Chapter%202%20%20Health%20And%20Safety

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Chapter 2 Health And Safety
Textbook Page
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Objectives

• Describe The Following Basic Toxicological
  Principles
• Exposure
• Toxicity
• Acute And Chronic Exposures
• Acute And Chronic Effects
• Routes Of Exposure To Hazardous Materials
• Dose/Response Relationship
• Local And Systemic Effects
• Target Organs
• Identify The Seven Types Of Harm Created By
  Exposure To Hazardous Materials And Their Effects
  Upon The Human Body.

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Objectives

• Define The Following Terms And Explain Their
  Significance In The Risk Assessment Process
  NFPA 472 - 6.2.5.2(a)
• Parts Per Million (PPM)
• Parts Per Billion (Ppb)
• Lethal Dose (LD50)
• Lethal Concentration (LC50)
• Permissible Exposure Limit (PEL)
• Threshold Limit Value/Time-weighted Average
  (TLV/TWA)

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Objectives

• Threshold Limit Threshold Limit Value/Ceiling
  (TLV/C)
• Threshold Limit Value/Short-term Exposure Limit
  (TLV/STEL)
• Immediately Dangerous To Life Or Health (IDLH)
• Emergency Response Planning Guideline (ERPG)
• Acute Exposure Guideline Levels (AEGL)
• Radiation Absorbed Dose (RAD Or RAD)
• Roentgen Equivalent Man (REM) Millierem (MREM)
• Roentgen

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Objectives

• Identify The Relative Advantages And
  Disadvantages Of The Following Heat Exchange
  Units Used For The Cooling Of Personnel In
  Chemical Protective Clothing NFPA 472
  6.3.3.3(d)
• Air Cooled
• Ice Cooled
• Water Cooled
• Identify The Physical And Psychological Stresses
  That Can Affect Users Of Specialized Protective
  Clothing NFPA 472 6.3.3.3(g).

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Objectives

• Identify The Signs And Symptoms And Emergency
  Care Procedures For Handling Heat Stress
  Emergencies.
• Identify Procedures For Reducing The Effects Of
  Heat Stress Upon Responders At A Hazmat Incident.
• Identify Procedures For Reducing The Effects Of
  Cold On Responders At A Hazmat Incident.
• Identify Procedures For Protecting Responders
  Against Excessive Noise Levels At A Hazmat
  Incident.

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Objectives

• Identify The Components Of A Medical Surveillance
  Program For Hazmat Responders As Outlined In OSHA
  1910.120(q). Identify The Components Of A
  Personal Protective Equipment (PPE) Program.
• Describe The Components Of A Site Safety Plan For
  Operations At A Hazmat Incident.
• List And Describe The Safety Considerations That
  Should Be Included In The Incident Action Plan
  Prior To Conducting Entry Operations At A Hazmat
  Incident NFPA 4726.3.5(c).

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Objectives

• Describe The Procedures And Components For
  Conducting Pre- And Post-entry Medical Monitoring
  For Response Personnel Operating At A Hazmat
  Incident.
• Describe The Procedures For Establishing And
  Operating A Rehabilitation Sector At A Hazmat
  Incident.

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Introduction

• The Health And Safety Of All Emergency Responders
  Is A Critical Issue.
• Preventing Exposures To Hazardous Materials Is
  Always A Primary Concern.
• Command Personnel Must Also Evaluate The Physical
  Working Conditions, Work Intervals, And The
  Stress Of Working In Personal Protective Clothing
  And Equipment.
• It Is Everyones Goal to Have Responders Come
  Home Safe

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Introduction

• Hazmat Incidents Are Characterized
• By Work Environment Hazards,
• Which May Pose An Immediate
• Danger To Life And Health (IDLH)
• These May Not Be Immediately Obvious Or
  Identifiable.
• Protecting The Health And Safety Of Emergency
  Response Support Personnel, And The General
  Public, Must Always Be The Incident Commanders
  (IC's) Primary Concern.

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Toxicology

• Toxicology Is The Study Of Chemical Or Physical
  Agents That Produce Adverse Responses In The
  Biologic Systems With Which They Interact.
• Toxicity Is Defined As The Ability Of A Substance
  To Cause Injury To A Biologic Tissue.

Exposure Toxicity Health Hazard
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Toxicology

• A Number Of Factors Determine The Toxicity Of A
  Chemical
• Exposure Means That You Have Had Contact With The
  Chemical.
• Dose Is The Concentration Or Amount Of A Material
  To Which The Body Is Exposed Over A Specific
  Period Of Time.
• Toxicity Refers To The Ability Of The Chemical To
  Harm Your Body Once Contact Has Occurred.

Exposure Toxicity Health Hazard
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Exposure Concerns

• Chemical Exposures And Their Health Effects Are
  Commonly Described As Acute Or Chronic.
• Acute Exposures Are An Immediate Exposure
• An Acute Health Effect Results From A Single Dose
  Or Exposure To A Material, Such As A Single
  Exposure To A Highly Toxic Material Or A Large
  Dose Of A Less Toxic Material
• Chronic Exposures Are Low Exposures Repeated Over
  Time
• Chronic Health Effects Result From A Single
  Exposure Or From Repeated Doses Or Exposures Over
  A Relatively Long Period Of Time.

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Routes Of Exposure

• Inhalation
• Skin Absorption
• Ingestion
• Direct Contact
• Injection

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Dose/Response Relationship

• The Dose/Response Concept Is Based Upon The
  Following Assumptions
• The Magnitude Of The Response Is Dependent Upon
  The Concentration Of The Chemical At The
  Biological Site Of Action (I.E., Target Organ).
• The Concentration Of The Chemical At The
  Biological Site Of Action Is A Function Of The
  Dose Administered.
• Dose And Response Are Essentially A Cause/Effect
  Relationship.

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Dose/Response Relationship
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Dose/Response Relationship
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Effects Of Hazardous Materials Exposures

• A Local Effect Implies An Effect At The Point Of
  Contact.
• A Systemic Effect Occurs When A Chemical Enters
  The Bloodstream And Attacks Target Organs And
  Internal Areas Of The Human Body.

Eyes
Skin
Liver
Blood
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Term - Target Organ - Examples

• Hepatotoxins
• Nephrotoxins
• Neurotoxins
• Respiratory Toxins

Liver Kidneys CNS Lungs
Carbon tetrachloride, Vinyl chloride monomer, and
nitroamines Halogenated hydrocarbons and
mercury Lead, toluene nerve agents,
organophosphate pesticides Asbestos, chlorine,
and System hydrogen sulfide
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Term - Target Organ - Examples

• Hematotoxins
• Dermatotoxins
• Teratogens
• Mutagens

Blood System Skin Fetus Mutagens
Benzene, chlordane, and cyanides Skeletal System
Bones Hydrofluoric acid and selenium irritants,
ulcers, chloracne, tar compounds, and high
levels and/or cause skin of ultraviolet
light pigmentation disturbances) Lead and
ethylene oxide Radiation, lead, and or
organisms ethylene dibromide
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Hazardous Materials Harm Events

• Thermal those Events Related To Temperature
  Extremes.
• Mechanical those Events Resulting From Direct
  Contact With Fragments Scattered Because Of A
  Container Failure, Explosion, Bombing Or Shock
  Wave.
• Poisonous those Events Related To Exposure To
  Toxins.
• Corrosive those Events Related To Chemical Burns
  And/Or Tissue Damage From Exposure To Corrosive
  Chemicals.

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Hazardous Materials Harm Events

• Asphyxiation those Events Related To Oxygen
  Deprivation Within The Body.
• Radiation those Events Related To The Emission
  Of Radiation Energy.
• Etiological those Events Created By Uncontrolled
  Exposures To Living Microorganisms.

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Toxicity Concerns

• Toxicologists List Four Categories Of Factors
  That Influence Toxicity
• Concentration Or Dose
• Rate Of Absorption
• Rate Of Detoxification
• Rate Of Excretion

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Measuring Toxicity

• Lethal Dose, 50 Kill (LD50) The Concentration
  Of An Ingested, Absorbed, Or Injected Substance
  Which Results In The Death Of 50 Of The Test
  Population.
• Lethal Concentration, 50 Kill (LC50) The
  Concentration Of An Inhaled Substance Which
  Results In The Death Of 50 Of The Test
  Population In A Specific Time Period (Usually 1
  Hour).

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Parts Per Million vs. Parts Per Billion
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The Hodge Sterner Table
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Exposure Values And Guidelines

• Exposure Values Are Only Guidelines, NOT Absolute
  Boundaries Between Safe And Dangerous Conditions.
  
• Common Exposure Values And Guidelines Are
• Threshold Limit Value/Time Weighted Average
  (TLV/TWA)the Maximum Airborne Concentration Of A
  Material To Which An Average Healthy Person May
  Be Exposed To Repeatedly For 8 Hours Each Day, 40
  Hours Per Week Without Suffering Adverse Effects.
• Permissible Exposure Limit (PEL) And Recommended
  Exposure Levels (REL)the Maximum Time-weighted
  Concentration At Which 95 Of Exposed, Healthy
  Adults Suffer No Adverse Effects Over A 40-hour
  Work Week.

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Exposure Values And Guidelines

• Short-term Exposure Limit (STEL) or Threshold
  Limit Value/Short-term Exposure Value. The
  15-minute, Time-weighted Average Exposure That
  Should Not Be Exceeded At Any Time, Nor Repeated
  More Than Four Times Daily With A 60-minute Rest
  Period Required Between Each STEL Exposure.
• Threshold Limit Value/Ceiling (TLV/C) the
  Maximum Concentration That Should Not Be
  Exceeded, Even Instantaneously. (The Lower The
  TLV/C, The More Toxic The Substance
• Threshold Limit Value/Skin indicates Possible
  And Significant Exposure To A Material By Way Of
  Absorption Through The Skin, Mucous Membranes.

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Exposure Values And Guidelines

• Immediately Dangerous To Life Or Health (IDLH)an
  Atmospheric Concentration Of Any Toxic,
  Corrosive, Or Asphyxiant Substance That Poses An
  Immediate Threat To Life, Or Would Cause
  Irreversible Or Delayed Adverse Health Effects,
  Or Would Interfere With An Individuals Ability
  To Escape From A Dangerous Atmosphere.
• Emergency Response Planning Guidelines
  (Erpg-2)the Maximum Airborne Concentration Below
  Which It Is Believed That Nearly All Individuals
  Could Be Exposed For Up To One Hour Without
  Experiencing Or Developing Irreversible Or Other
  Serious Health Effects Or Symptoms That Could
  Impair An Individuals Ability To Take Protective
  Action.

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Exposure Values And Guidelines

• Acute Emergency Exposure Guidelines (AEGL)
  Referred To As Eagles And Developed By The
  National Research Councils Committee On
  Toxicology, These Are Intended To Provide Uniform
  Exposure Guidelines For The General Public
• The Terms Used To Describe Chemical Toxicity And
  Exposures Can Seem Complicated, And Some Have
  Similar Meanings, Further Complicating The Issue
  
• Remember Health Hazard Exposure Toxicity

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Controlling Personnel Exposures

• The Primary Objective Of Using These Various
  Exposure Guidelines Is To Minimize The Potential
  For Both Public And Responder Exposures.
• Three Basic Atmospheres At An Incident Involving
  Hazardous Materials
• Safe Atmosphere No Harmful Hazmat Effects
  Exist.
• Unsafe Atmosphere If One Is Exposed To The
  Material Long Enough, Some Form Of Either Acute
  Or Chronic Injury Will Often Occur.
• Dangerous Atmosphere these Are Environments
  Where Serious Irreversible Injury Or Death May
  Occur.

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What Is Safe?

• All Of These Guidelines Have One Thing In Common
  Remain Below These Values And The Exposure Is
  Considered Safe To The Average Healthy Adult By
  All Information That Is Known By Todays Health
  And Safety Professionals.

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What Is Unsafe?

• A General Rule For Responders Should Be That If
  The Material Has Been Released From Its
  Container, Assume That An Unsafe Atmosphere May
  Exist And Some Form Of PPE Is Required.

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What Is Dangerous?

• When Concentrations Continue To Increase Above
  Unsafe Levels, There Is A High Potential For
  Life-threatening Injuries Or Death To Occur. This
  Concentration Level Is The IDLH
• There Are Four General IDLH Atmospheres
• Toxic
• Flammable
• Oxygen Deficient
• Oxygen Enriched

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Physical Indicators Of Likely IDLH Conditions

• Outside Or Open Air Environment
• Visible Vapor Cloud
• Release From A Bulk Container Or Pressure Vessel
• Large Liquid Leaks
• Inside Or Limited Air Environment
• Below Grade Rescues Or Release
• Confined Spaces
• Artificial Or Natural Barriers

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Physical Indicators Of Likely IDLH Conditions

• Biological Indicators (Using Your Common Sense!)
• Dead Birds, Discolored Foliage, Sick Animals
• Physical Senses And Street Smarts Be Aware Of
  Strong Odors And Other Sensory Warnings
• Hazmats With A Potential For Quick And Rapid Harm
• Poison Gases
• Explosives and Some Oxidizers
• Materials With Very Low IDLH Values
• Firefighting Overhaul Operations

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Carcinogens

• Carcinogens Are Physical Or Chemical Agents That
  Cause Abnormal Cell Growth And Spread.
• There Are As Many As 2000 Substances That Various
  Scientific And Regulatory Groups Have Labeled As
  Suspect, Probable, Or Definite Human
  Carcinogens.
• While Some Carcinogens May Have A TLV Value, Many
  Do Not.

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Radioactive Materials

• Radiation Is The Emitting Of Energy From An Atom
  In The Form Of Either Particles Or
  Electromagnetic Waves.
• Radiation Can Be Classified Into Two Types
• Non-ionizing Radiationcharacterized By Its Lack
  Of Energy To Remove Electrons From Atoms.
• Ionizing Radiationcharacterized By Its Ability
  To Create Charged Particles, Or Ions, In Anything
  That It Strikes.
• Four Types of Ionizing Radiation
• Alpha Particles
• Beta Particles
• Gamma Rays
• Neutron Particles

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Radioactive Materials

• Half-life Is The Time It Takes For The Activity
  Of A Radioactive Material To Decrease To One Half
  Of Its Initial Value Through Radioactive Decay.
• Exposure Versus Contamination
• Exposure Means That The Human Body Has Been
  Subjected To Radiation Emitted From A Radioactive
  Source.
• Contamination Means That The Actual Radioactive
  Material Has Come In Direct Contact With Ones
  Body Or Clothing (I.E., The Person Is Dirty).
• Exposure Guidelines For Radioactive Materials
  Are
• Time - Distance - Shielding

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Units Of Measurement For Radiation and Dose
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Exposure To Environmental Conditions

• Exposure To Weather Conditions Can Adversely
  Affect Both The Physiological And Psychological
  Conditions Of Response Personnel.
• Factors That Influence An Individuals
  Susceptibility To Environmental Conditions
  Include
• Lack Of Physical Fitness
• Acclimatization To The Elements
• Age and Obesity
• Dehydration
• Alcohol And Drug Use (Including Prescription
  Drugs)
• Infection Or Chronic Disease
• Allergies

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Heat Stress

• Experience Over The Last 20 Years Has Shown That
  Responders Wearing Chemical Protective Clothing
  (CPC) Are More Likely To Be Injured As A Result
  Of Heat Stress Than A Chemical Exposure.
• A Key Indicator Of Body Heat Levels Is The Body
  Core Temperature.
• Physical Reactions To Heat Include The Following
• Heat Rash Inflammation Of The Skin Resulting
  From Prolonged Exposure To Heat And Humid Air And
  Often Aggravated By Chafing Clothing.

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Heat Stress

• Physical Reactions To Heat Also Include The
  Following
• Heat Cramps Cramp In The Extremities Or Abdomen
  Caused By The Depletion Of Water And Salt In The
  Body.
• Heat Exhaustion Mild Form Of Shock Caused When
  The Circulatory System Begins To Fail As A Result
  Of The Bodys Inadequate Effort To Give Off
  Excessive Heat.
• Heat Stroke Severe And Sometimes Fatal
  Condition Resulting From The Failure Of The
  Temperature Regulating Capacity Of The Body. Heat
  Stroke Is A True Medical Emergency Requiring
  Immediate Transport To A Medical Facility.

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Heat Stress Emergencies
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Minimize The Effects Of Heat Stress

• Administrative Controls, Work/Rest Scheduling,
  Rehab, And Fluid Replacement PPE Options Are
  Outlined Below
• Air-cooled Jackets And Suits
• Ice-cooled Vests
• Liquid-cooled Vests And Suits
• Provide Plenty Of Liquids, Including Prehydration
  With 8 To 16 Ounces Of Fluids.

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Cold Temperature Exposures

• Exposure To Severe Cold Even For A Short Period
  Of Time May Cause Severe Injury To Body Surfaces,
  Especially The Ears, Nose, Hands, And Feet.
• Two Factors Significantly Influence The
  Development Of Cold Injuries
• Ambient Temperature
• Wind Velocity.

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Cold Temperature Exposures

• Response Personnel Should Also Understand Body
  Heat Is Lost
• It Is Essential That The Layer Next To The Skin,
  Especially Socks, Be Dry

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Noise

• Hazardous Materials Incidents Can Often Involve
  Excessive Noise Levels. The Effects Of Excessive
  Noise Levels Can Include The Following
• Personnel Being Annoyed, Startled, Or Distracted
• Physical Damage To Ears, Pain, And Temporary
  And/Or Permanent Hearing Loss
• Interference With Communications, Which May Limit
  The Ability Of ERP To Warn Of Danger Or Enforce
  Proper Safety Precautions (Verbal And Radio)
• Standardized Hand Signals Should Be Developed For
  Situations Where Excessive Noise Levels Make
  Verbal Or Radio Communications Impossible.

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Health And Safety Management Program

• A Health And Safety Management Program Should Be
  An Integral Element Of Any Emergency Response
  Organization.
• The Components Of A Health And Safety Management
  System Are Outlined In OSHA 1910.120, Hazardous
  Waste Site Operations And Emergency Response
  (HAZWOPER).
• Key Areas Within The Regulation Include Medical
  Surveillance, Personal Protective Equipment, And
  Site Safety Practices And Procedures.

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Medical Surveillance

• The Primary Objectives Of A Medical Surveillance
  Program Are
• To Determine That An Individual Can Perform His
  Or Her Assigned Duties, Including The Use Of
  Personal Protective Clothing And Equipment
• To Detect Any Changes In Body System Functions
  Caused By Physical And/Or Chemical Exposures.

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Medical Surveillance

• The Success Of Any Medical Program Depends On
  Management Support And Employee Involvement.
• Confidentiality Of All Medical Information Is
  Paramount. Responders Should Be Encouraged To
  Document Any Suspected Exposures, Regardless Of
  The Degree.

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Medical Surveillance Program

• Pre-employment Screening
• Periodic Medical Examinations
• Emergency Treatment
• Non Emergency Treatment
• Recordkeeping
• Program Review
• Critical Incident Stress

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Pre-Employment Screening

• The Objectives Of Pre-employment Screening Are To
  Determine An Individuals Fitness For Duty,
  Including Respirator And Protective Clothing Use.
  The Screening Should Focus On The Following
  Areas
• Occupational And Medical History
• Physical Examination
• Baseline Laboratory Profile

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Periodic Medical Examinations

• Periodic Exams Must Be Used In Conjunction With
  Pre-employment Screening. Under The OSHA 1910.120
  Requirements, Such Exams Shall Be Administered
  Annually. In Addition, More Frequent Intervals
  May Be Required Depending On The Nature Of
  Potential Or Actual Exposures.
• Periodic Screening Exams Can Include Medical
  History Reviews That Focus On Health Changes,
  Illness And Exposure-related Symptoms.

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Emergency Treatment

• EMS Personnel And Units Must Be Available At
  Each Hazmat Incident.
• OSHA 1910.120(q)(3)(vi) Requires That "Advanced
  First Aid Support Personnel, As A Minimum, Shall
  Stand-by With Medical Equipment And A
  Transportation Capability At Hazmat Emergencies."
  
• Advanced First Aid Personnel Are Considered As
  Individuals Who Have Been Trained To The Red
  Cross Advanced First Aid Level Or Higher
• Medical Equipment Is Not Required To Be On Scene
  But Must Be Available For Immediate Response.

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Emergency Treatment

• Specific Responsibilities Of EMS Or Medical
  Group Personnel Include The Following
• Provide Technical Assistance To Responders In The
  Development And Analysis Of EMS-related Data And
  Information.
• Designate A Treatment And Triage Area
• Perform Pre-entry And Post-entry Medical
  Monitoring
• Coordinate And Supervise All Patient Handling
  Activities
• Communicate And Coordinate With Local Hospitals
  And Specialized Treatment Facilities, Including
  The Poison Control Center, As Necessary.

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Emergency Treatment

• Hazmat Training Competencies For EMS Personnel
  Can Be Found In NFPA 473, Competencies For EMS
  Personnel Responding To Hazardous Materials
  Incidents
• Standard Operating Procedures (SOPS) For The
  Clinical Management And Transportation Of
  Chemically Contaminated Patients Must Be
  Developed As Part Of The Planning Process.

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Emergency Treatment

• Basic Principles Of Handling Chemically
  Contaminated Patients
• Always Ensure That EMS Personnel Are Properly
  Protected
• As A Rule Of Thumb All Patients Should Receive
  Gross Decontamination.
• The ABCs Can Be Administered To A Contaminated
  Victim If Rescuers And EMS Personnel Are
  Protected.
• Its A Much Better Option Than Having A Fully
  Decontaminated But Dead Patient.
• Always Coordinate With Your Local Medical
  Facilities.

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Nonemergency Treatment

• The Signs And Symptoms Of Certain Chemical
  Exposures May Not Be Present For 24 To 72 Hours
  After Exposure. Personnel Operating At An
  Incident Should Be Medically Evaluated Before
  Being Released.
• In Addition, The Termination Procedure Should
  Provide For A Briefing For All ERP On The Signs
  And Symptoms Of Exposure, Documentation And
  Completion Of Health Exposure Logs Or Forms,
  Post-incident Points Of Contact, And How To Get
  Immediate Treatment If Necessary.

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Recordkeeping And Program Review

• Recordkeeping Is An Important Element Of The
  Medical Surveillance Program. Individual Records
  Should Be Kept For All Personnel.
• Individual Medical Records Should Include All
  Medical Exams Completed, Their Purpose, The
  Examining Physicians Observations And
  Recommendations, And If They Were A Result Of A
  Specific Exposure.

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Recordkeeping And Program Review

• Regular Evaluation of the Medical Surveillance
  Program and Review The Following Elements On An
  Annual Basis
• Ensure That Each Accident/Illness Is Promptly
  Investigated To Determine Its Root Cause And
  Update Health And Safety Procedures, As
  Necessary.
• Evaluate The Effectiveness Of Medical Testing In
  Light Of Potential And Confirmed Exposures.
• Add Or Delete Specific Medical Tests As
  Recommended By The Medical Director And By
  Current Industrial Hygiene And Environmental
  Health Data.
• Review All Emergency Care Protocols.

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Critical Incident Stress

• Critical Incident Stress Should Be Recognized As
  An Issue That Can Potentially Impact The Health
  And Welfare Of Responders.
• Medical Debriefings As Part Of The Incident
  Termination Phase Are Essential Elements In
  Reducing The Level Of Stress.
• Employee Assistance Programs (EAP) And Critical
  Incident Stress Management (CISM) Teams Can Be An
  Effective Post incident Resource And Should Be
  Used As Necessary.

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Personal Protective Equipment Program

• The Objectives Of A PPE Program Are To Protect
  Personnel From Both Chemical And Physical Safety
  And Health Hazards.
• A Comprehensive PPE Program Should Include The
  Following
• Hazard Assessment
• Medical Monitoring Of Personnel
• Equipment Selection And Use
• Training Program
• Inspection, Maintenance, And Storage Program

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Personal Protective Equipment Program

• A Written PPE Program Outlining These Elements Is
  Required Under OSHA 1910.120(g)(5).
• Copies Should Be Made Available To All Employees.
  A Well-rounded PPE Training Program Often
  Reduces Associated Maintenance Expenses. A
  Written Respiratory Protection Program Is Also
  Required Per OSHA 1910.134(c)(1).
• Certain Personal Features Jeopardize Responder
  Safety Including The Following
• Facial Hair (Beards) And Long Hair
• Eyeglasses With Conventional Temple Pieces
• Gum And Tobacco Chewing
• Prescription Drug Use

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Site Safety Practices And Procedures

• Safety Is An Attitude, A Behavior, And A Culture.
  
• The Operating Philosophy Should Be, If We Cannot
  Do This Safely, Then We Will Not Do It At All.
• There Are Two Phases Of An Incident Where The
  Potential For ERP Injury And Harm Is Greatest
• During Initial Response Operations
• When The Incident Shifts Gears From The
  Emergency Phase To The Clean-up And Recovery
  Phase.
• Gaining And Maintaining Control Of The Incident
  Scene Is One Of The Most Difficult Tasks,
  Everyone Wanting To Get As Close As Possible To
  The Action.

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Safety Truths

• What Occurs During The Initial 10 Minutes Will
  Dictate What Will Occur For The Next Hour, And
  What Occurs During The First Hour Will Dictate
  What Will Occur For The Next Eight Hours.
• There Is Nothing Wrong With Taking A Risk.
  However, Always Remember That There Are Good
  Risks And Bad Risksif There Is Much To Be
  Gained, Then Perhaps Much Can Be Risked. Of
  Course, If There Is Little To Be Gained, Then
  Little Should Be Risked.

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Safety Truths

• Safety Must Be More Than A Policy Or
  Procedureit Is Both And Attitude And A
  Responsibility
• Protective Clothing Is Not Your First Line Of
  Defense But Is Your Last Line Of Defense.
• Final Accountability Always Rests With The
  Incident Commander.

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Site Safety Plan

• Although A Site Safety Plan Is Not Required Under
  OSHA 1910.120, Paragraph (q), Site Safety Must Be
  An Integral Element Of On-scene Response
  Operations. Sops And Checklists Should Be Used
  Both To Verify And Document That Safety Elements
  .
• Advantages Of Using Operational Checklists To
  Meet The Site Safety Requirements Are The Ability
  To Ensure That Specific Organizational Guidelines
  And Sops Are Followed.

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Standard Site Safety Practices

• Minimize The Number Of Personnel Operating In The
  Contaminated Area.
• Avoid Contact With All Contaminants, Contaminated
  Surfaces, Or Suspected Contaminated Surfaces.
• Advise All Entry Personnel Of All Site Control
  Policies Including Entry And Egress Points, DECON
  Layout And Procedures, And Working Times.

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Standard Site Safety Practices

• Always Have An Escape Route. Ensure That Everyone
  Knows The Emergency Evacuation Signals.
• Ensure That All Tasks And Responsibilities Are
  Identified Before Attempting Entry. If Necessary,
  Practice Unfamiliar Operations Prior To Entry.
• Use The Buddy System For All Entry Operations.
  Always Ensure That Properly Staffed And Equipped
  Back-up Crews Are In Place.

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Standard Site Safety Practices

• Maintain Radio Communications Between Entry,
  Backup Crews, And The Safety Officer (Whenever
  Possible).
• Prohibit Drinking, Smoking, And Any Other
  Practices That Increase The Possibility Of
  Hand-to-mouth Transfer In All Contaminated Areas.
• Follow Decontamination And Personal Cleanliness
  Practices Before Eating, Drinking, Or Smoking
  After Leaving The Contaminated Area.

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Safety Officer And Safety Responsibilities

• Under The OSHA HAZWOPER Regulation, The Safety
  Function Must Be Addressed At Every Incident In
  Which Hazardous Materials Are Involved. At Small,
  Level 1 Incident Scenarios, The Safety Function
  Can Be Easily Managed By The Incident Commander.
• At Incidents Where An HMRT Is Operating, Safety
  Responsibilities Will Often Be Divided Into Two
  Sreas
• The Safety Of All Units Operating On The Incident
  Scene And Under The Control Of The Incident
  Safety Officer
• The Safety Of Those Operating Within The ICS
  Hazmat Group And Under The Control Of The Hazmat
  Group Safety Officer.

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Safety Officer And Safety Responsibilities

• Overall Site Safety
• Ensure That The Safety Officer Is Identified To
  All Personnel.
• Ensure That All Personnel And Equipment Are
  Positioned In A Safe Location.
• Ensure That Hazard Control Zones Are Established,
  Identified, And Constantly Monitored And That
  Their Locations Are Communicated To All
  Personnel.
• When Necessary, Designate A Security Officer To
  Maintain Overall Site Security.
• Ensure That All Personnel In Controlled Areas Are
  In The Proper Level Of Personal Protective
  Clothing.

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Safety Officer And Safety Responsibilities

• Entry Operations
• Coordinate With The Medical Officer To Ensure
  That Pre-entry Medical Monitoring Has Been
  Conducted.
• Hold A Pre-entry Safety Briefing Prior To Recon
  Or Entry Operations.
• Coordinate Entry Operations With Backup Crews And
  The DECON Unit.
• Monitor Entry Operations And Advise Entry
  Personnel And The IC Of Any Unsafe Practices Or
  Conditions.
• During The Termination Phase, Advise All
  Personnel Of The Possible Signs And Symptoms Of
  Exposure And Ensure That Health Exposure Forms
  Are Documented.

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Pre And Post Entry Medical Monitoring

• Medical Monitoring May Be Defined As An Ongoing,
  Systematic Evaluation Of Individuals At Risk Of
  Suffering Adverse Effects Of Exposure To Heat,
  Stress, Or Hazardous Materials As A Result Of
  Working At A Hazardous Materials Emergency.
• The Objectives Of Medical Monitoring Are
• To Identify And Preclude From Participation
  Individuals Who Are At Increased Risk To Sustain
  Either Injury Or Illness
• To Facilitate The Early Recognition And Treatment
  Of Personnel With Adverse Physiological And/Or
  Emotional Responses.

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Pre- And Post Entry Medical Monitoring

• Components Of The Pre-entry Exam Should Include
  The Following
• Vital Signs
• Skin Evaluation
• Lung Sounds
• Mental Status (Alert And Oriented To Time,
  Location, And Person).
• Recent Medical History
• Pre-hydration With 8 To 16 Ounces Of Water.
• Criteria Should Be Established For Evaluating ERP
  Prior To Entry Operations. These Criteria Should
  Not Supersede Any Existing Criteria Established
  By The Local Medical Control.

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Exclusion Criteria For HRT Entry

• Entry Shall Be Denied If The Following Criteria
  Are Not Satisfied
• Blood Pressure BP Exceeds 100 Mm Hg Diastolic.
• Pulse greater Than 70 Maximum Heart Rate
  (gt115) Or Irregular Rhythm Not Previously Known.
• Respirations respiratory Rate Is Greater Than
  24 Per Minute.
• Temperature oral Temperature Less Than 97f Or
  Exceeds 99.5f. Core Temperature Less Than 98F
  Or Greater Than 100.5f.
• Body Weight No Pre-entry Exclusion

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Exclusion Criteria For HRT Entry

• Entry Shall Also Be Denied If The Following
  Criteria Are Not Satisfied
• EKG Dysrhythmias Not Previously Detected Must
  Be Cleared By Medical Control.
• Mental Status Altered Mental Status (E.G.,
  Slurred Speech, Clumsiness, Weakness).
• Other Criteria, Including
• Skin Open Sores, Large Skin Rashes, Or
  Significant Sunburn.
• Lungs Wheezing Or Congested Lung Sounds.
• Medical History

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Post-Entry Medical Monitoring

• Post-entry Medical Monitoring Is Performed
  Following Decontamination
• Any Signs Or Symptoms Of Chemical Exposure, Heat
  Stress, Or Cardiovascular Collapse
• Vital Signs
• Skin Evaluation
• Mental Status
• Hydration
• Vital Signs Should Be Monitored Every 5 To 10
  Minutes, With The Person Resting, Until They
  Return To Approximately 10 Of The Baseline

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Emergency Incident Rehabilitation

• The IC Should Consider The Circumstances Of The
  Incident And Make Adequate Provisions Early In
  The Incident For The Rest And Rehabilitation.
• The Incident Commander Should Establish A
  Rehabilitation Sector.
• At Most Hazmat Incidents, Rehabilitation Will Be
  The Responsibility Of The Hazmat Medical Group.

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Emergency Incident Rehabilitation

• The Rehabilitation Area Should Meet The Following
  Parameters
• Be In A Location That Provides Physical Rest By
  Allowing The Body To Recuperate From The Hazards
  And Demands Of The Emergency.
• Be Located In A Safe Location Within The Cold
  Zone.
• Provide Suitable Protection From The Prevailing
  Environmental Conditions.
• Be Large Enough To Accommodate Multiple Crews,
  Based On The Size Of The Incident.

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Summary

• Personnel Protection Is The Number 1 Priority At
  Any Hazmat Incident.
• The Health And Safety Concerns Of ERP At Any
  Incident Include
• Exposures To Hazardous Materials
• Physical Environment
• Toxicity And Health Exposure Guideline
• The Components Of A Hazmat Health And Safety
  Management System
• Site Safety Practices And Procedures

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O.T. and The Kid