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Chapter 2 Health And Safety

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Title: Chapter 2 Health And Safety


1
Chapter 2 Health And Safety
Textbook Page
2
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.

3
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)

4
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

5
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).

6
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.

7
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).

8
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.

9
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

10
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.

11
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
12
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
13
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.

14
Routes Of Exposure
  • Inhalation
  • Skin Absorption
  • Ingestion
  • Direct Contact
  • Injection

15
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.

16
Dose/Response Relationship
17
Dose/Response Relationship
18
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
19
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
20
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
21
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.

22
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.

23
Toxicity Concerns
  • Toxicologists List Four Categories Of Factors
    That Influence Toxicity
  • Concentration Or Dose
  • Rate Of Absorption
  • Rate Of Detoxification
  • Rate Of Excretion

24
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).

25
Parts Per Million vs. Parts Per Billion
26
The Hodge Sterner Table
27
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.

28
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.

29
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.

30
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

31
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32
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.

33
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.

34
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.

35
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

36
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

37
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

38
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.

39
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

40
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

41
Units Of Measurement For Radiation and Dose
42
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

43
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.

44
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.

45
Heat Stress Emergencies
46
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.

47
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.

48
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

49
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.

50
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.

51
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.

52
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.

53
Medical Surveillance Program
  • Pre-employment Screening
  • Periodic Medical Examinations
  • Emergency Treatment
  • Non Emergency Treatment
  • Recordkeeping
  • Program Review
  • Critical Incident Stress

54
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

55
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.

56
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.

57
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.

58
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.

59
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.

60
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.

61
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.

62
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.

63
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.

64
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

65
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

66
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.

67
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.

68
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.

69
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.

70
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.

71
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.

72
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.

73
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
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