Emergency response to environmental toxic incidents: The role of the occupational physician*
|
|
- Neil Powers
- 6 years ago
- Views:
Transcription
1 Occup. Med. Vol. 46, No. 5, pp , 1996 Copyright 1996 Rapid Science Publishers for SOM Printed in Great Britain. All rights reserved /96 Emergency response to environmental toxic incidents: The role of the occupational physician* R. J. McCunney Environmental Medical Service, Massachusetts Institute of Technology Cambridge, MA, USA A survey of accidental environmental releases of hazardous chemicals conducted by the Agency for Toxic Substances and Disease Registry indicates that fixed facility events accounted for 77% of the episodes whereas 23% of the releases were related to transportation activities, such as loading or unloading materials. In nearly all the events (88%) only one chemical was released. Volatile organic compounds, chlorine, herbicides, acids and ammonia were the most common substances involved. In nearly one out of six reported events, an injury occurred. To prepare for emergencies associated with the accidental release of hazardous materials, the federal government, industry and professional organizations including the medical community have all been involved. In the United States, the Superfund Amendment Reauthorization Act (SARA) Title III passed in 1986 addresses the need to establish local emergency planning committees, to report and collect data, and a number of other matters. Professional societies, including the Joint Commission for the Accreditation of Health Care Organizations, the American College of Occupational and Environmental Medicine (ACOEM), and the American Industrial Hygiene Association, have all attempted to ensure proper education and training of those professionals called to assist in such emergencies. The occupational physician can assume numerous roles in the challenge related to emergency response, by becoming familiar with computerized information available to promptly determine the type of hazard released and its appropriate antidote, advising on the proper personal protective equipment, awareness of secondary contamination and participation on local emergency planning committees among many others. Emergency release of hazardous materials continues to occur with a frequency in the United States that deserves active vigilance and planning. Key words: Emergency response: environmental chemical releases; occupational physician. Occup. Med. Vol. 46, , 1996 Received IS January 1996; accepted in final jorm 7 May INTRODUCTION Emergency response to environmental incidents continues to arouse the attention and demand the expertise of health officials in many industries, local communities and professionals. As a result of one 'Based on presentations made at the 1994 Annual Medichem Congress, Melbourne, Australia and the 1995 Annual Meeting of the American College of Occupational Medicine, Las Vegas, Nevada, USA. Medichem is a scientific advisory committee of the International Commission on Occupational Health. Correspondence and reprint requests to: R. J. McCunney, Environmental Medical Service, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 20B-238, Cambridge, MA, USA. Tel: (+1) ; Fax: (+1) particular episode, the 1984 release of methyl isocyanate gas in Bhopal, India, 1 a watershed of activity occurred worldwide, ranging from the government to the medical community to professional societies, and the chemical industry itself. 2 ' 3 The point of this paper is to (1) summarize reports related to the consequences of acute releases of hazardous materials; (2) describe appropriate United States regulations; and (3) propose how physicians can be instrumental in both the planning and implementation of related emergency measures. Previous reports Despite the recent emphasis on planning for emergency response, as well as requirements of certain laws,
2 398 Occup. Med. Vol. 46, 1996 including the Superfund Act Reauthorization Amendment (SARA), 2 reporting systems appear in need of improvement. 4 Presently, 14 state health departments collect and transmit information regarding emergency events to the Agency for Toxic Substances and Disease Registry (ATSDR). This information includes the names of the substances released and the public health consequences including illness, injuries and the need for evacuation. When instituted by the ATSDR in January, 1990, the programme included five states. At the completion of December, 1992, an additional nine states were enrolled. In the most recent summary, from January 1990 through December 1992, 33,125 events were reported, 5 with fixed facility events accounting for 77% of the episodes, and releases related to transportation activities making up the remaining 23%. Only one chemical was released 88% of the time. Volatile organic compounds, herbicides, acids and ammonias were the most common substances described. In approximately one out of six reported events, injuries occurred; 11 deaths were noted. The most frequently reported symptoms were respiratory and eye irritations. At least one out of six of these events resulted in an evacuation. Earlier, a Centers for Disease Control Report described accidental releases of hazardous materials that resulted in deaths, injuries or evacuations. 6 As part of the report, the three largest national databases, the National Response Center, the Department of Transportation Hazardous Materials Information System and the Acute Hazardous Events Database were reviewed. Of the 587 episodes described in 1986, 115 deaths, 2,254 injuries and 111 evacuations occurred. Since only eight (1%) of these 587 events were common to all three of the reporting systems, the author conducted an additional review of articles in the NEXIS Search System of Mead Data Central. 7 This survey of the general literature uncovered an additional 210 deaths, 6,490 injuries and 533 evacuations, which yielded an average of 3.3 acute chemical releases each day resulting in serious consequences. These releases were not reported to customary agencies, but were noted by the author through a review of newspaper accounts. The most common substances released were natural gas, gasoline and chlorine. These results indicate that the unexpected release of hazardous materials occurs with some frequency in the USA and often results in death, injuries and evacuations. As evidenced by the Binder study, many releases are not being reported through appropriate channels. HOW THE USA HAS RESPONDED Four major sectors have become more involved in responding to the accidental release of hazardous materials, including the federal government, the chemical industry, the hospital sector, and professional societies of industrial hygienists and physicians, among others. In 1986, the Federal Government passed the Superfund Act Reauthorization Amendment (SARA) (Title III), 2 which requires manufacturing facilities to report the identity and quantities of materials that they use to the local government. The Environmental Protection Agency establishes a list of extremely dangerous substances (approximately 400) that must be reported. After an unexpected release of a hazardous substance, the community emergency coordinator of the Local Emergency Planning Committee (LEPC) and the State Emergency Response Commission must be notified. The LEPC has specific roles that are outlined in Table 1. The Local Emergency Planning Committee (LEPC), consists of representatives of organizations that may respond in an emergency, including police, fire and medical professionals. The Act mandates the need for medical treatment protocols, among other healthrelated activities. Many sectors, including the chemical industry, hospitals and professional societies of industrial hygienists and physicians have responded directly to their role in preventing adverse health effects from the accidental release of hazardous substances. The chemical industry, through its trade association, the Chemical Manufacturers Association (CMA) developed a community awareness emergency response (CAER) programme. This programme includes guidelines for health and safety representatives of manufacturing facilities for participation in emergency planning procedures (see Table 2). The hospital community addresses emergency preparedness primarily through the Joint Commission for the Accreditation of Health Care Organizations (JCAHO). 8 These extensive requirements specify how hospitals must respond to the accidental release of chemical materials, including maintaining suitable medical references, providing access to specialized professionals and administering antidotes for treating exposure to certain hazards. 9 Failure to meet these dictates has serious ramifications for a hospital's eligibility for receiving third party funding, especially Medicare and Medicaid. In the aftermath of an unexpected release of a hazardous chemical, practical questions invariably surface about the safety of re-entry, especially in a confined area. To develop a scientific basis for addressing these Table 1. Role of the local emergency planning committee Identify facilities using hazardous materials in transportation routes Establish emergency procedures Designate a community and a facility coordinator to implement the plan Establish mechanisms for emergency notification Establish procedures for determining a release in estimating the affected area Describe community and facility equipment and identify responsible personnel Establish evacuation plans Schedule training programmes for emergency personnel
3 R. J. McCunney: Emergency response to environmental toxic incidents 399 Table 2. Community Awareness Emergency Response Community Emergency Plan: Implementation steps* 1. Identify participants and define their roles 2. Identify risks and hazards that may lead to emergencies 3. Encourage participants to review their own plan 4. Identify response tasks that are not covered by existing plans 5. Match these tasks to resources that are available 6. Make the changes to improve existing plans 7. Write an integrated community plan and obtain local government approval 8. Educate participants about the plan and trained emergency responders 9. Establish procedures for periodic testing review and updating of the plan 10. Educate the general community about the integrated plan * Developed by the Chemical Manufacturers Association, Washington, DC. important questions, the American Industrial Hygiene Association developed Emergency Response Planning Guidelines, that provide estimates of concentration ranges where adverse affects may occur. 10 The results are based on a committee review of short-term animal inhalation studies; concentrations listed are assumed to be safe for approximately one hour without protection. A Level 1 concentration is defined as capable of causing mild, transient and reversible effects; Level 2 concentrations may cause irreversible effects; Level 3 concentrations are considered life threatening. Approximately 35 substances have been evaluated by the Committee as of the writing of this report, (see Table 3 for phosphorous pentoxide, and Table 4 for a current listing of materials that have been evaluated). The American College of Occupational and Environmental Medicine has developed continuing education courses in environmental medicine, for its members and those of other specialties, a component of which pertains to emergency response procedures. The American College of Emergency Physicians has also sponsored similar educational efforts to enable its members to become more familiar with the evaluation and treatment of exposure to hazardous materials."' 12 Poison Control Centers, with the assistance of the Chemical Manufacturers Association, have a programme entitled MEDTREC, that facilitates access to current information on the toxicology of hazardous substances. Previous reports have estimated that about 10-20% of phone calls to poison control centers are related to occupational or environmental exposures. EMERGENCY RESPONSE: MEETING THE CHALLENGE Table 3. Current AIHA ERPGs t Chemical (CAS Number) Acetaldehyde ( ) Acrolein ( ) Acrylic Acid (79-1-7) Acrylonitrile ( ) Ally! Chloride ( ) Ammonia ( ) Benzene ( ) Benzyl Chloride ( ) Bromine ( ) 1,3-Butadiene ( ) n-butyl Acrylate ( ) n-butyl Isocyanate ( ) Carbon Disulfide ( ) Carbon Tetrachloride (5-23-5) Chlorine ( ) Chlorine Trifluoride ( ) Chloraacetyl Chloride ( ) Chloropicrin ( ) Chlorosulfonic Acid ( ) Chlorotrifluoroethylene ( ) Crotonaldehyde ( ) Diborane ( ) Diketene ( ) Dimethylamine ( ) Dimethyldichlorosilane ( ) Dimethyl Disulfide ( ) Dimethyl Sulfide ( ) Epichlorohydrin ( ) Ethylene Oxide ( ) Formaldehyde ( ) Hexachlorobutadiene ( ) Hexafluoroacetone Hexafluoropropylene ( ) Hydrogen Chloride ( ) Hydrogen Cyanide ( ) Hydrogen Fluoride ( ) Hydrogen Sulfide ( ) Isobutyronitrile ( ) 2-lsocyanatoethyl Methacrylate ( ) Uthium Hydride ( ) Methanol ( ) Methyl Chloride ( ) Methyl Iodide ( ) ERPG mg/m ppm ug/m 3 Methyl Isocyanate ( ) 0.0 Methyl Mercaptan ( ) 0.00 Methylene Chloride ( ) Methyltrichlorosilane ( ) 0. Monomethylamine ( ) Oleum ( ), Sulfur Trioxide ( ), and Sulfuric Acid ( ) 2 mg/m 3 Perfluoroisobutylene ( ) Phenol ( ) Phosgene ( ) Phosphorus Pentoxide ( ) Propylene Oxide ( ) Sulfur Dioxide ( ) Styrene ( ) Tetrafluoroethylene ( ) Titanium Tetrachloride ( ) Toluene ( ) Trimethylamine ( ) Uranium Hexafluoride ( ) Vinyl Acetate ( ) ERPG ppm mg/m 3 30 ppm ug/m ppm mg/m mg/m ERPG ppm 250ppm ppm 30 ppm 500 ig/m ppm ppm mg/m ,000 ppm 100 mg/m 3 Physicians responsible for emergency response have a number of options to enhance their preparation, including medical texts, computerized information, access to poison control centers, and a 24-hour on-line * The ER PG-i for this chemical has been lowered from. " NA = not appropriate t Reproduced with permission from The 1996 Emergency Response Planning Guidelines and Workplace Exposure Level Guides Handbook. AIHA, 1996.
4 400 Occup. Med. Vol. 46, 1996 service from the Agency of Toxic Substances and Disease Registry (Tel: [+1] ). B Computerized information Despite the proliferation of computer databases for access to current medical and toxicological information, it is preferable to learn about the hazards present in a facility well ahead of any release. In an emergency, immediate access to information related to the substance is essential. Many computer databases, including those of TOXNET and ANSWER are available. 14 One particular database, TOMES Plus, has sections on medical management, (Meditext) safe handling of hazardous materials (Hazard text), and reporting for Superfund Act Reauthorization Amendment (SARATEXT). Preparing for the response: Medical concerns The physician can play a major role in preparing for any potential emergency response, primarily with a thorough understanding of the materials that may be released, and a review of on-site healthcare resources, emergency medical technicians and ambulances. 15 Coordination of activities of an on-site facility with those located off-site is essential in an emergency. One needs to ensure that medical resources are prepared for treating symptoms due to exposure to toxic substances, especially with the administration of appropriate antidotes, such as calcium gluconate for hydrofluoric acid burns. Decontamination procedures for people injured in a release and for health care professionals as well as for the facilities must be established. 16 Medical evaluations of personnel involved in the emergency (both before and after an episode) are other responsibilities of the physician. 2 A related activity associated with examinations, is ensuring that emergency responders have proper personal protective equipment. These decisions may involve discussions with industrial hygiene and safety personnel. (Table 5 outlines the personal protective equipment grades). Physician participation in the local emergency planning committee (LEPC) can be extraordinarily valuable. The LEPC must coordinate numerous activities related to releases of hazardous materials and ensure appropriate training and drills for responders and file the necessary reports. THE RESPONSE In responding to a chemical release, it is wise not to drive or walk through spilled materials and to avoid contamination of equipment used in the rescue. Shipping papers, required for certain trucking activities should not be obtained unless adequate personal protective equipment is available. An awareness of meteorological patterns, especially in the context of a gas release, can help prevent illnesses. Table 5. Classes of personal protective equipment* A. Totally encapsulating chemical resistance suit with a self-containing breathing apparatus (SCBA) B. A splash protection with chemical resistance clothing and a positive pressure full face SCBA. C. Splash protection with chemical resistance clothing and a chemical resistant full-faced piece air purifying respirator. D. Standard work uniform. * Source: Reference 2. Fundamental medical treatment at an emergency scene includes ensuring that the airway is open, that bleeding is stopped and that consciousness is roused. Ideally, people should be treated outside of the contaminated areas in accordance with conventional triage procedures, especially for invasive procedures. Many health issues surface in responding to a chemical emergency, including selection of proper personal protective equipment and monitoring of airborne concentrations of the material released. One must also decide when and where to administer first aid and be aware of the need to neutralize the chemical with an appropriate substance. A careful review of the Material Safety Data Sheet (MSDS) will help avoid incompatibilities that can create further risk between the control measures and the hazard. Certain hazardous materials are more likely to cause secondary contamination of clothing and equipment, including acids, alkalis, cyanide salts, hydrofluoric acid solutions, mercaptans, pesticides and polychlorinated biphenyls (PCBs). 16 Immediate onsite treatment is necessary for organophosphate pesticides, hydrogen cyanide, hydrofluoric acid and hydrogen sulfide because of the acute hazard that these substances pose. THE ROLE OF THE PHYSICIAN The role of the physician in responding to the release of a hazardous material depends on background, training and interests, including the needs of the organization for which services are provided. A thorough understanding of the toxicity of the materials, including their acute and potential long-term effects, as well as biological monitoring techniques, is essential. Ideally, the physician will be a member of the LEPC and participate in training sessions along with other first responders, including emergency room physicians, police and fire personnel. Ensuring the accuracy of material safety data sheets, especially the corresponding treatment protocols will avoid confusion during an emergency. Consultative advice to other physicians, including the emergency room professionals, is often expected. Although serving as a spokesperson to the media is a potentially difficult task, it is essential that accurate information be conveyed to reduce the anxiety and uncertainty often
5 R. J. McCunney: Emergency response to environmental toxic incidents 401 associated with emergency releases. Rumors about the hazard or its health consequences can create confusion that may prove difficult to clear later. SUMMARY This discussion of the unexpected release of hazardous materials, with attention to the physician's role, has uncovered a number of findings. 1. The accidental liberation of hazards in the USA occurs frequently and results in preventable death, injury and evacuation. 2. The reporting and follow-up of releases need improvement The ATSDR initiative, if expanded to all 50 US states and if inclusive of newspaper accounts, will add substantial data to foster our understanding of the extent of the problem. 3. The role of the physician, especially the occupational medicine specialist, is not widely recognized either within or outside the profession. This observation, that is, of the nebulous responsibilities of the physician, has been noted in reports originating in the United Kingdom" and the European Union as well. 18 Recurring problems include the paucity of information available from previous disasters, coupled with questionable understanding of the response plan by participants, and the unique character of each release. The medical response is only one component of a multidisciplinary effort necessary in effectively dealing with these health emergencies. Repeat drills, despite their lack of appeal, can promote a familiarity with procedures, since a sense of urgency and panic is often present. One needs to act quickly, but not randomly, to prevent further illnesses and death among those with direct exposure to hazardous materials. REFERENCES 1. Mehta PS. Bhopal tragedy's health effects. JAMA 1990; 264: Hazardous Waste Operations and Emergency Response. 29CFR Health and Safety Executive. The Control of Major Industrial Accident Hazard Regulations, 1984 (CIMAH): Further Guidance on Emergency Plans. London: HMSO, Baxter PJ. Occupational and Environmental Medicine: What is it? Occup Environ Med 1994; 51: Hall HI, Dhara VR, Price-Green PA, Kaye WE. Surveillance for emergency events involving hazardous substances the United States, MMWR 1994; 43: Binder S. Deaths, injuries and evacuations from acute hazardous materials releases. AmerJ Public Health 1989; 79: Binder S, Bonzo S. Acute hazardous materials release. AmerJ Public Health 1989; 79: Thanabalasingham T, Beckett WM, Murray V. Hospital response to a chemical incident: Report on casualties of an ethyl dichloro saline spill. Brit Med J 1991; 302: US Department of Health and Human Services. Managing Hazardous Materials Incidents. Hospital Emergency Departments. A Planning Guide for the Management of Contaminated Patients. Atlanta (GA) USA: US Department HHS. Agency for Toxic Substances and Disease Registry. 10. Rusch, GM. The history and development of emergency response planning guidelines. J Haz Mat 1993; 33: Leonard, RB, Calabro.JJ, Ognogi, EK, Leviton, RH. SARA Superfund Amendments and Reauthorization Act, Title III: Implications for Emergency Physicians. Annals Emerg Med 1989; 18: Kirk MA, Cisekj, Rose SR. Emergency department response to hazardous materials incidence. Emerg Med Clin NAmer 1994; 12: Mitchell E The agency for toxic substances and disease registry. In: McCunney RJ, ed. A Practical Approach to Occupational and Environmental Medicine. Boston: Little Brown, 1994: Decker WJ. Toxicological information series IV. Information resources for chemical emergency response. FundAppl Toxicol 1990; 15: Baxter PJ, Davies PC, Murray V. Medical planning for toxic releases into the community: The example of chlorine gas. Bri J Ind Med 1989; 46: Lavoie FW, Coomes T, Cisekj E, Fulkerson L. Emergency department, external decontamination for hazardous chemical exposure. Veterin Human Toxicol 1992; 34: Baxter P. Major chemical disasters. Britain's health services are poorly prepared. Brit MedJ 1991; 302: Organization for Economic Cooperation and Development. OECD Environment Monograph Number 81 on Health Aspects of Chemical Accidents. Paris: OECD, 1994.
Formaldehyde Exposure Control Policy
Formaldehyde Exposure Control Policy POLICY AND PROCEDURES FOR WORKING WITH FORMALDEHYDE Policy: It is Columbia University (CU) policy to maintain formaldehyde exposure below the action level (AL) 0.5
More informationFormaldehyde Exposure Control Plan
A. Purpose To maintain formaldehyde exposure below the limits established by the Occupational Safety and Health Administration s (OSHA) Formaldehyde Standard 29 CFR 1910.1048. These limits are the Action
More informationIn all hazardous materials incidents, the following system will be used:
Purpose: This plan provides a basic philosophy and strategic plan for hazardous materials situations. Hazardous Materials incidents encompass a wide variety of potential situations including fires, spills,
More informationADAMS COUNTY COMPREHENSIVE EMERGENCY MANAGEMENT PLAN HAZARDOUS MATERIALS
ADAMS COUNTY COMPREHENSIVE EMERGENCY MANAGEMENT PLAN EMERGENCY SUPPORT FUNCTION 10A HAZARDOUS MATERIALS Primary Agencies: Support Agencies: Adams County Emergency Management Fire Departments and Districts
More informationNORTH CAROLINA A&T STATE UNIVERSITY Chemical Hygiene Plan
North Carolina Agricultural and Technical State University OFFICE OF ENVIRONMENTAL HEALTH & SAFETY Safety Manual Subject: Chemical Hygiene Plan Number: 5-1 Date February 1, 2009 Amends: None Supersedes:
More informationESF 10 Hazardous Materials
ESF 10 Hazardous Materials Purpose Emergency Support (ESF) #10 describes the prevention, preparedness, response and recovery activities actions unique to hazardous materials response. ESF-10 addresses:
More informationCHEMICAL HYGIENE PLAN
CHEMICAL HYGIENE PLAN The SDSU Laboratory Chemical Safety Program for Compliance with 29 CFR 1910.1450 and 8 CCR 5191: Occupational Exposure to Hazardous Chemical in Laboratories Prepared by San Diego
More informationJACKSON COUNTY MISSISSIPPI LOCAL EMERGENCY PLANNING COMMITTEE INFORMATION
JACKSON COUNTY MISSISSIPPI LOCAL EMERGENCY PLANNING COMMITTEE INFORMATION History and Background The LEPC is a product of federal legislation that was passed in the wake of the Bhopal disaster in India,
More informationRMM # 500 Title: Designated Substances Control Program Approved: Karen Belaire Vice President, Administration
McMaster University Risk Management Manual Submitted: Risk Management Support Group RMM # 500 Title: Designated Substances Control Program Approved: Karen Belaire Vice President, Administration Date: July
More informationCHABOT/LAS POSITAS COMMUNITY COLLEGE DISTRICT
CHABOT/LAS POSITAS COMMUNITY COLLEGE DISTRICT HAZARD COMMUNICATION PLAN Chabot/Las Positas Community College District Hazard Communication Program 2/2007 Pg 1 of 7 Hazard Communication Program Policy Policy
More informationRespiratory Protection
Respiratory Protection Program ENVIRONMENTAL HEALTH & SAFETY pg. 1 Table of Contents A. Introduction...3 B. Scope...3 C. Responsibilities...3 1. Department - Chair/Director...3 2. Environmental Health
More informationManagement Standards. EHS Policy and Program
Global Environment, Health and Safety Standards Abbott has an established Environment, Health and Safety (EHS) Policy and set of management and technical standards that form the basis of our EHS management
More informationControl of Substances Hazardous to Health (COSHH) Procedure
Control of Substances Hazardous to Health (COSHH) Procedure Objective The purpose of this procedure is: To ensure that the necessary use of substances hazardous to health is safe and controlled. To ensure
More informationRichland County Local Emergency Planning Committee (LEPC) By-Laws
Richland County Local Emergency Planning Committee (LEPC) By-Laws ARTICLE I: Section 1: General Provisions/Rules of Operation Preamble The Local Emergency Planning Committee (LEPC) serves Richland County,
More informationSpill Prevention and Control
Spill Prevention and Control Regulatory Requirements Hazardous Waste Operations and Emergency Response (HAZWOPER) 29 CFR 1910.120 Covers spill response teams Superfund Amendment and Reauthorization Act
More informationOak Grove School District Respiratory Protection Program
Oak Grove School District Respiratory Protection Program District Policy The purpose of this notice is to inform you that Oak Grove School District is complying with the OSHA Respiratory protection Standard,
More informationOdor Regulation in Japan
Odor Regulation in Japan Toshiro Segawa Noise and Odor Division Ministry of the Environment Keywords Offensive Odor Control Law, Odor Index Regulation, Triangular Odor Bag Method Abstract The Offensive
More informationStatement. of Qualifications
Statement..... of.... Qualifications Pacific EH&S Services, Inc. January 2007 Table of Contents Introduction... 1 Statement of Services and Capabilities... 2 Personnel Qualifications... 8 Project Experience...10
More informationOdor Regulation and Odor Measurement in Japan
Odor Regulation and Odor Measurement in Japan Kenji Kamigawara Noise and Odor Division The Ministry of the Environment, Japan Keywords Complaints, measurement, local government, regulation Abstract The
More informationWater & Environmental Chemistry Aquacheck Aquacheck Proficiency Testing Scheme Application Form
Please find below the Aquacheck 2017-2018 distribution schedule. Please complete all the relevant sections of the application form indicating the samples required on pages 2-6 and return to LGC Standards
More informationHAZARDOUS MATERIALS EMERGENCY. Awareness Level Response Plan 29 CFR (q) and 40 CFR 311
HAZARDOUS MATERIALS EMERGENCY Awareness Level Response Plan 29 CFR 1910.120 (q) and 40 CFR 311 This plan addresses health and safety protection for the Med-Care Ambulance Service Prepared By: Chris Moretto
More informationLicentiate of the Faculty of Occupational Medicine (LFOM)
Employee Handbook of the Royal College of Physicians of Ireland Licentiate of the Faculty of Occupational Medicine (LFOM) Examination Syllabus, 2016 Table of contents Heading 1... Error! Bookmark not defined.
More informationKENTUCKY HOSPITAL ASSOCIATION OVERHEAD EMERGENCY CODES FREQUENTLY ASKED QUESTIONS
KENTUCKY HOSPITAL ASSOCIATION OVERHEAD EMERGENCY CODES FREQUENTLY ASKED QUESTIONS Question - Why have standard overhead emergency codes? Answer Lessons learned from recent disasters shows that the resources
More informationHAZARDOUS SUBSTANCES POLICY Page 1 of 5 Reviewed: May 2017
Page 1 of 5 Policy Applies to: All staff employed by Mercy, Credentialed Specialists, Allied Health Professionals and contractors Related Standards: Health and Safety At Work Act, 2015 Hazardous Substances
More informationGreat Western Painting Arsenic
Arsenic 29 CFR 1910.1018, Inorganic arsenic 29 CFR 1910.1018, App A Inorganic arsenic substance information sheet 29 CFR 1910.1018, App B Substance technical guidelines 29 CFR 1910.1018, App C Medical
More informationMedical Surveillance and the New Cr(VI) Standard. Bruce A. Dalton, MD, MPH, FACOEM Medical Director, Workplace Group
Medical Surveillance and the New Cr(VI) Standard Bruce A. Dalton, MD, MPH, FACOEM Medical Director, Workplace Group Medical surveillance is the administration of medical tests for the purpose of detecting
More informationKanawha Putnam Emergency Management Plan Functional Annex. (completed by plan authors) Local / County Office of Emergency Management
Kanawha Putnam Emergency Management Plan Functional Annex Chemical HazMat Response A16 Coordination: Primary Agency: (completed by plan authors) Local / County Office of Emergency Management Support Agencies:
More informationSafe Storage of Hazardous Chemicals Policy
Safe Storage of Hazardous Chemicals Policy By maximising responsiveness of the prospective hazards of chemicals and equipment, we condense the risk of harm to educators, children and families by ensuring
More informationNBC Preparedness in Hospitals
Senate Department for Health, the Environment and Consumer Protection H E A L T H NBC Preparedness in Hospitals Decontamination Plan As of: January 2010 0 If a nuclear, biological, or chemical (NBC) incident
More informationI. Introduction. Definitions SP /16/2016. Chemistry Department Emergency Action Plan Spill Response
I. Introduction The CWU Chemistry department s highest priority is to protect employee and student health and safety. On that basis, CWU Chemistry employees or students will not attempt to clean up an
More informationWRITTEN HAZARD COMMUNICATION PROGRAM. Prepared for: BORO OF
Prepared for: BORO OF 2013 TABLE OF CONTENTS INTRODUCTION...1 POLICY:...1 OBJECTIVE:...1 PURPOSE:...1 RESPONSIBLE PERSONS:...2 HAZARD DETERMINATION...3 PHYSICAL HAZARDS:...3 HEALTH HAZARDS:...4 EXEMPT
More informationPublic Health Nurse Orientation. Human Health Hazards and Other Environmental Health. Overview of the Module. Public Health Nurse Orientation
Human Health Hazards and Other Environmental Health Module 5 Public Health Nurse Orientation Public Health Nurse Orientation Human Health Hazards and Other Environmental Health Issues Written by: Rebecca
More informationSafety and Health Movement: An Overview p. 1 Developments Before the Industrial Revolution p. 2 Milestones in the Safety Movement p.
Safety and Health Movement: An Overview p. 1 Developments Before the Industrial Revolution p. 2 Milestones in the Safety Movement p. 3 Tragedies That Have Changed the Safety Movement p. 5 Role of Organized
More informationEnvironmental Standard Operating Procedure Originating Office: MCAS Yuma Environmental Department
Environmental Standard Operating Procedure Originating Office: MCAS Yuma Environmental Department Revision: Final Supersedes: n/a Prepared By: EM-Assist, Inc. Kyle R. Petlock Approved By: Jerry McCluskey
More informationCENTRAL SERVICE (CS) PROFESSIONALS REQUIRE SIGNIFICANT
by Rose Seavey, MBA, BS, RN, CNOR, CRCST, CSPDT President/CEO of Seavey Healthcare Consulting Safety in Handling Chemical Sterilants LEARNING OBJECTIVES 1. Describe how governmental regulating agencies
More informationRCRA, Superfund & EPCRA Hotline Training Module
United States Environmental Protection Agency Solid Waste and Emergency Response (5305W) EPA550-B-98-005 June 1998 RCRA, Superfund & EPCRA Hotline Training Module Introduction to: Emergency Planning Requirements
More informationHealth, Safety, Security and Environment
Document owner and change code Document Owner Aaron Perronne Title HSSE Manager Mark X Change Code Description X N/A First Issue A Typographical/Grammatical correction; formatting change; text clarification-no
More informationNew OSHA Chemical Standard: What All Labs Need to Know!
Speaker 2013 Webinar Series New OSHA Chemical Standard: What All Labs Need to Know! September 19, 2013 Eric Clark, MS, Safety Officer, Los Angeles County, Downey, CA Eric Clark earned his MS in Analytical
More informationGUIDANCE NOTE FOR THE ASSESSMENT OF HEALTH RISKS ARISING FROM THE USE OF HAZARDOUS SUBSTANCES IN THE WORKPLACE [NOHSC:3017(1994)]
National Occupational Health and Safety Commission GUIDANCE NOTE FOR THE ASSESSMENT OF HEALTH RISKS ARISING FROM THE USE OF HAZARDOUS SUBSTANCES IN THE WORKPLACE [NOHSC:3017(1994)] MARCH 1994 Australian
More informationTEMPLE UNIVERSITY ENVIRONMENTAL HEALTH AND RADIATION SAFETY
Page 1 of 12 ISSUED: 6/94 REVISED: 06/07 Introduction: Purpose The purpose of this program is to ensure the protection of all employees from respiratory hazards through the proper use of respirators. Respirators
More informationPEC BASIC SAFEGULF SAFELANDUSA ORIENTATION TRAIN THE TRAINER
TRAIN THE TRAINER 2 PEC BASIC SAFEGULF SAFELANDUSA ORIENTATION TRAIN THE TRAINER This Train the Trainer program provides authorization to teach PEC Safety s orientation-level safety training, called Basic
More informationNortheast Fire Department Association Operations Date Issued: 12/2003 Date Revised: 8/2011
Northeast Fire Department Association Operations Date Issued: 12/2003 Date Revised: 8/2011 NEFDA Hazardous Materials Response Team Approved by: Wes Rhodes NEFDA President I. PURPOSE The intent of these
More informationSTATE EMERGENCY FUNCTION (SEF) 10 HAZARDOUS MATERIALS. I. Lead Agency: Colorado Department of Public Safety (CDPS), Colorado State Patrol (CSP).
1 ANNEX J STATE EMERGENCY FUNCTION (SEF) 10 HAZARDOUS MATERIALS I. Lead Agency: Colorado Department of Public Safety (CDPS), Colorado State Patrol (CSP). II. Supporting Agencies: CDOLA OEM CDPHE (Emergency
More informationIncident Command System Awareness Participant Guide May 2016
Incident Command System Awareness Participant Guide May 2016 Copyright 2016 Midwest Consortium for Hazardous Waste Worker Training Acknowledgments The Midwest Consortium developed this course for Hazardous
More informationFormaldehyde Program. For Compliance with Federal and State Regulated Carcinogen Regulations
Formaldehyde Program For Compliance with Federal and State Regulated Carcinogen Regulations Approved by Safety Committee April 20, 2017 Table of Contents PURPOSE... 1 AUTHORITY CITATIONS... 1 DEFINITIONS...
More informationCHEMICAL STOCKPILE EMERGENCY PREPAREDNESS PROGRAM (CSEPP) Hazard Specific Annex X
CHEMICAL STOCKPILE EMERGENCY PREPAREDNESS PROGRAM (CSEPP) Hazard Specific Annex X I. Background A. Purpose To provide for a coordinated response by Colorado state agencies in support to Pueblo County to
More informationEmergency Care 1/11/17. Topics. Hazardous Materials. Hazardous Materials Multiple-Casualty Incidents CHAPTER
Emergency Care THIRTEENTH EDITION CHAPTER 37 Hazardous Materials, Multiple-Casualty Incidents, and Incident Management Topics Hazardous Materials Multiple-Casualty Incidents Hazardous Materials 1 Hazardous
More informationDepartment of Homeland Security Chemical Facility Anti-Terrorism Standard (6 CFR 27)
Department of Homeland Security Chemical Facility Anti-Terrorism Standard (6 CFR 27) Preparing to Meet the New Chemical Facility Anti-Terrorism Standard September 19, 2007 Introduction of Speaker Over
More informationIs Your Company in Compliance with OSHA Standards for First Aid Training and Emergency Preparedness?
Is Your Company in Compliance with OSHA Standards for First Aid Training and Emergency Preparedness? Find Out How the American Red Cross Can Help. See inside for tips on meeting OSHA Guidelines... www.redcross.org
More informationHealth and Safety in the lab. Seyed Hosseini SA Pathology Chemical Pathology
Health and Safety in the lab Seyed Hosseini SA Pathology Chemical Pathology ISO 15190 This International Standard specifies requirements to establish and maintain a safe working environment in a medical
More informationResponding to A Radiological Dispersal Device (RDD) Medical Aspects of Response
Responding to A Radiological Dispersal Device (RDD) Medical Aspects of Response Initial Concerns Who is the radiation accident victim? Is he radioactive? What are the main types of radiation injury/illness?
More informationCORNELL UNIVERSITY EMERGENCY OPERATIONS PLAN. Cornell University Environmental Health and Safety Version 5.1
CORNELL UNIVERSITY EMERGENCY OPERATIONS PLAN Cornell University Environmental Health and Safety Version 5.1 Contents 1. Introduction... 1 2. Concept of Operations... 1 3. Objectives... 1 4. Incident Response
More information7700 East First Place Denver, CO ph (303) fax (303)
7700 East First Place Denver, CO 80230 ph (303) 364-7700 fax (303) 364-7800 www.ncsl.org Select School Indoor Air Quality Statutes July 2008 Compiled by Scott Hendrick Arizona A.R.S. 15-2132 ARIZONA REVISED
More informationTown of Brookfield, Connecticut Mass Casualty Incident Plan
Town of Brookfield, Connecticut Mass Casualty Incident Plan 1.0 Definition Of Mass Casualty Incident: A Mass Casualty Incident is an incident having multiple patients that would exceed the amount Brookfield
More informationFrom the Feds: Research, Programs, and Products
FROM THE FEDS From the Feds: Research, Programs, and Products Laurie Flaherty, RN, MS, Washington, DC Department of Health and Human Services Health Consequences Among First Responders After Events Associated
More informationSouth Carolina Drug Endangered Children Protocol (SCDEC Protocol)
South Carolina Drug Endangered Children Protocol (SCDEC Protocol) The SCDEC Protocol addresses a narrow but dangerous category of cases: The investigation of a home or other structure where children are
More informationUNIT STANDARD TITLE Provide risk-based primary emergency care/first aid in the workplace ORIGINATOR. SGB Occupational Health and Safety
All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is
More informationESF 10 - Oil and Hazardous Materials
ESF Annexes ESF 10 - Oil and Hazardous Materials Coordinating Agency: Arkansas City Fire/EMS Department (Fire District #5) Winfield Fire Department (Fire District #7) Primary Agency: Cowley County Fire
More informationAPPENDIX 11 REPRODUCTIVE AND DEVELOPMENTAL HEALTH POLICY
APPENDIX 11 REPRODUCTIVE AND DEVELOPMENTAL HEALTH POLICY Chemical Hygiene Guide October 2009 Appendix 11-1- Chemical Hygiene Guide October 2009 Appendix 11-2- Reproductive and Developmental Health Policy
More informationTRAINING. A. Hazard Communication/Right-to-Know Training
XIII. TRAINING A multitude of training requirements are addressed by OSHA and other safety, health and environmental regulations. A summary of these requirements are presented. A. Hazard Communication/Right-to-Know
More informationSafety in the Pharmacy
Safety in the Pharmacy Course Practicum in Health Science - Pharmacology Unit I Preparation for Practicum Essential Question Why is safety in the pharmacy important not only to the patient, but the pharmacy
More informationWest Virginia University
West Virginia University Environmental Health and Safety RESPIRATORY PROTECTION PROGRAM Revised January 2017 West Virginia University P.O Box 6551 Morgantown WV 26506 # 304-293-3792 Fax 304-293-7257 http://ehs.wvu.edu
More informationREPUBLIC OF LITHUANIA LAW ON SAFETY AND HEALTH AT WORK. 1 July 2003 No IX-1672 Vilnius (As last amended on 2 December 2010 No.
REPUBLIC OF LITHUANIA LAW ON SAFETY AND HEALTH AT WORK 1 July 2003 No IX-1672 Vilnius (As last amended on 2 December 2010 No. XI-1202) PART I GENERAL PROVISIONS CHAPTER I SCOPE, BASIC CONCEPTS AND APPLICATION
More information[Type here] RESPIRATORY PROTECTION PROGRAM
[Type here] RESPIRATORY PROTECTION PROGRAM 1 March 7, 2017 TABLE OF CONTENTS Section Title Page 1. Scope... 1 2. Program Administration and Responsibilities... 1 3. Immediately Dangerous to Life and Health
More informationSafety. 3.1 The Law Affecting Health and Safety in the UK UK Health and Safety at Work Act (HASWA) Statutory Duties of the Employer
3 Legislation Related to Health and Safety 3.1 The Law Affecting Health and Safety in the UK 3.1.1 UK Health and Safety at Work Act (HASWA) 1974 The 1974 HASWA defines the statutory duties UK employers
More informationProgram of Instruction Course Syllabus
Program of Instruction Course Syllabus Course Title: Hazardous Materials Technician B Course : 40 hours Program: Hazardous Materials Program Level of Training: Performance Offensive (OSHA Technician) Course
More information2016 APHL BIOSAFETY AND BIOSECURITY SURVEY
2014 APHL All Hazards Laboratory Preparedness Survey 2016 APHL BIOSAFETY AND BIOSECURITY SURVEY February 2016 Introduction 2016 APHL Biosafety and Biosecurity Survey Welcome to the 2016 APHL Biosafety
More informationPROCEDURE FOR THE PREPARATION AND FOLLOW-UP OF AN AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY (ATSDR) PUBLIC HEALTH ASSESSMENT
PROCEDURE FOR THE PREPARATION AND FOLLOW-UP OF AN AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY (ATSDR) PUBLIC HEALTH ASSESSMENT David F. McConaughy, MPH Navy and Marine Corps Public Health Center,
More informationRespiratory Protection Plan
Respiratory Protection Plan Contents: Sample Respiratory Protection Plan Introduction... ii Plan Cover Sheet... 1 Policy... 2 Responsibility... 2 Plan Elements... 3 Organizational Responsibility Chart...
More informationTEXAS HAZARD COMMUNICATION ACT AND RULES. Sec : EMPLOYEE EDUCATION PROGRAM
TEXAS HAZARD COMMUNICATION ACT AND RULES Sec. 502.010: EMPLOYEE EDUCATION PROGRAM (a) An employer shall provide at least once a year, an education and training program for employees. INTRODUCTION The Texas
More informationCourse Title: Emergency Medical Responder 3 Course Number: Course Credit: 1. Course Description:
Course Title: Emergency Medical Responder 3 Course Number: 8417171 Course Credit: 1 Course Description: This course prepares students to be employed as Emergency Medical Responders. Content includes, but
More informationDominic Cox Royal Free Hospital London Joan Pearson Leeds General Infirmary
POINT OF CARE TESTING (POCT) IN CRITICAL CARE Authors: Dominic Cox Royal Free Hospital London Joan Pearson Leeds General Infirmary In collaboration with ICS standards committee Introduction Point of Care
More informationHealth And Safety Instructions On Cleaning >>>CLICK HERE<<<
Health And Safety Instructions On Cleaning Materials At Home Identify the risks involved with window cleaning, choose the right access equipment to do the job. Vaccine Safety Guidelines for Flu Vaccination
More informationTopic 3 Contribute to safe work practices in the workplace 43
Contents Before you begin vii Topic 1 Follow safe work practices 1 1A Follow workplace policies and procedures for safe work practices 2 1B Identify existing and potential hazards, and report and record
More informationGUIDELINE FOR CONDUCTING PRE-EMPLOYMENT MEDICAL EXAMINATION
GUIDELINE FOR CONDUCTING PRE-EMPLOYMENT MEDICAL EXAMINATION 1.0 Introduction. Most employers require job applicants fulfil their requirements in term of qualification, experience and personal attributes
More informationProcedure: 3.4.1p4. (II. D. 4.) Hazard Communication Program Planning and Hazardous Material Inventory
Procedure: 3.4.1p4. (II. D. 4.) Hazard Communication Program Planning and Hazardous Material Inventory Revised: January 17, 2017; November 7, 2013 Last Reviewed: January 17, 2017; October 14, 2016 Adopted:
More informationFIRE TACTICS AND PROCEDURES HAZARDOUS MATERIALS 12 October 19, 2005 TECHNICAL DECONTAMINATION TASK FORCES 1. INTRODUCTION
FIRE TACTICS AND PROCEDURES October 19, 2005 1. INTRODUCTION 1.1 The grouping of several companies into a task force enables an Incident Commander to quickly deploy several units to address a specific
More informationDuties of a Principal
Duties of a Principal 1. Principals shall strive to model best practices in community relations, personnel management, and instructional leadership. 2. In addition to any other duties prescribed by law
More informationAccident Prevention Process
page 8 of 44 Accident Prevention Process Accidents and injuries can be prevented, but it takes planning, organizing, leadership and coordination to do so. Safety and health professionals have identified
More informationNorth York General Hospital Policy Manual
ORIGINATOR: Emergency Preparedness Committee APPROVED BY: Medical Advisory Committee Operations Committee ORIGINAL DATE APPROVED: September, 2002 DATE REVISED: April, 2012 DATE OF IMPLEMENTATION: June
More informationMEDICAL-TECHNICAL SPECIALIST: BIOLOGICAL/INFECTIOUS DISEASE
BIOLOGICAL/INFECTIOUS DISEASE Mission: Advise the Incident Commander or Section Chief, as assigned, on issues related to biological or infectious disease emergency response. Position Reports to: Incident
More informationSankei Shinbun Syuppan Co.,Ltd. READI-J-V. Readiness Estimate And Deployability Index Japanese-Version
Sankei Shinbun Syuppan Co.,Ltd. READI-J-V Readiness Estimate And Deployability Index Japanese-Version Purpose: The purpose of the READI -J-V is to estimate out how ready nurses are for a disaster or terrorist
More informationHazardous Materials and Waste Management Plan
Hazardous Materials and Waste Management Plan EC 01.01.01 EP 5; EC 02.02.01; EC 04.01.01 I PURPOSE MCG Health, Inc. (MCGHI) is a leader in health care for the state of Georgia and provides a full spectrum
More informationRobert H. Hill, Jr. Battelle Atlanta, Georgia
Robert H. Hill, Jr. Battelle Atlanta, Georgia Graduate students conducting research same institution, department 1 st Student Reaction exploded; acid splash in eyes, severely cut arm 2 nd Student, 5 mos.
More informationPaediatric First Aid Level 3
Paediatric First Aid Level 3 This qualification provides theoretical and practical training in emergency first aid techniques that are specific to infants aged under 1, and children aged from 1 year old
More informationOrdinance on Good Laboratory Practice (OGLP)
English is not an official language of the Swiss Confederation. This translation is provided for information purposes only and has no legal force. Ordinance on Good Laboratory Practice (OGLP) 813.112.1
More informationIFCS Indicators of Progress. Priorities for Action beyond 2000 and Forum Recommendations
IFCS Indicators of Progress Priorities for Action beyond 2000 and Forum Recommendations QUESTIONNAIRE Please provide the information described on the following pages concerning your country, giving the
More informationAmerican Industrial Hygiene Association Respiratory Protection Committee Research Needs in Respiratory Protection
American Industrial Hygiene Association Respiratory Protection Committee Research Needs in Respiratory Protection White Paper Executive Summary In recent years, the field of respiratory protection has
More informationDOD INSTRUCTION ASSESSMENT OF SIGNIFICANT LONG-TERM HEALTH RISKS
DOD INSTRUCTION 6055.20 ASSESSMENT OF SIGNIFICANT LONG-TERM HEALTH RISKS FROM PAST ENVIRONMENTAL EXPOSURES ON MILITARY INSTALLATIONS Originating Component: Office of the Under Secretary of Defense for
More informationLOCAL EMERGENCY PLANNING COMMITTEE (LEPC) HANDBOOK REGION 6
LOCAL EMERGENCY PLANNING COMMITTEE (LEPC) HANDBOOK REGION 6 March, 2005 Parts of this handbook have been extracted from the State of Texas Local Emergency Planning Committee (LEPC) Handbook: A Primer for
More informationHAZARDOUS MATERIAL (HAZMAT) INCIDENTS
Policy 706 Subject HAZARDOUS MATERIAL (HAZMAT) INCIDENTS Date Published Page 27 September 2017 1 of 6 By Order of the Police Commissioner POLICY Public Safety. It is the policy of the Baltimore Police
More informationAbu Dhabi Occupational Safety and Health System Framework (OSHAD-SF) Code of Practice
Abu Dhabi Occupational Safety and Health System Framework (OSHAD-SF) Code of Practice CoP 2.0 Personal Protective Equipment Version 3.1 June 2018 Table of Contents 1. Introduction... 3 2. Training and
More informationThe Power of Collaboration: Working with LEPC s. Jeff Suggs, CEM Emergency Management Coordinator City of La Porte
The Power of Collaboration: Working with LEPC s Jeff Suggs, CEM Emergency Management Coordinator City of La Porte Intro La Porte: Located in Harris County, on Galveston Bay Entrance to the Houston Ship
More informationRegulatory Guide 3.67 Standard Format and Content for Emergency Plans for Fuel Cycle and Materials Facilities
Regulatory Guide 3.67Standard Format and Cont... Page 1 of 22 January 1992 Regulatory Guide 3.67 Standard Format and Content for Emergency Plans for Fuel Cycle and Materials Facilities Publication Information
More informationCHAPTER 14 Safety. Safe Environment. Safe Environment
CHAPTER 14 Safety Slide 1 Safe Environment This implies freedom from injury with a focus on preventing falls, electrical injuries, fires, burns, and poisoning. The PT must be aware of potential safety
More informationCRITICAL INCIDENT MANAGEMENT
CRITICAL INCIDENT MANAGEMENT Dr Praveena Ali Principal Medical Officer Ministry of Health Fiji Performance Objectives Describe critical incident characteristics Discuss the characteristics of a mass casualty
More informationCOURSE CATALOG. Safety Through Preparedness
Safety Through Preparedness COURSE CATALOG MANDATORY & CRITICAL SAFETY TRAINING FOR REGULATORY COMPLIANCE OFFICERS EMERGENCY MANAGERS & INCIDENT COMMANDERS FIRST RESPONDERS HAZARDOUS MATERIALS TECHNICIANS
More informationUsing Body Mechanics
Promotion of Safety Using Body Mechanics Muscles work best when used correctly Correct use of muscles makes lifting, pulling, and pushing easier Prevents unnecessary fatigue and strain and saves energy
More informationHealth & Safety Policy and Procedures Manual SECTION 31 CADMIUM
SECTION 31 CADMIUM 1. CADMIUM A. Scope: This written compliance program applies to all Maul Electric, Inc employees or employees of Maul Electric, Inc subcontractors who may be exposed to cadmium at or
More informationINJURY AND ILLNESS PREVENTION SELF-ADMINISTERED TRAINING BOOKLET REV 1.1
INJURY AND ILLNESS PREVENTION SELF-ADMINISTERED TRAINING BOOKLET REV 1.1 Office of Environmental Health & Occupational Safety 2009 INTRODUCTION Welcome to California State University, Northridge (CSUN).
More information