Industrial Hygiene &

Respiratory Care

John Newquist

Draft 3 1 2015

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."

Exposure Limits

• Animal Studies

• Epidemiological

studies

• Industrial Experience

• STEL – 15 minutes

• Ceiling – never

exceeded

• Threshold Limit Value

Sampling

• Qualified person

• Appropriate

instrument

• Duration of sampling

• Pre and post

calibration

Hierarchy of Controls

• Engineering

• Administrative

• Personal Protective

Equipment

• Training

Problem #1 Noise

• BLS

• 125,000+ workers w permanent, hearing

loss since 2004

• In 2008 alone, 22,000 hearing loss cases

were reported

#1 Noise

• Hearing Protection worn 20%*

• Several processes involving hammering, cutting, blasting will cause overexposure

• Set up an effective hearing conservation program

REMEMBER!

• The aforementioned

applies to

overexposures above

90 dBA TWA

(Time-Weighted-

Average)

“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

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)

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

Hearing

Protection• Ear plugs

• Ear muffs

• Audiometric testing

• More information provided in

training on hearing

conservation

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

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

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

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

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

#2 Lead

• Requires compliance with 1910.1025

• Overexposure can occur in less than 5 minutes

when torch cutting or painting

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

#3 Silica

• Cutting, hammering,

drilling, blasting can

create high silica

levels

• Use wet methods and

wear respirators

• One of the oldest

occupational diseases

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.

#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?

#5 Total Dust

• All the things not

regulated.

• Good, bad, or

indifferent?

• Air blowing!

#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

#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

#8 Hex Chrome

• Stainless steel contains

nickel and chromium

• Plating, grinding,

welding are problems

• Some cements

# 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.

#10 Methylene Chloride

• Paint stripping

• Parts cleaners

• Cancer causing

Asbestos

• Common Fireproofing

material used pre-

1980s

• Found in pipe

insulation, ceiling

tiles, and floor tiles

• Must comply with

1926.1101 or

1910.1001

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.

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

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

HEAT RASH & CRAMPSSymptoms

• 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

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

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

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

Dehydration

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

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?

Waterproofing

• Volatile compounds

are heavier than air

and toxic.

• Death

• Hazards similar to a

confined space

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 ????

Mold

• Stachybotrys chartarum (also

known as Stachybotrys atra)

• Aspergillus sp.

• Penicillium sp.

• Fusarium sp.

• Trichoderma sp.

• Memnoniella sp.

• Cladosporum sp.

• Alternaria sp.

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

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

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.

Exposure Incident

Contact with blood or OPIM via:

• Cuts, puncture, needle sticks

• Mucous membrane

• Eye

• Non-intact skin

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:

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:

October 2014

Ebola

On The Horizon

• Silica?

• Noise?

• Confined Space

in Construction?

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

Respiratory protective equipment

Selection of suitable type

by competent personFactors:

• nature of hazards

• measured concentrations

• period of exposure

• vision

• communications

• confined spaces

• personal suitability

Respiratory protective equipment

Training in the use

of equipment must

be given

Stored in a clean

place with protective

enclosure

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

Respiratory protective equipment

Half-mask dust respirator:

• easily maintained

• freedom of movement

• may have ‘shelf life’

• colour coded cartridges

Respiratory protective equipment

• High efficiency

particulate air (HEPA)

dust respirator:

• full face protection

• correct fitting and use

• beards, spectacles, etc.

may lessen efficiency

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

Respiratory protective equipment

Helmet and visor respirator:

• battery-operated fan and

filter

• comfortable

• not for all hazards

• requires maintenance

schedules

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

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

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……

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

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

Voluntary Use Requirements

(Filtering facepiece only)

Appendix D only:

• Read and Heed all instructions

• Use approved respirators

• Properly selected

• Keep track of your respirator

#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

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

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

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

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.

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

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

Questions?

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