OSHA Compliance Management: A Guide For Long-Term Health Care Facilities

242 Pages·2000·5.697 MB·English

by  Elsie Tai

OSHA
Compliance
Management
A Guide for Long-Term Health Care Facilities
© 2001 by CRC Press LLC
OSHA
Compliance
Management
A Guide for Long-Term Health Care Facilities
Elsie Tai
g.c.g. risk management, inc.
New York, New York
LEWIS PUBLISHERS
Boca Raton London New York Washington, D.C.
© 2001 by CRC Press LLC
920067_CRC17_L1418_fm 11/25/00 2:25 PM Page iv
Library of Congress Cataloging-in-Publication Data
Tai,Elsie
OSHA compliance management:a guide for long-term health car facilities / by Elsie Tai.
p. cm.
Includes index.
ISBN 1-56670-418-0 (alk. paper)
1. Industrial hygiene--Handbooks,manuals,etc. 2. Long-term care facilities--Evaluation--handbooks,man-
uals,etc. 3. Industrial Safety--Handbooks,manuals,etc. 4. Long-term care of the sick--Quality control--Handbooks,
manuals,etc. I. Title
RC967.T35 2000
362.1′6′021873--dc21 00-048127
CIP
This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with per-
mission,and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reli-
able data and information,but the author and the publisher cannot assume responsibility for the validity of all materials or for
the consequences of their use.
Neither this book nor any part may be reproduced or transmitted in any form or by any means,electronic or mechanical,in-
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cation and explanation,without intent to infringe.
©2001 by CRC Press LLC
Lewis Publishers is an imprint of CRC Press LLC
No claim to original U.S. Government works
International Standard Book Number 1-56670-418-9
Library of Congress Card Number 00-048127
Printed in the United States of America 1 2 3 4 5 6 7 8 9 0
Printed on acid-free paper
© 2001 by CRC Press LLC
920067_CRC17_L1418_fm 11/25/00 2:25 PM Page v
Preface
This manual was originally developed for a group of about 130 long-term care facilities in New York
State under a special workers’compensation insurance program. The author of this book is the health
and safety advisor to this group. She developed highly customized guidance materials specifically
for the long-term care industry. These were then combined into a comprehensive manual that has
been evolving,and in use,for the past 6 years. The manual embodies everything a long-term care fa-
cility and its managers ought and need to know about OSHA,and how to manage the facility most
effectively. Discussions on political direction and agency organizational culture, which will affect
how regulations are interpreted,inspections are conducted,and how one should proceed in contest-
ing citations are included. The manual presents issues in the order,category,and method as OSHA
would view them. Each section provides the basic goal of the standard or subject,a summary,and a
discussion of any recent developments,followed by applicable sample policies and appropriate guid-
ance materials.
As the health and safety advisor assigned to this group of long-term care facilities,the author
became an integral part of many of the facilities’operations. This provided her with unique insights
on the resident focus,Department of Health surveys,Joint Commission surveys (for those that par-
ticipate),the particular styles of bureaucracy the facilities entail,and even practical matters,such as
dealing with dementia,and domestic violence of staff spilling over into the workplace. This intimate
familiarity with the industry is reflected in the propriety of the material. Everything is presented to
the long-term care operator and management team in an accommodating and palatable form. The
author believes that any effort invested in OSHA compliance should also pay dividends in real-life
safety management and performance,and other types of liability reduction,rather than be an act in
vain in the name of blind compliance.
“Rules and regulations are for the guidance of the wise,and the strict obedience of fools. Quality never
comes from mindless obedience,neither will safety.”
—B. Russell.
For the first time,this valuable resource is made available to the general public,outside this local
New York insurance program. The author trusts that readers may find it most helpful,effective,and
adaptive in managing for safety in the context of a long-term care setting,while meeting compliance
initiatives. All the sample policies and guides are available as Word and Excel files on the CRC Web
site at http://www.crcpress.com.
This information does not represent legal advice or opinion of current codes. Readers are urged
to seek advice of counsel on these issues.
v
© 2001 by CRC Press LLC
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The Author
Elsie Tai has specialized in the environmental and occupational
health and safety field for more than 14 years. Her last 9 years have
been spent consulting in the long-term care setting within the con-
text of a workers’compensation insurance program aimed at im-
proving facility operational efficacy. Her insights and approach to
safety programming and OSHA compliance management uniquely
reflect the integration of her continued learning, knowledge, and
experience of the issues,culture,and systems particular to this in-
dustry. She holds a B.S. degree in environmental science/occupa-
tional health and industrial hygiene from Rutgers University,N.J.,
and an M.S. in organizational leadership from Mercy College,N.Y.
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© 2001 by CRC Press LLC
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Co1ntents
Chapter 1 OSHA,The Agency
I. OSHA Reform 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
B. Target Inspection Program and the PEP—Enforcement Policies . . . . . . . . . . . . . . . 2
C. Chamber of Commerce Injunction and the OSHA Interim Plan . . . . . . . . . . . . . . . 3
D. Senate Hearings on OSHA Reform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
E. The CCP—Chamber of Commerce Injunction and Future Developments . . . . . . . . 4
F. The Interim Plan and New Inspection Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
G. OSHA Update—At a Glance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
II. Contact with OSHA and Reporting Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
A. Responsibility to Contact OSHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
B. OSHA Consultative Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
C. OSHA-Initiated Contacts by Mail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
D. OSHA-Initiated Contacts on Site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
E. General Response of a Facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
F. Receiving an Inspector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
G. Preemptive Strategy and the Warrant Advice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
H. Persuasive Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
I. Contest Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
III. Citations,Penalties,and Contests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
B. The (New) Penalty and Citation Ceilings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
C. Scope and Probability of Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
D. Traditional vs. Revised Pilot Test OSHA Civil Penalties and Adjustments . . . . . . . 12
1. Size Adjustment (old) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2. Size Adjustment (test) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3. Other-Than-Serious Adjustment (test) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
4. Good Faith Adjustment (old) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
5. Good Faith Adjustment (test) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
6. High-Gravity Serious Violations (test) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
E. Serious Violations Penalty Grading Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
1. Serious Violations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2. Other-Than-Serious Violations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3. Regulatory Violations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
4. Willful Violations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
5. Repeat Violations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
6. Failure to Abate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
F. Penalty Reality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
G. Contest Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
IV. Statistics and Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
B. Incident Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
C. The Incident Rate Formula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
D. Use of Incident Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
ix
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x Contents
E. OSHA 200 Log Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
V. Interface with Joint Commission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Chapter 2 Inspection Preparedness
I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
II. Guide:OSHA Inspection Policy and Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
A. General Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
B. Receptionist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
C. The OSHA Liaison . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
D. Verification of Inspection Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
E. Keeping a Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
F. Last-Minute OSHA 200 Log Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
G. Last-Minute Policy Drawing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
H. Last-Minute Rounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
I. Last-Minute Staff Knowledge Brush-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
J. Providing a Work Space for Document Inspection and Employee
Interviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
K. Providing Amenities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
L. Liaison-Accompanied Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
1. Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
2. Scope of Facility Tour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
3. Answering Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
4. Document Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
M. Employee Interviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
N. Following Up and Verifying Exchange of Information . . . . . . . . . . . . . . . . . . . . . . 26
O. Speaking Out Policy,or Making a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
P. When to Cooperate and When to Require Subpoenas . . . . . . . . . . . . . . . . . . . . . . . 27
Q. Patient’s Medical Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
R. Employee Medical Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
S. Fiscal Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
T. Videotaping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
U. Remaining Calm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
V. Closing Conference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
W. Seeking Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
III. OSHA Program Evaluation Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
B. Value of the PEP Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
C. Description of the PEP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
D. Written Health and Safety Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
E. Evaluation and Scoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
F. Health and Safety Activities Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
OSHA Program Evaluation Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Rating Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
IV. Sample Policy:Health and Safety Policy for Long-Term Care Facilities . . . . . . . . . . . . . 45
A. Mission Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
B. Philosophy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
C. Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
D. Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
E. Responsibilities,Accountability,and Commitment . . . . . . . . . . . . . . . . . . . . . . . . . 46
F. Employee Involvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
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G. Written Health and Safety Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
H. Health and Safety Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
I. Incident Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
J. Incentive Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
K. Performance Evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
L. Postings Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
M. Record Keeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
1. H&S Committee Minutes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
2. OSHA Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
3. Incident Report Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
4. Workers’Compensation Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
5. Employee Access to Medical and Exposure Records . . . . . . . . . . . . . . . . . . . 49
6. Record Retention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
7. Training Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
8. Building and Equipment Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
9. Mandatory Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
10. Additional Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
V. OSHA Preparedness:Health and Safety Activities Log . . . . . . . . . . . . . . . . . . . . . . . . . . 50
A. Safety Committee Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
B. Safety Program Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
C. Actual Safety Process vs. Inspection Elements of the Safety Process . . . . . . . . . . . 52
D. Optimal Use of the Health and Safety Activities Log . . . . . . . . . . . . . . . . . . . . . . . . 52
E. What Subjects to Report On . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
F. Which Words to Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
G. What Activities to Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
H. Other Practical Notes on Using the Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Chapter 3 OSHA Standards
I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
II. Managing Asbestos in a Facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
B. History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
C. Most Likely Scenario . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
D. Another Possible Scenario . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
E. Some Relevant Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
F. Critical Points Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
G. Asbestos Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
1. Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
2. Periodic Surveillance and Reinspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
3. Work Control/Permit System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
4. Operations and Maintenance Work Practices . . . . . . . . . . . . . . . . . . . . . . . . . . 63
5. Record Keeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
H. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Sample Form:Reinspection of Asbestos-Containing Materials . . . . . . . . . . . . . . . . . . . . 65
Sample Form:Job Request for Maintenance Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Sample Form:Maintenance Work Authorization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
III. Employee Access to Exposure and Medical Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
A. Goal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
B. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
© 2001 by CRC Press LLC
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C. Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
D. Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
E. Sample Letter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
F. Regulations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
IV. Bloodborne Pathogens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
B. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
C. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
D. Sample Plan:The Exposure Control Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
1. Employee Exposure Determination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
2. Definitions to Determine Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
3. Implementing Methods of Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
a. Universal/Standard Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
b. Engineering Controls and Work Practices . . . . . . . . . . . . . . . . . . . . . . . . 87
c. Personal Protective Equipment (PPE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
d. Hepatitis B Virus (HBV) Vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
e. Postexposure Evaluation Follow-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
f. Housekeeping and Laundry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
g. Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
h. Training and Communicating Hazards to Employees . . . . . . . . . . . . . . . 94
4. Record Keeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Sample Form:Hepatitis B Vaccine Immunization Record . . . . . . . . . . . . . . . . . . . . . . . 96
Sample Form:Exposure Incident Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Sample Letter:Request for Source Individual Evaluation . . . . . . . . . . . . . . . . . . . . . . . 97
Sample Form:Documentation and Identification of Source Individual . . . . . . . . . . . . . 98
Sample Form:Employee Exposure Follow-Up Record . . . . . . . . . . . . . . . . . . . . . . . . . 98
Sample Checklist:Regulated Waste Contracting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Sample Checklist:Postexposure Follow-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
V. Compressed Gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
A. Note . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
B. Basic Rules of Cylinder Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
VI. Confined Space . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
B. Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
C. Facility Survey and Hazard Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
1. Identify Confined Spaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
2. Hazard Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
a. Atmospheric Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
b. Mechanical Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
3. Employee Exposure Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
4. Classification of Confined Space . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Sample Survey:Confined Space Facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
D. Reclassification of a Potential Permit-Required Confined Space
into a Non-Permit-Required Confined Space by Determining the Airborne
Contaminant Concentration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Sample Worksheet:Air Sampling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
E. Reclassification of a Permit-Required Confined Space to a
Non-Permit-Required Confined Space by Removal of Safety Hazards
with the Implementation of Lockout Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Sample Certification Document:Reclassification of a Permit-Required
© 2001 by CRC Press LLC
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Confined Space by Instituting Lockout Procedures . . . . . . . . . . . . . . . . . . . . . . . . 107
F. Employee Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Sample Document:Training Record-Keeping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
G. Sample Policy:Confined Space Entry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
VII. Electrical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
B. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
C. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
VIII. Emergency Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
A. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
B. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
IX. OSHA Eyewash and Eye Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
A. Goal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
B. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
C. Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
X. Fire Extinguisher Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
A. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
B. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
XI. Hazard Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
A. Goal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
B. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
C. Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
D. Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
E. Hazard Communication Program Outline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
F. Sample Policy:Hazard Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
1. General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
2. Chemical Inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
3. Chemical Inventory and Purchase Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Sample Tool:Chemical Safety Management Review . . . . . . . . . . . . . . . . . . . . . . . 116
Sample Checklist:Area/Operation Hazard Evaluation . . . . . . . . . . . . . . . . . . . . . . 117
4. Material Safety Data Sheets (MSDSs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
5. Labels and Other Forms of Warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
6. Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Sample Letter:Requesting MSDS from Suppliers Who Insist
MSDSs Are Not Required of Them . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
MSDS Terms Glossary and Chemical Safety Primer for the Lay User . . . . . . . . . 122
XII. Lockout/Tagout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
A. Goal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
B. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
C. Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
D. Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
E. Sample Program:Lockout/Tagout (Hazardous Energy Control Program) . . . . . . . 125
1. Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
2. Preparation for Lockout/Tagout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
3. Sequence of Lockout/Tagout Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
4. Procedure Involving More Than One Person . . . . . . . . . . . . . . . . . . . . . . . . . . 126
5. Personnel Authorized to Lock Out/Tag Out . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
6. Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
7. Periodic Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
8. Contractors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
© 2001 by CRC Press LLC