REGISTRATION MAINTENANCE WORKSHEET

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REGISTRATION MAINTENANCE WORKSHEET Name: ROH #: Employer: Mailing Address: Telephone: Fax: e-mail: Signature of Applicant: Date: Period for review: to ( points required)

ROH REGISTRATION MAINTENANCE WORKSHEET Please enter the details for any registration maintenance activities that you are claiming. Please leave the sections blank. These are for the use of the reviewers only. 1. Professional Practice: A maximum of 5 points for each year and 25 points in a 5-year cycle may be claimed for active (more than 50% of your time) occupational hygiene practice. Management and administration of occupational hygiene services or personnel counts as active practice. Employer Dates Position 2. Professional Society Membership: A maximum of 1 point per year and 5 points in a 5-year cycle is allowed for all memberships. Please state society memberships and list inclusive dates. Provincial occupational hygiene associations, AQHSST, AIHA, BOHS, and ACGIH are all considered acceptable. Other societies will be considered on a case-by-case basis. Membership in the CRBOH and/or ABIH is not considered eligible for points award. Society Inclusive Dates

3. Technical/Professional Committee Service: Membership on a technical or professional committee receives 1 point per year for regular members and 1.5 points per year for chairs or similar leaders. Committees of accepted societies are considered acceptable in this category, as are CSA/ANSI or similar committees. Work on CRBOH or ABIH committees is considered eligible for this award. As well, ROH/ROHT exam proctors and oral examiners receive 1 point each. Committees that are part of your job are not eligible. There is no maximum on the points that may be claimed in this category. Organization Committee Name Position Occupied Dates 4. Teaching/Presentations 0.5 points for each hour will be awarded for teaching or presenting occupational hygiene material at seminars, meetings, and educational programs. Presentations that are part of your job are not eligible. A maximum of 10 points can be claimed for this category for a 5-year cycle. Society Presentation Title Dates

5. Conferences and Educational Courses: Attendance at acceptable occupational hygiene courses or conferences will be awarded 0.5 points for 3 hours (or half day). All conferences or courses approved by either the CRBOH or the ABIH will automatically be granted the points awarded by these organizations. Attendance at the CRBOH annual general meeting (AGM) will also be awarded 0.5 points (effective 2003). Other courses will be considered on a case-by-case basis. There is no maximum on the points that may be claimed through this category. Organization Title Dates CRBOH/ ABIH Code 6. Publications: Papers or Chapters dealing with occupational hygiene printed in peer-reviewed publications will receive 5 points for one author, 3 points for two authors, and 1 point for more than two authors. As well, publications in non-peer reviewed publications are eligible for 0.5 point per article. There is no maximum on the points that may be claimed through this category. Title of Paper/Chapter Journal/Book Publication Date

7. Other Activities: A poster presentation will receive 0.5 point. Questions for the CRBOH question bank which are accepted by the Examination Committee will be eligible for 1 point for every 5 multiple point questions, 2 points for each short answer essay question or oral exam question. Other activities will be considered for maintenance points on a case-by-case basis. In these cases, please state the sponsoring organization, the dates and how the activity contributed to the activities of the CRBOH or to a better understanding of occupational hygiene in general. For courses or sessions that may be accepted by the Board, please see the list on page 5. There is no maximum on the points that may be claimed in this category. Activity Date

Occupational Hygiene and related course types: Air sampling and sampling strategies, analysis and control measures (including air sampling for environmental purposes) Assessments of confined spaces Asbestos control Measurement and control of physical and biological agents Toxicology and epidemiology Application or enforcement of Canadian legislation and standard setting dealing with occupational hygiene Ergonomics Biohazards Engineering controls ventilation, noise reduction and others Program management and labour relations as they apply to occupational hygiene WHMIS, Transportation of Dangerous Goods Personal protective equipment selection and fit testing Hazardous chemicals handling and disposal Biological monitoring, including audiometric testing Workplace health monitoring Indoor air quality Health and safety auditing Risks assessment Emergency response Management in any of the above areas Instructing in any of the above areas Communications, report writing and similar activities Course work which will not garner registration maintenance points will include the following in the course title or objectives: Security work First aid Nursing or other medical professions (unless this involves topics which concentrate on occupational hygiene issues) Water sampling