FL W'dliam E. Koffel, Jr., Koffel Assoc., Inc., MD Frank M. Mastroianni,Johnson and Higgins, NJ

Rep. American Society of Safety Engineers Thomas D. Mattern, UCLA Medical Center, CA

Pep. National Assn. of Private Psychiatric Hospitals David A. MeWhinnie,Jr., Mechanical Dynamics, Inc., IL Hugh O. Nash, Jr., Smith Seckman Reid, Inc., TN

Rep. Institute of Electrical & Electronics Engineers, Inc. RayJ. Nichols, Jr., University of Texas Medical Branch, TX

Pep. American Society of Anesthesiologists Bryan Parker, Montefiore Hospital & Medical Center, NY Thomas L. Qualey, Jr., Aberley, Inc.,Jennings, LA Jack Piess, Kemper National Insurance Cos., GA

Rep. The Alliance of American Insurers Robert T. Shipley, Fisher Berkeley Corp., CA

Pep. National Electrical Manufacturers Assn. John P. Swope, U.S. Postal Service, Washington, DC Steven Werner, M&M Protection Consultants, WI Mayer D. Zimmerman, Baltimore, MD

Alternates

Harlan C. Ihlenfeldt, Kemper National Insurance, IL (Alt. toJ. Riess)

ClementH. Klffmeyer, Picker International, Inc., OH (Alt. to R. T. Shipley)

Kenneth Knight, Bethesda Hospital, OH (Alt. to W. T. Guy,Jr.)

Pauline N. Minardi, CIGNA Property & Casualty Companies, CA (AIt. to L. G. Fox-well)

Staff Liaison: Burton R. Klein

Subcommittee on Anesthesia Services

John P. Swope, CAa/rman U.S. Postal Service, Washington, DC

Michael J. Albano, AIG Consultants, Inc., MA JamesJ. Claffey, McPherson Community Health Center, MI

Rep. American Assn. of Nurse Anesthetists George Babe Hart, Memorial Hospital Medical Center of Long Beach, CA

Rep. College of American Surgeons Norman Menken, American Analgesia Society, NY

James A. Meyer, Pettis Memorial VA Hospital, CA Rep. American Sodety of Anesthesiologists

RayJ. Nichols, University of Texas Medical Branch, TX Rep. American Sodety of Anesthesiologists

Gerald M. Olderman, Baxter Healthcare, CA Michael R. Shoys, Wisconsin Hospital Assn., WI

Rep. NFPA Health Care Section Clevis T. Sveflik, Johnson & Higgins of Ohio, Inc., OH Gregory L. Welyczko, Ohmeda, Wl

Rep. Compressed Gas Assn.

Alternates Steven Benesh, Square D Co.

(Alt. to NEMA Rep.) John M. Bruner, Croton, MA

(Alt. to R.J. Nichols Hartley C. Ericson, Puritan-Bennett Corp., KS

(Alt. to G. L. Welyczko) Paul F. Leonard, Mayo Medical School, MN

(Alt. toJ. A. Meyer) S. E. Longo, Salvador E. Longo &Assoc., Inc., LA

(Alt. to M. 17,. Shoys) Gary Mominee, American Assn. of Nurse Anesthetists, IL

(Alt. toJ. Claffey) DouglasS. Erlckson, American Hospital Assn., IL

(Alt. to AHA Rep)

StaffLiaison: Burton R. Klein

Subcommittee on Disaster Planning

James w. Kerr, Cha/rman Winter Park, FL

Michael M. Athey, Fire Service Extension, WV Dale M. Brown, McDonnell Douglas Space Systems Co., CA C. Roger Camplln, Camplin, Barteis and Assoc., Inc., AZ John P. Jarreth New Paltz Nursing Home, NY

Rep. American Health Care Assn. David Kltchin,Joint Commission on Accreditation of Healthcare Organizations, IL James L. Mauney, Volusia County Department of Fire Service, FL JohnJ. Murphy, The New York Hospital, NY DavidM. Sine, David M. Sine & Assoc., TX

Pep. American Hospital Assn. Clevis T. Svefllk, Johnson & Higgins of Ohio, Inc., OH David E. Wacker, Princeton Insurance Co., NJ

Alternates

Douglas S. Erickson, American Hospital Assn., IL (AlL to D. M. Sine)

Staff Liaison: Burton IL Klein

Subcommittee on Electrical Equipment

Bryan Parker, Cha/rman Montefiore Hospital & Medical Center, NY

(Alt. to A. Lipschultz)

Saul Aronow, Technology in Medicine, MA Jack Berger,J. B. Thomas Hospital, MA

#;~ ew England Hospital Engineers Society Bershad, Cost Control Enterprises, Inc., NY

Rep. American Hospital Assn. Yadin David, Texas Childrens Hospital, TX

Rep. Institute of Electrical & Electronics Engineers, Inc. FloydJ. DeVore, General Electric Medical System Group, WI

Rep. Health Ind. Manufacturers Assn. Alfred M. Dolan, Canadian Medical Engeering Consultants, Ontario

Rep. Canadian Standards Assn. George Babe Hart, Memorial Hospital Medical Center of Long Beach, CA

Rep. College of American Surgeons Clement H.Kiffmeyer, Picker International, Inc., OH

Rep. National Electrical Manufacturers Assn. Alan Lipschultz, The Medical Center of Delaware, DE

Rep. Assn. for the Advancement of Medical Instrumentation

223

Alfred J. Longhlumo, Gage-Babcock & Assoc., Inc.., NY Rep. American Health Care Assn.

M. T. Merrlgan, Underwriters Laboratories Inc.., NY James A. Meyer, Pettis Memorial VA Hospital, CA

Rep. American Society of Anesthesiologists Lawrenee S. Sandier, U.S. Department of Veterans Affairs, Washing- ton, DC

Alternates

Douglas S. Erickson,American Hospital Assn.jL (Alt. to H. A. Bershad)

Paul F. Leonard, Mayo Medical School, MN (Alt. toJ. A. Meyer)


Subcommittee on Electrical Systems

Hugh O. Nash, Chai~nan Smith Seckman Reid, Inc.., TN

Rep. Institute of Electrical & Electronics Engineers, Inc.

Steven Benesh, Square D Co., WI Rep. National Electrical Manufacturers Assn.

James L. Crawford, U.S. Dept. of Health & Human Service, WA Albert C. Garlatti, ETL TestingLaboratories, NY George Babe Hart, Memorial Hospital Medical Center of Long Beach, CA Rep. College of American Surgeons

Lawrence F. Hogrebe, Automatic Switch Co., NJ James IL Iverson, Onan Corp., MN Eugene A. Lakos, The Methodist Hospital, NY

Rep. Greater New York Hospital Assn. Edward A. Lobnitz, Tilden Lobnitz & Cooper, Inc.., FL Alfred J. Longhitano, Gage-Babcock & Asso~, Inc.., NY

Rep. American Health Care Assn. M. T. Merrigan, Underwriters Laboratories Inc, NY James A. Meyer, Pettis Memorial VA Hospital, CA

Rep. American Society of Anesthesiologists Davad FL Norton, U.S. Dept. of Veterans Affairs, Washington, DC ThomasJ. O'Dea, University of MN Hospital & Clinic, MN John M. Owen, Hanover Engineers, VA

Rep. National Society of Professional Engineers PaulJ. Savoie, General Electric Co., CT Ronald M. Smidt, Charlotte-Mecklenburg Hospital, NC Rep. American Hospital Assn.

Raymond J. Swisher, Naval Healthcare Support Office, VA Walter N. Vernon, Flack + Kurtz, CA Herbert V. Whitudl, Caterpillar, Inc., IN Rep. Electrical Generating Systems Assn.

Alternates

Lawrence A. Bey, Onan Corp., MN (AlL toJ. R. Iverson)

Douglas S. Erickson, American Hospital Assn., IL (AlL to IL M. Smidt)

Jeffrey L. Steplowski, Dept. of Veterans Affairs, Washington, DC (AlL to D. Norton)


Subcommittee on Gas Equipment

RayJ. Nichols, Cha/rman University of Texas Medical Branch, TX

Rep. American Society of Anesthesiologists

M. Lee Bancroft, Beth Israel Hospital, MA Gary Fowier, Jefferson Reg. Medical Center, AR Rep. American Hospital Assn.

Leo G. Foxwell, Hartford Insurance Group, CT Rep. T/C Industrial and Medical Gases

George Babe Hart, Memorial Hospital Medical Center of Long Beach, CA Rep. College of American Surgeons

Alan Lipschullx, The Medical Center of Delaware, DE Rep. Assn. for the Advancement of Medlcal Instrumentation

T. K. Raman, Baystate Medical Center, MA Rep. American College of Chest Physicians

Joseph O. Weiss, St- Luke's/Roosevelt Hospital Center, NY Rep. Greater New York Hospital Assn.

Alternates

Douglas S. Erickson, American Hospital Assn., IL (Alt- to G. Fowler)

Nonvoting

DelilaA. Hughes, Upper Marlboro, MD Rep. American Assn. of Nurse Anesthetists

Staff Liaison: Burton 11. Klein

Subcommittee on Hyperbaric and Hypobaric Facilities

William H. L. Dornette, Cha/rman Kensington, MD

Frederick S. Cramer, Oxygen Research Foundation, CA Dave DeAngelis, Ocean Engineering & Construction Pro. Office, Washington, DC G. T. Greak, Keyes Offshore, Inc., TX W. T. Gurnee, Hyperbaric Oxygen Therapy Ststems, Inc.., CA R. W. Hamilton, Hamilton Research Ltd., NY George Babe Hart, Memorial Hospital Medical Center of Long Beach, CA Pep. College of American Surgeons

Terry H. Hayes, Naval Facilities Engineering Command, VA John Howard Klmzey, Eagle Engineering, TX James A. Meyer, Pettis Memorial VA Hosl~ital, CA

Pep. American Society of Anesthesiologists Stephen D. Reimers, Reimers Engineering, Inc.., VA Robert F. Schumacher, FG Hall Hypo/Hyperbaric Center, NC J. Ronald Sechrist, Sechrist Industries, CA Paul J. Sheffield, Office of Surgeon General, Boiling AFB, DC

Pep. U.S. Air Force/Office of the Surgeon General Clevis T. Svetlik, Johnson& Higgins of Ohio, Inc., OH Rep. NFPA Health Care ,Section

Joseph C. Weiss, St. Luke s/Roosevelt Hospital Center, NY Rep. Greater New York Hospital Assn.

Wilbur T. Workman, U,S. Air Force School of Aerospace Medicine, Brooks FB, TX

Alternates

Douglas S. Erickson, American Hospital Assn., IL (Alt- to American Hospital Rep.)


Subcommittee on Laboratories

Gerald A. Hoeltge, Chai,nan Cleveland Clinic Foundation, OH

Rep. College of American Pathologists

Spencer Burney, Clinpathaid Inc., MA Rep. American Society of Clinical Pathologists

C. Roger Camplin, Camplin, Barrels and Assoc.., Inc., AZ George D. I-Iarlow, Tufts New England Medical Center, MA Rep. American Hospital Assn.

Robert F. Hughes, Earl Walls Assoc..., CA Harlan C. lhlenfeldt, Kemper National Insurance, IL Rep. The Alliance of American Insurers

M. Carlisle McGarity, WMP Architects, Inc~, SC Kay N. Olson, University of Minnesota Hospital, MN Rep. American Society for Medical Technologists

Norman V. Steere, Norman V. Steere Assoc.., Inc. MN Rep. T/C Chemistry Labs

James O. Wear, Veterans Administration Medical Center, AR Rep. NFPA Health Care Section

224

Alternate

Douglas S. F.xickson, American Hospital Assn., IL (Alt. to G. D. Harlow)

Arden W. Forrey, University of Washington, WA (Alt. to American Assn. for C~inical Chemistry Rep.)


Alternates

Gerard Bashein, University of Washington, WA (Alt. to.[. M. Bruner)

DouglasS. Erickson, American Hospital Assn., IL (/fit. to K. Tobacman)

Staff Liaison: Burton R. IOeba

Subcommittee on Nonflammable Medical Piped Gas Systems

Leo G. Fox'well, Ou=rm~n Hartford Insurance Group, CT

Rep. American Insurance Services Group, Inc.

Mark Allen, Ohmeda Medical Engineering, GA Rep. Compressed Gas Assn.

M. Lee Bancroft, Beth Israel Hospital, MA Rep. Harvard Medical School

Elizabeth M. Bunn, U.S. Dept. of Veterans Affairs, MD Craig B. Doerksen, Doerksen Medical Gas Systems/US Ltd., AZ Danielle S. Earhart, U.S. Dept. of Health & Human Services, WA Peter Esherick, Patient Instrumentation Corp., PA Snivatore J. Farruggia, Syska & Hennessy, Inc., NY

Pep. American Society of Sanitary Engineers LeeW. Gibbs, Underwriters Laboratories Inc., IL Meryl W. Holmwood, Littells Oxygen, Inc., CA Hem'yR. gaht, Squire-Cogswell CO., IL Wayne C. Karcher, Allied Healthcare Products, Inc., MO Antonio A. Mesa, Nash Engineering CO., Norwalk, CT James A. Meyer, Pettis Memorial VA Hospital, CA

Rep. American Society of Anesthesiologists David B. Mohile, Medical Engineeringservices, Inc., VA Dennis Murray, KMS-Medical Gas System Cons. LTD, MI

Pep. American Hospital Assn. Reginald Nease, Medical Gas Services, Inc., NM John Michael Pappas, Flack + Kurtz, CA Joanne S. Parkes, Air Force Medical Logistics Office, MD WHliam J. Ulmer, Deltech Engineering, DE J. Richard Wagner, Poole & Kent Co., MD F. David Wyrick, Cambiare Ltd, NC

Rep. Int'l Analgesia Society

Alternates

Kyle Adriance, Puritan-Bennett Corp., MO (Alt. to M. Allen)

James Coppedge, Littelis Oxygen, Inc., CA (Alt. to M. Holmwood)

Douglas S. Erickson, American Hospital Assn., IL (Ah. to D. Murray)

David Eric Lees, Georgetown University School of Medicine, Washington, DC

(Alt. toJ. Meyer) MichaelJ. Pastore, Nash Engineering Co., CT

(/fit. to A. A. Mesa) Eldon P. Rosentrater, Allied Healthcare Products, Inc., MO

(Aft. to W. Karcher)


Subcommittee on the Use of High Frequency Electridty

Saul Aronow, Oia/rman Technology in Medidne, MA

John M. Bruner, Groton, MA Rep. American Society of Anesthesiologists

George Babe Hart, Memorial Hospital Medical Center of Long Beach, CA

Rep. College of American Surgeons Paul F. Leonard, Mayo Medical School, MN

~ hn W. Martin, Cameron-Miller, Inc., IL • Merrigaa, Underwriters Laboratories Inc., NY

F~nneth I. Tobacman, Grant Hospital of Chicago, IL Rep. American Hospital Assn.

Joseph G. Weiss, St. Luke's/Roosevelt Hospital Center, NY Pep. Greater New York Hospital Assn.

Subcommittee on Vacuum Systems and Equipment

David A. McWhlnnie, Cha/rman Mechanical Dynamics, Inc., IL

Mark Allen, Ohmeda Medical Engineering, GA l~el~ Compressed Gas Assn.

e Bancroft, Beth Israel Hospital, MA Rep. Harvard Medical School

David L. Brlttaln, Busch, Inc., VA Clyde M. Douglass, St. Mary's Hospital, MN

Rep. NFPA Health Care Section George Babe Hart, Memorial Hospital Medical Center of Long Beach, CA

Rep. College of American Surgeons Henry R. gaht, Squire-Cogswell Co., IL Wayne C. Karcher, Allied Healthcare Products, Inc., MO Antonio A. Mesa, Nash Engineering Co., CT Dennis Murray, KMS-Medical Gas System Cons. LTD, MI

Rep. American Hospital Assn. Richard J. Reilly, RJR ConsultingServices, NJ

Rep. American Society of Plumbing Engineers

Alternates

K • A I e Adriance, Puritan-Bennett Corp., MO t. to M. Allen)

Douglas S. Erickson, American Hospital Assn., IL (Alt. to D. Murray)

MichaelJ. Pastore, Nash Engineering Co., CT (Alt. to A. A. Mesa)

Eldon P. Rosentrater, Allied Hcalthcare Products, Inc., MO (Ah. to W. Karcher)

StaffLialson: Burton IL Klein

This list represents the membership at the time the Committee was balloted on the text of this edition. Since that time changes in the membership may have occurred.

The Report of the Committee on Health Care Fadlities is presented for adoption in two parts.

Part I of this Report wasprepared by the Technical Committee on Health Care Facilities, andproposes for adoption amendments to NFPA 99-1990, Standard for Health Care Facilities. NFPA 99-1990 is published in Volume 5 of the 1991 National Fire Codes, and in separate pamphlet form.

Part I of this Report has been submitted to letter ballot of the Technical Committee on Health Care Facilities, which consists of 27 voting members, of whom at least 2/3 voted affirmatively on each of the proposed actions on proposals, as calculated in accordance with Section 12-4 of Regnlations Governing Committee Projects. All ballots were returned. Committee members who voted negatively or abstained on the Committee Action on certain proposals, and their reasons for so voting, follows: {Vote is negative unless otherwise noted)

Proposal 99-8 (Log #201) (1-6.2)

Mr. McWhinnie: Section 1-6.2 organization omits a "General" Section (which could actually include Hazards); and omits an "Installation Section" (both of which were in parent documents 56F and 56K). This structure is common to requirements documents used for "Construction..." (1-2), and %. design, construction, inspection..." (1-3); and Construction Specifications Institute (CSI) widely accepted format.

The word ~Distribution ~ is vague, and lacks "user friendly" preciseness to direct designers, installers, AHJs, inspectors, certifiers to their respective areas of concern.

225

Section 1-6.2, item 4 appears (actually does in manyplaces in Code 99) to indude components mfgr. requirements, installation, testing- among other aspects of a technical discipline.

This proposal is for user friendliness and consistency with commonly used technical document specifications; including Code 99 parent documents such as 56K (O1. 2 General/ch. 3 Compo- nents/Ch. 4 Alarms/ch. 5 Installation) and 56F (Ch. 1 General/ Chapters 2, 3, 4-Components/ch. 5 Installation).

I urge reconsideration of this proposal - including AIP. It does need improvement.

Proposal 99-12 (Log#HYP-5) (2-2)

Dr. Dornette: (Abstain) My Subcommittee has had Mr. Frankel's complaint before it for a number of years. We have spent a disproportionate amount of time on it, and thought we had finally resolved i t . Reconstituted air can not economically be produced to closer tolerances. Leo Foxwell, Ray Nichols and I are jointly working on a resolution.

Proposal 99-25 (Log #ESE-12) (3-3.2.1.5)

Mr. Fischer:. I do not concur with the action taken by the committee on this proposal.

The intent of this and other ~ r a p h s concerning the essential electrical system is to assure the institution an adequate supply of electrical power when the normal power source fails not a portion of iL

The standard as written, states that if the system is normally used for purposes other than the exclusive use for the essential electrical system then you must have two or more generator sets. You are not permitted to have a single generator when the system is used for other purposes. Given this fact, then if you use the system normally for purposes other than the essential electrical system, and are required to have two or moregenerator sets, then they must be sized so that the demand and all other performance requirements of the essential electrical system can be met with the largest single generator set out of service.

This is not more restrictive for a two generator system than a one generator system as the committee states, since the sentence applies only to a two or more generator system and it only applies if the system is not normally used exdusively for the essential electrical system. The exceptions given are to allow for the excepted usage and still have the system classified as one normally usedfor the essential electrical system exdusively.

If the system is used for other purposes, the subcommittee that originally wrote this, felt that it would compromise the integrity of the essential electrical system. In order to permit other types of usage and ensure the integrity of the essential electrical system, the committee required two or more generators, with the system demand being carried with the largest single generator set out of service. The proposed change would permit a situation where after a generator failed, only the emergency system would have power leaving all the items on the equipment system without power, many of which are required for immediate proper patient care.

I must again stress that the change only affects systems that are not exclusively used for the essential electrical system and therefore are required to have two generators. It is for the reasons stated above that I would, re'~ct the proposal and am therefore voting against the committee action.

Proposal 99-70 (Log #192) (4-1.4, et al))

Mr. McWhinnie: To eliminate the continuing problem of misinterpretation, the following is for the purpose of "user friendly" clarification.

The NFPA Code 99, Chapter 4, 4-7 through 4-10, Medical-Surgical Vacuum Systems (MSVS) document covers a dedicated system, to be used only "for patient drainage, aspiration and suction(ing)" (Scope 4-1.4); and explicitly prohibits uses for "other nonmedical or nonsurgical applications" including Waste Anesthetic Gases Disposal (WAGD). The NFPAVacuum document contains no requirements for Waste Anesthetic Gas(es) Disposal. The WAGD topic is an environmental one which is within, and limited by Chapter 5 Scope, to Chapter'5 Environmental Systems.

Waste Anesthetic Gas(es) Disposal is an environmenud/ventiladng function "for the protection of operating room staff ~, which does not include patients. (See NFPA Health Care Facilities Handbook, 1990, pg. 220 commentary.)

WAGD mitigates the potential deleterious effect on surgery personal of long term exposure to random anesthetic agents in the working environment. It is not a ~patient system" for therapeutic drainage and aspiration - nor is it for the patients, who are administered anesthetic gases intentionally.

WAGD is not within the Scope of NFPA Code 99 Vacuum Systems. It is within the Scope of Code 99, Chapter 5 W~nvironmental Systems" - where it was placed by the NFPA Health Care Facilities Technical Committee, and duly approved by the NFPA Standards Council. Chapter 5 Scope covers all %.. environmental systems used within health care faciliues", and WAGD function is within the requirements text of Chapter 5.

NFPA Code 99 Medical-Surgical Vacuum Systems which are also used for WAGD cannot be certified as in compliance with NFPA requirements.

I. Documentation: Unless otherwise indicated, all following quotations are excerpts from NFPA Health Care Facilities Code 99, 1990, and /o r NFPA Health Care Facilities Handbook, 1990.

A. Scope. "It (WAGD) does not fall within the scope of this chapter (as listed in 4-1.4)."

B. Dedicated for MSVS. ~Naste anesthetic gas disposal (WAGD) is not a function of a medical-surgical vacuum system (MSVS)."

%.. the MSVS is not to be used for nonmedical or nonsurgical applications."

~l'he medical-surgical vacuum system shall not be used for... nonmedical or nonsurglcal applications." (Code 99, 4-10.2.1.7)

"The alarm systems and monitoring gauges required for MSVS cannot be used in a WAGD system."

"WAGD is an environmental control system-..'(exact title of Ch. 5)

~¢¢'AGD is a ventilation function..."

"12-4.1.2 Requirements for ALL Anesthetizing Locations."

~12-4.1.2.1 Ventilation. Ventilation of anesthetizing locations shall conform to... (Chapter 5 Environmental Systems)...for... (all) anesthetizing locations."

'T~ome of the valving and piping material acceptable for use in a MSVS is not acceptable for WAGD."

~A separate system for WAGD is consistent with the (Vacuum) committee's objective for a dedicated system..." (which excludes WAGD).

Note: The Code 99 Chapter 4 Vacuum Document is ~dedicated", and its Scope limits it to ~life support therapy'.

C. Hazards. "...the maximum safe negative pressure for the patient (-0.5 cm H20 ) is 0.0012 percent of the minimum degree of vacuum (required) in the MSVS (-12Hg)" or ~829.3 times the maximum safe degree of negative pressure...for the anesthetized patient."

WAGD applied to MSVS affects ~anesthesia and patient safety."

"...risks to patients."

"Mixing the two creates very onerous safety problems." (MSVS & WAGD)

"The negative pressure differential is vast..."

~...pressure swings can seriously affect patients."

~£here is a great disparity in requirements between the two uses."

At least three involved Anesthesiologists (NFPA and ANSI Committee Chairmen) agree to the documented hazards in the use of MSVS for WAGD.

226

MSVS is not to be used for WAGD "...particularly because of the risks to patients."

Exposure of a patient's breathing drcuit to the MSVS degree of vacuum "would not enable patient to breathe and thus kill patient." (Reported to NFPA HCF T/C, June 19, 1989)

Users are exhorted "to avoid exposing the breathing drcuit to any pressure less than atmospheric." (under score added.) - (NFPA 99, A-5-4.1 and 2 Wendiation of Anesthetizing Locadons.'/ANSI Z79,SC-4 - WAGD Scavenging and Disposal.)

W.ach scavenger (a device intended to reduce the degree of NFPA Code 99, Chapter 4 required degree of vacuum) tested failed to function safely when wall sucdon (MSVS) was applied to the (its) exhaust port." (NFPA HCF Handbook, Pg. 222, Ref. 1.) (This reference cites four potential traumas ff %rail suction" (MSVS) transverses a failed scavenger.)

"...in normal use some scavenging apparatus, even when operating properly, can alter the normal characteristics of an anesthetic breathing machine..." (ANSI Z79.11)

Although the Code 99 Vacuum committee has consdentiously researched this topic it has found no authorities individual or group to support the use of MSVS for WAGD application.

D. Non-patient Hazards. Waste anesthetic gases disposed of through the Medical-Surgical Vacuum System "are known to be incompatible" with the vacuum p p g i in system comLponents - "elastomers (O-rings)...valving (and inlet terminals)...components (containing) aluminum, brass, tin, magnesium and iead.. .-- (components include warning alarm systems' actuators/sensors).

~his (WAGD) acdvity will cause certain deterioration of the vacuum system. ~ (4-7.1.2.1 Note 2)

Wlammable (acknowledged by both Code 99, Chapter 4 committees to be in continuing use) and nonflammable gases are...incumpatible with...medical-surglcal vacuum systems." (last reference above)

~l'he station inlet (vacuum) performance tests (required by Code 99) are extremely important...and should be made at more frequent intervals..." if the MSVS is used for ~waste anesthetic gas disposal".

The "Vacuum Systems (Committee) is concerned that the emergency use of flammable anesthetics adds an additional and unnecessary hazard ifa medical-surgical vacuum system (MSWS) is used for WAGD." (4-7.1.2.1 Explosion Hazard, and 4-2.2 Vacuum Systems)

-Flammable anesthetic or other flammable vapors shall be diluted... ~ (4-7.1.2.1 Explosion Hazard)

'~Mechanical ventilation ~ . . . ( f o r ) . . . d i l u t i n g flammable gases.., n and "dilution of flammable gases (A-5-4.1)

Users are exhorted~...to avoid the dumping of any flammable vapors into a central suction system (MSVS) not designed for such ~ . " (above under-scored added) (A-5-4.2/ANSI Z79-Z79,SC- 4, Anesthesia Gas Scavenging Devices and Disposal Systems.)

As Medical-Surgical Vacuum Systems are completely dosed / pressure tight (per NFPA Code 99) there is no ambient dilution.

No Code 99 MSVS, or their pumps, are ~designed for such operation" (per NFPA and ANSI refs. last above).

There are at least three systems* (two of which are designed and built into every exisdng, and new, health care fadlity-which provide dilution, are much less costly, and safer for the anesthetized padent) all three of which "have been demonstrated to be effective for WAGD." and ~I'hey meet the intent of ANSI Z79.11-1982 that the pressure of a scavenging system approximate very dosely ambient pressure in normal use./" (NFPA Handbook, pg. 221, item 1).

*(Ambient differential, nonretum portion of ventilation system, and low differential blower/dampened-plenum/duct system.)

E. NFPA Code 99, 1990, "Chapter 5 Environmental Systems".

Chapter 5 Scope coves/includes any %f the environmental systems used within health care facilities. ~

Is dearly, per its very dde, Scope and recjuirements' text, for the "Ventilation (of both types of) Anesthetizing Locations. ~ (5-4.1, 5- 4.2, A-5-4.1 and 2; and 124.1.2 and 12-4.1.2.1)

"Requirements for ALL Anesthetizin~ Locations. Ventilation. u (12- 4.1.2) - refers the designers, installers, mspectors, AHJs and health care fadlities to specific Sections of Chapter 5 'Xnvironmentai Systems%

F. Index. "Chapter 5 Environmental Systems" is referenced for user guidance in Code 99 Index after the following main listings:

"Environmental systems ~ "Exhaust systems u "Fume hoods ~ "Scavenging apparatus'** "Ventilation" 'q~raste disposal u (requirements, 5-4.1.6)

*(used for the exact same purpose as "Scavenging apparatus ~)

** (an essential component of WAGD system - see the last few paragraphs under q-Iazards" above.)

The above main Index headings, along with the same terms in subheadings, appear in Code 99Index more than twenty times - all referring the user to Chapter 5 Environmental Systems.

Significantly, under Index "Medical-surgical vacuum systems" there is no subheadings for WAGD - but there is a subhead for ~Nonmedical use ~ (4-10.2.1.7) -which Sl~dfically prohibits the use of Medical-Surgical Vacuum Systems for the disposal of waste anesthetic gases.

The NFPA HCF Technical Committee's placement of WAGD as a requirement in Code 99, Chapter 5 with the required approval of the NFPA Standards Council, confirm all of the above fact,* and intent- that the technology of Waste Anesthetic Gas Disposal is an environmental/ventilation function "for the protection of operating room staff".

II. In addition to the references herein, and in the NFPA Health Care Facilities Handbook, 1990, pg. 222, see DESIGN AND INSPECTIONS/GOVERNING CRITERIA, item 4 , which is attached, and material to this topic.

The present WAGD references in Code 99, Chapter 4 contain an NFPA acknowledged hazard, which is inconsistent with the clear intent evidenced by the above documentation. This has presented a dilemma for A/E designers, AHJs, inspectors and other users of Code 99, as those references are misleading.

This review follows concerned inquiries at health fadlity conferences, related presentations, training programs, and from the field - indicating confusion and misunderstandings. It is intended as an aid to those responsible prindpals involved in these critical health care fadlity systems.

III. With the authoritive documentation above, and without substantiation, or design and performance criteria (per NFPA Committee Leadership Conference guidelines, Style Manual and Regulations), Medical-Surgical Vacuum Systems cannot be certified as being in conformity with NFPA Code 99, Otapter 4 requirements.

Proposal 99-154 (Log #125) (4-7 to 4-10)

Mr. McWhinnie: The Vacuum Committee has voted 82% in favor of this Proposal - consistent with two previous o v e r w h e l m i n . . . g votes, one of which was a stogie vote short of unantmous.

This proposal also was approved (82%) to unite the Vacuum Scope and discussion, 4-1.4 through 4-2.2, with its texL This is in accordance with NFPA 1M, Manual of Style, 1-1. See Log 195 Substantia- tion Items III c_, 1-1, 2-1.1, 2-2.1, 7-6.1, 7-6.$; and Code 99, 1-6.2.

As the T /C initially denied (and then amended to a failure to- recall, 10/22/91) its promise of a "stand alone chapter s the following TCR excerpt is submitted:

SUBMITTER: Bruce W. Osborne, FIT Pneumotive. ]7~ECOMMENDATION: Incorporate the entire contents of the latest version of NFPA 56F, Nonflammable Medical Gas Systems as a stand alone chapter in the soon to be reprinted NFPA 99, Health Care Fadlities, ] 9 8 .

227

SUBSTANTIATION: It made sense to include NFPA 56K, Medical- Surgical Vacuum Systems in hospitals (updated) in NFPA 99. The same rationale used to implement that change applies in regards to the proposal submitted in the above paragraph 2.

The Committee response to the above was the assurance of a "stand alone chapter" (the essence of the proposal) - and assuming it was within its scope "this Committee (current HCF T/C) will accept responsibility for iL a*

This was enough assurance that neither of the affected subcommittees was represented on the T / C restructuring ad hoc.

*("Committee comment. .................. ) (Text of fax unreadable)

The negative effect of combining these diverse dlsdpline is widely evident- as documented by several actual A/E project specifications which were provided to the T /C - illustrating the predicted confusion.

Contrary to the T /C Statement of"no new information..." the following (presented to the T /C 10/22/91 additional excerpts further document the serious and hazardous, confusion of combining these two widely disparate (opposite in this context) technologies in 99, Chapter 4.

These excerpts are from a current, vresent, project -still, as of this writing. - under construction - completion scheduled for Feb., '92:

(Documentation available from Secretary, Standards Council, at NFPA headquarters)

* This is a very serious hazard (re: installation of vacuum pressure switches immediately downstream of vacuum pump system) to patients, totally opposite to NFPA Vacuum requirements; but it is a requirement for NFPA Med-Gas systems.

No problem with the Medical Vacuum system, nor even it's complete failure, will ever be signaled by the required Vacuum alarm. (These sensors are in the vent/exhaust line to outside atmosphere.)

Degradation of the patient vacuum system will negatively affect patient suction therapy- even to the extent of a fatality in critical surgery; bio-lateral pulmonary suction;.., among others.

This project also requires secondary check-valves in thepatient vacuum inlet terminals- which are ~ in the NFPA Vacuum document - but are ~ by NFPA for patient gas outlets.

This requirement is certain to, at best degrade ....... (text of fax unreadable).

Because of these, and other code deviations resultingfrom Gas/ Vacuum confusion - and confusion of Vacuum/WAGD, the hospital has to make many changes. It has already abandoned WAGD devices and lines which were connected to the medical vacuum system and is installing a dedicated/separate WAGD system.

"c. Independent testing agency is: Mr. David McWhinnie,Jr., 9131 West Chestnut Drive, Hickory Hills, Illinois 60467. Telephone: 708- 839-8810."

It would be impossible for a qualified "certifier" to certify these systems as designed and partially installed. Prior to this contract others had certified earlier portions of this multi-phase project- which had to be decertified and corrected. (See Log 193 Substantia- tion I)

This project also requires Type K copper piping, silver brazed for vacuum and WAGD --which are not required by NFPA- and for WAGD are ludicrous. (also see Project 74fi-A in T /C files)

In answer to the T /C inquiry 10/22/91 our records (phone calls and correspondence) reveal a minimum of 17 inquiries indicating serious confusion and misinterpretation in connection with Chapter 4 Gases/Vacuum/Waste Anesthetic Gas Disposal, including a number referred by NFPA.

This dilemma results from a T /C Proposal: 1) which lacked a real or valid Substantiation (Log 193 Proposal Substantiation II), and 2) failed to respond to the often asked question as to the NFPA Form for Proposals, item 4, requirement for "Statement of Problem and Substantiation.~(Log 193 Proposal, page 4 exhibit dated 11/28/86.)

This NFPA 99, Chapter 4 Vacuum document structure contravenes NFPA Committee Leadership Conference basic guidelines; Code 99, 1-6.2 format; NFPA Manual of Style 1-4, 2-1.1, 7-1 (e), 7-6.3 (See Log 193 Proposal Substantiation Ill).

This Proposal has not received the depth of consideration necessary for an issue of this magnitude, and deserves more than cursary oversight. The need for a comprehensive study of this issue has been provided by the ~aell qualified experts which the T/C needs" (quote from T/C records) - as evidenced by the Vacuum Committee action on this Proposal.

Contrary to the claim in one nonconcurrence ballot on this Proposal, there couldn't possibly.be any "increase in the amount of written text ~ - and all above is sertous, and documented,justification for its Proposal.

This Proposal puts the Vacuum document in accordance with Code 99, 1-6.2; the intent of the former Vacuum T/C; the present Vacuum SS/C; the NFPA Manual of Style; NFPA Part VII Regulations - and makes it much more user friendly.

This Proposal is also consistent with the Standards Council dispatching of a delegation to preserve the separation of these two documents at an ANSI hearing, RF: Appeal to combine Gases w/ Vacuum. ANSI concluded that these documents be separated.

Proposal 99-153 (Log#194) (4-8.1.1.10)

Mr. McWhinnie: The partial approval of Log 194 exdudes the relocation of 4-8.1.1.10 which is an installation/~Execution (CSI)/ installers' procedure method.

The Proposal Recommendation Statement- "Delete 4-8.1.1.10, (etc)" was a poor choice of wording - as that Section is not deleted (as it might have appeared to some). It was intended simply to be relocated- where it becomes proposed 4-9.1.2.1.

What has been approved by the SS/C and T/C meets the intent of the proposal - to leave the listing of the required components in present Section 4-8.1.1 - which h'sts all of the required materials and components. These are all unrelated to "Execution" - or "Installa- tion" (which has now been approved as new 4-9.1.2).

4-8.1.1.10 is not a material or component but only requirements for "Execution"/Installation - the installers' workmanship, methods, techniques by excluding 4-8.1.1.10 from approved Section 4-9 it leaves that Section (4-9) with only some of its installation requirements - and leaves Section 4-8 with components (properly) - but also only some installation requirements which are now missing from Section 4-9. Section 4-9 covers everything from the general performance/overview perspective - to the final testing - between which the installation must be done.

Without present 4-8.1.1.10 the approved Section 4-9 provides performance requirements which installers must know up-front,-and next comes all the tests, none of which can be accomplished without first installing all of Section 4-8 components. Section 4-9 now tells the installer how the system is to perform - and how it should be tested. But by excluding proposed 4-9.1.2 and 4-9.1.2.1 (present 4- 8.1.1.10) Section 4-9 tells the installer nothing about how the system is to be installed to meet NFPA requirements.

In summary, with the exception, 4-8 covers components and only some installer requirements. 4-9 covers general-overview performance and testing but no installation procedures.

I urge the Committee to reconsider this matter.

Proposal99-184 (Log#184) (7-5.1.3.5)

Mr. Burnett: This and Proposals 99-185 (Log #71) and 99-209 (Log #185) all relate to the change in the leakage current requirements from the present value of 100/a to a new (higher) value. Substantia- tion discussion provided with Proposal 99-184 (Log#184) clearly supports raising value to 500/a. Such a value would continue to provide the required level of safety and would also bring the U.S. standards into closer agreement with standards of the IEC and Canada.

Mr. Kiffmeyer. 1 ) Decision to reject is based on a limited data base that has not been updated for many years. 2) The experience rate based on 500At in Europe was not considered.

228

Proposal 99-185 (Log #71) (7-5.1.$.5(a))

Mr. Burnem [Same reason as given for Proposal 99-184 (Log #]84).]

Mr. Kahn: Based on the reports and data presented, the basic rule should be =...not to exceed 500 microamperes" with specific exceptions listed where lower levels are required to insure patient safety.

Mr. Kiffmeyer. The 250/a value was based on operating parameters of frequency (Hz), voltage and current (Re: Study referenced in Proposal 99-184 (Log #184)) without regard for product wiring. This rationale would allow 500/a a t 940+ operating voltages.

Proposal 99-209 (Log #185) (9-2.1.13.4(c) (1))

Mr. Burnett: [Same reason as given for Proposal 99-184 (Log #184).]

Proposal 99-225 (Log #103) (10-7.2.5)

Mr. Ihlenfeldt: I agile the current wording of 10-7.2.5, which prohibits the storage of all flammable or combustible liquids in ordinary refrigerators, is probable too restrictive. However, the second part of this proposal, Log #105, goes too far in easing these restrictions. The proposal assumes there is n'o-'fiazard posedby storing any flammable liquid with a flash point of 40 degrees F or greater in an ordinary non-listed refrigerator. This is not correct. The temperature control thermostat of an ordinary refrigerator can easily be set above 40- degrees F.

Any refrigerator can also be used for storage of room temperature chemicals with the power turned off. The reference to the task of fire hazard or beer or low proof whiskey in the proposal substantiation is not valid. The low hazard of these liquids is due to the extreme dilution of the alcohol. Beer is mostly water and most whiskey is over 50% water. Concentrated liquids with flash points of 40 degrees F and 70 degrees F stored at room temperature or any temperature above flash point can pose considerable fire hazard.

The proposal could be made acceptable by raising the temperature cut-off from 40 degrees F to 100 degrees F. It is extremely unlikely that ambient temperatures in a lab environment, even in a refrigerator with the power turned off, would ever exceed 100 degrees F.

The current philosophy of the Laboratory Subcommittee, and the Technical Committee by overall acceptance of the subcommittee report, is to correlate Chapter 10 of NFPA 99 with NFPA 45 where it is prudent to do so. This makes sense in light of the overall concept

) of "user friendly" NFi A standards. The proposed modification of 10-7.2.5 of NFPA 99 is in direct conflict with 9-2.2.2 of NFPA 45. See also the good explan:ltory material in A-9-2.2.2 of NFPA 45. NFPS 45 currently draws the line at 100 degrees F flash point as suggested above. (See the definition of Flammable Liquid in B-1 of NFPA 45, taken from NFPA 50).

I vote negatively on this proposal as stated and encourage the committee majority to do the same.

Mr. Koffel: The submitter infers that domestic refrigerators should be acceptable. While NFPA 45, Standard for Laboratories Using Chemicals, permits modified domestic refrigerators, the Appendix note discusses the modification necessm3,. Similar guidance has not been proposed for NFPA 99. The submitter has also deleted the text concerning the individual containers. The submitter also presumes that all refrigerators will be maintained at 40 degrees F or less. This is not necessarily an accurate assessment of current practice.

Proposal 99-$29 (Log #DIS-2) (Annex 1, 1-3.4)

Mr. Mattern: Reason for negative ballot is that the proposed wording is not complete enough, and lacks direction for persons wishing to use this standard effectively.

While I ai~'ee in principal with the Subcommittees proposal, and the Committee's actions on the concept that is being presented, I feel that the action is not complete enough and could lead to discrimination against some minority groups.

Substantiation: In the hospital that I work in there are twenty-four (24) known languages spoken and in the community that we service there are thirty-seven (B7) different languages spoken and over 100 dialects from those basic thirty-seven languages.

I have a problem in determining when I should stop adding language information. As an example, ifI were to take the proposed standard as written, or if an A.H.J. were to enforce this proposed standard as written to have a sign that reads "IN CASE OF FiRE DO NOT USE ELEVATORS USE STAIRWELLS n I would have a sign that would measure approximately (16) six-teen inches by (4) four feet and at that I would have only covered the ~7 basic languages, and none of the dialects.

If this proposal were to have some number in it, I would feel much more comfortable in attempting to comply with this requirement, and not offend any of our good friends whose language may not be included in this sign.

Part II of this Report was prepared by the Technical Committee on Health Care Facihties, and proposes for adoption amendments to NFPA 99B-1990, Standard on Hypobaric Facilities. NFPA 9913-1990 is published in Volume 5 of the 1991 National Fire Codes, and in separate pamphlet form.

Part II of this Report has been submitted to letter ballot of the Technical Committee on Health Care Facilities, which consists of 27 voting members, all of whom voted affirmatively.

229

N F P A 99 m F92 T C R

PARTI

(Log # 56) 99-9-1- (F.Aitiozl - Edition): Rej~_t 8 u a M r r l g L w t ~ e gtrcher, Allied Hetlthcare Produca IIECOlgfl~dlT, NDATION: Add statement to front:

"This standard is revised every 3 years. Please check to make sure you are using a current revision." SUBSTANTIATION: We have people who are still trying to use old editions of NFPA 56F. COMMITIT,~ ACTION: Reject. COMMITTEE STATEMENT: NFPA can not mandate which edition of an NFPA document is to be used.

(LOg # 55) 99- 2 - (Entire Standard): Reject SUBMrlWER: Wayne garcher, Allied Healthcare Products RECOMMENDATION: Add page number when Appendix is referred to. SUBbWANTIATION: To prevent havingto thumb through the last 98 pages of NTPA 99 to find the properAppendix. COMMITTEE ACTION: Reject. COMMITrgg STATEMENT: At present, reference to appendix material is by paragz~_ph number, and is considedered adequate. Rest of document refers to other material in document by paragraph number.

(Log # 54) 99- 3 - (EntLre Standard): Accept in Principle SUBMITTER: Wayne Karcher, Allied Healthcare Products RECOMMENDATION: Revise text as follows:

"Update and publish NFPA 99C gas and vacuum systems as was done in 1987.'- SU~TANTIATION: NFPA 99C was easier for contractors and

~ lumbers to use. MMITIT~ ACTION: Accept in Principle.

Publish Chapter 4 of NFPA 99 plus applicable definitions from Chapter 2, portions of Chapter 12 to I7, and appropriate appendix material. COMMrrTF~ STATEM]Dfr: To make NTPA 99C complete, there is a need to include portions of Chapters 12 to 17 that state where requirements of Chapter 4 are applicable. [Issue is an NFPA management derision. The Technical Committee will recommend to NFPA management that this text be excepted from NTPA 99, and be printed and made available.]

(Log # 57) 99- 4 - (Entire Standard): Reject SUBMITrER: Wayne Karcher, Allied Healthcare Products RECOMMENDATION: Why doesn't NFPA have waining class for NFPA 99 like they have for the Life Safety Code, NFPA 101. SUBSTANTIATION: Education would bring about a better understanding of the Health Care Facilities Standard. COMMrFrEE ACTION: Reject. COMMrlWEE STATEMENT: Not a proper proposal. Issue will be referred to NFPA's Education Department.

99- 5 - (Entire Standard): Accept in Part S U B M r r r E ~ Paul K. Heilstedt, BOCA International RECOMMENDATION: Revise as follows: 1. Section 2-1; Official NFPADefinitions TIC a. Code

Replace "may be included only" with "is included'. T /C b. Standard

Replace "may be included only" with "is included'. Section 2-2; Definitions of Terms Used in the Standard

MGS a. Bulk 0xygen Sys..tem Replace ~ma.~ be with "are" in the eighth line and "raay be with "is in the ninth line.

ESE b. Critical Branch Replace "can" with "are permitted to" in the fifth line.

GAS c. Cylinder . Replace may with "are permitted to".

(Log # 195)

ELE d. Direct Electrical Pathway to the Heart Replace =may be" with "those" in the sixth line.

ANE e. Flammable be" with ,ed" ,he

LAB f. Fume Hood Replace *may not be" with "are not" in the fourth line.

ESE g. Grounding S~tem Replace h-aay be" with "is" in the third line.

ELE h. Impedance Delete "may" in the third line.

HYP i. Intrinsicall~t Safe Delete "may" m the fifth line.

LAB J, Labortmry Work Ares Replace "may or may not" with *is not required to" in the third line.

ELE k. Leakage Current Replace ¢may be" with "is" in the third line.

ESE 1. Life Safety Branch Replace "can" with "is permitted to in the fifth line.

MGS m. Medical Compressed Air (b) Delete the last sentence or relocate in a nonmandatory Appendix as the information it contains is commentary.

T /C n. Nursing Home Replace "niay be" with "are" in the third line.

GAS o. Oxygen, Liquid . Replace "can" with "will in the last line.

HYP p. Oxygen Toxicity (Hypobaric) Replace "may occur" with "occurs" in the fourth

line. ELE q. Patient Lead

Replace "may carry" with "carries in the second lin/~ and "may be'- -" with "is" in the third line.

ELE r. Patient Viclnity Replace "can touch" with "touches in the third line.

MGS s. Piped Distribution System Replace "may be" with "are" in the fourth line.

MGS t. Single Treatment Facility Replace "may get with "gets" in the seventh line.

GAS u. Tube, Endotracheal Replace "may" with "is permitted to'.

ANE v. Tube, Tracheotomy Mcs ;om Y" with "is pe tted to"

Replace "may comprise" with *is permitted to be comprised of'.

ESE 2. Section 3-2.1 Re..place...~ay be" with "are" in the t int line and £ I . 3 U A U i H l t ~ .

ESE 3. Section 3-2.4.1 The first three paragraphs should be deleted or relocated in a non-mandatory Appendix as the information they contain is commentary,

ESE 4. Section 3-2.4.2 Replace "may be" with *is" in the second line.

ESE 5. Section 3-3.2.1.1(0 Delete "could" in the second line.

ESE 6. Section 3-3.2.1.1(g) Replace "could not be" with "are not" in the third line.

ESE 7. Section 3-3.2.1.15 Replace -may be" with "will be" in the frost line of the third paragraph.

ESE 8. Section 3-4.1.2.6(a) a. Replace "may be" with "is" in the third line. b. Replace "may be waived provided that a" with

"are not required when" in the second line of Exception No. 2.

ESE 9. Section 3.4.2.1.4(a), Exception Replace "may be" with "is" in the first line.

ESE 10. Section 3.4.2.1.4(k) Replace "may" with ~wili" in the third line.

ESE 11. Section 3.4.2.2.3(d) (2) Replace "may be" with "are" in the last line of the second paragraph.

ESE 12. Section 3-4.3.2.1 a. Replace "may" with "is permitted to" in the

third line. b. Replace "may be" with "is permitted to" in the

eighth line.

230


ESE 13. Section 3-4.3.2,2 l~eplace "may" with "is permitted to" in the first

ESE 14. Section 3-4.3.3.3 1. Replace "can" with "will" in the third line. 2. Replace =may - with "is permitted to" in the

tint line of the Exception. ESE 15. Section 3-5.1.2.2(a) (5)

Replace "should fail" with "fails" in the first line. ESE 16. Section 3.5.1.2.2(b) (5)

Replace "should fail" with "fails" in the first fine. MOS 17. Section 4-5.1.2.1(g) ,,

Replace -may with ~ in the fifth line. MGS 18. Section 4-$.1.2.4(a)

~R~place "may" with "is permitted to" in the ninth

MGS 19. Section 4-3.1.3.1 a. Replace "can be ignited" with "will ignite" in the

tint line. h be ite." with ite" in the

MGS 20. Section 4-3.1.8.5 Replace "may" with "is permitted to" in the fourth fine.

MGS 21. Section 4-8.1.9.2 a. Replace "may" with "is permitted to" in the

third line of(a), b. Replace "may" with "are permitted to" in the

tint fine of the fourth paragraph. MGS 22. Secdon 4-3.1.9.4

a. Replace "should the in.eervice unit be" with "wl~en the in-service unit becomes* in the fifth line of the firstpav""'a~h.

b. Replace "should the m-eervice unit be" with *when the in-service unit becomes" in the fourth fine of (a).

MGS 23. Section 4-3.2.2.1 Replace "may" with "is permitted to" in the fifth fine.

MGS 24. Section 4-4.1.2.1 I. Replace "may" with "are permitted to" in the

fofirth line of (c). 2. Replace "may" with "are permitted to" in the

second fine of (d). 3. Replace "may'with "are permitted to" in the

fifth fine of (e) 4. Replace "may'with "are permitted to" in the

sixth line of (f). MGS 25. Section 4-4.1.2.2(b)

Replace "can be" with "is" in the fourth fine. MGS 26. Section 4-4.1.2.8(a)

Replace "may" with "shall" in the second fine. MGS 27. Section 44.1.2.4

1. Replace "may" with "shall" in the fourth fine of (d).

2. Replace "may be" with "are" in the fourth fine of (e).

MGS 28. Section 4-4.1.4.1 1. Replace -may" with "shall" in the first and

fourth fines of (a). 2. Replace "if neceum7" with "When the initial

cleaning does not completely clean the components of oil, grease or other readily oxidizable materi ah" in the sixth fine of (a) (1).

MGS 29. Section 4.4.3.1 (b), Exception Replace "may" with -is permstted to" in the last fine.

MGS 30. Section 44.3.1.1 Replace *if necessary" with "when the initial deanin 8 does not completely clean the components of oil, grease or other readily oxidizable matenah" in the fourth line.

MGS 31. Section 4~.I.2.3(a) (I) Replace -may" with "wili" in the last fine.

MGS 32. Section 4.5.1.S.4(b) (1) Replace "can" with "shall" in the seventh fine.

MGS 33. Section 4-5.1.4.1(a)(I) Replace "may be" with "are" in the first fine.

MGS 34. Section 4-6.2.1.2(m) Replace "may" with "will" in the fifth fine.

MGS 35. Section 4-6.2.2.2(a) Replace "may be" with "are" in the first fine.

MGS 36. Section ~-6.2.4.1(a) Replace "may" with "is permitted to" in the third llne.

MGS 37. Section 4-6.£.4.2 Replace "may" with "is permitted to" in the first fine.

MGS 38• Section 4-6.2.4•6 Replace "may be" with "are" in the fourth line.

VAC $9. Section 4-8.1.1.2 I. Replace "may" with -is permitted to" in the fifth

fine of m b p ~ h (f). 2. Replace "may" with is permitted to in the fifth

fine of subparagraph (g). ANE 40. Section 5-4.1.5

Replace "may" with "are permitted to" in the second line•

ANE 41. Section 5-4.2.5 Replace "may" with *are permitted to" in the tenth line.

LAB 42. Section 5-4.3.2, Exception Replace "may" with "are permitted to" in the third fine.

LAB 43• Section 5.4.4.5 Replace "may" with "shall" in the third line of the second paragraph.

ANE 44. Section 6-2.3 Delete "may" in the second fine.

ELE 45. Section 7-1.2 a. Replace "may" with "is" in the second line. b• Replace "may relate" with "relates" in the third

fine. ELE 46. Section 7-2.1

Delete "may" in the fourth and eighth lines. ELE 47. Section 7-5.1.2.2

Replace "may be" with "are also" in the sixth fine• ELE 48. Section 7-5.1.2.5

a. Replace "may be" with "are" in the seventh fine of Exception No. 1.

b• Replace "may" with "are permitted to" in the second fine of Exception No. 5.

ELE 49. Section 7-5.1.2.7 a. Replace "may" with *is to" in third line of (a). b, • Replace "may" with "shall" in the third fine of

(c). c. Replace "may" with "shall" in the fourth fine of

(0 (4). d. Replace "may" with "shaH" in the ninth fine of

().g~, ELE 50. Secdon 7-5.1.$.7

a. Delete "that may be" in the first fine of (b). b. Replace "may be" with "are" in the second fine

of Co), Exception No. 2. c. Delete "may* in the fourth fine of (b), Exception

No. 2. ELE 51. Section 7-5.2.2.1

Replace "may be" with "are" in the third line. ELE 52. Section 7-6.2.1.4, Exception ,

Replace "may" with "are permitted to in the first line.

ELE 53. Section 7-6.2.1.5 Delete "(such as those that may still be in use in anesthetizing locations)" in the fourth line or relocate to a non-mandatory Appendix as this information is commentary.

ELE 54. Sect/on 7-6.2.1.7 Delete "may" in the fourth line.

GAS 55. Sections 8-2.1 through 6-2.4 Delete these sections or relocate them to a nonman.tiatoryAppendix as the information they contain Is commentary.

GAS 56. Section 8-8.1.7 Replace "can be attached" with "attach" in the fou?th fine.

GAS 57. Section 8-3.1.8 Replace -may result" with "remits" in eighth fine.

GAS 58. Section 8-5.1.2.1(d) Replace "as described in" with "in accordance with" in the third line.

GAS 59. Section 8-6.2.1.3 a. Delete "Prudent pracdce dictates that in" in the

first line of (b). b. Reword the third line of (b) to read: "... nursing

units ~ be placed on . . . " c. Replace (c) with "Sparking toD, shall not be

permitte into any pediatrics nm-dng unit in which oxygen tents or oxygen hoods are used."

231

N F P A 99 - - F92 T C R

GAS 60. Section 8-6.2.2.4(b) Replace "may" with "shall" in the second fine.

ELE 61. Section 9-2.1.2.1 a. Replace ~nay" with "shall" in the second line of

(b), Exception No. 1. b. Replace "may" with "are permitted to" in the

fou/~ fine o f (c). ELE 62. Section 9-2.1.2.2(d), Exception

Replace "may" with "shall" in the second fine. ELE 63. Section 9-2.1.8.2

Replace "could result" with ~'e~dta" in the fourth line.

ELE 64. Section 9-2.1.9.2(b) (5) Delete "Since the operator holds the hi~gh-voltage patiet electrode paddles and defibrillation maybe a hurried emergency procedure," or relocate in a nonmandatoryAppendix as this information is commentary.

LAB 65. Section 10-2.1 Delete entire section or relocate to a non.mandatory Appendix as the information it contains is colnlnenUkry.

LAB 66. Section 10-2.2.1.1 Replace "may" with "will" in the first fine.

LAB 67. Section 10-2.2.$.1 Delete "may" in the fourth fine,

LAB 68. Section 10-$.1.1 Exception No. 2 Replace "may" with "shall ~ in the first fine.

LAB 69. Section 10.5.1.1 Replace "are not" with "shall be" in the first fine.

LAB 70. Section 10-5.1.2 Replace "are not" with "shall be" in the first fine.

LAB 71. Section 10-6 Replace "may be" with "are" in the second line.

T/C 72. Section 12-2.4 Delete "may" in the third line.

ELE 73. Section 12-2.6 a. Replace ~c~ay" with "are permitted to" in the

thirst line of the first paragraph. b. Delete "may" in the sixth'3.ine of mbparagraph

(a). ANE 74. Section 12-4.1.1.1

Delete entire section or relocate to a non-mandatory Appendix as the information it contains is corlLrnentary.

ANE 75. Section 124.1.I.5 a. Replace "may be" with "are" in the fourth fine of

(b). b. Replace "may" with "shall" in the second fine of

the second, third p arag~_ phs and in the first fine of the fourth paragraph of (c).

ANE 76. Section 1~-4.1.2.4(d) Replace "may be" with "is" in the fifth fine.

ANE 77. Section 12-4.1.2.6 a. Replace ~aay" with "are permitted to" in the

first fine of (c). b' firIRetPlinlaCe :~.n(e~ with "are permitted to" in the

ANE 78. Section 124.1.$.4 Replace "may" with "are permitted to" in the second fine.

ANE 79. Section 12-4.1.8.5 a. Replace "may" with "are permitted to" in the

third fine of (a), Exception No. I. b. Replace ".may" with "~re permitted to" in the

seventh and ninth fines of(g). ANE 80. Section 124.1.8.8

3. Replace _':gay" with "are permitted to" in the fifth fine of (d) (2).

b. Replace "of necessity apparently" with "required to be in the first line and-replace "may" with "shall" in the third line of (e) (5).

c. Replace "ma_ y" with "are permitted to" in the third line of (e) (7).

cL Replace "may" with "are permitted to" in the fourth line of (O (1).

e. t Re~l~e "way be" with "are" in the first line of

ANE 81. Section 12-4.1.8.9(e) Delete the second sentence or relocate it to a non.mandatory Appendix as the information it contains is commentary.

ANE 82. Section 12-4.1.S.10 a. Delete "may" in the second line of (c). b. Replace "may" with "shall" in the second line of

(e). ANE 85. Section 12-4.1.3.11(a)

Replace "may" with "are permitted to" in the fourth line.

ANE 84. Section 12-4.1.3.1$(e) Delete "may" in the fourth line.

ANE 85. Section 124.1.4.2 Replace "may" with "fl~ll" in the fourth line.

ANE 86. Section 13-4.1.1.1 & 13-4.1.1.2 Delete both sections or relocate them to a nonmandatory Appendix as the information they contain is commentary.

ESE 87. Section 16-3.$.2(a) Replace "may need" with "needs" in the second line.

ESE 88. Section 17-8.3.2(a) Replace "may need" with "needa" in the second line.

HYP 89. Section 19-1.1.1 through 19-1.1.4 Delete these sections or relocate them to a nonmandatory Appendix as the information they contain is commentary.

HYP 90. Section 19-2.2.4 Reword the second sentence to read "At least 150 percent excess pau-through capacity shall be provided, for ftiture use."

HYP 91. Section 19-2.3.1 Delete *whenever possible," in the tint fine.

HYP 92. Section 19-2.3.~ Replace "may" with "are permitted to" in the first fine.

HYP 93. Section 19-2.4.1, Exception Replace "should" with "shkU" in the second line.

HYP 94. Section 19-2.4.3 Replace "may" with "shall" in the second and fifth fines.

HYP 95. Section 19-2.5.3.$ Replace "may" with "are permitted to" in the fifth fine.

HYP 96. Section 19-2.7 Replace "may" with "are permitted to" in the second line.

HYP 97. Section 1~2.9.1.2, Exception Replace "may with "are permitted to" in the third line.

I-IYP 98. Section 19-2.0.2 a. Replace "should" with "shall" in the fourth fine. b. Replace ~lay with "are permitted to" in the

seventh and eleventh fines. HYP 99. Section 19-3.1.2

Replace "should" with "shall" in the ninth fine. HYP 100. Section 19-3.1.5.3

Delete entire section or relocate to a non-mandatory Appendix as the information it contains is commentary.

HYP 101. Section 19-3.1.5.4(d) Delete "may" in the second sentence,

HYP 102. Section 19-3.1.5.5(c) Replace "may" with "are permitted to" in the third fine.

HYP 103. Section 19-3.1.5.8 Replace "should" with "shall" in the third fine.

HYP 104. Section 19-$.3.1.1 Replace "may" with "are permitted to" in the third and fourth fines.

HYP 105. Section 19-3.4.3.1 Replace "should" with "shaLl" in the second fine.

HYP 106. Section 19-3.6.2.2 Delete "may" in the fourth line.

SUBSTANTIATION. The ba ~ for my comments is the lack of clarity in the entire standard caused by the widespread me of ~ermiuive and unclear terms, such as the terms "may', "can" and should'. The me of these terms dim~pu the puxlxne of the

standard by not clearly statingthe requirements for the standard in simple mandatory language. I t is my recommendation that this standard should undergo a complete review as a mandatory standard. My detailed comments follow. Supporting material available for review at NFPA Headquarters.

COMMI'I'T]~A_L~ON: (T/C) Reject 1. (2-1, "Code and "Standard"). Reject. l.n. Reject. 72. Reject.

232

NFPA 99 - - F92 TCR

COMMrrTE~ ~rATlgMl~q'r: 1. (2-1, "Code" and "Standard"). These terms and their definition are made by the NFPA Standards Council, and are not wlthin the jurbdictlon of thb Committee to m o b d ~ . " .

1.n. Wording b an accurate statement on Committee intent. 79. Recommendation would change intent of Committee.

COMMITTEE ACTION: (LAB) Accept in Part. l.f. Accept. l.j. Accept in Principle. Change sentence 2 in definition of Laboratory Work Area ('This

work area may or may not be enclosed.') to a Note. 43. Reject. 65. Accept in Principle. See Committee Action on Propo~199-913 (Log #LAB-3), which

a d ~ thb imle. 66. Reject. 67. Reject. 68. Accept in Principle. Change "may" to "dmli be permitted to" in Exception 9 of 10-3.1.1.

69. l~ject. 70. Re]ect. 71. Re]ect.

C O ~ J ' ~ E E STATEMENTs l.j. Material is explanatory, and is thus made a Note to conform toNFPA Style Manual.

43. Committee intent was not to restrict penon just to staff members. See also, Committee Action on]h'opmal 99-161 (Log

65. Material was moved to a Note, per Committee Action on Prop?m199-915 (Log #LAB-5).

66. Laboratories should not be required to have hazards, which the propo~d would do. Committees intent b for hazards to be evaluated.

6T. Emergencies are not mandated. Current wording is appropri. ate for contingency wordinjg.

68. Intent o f Committee m not to require openings to be held open, but rather how they are to be allowed to be held open, if desired.

69. Paragraph 10-5.1ol b a conditional clame of 10-5.1. 70. P m-ag~tph 10-5.1.9 is a conditional clause of 10-5.1. 71. Subrmtter's recommendation would change meaning of

paragraph. Use of term "may" does not refer to requirement for an emergency shower or eyeflush.

COMMrrrF~ AG~/'ION: (ELE) Accept in Part. 1.d. Accept 1.h. Accept in Principle In deflnitlon of "Impedance", change sentence 9 ( 'The circuit

element...or inductance.') to a NOTE. l.k. Accept 1.q. Acc.ept in Part In definition of "Patient Lead," make sentence 9 (This may

be...conductive tubing.') new NOTE 1. Make existing NOTE, NOTE 2.

1.r. Reject 45. (7-9.1)

ject Accept

46. (7-9.I) Reject 47. Reject 48. (7~.1.9.5)

a~ Reject b. Accept

49. a. (7-5.1.2.7(a)) Reject b. (7-5.1.9.7(c)) Accept in Principle In sentence 1, change "and may be provided to read "and shall be

permitted to beprovided'. c. (7-5.1.2.7(i)(4)) Accept in Principle End sentence after "ignition of flamr~ble anesthetic mixtures'. d. (7-5.1.9.7(8)) Accept in Principle Change last sentence ('~flash-tube operations...high-voltage

circuit,.') a NOTE. 50. a. Accept

b. Accept c. Accept.

51. Accept 52. Accept in Principle In 74~.1.~.4, Excepuon, delete "may be". 58. Accept In 7-6.9.L5, delete "(such as may be still be used in anesthetizing

locatiom) ". 54. Accept in Principle Change ~'which may include, but are not restricted to, to read as

follows: "including, but not restricted to,'.

61. a. (0-2.1.2.1(b), Exception No. 1) Accept in Principle Revi~ Exception No. 1 to read u follows: "Appliances, used in

special locations or for q>ecial purpmes, equlpp~-d with plugs approved for the location (e.g., 3-4.1.2.4). r

b. (9-2.1.2.1(c)) Accept 62. Accept in Principle In 9-2.1.2.2(d), Exception, change "it may be placed" to read as

followJ: "it ~ be permitted to be placed". 63. Reject 64. Accept In 9-2.1.9.2(b)(5), delete "Since the operator...a hurried emer-

gency procedure," 7S. 1~.2.6 a. Accept b. Acceept in Principle In 12-2.6-(a), change sentence 2 to a NOTE, and revise to read as

follows: "In such areas, patients may be connected to electromedical devices... (rest the same~." C O b l M I T r ~ STATEMENT: 1.h. To conform to NFPA Style Manual

1.q. For sentence 1, Subcommittee intent b that a deliberate connection may or may not carry current at any particular moment.

Sentence 2 is infornmtory, and isthus made a NOTE to conform to NFPA Style Manual.

l.r, Submltter's recommendation changes intent, which b that the definition considers potential conditions for makingconnection

45. a. Submitter's recommendation would mean flint all data are dangerous. Thb is not the Subcommittee's intent.

46. Intent of Section, 7-2 is the describing of hazards. 47. Appliances in question are not always in patients rooms. 48. a. Subcommittee intent b that Exception applied, whether

inserted or not. 49. a. Issue is about labeling and manufacturers indicating

whether their ecjulpment can~oe used in a flammable anesthetizing location. Subrmtter% recommendation would require equipment to be used in flammable anesthetizing locations.

b. Submitter's recommendation would make approval mandatory. is not Subcomnfittee's intent. Subcommittee's action retains

option as intended. c. Deleted wording is redundant, as items in subpar. (i3 are

exceptions to subpan. (a) through (e). d. Submitter's recommendation would create a very umaual

requirement (i.e., Flash robe operation "shall" be accompanied by spar.kin&..), and create a hazard. Making existing sentence a NOTE retains Committee intent as well as conforms to NFPA Style Manual.

59. Editorial. More common way of wording an exception. 54. Editorial. Subcommittee means the same as submitter's

recommendation. 61. a. More appropriate wording for an exception. 62. Submitter's wording would change intent. Subcommittee's

wording retains Committee intent. 63. Su~bmitter's recommendation changes intent. Improper me

does not ~wa~ result in injury or death. 73. b. Submmer's recommendation would change intent; patients

may not alwap be connected to appliances listed. Subcommittee retains intent b~_ changing sentence to a NOTE, and thin conforms to NFPA Style Manual.

COMMI'ITEZ &CTIONt (MSG) Accept in Part. 1.a. Acceptin Principle. In definition of ~bulk oxygen system," change last sentence (The

oxygen containen...as gas or liquid.') to a NOTE. 1.m. Accept. In definiuon of 'medical compressed air," delete the last sentence

ofsubpar. (b) ( 'Localou~de atmosphere...Grade Dreconstituted air.')

l.s. Accept. 1.t. Accept in Principle. In definition of '~ngle treatment facility," change "in which a

person may get to a second level" to read: -in which a person traveh to a second level'.

l.w. Accept. 17. Accept in Principle. In 4-$. 1.-2.1 (g), change "Racks for cylinder storage may be of

wooden construction.': to read: "Racia for cylinder storage are permitted to be of wooden construction." 18. Accept. 19. Accept in Principle. In 4-3.1.3.1, change par. 2 ('Similarly, materlah that can...inidally

at low pressure.') to a new NOTE 2. 20. Accept.. 21. Accept. 22. Accept.

~'3 3


28. Accept. 24. Accept. 95. Accept in Principle, In 4-4.1.~.2 (b), sentence 1, change "mj~p,!y such that" to read:

"supply to permit', and change "can be tsolated" to read: "to be isolated'.

26. Accept in Principle. In 4-4.1.2.S(a), sentence 1, chan~e "systems may be installed" to

read: =systems are permitted to be mstalied'. 27. Accept in Prificiple.

1. In 4-~.1.2.4(d), sentence 2, change "They may be recessed" to read: "They are permitted to be recessed'.

2. In 4-4.1.2.4(e), delete "that may be required." 28. Accept in Principle.

1. In 4-~.1.4.1 (a), sentence 1, delete "may be" in two places. 2. In 4-4.1.4.1 (a)(1), sentence 3, change "If necessary," to read:

"When requirements are not met,'. 29. Accept. SO. Accept in Principle.

In 4-4.3.~11, sentence 1, change "cleaned if necessary," to read: "cleaned when oil, grease or other readily oxydizable materials are present,'. 31. Accept. 32. Accept in Principle.

In 4-5.1.3.4(b)(1), sentence 4, change "Such systems can be checked" to read: "Such systems are permitted to be checked'. 33. Accept in Principle.

In 4-5.1.4.1 (a) (1), change "that may be included as part of an addition" to read: "that are a part of an addition'. 34. Accept. 35. Reject. S6. Accept. 37. Accept in Principle. In 4-6.9.4.2, change "may be located" to read: "are permitted to be

located'. 88. Reject. COMMITTEE STATEMENT: l.a. Material in question is explanatory.

l.t. More appropriate grammar ~ . 17. Submitter's recommendation changes intent of Subcommittee,

which only wants to allow the me ofwocklen racks, not mandate them. 19. Material inquestion is still informatory. 25. Submitter's recommendation would change intent. Subcom- mittee has reworded text to retain intent, and sdll conform to style manual. 26. Itwas not Subcommittee's intent to mandate that surface mounted medical gas rail systems be installed. 97. For 1., Submitter's recommendation would change intent of

text in question. Committee Action retains intent. For 2., Clause is unnecessary.

28. For 1., Editorial; words are not necessary. For 9., Submitter's recommendation would change intent of

text. Issue is with piping received at construction rite, not initial cleaninl~. 30. This situation is reevaluating an existing system when it may

have become contaminated, not a new system and initial cleaning. 32. Submitter's recommendation would change of intent of text.

Committee Action retains intent. 38. Warning systems ma~, not aiwa D be included. Committee

Action reflects that situauon. 55, Use of term "may" is appropriate. The order of use of cylinders

is conditional. 37. Editorial. 38. Use of term "may" is appropriate. Clause is an example, not a

requirement.

COMMITTEE ACTION: (ESE) Accept in Part. l.b. Accept in Principle. Change '~can be connected" to "are connected'. l.g. Accept. I.L Accent in Principle. Change can be automatically connected to "is automatically

connected'. 9. Reject. 8. Reject. 4. Reject. 5. through 16. Accept.

87. Accept. 88. Accept.

COMMITI'EE STATEMENT: l.b. Better statement of intent of Committee.

l.l. Better statement of intent of Committee. 2. Section 3-2 was intended as an informational section for reader

benefit, and has been identified as such.

3. Same reason as for item 2. 4. Proposal would change intent. Interruption of electrical power

is not a~vays a hazard.

COMMrrTEEACTION: (GAS) l.c. Reject(Cylinder) 1.o. Accept in Principle In definition of'O'~/gen, liquid', change sentence $ ( 'If spilled,

the liquid can came frostbite on contact with skin.') to a NOTE under term.

l.u. Reject (Tube, Endotracheai) 55. Reject (8-2) 56. Accept (&3.1.7) ....... 57. Accept in t'rinciple ~.t.oj Revise sentence 2 of 8-8.1.8 to end after the word "avoided," and

make the remainder of the sentence a NOTE. Text would thus read as follows:

"It is particularly important that the intermixing of oxidizing and fiamm~tble gases under pressure be scruj~ulously avoided.

NOTE: Such mixing may result in awolent explosion." 58. Accept (8-5.1.2.1(d)) 59.a. Accept (8-6.2.1.3(b))

b. Accept in Principle Revise 8-6.2.1.S(b) and (c) to become a new (b) to read as follows: (b) Spar.king toys shall not be permitted into any pediatrics

nursing umt. NOTE: Such ~ have been axsoclated with fire incidents in

health care facilities. ¢. Reject 60. Accept in Principle (8-6.2.2.4(b)) Rev~ 8-6.2.9.4(b) to read as follows: (b) Equipment operated at oxygen pressures under 60 tnig (0.414

kPa gauge)~gf~_~4;~g~II~,~L~ be sterilized with nonflammable mixtures, such as et.fiyiene oxide and carbon dioxide or ethylene oxide and fluorocarbon diluents. [Changes Underlined] COMMrI'rEE STATEMENT: 1.c. Cylinder pressure is a matter of the physics of the gas, and has nothing to do with being permitted or not permitted.

1.o Since sentence does not define liquid oxygen, it is made a NOTE to agree with submitter's recommendauon of separating requirements from informatory information (in accordance with NFPA Style Manual). Changing "can" to "will" is not correct in all situations. l.u. Sentence is part of the definition for endotracheai robes,

i.e.,they may or may not have an inflatable cuff. 55. I. Moving material (8-2) to AtDpendix would make document

less user friendly. Original intent of -2 Nature of Hazards was to provide this guidance at the beginning of each c _l~_pter. 2. Section 8-2 is dearly identified as ~Nature of H~rds," and has

not presented a problem to users of the document as far as the Subcommittee is aware. 57. Some mixtures of oxidizing and flammable gases do not result

in explosions (as long as the ignition point is not reached). Changing portion of sentence~2 to a NOTE conforms to NFPA Style Manual for informatory material. 59.b. and c. Existing 8-6.2.1.5(b) and (c) cover the same hazard.

Subcommittee agrees with prohibiting sparking toys, but not just when when oxygen tents or oxygen hoods are used. Hazard exists whenever oxygen is administered.

60. There are other methods of sterilizing than those listed. Wording by Subcommittee ailov~ for other methods to be used.

COMMITI'EEACTION: (HYP) Accept in Part. 1.i. Accept in Principle (Intrinsically safe) In definition of"Inwinsicaily Safe," make sentence 2 ('Abnormal

conditions may...other similar conditions.-) a NOTE. 1.p. Acc.ept in Principle (Oxygen toxicity (hypobaric)) In definiuon of 'Oxygen toxicity (hypobaricy," end definition after

the words "periods of tune." Make the remainder of the definition ( ' i t may occur...time of exposure.') a NOTE.

8g. Accept in Principle (19-1.1.1 to 19-1.1.4) Make Section 19-1.1 (19-1.1.1 through 19-1.1.4) aNOTE under

Section 19-1. Renumber 19-1.2 through 19-1.6 accordingly. 90. Accept in Principle (19-9.2.4) Make sentence 9 ("Prudent design...for future use.') a NOTE.

91. Reject (19-9.3.1) 92. Accept (19-9.3.2) 93. Accept (19-2.4.1) 94. Accept in Priniple (19-2.4.3) In sentences 1 and 2, change "may be accomplished" to 'is

P~5 rmitted'. • Acceptin Principle (19-2.5.3.3)

Change =may be provided" to "is permitted" in sentence 9. 96. Reject (19-9.7)

234

NFPA 99 ~ F92 TCR

97, Accept (19-2.9.1.2, Excep) 98. Reject (19-2.9.2) 99. Ac~pt (19-$.I.2) 100. Accept in Principle (19-S.1.5.5) Make 19;3.5.8 new NOTE 2 under 19-8.1.5.2. Change "shall" to

"should" in last sentence. 101. Accept (19.3.1.5.4(d)) 102. Accept (19.$.I.5.5(c)) 105. Accept (19-5.1.5.8) 104. Accept in Principle (19J.3.1.1) In sentence 2, change " m y be piped" to read: "are permitted to be

piped'. In sentence $, charige ~ be introduced irito" to read: "ai'e permitted in ' . 105. Accept (19-S.4.$.1) 106. Reject (19.S.6.2.2(a))

c o M M r r r E z STATEMENT: I.i. Reason: Subcommittee agrees that material is in£ormatory, but conditions listed are not always possible. Making material a NOTE retains Subcommittee intent as web as conforms to NFPA S~le Manual.

l.p. Ream. n: The phrase "it may occur" is appropriate because the condition [oxygen toxicity] will not necessari~ occur.

89. Reason: Meets the intent ofsubmitter, and conforms to NFPA S C~__aepManual. Subcommittee desires material at the beginning of

ter 19. 90. Reason: Submitter's recommendation changes the intent of

Committee on design considerations. Making material a NOTE retains intent, as well as conforms to NFPA Sb/le Manual.

91. Reason: Because of the state of the art, there are other paragraphs that allow lights _tObe ]~laced inside a chamber.

94. -Reason: Changing "may to shall would limit ways to accomplish warming, cooling, dehum/ficadon. Using term "is permitted" allows other methods to be used.

95. Reason: Editorial. "to be provided" is unnecessary. 96, Reason: Clause is a conddonal; Class B & C chambers may be

pgrmble. 98. Reason: Paragraph rewritten. See new 19-2.9 by Proposal 99-

287 (Log #H~.44). 100. Reason: Making text a NOTE is comparable to moving it to

the Appendix since material contains only informatory information (as required by NFPA Style Manual. 104. Reason: Editorial. 106. Reason: Existing text in question is conditional and [~a~n. mad-

cally correct: materlalii listed may or may not insulate conductive devices.

C O - - A C T I O N : (VAC) Accept $9. 4-8.1.1.2 I. Accept 2. Accept

COMMITTEE ACTION: (ANE) Accept in Part. 1.e. Reject (Flammable) 1.v. Reject (Tube, Trachentomy)

40. Accept (5-4.1.5) 41. Accept in Principle (5.4.2.5) . - - In sentence 4, change A flesh-air port may De proviaea. . ." to

read as follows: "A fresh.air port is permit ted . . . " 44. Accept (6-2.8) 74. Reject (12.4.1.1.1) 75. (12-4.1.1.5) L Accept (12-4.1.1.5(b)) . . . . . . . . b. Accept in Principle (lz-,Lt.l..~(c)) Make 12.4.1.1.5(c) a NOTE under subparagraph (b). Renumber

subparagraph (d) new subpm'agraph (c). 76. AcCept in Principle (I2.4.1.2~4(d)) End ]~ar~n'aph after "and anesthetizing locations, (i.e., delete "in

order dutt theft-informed cooperation is assured.') 77. (12.4.1.2.6) a. Accept (12.4.1.2.6(c)) b. Accept (19-4.1.2.6(e)) 78. Accept (12-4.1.5.4) 79. (12-,f.1.3.5) a. Accept (12-4.1.3.5(a), Exception No. I) b. Accept (12-4.1.$.5(g)) 80. 12-4.1.5.8 a. Accept (12-4.1.3.8(d)(2)) . . . h. Accept in Part ( 12-4.1.5.8 (e) (a)) In sentence I, change "of necessity" to "required to be" as

recommended. In sentence 1, change "this may be" to "this is permitted to be' . c. Accept (12-4.1.$.8(e) (7)) d. Accept (12-4.1.S.8(0 (1)) e. Accept (12-4.1.3.8(i) (2)) _ ,, 81. Accept in Principle (12-4.1.3.9(e)) Change sentence 2 ~'Whenever the cover...beneath the cover. )

to a NOTE. 82. (12-4.1.5.10) a. Accept (12-4.1.3.10(c)) b. Accept in Principle (12.4.1.3.10(e)) Change "may be o f silk* to read: "is permitted to be of silk'. 83. Accept (12-4.1.&II(a)!. 84. Accept (12-4.1.3.13(e))) 85. Accept (12.4.1.4.2) . . . . 86. Reject (15-4,1.1.1 & 15-4.1.1.2) . . .

COMMrrrEE ffYATEMENTt l.e. Sentence 2 renects grammaticaJ opdon of defining term (i.e., can be an acljective or an noun).

l.v. Supplemental definition to show other options. 41. Accept Recommendation. Editorial chang[e only. 74. Information places historical information m scope and purpose

of chapter. Text is clearly identified as informational. 75.b. Editorial. Alternate way of presenting text that is informa-

tional. 76. Deleted text is superfluous. 80.b. An ohmeter is not the only device that can be used for the

test. 81. NFPA Style Manual allows informational material to be in the

form of a NOTE. 82.h. Submitter's Recommendation would not permit other

materials than those listed, and thus chanse the intent. 86. Material is clearly identified is histoncal information.

(Log#S9) 99- 6 - (1-2): Reject SUBMITI'E~ Norman V. Steere, N.V. Steere & ,4Joc., Inc. RECOMMENDATIONt Revise Section 1-2 to add two new sentences after the first sentence:

"However, this document does not apply to health care facilities which do not have any patients on site who are incapable of self preservation. For example, clinical laboratories are covered by NFPA 45 if such laboratories are f~ee-standin[~ clinical laboratories that do not have any patients on site who are incapable of self

~ reservation." UBSTANTIATION: NFPA 99 does not adequately address free-

standing laboratories which do not see patients, such as most of the National Institutes of Health, the Centers for Disease Control, and clinical reference laboratories. NFPA 45 addresses all laboratories using chemicals. c o M M r r r ~ AcrIONt Reject. C O M H r r I ~ STATEMENT: NFPA 99 includes medical and dental offices, and clinics. Proposal would change scope ofendre document.

(Log#90) 99- 7 - (1-4): Reject SUBMITrF~ Norman V. Steere, N.V. $teere & Assoc., Inc. RECOMMENDATION: Revise Section 1-4 to add a new paragraph:

"Laboratory work areas, laboratory building, equipment and installations that do not comply strictly with ~ standard shall be considered to be in compliance flit can be shown that equivalent protection has beenpro~ided or that no specific hazard ~ be created or continued through noncompliance." SUBSTANTIATION: Existing paragraphs in Section 1-4 seem to give too much power to the authori/y having jurisdiction. The proposed addinon is intended to level the p]~,ying field. COMMrr r ]~ ACTION: Reject. COMMITTEE STATEMENT: Issue of equivalency is already included in paragraph 2 of existing 1-4. I t is not within the scope of this Committee to regulate the power of the Authority Having Jurisdiction.

(Log # 201) 99- 8 - (1.6.2 and 4-10.2.1.1): Accept in Principle SuBMrFYER: D.A. McWhinnie,Jr., Mechanical Dynamics Inc., Self NFPA Vacuum Systems SS/C, Chairman RECOMMENDATION: (a) Relocate 4-10.2.1.1 to tront of Vacuum Document.

(b) Revise 1-6.2 to: 1. Scope 2. Nature of Hazards 5. General 4. Components

6. Installation 7. Testing[ and Performance Certification 8. Administration

N F P A 99 ~ F 92 T C R

SUBSTANTIATION: "User friendliness", and conformity with Code 99, 1-2 "Construction.. . ' , and 99, 1.5 "Intended Use . . . in the desi~., construction, inspection and operation of health care facilities.. . ' ; and the design, intent (and approved) text of the Technical Committees on Medical Gases and Medical-Surgical Vacuum Systems - NFPA 56F and 56K.

The present requirements' text is not in agreement with the universal practice in the A/E design professions - construction project specifications; nor with the necessary construction/ installation procedures.

(a) Thepresent 4-I0.2.1.I should follow immediately after Scope, as does 1-2 through 1-5 (all "general" information) in 56F; and 1-5 through 1-8 (all "-general" information) in 56K- all before "Sources". Components always follow Scope and General information.

(b) Consistencywith above. The greatest responsibility of the designer-installer team is to

provide the client facility with completely operational, and Code complytn• systems- as (Ghu) reqmred by all (even simple) constructton contract documents. The very first "requirement" authored by the NFPA Vacuum

Comm. ittee (in 56K. 2-1 General) is that ofa "preplanning conference" with the client, without which it is impobsible to even start systems' design and the writing of s pecificauons. T h e T /C has made the designer/installer responsibility that of the victim facility. Any such conwact would totally discredit the A/E and would certainly be abrogated by any court of law - if it ever got past the facility counsel, the financing agency or investors, and insurers. COMMITrg~ ACTION: Accept in Principle.

Create new 4-7 to read as foUows, renumbering existing 4-7 to 4-10 accordingly.

4-7 Vacuum Systems. 4-7.1 Patient Vacuum Sys~ms. 4-7.1.1 (Insert existing 4-10.2.1.1) 4-7.1.2 (Insert existing 4-8.1.1.1) 4-8 Vacuum Systems Sources. (Use existing 4-7 and text) . 4-9 Vacuum System Distribution. (Use exisung ~ ana text) 4-10 Vacuum System Performance Criteria & Testing. (Use

existing 4-9 and text)) 4-11 Administration of Vacuum Systems. (Use existing 4-10 and

text) COMMITTEE STATEMENT: Moves additional general material on vacuum systems to besinnnin 8 of vacuum system requirements for ease of use of document.

(Log # ELE-5) 99-11 - (2-2): Accept SUBMITrER: Subcommittee on Electrical Equipment. . RECOMMENDATION: In definition ot patient care related electrical appliances, change "patient care area" to read: "patient care vicinl~'. SUBSTANTIATION: Clarifies extent of where definition ofpa. dent care related electrical appll~mce is app~cable. Current defimtion has been reported to be inisinterpreted and applied to any appliance taed in the patient care area. COMMrrrEE ACTION: Accept.

m

(Log # H~-5) 99-12 - (2-2): Reject SUBMITrER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Change term "Oxygen Enriched Atmo- sphere" to read: "Atmosphere of increased Oxygen concentration," but retain definition for *Oxygen Enriched Atmosphere" for defining new tenn. S ~ A N T I A T I O N : There is confusion with term ~TJtygen Enriched Atmosphere" as defined in NFPA 55M but tu~Vm Chapter 19 in NFPA 99. Term "Aunosphere of increased oxygen concentration" more clmely describes situation in Chapter 19. COMMITrEE ACTION: Reject. COMMnWEE STATEMENT: Confusion exists between the definition of "Oxygen enriched atmmpheres" and the proposed new term and definition *Atmosphere of increased oxygen concentra- t/on", and their use in the document.

(Log # HYP-1) 99.15 - (2-2): Accept SUBMITrF.~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMM~gNDATION: Delete the term and definition for "oxygen

ON: Hyp0baric facilities are not part of NFPA 99. COMMrrTEE ACTION: Accept.

(Log # 42) 90-9- (2-2): Reject SUBMITIT.~ Joanne Munger, Ft. Derrick, MD RECOMMENDATION: Change definition of Oxygen-Enriched Atmosphere to:

'~3xygen-Enriched Atmosphere. An atmosphere in which the concentration of oxygen exceeds 21 percent by volume or the partial pressure of oxygen exceeds 160 torr ~millimeters of mercury), or both." SUBSTANTIATION: The definition of the term Ox~en-Enriched Atmosphere presently does not account for changes m pressure. The explanatory material states that the value of 25.5 percent is used becatae the normal percentage of oxygen in air is 21 percent, and an added error factor of 10 percent for reading the meter and for manufacturer tolerance is considered necessary. We believe the s t~da rd should state the requirement of 21 percent. Individuah taking measurements of this type would account tor tolerances when taking measurements. Additionally, the present definition differs from NFPA 53M. COMMrITF~ ACTION: Reject. COMMrIWEE f f r A ~ . To specify a percent (21) without indicating tolerances often no advantage, and places an undo economic burden on produceres of air for medical purposes.

(Log # ELE-1) 99-10 - (2-2): Accept $ ~ Subcommittee on Electrical Equipment RECOMMENDATION: In definition of "Direct electrical pathway to the heart", change sentence 2 (Electrodes, such as...to the heart.') to a NOTE.. SUBSTANTIATION: To conform NFPA Style Manual. COMMrrrEE ACTION: Accept

(Log # 7) 99-14- (2-2): Accept SUBMITYER: Subcommittee on Use of High Frequency Electricity RECOMMENDATION: In definition of fle_quency, change sentence S "(Formerly the u n i t . . , preferred.)" to a Note. SUBSTANTIATION: Sentence is informtional, and not part of definition. COMMITrEE ACTION. Accept

(Log # 50) 99-15 - (2-2): Accept in Principle SUBMrIWE]~ Saul Aronow, Technology, in Medicine, Inc. RECOMMENDATIONs Change defininon of "Oil-Free Air Compressor" to:

"Oil-Free-Air Compressor. An air compressor designed specifically to exclude off from the air stream." SUBSTANTIATIONz The present definition is ambiguous as to whether it is the air stream that is to be oil-flee or the compressor that is oil-free. The intent is that the air stream be oil flee. The addition of the extra hyphen in the term and the deletion on the last phrase make the intent clear.

There was a proposal to chani[e the definition in the 1990 edition that was acceptedby the commlttee but returned to committee by the Standardi Council on appeal. If the committee wishes to prescribe design limitations that ensure that the air stream is oil-free, such provisions belong in Chapter 4 and not in the definition. COMMITTEE ACTION: Accept in Principle.

See Committee Action on Prol~osal 99-18 (Log #NON-17). COMMITTEE STATEMENTt Issue raised in this proposal is addressed by that proposal. Committee deleted term~3il Free Air Compressor', and defined a new term "Medical Air Compressor,"

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N F P A 99 ~ F 9 2 T C R

(LOg # 91) 99- 16 - (2-2): Reject SUBMrrFER: Norman V. Steers, Stillwater, MN RECOMMENDATION: Revise section containing Definitions: Revise definition of Health Care Facilities so that such facilities are not included if they do not have patients who are incapable of self

~ reservation, or if they do not see any patients. UBSTANTIATION: The present definition is too broad.

COMMITI~E ACTION: Reject COMMITTEE STATEMENT: The present definition is in accordance with the scope of the Committtee as stated by the NFPA Standards Council.

(LOg# 116) 99- 17- (2-2): Reject SUBMrIWER: Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Bring definitions of patient gas systems type I & 1I forward into Chapter 2 definitions. SUBSTANTIATION: User friendliness and ease of location and reference. COMMITTEE ACTION: Reject. COMM1TrEE STATEMENT: No definitions are currently included in NFPA 99 to bring forward into Chapter 2.

(Log # NON-17) 99- 18 - (2-2, 4-3.1.9, Appendix A): Accept SUBMI'lq'ER: Subcommittee on Nonflammable Medical Piped Gas I~E stems

COMMENDATION: 1. In 2-2, revise definition of "medical ~/ compressed air" to read as follows: "For purposes of this standard, medical compressed air is air" (a) supplied from cylinders, bulk containers, medical air compressors, or that has been reconstituted from oxygen USP and Nitrogen NF, and (b) that complies with the following: 1. Medical Air USP 2. Total hydrocarbons

liquid gaseous

3. Pressure dew point @ 50 psig

4. Permanent particulates

non-detectable <25 ppm <45 degrees F (6 degrees C)

1 micron nominal @ 98 percent efficiency"

2. In 2-2, delete the term and definition of "oil-free air compressor", Insert new term "medical air compressor" and defined as follows: ~A compressor that is designed to exclude oil from the air stream and compression chamber, and that does not under normal operating conditions or any single fault add any toxic or flammable contaminants to the compressed air. The medical air compressor shall be designed to prevent the introduction of contaminants or liquid into the pipe line by:

(a) elimination ofoii anywhere in the compressor, or (b) separation of the oil-containing-section from the compression

chamber by an area open to atmosphere. NOTE 1: Examples of (a) are liquid ring and permanently sealed bearing compressors. NOTE 2: Example of (b) is an extended head compressor with an atmospheric vent between the compression chamber and the crankcase."

3. In 4-3.1.9.1, sentence 1, delete "oil free" so that sentence reads: ~l'he medical air compressor shall be an air compres~ras defined in Chapter 2. ~ 4. In 4-3.1.9.4, add three new paragraphs to existing text as follows: ~l'he use of a liquid ring air compressor, as defined in Chapter 2

under medical air compressor - type (a), shall require separate compressor sensors that shut down that compressor when the water exceeds the design level in the separator, activate a local alarm as to which compressor is affected, andactivate the master alarm (single or multi-signals). In addition, high water level in the receiver shall activate an alarm that shuts down the liquid ring compressor system, and activates the master and local alarms. Service water and seal water shall be as recommended by the manufacturer. The use of permanently lubricated sealed bearing compressors, as

defined in Chapter 2 under medical air compressor - type (a), shall require monitoring of the air temperature at the immediate outlet of each cylinder with a "high temperature" switch that shuts down

the compressor, and activates both master and local alarms. If the air compressor has water cooled heads, a high water level switch in the receiver shall activate both master and local alarms. The use of a medical air compressor, as defined in C.~apter 2 under

medical air compressor - type (b), shall monitor air temperature at the immediate outlet of each cylinder with a ~high temperature" switch that shuts down the compressor, and activates both the master and local alarms. If the system includes water cooled heads, the compressor system shall have a high water level switch on the receiver tank thatactivates both master and local alarms. The compressor shall contain coalescing filters with an "element change indicator" and a charcoal filter with colormetric hydrocarbon indicator."

5. In 4-5.1.9.8, delete %¢hen air quality cannot be maintained,". 6. Revise Table 4-3.1.9.8 to read as follows:

ype of Dew point G.H. L.H. CO mpressor*

Freq'y Alarm Freq'y Freq'y Freq'y Alarm

(a) liquid ring C R NR NR C R

(a) recipro- cating C R NR NR C R

(b) recipro- cating C R Q** Q** c R

See Section 4-5.1.5 for performance criteria. G.H. = gaseous hydrocarbon L.H. ffi liquid hydrocarbon *Refer to 2-2 and definition of medical air compressor

**Pigment indicators C ffi continuous line monitoring Q = quarterly R = required NR = not required CO ffi carbon monoxide

7. In A-2-2 Medical Compressed Air, par. 1, change %fTable 2-2", to read: %f 2-2."

8. Delete Table A-2-2. 9. In A-4-3.1.9.7, par. 1, sentence 1, delete "(see Figure A-4-

3.1.9.7)". 10. Delete Figure A-4-3.1.9.7. 11. In A-4-4.3.1.9.7, revise par. 4, sentence 1 to read as follows: "Oil, grease or hydrocarbon vapor introduced into a compression

chamber will result in degradation products, such as carbon monoxide, if temperatures are high enough. ~ [change underlined] 12. Delete A-4-3.1.9.8. and Table A-4-3.1.9.8.

SUBSTANTIATION: 1. There is a need in the health care industry to establish a medical air compressor standard.

2. The Subcommittee on Nonflammable Medical Piped Gas Systems (via the Technical Committeee on Health Care Facilities) was required by the NFPA Standards Council to specifically review the issue of medical compressed air at the condusion of the issuance of the 1990 edition of NFPA 99. COMMITTEE ACTION: Accept.

(Log # 61) 99- 19 - (2-2 and 7-5.1.3.5(a) Exception No. 3 (New)): Accept in Part SUBMITrER: Bryan Parker, Montefiore Medical Center RECOMMENDATION: Proposal recommends revised and additional text.

a. Changhe the definition of "Patient-Care-Related Electrical Apoliance to:

~ISatient-Care-Related Electrical Appliance. An electrical appliance that is intended to be used in a patient care vicinity."

b. Change the definition of "Patient Vicinity" to read: "Fatient Care Vicinity. A space, within a location intended for the

examination and treatment of patients, extending six ft (1.8 m) beyond normal location of the bed, chair, table, treadmill or other device which supports the patient during examination and treatment. A patient care vicinity extends vertically to 7 ft 6 in. (2.$ m) above the floor."

c. Throughout the Standard change "Patient Vicinity" to ~Patient Care Vicinity".

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d. To Section 7.5.1.3.5(a) add: *Exception No. 3: Housekeeping and maintenance appliances,

such as vacuum cleaners and floor polishers, used u'ansito#ly in .~ent care vicinities areas shall meet the requirements of Section 7-

SUBSTANTIATION: The Subcommittee has received several queries which show that the intended applicability of Sections 7-5 and 9-2 is not clear.

Coals of Proposal: a. To clarify that any device (including "medical" devices)

intended for use outside a patient care vicinity, is excluded from the requirements of Sections 7-5.1 and 9-2. b. To atfirm that, unless specifically exempted, all electrical

appliances in a patient vicinity should meet the requirements of Section 7-5.1 and 9-2. COMMrITEE ACTION: Accept in Part.

a. Reject. b. Accept. c. Accept. d. Reject.

COMMITYEE STATEMENT: a. Would broaden definition to include devices that the Subcommittee did not intend to be included.

d. Section 7-5.1 applies only to patient care related electrical appliances.

(Log # 30) 99- 20 - (2-2, 7.5.2.2.1(b) (New)): Reject SUBMrITER: Philip E l%-zybyl, Marquette Electronics, Inc. RECOMMENDATION: P ar-~-raph 2.2

a. Change the definition of "Pa-tlent-Care-Related Electrical Appliance 1 to "An electrical appliance that is connected to a patient or ts intended to be used for dikgnotstic, therapeutic, or monitoring purposes in the patient vicinity."- b. Add a definition: Noncormected-Patient-Care Related Electrical Appliance. Equip-

ment primarily for use in a health care facility, but not connected to the patient or used in the patient vicinity.

Paragraph 7-5.2.2.1 Add ~ e following paragraph: (b) Nonconnected-Pauent-Care Related Electrical Appliance. The

chassis leakage current for nonconnected-patient-care related electrical appliances (e.g. Nurse station monitors, patient data management computers, etc.) shall be measured, and must be less than 500 microamperes. SUBSTA~rr~TION, A conflict exists between a hospitals' use of NFPA 99, and a manufacturers' use Of UL 544 Medical and Dental Standard, for measuring ~ leakage current. UL 544 clearly defines patient care eqtiipment as being connected to the patient or used in the patient vicinity, and assign~ a chassis leakage cdrrent limit of I00 uA. It also defines nonpatient care equipment, which is not connected to the patient or used in the patient vtcinity, and assigns a chassis leakage current limit ofS00 uA. The definition of pauent care equipment in NFPA 99 is such that

some hmpital personnel interpret it to mean il~ equipment used in the care of the patient, whether or not connected to the patient, or used in the panent vicinity. This puts a I00 uA chassis leakage current limit on all such equipment, including Nurse station monitors, patient data management computers, etc. The only nonpatlent equipment identified in NFPA 99 (with a chassis leakage current limit of 500 uA), is facility-owned household appliances, and laboratory equipment. CoMMrlTI~ ACTION: Reject. COMMrITI~ STATEMENT: See Subcommittee Proposal 99-II (Log #ELE.5) that addresses issue of extent of applicability. Connection or non-connection topatient is not considered germain to definition of patient care relatedelectrical appliance.

(Log # 115) 99- 21 - (2-2, Appendix B, Appendix C (New)): Reject SUBMITTER: MarkAllen, Ohmeda RECOMMENDATION: I. Add to Chapter 2, Definitions as follows:

Alarm. For the purposes of this standard, a device which signals a condition requiring attention and which may be life threatening. Medical gas and vacuum alarms include a continuous visual indication and a cancelable audio indication of the monitored condition. Alarm Sensor. A switch, transducer or other device which allows

the alarm to sense a condition. Common sensor types are pressure switches, pressure transmitters, vacuum switches, vacuum t/'ansmit- ters, float switches, etc.

Automatic Service Valve. A valve which operates to prevent the escape of gas when the station outiet finish assembly is removed from the outlet roujgh in. An automatic service valve is not required for vacuum station [ndets.

Check Valve. A valve which permits flow in only one direction, automatically dosing to prevent flow in the opposite direction.

Demand Valve. A valve which permits gas flow only when a mating part is engaged.

Primary Supply. The subsystem of the operating medical gas supply which is acu/ally supplying the pipeline.

Secondary Sup, ply. The subsystem of the medical gas operating supply which will automatically supply the pipeline when the primary system is exhausted or fails to operate.

Service Valve. Medical gas valves so located as to be accessible only to authorized personnel, used to isolate portions of a pipeline for maintenance or construction.

Source Valve. A valve located at the immediate outlet to the source of medical gas, upstream of the main line shut offvalve, such that the entire source of supply, including all accessory devices, can be isolated from the pipeline system. Terminal Outlet (Inlet). The terminal point of a piped gas

(vacuum) system where the user makes connectiom. Terminal Outlet (Inlet) Finish hmembly. Theportion(s) of a

terminal outlet (inlet) which is (are) a~xed to the rough in and may be removed for service. Generally indudes the cover plate(s) and may include the adapter latching mechanism or Diameter Index Safety System (D.I.S.S.) threads.

Terminal Outlet (Inlet) Rough in Assembly. The portion(s) of a terminal outlet (inlet) which is permanently a l ~ e d to the pipeline. The rough in usually contains the automatic service valve on pressure gas systems. Zone Valve. Valves in boxes intended to be accessed by floor

personnel in the event of an emergency to shut off fiow of medical gas or vacuum in sections of the piping.

Pressure Sens~ or Swltch wnh 114 NPTM t ro t hz~ng

[--

[

k

~ .., ~./4" N"PTF x lfB Coupler

L

D.I.S.S. Adapter x I/8 NPTM

D.I.S.S. Demand Cheek x I/4 N'PTM

C, as Specific C~ick Coupler Stem

Gas Specific Quick Coupler

N Pipeline with s w a t tee x 1/4 NYI'F

F i g u r e 1

238

N F P A 99 - - F92 T C R

2. Add to Reference Standards Appendix B Compressed Gag Asmciatlon V-5 q)iameter Index Safety System" Compreued Cat Association, 12$SJefferson Davis Highway,

Arlington, VA 22202 Compressed Gas Aszociation SB-6 "Safety Bulletin on Nitrous Oxide

Security and Control" Compressed Gas Association, 12$SJefferson Davis Highway,

Arlin~Cton, VA 22202 3. ] ~ s ~ e d new section 04.2 NOTE: Introduction to section 04.2 This section relates to the maintenance ofcen t ra~ piped medical

gas and vacuum systems in hospitals and other health care facilities. A planned preventative maintenance program can prevent unex- pected lou of service, can reduce the economic burden of leakage, and can reduce repairs performed as emergencies.

The user is encouraged to use ~ section as a point of departure for the development of a planned preventative maintenance program for centrally piped medickl gas and vacuum systems. The requirements given in tliis document are common to most installations. This document does not apply to construction or repair of a ~ c o m p o n e n t of a medical ~ system.

mph'ance of the system wsth all applicable national, state or provincial and local standards is assumed. Where a system does not comply, the system should be brought into compliance prior to impl-ementauon of a preventative maintenance plan.

This section contains minimal procedures and schedules and is intended to be supplemented with specific requirements and guidelines issued by manufacturers for specific equipment.

Users are encouraged topian and schedule maintenance as required by conditions within their facility.

G4.2.1 Preparation CA.2.1.1 A [,~reventadve maintenance program . should not be.

undertaken wlthout examining the system, as installed, It may De necessary to perform base line testing (eg. particulates, gas purity, etc.) prior to implementing a preventative maintenance plan.

O4.2.1.2 Auure that the location, labelling and conu-ot or monitoring areas of each component is known and is clearly documented.

O4.2.1.3 Riser diagram(s) or equivalent grap~cal representation (s) o f the exact ~ t e m cmUigm~tion should be prepared. Include In this diagram(s) all items defined in CA.2.1.$.1 ihrough CA.2.1.3.$, C-42.1.6, and 4.2.1.8.

CAUTION: The accuracy of existing diagrm-ns should be verified before use.

CA.2.1.3.1 The location of each vacuum or gas source, source valve, service valve, alarm sensor, zone valve, alarm and outlet. The location of each should be described thorough]y on the ~ ( s ) including as applicable room number or corridor designation, me wall the device m on or near, access panel location, tag number, access instructions, normal state for valves (normally olden or normall~ closed), locations of futures valves, location of emergency connecuon points.

C-4.2.1.$.2 The outlets controlled by each zone and service valve. and the areas monitored by each alarm should be visually indicatea on the diagram(,).

C-4.2.1.8.8 Where a system is provided with multiple sources of supply (eg. more than one vacuum pump) consider ea.ch as a separate source and describe each separate source on me diagram(s). Separate sources which are interconnected should have all details of the interconnecting piping, including valving arrangements, switch settings and procedure for use of the interconnect:on thoroughly described.

g]owmeter : • .0-10 scf-m (0-280 Ipm)

Vacuum Attachments: ~ Remove when ~sting

pressure gases.

~connecting ~ ~ I ~_ g : : [

.I. ~.ff~f]~.. ~"~.. ~ Adapter to match 1 o.ta y

i

Adap te r to ~ P l u g or ball va lve for match out le t

control l ing flow and type a n d gas static pressure testing

1

I

I

I Pressure Attachments: remove when testing vacuum.

l

Figazre 3 Flowmeter for Outlet Testing

239

N F P A 99 - - F92 T C R

04.2.1.4 Examine the system(s) for appropriateness, a c c ~ _ and visibility of labelling for service name andareas controlled and mouitored. All discrepancies in labelling should be corrected prior to beginning_ any preventative maintenance p.mgram.

04.9.1.5 Alarm semors should be separated from the piping with the use ofa D.I.S.S. or quick connect demand valve. These valves permit removal of the senmr without shutting down the system. (ref.

Fi~t~.l.6--1~ Determine through consultation with responsible system • u m and maximum operating premu~e~

sU~o~l~ t. ~ l i~nfr~or~non~hould be included on the diagram norm for each system.

04.9.1.7 Examine all sDtems for compliance with national, state or provincial, and local regulatiom. Where the systems are identified as deficient, a plan to bring them into compliance should be prepared and executed.

C.4.2.1.8 Determine the appropriate alarm set points including minimum and maximum acceptable pressures for pressure gases, minimum acceptable vacuum levels, Iow levels on all cyfinder and bulk liquid source equipment, high dew point level, and alarm levels for an purity monitoi'ing equipment.

04.9.1.9 Determine those areas of the facility which are consid. ered priority areas for repairs (eg. O.R., LC.U., etc.).

04.9.1.10 Obtain all operation and maintenance manuals, service manual, and other manufacturers documentation for the equip. ment to be serviced. Obtain most recent edition of all reference standards (See Appendix B).

04.9.1.11 Complete a formal, written maintenance policy includins~ safety procedures; listing of personnel to contact in the event of an emergency or system failure during maintenance; procedure for obtaining permission prior to testing or maintenance; iequence of areas to be tested and maintained; components and fufictlons to be tested; tests to be performed; frequehcy of test; parts to be replaced; frequency of replacement; information about conditions, hazard/and access m specific areas; maintenance audit p

~ 1 2 Train all personnel in safety and proper procedure. Training should include as a minimum 04.2.1.12 sections .1-.4.

04.9.1.19.1 General safety procedures for use with medical gases, including mfety hazards associated with the gas~, hazards associated with higfi preuure cylinders, hazards associated with the specific equipment, hazards associated with contaminated tools, parts, etc.

04.9.1.12.2 Procedures to prevent cross connections. (NOTE: Some older outlets are not inherently safe from cross

connection due to common threads or fittings used for different

s~:2~I.12.3 Mechanical skills required for work on equipment. 04.9.1.19.4 Procedures to follow prior to any shut down of a

service or during an emergency. 04.9.1.13 Allow only personnel trained and experienced in safety,

repair, operation, and use of medical gas and vacuum systems to perform this maintenance. Familiarize all personnel with the location and areas controlled for all valves.

04.9.1.14 Document all activities and maintain these records as part of the facility's permanent records. Include: areas serviced and tested; components serviced or replaced; date of service; testing performed; results of all tests; current system diagram(s); amend. ments to system diagram (s); maintenance audit records.

04.9.9 Tools 04.9.9.1 Keep all tools for medical gas work separate from other

tools and free of grease or oil. Use these tools for medical gas work

°C,~'ION:"~" use of tools not cleared for medical gas can result in contamination of the gas and risk of fire. 04.9.9.9 Appropriate tools for work on medical gas and vacuum

systems will include the list in Table A as well as tools required for work on sl~eclfic equipment and recommended by the manufacturer. Toois of custom design from the original manufacturer, and which simplify required procedures, should be added.

04.9.9.3 Lubricants, where used, mint be oxygen compatible and used strictly according to the manufacturers instructions. Table 1 Tools for work on medical gas and vacuum systems Adjustable wrenches (6 in. and 19 in.) Blunt probe Adapters for all outlets Dental pick or O~right tool Ferrulifig kit for hose repair Flashlight Flowmeter or flow .gauaugee (ref. F'~300. 3) Gauges (0-100 psig {0-690 kPa); i~ig {0-2070 kPa); 0-30 in. Hg

{0-766 ram} Vacuum) Hemmtats or forceps Inspection mirror Miscellaneous fittings as required

F O ~ e n compatible lubricant (eg. Vac Kote') m , Needle n m , slipjgint and retaining ring

Polytetrafluroeth~ene (Teflon') tape Portable work surface Set of allen wrenches Screwdrivers in appropriate types and sizes Vise Socket wrench set 8-12 in. length of hose for testing Thread chasers as appropriate Toothbrush or wire brush Vac Kote is a trademark of the Ball Corporation Teflon is a trademark of the DuPont Corporadon C-4.2.S Spares C-4.2.$.1 "Maintain mfl]clent spare ~ to parmi't emergency

service as well as to accommodate ~placement of expenc~ble parts. 04.2.3.2 Table B contains a list ofs .pares appropriate for com-

monly installed equipment. These minimum]ira should b e . supplemented by spares recommended by the manufacturer tor specific _equipment. Parts and sRares should be from or of equivalent quality to the original manfifacturer.

NOTE: Certain h~u-dware items commonly available which appear to be of equivalent quality and specification may not in fact be equivalent eg. may not be cleaned for oxygen, etc.

TableB Spare Parts Inventory

M~fifolds Manifold cylinder leads ('pigtaiis*) Regulators Preuure gauge l .~ht Bulbs High Pressure check valves Preuure refief valves

Bulk Liquid Systems Line pressure regulator Pressure gauges Pressure relief valves

Air Compressors Packing and/or seals Motor starter rebuild kit Belts Filters Light bulbs Fuses Timers Compressor overhaul kit Bearings Water solenoids ~ t s Check valves Line preuure regulator Automatic drain rebuild kit for receiver and dryer Pressure relief valves

Vacuum Pumps Packing and/or seals Motor starter rebuild kit Belts Filters ~ bull:~

Timers Pump overhaul kit Bearings Water solenoids Gaskets Check valves Vacuum regulator

Alarms Fuses Transformers Circuit boards LED or light bulbs Pressure/vacuum sensors

Valves Valve repair kits Zone valve windows and parts

Oudets Terminal outlet (inlet) repair kits Terminal outlet (inlet) fiz~h assemblies Ferrules for hose repair 04.2.4 General Work Requirements 04.9.4.1 During disassembly and ~ m b l y of any equipmen~

procedures must be followed to assure took and parts are zept clean and free of contamination in the form of dust, ~ grease or oil.

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N F P A 99 - - F92 T C R

04.2.4.2 After reamembly of any equipment where gas specificity must be maintained, the device should be tested prior to being returned to service for gas flow, premure and cross connection.

04.2.4.$ Good housekeeping procedures should always be observed such as removal of debris from the inside of boxes, cleaning of covers, removal of fingerprints, etc.

04.2.4.4 When major repair has been performed, reference should be made to all appropriate sections of this document and procedures as specified for new installations followed.

04.2.5 Scheduling 04.2.5.1 The testing and verification of a newly ~ installed or altered

medical gas or vacuum system is not considered a part of periodic maintenance. Such systems should be tested as new systems.

04.2.5.2 The scheduling of periodic maintenance should be at least as frequent as recommended by the manufacturer of the specific equipment. Maintenance should be scheduled more frequently i f required by frequent me or local conditions.

04.2.5.$ When emergency repair is required, all components considered maintainable should be examined and where necessary, replaced. 04.2.6 Equipment Checks 04.2.6.1 Terminal Oudets/inlets 04.2.6.1.1 It is not usually necessary to shut offsupply to the

terminal outiet/inlet to perform normal maintenance. Exceptions may include very old outlets/inlets without automatic service valves or any outlet/inlet not compliant with 4-4.1.2.4. Prior to performing any work on an outlet/inlet be sure the location of the controlling zone or service valve b known, and the appropriate steps to be taken prior to any shut down are clearly understood. Should an emergency occur during service, the gas supply can be expeditiously shut down with minimum impact on patient care.

04.9.6.1.2 Test the outlet/inlet for flow and pressure drop and external leakage with and without the adapter engaged.

04.2.6.1.$ Test the outlet/inlet latching mechanmn. 04.2.6.1.4 Examine the outlet/inlet for excessive wear or damage. 04.2.6.1.5 Periodic sampling at pressure outlets should be

performed to confirm that no particulates exist in the system. 04.2.6.2 Valves 04.2.6.9.1 Never close any valve without reference to the system

diagram and prior authorization from appropriate medical personnel in all affected areas. Patients maybe dependant on the gas or vacuum and interruption of supply may be hazardous.

04.2.6.2.2 Test the valve for exte/'nal leakage using soap solution or other method of leak detection safe for use with Oxygen.

04.9.6.2.8 Test the valve for internal leakage. Close the valve, depressurize the outlet/inlet side of the valve, insert a gauge in the terminal outlet/inlet and check for pressure change in the piping with the valve closed.

04.2.6.2.4 Return the valves to normal position. 04.2.6.3 Alarms O4.2.6.3.1 Prior to testing alarms, inform all personnel that a test

is in progress. During the test, it may be necessary to closely observe all system conditions for problems which may occur during the test. At the completion of the tests, inform all personnel that the tests are complete and that the alarms are again functional. Testing alarms reqmres stimulation of varinus conditions and can often be accomplished without interrupting supply in performed by competent _pe~-sons familiar with the systems and if the systems are properly cohr~gured.

04.2.6.$.2 High and ~ pressure alarms (pressure gases). Detach the pressure switches or sensors from the pipeline and attach them to an appropr~te controlled pressure source. Raise and lower the pressure to the desired set points, and observe operation of the alarm. Reattach the sensor or swiw2t. 04.9.6.3.3 Changeover and/or Reserve in Use alarms. Verify the

secondary and reserve supplies contain sufficient gas for the duration of the test. Close the primary supply valve and allow the secondary supply to come into bperadon. Veripy the operation of the changeover alarm. If the system is provided with a reserve, close the secondary supply valve and allow the reserve to come into operation. Veri~, the operation of the Reserve in Use alarm. Restore normal supply to reopening both secondary and primary supply valves.

C-4.2.6.3.4 Reserve LowAlarm (cylinder reserves). Verify the primary, secondary and reserve supplies have sufficient gas for the duration of the test. Isolate the reserve from the system by closing the reserve supply valve. Lower the pressure in the reserve system by allowing the gas to escape. This may require shutting off all cylinder valves and creating a leak at a cylinder lead or other opening, or it may be possible to detach the pressure sensor or switch.

CAUTION: Cylinders contain high pressure. Verify operation ot the Reserve in Use alarm.

Restore the reserve to normal operation by reopening the reserve supply valve and all cylinder valves.

C-~.2.6.$.5 Reserve Low Alarm (bulk liquid reserves). These reserves contain two alarms: a reserve low alarm and an o~. rating pressure low alarm. These alarms should only be tested with the cooperation of the bulk liquid system supplier.

C-4.2.6.8.6 Dew Point Alarm. Refer to G-4.2.6.9 C,-4.2.6.8.7 Air Purity Alarms. Test in accordance with the

instructions of the manufacturer of the instrument. C~.2.6.4 Manifolds C-4.2.6.4.1 Testing of a manifold designed and installed per 4-8

should be possible ~rithout interruption of supply to the system. Manifolds shouid be tested only by persons famillar with the operation of the manifolds.

C-4.2.6.4.2 Verify that the secondary supply has sufficient gas for the duration o f the test. Test for changeover by shutting off the valve from the operating header or by closing all cylinder valves on the operating header. Verify the secondary supply automatically begins to supply the system. Restore normal supply by reopening all valves closedearlier.

C-4.2.6.4.$ Following manufacturers instructions, test operation of all bypass and service ~alves.

C.4.2.6.4.4 Test for leaks using a soap solution or other means of leak detection safe for use with oxygen.

04.2.6.5 Air Compressors/Vacuum Pumps 04.2.6.5.1 The outline given herein is for the most common types

of controls. The actual control system used must be examined prior to performing these tests. If the manufacturer has instructions for the performance of these tests, they should be used in preference to this outline. Work inside any control cabinet should be performed only by persons familiar with the equipment and the hazmxls involved.

04.2.6.5.2 Observe normal operation. Note the pressures at which the compressor(s)/pump(s) start and stop.

C-4.2.6.5.3 Test for operation of the lag compressor/pump. Switch off the lead compressoi,/pump. Allow the pressure to fall (do not allow the receiver pressure to,all below the system pressure). Verify the lag compressor/pump operates and record the pressure. Restore the system to no/real operation. C-4.2.6.5.4 Test for simulumeom operation. Create a demand for

air/vacuum in excess of the capacity of a single compressor/pump. This may be done through opening a valve, a drain ~ock, outlets, or other method of controllably opening the s~tem to atmosphere. (Note: hearing protection maybe required). Observe the compressor/pump operation until all compressors/pumps operate simuitaneously. I n no case allow the recexver pressure to fall below normal system pressure. Restore the system to normal operation.

04.2.6.5.5 Examine the compressor(s)/pump(s) for evidence of wear (eg. condition of belts, bearing temperatures, abnormal noises, pumping speed, etc.)

04.2.6.~.6 Examine location of air intakes and vacuum exhausts for appropriate location.

04.2-.6.5-.7 Air quality at the compressor intake should be tested against USP Medical Air at least annually or if local air quality has significantly changed.

04.2.6.6 Automatic Drains 04.2.6.6.1 Automatic drains may be under pressure. Do not

attempt to disassemble an automatic drain unless all pressure has been relieved.

04.2.6.6.2 Verify that all drains are operating. Check for the presence of liquid water at the drain line. If water is not present, examine the bowl or vessel in which the drain is enclosed for excessive water accumulation. Reassemble the drain and verify proper operation. - 04.2.6.7 Filters

04.2.6.7.1 Filters may be under pressure. Do not attempt to disassemble a filter housing unless all pressu. ~ has been relieved.

04.2.6.7.2 It is ordinarily not possible to oetermine if a filter requires changing unless the filter is provided with appropriate instrumentation. Change filters at the frequency recommended by the filter manufacturer.

04.2.6.8 Air Dryers 04.2.6.8.1 The operation of air dryers should be continuously

monitored by dew point instrumentation. Consult with the manufacturer of the dryer for appropriate testing and service procedures.

04.2.6.9 Dew Point Monitors 04.2.6.9.1 Dew point monitors must be checked annually for

accurac~ and alarm set point. This may be done using a reference standard generated by appropriate instrumentation or by use o.fa second monitor which has been calibrated to a reterence sumoam. Consult with the manufacturer of the dew point monitor for assistance.

241

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N F P A 99 - - F92 T C R

O4.2.6.10 Bulk Oxygen Systems 04.2.6.10.1 Bulk o,x~en systems should be maintained and tested

in accordance with the instructions mad cooperation of the system manufacturer. 04.2.8.11 Gauges C-4.2,6.11.I W~ile testing other devices, observe if ganges are

indicating changes in pressure. CA.2.6.12 Pressure Relief Valves 04.2.6.12.1 Relief valves should be tested for leakage using a soap

solution or other means of leak detection safe for use with oxygen. CAUTION: Cracking pressures should only be tested by persons

having appropriate eq-ulpment. Elevating pressures can catae exploiion or premature r~allure of components in me system. ~ee chart on following page. SUBSTANTIATION: Present guidance in the 99 for maintenance is very non-specific and does not give sufficient help to the engineer. The proposal is more complete. COMMrrrEE ACTION: Reject. COMMrrrEE STATEMENT: I. Material is more appropriate for publication by other or~.~m, izations.

2. Propoml is too detmled for a recommended practice for facilities to try and follow as a general practice.

[Subcommittee on Nonflammable Medical Piped Gas Systems desires public comment for further guidance on this issue.]

(Log # ESE-11) 99- 22 - (S-3.2.1.1): Accept SUBMITTER: Subcommittee on Electrical Systems RF, COMMENDATION: Revise paragraph 1 to read:

"Dual sources of normal power shall be considered. Such dual sources of normal power shall not constitute an alternate source of power as described in this chapter.

NOTE: Facilities whose normal source of power is supplied by two or more separate central-station-fed services (dual sources of normal power) experience greater reliability than throe with onlya single feed."

SUBSTANTIATION: Editorial; to conform to NFPA Style Manual of a r a ~ ~ r c T i e m e n t s from recommendations.

ON: Accept.

(Log # 83) 99- 23- (S-3.2.1.1 (g)): Accept SUBMITrER: Ed Lobnitz, Orlando, H~ RECOMMENDATION: Eliminate "consideration shal l . . , and installed" from r_he beginning of the paragraph. SUBSTANTIATION: Change made to make wording style consistent withprevious (a) ~ (f). COMMITTEE ACTION: Accept.

(Log#~Z) 99- ~4 - (3-3.2.1.3): Reject SUBMITrF.~ Chand~ Solanld, Coney Island Ho~ital RECOMMENDATION: For an affirmative answer- Normal power source and alternate Power source should be reversed such as:

" . . . same generating units for their alternate power source . . , and an external utility ser~ce as the normal electric power source?" SUBSTANTIATIONs See copy of 99, 1990 Formal Interpretation Copy with sketch below.

Formal Interpretation

NFPA 99

Health Care Facilities

1990 Edition

Reference: 3-$.2.1.$ H. 84-2

Question: Is it the intent of section 3-3.9.1.3 of NFPA 99 to allow a group of adjacent hospitals, which have a contractual agreement relative to the acquisition of electric power, to use the same generating units for their normal electric power source, and an external utility service as the alternate power source?

Answer.. Yes.

Note: Each hospital otherwise meets the requirements for an essential electriol system as outlined in Chapter 3 of NFPA 99.

Issue Edition: 1984 Reference: 8-2.1.1.2, Exception 1 Date: March 1986

CoMMrrYF.~ ACTION: Reject. COMMrrrF.~ STATEMENT: Not evident as to intent of Submitter's Recommendation. Proposal appears to be on a Formal Interpretation, and not on text.

(Log # ~SE-t 2) 99- 25 - (3-3.2.1.5): Accept 8UBMITrF~ Subcommittee on Electrical Systems RECOMMENDATION: Revise sentence 2 to read:

q.f normally used for other pml3oses, two or more sets shall be installed, such that the demand and all other performance requirements of the emergency system of the essentia] electrical system shall be met with the largest +single generator set out of servicer[Change Underlined] SUBSTANTIATION: Current wording is more restrictive for a 2

[ ~ ~ m than a 1 generator system. ACTION: Accept.

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243

NFPA 99 - - F92 TCR

(Log # zse~) 9 9 - 2 6 - (8-4.1): Accept $ ~ Subcdmmlttee on Electrical Systems PJY.¢OMMENDATION: Change "Normal (AC) System" to *General'. SUBSTANTIATION: Paragraph 8-4.1 contains both normal and essential electrical system reqmrements, as well as AC and DC ments.

ACTION: Accept.

(Log # ESE-e) 99- 27- (3-4.1.2.1(a); 3-4.2.2.2(c) (I)): Accept $U]$MITr]©gz Subcommittee on ElectricaISDtems RECOMMENDATION: 1. Revi~ 3-4.1.2.1(a) to read as follows:

(a)* Circuits. Branch circuits serving a gi~_en patient bed location be fed from not more than one normal branch circuit

distribution panel When required, branch circuits serving a given patient bed Iocation shall be permitted to be fed from more than one emergency branch circuft distribution panel.

Exception: (Same as existing wording). - - 2. Add the followingpar_agraph to 3-4.1.2.1 (a): "Critical care areas ~ be ~rved by circuits from (1) critical

branch p .~el(s) served from a single automatic transfer switch, and (2) a minimum of one circuit serv~ by the normal power distribution system or by a system originating from a second critical branch transfer switch," 3, In 3-4.2.2.2(c) (I), change "all receptacles" to "selected

~t~T%rriATI e'" ON: Responds to the need for enhanced reliability of electrical service in critical care areas in the event of failure of the automatic transfer switch. COMMITTEE ACTION: Accept.

(Log # 164) 99- 28 - (3-4.1.2.1(a)): Reject S ~ Hy Rershad, Hospital Engineering Society of Greater New York RECOMMENDATION: Change to read:

(a) Circuits. Branch Circuits serving a given patient vicinity shall be fed from not more than one normal branch circuit distribution

el and/or one emergency branch dhtribution panel. TANTIATION: 1. Conform to NTPA 70, Article 517-19(a)

requirements. 2. Testing/Veritication of oj~ertion easier to accomplish.

COMMrrTEE ACTION: Reject. COMMITTEE STATEMENT: I. The number of receptacles and from where fed is performance criteria; thus, conformance to NFPA 70, which addresses installation requirements, is not necessary.

2. There is a pro lx~_ to NFPA 70 to correlate the requirements in NFPA 70 with throe in NFPA 99.

8. Committee intent is to allow more than one emergency branch distribution panel without mandating it.

4. See SubCommittee proposal 99-27 (Log #ESE.6) which also addresses this issue.

(Log # lS4) 99- 29 - (3-4.1.2.1(a)): Reject $UBMITrE~ Barry Duignan, Greater New York Hospital Associa- tion RECOMMENDATION: Change to read:

(a) Circuits. Branch Circuits serving a given patient vicinity shall be fed from not more than one normal branch circuit distribution ~ANTIATIanel and/or one emergency branch distribution panel.

ON: 1. Conform to NFPA 70, Article 517-19(a) requirements.

9. Testing/Verificadon of operation easier to accomplish. COMMITrEE AGWION: Refect. COMMITTEE $ T A ~ : Identical propma ! to Proposal 99-28 (Log #1.64). Thus, rejection is for same reason given in that p ropo~.

(Log # F, SE-1) 99- 80- (3-4.1.2.2): Accept SUBMITrER: Subcomn~ttee on Electrical Systems RECOMMENDATION: Revise 3-4.1.2.2 to read m follows:

3-4.1.2.2 Wring, Low-Voltage. (.a) [Same wording m in exit ing 3.4.1.2.2 ( 'Fixed systems of 30

volts.., primary voltage.') ] Exception: [Same wording as in Exception 1 to 3-4.1.2.2 ( A

groun¢led low-voll~tge.., grounding conductors.') ] (b) [Same wording as in Exception 2 to 3-4.1.2.2 ('Wiring fo r . . .

(see aho 12-4.1.3.)')] SUBSTANTIATION: Existing Exception 2 to 3-4.1.2.2 lsnot an Exception to 3-4.1.2.2, which addresses low-voltage wiring insulation requi.r, emenm. Existing Exception 2 addresses raceway, and anesthetizing lOCations, and permits low-voltage systems of types specified to be run in open mr venm metal racewa D. Thin; it is a d ~ . ". rent subject, but still belongs under the section on low-voltage

. C O ~ T T E E ACTION: Accept.

(Log # es) 99- 81 - (3.4.1.9.2): Reject SUBMITYF.~ Bryan Parker, Montefiore Medical Center RECOMMENDATION: Change section to read:

3-4.1.2.2 Wiring, Low-Vollage. For fixed ~ t e m s of 30 volts (dc or rrm) or less the conductor material, insuiatton and overcurrent protection shall be suitable for the purpose. Load currents shall not be carried in grounding conductors. SUBSTANTIATION: a. The existing requirements are over- specified. b . Grounded, fixed, low voltage systems can be practical and mfe.

They should not be lhted as an exception. c. It is also practical to design mfe low voltage circuits with

insulation dielectric strength less man that of the primary circuit. d. Exception Z is not relevant to me requirement.

COMMrrrEE ACTIONt Reject. COMMrrlY~ STATEMENT: I. Existing text is considered clearer th.an Recommendation. Exception I is an exception to requirement relative to [[rounding of a low voltage circuit.

2. Commtttee agrees that Exception 9 is not an Exception, and has b, enerated a propoml to correct rids (see Proposal 99-30 (Log #ESE- x)).

(Log # 202) 99- 32 - (3.4.1.2.2 Exception No. 1): Reject SUBMITrEI~ RobertT. Shipley, Berkeley Corporation RF.~OMMENDATIONI Addto the end of Exception No. 1 the following clause:

*and p, rovided that those appliances which can be taken into the patient s bed will not contain grounded circuits nor circuits that are i-eferred to ground." SUB~ANTIATION: The Code requires that patients be protected from le . a ~ . currents, but patients m bed are not protected from circuits which are referred to ground. Circuits that are referred to .l[l~ound are m hazardous to grounded patients m leakage currents. when a patient is grounded, and m n u l t a n e o ~ comes in contact with a ground-referenced circuit, current will flow through the patient. Frequently, the magnitude of the current which will flow exceeds the s~Lfe levels estabFahed for leakage currents. Pillow speakers, lighting controls, etc., which can 6e taken into bed with the patient, frequentb/contain ground-referenced circuits; are mbject to rougii use; and are often damaged while in use, exposing the patient to current carrying parts, thereby exposing patients to current. Also, electrolytes, which are often spilled on these appliances and the patient, supply another pa_th for fault current wh]ch does not reqtiire equipment damage. Paragraph 9-2.1.10.4 requires imlatlon, trot Exception No. 1 permit, imtallatiom which do not protect the patient fi'om ground-referenced hazards. COMM1TrgE ACHON: Reject. C O ~ STATEMENT: Recommendation refers to a vpli- ances, which is not pertinent to 3-4.1.2.2, which addreues ctrcuits. See also Committee Action on Propmal 99-207 (Log #70).

244

N F P A 99 ~ F92 T C R

(LUg # 84) 99. 35. (3.4.1.2.4): Accept in Part S U B M I T r ] ~ Ed Lobnitz, Orlando, FL R E C O ~ A T I O N : 1. Delete "and attachment plugs" from the tide.

2. In Section (d) delete "and attachment plugs" from the first sentence.

3. In Section (e) delete "plugs and" from the first line. 4. In Section (e) last sentence, change "plugs" to "receptacles" and

"A third contact" to '~he third contact'. 5. In Section (g) delete "and attachment plugs" from the first line. 6. Delete Secdon (h) and note.

SUBSTANTIATION: Attachment plugs are covered in detail in Section 9-2.1.2.1 and information r~-ga~ling plugs should be moved to that section and removed from 3-4.1.2.4 Which should only reference receptacles. C O M M r r r ~ ACTION: Accept in Part. Accept recommendations 1 to 5. Reject recommendation 6.

C O M M I T r ~ STATEMENT: 6, This paragraph is necessary for the compatibility of system

interconnection.

(LUg#81) 99- S4 - (5-4.1.2.4(b)): Accept in Principle S U B ~ DuaneJ. Telecky, Reno, NV RECOMMENDATION: Revise as follows:

CURRENT WORDING: (b) MINIMUM NUMBER OF RECEP- TACLES. The number of receptacles shall be determined bY the intended use of the patient care area. There shall be su£ficlent receptacles located so as to avoid the need for extension cords or multiple oudet adapters. In any case, there shall be provision for the attachment of at least four separate appliances for e~.h patient vicini . ~ t y

PROPOSAL CHANGE TO: (b) MINIMUM NUIMBER OF ~ C E P T A ~ . The number of receptacles shall be determined by the intended use of the patient care area. There shall be sumcient receptacles located so as to avoid the need for extension cords or multiple outlet adapters.

1. OENERAL CARE AREAS PATIENT BED LOCATION RECEP. TACLF_3: Each patient bed location shall be provided with a minimum of four receptacles, with two receptacles on a branch circuit which originates in a normal systc, m panel board.

£, CRITICAL CARE ARFAS PATIENT'BED LOCATION RECEP. TACLES: Each patient bed location shall be provided with a minimum of six receptacles, with four receptacles on a branch circuit which originates from the emergency sDtem panel board. SUBSTANTIATIONs Correlation with NFPA 70-517 NEC. COMMrlWEE ACTIONs Accept in Principle. Accept Submitter's Recommendation, but with the following

changes. 1) In submitter's subparagraph I), delete ~with two receptacles,.,

panel board", 2) In Submitter's subparagraph 2), delete "with four receptacles.,

• panel board'. 3) Add the following definition in 2-2: Patient Bed Location. The location of a patient sleeping bed, or

the bed or procedure table of a critical care area. 4) Retain Exceptions I and 2 in existing text.

COMMITTEE STATEMENT: For 1) and 2), branch circuit wiring is covered under S-4,1,2.1(a). For 3), defin/tion of term .padent bed Ioct/on" is necessary.

Definition is in concert with that proposed for NFPA 70. For 4), Exceptions I and 2 are still relevant, and were not covered

by propo,al,

(Log # 64) 99- 55 - (S-4.1.2.4(d)): Reject SUBMrrI'EIh Bryan Parker, Montefiore Medical Center RECOMMENDATION. Delete the first sentence *Receptacles and. . . listed for the use." SUBSTANTIATION: a. This proposal is submitted in response to the NFPA request to make documents more user friendly, and to remove extraneous material.

b. Redundant to 3-4.1.2.4(a). Receptacles which are suitable for use in Patient Care Locations are suitable for use in Nonflammable Anesthetizing Ix>cations. COMMrrYE~ ACTION: Reject.

COMMrrrEE STATEM]ENT: 1. Subparagraph (d) is not redundant to subparagraph (a) as it includes subject of listing of equipment.

2. Committee intent is that anesthetizing locations use listed receptacles.

(Log # 165) 99- 36 - (~-4.1.2.6, 7-2.2.2): Accept in Part S U B ~ Hy Bershad, Hmp. Engr. Society of Greater N,Y. RF~OMM]~NDATIONs 1. For See. S-4.1.2.6:

In exception No, 2, Line 6 and Line 15 delete wordJ: "...equipment connected by cord and p lug . . . " A]~o change line 10 of this exception to read " . . . of all fixed equip

l '2'. For Chapter 7, Sec. 7-2,2.2 add: "SeeSec. S-4.1.2.6 for Wet Locations." SUL.qTANTIATION: This Section relates to electrical installations, cord and plug requirements should be transferred to Chapter 7. COHMI'FrF~ ACTION: Accept in Part. I. Reject.

[ 2. Accept. COMMITrI~ STATEMENTs I. Exception 2 allows waiving of requirement under certain instances (inchiding that relating to fixed and Portable equipment). For ease of applying Exception, both need to be referenced in the Exception.

(Log # 135) 99- 37- (S.4,1.2.6, 7-2,2.2): Accept in Part SUBMITYE~ Barry Dulgnan, Greater New York Hospital Associa. tion RECOMMENDATION. I, For Sec. S-4.1,2,6:

In exception No. 2, Line 6 and Line 13 delete words: ", , . equipment connected by cord and plug. , ." .Also change line 10 of this exception to read "., .of all fixed equip.

• 2. For Chapter 7, Sec. 7-2.2.2 add: "See Sec, 5-4.1.2.6 for Wet Locations'. SUBSTANTIATIONs This Secdon relates to electrical iustalladons, cord and plug requirements should be transferred to Chapter 7, COMMITrg~ ACTION. Accept in Part.

See Committee Action on Proposal 99-36 (Log #165), COMMITF]~ STATEMENT: This proposal is identical to Proposal 99-36 (Log #165).

(Log # 19~) 99-38- (3-4,1.2.6(b) Note (New)): Reject S U B ~ Bobby Dale Brown, Smith Seckman Reid, Inc. RECOMMENDATION: Add Note under (b):

NOTE: Where normal sDtem receptacles are installed in operating and delivery rooms for the purj>ose of supplementing the critickl branch receptacles connectea to an isolated power system, normal sDtem receptacles in separate operating rooms may be supplied by a common normal system isolated power system, or a normal system receptacle shall be of the GFCI type shall be appropriately labeled.

SUBSTANTIATION: Panel 17 of NFPA 70 has tentatively accepted a proposal which defines patient bed location as a sleeping bedor treatment table of a patient care area. This would mean that all operating and delivery rooms would be required to have a normal receptacle. The proposed wording would ~[ive the user an option of ganginl~ normal receptacles on a common molated power system or /he option of udngGFCI receptacles. COMMITI'EE ACTION: Reject. COMMITrEE STATEMENT: Inappropriate to address this issue for

section. Issue is addressed under Proposal 99-27 (Log #ESE-6).

245

N F P A 99 - - F92 T C R

(Log # 198) 99- 89. (3-4.1.5 (Hew)): Accept in Principle ~J]BMITrE~ Bobby Dale Brown, Smith Seckman Reid, Inc. RECOMMENDATION: Check new text under part 8 proposal type the following:

3-4.1.5 Ground-Fault-Protection. When grgund-fault-protection is provided for operation of the service or feeder disconnecting means, an additional step of ground-fault-protection shall be provided and the next level of ~eeder downstream towards the load. Ground-fault- protection for operation of the Rrvice and feeder dhconnectin, g means shall be fully selective such that feeder device and not me service or feeder device shall open on ground.faultt on the load ride of the feeder device. The additional step of ground fault protection

not be required where the service or fe&ler dmconnecting means does not serve patient care areas or equipment intended to support life such as d/nlcal air compressors andvacuum pumps.

above. SUBSTANTIATION: 1. Article 517-17 of NFPA 70 (1990) provides installation criteria for ground-faultTprotecdon. NFPA 99 should include performance and testing criteria.

2. Placing the proposed wording in NFPA 99 will clarify the intent of the ground-fault requirement, which is to prevent "nuisance u-ip~ing" of mains which feed patient care areas which supply pauent care areas and life support equipment.

S. Some authorities having]_urisdiction have mandated two levels of ground-fault-protection where mains supply chillers, power- homes, or other patient care related facillues. Panel 17 of NFPA 70 has declined to address this problem became the Panel feels that this is performance criteria. C O M I ~ ' I T ~ ACTION: Accept in Principle. Revise Submitter's Recommendation as follows: 3-4.1.5 Ground Fault Protection. When pund-fauh-protection is

provided for operation of the service or feeder disconnecting means, an additional step of ground-fault-protection shall be provided in the next level of feeder downstream towards the load. Ground.fault- protection for operation of the service and feeder disconnecting means shall be fully selective such that the downstream device and not the ~glTJB!Ya~ device shall open for downstream ground-fault,. The additional step of ground fault protection shall not be required where the service or feeder disconnecting means does not serve l~dent care areas or equipment intended to support life such as clinical air compressors and vacuum pumps. When equipment ground-fault-protection is first installed, each level shall be performance tested to ensure compliance with the above. [Changes from Submitter's Recommendation underlined] COMMITTEE STATEMENT: Clarify as to where feeder disconnect device b to be located.

(Log # 85) 99- 40. (3-4.2.1.4(j)): Accept SUBMITrE~ Ed Lobnitz, Orlando, FL RECOMMENI~TION: Delete the last sentence and insert "to allow engine cooldown" between "minimum" and "shall" in the second line. SUBSTANTIATION: Editofiai. COMMITTEE ACTION: Accept.

(Log # 86) 99-41 - ($ -4 .2 .2 .1 ) : Accept SUBMITTE~ Ed Lobni-t-, Orlando, FL ~ M M F 2 f D A T I O N : Change the word "hospital" in the fourth line to "facility'. SUBSTANTIATION: Editorial correction in keeping with structure of NFPA 99. COMMITITAE ACTION: Accept.

(Log # 1~) 99-45. (8 -4 .2 .2 .1 ) : Accept S U B ~ Barry Duignan, Greater New York Hospital Associa- tion RECOMMENDATION: Line 4 change word "hospital" to "fa~]~". SLrLqTANTIATION: I. Type I essential electrlcal system ~ be used for other than "hospit~d'.

2. To maintain consistency in document. COMMITTEE A c r I o N : Accept.

(LOg # 20) 99- 44. (8 -4 .2 .2 .1 ) : Reject SUBMITYE~ James c. Seabury, HI, Smith Seckman Reid, Inc. RECOMMENDATIONt Revise hs t paragraph, last sentence as follows:

" . . . one transfer switch shall be permitted to serve one or more branches [or systems] ."

Delete: "in a facility with a maximum demand on the essential electrical system of150 KVA (120 KW). SUBSTAN'rIATIONz This tin-amended statement is in conflict with NFPA-70 - National Electrical Code: 517-80.4. Deleting the identified words above will eliminate the conflicts between the two codes on this issue. I believe it is the intent of both codes to require more than one transfer switch in Type I health care facilities. COMMrrTEE ACTION: Reject. COMMITTEE STATEMENT: Committee intent is to allow branches and systems to be combined on a single transfer switch for this size essential electrical system.

(Log # 167) 99- 45 - ( S - 4 . 2 . 2 . 2 ( b ) (6 ) , ~ - 4 . 2 . 3 . 2 ( g ) ) : Reject SUBMrITER: Hy Bershad, Hospital Engineering Society of Greater New York RECOMMENDATION: Add to 3-4.2.2.2(b) (6) and 3-4.2.8.2(g) the following:

" . . . as well as fire (or jockey) pumps required to maintain pressurized standpipe and/or sprinkler systems." SUBSTANTIATION: Life Safety equipment includes firepumps for standpipes and sprinklers and should be included in the life safety branch. Many existing other local Codes already do require thisl COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: 1. NFPA 99, paragraph S-1.5 permiu fire pumps to be placed on essential electrical system.

2. Committee has received no documented history to indicate a need to mandate fire pumps on the life safety branch, as recommended.

3. Fire pumps, because of their electrical characteristics, belong on equipment system, ~f it is desired to place them on essential electrical system.

(Log # 137) 99- 46- (S-4.2.2.2(b) (6), ~4.2.$.2(g)): Reject SUBMITrER: Barry Duignan, Greater New York Hospital Associa- tion RECOMMENDATION. Add to 3-4.2.2.2(b) (6) and 3-4.2.3.2(g) the following:

" . . . as well as fire (or jockey) pumps required to maintain pressurized standpipe and/or sprinkler systems." SUBSTANTIATION: Life Safety equipment includes firepumps for standpipes and sprinklers and should be included in the life safety branch. Many existing other local Codes already do require thisl COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: Identical to Proposal 99-45 (Log #167). Thus, rejected for same reasons.

(Log # 166) 99- 42 - (3-4.2.2.1): Accept S ~ Hy Bersh~, Hospital Engineering Society of Greater New York RECOMMENDATION: Line 4 change word "hospital" to "facility". SUBSTANTIATION: 1. Type I essential electrical system ~ be used for other than ~ospithl".

2. To maintain consistency in document. COMMITIT~ ACTION: Accept.

(Log# 1C~) 99- 47 - (S-4.2.2.2(c) (1)): Accept in Principle SUBMITrF.R: Hy Bershad, Hospital Englfieering Society of Greater New York RECOMMENDATION" Change (I) to read as follows:

(1) Anesthetizing Locations 2£) Task illumination, all receptacles exceot ded~nated normal circuit duplex rece13tacles which may be

and fixed equipment. - SUBSTANTIATION: This would ~ normal power in anesthetizing locations that could be usable and useful m the event of a failure of the ATS returning from emergency power to normal power.

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C O M M r r D ~ ACTION: Accept in Principle. See Committee Propma199-27 CLog #ESE-6).

CoMMrrrF.~ STATEMENT: Proposal ESE-6 responds to issue raised in this proposal.

(Log # 188) 99- 48 - (5-4.2.2.2(c) (I)): Accept in Principle S U B ~ Barry Duignan, Greater New York Hospital Assocla. tion RECOMMENDATION= Change (1) to read as follows:

(1) Anesthetizing Locadons 2D Task illumination, all receptacles cxcen~ dedtmated normal circuit dunlex recentacles which mav be

and fixed equipment. - SUBSTANTIATION: This would ~ normal power in anesthetizing locations that could be laable and useful in the event of a failure of the ATS returning from emergency power to normal D o w e r . e r . ~OMMrrTEE ACTION: Accept in Principle.

See Committee Proposal 99-27 (bog #ESE-6). COMMITTEE STATEMENT: Proposal 99-27 (Log #ESE-6) responds to issue raised in this proposal.

(bog # 87) 99- 49 - (5-4.2.2.2(c) (1)): Accept in Principle SUBMITrE~ Ed Lobnitz, Orlando, FL RECOMMENDATION= Change (1) to read:

(1) Critical patient care areas that utilize anesthetizing gases - task illumination, all receptacles and fixed equipment. (See NFPA 70, National Electric Code for definition of Critical Patient Care Areas.) S ~ A N T I A T I O N : This section of the Code has existed as-is for many years and is not applicable to all areas where anesthetizing gases are used. MRI's and CAT scan equipment rooms for instance, are now being equipped with anesthetizing gas and even though only used as a relaffve analgesia qualifies as an anesthetizing location as defined in Chapter 2 of this standard. There is no reason to require CAT scans, MRI's and similar equipment and areas to comply with this requirement. This requirement should only apply to c.nucal care areas. COMMITTEE ACTION: Accept in Principle.

1. In Submitter's Recommendation, change "critical patient care area" to "critical care areas', and delete "(See NFPA 7 0 . . . care a r e a s . ) m

2. Move 12-2.6(a) ( 'General care areas. . .") to Chapter 2, Section 2-2, and insert under definition ofpadent care area.

S. Move 12-2.6(b) ('Critical care a reas . . . ") to Chapter 2, Section 2-2, and insert under definition of patient care areas.

4. Revise 12-2.6(a) to read: ~ene ra l Care Areas. (See definition in Chapter 2.)"

5. Revise 12-2.6(b) to read: "Critical Care Areas. (See definition in Chapter 2.)" COMMITTEE STATEMENT: For 1), NFPA 99 uses the term "critical care area'. For 2) and 3), NFPA 99 already defines terms. For 4) and 5), editorial, foliowmg actions 2) and 5).

(Log # 52) 99- 50 - (3-4.2.2.2(c) (I) Exception (New)): Accept in Principle SUBMIIWER: W'dllam T. Guy, Jr., Elizabeth General Medical Center RECOMMENDATION: Add the following text as an Exception:

Exception: 50% of task illumination in anesthetizing locations shall be permitted to be fed from the normal power branch of the distribution system. SUBSTANTIATION. If 100% of task illumination is supplied by critical branch, all lighting will be lost in the operating room if any problem occurs with the tranffer switch or circuit. Allowing up to 50% of lighting to be off the normal branch, will

ensure adequate light for operating room personnel to care for the tient. MMITrEE ACTION: Accept in Principle.

Insert new 3-4.1.2.1 (e) (1) (v) to read as follows: (v) General Purpose. A general-purpose lightinl~ circuit connected

to the normal grounded service shall be installed m each operating room.

Exception: Where connected to any alternate source permitted in NFPA~0, Section 700.12, which is separate from the source serving the emergency system.

COMMrITEE STATEMENT: 1. Issue is already addreued in 517- 63(a) of NFPA 70, and is conddered acceptable in NFPA 99 because it is performance criteria.

2. Paragraph 5-4.2.2.2(c)(1) is not appropriate location for this guidance.

(Log # 65) 99- 51 - (3-4.2.2.2(c) (I)): Accept in Principle SUBMrITER: Bryan Parker, Montefiore Medical Center RECOMMENDATION: Delete "all'. SUBSTANTIATION: Conflicts with the note at end of section. It may well be desirable to connect some receptacles in Anesthetizing Locations to the Normal Branch. Also conflicts with second paragraph of 3-4.1.2.5 (d).

COMMITTEE ACTION: Accept in Principle. See Committee Proposal 99-27 (Log #ESE-6).

COMMITTEE STATEMENT, Proposal #ESE-6 responds to issue raised in this proposal.

(Log # ~E-7) 99- 52 - (S-4.2.2.3(a)): Accept S ~ Subcommittee on Electrical Systems RECOMMENDATION: Delete sentence 2 ("It shall be permitted to be connected to equipment listed in Appendix A-5-4.2.3.3(c).') SUBSTANTIATION: I. Not in accordance with NFPA Style Manual to reference Appendix material for requirements.

2. Issue alreaHy covered under 3-4.2.2.3(d) (8). COMMITr]~ ACTION: Accept.

(us # 189) 99- 55- (5-4.2.2.3(c) (4) (New)): Reject SUBMrI'rER: Hy Bershad, Hospital Engineering Society of Creater New York RECOMMENDATION: Add new item (4) as follows:

(4) Fire Extinguishing and/or Smoke Detection and Control Systems. SUBSTANTIATION: Life safety concerns requires that these types of systems be included in Essential Electrical Systems. COMMn'TEE ACTION: Reject. COMMITTEE STATEMENT: 1. Not appropriate to include smoke detection systems under equipment system because they are already included under life safety branch (3-4.2.2.2 (b) (3)).

2. Reference to fire extinguishing systems is unclear because mere are several types of such systems (and controls).

(Log # 139) 99- 54 - (3-4.2.2.3(c) (4)): Reject SUBMITrF..R: Barry Duignan, Creater New York Hospital Associa- tion RECOMMENDATION: Add new item (4) as follows:

(4) Fire Extinguishing and/or Smoke Detection and Control Systems. SUBSTANTIATION= Life safety concerns requires that these types of systems be included in Essential Electrical Systems. COMMrI'rEE ACTION: Reject. COMMITTEE STATEMENT: Proposal is identical to Proposal 99-53 (Log #169), and thus reason for rejection is the same as listed in that proposal.

(LO~ # 88) 99-55- (3-4.2.2.3(c)(4) and (5) (New) and 3-4.2.3.3(b)(S) and (4) (New)): Accept in Principle SUBMITrE~ Ed Lobnitz, Orlando, FL RECOMMENDATION: I. In 3-4.2.2.3(c), add new items (4) and (5) as follows:

(4) Required smoke control and stair preuuriziation systems. (5) Kitchen hood supply and/or exhaust systems, if required to

operate during a fire in or under the hood. ~. In S-4.2.$.~(b), add the same two items as in recommendation

No. 1 as new items (3) and (4).

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SUBSTANTIATION: When the fans listed are required to operate, normal power is usually turned off manually or lost due to the fire. If emergency power and circuits are capable of supplying power to the fans, they must operate to provide required andexpected smoke and fire control. COMMrrrEE ACTION: Accept in Principle.

In Submitter's Recommendation 1, item (4), delete *Required". COMMITTEE STATEMENT: Committee intent is to require such systems, • ~ ta l l ed , to be on essential electrical systems, not to require such systems.

(Log # ESE-8) 99- 56 - (3-4.5.2.1, Note 1): Accept SUBM1TrER: Subcommittee on Electrical System~ RECOMMENDATION: Delete Note !. Renumber Notes 2 to 4 accordingly. SUIk~TANTIATION: Unnecessary. Does not conform to NFPA Style Manual. COMMrrI~E ACTION: Accept.

(Log # 1) 99- 57 - (3-4.3.3.6): Accept in Principle S U B M r r r E ~ Saul Aronow, Technology in Medicine, Inc. RECOMMENDATION: In sentence 2, change "corresponding to at least the total hazard current at the nominal voltage" to "corresponding to a total hazard current of 5.0 milliamperes at the nominal~line voltage, or to a lesser alarm hazard current if the line isolation monitor ~s so rated." SUBSTANTIATION: 1. The proposal wording misinterprets the meaning of "hazard current", and would allow the test to run at any value o f hazard current. The revision makes provision for the usual 5.0 mA LIM or a leuer value rating.

2. The proposal was originally intended for NEC 517, which lacks a corresponding section in the LIM disctmion. That is why it appears redundant in 99. COMMITrF.,E A.~CTION: Accept in Principle.

Change submitter s recommendation to as follows: "corresponding to the rated total hazard current at the nominal line voltage, or to a lesser alarm harzard current if the line isolation monitor Is so rated." [change underlined] COMMITTEE STATEMENT: LIMs may have more than one rated current, and the test switch should operate at the rated current.

(Log # ESE-9) 99-58- (3-5.1, 3-5.2): Accept SUBMrrTER: Subcommittee on Electrical Systems RECOMMENDATION: I. Relocate the following paragraphs from 3-5.1 and 3-5.2 and renumber as follows:

3-6.2.3 Maintenance and Testing of Normal Electrical System. 3-6.2.5.1 Testing Interval for Receptacles in Patient Care Areas.

[Insert 3-5,2.2.2] 3-6.2.3.2 Criteria for Acceptability of Existing Grounding System.

[Insert 3-5,2.1.6(b) ] 3-6.2.3.3 Testing Interval for GFCIs in Patient Care Areas. [Insert

3-5.2.5.2] 3-6.2.4 Maintenance and Testing of Essential Electrical System. 3-6.2.4.1 Maintenance and Testing of Ahernate Power Source and

Transfer Switches. [Insert 3-5.1.2,3~n total] 3-6.2.4.2 Maintenance and Testing of Circuitry. [Insert 3-5.1.2.4] 3-6.2.4.3 Maintenance of Batteries. [Insert 3-5.1.2.5] 2. Renumber 3-6.2.5 and 3-6.2,4 accordingly.

SUBSTANTIATION: Separate new requirement [3-5] from existing requirements C3-6]. COMMITrEE ACTION: Accept.

SUBSTANTIATION: Generator sets exercised at less than 50 ercent load have decreased reliability and operating life. OMMITrEE ACTION: Accept.

CLog # ~00) 99- 60 - (3-5.1.2.3(b) (I) NOTE): Accept SUBMrrrEIh Bobby Dale Brown RECOMMENDATION: Amend Note to read:

NOTE: Records of changes to the essential electrical systems should be maintained so that the actual nroduced bv the connected load will be within the available capacity. (Note that the proposed words have been underlined)

S ~ A N T I A T I O N : This note has been construed by some users and authorities having jurisdiction to mean that the system capacity shall be equal to or greater than the connected load. The intent is for the system to be able to support the demand. COMMrrTEE ACTION. Accept.

(Log # F..SE-2) 99- 61 - (3-5.2.1.1): Accept S U B ~ Subcommittee on Electrical Systems RECOMMENDATION: Revise 3-5.2.1.1 to read as follows:

3-5.2.1.1 Grounding System Testing. [Use existing wording] (a) New Construction. [Use existing wording] Exception No. 1: [Use existing wording under 3-5.2.1.1 (b) ] Exception No. 2: [Use existing wording under 3-5.2.1.1 (b) ]

( °(b~.~ja [Use existing wording from 3-5.2.1.1 (c), but not NOTE under

NOTE (New): The grounding system (reference ]~'ound and conduit) is to be tested as an integral system. Lifting of grounds from receptacles and fixed equipment is not required or recommended for the performance of this test. [Recommendation deletes existing 3-5.2.1.1 (b) and the existing

NOTE under 3-5.2.1.1 (c) ] SUBSTANTIATION: The effectiveness of grounds does not significantly chanl~e over the aging of the system. It was the Committee's opimon that the annual recommendation (to test system) is not appropriate. The addtion of a new NOTE is for clarifying how the system is to be tested. COMMITrEE ACTION: Accept.

(Log # 34) 99- 62 - (3-5.2.1.1): Reject S U B M H T F ~ Jack Berger, N.E. Hospital Engineers Society RECOMMENDATION: Add new paragraph~-5.2.1.1 as follows:

3-5.2.1.1 Grounding drcuits and conduciors in patient care areas. In all patient care areas the reliability of an iustalIed groundinl[ circuit to a power receptacle shall be at equivalent to that prowded by an electr]ca~lly continuous copper conductor of appropriate ampacity run f~om the receptad~ to a grounding bus-in the distribution panel. The grounding cofiductor shall conform to NFPA 70, National Electrical Code. This is intended as a design and not testing requirement.

The existing paragraphs, 3-5.2.1.1, 3-5.2.1.2, and 3-5.2.1.3, etc. should be increased by one number. SUBSTANTIATION: This p ayag~_ ph was omitted from the 1987 and 1990 editions of this standard. ~It appeared in the earlier verions and should be continued to clarify a key|ssue regarding ground circuit ampadty mentioned in NFPA 70. The last sentence of the proposal is added to make clear that testing ground circuit ampacity can create hazardous conditions in a health care setting. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: 1. This is installation criteria and outside the scope of Committee.

2. Committee believes issue is adequately addressed in NFPA 70, Article 250-51, Effective GroundingPaths.

(Log # ESE-10) 99- 59 - (~5.1.2.5(b) (I)): Accept SUBMITI'ER: Subcommittee on Electrical Systems RECOMMENDATION: Revise 3-5.1.2.3(b)(1) m read:

(I) Test Interval and Load. Generator sets serving emergency and equipment systems shall be inspected weekly and shall be exercised under at least 50 oercent rated load at oDeratin~ temneratures for at least 30 minutes i t intervals of not more-than $0 days~ [Change Underlined]

(Log # 199) 99- 63- (3-5.2.1.I(c) NOTE): Reject SUBMITYE~ Bobby Dale Brown, Smith Seckman Reid, Inc. RECOMMENDATION: Revise the note to read as follows:

NOTE: A minimum testing interval of one year is recommended. It is not intended m require installation testing by the installing contractor.

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SUBffrANTIATION: Some authorities havingjuriKlicfion have required installation testing[ of each and every receptacle by the installing contractor. This ~ not the intent of NFPA 99, and such testing unduly increases the costs of bospital construction. C O M I ~ I ' r ~ ACTION: Reject. COMMrlWEE STATKMENT: 1. Proposal mllgsests initial testing is not necessary. However, initial testing is reqmred, per paragraph 5.2.1.1 (a). 2. It is Committee's intent not to specify who is to do testing.

(Log # 22) 99- 64- (3-5.2.1.4(a) and (b)): Reject SUBMITrE~ Jack Berger, N.E. Hospital Engineer's Society RECOMMENDATION: Revise as follows:

Whe impedance measurement shall be made by applying a 60I-Iz voltage between a point under test and a reference point. The impedance is the ratio of the 60Hz voltage to the current." SUBSTANTIATION: It is very difficult to understand the present wording of this simple test. Present wording: The impedance measurement shall be the ratio of the 60Hz voltage developed between a point under test and a reference point to 60Hz current applied to the point under test. COM~IrrTEE ACTION: Reject. COMMITrF~ STATEM]D~: Committee cannot determine which text Submitter wants revised.

(Log # 25) 99- 65 - (3-5.2.1.5(b)): Reject S U B M 1 T r l ~ Jack Berger, N.E. Hospital Engineer s Society RECOMMENDATION: Add "unless additional safety measures are taken" to the end of the paragraph. SUBbWANTIATION: Since the test inm'uments and the test procedure are not specifically identified, it is inappropriate to establish fixed limits as have been done. Adding the clause recommended allows for engineering techniques not yet determined. COMMITrEE ACTION: Reject. C o M M r I T ~ STATRMENT: Current wording in document sets safety limits for measurements, irrespective of instrumentation used. Submitter's Recommendation would allow higher limits without specifying what safety precautions would be necessary,

(Log # 51) 99- 66- (3-5.2.1.6(a)): Reject $UBM]TYER: Hy A. Bershad, Staten Island, NY RFX~OMMENDATION. Change 3-5.2.1.6(a) to read as follows:

(a) For both new construction and exhting construction (1) Voltage limit shall be 500 MV (2) Impedance limit shall be 0.2 OHMS.

Retain the 1st note as follows: NOTE: The 500 MV limit is based on phDiological values. Since

actual voltages measured in modern construction may be of the order of 10-20 MV, voltages exceeding 20 MV may indicate a deteriorating condition and should be investigagted.

SUBSTANTIATION: 1. There is no basis in establishing levels of safety of 20, 40 and 500 MV for the same type of patient care a r e a s .

2. The 20 MV requirement would relate to all patient examination rooms, therapeutic and diagnostic areas includingradiology (or imaging), laboratory areas, outpatient areas as well as inpauent a r e a &

3. If 500 MV is ~ the safe ~ for a permitted maximum potential difference between any two exposed conductive surfaces in it natient vicinity then this standard, which is to concern itself with pitient safety ~ and not the quality of construction, should have one established level of safety ~ the maximum potential differences permitted ~o 500 MV (see, for example, Sec. 7-5.1.3.5 Exception No. 2).

4. If new construction cannot meet the existing established limits can tests be scheduled for a week after opening considering the facility now as an "existing facility"? The differentiation between new and ~ is not appropriate in establishing a firm level of safe . i v .

5. Why should an existing critical care area be permitted a 40 MV limit as opposed to a new routine medical.4urt, ical natient room with a 20 MV ll/niO What is the rationalization for-this?-

6. Some electrical Contractors have indicated that the ~ d e d cmt for building a routine patient care room with a maximum of 20 MV of potential difference would be of the order of $1500-$~00/room. Certain electrical Consultant Engineers concur. There appears to be no benefit that would result fi;om the added costl COMMITTEE ACTION: Reject. COMMITrEE STATEM]ENT: I. See reamns in Committee Statement of Proposal 99.67 (Log #170) as they apply to this proposal.

2. It would appear that excessive costs are the result of inappropriate testing techfiique. (See Subcommittee Proposal 99-61 (Log #ESE-2) that addresses that aspect.)

(Log # 170) 99- 67 - (3-5.2.1.6(a) and (b): Reject SUBMrI'rEi~ Hy Rershad, Hmpital Engineering Society of Greater New York RECOMMENDATION: Change to read as follows: (a) New Construction (1) Voltage limit shall be 40MV for critical care areas and 500 MV for General care areas

I?! ~ m ~ d ~ c e l ~ i t s h ~ be 0.2 OHMS D) Lvasting ~onstrucdon

(1) VoltageLimit shall be (i) 500 MVfor General Care Areas (fi) 40 MV for Critical Care Areas

S ~ A N T I A T I O N : 1. Conform to NFPA 7001990 National Electrical Code.

2. If requirement for ~ installations is safe then same requirements should apply to new installafiom.

3. Fine Print Notes may be retained. C O ~ ACYION: Reject. COMMITTEE STATEMENT: I. Experiences of members of Subcommittee have shown that existing requirements can be readily achieved assuming appropriate techniques are used. In the interest of clarifying measurement techniques, Subcommittee has generated apropmal (see Proposal 99-61 (Log #ESE-2)) . .

2. Higher voltages are allowed to account tor me aging oza system, and does not relate to the isme of ~fety.

(Log# 140) 99- 68. (s-5.2.1.6(a) and (b): R~ect SU'BMITIT.q: Barry Dulgnan, Greater New York Hospital Associa- tion RECOMMENDATION: Change to read as foUows: (a) New Construction (1) Voltage limit shall be 40MV for cridcal care areas and 500 MV for General care areas

(2) Impedance limit shall be 0.2 OHMS (b) Existing Construction (1) VoltageLimit shall be (i) 500 MV for General Care Areas (fi) 40 MV for Critical Care Areas

SUBSTANTIATION: 1. Conform to NFPA 7001990 National Electrica/Code.

2. If requirement for ~ installations is safe then same requirements should apply to new installations.

3. Fine Print Notes may be retained. COMMITFEE ACTION: Reject. C O M M I T F ~ STATF, MF2~: Proposal is identical to Proposal 99-67 (Log #170), and is thus rejected for same reasons.

(Log # 190) 99- 69 - (Chapter 4, through Section 4-6): Reject SUBMrFIT, R: D.A. McWhinnie,Jr., Mechanical Dynamics Inc., Self NFPA Vacuum Systems SS/C, Chairman RECOMMENDATION: Delete all dew point references and relocate to Appendix. SUBSTANTIATION: Dew Point is a maintenance function which belongs in, and was improperly removed from Code 99 Appendix.

To require, without valid substantiation, these urmeededand expensive devices is in violation of NFPA Part VII Regulatiom:

1. 10010(c) No "statement of the problem" or "subitantiadon" to support the claim that without these components "there is a distinct hazed to life" has ever been submitted to the T/C.

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(If a hazard to llfe is "distinct" there would certainly be medical testimony and/or documentation which is requiredbefore imposing this mandate on the entire health care industry - on the basis of a simple and frightening seven-word claim.)

2. 10-13 The required %tatement..(on)..the reason for i t s action...shall be sufficiently detailed so as to convey the Technical Committee's rational..." was never provided, although requested.

(The COMMITTEE STATEMENT '89 TCD 99-$5 was that "it is aware of reports that list hazards associated with high dew point'. Without "a statement of the problem and substanuadon.., w this Regulation has been breached. To impose a mandate, particularly of this. .n~.itude, requires those substantiating "reports" and "hazards hst', and a dear statement of the ~.he problem" for the T / C's evaluation.

3. 10-10(c) and 10-15 A specific requirement arbitrarily selected - "for lack of a firm number '~- with no rationale or documentation can only be summarily rejected - ('89 TCR 99-152).

Dewpoint is a maintenance function which is achieved daily in a myriadof hospitals throughout the world by the presentiy required (99, 4-$.1.9.7) "aftercoolers and/or air dryers". Medical Compressed Air Systems with on-site compressors have been installed for over 40 years, with only aftercoolers on much less advanced compressors, and although only some developed condensate, there have been NO known reports of patient hazard due to any level of dew point. It is the responsibility of any member of any NFPA Health Care Facilities committee to assist NFPA efforts by providing such (authorative) documentation, if any exist. What new knowledge has been learned to justify, all of a sudden,

making an Appendix item a requirement? All involved individuals and committees have a right, and responsibility, to know.

Code 99, 2-2 Medical Compressed Air(b) need "not be equal in puritygr_il~glgll (underscore added) to the commodity specifica- tionGrade D reconstituted air." This applies specifically to the vast majority of Health Care Facilities - empmcally 98%+.

Many HCFs, with aftercooler/dryer failure, have foregone repair in lieu of 40°F pressure dew point desiccant component, and/or trainable condensate traps downstream of aftercoolers - successfully - with no before or after knowledge of dew point levels, or reports of patient "hazard". (Low point drip legs have worked.) This unsubstantiated and arbitrary requirement would result in 8%

RH @ 1 atm in 78%F ambient- and 8.5% RH @ 1 atm in 68"F (a reasonable temperature range allowance for patient areas). This value is most certainly not required for inhalation therapy but, conversely, is detrimental to respiratory effort. This additional component and function has not been claimed,

demonstrated or documented in NFPA to enhance the present safe treatment of patients.

See "...all ventilators provide for the humidification of inspired air...", and in "TRACHEOSTOMYcare...on a respirator...some method for moisturizing the air is provided. The fact...the air passages must be kept moist whenever a respirator is used..." (From Ventilator text - Enc~lopedia and Dictionary of Medicine, Nursing and Allied Health, by Mfller and Kean, Publ., W. B. Saunters Co.) The requirement for the arbitrarily required ("for lack of a firm

number') dew point alarm level so close to the refrigerant dryers has caufl~d:

1. Conscientious attempts, with undue concern, to meet this unsubstantiated Code requirement in locations where problems have never been experienced.

2. Use of desiccant components with 15-20% purge loss- continu- ous rating - 30-40% at 50% design operating cycle.

3. The practice of much higher operating pressures than needed, and then necessarily reducedsimply to achieve compliance with an unsubstantiated NFPA Code requirement.

4. Higher operating pressure than necessary which increases power consumption, adiabatic heat generation, mechanical stress, and total air pressure and partial oxygen pressure volatility with the net result of:

a. Hazard of reduced air quality from chemical breakdown a/c of combined higher partial oxygen pressure and temperature of compressor components and/orhydrocarbons.

b. Increased compressor failure rates well known for more thermally and physically stressed machines.

c. Greater energy costs. d. Increased maintenance demands and downtime.

5. Possible, and reasonable, meter error with consequent false alarms and unscheduled maintenance demands although no patient hazard exists. To require expensive dew point meters, sensors, alarms, mechani-

cal/electrical installation and maintenance costs, there must be authoritatively documented substantiation of the proponent's claim of "a distincthazard to life" - following a dear and concise "statement of the problem" (NFPA Part VIIRet~ulations 10-10 (c) and 10- 13). On this issue, neither the letter nor intent of the applicable Regulations have been met.

ANNEX~ Experience with lite.ral.l~, thousands of medical gases and vacuum central piping systems indicates that an insignificant number are ever exposed to critically low ambient temperatures. Such rare instances can easily (should) be addressed in an appendix or footnote (NFPA IM, Manual of Style); and can be deait wRh effectively, and at much lower cost, by routing, insulation, heat-wrap, etc. COMMrrrEE ACTION. Reject. COMMITTEE STATEMENT: The reasons for this requirement are clearly substantiated by the experience of the Subcommittee who are aware that water in air, derived from the normal operation of compressors, is the single most problem in medical gas .s~stems.

It is very clear, by the logic above, that the presence of hquid water in the air line constitutes a distinct hazard to life, namely ranging from drowning (in severe cases) to damage to equipment, on which the patient may be dependent. The dew point monitor is the best and simplest way, in the opnion

of the Subcommittee, to prevent the buildup of this water. The set point for the alarm was selected based on technical

capabilities of the equipment in common use. As this equipment, properly sized and used, has proven generally satisfactory, there was not felt to be any sufficient reason to mandate some other, and therefore arbitrary, set point for this alarm. The submitter argues that *dew point is a maintenance function."

Quite so. It is in support of this statement that the Subcommittee has provided a device to allow this function to be properly monitored. The knowledge learned is not new, but has been ignored. This

knowledge is the physics of water vapor, combined with the operating principles of the several components of the medical air compresor system. This knowledge allows the Subcommittee to assert that water is a potential hazard to life even in the absence of the experience of the Subcommittee with actual installations. The Subcommittee does not, through _an~. requirement, intend that

medical air be "equal in purity or dryness to Grade D air. In the case of dryness, it could not so require, as there is no dryness specification for Grade D required by the Compressed Gas Associa- tion.

The use of any particular technology was carefully and intentionally avoided by the Subcommittee. How a health care facilit~ resolves any problem with dew point is left to their informed opuon, hopefully, by a dew pomt monitor which allows them to assess the effect oftheir actions. That an), facility has successfully resolved dew point problems by blindly adding drip legs, etc., in no way prejudices the fact that they would have been enabled to resolve their problem better if in possession of real time knowledge of their facility's air dew point.

This requirement is intended to be applied to facilities designed and approved after February, 1990. The Subcommittee disagrees with the assertion that a facility can,

by application of "routing, heat tape, insulation, heat wrap, etc.", resolve a problem with water in medical air. In ignorance of the actual dew point and knowledge of the physics ofwater vapor, a facility is exceedingiy poorly advised to take measures such as these, and may well make their problems worse. A properly designed and monitored air compressor does not require mese measures.

99- 70 4-1 4 4-7 and Se (Log # 192) - ( . , , ctions 4-7 through 4-10): Reject SuBMrITEIh D.A. McWhinnie, Jr., Mechanical Dynamics Inc. RECOMMENDATION: Revise as follows:

(a) 4-1.4 After %.. apply to" in second sentence insert "Waste Anesthetic Gas Disposal (WAGD), or"

(b) Immediately above 4-7 and below existing NOTE add new Note 2:

NOTE: The following Medical-Surgical Vacuum System (MSVS) Document does not cover Waste Anesthetic Gas Disposal (WAGD). WAGD requirements are in Chapter 5, Environmental Systems. ( c ) 4-7 through 4-10 - delete all Waste Anesthetic Gas Disposal

(WAGD) references from the Vacuum Systems and Equipment Committee document on Medical-Surgical Vacuum Systems (MSVS). SUBSTANTIATION. A. WAGD technology and function is not in the Scope of NFPA

Vacuum Document, which expressly prohibits "nonmedical or nonsurgical applications." WAGD inclusion in this document introduces a ltriown patient hazard, and is contrary to Code 99, 2-2 and ,N~ADirectory, 1990, Part VII Regulations, 2-2 "Code" and "Standard ; and Manual of Style 1-3(a) and 2-1.1. WAGD is a Chapter 5 topic (per item C.below). The proposed deletions, now in the requirements' text, are without

requirements, performance or criteria ofiglg kind. Incredibly, the Appendix ignores the internationally accepted, and volun~inously documented "cautions", "hazards and "risk to patients which, more incredibly, are partially documented and referenced in the

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Technical Committee files and each edition of NFPA HCF Hand- book (see B. below).

The T / C acknowledged the hazards reported (in committee) by theJCAHO representative, and three Afiesthesiologists - ANSI Z79.11 Chairn~m, and the Chairmen of NFPA committees on Anesthesia Services, and Gas Equipment (MSVS degree of vacuum in the breathing circuit "would not enable patient to breath and thus kill patient'). (6-19-89 T / C minutes.) Among the many authorative references to WAGD hazards in the

use of MSVS: a. Potential Puimonary Barotrauma when Venting Anesthesia

Gases to Suction. (MSVS) Anesthesiology 46: 152-I54; 1977. b. Scavenging apparatus *. . . even when operating properly

(normal use) can alter the normal characteristics of an anesthesia breathing mach ine . . . " (ANSI Z79.11 - 1982).

c. "eacI~ scavenger value (for WAGD) failed to function safely when wall suction (MSVS) was appfied to the exhaust port." (Ref. A. above). - -

d. "Care must be t aken . . , to avoid exposing the breathing circuit to ~ (underscore added) pressure ~ M . ~ • . ." (NFPA Code 99, A-5-4.2 -ANSI Z79).

NOTE 1: There are, at least, three much safer and much less expensive (hospital cost containment), and proved effective, methods for WAGD function - two ofwhlch exist in (are built into) eV~Ahospital anesthetizing area.

Code 99 is contradictory in leaving WAGD in its Vacuum Document while simuitaneoudy acknowledging in Chapters 4, 5, and 12 the continuing use of flammable anesthetic gazes which, in this application, presents *fire and explosion hazards" (Code 99, 4- 2.2, 1st sent.), and "will cause certain deterioration of the vacuum system." Nonflammable medical/anesthesia gazes, also, "will cause certain deterioration of the vacuum system." (4-7.1.2.1, Note 2.) NOTE 2: No Code 99 Medical-Surgical Vacuum System is "designed for such operation" (Code 99, A-5-4.2. ANSI Z79) - and, although required in Code 99 (4-7.1.2.1, "shall be"), no performance orprocedure is provided for the r~lgi~Y~[ "dilution".

In 1986 the Vacuum Committee voted for this proposal (to delete WAGD) which was overturned by the HCF T/C. In 1989 the Vacuum Committee voted, one ballot short of

unanimous, for deletion of WAGD from its document ('89 TCD, 99- 18 and 99-48). Disregarding the hazards rej~mrted in at least three NFPA committees, the HCF T / C left them m the Vacuum Docu- menu

Contrary to its mandate, Part VII, I-2, the Standards Council failed in its 90-7 action, to adjudicate or even address, the T / C action on WAGD issue - ('89 TCD, 99-18 and 99-48).

B. It is impossible to justify the inclusion of WAGD in the NFPA Vacuum Document when the simultaneously published NFPA HCF Handbook, 1990 states:

WAGD "does not fall within the scope of this chapter (as listed in 4- 1.4)." WAGD "is not a function of a medica]-~urgical vacuum system

(~VS) . " WAGD "is an environmental control system'. (The tide of NFPA

99, Ch. 5) WAGD "is a ventiiation function". (12-4.1.2.1 refers only to

Chapter 5) "MSVS is not to be used for noumedical or nonsurgical applica-

tions, ~ MSVS "alarm systems and monitoring gauges . . , cannot be used in

a WAGD system." Requirements for WAGD "will appear in Chapter 5." (See third

item above) "The International Standards Organization (ISO) and the British

Standards Institute (BSI) both oppose using a MSVS for WAGD.. . (Because) . . .There is a great disparity in requirements between the two uses; the vacuum (degree) o fa MSVS is approximately I000 times in excess of that required for WAGD."

"Mixing the two creates very onerous safety problems. The negative pressure differential is vas t . . , and pressure swings can seriously affect patients." (See A.d. above.) The NFPA Medical-Surgical Vacuum Systems Technical Committee,

unanimously, "advocates separation of WAGD from MSVS" because of patient hazard. (1984) The Vacuum committee "STRONGLYDISCOURAGES such

combined u s e . . . " based upon patient safety. (1987) The Vacuum committee ~trongiy discourages combining a WAGD

system into a medical-surgical vacuum system.. , particularly because of the risks topatients." The above NFPA HCFHandbook, 1990 commentary quotes "have

been researched, written, and reviewed by experts in the field of health care safety. (Handbook Inwoduction, pg. iv)

For the NFPA Vacuum Code (or any NTPA document) to reference, and actually encourage by implication within the required text ( ' i f used", "if intended, to .use" ~rovided that', etc.),, an internadon-. ally known and authontauvely documented hazard is an affront to its authors, and a discredit to the process. This circun~tance is a glaring contradiction which has resulted in designer, supplier, installer and user confusion, rni~nterpretation, avanc" ious (or nescient) exploitation,* and ignores the hazard which is acknowledged in the HCT T /C and at least three SS/Ca.

*(Documented) All of the documentation of WAGD hazard referred to above,

among others, contained cautions about Vacuum me in application. After encouraging (in essence approving) this ill- advised application (two paras, above) NFPA Code 99 contains not one word of caution between its covers.

C. WAGD technology and its requirements are, presently and properly, in the Scope and text o f Chapter 5 "Environmental Systems". NFPA Code 99, Cha~.ter 5 Scope includes any " . . . enviroumentsl Systems used within health care facilities.": NFPA Code 99, 1990 Index refers all of the following to Chapter 5

Environmental Systems: "Environmental systems" "Exhaust systems" "Ventilation" "Scavenging apparatus" "Waste d i spos~ requirements Significantly, under Index, "Medical-surgical vacuum systems" there

is no sub-head for WAGD - but there is a sub.head for "Nonmedical use"-which prohibits the use of MSVS for WAGD. NFPA Code 99, Chapter 12 "Hospital Requirements" coven

"Ventilation" - ~l~-quirements for ALL Anesthetizing Locations" - and refers snecifica]ly to me rea_uirements of Chaptg r ~ (NFPA 99, 12-4.1.2.1)." Any reference in the Code 99 Vacuum Document to Waste

Anesthetic Gas Disposal belongs in the Appendix only- and should be limited to the appropriate chapter covering that topic. After extensive research neither this proponent, the NFPA Vacuum

Committee, nor the NFPA Health Care Technical Committee have found any authoritative source or documentation to imply, endorse or allow the acknowledged hazardous use of the Medical-Surgical Vacuum System for Waste Anesthetic Gas Disposal. COMMITrF.~ ACTION: Reject. COMMITYEE STATEMENT: Subcommittee believes that waste anesthetic gas disposal criteria is necessary in Chapter 4 since these systems are currently being used in medical practice.

(Log # 8O) 99-71- (4-5.1.2.1 (b) & (g) and 4-3.1.2.3): Accept in Part SUBMITrER: Peter Ferraro,Jr., Phoenix, AZ RECOMMENDATION. 1. Revise 4-3.1.2.1(b) first sentence to:

"Enclosures shall be provided for supply systems cylinder storage or manifold locadons for oxidizing agents such as oxygen and nitrous oxide."

2. Revise 4-3.1.2.1 (g) t int sentence to: "Combustible materials, such as paper, cardb6ard, plasti~ and fabrics shall not be stored or kept near supply systems cylinders or manifolds containing oxygen or nitrous oxide."

S. Revise 4-3.1.2.3 in total as follows: Additional Storage Require- ments for Nonflammable Gases Less than 2000 cuf t (57 ms).

(a) Supply systems cylinder storage or manifolds locations shall comply ~nth the requirements of 4-$.1.2.1 (b) and (g), and 4-$.1.2.2 (d).

(b) Other cylinder storage shall be separated from combustibles by one of the following:

(I) At least 20 ft minimum distance, or 5 ft minimum distance if the entire room in which located is protected by automatic sprinklers.

(2) A barrier at least 5 ft high of at least 1/2 hour fire resistance rated non-combustible construction.

(S) An enclosed cabinet of non-combustible construction of at least I / 2 hour fire protection rating.

NOTE: An approved flammable liquid storage cabinet may be used, vented to the room. (c) Other cylinder storage locations shall be vented by mechanical

or natural means to provide at least 5 air changesper hour. SUBSTANTIATION: Medical gases storage requirements were brought together in one location under 4-S.I.2 and text restructured in 1984 and 1989 editions. In thatprocess, previously recognized lower hazard traditionally identifiedas 2000 cuft or less total capacity connected or in storage for nonflammable medical gas

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piping supply systems, as well as the lower hazard asmciated with storage of respiratory therapy cylinders for individual use, was subsumed under 4-8.1.9 requirements, which derived directly from NFPA 56F and were formulated and intended for supply~Rip~g systems installations m dearly stated in 111 and 118 of NTPA 56F- 1977. Further, under 232, even NTPA 56F-1977 recognized a lower hazard for 2000 cuf t or less total capacity connected or in storage for nonflammable medical gas systems by not requiring one hour radng of enclosures, nor venfin~ to the outside--the two distinctions from the requirements for locauons of more than 2000 cuf t provided in 251.

(NOTE: Supporting material is available for review at NFPA

Headquar t e r , . ) i Also, second sentence of present 4-3.1.2.3, which purports to meet requirements of NFPA 101, where the location of the supply system door opens onto an exit access corridor, pro~des two of its three alternatives (b) and (c) which cali for a ventilation opening '~ith fire damper(s) of appropriate rating." This directly conflicts with NFPA 101-1988, 12-5.6.~t and 13-8.6.4, which prohibit "transfer [p'illes, whether or not protected by fusible link operated dampers" m corridor walls or doors, as well as NFPA 90A-1989, 2-3.11.1, and NFPA 80-1989, 1-8.2, both of which similarly address openings in e~thess corridors.

er standards recognize the lesser hazard with smaller quantifies of oxidizing gas storage. NFPA 43C-1986, 1-2.2 excepts applications where aggregate gas capacity is 100 lb or less (approximately 5 large (H or K.size) oxygen cylinders). NFPA 51-1987,1-1.5 excepts application to systems comprised of a single cylinder of oxygen and weldlng/cuu.ing torch set.

Other standards establish lesser protection requirements for [ oxygen stontge in occupancies where exposures to flammables, I com~bustibles or ignition sources may be far greater than in health care facilities. NFPA 51-1987, 2-2.1 requires cylinders be stored with 20 ft separation from flammable and combustible liquids and easily ignited forms of materials; and under 2-4.8 requires oxygen cylinder storage separated from fuel gas cylinders or combustible materials by 20 ft minimum distance, or a non-combustible barrier at least 5 ft ~GMh having a fire resistance rating of at least 1/2 hour. Compressed

.Maoclation Pamphlets P.1-1984, 4.2.2 requires the same, and P- 2-1978, 4.3 requires only enclmure or separation hut not time rated construction.

Hospitals must utilize oxygen cylinders, even if completely served with l~iped systems, for patient movement by wheelchairs or wheeled stretchers, as well as for emergency use should the piped systems be inoperative or faiL Almmt invariably at least small ~ cylinders, containing only approximately 28 cuf t compared to approximately 244 cuf t for large H or K-Mze cylinders, are stored on nursing units or floors. Although NFPA 99-1990 ~, 4-1.8 excepts appficadon to "portable compre~ed gas ~/stems, 4-8.1.2 storage provisions remain applicable ~nce NFPA~I01-1988, 13-3.2.4 requires protection in accordance with NFPA 99 for existing health care occupancies medical gas storage. In practice it is common to find small numbers of E-cylinders and occa~onal H or K-cyllnders for oxygen therapy stored in utility rooms and with other storage, including combustible boxed supplies, or in other use spaces. Even where a separate storage room exists, it is often not of I hour fire resistance rated construction or ventilated as described in 4-3.1.2.8. It is reasonable, as well as in accordance with established precedent, to distinguish between storage of lesser c[uantides meriting lesser protection, and greater quantities, especially since it is permitted to have oxygen in larger (Hor K-size) cyUnders in use at the bedside, simultaneously at multiple bedsides in a multi-bed room, in proximity m combustible furnishings, bedding and linens, other plastic and paper care and comfort ~tems, etc. Accordingly, revisions areproposed to restore differentiadon of requirements for locations I usedfor 2000 cuf t or less, between piping supply system cylinder storage and man,old locations where a leak could discharge more than one cylinder s volume over a sustained time; and the ~44 cuft total discharge from a single large H or K-size cylinder or 23 cuf t total discharge from a single small E-eize cylinder. Proposed reviMons aho eliminate conflicts with other NFI'A documents on cylinder storage venting and establish a modest performance venting requirement for other (non-piped supply systems) storage appropriate to the lesser hazard to counter oxen. n concentration in the event of a cylinder leak, without requiring separate dedicated venting. COMMITTEE ACTION: Accept in Part.

I. Accept Recommendation L 2. Accept Recommendation 2. 3. Reject Recommendation 8.

COMMrrrEE STA'rEMENTg Recommendation 8 does not take into consideration storage room doors that may open onto an exit access corridor. Parts b) and c) of Recommendation 8 address storage requirements for non-piped gas_. systems that are outside the scope of Chapter 4; they need to be addrt'med in Chapter 8.

(Log # NON-l) 99- 7¢2 - (4-8.1.2.1(g)): Accept $UBMrYTEI~ Subcommittee on Nonflammable Medical Piped Gas

ten~ ~COMMENDATION: I. Revise sentence 3 to read:

'Tacks for cylinders storage ~ to be of wooden construction. " (Change Underlined)

9. Revise sentence 2 to be an exception, to read as follows: Exception: Shipping crates or storage cartons for cylinders.

S~ANTIATION: I. Conform to NTPA Style Manual. 2. Sentence 2 is an Exception. Revision is to conform to NFPA

Style Manual. COMMITIT~ ACTION: Accept.

(Log # NON-2) 99- 78- (4-3.1.2.1(j)(I)): Accept $UBMrrrER: Subcommittee on Nonflammable Medical Piped Gas S~tems

OMME2~DATION: Add "compressed air," between "for" and "oxTgen ~. SUBSTANTIATION" Clarify that medical compreued air is included in the type of gases covered by the requirements of this

~ O ~ ACTION: Accept.

(Log # NON-20) 99- 74- (4-8.1.2.2(d), 4-8.1.2.8): Accept $UBMH'rEIu Subcommittee on Noz~flammable Medical Piped Gas S l ~ o ms

MMENDATION: 1. In existing 4-3.1.2.2(d), change "more than 2000 cu ft (58 cu m)" to read m follows:

*more than $000 cuf t (87 cu m)". 2. In existing 4-3.1.2.3, change "less than 2000 cuft (58 cu m)" to

read as follows: "less than 3000 cuft (S7 cu m)".

SUBSTANTIATION: The pro'pose of 4-8.1.2.8 was to permit small gas storage manifold systems for both Type I and Type II gas systems. The limit of 2000 cuf t was based on four oxygen and two nitrogen cyfinders of'G" size. "I-I" size cylinders are commonly being today with no reports to Subcommittee of hazards. The limit of 2000 cuft is increased to 3000 cuf t to reflect individual practices with

Accept.

(Log # 8S) 99- 75 - (Figure 4-3.1.5): Accept SUBMITrE~ LarryJ. Wemer, O'Connell Robemon and Associ- ates, Inc. RECOMMENDATION, Revise text u follows:

Note I: Indicates "See 4-$.8.$." No Sub-Sectlon 4-3.8.$ exists. Note 1 mhould be corrected to read: "Note 1: See 4-S.1.8.S." SUBSTANTIATION: Note directs the reader to *See 4-8.8.$." A review of chapter indicate, that sub-sections only go as high as 4-$.4 other gases. Therefore, 4-$.8.$ does not exist and-must be auumed to be a typographical error. C O - - A C T I O N : Accept.

(Log # 175) 99- 76 - (Figure 4-3.1.7): Reject SUBMITrER: Hy Bershad, P.E., Hosp. Engr. Society of Greater New York RECOMMENDATION. Modify drawing to ~ o w low-preuure emergency supply connection from street. SUBSTANTIATION. This is shown on Figure 4-3.1.10 and would be consistent.

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N F P A 99 ~ F92 T C R

COMMITYEE ACTION: Reject. COMMrrrgE STA'I'gMgNTz It is considered adequate to include in only F~ure 4-3.1.10.2. The emergency oxygen supply connection is not considered a pan of the bulk supply system.

(Log # 141) 99- 77 - (Figure 4-3.1.7): Reject S U B M 1 T r E ~ Barry Duignan, Brooklyn, NY RECOMMENDATION: Modify drawing to ~ o w low-pressure emergency supp~ connection from street. SU2b"rANTIATION: This it shown on Figure 4.3.1.10 and would be consistent. CoMMrlTEE ACTION: F~eject. COMMITYFI STATEMENT: Identical to Proposal 99-76 (Log #175). Rejected for the same reason.

(Log # 48) 99. 78. (4-5.1.8.5(a)): Accept in Principle S U B M r r r E ~ David B. Mobile, Medical Engineering Services, Inc. R E C O ~ g N D A T I O N : Add the following to existing 4-5.1.8.5(a):

"The outlet pressure of all gases desi~,ned for patient application including but not limited to oxygen, mtruus oxtde, medidal air, carbon dioxide and combinations of the above gases, shall be 50 psig. The oudet pressure ofniwogen used for tools in the operating room should be I60 psig. The pipe sizes in a pipeline system of a facility shall be large enough to allow for line pressure loss and still maintain these pressures, r SUBSTANTIATION: Since all therapy equipment is designed and calibrated to a 50 paig ~tandard by the manufacturers, facih'ties should provide this pressure gas. Many facilities have a variety of pressures and do not check them. As a result, pressures vary, and this can create a problem. For instance, if the pressure delivered to a flowmeter calibrated to deliver 10 liters per minute at 50 psigis increased to 55 psig, the flowmeter is no longer delivering 10 liters per minute, but some amount of oxygen greater than 10 liters per minute. Another problem that arises is when the oxygen and air systems are

maintained at different pressures. If a blender (used to blend the oxygen and air at the site of ventilator usage) has a defective check valve, the higher pressure gas can enter the pipingsystem of the lower pressure gas, thereby causing a lower orhigber concentration of oxygen. For mstanc¢,ifa higher pressure oxygen system were allowed to back feed into a lower pr&sure medical air system, then the oxygen concentration in the medical air system could be increased from a nominal 21% to 60% or more, depending on the

ma'e differential. MMrrTEE ACTION: Accept in Principle.

Revise 4-5.1.3.6(a) to read as follows: (a) Piping systems, with the exception of nitrogen systems, shall

maintain pressure at 50 +51-0 psig (345 +551-0 kPa gauge) at all outlets at the maximum flow rate. CoMMrlTEE STATEMENT: 1. Requirement is a performance criteria and belongs in Section 4.5.

2. Pipe sizing criteria is already addressed in 4-4.1.2.1(a). 3. Criteria for outlet pressure for nitrogen systems is stated in 4-

5.1.3.6(c).

(Log # 57) 99- 79 - (4.S.I.8.5(a)): Accept in Principle SUBMITTE~ Dr. Susan Mitchell (Ed. D.), Midas Rex Pneumatic Tools RECOMMENDATION: Revise text as follows:

In last line, change "200 psig (1.4 MPa gauge)" to ~S0 psig (1.6 MPa ~nge)" . Text would thus read:

(a) The pressure relief valve downstream of the line pressure regulator in nitrogen systems, used to provide power for gas-driven medi- "'cal tools, insfrume nts, or other sys-tems, tha-t vary from - • normal 50-55 psig (345.580 kPa gauge) line pressure (for example, systems supplying medical gases to hyperbaric chambers), shallbe set at 50 percent above line pressure or 230 psig (1.6 MPa gauge), whichever is lower. (Change underlined) SUBSTANTIATION: PROBLEM: The NFPA standard cited above limits central supply nitrogen in connection with the gas-driven Midas Rex instrumentation in the hospital operating room. To perform with maximum efficiency for surgery involving bone, biometals, and bioplastics, the Midas Rex motor requires a pressure of 200 psig when the motor is running, with a flow rate of 12 to 15 cubic feet per minute.

Because the relief devices are set at exactly the 200 psig which the Midas Rex motor requires as its actual running pressure, and due to tolerances involved, many hospitals bring cylinders of nit2"~, en to the operating room for me with the Midas Rex system. Cyi~der traffic to the operating room is obviously less safe and less convenient than using cenwal supply nitrogen; therefore, an increasing number of hospitals inquiri.'how to adjust their central supply nitrogen. SUBSTANTIATION. The need for hospitals to be able to combine the safety and convenience of central supply nitrogen with the advanced bone surgery technolog 7 affordedby the Midas Rex instrumentation is the substantianon for this proposal to set the pressure relief valve at 2S0 pslg (1.6 MPa gauge).

Supporting material available for review at NFPA Headquarters. COMMITTEE ACTION: Accept in Principle.

1. Revise 4.1.1 to read as follows: 4.1.1 This chapter covers the performance, maintenance,

installation, and testing of (1) nonflammable medical gas systems with oneratln~ pressures below 275 pslg. and (2) vacuum systems used within h~alth care facilities.

NOTE: Maximum allowable oneratin~ ¢ressure was determined ]~g311gllg.R~working maxlmum-of $ in.~ Type L copper piping." [Changes Underlined]

2. Add to 4-5.1.8.3, the following: "Where multiple pipeline systems at different operating pressures

are required, separate pressure regadatlng equipment, relief valves and source shutoffvalves shall beprovided f t r each pressure."

5. In 4.5.1.8.5(a), delete: "or 200 psig (1.4 MPa gauge), whichever is lower."

4. Add new 4.5.1.9.11 to read as follows: 4.5.1.9.11 Where medical air pipeline systems at different

operating pressures are required, the pipelines shall separate after the filters, but shall be provided with separate line regulators, relief valves and source shutoffvelves.

5. Revise 4-4.1.2.10) to read as follows: (j) Pipelines, shutoffvalves and station outlets for systems at non-

standard nressures ¢50 nsi~ for systems other than bhtro~en at lO0 nsi~) shall be labelled fbr/ms name and oneratin~ nressftre. ~Cfiange Underlined] - - -

6. Add new 4-4.1.2.1(k) to read as follows: (k) Where a system originally used or constructed for use at one

pressure and for a gas is converted for operation at another pressure or for another gas, all provisions of 4-4.1.2.4, 4.4.1.3, 4-4.1.4/rod 4-5 shall apply as i f the system were new. Vacuum systems shall never be convertedfor use as gas systems.

7. Revise 4-4.1.2.2(g) to read as follows: (g) Pipelines, shutoffvalves and station outlets for systems at non-

standard oressures (50 osi~ for systems other than Nitrogen at 160 osi~) shaft be labelled fbr/ms name and oneratin~ nressfa'e. [Cfiange Underlined] . . . .

8. Add at the end of 4-4.1.2.4(a) the following: "Station outlets for me with systems operated at non-standard

pressures (i.e., 50 psi for all systems except Nitrogen at 160 psi) shall be gas and pressure specific (e.g., a station outlet for 80 psi oxygen shall not accept an adapter for 50 psi oxygen)."

9. Revise 4-4.1.2.4(g) to read as follows: (g) Pipelines, shutoffvalves and station outlets for systems at non-

standara nressures iS0 osi~ for systems other than Nitrofen at 160 psi~ shall be labelled for ~ name and ooeradn~ oressftre. ICfiange Underlined] - - " 10. Add at the end of 4-5.1.1.2(a) the following: "When systems operated at different pressures are installed, each

pipeline shall be tested separately." 1 L I n 4-5.1.1.2(a) (3), afrer "other piping systems exists is:", insert

the following: "[Systems at non-standard pressures shall be tested at a pressure at

least 10 psi greater or less than any other system.]" 12. In 4.~,5.1.5.4(a), change "subjected to a minimum test pressure of

150 psig (1 MPa gauge) [200 ling (1.4 MPa gauge) maximum]" to read as follows:

"subjected to a test pressure of 1.5 times the working pressure'. 15. Delete 4.5.1.5.6(b). Renumber 4-6.1.5.6(c) to 4-5.L3.6(b).

Insert new 4-6.1.5.6(c) to read as follows: 4.5.1.3.6(c) Piping systems that vary from the normal pressures in

4-5.1.5.6(a) and (b) above shall be capable of delivering flows and pressures consistant with their intended use. 14. Revise 4-6.4.1.1, sentence 1 to read as follows: "The gas content and on¢~tin~ pressure of medical gas piping

systems shall be readily identifiable by appropriate labeling with the name and oressure of the gas contained.' [Changes Underlined] COMM1TrEE STATEMENT: Change in pressure limit to anow higher operatlngleveis for nitrogen systems requires more than change to just 4.5.1.8.5(a). Changes listed in Committee Action reflect this necessity.

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(Log # 38) 99- 80- (4-3.1.9): Reject S U B M I T r l ~ Steve Stepheus, P.E.,JMGR, Inc. REP, OMMY.,NDATION: A committee needs to be formed to develop ~lzing[ requirement, and required number of outlets for compre~ed mr ty~tena. Refer to Appendix C - Vacuum Systems for Similar Sizing Information. SUBSTANTIATION: There is no standard for sizing. We obtained 7 (seven) diffe~nt methods for sizing from vendors. This has a major impact on maintenance and other issues if a compressor is either over or under sized. COMMrrI 'E~ ACTION: Reject. COMMrI'rEE STATEMENT: It is not within the scope of the Subcommittee on Nonflammable Medical Piped Gas Systems. Also, there are existing standard references that can be used to size compressors adequately. (This issue was extensively discussed at April 29/30, 1991 meeting of the Subcommittee.)

(Log # 59) 99- 81 - (4-3.1.9 and 4-7.1.1.1): Reject SUBMITFER: HarryJordan, Medical City Hosp. Dallas RECOMMENDATION= 1. Add a requirement to section 4-3.1.9:

'Where an air compressor requires utility supply other than electricity, such as water for liquid ring compressors, a secondary supply ahall be provided in the event of a loss of the prim a~ry supply. TIiht supply shall be self contained within the facility and shall operate automatically in the event of diL.'uption of the primary supply."

2. Add a requirement to section 4-7.1.1.1: ~Vhere a vacuum pump re.quires utility supply other than

electricity, such as water for fiquid ring pumps, a secondary sup.ply shall be provided in the event of a loss of the primary supply. Tins supply shall be self contained within the facility and shall operate automatically in the event of disruption of the primary supply. ~ SURSTANTIATION: Liquid ring compressors and pumps rely on a continuous feed of water for their operation. Should this water supply be disrupted as has occurred as a remit of hurricanes or ea?thquake or may occur during utility construction or repair, or which may occur as a result of water pollution (e.g., Ohio River oil spill of 1988); the facility may find itself without these essential services, in spite of best precautions regarding generators, etc.

If this technology is used, it should be properly protected against loss of all essential utilities. JCAHO Standard PL.4 requires a facility operate a utility manage-

ment program. This ~uidance in the NFPA 99 would be of great value to a facility seeking to implement thisJCAHO requirement. COMMITTEE ACTION: Reject. COMMITrEE STATEMF2Cr: 1. Hospitals are not able to provide another utility as proposed. There are alternative methods other than that proposed b~/Submitter. Subject is also covered byJCAHO requirement that facilities develop a utility management program.

2. There are other options available to compensate for the loss of water supply to vacuum pumps that use water (e.g., emergency pumps, water from trucks).

(LOg # 117) 99- 82 - (Figure 4-3.1.9): Accept SUBMITrER: Antonio A. Mesa, Na~h Engineering Company RECOMMENDATION: Relocate final filter(s) upstream ofpresmre regulating valves. SUBSTANTIATION: Filter pressure drop will vary anti effect overall distribution pressure if downstream of re~lulators. COMMrIWEE ACTION: Accept.

(Log # NON-16) 99-83- (Figure 4-3.1.9): Accept SUBMrrTER: Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: 1. Add a condensate trap below after coolers.

2. In item with =*~ at bottom of figure, change "alternate aftercooler and/or dryer" to read:

=alternate aftercoolers and/or dryers". SUBSTANTIATION: To agree with text of 4-3.1.9.7. COMMITYF~ ACTION: Accept.

(Log # 118) 99- 84 - (4-3.1.9.1): Accept SUBMITYER: Anton io A. Mesa, N a ~ Engineering Comp.any RECOMMENDATIONt Move last sentence retadng to maintenance into "Administrative" Section 4-6, perhaps displacing 4-6.2.S.

Move existing 4-6.2.3.3 to proper "Installation" Section 4-4, perhaps adding to 4-4.I.4.1. SU'~TANTIATION: To promote user friendliness and adhere to NFPA format. C O M ~ ACTION: Accept.

1. Make last sentence of 4-3.1.9.1 ("Maintenance programs in accordance. . , each individual installation.') new 4-6.2.3.3.

2. Make existing 4-6.2.3.3 new 4-4.1.4.4. COMMITTEE STATEMENT: Appropriate location for this text.

(Log # 173) 99- 85 - (4-3.1.9.2): Accept in Principle SUBM1TrER: Hy Bershad, P.E., Hosp. Engr. Society of Greater New York RECOMMENDATION: Add the following words to the last sentence of the first paragraph:

"...with screening ~ a t sfiall-be fabricated or composed of a non- corro~ve materiai such as stainless steel or other mitable material." SUI~TANTIATION: Screen and intake piping for medical compressed air should be a non-corrode nature to prevent overburdening of the filtration system and to promote maximum safety for the air supply to patients. COMMITTEE Ac'rION: Accept in Principle. Insert Submitter's Recommendation afte~ the word "screened" in

the last senmece of the first paragraph. COMMITTEE STATEMENT: In order to allow for methods of protection other than screening.

(Log # 142) 99- 86 - (4-3.1.9.2): Accept in Principle SUBMITFER: Barry Dmgnan, Greater New York Hospital Associa- tion RECOMMENDATION= Add the following words to the last sentence of the t int paragraph:

"...with greening that shall be fabricated or composed on a non- corrosive material such as stainless steel or other suitable material." SU']~TANTIATION: Screen and intake piping for medical compressed air should be a non-corrosive nature to prevent overburdening of the filtration system and to promote maximum safety for the air supply to patients. COMMrITEE ACTION= Accept in Principle.

See Committee Action on Proposal 90-85 (Log #173). COMMITFEE STATEMENT: Identical proposal. Thus, Committee Action and Statement is the same.

(Log # 174) 99- 87- (4-3.1.9.2(a)): Accept SUBMIT1W.R: Hy Bershad, P.E., Hosp. Engr. Society of Greater New York RECOMMENDATION: Add to (a) the following:

"I'his alternate source of supply air must be available on a continuous 24-hour per day 7-day per week, basis." SUBSTANTIATION: Alternate systems (such m operating room ventilation systems) are occasionally turned off when not in use and, as a result, the air supply for the compressed air system may be sucked from occupied rooms or spaces which are not suitable sources of supply. Additionally there may be an increase in static pressure that could affect the quantity of supply air or operation of the compressed air system.

I COMMITIT, E ACTION. Accept. Change ~rnusC to %hall" in Submitter's Recommendation.

COMMITTEE STATEMENT: Conform to NFPA Style Manual.

254

N F P A 99 -- F92 T C R

(Log # 143) 99- 88. ( 4 - S . l . 9 . 2 ( a ) ) : Accept SUBMrrrER: Barry Duignin, Greater New York Hospital .Msocla- don EgCOMggNDATION: Add to (a) the following:

"This alternate source of supply air must be avat3able on a continuous 24-hour per day 7-itay per week, basis." SUBSTANTIATION: Alternate ~ t e m s Ouch as operatinjg room ventilation systems) are occasionally turned offwhen not m use and, as a result, the air supply for the compressed air system may be sucked from occupied rooms or spaces which are not suitable sources of supply. Additionally there may be an increase in static pressure that could affect the quantity of supply air or operation of the compressed air system. COMMrrFEE ACTION: Accept.

Change *must" m "shall" in Submitter's Recommendation. COMMITTEE STATEMENT: Conform to NTPA Style Manual.

(Log # NON-3) 99- 89 - (4-3.I.9.2(a)): Accept SUBMITrER: Subcommittee on Nonflammable Medical Piped Gas Systems RECO~O~IENDATION: Change "it may be used for the medical air compressors." to "it shall be permitted to be used for the medical air compressors." SU]~TANTIATIONz Conform to NFPA Style Manual. c o H l ~ f f r r g g ALl 'ION: Accept.

(Log # 119) 99-90- (4-$.1.9.4): Accept SUBMrrl 'EI~ Antonio A. Mesa, Nash Engineering Company RECOM2~gNDATION: Delete the word %ystem'~rom the first sentence to read:

~Each compressor shall beprov lded . . . " SUBffrANTIATION: Clari~ compreuor vs. compressor "system', which may imply one disconnect I/er multiplex. - COMMrlWEE ACTION: Accept.

(Log # NON-11) 99- 91 - (4 -3 .1 .9 .4) : Accept SUBMITrF, R: Subcommittee on Nonflammable Medical Piped Gas SDtems RECOMMENDATIONs Revise first paragraph of 4-3.1.9.4 to read:

W.ach compressor shaU be provided with a disconnect switch and motor starting device with overload protection. LX~2.g¢~iP.~tll~ swtem shall be nrovided with automatic alternation of" . . . (rest the ~/ae) [Changes Underlined] SUBSTANTIATION: Acceptance of Proposal 99-90 (Log #119) required modification to text for correlauon. Changes are editorial. COMMrrTEE ACTION: Accept

(Log # 121) 99- 95 - (4-3.1.9.7 Note (New)): Reject SLrBMHTRR: Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Add Note after tliird paragraph addressing dryer requirements:

NOTE: A twin tower desiccant dryer does not constitute a redundant dryer installation.

S ~ A N T I A T I O N : Clarification - both towers are necessary to achieve a working dryer. COMMYITEE ACTION: Reject. COMMITrEE STATEMENTs Subcommittee desires to revise text to make requirement relative to dryers clearer. [See Proposal 99-94 (Log #NON-9) ].

(Log # NON-0) 99- 94 - (4-3.1.9.7): Accept S U B M r r r F ~ Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: 1. Revise paragraph 3 to read:

"Dryer systems shall be, at a minin~um, duplexed, and valved to permit isolation of individual components to allow for maintenance or repair in the event of failure, while still continuing to adequately treat the flow of air. Under normal operation, only one dryer shall be open to air flow with the other dryer valved off. Each dryer system shall be capable of providing dry air at the peak calculated demand of the system. (See 4-5.1.~)"

2. Revise paragraph 4 to read: Aftercoolers, where required, shall be duplexed, ~ be provided

with a condensate trap, and shall not rely on the receiver d/aln to remove aftercooler condensate." SUBSTANTIATION: 1. Clarify requirements for dryers, irrespec- five of type.

2. Editorial, to separate dryer requirements from aftercooler e~mMMiTTgErements.

ACTION: Accept.

(Log # 5s) 99-95- (4-3.1.10(b) and (c) (New)): Accept SUBMrITER: Wayne Karcher, Allied Healthcare Products, Inc. RECOMMENDATION: Add the new sections (b) and (c) as follows:

(b) The emergency oxygen supply connection shall have incorporated within it the proper pressure regulating devices,

(c) The inlet shall be the oxygen connection listed in Compressed Gas Association pamphlet V.1 Type 540. SUBSTANTIATION: 1. Most low pre,~ure oxygen connections do not have enough flow to supply hospital

2. What low pressure source of oxygen would have enough flow to supp!y hospital?

3. Since no fitting type is called out, there are various types being used. These include standard pipe threads to which many things could be connected. COMM1TrgE ACTION: Accept.

(Log # 120) 99- 92 - (4-3.1.9.4(c) (New)): Accept in Principle SuBMrFFER: Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Add new section (c) as follows:

(c) The electrical control circuit shall be arranged as to remain energized to serve required control and alarm functions until both or all-compressors are electrically disconnected from the system. SUBSTANTIATION: Control arrangements with only one control transformer wired under a motor disconnect may disable all alarm and control functions if that disconnect is opened. COMMITTEE ACTION: Accept in Principle. Add a new paragraph (c) to read as follows: (c) Required control and alarm functions shall be operational

while any compressor is operational. COMMITYEE STATEMENT: To allow for any electrical configCVa- tion or alternate technology. SubmiRer's Recommendation would not have allowed control c~cults to remain energized when any compressor was operational.

(Log # 122) 99-96. (4-3.1.10): Accept SuBMrr rg lh Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Relocate and renumber 4-3.1.10 as 4-3.1.8.8 SUBSTANTIATION: Emergency oxygen connection would most likely be looked for under ~C, eneral requirements for gas central supply systems" rather than after "Medical Compressor Systems". COMMrrrEE ACTION: Accept.

(Log # NON-4) ~ c 9 9 - ~ e 4-3.1.10): Accept

Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMF.,N'DATION: In Figure F-$.I.10, delete "At least 6 ft of pipe (see Note 1)" in upper right portion of figure. SUBSTANTIATION: Cbrrehte w2th changes made to 4-4.1.3.3 and 4-4.1.3.2 that shutoffvalves are to be located outside each anesthetiz~ n8 location.

MMITYEE ACTION: Accept.

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N F P A 99 - - F92 T C R

(Log # NON-5) 99- 98. (Figure 4.3.1.10): Accept SUBMITrEIU Subcommittee on Nonflammable Medical Piped Gas Systems m RF.,COMMF2qDATION: Renumber "Figure 4-3.1.10 to be "Figure 4- 4.1". Renumber references in text accordingly. SUBSTANTIATION: Figure depicts patient piping distribution. Section 4-4 coven gas system disirinuuon. Section 4-4.1 covers patient gas distribution. ~OMMrrrEE ACTION: Accept.

(Log # NON-6) 99- 99 - (4.3.2,2.1): Accept S U B ~ Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: In sentence 3, change "it may be unlocked." to "it shall be permitted to be locked." SUBSTANTIATION: Conform to NFPA Style Manual. COMMITIT~ ACTION: Accept.

(Log # 72) 99-100- (4.3.2.2.2 (New)): Accept in Principle SUBMITrER: Leo G. Foxwell, Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: Add the new text as follows:

4.3.2.2.2 A second storage location per 4.3.1.2.3 shall be permitted if one is active and the other is passive (just storage). The locations shall not be adjacent to each other or across the hallway with facing louver doors. SU]~TANTIATION: Some remote locations use gas such that a single storage location is not feasible. This will permit the basic intent to be met but provide flexibility do not require daily deliveries. COMMITrEE ACTION: Accept in Principle.

See Committee Action No. 10 on Proposal 99-101 (Log #73). COMMITrgR STATEMENT: Issue of a second storage location is mainly a medical/dental office issue, and thus more appropriate to address in Chapter 15.

99-101 - (4-3.2.3 (New)): Accept in Principle (Log # 73) S U B M r r r E ~ Leo G. Foxwell, Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: 1. Add the following new definition in 2-2:

Dental Compressed Air*. For purposes of this standard, dental compressed air is:

(a) Air supplied from cylinders - that complies as a minimum with grade D in ANSI 7,86.1, commodity specification for air (CGA) Pamphlet G-7.1, or;

(b ) Local indoor atmosphere to which no contaminates in the form of particulate matter, odor, oil vapor, or other gases have been added by a compressor system. The air del':vered shall have the following characteristics:

(1) A maximum dew lX~int of 35"F at 100 psig measured immediately downstream of the receiver in the system.

(2) Particulate filter of 10 microns max at 98% efficiency with less than 1.0 PPM WT/WT or 1.mg/L after the receiver and prior to the line pressure regulator.

NOTE: Local atmospheric air may not be equal in purity or dryness to the commodity specification Grade D in (a). 2. Revise 4-3.2.3 to read as follows: 4.3.2.3 Dental Air Compressor Supply Systems (See figure 4-

3.2.3.7) 4.3.2.3.1. The dental air compressor shall provide dental

compressed air as defined in Chapter 2. The dental air compressor shall not add contaminates in the form of particulate matter, odor, or other gases. It shall be connected only to the dental air piping distribution system and shall not be used for any otherpurpose other than dental laboratory support and for dynamic devices for pocl_ iatry, plastic surgery and similar applications.

NOTE: Compreued air for dental applications isprimarily used to drive gas powered dynamic devices. Similar applications are in podi'atry and plastic surgery. The examples of these are air to drive turbine powered drills and air to dry teeth and gums. Some dental hand pieces have an internal self-contained air r e t u r n system while otherhand pieces may discharge air into the oral cavity. Some may discharge a mixture nfair and water.

4.S.2.3.2 Dental compressed air shall not be used to ol~y~te air powered venturi evacuation devices unless the exhaust of the evacuation system is a closed vent to outside the building.

4.3.2.3.S Equipment shall be obtained from and be installed under the supervision of a manufacturer or suppliers familiar with proper practices for its construction and use. Maintenance programs, in accordance with the manufacturers recommendations, shah be established for the dental air compressor supply system as connected in each individual installation.

4-5.2.S.4" The compressor system shall be permitted to be a single, duplex, or multi-compressor system.

4-3.2.3.5 Each compressor system shall be provided with appropriate disconnect switches, motor starting devices, motor overlo~td protection, alteration of units if applicable, and a means to activate the additional unit(s) should the m-service unit(s) be incapable of maintaining adequate pressure.

4-3.2.3.6 The receiver shall be equipped with a safety valve, manual drain, and pressure gauge and shall h~ive the ~pacity to ensure practical on/off operation. The receiver shall comply with section Viii ("unfired pressure vessels') of the ASME Boiler and Pressure Vessel Code. 4.3.2.3.7* Compressor systems for dental air shall be equipped with

intake filter-mufflers of the dry type, air dryers, and downstream pressure regulators to ensure the delivery of compressed air (see definition of dental compressed air in section 2). The compressor air intake shall be located where no contamination from vacuum system discharges or particulate matter, is anticipated. The compressor air intake shall be taken from a room source other than an operatory or the room where an open or semi-open dental vacuum discharges. See Figure 4-3.2.3.7 above.

4-3.2.3.8* Appropriate monitoring sensors shall be provided. A colored dew point indicator shall be provided in two locations. The first shall be located at the outlet of the receiver. The second indicator shall be located inside the treatment facility in a readily visible area and appropriately labeled. The second color dew point indicator shall take its source from the pressure line, prior to any regulator in the treatment facility.

4.3.2.3.9 Any outlet of a dental compressed air system that allows for a temporary, quick attach connecuon shall be labeled with the pressure identified as dental compressed air, and shall also be labeled "DO NOT USE FOR MEDICAL AIR PURPOSES". The oudet connector shall not be of a configuration that complies with 4- 4.1.2.4.

4-3.2.3.10 When the system is providing medical compressed air to one or more use points with temporary quick attach connection, the use point shall have a fixed regulated pressure of 50-55 psig, have a station oudet configuration tlfat complies with 4-4.1.2.4 and is identified as being used for medical compressed air purposes.

4-3.2.3.11 Any air compressor supply system which: (a) contains a station outlet per 4-4.1.2.4 or; (b) is intended to provide medical compressed air shall be an oil

less air compressor and provide medical compressed air, both as defined in Chapter 2.

Examl?les would be the intent to use air to operate a respirator, analge=a, or anesthesia equipment. Applicauons for oral surgery are one such application.

3. Add the following Appendix material: A-2-2 Dental compressed air for general dentistry, podiatry, and

plastic surgery use operates at general line pressures of 80.160 psig. The individual use points are separately ar, d manually regulated from 30 to 120 psig for the individual hand piece andapplication/ use. This is significantly different than a medical compressed air system which typically operates at pressures of 50-55 psig. A major concern oral/quality is the potential for bacteria breeding

with moisture that can accumulate in the receiver and in the lines downstream of the pressure regulator. Therefore, attention should be paid to system parameters that will prevent moisture accumulation in the air system. Moisture and the presence of partlculate matter in the compressed

air will pit, corrode and damage the high speed turbine handpiece. Moisture and oil in the air wilginhibit dental bonding procedures. The compressor supply system should take these elements into consideration in filtering the air to be delivered through the distribution system. A-4-3.2.3.1 The application of dental compressed air is not used for

life support purposes such as respirators, IPPB machines, analgesia, or anesthesia, etc. Air discharged into the oral cavity is incidental and not a primary source of air to sustain life. However, if there is a coincident use of dental air for providing respiratory support, the requirements of dental air will be superseded by those o f the respiratory support and the compressed air system must produce the higher quality- inedical compressed air as defined in Chapter 2. This may affect the selection of a compressor.

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N F P A 99 - - F 9 2 T C R

F i l t e r M u f f l e r I n t a k e

= 1 D e w P o i n t I n d , c a t o r

R e c e i v e r

©

J F i l t e r l o c a t i o n 6 e f o r e F~ecelver o r A f t e r qs rvIfg O p t i o n

----2 D e w P o i n t t n d , c a t o r

Use P o i n t s ~n

T r e a t m e n t F a c d ~tV

New Figure 4-5.2.5.7

A dental compressor air system should not be used to provide power for an mr powered evacuation system without specific attention paid to the discharge of the gases and I/quids. An open discharge of gases into the general em~ironment of an operato~ may compromise the Quality of Breathir~ Air in the treatment facihty. Onl)~ systems in which air discharge as sealed and connected to a sanitary vent should be considered. An air power evacuation system may require significant quantities

of air to operate. Consideration shouldhe paidto proper sizing of the air compressor for' the entire system de,hand. Inadequate sizing can result in overheating, premature compressor failures, inadequate operating pressures and flows. A-4-3.2.&4 The compressor system should be sized to have a

general duty cycle of about 65% for maintenance of norrnal demand.

A-4-3.2.&7 The environmental air source for the compressor inlet should take into consideration possible contamination by particulates, concentrations of biological waste contaminant, ozone from nearby electrical motors, and exhaust fumes from engines. Air taken from an outside atmosphere may cause harmful

condensation problems in the compressor. Long runs of inlet pipe should also be avoided as it will degrade compressor performance. A dental air compressor and dental vacuum system may be in the

same equipment room as long as the inlet for the dental air compressor does not draw air from the same room as the open discharge to the drain of a dental vacuum system. The Quality of Air in an operatory may have traces of mercury

vapor and other contaminant. A compressor inlet location which would draw its supply directly from an operator should be avoided,

A-4.&2.8.8 A color dew point monitor downstream of the receiver indicating the Quality of Air coming into the receiver is desirable. A color dew point monitor in the main treatment facility is

appropriate to help, the staff promptly identify when the system is being deip'aded with air of dew point higher than is acceptable.

The de ign of the color monitor should be such that the normal tolerance of vaciations will limit the maximum moisture at 39°F at 100 psig at activation. SUBSTANTIATION: At present there is great confusion on interpretation and misinterpretation of tlie air compressor needs for dent~ applications. This often is confused with meitical air requmements.

P-aragraph 4.3.2.5 has been reserved for dental air compressor supply systems. The above revisions are proposed to define dental system requirements.

COMMITrFA~ ACTION: Accept in Principle. Accept submitter's recommendations but with the following

changes: I. In new definition of dental compressed air, change "a maximum

dew point oF' to read as follows: "a maximum pressure dew point of'.

2. In new 4-&2.3.I, delete sentence 3 (~It shall be connected...and similar applications.")

3. In new 4.3.2.&I, NOTE, revise sentence I to read as follows: "Dental air is primarily. . . "(rest the same). 4. Revise new 4-3.2.3.2 to read as follows: 4-3.2.3.2 Dental compressed air shall be permitted to be used to

power air powered devaces for evacuation only if the exhaust of the evacuation device h a closed vent to the outside of the building.

5. Revise new 4-3.2.3.5 to read as follows: 4-3.2.3.5 Each compressor shall be provided with appropriate

disconnect switches, motor starting d&tices and motor overload protection. When multiple compressors are used, alternation of units, and ameans toactivate the additional unit(s) should the in- service unit(s) be incapable of maintaining adequate pressure, shall be provided.

6. Revise new 4-3.2.3.8* to read as follows: 4-$.2.3.8 An appropriate monitoring sensor shall be provided. A

colored dew point indicator or equivalent shall be provided. 7. In new 4-3.2,3.II, chan[~e "an oil less air compressor to read as

follows: "an air compressor. 8. In new A-2-2, add tide "Dental Compressed Air". 9. In new Fig. 4-3.2.3.7, I) change ~#I dew l~int indicator" to read

as follows: "Dew point indicator or equivalent ; and 2) delete #*2 dew ipi 0in t indicator.

• Add the following Exception to existing 15-3.4.1: Exception: When the delivery of gases to meet the facility's needs is

not available within 48 hour interval, a second non-connection storage reserve location complying with 4-3.1.2.3 shall be permitted. The Iocations shall not be adjacent to each other or directly across the hallway with facing louver door. COMM1Tr]~ STATEMENT: 1. Changes 1. to 8. are for correlating with changes made for medical compressed air.

2. Chan~e 9. is made as there may not be a need for two color dew point indicators. Equivalent methods are acceptable. Diagram is changed to reflect this.

& Change 10. addresses the hazard of more than one storage location for gases used by a medical or dentist office.

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N F P A 99 ~ F 9 2 T C R

(LOg # 18) 99- 102 - (4-4.1.1.2(g) (New)): Accept in Principle SUBMrFrER: John Lewis,John Lewis & Assoc. RECOMMENDATION: Add a new subparagraph (g):

(g) When a cryogenic liquid storage unit is used as the reserve for a bulk supply system, audible and noncancellable visual signals shall be connected to switches indicating each of the following conditions separately: when the reserve supply is reduced to one average day's supply and if the gas pressure available in the reserve unit is reduced below the pressure required to function properly. SUBSTANTIATION:These requirements for Master Alarm are stated in NFPA 99, 4-3.1.7.2(c) but not listed in the para listing required Master Alarms.

NOTE: Must also revise last line of 4A.l.l.2(d) to indicate subpara =(g)" instead of (f).

COMMIqq'EEACTION: Accept in Principle. 1. Insert new subparagraph (e) to read as follows: (e) When a cryogenic liquid storage unit is used as a reserve for a

bulk supply system, separate audible and noncancellable visual signals shall indicate when the contents of the reserve are reduced to one day's average supply, and when the gas pressure available in the reserve unit is reduced below the pressure required to function properly.

Renumber existing subparagraphs (e) and (f) accordingly. 2. In existing subparagraph (a), change lastword from (f)." to

"(g)." 3. In Table 4-4.1.1.2, for "All Pressure Gas Systems" change

reference from "4--4,1.1,2(e)" to =~. l . l .2( f ) . " 4. In Appendix C-4.1.12, change =[4-4.1.1.2(d)]" to =[44.1.1.2(d)

and (e) ]". 5. In Figure 4-3.1.7, add a dotted actuatin~ switch the supply line

for the =Reserve Supply, one or more containers," and labelit =Actuating switch (see Note 9)." Revise the wording under the existing dotted actuating switch to read =(See Note 6 and 9)." At b o t t o m of figure, add new Note 9 to read: =Note 9: See 4- 4.1.1.2(3).)" COMMITTEE STATEMENT: Reworded for clarity. Placement as subparagraph (e) is more appropriate location for this material. Other changes are for correlation in text.

(Log # 39) 99- 103- (4-4.1.1.3): Reject SUBMrITER: Steve Stephens,jMGR Inc. RECOMMENDATION: (None provided.) SUBSTANTIATION: There is a need to more closely detail what requires area alarms in medical gas systems including vacuum. COMMITTEE ACTION: Reject. COMMITI'EE STATEMENT: Text of 4-8.1.1.8 (on area alarms) is considered adequate as written. Also, no recommendations included in Submitter's proposal.

(Log # NON-10) 99- 104 - (4-4.1.1.3(a)): Accept SUBMITFER: Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: Revise 4-4.1.1.3(a) to read as follows:

(a) Area alarms shall be provided for anesthetizing locations and critical are areas. Warning signals shall be provided for all medical gas piping systems supplying these areas to indicate if the pressure increases or decreases from the normal operatingpressure. SUBSTANTIATION: 1. The Subcommittee on Electrical Systems has proposed that the definitions of General Care Area and Critical Care Area be moved from Chapter 12 to Chapter 2, thereby making them applicable to all occupancies.

2. The areas listed in the definitions of anesthetizing location and critical care area identify those locations that need area alarms so that staff is aware of a pressure variation beyond the normal operating range.

$. Addresses and darifies the issue of the location of area alarms as raised in Proposal 99-103 (Log #39). COMM1TrEE ACTION: Accept.

(Log # 123) 99- 105 - (4-4.1.1.3(b)): Accept in Principle SUBMITTER: Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Complete last sentence. SUBSTANTIATION: Incomplete sentence due to printing error. COMM1TrEEACTION: Accept in Principle.

In 4-4.1.1.3(b), delete the text after the first sentence ("indicate if the pressure in the piping system increases or~). COMM1TrEE STATEMENT: Typographical error.

(Log # NON-19) 99-106- (4-4.1.2.1,4-4.1.4, 4-5.1.3.3): SUBMITFER: Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: 1. Revise 4-4.1.2.1 to read as follows:

4-4.1.2.1 Gas Piping. The provisions of this Section apply to field- installed piping for the distribution of nonflammable medical piped gases.

(a) Pipe, tubing, valves, fittings, station outlets, and other pipeline components in medical gas systems shall have been cleaned for oxygen service prior to installation.

(b) Piping for nonflammable medical gas systems shall be suitable for oxygen service in accordance with 4-4.1.4.1. Where tubing is cleanedby the manufacturer, each length shall be permanendy labeled, and delivered plutgged or cap)j:~ecd. Fittings, valves, and other devices shall be sealed and marked. The installer shall furnish documentation certifying that all installed piping materials comply with the requirements of this paragraph.

(c) Piping shall be seamless Type Kor L (ASTM B88) copper tubing or seamless ACR/OXY (ASTM B280) copper tubing. ACR (ASTM B280) copper tubing which has not been specifically cleaned for oxygen service and is not marked ACR/OXYshaU not be used. Except as provided in 4-4.1.2.1 (f) and (g),joints in copper tubing shall be brazed using capilary fittings complying with ANSI B16.22, Wrought Copper and Copper Alloy Solder--J(oint Pressure Fittings. Cast fittings shall not be used for brazedjo|nts.

NOTE: It is recognized that brass and other acceptable materials (other than copper tubing) are used in the manufacture of some medical gas eqmpment. (d) Piping systems shall be designed and sized to deliver the

requiredflow rates at the utilization pressures. (e) Piping shall be supported from the building structure in

accordance with MSS Standard Practice SP-69, Pipe Hangers and Supports - Selection and Application. Hangers and supports shall comply with MSS Standard Practice SP-58, Pipe Hangers and Supports - Materials, Design and Manufacture. Portions of hangers in contact with copper tubing shall have a copper finish or other protection against galvanic corrosion. Maximum support spacing shall be as follows: 3/8 in. nominal 6 ft 1/2 in. nominal 6 ft 3/4 in. nominal 7 ft

1 in. nominal 8 ft 1-1/4 in. nominal 9 ft 1-1/2 in. nominal and larger 10 ft (f) Listed or approved valves or fittings having flare or compression

joints are permitted to be used in piping 3/4 in. nominal size or smaller where the fitting will be visible and readily accessible.

(g) Listed or approved metallic ~ tubing fittin~{s that, when made up, provide a permanent joint having the mechanmal, thermal, and sealing integrity of a brazed joint are permitted to be used in lieu of brazed joints.

(h) Turns, offsets, and other changes in direction in piping shall be made with fittings complying with 4-4.1.2.1 (c).

(i) Buried piping shall be protected against frost, corrosion, and physical damage. Piping under roadways, driveways, parking areas, or other locations subject to surface loads shall be installed in a PnrOtectlve sleeve or casing. Piping in concrete floors or walls shall be

stalled in a continuous conduit. (j) Mecical gas risers are permitted to be installed in pipe shafts ff

protected from physical damage, effects of excessive heat, corrison, or contact with oil.

(k) Piping shall not be installed in areas having open-flames or other sources of ignition, such as fuel-fired heater rooms, kitchens, electrical switchgear rooms, or other hazardous areas.

(I) Medical gas piping is permitted to be located in the same service trench or tunnel with fuel gas lines, fuel oil lines, electrical lines, steam lines, and similar utilities provided that the space is ventilated (naturally or mechanically) and the ambient temperature around the medical gas pipikng is limited to 130°F maximum.

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Medical ~ piping shall not be located where subject to contact with oil, including flo&iing in the case of a major oil leak.

(m) Where piping ~netra tes fire-rated construction, openings around the piping ~/all be fire-stopped.

(n) Piping exposed in corridors and other areas where subject to physical damage from the movement of carts, stretchers, portable equipment, or vehicles, shall be suitably protected. (o) Hoses and flexible connectors, both metallic and nonmetallic,

shall be no longer than necessary and shall not penetrate or be concealed in walls, floors, ceilings, or partitions.

(p) Where piping systems operate at pressures other than the normal 50 ling (160 psig for nitrogen), the piping shall be so labeled.

2. Revise 4-4.1.4 to read as follows: 4-4.1.4 Installation o~Gas Piping Systems. 4-4.1.4.1 Cleaning for Medical Gas Service. Before installation,

piping, valves, fitfifigs, and other components for nonflammable medical ~ systems shall be thoroughly cleaned of oil, grease, and other readily oxidizable materials as if for oxygen service. After cleaning, such material shall be plugged, capped or otherwise sealed. Particular care shall be taken in the storage and handling of such material to maintain its clean condition. At the time of final installation, such material shall be visually examined internally for contamination. Material which has become contaminated and is no longer suitable for o xyl~en service shall not be installed.

(a) Piping, valves, fimngs, and other components shall be especially cleaned for oxygen service in a facility equipped to clean, rinse, and purge the material in accordance with the requirements of 4-4.1.4.1 (a) (I) or shall be prepared in accordance with 4- 4.1.4.1(a) (2).

(1) Piping, valves, fittings, and other components that have been prepared by the manufacturer or suppfier shall have been cleaned in accordance with the provisions of CGA Pamphlet C,-4.1, Cleaning Equipment for Oxygen Service and shall be appropriately marked. Such materials shallbe stored, handled, and respected as required in 4-4.1.4.1. If such materials become contaminated and are no longer suitable for medical gas service, they are permitted to be used if recleaned accordingto 4-4.1.4.1 (a) (1) or 4-4.1.4.1 (a) (2).

(2) Piping, raves, fittings, and other components prepared b~ the installer at the job site or his shop shall be cleaned by washing m a dean, hot water/alkallne cleaner solution, such Ls sodium carbonate or trisodium phosphate (proportion of one pound to three gallons of potable water).- Interior sfirfaces shall be scrubbed to ensure complete cleaning. After washing, the materials shall be thoroughly rinsed in dean, hot potable water. Cleaned materials shall be plugged, capped, or otherwise sealed as required in 4-4.1.4.1 and shanbe appropriately tagged or marked.

4-4.1.4.2 Brazed Joints. (a) Brazed pipe joints shall be the socket ~pe. Filler metals shall

bond with and be metallurgically compatible with the base metals being joined. Flux shall not be used except where permitted under 4-4.1.4.2(a) (2). Brazing filler metals sha/l-complywith ANSI/AWS 5.8, Specification for Filler Metals for Brazing, except that fiUer metals havin[~ compositions not conforming to the exact ANSI/AWS 5.8 classificauons are permitted when used according to the manufacturer's installations.

(1) Copper-to.coppe.r joints shall be brazed using a copper- phosphorus or copper-phosphorous-silver brazing fiUer metal (BCuP series) without flux.

(2) Dissimilar metalJ, such as coppe.r and bronze or brass, shall be brazed using an appropriate flux ~ t h either a copper.phosphorus, copper-phosphorous-sliver (BCuP series) or a silver (BAg series) brazing filler metal.

(b) jbints to be brazed in place shall be accessible for proper pre .p.aration, assembly, heating, fillere application, cooling, cleaning, and inspection.

(c) Tftbe ends shall be cut square using a sharp tubing cutter to avoid deforming the tube. The cutting wheel shall be flee from grease, oil, or other lubricant not suitable for oxygen service.

(d) The surfaces to be brazed shall be mechanically cleaned using a dean stainless steel wire brush or equivalent. The use of steel wool is prohibited due to the possible presence of oil in these abrasives. Mechanical cleaning shall not resuit in grooving of the surfaces to be joined. After mechanical cleaning, the surfaces shall be wiped using a dean, lint-free white cloth. During this cleaning, care shall be taken to avoid contamination of the "deaned for oxygen" internal surfaces of the pipe and components. Joints shall be recleaned if contaminated prior to brazing. Joints shall be brazed within one hour of being cleaned.

(e) Where diuimilar metals, such as copper and bronze or brass, are being brazed, flux shall be applied sparingly to minimize contami/~tion of the inside of th/" pipe with flux. The flux shall be applied and worked ove, r the surfaces to be brazed using a stiff stainless steel bristle bnzsh to ensure adequate coverage and wetting

of the surfaces with flux. Where possible, short secdons of copper tubing shall be brazed to the non-copper component and the interior of the subauembly shall be cleaned of flux prior to installation in the pipingsystem. Flux-coated brazing rods are permitted to be usedinl ieu of the application of flux to the surfaces to be joined on tubing 3/4 in. nominal size and smaller.

(t) Tube ends shall be inserted fully into the socket of the fitting. Where flux ispermitted, the joint shall be heated slowly until the flux has liquefied. Once this has occurred, or where flux is not used, the joint shall be heated quicklyto the brazing temperature, taking care not to overheat the joint. Techniques for heating the joint, applying the brazing filer metal and making horizontal, vertical, and large diameter joints shall be as stated in the CDA Copper Tube Handbook.

(g) While b e ~ ~ join= ~ 1 be conanuously ~ with off-fr~ dry nl~ogea t to p e ~ t the formation of ~ oxide on the inside surface of thejotut, the flow of purge g u shall be maintained until the jolnt is cool to the t o u c h .

Exception: Purging of a connection to an existing system. (h) During and after installation, openings in the piping system

shall be kept capped or plugged to avoid unnece~lry loss ofp _urge gas while brazing and to prevent debris or other conimninants from entering the system, except that during brazing, a discharge opening shall be provided on the opposite side of the joint from where the purge gas is being introduced. During brazing, the purge gas flow rate shall be maintained at a level that will not produce a positive pressure in thepiping system. After brazing, the discharge opening shall be pluggedor capped to prevent contamination of the mside of the pipe.

(i) On joints where flux has been used, after brazing, the outside of all joints shall be cleaned by washin[~ with hot water and a stainless steel wire brush to remove any flux remdue to permit clear visual inspection of the joint. (j) Each brazed joint shall be visually examined after completion

of brazing and, where flux has been used, cleaning of the outside of the joint. The following conditions shall be considered unacceptable:

(1) flux or flux residue. (2) excessive oxidation of the joint. (S) presence of unmelted filler metal. (4) failure of the filler metal to be clearlyvislble all the wa~

around the joint at the interface between the socket and the ptpe. (5) cracks in the pipe or component. (6) cracks in the braze filler metal. (7) failure of the joint to hold the test pressure under 4-5.1.3.4.

(k) Brazed joints which are found to be defective under 4- 4.1.4.2~j) (1)(3)(4)(6) or (7) are permitted to be repaired.

(1) Except as provided under 4-4.1.4.2(m), brazing procedures and brazer performance shall be qualified in accordance with Section IX, Welding and Brazing Qualifications, of the ASME Boiler and Pressure VesseICode, as modified below.

(1) Procedures and brazers shall be qualified by tension tests. (2) The Brazing Procedure Specification shall address cleaning,

joint clearance, overlap, internal purge gas, and purge gas flow rate. (3) The brazing P~ocedure ~h~alifi..cation Record and the record

of Brazer Performance Quadificanon shall document cleaning, joint clearance, overlap, internal purge ~as and flow rate used dunng brazing of the test coupon, and no internal oxidation exhibitedon the completed test coupon.

(4) Brazing procedures qualified by a technically competent group or agency are permitted under the following conditions:

(i) The Bracing Procedure Specification and the Procedure Qualification Record shall meet the requirements ofASME Seciton IX and the requirements of this Standard.

(ii) The employer shall obtain a copy of both the Brazing Procedure Specification and the supporting qualification records, and shall sign and date these records, thereby accepting responsibility for the qualifications which were performed by the group or agen .~..

(iii) The employer shall qualify at least one brazer following each Brazing Procedure Specification used.

(5) An employer b permitted to accept Brazer Qualification Records of a previous employer under the following conditions:

(i) Thebrazer shallhave been qualified following the tame or an e~lulvalent proceudre as that which he will use for the new

emr'(:u¢)';Fhe'~='~"-- new employer shall obtain a copy of the record of Brazer Performance Qualification tests from the previous employer and shall sign and date these records, thereby accepting responsthil- ity for the qualifications performed by the previous employer.

(m) The authority having jurisdiction is permitted to wmve the requirements of 4-4.1.4.2(I) and permit on-site testing of brazers.

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The brazing procedures used shall meet the requirements of 4- 4.1.4.2. The ~,'iterla for acceptance shall be in accordanc with 4- 4.1.4.2G).

4-4.1.4.3 Threaded Joints. (a) Threads on pipe and fittings shall be tapered pipe threads

comp_~' g Mth ANSI B1.20.1, Pipe Thread,, GeneralPurpose. (b) Threaded joints in piping systems shall be tinned or made up

with polytetrafluoroethylene (such as Teflon) tape or other thread sealant suitable for oxygen service. Sealants shall be applied to the male threads only.

3. Delete: 4-5.1.3.3. Reference~ ASME. American Society of Mechanical Engineers,

345 E. 47th Street, New York, NY 10017. AWS. American Welding Society, Inc., 550 N.W. Lejeune Road,

Miami, FL 33135. CDA. Copper Development Association, Greenwich Office Park 2,

Greenwich, ~ 06836-1840. CGA. Compressed Gas Association, Inc., 1235Jefferson Davis

Highway, Arrmgton, VA c22202. MSS. Manufacturers Standardization society of the Valve and

Fittings Industry, Inc., 127 Park Street, N.E., Vienna, VA 22180. SUBSTANTIATION: Subcommittee has received many inquiries on the piping and brazing criteria currently included in Chapter 4. Issues addressed by this pro p ~ I include:

1. Limiting this section to Beld installation; 2. Installer certification as to proper piping; 3. Acceptable pip'rag material; plain ACR tubing is unnacceptable; 4. Defining materiaI for fittings (copper acceptable; cast fittings

unacceptable); 5. Rewording pipe sizing based on design; 6. Pipe supports (reference MSS standards; protection against

galvanic co/roslon; support spacing);

7. Flare and compression fitting permissibility; 8. Bending of sollng; 9. Where piping can and can not be installed (4-4.1.2.1(0 and

(~0 TM . Protection for concealed piping; 11. Brazing procedures (filler material; reference to Copper

Development Association; delete CO2 as a pur~e gas; only oil-free dry nityrogen allowed; add tension tests; cntena for visual inspection revised; create qualified brazing procedures); COMMITTEE ACTION: Accept.

(Log # 49) 99- 107 - (4-4.1.2.1 (a)): Accept in Principle S U B ~ David B. Mohile, Medical~Engin~ring Services, Inc. RECOMMENDATION= Delete first three sentences of first paragraph which read as follows: - ~pil~ing shall be Type K or L (ASTM B88) copper tubing, Seamless ACR (ASTM B280) copper tubing, or standardweight (Schedule 40) bran pipe." Piping shall be joined using listed or app_mved fittings. Piping for all non.flzmmahle medical ~ systems shall be cleanedin accordance with 4-4.1.4.1 prior to imtkllation."

Replace first three sentences as follows: ~Piping for all nonflammable medical gas services shall be Type K

or L copper tubing especially cleaned, prepared, and labeled for oxygen service by the manufacturer. All fittings used for medical gas pipelines shall be wrought copper and cleaned for oxygen service. It shMl be the installer's responiibility to document and ensure that piping has been ordered and delivered cleaned for oxygen service and has not been recontaminated prior to installation. I n the case of recontaminatlon, or with piping or fittings that were delivered not cleaned and/or labeled for oxygen, piping and fittings shall be cleaned in accordance with 4.4.1.4.1." SUBSTAN'rlATION: Many contractors only get as fox as the ACR designation and order refrigeration robing to be used on medical gas systems. And while some of the robing manufacturers I have spoken with during the last year or so have indicated that they use the same cleaning process for ACR as they do for oxygen service tubing, several would not confirm this. The potentia/for contamination from using improperly cleaned tubing is very real This change in the wording simplifies the selection of piping to be

used. No one uses brass pipe anymore, and the references to the ASTM codes are not necessary and frequently confuse the issue, especially since the ASTM codes referenced have their own cleaning requirements. This proposed change also makes it clear that the fimngs have to be cleaned.

It also puts the responsibility for documentation of cleaning on the installer. This would tend to make the installer more carehdwhen he orders piping from a distributor, how he stores the piping, and handling of the piping prior to installation.

I COMMITTEE ACTION= Accept in Principle. See Proposal 99-106 (Log #NON-19).

COMMITYEE STATEMENT: Proposal 99-106 CLog #NON.10) addresses the issue raised here.

(Log # 29) 99-108- (4-4.1.2.1 (b) and (c)): Reject SUBM1TTER: Peter Esherick, Patient Instrumentation Corporation RECOMMENDATION: Under types offittlngs in subparagraph (b) include:

"dielectric couplings - suitably protected against fire damage up to 1,000°F or higher." SUBSTANTIATION: .Man~ magnedc resonance ~ . ~ 1 ~ (MRI), cat scanners, etc. require that there be no extraneom electrical interference; i.e.: they be completely isolated electrically from the main power ~ t e m .

Byprotecting the dielectric coupllnss with appm..priate insulation, the high temperature joining of medical gas pipeh?nes will not be violated.

Perhaps a dielectric coupling could be made with flint glass, mica, or some other high temperature resistant insulating material. COMMITrF.,E ACTION: Reject. COMMITTEE STATEMENT: 1. Subcommittee is unaware of dielectric couplings that will meet temperature requirements listed.

2. There are other methods of achieving results. [Subcommittee desires input from manufacturing community on

this issue.]

(Log # 124) 99-109 - (4-4.1.2.2): Accept SUBM1TYER: Antonio A~ Mesa, Nash Engineering Company RECOMMENDATION: Identify the second paragraph i/t (b) and add "This value shall be identified." Then delete existing (c). c)

as(

surBSTANTIATION: Editorial, duplication of material. COMMITTEE ACTION: Accept.

(Log # 188) 99- 110 - (4-4.1.2.2 (New)): Reject SUBMrr rE~ D.A. McWhinnie,Jr., Mechanical Dynamics Inc. RECOMMENDATION: Add a requirement for a Section/Zone Valve Chart:

A valve chart shall be provided for each shutoffvalve in each medical gas system, including bare valves in concealed or secure locations for maintenance. The chart shall list:

1. Name of ~ t e m . 9. Number of valve. 3. Precise location of valve. The chart shall be maintained for ready reference in the fire

control office, securi~, office, and plant executive office, or similar emergency response Iocztions. SUIkqTANTIATION. In the event of fire* or other dangerous incident or threat of danger, damage to, or failure of oyadizing medical gas systems can ~eatiy increase the hazard. To isolate the hazard area, while malntkining normal operation in all other areas, requires immediate protective action under s~esJ conditions.

* (Following a hospital fire incident in May, 1900, one authorative report indicated that it was not known when or if the appropriate valves were shut off, or who knew their location.) COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: The charting and tagging of shutoff and yolk valves at the conclusion of a project or system modification is covered by the requirements in 4--6.2.3.3. This section calls for gas piping system installers to include directions and information deemed by the manufacturer to be adequate for attaining proper installation, testing, maintenance and operation of the medical gas system.

99- 111 - (4-4.1.2.20) (New)): Accept in Principle SUBMITrE~ David B. Mohile, Medical Engineering Services, Inc. RECOMMENDATION: Add new paragraph (i) in 4-4.1.2.2 to read as follows:

(i) Manual shutoff valves in boxes shall be installed where they are visible and accessible at all times. The boxes shall not be installed behind normally open or normally closed doors, or in an area where they will be blocked by supply carts or furniture, or otherwise hidden from plan view.

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N F P A 99 - - F92 T C R

SUBSTANTIATION: Zone valve box assemblies (ZVBA's) are often installed behind doors that are normally open and close only in an emergency. However, since the valves would ordinarily be accessed during an emergency, the doors are frequently open to remove patients or fight a fire, thereby blocking access to the valves when it ~s needed most. This is especially true ~vhen valves are behind doors that are controlled by electric treadplates. The same problem with accessibility to the valves is present ~vhen the ~ is installed behind a n o r m S , closed door. The intent of thts change is to make it clear to designers and facility

personnel that these are emergency devices that must be readily accessible at all times. COMMrlW~ACTION: Accept in Principle. Accept Submitter's Recommendation, but delete "or in an area

where they will be blocked by supply carts or furniture,'. CoMMrITEE STATEMENT: It is beyond control of designers where such ~tems will be located. It is the responsibility o f the facility to not compromise accessibility.

(Log # 2) 99-112 - (4-4.1.2.4): Accept in Part SUBMI ' r rE~ DA. McWhinnie,Jr., 9131 West Chestnut Drive, Hickory Hills, IL 60457 RECOMMENDATION: Add outlet minimum flow required for opt/mum patient treatment using the maximum demand respiratory devices. SUBSTANTIATION: [Refer to Committee Statement of Proposal 99-153 in TCR for NFPA 1989 Fall Meeting.]

1. Simply not so. Maximum quality patient need is equal to the minimum flow required to properly operate the demands of the highest use respirator~ care de~ce.

2. This statement is m'esponsible, in that it ignores, doesn't consider or address, the substantiations in Logs 133, 134, 10 and 11 [Proposals 99-153, 99-284, 99-285, and 99-288, respectively in TCR]; nor the pertinent and documented information known throughout the health care field ~ of'~,833" faulty outlets (some completely occluded), m Plumbing Engineer, September, 1983. It als0 ignores the documented flow demand(s) data in Subcommittee documentation (Log 135, Proposal 99-124), and Project 746A on medical compressed air systems. Material to, and a part of, this Substantia- tion are Log 135 [Proposal 99-124 in TCR], Log 137 [Proposal 99- 163], and Log 141 [Pro~msal 99-164 in TCR]; ~ Many others involved m this unique techno/ogy nave reportea, on

the record, station terminal floor problems. 3. This proposal is, for life-support gases delivery components,

more "germalne" than for 49. The Subcommittee falls to address substantiations paragraph 6, Log 133 [Proposa~ 9 0 - 1 5 3 ] , p ~ p h 4, Log 134 [Proposal 99-284 in TCR]; paragraph 5, LOg I0 [Orioisak 99-284 in TCR] and has disregarded the objectives andintent of ReguLations 10-3 - -whi le inconsistently citing those same objectives i~r~lLc~gs 135 and 174 [Proposals 99-124 and 99-132 respectiveb/in

4. They have been for years - - and wander over an inconceivably broad range. See Med. Airportlons (two) of attachments, Log 135 [Proposal 99-124 in TCR]; Project 746A (Medical Air portion) and Plumbing Engineer . September, 1983.

Many A/E designers have done no Medical Gas or Vacuum systems, and some have done only one or two. They all require reasonable consensus guidelines. They need better than wide]y divergent prolprietm 3, information. See last references above for both over and unaer sizing. What happened to Hold For Further Study', (Logs 10 and II)? A means to initially determined medical gases outlet performance, and periodically check for proper flow, is not only appropriate but needed to assure Ol3timum pauent care. It would be hard to find a hospital that doesnt have in its normal inventory the few, and adequate, items so easily determine outlet flow performance. A medical gas outlet is a valve, and no valve is Immortal - nor

should one be expected to operate consistently throughout its useful life. Field spot checks of outlets have revealed flow restrictions due to

torn or broken-off pieces of the elastomeric seals, tensionloss or breakage of springs, as well as costly concealed, undetectable leaks which, under certain conditions, can elevate gas concentrations in concealed and/or confined spaces. (See 8-2.1.1.5). Hospitals should be enco..ur.a~ed to periodically check medical

gases outlet performance (winch, experience indicates, is seldom done). Such checks are especially important in ORs and critical care areas. Methods to perform outlet flow and leak tests need not be complex

or require expensive apparatus, would encourage maintaining peak performance, would assure optimum patient care and would reduce

costs and potential hazards due to leaks. Such tests could be accomplished simultaneously. COMMITTEE ACTION: Accept in Part.

See Proposal 99-121 (Log #NON-21). COMMrITEE STATEMENT: 1. Flow requirements are proposed in Propoml 99-121 (Log #NON-21).

2. Subcommittee can only apply this new requirement to new construction.

(Log # 36) 99- 113 - (4-4.1.3.1): Accept in Principle SUBM1TrER: Harold Matthias, Fairfax, VA RECOMMENDATION: Revise text as follows:

" . . . , shall be supplied directly from the riser va/ve wi thout . . . " 8 ~ A . N T I A T I O N : The following handbook note is correct where it says the above statement should prohibit a shutoffvalve between a zone valve and a riser valve. The code eliminates a riser valve which actually reduces patient safety and increases the impact of planned system modification. COMMITTEE ACTION: Accept in Principle. ,

Near the end of 4.4.1.3.1, after "as provided in, add the following: "4-4.1.2.2(f)," COMMrrrEE STATEMENT: Suhmitter's recommendation does not define "riser valve." Subcommittee accepts intent of proposal by adding reference to 4.4.1.2.2(f) because it allows in-line shut-off valves.

(Log # NON-12) 99- 114 - (4-4.1.3.2, 4-4.1.3.3, 4--6.4.1.2, 4-6.4.1.4, 4-4.1.3.2): Accept SUBMITTFJt: Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: 1. Revise 4-6.4.1.2 to read:

4-6.4.1.2 The shutoffvalves described in paragraphs 4-4.1.2.2(a), 4- 4.1.3.2 and 4-4.1.3.3 shall be labeled in sufistance as follows:

CAUTION - (NAME OF MEDICAL GAS) VALVE DO NOT CLOSE EXCEPT IN EMERGENCY

THIS VALVE CONTROLS SUPPLYTO... 2. Delete 4-6.4.1.4 3. In 4-4.1.3.2, par. 1, sentence 2, change "4.6.4.1.4" to read:

"4-6.4.1.2". 4. In 4-4.1.3.3, sentence 3, change "4-6.4.1.4" to read: "4-6.4.1.2. ~

SUBSTANTIATION: Paragraph 4.6.4.1.4 is no longer necessary as changes to prior edition of NFPA 99 deleted requirement relative to shutoffvalves inside and outside of anesthetizing locations COMMITTEE ACTION: Accept.

O.,.<~g # 3) 99-115 - (4-4.1.4.1): Reject SUBMrITER: D.A. McWhinnie, Hickory Hills, IL RECOMMENDATION: Delete "at the job site'. SUBSTANTIATION: The Subcommittee prompts the question did anyone read the proposal? "Disposal" of the agent was (is) not the issue; and to so infer requires s high degree o f imagination. Disposal of hazardous wastes is not within the scope of this Subcom- mittee, and, as a non-response to the problem of patient hazard, is in confiictwith Regulations 0-13, 11-9, and 11-10. -

The hazard exists, especially with capped or sealed system components, no matter where the process is performed. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: Existing industry standards, e.g., CGA GA.1, Cleaning Equipment for Oxygen Service, are considered acceptable. Subcommittee is unaware of any problems when standards are used properly.

(Log # NON.7) 99- 116- (4-4.1.4.1(a)): Accept 8UBMrrrFJu Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: I. In 4-4.1.4.1 (a), sentence I, change "may be" to "shall be" in two places, so that sentence reads:

~Piping, valves, fittings, and other components sh~l be especially prepared in a facility equipped m clean, rinse, and purge the material in accordance with the requirements of 4-4.1.4.1(a)(1) or ,

prepared on the job site in accordance with 4-4.1.4.1 (a) (2). [Changes Underlined]

261

N F P A 9 9 - - F 9 2 T C R \ / 2. In 4.4.1.4.1(a) delete sentences 2 and 3 (Trichloroethylene shall d r

n o t . . . Carbontetrachloride shall n o t . . . ) 3. In 4-4.1.4.1 (a)(2), sentence 2, revise to read: "Piping, valves, fittings and other components prepared at the job

site shall be cleaned by washing in a hot alkaline cleaner-water solution of either sodium carbonate or trisodium phosphate (proportion of one pound to three gallons)." SUBSTANTIATION: Subcommittee wants to set a limit as to what cleaning methods are ~ . Listing just ~ unacceptable methods is not complete as there are many other unacceptable deaning solvents. COMMITTEE ACTION: Accept.

(Log # NON-8) 99- 117- (4-4.1.4.1(a)): Accept SUBM1TrER: Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: Renumber 4-4.1.4.1 (a) as paragraph 2 under 4-4.1.4.1. Renumber 4-4.1.4.1 (a) (1) and (2) as 44.1.4.1 (a) and (b). SUBSTANTIATION: Editorial. There is currently no subparagraph 4-4.1.4.1 (b). COMMITI"EE ACTION: Accept.

(Log # 17) 99-118 - (4-4.1.4.2): Accept in Principle SUBMITrER: GeraldJ. Tucker, AIM Testing Laboratory RECOMMENDATION: Revise text as follows:

44.1.4.2 All brazers and brazing operators shall be qualified by Training and Certification in accordance with the AWS Standard For Brazing Procedure and Performance Qualification (AWS B2.2-85). SUBSTANTIATION: No reference to the governing Standard for

alification of Brazers. MM1TTEEACTION: Accept in Principle.

See Proposal 99-106 (Log #NON-19). COMMITTEE STATEMENT: Proposal 99-106 (LOg #NON-19) addresses the issue raised here.

(LOg # 47) 99-119 - (4-4.1.4.2): Accept SUBMITrER: Peter Esherick, Patient Instrumentation Corp. RECOMMENDATION: Add: "All joints in piping shall be brazed except as provided in 4-4.1.2.1 (c) & (d) and 4-4.1.4.3." SUBSTANTIATION: Refer to 5-1.2 of NFPA 56F-1983. Present 4- 4.1.4.2 does not state that all joints to be brazed. There is only an inference that joints must be brazed. COMMITTEE ACTION: Accept. Insert Submitter's Recommendation at the beginning of 4.4.1.4.2.

COMMITTEE STATEMENT: Editorial.

(Log # 4) 99- 120 - (4-4.1.4.2, 4.8.1.1.8(a)): Accept in Principle SUBMITrER: Robert M. Henson,J.W. Harris Co., Inc. RECOMMENDATION: Revise 4-4.1.4.2 as follows:

" . . . comply with specification for Brazing Filler Metal ANSI/AWS A5.8 or a suitable alternative as noted in (a).

(a) Copper to copper joints shall be made using a copper- phosphorous or copper-phosphorous-silver brazing filler alloy similar to or complying with the requirements of the AWS BCuP series without flux."

Revise 4-8.1.1.8 Note as follows: " . . . medical gas piping. (Refer to 4-4.1.4.2 for recommended

brazing filler metals.)" SUBSTANTIATION: The reference to brazing should refer the reader to 4-4.1.4.2 to find out what brazing filler metals are acceptable. At the same time 44.1.4.2 should be expanded because these are copper-phosphorous and copper-phosphorous-silver filler metals not listed in AWS A5.8 that are commonly used in industry. These filler metals exhibit the same joint strength properties, melt above 1000°F, and can be used without flux on cop-per o copper joints. COMMITrEEACTION: Accept in Principle. See Proposal 99.106 (Log #NON-19).

COMMITTEE STATEMENT: Proposal 99-106 (Log #NON-19) addresses the issue raised here.

(Log # NON-21) 99- 121 - (4-4.1.4.4 (New), 4-5.1, 4-6.2.3): Accept SUBMrrrER: Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: 1. Insert new 4-4.1.4.4 to read as follows:

4-4.1.4.4 The following tests shall be conducted after installation of piping.

(a) "~Insert existing 4.5.1.2.1 ] (b) [Insert existing 45.1.1 on Cross-Conneedon Testing] (c) Piping Purge Test. For each positive pressure gas system, verify

deanliness of pipingsystem. Filter a minimum of 3.5 cubic feet (100 liters) of gas through a clean white 0.45 micron filter at a minimum velocity of 3.5 scfm (100 1pro). Filter shall show no discoloration, and shall accrue no more than 0.1 mg of matter. Test each zone at the outlet most remote from the source. Perform test with the use of an inert gas as described in CGA P-9.

(d) Piping Purity Test. For each psotive pressure system, verify purity o f piping system. Test each zone at the most remote outlet for dew point, carbon monoxide, total hydrocarbons (as methane), and halogenated hydrocarbons, and compare with source gas. The two tests must in no case exceed variation as specified in Paragraph 4-5.1.4 (Maximum Allowable Variation). Perform test with the use of an inert gas as described in CGA P-9.

(e) Pressure Testing. [Insert existing 4.5.1.3.4 on Pressure Testing]

(f) Valve Testing. [Insert existing 4-5.1.3.2 on Valve Testing] 2. Revise 4-5.1 to read as follows: 4.5.1 Patient Gas System- Type I. 4-5.1.1 General Requiremen~ for Central Supply Systems [Insert

existing 4-5.1.3.6] 4-5.1.2 Flow Criteria for Station Outlets. a. Test all outlets for flow. Tests shall be performed with the use

of an inert gas as described in CGA P-9. b. Oxygen, nitrous oxide and air outlets shall deliver 3.5 scfm with

P~G.a ressure drop of no more than five PSIG, and static pressure of 50

c. Nitrogen outlets shall deliver 5.0 scfm with a pressure drop of no more than five PSIG, and static pressure of 160 PSIG. 4.5.1.3 Medical Gas Concentration Criteria. a. Analyze each pressure gas source and outlet for concentration

of gas, by volume. b. Make analysis with instruments designed to measure the specific

gas dispensed. c. Allowable concentrations shall be within the following:

1. Oxygen 99 plus percent oxygen. 2. Nitrous oxide 99 plus percent nitrous oxide. 3. Nitrogen Less than one percent oxygen or

99 plus percent nitrogen. 4. Medical air 19.5 percent to 23.5 percent oxygen

4-5.1.4 Medical Gas Contamination Criteria. Analyze each essure gas source for concentration of contaminants, by volume.

e samples for air system test at the intake and at a point immediately downstream of the final filter outlet. The compared tests shall in no case exceed variation as specified under Maximum Allowable Variation. Allowable concentrations shall be as follows:

a. Dew point - air +39°F pressure All other gases -20°F pressure

b. Carbon monoxide c. Carbon dioxide - air

- all others d. Gaseous hydrocarbons - air e. Halogenated hydrocarbons - air

10 ppm. 1 0 0 0 ppm.

300 ppm. 5 ppm. (as methane) 2 ppm.

Maximum Allowable Variation between comparative test results required are as follows:

a. Dew point 5°F b. Carbon monoxide 2 ppm. c. Total hydrocarbons as methane 1 ppm. d. Halogenated hydrocarbons 2 ppm.

4-5.1.5 Dew Point Criteria for Medical Compressed Air [Insert existing 4-5.1.5] 4-5.1.6 Alarm System Criteria for Gas Systems [Insert existing 4-

5.1.4, excq~g_~pA for 4-5.1.4.1 (b) ]

$. Renumber existing 4-5.1 .$.1 as new 4-6.2.5.7. 4. Renumber existing 4-5.1.2.5(b) as new 4-6.2.$.8. 5. Renumber existing 4-5.1.4.1 (b) as new 4-6.2.3.9.

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SUB,~AN'rIATION: i. To address the issue of minimum flow criteria (Proposal 99-79 (Log #NON-2)) and particulate testing (Propo~ 99-125 (Log ~ 8 ) ) . 2. Movement of existing text into 4.4 and 4-6 (from 4-5) is for

structure of NFPA 99 (4-4 instafiation cr/teria, 4,5 performance criteria mew ,y, tems), 4-6 Administration ~ ,y.tems).

8. Purge,~urity, flow, concentration, contaminauon criteria is baaed on U:S. Department of Veteran Affairs Test protocol. COMMrrTIgE ACTION: Accept.

(Log # 74) 99-122- (4-4.2.7.1): Accept in Principle S U B ~ Leo G. Foxwell, Subcommittee on Nonflammable Medical Piped Gm Systems RECOMMENDATION: Reword paragraph to read:

4-4.2.7.1 Two Cylinders of Oxygen and two cylinders of h i ,o re oxide (if used) and storage is remote. If storage is not remote 1 cylinder of nitrous oxide shall be minimum (if used). SU]BSTANTIATIONs The original draft text dating to NFPA 56F chapter 6 had required only 1 tank of nitrous if storage was not remote, but two if remote storage existed, this corrects in error that has crept into standard. COMM1TI"KE ACTION: Accept in Principle.

Revise 4-4.2.7.1 to read: 4.4.2.7.1 Two cylinders of oxygen and two cylinders of nitrous

oxide (if reed) if storage is remote, or two cylinders of oxygen and one cylinder of nitrous oxide (if used) if storage is not remote. COMMITrEg ~ r A ~ : Editorial; clarify intent.

(Log # NON-IS) 99-123 - (4-4.2.11.I): Accept SUBMITr]g~ Subcommittee on Nonflammable Medical Piped Gas Systems

I RECOMMENDATION1 In 4-4.2.11.1, change reference of "4.4.1.2" to "4-4.1.2.1". SUBSTANTIATIONI To reference requirements specifically on gas

i ~ ~ A C T I " 1"2"1)' ON: Accept.

(Log # 75) 99-124. (4-4.2.12.2): Accept SUKMrrYE~ Leo G. Foxweli, Subcommittee on Nonflammable Medical Piped Gas SDtems RECOMMENDATION~ Cha~ge 8rd sentence to read as follows:

"A remotely activated shutoffat the supply cylinder, shal / . . ." S ~ A N T I A T I O N : It was never the intent of Committee to allow shutoffat anything[ except cylinders. See Figure A 4-4.2.12.1. A shutoff at the manifold downstream of a flexible hose was never intended to be allowed. COMM1TI '~ ACTION: Accept.

(Log # 28) 99-125- (4-5.1.2.2): Reject S U B ~ Frank P. Primiano,Jr., Thomas E. Bradbury, Mentor, OH RECOMMENDATION: Revise text as foUows:

(b) After the system is purged, the permanent particulate matter p r ~ u c e d at any outlet b;/a flow of 100 lpm is not to exceed 1 rag/ m . This is to be checked every 3 months for the medical air system and annually for all other _gas vstems. SUBSTANTIATION: The intent of the "white cloth test" described in 4.5.1.2.2 (a) seems to be that there should be no particulate matter in medical gas systems. However, no quantitative standard is given in that paragraph or elsewhere in NFPA 99. Another condderatlori is tfiat some metallic salts found in gas lines are white and not eadly visible on a white cloth. We feel that quantitative guidelines should be provided by which gas system can be judged to be "cle~u~" with respect to particulate matter. CSA and OSI-IA give 5 mg/m as limits for the respirable fracdon of inert mineral dust in ambient air (see 29 CFR Cli. XVII (7-1-88 Edition) OSHA, Labor, p. 710). Based on our oblervations it is reasonable to expect that a system can be maintained with no more than 1 rag/too of parfienlate matter. This is less than OSHA's requirement for respirable air, and from our experience, will not foul sensitive medical equipment such as blenders and ventilators. COMM/TrEE ACTION: Reject. CoMMrFYF,,E STATEMENT: The Submitter does not justify by a statement of problem the need for conducting a permanent particulate test. The reference to CC, A and O~qA limits on inert

mineral dust in ambient air is not a proper source. No justification has been received by the Subcommittee displaying~ a need for the flow, weight and tesdng schedules recommended m this proposal.

(Log # 171) 99- 126- (4.5.1.2.3(b)): Accept $ ~ Hy Rershad, P.E., Hosp. Engr. Society of Greater New York RECOMMENDATION: ~ in line S. the word and to or so that text reads:

"whenever a system is breached or whenever modifications..." SUBSTANTIATION: Clarity of requirement. CoMMrFr ]~ ACTION: Accept.

(Log # 144) 99.127- (4-5.1.2.8(b)): Accept SUBMITrE~ Barry Duignan, Greater Hew York Hospital Associa- tion RECOMMENDATION: ~ a a g g in line ~ the word and to or so that text reads:

"whenever a system is breached or whenever modifications..." SUBSTANTIATION: Clarity of requirement. COMMITY~ ACTION: Accept.

(Log # lS0) 99-128 - (4.5.1.2.$(b)): Accept. SUBMITYER: D.A. McWhinnle,Jr., Mechanical Dynamics Inc.

I RECOMMENDATION, Delete last ten words - end paragraph with a period after the word "performed". SUBSTANTIATION: This test should (must) be done in all areas. Cross-connections have been found in all sections of all systems - includingin January, 1991, in a surgical patient wing in a very large Medical Center (after "certification'). CoMMrrTEE ACTION: Accept.

(Log # 5) 99-129 - (4-5.1.8.6 (b)): Accept in Principle SUBM1TFER: Antonio A. Mesa, Nash Engineering Co. RECOMMENDATION: Add:

"If supplied by the central medical air system, it shall be separately piped upstream of the main line regulator and have its own isolation ;~a]ve, re~gulator, alarm,, etc." SUBSTANTIATION: (A) Simplification of piping, regulators, and alarms for nominal ,50 lb medical air system.

(B) This would keep industry from distribudng unregulated air and regu~ting at multiple locations, resulting in less consistent pressure throughout hospitals and creating master alarm difficulties. COMMITI']~ ACTION: Accept in Principle.

See Committee Action on Proposal 99-79 (Log #87). COMMrlWEE STATEMENT: Issue is similar to that in Proposal 99- 79 (Log #ST).

(Log # 191) 99-130 - (4.6.2.8.5(a) (2)): Reject SUBMrITER: D.A. McWhinnie,Jr., Mechanical Dynamics Inc. RECOMMENDATION: Delete paragraph 4-6 .2 .8 .~(a)(2) SUBSTANTIATIONs Who is "q-=liKed is not within the SS/C Scope, nor that of NFPA~ Mechknical systems A/Es are presumed to be quaked .

Allinstxilafion/construcdon contracts are awarded on the baals of competitive bids - and q-=l;~cafions. NFPA cannot establish criteria for any bidder and hat no latitude in this area. This k the domain of .the A/E designers and/or other principals involved in the contract- mg process. 'q~ed" in this document is without defin fion or criteria and is esumptuous.

MMrlWEE ACTIONz Reject. CoMMrlTKE 8TA~: By including the term -q.=li~ed, Subcommittee is ad "vising_ users of this document that some measure of experience in i n s t a l ~ piped gas systems is necessary. Exact qualifications of ex-~rience are not considered necessary; this is determined by designers, owners, and authorities having jurisdiction.

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(Log # NON.I 5) 99-151 - (4.6.2.4.1,4.6.2.4.3,'4.6.2.4.6, 13-3.4.1, 14~.4.1, I5-3.4.1, 16- 3.4.1, 17.5.4.1): Accept SUBMI'----Tr]Oi: Subcommittee on Nonflammable Medical Piped Gas l .ctems

OMMENDATION: 1. Revise 4-6.2.4.1 to read as follows: 46.2.4.1 Type II systems cover nonflammable gas system installa-

tions that: (a) [Same as existing (a)] (b) [Same as existing (b)] (c) [Sane as existing (c)] (d) [Same as existing (d)]. 2. In 46.2.4.5, delete "and laboratories". 5. In 46.2.4.6, delete "or 46.2.4.5". 4. Revise 15-3.4.1 to read as follows: 15-5.4.1 Patient piped gas systems in facilities that do not include

critical care areas are permitted to have a Type II gas system in accordance with Sectiom 4-5 to 46 of Chapter 4. Patient piped gas systems infacilities that indude critical care areas shall conform to Type I gas systems in accordance with Sections 4-5 to 46 in Chapter 4.

5. In 14.5.4.1, sentence 1, delete "if they are non-hospital based and meet the requirements of 4.6.2.4.1".

6. In 15-5.4.1, sentence I, delete '~if they are non-hospital based and meet the requirements of 46.2.4. I ' .

7. In 16-5.4.1, sentence 1, delete, "if they meet the requirements of 4-6.2.4.1".

8. Insert new 17-3.4.1 to read as follows: 17-5.4.1 Patient piped gas systems shall conform to Chapter 4,

Sections 4-3 through 4.6, Type II systems. Otherwise, conformance to the Type I gas systems, aslisted in Sections 4-3 through 4-6 of Chapter ~t, is/equlred. S ~ A N T I A T I O N : 1. Clarify the structure of 4-6.2A.1 to make it non.facility specific, per structure of NFPA 99.

2. Determination of which Type of piped gas system is to be installed in a facility is determined by the level of care provided. The Subcommittee believes a Type I patient piped gas system is necessary in an ambulatory health care center that has critical care a r e a s . COMMrrYEE ACTION: Accept.

(Log # NON-14) 99-132 - (4-6.2.4.2, 12-$.4.1): Accept SUBMITTER: Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: 1. Delete 4-6.2.4.2.

2. Add the following Exception to 12-3.4.1: Exception: AType II Gas System as defined in 4-6.2.4.1 when it is

not se/ved by the hospital's central supply system. SUBSTANTIATION: I. This requirement does not belong in Chapter 4, per structure of NFPA 99.

2. Excepuon places allowance for a Type H ~as system in hospitals (as provided by 4-6.2.4.2 under certain condiuons) in appropriate location in NFPA 99. COMMITrF~ ACTION: Accept.

(Log # 193) 99-133 - (4.7): Reject SUBMITZX~ D.A. McWhinnie,Jr., Mechanical Dynamics Inc, RECOMMF.aNDATION: a. Insert Vacuum Scope and Hazards in the Vacuum Systems Document immediately above 4.7.

b. Insert "Vacuum Systems" immediately above Vacuum Scope. c. Insert "Chapter (appropriate number)" above Vacuum

Document Scope. d. Renumber according to NTPA IM Manual of Style.

SUBSTANTIATION: Project construction documents and specifications are still being misunderstood and inadvertently or convenientb/combined, some at considerable excess cost and/or Code deviauons - including patient risk errors. To improve clarification - ~lser friendliness" - and compliance with

Part VII Regulations, Manual of Style, Committee Leadership Conference Guidelines, and Vacuum SS/C intent.

Substantiation detaiis follow. I. The NFPA Health Care Facilities Technical Committee

acknowledges that the Code 99, Vacuum Systems Document covers a totally "different technology" with totally "different requirements" (than gas systems) - per Fall Meetings '86 and '89 abstracts, and other documentation (in Vacuum Committee flies)•

Evidence of the T/C's acknowledgment of the total differences of the Vacuum Document includes the Code 99 page separations before and after the Vacuum Document, the NOTE above 99, 4-7, the NOTE 3: above 99, 4-1, and 50+ T / C changes, to say nothing of the Vacuum SS/C changes.

These changes confirm the fact of many fundamental differences between disparate technolggies, but are minor and do not resolve the basic issue of Part VII RdgtJla_ dons (Ill below), and Manual of Style 1-4 Chapter, 2-1.1, 2-2.1, 7-I (e), 7-6•1 and 7.6.$.

If• The combining in a single chapter of two widely diverse - (conceded)-technologies (totally opposite in this context) is, without substantiation, a contravention of Part VII Regulations 10- 10(c) and 11-10 which are qnterpreted literally" (per Standards Council Secretary 6/7/88), and "require" - =must state the problem", "substantiation" and "why. No "problem" was ever stated. The only reason ever stated "a feeUn$" of an unqualified* member of an unqualified* ad hoc commtttee. (That committee had no representation from either of the two affected committees.)

* (unqualified as to systems' design, contracting, installation and day-to-day hands-on experience.)

No thoughtful individual, group or process can accept "a feeling" as the sole reason, and dete/'minant, in a matter of this importance. When asked by the Chairmen of two NFPA Fall Meetings ('86 and

'89) for an answer to specific questions from the floor as to substantiation for combining disparate NFPA Documents the T /C response did not include answers to those specific questions. (See Attachment A, and meeting abstracts.)

The "restructuring" ad hoc committee did not respond to a written request (11/28/86, w/copies to T / C Chron., and NFPA staff) for substantiating rationale - (Attachment A).

On 5 / l l / 8 7 t h e T / C "review ad hoc committee (actually the restructuring ad hoc reviewing its own work) also failed to answer the question from one of two qualified guests, as to the "problem" with maintaining separate documents, and reason for combining opposite documents. The ad hoc reply did not address those most important questions but, confirming this Proposal, stated that "it was possible edt'~torially" (to maintain the proper separation of the two divergent documents). The other, also very qualified, guest "preferred" separate docu-

ment~, each coveting its own umque technology• Previously, the NFPA Standards Council had appointed a delega-

tion to defend separate documents at an American National Standards Institute hearing in New York on this same issue - combining these two NFI'A Documents. The NFPA position prevailed - ANSI endorsed separate documents for unlike medical- surgical systems - as they had always existed in the sciences of fluidics - chemistry and physics.

III Applicable NFPA requirements and guidelines: A. PartVII Regulations• 10-10(c) No "statement" (to date) of a "problem". No valid

"substantiation". 10-11 Committee Proposals; same as 10-10(c) last above. 10-13 No "statement. . . on the reason . . . " and nothing "suffi-

ciently detailed so as to convey. . , rationale". 11-10 T / C statement did not address the several material substan-

tiations in the Comments. B. NFPA Code 99. 1-6•2 The Vacuum System Document is without its Scope and

Hazards Sections. C. NFPA 1M Manual of Style. 1-1 "This Manual . . . (is) . . . consistent with the Regulations

Governing Committee Projects and is intended to be u sed . . . (for). •. all Technical Committee documents." It is obvious that the T /C "restructuring" process has breached, at the very least, the intent of the synergism - all aspects of Regulations and Style being equal to each other. This statement is made on the bases of no scope or hazards in the body of a "major division" (1-4), a "distinct division" (2-2.1), "dealing wtth a broad subject area"; and no "statement of a problem and a major decision affecting thousands of health care facilities based only upon *a feeling".

1-4 The Vacuum Document covers a true life-support system for surgical, and other critical, patients and qualifies as a "major" and "distinct division" - a chapter. 2-1.1 The Vacuum Document (like any other) "should start with

(its) scope". 2-2,1 Same as I-4 above. 7-1 (e) Applies to this Proposal.

• 7-6.1 User friendly" for the vacuum system designer, installer, other users.

7-6.3 The Vacuum System Scope is one full, document away from its texL

7-6.4 See 7-6.1.

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N F P A 99 ~ F92 T C R

D. Committee Leadership Conferences. Too many of the actiom on the mbject of this Propoml lack accord

with the Conference guidelines and their clear intent. Supporting material-available for review at NTPA Headquarters.

COMMITrI~ AGWION, Reject. C O ~ S T A ~ : See Committee Action on Proposal ~J-lS4 (Log #1~).

(Log # ]25) 99-1M- (*7 through *I0) : Reject SuBMrI ' r l s~ Antonio A. Mesa, Nash Engineering Company RECOMM]~IDATION: Move entire vacuum systems matter into a new and separate Chapter. Unite Scope discussion and renumber sections pei" organizattonal intent of 1;6.2. No content chan~e. S~A.NTIATION: Enhanced user friendliness and conformance to I;6.2 stated format for consistency. COMMrITEE ACTION: Reject. COMMITTEE STATEMENT: No new information presented to alter past decision (of placing g ~ and vacuum system requirements in one chapter). Text adequately indicates separadon of gas and vacuum system requirements. [Issue extensively discussed at October 21/22, 1991, Technical Committee meeting.]

(Log # VAC-~) 99- 135- (4-7.1.1.1(e)): Accept SUBMI'ITE~ Subcommittee on Vacuum Systems RECOMM]DO)ATION: 1. Revise sentence I to read as follows:

"Each vacuum pump motor shah beprovided with a separate motor.starting device and overload protec-

don." [Change Underlined] 2. In sentence 9, change the first word from "A" to "rhe' . 3. Revise sentence $ to read as follows: • ..lecwical conu~ol circuits shall be so arranged that shutting offlgt~

vacuum pump will not affect the operation of f l ~ . _ r . g ~ i ~ pump(s)." SUlk~ANTIATION: I. Eliminate reported misinterpretations on the installadon of disconnecting devices for vacuum pumps.

2. Editorial as a result of Committee Action No, 1. $. ~ arrangement of pump wiring in the event of failure of

ON: Accept.

(Log # 126) 99-1S6 - (.7.1.1.1(f)): Accept in Principle SUBMITTF.~ Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Insert after first sentence:

" . . . cause excessive cycling of the pump(s), r ~ J ~ t l I 3 K I L 0 2 . ~ of walvanized steel or other corrosion reststant material. A suitable method . . . " SUBSTANTIATION: Clarification of minimum COMMrrrEE ACTION: Accept in Princi le requirement. Add new sentence 2 in .7.1.1.1 (f) to r~c~ u follows: (t) Receivers shall complywith Secdon VIII ('Unfired Pressure

Vessels') of the ASME Boiler and Pressure Code, and shall meet the standing pressure tests of 4-9 of this chapter, and full vacuum. COMMITrEE STATEMENT: The ASME standard is more comprehensive on the subject, and is a recognized ANSI standard and appropriate for the subject of vacuum receivers.

(Log # 127) 99-137- (,7.1.1.1(0): Accept SUBMrr rE~ Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Delete ~ " from the last sentence. SUBSTANTIATION: Previous sentence states "a suitable method ~an be provided..." COMMITTEE ACTION: Accept.

(Log # VAC,~) 99-138 - (.7.1.1.1 (h); l r~n 'e .7.1.1.1 (j)): Accept SUBMrr rE~ Subcommittee on Vacuum systems RECOMMENDATIONs I. In 4-7.1.I.I(h), add the following s e n t e n c e :

"If used, flexible couplings shall be rated for temperature, and pressure or vacuum, at the point of imudlafion."

2. In Figure 4-7.1.1.1 (j), change flexible couplings to dotted flexible couplings. S ~ A N T I A T I O N : 1. Reports received of flexible coupling failures from inappropriate material selection of couplings.

9. Text does not require use of flexible couplings. COMM1Tr]~ ACTIONs Accept.

(Log # 128) 99- 159 - (4-7.1.2): Accept in Prindple SUBMITrER: Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Revise .7.1.2 as follows:

.7.1.2 Where a Medical-Surglcal Vacuum System is used for the dispo~_ of anesthetic gases, that system shall havepumps conforming to the requirements of.7.1.2.2. [Proposed .7.1.2.2 in Proposal 9o~X44 ~144 (Log #1~ ( #129).] su TioN: 0ement of tem oty oot restricting medical practice. Anesthetic gas contains nitrons.oxide and oxygen, both strong oxidants. If present in a vacuum system, these gases should be directed towards p u m p (or blowers) free of oil to eliminate any possibility of exciting or fueling a fire. COMMITYF~ ACTION: Accept in Prindple. Insert a new paragraph under .7.1.2 to read as follows: .7.1.2 Where pumps are used in a dedicated vacuum system used

for the disposal of anesthetic gases, these pumps shall conform to the requirements of 4-7.1.2.2, Retain existing Note in .7.1.2.

COMMrrrEE STATEMENT: The problem of pumps creating a fire hazard is restricted to those systems that are dedicated to the disposal of anesthetic gases. I n view of the diludon factors that occur w/th central vacuum systems, restrictions on pumps for those systems is not considered warrented.

(Log # 40) 99-140- (4-7.1.2): Reject SUBMrI ' rF~ Steve Stephens, P.E.,JMGR Inc. RECOMMENDATION: Form a committee to rewrite the sizing

rocedures for medical EVAC systems. ON: There is no sizing requirements for medical

EVAC systems. Current data n e e ~ to be expanded. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: Subcommittee is unable to assess sizing requirements as submitted.

CLog# 6) 99- 141 - (4-7.1.2, 4-8.1.1.1(a) and (b), 4-8.1.2, C.4.6(3), C-*$.1(b)):

D.A. McWhinnie, Hickory Hills, IL RECOMMENDATION: Delete ,7.1.2,4-8.1.2; C-4;6(3); O4-3.1(b) double asterisks; 4-8.1.1.1 "but does . . . (through) . . . gases'; ~ n t h e t i c a l and "NOTE" under Table 4-8.1.1-.1 dde; 4-10.4.1.4 "or, if used," and WAGD (box); A-4-8.1.1.1 (a) second line; and A-4- 8.1.1.1(b) "NOTE 1". Add: Disclaimer B, Log 129 [Proposal 99-107 in TCR]. SUBSTANTIATION: All Subcommittee Statements (Logs 129, 143) Proposals 99-107 and 99-168 in TCR for 1989 Fall Meedng are uniformed, unsubstantiated, lack basis and completely contradict the authoritative documentation in the Subcommittee (Propmal 99- 168, Log 143 in TCR for 1989 Fall Meeting). There are at least 25 references in the hands of the Subcommittee and Technical Committee refuting the Subcommittee and Technical Committee 1988 acdons. (If flie references were reviewed they've not been addressed.)

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(a) Subcommittee "Statements" [Logs 129 and 143 (Proposah 99- 107 and 99-168, respectively in TCR for 1989 Fall Meeting)]: Statement 1. WAGD is not in the sc0,~. ~ 4-1.4; it is not for :patient

drainage, aspiration and suction(ing) ; it is not used on pauents for lgkY treatment, or other, procedure. The literature is dear that exposure of the anestheuzed patient to the MSVS degree of vacuum in the breathing circuit could came various types of trauma (at least four document&i in Subcommittee/Technic a] Committee Records). The Subcommittee and Technical Committee files contain at least 25 references refuting Subcommittee Statement 1.

"ANSI Z79" reference ~ A5-4.1 and 2 "Ventilation of Anesthedr~g Lo~tion." <the ~ s~.~s ..m;~. ~at the issue is environmental) cautiom against any application ot equipment that could expose "the~breathing circuit to ~ preuure l f ~ " (underscores added).

Further, that same reference (in NFPA 99, A-5-4.1 anti 2) cautions against "the dunking" of any flammable vapors into a central suction system not designed for inch operation." (Chapter 4 MSVS is not so designed). Additional hazard: "Flammable anesthetics are still being used" [Log 52 (Proposai 9oo-2 in TCR for 1989 Fall Meeting) and EE Subcommittee 8-15-88]. There remain ORS without WAGD, and many with WAGD/

scavengers/'evac" not being used - - and performing surgery daily. Its obvious that these are certainly notpauent treatment systems, and do not qualify as "patient" or "medical-surgical" (4-7.1) systems.

Statement2. This statement is without thought, being only a partial" one. The Subcommittee has a very senous responsibiLity as to • e intended application of its assigned project. Vh-tda~y. every NFPA document limits to some degree its application, depending upon its intent,P_mfpose and scope. Almost everyone knows that [NFPA] 99, 4-1.4limits its application and excludes/prohibits a specific application. It should not be necessary to explain "dedicated" systems, or to list the hundreds of exclusions, prohibitions or other application limits throughout NFPA documents.

Statement S. This statement reflects a lack of concern about hazards, or knowledge of the facts. NFI'A texts should not include, and infer by reference, applications which have voluminous documentation citing patient hazards (regardless of degree), and lists Of potential patient trauma.

Techriicai Committee %1-86: q_f the Technical Committee is to err let's do so on the side of safety." It is at least inconsistent, if not irrational to include, infer by reference, and "permit" (Subcommit- tee Statement) an application with documented, by name, at least 4 hazards/traumas (pulmonary barotrauma, ref. in Proj. 746-A in Subcommittee-Technical Committee files) - - and simultaneously ~glgr£" in. the. same NFPA. 99 chapter, the monitoring and alarming ofa condinon for winch there Is no documented hazard (dew

int), and no Subcommittee Substantiation (per Regulation 10-3, 10). To ~ an arbitrarily selected limitq3ecause of "the lack

of a firm n u m b e r . . . " [Subcommittee Log 174 (Proposal 99-132 in TCR for 1989 Fall Meeting) ] is inconceivable.

Statement 4. This is a non-statement as it's irrelevant. The Submitter of that statement has failed to provide the Subcommittee with the requested documentation on that project. In any event it is not pertinent as "scavenging devices" are not within the Subcommit- tee Scope. (See Subcon/mittee Statement 2, Log 129 [Proposal 99- 107 in TCR for 1989 Fail Meeting].)* WAGD inclusion without substantiation violates NFPA regulations.

• (a) Ai~ough irrelevant, scavenging devi'ces are well known for failure to function safely when ~ was applied to the exhaust port." Note: "Wall suction" is relevant to this Subcommittee. (See "Governing Criteria" item 1 below.) (b) ". . . in normal use, some scavenging apparatus, even when operating properly, can alter the normalch/uracteristics of an anestheticbreathing mach ine . . , for medical use." (See "Governing Criteria" item 2 below.) Underscores in quotes above have been added. WAGD is an environmental problem "to minimize pollution of

ORs, and occupational exposure of OR personnel" and, therefore, is an OR "ventilation" funcuon as is confirmed by its inclusion in [NFPA] 99, A-5-4.1 and 2. Without the clarification of this proposal the patient, medical staff

and hospital are at risk. The Heaith Care Facilities Technical Committee has accepted 1/

12/88, the fact of patient hazard in this application. End of resnouse to Subcommitte~ -statemenra",

(b) It is appropriate to note that ISO and IkSI (British Standards Institute) oppose MSVS use for WAGD because of "very onerous safetyproblems" which "can seriously affect patients".

The following is based upon Health Care Facilities conferences, seminars, training programs and field experience:

It has been noted, and is clear, that this function is one of environmental ventilation for "staff i?rotection from pollution by anesthetizing gases" and, therefore, ,~ appropriate to the "Ventilat- ing" section. N~PA 56K, 1980; Codes 99, 1984 and 1987; and NFPA Health Care

Facilities Handbooks, '84 and '87 all caution against the me of MSVS and WAGD/'evac" due to the documented and acknowledged hazard to anesthetized patients. WAGD/'evac" is neither a 'Medical-Surl~ical" patient system per 99, '87, 2-2 nor is it for ~atient drainage, asptration a, nd suction(ing)" per 99, '87, 4-1.4. NFPA "strongly discourages this use of the MSVS (Health Care Facilities Handbooks '84 and '87).

In answer to a direct question on this issue at the NFPA Health Care Facilities Technical Committee meeting less than f'we months ago the members were advised by John P. Swope, M.D., Chairman of the Anesthesia Services Subcommittee, that the use of the MSVS for WAOD/'evac" is hazardous to the anesthetized patient. The fact of this hazard was accepted without dissent by the NFPA Health Care Facilities Technical Committee on 10/12/88.

This also is further affirmation of the telephone communication to the May 6, 1980 MSV Technical Committee by John H. Lecky, M.D., Chairman of the ANSI Z79.11 Committee on ".. . excess anesthetic gases', and Editor of the ASA 1980 document Waste Anesthetic Gases in Operating Room Air.

The -intent ofANSIZ79.11 (A-3-3.1.3.3.5) is that the negative/ vacuum pressure "approximate ambient pressure':

" . . . in normal use, some scavenging apparatus, even when operating properly, can alter the normal characteristics of an anestheucbreathing machine, extracorporeai oxygenator, or breathing machine for medical me."

Employmg the normal barometric premme differential between the anesthetizing area and its mrroundinl~ local atmosphere, the non-recircnlating ventilation system "is gamble for waste anesthetic gas disposal ~ (ASA "Waste Anesthetic Gases in Operating Room Air', 1980) - reconfirmed by Charles Whitcher, M.D., a principal investigator, and many others.

Or "a dedicated. . , blower system." (ASA, and others); and maintaining a degree of vacuum not exceeding "0.5 cm H20 during normal operating condit ions. . , to protect the patient" is effective without "compromise" of the anesthetized patient (ANSI Z79.11).

"CLINICAL REPORTS" (Anesthesiology 46:152-154, 1977): "Our data confirm their (Whitcher et al.) fears and extend their observa- tions of the possible consequences of venting gases to suction." (N.E. Sharrock, M.D., andD.E. Leith, M.D.) None of the warnings against the use Of MSVS for WAGD/'evac',

including the BritishStandards Institute and the International Standards Organization, has been refuted, or even challenged.

Without any (to say nothing of substantive) rationale it is folly for Codes, Standards or gegulauons which become requirements, to include an admittedly (and documented) hazardous application. This action promulgates and provides "justification" by nnplication for unintended me, additional danger to patients, and potential liability. To be unclear about a totally unnecessary medical risk, regardless of de~..ee, is a grave mistake. NFPA text vs. Appendix and Health Care Facdities Handbook commentary send contradictory messages. All of the documentation researched on this subject, and based

upon scientific studies and performance testing, warn against this hazard. Therefore, patient safety and integrity demand that valid rationale for the me of MSVS for WAOD/'evac', if any, be put before the appropriate assemblage(s).

Became of the present mixed and contradictory signals, life- support systems' designers, inspectors and certifiers are obligated, in conscience and for their own lega]protection (JCAHO Handbook: Uand for litigation purposes'), to advise all principals involved of the patient hazard and attendant liability.

Participants in the development of documentation containing these warnings include: AANA, AART, ACCP, AORND, ASA, CGA, UL, USAF, USN, USVA, among many other involved professionals. The following includes other references anti some applicable

excerpts: DESIGN AND INSPECTIONS: Waste Anesthetic Gas Disposal - Ventilation of Anesthetizing Locations.

GOVERNING CRITERIA: The applicable, authoritative consensusdocuments, all of

which cite the cautionary rationale (of potential hazard) against the me of Medica]-Surgical Vacuum pumps or systems for WAGD "evac". 1. Potential Pulmonary Barotranma When Venting Anesthesia Ga~s To Suction; Sharrock, N.E., and Leith, D.E.; Anesthesiology 46; 152- 154; 1977.

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2. ANSI Standard Z79.11-1982; American National Standards Institute; " . . . intended to set minimum performance and safety cr i ter ia . . . Scavenging system pressure should "approximate the ambient pressure in normal use." *. . . rationale is provided for the requirements in this standard." 3. National Fire Protection Association; Health Care Facilities Handbook, 2nd Edition, 1987; Rationale and Commentary on NFPA 99: The Intent of NFPA Health Care Facilities Standard No. 99 (both 1984 and 1987 Editions) is that Medical-Surgical type vacuum pumps, and MSVS systems not be used for WAGD =evac": and that a separate dedicated ambient differential, ventilation exhaust, or "micro-vac" blower system be used. (see NFPA Health Care Facilities Handbook, '87, 4-7.1.2, ~ 177-178, and Prologue, Pg. 170. For volunm displacement see pg. 177, lines 13 and 14. " . . . the maximum safe pressure for the patient shall not exceed (0 negative) -0,3 cra H20 (0.01446847" hg vac.)" This 0.0012 percent of the MSVS required minimum 12: Hg vac. and "829.3 times the maximum safe degree of negattvepressure that should be experienced by the anesthetized padent~and over I000 times excess degree of vacuum when the MSVS is on stream within its normal operating range. Further, no limit has been set for MSVS maximum degree of vacuum. 4. "Hospital Special-Care Facilities (Clinical Engineering Series); Academic Press, 1981 - Chapter 14: " . . . l~eferable (WAGD) disposal m e t h o d . . , air conditioning (ventilation.. . exhaust," "Advantages... not hazardous to the pa t ien t . . , is economical . . , negative premire is l ow . . , no special machinery is necessary.. , and is safe because the pressures (negative) are inherently l imi ted . . . " 5. T h e Brithh Standards Institute and The International Standards Organization both oppose the user of the MSVS for WAGD-'evac" because of the "very onerous safetyproblems" which "can seriously affect patients." (See reference 3 above).

Ref. I above: *. . . another potential hazard for the patient and anesthesiologist," " . . . each scavenger valve tested failed to function safely when ~ali ruction was apnlied to the exhaust vort," "Such subatmosvhertc vressures may mducevulmonary e~iema 2 or

. = .

atlectams, $ a n d . . , could result m card~ovazcular collapse 4 or trauma to pulmonary parenchyma." Ref. 2 abo~e " . . . in normal use some scavenging apparatus, even when operatingproperly, can alter the norn~al characteristics of an anesthetic breathing mach ine . . . " At its October 12,1988 meeting the NFPA Health Care FaciLities

Technical Committee members were advised by John P. Swope, M.D., Chairman, Anesthesia Services Subcommittee, that the use of the Medical-Surgical Vacuum system for WAGD/*evac" can be hazardous to the anesthetized patient, confirming that hazard reported to NFPA Technical Committee on Medical-Surgical Vacuum SDtems meeting May 6, 1980 by telephone communication fromJ.H. Lecky, M.D., Chairman, ANSI Z79.11 Committee.

The fact of the hazard was accepted by the NYPA Health Care FacU/ties Technical Committee, without discent, at its meeting on October 12, 1988.

Proper design and application of life-support systems in health care facilities, and-the meticulous avoidance ofany d .e[~,ree of patient hazard, are essential "for various agencies, inducting government and insurance agencies, for litigation purposes" (]CAHO Hand- book).

For self-protection and, especially, that of the patient, it is incumbent upon prudent professionals to advise their clients accordingly. - COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: Same Recommendation as Proposal 99-70 (Log #192), and is thus rejected for same reasons.

(Log # VAC-9) 99- 142 - (4-7.1.2.1): Accept SUBMrrFER: Subcommlttee on Vacuum Systems RECOMMENDATION: Delete the word "significantly". SUBSTANTIATION: Term is not quantifiable. COMMITYF.E ACTION: Accept.

(Log # VAC.4) 99-143 - (4-7.1.2.1, Note 2): Accept SUBMrITEBa Subcommittee on Vacuum Systems RECOMMENDATION: I. In sentence I of NOTE 2, change "with the seals" to read as follows: "with some seals'.

2. In sentence 2 of NOTE 2, change "this activity will cause certain deteriorization of ' to read as follows:

activity may cause deterioration of' . SUBSTANTIATION: There are seals available that are compatible. C O l ~ ACTION: Accept,

CLog # 129) 99- 144- (4-7.1.2.2 (New)): Accept in Principle SUBMrrFEIh Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Add new sentence as follows:

*Pumps handling any waste anesthetic gas shall have no c.'.l present in the compression chamber." SURc~rANTIATION: Anesthetic gas include mixtures of strong oxidants, inch as nitrous-oxide and oxygen. Lubricating (or sekling) oils could fuel the mixture, especially m the presence ofcompreuive heat.

CSA also observes this threat. COMMrFFEE ACTION: Accept in Principle. Insert new text under 4-7.1.2.2to read as follows: "Pumps of dedicated waste anesthetic gas disposal systems shall be

water sealed or have inert materials in the compression chamber. COMMITFEE STATEMENT: To allow for various types of acceptable pumps. To address the mfety issue with as much flexibility as possible.

(Log # is0) 99. 145 - (4-7.2.1) : Accept in Prindple SUBMITrER: Antonio A. Mesa, Nash Engineering Company RECOMMF2qDATION. Change to read:

4-7.2.1 Where only one set of vacuum pumps is available for combined medical-surgical vacuum system and analysis, research, or teaching laboratory vacuum systems, such laboratories shall be nined sevaratelv of the medica14ur~ical svstem direcdv to the receivel; tknk th~ovah its own isolation vane located at the re~:eiver. (Change underlined) SUBSTANTIATION. Proposed wording provides adequate protection to life support system, espedally since the receiver shall be equipped for dralnage or service without interrupting service per 4-7.1.1.1(f). Wording adds an isolation valve to enhance patient protection.

It is already stated in 4-10.2.1.5 and 6 that the system will not be used for the disposal of liquid or debris and that external traps shall be employed if such ~ v e r should occur. The receiver will provide adequate seconoary protection.

Reference is made to CSA Z305.1, Section 21.5 (Supporting material is available for review from NFPA Headquarters). COMMITrEE ACTION: Accept in Principle.

I. Accept Submitter's Recommendation, but insert after "its own isolation ~.Ive" the following: "and fluid trap'.

2. Add a new sentence 9 to read as follows: "Between the isolation valve and fluid trap, a scrubber shall be

permitted to be installed." S. Revise F/gure 4.7.1.1.1(j) by doing the following: - Change "From piping system" to read as folinws: "From medical

piping system". - Add a laboratory distribution line, with isolation valve and fluid

trap, in dotted form to receiver, and label it "prom laboratory piping

~.2.~ m**'. Insert ***" at bottom left in Figure, followed by "See 4- • • o W

COMMI'IWEE STATEMENT: I. Subcommittee retains requirement for fluid trap so that a common receiver is not compromised.

2. Installation of a scrubber is application dependent. 3. Revisions to Figure is to reflect changes from Committee Acdon.

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(Log # 76) 99-146- (4-7.2.2 (New)): Reject S u B M r I ' r l ~ Leo G. Fox'well, Subcommittee on Nonflammable Medical Piped Ca= Systems RF.,COMMENDATION= Expand existing 4-7.2.2 Other (reserved) as followt:

4-7.2.2 DentalVacuum Systems 4-7.2.2.1 The dental vacuum system should provide suction for use

in removing fluids, fillings, etc., from oral cavirieL The discharge of the vacuum system shall not be directly into an open arain. .

4-7.2.2.2 The discharge shall be through a water separator anct shall be directly connected to the sanitary drainage system through a trapped waste.

4-~2.2.S There shall be an air vent from the water separator which shall direcdy vent to the roof. An existing air vent shall be permissible to tie into the air vent, either dedicated or including the existing vent, shall be dzed to accommodate the ~ t e m and shall not be undersized so as to "blow" the other trapL~ed waste connections. The air vent shall be 1" diameter/HP with a 2" diameter minimum.

4-7.2.2.4 When a liquid ring vacuum system is used, the system shall include flow sensor shut-off and alarms to indicate a failure in the pump, this shall prevent excessive water discharge. 4-7.2.2.5 The piping material shall be of corrosion resistant

material having a smooth interior surface. The pipe size shall be increased accohiing to the manufacturer's recommendations. All pipinl~ shall be provided with adequate and accessible clean-out fa~fiue= on mains and branches and shall be accessible for inspec- riom, maintenance and replacement. SUBSTANTIATION: At present no dent=l vacuum requirements are addressed and t h ~ need to be for safe installations. C O ~ ACTION: Reject. COMM]Tr]g~ STATEMEI~Frl I. Submitter's Recommendation has a~parent contradictions with codes .gc~verning venting, disposal, etc.

• While Subcommittee recognizes the need for dental mr ~ criteria, recommendation is incomplete and technically inadequate,

(LOg # VAC-2) 99-149- (4.8.1.1.2(d)): Accept SUBMITrE~ Subcommittee on Vacuum Systems RF, C.J)MM]ENDATION, Change "shall be wrought copper" to read as follows:

• It is not necessary to specify the type of copper. COMMITTEE ACTION: Accept.

(LOg # VAC-3) 99- 150. (4-8.1.1.5(b)): Accept SUBM1TrF, R: Subcommittee on Vacuum Systems RECOMMENDATION: Revise paragraph to read as follows:

"Shutoff'~lves shad be ~ of a type that will create n o . . . (rest the same)." [Changes Underlined] SUBSTANTIATION: Piping for medical vacuum systems is required to be metallic for firesafety reasons. Since valves are an integral part of p.iping systems, these need to meet the same standard as the

Accep

(Log # VAC.1) 99-151 - (4.8.1.1.6(a)): Accept SUBMrFrER: Subcommittee on Vacuum Systems J RECOMMENDATION: Insert following note at end of paragraph:

NOTE: See 4-8.1.2.1 relative to waste anesthetic gas disposal. SUBSTANTIATION= Increase user friendliness of document by indicaflng a caution contained in another portion of document. COMMITrF.£ ACTION: Accept.

(Log # 172) 99- 147- (4.8.1.L2(c)): Accept in Principle SUBMI'FYE~ Hy Bershad, P.E., Hosp. Engr. Society of Greater New York RECOMMENDATION: Revise 4.8.1.1.2(c) to read:

"(c) Pipe s.u~ports. Vacuum Piping shall be supported directly from the buildi~ng structure by pipe hooks, metal pipe straps, e t c . . . " SUL~ANTIATION: Conform to Section 4-4.1.2.1

Emphasize how to properly support rather than how not to support i i n .

ept in ciple 1. Accept Submitter's Recommendation i'or change to sentence 1. 2. Insert new sentence 2 in 4-8.1.1.2(c) to read as follows: "Vacuum piping shall not be supported by other piping or

ductwork." COMMITTEE STATEMENT: Retain cautionary statement as to where piping is not to be hung from (new sentence 2) so as to make clear that piping is to be supported directly from building structure without any intermediary.

(Log # 145) 99-148- (4.8.1.1.2(c)): Accept in Principle SUBM1TrER: Barry Duignan, Greater New York Hospital Associa- tion RECOMMENDATION: Revise 4-8.1.1.2(c) to read:

"(c) Pipe gu]~pons. Vacuum Piping shall be supported directly from the building su'ucture by pipe hooks, me taI pipe straps, e t c . . . " SUBSTANTIATION: Conform to Section 4-4.1.2.1

.Era. phasize how to properly support rather than how not to support

~ I S ~ ' I ' E E ACTION: Accept in Principle. See Committee Action on Proposal 99-147 (Lol~ #172).

COMMrI'rEE $TATEblENT: Proposal is idenucal.

( tog # 58) 99-152 - (4.8.1.1,7(g)): Accept SUBMITrER: Wayne Karcher, Allied Healthcare Products RECOMMENDATION: Revise as foUows:

(g) If computers are used as a secondary master alarm, the requirements of 4.8.1.1.7(~-) and (t) shall be met. SU'BSTANTIATION: If you refer to 4.8.1.1.5(e) and (t) as currently stated: (e) refers to valve boxes, which does not relate to alarms and (f) does not exist. COMMrlWEE ACTION: Accept.

(Log # 194) 99-153. (4-8.1.1.10, 4-8.1.1.11, and 4-9.1): Accept in Principle SUBMITFER: D.A. McWhinnie,Jr., Mechanical DynamicsInc. RECOMMENDATION: Revise text to be *user friendly" and in accordance with the technical needs and application of the systems designers, installers and users. For clarification. DeIete 4-8.1.1.10, its rifle, and all following 4-8 numbering. Replace

with "4-9.1 PadentVacuum Systems', and: 4-9.1.1 Performance (a) Insert text w/NOTE from deleted 4-9.1.2.3. (b) Insert text w/NOTE from deleted 4-9.1.2.2. (c) Insert text w/NOTE from deleted 4-9.1.2.1. 4-9.1.2 Installation. 4-9.1.2.1 Piping (Insert text from deleted 4-8.1.1.10, (a) through

(13 .) 4-9.1.3 Testing. (Insert text from deleted 4-9.1.3.4.) 4-9.1.3.1 Leak~e. (Insert new text replacing existing 4-9.1.3): The following tests are required to assure proper operation of the

system upon completion o f the instaUarion;and before turn-over to the facflhy for patient use:

(a) A visual inspection of each soldered or brazed joint, ff any, shall be (from here copy balance of text from deleted 4-0.1.3.1).

(b) (Insert text from-deleted 4-0.1.3.2) (c) (Insert text from deieted 4-0.1.2.4) (d) (Insert text from deleted 4-9.1.1) (e) After connecting the vacuum piping to the vacuum pumps,

receiver (tank), vacuum gauges and vacuum alarm switches, a vacuum test shall be perfornied on the entire system.

Add NOTE from deieted 4-0.1.$.$. (Delete 4-0.1.3.3 which is not a designer or installer requirement.)

4-0.1.3.2 (Insert text from deleted 4-9.1.4)

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SUBSTANTIATION: Section 4-9.1 contains requirements which are only a part or responsibility of the system designer, contract documents or the installer. It applies only to the design and essential step-by-step construction process, before a completed, acceptable, system can be turned over to the facility for patient use.

Section 4-10applies only to the facility "Administration of Vacuum Systems" - and fl/elr maintenance - after completion and third party certification of Code compliance. C O M M I T r ~ ACTION: Accept in Principle. Accept Submitter's Recommendation, except retain Section 4-

8.1.1.I0 in its present location. All other reoi-ganization is accepted, with text renumbered accordinlgy. (See below)

[How 4-9 would read as a result of Subcommittee Action.] 4-0 Vacuum System Performance Criteria and Testing. ] 4-9.1 Patient Vacutm: System. t 4-9.1.1 Performance. 4-9.1.1.1 Minimum Vacuum and Operating Range. The vacuum

pumps and collection piping shall be capable of maintaining a vacuum of 12 in. of mercury (Hg) at the station inlet farthest away from the central vacuum source when the calculated demand for the hospital is drawn in the system. (See Appendix C-4.3 for examples.)

NOTE: An operating range of 15 in. to 19 in. Hg is suggested at the receiver. 4-9.1.1.2 Overall System Pressure-Drop Criterla~ Pipe sizes shall be

in conformity with good engineering practice for delivery of maximum design volumes.

NOTE: It is reco .ram ended that vacuum pressure loss, from source to farthest station inter when the calculated demand is drawn on [ the vacuum system, be limited to 3 in. Hg. I 4-9.1.1.3 Minimum Flow and Pressure Requirements at Vacuum

Station Inlets. Piping shall be sized such that 3 SCFM can be evacuated through any one station inlet without reducing vacuum pressure below 12 in. Fig at an adjacent station inlet.

NOTE: This is not a criterion for pump sizing purposes. See Appendix C-4.3 for pump sizing recommendatmns. 4-9.1.2 Testing. The following tests shall be conducted to assure

proper operation of the system upon completion of the installation, and-before turn-over to the facility for pauent use.

4-9.1.2.1 Inspection of Vacuum Systems. Avisual inspection of each soldered-or brazed joint, if any, shall be made to kssure that the [ alloy has flowed completely in and around the joint and that hardened flux has not formed a temporary seal that holds test pressure. All excess flux shall be removed for clear visual inspection of connections.

4-9.1.2.2 Leakage Tests. Before attaching the vacuum lines to the vacuum pumps, receiver(s) (tank), and alarm signaling system(s) switches and gauges, each section of the vacuum piping system shall be subjected to a test p.ressure not less than 150 psig (1034 kPa gauge) by means of od-free, dry nitrogen or air. This test pressure shall be maintained until eachjoim has been examined for leakage by use of soapy water or other suitable means. All leaks shall be [ repaired and the section retested. (See Compressed Gas Association Pamphlet G-I0.I, Commodity Specification for Nitrogen.)

4-9.1.2.5 Standing Pressure Test. After installing a vacuum system, including station inlets, but before attaching the vacuum lines to the vacuum pumps, receiver(s) (tank), and alarm system(s) switches and gauges, the entire system or sections of the system shall be subjected to a test pressure of not less than 60 psig (413 kPa gauge) by means of oil-free, dry nitrogen or air. After allowance for temperature variation, the pressure at the end of 24 hours shall be within 5 psig (345 kPa gauge) of the initial pressure. Corrective action shall be taken if this performance is not verified. After completion of the test, corrections, and reverification if necessary, the system shall be connected to the vacuum pumps, receiver(s), alarm actuators (vacuum switches), and gauges.

NOTE: For information on how to correct pressure for temperature changes, see Sections 4-3 through 4-5. 4-9.1.2.4 Cross-Connection. Cross-connection testing shall be

performed as described in 4-5.1.1. 4-9.1.2.5 After connecting the vacuum piping to the vacuum

pumps, receiver (tank), vacuum gauges, and vacuum alarm switches, I a vacuum test shall be performed on the entire system.

i NOTE: An acceptable method of testing is by means of shutting down portions of the system using the si~utoffvalves described in 4- 8.1.1.5 to determine the capability of the section to maintain a vacuum. An acceptable condition is a vacuum level loss of less than 1.5 Hg in one hour with the vacuum system piping initially at a vacuum in excess of 12 in. Hg.

49.1.2.6 Vacuum System Alarm Testing. The vacuum system master alarm and any secondary master alarm shall signal when the vacuum in the main line drops below the level required to maintain 12 in. Hg (vacuum) at the station inlet farthest from the source. 4-9.2 Nonpatient Vacuum System. (Reserved)

COMHITFEE STATEMENT: Brings text in question into more user friendly order.

(Log # VAC.7) 99-154 - (4-9.1.3): Accept SUBMrFrER: Subcommittee on Vacuum Systems RECOMMENDATION: 1. Revise sentence 1 to read as follows:

Whe following tests ~ be performed to cert ify. . ." (rest the same). [Change Underlined]

2. Delete sentence 2. (~.outine tes ts . . , in 4-10.2") SUBSTANTIATION: 1. Use proper code language.

2. Sentence is only a statement where subject oldest, can be found. COMMrITEE ACTION: Accept.

(Log # VAC.8) 99-155. (4-10.2.1.3): Accept SuBMrrTER: Subcommittee on Vacuum Systems RECOMMENDATION: Change reference in paragraph from "4- 9.1.3.4" to "4-9.1.3". SUBSTANTIATION: Correct reference. COMM1TT~ ACTION: Accept.

(Log # 162) 99-156 - (5-4.1.2 and 5-4.1.3): Accept in Part $UBMrrrF.~ MichaeIA. Crowley, RoifJensen &Associates, Inc. RECOMMENDATION: 1. Delete 5-4.1.2.

2. Add to 5-4.1.3 second sentence after "that', add "automatically'. SUBSTANTIATION: NFPA 90A and ASHRAE Handbook on Smoke Control Design have stated that smoke exhaust or smoke venting[ will not improve the habitable conditions within the area of fire origin. While the intent of this section is laudable in application, these systems will not improve the tenable conditions within the room of fire origin. Modifications to Section 5-4.1.3 w/ll provide reasonable assurance of limited smoke movement through the Anesthetizing locations. COMMrIWEE ACTION: Accept in Part.

I. Reject. 2. Accept.

COMMrITEE S T A ~ : 1. Section 5-4.1.2 addresses a fire inside an anesthetizing location, while Section 5-3.1.3 addresses a fire outside an anesthetizing location.

(LOg # 176) 99.157 - (5-4.2.2): Accept in Principle SU'BMrI'I 'F~ Hy Ikrshad, Hospital Engineering Society of Greater New York RECOMMENDATION: Change 5-4.2.2 m read:

5-4.2.2 Other requirements . . , are set forth in paragraphs 5-4.1.2 through 5-4.1.6 inclusive. SUBSTANTIATION: ~ t i e of 5-4.1 relates to nonflammable anesthetizing agents. Would be preferable to cornbme 5-4.1 and 5-4.2 with heading:

Ventilation-Anesthetizing Locations and with 5-4.1.1 including relative humidity requirements for b o ~ types of anesthetizing locations. COMMIITEE ACTION= Accept in Principle.

Revise paragraph 5-4.2.2 m read as follows: 5-4.2.2 Requirements for ventilation and cooling set forth in 5-

4.1.2 to 5-4.I.6 shall apply. COMMITTEE STATEMENT: Original intent was for 5-4.1.2 to 5- 4.1.6 to apply to flammable anesthetizing locations. Rewording is to indicate thu intent.

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(Log # 146) 99- 158 - (5-4.2.2): Accept in Prindple S U B ~ Barry Duignan, Greater New York Hospital Association RECOMMENDATION: Change 5-4.2.2 to read:

5-4.2.2 Other requirements . . , are set forth in paragraphs 5-4.1.2 through 5-4.1.6 indmive. SUBSTANTIATION: ~ of 5-4.1 relates to nonflammable anesthetizing agenunts. Would be preferable to ~ 5-4.1 and 5-4,2 with heading:

Ventilation-Anesthetizing Locations and with 5-4.1.1 including relative humidity requirements for b o ~ types of anesthetizing locations. COMMITTEE ACTION: Accept in Principle.

See Committee Action on Pro~pod 99-157 (LOg #176). COMMI'ITEE STATEMENT: Proposals are identical.

(Log # 92) 99-161 - (5.4.4): Accept S U B ~ Norman V. Steers, Stllh~ter, Iv~ R E C O ~ T I O N z Revise Section 5-4.4 by deleting all p, resent text and adding a direct reference to the greater detail prowded in Chapter 6 of NFPA 45. S ~ A N T I A T I O N : The section is not comprehensive enough, and it may be seen as in conflict with NFPA 45. The chapter on ventilation in NFPA 45 has had a long~ and comprehensive review and should be used as the primary gmdance on laboratory hoods and ventilation systems. COMMITrF~ ACTION: Accept.

1. Revise .5-4.4 to read as follows: 5-4.4 Fume Hoods. Laboratories. Fume hood requirements shail

comply with NFPA 45, Standard for Laboratories Using chemicals 2. Delete Appendices A-5-4.4 and A-5-4.4.6.

COMMrrr]~:STATEMENT: To meet the intent of Submitter s recommendations.

(Log # 177) 99- 159- (5-4.8.8 Exception (New)): Reject SUBMrFrF.R: Hy Be/~thad, Hospital Engineering Society of Greater New York RECOMMENDATION: Add Exception as follows:

Exception No. h Exhaust air from a laboratory may be discharged through the side wall of a laboratory providing all ductwork is sealed, the exhaust fan is outside the laboratory wall and at least 15 ft above adjacent grade level, and there is no operable sash or fresh air intake within 50 ft of the discharged air. SUBSTANTIATION: Some laboratories are located at lower levels of facilities and the requirement to run the discharge above the roof is unduly onerous and unreasonable. This exception is reasonable and preserves the safety intent of this section.

Because of constant Hospital alterations new or relocated laboratories with exhaust hoods may find it difficult, ffnot impossible, to install new vertical exhaust ducts. COMMrrrEE ACTION: Reject. CoMMrITEE STATEMENT: The Committee recognizes the diiBculty and expense of running the exhaust duct for a fume hood on the low floor of a muid-story building all the way to the roof. However, the committee also recognizes thepressure effect of the wind and its ability to overcome the ability o f low pressure fans that are typically used to exhaust the fumes from fume hoods. The proposer's specifics do not assure that the location of the fan ~iischarge will be away from the influence of the high pressure zone on the outside of a building during high wind conditions. And, because the determination of a sathfactory location for such a dlscharg e, that doem' t allow back-flow through the fume hood under wind conditions, is so site specific in terms of the b u i l d i n g shape, the influence of eddy currents and other factors as described in the American Society of Heating, Refrigerating and Air Condi- tioning Engineers, Inc. (ASHRAE) book on Fundamentals (1989), Chapter 14 Air Flow Around Buildings, and is so critical to the c a r ~ engineering of a proper fan, his, thus, not appropriate to allow a genera] approval as requested.

(Log # 147) 99- 160- (5-4.3.8 Exception (New)): Reject S U B M r r l T ~ Barry Duignan, GreaterNew York Hospital Associa- tion RECOMMENDATION" Add Exception as follows:

Exception No. 1: Exhaust air from a laboratory may be discharged through the side wall of a laboratory providing all du~twork is sealed, the exhaust fan is outside the laboratory wall and at least 15 ft above adjacent grade level, and there is no operable sash or fresh air intake within 50 ft of the discharged air. SUBSTANTIATION: Some laboratories are located at lower levels of facilities and the requirement to run the discharge above the roof is unduly onerous and unreasonable. This exception is reasonable and preserves the safety intent of this section.

Because of constant Hospital alterations new or relocated laboratories with exhaust hoods may find it difficult, ff not impossible, to install new vertical exhaust ducts. C O M M r r r ] ~ ACTION: Reject. COMMITTEE STATEMENT: Identical to Proposal 99-159 (Log #177). Rejected for same reason.

(Log#LA~I ) 99-162 - (5-4.4.5): Accept SUBMITrER: Subcommittee on Laboratories RECOMMENDATION: Change last sentence of paragraph 2 (~'be qualified person may be a staff member of the facility.') to a Note. SUBSTANTIATION: Conform to NFPA Style Manual for text that is y ACTION: Accept.

(Log # 35) 99-165 - (5-4.4.8 (New)): Accept in Principle SUBMrlWE~ Victor Amoruso, Jr., Hansen Lind Meyer RECOMMENDATION: Add new text as follows:

54.4.8 Automatic fire dampers shall not be used in laboratory hood exhaust systems. Fire detection and alarm systems shall not be interlocked to automatically shutdown laboratory hood exhaust fans.

Exception: Where a gaseous fire extinguishing system is used to protect a laboratory hood, the protected laboratory hood shall be independent of all other hoods and its exhaust system may be interlocked to shut down upon actuation of the fire extinguishing system.tem. SUBSTANTIATION: Currently, the NFPA 99 defers to NFPA 101 for issues not specifically covered in the NFPA 99 test. NFPA 99 does not specifical~ address fire dampers in laboratory fume hood exhaust ducts. NFPA 101 requi~s fire dampers in ducts penetrating fire barriers and interlocking of the duct system with the fire detection sDtem regardless of the use. Several state and federal agencies are now requiring fire dampers in laboratory hood exhaust ducts and the interlocking of the exhaust with the fire detection system. The use of fire dampers in fume hood exhaust ducts and the interlocking of the fume hood controh with an external fire alarm system are unsafe because: a. The fire damper fusible link which is susceptible to corrosion

failure can cause the damper to fail closed without warning, placing the hood exhaust in a potenfia]ly dangerous mode. Unlike most cases, failure to a closed position in a hood exhaust system is not safe.

b. Fire dampers restrict air flow in the fume hood exhaust duct and are a point of collection of airborne contaminants. Conse- quendy, the primary funcdon of the fv~ne hood exhaust duct, which is to carry away fumes as directly and efficiently as possible without obstruction, is compromised significantly. c. Access panels are required at each fire damper for maintenance.

These openings in the fume hood duct are breaches in the exhaust duct pressure boundary.

d. Shutting down the laboratory fume hood exhaust from fire alarm signal external to laboratory area sets up a potentially hazardous situation at the hood and in the laboratory. Fume hood exhaust control should be at the fume hood not from external sources.

I COMMITTEE ACTION: Accept in Principle. See Committee Action on Proposal 99-161 (Log #92).

COMMITIT, E STATEMENT: Committee Action on Proposal 99- 161 (Log #92) incorporated by reference material from NFPA 45, including the iuue rahed in this proposal.

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(Log# 178) 99- 164 - (5-6.2): Accept in Principle SUBMITTEIh Hy A. Rershad, Hospital Engineering Society of ureater New York RECOMM]ENDATION: Revise as follows:

5-6.2 Such warning signs shall include detailed information relating to the changing, handling and disposal of filters, where applicable. SUBSTANTIATION: Information should be readily available to malnt, personnel who may be called on to change and dispose of filters serving laborato~ exhaust systems. COMMrlWEE ACTION: Acceptin Principle.

1. Add a tend of existing sentence of 5-6.]~ the following: "access points and filter locatlom. 2. Insert new Appendix A-5-6.2 to read as follows: "Warning signs should include, or reference, information on

hazards, and on the changing, handling and disposal of filters." COMMrITEE STATEMENTz 1. There is too much information on hazards to include on a local warning sign.

2. Warning signs are needed at more than just filter locations.

(Log # 52) 99- 165 - (5-6.2): Accept in Principle SUBMI'I ' rE~ Hy A. Rershad, P.E., Staten Island, New York RECOMMENDATION: Revise 5.6.2 to read:

5-6.2 Such warning signs shall include detailed information relating to the changing, handling and disposal of filters, where applicable. SUi~TANTIATION: Information should be readily available to malnt, personnel who may be called on to change and dispose of filters serving laboratory exhaust systems. C o M M r I ' r l ~ ACTION: Accept in Principle.

See Committee Action on Pro~osal 99-164 (Log #178). COMMITTEE STATEMENT: This proposal is identical to Proposal 99-164 (Log #178). Same action is recommended.

(LOg # ANE-1) 99-166 - (6-2.1): Reject SUBMrITE~ Subeommittee on Anesthesia Services RECOMMENDATION: Insert 6-2.1 to read as follows:

6-2.1 Flammability. In thepresence of ignition sources [such as electrocautery (line-operated or battery), electrosurgical units, fiberoptlc and laser d~ices], textiles, textile-like and plastic film materials, and flammable liquids used in a variety of diagnostic and therapeutic procedures canbe ignited and will burn, especially in oxygen enriched environments. Safety measures to prevent ignition, as well as to extinguish fires, shall be defined and put into practice. Periodic traimng in hazard awareness and safety measures shall be provided to all personnel associated with these diagnostic and therapeutic procedures. (Also see Sections 7-2.3.2, 8-2.1.1, 8-2.3.1, 12A.I.I and Appendix C-12.1.) SUBSTANTIATION: To recognize a growing hazard in medical practice, and recent fatal fire incidents. C O ~ ACTION: Reject. COMMH'rEE STATEMENT: Committee agrees that problem is a serious one. However~ proposal is an inappropriate code language, and there is no reference to standards.

(Log # 153) 99-167- (6-2.1.1 (New)): Reject SUBMITIT~ D. R. Parsons, Los Angeles City Fire Department RECOMMENDATION: Add new text as follows:

6-2.1.1 Those fabrics used in the operating room in conjunction with and within the vicinity of high energy surgical heat sources shall meet the Class I flammability rating as identified in 6-5.1. SUBSTAN'IIATION: During tests conducted as a result of the UCLA Operating Room Fire, it was found that the disposable drape and gown material exhibited easy ignition characteristics, rapid flame spread, and was di~cult to extinguish with water. The materia] in question was classified as meeting the requirements for an NFPA 702-1980 Class 3 fabric.

As a result of the nature of the tested fabric, it is being recommended that only materials meeting the Class 1 rating ofpropmed 6-5.1 be allowed m operating rooms where high enerl~ 7 surgi~.al devices are used. It should be noted that no standard exists for fabrics used in oxygen enriched environments, and this recommendation does not attempt to address that issue.

This Proposal is dependent on a separate Proposal for the addition of 6-5.1. COMMrI'YEE ACTION: Reject. COMMrITEE STATEMENT: Proposal relates to proposal 99-168 (Log #154), and is rejected for the same reason.

(Log # 154) 99- 168 - (6-5.1 (New)): Reject SUBM1TrER: D.R. Parsons, Los Angeles City Fire Department RECOMMENDATION~ Add new text as follows:

6-5.1 Classification of the Flammability of Fabric. 0-1 The flammability of fabrics is dependent on the following

primary facton: (a) Basic fiber or fibers (b) Weight and weave of material (c) Sur~ce characteristics of fabric (d) Design of the finished product.

0-2 All fabrics of natural or regenerated cellulose, as well as most types of finished and unfinished fabrics made from other natural or synthetic fibers, are combustible and many are relatively flammable.

0-3 In addition to the characteristics of the fabric, the age, mental and physical alermess, and ability of the person involved are very important factors in determining the consequences of a fire accident.

0-3.1 Studies have demonstrated that a large percentage of the serious burn cases occur with children who are too young to avoid the fire or to react wisely and promptly in the fire emergency, and with older people and patients in hospitals and institutions who, for physical or mental reasons, do not react promptly and effectively.

0-$.2 Another group that nee& special consideration includes workers whose occupations are ~ o u s because of abnormal exposure to flammable materiah or sources of ignition.

0-4 Because of these limitations, standards in this field can have only limited value. Prevention is the only effective curel

Chapter 1 General

1-1 Scope. 1-1.1 ~ standard shall apply to methods for testing the flamma.

billty of fabrics used or intended for use in health care facilities, shall establish classes of fiammability and shall set forth the requirements which textiles shall meet to be so classified.

1-1.2 This standard shall not apply to gloves, footwear and interlining fabrics. Interlining fabrics are not conddered dangerously flammable when used as interlinings. When used for other purposes, however, they shall be tested and classified in the normal manner.

I-1.3" Pyroxylin-coated fabrics for wearing apparel shall be classified as ~dangerousiy flammable" under this standard without requiring testing of any sort.

1-~ Purpose. The Pro'pose is to reduce danger of injury and loss of life by providing standai'd methods for testing and classifying the flammability of textile and other products used in health care facilities.

1-3 Definitions. Shall Indicates a mandatory requirement.

Chapter 2 Test Apparatus 2D Textiles 2-1 Flammability Tester. 2-1.1" The flammability tester shall consist of a draft-proof

ventilated chamber enclosing a standardized ignition inedium, sample rack, and automatic timing device. The flammability tester shall conmt of the followinLg]parts:

2-1.1.1 Draft-proof Chamber with Vented Top (A, Figure 2-1.1). This metal chamber prevents air circulation around the specimen rack and flame, but permits free ventilation for rapid oxidation. The chamber is 14 1/2 in. (368.3 mm) wide by 8 1/2 in. (215.9 ram) deep and 14 in. (355.6 ram) in height. There are 12 one-half in. (13 mm in diameter) holes equidistant along the rear of the top closure. A ventilating strip is provided at the base of the sliding glass door in the front of-the apparatus.

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2-I.I.2 Specimen Rack (B, Figure 2-I.I). The spedmen rack provides support for the frames in which the specimens are mounted. The angle of inclination is 45 degrees. Two guide pins . projecting downward from the center of .the ~ of th.~ rack travel m slots p/ovided in the floor of the cnamoer so mat adjustment can be made for the thickness of the specimen in relation to the flame front. A stop is provided in the baie of the chamber to assist in adjusting die position of the rack.

2-1.1.~ Specunen Holder (C, Figure 2-1.1). The specimen holder consists o f two 1/16 in. (1.6 ram) matched metal prates with clamps mounted along the sides, between which the specunen is fixed. The prates are dotted and loosely pinnedfor alignment. Two guides are located on the top plate of the specimen holder to assist m positioning the stop threaid. The guides hold the thread precisely 5/16 in. (7.9 mm) from the upper surface of the top plate and 5 in. (127 mm) from the point where the center of the ignition flame impinges on the specimen.

2-1.1.4 Indicator Finger (D, Figure 2-I.I). The indicator rack is adjusted to compensate for the thickness of the specimen. When the finger is in contact with the face of the specimen and the gas burner is in its most forward position, the orifice of the burner is positioned 5/16 in. (7.9 mm) from the face of the specimen.

2-1.1.5 Ignition Medium (F, Figure 2-1.1). The ignition medium consists of a spring-loaded or motor-driven gas jet formed around a 26 gage hypodermic needle. The gas jet is protected by a metal shield.

2-1.1.6 Stop Cord (G, Figure 2-1.1). This cord, stretched from the spool (P, Figure 2-1.1) through suitable thread guides provided on the specimen frame and chamber walls, permits the lacing of the cord in the proper position exactly 5 in. (127 ram) from the point where the center of the ignition flame impinges on the test specimen.

2-1.1.7 Pulley or Eye (H, Figure 2-I.I). Support and guide for stop cord. 2-1.1.8 Stop Weight (I, Figure 2-1.1). The weight (35 ± 0.5 grams),

attached by means of a clip to the stop cord, in dropping actuates the stop mechanism.

2-1.I.9 Slide Door Control (F, Figure 2-1.1). This knob moves the catch mechanism used to hold the sliding door in an open position for insertion of test specimen racks.

2-1.1.10 Slide Door (K, Figure 2-1.1). A glass door slides in the grooves at the front of the cabinet.

2-1.1.11 Fuel Control Valve (L, Figure 2-I.I). Consists of a sensitive control device for regulating the fuel supply at the tank. The valve ends in a I/2-in. (13-ram) male connecnon for attachment to a standard butane tank of 2 Ib capacity.

2-1.1.12 Flow Meter (V, Figure 2-I.I). A manometer is used to bring the fuel supply to test level by means of the control valve. The manometer consmts of a U-shaped glass tube cut into the gas llne in a manner to register the gas pressure delivered to the microburner. Amtched to the case wall behind the flow meter is a movable metal prate with two parallel horizontal lines properly spaced for the desired flame Iength. When the pressure is off, the plate is so regulated that the liquid level in both sides of the U-shaped tube meets the lower line. When the valve is open, the pressure in the line causes the liquid level to be higher in one side of the tube than the other. The upper line on the plate serves as an approximate setting for the gas pressure to provide the 5 /8 in. (15.9 mm) required flame size. (see 4;5.1.)

2-1.1.13 C.P. Butane Container (M, Figure 2-1.1). This fuel supply is a No. 4 cylinder of C. P. butane.

2-1.1.14 Timing Mechanism (N, Figure 2-1.1). This timing device, by means of special attachments, is actuated to start by connection with the gas je t (F, Figure 2-1.1). The gas jet is moved to its most forward position by a driving mechanism (O, Figure 2-1.1) or manually (T, Figure 2.1.1) and automatically starts the timing at the moment of frame impact. The failing weight (I, Figure 2-1.1), when caused to move by severance of cord(G, Figure 2-1.1), stops the watch. Timing is read directly to the nearest 0.I sec.

2-1.1.15 Starting Lever, Mechanical (O, Figure 2-1.1). This lever is operated from left to fight in one stroke and released. This actuates a driving mechanism on the rear of the cabinet which moves the gas jet to its most forward position for exactly I sec. This procedure is used only for fabrics having a raised fiber surface. Electrical models are activated by pushing a start button. (See 4-5.2.4.) 2-1.1.16 Starting Lever, Manual (T, Figure 2-1.1). This lever

controls the manfial application of the gas jet to the lower edge of the specimen. The jet is held in posidon until ignition occurs. This procedure is used for all fabrics except those subject to surface flash with base ignition. (see 4-5.2.4.)

2-1.1.17 Cord Supply (P, Fil~re 2-1.1). This supply, consisting of a spool of No. 50, 3-ply mercerized cotton sewing thread, is fastened to the side of the chamber and can be withdrawn by releasing the thumb screw holding same in position.

2-1.1.18 Cord Loop (Q, Figure 2-1.1). At a point behind thestop cord (G, Figure 2-I.I) on the rear panel there is insmuea anomer loop to draw the cord away from directly over the flame.

2-L1.19 Draft Ventilator Strip (R, Figure 2-1.1). A draft ventilator strip is placed across the front opening, sealing the space between the sildmg door when in lowered position and the base on which the gri'd rack is attached.

2-2 Brushing Device (see Figures 2-2.1 and 2-2.2). 2-2.1 This device shall consist of a baseboard over which a smaller

carriage is drawn. This carriage shall run on parallel tracks attached to the edges of the upper surface of the baseboard. The brush shall be hinged with pin hmges at the rear edge of the baseboard and shall rest on the carriage vertically with a pressure of 150 grams = 5 grams.

2-2.2 The brush shall consist of two rows of stiffnylon bristles mounted with the tufts in a staggered position. The bristles shall be 0.016 in. (0.41 mm) in diameter and ([.75 in. (19.1 mm) in length. There shall be 20 bristles per tuft and 4 tufts per in.

A plate 1/8 in. (3.2 ram) thick is attached to the movable carriage to permit holding the specimen frame on the carriage during the brushing operation.

2-3 Dry Cleaning Apparatus. 2-3.] The apparatus shall be a cylinder, preferably metal, approxi-

mately 13 in. (330.2 ram) high and about 8 3/4 in. (222 nun) in diameter [capacity 3gal (11.4 L].

2.3.2 The cylinder shall be mounted in a vertical position on an axis which is inclined 50 degrees to the ~ of thecylinder.

Chapter 3 Test Specimens 2D Textiles 3.1 Number and Size of Specimens. 3.1.1 Five specimens, each measuring 2 in. x 6 in. (50.8 ram x

152.4 mm), shall be obtained for each test. 3-1.1.1 For textiles without a raised fiber surface, the long

dimension shall be that in which they burn most rapidly and the more rapidly burning surface shall be tested. To establish the long dimension and the surface, pre ' .liminary tests are made as described in Section 4-5 with specimens cut in different directions.

3-1.1.2 For textiles having a raised fiber surface, the direction of the lay of the surface fibers shall be parallel with the lonjg dimen- sions of the specimens. For this type of textiles with varying depths of pile, tufting, etc., the specimens shall be taken from that part and tested on that surface which has the fastest rate of burning.

3-2 Preconditioning of Test Specimens. When the preliminary test indicates treatment with a fire retarding finish, a swatch large enough toprovide the specimens reqmred for the test, with allowance for shrinkage in dry cleanin~ and washing, shall be subjected to the dry cleaning and washing procedures described in Section 4-1. The specimens for the flammability test shall then be taken from it. This procedure shall not be required for fabrics which are nonflammable due to inherent properties of their fibers.

3-3 Marking of Test Specimens. 3-3.1 The specimens required for testing, each 2 in. x 6 in. (50.8

nun x 152.4 ram), shall be marked out on the back (or underside) of each sample with the long dimension in the direction in which burning is most rapid, as established in the preliminary trials.

3-3.2 A staple shall be attached for identification to the end of the specimen toward which burninl~ is most rapid, the staple being applied to the face of the material which shows mint rapid flame spread (Figure 3-3). The specimens shall then be cut out.

Chapter 4 Method of Test 2D Textiles 4-I Pre-Conditioning of Flame Retardant Textiles. 4-1.1 A swatch from each sample, as required in Section 3-2, shall

be dry cleaned according to the following procedure. 4-1.1.1 The dry cleaning apparatus is filled approximately one-

third with perchlorethylene to which is added 270 mi of dry cleaning soap. The soap shall be made by dissolving 56 grams of caustic potash (KOH) in I00 ml of water. The potassium hydroxide solution shall be poured slowly with constant stirring into a mixture of 340 grams of oleic acid, 400mi of Stoddard Solvent (Commercial Standard CS 3-40 grade), and I00 ml of tertiary butyl alcohol or an equal quantity of butyl celiosolve. 4-1.1.2 The swatches shall be placed in the dry cleaning apparatus

along with sufficient suitable worsted cloth in 12 in. x 12 in. (304.8 nun x 304.8 mm) pieces. Total dry load shall be 1 lb.

4-1.1.3 The dry cleaning apparatus shall be operated for a cleaning cycle of 25 rain.

4-1.1.4 Upon completion of the cleaning cycle, the cleaning solution shall be removed. The dry cleaning apparatus shall be refilled approximately one-third with fresh perchlorethylene only.

4-1.1.5 The dry cleaning apparatus shall then be operated for three separate rinse cycles of 5 min each. The rinse solution shall be replaced with fresh perchlorethylene each time.

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4-1.1.6 Upon completion of the rinse cycles, the swatches shall then be removed. The excess solvent shall be removed by a n y convenient means (such as rolling between two layers of Turkish toweling or between two layers ofabsorbent paper) and allowed to ch~Ylat room temperature.

.9 The swatches, after being subjected to the dry cleaning procedure of 4-1.1, shall then be immersed and wo/'ked gendy for 5 rain in a bath of soft water in which 0.5 percent neutral chip soap haJ been dissolved.

4-1.9.1 The volume of the bath shall be 90 times the weight of the lwatches and the temperature shall be between 95"F (~5°C) and 100"F (37.8"C). 4-1.3 The swatches shall finally be rinsed twice in water at 80"F

(26.70C), extracted and dried. 4-1.4 The individual specimens shall then be cut out as described

in Section S-1 and tested as described in Section 4-3. 4-9 Bnahing of Specimens. 4.9.1 Each specimen having a raised fiber surface, in its original

condition or after dry cleaning E and washing, shall beplaced on the brushing device carnage (Secnon 2-2) and drawn under the brush once against the lay of the raised fiber surface (see Figure 4-1).

4.9.1.1 The mounted specimens shall be placed on the carriage of the brushing device. The brush shall then be raised, the carriage pushed to the rear, and the brush lowered on the face of the test specimen. The carriage shall then be drawn forward by hand, at a uniform rate. Exception: All other specimens do not require brushing.

4.3 Mounting Specimens. 4-3.1 All specimens shall be clamped individually in the specimen

holders with the staple on top and the stapled end at the closed end of the holder.

4-3.1.1 Specimens having a raised fiber surface shall be mounted in the specimen holder so that the ignition flame will impinge on the speamen surface. The bottom edge of the specimen shallbe positioned in line with the lower edge of the top plate.

4-3.1.9 All other test specimens shall be mounted so that the ignition flame will impinge on the bottom edge of the specimen. The bottom edge of the test specimen shall be positioned exactly 5 in. (127 ram) below the line of the stop cord.

4.4 Drying of Specimens. 4-4.1 After spe~mens are mounted in the specimen holders as

described in Section 4-3, they shall be dried in a horizontal position in a drying oven for 30 rain at 221"F (I05"C).

4-4.9 After drying, the mounted specimens shall be removed from the oven and placed in a dessicator containing anhydrous calcium chloride until cool but for not less than SO rain.

4-.5 Test Procedure. 4.5.1 Prelimin Adjustments. 4-5.1.1 The ~uela~'~e shall be purged by openin~ the fuel supply

control valve and purging for al?proximately 5 ram. 4-5.1.9 After purging the fuelline, the gas shall be ignited and the

flame shall be ~tdjustea to a length of 5/8 in. (15.9 mm) measured from its tip to the opening in the gas nozzle.

4-.5.1.3 The rack of the flammability tester, with a holder and trial specimen in place, shall then be pcm'tioned so that the tip of the indicator finger touches the face of the specimen.

4-5.2 Performing the Test. 4-5-9.1 The test shall be conducted in a draft-free room with the

apparatus at room temperature. 4-,5.2.2 The mounted test specimen shall be removed from the

dessicator and shall be inserted in position on the rack of the flammability tester.

4-5.2.3 The stop cord (No. 50 5.ply cotton sewing thread) shall be strung from the spool through the sky hook and then through the guides in the upper plate of the specimen holder across the top of the specimen and through the guides at the rear of the chamber over the guide ring. The sky hook is positioned over the front thread guide of the specimen holder. It ensures that the thread is parallel to the fabric and precisely 5/16 in. (7.9 ram) above the top plate. The weight shall be hooked in place close to and just below the guide rifig. The timer shaU be set at zero. The door of the apparatus shall be closed.

'1' a 4-5.2.4 The appropriate staffing lever shall be actuated [see ( ) and (b) below].This starts the timing mechanism and applies the flame to the specimen. This shaft be done within 45 sec of the time the specimenh removed from the dessicator. Timing is automatic, starunr g upon application of the flame and ending when the weight is released by the burning of the stop cord.

(a) For fabrics having a raised fiber surface, the mechanical starting lever (O, Figure 9-1) shall be mini. The time of flame spread (reading of stop watch) shall be recorded and it shall be noted whether the base is ignited or fused to a point where the damage is apparent from the back or reverse side of the specimen. If the burning is self-extinguishing before reaching the stopcord, that result shall be recorded as [BE (ignited but extinguished). Under

either of the following conditions, the same specimens shall be reconditioned, retested and classified in accoidance with the procedure for textiles without a raised fiber surface, and the results reported per Section 5-8.

(I). Base ignition or fusing does not occur on any of the five speamens.

(2). Burning of the stop cord does not occur on any of the five speomens.

(b) For fabrics without a raised fiber surface, the manual starting lever (T, F'~gure 2) shall be used, holding the flame in its lowered position until the specimen is ignited. The time of flame spread (reading of stop watch) for each specimen shall be recorded. 4-6 Recording anti Reporting Test Results. 4-6.1 Time of Flame Spread. The time of flame spread of the

textile shall be taken as an average time for five specimens. Results of tests of specimens before and after dry cleaning and washing shall be recorded and reported separately.

4-6.2* Base Fabric Ignition or Fusing. For fabrics having a raised fiber surface, when neither condition (I) or (9) under 4.5.9.4.(a) applies, the time of flame spread shall be taken as the average time for those specimens in which burning severs the stop cord. If this occurs with only one specimen, then this shall be the time taken.

i I 5

M

1

I

Figure 2-1.1 Flammability Tester

273

NFPA 9 9 - F92 TCR

4-6.3 Reporting Results. The reported results shall be the average time of flame spread before or after dry cleaning and washing, whichever is the lower, and, based on this result, the textile shall be placed in the proper classification as given in Chapter ft.

Chapter 5 Classification 5-1 Flammability 2D Textiles. 5-1.1 Normal Flammability. 5-1.1.1 This general class ~hall include textiles which meet the

minimum req/drements set forth in (a), (b) and (c) below. These are generally accepted as having no unusual burning characteristics.

(a) Class 1. This class shall include all textiles which show a time of flame spread of 20 sec or more when tested, as described in Chapter 4, and may be considered relatively slow burning.

SUBSTANTIATION: NTPA 702-1980 has been withdrawn. As a result, there is no current standard which can be referenced for flammability and flame spread characteristics for fabrics used in operating rooma which meets the identified need. Specifically, the research conducted during the investigation of the UCLA Operating Room fire indicated the need for a fabric meeting the Class I rating of that former standard.

NFPA 701-1989, although current, is viewed as impr~fical for the operating room environment, and too costly to "unptement- During tile investigation of the UCLA Operating goom lure, it was octet- mined that there are fabrics, currently available on the market, which meet the specification of NFPA 702-1980 Class I.

A separate Proposal has also been forwarded which is dependent on this Proposal COMMrlTEE ACTION: Reject. COMMITrEE STATEMENT: 1. NFPA 702.1980 is a 12 year old document that has been withdrawn by NFPA, and Subcommittee is unsure if the test methods listed are still valid for the purpose of testing surgical drapes.

2. Subcommittee does not have expertise to determine if this method is acceptable.

5. Subcommittee agrees that flammability of fabrics is a serious issue, but that it is part of the total hazard situation in an operating r o o m .

_ _ ]

Figure 2-1.2 Photo of Flammability Tester

(b) Class 2. This class shall include all textiles which show a time of flame spread of 8 to 19 sec inclusive when tested as described in Chapter ~ a n d may be considered moderately flammable.

(c) Class 3. This class shall include all textiles which show a time of flame spread of 3 to 7 sec inclusive when tested as described in Chapter 4, and may be considered relatively flammable.

6-1.2 Rapid Burning. This general class shall include all textiles which are considereddanserously flammable and recognized as being unsuitable for clothing because of their rapid burning.

(a) Class 4. This class shall include all textiles which show a time of flame spread o f l eu than 3 sec when tested as described in Chapter 4.

(b) Pyroxylin-coated fabrics are considered dangerously flammable and recognlzed as being unsuitable for clothing because of their ease of ignition, rapid and intense burning, and generation of toxic products of combustion (see 1-1.4).

Appendix This Appendix is not a part of the requirements of this NFPA document, but is included for information purposes only. A-2-1.1 Blueprints of working plans for the manufacture of this

apparatus are available at a nominal charge from the Nationwide Cdnsumer Testing Institute, Inc., 1415 Park Avenue, Hoboken, NJ 07030. A-4-5.2.4 Valid evaluation of surface flash hazard presents complex

and different problems. The intent and purpose of this sub.section is first to test for surface flash characteristics. If these prove to De nonhazardous (i.e., very low intensity, or serf-extinguishing before reaching the stop cord) the same specimens are remounted in the frames for test by edge ignition. This procedure is made necessary because some textiles with a light surface nap, particularly cotton flannels and suedes, can be subject to two entirely separate and distinct types of burning, which can take place simultaneously or independently. A-4-6.2 Base ignition and timing burning need not occur on the

same specimen.

Figure 2-2.1 Brushing Device

Figure 2-2.2 Photo of Brushing Device

274


" ~ A P L E

--~ DII~ECTION IN WHICH FAE~I~IC BURNS M O S T RAPIDLY

Figure 3-3 Specimen Showing Staple (Log # 66)

99-169 - (Chapter 7 Title, 13-3.7.1): Accept in Principle SUBMITTEI~ Bryan Parker, Montefiore Medical Center RECOMMENDATION" a. From the title of Chapter 7 delete ", Health Care Facilities".

b. From 13-3.7.1 delete "Electrical Equipment, Health Care Facilities', as applicable to patient care areas. SUBSTANTIATION: a. This proposal is submitted in response to the NFPA request to make the document more user friendly, and to remove extraneous material. b. Title words: Redundant, already_ stated in Chapter 1, Section

1.1. Not used in other' floes, except for Chapter 8 g, here it is also redundant.

c. In 13-$.7.1 the words are superfluous. The style of 13-3.8.1 is preferable. COMMrrTERACTION: Accept in Principle.

1. Accept Submitter's Recommendation. 2. Make changes to title of Chapter 12 and to 12-3.7.1 similar to

that as recommended for Chapter 13. COMMI'rYEE STATEMENT: For correlation.

(Log # ELE-2) 99- 170 - (7-2): Accept. SUBMrrrER: Subcommittee on Electrical Equipment RECOMMENDATION: Under title of %2, add the following NOTE: NOTE: This Section is intended to be informational.

SUBSTANTIATION: Original intent when restructuring NFPA 99 was to provide informational type material within the body of the document. COMMrrTEE ACTION: Accept

(LOg # 155) 99-171 - (7-2.1.1 (New)): Reject SUBM1TrER: D. R. Parsons, Los Angeles County Fire Department RECOMMENDATION: Add new text as follows:

7-2.1.1 Exfingnishment or Containment of Fire. An appropriate fire extinguisher shall be installed and maintained

in hospital operating rooms. Hospital operating room personnel shall be trained periodically in the proper use of this extinguisher, SUBSTANTIATION: The investigation of the circumstances surrounding the UCLA Operating Room fire determined that hospital operating room personnel must be prepared to react quickly toincipie/R fire conditions. As part of this required ability to react c~uickly, ~fire extinguisher must be maintained within the operating room.

It was also determined that operating room personnel are not necessarily trained on the proper use of exflnguishing equipment COMMITTEE ACTION: Reject. COMMITTEE STATEMENT= 1. Issue of fire response in operating rooms is included in Appendix C-12.4.4.

2. Placement and v~pe of fire extin[~i.'shers within operating rooms needs to be decided tn connection with addressing the overan facility disaster planning and risk assessment iMue.

3. NFPA 101, Life Safety Code, includes general criteria for responding to fires in health care facilities, and on portable fire exungnishers..

4. Distribution criteria of portable fire extinguishers is included in NFPA 10, Standard on Fire Extinguishers.

5. Issue of training on portable fir extinguishers is addressed in other proposals.

//////////.// ~/////////////

VVITH NAP AGAINST I',,IAR

Figure 4-1 Lay of Nap

99- 172- (7-2.2.1.1): Accept SU'BMITYF~ Subcomrmttee on Electrical Equipment RECOMMENDATION. Delete the word "shall" in line 3. SUBSTANTIATION: To be condstent with intent of first half of sentence. COMMITrF~ ACTION: Accept.

(Log # 156) 99- 173- (7-2.3.2): Reject S U B M r r r E ~ D.R. Parsons, LOs Angeles City Fire Department RECOMMENDATION: Delete text:

See Annex 2, ~ 'he Safe Use of High Frequency Electricity in Health Care Facilities." SUBSTANTIATION: A separate Propmal, which inserts several intervening paragraphs, will require that this sentence be moved. COMMITrEE ACTION: Reject. COMMITrF, E STATEMENT: Since prol~sal 99-177 (Log#160) was rejected, retention of reference to Annex 2 is necessary and appropriate.

(Log # 157) 99-174- (7-2.3.3 (New)): Accept in Principle SUBMITrER: D. R. Parsons, LOs Angeles City Fire Department RECOMMENDATION: Add new text as follows:

7-2.3.3 All high energy surreal heat sources shall be placed in a holder or other location as recommended by the manufacturer of the device when not in active use. SUBSTANTIATION: During the research conducted for the investigation of the UCLA Operating Room fire, it was determined that there is a dgnificant potential for arcing of the ESU pencil to locations other than the surgical site. Replacing the pencil in the provided holster will preclude such accidental sources of ignition. The manufacturer o f the device specifically recommends that this

ocedure be followed. ACTION: Accept in Principle.

1. Create a new paragraph 7-6.2.3, titled: "During Surgery. 2. Add the following new paragraph to new 7-6.2.3. 7-6.2.3.1 Active electrodes or other applicators of electro-surgical

devices shall be j~roperly secured, as recommended by the manufacturer of the dewce, when not in active me. This includes, but it is not limited to: electrosurgical devices, surgical lasers, electrocautery, and fiberopdcs.

3. Renumber existing 76.2.3 and 7-6.2.4 accordingly. C O M M r r T ~ STATEMF2qT: 1. Submitter's recommendation belongs in Section 7-6 because subject includes requirements for

equipment. Section 7-6 covers requirements for existing eqmpment. 2. Submitter's recommendation is reworded because there are

other sources of thermal energy than "high energy" surgical heat s o u r c e s .

(Log # 158) 99-175- (7-2.3.4 (New)): Accept in Principle SUBM1TFER: D. R. Parsons, Los Angeles City Fire Department RECOMMENDATION: Add new text as follows:

7-2.3.4 The cord whichprovides power from the electrosurgical unit generator to the highenergy heat source shall be disconnected and removed from the operating table when contamination occurs or when the device is nolonger needed. SUBSTANTIATION: The source of ignition for the UCLA Operating Room fire was determined to be an ESU pencil that had been abandoned, but was still connected to the generator.

Due to the high potential for accidental ignition of materials by high energy instruments, it is imperative that the power for such devices be removed as soon as practical.

275


COMM/T/3E]E ACTION= Accept in Principle. I m r t as new 7-6.9.3.2 created'in Propoas] 99-175 (Log #158), and

reword as follow,: "The cable that provides power from the electrmm'gical generator

to the active elecfi'ode shall be disconnected from the generator when conmminadon occurs." COMMITTEE STATEMENT: 1. Material belongs in Section 7-6 since it addresses existing equipment and its proper usage.

2. Issue of action to be taken when an electrode is no longer needed is adch~_, ssed in Proposal 99-174 (Log #157).

3. Submitter s recommendation is reword&i for technical accuracy.

(Log # 159) 99- 176- (7-2.$.5 (New)): Reject SUBMITrER: D.R. Patrons, Los Angeles City Fire Department RECOMMENI~TION: Add new text as follows:

7-9.$.5 Directly clamping or winding of the cords of high energy heat sources to or around any objects shall be prohibitea. SUBSTANTIATION: The manufacturer's ~fdty recommendations for the ESU specifically identifies the potential for "leakage current" to travel through a conductive object, which is looped with the ESU cord, to the patient. The creation of "leakage current" was confirmed during testing conducted as a result of the UCLA Operating Room fire. This presents the possibility of causing a burn to the patient, or

igniting fabrics. Also, directly clamping the cord presents the . po~ibility of causing .daxna~ to the co/xL Among the acceptect alternatives to this practice m the option of mspending the cord within the foldl of a drape, and applying the clamp to the drape. COMMITYEE AcrION: Reject. COMMITrF~ STATEM]B2~rr: Premise upon which recommendation is based (Test No. 34 in Report submitted with proposal) is not a realistic condition nor a reasonable practice.

(Log # 87) 99- 178- (7-5.1.9.9): Accept in Principle SUBMITrER: Bryan ParRer, Montefiore Medical Center R E C O ~ A T I O N : ,Relocate entire 2nd paragraph "Household o r . . . in their power cord~, with the heading- ~7-5.2.2.1(b) Grounding of Appliances . SUBSTANTIATION: a. This proposal is submitted in response to the NFPA request to make documents more user friendly, and to remove extraneous material.

b. Section 7-5.1 concerns equipment in the vicinity, ofpadenu in locations wherein patients are intended to be examined and treated. COMMITTEE ACTION= Accept in Prindple.

Move paragraph 2 ("Household or office appl iance. . , in their power cord?), and make it new paragraph 2 finder 7-5.2.2.1 (a) without a tide. COMMITrF~ STATEMENT: More appropriate location for this material.

(Log # 148) 99-179 - (7-5.1.9.9): Reject SUBMITrK~ Barry Dulgnan, Greater New York Hospital Auoda- tion RECOMMF2~DATION: Revise text as follows:

Change everything after the 1st sentence in the paragraph after the excepu~on into a note since it does not r e ~ to eqmpment within a patient vicinity. SUBSTANTIATION: Somewhat confusing and unrelated. Ex- amples are not Code language and shouldl~e included in a note. COMMITrF, E ACTION( Reject. COMMITTEE STATEMENT: Committee Action on Proposal 99- 178 (Log #67) relocated material to appropriate location in text.

(Log # 160) 99-177- (7-9.3.6 (New)): Reject SUBMITTER: D. R. Parsons, Los Angeles City Fire Department RECOMMENDATION: Add new text as follows:

7-2.$.6 Patients shall be continuously monitored for isolation from conductive paths (e.g., operating table metal surfaces, Mayo tray, etc.). Addi-onaHy, operating table sheets shall be secured in such a way as to prevent contact with metal surfaces. While it is not always possible to maintain isolation of the patient or sheets from conductive surfaces, this issue must be routinely addressed as part of operating room safety procedures. AIs0 see Annex 9, " the Sa£e Use of High Frequency Ele~triclty in Health Care Facilides." SUBSTANTIATION: Many of the tests performed as a result of the UCLA Operating Room fire focused on the ability of the ESU to utilize alternate conductive paths for the discharge of the energy. It was found that the energy from the ESU would cause an arc through a variety of materials under different condidous, and usually with sufliciem energy to ignite the test materials. Further, it was determined that, as part of a conductive path, an arc could be produced using the test dssue. This presents both the possibility of an ignition source and a potential for injury to a padent.

It is well understood that it is not always possible to maintain isolation of the patient from conductive materials, and in fact, many operations require that padents be in direct contact with conductive materials. However, the intent of the proposal is to have operating room s,'aff maintain an awareness of patient isolation and the potential for undesired paths for the discharge of ESU energy. This simple vigilance should introduce a degree of safety for the patient.

It fi also understood that it is difi%ult to secure operating table sheets in a manner which maintains isolation from conductive surfaces. Some bran& of operating tables simply do not allow for this condition. However, the intent is to cause this issue to be routinely addressed as part of operating room safety procedures. COMM1TI'EE ACTION= Reject. COMM]Tr]ZE STATEMENT: Uniformprevention of patients from contacting conductive surfaces is unreahTstic. Prevention of sheets from contacting metal surfaces is virtually impossible.

(Log # 179) 99- 180 - (7-5.1.2.2)= Reject SUBM1TYER: Hy Bershad, Engineering Society of Greater New York RECOMMN2qDATION: Chan~e everything after the 1st sentence in the paragraph after the Excepuon into a ~ since it does not relate to equipment within a patient vicinity. SUBSTANTIATION: Somewhat confusing and unrelated. Ex. amples given are not code language and should be included in a n o t e . COMMYrlT~ ACTION: Reject. C O ~ STATKMF2~: Proposal is identical to Proposal 99- 179 (Log #148), and is thus rejected for the lame reason.

(Log # F.LE-12) 99-181 - (7-5.1.2.5(a)): Accept S U B ~ Subcommittee on Electrical Equipment RECOMMENDATION= In 7-5.1.2.5(a), delete =designed to minimize damage to the cord during storage" so that paragraph reads as follows:

(a) Portable equipment shall be provided with a storage device for its flexible cord. SUBSTANTIATION: Deleted phrase is ambiguous and unneces-

c s a r ~ ~ ACHON: Accept.

(Log # 41) 99-182 - (7-5.1.S): ReJect SUBMITI'ER: Donald Whiteside, Hurley Biomedical Engineering RECOMMENDATION: Propose that leakage current test modes and maximum permissible current limits be summarized in a table format to be included in this section. SUBSTANTIATION: Proposed table would provide dear and convenient information to readers. COM3/I 'rrEE ACTION: Reject. COMMrrrEE STATEMENT: Requirements for leakage current limits are not possible to summarize without losing pertinent data in the process.

276

N F P A 99 - - F 9 2 T C R

(Log # 45) 99-185- (%5.1.3.3(d)): Accept in Principle SUBMITrER: Alan Lipschultz, Medical Center of Delaware RECOMMENDATION: Revise the last sentence of 7-5.1.3.3(d) to read:

'q'he leakage current Hmits in %5.1.3.7 and %5.9.2.1 shall not be exceeded in any of these conditions." SUBSTANTIATION: The current %5.1.3.6 in the text and the accompanying diagrams specifies leakage currents be done with power cord connected normally and the device on. This is different than the requirements ,of 7-5.1.$.3(d). This change is editorial to remove the discrepanq, by excluding 7-5.1.3.6 from the requirements of %5.1.3.3(d). COMM1TrEEACTION: Accept in Principle.

1. Delete sentence 2 in current %5.1.3.3(d). 2. Revise sentence 1 in current 7-5.1.3.3.(d) to read as follows: "Leakage current m~lsurements shall be made with the polarity of

the power line normal, the power switch of the appliance in the position shown in Table %5.1.3.3(d), and with alloperating controls in the position to cause maximum leakage current readings."

Par. No.

%5.1.3.4 %5.1.3.5 7-5.1.3.6(a) 7-5.1.3.6(b) 7-5.1.3.6(c) %5.1.3.6(d) 7-5.1.5.6(e)

Table %5.1.3.3(d)

Power switch setting On and off

X X

X

On

X X

X X

COMMITTEE STATEMENT: More user friendly to list power switch settings in tabular form.

(Log # 184) 99-184 - (7-5.1.3.5): Rc~ject SUBMrrrER: FloydJ. Devore, HIMA RECOMMENDATION: Revise text as follows:

Change the second sentence from: 'q'he limit shall be 100 microamperes.~; to: ~I'he limit shall be 500 microamperes." SUBSTANTIATION: The Working Group was directed to use the CSA rationale for determining acceptable limits for NFPA-99; i.e., leakage currents under normal conditions shall not cause discomfort; and may, under single fault conditions, cause discomfort but shall not be unsafe. Larry's report reviews what might be considered a discomfort and unsafe, and references UL's limit of 500ua for domestic appliances. The report concludes that 500ua might be OK for the general public, but special considerations should be given to patients; i.e., a limit something less than 500ua. The report should recognize that: 1. The 500ua domestic appliance limit is for normal operating

conditions; i.e., one could conduct 500ua from the surface of an appliance 2D this is considered normal and safe.

2. The 500ua includes a safety factor of 2 for the threshold of sensation/pain for the majority of the population 2D based on the threshold being 1 milli:unpere as notedin Larry's report, and NFPA 99 A-9-2.1.1 $.4(c) which notes that a small percentage of the population, perhaps 5%, will react to leakage currents of 500ua.

3. S~cial consideration is given, to medical equipment, by reducing accesskble leakage currents dunng normal operauon to a few microamperes via the grounding. 4. Many of the people using domestic appliances are patients

under home care programs. The report goes through an analysis on the relationship of leakage currents and line voltages, the analysis concludes that equipment operatingon US 120v power with 250ua leakage would be in harmony with IEC's 500ua limit when operating on 240v power (the calculations show 300ua @ 120v is needed). This is true in concept. However, it depends on how the product is connected to the mains for each of the different line inputs. We have some products which have essentially the same leakage currents at 120v and 240v operation because of how the input transformer is rewired for the different voltages. Also some cordconnected products are operated at 220v. This analysis should not be a factor in determining the leakage current limits. It does not relate to the rationale for determining allowable leakage current based on safety and discomfort.

The report includes a Risk Analysis based on leakage currents and open equipment grounds. This Risk Analysis fails to address the most significant hazard involving opened grounds. The primary purpose of the ground is protect against faults which could energize the chassis with line power. Any device operated with a broken ground is dangerous. But not because of normal leakage currents.

Going back to the rationale: 1. There doesn't seem to be any issue on a properly grounded

device meeeting the first requirement of the rationale; i.e., no discomfort under normal operating conditions.

2. There is enough evidence to conclude that a chassis leakage limit of 500ua meets the second requirement of the rationale; i.e., possible discomfort, but not unsafe.

Based on the above review I am submitting the attached petitions for changing the chassis leakage current limit from 100ua to 500ua. (Supporting material available for review at NFPA Headquarters.) Because o f the potential danger of using equipment with open

grounds, I suggest that the Electrical Systems Subcommittee give serious thought to requiring Ground fault circuit interrupt protection for receptacles in patient care areas. COMMITrEE ACTION: Reject. COMMITTEE STATEMENT: See Committee Action on Proposal 99-185 (Log #71). Decision is based on: 1) Working Group Report; 2) Subcommittee on Electrical Equipment symposium andmeetings on issue; 3) Subcommittee voting on issue (for which a 2/3 concurrance was not achieved); and 4) Technical Committee review of issue at its October 21/22, 1991, meeting. Copies of Report, symoposium, etc. are available from NFPA. Technical Committee desires further comment from the public on

this issue.

(Log # 71) 99- 185 - (%5.1.3.5(a) and Exception; 9-2.1.13.4(c) (1) and Exception (New)): Accept SUBMITIT_.R: Bryan Parker, Montefiore Medical Center RECOMMENDATION: a. For correlation: in 7-5.1.3.5(a)change "100" to "250". Also delete Exception 1 and substitute the proposed exception below.

b. Revise 9-2.1.13.4(c)(1) to read: (1) Cord Connected Appliances that are intended for use in the

patient vicinity shall not exceed 250 microamperes of chassis leakage current as measured in 9-2.1.13(a), ~I'est Methods". Exception: For cord connected devices which may be in intimate

, proximity to padents during procedures which involve the use of juxtacardiac electrical conductors the leakage current shall not exceed 100 microamperes. Specifically these devices include electric patient beds intended for used in hospitals, electrocardiographic or electrophysiological devices, angiographic injectors and line operated pacemakers. SUBSTANTIATION: The 100 uA limit is unnecessarily restrictive for most patient<are-related equipment. A current of 100 uA which enters and leaves a person at the skin is unlikely to cause significant stimulation. However, 250 uA focused at the heart is a significant risk as compared to 100 uA. The proposer is concerned about those techniques, particularly bedside procedures, which involve exterior- izedjuxtacardiac electrical conductors. COMM1TFEE ACTION: Accept

(Log # ELE-11) 99-186 - (%5.1.$.6(a); 9-2.1.13.5 (a) ) : Accept SUBMITI'ER: Subcommittee on Electrical Equipment RECOMMENDATION: In %5.1.$.6(a) to (e) and in 9-2.1.13.5(a) m (e), change "shall be less than" to read as follows:

"shall not exceed". SUIkgTANTIATION: To be consistent with terminology used in % 5.1.$.5 and 9-2.1.13.4. COMMITrEE ACTION: Accept.

277

N F P A 99 - - F92 T C R

(Log # 46) 99-187- (7-5.1.3.7): Reject SUBMITrgI~ EdwardJ. Orogan, Alexandria Hospital RECOMMENDATIONs Tesffng Intervals for Criu'cal Care Areas should be increased from 6 to 112 months. SUBSTANTIATION: JCAHO has recently (1989) increased the nominal tmpecfion inferval for medical equipment from 6 months to 12 mond/s. Though, by nature, some eqmpment ma]r remain on a 6 month im .pection schedule, many devices used in critical care areas only nedd to be ImL~tod for performance (and calibrated, etc.) on an annual basis. With flnandal pressures in health care today, and an ever increming eq~pment inventory, it would prove beneficial to increase this tesfin[[ interval. I believe that increasing the interval will not Increase patient risk from Potentially unsafe medical devices. COMMrrrEE ACTION: Reject. C O M M r r r l ~ ST&TEMENT: Exception No. 1 to 7-5.1.3.7 allows for longer intervals than those listed for testing.

(Log # my..7) 99- 188- (7-5.1.3.7): Accept SUBMYrrF.,g~ Subcomlmttee on Electrical Equipment REODMMENDATION: 1. Move 7-5.1.3.7, and insert as new 7- 6.2.1.2.

2. Delete existing 7-6.2.1.2. SUBSTANTIATION: 1. Requirements for existing equipment belong in Section 7-6, per structure of NFPA 99.

9. Existing 7-6.2.1.2j/at refers reader to existing 7-6.1.3.7. COMMITrEg A c r I o N : Accept.

SUBSTANTIATION: Electrical safety standards do not exist.for . most laboratory equipment. It does not seem wise to give unllmitea power to the authority havingjur i~cdon. I X } ~ ACTION: Reject. COMMrrTEE STATEMENT1 At the current time, the Committee desires to have the Authority HavingJurisdicdon determine acceptahle standards.

(LOg # 94) 99-194- (7-6.2.4.2): Accept in Principle S U B ~ Norman V.. Steere, Stlllwater, MN RECOMMENDATION: Delete Section 7.6.2.4.2. SU~qTANTIATION: The National Electrical Code and NFPA 45 address the question of classification of electrical equipment for hazardous iocatious, and it does not seem useful to]ntroduce other wording which may introduce problems with interpretation or enforcement. COMMrrrF~ ACTION: Accept in Principle.

Revise 7.6.2.4.2 to read as follows: 7-6.2.4.2 Electrical equipment intended for use in hazardous areas

in Laboratories shall meet the reouirements ofNFP A ~ , Standard for Laboratories Usin~ Chemical. (See definition of'Hazardous area in laboratories" ifi 2-2 of Chapter 2.) [Change Underlined] COMMrlWER STATEMENT: 1. Since NTPA 45 contains requirements on mue, it is deemed appropriate to reference that docu- menu

2. NFPA 70, National Electrical Code, coven installation of electrical wiring in buildings, not wiring in electrical appliances.

(Log # 44) 99-189 - (7-5.1.3.7 Exception No. 1): Accept $UBMrITE~ Alfred_]. Longhitano, Mt. lCu¢o, NY I~COMMENDATION: In Exception No. 1, change the word

ON: Editorial change for consistency with the remainder of the paragraph. C o M M r I w ~ ACTION: Accept.

(Log # 180) 99- 190- (7-5.1.3.7(b)): Accept SUBMITTF~ Hy Rershad, Hosp. Engr. Society of Greater N.Y. RECOMMENDATION: Delete word "Hospitals" from Exception No. 1 Line 2, and substitute the word *facih'ty'. SUB~ANTIATION: Consistency in Standard language COMMrrTgE ACTION: Accept.

(Log # 149) 99- 191 - (7-5.1.$.7(b)): Accept SU2MITI~R: Barry Duiguan, Greater New York Hospital Associa- tion RgCAZ)MMF3qDATION: Delete word "Hospitals" from Exception No. I Line 2, and substitute the word _'Tacifi'ty'. $ ~ A N T I A T I O N : Consistency in Standard language. COMMYYrEE ACTION: Accept.

(Log # FJ.Y~) 99-192 - (7-5.2.2.1): Accept 8UBM/TrER: Subcomrmttee on Electrical Equipment RECOMMENDATION: Change title of 7-5.2.~.1 to read as follows:

7-5.2.2.1. FacilltyOwned Appliances. SUIk~ANTIATION: Existing title does not reflect the intent of addressing the hazards of non-patient electrical appliances in the patient care vicinity. COMMITTEE ACTION: Accept.

(Log # 93) 99.193. (7-6.2.4.1): Reject SUBMITI'ER: Norman V. Stcere, Stillwater, MN RECOMMENDATION: Revise Section 7-6.2.4.1 to add to the sentence:

"If such standards have been established by a nationally recognized standards making organization."

(LOg # 161) 99- 195 - (7-6.5.1): Accept in Part. SUBMITI'ER: D. It. Parsons, Los Angeles City Fire Department RECOMMENDATION: Add the following:

"7-6.5.1 . . . Thisprogram will include periodically reviewingthe manufacturer's safety guidelines and usage requirements for~high energy surgical equipment and fire and life safety training." SUBSTANTIATION: During the investigation of the UCLA Operadng Room fire, itwas determined i ~ t operadng room staff

not necessarily organized or trained to respond to fire emergen. C l e s . Also, it was found the O.1L personnel were not required to

periodically review the manufacturer's usage and safety guidelines for high energy surgical devices. COMM1Tr~-ALTION: Accept in Part.

1. Add the following to 7-6.5.1: "1"his program shall]ndude periodic reviewing of man-f-acturer's

safety guidelines and usage requirements for electrosurgical units and ~ appliances."

2. Insert new 7-6.5.9: "Personnel involved in the use of energy delivering devices,

including but not limited to, electrmurgtcal units, surgical lasers, electrocauterizers, and fiberopticj, shall receive periodic training in fire suppresdon." COMMrrrF1 STATEMENT: I. Submitter's recommendation addresses two different issues (fire,~fety training and lifesafety training). Subcommittee believes separating iuues will enhance recogmtion of these hazards.

2. Life safety tr~ain.ing is already required in Chapter 31 of NFPA I01, Life Safety uoae. 3. See Proposal 9c3-2S0 (Log #HGH-I), which proposes fire and

additional life safety training.

(Log # 68) 99- 196 - (Chapter 8): Accept SUBMrlTER: Bryan Parker, Montefiore Medical Center RECOMMENDATION: From the title of Chapter 8 delete ", Health Care Fadlides". SUBSTANTIATION: a. This proposal is submitted in response to the NFPA request to make the document more user friend]y, and to remove extraneous material.

b. Redundant, already stated in Chapter 1, Section 1.1. c. Not used in other udes, except for Chapter 7 where it is also

redundant. COMMITTEE ACTION: Accept.

278

NFPA 9 9 - F92 TCR

(Lo~ # 181) 99-191- (8-6.4.1.4 (Note)): =_Reject S U ] B ~ Hy Ber*had, Hmp. Engr. Society of Greater N.Y. RECOMMENDATION: Revise text as follows:

Add to label text the following: " . . . Permitted within this endomre"

SUBSTA~FIIATION, Clarification. Electrical appliances may be in me outside of the enclosure or canopy (e.g. electric bed) COMMr][wEZ ACTION: Reject. COMMrrTEE STATEMENT: Suggested text is a minimum, and any additional appropriate words may~te added.

(Log # 150) 99-198- (8-6.4.1.4 (Note)): Reject SuBMrI 'TN~ Barry Dulgnan, Greater NewYork Hospital Associa- tion RECOMMENDATION: Add to label text the following:

" . . . Permitted within this enclosure" SUBSTAN'I~TION: Clarification. Electrical appliances may be in use outside of the enclosure or canopy (e.g. electric bed) C O M M 1 T r ~ ACTION: Reject. COMMITTEE STATEMENT: Identical to Proposal 99-197 (Log #181) and is thus rejected for the same reason.

(Log # 182) 99- 199- (8-6.4.2): Reject SUBM1TrE~ Hy Ber*had, Hosp. Eng r. Society of Greater N.Y. RECOMMENDATION: Sign associated with ~ is to have end of 2nd sentence removed so it reads as follows:

" . . . No electrical equipment is allowed within an oxygen enclosure. w

Delete wording below the sign in Note 2, i.e. "This sign is intended to caution those not familiar with this chapter." SUBSTANTIATION: Statement of 5 foot limitation is confusing and unnecessary and can be interpreted to include electric beds and other electrical equipment (overbed light, e.g.) outside of the oxygen endmure.

Deletion of wording at end of No= 2 will empha=ze that even those familiar with this chapter may benefit from the cautionary wording. COMMrITEE ACTION: Reject. COMMrITEE STATEMENT: Sign is intended for general public that vi~m health care facilities, and as such, more su'ingent precau- don should be recommended.

(Log # 151) 99- 200 • (8-6.4.2): Reject SUBMITYEI~ Barry Duignan, Greater New York Hospital Auocia- tion RECOMMENDATION: Sign assodated with ~ is to have end of 2nd sentence removed so it reads as follows:

" . . . No electrical equipment is allowed within an oxygen enclo- S U r e . ~'

Delete wording below the sign in Note 2, i.e. ,'This sign is intended to caution those not familiar with this chapter. SUBSTANTIATION= Statement of 5 foot limitation is confusing and unnecessary and can be interpreted to include electric bed/and other electrical equipment (overbed light, e.g.) outside of the oxygen enclosure. Deletion of wording at end of ~ will emphasize that even

those familiar with this chapter may benefit from the cautionary wording. COMMrITF~ ACTION. Reject. COMMrrrEE STATEMENT: Identical to Proposal 99-197 (Log #181), and is thus rejected for the same reason.

(Log # 31) 99- 201 - (8-6.4.2): Reject SUBMITrER: TerryW. Stage, Robinson Memorial Hospital RECOMMENDATION: In those facilities that are declared and

~ ..4s.~..d a= "Non smoking', dgnage is not required as outlined in 8-

SUBSTANTIATION: This and many other health care facilities are now "Smoke Free" and find it unnecessary to display signage by each patient room.

COMM1TI'EE A c r I o N t ReJect. COMMrrTEE STATEMENT: While facilities may have polldes about being =smoke free," the sight of oxygen administration presents fire hazards, and as such deserve particular notice about no open flames including that from smoking.

(Log # ELE~) 99- 202 - (Chapter 9): Accept SUBMrITE~ Subcommittee on Electrical Equipment RECOMMENDATION: I. At the beginning of Chapter, delete NOTE 2.

2. Delete 9-2.1.9.$(b). 3. In Figures 9-2.1.9.3(a) to (f), remove dagger 0, and delete

NOTE under each figure. 4. Renumber 9-2.1.9.3 accordingly.

SUBSTANTIATION: NFPA 493 was withdrawn by NFPA. However, these figures are still relevant. COMMITIIEE ACTION: Accept.

(Log # r~-9) 99- 203 - (9-2.1): Accept SUBMITrE~ Subcommittee on Electrical Equipment RECOMMENDATION: Change title of 9-2.1 to read: "Patient-Care- Related Electrical Appliances". SUBSTANTIATION: Editorial. Use defined term. COMMITTEE ACTION: Accept.

(Log # 2O4) 99- 204. (9-2.1.6.4 (New)): Accept SUBM]TI3E~ Saul Aronow, Technology in Medicine, Inc. RECOMMENDATION: Add a new Section 9-2.1.6.4 aa follows:

9-2.1.6.4 Operation with Essential Electrical System. (a) General. Equipment (fixed or appliances) shall be designed to

operate normally wl~en energized by a standby power source that conforms to the requirements of Chapter 3.

(b) Power Transfer. Following transfer of power between the normal power system and the essential electrical system, a patient- related appliance shall resume hmction in the mode of operation that existe~ prior to the transfer.

Exception: If the appliance cannot maintain its mode of operation in the event of a power transfer, it shall default to a nonhazardous status and dearly indicate by audible or visible signals that its mode of operation has changed.

(c) Programmable Appliances. Deenergization of the power supply o f a programmable appliance shalI not result in the loss or c h ~ g e of any part of the program or data required for normal operation.

Exception No. 1: This requirement does not apply to computers and programmable appllarices that are not directly related to patient c a r e ,

Exception No. 2: Patient care appliances that may suffer loss of program or vital data shag default to a start-up status and clearly indicate by audible or visual signals that its program or data has been altered or lost. SUBSTANTIATION: [This is a Tentative Interim Amendment (99- I) for the 1990 edition of NFPA 99. TIA's automatically become proEosats for the next edition of a document. The reason for the TIA is lbted below, as provided by Submitter of document.J Within the last few years there has been an explosive increase in me

number and complexity of medical appliances .used for patient care. These are largelyba~d on digital components mat are much more sendtlve to power supply problems than old-fashioned devices, and on computer programs Which n~_y require uninterrupted power. NFPA 99 has recognized ~ technological change and some ~s_ponses to it have been included in the new edition in proce,~.

However, an emergency situation has developed. Equipment manufacturer, are not all aware of the reality that health care facilities have emergency power ~ t e n a that in me, and in monthly tests, twitch over wii'~ a 10-second power interruption. It has been repreatedly reported that equipment is being sold that fails during power transfer, sometimes creating[ l l fe-~ . , arching situations.

This TIA wig add a requirement mat calls this problem to manufacturer,' attention, since it is a problem that is readily amenable to a technological solution.

279

N F P A 99 m 1¢92 T C R

COMMITrgg ACTION: Accept. Change "patient care appliance and "patient related appliance" to

"patient care related apl~liance'. c o M M r r r l ~ STATIDA[ENT: Editorial. Term used in document.

(Log # ZLE-4) 99- 205. (9-2.1.9.2(b)(5)): Accept s u B M r r r E l h Subcommittee on Electrical Equipment RECOMMENDATION: In the middle of the sentence, change "the appliance shall" to read: "cardiac defibrillators shall'. SLTBSTAN'rIATION: Editorial (grammar). CoMMrITEE ACTION: Accept.

(Log # 185) 99- 209 - ( 9 . 2 . 1 . 1 3 . 4 ( c ) ( 1 ) ) : Reject SUBMI ' r rE~ FloydJ. Devore, HIMA RECOMMENDATION: Chanl~e the first sentence from: "Cord- connected appliances that are mtented for me in the patient vicinity shall not exceed 100 microamperes. . ." to read: 'V, ord-connected appliances that are intended for use in the patient vicinity shall not exceed 500 microamperes. . ." SUBSTANTIATION: See Substantiation for Proposal 99-184 (Log #184). COMMITrEE ACTION: Reject. COMMITTEE STATEMENT: See Committee Statement on Proposal 99-184 (Log #184) since issue is the same, i.e., chaJsis leakage current fimit for patient care related electrical appliances.

(LOg # 69) 99- 206 - (9-2.1.10 through 9-2.1.10.4): Reject SuBMrITER. Bryan Parker, Montefiore Medical Center RECOMMENDATION: a. Delete heading 9-2.1.10.

b. Delete section 9-2.1.10.1 General. c. Renumber Sections 9-2.1.10.2, 9-2.1.10.5, and 9-2.1.10.4 to be 9-

2.1.10, 9-2.1.11 and 9-2.1.12, respectively. Renumber all affected subsequent paragraphs. SUBSTANTIATION: This proposal is submitted in response to the NFPA request to make documents more user friendly, and to remove extraneous material.

b. Section 9-2.1 applies to all Patient-Care-Related Electrical Equipment. The sub grouping on *IAnv-Voltage Appliances and Appliances Not Connected to the Electric Power D%tribution System" is unnecessary. There is no section, for example, on appliances connected to the electric power distribution system. COMMrI'FEE ACTION: Reject. C O ~ STATEMF.~]T: Text in question is considered relevant.

(Log # 70) 99- 207 - (9-2.1.10.4): Accept SUBMrITERz Bryan Park, dr, Montefiore Medical Center RECOMMENDATION: Revise 9-2.1.10.4 to read:

9-2.1.10.4 Circuits of 30 volts (dc or ac rms) or less shall be electrically isolated from the power distribution system. Grounded low voltage circuits shall be permitted provided that load currents are not carried in the grounding conductor. SUBSTANTIATION: a. To clarify that low voltage circuits need not be isolated from ground. The electric power distribution system includes the ground, and some have questioned the wording of this section. b. For consistency with ~4.1.2.2.

COMMITTEE ACTION: Accept.

(Log # 203) 99- 208 - (9-2.1.10.4): Reject SUBMrI ' rE~ Robert T. Shipley, Fisher Berkeley Corporation RECOMMENDATION: Add to the end of the paragraph the words, "and shall be isolated from ground." SUBSTANTIATION: Some manufacturers, AHJ's and NRTL's have interpreted the paragraph to mean that low voltage circuits can be grounded so long a~ they are not connected to either the hot or neutral circuits. This revision will clarify that low voltage circuits in Section 9-2.1.10 are to be isolated from ground. The code requir.es that patients be protected from leakage currents, but patients an bed also need to be protected from circuits which are referred to ground. Circuits that are referred to ground are as hazardous to grounded patients as leakage currents. When a patient is grounded, and simuitaneously comes in contact with a ground-referenced circuit, current will flow through the patient. Frequently, the magnitude of the current which will flow exceedsthe safe levels established for leakage currents. COMMrrrEE ACTION: Reject. COMMITTEE STATEMENT: Subcommittee believes it is possible to design safe, grounded low-voltage circuits for equipment. See Committee on Proposal 99-207 (Log #70).

(Log # EI.Y.A0) 99- 210. (9-2.1.14): Accept SUBMITFER: Subcommktee on Electrical Equipment RECOMMENDATION: Delete 9-2.1.14. SUBSTAN'IIATION: Subject already addressed in 9-2.1.7.3. COMMITTEE ACTION: Accept.

(Log # 196) 99- 211 - (Chapter 10): Accept in Part SUBMITYER~ Arden Forrey, Seattle, WA RECOMMENDATION: Revise Chapter I0 of NFPA 99 as follows:

10-1 Scope. 10-1.1 (Existing wording) 10-1.2 (Existing wordinl~ ) 10-1.3 Interface with exming codes and standards. 10-1.3.1 (Existing wording) 10-1.3.2 Where necessary, due to the special nature of laboratories,

referenced codes and standards are supplemented in this text, so as to apply more specifically, when needed, to laboratories in Health Care Occupancles, as dd'med by NFPA I01. In addition to NFPA I01, the LiFe Safty Code, the prmae reference for fire safety in laboratories is NFPA 45, Safety in Laboratories Using Chemicals and the other standards therein referenced.

10-1.4 Definitions (include NFPA 99 2-1, 2-2 and NFPA 45 sections)

10-2 Nature of Hazards. 10-2.1" General (Existing wording) 10-2-2 Fire Low Prevention. 10-2.2.1.2.3 (Existing wording) 10-2.2.1.4 (Existing wording), in addition Ref NFPA 45 A-7-1. 10-2.2.2 (Existing wording) 10-2.2.3 Emergency procedures (Existing wording) 10-2.2.4 Orientation and Training (Existing wording) 10-2.3 NFPA 704 references concepts relating[ to health hazards

should be upheld and related to medical survedlance procedures used for occupational health for both laboratory and fire service professionals. NFPA 704 is only related to the properties of these materiah in a fire. Fire safety and emergency response by fire service personnel is much broader than this.

10-3 Structure. 10-3.1 Construction and Arrangement. 10-3.1.1 Laboratories in Health Care Occupancies, as defined in

NFPA 101, shall be separated from surrounding health care areas and from exit corridors by fire resistive construction with a minimum rating of one hour, and all openings protected by 3/4 hour- rated assemblies.

10-3.1.2 The construction of laboratories in health care occupancies shall comply with Chapter 3 of NFPA 45 and the characteristics stated in Chapter 2 of that document. The means of egress, stated in NFPA 45 secuon 3.5, are required to comply with the requirements stated in NFPA 101.

10-3.2 Exits. The requirements of NFPA 45 Section 3.4 and NFPA 101 shall be followed.

10-3.2.1 A further restriction for health care occupancies is tha t . . . 10-3.5.2 (Existing ~ r d i n g ) 10-5.2.5 (Presen0 (Strike) 10-5.2.4 (present; new 10-5.2.5) (Existing wording) 10-5.2.5 (Present new; 10-3.2.4) (Existing wording)

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N F P A 99 ~ F92 T C R

10-5.5 Exhaust Air (Strike because it is covered by NFPA 45 Chapter 6 as below)

10-5.4 (Present; new 10.3.5 Ventilation) Ventilation in laboratories in Health Care Occup~cies shall conform to the requirements of NFPA 45 Chapter 6. (Note current reference to 5.4 f'ders to N'FPA 90A which, for laboratories refers to NFPA 45 so that this reference is more direct. Strike 5.4.$).

10-5.4.1 (Present; new 10.5.5.1) Exhaust air shall conform to NFPA 45 section 6-5.

10.5.4.2 (Present; new 10-3.5.2) Air supply shall conform to NlVPA 45 section 6-4.

10-5.5 (Present; new 10.3.4) Laboratory Hoods (vice current reference to "Fume Hoods') shall conform to NFPA 45 sections 6-9 through 6-14. (Strike 5.4.4, 5.6.2)

10-3.5 (New) Vacuum Systems (Exisfingwording of 4-7.2.1, also replace 4-7.2.1 with: "Vacuum systems for laboratoriesshall comply with the requirements of section 10-,$.5 of Chapter 10. and propose adding4-7.2.1 (modified) to NFPA 45 as section 9-2.6.)

10-4 Eq~ulpment. 10-4.1 Health Care Occupancies shall conform to the requirements

for equipment in NFPA 45, section 9-2. 10-4.2 Equipment employing liquids. 10-4.2.1 (Current secuon 1024.1.1 existing wording) 10-4.2.2 Current section 10-4.1.2 exisfingwording. 10-7.5.2.2 (Present; new 10-4.3 ElectricaI equipment in laboratories

in Health Care Occupancies sball conform to the requirements of NFPA 45 sections 5.6.2, 9-2.2.2, 9-2.4 and 9-2.5. Strike 7-5.2.2 and 7- 6.2.4.

10-5 Fire Protection. 10-5.1 General fire protection in laboratories within Health Care

Occupancies sball comply with the requirements of NFPA 45 Chapter 4. (Strike 16-5.1, 10.5.2, 10-5.S)

10-6" (Existing wording) 10-7 Flammable and Combustible Liquids. 10-7.1 Genend. 10-7.1.1 (Existing wording, except reference NFPA 45 Chapter 7) 10-7.2 Storage and Use. 10-7.2.1 Flarkmable and combustible liquids shall be stored as

required in NFPA 45 section 7-2.3 and as follows. (Current 10-7.2.2) 10-7.2.2 (Present) (Strike) 10-7.2.5 (Present; new 10-7.2.2) (Existing wording) 10-7.2.4 (Present; new 10-7.2.3) (Existing wording) 10-7.2.4 (New) The provisions of NFPA 45, secdons 7-2.2 shall be

observed. 10-7.2.5 (Strike existing wording) See NFI'A 45 section 9-2.2.2. 10-7.5 Handling and use o f ~ l e and Combustible Liquids.

(Existing wording of 10-7.5 plus reference to NFPA 45 7-2.2) 10-7.3.1, 10-7.5.2 (Existing wording of 10-7.4.1, 10-7.4.2) 10-7.4 Dispmal of Chemicals and Hazardous Waste. 10-7.4.1 The requirements of NFPA 45 section 7-5 shall be

observed. 10-8 Maintenance and Inspection (Existing wording, which should

also be incorporated into NFPA 45, it renumbered to 10-10.) 10-9 (Present; new 10-8) Compressed and Flammable Gasses. 10-8.1 The requirements of NFPA 45 Chapter 8 shall be observed. 10-8.2 (From current: 10-9.2) 10-8.3 (From current 10-9.1) 10-8.4 (From current 10-9.3) 10-9 Hazard Identification (from 10-8.2) 10-9.1 The requirements of NFPA 45 Chapter 10 ~ be observed. 10-10 (New) From 10-8.1. 10-11 (New) Electrical (Strike 7-6.2.4, in 7-5.2.2.2 substitute:

"Laboratories shall comply with the requirements of Chapter I0", in 12-$.7.2 substitute: WAectrical equipment in laboratories shall conform to the requirements in section 19-11 of Chapter 10.") Laboratories shall comply with sections 9-2.1, 9-2.2, 9-2.5, 9-2.4, 9-2.5, 9-2.7 of NFPA 45 and electrical equipment + laboratory use shall be tested for electrical safety by standards acceptable to the authority having jurisdiction. SUBSTANTIATION: ,On behalf of the American Associadon for Clinical Chemistry Committee on Safe Laboratory Practices and as a member of NFPA 45 1 submit the following proposal for aligning Chapter I0 of NFPA 99 with NFPA 45. For over 15 years the AACC has sought consistency between the original NFPA 56C and NFPA 45. Now the evolution of NFPA 45 and the absorption of 56C into NFPA 99, coupled with the move of a large number of clinical laboratories out of health care occupancles as defined by NFPA I01, has resulted in most clinical l a b o ~ e s being located in non- healthcare occupancies and thus being governed byNFPA 45. The complexities of educating laboratory professionals to more than one standard for fire safety in laboratories argues strongly in favor of consistency in the standards documents and simplicity in referring to them. Moreover, a consistent simple reference to the principles of laboratory safety for the purpose of interfacing with fire set,ace personnel wlil enhance safe practices in the c]Tmical laboratory.

There h no need to consider elimination of Chapter 10, but, rather, crafting it to contain conmtent references to NFPA 45 with certain extensions and more stringent criteria needed to mit bealthcare occupancies. NFPA could then consider publishing the .two documents together so that laboratory fire safety stanoams are found in one publication. NFPA 45 could aim consider including general POints now in Chapter 10 but which are applicable to all laboratories.

With all laboratory fire safety issues made consistent, the combined document could then be the authoritative reference for laboratory safety programs sPOnsored bymch organizations as National Safety Council, AACC, American Chemical Society and numerous universities andprofessional societies, h would also induce users to work out synergtsficjoint programs with fire services and promote integration with occupadonaIhealth and safety pmgrana - for the woAp!ace in general, as they win evolve over the next few years.

I enclose a pro~oosed set of wording changes, also submitted to John Fresina NFPA 45 Chair, to be considered in proposing joint work groups needed to make the changes a reality. Mr. Norm Steere and Mr. Bob Hughes, my colleagues on the task group who also hold joint membership on NFPA 99, have contributed. COMMITrEE ACTION: Accept in Part.

See Committee Act/on on Pro~omb 99-161 (Log #92), 99-215 (Log #LAB-3), 99-214 (Log #95), 99-215 (Log #96), 99-219 (Log #100), 99-220 (Log #101L 99-222 (Log #102),99-225 (Log #105), 99-224 (LO~ #105), 99-234 (Log #106), 99-238 (Log #107), 99.240 (Log

COMMrFrEE STATEMENT: Action on these propos~ did the following : I. modified the scope of Chapter I0; 2. references NFPA 45 as the base document for laboratory requirements in general; 5. references NFPA 45 for ventilation requirements for health care facility laboratories, and NFPA 45 for fume hood requirements; 4. adds reference to NFPA 45 for laboratory equipment re¢luirements; 5. references NFPA 45 for flammable and combustible liquids used in laboratories; and 6. references NFPA 45 for laboratories in hospimis, ambulatory health care centers, and cl!nics. These changes incorporate all of the Submitter s issues except

Section 10-5,Fire Protection, but this section only addresses the issue of automatic fire extingui. 'shing systems, which is now moot with the adoption of the 1991 edition of NFPA 101, Life Safety Code.

(Log # 1 ss) 99, 212. (Chapter 10 et al): Accept in Principle SUBMI'rrEI~ John M, Fredna, Cambridge, MA RECOMMENDATION: Make the necem,, 7 changes to NFPA 99 to incorporate NFPA 45 as a reference for basic design and construction guidelines for laboratory occupancies within health care facilities, giving due consideration for specific restrictions or exemptions appropriate for laboratories impacting patient care areas. (See fist berow of duplicative text.)

COMPARISON OF NFPA 99 AND NFPA 45

10-1.2.1 10-2.2.1.3 10-2.2.1.1 10-2.2.1.2 10-2.2.1.4 10-2.2.3.3 10-3.1.1 10-3.2.1 10-3.3 (5-3.1) 5-4.3.1 5-4.4.1 5-4.4.2 5-4.4.3 5-4.4.5 5-4.4.6 5-4.4.7 5-6.2 7-5.2.2.2 &

7-6.2.4 8-5.2.1.5 20-1.1 2-1

TOPIC Scope 1-2.2 Unattended operations 9-1.2.$ Evaluation of hazards 9-1.1.1 Periodic reviews 9-1.1.2 Ordering chemicals A-7-1 Clothing fires A-4-6.1.2 Fire separations Table 5-1 & App. D Number of exits 3-4 Recirculation of air 6-5,1 Air negative 6-5.4 Hood mrbuience 6-10.1 Hood glazing[ 6-9.2 & 6-2.2 Perchloric acld 6-12 Hood imbalance 6-6.9 Face velocity 6-5.5 Hood services 6-9,5.1 Hood signs 6-15 & 10-2 Electrical equipment 9-2.5, 9-2.4.1,

~ . 2 Gas appliances N.A. In corporation 11.1 Definitions: 1-4

bwork area Unattended operations Hazardous chemical No flammbility 2

281


SUBSTANTIATION: To support an eft'on to streamline the design and comtruction requirements for laboratory occupancies and eliminate duplicative requirements to achieve a uniform set of guidelines for laboratory occupancies within health care facilities with respect to the definitions and provisions in NFPA 101, Life Safety Code. COMMITTEE ACTION: Accept in Principle. COMMrITEE STATEMENT: 1. With Committee Action on a number of proposals, NFPA 45 is now referenced in many places. Other proposa b, e.~., propgsal 99-214 (Log #95), have addressed the iuue of scope for Chapter 10.

2. With no specific recommendations included in proposal, the Subcommittee on Laboratories could only make changes it deemed appropriate.

(Log # LA~-3) 99- 213- (10-1, 10-2.1): Accept SUBMITrER: Subcommittee on Laboratories RECOMMENDATION: Revise to read as follows:

10-I Scope. 10-1.1 This chapter establishes criteria to minimize the hazards of

fire and explosions in laboratories, as defined in Chapter 2. Note I (use text of current 10-1.1 and 10-1.2.1). Note 2 (use text of current 10-2.1).

10-1.2 Interface with existing codes and standards. 10-1.2.1 (Use text of 10-1.3.I). 10-1.2.2 (Use text of 10-1.3.2).

SU]~TANTIATION: 1. There was no scope statement for Chapter 10. 2. Movement of material is to conform to NFPA Style Manual for

informatory material. COMMrITEE ACTION: Accept.

(Log # 95) 99- 214 - (10-1.3.1): Accept in Princip.le SUBMITIT, IU Norman V. Steere, Stillwater, MN RECOMMENDATION: 1. Revise Section 10-1.3.1 to insert two new sentences before the existing wording:

~NFPA 45, Fire Protection Standard for Laboratories Using Chemicals, is the primary NFPA standard for laboratories that covers the basic construction, ventilation systems and related fire protection of all laboratories in all facilities. However, this standard has more stringent requirements for laboratories located in health care occupancies where there may be patients incapable of self preserva- fion.-

2. Add an Appendix item A-10-1.3.h A-10-1.3.1 Wlfile NFPA 45 provides basic requirements and

guidance for laboratory design, fire separation and sprinkler requirements are more stringent for laboratories in health care faclfities. In addition, N'FPA99 has more stringent and realistic limitations of quantities of flammable liquids in laboratories, requires hood discharge above the roof, allows valves on emergency water supplies, encourages laboratory safety program activities, a n d recommends placement of flammable gas cylinders outside of the laboratory. SUBSTANTIATION: The existence of two different NFPA standards for laboratories creates a serious problem for coherent design of laboratory facilities. As an example, a laboratory built solely to requirements of NFPA 99 in a hospital, would not be in compliance if the hospital were sold for non-health care uses. The scope of NFPA 99 should refer to NFPA 45 as the basic document and then give the additional requirements for laboratories in health care facilities where there may be patients incapable of self t~)eservadon.

MMrITEE ACTION: Accept in Principle. 1. In Submitter's recommendation I, sentence I, change "primary"

to "basic" and change "covers the basic construction" to "covers the construction."

Change sentence 2 to read: "However, this chapter (10) has more stringent requirements for

laboratories located in health care facilities." 2. Accept Submitter's recommendation 2 for new Appendix A-10-

1.3.1. COMMITrF.,E STATEMENT: Chapter 10 in NFPA 99 is referenced in Chapters 12 to 18 of NFPA 99, and some of the facilities in Chapters 12 to 18 have patients who are capable of self-preservation.

(Log # 96) 99- 215 - (10-3.1.1): Accept SUBMrlTER: Norman V. Steere, Stillwater, MN I~COMMF2qDATION: 1. Revise Section 10-3.1.1 to add a new sentence at the beginning of the paragraph:

"Construction of laboratories shall comply with the requirements of NFPA 45 and NFPA 101, and with the following additional requirements."

2. Add an Appendix item A-10-3.1.1: A-10-$.1.1 NTPA 45 provides basic requirements and guidance for

laboratory desig 9 but-fire separa, tion and sprinkler req~firements are more stringent for laboratories in health care facilities. In addition, NTPA 99 requires hood discharge above the roof, allows valves on emergency water supplies, and has other specific requirements based-on the unique nature of facilities for care of padents who may be incapable of self preservation. SU~TANTIATION: The existence of two different NTPA standards for laboratories creates a serious problem for coherent design of laboratory facilities. As an example, a laboratory built solely to requirements of NFPA 99 in a hospital, would not be in compliance if the hospital were sold for non-health care uses. The scope of NFPA 99 should refer to NFPA 45 as the basic document and then give the additional requirements for laboratories in health care faciliue ~ s where there may l~e patients incapable of self

tion ACTION: Accept.

(Log # 97) 99-216- (10-3.2.1): Reject SUBMrITF, R: Norman V. Steere, Stillwater, MN RECOMMENDATION: 1. Revise Section 10-3.2.1 to add two additional sentences:

"A second means of acceu to an exit shall be provided for laboratory work areas in excess ofS00 sq ft ift~e quantities of flammable liquids in the area exceed the limits specified in NTPA 45 for a high ha~rd laboratory. A second means of access to an exit shall be provided for any laboratory work areas in which other hazards exist as specified in NFPA 45."

2. Add an Appendix item: A-10-3.2.1 NFPA 45 lists hazards which require a second means of

egress, such as a having a hood located adjacent to the primary means of exit access, me existence of a specific explosion hazard, and containers of compressed or liquified gases which could prevent safe egress in case ofacddent. SUBSTANTIATION: NFPA 99 has not addressed egress problems which may occur in some types of laboratories, inch as research facilities using large quantifies of hazardous materials. These changes will refer des~ners and users to the more comprehensive reqmremenu in NFPA 45. COMMITTEE ACTION: Reject. COMMITTF~ STATEMENT: Iame of quantity restriction is covered under 10-7.2.2. Complying with 10-7.9.2 precludes a high hazard laboratory as defined in NFPA 45.

(Log # 98) 99- 217 - (10-3.2.2 arid 10-3.2.~): Reject SUBMITrEg: Norman V. Steere, 5tillwater, MN RECOMMENDATION: Delete Section 10-$.2.2, and revise I0-3.2.$ to read as follows:

10-3.2.3 Means of egress for labortory buildings, laboratory units and laboratory work areas shall comply with NFPA 101, Life Safety Code. SUBSTANTIATION: The basic requirements for means of egress are in the Life Safety Code. COMMITTEE ACTION: Reject. COMMrrrEE STATEMENT: There are some hazards in laboratories that make the 75 foot distance to an exit access door a reasonable criteria. This requirement is not in conflict with NFPA 101, Life Safety Code.

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(Log # ~ ) 99- 218- (10-S.$): Reject SU]BMrrTEIh Norman V. Steere, Sdllwater, MN RECOMMENDATION: 1. Revise Section 10-3.3 to read as follows:

10-$.5 Exhaust air from laboratories shall not be recirculated. 2. Add an Appendix item: A-10-$.$ NFPA 45 prohibits recircuiation of exhaust from

laboratory hoods, q~edal exhaust ventilation, and laboratory work areas. SUBSTANTIATION: The present wordingreferred to by 10-8.3 in 5-5.1 allows recirculation in laboratory work areas of air exhausted from laboratory work areas. If adequate hood or special exhaust is not provided, this will allow buildup of volatile ~ o u s materials used within laboratory work areas. C O M M I ' I T ~ ACTION: Reject. COMMITTEE STATEMENT: There are dtuations where the exhaust air in a laboratory can be safely recircuiated within the laboratory.

(Log # 10~) 99- 222- (10.7.2.1): Accept SUBMrrrER: Norman V. Steere, Stillwater, MN RECOMMENDATION: 1. Revise Secdon 10-7.2.1 to read as follows:

10-7.2.1 Flammable and combustible liquids shall be used from and stored in approved containers in accordance with NFPA 45, Fh-e Protection Standard for Laboratories Using Chemicals, and NFPA SO, Flammable and Combustible Liquids Code.

2. Add an Appendix items: A-10-7.2.1 NFPA 45 provides more specific guidance for use of

flammable and combustible liquids in laboratories, in addition to basic requirements set forth in NFPA SO. SUBSTANTIATION: NFI'A 45 provides requirements in addidon to those in NFI'A SO, and therefore should be clearly referenced. COMMrlWEE ACTION: Accept. Accept revision to 10-7.2.1. Add Submkter's Appendix recommen-

dation to existing Appendix text. COMMrrrgE S T A ~ : Existing Appendix text is usefui guidance.

(Log # 100) 99- 219 - (10-3.4 and 10-3.5): Accept in Part SUBMrrTER: Norman V. Steere,Sdllwater, MN RECOMMENDATION: I. Revise Sections 10-3.4 and 10-3.5 to read as follows:

"v'entilation shall comply with Section 5-4.3 and with the require- menus of NFPA 45."

2. Add an Ap~pendix item: A-10-3.4 and A-10-8.5 Section 5-4.3 gi~s ventilation requirements

~ a t are specific for laboratories in health care facilities and in addidon to the basic laboratory ventilation requirementa contained Tioter 6 Of PA 45

N: ']'he existence of two different NFPA standards for laboratories creates a serious problem for coherent design of laboratory facilities. A laboratory~m a hospital built solely to requirements Of NFPA 99 would not be in compliance if the hospiial were sold for non-health care uses. The scope of NFPA 99 should refer to NH'A 45 as the basic document and then ~ve the additional requirements for laboratories in health care facilities where there may be patients incapable of self preservation. C O ~ Acr ION: Accept in Part. Accept Submitter's recommendation for 10-5.4 and A-10-5.4.

COMI~TrEE S T A ~ : Issue of fume hood requirements (10- 3.5) was addressed in Proposal 99.161 (Log #92).

(Log # ]0]) 99- 220 - (10-4.1): Accept in Principle S U B M r r r F ~ Norman V. Steere, Stiliwater, MN RFJDOMMENDATION: Add a new paragraph preceding present 10- 4.1.1:

~..aboratory equipment and apparatus shall comply with the requirements of Section 9-2 of NFPA 45, and with the additional requirements of this section." SUBSTAN'I~TION: Many hazards of laboratory equipment and apparatus are covered more comprehensively in NFPA 45 than in NFPA 99. This added langnag[e will give direct reference to NFPA 45 and point out additional reqmrements established for laboratories in health care facilities. COMMITTEE ACTION: Accept in Principle.

1. Insert a new 104.1 to read as follows: 104.1 Equipment. Laboratory apparatus shall comply with

requirements in NFPA 45, Standard for Fire Protection for Labomto- ties Using Chemicals.

2. Renumber existing 104.1 to be new 104.2. COMMITTEE STATEMENT: Requirements in NFPA 45 apply to all laboratory apparatus, and not just those employing liquids.

(Log # LAB-2) 99- 221 - (10-5.1.1 and 10-5.1.2): Accept S U B ~ Subcommittee on Laboratories I~ECOM]~B2~ATION: Redesignate 10-5.1.1 to "(a)".

Redesignate 10-5.1.2 to *(b)'. S U ~ T A I ~ I A T I O N : Confusion reported as currently numbered, Paragraphs 10-5.1.1 and 10.5.1,2 are part of 10-5.1. C O M M r r I ~ ACTION: Accept,

(Log # 10S) 99- 223 - (10-7.2.5): Accept SU]BMrYrER: Norman V. Steere, Sdllwater, MN RECOMMENDATION: 1. Revise Section 10-7.2.5 so that the first two sentences read as follows:

"Class IA flammable liquids shall not be stored in refrigerators, freezers or other enclosed unventilated spaces unless the storage compartment has no posible ignition sources. If it is necessary to store Class IA flammable liquids under refrigeration, the storage device must be a listed flammable materials storage refrigerator, or a refrigerator listed for Class I, GmUp C."

2. Revise Section 10-7.2.5 to add two additional sentences after the first two:

~Clau IB flammable liquids with flashpoint temperatures less than 40"F shall not be stored in refrigerators, freezers or other enclosed unventilated spaces unless the storage compartment has no possible ignition sources. If it is necessary to store Class IB flammable liquids with flashpoint temperatures less than 40°F under refrigeration, the storage device must be a listed flammable materials storage refrigerator, or a refrigerator listed for Class I, Group D.r SUBSTANTIATION. While there is a ve T real haza~rd of an explosion if ethyl ether or a similarly volatile flammable liquid is stored in an unventilated enclosure contalningan ignition source, there is almost no hazard from storing ethanolic standard solutions in ordinary domestic or commercial refrigerators. The proposed change will allow laboratory managers to use limited resources better if they are not required to purchase an explosion-proof refrigerator for storage of flammable liquids that have no greater hazard than beer or whiskey. C O M M H T ~ ACTION: Accept. C O ~ S'rATEMF2qT: Subcommittee on Laboratories requests actual experience on this subject.

(Log # 105) 99- 224 - (10-8.2): Accept in Principle SUBMI'ITF.,~ Norman V. Steere, Sdilwater, MN RF.~OMMENDATION: If Section 10-8.2 is not deleted as proposed, revise the secdon to the following:

10-8.2 No laboratory or other room shall be identified with a hazard signal sign unless the area contains a significant quantity of hazardous material. No area shall be considered to conthin a significant quantity of hazardous materials unless the contents include hazardous materials in glass containers that are one gallon in size or larger, hazardous compressed gases or cryogenic liquids in containers greater than 5 in. in diameter and 15 in. m length, or dry hazardous materials in containers in excess of 5 lb. No area shall be considered to contain a significant quantity of hazardous materiah unless the quantity of hazardous materials exceeds ~ 0 lb. No laboratory or storage area shall be identified with a hazard signal sign unless hazardous materials in significant quantifies has one or more hazard ratings of 2 or greater. SUBSTANTIATION: The revised edition of NFPA 704 omits earlier language contained in Section I-8 which allowed the area hazard ratihg to be reduced if the ratings would be mideading. When a Fire Science class in Minneapplis was shown a slide of the hazard ratings of $-4-4-W on the door of a Minneapolis clinical laboratory, not one of the experienced firefighters were willing to enter the h/boratoryz

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I believe their apj~rehension was attributable to equating the hazards that would exist m a warehouse containing hazards rating 3-4-4.W with those in the laboratory, although the quantities in the laboratory were considerably less, several materials were diluted, and several were in flammable liquid storage cabinets.

Specific limitations are proposed so that the revised edition of NFPA 99 will not lead to unnecessary apprehension on approaching fires or spills. COMMITrKg Ac'rlONs Accept in Principle. Add Submitter's recommendation at the end of existing text of 10-

8.2.1, bm with the following changes: 1. Modify sentence 1 of Submitter s Recommendation to read: "No laboratory or other room shall be ~ identified

wi th . . . (rest the same)." (Change underlined) 2. At the end of sentence 3 of Submitter's Recommendation, after

"exceeds 200 pounds," add the following: "or 10 gallor/s of flammable liquids'.

COMMITTEE STATgM]gNT. I . To allow for identification of laboratory where mandated or otherwise desired.

2. To recognize hazard that 200 pounds is an excessive limit for flammable liquids.

(Log # 104) 99- 225- (10-8.2): Reject SU]SMrYTEPa Norman V. Steere, Stillwater, MN RECOMMENDATIONz Delete Section 10-8.2. SUBSTANTIATIONs NFPA 704 was revbed so that it no longer addresses the emergency health hazards of chemicais, but their inherent toxicity regardless of volatility or hazard. For this reason, aMignment of health ratings baaed on the.new definitions would give numbers in the NFPA 704 diamond that mow toxicity information and not emergency health hazards.

The second major problem is that emergency personnel are likely to treat laboratories With !figh numbers hi the NFPA 704 diamond as they would warehouses with similar numbers, and fight fires outside and from safe distances based on the ratings. If the quantities in laboratories are small or the materials diluted, the use of "warehouse firefighting precautions" are likely to prevent an emergency response that is appropriate and necessary. A third set of problems include the practical one of keeping

numbers up.to2date with chan|lln ~ procedures, and detez=mlning or inventing numbers for the majority of iaboratory chemicals which do not have NFPA committee-assigned ratings. COMMrI'IT, E ACTIONt Reject. COMMrrTEE STATEMENTs Experience of Subcommittee members on this subject shows that the use of NFPA 704 diamond is helpful to fire service personnel.

(Log # 62) 99- 226 - (Chapter 12): Reject SuBMrITERz Bryan Parker, Montefiore Medical Center RECOMM]gND&TIONz Tranffer all material related to Flammable Anesthetizing Locations to a new Annex 3 as detailed below.

1. Delete the following material from the standard: 2-2 in definition of Anesthetizing Location: words "any flammable or non-flammable'. 3-4.1.2.1 (e) (2), entire section. 3-4.1.2.2 Exception No. 2. 3-4.1.2.3(2), entire section. 3-4.1.2.4 (e) words "non-hazardous areas of flammable anesthetizing locations and". 4-7.1.2.1 words Wlammable anesthetic or other". 7-5.1.1.2 words "installed outside the hazardous area of a flammable inhalation"; substitute "in art". 7-5.1.1.5, entire section. 7-5.1.2.7, entire section. 7-5.1.2.8, entire section. 7-6.2.2.5, entire section. 12-4.1.1.2, first pmagraph, worJs "both flammable and" 12-4.1.3, entire section. 12-4.1.5, entire section. 13-4.1.3, entire section. A-2-2, entire section. A-12-4.1.3.2, entire section. A-12-4.1.3.8(b), entire section. A-12-4.1.3.8(i), entire section. A-12-4.1.3.10(a), entire section. A-12-4.5, entire section.

2. NEWANNEX3. Add anewAnnex S thus: 3.1 Introduction. 3.1.1 Forward. When the material concerningFlammable

Anesthetizing locations was first published in 1941 as a separate document, the majority of inhalation anesthetics were administered with flammable agent,. Since 1950 nonflammable anesthetics possessing relatively safe properties have been developed. By 1990 the nonfl/unmable agents had di~laced the flammable ones to the point where, with the exception of diethyl ether, the manufacture of flammable inhahtlon anesthetics had ceased worldwide. It was estimated that all existing stocks would have been used by the end of 1991. Ether may be used in the field in emergencies, but it is no longer l i l l y to be used in code compliant locations intended for the adrfiinistranon of fiammable anesthetics. Further, it has become essentially impouible to equip an operating

room to the standards for flammable anesthetizing]ocations. Electrosurgery is now ubiquitous, lasers are common, and video endoscopy takes elaborate equipment and energy producing devices into the body itself. Faced with these realities manufacturers of electrical equipment commonly used in anesthetizing locations have long since ceased to seek listing for use in flammable anesthetizing locations.

Requirements for the control of hazards associated with flammable anesthetics having become moot, they have been removed from the text of the standard.

3.1.2 Scope. This annex serves as a transition record for facilities which have maintained flammable aneathetizing locations or mixed facilities.

3.2 Recommendations The recommendations herein are in addition to the requirements

of standard NFPA 99 for all anesthetizing locations. 3.2.1 Electrical Systems 3.2.1.1 Wiring, Regular Voltage. [Copy NFPA 99, Chapter 3,

Section 5A.1.2.1 (d)(2).] 3.2.1.2 Switches. [Copy NFPA 99, Chapter 3, Section 3-4.1.2.3(2).] 3.2.1.3 Receptacles and Attachment Plugs. [Copy NEPA 99,

Chapter 3, Section 3-4.1.2.4(8 ) and (h).] 3.9.2 Environmental Systems 3.2.2.1 Ventilation - Flammable Anesthetizing Locations. [Copy

NFPA 99, Chapter 3, Section 5.4.2 and all sub paragraphs. Adjust Paragraph numbers.]

3.2.$ Electrical Equipment 3.2.3.1 Performance Criteria and Testing 3.2.3.2 Patient-Care-Related E]ecu'ical Appliances and Equipment 3.2.3.2.1 Permanently Connected (Fixed) 3.2.3.2.1.1 Grounding of Appliances. [Copy NFPA 99, Chapter 7,

Section 7-5.1.1.2] 3.2.3.2.2 Cord and Plug Connected (Portable) 3.2.3.2.2.1 Line Voltage Equipment. Fiammable Anesthetizing

Locations. [Col~ NFPA 99, Chapter 7, Section 7-5.1.2.7] 3.2.3.3 Admimstration [copy NFPA 99, Chapter 7, Section 7-

6.2.2.5] 3.2.4 Manufacturer Requirements 3.2.4.1 Flammable Gases [Copy NFPA 99, Chapter 9, Section 9-

2.1.14] 3.2.5 Hospital Requirements 3.2.5.1 Requirements for Flammable Anesthetizing Locations.

[copy NFPA 99, Chapter 12, Section 12-4.1.3 and all sub paragraphs. Adjust paragraph numbers]

3.2.5.2 Requirements for Mixed Facilities. [copy NFPA 99, Chapter 12,Section 12-4.1.5 and all sub paragral~hs. Adjust paragraph numbers]

3.2.8 Amlmlatory Health Care Facility Requirements. 3.2.6.1 Electrical Systems 3.2.6.2 Requirements for Flammable Anesthetizing Locations.

[copy NFPA 99, Chapter 13, Section 13-4.1.3]. Aim delete the first sentence: Whis section does n o t . . , flammable agents'.

3. General: Throughout the new Annex 3 change "shall" to "should ".

4. References: l . Wilkinson, J.D., Wlammable anaesthetics to be discontinued',

Anesthesia News, No. 38, September 1990, p. 1. _ 2. Taber's Cyclopedic Medical Dictionary, Ed. Thomas C.L., Edition 16. 1989, F.A. Davis, Philadelphia. SUBSTANTIATION: a. This proposal is submitted in response to the NFPA request to make documents more tater friendly, and to remove extraneous material.

b. When the material concerning Flammable Anesthetizing Locations was firstpublished in 1941 as a separate document, the majority of inhalanon anesthetics were administered with flammable agents. Since 1950 nonflammable anesthetics possessing relatively safe properties have been developed. By 1990 the nonflammable agents had displaced the flammable ones.

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N F P A 99 - - F92 T C R

Note 1 The use of cyclopropane, the last generally used flammable anesthetic, has diminished over the past twenv/yea~_ to the point where production, worldwide, has been dhconunued. CycIopropane has not been sold in North America for more than three years. It llas been estimated that practically all stocks have now been used. i Note 2 Diethyi ether, .l~-vioudy used in a~esthesia, causes

postoperative nausea and profuse salivation . Anesthetic ether is rarely used and almost never in code compliant locations intended for the administration of anesthetics. Faced with this reality manufacturers of electrical equipment

commonly used in anesthetizing - locations have long[ iince ceased to seek listing for use in flammable anesthetizing locations. Thus it has become essentially impossible to equip an operating room to the standards for flanunal~le anesthetizlng locations. Pfirther electrosurgery is now ubiquitous, iasei's are common, and video endoscopy takes elaborate equipment and energy producing devises into the body itself. Most of these devices are inherently potential sources of ignition for flammable anesthetics.

The pr indp~ training centers for anesthesiologists no longer give instruction m the use of flammable anesthetics.

c. If retained within the body of standard, the volume of verbiage concerning flammable Anesthetizing Agents may lead to misunderstandings concerning its need. Over-specification is an unnecessary econonuc burden.

d. Therefore there is every reason not to clutter the standard with obsolete requirements.

e. However, in order to retain reference material during a transition period, the committee may wish to retain the subject matter in an annex of NFPA 99. C O M M 1 T I ~ ACTION~ Reject. C oMMrr rF~ STATEMENT: NFPA 99 is used internationally, and flammable anesthetics are still used out ,de the U.&

(Log # ANE-4) 99- 227 - (12-4.1.1.4(d)): Accept $UBMrrrER: Subcommittee on Anesthesia Services RECOMMENDATION: Revise "adopt adequate regulations" to read: "adopt regulations', SUBSTANTIATION: Editorial. COMMITTEE ACTION: Accept.

(Log # 183) 99- 228- (12-4.1.2.3): Reject S U B ~ Hy Bershad, Hospital Engineering Society of Greater New York RECOMMENDATION: Why is this section included? For safety p_m'p0ses suggest the following: 12;4.1.2.8 Smoking and open flames shall be prohibited in all

patient care areas and areas where flammable materials are present. SUBSTANTIATION: @ Limiting "No Smoking" to anesthetizing areas was applicable in days of flammable anesthetics.

@ Smoking is a hazard to all patients, staff and visitors. @ Many hospitals prohibit smoking throughout their facility not

only in anesthetizing locations. C O M M r r Y ~ ACTION: Reject. COMMrITEE STATEMENT: I. There are still flammable ignition sources used in anesthetizing locations.

2. Individual health care facilities have to determine their own policies on smoking.

(Log # 152) 99- 229 - (12-4.1.2.3): .Reject S I . ~ 1 ~ Barry Duignan, Greater New York Hospital Associa- tion RECOMMENDATION: Why is this section included? For safety purposes sugges,st the following:

12-4.1.2.8 Smoking and open flames shall be prohibited in all patient care areas and areas where flammable materials are present. SUBSTANTIATION: @ Limiting "No Smoking" to anesthetizing areas was applicable in days of flammable anesthetics.

@ Smoking is a hazard to all patients, staffand visitors. @ Many hospitals prohibit smoking throughout their facility not

only in anesthetizing locations.

COMMrrrEE ACTION: Reject. COMMrIT]EE S T A ~ : Proposal is identical to Proposal 99- 228 (Log #185).

(Log # HGH-I) 99- 250 - (12-4.1.2.10): Accept SuBMrrrER: Subcommittee on the Use of High Frequency Electricity RECOMMENDATION: Insert new Section 12-4.1.2.10 "Fire Loss Prevention'.

12-4.1.2.10 Fire Loss Prevention. (a) Hazard Auessment. (i) An evaluation shall be made of hazards that may_ be encoun-

tered during surgical procedures. The evaluation shall include hazards associated with the properties of electricity, hazards associated with the operation of surgical equipment, and hazards associated with the nature of the environment.

(fi) Periodic reviews of surgical operations and procedures shall be conducted with special attention given to any change in materials, operations, or personnel.

(b) Irtre Prevention Procedures. Fire prevention procedures shall be established.

(c) Emergency Procedures. (i) Procedures for ope.rating room/surgical suite emergencies

shall be developed. Such procedures shall include alarm actuation, evacuation, and equipment shutdown procedures, and providons for control of emergenaes that may occur in the operating room including specific detailed plans for control operation~by an emergency control group within the organization or a public fire department.

Cd) Emergency procedures shall be established for controlling chemical spills.

Off) Emergency procedures shall be established for extinguishing drapery, clothing or equipment fLres.

(d) Orientation and Trkining. (i) New operating room/surgical suite personnel shall be taught

general safety practices for the area, and specific safety practices for the..equipmen~. . and procedures.they will u ~ . . . . -

(u) Continuing safety educauon and superv~on shall be provided, incidents shall be reviewed monthly, and procedures shall be reviewed annually.

(ili) Fire-exit drills shall be conducted periodically. SUBSTANTIATION: I. Subcommittee on Use of High Frequency Electricity is responsible for those electrical appliances that are most likely to be ignition sources in anesthetizing locations.

2. Proposalresponds, in part, to Proposais 99.195 (Log #161) and 99-$35 (Log #I$$), which recommend fire and life safety training. COMMITYEE ACTION: Accept.

(Log # ~_..2) 99-281 - (12-4.1.5.8(b)(7)(iv) Note): Accept SUBMrYI'ER: Subcommittee on Anesthesia Services RECOMMENDATION: Revise "shaft be considered" to read: "may be considered'. SUBSTANTIATION: Conform to NFPA Style Manual for informatory text. COMMITYEE ACTION: Accept.

(Log # ~V.,-S) 99- 282 - (12-4.1.8.8(d)(4) Note): Accept SUBMrYrER: Subcommittee on Anesthesia Services RECOMMENDATION: Revise sentence 2 ("Regular materials . . . ' ) to read:

"Any material may be employed if clearly nonhazardous owing to improbability of acquiring and holding a significant charge, e.g., suction catheter, endotracheal tube, plastic inserts injoint ~UBSTANTIATI r°theses'"

ON: Ciarif 7 when certain material can be used. COMMITT~ ACTION: Accept.

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NFPA 99 -- F92 TCR

(Log # A~-5) 99- 2S$ - (12.4.1.5.2(b)): Accept S ~ Subcommittee on Anesthesia Services RECOMMgNDATION: Revise 12-4.1.5.2(b) to read as follows:

(b) Nonflammable anesthetizing locations shall be designed, constructed and equipped as stated in 12-4.1.2 and 12-4.1.4. SUBSTANTIATIONs Correlate with wording used in 12-4.1.5.2(a), and conform to NFPA Style Manual. COMMrrrEE ACTION: Accept.

(Log # 1o6) 99- 234- (12-4.2): Accept SUBMITrER: Norman V. Steere, Stillwater, MN RECOMMENDATION: 1. Revise Section 12-4.2 to read as follows:

12-4.2 Laboratories in hospitals shall comply with the requirements of Chapter I0 as applicable and the requirements of NFPA 45 as a plicable. ~. Add an Appendix A-12-4.2 to read as follows: A-12-4.2 NFPA 45, Fire Protection Standard for Laboratories Using

Chemicals, establishes basic requirements for all laboratories using chemicals, but important additional requirements are contained in Chapter 10 and in Chapters 4, 5, and 7. S ~ A N T I A T I O H : NFPA 99 does not contain comprehensive requirements for laboratories using chemicais. In addition to establishing general requirements that should be applied to all laboratories using chemicals, NFPA 45 addresses issues of venfiladon and flammable liquids that are not covered adequately in NFPA 90 and91 or in NFI'A S0. COMMrrrEE ACTION: Accept.

(Log # £SE.4) 99- 255 - (lS-5.5.2): Accept SUBMITrE~ $ubcomrmttee on Electrical Systems RECOMMENDATION: 1. Revise 155.5.2 to read as follows:

15-5.5.2 Essential Electrical Distribution System. The essential electrical distribution system shall conform to a Type I system as described in Chapter 5 if critical care areas are present in the facility. Otherwise, the essential electrical distribution system shall conform to a Type HI system as described in Chapter S.

2, Delete 13-3.5.2.1. SUBSTANTIATION: I. Ambulatory health care centers require a Type I essential electrical distribution system only if critical care areas are present. Otherwise, a Type III system is acceptable.

2. Paragraph I~-5.5.2.1 is deleted because ~.2 .4 .5 allows a battery powered s~mm integral with equipment. C O ~ ACTION: AccepL

(Log # TC-1) 99- 256 - (IS-S.4.$; IS-S.4.4): Accept SUBMITTER: Technical Committee on Health Care Facilities RECOMMENDATION: 1. Revise 13-5.4.5 to read the same as 12- 3.4.3, i.e.,15-S.4.$ Patient piped vacuum systems shall conform to 4-7 through 4-10.

2. Revise 18-5.4.4 to read the same as 12-3.4.4, i.e.,IS-3,4.4 Laboratory piped vacuum systems shall conform to 4-7 through 4-10. SUBSTANTIATION: Ambulatory care centers have similar vacuum systems to those of hospitals, with the same level of hazards. Therefore, these systems should meet the same requirements as those in hospitals. C O M M r r r ~ ACTION: AccepL

(Log # HGH-2) 99- 257 - (1~-4.1.2.10): Accept SUBMITIT, ga Subcommittee on the Use of High Frequency Electricity RECOMMENDATION: Add new Section 15-4.1.2.10 as follows:

15-4.1.2.10 Fire Loss Prevention. The requirements of 12-4.1.2.10 shall apply. SUBSTANTIATION: Fire hazards in ambulatory health care center anesthetizing locations are now approximately the same as those in hospitais. COMMITrEE ACTION: Accept.

(Log # 107) 99- 258 - (13-4.2): Accept SUBMITYF~ Norman V. Steere, Sfillwater, RF.,COMMENDATIONt Revise Section 15-4.2 to read as follows:

15-4.2 Laboratories in ambulatory health centers shal/comply with the requirements of Chapter I0 as applicable and the requirements of NFFA 45 as applicable. Add an Appendix A-19-4.2 to read as follows: A-15-4.2 NTPA 45, Fire Protection Standard for Laboratories Using

Chemicals establishes basic requirements for all laboratories using chemicals, but imp?rtant additional requirements are contained m Chapter 10 and in Chapters 4, 5, and 7. SUBSTANTIATION: NFPA 99 does not contain comprehensive requirements for laboratories using, chemicals. In addition to establishing general requirements that should be applied to all laboratories rising chemicals, NFPA 45 addresses issues ofventiladon and flammable liquids that are not covered adequately in NFPA 90 and 91 or in NFPA S0. COMMITYF~ ACTION: Accept.

(Log # £sE.5) 99- 239 - (14-5.5.2): Accept SUBM/'ITE~ Subcommittee on Electrical Systems RECOMMENDATION. 1. Revise 14-5.5.2 to read as follows:

14-5.5.2 Essential Electrical Distribution System. The essential electrical distribution system shall conform to a Type IT[ system as described in Chapter $.

Exception: If electrical life support equipment is required, the essential electrical distribution system shall conform to a Type I system as described in Chapter 3 .

2. Delete 14.5.3.2.1. SUBSTANTIATION: The reasons given in the Committee Statement for Proposal 99-244 (Log #77) are applicable for a clinic as well. CoMMrI 'rKE ACTION: Accept.

(Log # 108) 99- 240 - (14-4.2): Accept SUBMITrER: Norman V. Steere, Sdllwater, MN RECOMMENDATION: 1. Revise Section 14-4.2 to read as follows:

14-4.2 Laboratories in clinics shall comply with the requirements of Chapter 10 as applicable and the requirements of NFPA 45 as applicable. 2. Add an Appendix A-14-4.2 to read as follows: A-14-4.2 NFPA 45, Fire Protection Standard for Laboratories Using

Chemicals establishes basic requirements for all laboratories using chemicals, but important additional requirements are contained in Chapter 10 and in Chapters 4, 5, and 7. SUBSTANTIATION: NFPA 99 does not contain comprehensive requirements for laboratories using chemicals. In addition to establishing general requirements that should be applied to all laboratories using chemicals, NFPA 4.5 addresses issues of ventilation and flammable liquids that are not covered adequately in NFPA 90 and 91 or in NTPA S0. c o M M r r r ~ ACTION: Accept.

(Log # 77) 99- 241 - (15.S.S.2): Accept in Principle SUBMrITER: Leo G. Foxweli, Hartford, CT RECOMMRNI)ATION: Change paragraph 1.5-3.3.2 to read:

~ 'he essential electrical distributaon tern shall conform to the Type III system as described in Chapter S i f ~ conscious sedation anesthetics are used or . . .cont inue." SUBSTANTIATION: General dental practice uses nitrous oxide as means to relax the patient but not completely sedate patient to unconsious state; these devices are independent of electrical power and a power failure does not endanger patient.

However, where unconsious sedation is practiced such as in oral surgery, the system should be Type I. COMMITYF~ ACTION. Accept in Principle.

1. Revise 15.5.S.2 to read as follows: 15-3.$.2 Essential Electrical Distribution System. The essential

electrical distribution system shall conform to a Type HI system as described in Chapter 5.

Exception: If electrical life rapport equipment is required, the essenual electrical disuibution system shall conform to a Type I system as described in Chapter 5 .

2. Delete 15-5.3.2.1.

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NFPA 99 - - F92 TCR

COMMrrTEE STATEMENT: I. Reference to the use of inhalation .an. es..theticJ as a determination of the type of euential electrical distribution system required is eliminated because the need for elec.trical power in an emergency (i.e., loss of normal power) is not an electrical life safety issue as it relates to the nee& of a patient under any type of anesthesia in a medical/dental office. Lighting is the mint cru~tl item, and this is adclrem.-d with a Type HI system. The nudn electrical concern is with electrical life support equipment, and ~ is addressed with the Exception in Coinmittee Action 1.

2. Paragraph 15-3.3.2.1 is deleted because S-4.2.4.S allows a battery powered syltem integral with equipment.

99- 242 - (15-3.3.2): Accept in Principle (Log # 43) SUBMrI'rER: Louis Pouletsos, FireMarshah Benevolent Associa- tion RECA)MMENDATION: ']'he following is idea for content, it is by no means a pmpoud.

15-3.3.2 Exception to Type I System: Dental and medicalpracflces that provide on an outpatient basis, treatment as described-in the note following 3-4.2 for not more than 3 persons simultaneously, where the staff to patient ratio is 1:1 and all provisions of this note are met. SUBSTANTIATION: Section 15-3.S.2 calls for a Type I essential electrical system in a dentists office where oral surgery is performed usin[[ general anesthesia. Type I systems as described in Chapter 3 re¢!mre automatic generators, special branch circuits, trander switches etc. The "Disomion" at Section 3-4.2 appears to allow battery operated systems as the alternative source of _power. Section 3-4.2.2.1 describes general requirements for "I-Iospital Operation'.

Due to the nature of the dental office and the limited number of under, or recovering from anesthesia, we believe their

illties should be addressed separately. If staff to patient ratios are addressed together with e qulpmentprovided with battery backup and emer~ncy lighting, tile mfe andorderly cemtion of procedure can be pe/'formed" and the person can be evacuated.

G e n e r a . we are speaking about an office where no more than 8 persons will be under the fidluence of general anestheda (NFPA 101-1988, Section 12-1.3B) and therefore classified as a business occupancy. All other requirements of Chapter 15 of NFPA 99 will be in e/~ect. COMMITFF~ ACTION: Accept in Principle. COMMrl'I 'F~ STATEMENT: See Comnmtee Action on Proposal 99-241 (Log #77) since it addresses this issue.

(Log # 78) 99- 243 - ( 1 5 - 3 . 4 . 3 ) : Reject SUBMrI 'I 'E~ Leo G. Foxwell, Subcommittee on Nonflammable Medical Piped Gas Systems RECOMMENDATION: Reserved should be restated to read:

Dental vacuum systems shall conform to paragraph 4-7.2.2. SUBSTANTIATION: The pro _p_osed new 4-7.2.2 fieeds to be referenced in Chapter 15-3.4.3 [see proposal 99-146 (Log #76)]. COMMITTEE ACTION: Reject. COMM1TYEE STATEMENT: Because of Committee Action rejecting Propoml 99-146 (Log #76), there is no material to reference.

(Log # # ~ - 1 5 ) 99- 244 - ( 1 9 - 1 . 1 . 1 ) : Accept SUBMITI'E]~ Subeommlttee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Add to paragraph 19.1.1.1 the following:

"Recently however, the level of knowledge and expertise has increased so dramatically that the codes are in need of updating. By the end of 1988, there were 218 hyperbaric facilities in operation in the United States and Canada. Th~.~se facilities have supported hyperbaric medical treatments for 62,546 patients from 1971 to 1987. As these facilities provide therapy for disorders indicated for treatment, these numbers will continue to increase. As the number of facilities increase, the patients treated will also increase." SUBSTANTIATION: Brings history of hyperbaric medicine up to date. COMMITTEE ACTION: Accept.

(Log # H~.le) 99- 245 - (19.1.2.1 NOTE): Accept SURMITTEI~a Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise NOTE to read as follows:

NOTE: Much is known about the safe annlication ofhvoerbarie medicine for the nrotection of hardware.- nermnnel and facilities. Nonethe]ess. as new medical instrhmentadon and en~ineerin~ technioues are develoned, new mfetv issues will cofitinue t~arise. Conseouenflv, the-Subcomm|ttPe on Hyper- baric and Hwobaric Fac'dities believes that this nublication-ls needed for ~eneral mddance in areas of tec.hnoloaical chan~f and uncertafntv as well as for firm reauirements in-areas where the technolo~v is well understood and stable. Comments based on continuing experience are solidted so that ~ chapter may be revised f ~ m time to time. [Change Underlined]

SUBSTANTIATION: It was felt that the previous "Note" left the impression that we are still in the "dark ages" of the discipline. The recommended "Note" leaves a more positive attitude. COMMrrTEE ACTION: Accept.

(Log # HYP-17) 99- 246- (19-1.2.2) (New)): Accept SUBMT/TEga Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Transfer 19.2.10.3 here, and renumber it as 1 9 . 1 . 2 . 2 . SUBSTANTIATION: More appropriate location in chapter for thb material. COMMITTEE ACTION: Accept.

(Log # H~.18) 99- 247 - (19-1.4): Accept SU~MITYE~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise sentence 1 of 19-1.4 to read as follows:

"This chapter shall be applied only to the following: new construction; new equipment added to new facilities; new equipment added to existing facilities." SUBSTANTIATION: In reality, this standard should be applied to all h~)erbaric systems. There ts no way existing facilities can be reqmred to comply with new changes in the code. This change will ensure, however, that any changes made to an existing facility, when for purposes of normal equipment replacement or for intentionkl changes in facility design, will meet current safety standards. COMMITYEE ACTION: Accept.

(Log # 7) 99- 248- (19-2.1.1): Reject SUBMITYEga PauiJ. Sheffield, Office of the U.S. Air Force

C'eneral ON. Request that pro .1.1.1.~ 99-261 (Log #47) in

the TCR for 1989 Fall Meeting be accepted. SUBSTANTIATION: The purpose of this proposal b to provide for equal fire safety treatment of Clau A and Class B chambers. If there is a valid requirement for two-hour separation construction, the requirement should apply equally to multiplace Class A chambers and monoplace Class B chambers. We have consulted the Air Force hyperbaric facility experts at USAFSAM, Brooks AFB, TX, and the Navy hyperbaric cerKfication experts at the NAVFAC System Certification Authority, Alexandria, VA, and we can find no rationale tojus~-y different safety standards based on number of chamber occupants. Thus, we take exception to the Committee statement as follows:

(a) The "Stringent Exception" referred to in the Committee Statement is not unique to Clau B chambers. Class A chambers also comply with the "Stringent Exception. Since both Class A chambers and Class B chambers present the same undo hazard m those in surrounding rooms, Class B chambers should not be exempted if there is a valid requirement to have two-hour separation construction.

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(b) Sub6equent to the writing of this standard, the application of Class B chambers has changed. Some Class B chambers have been used for more than one occupant (1). Some Class B chambers are now equipped with ventilators or oxygen mash that enable patients to be treated at greater pressure (2-8.$ ATA) and on intermsttent air breathing (2,3).Hyperbaric oxygen therapy litermre has carried several recent articl~ encouraging the treatment of air embolism and decompression sickness in C I ~ B chambers (4,5). The current thrtmt for O.ass B chambers to treat air embolism and decompression sickness cases prevents the chamber from rapidly ascen~mg to the surface, making the ascent time the same as Class A chambers. Regardleu of the type of chamber, rapid ascent of a decompression siclmess or air embolism patient will have the same negative outcome. Thus, the room in which either a Class A or Class B chamber b located requires the same protection from fires outside the room. The followfng references di:scribe the changes in me of monoplace Class B chambers that make their me more like multiplace Class A chambers. If there is a valid recjuirement for two- hour separation construction, the current expanding me of Clau B chambers preclude their exemption from the Lequirement.

1. Martorano, FJ and Hoover, D. The Child Hyperbaric Patient. J. Hyperbaric Medicine 1986:1(1):15-21

2. Weaver LK. Air Breaks with the Sechrist 500A Monoplace Hyperbaric Ventilator. J . Hyperbaric Medicine 1988 3 (3) :179-186.

3.- Raleigh, G.W. Air Breaks in the Sechrist Model 2500B Monoplace Hyperbaric Chamber. J. Hyperbaric Medicine 1988 3(1):11-14 4. Hart, GB, Strauss, MB, and Lennon, PA. The Treatment of

Decompression Sickness and Air Embolism in a Monoplace Chamber. J. Hyperbaric Medicine 1986, (1):1-7

5. Kindwall, E.P., Goldmann RW and Thombs PA. Multiplace Chamber in the Treatment of Diving Diseases. J. Hyperbaric Medicine 1988 (3) ( 1 ) 5 . ] 0

[Copies available from Secretary, NFPA Standards Council, NFPA Headquarters.] COMMr'ITEE ACTION: Reject. COMMITTEE STATEMENT: Evacuation of patients from Class B chambers can be accomplished relatively quickly in comparison to Class A chambers for fires external m the chamber.

[Secretary's Note: Original proposal (99-261 in TCR Fail 1989 Meeting) recommended adding and Class B after ~Clmm A" in line 1 of 19-2.1.1.]

types of chambers. Time has shown that Class B chambers are being U/ed more like ~ A chambers and, as such, should not be exempt from the requirement.

(c) This office has conferred with the Office of Device Evaluation of the Food and Drug Administration reSasxting this issue. It is th.e opinion of a reviewer in that office that me sta:n, dards should not t~e b ~ l on the type of chamber in operation; satety standards should be equally appfied, C o M M r r r E E ACTION: Reject. COMMITTEE STATEMENT: Recommendation is the same as for Proposal #99-14 (Log #7). , . _

[Secretary's Note: See Secretary s ~ote tor Proposal 99-14 (Log #7).

(Log # 9) 99- 250- (19-2.1.1.2): Accept S U B ~ Paul]. Sheffield, Office of the U.S. Air Force Surgeon General

I RECOMMENDATION: Request . t~t Propo~. 99-262 (Log #49) in the TCR for the 1989 Fall Meeting ~e acceptea. SUBSTANTIATION: The purpose of this-propo~ is to provide for equal fire safety treatment of Cling A and ~ B chambers. If there is a valid requirement to reserve a room exclusively for the use of a chamber, we see no difference in the fire safety requirement for multiple occupancy Class A chambers and single occupancy Class B chambers. Subsequent to the writing of this standard, new chamber designs were introduced that challenge the currently accepted designation of Class A and Class B cham..bers. For example, some models of Class A chambers for two to tm'ee occupants are portable. Conversely, Dr. George B, Hart, former president of the Undersea and Hyperbaric Methrcal Society, has reported that, on occa~.ion, treatments in ~ B chambers have in~Juded an infant and an adult, which, under the current definition, would classify it as a Class A chamber. Article by Martotano and Hoover (1986) is available for review from NFPA Headquarters. We feel that the presence of a second chamber occupant has no bearing on the exclusive me of the room. If there is a valid requirement for exclusive me of the room for hyperbaric chambers, the rule should apply equally to Class A and Class B chambers, whenever the chamber is present. COMMrrrEE AGWIONs Accept.

[Secretary's Note: Original Proposal (99-262 in TCR for Fall 1989 Meeting) recommended adding "or Cling B" after "Class A" in line 1 of 19-2.1.1.2.]

(Log # 8) 99- 249- (19-2.1.1): Reject S ~ Wilbur T. Workman, USAF School of Aerospace Medicine RECOMMENDATION: Request that Proposal 99-281 (Log #47) in the TCR for 1989 Fall Meedng be accepted. SUBSTANTIATION: It is the intent of this proposal to provide for the equal treatment of Class A and Class B chambers with regards to fire safety. Assuming the requirement for a two-hour separation construction is a valid one, there should be no differentmtion based on the type of chamber and therefore, ~ A and Class B chambers should be treated equally. Historically, this distinction has been based upon the number of occupants the chamber can accommodate. This office cannot understand the basis for this position. With specific reference to the Committee Statements on this

proposal, the following exceptions are noted: (a) What differentiates Class A and Class B chambers when both

chambers routinely comply with the "Stringent Exception" cited in p ~ p h 19-2.1.2 of the Code? Class A chambers comply with the reqmrements for discharge of effluent gases. Therefore, m this regard, both chamber types are installed using the same criteria. As a result, the hazards presented to those in adjacent areas is equivalent. If there is a valid requirement for the two-hour construction sepatation, then Class B chambers should not be exempt.

(b) With increasing numbers of Class B chambers being placed into operation throughout the country, it is a logical progression that they be used to treat a greater variety of disorders. .~ more critical patients are bein~ treated in these types of chambers, some treatments actually requiring an inside medical attendant (for example in the treatment of infants and small children in clau B chambers). Many of these chambers are even being retrofitted to allow the chamber to be pre~,urized with compressed air, with 100 percent oxygen being administered to the pauent via an oro-nasai mask. In this conf~,ur.a, tion, the concept of oxygen delivery to the patient is the same m both chamber classificati6ns. Use of Class B chambers in this manner puts them into the same operational mode as Clau A chambers with the same decompression limitations. In such a case, the amount of ~me to safety decompress the air embolism or decompression sickness patient is the same for both

(Log # 10) 99- 251 - (19-2.1.1.2): Accept 8UBMITrF.2g: Wdbur T. Workman, USAF School of Aerospace Medicine

I RECOMMENDATION: Request Proposal 99-282 (Log #46) in the TCR for the 1989 Fail Meeting be accepted. SUBSTANTIATION: The intent of this proposal is to provide for equal fire protection of Class A and Class B chambers. The argument that ~ B chambers are portable is not valid. There are increasing numbers of Clau A chambers that are also portable (supporting material available for review at NFPA Headquarters). It has been reported in the literature that Class B chambers are being used more llke Class A chambers (supporting material available for review at NFPA Headquarters). Applying the strict chamber classification criteria, ~,hen Class B chambers are used in this manner, they become Class A chambers. The number of chamber occupants has no bearing on the exclusive use of the room, nor does the portability of the chamber. If the requirement for the exclusive use of a room for hyperbaric purposes is valid, then there should be no exception with the Code applying equally to both chamber types. COMMITTEE ACTION: Accept.

I [Secretary's Note: See Secretary's Note for Proposal 99-250 (Log #9) .

(Log @ HYP.19) 99- 252 - (19-2.1.1 .2): Accept SUBMITTER: Subcommittee on Hyperbaric and Hypobaric Facilides RECOMMENDATION: Rev~ 19-2.1.1.2 to read m follows:

19-2.1.1.2 The room or rooms homdng Class A orB chambers and service equipment ~ s h a l i be for the exclusive use of the hyperbari~ operation. [Changes Underlined] SUBSTANTIATION: (1) Committee feels that Class B chambers be housed in rooms segregated from other use areas. (2) Phrase deleted to avoid cross reference to chamber housing issue. COMMITTEE ACTION: Accept.

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N F P A 99 - - F92 T C R

(Log # 11) 99- 253. (19-2.1.2): Accept in Prindple SUBMI3WER: W'dbur T.Workman, USAF School of Aerospace Medicine RECOMMENDATION: Request Proposal.99-264 (LOg #48) in the TCR for the 1989 Fall Meeting be acceptect. SUBSTANTIATION: Given the am~mption that the "Exception" cited in paragraph 19-2.1.2 is valid, it shouldapply to both Class A and ~ B cha/nbers. The vast majority of Cra= A chambers also comply with ~ Exception. The Committee Statement referred to the fact that Class B chambers have shown to have a reasonable level of safety. This is aho true for ~ A chambers. This office knows of no evidence indicating that Class B chambers are any more safe than Class A chambers. The rationale presented for Proposal 99-249 (LOg #8) also applies to thisproposal. C O ~ ACTION: Accept in Principle. See l'ropma199-257 (Log #HYP-20).

COMMrrTEE STATEMENT: Proposal 99-257 (Log #HYP-20) deleted 19-2.1.2.

[Secretry's Note: Original Propo_sal (99-264 in TCR for 1989 Fall Meeting) recommended deletizig Exception to 19-2.1.2.]

(LOg # 12) 99- 254. (19.2.1.2): Accept in Principle s t m ~ r T ~ P~ulj. Sh/~ffield, Office of the U.S. Air Force

on General MMENDATION: Request that Proposal 99-264 (Log #48) in

TCR for 1989 Fall Meeting be accepted. SUBSTAHTIATION: The purpose of this Proposal is to provide for equal fire mfety treatment of Class A and Class B chambers. If there is a valid justification for the -F~ception," it should apply to both Class A and Class B chambers. Like some portable Class B chain- bent, most Class A chambers also meet the requirements of this Exception. Like Class B chambers, Class A chambers have also been shown to provide a reasonable level of safety. In a thorough review of all hyperbaric chamber fires documented since the first NFPA hyperbai-ic facility safety code was implemented 1970, we fail to find any correlation between numbers of chamber occupants and level of safety. We also fail to find any evidence that Class Bchambers prowde a level of safety any better than Class A chambers. In the absence of addresting Class A chambers that would qualify under the W_.xception," we feel that it is inappropriate to grant exceptions to Class B chambers, whose level ofmfety is no better than Class A chambers. Our rationale for recommending acceptance of Proposal 99-249 (Log #8) is also considered applicable to this proposal. COMMrrTF, E ACTION: Accept in Principle.

See Proposal 99-257 (Log #HYP-20). C O M M r l ' r ~ STATEMENT: Same as Proposal 99-253 (Log #11).

[Secretary's Note: See SecretmT's Note for Proposal 99-253 (Log #11).

(Log # IS) 99- 255 - (19.2.1.2): Accept in Principle SUBMrrrER: PaulJ. Sheffield, Office of the U.S. Air Force

u ~ e o n General OMMENDATION: Request that Proposal 99-265 (LOg #6) in

TCR for 1989 Fall Meefin 8 be accepted. SUBSTANTIATION: The pro-pose of this proposal, is to provide for equal fire safety treatment of Class A and Class B chambers. If there is a valid requirement for sprinkler protection in rooms housing

A chambers, the requirement should also apply to Class B chambers. We fail to =ee a correlation between th/: number of chamber occupants and the need for protection of life and property. We take exception to the Committee Statement in Proposal 99-261 (Log #47): "For Class A chambers, operation may have to continue to a longer period of time than Class B chambers. Thus, the room in whiclx C l ~ A chambers are located require greater protection from fires outside the room. . . " Subsequent to the writing of thls standard, the concept of use for Class B chambers has changed to include the treatment of decompression sickness and air embolism patient=; making ascent rates of CL~s B chambers more like those of CIS~ A chambers. Articles by GB Hart et al (1988) and Ep Kindwall et al (1988) are available for review at NFPA Headguarters. Thus we feel that the requirement for sprinkler protection m the room should be the same for Class A and Class B chambers. Our rationale for recommen "ding acceptance of Proposal 99-249 (Log #8) is also considered applicable to this propma/. COMMI'rrEZACTION: Accept in Principle.

See Proposal 99-257 (Log #HYP-20).

COMMITTEE STATEMENT= Same as Proposal 99-253 (Log #II) . [Secretary's Note: Original proposal (99-26,5 in TCR for 1989 Fall

Meeting) recommended deleting some text in Exception to 19-2.1.2. Current Proposal 99-257 (Log #HYP-20) deleted 19-2.1.2.

(Log # 14) 99- 256 - (19-2.1.2): Accept in Principle SU'BMrrI'E~ Wilbur T.Workman, USAF School of Aerospace Medicine RECOMMENDATION: Request that Proposal 99-265 (Log 06) in TCR for 1989 Fall Meetin 8 be accepted. SUBSTANTIATION: A~ initiallyproposed, this suggestion was to provide for the equal fire protecu~on for both Class-A and ~ B chambers. With Class B chambers now being used more like Class A chambers (e.g., for the treatment of air emb~3lism and decompression sickness with modifications for oxygen administration vla a vast delivery system), the same operational limitations apply as they do for ~ A chambers. Of spL-cific note here is the decompreuion requirements incurred by the patient when he/she has been treated in a Class B chamber as configured. If the requirement for sprinkler protection is valid, it should apply to both types of chambers. The rationale provided for P r o p o ~ 99-249 (Log #8) aim pertains to this proposal. COMMITTEE ACTION' Accept in Principle.

See P r o p o ~ 00-257 (Log #HYP.20). COMMITYEE STATEblENT: Same as Proposal 99-253 (Log #11). [Secretary's Note: See Secretary's Note to proposal 99-255 (Log

13)].

(Log # ~'~'-20) 99- 257 - (19-2.1.2): Accept SUBMITrF~ Subcomn~tee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Delete 19-2.1.2, including Exception. SUR~ANTIATION: I. All Class B chambers fabricatedof nonmetallic pressure-containing components are constructed according to ANS/PVHO-I. Therefore, the Exception in 19-2.1.2 is no longer needed in as much as all Class B chambers are required to be vented to the exterior of the building (per 19-2.10.2).

2. Because operating procedures of Class B chambers allow for ready removal and evacuation of the single patient in the chamber from the area of use, sprinkler protection for the room in which Class B chamber(s) are operaung is not deemed necessary (in so far as it relates to a Class B cl~amber). COMMITIT~ ACTION: Accept.

(Log # 15) 99- 258- (19-2.1.3): Reject SUBMITrF..R= PaulJ, Sheffield, Office of the U.S. Air Force SR OonGeneral

MMENDATION= Request that Proposal 99-266 (Log #7) in TCR for 1989 Fall Meeting be accepted. SUBSTANTIATION= The purpose of this proposal is m provide for equal fire safety treatment of Class A and Class B chambers. If there is a valid reason for sprinkler protection of rooms in which Class A chambers are located, then the rule would seem to also apply to Class B chambers. Like most Clau B chambers, most Class A chambers comply with the "one stringent exception" referred to in the Committee Statement. Thus, there exists a double standard for hm~ecerbaric chambers, depending on the number of occupants.

Class A chambers aho comply with the "one stringent exception', the rationale for exempting Class B chambers from sprinkler protection requirement m not clear. Our rationale for acceptance of Proposal~J-249 (Log #8) is also considered applicable to th~ proposal. C O M M r r r l ~ ACTION: Reject. COMMITYEE STATEMENT: Same issue as Proposal 99-248 (Log #7) in this TCR. Rejected for same reason.

[Secretary's Note: Original proposal (99-266 in T CR for NFPA 1989 Fall Meeting) recommended adding "or Class B after ~lass A" in sentence 1 of 19-2.1.3.]

289


(Log # 16) 99. 259- (19-2.1.3): Reject SUBMITYEga W'dbur T. Workman, USAF School of Aerospace Medicine RECOMMENDATIONs Request Proposal 99-266 (Log #7) in TCR for 1989 Fall Meeting be accepted. 8 ~ A N T I A T I O N ~ Given the fact that Clam A chambers also comply with the "Exception" referenced in the Committee State- ment, the validity of requiring sprinkler protecdon for Class A chambers and not requiring the same level of protection for Class B chambers is not clear. Basing the requirement on the number of chamber occupants is not felt to be valid. There appears to be a double standard in this area. The rationale presented for Proposal 99-249 (Log #8) also applies to this comment. CoMMrlTEE ACTION: Reject. COMMrrrF~ STATEMENT; Same issue as Proposal 99-248 (Log #7). Rejected for same reason.

[Secretary's Note: See Secretary's Note for Proposal 99-258 (Log #15).3

(Log # m,P.21) 99- 260- (19-2.1.5): Accept 8UBMrrrF.J~ Subcomnnttee on Hyperbaric and Hypobaric Facilities RECOMMF2qDATION: 1. Revise 19-2.1.3 to read as follows:

19.2.1.3 A hydraulically calculated automatic wet pipe sprinkler system meetin~ the reouirements of NFp~, 13. Standard for the Installation of3nrinkldr Swterm. shall be installed in the room housing a Clau-A charnber and in any ancillary equipment r o o m s . [Changes Underlined]

2. Insert a new 19-2.1.3.1 and NOTE to read as follows: 19-2.1.3.1 Chamber room sprinkler heads shall be an approved type

equipped with fusible elements. The element temperature ratings shallbe as low possible, consistent with the requirements against false operation in the "Sprinklers" paragrap.h of NFPA 13.

NOTE: In addition to the functions o f building protection, the chamber room sprinkler system must be designed to assure a degree of protecuon to chamber operators and occupants who likely will not be able to immediately evacuate the premises in the event of a fire.

SUBSTANTIATION: I. Reference NFPA 13 for sprinkler system requirements. Separate sprinkler head requirements into its own p h.

2 . a ~ e requirement that the sprinkler system is intended to protect people in the room (and chamber)as well as the property m the institution needs to be made clear. Most sprinkler systems are not intended to protect people, sincepeople can generally evacuate a fire area, and system designers therefore tend to use fusible elements of higher temperature radngs to maximize the safety factor against premature operation of the sprinkler heads. Thus, words regarding element temperature rating and the proposed "Note" are fel t necessary to ensure that those who design and install the sprinkler systems are aware of the purpose of the system. The sprinkler section of NFPA 13 contains requirements for temperature radnga for given locations based on maximum localized temperatures, etc. COMMITTEE ACTION: Accept.

(Log # HYP-22) 99- 261 - (19-2.2.1): Accept 8UBM1TrER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-2.2.1 to read as follows:

19-2.2.1 Chambers for human occuvan~v, and their sunv~rdn~ shall be designed and fabricated/o meet ANSITASME - , Safety Standard for Pressure Vessels for Human Occu-

pancy, by personnel qualified to fabricate vessels under such codes. a minimum, animal chambers shall be dedamed, fabricated, and

stamoed m meet ANSI/ASME Section VIII. Dfvidon I code [Changes Undelined]

ON: Requirements for animal and human occupancy differ. C o M M r r r E E ACTION: Accept.

(Log # I-m,-23) 99- 26£ - (19-2.2.2.4) (New)): Accept 8UBMrrrER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Insert new 19-2.2.2.4 to read as follows:

19-2.2.2.4 If the interior floor of a Class A chamber consists of removable floor (deck) plates, the plates shall be mechanically secured and electricaily bonded to the chamber to insure a positive electrical ground and to prevent movement of the plate which could cause injury to personnel. SUBSTANTIATION: For chambers that are equipped with this type of flooring, this ensures that proper ~Founding is maintained and the opportunity for an accident resumng from the shift of a floor plate are minimized. C o M M r r r ~ ACTIONs Accept.

(Log # HYP-24) 99- 263- (19.2.2.3.1): Accept SUBMITFER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATIONs 1. Insert new 19.2.2.3.1 to read as follows:

19-2.2.3.1 If the interior of a Class A chamber is treated (painted) with a finish listed above, a minimum of 72 hours shall pau before chamber operations with chamber personnel aboard to allow sufficient time for offga~ng to occur.

2. Renumber existing 19.2.2.3.1 to 19-2.2.3.2. SI.Y]~TANTIATION: Unde r hyperbaric conditions, the partial pres~mres ofgase s are elevated. Should any gas be toxic or at the least irritating, their effect would be enhanced under pressure. This provides a rmnimum standard to allow for "off-saMing." COMMITrF~ ACTIONs Accept.

(Log # ~tP-25) 99- 264- (19-2.2.5.1): Accept SUBMI'ITER: Subcommittee on Hyperbaric and Hypobaric Facilities RFXIOMM]HZNDATION: Insert to the follc~ving NOTE under existing 19-2.2.3.1: NOTE: Many commercial sound deadening materials that may be flame resistant, are porous and will absorb water from activataon of the fire suppression system and retain odor. Metallic panels which contain a large quantity of amail holes or are made of wire mesh and are installed about one inch away from the chamber wall can be used to form an acousdc baffle. These panels should be made from corrosive resistant materials such as stainless steel or aluminum and may be painted in accordance with paragraph 19. 2.2.3.

SUBSTANTIATION: Hyperbaric chambers contain atmospheres of high humidity. Condensation is a real problem. COMMITTEE ACTION: Accept.

(Log # m'P-2~) 99- 265 - (19-2.2.4): Accept 8 U B ~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19.2.2.4 to read u follows:

19-2.2.4 A sufficient number ofviewlng _ports and access ports for piping and monitoring and related leads ~ be installed during imtial fabrication of the chamber. Prudent desigrt considerations

that at least 50 percent exceu pau-throu-gh capacity be provided, for future use, ~iven the di~culw of affdin~ m~-throu~hs to the chamber after it is c.onstructed and tested. [Ch-afiges Underlined] SUBSTANTIATION: I. While the sentence in which thisphrase appears is worded as a recommendation, it is felt that the figur e "150 per cent excess pass-through capacity" is somewhat excessive. The potential that some people may treat this figure as a requirement could lead to unnecessary cost escalations in the facility. Many standards recommend excess capacity figures on the order of 25 to 35 percent. It is suggested that the 50 percent figure is a reasonable recommendation.

2. Adds greater flexibility without the necessity of penetrating the chamber s~011. COHMrr rEE ACTION: Accept.

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NFPA 99 - - F92 TCR

(Log # HYP.27) 99- 266 -(19-2.2.4.2): Accept $ U B M r I ' r I ~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-2.2.4.2 to read as follows:

19-2.2.4.2 Viewports ~ t ~ shall be designed and fabricated according to ANSI/ASME PVHO.I, Safety Standard for Pressure Vessels forHuman Occupancy. [Changes Underlined] SUBSTANTIATION: Provides consistency with paragraph 19-2.2.4. C o M M r r r E ~ ACTIONs Accept.

( L o g # HYP-28) 99- 267 - (19-~.3.1): Accept SUBMrIWE~ Subcomm|ttee on Hyperbaric and Hypobaric Facilities l tECOMMENI~TIO~ Revise 19-2.3.1 to read as follows:

19-2.~.1 Unless desitmed for chamber use. sources of illuminadon shall be mounted outside the pressure chamber and arranged to shine throug h chamber ports or throuuh chamber uenetrators desitmed for fiberovtic or similar li~ht~q~. [Changes Underlined] SUBSTANTIATION: (1) Recogniz-ed new, state-of-the-an equipment that is becoming available.

(2) Clarifies and recognizes current reliance on fiberoptic lighting in new facilities. COMMrITEE ACTION: Accept.

(Log # m~-29) 99- 268 - (19-2.3.1.I): Accept S U B ~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-2.3.1.1 to read as follows:

19-2.S.I.1 Lighting fixtures used in conjunction with viewports shall be designed so that temperature ratings for the views_ rt

in /As E Changes

SUBSTANTIATION: A_NSI/ASME Irv'HO-1 does not give speci~cations for lighting fixture design Per se. It does, however, spell out temperature ratings for the wewport designs. This is the parameter of importance when lights are shined through the viewports, and it should be clearly stated. COMMrI'rEE ACTION,: Accept.

(Log # HYP-30) 99- 269- ( 1 9 - 2 . 3 . 1 . 2 ) : Accept $UBMI'ITER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Delete sentence 2 ("Where practical, non- combustible gasket material shall be employed.'). SUBSTANTIATION: Noncombustible gasket material not available. COMMrrTEE ACTION~ Accept.

(Log # I-IYP-Sl) 99- 270 - ( 1 9 - 2 . 3 . ~ . ) : Accept S U B ~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-2.3.4 to read as follows:

19-2.3.4 Permanent lighting fixtures installed within the hyperbaric chamber, s h a l l m e e t the requirements of L ~ ] ~ 1 1 ~ [ . l ~ bf rated for an external workin~ nressure of 1 1/2 times maximum chamber onerafin~ uressures. Pdrtable li~htin~ units used in the chamber siiall con~n-lv with the reaulreme~nts f6r normble eaulnment in 19-2.7.S.11. - ~ [Changes Underlined] - - - SUBSTANTIA"~-'6"N: Proposed new section 19-2.7 is intended to address all electrical requirements, including fixed and portable equipment inside the ~ b e r . COMMITTF~ ACTION: Accept.

(Log # HYP-S2) 99- 271 - ( 1 9 . 2 . 8 . 4 . 1 ) : Accept SUBM/TTER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Delete 1 9 . 2 . 3 . 4 . 1 . SUBSTANTIATION: The proposed new 19-9.3.4 covers the topics addressed by old paragraphJ I9-2.$.4 and 19-2.$.4.1. COMMITTEE ACTION: Accept.

(Log # Fr~r.ss) 99- 272 - (19-2.3.5) (New)): Accept SUBMITrER: Subcommittee on Hyperbaric and Hypobaric Facidiities RECOMMENDATION: Insert new 19-2.$.5 to read as follows:

19-2.3.5 Emergency lighting. Where normal chamber interior lighting is provided byinternally mounted fix .rare. s, provisions shall be made for externally mounted automatica~-activated emergency lights. SUBSTANTIATION: This is implied, but not stated, in parag~ph 19.2.5.1. It thus appears that this is the intention of this standa/d and it should therefore be stated. COMMITrF~ ACTION: Accept.

(Log # HYP-54) 99- 2'78 - ( 1 9 . 2 . 4 ) : Accept SUBMrITEg: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise title of 19.2.4 from "Ventilation of Class A Chambers" to read: "Chamber Ventilation." SUBSTANTIATION: The Standard, though it covers Clau A, B, and C chambers, addresses ventilation rates only for Class A chambers. For thoroughness, it is suggested that the two new paragraphs be added and that the title for the overall section be changed accordingly. The other subparagraphs in this section (19.2.4) specify the chamber class for which they are intended and thus require no changes based on this revision. C O M M I T I ' ~ ACTION: Accept.

(Log # z-~-ss) 99- 274 - (19.2.4.1.1): Accept SUBMITTE~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION. Revise 19-2.4.1.1, including Exception, and add new NOTE, to read as follows:

19-2.4.1.1 The minimum ventilation ra~ for a Class A chamber shall be 5 ~ t u a l c u f t (0.085 ~ m a l m ~ p e r rain.) o fa i rper c h ~ r occupant I/&t, usin~ a hIvathin~ mask overboard dumn I~tem which e*rhanlts exhaled ~,SeS. The rt~inimum threshold rate xhall be ,~ actual cu. ft, uer nrdn. ¢.085 actual mS uer min.L

Excention: "I'he ventilation rate remilrements of this naram'anh are wilved when saturation oc.eratiofis are conducted in th~ chamber, nrovided that carbon dioxide removal and odor control is accomnHshed and that the monitorinff reoulrements of n ~ n s 19-2.8.5.1 and 19-2.8.6 are met. " (New) NOTE: Experience and practice may dictate the need for

a threshold ventilation rate in excess of the minimum specified for sanitary reasons. It is recommended that consideration be given, if necessary, to the use of odor filters in the chamber circulation system as a means of keeping sanitary ventilation rate requirements to a minimum," [Changes Underlined]

SUBSTA,N'I]ATION" 1. The term "actual" cubic ft., when referring to quantities of gas measured at other than standard condition, is an accepted industry phrase. The former "Exception" is incorporated into the normal ventilation requirements to make the req~drement more concise.

2. The new *EXCEPTION" is added to address the case of saturation operations, a capability which many of the newer chambers possess. This situation has not been addressed by this standard previously. Reference is made to proposed new ~ h s dealing with the monitoring of the chamber atmosphere duringsamration operations. B. The newNOTE is felt to be pertinent to the topic of sanitary

ventilation. COMMrrrEE ACTION: Accept.

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N F P A 99 - - F92 T C R

(Log # m,P.SS) 99- 275 - (19.2.4.1.2): Accept SUBMITrER: Subcommittee on Hyperbaric and Hypobaric Facllides RECOMMENDATION: I. Revise 19.2.4.1.2 to read as follows:

19-2.4.1.2 If j/li~aL~;[glk.~J, Lh, etlc agents are being utilized (e.g., nitrous oxide,_ methox,/flurane, halothane), a dosed anesthetic system with exhaled-gas scavenging and overboard dumping shall be employed." [Changes Underlined]

2. Delete N O T E under 19-2.4.1.2. SUBSTANTIATION: I. This, a preferable soludon to disposin~ of waste anesthetic gases, which may be teramgenic, is employed m practically all hospital operadnl~ rooms today.

2. Moved to 19-2.4.1.1 and reva~d (via Proposal 99-274 (Log #I-I~- 55)) where sanitaryvendladon is addressed. COMMITrF~ ACTION: Accept.

SUBSTANTIATION: Even though most compressor intakes can be located in such a manner that routine exposure to toxic fumes is minimized, situations exists that sdll allow for accidental uptake. For example, if a compressed air intake is located within an enclosed area and painting or other building maintenance is being conducted (such as hying new tile, etc.), the off-ga~'d fumes wouldbe drawn into the compressor and accumulator and thus into the chamber. Such is also the case if a compressor is located outside and any maintenance is being conducted around the compressor by personnel who are not knowledgeable about the iffects of toxic fumes under hyperbaric conditions. Even though there are no guarantees that a warning sign would be read, at least it is an attempt. Most people might infer that compressor intakes is alluded to, given the context. However, for the sake of those who might be confused by the present wording, the word "compressor" should be clearly understo6d. COMMrrrE~ ACTION: Accept.

(Log # m~-ST) 99- 276- (19-2.4.1.2.1): Accept SUBMITITA~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Insert new 19.2.4.1.2.1 to ead as follows:

19-2.4.1.2.1 Flammable inhalation anesthetics (i.e., cyclopropane, ethyl ether, ethylene, and ethyl chloride) shall not be employed. SUBSTANTIATION: The use of such agents poses an unacceptable hazard within any chamber. COMMITYEE ACTION: Accept.

(Log # H~P-S8) 99- 277 - (19.2.4.1.4): Accept S ~ Subcommittee on HFperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19.2.4.1.4 to read as follows:

19-2.4.1.4 Individual breathing apparatus shall be supplied for each occupant of a ~ A chamber for use in case air m the chamber is fouled by combusdon or otherwise. Each breathing apparatus shall be available for immediate use and the breathing mixture shall be independent of chamber atmosphere. The ]~r, gl~ittggm" supply shah be sul~cient for simultaneous use of all breathing apparatus. Such apparatus shall function at all pressures that may be encountered in the chamber. ]~gg.l~r, g L g ~ within a chamber, orovidon shall be made to switch all breathin~ anoarams to an alr.suDnlv which is indenendent of the chamber- affnosnher¢, [Chang/.'iUnderlined] - SU~TANTIATION: 1. To make it clear that the emergency breathing mixture is required to be air. The present wording only implies this.

2. Most facilities are presently being designed to provide hyperbaric oxygen therapy £'hereby various breathing gas mixtures can be selectively administered to the padents through their breathing masks (or hoods). It is important that, durin~ an emergency in the chamber, all of these breathing devices be swnched to air. Since it must be presumed that chamber attendants and operators will have to quickly respond to the emergency, a simple, non-time consuming method of switching the breath~ng mediums should be specified. COMMITFEE ACTION: Accept.

(Log # HYP-40) 99- 279 - (19-2.4.2.1): Accept SUBM1TYER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-2.4.2.1 to read as follows:

19-2.4.2.1 Positive efforts shall be undertaken to assure that air for th~_d~.~.~.mChamber atmosphere is not fouled by handling (i.e., by oil

pressors and the like). This air sunulv shall be monitored i ~ . [Changes Underlin~ci] SUBSTANTIATION: To relate the requirements in this paragraph with the related topic of chamber air supply monitoring covered in L ~ s e d paragraph 19.2.8.7. (See Propom199-287 (Log #HYP-

COMMrrTEE ACTION: Accept.

(Log # 151) 99- 280 - (19-2.4.2.1): Reject SUBM1TYE~ Antonio A. Mesa, Nash Engineering Co. RECOMMENDATIONs Revise as follows:

19-2.4.2.1 Compressor for Class A chamber shall meet the definition of an oil-free compressor given in Chapter 2. SUBSTAI~r/ATION: Clarification ofcom]~ressor type and benefit of considerations given for medical air semce. COMMITTEE ACTION: Reject. COMMITTEE STATEMENT: Term "oil free compressor" is proposed for deledon by SubCommittee on Nonflammable Medical Piped Gas System.

(Log # HYP-8) 99- 281 - (19-2.4.2.1): Accept S U B ~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: In 19-2.4.2.1, delete "(i.e., by oil bath compressors and the like) ". SUBSTANTIATION: Term "oil bath compressor', while cited as an example, is confusing. COMMrITEE ACTION: Accept.

(Log # ~-S9) 99- 278 - (19-2.4.2): Accept SUBMrrYF.~ Subeomn~ttee on Hyperbaric and Hypobaric Facilides RECOMMENDATION: I. Revise 19.2.4.2 to read as follows:

19.2.4.2 Sources of air for m c h a m b e r atmospheres shall be such that toxic or flammable gases are not introduced. intakes shall be located so m to avoid air contaminated by exhaust from activities of vehicles, internal combusdon fn~rin,~s, stationary engines, or building exhaust oudets.

2. Add the following new "Note" under 19-2.4.2: NOTE: If intakes are located where it may be possible for maintenance to be conducted in the immediate vicinity, a warning sign should be posted.

(Log # I~P-41) 99- 282 - (19.£.5): Accept S ~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise Section 19-2.5 entirely to read as follows: 19-2.5 Fire Protection in Class A Chambers. 19-2.5.1 General Requirements. 19-2.5.1.1 A fire suppression system consisting of an indepen-

dendysupplied and operating handllne and deluge system shall be installed in all Class A chambers.

19-2.5.1.2 Design of the fire suppression system shall be such that failure of components in either the handline or deluge system will not render the other system inoperative.

2 9 2

N F P A 9 9 - F92 T C R

19-2.5.1.3 System design shall be such that activation of either the handline or deluge system shall automatically cause the following:

a) Visual and aural indication of activadon shall occur at the chamber operator's console.

b) All unlgrounded electrical leads for power and lighting circuits contained mside the cb.tmber shall be disconnected. Intrt~nsically safe circuits, including sound-powered communications, need not be disconnected.

c) Emergency lighting (see 19-2.3.5) and communication, where used, shall-be activated.

19-2.5.1.4 A fire,~a~m dgnaling device shall be provided at the chamber operawr s control console for signallng the telephone operator or a suitable authority to activate the emergency fire/ rescue network of the instimuon containing the hyperba~c facility.

NOTE: This requirement does not preclude the use of an alarm system affording direct fire department contact.

19-2.5.1.5 Fire blankets and portable carbon dioxide extinguishers shall not be installed in or carried into the chamber. NOTE: Experience has shown that fire blankets, portable carbon dioxide extmgnishers, and other methodology intended to "muff- out" fires b~ excluding air are not effective in controlling fires in oxygen-enriched atmospheres. Valuable time can be lost in attempting to use such devices. 19-2.5.1.6 Booster pmnln, control circuitry, and other electrical

equipment involved m fire suppre~on system operation shall be powered from a Critical Branch of the Emergency Electrical System as specified in paragraph 19-2.7.2.2(e).

19-2.5.2 A fixed water :deluge extinguishing system shail be installed in all chamber compartments which are designed for manned operations. In chambers that consist of more than one chamber compartment (lock), the design of the deluge system shall ensure adequate operation when the chamber compartments are at different depths (pressures). The design shall also ensure the independent or simultaneous operation of deluge systems.

Exception: Chamber compartments which are used strictly as personnel transfer compartments (locks), and for no other purposes, are not required to have a fixed deluge system.

19-2.5.2.1 Manual activation and deactivation deluge controls shall be located at the o~pe.rator's console and in each chamber compartment (lock) contaminga deluge system. More than one control station may be required in a compartment (lock) depending on its size. Controls shall be ,designed to prevent unintended activation.

19-2,5,2.2 The deluge valve shail open within one second of a signal to activate the deluge. Water shall be delivered from the sprinkler heads beginning not less than three seconds after the activation signal.

19-2.5.2.3 The number and positioning of sprinkler heads shall be sufficient to provide reasonably uniform spray coverage with vertical and hor i zon~ (or near horizontal) jets. Average spray density at floor level shall be not less than 2 gpm per square foot (81.5 L / rain/m2) with no floor area larger than 1 square meter receiving less than 1 gpm per square foot (40.75 L/rain/m2).

NOTE 1: Experience has shown that when water is discharged through conventional sprinkler heads into a hyperbaric atmosphere, the spray angle is reduced because of increased resistance to water droplet movement in the denser atmosphere. This is so even though the water pressure differential is main- rained above chamb]:r pressure. Therefore, it is necessary to compensate by increasing the number of sprinkler heads. It is recommended that spray coverage tests be conducted at maximum chamber pressure. NOTE 2: Some chamber configurations, such as smaU diameter horizontal cylinders, ma~ have a very tiny "floor," or even no floor at all For horizontal cylinder chambers and spherical chambers, "floor level" shall be taken to mean the level at one quarter diameter below the chamber centeriine or actual "floor level," whichever gives the larger floor area. 19-2.5.2.4 There shall be sufficient water available in the deluge

system to maintain the flow specified in 19-2.5.2.S simultaneously in each chamber comparunem (lock) containing the deluge system for one minute. The limit on maximum extinguishment duration shall be governed by the chamber capacity (bilge capacity also, if so equipped) and/or its drainage system.

I9-2.5.2.5 The deluge system shall have stored pressure to operate at least 15 seconds without electrical branch power.

19-2.5.2.6 A deluge test bypass circuit shall be included in system design to allow periodic testing of the deluge system without discharging water into Lhe chamber. Such a circuit shall:

au be located outside the chamber downstream of the deluge control valve;

b. direct the water discharge to a drain or storm drain of suitable capacity to accept full flow, or to another location where water damage will not result; and,

c. be m dedgned m as not to remain in the test mode after completion o f a test.

NOTE: Both handiine and deluge suppression systems shall be functionally tested at mazlmum operational pressures at least annually. 19-2.5.3 A handllne extinguishing system shall be installed in all

chamber compartments (locks). A1 least two handlines shall be strategically located in treatment compartments (locks). At least one handllne shall be located in each personnel wander compartment (lock). If any chamber compartment (lock) is equipped with a bilge access panel, at least one handiine shall be of ~ c i e n t length to allow use of the handiine for fire suppression in the bilge a r e a .

19-2.5.3.1 Handlines shall have 1/2 inch minimum internal diameter and shall have a rated working pressure greater than the highest supply pressure of the supply system.

19-2.5.3.2 Eai:h handiine shall hie activated by a manual quick- opening quarter.turn valve located within the lock.

19-2.578.3 Handiines shall be equipped with override valves placed in easily-accessible locations outside the chamber.

19-2.5.3.4 The water supply for the handline system shall be designed to assure a 50 psi minimum water pressure above the maximum chamber pressure. The system sh:ill be capable of supplying a minimum of 5 gpm (18.8 L/min) simultaneously to each o f any two of the handllnes at the maximum chamber pressure.

19-2.5.4 Automatic fire detection sTstems are optional. Whether installed and used in an alarm funcuon or in an automatic deluge activation function, they shall meet the requirements set forth below.

19-2.5.4.1 Surveillance fire detectors responsive to the radiation from flame shall be employed. TYpe and arrangement of detectors shall be such as to respond within one second of flame origination.

19-2.5.4.2 The number of detectors employed and their location shall be dependent on the sensitivity of each detector and the configuration of the spaces to be protected.

NOTE: Additional detectors are recommended to avoid "blind" areas if the chamber contains cornpartmentafion. 19-2.5.4.3 The system shall be powered from the critical branch of

the emergency electrical system or shall have automatic battery backu .

19-2.g.4.4 If used to automatically activate the deluge system, the requirements for manual activation/deactivation in 19-2.5.2.1 and deluge system response time in 19-2.5.2.2 ~ still apply.

19-2.5.4.5 The system shall include self-monitorin~ functions for fault detection and appropriate fault alarms and indications." SU]~TANTIATION: Becatme of the numerous changes in this section over the years, it is felt that a reorganization of the contents will lead to agood deal of ciariflcation of the points covered. We believe that the proposed writing will thus lead to more cost effective fire system design by clearly setting forth the minimum requirements needed by system designers and builders to construct these systems. Besides thehierarchical rearrangement of the paragraphs (and some sentences within paragraphs) in the section, several substantive changes have been proposed. These changes are as follows (references are to proposed new paragraph numbers):

19-2.5.1.2 We agree with proposal 99-99-(19-2.5) of 1986 that the handline and de~ge systems should be of equal status. The structure of the proposed section I9-2.5 is intended to emphasize this. If the handlines and deluge are viewed as providing a "redundant fire suppression system, then the requirement in this proposedparagraph should be included.

19-2.5.1.4 Current paragraph 19-2.5.3.6 seems to tie the institu- tional fire alarm signal directly to the chamber fire mppreudon activation alarm. This is overly restrictive in that no provision is then made for signaling in the event of a hyperbaric room fire (unless the room sprinklers activate, which may not occur until some time after the onset of the fire). A fire in the room and in the chamber are of equal criticality insofar as signaling for fire auisUmce is concerned, and-the chamber operator should be able to signal for this assistance directly from the control console in either instance.

19-2.5.1.4 Requirements regarding the critical electrical branch were added to relate this p~iragraph to 19-2.7.2 in the electrical section where the specific electrical requirement is properly addressed.

19-2.5.2 The standard is somewhat ambiguous concerning whether deluge system is required in transfer locks. The commentary notes in the 1984 Handbook (paragraph 10-2.5.4.2) would seem to indicate that it is not, and this is the actual state in some current chambers. Thus, the new W.xception" is proposed to address this issue. Additionally, this paragraph addreues the minimum performance characteristics~or deluge systems that are installed in multicompartment (lock) chamber designs where each compartment canbe pressurized simultaneously to different depths.

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NFPA 99 - - F92 TCR

19-2.5.2.1 It is felt that all manual deluge control stations should have the means to shut the deluge otfas well as to activate it. This would afford additional protection against accidental activation as will the requirement for control design. We believe this will also cover the intent of old paragraph 1922.5.4.6.

19-2.5.2.2 The time constrafntafor deluge system activation have been expanded upon somewhat to define more clearly, from a system dedgn point ofv3ew, what is required. Present wording regarding deluge reaction time could be construed in a way re¢luiring a system which, inpractical reality, cannot be built. The propo~, d requirements are felt to represent practical and attainable gokls which still assure the critical quick response time necessary to deal with chamber fires.

19-2.5.2.3 Further definition is ~v.en w. spray.density requirementa to provide information criucal to determining me .v~,, number and p ~ g of deluge sprinkler heads. The "Note is expanded to can attention to an important factor in the system deiign; the final sentence is added to reflect what is implied in the preceding sentences of the "Note."

19-2.5.2.4 Deluge system cal?acity is further defined to cover the situation of multiple locks having deluge sprinklers.

19-2.5.2.6 This p.m'agraph is proposed to support and address the recommendation m proposal 99-100- (9.2.5) of 1986. The proposed requirements are of-the nature of those for test-bypau circuits addreued in NFPA 13, Standard for the Installation of Sprinkler Systems. Additionally, the rec[~rement is added to annually test the suppreuion ~/s, tern. Many facilities neglect this and are surprised when it doem t work.

19-2.5.3.1 Further requirements are given for the handlines because of the type o f service they are intended for. Pressure and service ratings are considered important requirements.

19-2.5.3.$ The handiine override valve requirement is modified to state that the valve be controlled from, not necessarily located at, the control console. The current requirement is unnecessarily restrictive and means likely added cost for facilities because of longer pipe runs. The Exception is added because, with the hose pressure rating requirements and the requirement for a hose valve in the lock, a *deadman" type spray nozzle will afford the same safety which the override ~ ls intended to give.

19-2.5.3.4 Flow rate requirements added here are felt to be an important minimum ~t tem design comideradon.

19-2.5.4 The wording here is proposed to clearly express the intent of this Standard as reflected in the Technical Committee Reports of the past several years that automatic fire detection systems and automatic activation of the deluge system are optional. It should be noted that automatic detection systems can be used either for alarm or automatic activation purposes. Most are presendy used as alarms to insure against false activation of the deluge. COMMITTEE A c r I O N : Accept.

(Log#~0) 99- 283- (19-2.5.4.1): Reject SUBMITrER: J.H. Kimzey, Houston, TX RECOMMENDATION: Add to existing note:

"Perhaps more d gnificant is the increase in the relative toxicity of carbon dioxide under hyperbaric conditions, as shown in Appendix A, Table A-2-2, page 99-136, further dictating against its use. ' - SUBSTANTIATION: None. COMMITTEE ACTION: Reject. COMMYIWKE STATEM]ENT: There ls no established limit for toxicity of carbon dioxide in the hyperbaric environment.

(Log # HYP-42) 99- 284 - ( 1 9 - 2 . 6 ) : Accept SUBMrITE~ Subcom:m/ttee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Renumber 19-2.6, Ventilation of Class B Chambers, m new 19-2.4.4, and renumber 19-2.6.1 as new 19-2.4.4.1. Delete parentheds (*See 19-2.4.'). SUBSTANTIATION. Covered under revised 19-2.4. (See Proposal 99-27S (Log #HYP-~).) COMMrI ' rEg ACTION: Accept.

(Log # HW-43) 99- 285 - (19-2.7): Accept SUBMrITER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-2.7 to read as foUov~:

19-2.7 Fire Protection in Clau B and C Chambers. Clau B and C chambers shall not be required to comply with 19-2.5, Fire Protec- tion in Class A Chambers. SUBSTANTIATION: I. Inasmuch as all chambers must be vented to the exterior of the building, sprinkler protection is no longer needed. 2. Revison reflects standard practice. Revision clarifies committee's intention. Fire protection measures described in 19-2.5 are not effective in environment with increased oxygen concentration. COMMITr]~ ACTION: Accept.

(Log # HYP-2) 99- 286 - (19-2.7, Tide): Accept SUBMrITER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Change Wire Protection in Clau B and C Chambers." to read: "Fire Protection for Class B and C chambers. [Change Underlined] SUBSTANTIATION: Editorial; existing wording technical incorrect. COMMITrEE ACTION: Accept.

(Log # HYP-~) 99- 287 - (19-£.8 and 19-£.9): Accept SUBMITI'E~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-2.8 and 19-2.9 entirely to read as foUows:

19-2.8 Electrical 19-2.8.1 General. s~tems" 19-2.8.1.1 The requirements of NFPA 70, Nadonal Electrical Code,

or local electrical codes shall apply to electrical wiring and equipment in hyperbaric facilities within the scope o f this chapter, except as such ruies are modified in this section. Where unusual conditions exist in a specific facility, the authority having jurisdiction shalljudge with respect to the application of specific rides.

19-2.8.1.2 Hyperbaric Chamber Se/vice Equipment. All hyperbaric chamber service equipment, switchboards, panels or control consoles shall be located outside of, and in the vicinity of, the chamber.

19-2.8.1.3 Console or module spaces containing both oxygen piping and electrical equipment shall be continuously ventilated or continuously monitored f-or excessive oxygen concentrations whenever the electrical equipment is energized.

19-2.8.1.4 For the fixed electrical installation, no circuit breakers, linefuses, motor controllers, relays, transformers, ballasts, lighting panels, or power panels shall be located inside of the chamber. It is recommended that system design be such that electric motors not be located inside the chamber. If motors must be located in the chamber, they shall meet the requirements of 19-2.8.$.9.

19-2.8.1.5 All electrical equipment connected to or used in conjunction with hyperba~c patients shall comply with the requirements of Chapter 7, Electrical Equipment in Health Care Facilities, and with the applicable paragraphs of section 19-2.8.3.

19-2.8.1.6 In the event of acflvau~on o~" the room sprinkler system, electrical equipment shall be protected from sprinkler water to the maximal extent possible, but not need remain functional so long as manual means sufficient to safely terminate a dive are provided.

19-2.8.2 Electrical Service. 19.2.8.2.1 All hyperbaric facilities intended for human occupancy

shall contain an electrical service which is supplied from two independent sources of electric power. For hyperbaric facilities located in a hospital, one _power source shall be a prime mover driven generator set located on the premises of the facility. This service shall be designated as the Emergency System and shall meet the requirements of Chapter 3, Electrical Systems, of this Standard for hyIserbaric systems b u e d in health care facilities. NFPA 70 Article 700, Emergency Systen~, shall apply to hyperbaric systems located in other than health care facilities.

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19.2.8.2.2 Electrical ec~uip..ment amociated with life support functions of hyperbaric facility shall be connected to the Critical Branch of the Emergency SDtem; that is, such equipment shall have electrical power restored within 10 seconds of interruption of normal power. Such equipment shall include, but not necessarily be limited to:

a) Electrical power oudets located within the chamber. b) Chamber emergency lighting, whether internally or externally

mounted. c) Chamber intercommunications. d) Alarm systems, including fire detectors. e) Chamber fire suppression system equipment and controls.

Booster puml~ (if instilled) shallbe on separate branch circuits serving no other loads.

f} Other electrical controh used for chamber pressurization and ventilation control.

g) A number of chamber room lights (either overhead or local) to ensure continued safe operation of the facility during a normal p~] 9wet outage.

2.8.2.8-Electric motor-driven compressors and amdiiary electrical equipment horridly located outside the chamber and used for cb.~nber atmospheric control shall be connected to the Equipment System (see Ch_apter 3, Electrical Systems ) or the Emergency System (see NFPA Article 700), as applicable. Such equipment shall be arranged for delayed automauc or manual connection to the alternate power source so as to prevent excessive current draw on the system during restarting.

Exception: When reserve air tanks of sufficient capacity to maintain pressure and ventilation air flow within the chamber and to supply high pre~mre air for the rapid pressurization of the chamber are provided, the compressor and auxiliary equipment need not have an alternate source of power. It is the intent of this paragraph that chamber occupants be assured of adequate ventilation air and that they are protected from rapid decompression in the event of a Ic~ of normal power.

19-2.8.2.4 Electrical control and alarm systems design shall be such that hazardous conditions (Le., loss of chamber pressure control, deluge activation, spurious alarms, etc.) do not occur during power interruption or during power restoration.

19.2.8.$ W'wlng andEqulpment Inside Chambers. Electric wiring and fixed equipment installed in the chamber shall comply with NFPA 70 Article 500 for the hazard group classification as specified in the following paragraphs. No equij~ment installed or used in the chamber shall present an implosmn or explosion hazard in the pressurized chamber environment.

Exception: Where conformance with Class I, Division 1 requirements is specified in the following paragraphs, conformance with Class 1 DiVision 2 requirements ~ y be-sub0tituted if the following condition is met:

a) The limitations on the use in the chamber of alcohol and other agExents which emit flammable vapors in pm-ag~ph 19-3.1.5.2

ception No. 1 are strictly observed and such restrictions are prominently poeted.

19.2.8.3.1 Insulation. All conductors inside the chamber shali be insulated with a material ~ e d as flame resistant as defined in Chapter 2. This requirement does not apply to conductors that form an integral pan of electrlcal equipment which is approved for use inside of the chamber.

Exception: Ground conductors inside of conduit need not be insuia~-d.

19-2.8.3.2 Wh'ingMethods. Fixed wiring shall complywith the requirements for Class I, Division 1 locations of NFPA 70 Article 50I-4, WuLng Methods. Wu'ing classified as intrinsically safe for Class I, Division 1, Group B locations shall be permitted using any of the methods suitable for ordinary locations. Intrinsically safe wiring shall meet the installation requirements of ANSI/ISA-RP12.6 "Inst~ll~tion of Intrinsically Safe Instrument Systems in Class I Hazardous Locations." Fixed conduit, boxes and enclosures shall be approved explosion-proof for Class I, Group A or B locations.

19.2.8.3.3 Sealing and Drainage. Sealing and dralnag e shall be provided for the fixed conduit and equipment enclosures inside the chamber as required in NFPA 70 Krticle 501-5 for Oazs I, Division 1.

19-2.8.3.4 Flexible cords used to connect portable utilization equipment to the fixed electrical supply circuit shall be of a type approved for extra-hard utilization in accordance with NFPA 70 Table 70-4, shall include a ground conductor, and shall otherwise meet the requirements of NFPA 70, Article 501-11.

19-2.8.3.5 Receptacles and attachment plugs shall meet the requirements of NFPA 70 Article 501-12 and-shall be approved for Group A or B locations. They shall be part of an appr~ed unit device with an interlocking mechanism arranged so that theplug cannot be withdrawn or inserted when the circuit is energized.

NOTE: It should be recognized that interruption of any _~_ ered circuit, even of very low voltage, may prodiice a spark stifllcient to ignite a flammable agent. 19-2.8.3.6 Switches shall-meet the requirement of NFPA 70,

Article 501-6, Class I, Division 1, except that twitches for intrimically safe circuits may be of a type for o "rd/nazy locations.

NOTE: It is recommended that all control switching functions inside the chamber be accomplished using intrindca]ly safe circuits which control power and control circuits located outside of the chamber. 19-2.8.3.7 No equipment shall be installed in or allowed in the

chamber which does not meet the temperature rating requirements of NFPA 70 Article 500-2(a), (b) and (c).

19.2.8.3.8 There shall be no exposed live electrical par~ other than those that are intrinsically safe.

19.2.8.3.9 Motors shall meet the requirements of NFPA 70 Article 501-8(a) (1) for the chamber pressure and oxygen concentration, or shall be of the totally enclosed types meeting NFPA 70 Article 501- 8(a)(2) or (3).

19.2.8.3.10 Internally installed lighting fixtures shall be endmed types which are protected by a positive pressure ventilating system in which clean air or diluent gas is circulated at a pressure at least 1 in. (2.5 cm) ofwater above chamber pressure, andinwhleh fixtures in which ventilation pressure differential drops below l^in. (2.5 cm) of water or the ventilation gas temperature exceeds 140OF are automatically deenergized.

19.2.8.$.11 Portable (including battery-operated) electric or electronic equipment used in the chamber and permanently installed sensors, communicadons, signaling, a~arm, or remote- control equipment shall meet one of the following:

a) Listed intrinsically sa£e for Class I, Division 1, Group B locations.

b) Meet NFPA 70 Article 501.8(a) (2) or ($). c) Be hermetically sealed, filled with inert 8as, and designed to

be automadcalIy de-energized when the internal temperature exceeds a maximum of 248OF (120oc) or when the internal pressure deviates from the initial charge pressure by more than I0 percent.

19-2.8.4 Grounding and Ground Fault Protection. 19-2.8.4.1 The chamber shaft be grounded according to the

requirement Of NFPA 70 Article 250, Grounding. ReJ~tstance between the chamber and ground point shall not exceed one ohm.

19-2.8.4.2 In health care facilities, electrical power circuits located within the chamber shall be supplied from an ungrounded electrical system equipped with a Line Isolation Monitor ~ t h appropriate signal lamps and audible alarms. Such circuits shall meet the requirements of NFPA 70 Article 517-104(a), Isolated Power Systems, and 517-104(b), Line Isolation Monitor.

19-2.8.4.3 W'L,'ing located both inside and outside the chamber, which serves line level circuits and equipment located inside the chamber, shall meet the grounding and bonding requirements of NFPA 70 Article 501.16.

19-2.8.5 W~ing Outside the Chamber. 19-2.8.5.1 Those electrical components that must remain func-

tional for the safe termination of a dive following activation of the room sprinkler system shall be endmed in waterproof housing.

19-2.8.5.1.1 All associate conduit shall be waterproof and shall meet the requirements of NFPA 70. Such condmt shall be equipped with approved drains.

19-2.8.5.2 All other electrical devices outside the chamber shall ,meet the requirements of NFPA 70.

NOTE: It is necessary that these circuits be protected from exposure to water from the room sprinkler system protecting the chamber homing in the event of a fire in the vicimty of the chamber while it is in operation. 19.2.8.6 Wiring and Equipment Inside Clau B Chambers. 19.2.8.6.1 Electrical equipment inside Class B chambers shall be

restricted to communication functions and patient physiological monitoring leads. Circuits shall not exceed 28 volts and one-half watt.

19-2.8.6.2 Conductor insulation shall conform to 19-2.7.3.1 insulation.

19-2.8.6.3 Lighting inside the chamber must be supplied from external sources.

19-2-8.6.4 No flammable liquids, gases, or vapors shall be permitted inside any Class B chamber.

19-2.9 Communications and Monitoring. 19-2.9.1 General. 19.2.9.1.1 Detectors, sensors, wansducers, and communications

equipment located inside the chamber shall meet the requirements of 19.2.8.3.11. W'wing methods in the chamber shall meet the applicable requirements in section 19-2.8.3.

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19-2.9.1.2 Control equipment, power amplifiers, output transformers, and momtors associated with communications and monitoring equipment shall be installed outside the chamber or shall otherwhe meet the requirements of 19-2.8.3.11.

19-2.9.2 Intercommtmicauons. NOTE: Intercommunications equipment is mandatory for safe operation of a hyperbaric facility.

19-2.9.2.1 An intercommunication ~ t e m shall connect all personnel compartments (locks), main compartments (locks), and the chamber operator s control console. It is recommended that m~dtiple compartment (lock) Class A chambers be equipped with multiple channel syltems, and that, in addition, a soundpowered telephone or surveillance microphone be furnished.

19-2.9.2.2 Oxygen mask microphones shall be approved intrinsically safe at the maximum proposed pressure and95 + 5 percent

en. °1x~2.9.3 Automatic fire detection equipment, when used, shall meet the `applicable requirements in sections 19-2.7 and 19.2.5.4.

19-2.9.4 Combustible Gm Detection. 19-2.9.4.1 The chamber atmosphere shalI be continuously

monitored for combustible gas concentrations whenever any volatile agents (see 19-2.4.1.2) are used in the chamber. The monitor shall be set to provide audible and visual alarms at 10 percent lower explosion limit (LEL) for the particular gas used.

19-2.9.5 Oxygen Monitoring. 19-2.9.5.1 Oxygen leveis shall be continuously monitored in any

chamber in which nitrogen or other diluent g u is added to the chamber to reduce the volumetric concentration of oxygen in the atmosphere (nxuration operations). Audible and visual-alarms shall indicate un.at'e low oxygen _l~_'al pressure in the chamber.

19-2.9.5.2 Oxygen levels shall be continuously monitored in chambers when ~reathin 8 mixtures containing m excess of 21 percent oxygen by volume are being breathed by patients or attendants and/or any flammable agents are present in the chamber. Audible and visual alarm/shall indicate volumetric oxygen concentrations in excess of 23.5 percent.

19-2.9.6 Carbon Dioxide Monitoring. The chamber atmosphere shall be monitored during mmrafion operations when e~.r ventila- u.'on is not used (see paragraph 19-2.4.1.1 "Exception ) to assure mat carbon dioxide levels do not exceed safe levels.

19-2.9.7 ChamberAir Supply Monitoring. 19-2.9.7.1 The air supply of Class A and Class B chambers shall be

sampled periodically for concentrations of carbon monoxide. The frequency of such monitoring shall depend on the location of the air retake relative to j)o..tendal sources ofcontaminadon. It is recommended that mr be sometimes sampled at the air intake location at times when the intake air is likely to have maximum impurities (for example, when vehicles or stationary engines upwind of the intake are running, etc.). Air supplied from oil lubricated compressors shall be continuousb/-momtored for volatilized hydrbcarbons as well as carbon monoxide at a location downstream from the oil filter when the compressors are running.

NOTE: Because of the potential for contaminated air from oil- ]u.brica .t~l compressors, the use of oil-lubricated compressors is nlgmy di~ouragea. 19-2.9.7.2 Air, oxygen, or other breathing mixtures from certified

commercially supplled flasks shall be randomly sampled to ensure quafity control of subject gas.

19-2.9.8 Electrical monitoring equipment used inside the chamber shall comply with the applicable requirements of Section 19-2.8.

NOTE: It is recommended that information about the status of an anesthesized or otherwise monitored patient be transmitted to the inside chamber attendants via the intercommunicadons system. As an alternative, the monitor indicators may be placed adjacent to a chamber viewport (or viewports) for direct observation by inside ~ 2 . 9 nneL

.9 Closed circuit TV monitoring of the chamber interior shall be employed for chamber operators who do not have direct visual contact of the chamber interior from their normal operating location. SUBSTANTIATION: Sections 19-2.8 and 19-2.9 have been reorganized. The basic philosophy behind this reorganization is the belief that all matters relating to electrical equipment and electrical safety in the hyperbaric facility (i.e.,. matters pertaining to electrical egul..~ment, w3nng, installation, and design are addressed in NFPA /v -National Electrical Code') should be contained in one section (19-2.8). The other section (19-2.9) is then intended to address ~eneral requirements and needs for monitoring various aspects of

yperbaric operations (including communications), but not, except as a ~eneral reference to the electrical section, the electrical reqmrements. To these ends, the proposed new sections have been organized by topics. To auist m relating the proposed sections to the old sections, matters discuued in the old paragraphs are related to the new structure under the column "OLD

Para(~aph): ' . Referring to this for example, it can be seen that severm requirements d e , r i g with wiring and installation have been shifted from 19-2.9 to 19-2.8, and that several new ismes have been introduced in both sectiont The following discussion is to the substantive changes and additions that are proposed. Paragraph references, unless otherwise noted, are to the proposed new ~ 2 . a ~ ph~ A. Title has been expanded to better reflect the scope of this

section. B. The requirement for fuses inside equipment (old paragraph 19-

2.8.2.6) used in the chamber has been dropped for the following reasons:

a) Fuses in intrinsically safe equipment must meet the hazard classification anyway.

b) The other methods of rendering equipment safe, i.e.,. purging ana inerting, as required in ~ proposed section, are designed to reduce the volume inside the electrical equipment enclosure to a non-hazardota classification. This wou]d render the fuse requirement unnecessary in this case.

c) All other power circuit fuses are required to be located outside of the chamber by new 19-2.8.1.5.

C. The requirements in old pm-agraph 19-2.8.2.1 have been incorporatect in new section 19-2.8.3.

19-2.8.1.1 This is a "boiler-phte" paragraph intended to place the requirements of the section into proper context with respect to the National Electrical Code (NEC). This is imp?rtant because those who design and install electrical systems for hyperbaric facilities, while they should be familiar with the NEC and local electrical codes, may not be completely aware of all of the specialized needs peculiar to hyperbaric installations. The intent of this proposed section 19-2.'5is to address those specialized requirements, with reference to specific sections of the NEC or other standards where special empham is felt necessary. This is the general format foliowed for most specialized occupancies and locations in the various NFPA electrtcal standards, i.e., to expand upon the requirements of the NEC.

19-2.8.1.3 It is felt that oxygen handled in enclosed spaces containing electrical equipment needs special mfety precautions. It should be noted that today's gas monitoring equipment, whereby sensors and monitors can be separately located, n~ake it unnecessary to route gas (especially oxygen)piping into a control console.

19-2.8.1.4 This paragraph is intended to pull together a requirement alluded to m sever/d old paragraphs in a single coheslve requirement.

19-2.8.1.5 The requirement stated here was alluded to indirectly in old paragraph 19-2.9.2.1. It is felt that references should be mad.e to the section NFPA 99 dealing with patient monitoring. Intrinsically safe wiring inside the chamber is addressed in the referenced section 19-Z8.3.

19-2.8.2.1 The reference to Article 700 is added to include chambers, such as portable systems (Class A as well as Class B) which have been manufactured, which may not be located in health care facilities. In such cases NFPA 70 Article 700, Emer- ~ ncy Systems, would properly address the parameters required for

e backup power system. 19-2.8.2.2 The requirement of old 19-2.8.1.2 and 2.8.1.4 address

the rome topic and should be combined in the interest of clarity. Some chamber room lighting, not clearly addre~u.-d previously, should be added as a Critical Branch requirement.

19-2.8.9.3 The requirement for delayed automatic or manual connection to the emergency power source is an important consideration for large motors, such as compressors, boost pumps, etc., and should be emphasized.

19-2.8.2.4 This is an trnportant point which should be emphasized. Chamber operators and personnel may have more important things to do during power interruptions than to respond to fahe alar/ns, regain control of chamber pressure, etc. The topic addressed is often overlooked in systems design, but this requirement can and should be met by designers.

19-2.8.3 The proposed Section 19-2.3.7 and its subparagraphs attempt to correct one of the major deficiencies of the hyperbaric standard, namely that arising from the requirement that.equipment

tested and approved for ~ I, Division 1, Group C atmospheres at the maximum pressure and oxygen concentration." The

assumption behind this requirement (and all of the references to this topic in the current standard) is certainly correct, it recognizes that equipment which h approved for one atmosphere air enva, on- menu may not provide the intended protection m pressurized, oxygenated Class I hazardous environments. However, the requirement, though it has been on the books for over 16 years, has notresulted in the appearance of equipment specifically approved tat least by the criteria ot current stand~ds for hazardous location equipmen0 for chamber me. Among the reasons for this situation are:

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a) Development and testing of such equipment for t pp ron l is an expensive process for an equipment manufacturer compared to the relatively small size and voladllty of the medical hyperbiric market.

b) Criteria (i.e., pressures, flammable gases, oxygen concentra- dons) needed for cha~cat ion and testing are not suffidenfly and dearly set forth.

c) Development of such equipment, in addition to (a), is research and development work which no hyperbaric contractor should be expected to perform on a construcnon contract.

The result of this situation is that: a) There is very little equipment that can be used in a chamber

without being in technical violation of the standard. This is the case, for instance, With explosion-proof boxes, conduit fittings and power receptacles and with intrinsically safe equipment. In essence,-the only equipment which presently meets the requirements of the standa/zl are sound-powered phones and inert gas purged equip ment. It is expensive and iml~racfical to purge all equipment,

b) People are forced to 'Took the other way" when n comes to these matters. This puts someone in a position of liability with respect to the hyperbaric standard. This situation is not right. The proposed section 19-2.8.3 attempts to confront the problem by modifying the approach taken toward intrinsically safe and explosion-proof equipment, the two types of equipment primarily affected by the abo~ discussed requirement. With regard to intrinsically safe equipment, it is auerted that

equipment rated for ~ I, Division 1, Group B locations (1 atmosphere) will be equally rife for Group C gases in a chamber at three atmospheres for an oxygen concentration not exceeding 23.5%. This position is supported by the following evidence:

a) Theory predicts, and research has confirme]i, that minimum igniting current for a given mixture of flammable vapor and air is inversely proportional to the pressure of the mixture. The minimum igmdng current is the critical factor in intrinsic safety Group classificadon,

b) The ignition characteristic curves for the various circuits and Group classifications and other data show that ignition currents for Group B clasdficadon to be from 2.3 to 2.5 times lower than ignidon currents for Group C claEfication. (Group A and Group B classifications are equivalent in intrinsic safety terms.)

c) The ignition characteristic curves are derived from very conservatively conceived experiments.

d) Conservative safety f~tors are incorporated into the equip ment design. Because of these points, the proposed requirements specify Group B equipment where intrinsically safe eqmpment is applicabie (paragraphs 19-2.8.3.2 and 19.2.8.3.11).

To ensure that this strategy remains valid and that safety is properly maintained:

a) The atmospheric oxygen monitoring requirement of paragraph 19-2.8.5.2 is estal~iished (research has shown that mcreming the oxygen concentration of a flammable gm mixture greatly reduces the igniting current).

b) Use of flammable medical agents is forbidden in chambers in pressures exceeding 3 ATA (paragraph 19.3.1.5.2). The case for explosion-proof eq-uil~ment rating follows a very

similar line to the one just presented for intrinsically safe equip ment:

a) As a rule-of-thumb, explosion pressures are proportional to the initial pressure of a given flamn~ble mixture, although numerous secondary effects can skew this proposition.

b) Group A and B equipment must be rated for higher prewares than Group. C equipment. Safety factors are included in allof these pressure ranngs.

c) The re~[uire, ments for oxygen monitoring and chamber pressure restrictions contribute to this strategy for explosion.proof equipment rating for chamber use in the same way as for inmnsi- ca]ly safe equipment. The case for accepting Group A or B explosion-proof ecluil?ment

for chamber use is not presently as strong as that for intrmucally safe ecLuipment. However, the proposed requirements restrict explosion-proof equipment to conduit, fittings, wiring boxes (paragraph 19-2.8.3.2)and power receptacles (paragraph 19. 2.8.3.5). These are devices of small volume in which lower probability of fauit conditions exist than in my, motors or other power utilization equipment. In addition, conduit sealing is required (p.aragraph) 19-~.8.3.3) to mitigate possible effects of pressure pding(ref. 11) in the increased chamber pressure, h h suggested that this represents a more desirable simanon than that which exists under current sumdards.

19-2.8.3.1 The exemption for conductors integral to equipment is proposed for the following reasons:

a) It is impractical to require that equipment be rewired for chamber use (uniess there is some compelling reason).

b) Purged equipment wiring, for example, represents no hazard in a chamber.

c) The small amount of expo6ed non-flame retardant wiring which might result (headset and handset cables, for emunple) should be part of intrinsically safe circuits and should not represent a

e.gnificant fuel or toxic gas source even in the event of a chamber

19-2.8.$.2 Paragraph referenced in NFPA 70 is the one which sp~_cified the conduit, fittings, joints, and boxes to be used in I, Division 1. The requirement for the intrimicadly safe wiring is simply intended to reinforce the intention for which the intrinsic safety concept has been developed--to allow normal wiring methods in hazardous areas. The ISA standard is the one gnyerning instaliaflon and wiring methods for inU-indcally safe systems (NFPA does not have a standard concerned with this. NFPA 495 deals with intrinsically safe equipment design, construction and testing oulT. )

19-2.8.$.S This r~quirement is added to prevent hazard, assoctated with. the increased danger of pressure piling in explosion-proof conduits, boxes, and fltdngs in the premmr~d chimber environment (see discussion of explodon-proof methods for paragraph 19- ~.8.S).

19-£.8.S.5 The current requirement for receptacles and plugs refers to another NFPA 99 chapter which in turn refers to the NFPA 70 requirement. Indirect references of this type are unnecemry - and waste people's time. While it is understo~i that the hyperbaric standard was originally largely edited from the standard governing Inhalation Anesthetizing Locaflom, it is felt that these indirect references should be eliminated from the hyperbaric standard.

19.2.8.3.G The dted NFPA 70 reference is'the one jgove., rning switches in Class I, Division 1 locations. The intrinsically safe method of control switching is felt to be the safest and mint practical way to control circuits from inside the chamber.

19.2.8.S.7 Hot surfaces are a primary igni_don source of fires in hazardous locations, both for gases and solids which might be in a chamber. The NFPA 70 reference governs this characteristic of rating equipment for hazardous locations.

19.~.8.$.8 This requirement (which may be obvious to some, but should, nevertheless, be set forth for thoroughness):

a) Protects people from shock (the obvious point). b) Protects agmnst fire hazard from sparks causedby electrical

faults. 19-2.8.3.9 This requirement allows: a) Explosion-proof motors which are tested and approved Chug I,

Division I, Group C at maximum chamber pressure and oxygen concentration. Such equipment for the h]lperbaric environment is not available for all pracd&tl purposes. It I, unlikely to become available due to the relatively high cost of testing such equipment compared to the size of the hyperbaric market. However, this standard should not discourage development of such explodon- proof equipment if it proves femible.

b) Purged or inert gas-fiUed motors which automatically deenergi/e when the protective method fails. This is really the only practical method for rarely using motors in chambers at present since motors use more power than the intrinsic safety approach tolerates.

19.2.8.3,10 AJ with the reasons given for paragraph 19.2.8.3.9, it is felt that the purge_ g method is the only mfe way to use internally installed lighting fixtures. There is no known explodon-proof equipment (see discussion for paragraph 19-2.8.3) presently available which meets the speci,~l hyperbaric requirements.

19-2.8.3.11 The methods cried for lkfely utilizing portable and low power e~uipment in the chamber are believed to be those which will most easily allow such equipment to be adapted for such purposes:

a) Agood deal of the mfi-imi _c~dly safe equipment presently a ~ b ~ is approved for Group B aunospheres.

h) The other methods allowed, purging and inerdng (ref. 12), are the easiest way to adapt most equipment ~vhich cannot-be made intrinsically safe.

19.2.8.4.1 Chamber grounding is necessmT: - . a) Because electrical equipment is attached to it. b) To make the isolated power system Line Isolation Monitor

work. c) To make the intrinsic safety approach work. Most intrinsically

safe equipment requires a resistance to ground on the order of one or a very few ohms.

19-2.8.4.2 The NFPA 70 references cited are the ones covering isolated power systems and should be referenced directly. NFPA 70 Article 517-104 covers circuits, c~-uit fusing, circuit switching, monitorinlg, and all other factors required for a mfe isolated power system whlch were covered in the variota old paragraphs ( 1 9 - 2.7.2.3, 2.7.2.6 and 2.7.2.7).

19-2.8.4.3 This requirement is intended to ensure that: a) The equipment ground circuit for equipment used in the

chamber (see requirement for ground conductor in 19-2.8.3.4) is reliable given the hazard ~ c a t i o n of the chamber.

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b) A reliable ground path is maintained for the Line Isolation Monitor (19.2.8.4.2).

19-2.8.5.1 The current stipulation that all conduit outside ~ e . chamber be rigid metal conduit is unnecessarily restrictive. It only serve, to increase the installation cost of hyperharic facilities without commensurate benefit. It is felt that the re~iuirement for waterproofing in this propmed paragraph along voth the various ardelos in NFPA 70, Chapter $, deafing with the various types of conduits and racewayz, and where the}, can and cannot be used, are sufficient to ensure proper and safe wiring methods outside of the chamber.

19-2.8.6 and subparagraphs. Electrical use inside Class B chambers has not been ~ddressed previously. The proposed paragraphs codi~ current industry practice. "19-2.9 -The following basic changes]~ave been made to this section:

a) Several requirements dealing with wiring methods (from old parag~, ph 19-2.9.1.1, 2.9.1.4, 2.9.2.1 and 2.9.~) have been included m section 19.2.7 as mentioned previously. General reference to applicable parts of 19.2.7 are then made in 19.2.8.1 General.

b) The requirement in oldparagraph 19-2.9.1.2 that communication egulpment be inu'insicaiIy safe and "operate on less than 5 volts" m unnece~ary and overly restrictive and has been dropped. The requirement for intrinsic safety is certainly valid and is covered in newlg-9.8.3.11. However, the 5 volt requirement is unnecessary for intrinsic safety. There are well defined design parameters backed up by extensive testing for voltages up to 200 volts for intrinsically safe circuits. In addition, very conservative safety factors are incorporated into the actual equl]?ment design and construction. One other point is that there is ver~ little or no commercially available intrinsically safe commumcations equipment that operates at under 5 volts.

c) The "NOTE" in old paragraph 19-2.9.2.1 has been dropped. See ~ o n of intrinsi~ ~fe~v/for new paragraph 19-2.8.3.

d) The "Exception" to old paragraph I9.2.9.1.]~ has been dropped. The topics covet, ed are felt to be adequately addreued in the appllca~ole paragraph, of new 19-2.8.$. At any rate, it should be noted that hern~e6cally sealed ~vitches as described in the old "F, xception" do not qualify as ~ I, Division I equipment (see NTPA 70 Article 501-6(a)).

e) Several new requirements have been added. These are discussed in the following pages.

19-2.9.4 Combustible gas monitoring along with ventilation is the most effective way of preventing a ~ o u s gas mixture from occtm'ing in the chamber when flammable gases are used. The 10% lower explosive limit (LEL) alarm level will give plenty of advance warning so that effective measures to prevent buildup of gas concentrations to flammable concentrations can be taken. The [ow alarm level will alto allow for some possible stratification of flammable 8as (alcohols and flammabl~e anesthetics are somewhat heavier than air and will tend to concentrate more heavily toward .the floor!. The LEL for a given gas is essentially unchanged for an increase m pressure.

19-2.9.5.1 The topic of chamber saturation operatiom has not been addressed by the code. It is believed that the hazard from potential low oxygen levels in the chamber during such operations warrants the pro ~pmed requirements.

19-2.9.5.2 Another factor making the propo~d intrinsic safety approach workable (see disctmion ofintfin~c safety for ~ p h 19;2.7.8) is keep'rag the oxygen concentration from rising above that for normal air. Thus this requirement is important in guarding against hazardous situations. It should be noted that when no flammable agents (neither ~iquld, gaseous, or solid) are present in the chamber, then one of the thre~ elements, fuel (the other two being oxygen and an ignition source), required for combustion is absent and no hazard limation exists, regirdless of the oxygen concentration.

19-2.9.6 This requirement is intended to cover another situation which can arise d - 'uring saturation ope.rations, pmsible buildup of CO2 levels when carb6n dioxide scrubbing may be used in lieu of ventilation (hence the reference to propmed 19-2.4.1. "Exception'). Alarm levels, being dependent on the specific situation, should be left to the discretion o~ the safety officer or other responsible individual and are not stipulated here.

19-2.9.7.1 The prohab[llv/ofcontaminadon of the compreued air supply varies ~,idely from site to site, and thus the frequency of samplL~g should be derided by the safety officer. A location with a fairly high probability of contamination (this includes air system using off-lubricated compreuors) should be continuously monitored whenever the compressor is running.

19-2.9.7.2 Commercial ~ suppliers are required to analyze their gas mixtures; however, it m the experience of many operators that this is not alway~ done and 8aseous composition varies widely.

19-2.9.9 This requirement is intended to codify that which, is implied in old paragraph 19.9.8.3 and what is, in fact, stanoara industry practice. C O ~ ACTION: Accept.

(Log # HYP.~) 99- 288 - (19.9.10.1): Accept SUBMITYER: Subcommittee on Hyperbaric and Hypobaric Facilities RECA)MMENDATION: Revise 19.2.10.1 to read as follows:

19.2.10.1 All furnimrepermanentiy installed in the hyperbaric chamber shall be grounde& S ~ A N T I A T I O N : Only permanently installed equipment need be grounded. COMMrrIT, E ACTION: Accept.

(Log # HYP.3) 99- 289 - (19-3.1.2): Accept SUBMITrE~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: I. In sentence 9, change "by all personnel" to read: "by the safety director'.

2. In sentence $, change "as a test by* to read: "as a text by*. SU]~TANTIATION: 1. Current text is va~ue. It is the responsibll- iv/of the safety director to impart informauon of Appendix C-19 in the most productive manner.

2. Editorial. Misspelling, COMMITTEE ACTION: Accept.

99- 290- (19.3.1.5.1): Accept SUBMITYEI~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: In sentence 1, change "but in the vicinity of the chamber" to read: "and in the vicinv/of the chamber'. SUBSTANTIATION: Incorrect 8rammar. COMMYrrEE ACTION: Accept.

(Log # I-I~-47) 99- 291 - (19-3.1.5.2): Accept SUBMYITE~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-3.1.5.2, including Exception. Add two new NOTES. par#graph 19-$.1.5.2 would thus read as follows:

19-8.1.5.2 Flammable Gases and Liquids. (includin~ devices such as laboratory burners emnlovin~ bottled or natural ~ and dr, arctic lifhters~ diall be forbidden i r~de the chambe? and frorfi the nro-ximltv of the comuretsor intakf, Exception: Flammable a~ents Used for natient care. such as alcohol

swabs.um'enteral alcohol-fiased Dharmac-euficals. mnical creams. etc.. mitv be nermitted in the clfamber if the followin~ conditions

a~ Such use is aDoroved bv the safety director, or other authority

~ of inch a~ents are limited so that they are ineanahle-of rele=min~ glflqei~nt flammable Viil~r into the ehaml"~l" atm6mhere to exceed the LEL for the materi~. A safety factor shall be included to account for the localized concentrations~ stratification. and the absence of ventilation. See Note S for a samnle ~culadon

f) The oxygen monitorln~ reauirement of naram-a~h 19-2.8.5.2 is

NOTE: 1: Allowable o~nfifies for the Excentinn can be determined from the- chamber volume, flahzmable auzent vanor density and LEL. flower exmlosive limit] ~rlence fias shown that ifirre.~u,d Dresmlre hai-fitt.]e effect on I.gl. for a ~ivPn flammable ns~md oxygen concentration. A safety factor of 10 b recommended. Flamr~able linulda should be confined to non- breakable, non-shill containers. NOTE 9: Examfile of Limitin~ Ouantitv of Flammable A~ent Substance: Ison-mnvl alcohol 12-~mnanol~ T J~.T, = 29~/Vol. (ir~mectlve of ehan~her uret~ure~

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Vanor derml~ 2.1 reladve to air Li6uid dendtv: 786 It/! Air-dend~. 0.075 IbTcu. ft at fliT,

The llmidn~ case occurs at the lowest ambient nremure, i.e.. 1

~ r d~nsilv at lY.=L . ~

= 1.43 f / c u . / ~ For a relatively ma l l 500 cu. ft. chmber , this imnlles: 1.43 x 500 = 715 • alcohol vapor at !.1~.I.

Usin~ a safew factor of 10 to iccount for uneven vapor concenu- 4- tions-~ives 71.5 • = 91 ml alcohoL One ~ni~ht conclude that even 90 ml alcohol is more than ,~guld

neea~ed for mint anv medical nrocedure. The above calculation also does noi account for the mid~atin~ effect of

NOTE 3: Many ~nert" halogenaced compounds have been found to act explosively in the presence of metals, even under normal atmospheric condidom, despite the fact that the halogen compound itself does not ig~iite in oxygen, or, in the case of solids such as poly~eu'afluoroethyiene, is self-extinguishing. Apparently these materials are strong oxidizers whether as gases, li~luids (solvents, greases), or solids (electrical insulation, fabric, or coatings). Some halogenated hydrocarbon, that will not burn in the presence of low-pressure oxygen will ignite and continue to bum in high-pressure oxygen. Cus¢omarily, Class A chambers malnmininternal oxygen concentration that does not exceed 25.5 percent. [Changes Underlined]

SUBSTANTIATION: The current chapter is ambiguous with regard to the use of flammable inhaladon anesthedcs for the following reasons:

a. Present p ~ p h 19-$.1.5.2 could be interpreted as prohibiting such use unconditionally.

b. The chapter nowhere addresses the conditions under which such agents can be sa~ely used. COMMrI'rEE ACTION: Accept.

(Log # HYP-4) 99- 292- (19-5.1.5.$): Accept SUBMITYE~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Delete last sentence of existing 19-3.1.5.3 ('Maximum precautions within reason shall be taken. ') SUBSTANTIATION: Sentence is vague, undefinable and an unenforcable statement. COMMITTEE ACTION: Accept.

(Log # ~ ) 99- 295 - (19-5.1.5A(c)): Accept SLrBMITrE~ John S. Selby, S.O.S. Limited RECOMM£NDATIONs Revise text as follows:

"In Class A ~ d Class B chambers with oxygen-enriched atmospheres, electrical Rrounding 0f the pa t i en t , . . (as before)." [Change U n d e r l i n e d ] $ ~ A N T I A T I O N : SOS Limited have developed a non-metallic folding portable hyperbaric chamber as per the enclosed brochure. We have used NFPA 99 in the development of the chamber. However the "Hyperfite" chamber differs from normal Clan B chambers in that the chamber is premxrlsed with air and the patient breathes oxygen through a BIBS system. In our view neither the "Hyperlite" chamber nor its patient needs earthing.

(Sfipporflng material is av~able for review at I~FPA Headquarters) C O M M I T r ~ ACTION: Accept.

(Log # H~-7) 99- 296 - (19-5.1.5A(c)): Accept SUBMrrrF.~ Subcommittee on Hyperbaric and Hypobaric FaciHdes RF.,COMM]ENDATION: Change "conductive strap" to read: "high impedance conductive strap'. SUBSTANTIATION: Correlate with terminology used in 12- 4.1.$.10(b). COMMITrEE ACTION: Accept.

(Log # H~-60) 99- 297 - (19-3.1.5.4(e)): Accept S u R M r I T E ~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Transfer and renumber as new 19-3.2.4. Revise as follows:

19-8.2.4 Equipment of cerium, magnesium, magnesium alloys, and similar manufacture shall be pmh/blted

(See also Note under 19-$.2.£.) SULqTANTIATION: 1. More appropriate location for.this text,

2. This sentence addresses "eqmpment* not personnel. 8. The intent is to prohibit such equipment from the chamber

interior, where it would comtimte a fire hazard in the hyperbaric atmosphere. There is no necessity to ban this equipment outside the chamber, The proposed wording should clarify th~ point. C o M M r l T ~ ACTION: Accept.

(Log # HYr-4S) 99- 29S - (19-5 .1 .5 .4(b) ) : Accept SUBM]TFF~ Subcommittee on Hyperbaric and Hypobadc Fad]ides

J RECOMMENDATION: Revise 19-3.1.5.4(b) to read as follows: (b) . Andstafic procedures as directed by the safety

director shall be employed whenever_ _ atmospheres QYCr 23.5% oxygen ~v volume are used. [Changes Underlined] S U B S T ~ T I O N i I. Deledon of sentence I reflects current practice.

2. Changes in sentence 2 reflect the proposed definition of Atmosphere of Increased Oxygen Concentration. COMMrI'rEE ACTION: Accept.

(Log # re'P-40) 99- 294 - (19-$.1.5 .4(c) ) : Accept SUBMITrE~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-8.1.5.4(c) to read as follows:

(c) In Class A chambers with ~ atmospheres 25.5% oxwen by volume, and in all Class B chambers, elecm" ~cal grounding-of the patient shall be a~mred by the provision of a conductive strap in contact with the patient's s k i n . . [Changes Underlined] SUBSTANTIATION: I. Reflect definition of Aunosphere of Increased Oxygen Concenmation.

2. Allow alternative methods of grounding connection. COMMrrTEE ACTION: Accept.

(Log # H'a'-51) 99-298- (19-$.1.5.5(a) and (b) ) : Accept SUBMITrE~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-3.1.5.5(a) and (b) m read as follows:

(a) Silk, wool or synthetic textile materials shall not be permitted in Class A or Class B chambers, unless the fabric meets the flame resistant requirements of 19-8.1.5.5(d).

(b) Garments fabricated of 100% cotton or an antistatic blend of coUon and a polyester fabric shall be . ~ . . ' n e d in Class A chambers eel_ uippod with fire protection as specified in 19.2.5, and in ~ B chambers. SUBSTANTIATION: Implementing the two changes in paragraph 19-$.1.5.5(a) and 19-S.l.5.5(b) eliminates a double standard for inside medical personnel and pafiencs. The wisdom of requiring stringent fire remrdant textile standards for environments not exceeding 25.5% 02 concentration .b~ volume in traditional Class A hyperban~c chambers and not requiring at least the same level of re/ardancy or resistance for 100% oxygen environments (Class B hyperbaric chambers) is not clear. The level of protection afforded to inside personnel (observer or padent) shouldbe applied consistently. COMMITI'EE ACTIONz Accept.

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(Log # HYP-52) 99- 299 - (19-8.1.5.7 and 19-8.1.5.9): Accept 8UBM1Tr]~a Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Tranifer 19-3.1.5.9 into 19-3.1.5.7, and make it new sentence 1 so that paragraph reads:

19-3.1.5.7 The use of flammal~le h~sprays , hair oils, and skin oils shall be forbidden for all chamber occupants- patients as well as permnnel. Whenever pouible, patients shall be stripped of all ~.lothing, p a r t i ' ~ if it is contaminated by dirt, grease, or .solvents, and then i-edothed as spec~fi" ed in 19-3.1.3.6. All cosmetics, lotions, and oils shall be remov~ from the patient's ~ and hair. SUBSTANTIATION: The two paragraphs address substantially the same topic and should not be separateit. The wording in 19-3.1.5.7 follows most logically from the wording in 19-3.1.5.9. C O M M I T r ~ ACTION= Accept.

(Log # HYP-87) 804. (19-3.2.3): Accept

S U B M I T r l ~ Subcomnmtee on Hyperbaric and Hypobaric Facilities RECOMMENDATION= Revise 19-3.2.3, including adding an Exception. Par. to read as follows:

19-~.2.8 Equipment used inside the chamber requiring lubrication shall be lubricated with oxysen-compatible flame-resistant material. Rffi~a-,n= ~ e w ) F.~. .v .a~la . ! ,maf-t4.-tl,~ lu.~rln~ ~k=ll _k~

gq~fmlhaA_ tO be =m=~! wi th ~tanAm,d h~h'ocal'h~n h=hr[s.anta in I']lmm ,4.,.nh,~.s that do not ~ n l , w =*m,~,k. . rm o f ~ o x w ~

m ~ m t t i o ~ " [Changes Un/terllned] "- SULqTANTIATION: L To clarify the intent and scope of the admonition.

2. Allowance under exception pines no threat to personnel inside A chambers with oxygen concentrations closely monitored.

COMMrrI1EE ACTION= Accept.

(Log # HYP-SS) 99- 300 - (19-3.2.1): Accept S U B M I T r F ~ SubcowJmttee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: In sentence 1 of 19-3.9.1, change "hyperbaric facility" to read: "hyperbaric chamber'. SUBSTANTIATION: To give proper and equal emphasis to the status of the interior of the chamber as a part of the overall hyperbaric "facility." Section 19-9 devotes (quite properly) a good portion to addressing the special requirements inside the chamber. COMMrI'rlzR. ACTION= Accept.

(Log # i-i~-58) 99- 305- (19-3.9.5) (New)): Accept 8UBMITYER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Transfer existing 19-8.4.2 here, and renumber as new 19-8.2.5. SUBSTANTIATION= This paragraph discusses equipment and the conditions under which it can be used inside the hyperbaric chamber. The paragraph does not come under the topic of maintenance. COMMrrrEE ACTION: Accept.

(Log # HYP-54) 99- 301. (19-3.9.1.1): Accept 8 u B M r r r E ~ Subcommittee on Hyperbaric and Hypobaric Facilities R E C O ~ T I O N : Revise sentence 1 of 19-3.2.1.1 to read:

"Portable X-ray devices, electrocantery equipment, and other similar high-energy devices shall not be operated in the hyperbaric chamber finless approved ]~fLIkf.glfgl~ggI~ for such use." [Changes Underllfied] SUBSTANTIATION= The safety director, as in ] ~ a ~ a p h 19-3.2.1.2, is the on-scene person who should be designated m having authority in these matters. COMMITTEE ACTION: Accept.

(Log # HYP-~5) 99- 302 - (19-3.9.1.9): Accept SUBMrITER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMF2qDATION: Revise "(See 19-9.5.2)" to read: "(See 19- 8.13.2)'. SUBSTANTIATION: The original proposal, as passed by the Committee [TCR.NFPA 1981 Fall Meeung, proposal 56D-119- (8.2.1.9) (g)], intended referencing paragraph "-3.1.3.2." Referring to "-2.5.2" makes no sense in the 8~ven context. COMMITFEE ACTION= Accept.

(Log # }m,-58) 99- 303 - ( 19 -3 .9 .1 .4 ) ( N e w ) ) : Accept 8UBMI'ITE~ Subcommittee on Hyperbaric and Hyperbaric Facilities RECOMMENDATION: Insert new 19-8.2.1.4 to read as follows:

19-3.2.1.4 No .equipment shall be allowed in the chamber which does not meet me temperature requirements of NFPA 70 Article 500-2(a), (b) and (c). 8 ~ A N T I A T I O N : To insure that one of the most important aspects of fire prevention in chambers is observed, namely that of hot surfaces as iguidon sources (both for gaseous and solidmatter). C O M M I T r ~ x u r I O N : Accept.

(Log # H~-59) 99- 306 - ( 19 -5 .3 ) : Accept SUBMrITER: Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise 19-3.3 entirely to read as follows:

19-8.8 Handling of Gases. 19-3.3.1 General. The institution's administrative personnel shall

ensure that rules and regulations are provided to ensure the safe handling of gases in thehyperbaric fi/cifity (see 19-3,1.5.2 and Appendix C-19-1.1.3.2).

I 9 - 3 . 3 . 2 0 " ~ _ n and other gases shall not be introduced into the chamber in the liquid state.

19-3.8.3 Flammable gases shall not be used or stored in the chamber or in the hy]~erbaric facility.

19-8.3.4 Pressurized ~ontainers of gas may be introduced into the hyperbaric chamber, provided that the container and its contents are approved for mchuse by the safety director. Quanfides of oxygen stored in the chamber shall be kept to a minimum.

19-3.3.5 Nonflammable gases may be piped into the hyperbaric facility. Shut-off valves accessible to fac'tlity personnel Sr~ll be provided for such piping at the point of entry to the room housing the chamber. Storage and handlin" g of nonflammable gases shall meet the applicable requirements of NFPA 99, Chapter 4, Gas and Vacuum SDtems, and NFPA 50, Bulk Oxygen Systems at Consumer Sites, Installation Of. SUBSTANTIATION: It is felt that the proposed change results in an improved arrangement and dearer presentation of-the points covered. The "Exception" clause reference is added in 19-3.3.3 to conform with the ~cepf ions" in 19-3.1.5.2. Reference to the safety director as the cognizant authority is added to 19-8.3.4. Finally, the topic of nonflammable gas handling and storage is best addressed by the added NFPA references cited in 19-8.3.$. COMMITT]~ ACTION: Accept.

(Los # I~P~0) 99- 307 - (19-3.4.1.5): Accept S U B ~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION8 Revise 19-3.4.1.5 entirely to read as follows:

19-3.4.1.5 Storage areas for hazardous materials shall not be located in the room (see 19-9.1) housing the hyperbaric chamber. Flammable gases, except as provided in19-$.1.5.2, Exception No. I, shall not be used or stored ih the hyperbaric room.

300

N F P A 99 - - F92 T C R

SUBSTANTIATION: To better define which type of storage areas .are prohibited and where they are prohibited from. It is believed mat it is not intended that all storage facilities (i.e., those needed for normal operation of the chamber) be prohibited. The reference to paragraph 19-2.1 is included to define the prohibited area as that with~ the f i rew~ construction homing the chamber. COMMrrrEE ACTION: Accept.

(Log # HYP-61) 99-308. (19.~.4.1.6) (New)): Accept $1~Mrrrg~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMM]~NDATION: Insert new 19-~.4.1.6 to read as follows:

19-3.4.1.6 All replacement parts and components shall conform to original design Sl~Cification. $ ~ A N T I A T I O N : Covers important practice not covered in existing document. COMMrVrF~ ACTION: Accept.

(Log # H~-62) 99. 309 - (19-&5.1.1): Accept 6uBMrrrE~ Subcommittee on Hyperbaric and Hypoharic Facilities RECOMMENDATION: Revise 19.5.3.1.1 to read as follows:

19.S.5.1.1 All electrical circuits shall be tested before chamber pressurization. This test shall include a ~ check to verify that no conductors are grounded to the chambcr, as well as a test of normal functioning (see 19.2.8.2.3). [Change Underlined] SUBSTANTIATION: Test suggested is the proper one. COMMrrrEE ACTION: Accept.

(Log # I - m , ~ s ) 99. 310 - (19-3.6.2.1): Accept SUBMITrER: Subcommittee on Hyperbaric and Hypoharic Facilities RECOMMENDATION: Revise 19-3.6.2.1 to read as follows:

19-3.6.9.1 For chambers containin~ conductive floors, the requirements of 19-4.1, "Anesthefizifig Locations," I~]LgiT~." [Changes Underlined] _ . SUBSTANTIATION: Conductive ttoors are no longer a requirement in chambers. Thus, not all chambers will have them. COMMrlWEE ACTION: Accept.

99- 311 - ( 19~ .6 .9 .2 Title): Accept SUBMITrlgR: Subcommittee on Hyperbaric and Hypobaric Facilities RF.~OMMENDATION: Revise tide of 19-5.6.2.2 to read as follows:

19-5.6.2.2 Furniture J . ~ . K J R ~ . ~ I ~ . [Change Underlined] SU~qTANTIATION: To clearly define the scope to which the special requirements in this paragraph apply. COMMrITF~ ACTION: Accept.

99- 312 - (19-5.6.2.2(b)): Accept SUBMI'VI'JE~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise sentence 9 of 19-5.6.2.9(b) by deleting first word "Such" so that sentence reads as follows:

"Lubricants shall be oxygen compatible and flame resistant." SUBSTANTIATION: OrammaticaUy incorrect when used in context with first sentence. COI~WrTF.~ ACTION: Accept.

(Log# HYP~) 99- 513 - (19-3.6.2.2(b) NOTE) (New)): Accept SUBMrr I 'E~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Insert new NOTE to read as follows:

NOTE: Wheelchairs and gurneys with bearings lubricated and sealed by the manufacturer may be used in ~ A chambers where conditions prescribed in paragraphs 19-9.9.4.1, 19-9.9.5.1, 19-2.9.5.2 are met.

SUBSTANTIATION: New wheelchairs and gurneys are equipped with bearings which are sealed and diffico[t to open without causing harm to the bearings or seals. These tightly sealed bearings, in good repair, pose little or no threat to personnel inside ~ A chambers where the oxygen concentration is closely monitored and controlled.

[Sccre t~uy's Note: Paragraph numbers refer to those in Proposal 99-987 (Lbg #HYe-44)]. COMMrrrEE ACTION: Accept.

(Log # HYP-67) 99- 314 - (19-5.6.9.5): Accept S U B ~ Subcommittee on Hyperbaric and Hypobaric Facilities REGOMMF, NDATION: Revise 19-5.6.2.5 to read as follows:

19-5.6.9.5 Conductive Accessories. Conductive accesories, such as beltin~r, rubber accessories, nlasfics, covers, and sheetinn used insld¢ the ~ b e r shall meet the ~onductivitv and anti-static reouirements of the section "Reduction in Electrostatic Hazard" of Chanter 12 "Anesthedzin~ Locations." [Changes Underlined] SUBSTANTIATION: Proposals eliminates the word "replacement" since requirement should apply to original equipment as well. The section reference is felt to be the one applicable to the topic covered in this paragraph. COMMI'ITEE ACTION: Accept.

(Log # NON-~ 8) A-2-9, A4S : Accept

Subcommittee on Nonflammable Medical Piped Gas Systems ~ M M E N D A T I O N . Move the following appendix and make them a NOTE under the paragraph cited:

1. A-2-9 Medical Compreued Air, paragraphs 1 to 5. Move to 9-9, under definition of -M~tical Compreued Air" as new NOTE 1.

9. A-2-9 Medical Compressed Air, paragraph 4. Move to 2-9, under definition of 'Medical Compressed Air" as new NOTE 9.

5. A-4-5.1.9.1. Move to 4-$.1.9.1 as a new NOTE. 4. A-4-5.1.9.4(b). Move to just below ,1-5.1.9.4(b) as a new NOTE. 5. A-4-5.1.9.6. Move as new NOTE 1 at the end of three new

paragraphs added to 4-5.1.9.4 by Proposal 99-18 (Log #NON.17). 6. A-4-~5.1.9.7, paragraphs 1 and 9. Move and add as a new NOTE

after paragraph 5 in 4-3.1.9.7. 7. K-4-5.1.9~, paragraph 4. Move and add as new NOTE 2 at the

end of the three new paragraphs added to 4-5.1.9.4 by Proposal 99- 18 (Log #NON-17). . .

8. A-4-$.1.9.7, NOTE at end oz paragraph 4. Move and insert after

ON: To make it easier for users of document to understand requirments in Chapter pordon of document by having informatory information immediately following the text with which it is associated. C O M M r I T ~ ACTION: Accept.

(Log # 2S) 99- $16 - (A-S-5.2.1.1): Accept S U B ~ Jack Berger, N.E. Hospital Engineer s Society RECOMMENDATION: In the 9th paragraph, chang~e *the leakage current becomes a fault', to read ~ e leakage condiuon becomes a fault condition*. SUBSTANTIATION: Realistically, the leakage current in the situation described continues as k. An added current, "fault current" is introduced to the condition. COMMITr]~ ACTION: Accept.

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N F P A 99 m F 9 2 T C R

0-~ # 24) 99. $17. (A.S-5.2.1.1, paragraph 15): Accept $UBMrrT]gh Jack Berger, N.E. Hospital Engineers Society RECOMMENDaTIONs Delete entire paragraph 15 ofA-3-5,2.1.1 or make the following changes:

1. 7-5.1.3.2... tludl be less than 0.50 ohms, to less than 0.5 ohms, 2. 9-2.1.13.2... shall be leu than 0.15 ohms. to less than 0.2 ohms.

SUBSTANTIATIONs A. Test equipment available todayd permit accurate measurement uf fractional ohms.

B. This reference, A-~.2.1.1 pm'agraph 15, contradicts the degree of accuracy called for in Articlei 7-52.3.1 and 9-2.1.13.2. C O M M H ' r ~ ACHON: Accept.

Delete paragraph 15 in appendix A-3-5.2.1.1. C O M M I Y T ~ STATEMENT: Submitter included two options in proposal. Committee selected an option.

(Log # 26) 99- 318 - (A-3.5.2.1.3): Accept in Part S U B ~ Jack Rerger, N.E. Hospital Engineers's Society RECOMMF2qDATION: I. Change turead: A-3-5.2.1.3 and A-3-5.2.1.4, add asterisk to 3-5.2.1.4. 2. Change to read: "requirements uf both Chapter 3 and Article 250 of NFPA-70,

National Electrical Code." 3. Insert between paragraphs 1 and 2 the following: "Effective grounding path~ampacity (Art. 250-51, NFPA-70) is

intended to be a des~fi and not testing requirement." $UDSTANTIATION: 1. A-3-5.2.1.3 mentions both voltage and impedance measurements.

2. Specificity. 3. Article 250-51 mentions ampacity .ofgrounti circuits. Other

than by low energy resistance or impedance measurements, it could be unsafe to measure actual ampaclty o f a ~round circuit in a health care facility while occupied and active. Thin added ~ p h will make it clear that actual measurement of ground ampaaty is not a routine test requirement. COMMI'ITEE ACTION: Accept in Part.

For 1, Reject. [ For 2, Accept.

For 3, Reject. COMMrrYEE STATEMENT: For 1., Appendix material addresses only voltage measurements, not impedance measurements.

For S., Subm/tter's Recommendation could be confusing as Appendix material is on testing and test equipment.

(Log # 113) 99- 319 - (A-4.3.1.9.7): Accept SUBMrrrER: Mark Allen, Ohmeda RECf)MMENDATIONt Delete third paragraph:

"Nonlubricated...harmful gases." S U ~ A N T I A T I O N : This statement is not substantiated by experience or by the literature. The temperatures necessary to produce the "outgas~g of harmful gases" are much higher (>842°F (450"C)). At lower temperatures, parficuiate matter is the harmful product, and filtration as required'by 4-3.1.9.7 eliminates this

Ootentlal hazard. TE: Supporting material is available for review at NFPA

Headquarters. C O M M r r I ' ~ ACTION: Accept.

(Log # 114) 99- 520 - (A-4-$.1.9.7): Reject SUBMITTER: MarkAllen, Ohmeda RECOMMENDATION: Add a new paragraph as follows:

"Liquid ring air compressors using chlorinated water as a sealant havebeen implicated m the premature degradation of certain widely used engir~eeringplastics such as Delrin. Selection of this technology shofild inclui~ appropriate water treatment equipment to remove chlorine." SUBSTANTIATION: Incidents of the depolymerization of acetal copolymer plastics (eg. Deirin) have been traced to the use of liquid ring air co m.preuors using chlorinated city water as their feed water. The exact tifinensinns of /he problem are not known to the writer, but stt~cient evidence exists to include this warning statement. C O M M r r I ' ~ ACTION: Reject.

COMMITTEE STATEMENT: The problem as stated cannot be attributed at the present time to a specific cattse. More research is required. However, the Subcommittee did respond by adding in 4- 3.1.9.4 the need that service water be provided-as recommended by the manufacturer.

(Log # 19) 99- 521 - (A-4-3.1.9.8): Reject SUBMITrE~ Peter F.atherick, Patient Inslrumentation Corp. RF.~OMMiD4DATION: Add to recommended analytical testa Table A-4-$.1.9.8:

"Tests for Nitrogen Dioxide, Nitric Oxide and Sulfur Dioxide." SUBSTANTIATION: Tests for these contaminants are required by USP as of Jan.-Feb., 1988. Limits: 2.5 ppm: NO & NO 2

5 ppm: SO 2 COMMrITEE ACTION: Reject. CoMMrrTEE STATEMENT: Specific reference to values could place material out of step with USP document.

(LOg # 109) 99- 322 - (A-5-4.4): Reject $UBMITrER: Norman V. Steere, Stillwater, MN RECOMMENDATION: Revise Section A-5.4.4 to add to the paragraph:

Whe American National Standarde Institute,. SUBSTANTIATION: The American National Standards Institute is developing a standard for laboratory ventilation. COIM[~ AcYrlON: Reject. COMMrITEE STATEMENT: Committee Action on Proposal 99- 161 (Log #92) deleted A-5-4.4.

(Log# 110) 99. 323 - (A-5-4.4.6): Reject SUBMn'Y]Z~ Norman V. Steere, Stillwater, MN RECOMMENDATION: Revise Section A-,,r~.4.6 to delete the second pa n of the first sentence which reads:

"; unuiual conditions may require velocities greatly in excess of this flow." SUBSTANTIATION: This is dangerous information because tests by the Environmental Protection Agency have shown that increasing face velocity above about 100 fpm will cause increasing turbulence and a decrease in the capture effectiveness and safety performance of a hood. If references are given to NFPA 45, laboratory designers and users will have access to more comprehensive information on l tilation

ACTION: Reject. COMMITTEE STATEMENT: Committee Action on Propom199- 161 (Log #92) deleted A-5-4.4.0.

(Log # 111) 99. ~24 - (A-10-6): Accept in Principle SUBMrITER: Norman V. Steere, Stillwater, MN RECOMMENDATION: Revise Section A.10-6 so that it reads as follows: A.10-6 Floor drains in areas of hospitals and other health care

facilities are likely to dry out if the floors are not wet-mopped regularly, and dry traps can permit passage of gases, vapors, odors and vermin. Since a floor drain wit[ be of great value if a ,afety shower is used and several hundred gallons of water are released, it is recommended that floor drains be filled with water regularly, or in new construction that some plumbing be provided to fill the traps manually, automatically, or incldenudly b~ plumbing design. SUBSTANTIATION: Operation o fa safety shower for the minimum recommended time of 15 minutes at a recommended rate of~0 gallons per minute will release 4.50 gallons ofwaterl To minimize water damage to the building, it will be very desirable to have a floor drain m direct much of the water to inunedlately. COMMITr l~ ACTION: Accept in Principle.

Replace existing paragraph S ('Floor drains a r e . . , and odors.') with Submitter's recommendation. COMMITY]~ S T A ~ : Other material in A-10-6 is still relevant.

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(Log # 112) 99- 325 - (A-10-8.1.6): Accept SUBMITrER: Norman V. Steere, Stillwater, MN RECOMMENDATION: Revise Section A-10-8.1.6 so that the first sentence deletes reference to NFPA 49 as a source of information on disposal of hazardous chemicals, and reads as follows:

"Information sources for safe handling, storage and emergency response to spills or fires in hazardous materials indude NFPA 49, Hazardous Chemicals Data." SUBSTANTIATION: NFPA 49 does not provide information on disposal of hazardous chemicals. However, as Chairman of the Technical Committee v/aich just completed a revision and updating of NFPF 491 believe it is a superb document which would be valuable in all health care facilities and laboratories which store and use hazardous chemicals. COMMITrEE ACTION: Accept.

(Log # DIS-2) 99- 329 - (Annex I, I-3.4): Accept S U B ~ Subcommittee on Disaster Planning RECOMMENDATION: Add at the end of paragraph I the following: ~Vhile large numbers of the local populace do not speak English as

their first language, provisions for multi-lingual signs, announcements and reception personnel should be considered. Efforts need to be made to assure that emergency procedures and instructions are understood by occupants and population. Primary reliance on pictograms, through the use of NFPA 170, Standard on Firesafcty Symbols, is recommended." SUBSTANTIATION: Many disaster authorities refer to linguistic barriers to success. COMM1TFEE ACTION: Accept.

(Log # LAB-4) 99- 326 - (A-I0-8.2.1 (New)): Accept S U B ~ Subcommittee on Laboratories RECOMMENDATION: Add new Appendix A-10-8.2.1 to read: A-10-8.2.1 NFPA 704 identification system is encouraged to be used

on doors of approved flammable liquid storage cabinetry and on doors of refrigerators. SUBSTANTIATION: This identification is useful to fire service CpeOrsonnel.

MMITTEE ACTION: Accept.

(Log# 132) 99- 327 - (C-4.4): Rejecx SUBMITTER: Antonio A. Mesa, Nash Engineering Company RECOMMENDATION: Change constant in Equation 1 ,Page 168 from .00341 to .01414 SUBSTANTIATION: (From correspondance to Submitter) It was recently brought to my attention that there is an error in the pipe pressure drop formula which is used in the NFPA document 99- Health Care Facilities (Pa~ge 154). The formula constant is incorrect and should be 0.01414, not

.00341 as it currently stands. For reference please see page 1-6 from Crane Technical Paper No.

410, Equation 1-4 which gives pressure in terms of PSI. The constant in the NFPA formula is derived as:

1 0.01414 (144) (0.4912)

where .4912 is the conversion for PSI to in. hg. The good news is that the vacuum flow charts in the NFPA are OK

as is. That is, the only error is the formula. The curves of pressure drop vs. pipe size were ,drawn using the correct formula. I 'd appreciate it if you would bring this to the attention of the

proper people within the NFPA committee. (Supporting material is available for review from NFPA Headquar-

ters.) COMMITTEE ACTION: Reject. COMMITI'EE STATEMENT: There are questions on the formula itself that will be restudied during the public comment period.

(Log # DIS-l) 9% 328- (Annex 1, 1-1.2): Accept SUBMITrER: Subcommittee on Disaster Planning RECOMMENDATION: Revise last sentence to read as foUows:

~ h i l e , this annex primarily addresses hospitals, many parts are readily usable in upgrading emergency preparedness of even the smallest facility, from outpatient diagnostic centers to ambulatory health care centers to limited care facilities and nursing facilities. The principles involved are universally applicable; the implementation needs to be tailored to the specific facility." [Changes Under- lined] SUBSTANTIATION: Many people and organizations have requested clarification as to apph'cability of Annex 1 to small and rural facilities. COMMITTEE ACTION: Accept.

(Log # DIS-6) 99- 330 - (Annex I, I-3.1.14): Accept SUBMITrER: Subcommitee on Disaster Planning RECOMMENDATION: Revise 1-3.1.14 to read as follows: ~¢arious accreditation or certification authorities or institutions

specify requirements for periodic rehearsal of disaster plans. Implementation of a facility's emergency preparedness program may be evidenced by documentation of a rehearsal or an actual disaster occurance. In either case, it is recommended that facilities comply with relevant criteria. It is extremely important the disaster exerose . . . [rest of paragraph the same] ~ SUBSTANTIATION: There are other accreditation/certification organization besidesJCAHO that prescribe the rehearsal of disaster plans. COMMITTEE ACTION: Accept.

(Log # D1S-3) 99-331 - (Annex 1, 1-3.14): Accept SUBM1TTF_J~ Subcommittee on Disaster Planning RECOMMENDATION: Insert the following just before the last sentence in 1-3.14:

~Local fire and emergency management authorities usually also have requirements for rehearsals and followup; these agencies need to be involved at all stages of planning, testing and execution. This is best achieved through reciprocal and integrated training and management." SUBSTANTIATION: Health care facilities must not develop their disaster plans in isolation. Some recent incidents have occurred that point to this need for coordination. COMMITFEE ACTION: Accept.

(Log # DIS-4) 99- 332 - (Annex l, I-4.1): Accept SUBMITrER: Subcommittee on Disaster Planning RECOMMENDATION: Add the following at thc end of I-4.1: uLocal authorities may designate the emergency management

official as final authority for terminating disaster operations. Administrators need to coordinate decisions and announcements with such authorities, and proceed with internal recovery operation$." SUBSTANTIATION: Although local authorities may terminate their activities, recovery operations of facilities may take an extended CPeoriOd of time.

MMITrEE ACTION: Accept.

(Log # DIS-7) 99- 333 - (Annex 1, 1-6.4): Accept SUBMITFER: Subcommittee on Disaster Planning RECOMMENDATION: Revise 1-6.4 to read as follows:

1-6.4 Fire and /or Explosion Protocol (Including Arson Attempts). In the event that the health care facility need no tbe completely evacuated immediately, the following actions need to be accomplished as applicable, with the order of implementation dependent on circumstances.

(a) Notify emergency services (e.g., fire department, ~911 ~); (b) Alert any facility emergency respooders; (c) Contain and/or extinguish fire according to the fadlity's

policies and procedures;

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(d) Rescue all persons in immediate danger; (e) Meet responding emergency services personnel and direct

them to scene; (0 Secure the affected area; (g) Control movement of all patients and visitors; and (h) Evacuate facility of p?rfions thereof, as directed.

SUBSTANTIATIONs Existing text and guidance has become datect. C O M M r I T ~ ACTION: Accept.

(Log # DIS-5) 99- $$4 - (Annex 1, 1-7.1): Accept S U B ~ Subcommittee on Disaster Planning RECOMMENDATION: Add to 1-7.1 the following:

"NFPA 170-1991, Standard for Firesafety Symbols ~'. S ~ A N T I A T I O N : Include new NFPA standard on the subject of firemfety I~/rabois. C O M M I T r ~ ACTIONt Accept.

(Log # 133) 99- 385 - (Annex 2): Reject S ~ Joseph G. Weiu, Greater N.Y. Hospital Assoc. RECOMMW.ND-ATION: Place entire document, now in Annex 2 into main body of Code. SUBSTANTIATION: Recent O.1t. fires, which have been traced to misuse of electro surgical units, demonstrate that the information contained in "The SaSe Use of High Frequency Electricity in Health Care Facilities" needs to be given the emphasis and importance of being part of the 'Yequirement~" of NFPA 99, and not just a recommendation. COMMITTEE ACTION: Reject. COMMI'ITEE STATEMENTz Annex 2 is currently not written in a form that can be readily and easily transferred from a guide to a standard.

(Log # HGH-8) 336 - (Annex 2, 2-2.1.I.3): Accept

S ~ Subcommittee on the Use of High Frequency Electricity RECOMMENDATION: In sentence 1, change "pulse train" to "continuous pulse train". SUBSTANTIATION: Clarify technical content. COMMITrF_~ ACTION: Accept.

(Log # HGH-4) 99- 337 - (Annex 2, 2-&2.1): Accept SUBM/TrER: Subcommittee on the Use of High Frequency Electricity RECOMMENDATION: Add at end of paragraph:

may be of particular concern if the affected apparatus is computer-based since rome digital circuits are very sensitive to interference.* SUBSTANTIATION: To take note of effect on current technology. COMMITTEE ACTION: Accept.

(Log # HGH-5) 99-338- (Annex 2, 2-S.4.1): Accept SUBMITYER: Subcommittee on the Use of High Frequency Electricity RF2~.,OMMENDATION: 1. Change "these can be classified as:" to read "The dispersive electrode may be connected in either of two way~:"

2. In 2-3.4.1 (a), add at end: "See Figure 2-3.$.1.4(a) ; 3. In 2-3.4.1 (b), add at end: "See Fig~u/e 2-3.3.1.4(b) .

SUBSTANTIATION: 1. Correct an editorial error fi-om a previous edition.

2 and 3. Reference figures for illustrative purposes. COMMrrrEE ACTION: Accept.

(Log # HGH-6) 99- 339 - (Annex 2, 2-3.4.5): Accept S U B ~ Subcommittee on the Use of High Frequency Electricity RECOMMENDATION: Revise last sentence (*~[x~wvoh... system.') to read "Such low voltage equipment should not be used unleu provided with an isohted powe r mpply." SUIBkqTANTIATION: To cAarify which equipment is being referenced. Such equipment has to be on rome type of isolated power su C AC ON, Accept.

(Log # 186) 99- 340 - (Annex 2, 2-$.6.5): Accept in Part SUBM1Trg~a Saul Aronow, Teclinology in Medicine, Inc. RECOMMENDATION: Add new text as follows:

2-$.6.5 Use of Hand Controls The use of pencil-type electrodes that include hand controls,

particularly multiple electrodes on the same electrosu~gical unit, or contact-activated electrodes present s[~ecial problems because of ease of misuse and inadvertant activation. Appropriate hoisters should be provided to house electrodes in the sterile field when not in use. Periodic retraining of staff, ~ l y w h e n new equipment is used, should be required. (See 2-5.2.5) SUBSTANTIATION: There have been many reports of fires, patient burns and patient ~juries because staff members are often not aware of incidental hazards that may accompany the use of more convenient devices. Although manufacturers try to make the devices as fool-proof as _possible, users accustomed to older simpler controls, may appreciate that other kin& of precautions are now appropriate. COMMrITEE ACTION: Accept in Pan. Accept Suhmitter's recommendation, except delete last sentence of

recommendation (i.e., "Periodic. . . required.') COMMITTEE STATEMENT: Committee Acdon on Proposal 99- 195 (Log #161) addresses issue of requiring periodic training.

(Log # 187) 99- $41 - (Annex 2, 2-5.2.5): Accept SUBMITYERt Saul Aronow, Tec~o logy in Medicine, Inc. RECOMMENDATION: Add new text as follows: 2-5.£.5 In Service Training The health care facilit~ adininistration should insdmte an

obligatory in-service trmning program for the surgical staff and others involved in the use of high-frequency energy sources. With the current rapid changes in medical device technology, many techniques that were appropriate a short time in the past are no longer so. There is a great potential for patient injury and fire ignition if these high powered e n e r ~ devices are improperly used. Education and retraining are euenual to avoid these hazards. SLr~TANTIATION: There have been numerous recent reports of fire and injury because of the misuse of electrosurgical equipment. The purpose of this section is to remind the hospiial administration that even experienced surgeons should be retrained when new equipment, with new problems, is acquired. COMMrrrEE ACTION: Accept

(Log # HGH-8) 99- $42 - (Annex 2, 2-9): Accept SUBMITYER: Subcommittee on the Use of High Frequency Electricity RECOMMENDATION' i. In 2-9.2, update ANSI C95.1 to reference 1991 edition. 2. In 2-9.4 add following reference: Pearce,J.A., PhD,

~Electrosurgery." John Wiley & Sore, New York, 1986. 3. In 2-9.4, delete following reference: Kovacs, P,., MD, "Electro-

ther-,py... 1950." SUBSTANTIATION: I. A new edition of this document has been

ad°PAtemdore recent book that is a useful reference. 3. Reference is no longer appropriate.

COMM1Tr~ ACTION: Accept.

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(Log # I-~-8) ~JB- 1 - (S-2.2.2): Accept S ~ Subcommittee on Hyperbaric and Hypobaric Facilities R g C O ~ A T I O N : Revim text at follows:

I. Make sentence I ('Where feasible.. , dust, or liquids.') sentence I of exisdni[ NOTE.

2. Revise sentence :Z to read: "In a hypobarlc chmber , i fa bilge g ~ / ' A . ~ - ' r l x r l ' ' [rest the .ame]."

OSs Comply with NFPA Manual of Style for informatory text. COMMrrrEE ACTION: Accept.

(Log # HYP-9) 99B- 2 - (3.7.1): Accept $uBMrrrEga Subcommittee on Hyperbaric and Hypobaric Facilities R F . A P ~ ~ T I O N : Revise S-7.1 to a NOTE under 3.7. Renumber 3.7.2 and 3.7.$ as 3-7.1 and 3-7.2, respectively, SUBSTANTIATION: Comply with NFPA Manual of Style for

ACTION: Accept.

(Log # HYP-IO) 99B- $ - (3.7.S,6): Accept SUBMITTERs Subcommittee on Hyperbaric and Hypobaric Facil/des RECOMMENDATION: In semence 2, revise "may have its own" to read:

"is perrnitted m have ire own." SUB'STANTIATION: Comply with NFFA Manual of St~e for required text. COMMITTE~ ACTIONs Accept,

(Log # m ~ l s ) 99B- 5 - ( 4 - 1 2 ) : Accept SUBMITrER: Subcommittee on Hyperbaric and Hypobaric Fadlifies RECOMMENDATIONs In sentence S, revise "should be reviewed by all personnel" to read as follows:

"shall be reviewed by the m/'e~ director." SUBSTANTIATION: 1, Comply with NFPA Manual of Style for required text.

2. Safety Director ia the approprlate person w mmign re~onsibilky for disseminating intormauon. COMMrr r ]~ ACTION: Accept.

(Log # HYP-X s) 99B- 6 - (4-1.3.3): Accept SuBMrrrE~ Subcon~nittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: In sentence I, revise "should be desig- hated" to read as follows:

"shall be designated." SIYJ~TANTIATION: Comply with NFPA Manual of Style for

ired text. ACTION~ Accept.

(Log # HYPq4) 99B- 7 - (4-1.7.4): Accept SUBMrrYE~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: Revise "and should be as" to read as follows:

". The 7 shall be as'. SUBSTANTIATION: Comply with NFPA Manual of Style for required text. COMMITT]~ ACTIONx Accept.

(Log # H~.11) 99B- 4 - (3-8.2): Accept SUBMrI ' r ]~ Subcommittee on Hyperbaric and Hypobaric Facilities RECOMMENDATION: In sentence 2 revise "may be employed" to read:

"are permitted." SUBSTANTIATION: Comply with NFPA Manual of Style for required text. COMMrrrF~ ACTION: Accept.

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