A short presentation that I used in 2015

1. Health Hazards
John Newquist
Draft 1 8 2016

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. Worst Job?

4. Introduction
• Top Ten Health Issues found by OSHA
• Problem correlated to Overexposures
• Effect Measure
• Best Practices
• Sampling Data 2004-2010, Region V, all
industries

5. Clean Air Paradox
• Quality of Air
• 78.1% Nitrogen
• 20.9% Oxygen
• 0.9% Argon
• 0.03% Carbon
Dioxide

6. Units Seem Small
1 % = 10,000 ppm
PEL = Permissible
Exposure Limits
(OSHA)
5 Mg/M3 is very small
2 f/cc = 2,000,000f/M3

7. Health Effects
• Irritation
• Asphyxiation
• Organ Specific Effects
• Mutagen
• Teratogen
• Acute/Chronic
• Reversible vs.
Nonreversible

8. Factors
• Genetics
• Age
• Health status
• Route of entry
• Frequency and
duration of exposure

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

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

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

12. Past Health Hazards
• 400 BC Hippocrates
describes lead poisoning
in mines
• 1473 Ellenbog – Mercury
Poisoning
• 1700 Dr. Ramazzini
published the first edition
of his most famous book,
the De Morbis Artificum
Diatriba (Diseases of
Workers)
“I can hire one-half the
working class to kill the
other half.” Jay Gould

13. Alice Hamilton
• In 1908, Hamilton was
appointed to the newly formed
Occupational Diseases
Commission of Illinois, the first
such investigative body in the
United States
• Lead in dishes, added to
gasoline and paints
• Silica in granite cutting,
• Benzene in solvents
• Carbon-monoxide gassing in
the steel mills
• Pneumonia and rheumatism in
the stockyards

14. Phossy Jaw
• Alice Hamilton
discovered
matchstick workers
risked the dreaded
"phossy jaw, which
comes from
breathing the fumes
of white or yellow
phosphorus

15. Mad as a Hatter
• Alice Hamilton
found that Mercury
poisoning in the felt
hat industry caused
uncontrollable
jerking of arms and
legs and mental
illness

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

17. #1 Noise
• Hearing Protection worn
20%*
• Several processes
involving hammering,
cutting, blasting will cause
overexposure
• Set up an effective hearing
conservation program

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

19. “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

20. 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)

21. #2 Lead
• Requires compliance with 1910.1025
• Overexposure can occur in less than 5 minutes
when torch cutting or painting

22. 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

23. #3 Silica
• Cutting, hammering,
drilling, blasting can
create high silica
levels
• Use wet methods and
wear respirators
• One of the oldest
occupational diseases

24. 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.

25. #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?

26. #5 Total Dust
• All the things not
regulated.
• Good, bad, or
indifferent?
• Air blowing!

27. #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

28. #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

29. #8 Hex Chrome
• Stainless steel contains
nickel and chromium
• Plating, grinding,
welding are problems
• Some cements

30. # 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.

31. #10 Methylene Chloride
• Paint stripping
• Parts cleaners
• Cancer causing

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

33. 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.

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. Dehydration

41. 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

42. 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?

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

44. 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 ????

45. Back Strains
• Many workers out in
with bad backs
• Due to lifting and
twisting constantly
• Heavy loads should
have assistance via
machines or another
person

46. West Nile
• Use DEET or lemon
eucalyptus based sprays
for protection
• Clothing can be treated
with Permethrin
• Wear light color clothing
and reduce exposed skin

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

48. 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

49. 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

50. 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.

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

52. 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:

53. 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:

54. October 2014

55. Ebola

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

57. Quiz
• CO PEL is ___ ppm.
• Name one place where cadmium can be found .
______________
• ____% Oxygen is in normal air.
• Which color smoke from a diesel engine is a concern?
__________________
• Overexposure can occur in less than ____ minutes
when torch cutting lead painted surfaces
• The Short Term Exposure Limit (STEL) is for ____
minutes