Previous month:
May 2016
Next month:
July 2016

June 2016

Safe Lifting Training Goes Hard Core

LarochellePosted by Greg LaRochelle, WCP

MEMIC has long advocated a no-lift program using mechanical devices to control overexertion strains for healthcare workers assisting patients and residents.  The forward lean posture often assumed by caregivers increases the potential for a back injury as a result of the cumulative effect of the micro-trauma placed on the spine and surrounding soft tissue.  As an adjunct to a comprehensive safe patient handling program that employs engineering controls, MEMIC's healthcare team promotes the benefits of core muscle conditioning and contraction.  Core training has broader implications for all industries where manual material handling is performed and education is provided on safe lifting technique. 

There are roughly twenty-nine muscles considered to comprise the core, essentially those that originate and/or insert from the pelvis to the base of the ribs.  These muscles can be categorized into the following groups: pelvic floor, lumbar spine, abdominal wall, and hip musculature.  Click here to visualize core strengthening exercises with the Mayo Clinic.

The need to condition the core muscles for proper posture and support is revealed by examining the skeleton in relationship to the effect of gravity and load placed on the bony structure.  In an upright position, there is the mass of the skull, upper extremity, and rib cage articulating with the spinal column in our mid-section which in turn connects to the mass of the pelvic girdle.  A rigid wall of soft tissue to shore up the upper mass of our body is naturally preferred over a weak wall for optimal support. 

Proper conditioning and contraction of the core muscles provides for the following:

  • Promotes stability of the spine for extremity movement
  • Helps to maintain proper posture and center of gravity alignment
  • Optimizes movement efficiency throughout the body

For more information on material handling and safe lifting, check out the MEMIC Safety Director resource library.  

  Male Muscular System


Don’t Hold the Ice: Crushed Ice for Control of Heat Stress

JonesPosted by Anthony Jones, R.N., COHN

Today is the first day of summer!  The Summer Solstice, being the longest day of the year, is a glorious day for those who like fun in the sun.  However, heat related illnesses in the workplace present a significant hazard.  Early in my career in occupational health nursing, I saw a big problem with heat related disorders in the leather manufacturing industry.  The process of leather manufacture requires tremendous amounts of heat for drying wet leather hides.  Couple this with the hot and humid weather of July and August and employees were at risk. Workers were frequently suffering from the symptoms of heat related disorders and in severe cases required emergency transport to the local hospital. 

Air conditioning systems in manufacturing facilities, or even offices, may not be able to keep up with the demand as summer progresses.  But working outside may be even more hazardous as the hot sun shines down on road construction crews, landscapers, and agriculture employees.  

As a reminder, look over the typical signs and symptoms of heat related stress from the Centers for Disease Control (CDC)

Heat Exhaustion:

  • Heavy sweating
  • Weakness
  • Cold, pale, and clammy skin
  • Fast, weak pulse
  • Nausea or vomiting
  • Fainting

Heat Stroke

  • High body temperature (above 103°F)*
  • Hot, red, dry or moist skin
  • Rapid and strong pulse
  • Possible unconsciousness

But why wait until a person is exhibiting the signs and symptoms of a heat stress disorder?  These problems can be significantly reduced by simple approaches to injury prevention. Frequent rest breaks in a cool environment and providing plenty of fluids with the opportunity to drink them.  The following tips are from the Mayo Clinic; click here for more information. 

  • Wear loose-fitting, lightweight, light-colored clothing
  • Avoid sunburn; wear a hat and appropriate sunscreen
  • Seek a cooler place and avoid the hottest spots or hottest portion of the day
  • Drink plenty of fluids
  • Take extra precautions with certain medications
  • Let your body acclimate to the heat

Back in my tannery days, during a very prolonged hot spell the company provided ice chips from an ice provider. The workers chewed on the ice chips and cooled their drinks. It was so well received, the company purchased its own ice machine. New studies say crushed ice has shown its superiority in cooling firefighters, electrical utility workers, and miners in severe heat stress situations. Ingestion of approximately 12-16oz of crushed ice for a 200lb worker is recommended.   

Ice availability along with frequent breaks in air conditioned spaces encouraged the drinking of fluids.  Watching out for each other made a big difference as well. The result was the elimination of heat related disorders and the production levels remained high. So don’t wait until it’s too late; start providing cooling procedures as a preventive measure. 

Check out this OSHA Quick Card and Heat Stress Guide or these other Safety Net posts for additional information.  Stay safe this summer!


Part III - Are You Ready For OSHA’s New Respirable Crystalline Silica Standard?

  PierettiPosted by Luis Pieretti, PhD, CIH, CSP

Our prior posts covered the new exposure limits, exposure assessments, regulated areas, methods of compliance, and housekeeping requirements of the new standard.  Now we will cover the medical surveillance and training requirements and the effective dates of the standard.

Medical Surveillance

Another requirement that will be triggered by the employee’s exposure to respirable crystalline silica is the medical surveillance requirement.  This section of the standard applies to those employees whose exposures are above the action level of 25 µg/m3 for 30 days or more during a year.  This surveillance should be administered within 30 days of the initial assignment (considered to be the baseline) and be repeated within 3 years of the initial medical surveillance assessment.

The assessment includes:

  • A medical and work history with emphasis on silica, dust, and other agents affecting the respiratory system.
  • A physical examination with emphasis on the respiratory system, chest X-rays, pulmonary function tests, tuberculosis testing, and other tests deemed appropriate by the physician or other licensed health care professional (PLHCP).
  • The standard includes what information should be included in the written medical report for the employee and the written medical opinion to the employer.

The medical report to the employee should contain a statement with the examination results, including “any medical condition(s) that would place the employee at increased risk of material impairment to health from exposure to respirable crystalline silica and any medical conditions that require further evaluation or treatment; any recommended limitations of the employee’s use of respirators; any recommended limitations on the employee’s exposure to respirable silica and a statement if the employee should be examined by a specialist depending on the results of the x-ray[i]”. 

This information is available to the employee, not the employer.  The written medical opinion for the employer will only contain:

  • Date of the exam.
  • A statement that indicates that the examination met the requirements of the standard.
  • Any recommended limitations on the employee’s use of respirators.

However, the employee could provide written authorization to share this information regarding the employer such as the recommended limitations on the employee’s exposure to respirable crystalline silica and the exam results statement if the employee should be examined by a specialist.  If the PLHCP recommends that the employee be examined by a specialist, the employer should make available a medical examination by a specialist within 30 days after receiving the written opinion of the PLHCP.  The requirements of the medical surveillance should be available at no cost to the employee. 

Training

Training for the affected employees should include the health hazards associated with respirable crystalline silica, the specific tasks that could result in exposure, specific measures the employer has implemented to protect the employees, and the purpose and description of the medical surveillance.

Recordkeeping

The employer should maintain information about all exposure assessments:

  • The measurement dates for each sample.
  • Task monitored.
  • Sampling and analytical method used, number of samples, duration of sampling and results.
  • Identity of the laboratory that performed the analysis.
  • Personal protective equipment used by the monitored employees.
  • Name (and social security number) and job classification of all employees represented by the monitoring and indicating which employees were actually monitored.

If objective data was used the employer should document the material containing crystalline silica, the source of the objective data, the testing protocol and results of the testing, description of tasks which the objective data were based on, and any other relevant data. The employer should maintain all the information generated by the medical surveillance requirement as well.

Effective Dates

The standard is effective June 23, 2016.  The requirements regarding medical surveillance are effective on June 23, 2018 for those employees exposed to levels above OSHA’s PEL for more than 30 days.  The medical surveillance requirements for employees exposed to levels above OSHA’s action level for more than 30 days take effect on June 23, 2020.  Some provisions for hydraulic fracturing operations will take place on June 23, 2021.

 

The information provided about the regulatory requirements is just a summary.  It should not be interpreted/assumed as the complete text of the OSHA standard. 

 

[i] OSHA’s Final Rule to Protect Workers from Exposure to Respirable Crystalline Silica: https://www.osha.gov/silica/


Part II: Are You Ready for OSHA’s New Respirable Crystalline Silica Standard?

PierettiPosted by Luis Pieretti, PhD, CIH, CSP

This is the second post in a three-part series reviewing OSHA’s new standard for respirable crystalline silica.  In part one, we mentioned that the new permissible exposure limit (PEL) for respirable crystalline silica is 50 µg/m3 with an action level of 25 µg/m3.  A series of requirements will be in effect depending on the employee’s exposure. 

Exposure Assessment   

Employers have two options to characterize the employee’s exposure.  The first option or “Performance Option” is based on a combination of air monitoring data or objective data considered to accurately characterize the employee’s exposure.  The other option is to conduct an initial monitoring assessment.  This option should consider the employee’s exposure for each job classification/shift/tasks where there is a potential for exposure to respirable crystalline silica.  If the initial assessment shows results below the action level (25 µg/m3), no additional monitoring is needed unless there is a change in the process.  If exposures are above the action level, but below the permissible exposure limit, the employer needs to repeat the assessment every six months.  If exposures are above the permissible exposure limit then the assessment needs to be repeated every three months.

What if the initial assessment indicates that exposures are above the action level and/or the permissible exposure limit and the employer invests in controls to reduce the employee’s exposure?  In that case, the employer should conduct two consecutive assessments, at least seven days apart, with results below the action level before discontinuing the scheduled monitoring. If monitoring is performed, the monitored employees should be notified in writing of the results of the assessment within 15 working days after completing the assessment.  If the results are above the permissible exposure limit, the written notification should describe the corrective action being taken to reduce exposure of the employee below the permissible exposure limit (PEL)[i].

Regulated Areas

A regulated area is an area where the airborne concentrations of respirable crystalline silica are/or are expected to be above the PEL.  Therefore, the employer should limit the access to these areas, authorized employees working in these area should wear respiratory protection, and there should be signage in the area stating “Danger, Respirable Crystalline Silica, May Cause Damage to the Lungs, Wear Respiratory Protection in This area, Authorized Personnel Only”i.

Methods of Compliance

Similar to the lead standard, this new standard requires the implementation of engineering controls and a written exposure control plan.  If exposures are above the PEL, this new standard requires employers to use engineering and work practice controls to reduce and maintain the employee’s exposures below the PEL.  If such controls cannot lower the exposure to levels below the PEL, the standard calls for continued use of these controls to lower the employee’s exposures to the lowest feasible level and then require the use of respiratory protection.   

The written exposure control plan should include the following items: a description of the tasks that involve exposures to respirable crystalline silica, a description of the controls (engineering, work practices and/or respiratory protection) for each of the affected tasks, and a description of the housekeeping practices to limit the employee’s exposure to respirable crystalline silica.  The standard calls for an annual review and evaluation of the effectiveness of this written plani.

Housekeeping

This new standard would not allow dry sweeping and/or brushing if these activities could contribute to an increase employee’s exposure to respirable crystalline silica.  It would allow wet sweeping, HEPA filtered vacuuming or other methods that would minimize the employee’s exposure.   The use of compressed air to clean clothing and/or surfaces would not be allowed unless the compressed air is used with a ventilation system that captures the dust cloud or no alternative method is feasible.

Our next post will address the medical surveillance and training requirements.

 ______________________

[i] OSHA’s Final Rule to Protect Workers from Exposure to Respirable Crystalline Silica: https://www.osha.gov/silica/


Are You Ready for OSHA’s New Respirable Crystalline Silica Standard?

PierettiLuis Pieretti, PhD, CIH, CSP

On March 25, 2016, the Occupational Safety and Health Administration (OSHA) published the long awaited respirable crystalline silica standard which they say will affect 2 million construction workers who drill, cut, crush, or grind silica-containing materials such as concrete and stone, and 300,000 workers in general industry operations such as brick manufacturing, foundries, and hydraulic fracturing. This standard will be effective on June 23, 2016, with some of the provisions taking effect at a later date.  It should be noted that it is being legally challenged through the courts and it is possible the standard may be quite different after these legal processes.

OSHA published two standards for respirable crystalline silica; one for the general and maritime industries and the other applicable to the construction industry.  In this 3-part series we will address the current provisions of the new standard applicable to the general and maritime industries. These posts are not meant to be the complete regulatory text of the standard, but rather a superficial summary.  Employers should review the standard from the OSHA website.

Silica is a mineral that can be found in the amorphous and crystalline state, the main difference is the crystalline state has atoms arranged in a repeating pattern.  Crystalline silica is mainly found in the forms of quartz, cristobalite, and tridymite and is known to cause health effects such as silicosis, lung cancer, chronic obstructive pulmonary disease (COPD), and kidney disease[i].

Currently, OSHA’s permissible exposure limit (PEL) for respirable crystalline silica is not a value but rather a formula (contained in 29 CFR 1910.1000 Table Z-2) used to estimate the employee’s exposure based on the silica percentage found in an air monitoring sample.  This exposure limit was adopted from the 1968 Threshold Limit Values recommended by the American Conference of Governmental Industrial Hygienists (ACGIH). 

For example, if dust collected in the working atmosphere is 100% quartz, OSHA’s permissible exposure limit would be 100 µg/m3 (100 micrograms per cubic meter of air).  The value will be lower if crystalline silica in the cristobalite and/or tridymite form are also present.  If 0% is found in the sample, the exposure limit is 5 mg/m3, which is the same as the PEL for particulates not otherwise classified in the respirable range[ii]. These values are based on an 8 hour time weighted average.  In 1974, the National Institute for Occupational Safety and Health recommended that employees should not be exposed to respirable crystalline silica levels above 50 µg/m3 without any kind of protection[iii].  Under the new standard, the PEL will not be based on a formula but rather a specific number.

New Permissible Exposure Limit

The new PEL is 50 µg/m3 with an action level of 25 µg/m3.  These values will take in consideration all forms of crystalline silica (the sum of all types of crystalline silica present in the work atmosphere collected in the air sample). Does that mean employers need to do air monitoring, even if prior testing were done?  The short answer is… it depends. 

Using a hypothetical example, let’s say that one of the tasks at ABC Company involves the use of silica sand that is 100% quartz (documentation is available showing that only the quartz form is present). The safety manager of the company hired an industrial hygienist three years ago to do a series of assessments to determine the employee’s personal exposures to crystalline silica.  The production process, controls, and production volume are the same as during the assessments.  If the safety manager has the knowledge, she/he could review the report and re-interpret the laboratory results (if they were included in the report) or ask the industrial hygienist to review the assessment and compare the results to the new limits.  If the company has never done any kind of assessment in the past, the new standard requires employers to perform an initial assessment or a performance based option (this will be covered in our next blog).  How about if ABC Company only has industrial hygiene data related to quartz but not the other forms of crystalline silica; and the company does not have any objective data indicating otherwise?  In this case, re-assessment of the work areas would be recommended.

Our next post on this topic will address what requirements apply if exposures are above the action level or the PEL.

 ____________________________

[i] NIOSH Hazard Review: Health Effects of Occupational Exposure to Respirable Crystalline Silica.

http://www.cdc.gov/niosh/docs/2002-129/pdfs/2002-129.pdf

[ii] 29 CFR 1910.1000 Table Z-1

[iii] NIOSH Criteria for a Recommended Standard: Occupational Exposure to Crystalline Silica.

http://www.cdc.gov/niosh/docs/1970/75-120.html