Managing OSHA Health Programs

WITC – New RichmondApril 14, 2011

Mary Bauer CIH, CSPCompliance Assistance SpecialistEau Claire, WI 54701 715-832-9019

My Background

Mary Bauer

25 years w/ OSHA 20 Compliance Officer 5 Compliance Assistance Specialist

IH/ Safety CIH: Certified Industrial Hygienist CSP: Certified Safety Professional 1000 + Inspections

Today’s Agenda

What are OSHA Health Programs? How do I know if I need one? Required Documentation Maintenance/Retention of Records Exposure and Medical Records Tips on Record Maintenance

“Paperwork Reduction Act”

1942, 1980 & 1995 1980 Created “Office of Info & Regulatory

Affairs” “Burdent Hours”: Time & Expense to Fill Out

Forms The purposes of this chapter are to:

minimize the paperwork burden for individuals, small businesses, educational and nonprofit institutions, Federal contractors, State, local and tribal governments, and other persons resulting from the collection of information by or for the Federal Government;

“Older” vs. “Newer” Standards

Older Standards Require a “program” Don’t Require it written

1910.95: Hearing Conservation Program

Newer Standards Requires a Written Program

Bloodborne Pathogens Respirator

Written Program Periodic Review

Industrial Hygiene from an OSHA Perspective

Focus on workplace health hazards Goal: reduce or eliminate hazards that

can cause sickness or impaired health Identify & analyze workplace health

hazards * chemical * physical * ergonomic * biological

Health Hazards:

Air Contaminates Lungs Central Nervous System Internal Organs Blood

Skin Contact - Dermal Irritant Burns

Noise Hearing Loss Ringing in the Ear

Bloodborne Hepatitis…..B and C HIV/AIDS

Spill/Leak of Chemical

Immediate orChronic (Long Term)

Effects

Health Standards List is NOT Complete

1910.95: Hearing Conservation / Noise 1910.120: Emergency Response 1910.132: Personal Protective Equipment 1910.134: Respiratory Protection Program

1910.1001-1910.1052 Expanded Health Standards

Expanded Standards:

Asbestos Coal Tar Pitch Volatiles 13 Carcinogens Alpha-Naphthylamine Methy Chloromethyl Ether 3,”-Dichlorobenzidine Bis-Chloromethyl ether Beta-Naphthylamine Benzidine 4-Aminodiphenyl Ethyleneimine Beta-Propiolactone 2-Acetylaminoflurorene 4-Dimethylaminoazobenzene N-Nitrosodimethylamine

Vinyl Chloride Inorganic Arsenic Lead Hexavalent Chromium Cadmium Benzene Coke Oven Emissions Cotton Dust 1,2-dibromo-3-chloropropane Acrylonitrile Ethylene Oxide Formaldehyde Methylenedianiline 1,3-Butadiene Methylene Chloride

Health Standards

1910.1020: Formerly 1910.20 Access to Exposure and Medical Records

1910.1030: Bloodborne Pathogens 1910.1096: Ionizing Radiation 1910.1200: Hazard Communication 1910.1450: Chemical Hygiene Plan -

Labs

Standards: Construction 1926.50: Medical Services and First Aid 1926.51: Sanitation 1926.52: Occupational Noise 1926.53: Ionizing Radiation 1926.55: Gases, Vapors, Fumes, Dusts and

Mists 1926.56: Illumination 1926.57: Ventilation 1926.59: Hazard Communication:

REFERENCES: General Industry 1910.1200

Subpart C: 1926.33: Access to Medical and Exposure Records

References General Industry: 1910.1020

Standards: Construction

Subpart D: Continued

1926.60: Methylenedianiline 1926.62: Lead 1926.64: Process Safety Management 1926.65: Haz Waste Operation & Emer Response 1926.66: Spray Booths

Subpart Z:

1926.1101-.1152: Expanded Standards

Related Standards

PPE 1910.132: General 1910.133: Eye & Face 1910.138: Hand

Ventilation: 1910.94

Flammable: 1910.106 LEL/UEL vs. PEL

Emergency Response: 1910.120 PSM: 1910.119 Medical Services and First Aid: 1910.151

Expanded Standards: Common Paragraphs

Scope and Application Definitions AL / PEL / STEL / Action Level Monitoring

Initial & Subsequent Ees Access

Regulated Areas Method of Compliance Respiratory Protection

Expanded Standard: Common Paragraphs

Training Medical Surveillance Hygiene / Work Clothing / Showers Signs / Labels / Warnings Records / Recordkeeping Appendices Written Compliance Plan Emergencies / Spills Effective Dates

How Do I Evaluate the Hazard?

MSDS Observation: Smell, Taste, See, Feel Screening – Next Session

Direct Reading Instruments Short Term Sampling- Next Session TWA Sampling – Next Session Bulk Sampling Interviews: Mgmt – Ees

Hazard Review

Chemical or Hazard: What’s used? How Much? How Often? Previous Sampling? Controls?

Existing? Determined Effective?

Changes in Process since Determined Maintained? Measured? (Manometer)

Sampling: Only way to really know!

Qualified Person State Consultation Insurance Carrier Private Consultant OSHA: Enforcement!

Appropriate Instrument

Duration of sampling Pre and post

calibration

How to you Attack the Problem?Hierarchy of Controls

Engineering Administrative Personal

Protective Equipment

Training

Controls or Abatement Methods Classic Hierarchy:

Product Substitution / Elimination Methylene Chloride: Have Avoided at all costs! Asbestos – Limited to No Mfg or Product Containing

Engineering Control Ventilation Barrier / Distance / Automation

Administrative Controls: Rotation Prohibited for Some Contaminates (Pb)

PPE Respirator Hearing Protection

Noise: 1910.95(m)

Exposure Measurements Sound Level or Dosimeter Readings

Retain for 2 Years * HOWEVER, Need to Show Monitoring Results *

Audiograms: Employee Info Testing Equipment Information Duration of Affected Employee’s Employment Includes Specific Information

Occupational Noise Exposure

Assess your workplace! Monitor areas of concern Sample worker’s full-shift noise

exposure

Engineering Controls or Hearing Protection???

Hearing Conservation Requirements

Monitoring Employee Notification Audiometric Testing Hearing Protectors Training Access To Records Recordkeeping

Noise Sampling – Some Tools Industrial Hygienists Use:

Sound level meter: Spot Checks Noise dosimeters: Exposure Determination

Occupational Noise Exposure

If full-shift noise exposure averages above the OSHA PEL of 90 dBA (decibels A-weighted) Hearing protection must be provided &

used

If full-shift noise exposure averages above OSHA Action Level of 85 dBA A hearing conservation program must

be implemented

Hearing Conservation Program (HCP)

Purpose: prevent or reduce progression of noise-induced hearing loss

HCP must include: Noise monitoring Hearing protection Hearing testing

(audiograms) Training Recordkeeping

NRR: EPA Rating

Audiometric Testing

New Hires Annual Standard Threshold Shifts Testing Equipment Notification to Employee Revised Baselines or Retesting

VAN EXEMPTION

Respiratory Protection1910.134

Written Copy of Respiratory Program 1910.134( c)(1)(i)-(ix)

Written PLHCP Opinion

Fit Testing

Certification / Inspection Emergency Use

Respiratory Protection

When must you provide your workers with respiratory protection? When they are

exposed to a chemical in excess of the OSHA PEL

Until engineering, administrative, & work practice controls have been implemented to control exposures (& re-sampling shows exposures in compliance with PEL)

Respirator-Use Requirements per 29 CFR 1910.134(c)

Voluntary Respirator Use

What if air sampling results are below the PEL & you only allow voluntary use of filtering face piece dust masks?

You must inform workers about Appendix D of 1910.134 ("Information for Employees Using Respirators When Not Required Under the Standard")

Voluntary Respiratory Use:Other than “dust mask”

What if you allow voluntary use of other types of respirators?

Must have written respirator program that provides for:

medical evaluation, cleaning, maintenance & storage of

respirators

What if your workers are required to wear respirators?

Written program Respirator selection

Must be appropriate for hazard If selecting a gas or vapor cartridge respirators, must

develop cartridge change-out schedule (unless it has an ESLI)

Medical Evaluations Fit testing Proper use of respirators Continued effectiveness

Cleaning, disinfecting, storage

Training

Medical Evaluation

You must provide an evaluation before respirator use and before fit testing

You need to identify a professional Licensed Health Care person to conduct an evaluation through using a medical questionnaire or an initial medical examination that contains the same information.

Medical Evaluation-cont.

Medical evaluations need to contain the information requested in the questionnaire in Section 1 and 2, Part A of Appendix C of 1910.134

Follow up examinationsFollow up examinations A positive response to any question 1-8 of

section 2 OR Initial medical exam demonstrates the need

for a follow up

Fit Testing

Fit Testing

Qualitative Quantitative

Next SessionPortaCount Rep &

Equipment

Fit Testing

Before the use of any negative or positive TIGHT FITTING face piece respirator

No Fit Testing Required

Hoods, helmets and loose-fitting facepieces Escape-only respirators Voluntary use respirators

Hood Helmet Loose-fitting

User Seal Check

Non-Air Contaminate/Expanded Std.

1910.1020: Access to Med & Exp Records

1010.1030: Bloodborne Pathogens 1910.1096: Ionizing Radiation 1910.1200: Hazard Communication 1910.1450: Chemicals in

Laboratories

Access to Medical and Exposure Records 1910.1020

Formerly 1910.20 – WRONG in OSHA Standards to this day!

Where it says to keep MSDS for 30 years! Sampling Data Medical: Audiograms Medical Access Order is Related: 1913.10

http://www.osha.gov/SLTC/medicalaccessorder/index.html

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10207

Availability of Med & Exp Records 1913.10(b)(3) This section does not apply to OSHA access to,

or the use of, aggregate employee medical information or medical records on individual employees which is not in a personally identifiable form. This section does not apply to records required by 29 CFR Part 1904, to death certificates, or to employee exposure records, including biological monitoring records treated by 29 CFR 1910.1020(c)(5) or by specific occupational safety and health standards as exposure records.

1913.10(b)(4) This section does not apply where OSHA compliance personnel conduct an examination of employee medical records solely to verify employer compliance with the medical surveillance recordkeeping requirements of an occupational safety and health standard, or with 29 CFR 1910.1020. An examination of this nature shall be conducted on-site and, if requested, shall be conducted under the observation of the recordholder. The OSHA compliance personnel shall not record and take off-site any information from medical records other than documentation of the fact of compliance or non-compliance.

Access to Medical and Exposure Records 1910.1020

Inform Upon Initial Hire and Annually There after….NOT TRAINED Posting

Wisconsin Council of Safety Example

Producing the Record after Requested What is a request Who can request 15 days

Access To Exposure & Medical Records: 1910.1020

Exposure Record MSDS Industrial Hygiene Monitoring

Medical Records Medical Surveillance Results Written Medical Opinions

WCS Website w/ sample program: http://www.doa.state.wi.us/docs_view2.asp?docid=2510

Access To Exposure & Medical Records: 1910.1020 Retention Time:

Unless specified in a “vertical” standard "Employee medical records." The medical record for

each employee shall be preserved and maintained for at least the duration of employment plus thirty (30) years, except that the following types of records need not be retained for any specified period:

The medical records of employees who have worked for less than (1) year for the employer need not be retained beyond the term of employment if they are provided to the employee upon the termination of employment.

"Employee exposure records." Each employee exposure record shall be preserved and maintained for at least thirty (30) years, except that:

BLOODBORNE PATHOGENS1910.1030

Written Exposure Control Plan Reviewed at least annually

Training Date(s) Content or Summary Names and Qualifications of Trainer Names and Titles of Attendees Retained for 3 Years

Training Materials Sharps Log

Coverage

Standard applies to all occupational exposure to blood or other potentially infectious materials

If you answer NO

Develop a policy stating that there are no first aid responders or cleanup and that the company will rely on 911 for any type of response to injuries

If you answer YES

Develop and implement all elements of a written bloodborne pathogens program

•Exposure Control Plan must provide:•Engineering controls (where applicable)•Hygiene (hand washing)•PPE (e.g., gloves, CPR masks)•Housekeeping•Disposal of regulated waste•Hepatitis B vaccine•Post-exposure evaluation & follow-up•Training

Exposure Control Plan Requires employers to:

identify potentially exposed workers those who need training PPE Vaccination Engineering Controls (Safer Needle Devices)

Required to be reviewed and updated annually with Employee Input

Bloodborne Pathogens

Are your employees going to be exposed or have the potential to be exposed to Bloodborne Pathogens or other potentially infectious materials?

Who performs cleanup of blood or fluids?

Are you going to appoint designated first aid responders?

Bloodborne Pathogens 1990’s

Directive to Use any / all standards + 5a1 Effective Date: March 6, 1992 1993 FAQ – One of the First Latex Allergies Surfaced and Addressed Collateral Duty Clause:

First Aid as additional responsibility All Other Provisions in Place After Opportunity to Perform 1st Aid

Offer Hep B Vaccination Region V Policy for BBP Sharps Log /Safer Needle Devices: 2001

Revisions to 1910.1030 as a result of the Needlestick Safety and Prevention Act: Paragraph 1910.1030(d)(2)(i) requires the use of engineering

and work practice controls to eliminate or minimize employee exposure to bloodborne pathogens.

Employers must keep a Sharps Injury Log for the recording of

percutaneous injuries from contaminated sharps [1910.1030(h)(5)(i)].

The Exposure Control Plan (1910.1030(c)(1)(i)) shall: Reflect changes in technology that eliminate or reduce exposure to

bloodborne pathogens [1910.1030(c)(1)(iv)(A)]. Document annually consideration and implementation of

appropriate commercially available and effective safer medical devices designed to eliminate or minimize occupational exposure [1910.1030(c)(1)(iv)(B)].

Solicit input from non-managerial employees responsible for direct patient care, who are potentially exposed to injuries from contaminated sharps, in the identification, evaluation, and selection of effective engineering and work practice controls and shall document the solicitation in the Exposure Control Plan [1910.1030(c)(1)(v)].

Methods of Compliance

Universal Precautions

Engineering Controls

Personal Protective Equipment

Housekeeping

Handling of regulated waste

Training Employees

All employees (including part-time and temporary) must receive initial and annual training

Must be conducted in the language the employee understands

Must be “interactive” 14 Points Qualified Trainer

1910.1200Hazard Communication / “Right to Know”

“Right to Know” MN Terminology: St. Croix Valley Companies Previously: State of WI

The Four Stages of the Program Material Safety Data Sheets (MSDSs) Labeling and Marking Systems Employee Training Written Plan

Hazard Communication1910.1200

Written Program Program MSDS Labeling Training

MSDS: Material Safety Data Sheets 30 years after you stop using it

Hot Topics:

Article Brick / Block = Article Silica = Chemical Exposure if Sawn

Electronic Access – Readily Available Devices must be readily accessible in workplace Workers must be trained in their use Must be back-up system to address emergencies

Labeling

Target Organ Compromises: Additional Training

HMIS: Paint Industry NFPA

Placarding Allowed Welding Areas Color Coded Bottles

Secondary Containers Primary Problem If not used w/in the shift

Labeling and Marking SystemsHMIS Labels

Blue = Health Red = Flammability Yellow = Instability White = Personal

Protective Equipment or special protection information

Numerical Rating of 0-4

Labeling and Marking SystemsNFPA Diamonds

4= Deadly Hazard 3= Severe Hazard 2= Moderate Hazard 1= Slight Hazard 0= No Hazard Color coded, numerical

rating system Will be located near

main entrances, fire alarm panels, or on outside entrance doors

Provide at-a-glance hazard information

What Documents Should I NOT Possess?

What Documents Should I NOT Possess?

Specific findings or diagnoses unrelated to occupational exposure - Do NOT Possess: Pass/Fail or Satisfactory/Unsatisfactory on Medical Tests Medications, Blood Pressure, History, etc. Ee Completed Appendix C: Respirator Medical Evaluation

Instead - Possess “Written Opinions” from: Respirator Medical Evaluations Emergency Response Medical Evaluations Bloodborne Pathogen Test Results, etc.

HIPAA: http://www.hhs.gov/ocr/hipaa/ Provisions for Confidentiality if Medical Records are Kept. Plant Nurse or Health Department

Written Opinion vs. Medical Test Results

Written Opinion: No Specific Results Can Perform Duties Can Not Perform Duties Can Perform Duties w/ Following Limitations

Medical Tests: ER Needs to Know Results Audiograms to Determine STS Worker Comp and OSHA Log Info - Diagnosis Biological Indicators for Chemicals

Blood Lead Test Results and other Metal Test Results

More Common Standards

List is NOT Complete: 1903: Abatement Verification 1904: Injury & Illness Log 1910.38 & .39: Emergency Action & Fire Plan 1910.95: Hearing Conservation / Noise 1910.119: Process Safety Management (PSM) 1910.120: Emergency Response -HAZWOPPER 1910.132: Personal Protective Equipment- PPE 1910.134: Respiratory Protection Program 1910.146: Permit-Required Confined Spaces

Most Common Standards

1910.147: Lockout - Tagout 1910.157: Portable Fire Extinguishers 1910.178: Powered Industrial Trucks 1910.179: Overhead and Gantry Cranes 1910.180: Crawler Locomotive & Truck Cranes 1910.184: Slings 1910.217: Mechanical Power Presses 1910.266: Logging 1910.268: Telecommunications 1910.269: Power Gen, Trans, & Distribution 1910.401: Commercial Diving

Most Common Standards

1910.1001-1910.1052 Expanded Health Standards

1910.1020: Formerly 1910.20 Access to Exposure and Medical Records

1910.1030: Bloodborne Pathogens 1910.1200: Hazard Communication 1910.1450: Chemical Hygiene Plan - Labs

Maintain in What Form?

Readily Accessible On or Off Site 24/7/365 How to access

Withstand Changing Technology Electronic Forms Constantly Changing Need 30 Plus Years Software Changes

What about your Contractors?

Do your outside contractors have the required documentation of their safety and HEALTH program?

Do you ask? Do you receive copies? What programs would you ask for?

Eau Claire

Madison Milwaukee

Appleton

For More Help

Kelly Bubolz, Appleton Area Office

1648 Tri Park WayAppleton, WI 54914920-734-4521

Mary Bauer, Eau Claire Area Office 1310 West Clairemont Eau Claire, WI 54701715-832-9019

Leslie Ptak, Madison Area Office 4802 E. BroadwayMadison, WI 53716608-441-5388

Pat Ostrenga, Jim LutzMilwaukee Area Office 310 W. Wisconsin Ave. Rm 1180Milwaukee, WI 53203414-297-3315

QUESTIONS

Disclaimer

This information has been developed by an OSHA Compliance Assistance Specialist and is intended to assist employers, workers, and others as they strive to improve workplace health and safety. While we attempt to thoroughly address specific topics or hazards, it is not possible to include discussion of everything necessary to ensure a healthy and safe working environment in a presentation of this nature. Thus, this information must be understood as a tool for addressing workplace hazards, rather than an exhaustive statement of an employer’s legal obligations, which are defined by statute, regulations, and standards. Likewise, to the extent that this information references practices or procedures that may enhance health or safety, but which are not required by a statute, regulation, or standard, it cannot, and does not, create additional legal obligations. Finally, over time, OSHA may modify rules and interpretations in light of new technology, information, or circumstances; to keep apprised of such developments, or to review information on a wide range of occupational safety and health topics, you can visit OSHA’s website at www.osha.gov.