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2015 industrial hygiene & respiratory care

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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.,

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2015 industrial hygiene & respiratory care

  1. 1. Industrial Hygiene & Respiratory Care John Newquist Draft 3 1 2015
  2. 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. 3. Exposure Limits • Animal Studies • Epidemiological studies • Industrial Experience • STEL – 15 minutes • Ceiling – never exceeded • Threshold Limit Value
  4. 4. Sampling • Qualified person • Appropriate instrument • Duration of sampling • Pre and post calibration
  5. 5. Hierarchy of Controls • Engineering • Administrative • Personal Protective Equipment • Training
  6. 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. 7. #1 Noise • Hearing Protection worn 20%* • Several processes involving hammering, cutting, blasting will cause overexposure • Set up an effective hearing conservation program
  8. 8. REMEMBER! • The aforementioned applies to overexposures above 90 dBA TWA (Time-Weighted- Average)
  9. 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. 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. 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. 12. Hearing Protection • Ear plugs • Ear muffs • Audiometric testing • More information provided in training on hearing conservation
  13. 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. 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. 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. 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. 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. 18. #2 Lead • Requires compliance with 1910.1025 • Overexposure can occur in less than 5 minutes when torch cutting or painting
  19. 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. 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. 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. 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. 23. #5 Total Dust • All the things not regulated. • Good, bad, or indifferent? • Air blowing!
  24. 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. 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. 26. #8 Hex Chrome • Stainless steel contains nickel and chromium • Plating, grinding, welding are problems • Some cements
  27. 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. 28. #10 Methylene Chloride • Paint stripping • Parts cleaners • Cancer causing
  29. 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. 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. 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. 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. 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. 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. 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. 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. 37. Dehydration
  38. 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. 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. 40. Waterproofing • Volatile compounds are heavier than air and toxic. • Death • Hazards similar to a confined space
  41. 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. 42. Mold • Stachybotrys chartarum (also known as Stachybotrys atra) • Aspergillus sp. • Penicillium sp. • Fusarium sp. • Trichoderma sp. • Memnoniella sp. • Cladosporum sp. • Alternaria sp.
  43. 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. 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. 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. 46. Exposure Incident Contact with blood or OPIM via: • Cuts, puncture, needle sticks • Mucous membrane • Eye • Non-intact skin
  47. 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. 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. 49. October 2014
  50. 50. Ebola
  51. 51. On The Horizon • Silica? • Noise? • Confined Space in Construction?
  52. 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. 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. 54. Respiratory protective equipment Training in the use of equipment must be given Stored in a clean place with protective enclosure
  55. 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. 56. Respiratory protective equipment Half-mask dust respirator: • easily maintained • freedom of movement • may have ‘shelf life’ • colour coded cartridges
  57. 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. 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. 59. Respiratory protective equipment Helmet and visor respirator: • battery-operated fan and filter • comfortable • not for all hazards • requires maintenance schedules
  60. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 73. Questions?
  74. 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

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