Just a ppt I made to focus on Respirators and Noise issues among others in IH, I am seeing many not do medical surveillance, fir testing and wearers cannot do a User Seal check.,

1. Industrial Hygiene &
Respiratory Care
John Newquist
Draft 3 1 2015

2. August 2013
• Franklin, NC
• One person has died and 16 others
were hospitalized from exposure to
high levels of carbon monoxide in
a packing facility
• "We monitored the (carbon
monoxide) levels once we got
there, and the highest reading we
got was 1,000 parts per million."

3. Exposure Limits
• Animal Studies
• Epidemiological
studies
• Industrial Experience
• STEL – 15 minutes
• Ceiling – never
exceeded
• Threshold Limit Value

4. Sampling
• Qualified person
• Appropriate
instrument
• Duration of sampling
• Pre and post
calibration

5. Hierarchy of Controls
• Engineering
• Administrative
• Personal Protective
Equipment
• Training

6. Problem #1 Noise
• BLS
• 125,000+ workers w permanent, hearing
loss since 2004
• In 2008 alone, 22,000 hearing loss cases
were reported

7. #1 Noise
• Hearing Protection worn
20%*
• Several processes
involving hammering,
cutting, blasting will cause
overexposure
• Set up an effective hearing
conservation program

8. REMEMBER!
• The aforementioned
applies to
overexposures above
90 dBA TWA
(Time-Weighted-
Average)

9. “Effective hearing conservation
program?”
Monitoring
Engineering, work practice,
and administrative controls
Hearing protectors with an
adequate noise reduction
rating
Employee training and
education in hazards and
protection measures
Baselines and annual
audiometry

10. Audiograms
• Conduct a baseline analysis on
all equipment (New too!)
• Employees can request personal
noise monitoring at any time at
VPP sites
• 60 employees were tested in IL.
• It cost $29.00 per person plus
some labor cost (VPP)
• Insurance carrier will charge
$35.00 per person. (VPP site)

11. Ear protection
Re-usable ear plugs:
• regular and careful washing
• fitted by a trained person
• must be good fit
• dust may irritate
• Ear defenders:
• well designed
• well made
• must be good fit

12. Hearing
Protection
• Ear plugs
• Ear muffs
• Audiometric testing
• More information provided in
training on hearing
conservation

13. Hearing Protection Basics
• Noise induced hearing loss can occur with
exposures >90 dBA
• A hearing conservation program becomes a
requirement at exposures >85dBA
• Higher levels of noise exposure have
shorter allowable exposure times

14. Noise levels versus Duration
Sound Level (dBA)
90
92
95
100
105
110
115
Exposure (hours)
8
6
4
2
1
0.5
0.25

15. Hearing Protection
• Rule of Thumb - if you cannot carry on a
conversation in a normal tone of voice with
someone at arm’s length, you are likely near
90dBA
• All hearing protection devices should have
a Noise Reduction Rating (NRR) = # of
decibels they will reduce noise levels
• Be conservative when using NRRs

16. A couple examples
• Example 1
– Ear plugs with NRR of 25 dBA
– exposure = 105 dBA
– 105 minus 25 = 80 dB therefore okay
• Example 2
– same plugs
– exposure = 125 dBA
– 125 minus 25 = 100 dB not acceptable; must be
below 90 dB

17. Hearing Protection - Types
• Ear Plugs - less expensive, disposable, good
ones have fairly high NRRs - sometimes
difficult to tell if employees are wearing
them
• Ear Muffs - more expensive, more durable,
typically higher NRRs than plugs, more
obvious
• Can be used together in very high noise
areas

18. #2 Lead
• Requires compliance with 1910.1025
• Overexposure can occur in less than 5 minutes
when torch cutting or painting

19. Lead effects
• Chronic overexposure - severe damage to
the blood-forming, nervous, urinary, and
reproductive systems
• High levels will require medical removal
• Bridge Painting/Removal continues to be
ones of the consistent lead issues in
construction

20. #3 Silica
• Cutting, hammering,
drilling, blasting can
create high silica
levels
• Use wet methods and
wear respirators
• One of the oldest
occupational diseases

21. Silica
• 150-200 deaths a year
(2009)
• 1150-1200 deaths a
year (1968)
• Yet….one company
had 3 silicosis and
10x+ severe
respiratory diseases
Gauley Bridge in 1920’s had
workers die in months.

22. #4 Copper Fumes - Welding
• Copper is inhalation
hazard affecting
respiratory system
• Mild steel (red iron)
and carbon steel
contain manganese
• Manganese may
cause Parkinson's
disease
What do you see?

23. #5 Total Dust
• All the things not
regulated.
• Good, bad, or
indifferent?
• Air blowing!

24. #6 Iron Oxide -Welding
• Metal fume fever
• Direct Draw or forced
ventilation should be
used
• Personal Protective
Equipment should be
used
• Bystanders should be
protected as well

25. #7 Carbon Monoxide
• Generators are most
common problem of
CO
• Heaters out of tune are
another cause
• CO TWA is 50 ppm
• Others set levels 25
ppm

26. #8 Hex Chrome
• Stainless steel contains
nickel and chromium
• Plating, grinding,
welding are problems
• Some cements

27. # 9 Cadmium
• Overexposure to
cutting cadmium bolts,
coated poles
• Torch cutting should
never be used
• Use hydraulic bolt
cutters
• Comply with
1926.1127 Cadmium bolts are often
found in sprinkler pipe use.

28. #10 Methylene Chloride
• Paint stripping
• Parts cleaners
• Cancer causing

29. Asbestos
• Common Fireproofing
material used pre-
1980s
• Found in pipe
insulation, ceiling
tiles, and floor tiles
• Must comply with
1926.1101 or
1910.1001

30. June 2014
• The asbestos lawsuit that
saw a $1 million award
• Richard Rost has
Mesothelioma
• Defendants included Ford
Motor Company (Ford),
General Electric,
Westinghouse and Ingersoll-
Rand.
• However, the latter three
defendants settled with the
plaintiffs out of court, before
the trial had an opportunity
to begin.
Overall, nearly 3,000 people
are diagnosed with mesothelioma each
year in the United States, which represents
0.02 percent of all U.S. cancer cases.

31. Heat Stress
• Train the workforce
• Perform the heaviest work in the
coolest part of the day
• Slowly build up tolerance to the
heat and the work activity
(usually takes up to two weeks)
• Drink plenty of cool water (one
cup every 15-20 minutes)
• Wear light, loose-fitting,
breathable (cotton) clothing
• Take frequent short breaks in
cool or shaded areas
• Provide fans

32. SUNBURN
Dealing with Heat Stress
Heat stress can be more than a minor inconvenience for those who work in
extremely warm conditions. Knowing how to prevent, identify and treat its
symptoms can literally save lives.
Symptoms
• Red, painful skin (first degree burns)
• Blistering and/or peeling (second degree burns)
Treatment
• Skin lotions
• Topical anesthetics
Prevention
• Limit sun exposure on bare skin

33. HEAT RASH & CRAMPS
Symptoms
• Red rash and itching
• Hot, moist skin
• Normal to slightly high body temperature
Treatment
• Ointment
Prevention
• Keep skin dry and clean
• Loosen clothing
• Drink lightly salted liquids (.1% saline)
• Seek medical aid if cramps persist
Dealing with Heat Stress

34. HEAT EXHAUSTION
First Aid Treatment
• Loosen or remove clothing and boots
• Cool the victim as fast as possible
• Call 911 if victim becomes faint or is unconscious
Symptoms
• Heavy sweating
• Intense thirst from dehydration
• Fatigue, weakness or loss of coordination
• Tingling in hands and feet or headache
Dealing with Heat Stress

35. HEAT STROKE
Early Symptoms
• High body temperature
• Hot, red or flushed, dry skin
• Headache or dizziness
• Confusion or delirium
Advanced Symptoms
• Seizure or convulsions
• Loss of consciousness
• No detectable pulse
Call 911 at the first sign of the above symptoms!
Dealing with Heat Stress

36. HEAT STROKE
Treatment
• Lower the victim’s body temperature as fast as possible
• Don’t give liquids to unconscious victims
Other tips for controlling heat stress
• Allow your body to become acclimatized to
your surroundings
• Follow scheduled work/rest cycles to avoid
overexertion
• Drink 5-7 ounces of cool water every 15 minutes
• Consume a light, cool lunch instead of hot,
heavy meals
Dealing with Heat Stress

37. Dehydration

38. Confined Spaces
• Manholes, pits, vaults,
tanks, are common
confined spaces
• Ensure atmosphere is
safe by testing and
ventilating
Worker in a sludge pit exposed
to lead, arsenic, and cadmium

39. Paint Solvents
• Ventilation is required
or overexposure can
result
• Fire Hazard
• Electrical must be
Class I if within 20
feet during open
spraying with
flammable paints
Tank painting. What could go
wrong?

40. Waterproofing
• Volatile compounds
are heavier than air
and toxic.
• Death
• Hazards similar to a
confined space

41. Diesel Fuel Exhaust
• blue smoke (mainly oil and
unburnt fuel)
• black smoke (soot, oil and
unburnt fuel);
• white smoke (water droplets
and unburnt fuel)
• Diesel Fuel Exhaust is
reasonably anticipated to be
a human carcinogen per
IARC
What else is toxic
in this ????

42. Mold
• Stachybotrys chartarum (also
known as Stachybotrys atra)
• Aspergillus sp.
• Penicillium sp.
• Fusarium sp.
• Trichoderma sp.
• Memnoniella sp.
• Cladosporum sp.
• Alternaria sp.

43. First Aid
First aid training
Good Samaritan Collateral duty* Designated responder
Not covered by
BBP Standard
BBP standard applies
* if First-Aid response is
an expected part of the
job
BBP standard
applies

44. Universal Precautions
Treat as if known to be infectious
All human
blood
Certain human
body fluids
All human body fluids if they can’t be distinguished

45. Regulated Waste Handling
• When moving containers:
» Close immediately
» If leaking, place in
secondary container
» If reusable, clean in a
manner that will not
expose employees.

46. Exposure Incident
Contact with blood or OPIM via:
• Cuts, puncture, needle sticks
• Mucous membrane
• Eye
• Non-intact skin

47. Post Exposure Evaluation
• Provide medical evaluation ASAP
• Testing for HBV, HCV, HIV
• HIV/HBV PEP when indicated
• Identify source individual, if possible
• Obtain consent for blood test
• Provide information to healthcare provider
• Routes of entry
• Employee’s job duties
• Copy of the regulation
Employer Responsibility:

48. Medical Evaluation and Follow-up
• Provide in writing to employer:
• Employee has been informed of the results
• Employee has been informed of any medical
conditions resulting from exposure
• All specific findings or diagnoses are
confidential to employee
Healthcare Provider’s Responsibility:

49. October 2014

50. Ebola

51. On The Horizon
• Silica?
• Noise?
• Confined Space
in Construction?

52. Respiratory
Protection
• 1910.134
– Written program #2
– Medical evaluation #1
– Fit testing #3, #6
– Selection, Evaluation of
exposure #5
– Maintenance, Storage, and
Care #9
– Annual Training #8
– Program evaluation #10
– Beards #7
Voluntary use App D - #4

53. Respiratory protective equipment
Selection of suitable type
by competent person
Factors:
• nature of hazards
• measured concentrations
• period of exposure
• vision
• communications
• confined spaces
• personal suitability

54. Respiratory protective equipment
Training in the use
of equipment must
be given
Stored in a clean
place with protective
enclosure

55. Respiratory protective equipment
Disposable face mask:
• light, comfortable, cheap
• one user only
• eight hour maximum
use, but less if high dust
levels
• dispose of after use
• May not be ok for silica
• Not for lead and
asbestos

56. Respiratory protective equipment
Half-mask dust respirator:
• easily maintained
• freedom of movement
• may have ‘shelf life’
• colour coded cartridges

57. Respiratory protective equipment
• High efficiency
particulate air (HEPA)
dust respirator:
• full face protection
• correct fitting and use
• beards, spectacles, etc.
may lessen efficiency

58. Respiratory protective equipment
Positive pressure powered
respirator:
• for long periods of work
• pump and filter
• approximately seven hours
use
• air leaks go outwards
• requires battery and filter
maintenance

59. Respiratory protective equipment
Helmet and visor respirator:
• battery-operated fan and
filter
• comfortable
• not for all hazards
• requires maintenance
schedules

60. Respiratory protective equipment
Compressed airline breathing
apparatus:
• mask or hood with
compressed airline
• requires pure air at correct
pressure, humidity and
temperature
• air hose can restrict
movement

61. Respiratory protective equipment
Self-contained breathing
apparatus:
• mask, air regulator and
cylinder
• used only by a trained
person
• selected by competent
person
• cylinder duration is 20 – 30
minutes

62. Evaluation
• "The employer shall identify
and evaluate the respiratory
hazard(s) in the workplace; this
evaluation shall include a
reasonable estimate of
employee exposures to
respiratory hazard(s) and an
identification of the
contaminant's chemical state
and physical form
• Does not require air sampling
but……

63. Training Requirements
• Training must be provided
prior to use
• Retraining is required
annually, and when:
– changes in the workplace
or type of respirator render
previous training obsolete
– there are inadequacies in
the employee’s knowledge
or use
– any other situation arises
in which retraining
appears necessary

64. Voluntary Use Requirements
(other than filtering facepiece respirator)
• Medical evaluations
• Maintenance,
Cleaning, Storage
• Appendix D
• The basic advisory
information in Appendix D
must be provided to
employees who wear
respirators when use is not
required by this standard or
by the employer

65. Voluntary Use Requirements
(Filtering facepiece only)
Appendix D only:
• Read and Heed all
instructions
• Use approved
respirators
• Properly selected
• Keep track of your
respirator

66. #1 1910.134(e)(1)
• The employer shall provide a medical
evaluation to determine the employee's
ability to use a respirator, before the
employee is fit tested or required to use the
respirator in the workplace.
• The employer may discontinue an
employee's medical evaluations when the
employee is no longer required to use a
respirator

67. Medical Evaluation Requirements
• Evaluation completed prior to wearing respirator
• Evaluation include information in Sections 1 and 2, Part 1
Of Appendix C
• Conducted by a physician or licensed health care
professional

68. Medical Signs and Symptoms
• The following are
signs or symptoms
that may prevent the
use of a respirator:
– Seizures
– Claustrophobia
– Asthma
– Emphysema
– Pneumonia
– Collapsed Lung
– Lung Cancer
– Broken Ribs
– Chest
Injuries/Surgeries
– Any other lung
problems
– Heart or Circulation
problems
– Anxiety

69. Fit Testing
Quantitative fit testing uses a machine to
measure the actual amount of leakage
into the face piece and does not rely
upon your sense of taste, smell, or
irritation in order to detect leakage
The fit test shall be administered
using an OSHA-accepted QLFT or
QNFT protocol.
Fit test before use. #6
Fit test not done annually #3

70. Fit Testing
• Qualitative fit testing is
normally used for half-
mask respirators - those
that just cover your mouth
and nose.
• Half-mask respirators can
be filtering facepiece
respirators - often called
"N95s" - as well as
elastomeric respirators.

71. User Seal Check
An action conducted by the respirator
user to determine if the respirator is
properly seated to the face.
Positive Pressure
Check
Negative Pressure
Check

72. Protection Factors
• Protection Factor
• Half-Face Respirator 10 x PEL
• Full-Face Respirator 50 x PEL
• Powered Air Respirator 100 x PEL
• Air-line 100 x PEL

73. Questions?

74. Background
• Classes: OSHA 10/30 Hour,
Incident Investigation,
Confined Space, Excavation
Safety, Cranes Signaling and
Rigging, Fall Protection,
Scaffold Safety, and many more
• Services: Mentoring new safety
professionals, Mock OSHA
Inspections, Site Safety Audits,
OSHA Litigation Consultation,
Expert Witness, Reducing
Worker Compensation Risk,
Improving Site safety
74
• 34 years working with top
companies to achieve ZERO
injuries
• Certified Safety Professional
• OSHA 1983-2012
• Founding Member of ANSI Z359
• 815-354-6853
• Johnanewquist@gmail.com