SECTION I A: FINANCE
C S H M
PREPARATION GUIDE
VOLUME 3
Area III Safety, Health, and Environmental Applications Study Notes, Questions, and Answer Key
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Prepared by
Steven J. Geigle, M.A., CSHM
Published by OSHA Training Network
Disclaimer
The information in this preparation guide has been compiled by the OSHA Training Network () from texts recommended by ISHM for study, and represents the best current information on the various subjects. No guarantee, warranty of other representation is made as to the absolute correctness or sufficiency of any information contained in this preparation guide. OSHA Training Network assumes no responsibility in connection therewith; nor can it be assumed that all acceptable safety measures are contained in the preparation guide or that other or additional measures may not be required under particular or exceptional circumstances.
OSHA Training Network (OTN) cannot warrant that the use of this preparation guide will result in certification from the Institute for Safety and Health Management (ISHM). While the content is representative of the knowledge required of a safety and health manager, the successful completion of the CSHM examination is depends on many factors including the applicant's academic background, safety management experience and individual study for the examination. This information is for educational purposes only and does not replace any regulations promulgated by state of federal government agencies.
As this preparation guide will continue to be updated and revised on a periodic basis, contributions and comments from readers are invited. Additional volumes to this preparation guide will be produced and made available in the future.
TABLE OF CONTENTS
Preface Introduction to the CSHM Preparation Guide
Part I Notes
Section A. Compliance Management 1
Section B. Environment 36
Section C. Ergonomics 44
Section D. Toxicology 76
Section E. Epidemiology 134
Section F. Industrial Hygiene 164
Section G. Construction 169
Part II Questions and Key
Introduction 182
Section A. Compliance Management 183
Section B. Environment 198
Section C. Ergonomics 203
Section D. Toxicology 210
Section E. Epidemiology 218
Section F. Industrial Hygiene 220
Section G. Construction 233
Answer Key 240
SECTION III A: COMPLIANCE MANAGEMENT
BACKGROUND AND HISTORY OF OCCUPATIONAL SAFETY
Occupational safety did not begin with the passage of the Occupational Safety and Health Act of 1970 (OSHAct). The ill effects of the environment on the worker have been known for thousands of years. Unfortunately, just because the hazards are known does not mean that they have been corrected.
Some significant events in occupational safety in the United States include:
In 1812, the Embargo of the War of 1812 spurred the development of the New England textile industry and the founding of factory mutual companies. These early insurance companies inspected properties for hazards and suggested loss control and prevention methods in order to secure low rates for their policyholders.
In 1864, The Pennsylvania Mine Safety Act (PMSA) was passed into law.
In 1864, North America's first accident insurance policy was issued.
In 1867, the state of Massachusetts instituted the first government-sponsored factory inspection program.
In 1877, the state of Massachusetts passed a law requiring guarding for dangerous machinery, and took authority for enforcement of factory inspection programs.
In 1878, the first recorded call by a labor organization for federal occupational safety and health law is heard.
In 1896, an association to prevent fires and write codes and standards, the National Fire Protection Association (NFPA), was founded.
In 1902, the state of Maryland passed the first workers' compensation law.
In 1904, the first attempt by a state government to force employers to compensate their employees for on-the-job injuries was overturned when the Supreme Court declared Maryland's workers' compensation law to be unconstitutional.
In 1911, a professional, technical organization responsible for developing safety codes for boilers and elevators, the American Society of Mechanical Engineers (ASME) was founded.
1911-1915, During this five-year period, 30 states passed workers' compensation laws.
In 1911, the American Society of Safety Engineers (ASSE) was founded. The ASSE was dedicated to the development of accident prevention techniques, and to the advancement of safety engineering as a profession.
In 1912, a group of engineers representing insurance companies, industry, and government met in Milwaukee to exchange data on accident prevention. The organization formed at this meeting was to become the National Safety Council (NSC). (Today, the NSC carries on major safety campaigns for the general public, as well as assists industry in the development of safety promotion programs.)
In 1916, the Supreme Court upheld the constitutionality of state workers' compensation laws.
In 1918, the American Standards Association was founded. Responsible for the development of many voluntary safety standards, some of which are referenced into laws, today, it is now called the American National Standards Institute (ANSI).
In 1936, Frances Perkins, Secretary of Labor, called for a federal occupational safety and health law. This action came a full 58 years after organized labor's first recorded request for a law of this nature.
In 1936, the Walsh-Healey (Public Contracts) Act passed. This law required that all federal contracts be fulfilled in a healthful and safe working environment.
By 1948, all states (48 at the time) now had workers' compensation laws.
In 1952, Coal Mine Safety Act (CMSA) was passed into law.
In 1960, specific safety standards were promulgated for the Walsh-Healey Act.
In 1966, the Metal and Nonmetallic Mines Safety Act (MNMSA) was passed.
In 1966, the U.S. Department of Transportation (DOT) and its sections, the National Highway Traffic Safety Administration (NHTSA) and the National Transportation Safety Board (NTSB), were established.
In 1968, President Lyndon Johnson called for a federal occupational safety and health law.
In 1969, the Construction Safety Act (CSA) was passed.
In 1969, the Board of Certified Safety Professionals (BCSP) was established. This organization certifies practitioners in the safety profession.
In 1970, President Richard Nixon signed into law the Occupational Safety and Health Act (OSHAct), thus creating the OSHA administration and the National Institute for Occupational Safety and Health (NIOSH).
__________________________________________________________________________________________
Excerpts: OSHA Act of 1970
Public Law 91-596
84 STAT. 1590
91st Congress, S.2193
December 29, 1970,
as amended through January 1, 2004. (1)
An Act
To assure safe and healthful working conditions for working men and women; by authorizing enforcement of the standards developed under the Act; by assisting and encouraging the States in their efforts to assure safe and healthful working conditions; by providing for research, information, education, and training in the field of occupational safety and health; and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, this Act may be cited as the "Occupational Safety and Health Act of 1970."
SEC. 2. Congressional Findings and Purpose
(a) The Congress finds personal injuries and illnesses arising out of work situations impose a substantial burden upon, and are a hindrance to, interstate commerce in terms of lost production, wage loss, medical expenses, and disability compensation payments.
(b) The Congress declares it to be its purpose and policy, through the exercise of its powers to regulate commerce among the several States and with foreign nations and to provide for the general welfare, to assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources --
29 USC 651
(1) by encouraging employers and employees in their efforts to reduce the number of occupational safety and health hazards at their places of employment, and to stimulate employers and employees to institute new and to perfect existing programs for providing safe and healthful working conditions;
(2) by providing employers and employees have separate but dependent responsibilities and rights with respect to achieving safe and healthful working conditions;
(3) by authorizing the Secretary of Labor to set mandatory occupational safety and health standards applicable to businesses affecting interstate commerce, and by creating an Occupational Safety and Health Review Commission for carrying out adjudicatory functions under the Act;
(4) by building upon advances already made through employer and employee initiative for providing safe and healthful working conditions;
(5) by providing for research in the field of occupational safety and health, including the psychological factors involved, and by developing innovative methods, techniques, and approaches for dealing with occupational safety and health problems;
(6) by exploring ways to discover latent diseases, establishing causal connections between diseases and work in environmental conditions, and conducting other research relating to health problems, in recognition of the fact occupational health standards present problems often different from those involved in occupational safety;
(7) by providing medical criteria which will assure insofar as practicable no employee will suffer diminished health, functional capacity, or life expectancy as a result of his work experience;
(8) by providing for training programs to increase the number and competence of personnel engaged in the field of occupational safety and health; affecting the OSH Act since its passage in 1970 through January 1, 2004.
(9) by providing for the development and promulgation of occupational safety and health standards;
(10) by providing an effective enforcement program which shall include a prohibition against giving advance notice of any inspection and sanctions for any individual violating this prohibition;
(11) by encouraging the States to assume the fullest responsibility for the administration and enforcement of their occupational safety and health laws by providing grants to the States to assist in identifying their needs and responsibilities in the area of occupational safety and health, to develop plans in accordance with the provisions of this Act, to improve the administration and enforcement of State occupational safety and health laws, and to conduct experimental and demonstration projects in connection therewith;
(12) by providing for appropriate reporting procedures with respect to occupational safety and health which procedures will help achieve the objectives of this Act and accurately describe the nature of the occupational safety and health problem;
(13) by encouraging joint labor-management efforts to reduce injuries and disease arising out of employment.
SEC. 5. Duties
(a) Each employer --
(1) shall furnish to each of his employees employment and a place of employment which are free from recognized hazards are causing or are likely to cause death or serious physical harm to his employees;
(2) shall comply with occupational safety and health standards promulgated under this Act.
29 USC 654
(b) Each employee shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his own actions and conduct.
SEC. 8. Inspections, Investigations, and Recordkeeping
(a) In order to carry out the purposes of this Act, the Secretary, upon presenting appropriate credentials to the owner, operator, or agent in charge, is authorized --
29 USC 657
(1) to enter without delay and at reasonable times any factory, plant, establishment, construction site, or other area, workplace or environment where work is performed by an employee of an employer; and
(2) to inspect and investigate during regular working hours and at other reasonable times, and within reasonable limits and in a reasonable manner, any such place of employment and all pertinent conditions, structures, machines, apparatus, devices, equipment, and materials therein, and to question privately any such employer, owner, operator, agent or employee.
(b) In making his inspections and investigations under this Act the Secretary may require the attendance and testimony of witnesses and the production of evidence under oath. Witnesses shall be paid the same fees and mileage are paid witnesses in the courts of the United States. In case of a contumacy, failure, or refusal of any person to obey such an order, any district court of the United States or the United States courts of any territory or possession, within the jurisdiction of which such person is found, or resides or transacts business, upon the application by the Secretary, shall have jurisdiction to issue to such person an order requiring such person to appear to produce evidence if, as, and when so ordered, and to give testimony relating to the matter under investigation or in question, and any failure to obey such order of the court may be punished by said court as a contempt thereof.
(c) (1) Each employer shall make, keep and preserve, and make available to the Secretary or the Secretary of Health and Human Services, such records regarding his activities relating to this Act as the Secretary, in cooperation with the Secretary of Health and Human Services, may prescribe by regulation as necessary or appropriate for the enforcement of this Act or for developing information regarding the causes and prevention of occupational accidents and illnesses. In order to carry out the provisions of this paragraph such regulations may include provisions requiring employers to conduct periodic inspections. The Secretary shall also issue regulations requiring employers, through posting of notices or other appropriate means, keep their employees informed of their protections and obligations under this Act, including the provisions of applicable standards.
(2) The Secretary, in cooperation with the Secretary of Health and Human Services, shall prescribe regulations requiring employers to maintain accurate records of, and to make periodic reports on, work-related deaths, injuries and illnesses other than minor injuries requiring only first aid treatment and which do not involve medical treatment, loss of consciousness, restriction of work or motion, or transfer to another job.
(3) The Secretary, in cooperation with the Secretary of Health and Human Services, shall issue regulations requiring employers to maintain accurate records of employee exposures to potentially toxic materials or harmful physical agents which are required to be monitored or measured under section 6. Such regulations shall provide employees or their representatives with an opportunity to observe such monitoring or measuring, and to have access to the records thereof. Such regulations shall also make appropriate provision for each employee or former employee to have access to such records as will indicate his own exposure to toxic materials or harmful physical agents. Each employer shall promptly notify any employee who has been or is being exposed to toxic materials or harmful physical agents in concentrations or at levels which exceed those prescribed by an applicable occupational safety and health standard promulgated under section 6, and shall inform any employee who is being thus exposed of the corrective action being taken.
(d) Any information obtained by the Secretary, the Secretary of Health and Human Services, or a State agency under this Act shall be obtained with a minimum burden upon employers, especially those operating small businesses. Unnecessary duplication of efforts in obtaining information shall be reduced to the maximum extent feasible.
(e) Subject to regulations issued by the Secretary, a representative of the employer and a representative authorized by his employees shall be given an opportunity to accompany the Secretary or his authorized representative during the physical inspection of any workplace under subsection (a) for the purpose of aiding such inspection. Where there is no authorized employee representative, the Secretary or his authorized representative shall consult with a reasonable number of employees concerning matters of health and safety in the workplace.
(f) (1) Any employees or representative of employees who believe a violation of a safety or health standard exists threatens physical harm, or an imminent danger exists, may request an inspection by giving notice to the Secretary or his authorized representative of such violation or danger. Any such notice shall be reduced to writing, shall set forth with reasonable particularity the grounds for the notice, and shall be signed by the employees or representative of employees, and a copy shall be provided the employer or his agent no later than at the time of inspection, except , upon the request of the person giving such notice, his name and the names of individual employees referred to therein shall not appear in such copy or on any record published, released, or made available pursuant to subsection (g) of this section. If upon receipt of such notification the Secretary determines there are reasonable grounds to believe such violation or danger exists, he shall make a special inspection in accordance with the provisions of this section as soon as practicable, to determine if such violation or danger exists. If the Secretary determines there are no reasonable grounds to believe a violation or danger exists he shall notify the employees or representative of the employees in writing of such determination.
(2) Prior to or during any inspection of a workplace, any employees or representative of employees employed in such workplace may notify the Secretary or any representative of the Secretary responsible for conducting the inspection, in writing, of any violation of this Act which they have reason to believe exists in such workplace. The Secretary shall, by regulation, establish procedures for informal review of any refusal by a representative of the Secretary to issue a citation with respect to any such alleged violation and shall furnish the employees or representative of employees requesting such review a written statement of the reasons for the Secretary's final disposition of the case.
(g) (1) The Secretary and Secretary of Health and Human Services are authorized to compile, analyze, and publish, either in summary or detailed form, all reports or information obtained under this section.
(2) The Secretary and the Secretary of Health and Human Services shall each prescribe such rules and regulations as he may deem necessary to carry out their responsibilities under this Act, including rules and regulations dealing with the inspection of an employer's establishment.
(h) The Secretary shall not use the results of enforcement activities, such as the number of citations issued or penalties assessed, to evaluate employees directly involved in enforcement activities under this Act or to impose quotas or goals with regard to the results of such activities.
Pub. L. 105-198 added subsection (h).
SEC. 9. Citations
(a) If, upon inspection or investigation, the Secretary or his authorized representative believes an employer has violated a requirement of section 5 of this Act, of any standard, rule or order promulgated pursuant to section 6 of this Act, or of any regulations prescribed pursuant to this Act, he shall with reasonable promptness issue a citation to the employer. Each citation shall be in writing and shall describe with particularity the nature of the violation, including a reference to the provision of the Act, standard, rule, regulation, or order alleged to have been violated. In addition, the citation shall fix a reasonable time for the abatement of the violation. The Secretary may prescribe procedures for the issuance of a notice in lieu of a citation with respect to de minimis violations which have no direct or immediate relationship to safety or health.
(b) Each citation issued under this section, or a copy or copies thereof, shall be prominently posted, as prescribed in regulations issued by the Secretary, at or near each place a violation referred to in the citation occurred.
(c) No citation may be issued under this section after the expiration of six months following the occurrence of any violation.
29 USC 658
SEC. 10. Procedure for Enforcement
(a) If, after an inspection or investigation, the Secretary issues a citation under section 9(a), he shall, within a reasonable time after the termination of such inspection or investigation, notify the employer by certified mail of the penalty, if any, proposed to be assessed under section 17 and the employer has fifteen working days within which to notify the Secretary he wishes to contest the citation or proposed assessment of penalty. If, within fifteen working days from the receipt of the notice issued by the Secretary the employer fails to notify the Secretary he intends to contest the citation or proposed assessment of penalty, and no notice is filed by any employee or representative of employees under subsection (c) within such time, the citation and the assessment, as proposed, shall be deemed a final order of the Commission and not subject to review by any court or agency.
(b) If the Secretary has reason to believe an employer has failed to correct a violation for which a citation has been issued within the period permitted for its correction (which period shall not begin to run until the entry of a final order by the Commission in the case of any review proceedings under this section initiated by the employer in good faith and not solely for delay or avoidance of penalties), the Secretary shall notify the employer by certified mail of such failure and of the penalty proposed to be assessed under section 17 by reason of such failure, and the employer has fifteen working days within which to notify the Secretary he wishes to contest the Secretary's notification or the proposed assessment of penalty. If, within fifteen working days from the receipt of notification issued by the Secretary, the employer fails to notify the Secretary he intends to contest the notification or proposed assessment of penalty, the notification and assessment, as proposed, shall be deemed a final order of the Commission and not subject to review by any court or agency.
(c) If an employer notifies the Secretary he intends to contest a citation issued under section 9(a) or notification issued under subsection (a) or (b) of this section, or if, within fifteen working days of the issuance of a citation under section 9(a), any employee or representative of employees files a notice with the Secretary alleging the period of time fixed in the citation for the abatement of the violation is unreasonable, the Secretary shall immediately advise the Commission of such notification, and the Commission shall afford an opportunity for a hearing (in accordance with section 554 of title 5, United States Code, but without regard to subsection (a)(3) of such section). The Commission shall thereafter issue an order, based on findings of fact, affirming, modifying, or vacating the Secretary's citation or proposed penalty, or directing other appropriate relief, and such order shall become final thirty days after its issuance. Upon a showing by an employer of a good faith effort to comply with the abatement requirements of a citation, and abatement has not been completed because of factors beyond his reasonable control, the Secretary, after an opportunity for a hearing as provided in this subsection, shall issue an order affirming or modifying the abatement requirements in such citation. The rules of procedure prescribed by the Commission shall provide affected employees or representatives of affected employees an opportunity to participate as parties to hearings under this subsection.
29 USC 659
SEC. 11. Judicial Review
(a) Any person adversely affected or aggrieved by an order of the Commission issued under subsection (c) of section 10 may obtain a review of such order in any United States court of appeals for the circuit in which the violation is alleged to have occurred or where the employer has its principal office, or in the Court of Appeals for the District of Columbia Circuit, by filing in such court within sixty days following the issuance of such order a written petition praying the order be modified or set aside. A copy of such petition shall be forthwith transmitted by the clerk of the court to the Commission and to the other parties, and thereupon the Commission shall file in the court the record in the proceeding as provided in section 2112 of title 28, United States Code. Upon such filing, the court shall have jurisdiction of the proceeding and of the question determined therein, and shall have power to grant such temporary relief or restraining order as it deems just and proper, and to make and enter upon the pleadings, testimony, and proceedings set forth in such record a decree affirming, modifying, or setting aside in whole or in part, the order of the Commission and enforcing the same to the extent such order is affirmed or modified. The commencement of proceedings under this subsection shall not, unless ordered by the court, operate as a stay of the order of the Commission. No objection that has not been urged before the Commission shall be considered by the court, unless the failure or neglect to urge such objection shall be excused because of extraordinary circumstances. The findings of the Commission with respect to questions of fact, if supported by substantial evidence on the record considered as a whole, shall be conclusive. If any party shall apply to the court for leave to adduce additional evidence and shall show to the satisfaction of the court such additional evidence is material and there were reasonable grounds for the failure to adduce such evidence in the hearing before the Commission, the court may order such additional evidence to be taken before the Commission and to be made a part of the record. The Commission may modify its findings as to the facts, or make new findings, by reason of additional evidence so taken and filed, and it shall file such modified or new findings, which findings with respect to questions of fact, if supported by substantial evidence on the record considered as a whole, shall be conclusive, and its recommendations, if any, for the modification or setting aside of its original order. Upon the filing of the record with it, the jurisdiction of the court shall be exclusive and its judgment and decree shall be final, except the same shall be subject to review by the Supreme Court of the United States, as provided in section 1254 of title 28, United States Code.
29 USC 660
(b) The Secretary may also obtain review or enforcement of any final order of the Commission by filing a petition for such relief in the United States court of appeals for the circuit in which the alleged violation occurred or in which the employer has its principal office, and the provisions of subsection (a) shall govern such proceedings to the extent applicable. If no petition for review, as provided in subsection (a), is filed within sixty days after service of the Commission's order, the Commission's findings of fact and order shall be conclusive in connection with any petition for enforcement which is filed by the Secretary after the expiration of such sixty-day period. In any such case, as well as in the case of a noncontested citation or notification by the Secretary which has become a final order of the Commission under subsection (a) or (b) of section 10, the clerk of the court, unless otherwise ordered by the court, shall forthwith enter a decree enforcing the order and shall transmit a copy of such decree to the Secretary and the employer named in the petition. In any contempt proceeding brought to enforce a decree of a court of appeals entered pursuant to this subsection or subsection (a), the court of appeals may assess the penalties provided in section 17, in addition to invoking any other available remedies.
Pub. L. 98-620
(c) (1) No person shall discharge or in any manner discriminate against any employee because such employee has filed any complaint or instituted or caused to be instituted any proceeding under or related to this Act or has testified or is about to testify in any such proceeding or because of the exercise by such employee on behalf of himself or others of any right afforded by this Act.
(2) Any employee who believes he has been discharged or otherwise discriminated against by any person in violation of this subsection may, within thirty days after such violation occurs, file a complaint with the Secretary alleging such discrimination. Upon receipt of such complaint, the Secretary shall cause such investigation to be made as he deems appropriate. If upon such investigation, the Secretary determines the provisions of this subsection have been violated, he shall bring an action in any appropriate United States district court against such person. In any such action the United States district courts shall have jurisdiction, for cause shown to restrain violations of paragraph (1) of this subsection and order all appropriate relief including rehiring or reinstatement of the employee to his former position with back pay.
(3) Within 90 days of the receipt of a complaint filed under this subsection the Secretary shall notify the complainant of his determination under paragraph 2 of this subsection.
SEC. 12. The Occupational Safety and Health Review Commission
(a) The Occupational Safety and Health Review Commission is hereby established. The Commission shall be composed of three members who shall be appointed by the President, by and with the advice and consent of the Senate, from among persons who by reason of training, education, or experience are qualified to carry out the functions of the Commission under this Act. The President shall designate one of the members of the Commission to serve as Chairman.
(b) The terms of members of the Commission shall be six years except
29 USC 661
(1) the members of the Commission first taking office shall serve, as designated by the President at the time of appointment, one for a term of two years, one for a term of four years, and one for a term of six years, and
(2) a vacancy caused by the death, resignation, or removal of a member prior to the expiration of the term for which he was appointed shall be filled only for the remainder of such unexpired term.
A member of the Commission may be removed by the President for inefficiency, neglect of duty, or malfeasance in office.
(c) (Text omitted.)
(d) The principal office of the Commission shall be in the District of Columbia. Whenever the Commission deems the convenience of the public or of the parties may be promoted, or delay or expense may be minimized, it may hold hearings or conduct other proceedings at any other place.
(e) The Chairman shall be responsible on behalf of the Commission for the administrative operations of the Commission and shall appoint such administrative law judges and other employees as he deems necessary to assist in the performance of the Commission's functions and to fix their compensation in accordance with the provisions of chapter 51 and subchapter III of chapter 53 of title 5, United States Code, relating to classification and General Schedule pay rates: Provided, assignment, removal and compensation of administrative law judges shall be in accordance with sections 3105, 3344, 5372, and 7521 of title 5, United States Code.
(f) For the purpose of carrying out its functions under this Act, two members of the Commission shall constitute a quorum and official action can be taken only on the affirmative vote of at least two members.
(g) Every official act of the Commission shall be entered of record, and its hearings and records shall be open to the public. The Commission is authorized to make such rules as are necessary for the orderly transaction of its proceedings. Unless the Commission has adopted a different rule, its proceedings shall be in accordance with the Federal Rules of Civil Procedure.
(h) The Commission may order testimony to be taken by deposition in any proceedings pending before it at any state of such proceeding. Any person may be compelled to appear and depose, and to produce books, papers, or documents, in the same manner as witnesses may be compelled to appear and testify and produce like documentary evidence before the Commission. Witnesses whose depositions are taken under this subsection, and the persons taking such depositions, shall be entitled to the same fees as are paid for like services in the courts of the United States.
(i) For the purpose of any proceeding before the Commission, the provisions of section 11 of the National Labor Relations Act (29 U.S.C. 161) are hereby made applicable to the jurisdiction and powers of the Commission.
(j) An administrative law judge appointed by the Commission shall hear, and make a determination upon, any proceeding instituted before the Commission and any motion in connection therewith, assigned to such administrative law judge by the Chairman of the Commission, and shall make a report of any such determination which constitutes his final disposition of the proceedings. The report of the administrative law judge shall become the final order of the Commission within thirty days after such report by the administrative law judge, unless within such period any Commission member has directed such report shall be reviewed by the Commission.
(k) Except as otherwise provided in this Act, the administrative law judges shall be subject to the laws governing employees in the classified civil service, except appointments shall be made without regard to section 5108 of title 5, United States Code. Each administrative law judge shall receive compensation at a rate not less than prescribed for GS-16 under section 5332 of title 5, United States Code.
SEC. 13. Procedures to Counteract Imminent Dangers
(a) The United States district courts shall have jurisdiction, upon petition of the Secretary, to restrain any conditions or practices in any place of employment which are such a danger exists which could reasonably be expected to cause death or serious physical harm immediately or before the imminence of such danger can be eliminated through the enforcement procedures otherwise provided by this Act. Any order issued under this section may require such steps to be taken as may be necessary to avoid, correct, or remove such imminent danger and prohibit the employment or presence of any individual in locations or under conditions where such imminent danger exists, except individuals whose presence is necessary to avoid, correct, or remove such imminent danger or to maintain the capacity of a continuous process operation to resume normal operations without a complete cessation of operations, or where a cessation of operations is necessary, to permit such to be accomplished in a safe and orderly manner.
(b) Upon the filing of any such petition the district court shall have jurisdiction to grant such injunctive relief or temporary restraining order pending the outcome of an enforcement proceeding pursuant to this Act. The proceeding shall be as provided by Rule 65 of the Federal Rules, Civil Procedure, except no temporary restraining order issued without notice shall be effective for a period longer than five days.
(c) Whenever and as soon as an inspector concludes conditions or practices described in subsection (a) exist in any place of employment, he shall inform the affected employees and employers of the danger and he is recommending to the Secretary relief be sought.
(d) If the Secretary arbitrarily or capriciously fails to seek relief under this section, any employee who may be injured by reason of such failure, or the representative of such employees, might bring an action against the Secretary in the United States district court for the district in which the imminent danger is alleged to exist or the employer has its principal office, or for the District of Columbia, for a writ of mandamus to compel the Secretary to seek such an order and for such further relief as may be appropriate.
29 USC 662
SEC. 14. Representation in Civil Litigation
Except as provided in section 518(a) of title 28, United States Code, relating to litigation before the Supreme Court, the Solicitor of Labor may appear for and represent the Secretary in any civil litigation brought under this Act but all such litigation shall be subject to the direction and control of the Attorney General.
29 USC 663
SEC. 15. Confidentiality of Trade Secrets
All information reported to or otherwise obtained by the Secretary or his representative in connection with any inspection or proceeding under this Act which contains or which might reveal a trade secret referred to in section 1905 of title 18 of the United States Code shall be considered confidential for the purpose of section, except such information may be disclosed to other officers or employees concerned with carrying out this Act or when relevant in any proceeding under this Act. In any such proceeding the Secretary, the Commission, or the court shall issue such orders as may be appropriate to protect the confidentiality of trade secrets.
29 USC 664
SEC. 16. Variations, Tolerances, and Exemptions
The Secretary, on the record, after notice and opportunity for a hearing may provide such reasonable limitations and may make such rules and regulations allowing reasonable variations, tolerances, and exemptions to and from any or all provisions of this Act as he may find necessary and proper to avoid serious impairment of the national defense. Such action shall not be in effect for more than six months without notification to affected employees and an opportunity being afforded for a hearing.
29 USC 665
SEC. 17. Penalties
(a) Any employer who willfully or repeatedly violates the requirements of section 5 of this Act, any standard, rule, or order promulgated pursuant to section 6 of this Act, or regulations prescribed pursuant to this Act, may be assessed a civil penalty of not more than $70,000 for each violation, but not less than $5,000 for each willful violation.
(b) Any employer who has received a citation for a serious violation of the requirements of section 5 of this Act, of any standard, rule, or order promulgated pursuant to section 6 of this Act, or of any regulations prescribed pursuant to this Act, shall be assessed a civil penalty of up to $7,000 for each such violation.
(c) Any employer who has received a citation for a violation of the requirements of section 5 of this Act, of any standard, rule, or order promulgated pursuant to section 6 of this Act, or of regulations prescribed pursuant to this Act, and such violation is specifically determined not to be of a serious nature, may be assessed a civil penalty of up to $7,000 for each violation.
(d) Any employer who fails to correct a violation for which a citation has been issued under section 9(a) within the period permitted for its correction (which period shall not begin to run until the date of the final order of the Commission in the case of any review proceeding under section 10 initiated by the employer in good faith and not solely for delay or avoidance of penalties), may be assessed a civil penalty of not more than $7,000 for each day during which such failure or violation continues.
29 USC 666
Pub. L. 101-508 increased the civil penalties in subsections (a)-(d) & (i). See Historical notes.
(e) Any employer who willfully violates any standard, rule, or order promulgated pursuant to section 6 of this Act, or of any regulations prescribed pursuant to this Act, and violation caused death to any employee, shall, upon conviction, be punished by a fine of not more than $10,000 or by imprisonment for not more than six months, or by both; except if the conviction is for a violation committed after a first conviction of such person, punishment shall be by a fine of not more than $20,000 or by imprisonment for not more than one year, or by both.
(f) Any person who gives advance notice of any inspection to be conducted under this Act, without authority from the Secretary or his designees, shall, upon conviction, be punished by a fine of not more than $1,000 or by imprisonment for not more than six months, or by both.
(g) Whoever knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained pursuant to this Act shall, upon conviction, be punished by a fine of not more than $10,000, or by imprisonment for not more than six months, or by both.
Pub. L. 98-473 Maximum criminal fines are increased by the Sentencing Reform Act of 1984, 18 USC § 3551 et seq. See Historical notes.
See historical notes.
(h) (1) Section 1114 of title 18, United States Code, is hereby amended by striking out "designated by the Secretary of Health and Human Services to conduct investigations, or inspections under the Federal Food, Drug, and Cosmetic Act" and inserting in lieu thereof "or of the Department of Labor assigned to perform investigative, inspection, or law enforcement functions".
(2) Notwithstanding the provisions of sections 1111 and 1114 of title 18, United States Code, whoever, in violation of the provisions of section 1114 of such title, kills a person while engaged in or on account of the performance of investigative, inspection, or law enforcement functions added to such section 1114 by paragraph (1) of this subsection, and who would otherwise be subject to the penalty provisions of such section 1111, shall be punished by imprisonment for any term of years or for life.
(i) Any employer who violates any of the posting requirements, as prescribed under the provisions of this Act, shall be assessed a civil penalty of up to $7,000 for each violation.
(j) The Commission shall have authority to assess all civil penalties provided in this section, giving due consideration to the appropriateness of the penalty with respect to the size of the business of the employer being charged, the gravity of the violation, the good faith of the employer, and the history of previous violations.
(k) For purposes of this section, a serious violation shall be deemed to exist in a place of employment if there is a substantial probability death or serious physical harm could result from a condition which exists, or from one or more practices, means, methods, operations, or processes which have been adopted or are in use, in such place of employment unless the employer did not, and could not with the exercise of reasonable diligence, know of the presence of the violation.
(l) Civil penalties owed under this Act shall be paid to the Secretary for deposit into the Treasury of the United States and shall accrue to the United States and may be recovered in a civil action in the name of the United States brought in the United States district court for the district where the violation is alleged to have occurred or where the employer has its principal office.
SEC. 18. State Jurisdiction and State Plans
(a) Nothing in this Act shall prevent any State agency or court from asserting jurisdiction under State law over any occupational safety or health issue with respect to which no standard is in effect under section 6.
(b) Any State which, at any time, desires to assume responsibility for development and enforcement therein of occupational safety and health standards relating to any occupational safety or health issue with respect to which a Federal standard has been promulgated under section 6 shall submit a State plan for the development of such standards and their enforcement.
(c) The Secretary shall approve the plan submitted by a State under subsection (b), or any modification thereof, if such plan in his judgment --
29 USC 667
(1) designates a State agency or agencies as the agency or agencies responsible for administering the plan throughout the State,
(2) provides for the development and enforcement of safety and health standards relating to one or more safety or health issues, which standards (and the enforcement of which standards) are or will be at least as effective in providing safe and healthful employment and places of employment as the standards promulgated under section 6 which relate to the same issues, and which standards, when applicable to products which are distributed or used in interstate commerce, are required by compelling local conditions and do not unduly burden interstate commerce,
(3) provides for a right of entry and inspection of all workplaces subject to the Act which is at least as effective as provided in section 8, and includes a prohibition on advance notice of inspections,
(4) contains satisfactory assurances such agency or agencies have or will have the legal authority and qualified personnel necessary for the enforcement of such standards,
(5) gives satisfactory assurances such State will devote adequate funds to the administration and enforcement of such standards,
(6) contains satisfactory assurances such State will, to the extent permitted by its law, establish and maintain an effective and comprehensive occupational safety and health program applicable to all employees of public agencies of the State and its political subdivisions, which program is as effective as the standards contained in an approved plan,
(7) requires employers in the State to make reports to the Secretary in the same manner and to the same extent as if the plan were not in effect, and
(8) provides the State agency will make such reports to the Secretary in such form and containing such information, as the Secretary shall from time to time require.
(d) If the Secretary rejects a plan submitted under subsection (b), he shall afford the State submitting the plan due notice and opportunity for a hearing before so doing.
(e) After the Secretary approves a State plan submitted under subsection (b), he may, but shall not be required to, exercise his authority under sections 8, 9, 10, 13, and 17 with respect to comparable standards promulgated under section 6, for the period specified in the next sentence. The Secretary may exercise the authority referred to above until he determines, on the basis of actual operations under the State plan, the criteria set forth in subsection (c) are being applied, but he shall not make such determination for at least three years after the plan's approval under subsection (c). Upon making the determination referred to in the preceding sentence, the provisions of sections 5(a)(2), 8 (except for the purpose of carrying out subsection (f) of this section), 9, 10, 13, and 17, and standards promulgated under section 6 of this Act, shall not apply with respect to any occupational safety or health issues covered under the plan, but the Secretary may retain jurisdiction under the above provisions in any proceeding commenced under section 9 or 10 before the date of determination.
(f) The Secretary shall, on the basis of reports submitted by the State agency and his own inspections make a continuing evaluation of the manner in which each State having a plan approved under this section is carrying out such plan. Whenever the Secretary finds, after affording due notice and opportunity for a hearing, in the administration of the State plan there is a failure to comply substantially with any provision of the State plan (or any assurance contained therein), he shall notify the State agency of his withdrawal of approval of such plan and upon receipt of such notice such plan shall cease to be in effect, but the State may retain jurisdiction in any case commenced before the withdrawal of the plan in order to enforce standards under the plan whenever the issues involved do not relate to the reasons for the withdrawal of the plan.
(g) The State may obtain a review of a decision of the Secretary withdrawing approval of or rejecting its plan by the United States court of appeals for the circuit in which the State is located by filing in such court within thirty days following receipt of notice of such decision a petition to modify or set aside in whole or in part the action of the Secretary. A copy of such petition shall forthwith be served upon the Secretary, and thereupon the Secretary shall certify and file in the court the record upon which the decision complained of was issued as provided in section 2112 of title 28, United States Code. Unless the court finds the Secretary's decision in rejecting a proposed State plan or withdrawing his approval of such a plan is not supported by substantial evidence the court shall affirm the Secretary's decision. The judgment of the court shall be subject to review by the Supreme Court of the United States upon certiorari or certification as provided in section 1254 of title 28, United States Code.
(h) The Secretary may enter into an agreement with a State under which the State will be permitted to continue to enforce one or more occupational health and safety standards in effect in such State until final action is taken by the Secretary with respect to a plan submitted by a State under subsection (b) of this section, or two years from the date of enactment of this Act, whichever is earlier.
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SEC. 19. Federal Agency Safety Programs and Responsibilities
(a) It shall be the responsibility of the head of each Federal agency (not including the United States Postal Service) to establish and maintain an effective and comprehensive occupational safety and health program which is consistent with the standards promulgated under section 6. The head of each agency shall (after consultation with representatives of the employees thereof) --
29 USC 668
(1) provide safe and healthful places and conditions of employment, consistent with the standards set under section 6;
(2) acquire, maintain, and require the use of safety equipment, personal protective equipment, and devices reasonably necessary to protect employees;
(3) keep adequate records of all occupational accidents and illnesses for proper evaluation and necessary corrective action;
(4) consult with the Secretary with regard to the adequacy as to form and content of records kept pursuant to subsection (a)(3) of this section; and
(5) make an annual report to the Secretary with respect to occupational accidents and injuries and the agency's program under this section. Such report shall include any report submitted under section 7902(e)(2) of title 5, United States Code.
Pub. L. 50-241
(b) The Secretary shall report to the President a summary or digest of reports submitted to him under subsection (a)(5) of this section, together with his evaluations of and recommendations derived from such reports.
(c) Section 7902(c)(1) of title 5, United States Code, is amended by inserting after "agencies" the following: "and of labor organizations representing employees".
(d) The Secretary shall have access to records and reports kept and filed by Federal agencies pursuant to subsections (a)(3) and (5) of this section unless those records and reports are specifically required by Executive order to be kept secret in the interest of the national defense or foreign policy, in which case the Secretary shall have access to such information as will not jeopardize national defense or foreign policy.
Pub. L. 97-375
SEC. 20. Research and Related Activities
(a) (1) The Secretary of Health and Human Services, after consultation with the Secretary and with other appropriate Federal departments or agencies, shall conduct (directly or by grants or contracts) research, experiments, and demonstrations relating to occupational safety and health, including studies of psychological factors involved, and relating to innovative methods, techniques, and approaches for dealing with occupational safety and health problems.
29 USC 669
(2) The Secretary of Health and Human Services shall from time to time consult with the Secretary in order to develop specific plans for such research, demonstrations, and experiments as are necessary to produce criteria, including criteria identifying toxic substances, enabling the Secretary to meet his responsibility for the formulation of safety and health standards under this Act; and the Secretary of Health and Human Services, on the basis of such research, demonstrations, and experiments and any other information available to him, shall develop and publish at least annually such criteria as will effectuate the purposes of this Act.
(3) The Secretary of Health and Human Services, on the basis of such research, demonstrations, and experiments, and any other information available to him, shall develop criteria dealing with toxic materials and harmful physical agents and substances which will describe exposure levels are safe for various periods of employment, including but not limited to the exposure levels at which no employee will suffer impaired health or functional capacities or diminished life expectancy as a result of his work experience.
(4) The Secretary of Health and Human Services shall also conduct special research, experiments, and demonstrations relating to occupational safety and health as are necessary to explore new problems, including those created by new technology in occupational safety and health, which may require ameliorative action beyond which is otherwise provided for in the operating provisions of this Act. The Secretary of Health and Human Services shall also conduct research into the motivational and behavioral factors relating to the field of occupational safety and health.
(5) The Secretary of Health and Human Services, in order to comply with his responsibilities under paragraph (2), and in order to develop needed information regarding potentially toxic substances or harmful physical agents, may prescribe regulations requiring employers to measure, record, and make reports on the exposure of employees to substances or physical agents which the Secretary of Health and Human Services reasonably believes may endanger the health or safety of employees. The Secretary of Health and Human Services also is authorized to establish such programs of medical examinations and tests as may be necessary for determining the incidence of occupational illnesses and the susceptibility of employees to such illnesses. Nothing in this or any other provision of this Act shall be deemed to authorize or require medical examination, immunization, or treatment for those who object thereto on religious grounds, except where such is necessary for the protection of the health or safety of others. Upon the request of any employer who is required to measure and record exposure of employees to substances or physical agents as provided under this subsection, the Secretary of Health and Human Services shall furnish full financial or other assistance to such employer for the purpose of defraying any additional expense incurred by him in carrying out the measuring and recording as provided in this subsection.
(6) The Secretary of Health and Human Services shall publish within six months of enactment of this Act and thereafter as needed but at least annually a list of all known toxic substances by generic family or other useful grouping, and the concentrations at which such toxicity is known to occur. He shall determine following a written request by any employer or authorized representative of employees, specifying with reasonable particularity the grounds on which the request is made, whether any substance normally found in the place of employment has potentially toxic effects in such concentrations as used or found; and shall submit such determination both to employers and affected employees as soon as possible. If the Secretary of Health and Human Services determines any substance is potentially toxic at the concentrations in which it is used or found in a place of employment, and such substance is not covered by an occupational safety or health standard promulgated under section 6, the Secretary of Health and Human Services shall immediately submit such determination to the Secretary, together with all pertinent criteria.
(7) Within two years of enactment of the Act, and annually thereafter the Secretary of Health and Human Services shall conduct and publish industry wide studies of the effect of chronic or low-level exposure to industrial materials, processes, and stresses on the potential for illness, disease, or loss of functional capacity in aging adults.
(b) The Secretary of Health and Human Services is authorized to make inspections and question employers and employees as provided in section 8 of this Act in order to carry out his functions and responsibilities under this section.
(c) The Secretary is authorized to enter into contracts, agreements, or other arrangements with appropriate public agencies or private organizations for the purpose of conducting studies relating to his responsibilities under this Act. In carrying out his responsibilities under this subsection, the Secretary shall cooperate with the Secretary of Health and Human Services in order to avoid any duplication of efforts under this section.
(d) Information obtained by the Secretary and the Secretary of Health and Human Services under this section shall be disseminated by the Secretary to employers and employees and organizations thereof.
(e) The functions of the Secretary of Health and Human Services under this Act shall, to the extent feasible, be delegated to the Director of the National Institute for Occupational Safety and Health established by section 22 of this Act.
EXPANDED RESEARCH ON WORKER SAFETY AND HEALTH
The Secretary of Health and Human Services (referred to in this section as the "Secretary"), acting through the Director of the National Institute of Occupational Safety and Health, shall enhance and expand research as deemed appropriate on the health and safety of workers who are at risk for bioterrorist threats or attacks in the workplace, including research on the health effects of measures taken to treat or protect such workers for diseases or disorders resulting from a bioterrorist threat or attack. Nothing in this section may be construed as establishing new regulatory authority for the Secretary or the Director to issue or modify any occupational safety and health rule or regulation.
29 USC 669a
Pub. L. 107-188, Title I, § 153 added this text.
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SEC. 21. Training and Employee Education
(a) The Secretary of Health and Human Services, after consultation with the Secretary and with other appropriate Federal departments and agencies, shall conduct, directly or by grants or contracts --
29 USC 670
(1) education programs to provide an adequate supply of qualified personnel to carry out the purposes of this Act, and
(2) informational programs on the importance of and proper use of adequate safety and health equipment.
(b) The Secretary is also authorized to conduct, directly or by grants or contracts, short-term training of personnel engaged in work related to his responsibilities under this Act.
(c) The Secretary, in consultation with the Secretary of Health and Human
Services, shall --
(1) provide for the establishment and supervision of programs for the education and training of employers and employees in the recognition, avoidance, and prevention of unsafe or unhealthful working conditions in employments covered by this Act, and
(2) consult with and advise employers and employees, and organizations representing employers and employees as to effective means of preventing occupational injuries and illnesses.
Pub. L. 105-97, §2 added subsection (d). See Historical notes.
(d) (1) The Secretary shall establish and support cooperative agreements with the States under which employers subject to this Act may consult with State personnel with respect to --
(A) the application of occupational safety and health requirements under this Act or under State plans approved under section 18; and
(B) voluntary efforts employers may undertake to establish and maintain safe and healthful employment and places of employment. Such agreements may provide, as a condition of receiving funds under such agreements, for contributions by States towards meeting the costs of such agreements.
(2) Pursuant to such agreements the State shall provide on-site consultation at the employer's worksite to employers who request such assistance. The State may also provide other education and training programs for employers and employees in the State. The State shall ensure on-site consultations conducted pursuant to such agreements include provision for the participation by employees.
(3) Activities under this subsection shall be conducted independently of any enforcement activity. If an employer fails to take immediate action to eliminate employee exposure to an imminent danger identified in a consultation or fails to correct a serious hazard so identified within a reasonable time, a report shall be made to the appropriate enforcement authority for such action as is appropriate.
(4) The Secretary shall, by regulation after notice and opportunity for comment, establish rules under which an employer --
(A) which requests and undergoes an on-site consultative visit provided under this subsection;
(B) which corrects the hazards have been identified during the visit within the time frames established by the State and agrees to request a subsequent consultative visit if major changes in working conditions or work processes occur which introduce new hazards in the workplace; and
(C) which is implementing procedures for regularly identifying and preventing hazards regulated under this Act and maintains appropriate involvement of, and training for, management and non-management employees in achieving safe and healthful working conditions, may be exempt from an inspection (except an inspection requested under section 8(f) or an inspection to determine the cause of a workplace accident which resulted in the death of one or more employees or hospitalization for three or more employees) for a period of 1 year from the closing of the consultative visit.
(5) A State shall provide worksite consultations under paragraph (2) at the
request of an employer. Priority in scheduling such consultations shall be assigned to requests from small businesses which are in higher hazard industries or have the most hazardous conditions at issue in the request.
SEC. 22. National Institute for Occupational Safety and Health
(a) It is the purpose of this section to establish a National Institute for Occupational Safety and Health in the Department of Health and Human Services in order to carry out the policy set forth in section 2 of this Act and to perform the functions of the Secretary of Health and Human Services under sections 20 and 21 of this Act.
(b) There is hereby established in the Department of Health and Human Services a National Institute for Occupational Safety and Health. The Institute shall be headed by a Director who shall be appointed by the Secretary of Health and Human Services, and who shall serve for a term of six years unless previously removed by the Secretary of Health and Human Services.
(c) The Institute is authorized to --
29 USC 671
(1) develop and establish recommended occupational safety and health standards; and
(2) perform all functions of the Secretary of Health and Human Services under sections 20 and 21 of this Act.
(d) Upon his own initiative, or upon the request of the Secretary of Health and Human Services, the Director is authorized (1) to conduct such research and experimental programs as he determines are necessary for the development of criteria for new and improved occupational safety and health standards, and (2) after consideration of the results of such research and experimental programs make recommendations concerning new or improved occupational safety and health standards. Any occupational safety and health standard recommended pursuant to this section shall immediately be forwarded to the Secretary of Labor, and to the Secretary of Health and Human Services.
(e) In addition to any authority vested in the Institute by other provisions of this section, the Director, in carrying out the functions of the Institute, is authorized to --
(1) prescribe such regulations as he deems necessary governing the manner in which its functions shall be carried out;
(2) receive money and other property donated, bequeathed, or devised, without condition or restriction other than it be used for the purposes of the Institute and to use, sell, or otherwise dispose of such property for the purpose of carrying out its functions;
(3) receive (and use, sell, or otherwise dispose of, in accordance with paragraph (2)), money and other property donated, bequeathed, or devised to the Institute with a condition or restriction, including a condition the Institute use other funds of the Institute for the purposes of the gift;
(4) in accordance with the civil service laws, appoint and fix the compensation of such personnel as may be necessary to carry out the provisions of this section;
(5) obtain the services of experts and consultants in accordance with the provisions of section 3109 of title 5, United States Code;
(6) accept and utilize the services of voluntary and noncompensated personnel and reimburse them for travel expenses, including per diem, as authorized by section 5703 of title 5, United States Code;
(7) enter into contracts, grants or other arrangements, or modifications thereof to carry out the provisions of this section, and such contracts or modifications thereof may be entered into without performance or other bonds, and without regard to section 3709 of the Revised Statutes, as amended (41 U.S.C. 5), or any other provision of law relating to competitive bidding;
(8) make advance, progress, and other payments which the Director deems necessary under this title without regard to the provisions of section 3324 (a) and (b) of Title 31; and
(9) make other necessary expenditures.
Pub. L. 97-258
(f) The Director shall submit to the Secretary of Health and Human Services, to the President, and to the Congress an annual report of the operations of the Institute under this Act, which shall include a detailed statement of all private and public funds received and expended by it, and such recommendations as he deems appropriate.
(g) Lead-Based Paint Activities.
Pub. L. 102-550 added subsection (g).
(1) Training Grant Program.
(A) The Institute, in conjunction with the Administrator of the Environmental Protection Agency, may make grants for the training and education of workers and supervisors who are or may be directly engaged in lead-based paint activities.
(B) Grants referred to in subparagraph (A) shall be awarded to nonprofit organizations (including colleges and universities, joint labor-management trust funds, States, and nonprofit government employee organizations) --
SEC. 24. Statistics
(a) In order to further the purposes of this Act, the Secretary, in consultation with the Secretary of Health and Human Services, shall develop and maintain an effective program of collection, compilation, and analysis of occupational safety and health statistics. Such program may cover all employments whether or not subject to any other provisions of this Act but shall not cover employments excluded by section 4 of the Act. The Secretary shall compile accurate statistics on work injuries and illnesses which shall include all disabling, serious, or significant injuries and illnesses, whether or not involving loss of time from work, other than minor injuries requiring only first aid treatment and which do not involve medical treatment, loss of consciousness, restriction of work or motion, or transfer to another job.
(b) To carry out his duties under subsection (a) of this section, the Secretary may --
29 USC 673
(1) promote, encourage, or directly engage in programs of studies, information and communication concerning occupational safety and health statistics;
(2) make grants to States or political subdivisions thereof in order to assist them in developing and administering programs dealing with occupational safety and health statistics; and
(3) arrange, through grants or contracts, for the conduct of such research and investigations as give promise of furthering the objectives of this section.
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OSHA requirements related to safety and health programs, including standards and compliance directives
Standards
General Duty Clause. Section 5(a)(1) of the OSH Act, often referred to as the General Duty Clause, requires employers to "furnish to each of his employees employment and a place of employment which are free from recognized hazards are causing or are likely to cause death or serious physical harm to his employees". Section 5(a)(2) requires employers to "comply with occupational safety and health standards" promulgated under this Act
1910.119(h)(2)(i). The employer, when selecting a contractor, shall obtain and evaluate information regarding the contract employer's safety performance and programs.
Safety and Health Plan for Multi-Employer Worksite..
Each contractor/subcontractor is responsible for compliance with all safety and health protection requirements for their employees. An employer's safety and health plan can be used by contractors/subcontractors at the site if it appropriately addresses their activity and potential safety and health hazards. In general, a site plan organized as a single document, with component sections/appendices covering all tasks, operations, and contractors/subcontractors, may promote use efficiency; enhance completeness, clarity and coordination among all affected parties. (OSHA Letter of Interpretation, Boggs, 1989)
1960.11 Evaluation of occupational safety and health performance.
Each agency head shall ensure any performance evaluation of any management official in charge of an establishment, any supervisory employee, or other appropriate management official, measures employee's performance in meeting requirements of the agency occupational safety and health program, consistent with the employee's assigned responsibilities and authority, and taking into consideration any applicable regulations of the Office of Personnel Management or other appropriate authority. The recognition of superior performance in discharging safety and health responsibilities by an individual or group should be encouraged and noted.
1960.36 Occupational Safety and Health Committees .
The occupational safety and health committees described in this subpart are organized and maintained basically to monitor and assist an agency's safety and health program. These committees assist agencies to maintain an open channel of communication between employees and management concerning safety and health matters in agency workplaces. The committees provide a method by which employees can utilize their knowledge of workplace operations to assist agency management to improve policies, conditions, and practices.
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Worker Rights Under the OSHA Act of 1970
As a worker, you have a right to:
1. Get training from the employer as required by OSHA standards.
Get training from your employer on chemicals you are exposed to during your work and information on how to protect yourself from harm. Employers must establish a comprehensive, written hazard communication program (Chemical Hazard Communication) Your employer must label chemical containers, make material safety data sheets with detailed hazard information available to employees, and train you about the health effects of the chemicals you work with and what the employer is doing and what you can do to protect yourself from these hazards.
The program must list the hazardous chemicals in each work area, how the employer will inform employees of the hazards of non-routine tasks (for example, the cleaning of reactor vessels), and hazards associated with chemicals in unlabeled pipes and how the employer will inform other employers at a multi-employer worksite of the hazards to which their employees may be exposed.
Get training from your employer on a variety of other health and safety hazards and standards your employer must follow. These include lockout-tagout, bloodborne pathogens, confined spaces, construction hazards and a variety of other subjects.
2. Request information from your employer about OSHA standards, worker injuries and illnesses, job hazards and workers' rights.
Request information from your employer on safety and health hazards in your workplace, chemicals used in your workplace, tests your employer has done to measure chemical, noise and radiation levels, precautions you should take and procedures to be followed if you or other employees are involved in an incident or are exposed to hazardous chemicals or other toxic substances. You have a right to:
• Request copies of appropriate standards, rules, regulations and requirements your employer should have available at the workplace.
• Review the Log and Summary of Occupational Injuries and Illnesses (OSHA 300) at a reasonable time and in a reasonable manner or have an authorized representative do so for you. (29 CFR 1904.7)
• Access relevant exposure and medical records. (29 CFR 1910.1020)
•
Employers must inform you of the existence, location and availability of your medical and exposure records when you first begin employment and at least annually thereafter. Employers also must provide these records to you or your designated representatives within 15 working days of your request.
When an employer plans to stop doing business and there is no successor employer to receive and maintain these records, the employer must notify you of your right of access to records at least 3 months before the employer ceases to do business.
You also have a right to observe any monitoring or measuring of toxic materials or chemicals, as well as harmful physical agents, such as noise, and see the resulting records. If the exposure levels are above the OSHA limit, the employer must tell you what will be done to reduce the exposure -- the right to observe monitoring exists only where monitoring is performed pursuant to a standard provides employees with the right to observe.
3. Request action from your employer to correct hazards or violations.
You may ask your employer to correct hazards even if they are not violations of specific OSHA standards. Be sure to keep copies of any requests you make to your employer to correct hazards.
4. File a compliant with OSHA if you believe there are either violations of OSHA standards or serious workplace hazards.
File a complaint and request OSHA to conduct an inspection if you believe serious workplace hazards or violations of standards exist in your workplace. You can file a complaint online, in writing, by telephone or fax. If you want an OSHA inspector to come inspect your workplace, put your complaint in writing and send it to the OSHA office nearest you. (OSH Act, Section 8), (29 CFR 1903.11)
Request in your written complaint OSHA keep your name confidential if you do not want your employer to know who filed the complaint. (OSH Act, Section 8)
5. Be involved in OSHA's inspection of your workplace.
You have a right to have an authorized employee representative (such as a union representative) accompany the OSHA compliance officer during the inspection tour. (OSH Act, Section 8), (29 CFR 1903.8) The authorized employee representative has a right to accompany an OSHA compliance officer (also referred to as a compliance safety and health officer (CSHO) or inspector) during an inspection. Under no circumstances may the employer choose the workers' representative. Where there is no union or employee representative, the OSHA inspector must talk confidentially with a reasonable number of workers during the course of the investigation.
You have a right to respond to questions from the compliance officer and tell the compliance officer about workplace hazards, particularly if there is no authorized employee representative accompanying the compliance officer on the inspection "walkaround." (OSH Act, Section 8)
You and your coworkers have a right to talk privately and confidentially to the compliance officer whether or not a workers' representative has been chosen. You may point out hazards, describe injuries or illnesses or near misses resulted from those hazards and describe past complaints about hazards. Inform the inspector if working conditions are not normal during the inspection. Make sure the inspector is aware if equipment has been shut down, windows opened or other conditions changed from normal.
6. Find out the results of OSHA inspections.
You have a right to find out the results of OSHA inspections and request a review if OSHA decides not to issue a citation. (CPL 2.115) If health hazards are present in your workplace, a special OSHA health inspection may be conducted by an industrial hygienist. This OSHA inspector may take samples to measure levels of chemicals or other hazardous materials. OSHA will let the employee representative know whether your employer is in compliance. The inspector also will gather detailed information about your employer's efforts to control health hazards, including results of tests your employer may have conducted.
7. Get involved in any meetings or hearings to discuss any objections your employer has to OSHA's citations or to changes in abatement deadlines.
8. File a formal appeal of deadlines for correction of hazards.
File an appeal of the deadlines OSHA sets for your employer to correct any violation in the citation issued to the employer. Write to the OSHA Area Director within 10 working days from the date the employer posts the notice requesting on extension of the abatement deadline if you feel the time is too long. (29 CFR 1903.17)
9. File a discrimination complaint.
File a discrimination complaint (under Section 11(c) of the OSH Act) within 30 days if you are punished or discriminated against for exercising your safety and health rights or for refusing to work (not guaranteed by the OSH Act) when faced with an imminent danger of death or serious injury and there is insufficient time for OSHA to inspect.
10. Request a research investigation on possible workplace health hazards.
* Contact the National Institute for Occupational Safety and Health (NIOSH) to request a health hazard evaluation if you are concerned about toxic effects of a substance in the workplace.
11. Provide comments and testimony to OSHA during rulemaking on new standards.
The Whistleblower Program
The Occupational Safety and Health Act was enacted to achieve safer and more healthful workplaces throughout the nation. The Act provides for a wide range of substantive and procedural rights for employees and representatives of employees.
To help ensure employees are, in fact, free to participation in safety and health activities, Section 11(c) of the Act prohibits any person from discharging or in any manner discriminating against any employee because the employee has exercised rights under the Act.
These rights include complaining to OSHA and seeking an OSHA inspection, participating in an OSHA inspection, and participating or testifying in any proceeding related to an OSHA inspection.
"Discrimination" can include the following actions:
• Firing or laying off
• Assigning to undesirable shifts
• Blacklisting
• Demoting
• Denying overtime or promotion
• Disciplining
• Denial of benefits
• Failure to hire or rehire
• Intimidation
• Transferring
• Reassigning work
• Reducing pay or hours
•
OSHA also administers the whistleblowing provisions of thirteen other statutes, protecting employees who report violations of various trucking, airline, nuclear power, pipeline, environmental, and securities laws.
The 14 statutes enforced by OSHA and the regulations governing their administration are listed below. Click on any statute to review the text of the whistleblower protection provisions.
• Section 11(c) of the Occupational Safety and Health Act of 1970 (OSHA)
• The Surface Transportation Assistance Act of 1982 (STAA)
• The Asbestos Hazard Emergency Response Act of 1986 (AHERA)
• The International Safety Container Act of 1977 (ISCA)
• The Safe Drinking Water Act of 1974 (SDWA)
• The Federal Water Pollution Control Act of 1972 (FWPCA)
• The Toxic Substances Control Act of 1976 (TSCA)
• The Solid Waste Disposal Act of 1976 (SWDA)
• The Clean Air Act of 1977 (CAA)
• The Comprehensive Environmental Response, Compensation and Liability Act of 1980 (CERCLA)
• The Energy Reorganization Act of 1978 (ERA)
• The Wendell H. Ford Aviation Investment and Reform Act for the 21st Century (AIR21)
•
Source: OSHA
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Mine Safety and Health
The Federal Mine Safety and Health Act of 1977 (Mine Act) (30 USC §§ 801 et seq.; 30 CFR Parts 1 to 199)
Who is Covered
The Mine Act covers all mine operators and miners throughout the U.S., including the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, American Samoa, Guam, and the Trust Territory of the Pacific Islands. Under the Mine Act, a mine "operator" is defined as: "any owner, lessee, or other person who operates, controls, or supervises a coal or other mine or any independent contractor performing service or construction at such mine." A "miner" is any individual working in a coal or other mine. At this time, the Mine Act covers approximately 300,000 miners and almost 14,000 mines.
Basic Provisions/Requirements
The Mine Act requires that the Mine Safety and Health Administration (MSHA) inspect all mines each year. All underground mines are to receive at least four inspections annually; all surface operations are to be inspected at least twice annually. MSHA is specifically prohibited from giving advance notice of an inspection, and it is specifically authorized to enter mine property without a warrant.
The Mine Act requires or authorizes additional inspections and investigations to ensure safe and healthy work environments for miners. For example, mines that release large amounts of methane gas are to receive more frequent inspections; mines determined to be exceptionally hazardous may receive more frequent inspections. Additionally, MSHA must investigate all fatal accidents and miners' complaints of discrimination based upon the exercise of their rights under the Mine Act.
To promote compliance with the provisions of the Act and its safety and health standards, all violations found during inspections and investigations must be cited. All violations are subject to civil penalties, and all violations must be corrected within the time frames established by MSHA.
The Mine Act permits representatives of the operator and the miners to accompany MSHA during inspections and participate in pre- and post-inspection conferences. If violations are cited, the circumstances surrounding the violations are discussed during post-inspection conferences.
If these discussions do not result in resolution, the mine operator may appeal the citation and the penalty to the Federal Mine Safety and Health Review Commission, an independent body, with further appeal to the U.S. Courts of Appeals.
In addition to setting safety and health standards for preventing hazardous and unhealthy conditions, MSHA's regulations establish requirements for immediate notification of accidents, injuries and illnesses; for training programs that meet the statutory requirements of the Mine Act; and for obtaining approval for certain equipment used in gassy underground mines.
Mine operators must notify MSHA when they open or close a mine, and they may request the modification of an existing safety standard on a site-by-site basis. Under the Mine Act, MSHA may approve modifications only if it determines that the alternate method proposed will guarantee no less than the same measure of protection afforded by the existing standards, or that the application of MSHA's standard at the mine will result in a diminution of safety for miners.
Employee Rights
A good safety and health program depends on the active participation and interest of everyone at a worksite. Because Congress wants to encourage an active, responsible role for all parties in matters of mine safety and health, the Federal Mine Safety and Health Act of 1977 gives individual miners, their representatives, and job applicants many rights. Deaths, injuries, and illnesses in the workplace can be decreased if all parties take advantage of these rights.
The Act gives miners the rights to:
• Designate a representative to accompany federal inspectors during inspections at a mine;
• Obtain an inspection of the mine where reasonable grounds exist to believe that an imminent danger, or a violation of the Act or of a safety or health standard exists;
• Receive health and safety training;
• Be paid during certain periods of time when a mine or part of a mine has been closed because of a withdrawal order;
• Be protected against discrimination based on the exercise of rights under the Act; and
• Be informed of, and participate in, enforcement and legal proceedings under the Act.
Miners' representatives also have specific rights under the Act in addition to those rights given to individual miners. Moreover, applicants for mine work have the right not be discriminated against in hiring because they have previously exercised rights provided under the Act.
If a miner, representative of miners, or job applicant, has general or specific questions about rights under the Act, he or she should contact the nearest MSHA office. The MSHA Web site lists locations and telephone numbers for its offices nationwide.
Compliance Assistance Available
MSHA develops safety and health training programs in cooperation with industry and labor, tests new mining equipment, works with other agencies to advance safety and health research programs, and compiles and analyzes accident, injury and illness data to better address serious workplace hazards.
MSHA has developed booklets, pamphlets and pocket-size laminated cards, which address known safety and health hazards and identify acceptable compliance processes. MSHA routinely distributes its accident prevention materials to the mining industry at large, or to those sectors of the industry that are experiencing the injuries addressed by the materials.
MSHA's Web site contains compliance assistance information, guidance, and helpful tips for the mining community. For example, it lists upcoming seminars designed for mine operators and others to receive the latest information about the requirements of a rule or to hear about solutions to various safety and health problems.
Also, the Web site provides model forms, records, and plans for the mine operator to use to comply with MSHA requirements, thus avoiding the need for the operator to create these items independently. Through the Web site, mine operators may file various reports directly with MSHA.
The Mine Act authorizes a state grants program, funded at about $7.6 million annually, which MSHA administers. MSHA works with the states to stimulate the development of individual state programs that focus on identifiable safety and health problems. Many of the states use the grants for education and training, particularly for smaller mining operations that cannot provide updated, effective training.
MSHA's Mine Health and Safety Academy, located in Beckley, West Virginia, develops and provides safety and health training courses for its own inspectors as well as for industry and labor. A "Mine Simulation Laboratory", located on the Academy grounds, provides hands-on training in rescue and recovery operations for certain mine emergencies.
MSHA's Approval and Certification Center (A&CC), located near Wheeling, West Virginia, houses laboratories, equipment and personnel to test equipment that must be approved before it can be used in certain areas of gassy underground mines. The A&CC also is responsible for monitoring the performance of approved products to ensure that they meet the standards under which they were originally approved.
A variety of information on MSHA's programs, as well as its existing and proposed standards, can be found on MSHA's Web site. Also, MSHA has a number of elaws Advisors that provide assistance in understanding and applying MSHA’s regulations.
MSHA maintains a 24-hour toll-free telephone number that can be used to report accidents. That number is 1-800-746-1553. MSHA maintains another toll-free number to report hazardous conditions. That number is 1-800-746-1554, and the caller need not identify himself or herself. The appropriate district office also can be contacted.
Additional information about MSHA, its programs and policies may be obtained from the MSHA Office of Information, Room 601, 4015 Wilson Boulevard, Arlington, Virginia, 22203-1984. The telephone number is 202-693-9422.
Penalties/Sanctions
The Mine Act established a maximum penalty of $10,000 per violation against mine operators for violations found and cited. As a result of the Omnibus Budget Reconciliation Act of 1990, the maximum was increased to $55,000.
Non-serious violations (violations that are not designated "significant and substantial") that are promptly corrected normally receive a "single penalty" assessment of $55. More serious violations and non-serious violations that are not promptly corrected are usually assessed using a formula that incorporates six criteria specified for determining penalty amounts by the Mine Act.
Some violations are of such a nature or seriousness that use of the formula would not result in an appropriate penalty. In these cases — most often involving fatalities, serious injuries, and unwarranted failure to comply with standards — MSHA may waive the formula and propose a "special assessment." In developing such an amount, the facts are independently reviewed to determine a penalty amount that will have the deterrent effect contemplated by the Statute. Title 30, Part 100 of the Code of Federal Regulations contains the regulations governing the civil penalty process.
The Mine Act also provides for either civil penalties against individuals for "knowing" violations, or criminal sanctions against mine operators who "willfully" violate safety and health standards. MSHA reviews particular citations and orders for possible knowing or willful violations. In general, the violations reviewed include those involving imminently dangerous situations and a high degree of negligence or reckless disregard. MSHA initiates and conducts investigations of possible knowing or willful violations. If evidence of willful violations is found, the case is referred to the Department of Justice.
Relation to State, Local and Other Federal Laws
The Mine Act does not give MSHA the authority to cede its responsibilities to states or any other political subdivisions. The Mine Act does not preempt state mine safety and health laws, except insofar as they may conflict with the Mine Act or MSHA's regulations. States may have more stringent health and safety standards.
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Accountability: Employer's Responsibility to Comply with OSHA Law
Source: Steven Geigle, M.A., CSHM
Introduction
Accountability ranks right at the top with management commitment as a critical ingredient in a company's safety and health management system. Why do we behave the way we do in the workplace? Consequences. Why do we take the unsafe shortcut? Consequences. Management may impose all kinds of safety policies, programs, written plans, directives, rules, training...on and on...yet if appropriate application of effective consequences within a culture of accountability does not exist, desired behaviors will not be sustained. If employees do not believe they are going to be held accountable for the decisions they make and the actions they take, you can be sure any safety effort is ultimately doomed to failure.
What is Accountability?
You hear a lot about responsibility and accountability in safety and health, and sometimes people speak as though the two terms have the same meaning. But, as used in OSHA standards and generally in safety and health management, these two terms have very different meanings. Let's find out why.
Take a look at a dictionary. You'll find responsibility and accountability defined something like: Responsible - expected or obliged to account for or answer to; involving obligation or duties. Responsibility - able to account for or answer to. Accountable - responsible; liable; legally bound or subject to giving an account (or explanation), answerable. Accountability - able to give account or answer to.
If you examine only these two definitions, it's understandable why we might conclude these two terms have virtually the same meaning. However, notion of being "liable or legally bound" sets accountability apart. When applying these two concepts to management in the workplace, they take on very important and distinct differences in meaning and application.
• Responsibility may be thought of as simply the "obligation to fulfill a task." To be responsible, you need only be assigned one or more duties.
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• Accountability may be thought of as establishing the "obligation to fulfill a task to standard or else." When you are held accountable, your performance is measured against some specific criteria or standard and consequences are applied appropriate to your performance.
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The six elements of an effective accountability system
Accountability may also be thought of as one of the very important subsystems within the overall safety management system. The safety committee or coordinator may use these guidelines to help develop, monitor and improve workplace accountability for safety. Six important elements should be present in an employer safety accountability system:
1. Established formal standards of performance
OSHA has developed rules in occupational safety and health which serve as standards of performance for employers. Similarly, employers are required to establish company policies, procedures, written plans, processes, job descriptions and rules to clearly convey their standards of performance in safety and health to employees.
Safety policies and disciplinary procedures should be clearly stated in writing and made available to everyone. In fact, it is necessary to educate all employees on these policies and procedures. Make sure they certify they have read, understood, and will comply with those safety policies and procedures. Do this when they are hired, and annually thereafter.
If standards of acceptable behavior and performance are not established and clearly communicated to employees, an effective accountability system is impossible. Management may not be justified in administering discipline without clearly written and communicated standards.
2. Resources to meet the standards of performance
Before employers are justified in administering appropriate consequences, they should first provide their employees with the means and methods to achieve the standards of performance. Employers should provide a safe and healthful physical and psychosocial workplace environment.
• Physical resources. Ensures safe and healthful conditions. Safe tools, equipment, machinery, materials, workstations, facilities, environment. OSHA emphasizes this category.
• Psychosocial support. Ensures safe behaviors. Effective safety education and training, reasonable work schedules and production quotas, human resource programs, safe work procedures, competent management, tough-caring leadership. Through the years, Federal OSHA and professional safety organizations have demonstrated more emphasis in this area as evidenced by increased interest in developing rules requiring a comprehensive safety and health program, and workplace violence standards.
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3. A system of performance measurement
Once again, when applied to safety behavior and performance, accountability demands more than simply being answerable. In an effective accountability system the quality or level of safety performance is measured regularly and often. Measurement processes include informal/formal observations. Real measurement means more than merely observing behaviors. It also includes quantifying observations...adding up the numbers. Those numbers form the statistics you can then use to improve the safety management system.
Accountability and authority A basic rule of thumb for any accountability system states, "a person should held accountable for a responsibility only if person has the authority or the ability to control." If a person is being measured and held accountable for results over which they have no control, that person will attempt to gain control somehow. The attempt to establish control may include inappropriate strategies.
For example, a supervisor who's measured only on department accident rates may threaten to fire anyone who completes an OSHA 101 injury report. Not only is behavior counterproductive for the company, its illegal!
The employer ultimately controls all of the many operational variables such as raw materials, equipment, machinery, work schedules, personnel, and policies make up the day-to-day work environment. Employer performance in providing resources and implementing policies, etc., should be measured.
On the other hand, employees may have very little control over operations in the workplace. They do, however, have control over their own behavior. Employees have the ability to make a choice to comply with safety rules, and they may choose to report injuries and hazards in the workplace. Consequently, we need to measure these personal behaviors.
In the workplace, it's important supervisors measure their employees' safety behaviors. Managers should measure supervisor activities and behaviors. OSHA doesn't merely observe, they inspect and investigate...issue citations may include monetary penalties: now 's measurement with consequences, isn't it.
Element 4. Appropriate application of consequences
Without the expectation of consequences, accountability has no credibility and will not be effective. No consequences...no accountability. Consequences need to be appropriate as well as effective. This is the element with which everyone is probably most familiar. Unfortunately, in some companies, consequences are either not appropriate, not effective, or both.
What are effective consequences?
Simple: Effective consequences increase desired behaviors or decrease undesired behaviors. If employee safety performance meets or exceeds the standards set by the employer, some sort of recognition should follow. On the other hand, if the employee makes an informed choice not to comply with the company's safety rules, some sort of appropriate corrective action should follow. There are various strategies for administering positive and negative consequences. Careful planning is critical to ensure consequences are effective. Let's take a look at four approaches to consider.
Four categories of consequences
Positive reinforcement - If we do something well, we get rewarded.
• Must always increase desired behavior.
• Worker performs to receive a positive consequence
• Worker may perform far beyond minimum standards - discretionary effort
• Focus is on excellence - success based
• “If you report a hazard, you will be recognized.”
• “If you prevent an injury or save money, you will be rewarded.”
Negative reinforcement - If we do something well, we don't get punished.
• Worker performs to avoid the consequence
• Intent is to increase desired behavior.
• Worker performs to minimum standard - just enough to get by
• Focus is on compliance - fear based
• “If you comply with safety rules, you won’t be punished.”
Punishment - If we do something wrong, we get punished.
• To avoid the consequence, the worker does not perform.
• Must always decreases undesired behaviors.
• Is usually unintentional in organizations
• “If you engage in horseplay, you will be suspended from work.”
Extinction - No matter how well we do, we don't get rewarded.
• Withdrawal of positive reinforcement.
• Worker eventually performs without expectation of consequences (other than wages)
• Person is ignored - no relationship with management
• Is epidemic in organizations
• “It doesn’t matter how hard I work around here.”
• “Apathy is rampant, but who cares.”
In all instances, to be effective, consequences should be soon, certain, significant, and sincere. Accountability is operating effectively only when consequences follow behavior. When consequences are nonexistent or inconsistent, accountability is not functioning properly in your company.
Consequences for safety behaviors meet or exceed expectations usually include recognition and rewards. However, only appropriate behaviors should be rewarded. The employer should recognize employees for behaviors and performance over which they have exclusive control. If the person has authority...decision-making control, then the person should be held accountable for the decision and subsequent behaviors and personal outcomes. Managers and supervisors have varying degrees of control over the conditions of their work areas and the behaviors of their employees. For employees, control usually refers only to personal behaviors. Let's look at some examples of activities and behaviors are typically accountability measures.
Examples of measured safety behaviors and performance at various levels include:
(adapted from Petersen, Safety Management)
Top/mid-level managers. Unfortunately, measurement at this level usually includes results statistics over which top managers actually have little direct control. These measures include:
• Accident rates.
• Experience modification rate (MOD Rate).
• Workers' compensation costs.
This situation puts potentially enormous pressure on top managers to put pressure supervisors to hold down the number of accidents in their departments. Consequently, the result may be ineffective measurement at all levels. Appropriate behaviors and activities to measure at top/mid- level management include:
• Involvement in safety management system formulation and implementation.
• Developing effective safety policies, programs, procedures.
• Arranging management/supervisor safety training.
• Providing physical resources and psychosocial support.
• Involvement in safety education/training.
• Supporting involvement in the safety committee.
Supervisors. Supervisors may not be able to completely control the results (such as the accident rate) of their work area. They do, however, have the ability to control their safety management and leadership activities.
Therefore, measurement at this level should primarily include personal safety behaviors and activities such as:
• Making sure workers have safe materials, tools, equipment, machinery, etc.
• Ensuring a healthful psychosocial environment
• Following company safety rules
• Conducting safety inspections
• Enforcing safety rules
• Training safe work procedures
• Recognizing employees for safety
• Conducting safety meetings
Employees. Measurement of employees usually includes personal behaviors such as:
• Complying with company safety rules
• Reporting injuries immediately
• Reporting hazards
• Making suggestions
• Involvement in safety activities
After all is said and done, if the behaviors and activities above are expected and recognized, the results we all worry about will take care of themselves. Improve the process and watch the outcome follow! Is this all "pie in the sky"? It doesn't have to be. Now let's take a look at some real-world problems related to this element.
Good intentions...bad results
Most employers establish safety incentive programs to increase awareness and influence behaviors in a positive direction. However, some of those employers unintentionally reward their employees for not reporting injuries. Their intention is to do the right thing, but the problem is they're not doing the thing right.
Although the company may be able to boast of thousands of production hours without a reported injury, some of their employees may actually be injured or ill. (I call this the "walking wounded" syndrome.) However, negative peer pressure, the desire to "win", or other workplace factors may cause the employee to decide not to report their injury or illness.
Not only is the behavior being rewarded not appropriate, it's not legal! According to the OSH Act of 1970, Section 5(a) Each employer must:
• Furnish to each of his employees employment and a place of employment which are free from recognized hazards are causing or are likely to cause death or serious physical harm to his employees.
• Comply with occupational safety and health standards promulgated under this Act.
• Ensure each employee complies with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his own actions and conduct.
Since reporting injuries is a mandated responsibility, the employer should do what is necessary to promote this behavior, and nothing promotes "not reporting."
Consequences for below standard safety behavior typically includes negative performance appraisals, some form of progressive discipline, or forfeiture or some reward like a bonus.
Performance appraisals should index specific safety behaviors and performance just as other production/service criteria are evaluated.
Remember, for an accountability system to work most effectively, managers, supervisors and employees should be measured only for those behaviors over which they have control.
Element 5. Appropriate application of consequences
Without the expectation of consequences, accountability has no credibility and will not be effective. No consequences...no accountability. Consequences need to be appropriate as well as effective. This is the element with which everyone is probably most familiar. Unfortunately, in some companies, consequences are either not appropriate, not effective, or both.
What are the criteria for appropriate consequences?
• They are justified.
• They correspond to the degree of positive or negative results of the behavior.
• They are applied consistently throughout the entire organization.
Are consequences justified?
Negative consequences are justified when the person administering discipline has fulfilled their own accountabilities first. Positive consequences are justified any time employees meet or exceed expectations. Here's an important principle (I call it the 4-R principle) : The more regularly you recognize, the more rarely you'll have to reprimand.
Before administering progressive discipline, managers and supervisors make a judgment about how well they have fulfilled their own accountabilities. This is important to make sure they are actually justified in administering corrective actions.
Determining the appropriateness of administering negative consequences does not have to be difficult. It can be a simple straightforward process. Honestly answer the following questions in the affirmative:
1. Have I provided the employee with a safe and health workplace? Do they have the physical resources and psychosocial support to comply?
2. Have I provided adequate safety supervision? I'm not stuck in my office all day...I'm overseeing their work regularly I'm able to "catch" unsafe behaviors and hazardous conditions before they cause an injury.
3. Have I provided (or has the employee received) quality safety training? The employee has the required knowledge and skills to comply. The employee understands the natural and system consequences of noncompliance.
4. Have I applied safety accountability fairly and consistently in the past? Does the employee know he or she will be disciplined if caught? Or, do they know all you will do is threaten them..."if I catch you doing that again."
5. Have I demonstrated leadership? Do I set the proper example by complying with policies and rules. Do I do the right thing at the right time for the right reasons?
If a manager or supervisor can honestly answer yes to each of the above four questions, it is probably appropriate to administer negative consequences because he or she has fulfilled their own accountabilities first. If a manager cannot honestly answer each question in the affirmative, leadership requires an apology and a commitment to make improvements.
Do consequences correspond with the positive or negative results of the behavior?
• The significance of consequences of an unsafe behavior should increase with the severity of the potential injury or illness resulting from the behavior. If an employee is performing an unsafe work practice, a fatal injury to himself or another employee could occur, and it certainly warrants a severe consequence. On the other hand, an employee who performs a behavior that violates a safety rule not resulting in an injury or illness, a less severe consequence is more appropriate.
• Consequences should increase with the level of responsibility of the person performing the behavior. If an employee neglects to perform a safe work practice such as wearing ear protection, a safety rule has been violated and discipline may be in order. However, if a supervisor or manager neglects to wear the ear protection, we're not just talking about violating a safety rule. The mandatory safety rule has, in effect, been transformed into a discretionary guideline.
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A more severe level of discipline would be in order because of the position of responsibility they assume. The supervisor or manager, in fact, gives permission for all employees to do violate the same safety rule. The negative impact on the safety of employees has the potential to be much greater when the supervisor or manager violates a safety rule. On the other hand, if a supervisor or manager does something positive, the net impact will likely be greater. Consequently, more significant positive consequences are certainly in order.
Are consequences applied consistently at all levels of the organization?
To build a high level of trust between management and labor, accountability must be applied consistently at all levels of the organization: up and down, and across functions. Every supervisor and manager must be held accountable in the same fair manner consistent with employees. If labor perceives the accountability system as applying only to them, they will naturally consider it unfair: the primary failure mode for accountability systems.
Element 6. A process of evaluate the accountability system.
Although as a supervisor you may not be responsible for formally evaluating the accountability system it's good to know someone is. Usually, the safety manager and safety committee are involved this activity. In some "state-plan" states, like Oregon, the safety committee is required by law to conduct an evaluation of the employer's accountability system.
The process usually involves three levels of activity:
• Identification. Inspect the accountability system policies, plans, procedures, processes to identify what exists.
• Analysis. Dissect and thoroughly study each accountability system policy, plan, procedure, process to understand what they look like. The devil is in the detail.
• Evaluation. Compare and contrast each accountability system policy, plan, procedure, process against benchmarks and best practices to judge their effectiveness.
If you believe there are weaknesses in your employer's accountability system, make sure to take notes on the behaviors and conditions you see in the workplace may be pointing to accountability system policies, plans, processes, and procedures are inadequate or mission.
Evaluating for Accountability
OSHA looks primarily for two program elements when evaluating an employer for accountability: Policy and consequences. OSHA does not mandate specific recognition/disciplinary procedures. Rather, it's the responsibility of the employer to design those procedures, and make sure a clearly written and communicated policy should be in place.
Who's accountable for what?
Employers are held accountable by law for ensuring a safe and healthful workplace, and employees are held accountable by their employers for individual safety behavior. It's important to note if employees are "empowered" (authorized) to perform certain responsibilities and have control over those responsibilities, they should also be held accountable. For instance, if an employee is empowered to fix minor hazards in their work area, they should realize if they don't follow through they should expect some sort of consequences as a result.
When are negative consequences appropriate?
Put yourself into the role of a supervisor. It may not be appropriate to administer disciplinary procedures even if it first appears an employee is not complying with safety rules. Before disciplining an employee, it is appropriate to first ask some very important questions to determine if you, as a supervisor, have fulfilled your own safety responsibilities adequately.
To think of it another way, you may be pointing the finger of discipline at an employee, but remember, the other fingers are all pointing back at you, as if to ask some very pointed questions about how well you're fulfilling your supervisor accountabilities.
The first supervisor accountability: Providing a safe environment. As stated earlier, one very important supervisor accountability is to provide a safe and healthful work area. This means providing all those resources necessary for employees to complete their tasks safely.
The second supervisor accountability: Safety Training. Providing safety training is an important supervisor accountability. Training teaches the skills to apply the knowledge the employee has learned. Demonstration is essential to effective safety training.
The third supervisor accountability: Safety Oversight. OSHA attaches a rather narrow definition to the term "supervision," considering it to be primarily a control and monitoring function. OSHA expects someone with authority to oversee work being accomplished to make sure unsafe work conditions do not exist, and employees use safe work practices. Adequate supervision means detecting and correcting hazards before they cause an injury or illness.
The fourth supervisor accountability: Enforcing safety rules. Accountability is generally thought to mean "enforcement of safety rules" using progressive discipline. However, it's important to understand consequences may take many forms, and they are not always negative. If progressive discipline is used, it's important for supervisors to understand how to administer it fairly and consistently. Supervisors should never merely encourage safety: they must insist all employees comply with mandatory rules.
The fifth supervisor accountability: Demonstrating safety leadership. Leadership occurs when the supervisor does the right thing at the right time for the right reason. Setting the proper example by effectively fulfilling the first four accountabilities in a timely manner to protect employees sends an effective message of leadership to all employees.
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DEVELOPING ACCOUNTABILITY
Source: Missouri Department of Labor and Industrial Relations
DISCIPLINARY SYSTEM WORKSHEET
The nature and severity of disciplinary action should be appropriate for the seriousness and frequency of the violation. Below are a series of questions designed to help you develop a disciplinary system that best meets the needs of your workplace. You already may have addressed the first two areas when you developed safe work practices for various jobs. If you have not yet developed these practices, it makes sense to do so before developing a disciplinary system. Other workplace problems, such as attendance and attitude, are equally important but are not addressed here.
1. Operations. What key operation(s) occur at your workplace? What equipment is used? By whom? What materials are used, and by whom? Are there any hazards associated with the use of the equipment or the materials?
2. Practices and Procedures. What are the key types of jobs at your workplace? What do most people do in the course of their work? What is the most efficient way for them to perform their jobs? What is the safest way for them to perform their jobs? (Note: You will need to perform a job hazard analysis to properly answer this. For information, see OSHA Publication 3071 (Revised 1992), "Job Hazard Analysis."
3. Problems. What would happen if a job or a procedure were not done safely? Exactly what would happen if an employee performed in an unsafe or unhealthful manner? What would happen if all employees did the same thing? How serious would the consequences be? Would the unsafe action or behavior affect just one employee, or all employees?
4. Correction. For each type of safety and health violation you have identified, what kind of corrective action seems appropriate? What would you do for a second offense, or for repeated violations of the same rule? Should warnings be oral or written? How long a suspension is warranted for what type of violation? Are there any actions that should automatically result in termination?
For this last stage in developing your disciplinary system, you may find it helpful to develop a grid, like the one on the next page, to identify corrective actions for different kinds of violations and repetitions.
|VIOLATION |FIRST OFFENSE |SECOND OFFENSE |REPEATED VIOLATION |
|Unsafe work habits | | | |
|Refusal to follow safety instructions | | | |
|Unsafe actions that jeopardize self | | | |
|and others | | | |
It is useful to make a list of the kinds of violations that are considered major or serious and a second list of other types of behavior that, while not as serious, are still not acceptable. The following suggested rules can be starting point.
Major Offenses:
• Failure to follow rules use of company equipment or materials
• Horseplay in work areas or otherwise creating unsafe conditions
• Tampering with machine safeguards or removing machine tags or locks
• Not wearing required PPE
• Provoking or engaging in an act of violence against another person on company property
• Using or being under the influence of alcohol or illegal drugs on the job
• Major traffic violations while using a company vehicle, and
• Other major violations of company rules or policies
General Offenses:
• Minor traffic violations while company vehicles
• Creating unsafe or unsanitary conditions or poor housekeeping habits
• Threatening an act of violence against another person while on company property
• Misrepresentation of facts or falsification of company records
• Unauthorized use of company property
• Other violations of company policy and rules
Link each type of offense to a structured procedure f or corrective action. Your goal is to make sure that the corrective action is appropriate to the seriousness of the violation; that employees are given the opportunity to correct their own behavior; and that the system is workable, and consequently, used and useful.
GENERAL WORKPLACE SAFETY AND HEALTH RULES
|Written Warning |No safety glasses |
| |Horseplay |
| |Unsafe work habits |
| |Violation of other safety or health rule or regulation |
|Suspension (8 hours without pay) |Three or more safety or health violations of the same type |
| |General overall record of unsafe practices |
| |Refusal to follow safety and health guidelines or instructions |
|Termination |Excessive and repeated safety and/or health violations |
| |Purposely ignoring safety and/or health rules |
| |Unsafe actions that seriously jeopardize the safety or health of others |
| |General disregard for safety and health of self and others |
RECORDKEEPING
Source: Missouri Department of Labor and Industrial Relations
OSHA requires that you keep certain records. Employee visits to the health office or to an off-site clinic or health care professional's office will generate additional records. Maintaining your records using the resources of your OHDS is a good idea. The occupational health professionals connected with your OHDS have the training to answer your employees' questions about these records and to decide whether their complaints are work-related.
What follows is a description of the health-related records that you should have in your business. It is meant to give you enough information to decide if you want to manage these records within your OHDS. You need to consult the standards or the other references for more details. The Code of Federal Regulations (CFR) numbers or publication titles have been included for your convenience. For further assistance, contact the OSHA-funded, State-operated consultation service or your nearest Federal or State OSHA office.
OSHA-300 LOG
OSHA requires that you keep track of all the work-related injuries and illnesses that occur at your worksites. OSHA Form 300, often called the OSHA-300 Log, is used for this purpose. Another form, the "Supplementary Record of Occupational Injuries and Illnesses" (OSHA Form 101), or its equivalent, also must be kept. Employers often use the "First Report Of Injury," required by the workers' compensation system, as an equivalent supplementary record.
THE OSHA RECORDKEEPING STANDARD, 29 CFR 1904
This standard also tells you how long you must keep the records, and how you are to inform your employees about the injuries and illnesses occurring in your company. For more information, see this standard and OSHA's 1986 guidelines entitled "A Brief Guide to Recordkeeping Requirements for Occupational Injuries and Illness," or the more comprehensive "Recordkeeping Guidelines for Occupational Injuries and Illnesses" (both published as OMB 1220-0029). These publications can be obtained from the OSHA Publications Office, U.S. Department of Labor, 200 Constitution Ave., NW, Room 3101, Washington, DC 20210, telephone (202) 219-4667.
ENVIRONMENTAL AND EMPLOYEE HEALTH MONITORING RECORDS
When you do any type of environmental monitoring, such as air sampling, OSHA requires that you keep the results. If you test employees for exposure to hazards, you must keep this information, also. The publication "Access To Employee Exposure and Medical Records," 29 CFR 1910.20, tells you that employees and their representatives must be allowed to see and copy the records, and indicates how long the records must be kept.
RECORDS REQUIRED FOR SPECIFIC HAZARDS
OSHA has issued a number of standards specifying things that you must do when your business involves certain hazards. Often this includes testing employees and the workplace for signs of the hazard. When this is the case, the standard also tells you how long you must keep the results of the tests. Three examples of this type of standard are the bloodborne pathogens standard, 29 CFR 1910.1030, the asbestos standard, 29 CFR 1910.1001(m), and the occupational noise exposure standard, 29 CFR 1910.95.
HAZARD COMMUNICATION
The Hazard Communication Standard addresses more than recordkeeping. It tells you how you must communicate to your employees about the chemicals you use or make in your business. Because the standard requires that you keep certain documents and communicate certain information, we discuss it here.
The standard says, among other things, that you must keep a list of all hazardous chemicals present at your worksites. You must have labels and signs to warn people about these chemicals. You must have material safety data sheets (MSDSs) for all hazardous chemicals. MSDSs provide information from the manufacturer about the ingredients and health effects of a chemical. In addition, employees must be trained about the chemicals to which they are exposed. The training must include information about what you are doing to protect employees and what they need to do to protect themselves. (See 29 CFR 1910.1200.)
INDIVIDUAL EMPLOYEE HEALTH RECORDS
Employee visits to the health office will generate records that should be kept in order to document what treatment is being provided and how the employee is responding. This data can also be analyzed by an occupational health professional seeking to uncover unrecognized hazards.
An important reminder: The confidentiality of individual employee health information is a fundamental concept of good occupational health practice. Moreover, your employees' legal rights to privacy extend to information that may be contained in their workplace health records. Therefore, access to these records should be controlled by health professionals who understand the requirements of confidentiality and the circumstances under which disclosure may be made. It is not proper for an employer to review individual employee health records. Should an employer wish to examine health information, for example, in order to spot injury or illness trends, this review must be limited to anonymous aggregate data. Such data can be compiled by the health professional who controls the individual employee records or by another person who is properly authorized to examine the records.
AREA III B: ENVIRONMENT
CERCLA Overview
Source: EPA
The Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), commonly known as Superfund, was enacted by Congress on December 11, 1980. This law created a tax on the chemical and petroleum industries and provided broad Federal authority to respond directly to releases or threatened releases of hazardous substances that may endanger public health or the environment. Over five years, $1.6 billion was collected and the tax went to a trust fund for cleaning up abandoned or uncontrolled hazardous waste sites. CERCLA:
• established prohibitions and requirements concerning closed and abandoned hazardous waste sites;
• provided for liability of persons responsible for releases of hazardous waste at these sites; and
• established a trust fund to provide for cleanup when no responsible party could be identified.
The law authorizes two kinds of response actions:
• * Short-term removals, where actions may be taken to address releases or threatened releases requiring prompt response.
• * Long-term remedial response actions, that permanently and significantly reduce the dangers associated with releases or threats of releases of hazardous substances that are serious, but not immediately life threatening. These actions can be conducted only at sites listed on EPA's National Priorities List (NPL).
CERCLA also enabled the revision of the National Contingency Plan (NCP). The NCP provided the guidelines and procedures needed to respond to releases and threatened releases of hazardous substances, pollutants, or contaminants. The NCP also established the NPL.
CERCLA was amended by the Superfund Amendments and Reauthorization Act (SARA) on October 17, 1986.
SARA Overview
The Superfund Amendments and Reauthorization Act (SARA) amended the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) on October 17, 1986. SARA reflected EPA's experience in administering the complex Superfund program during its first six years and made several important changes and additions to the program. SARA:
• stressed the importance of permanent remedies and innovative treatment technologies in cleaning up hazardous waste sites;
• required Superfund actions to consider the standards and requirements found in other State and Federal environmental laws and regulations;
• provided new enforcement authorities and settlement tools;
• increased State involvement in every phase of the Superfund program;
• increased the focus on human health problems posed by hazardous waste sites;
• encouraged greater citizen participation in making decisions on how sites should be cleaned up; and
• increased the size of the trust fund to $8.5 billion.
SARA also required EPA to revise the Hazard Ranking System (HRS) to ensure that it accurately assessed the relative degree of risk to human health and the environment posed by uncontrolled hazardous waste sites that may be placed on the National Priorities List (NPL).
Introduction to the Clean Water Act
The Clean Water Act (CWA) is the cornerstone of surface water quality protection in the United States. (The Act does not deal directly with ground water or water quantity issues.) The statute employs a variety of regulatory and nonregulatory tools to sharply reduce direct pollutant discharges into waterways, finance municipal wastewater treatment facilities, and manage polluted runoff. These tools are employed to achieve the broader goal of restoring and maintaining the chemical, physical, and biological integrity of the nation's waters so that they can support "the protection and propagation of fish, shellfish, and wildlife and recreation in and on the water."
For many years following the passage of CWA in 1972, EPA, states, and Indian tribes focused mainly on the chemical aspects of the "integrity" goal. During the last decade, however, more attention has been given to physical and biological integrity. Also, in the early decades of the Act's implementation, efforts focused on regulating discharges from traditional "point source" facilities, such as municipal sewage plants and industrial facilities, with little attention paid to runoff from streets, construction sites, farms, and other "wet-weather" sources.
Starting in the late 1980s, efforts to address polluted runoff have increased significantly. For "nonpoint" runoff, voluntary programs, including cost-sharing with landowners are the key tool. For "wet weather point sources" like urban storm sewer systems and construction sites, a regulatory approach is being employed.
Evolution of CWA programs over the last decade has also included something of a shift from a program-by-program, source-by-source, pollutant-by-pollutant approach to more holistic watershed-based strategies. Under the watershed approach equal emphasis is placed on protecting healthy waters and restoring impaired ones. A full array of issues are addressed, not just those subject to CWA regulatory authority. Involvement of stakeholder groups in the development and implementation of strategies for achieving and maintaining state water quality and other environmental goals is another hallmark of this approach.
Clean Water Act History
Growing public awareness and concern for controlling water pollution led to enactment of the Federal Water Pollution Control Act Amendments of 1972. As amended in 1977, this law became commonly known as the Clean Water Act. The Act established the basic structure for regulating discharges of pollutants into the waters of the United States. It gave EPA the authority to implement pollution control programs such as setting wastewater standards for industry. The Clean Water Act also continued requirements to set water quality standards for all contaminants in surface waters. The Act made it unlawful for any person to discharge any pollutant from a point source into navigable waters, unless a permit was obtained under its provisions. It also funded the construction of sewage treatment plants under the construction grants program and recognized the need for planning to address the critical problems posed by nonpoint source pollution.
Subsequent enactments modified some of the earlier Clean Water Act provisions. Revisions in 1981 streamlined the municipal construction grants process, improving the capabilities of treatment plants built under the program. Changes in 1987 phased out the construction grants program, replacing it with the State Water Pollution Control Revolving Fund, more commonly known as the Clean Water State Revolving Fund. This new funding strategy addressed water quality needs by building on EPA-State partnerships.
Over the years, many other laws have changed parts of the Clean Water Act. Title I of the Great Lakes Critical Programs Act of 1990, for example, put into place parts of the Great Lakes Water Quality Agreement of 1978, signed by the U.S. and Canada, where the two nations agreed to reduce certain toxic pollutants in the Great Lakes. That law required EPA to establish water quality criteria for the Great Lakes addressing 29 toxic pollutants with maximum levels that are safe for humans, wildlife, and aquatic life. It also required EPA to help the States implement the criteria on a specific schedule.
The electronic version of the Clean Water Act (available below) is a thirtieth anniversary snapshot of the law, as amended through the enactment of the Great Lakes Legacy Act of 2002 (Public Law 107-303, November 27, 2002). Provided by the Congressional Great Lakes Task Force, it is the amended law as of that particular point in time. This electronic version annotates the sections of the Act with the corresponding sections of the U.S. Code and footnote commentary on the effect of other laws on the current form of the Clean Water Act.
Features of the 1990 Clean Air Act
The role of the federal government and the role of the states Although the 1990 Clean Air Act is a federal law covering the entire country, the states do much of the work to carry out the Act. For example, a state air pollution agency holds a hearing on a permit application by a power or chemical plant or fines a company for violating air pollution limits.
Under this law, EPA sets limits on how much of a pollutant can be in the air anywhere in the United States. This ensures that all Americans have the same basic health and environmental protections. The law allows individual states to have stronger pollution controls, but states are not allowed to have weaker pollution controls than those set for the whole country.
The law recognizes that it makes sense for states to take the lead in carrying out the Clean Air Act, because pollution control problems often require special understanding of local industries, geography, housing patterns, etc.
States have to develop state implementation plans (SIPs) that explain how each state will do its job under the Clean Air Act. A state implementation plan is a collection of the regulations a state will use to clean up polluted areas. The states must involve the public, through hearings and opportunities to comment, in the development of each state implementation plan.
EPA must approve each SIP, and if a SIP isn't acceptable, EPA can take over enforcing the Clean Air Act in that state.
The United States government, through EPA, assists the states by providing scientific research, expert studies, engineering designs and money to support clean air programs.
Interstate air pollution
Air pollution often travels from its source in one state to another state. In many metropolitan areas, people live in one state and work or shop in an- other; air pollution from cars and trucks may spread throughout the interstate area. The 1990 Clean Air Act provides for interstate commissions on air pollution control, which are to develop regional strategies for cleaning up air pollution. The 1990 Clean Air Act includes other provisions to reduce interstate air pollution.
International air pollution
Air pollution moves across national borders. The 1990 law covers pollution that originates in Mexico and Canada and drifts into the United States and pollution from the United States that reaches Canada and Mexico.
Permits
One of the major breakthroughs in the 1990 Clean Air Act is a permit program for larger sources that release pollutants into the air.[2]
[2] A source can be a power plant, factory or anything that releases pollutants into the air. Cars, trucks and other motor vehicles are sources, and consumer products and machines used in industry can be sources too. Sources that stay in one place are referred to as stationary sources; sources that move around, like cars or planes, are called mobile sources.
Requiring polluters to apply for a permit is not a new idea. Approximately 35 states have had state- wide permit programs for air pollution. The Clean Water Act requires permits to release pollutants into lakes, rivers or other waterways. Now air pollution is also going to be managed by a national permit system. Under the new program, permits are issued by states or, when a state fails to carry out the Clean Air Act satisfactorily, by EPA. The permit includes information on which pollutants are being released, how much may be released, and what kinds of steps the source's owner or operator is taking to reduce pollution, including plans to monitor (measure) the pollution. The permit system is especially useful for businesses covered by more than one part of the law, since information about all of a source's air pollution will now be in one place. The permit system simplifies and clarifies businesses' obligations for cleaning up air pollution and, over time, can reduce paperwork. For instance, an electric power plant may be covered by the acid rain, hazardous air pollutant and non-attainment (smog) parts of the Clean Air Act; the detailed information required by all these separate sections will be in one place--on the permit.
Permit applications and permits are available to the public; contact your state or regional air pollution control agency or EPA for information on access to these documents.
Businesses seeking permits have to pay permit fees much like car owners paying for car registrations. The money from the fees will help pay for state air pollution control activities.
Enforcement
The 1990 Clean Air Act gives important new enforcement powers to EPA. It used to be very difficult for EPA to penalize a company for violating the Clean Air Act. EPA has to go to court for even minor violations. The 1990 law enables EPA to fine violators, much like a police officer giving traffic tickets. Other parts of the 1990 law increase penalties for violating the Act and bring the Clean Air Act's enforcement powers in line with other environmental laws.
Deadlines
The 1990 Clean Air Act sets deadlines for EPA, states, local governments and businesses to reduce air pollution. The deadlines in the 1990 Clean Air Act were designed to be more realistic than dead- lines in previous versions of the law, so it is more likely that these deadlines will be met.
Public participation
Public participation is a very important part of the 1990 Clean Air Act. Throughout the Act, the public is given opportunities to take part in deter- mining how the law will be carried out. For in- stance, you can take part in hearings on the state and local plans for cleaning up air pollution. You can sue the government or a source's owner or operator to get action when EPA or your state has not enforced the Act. You can request action by the state or EPA against violators.
The reports required by the Act are public documents. A great deal of information will be collected on just how much pollution is being released; these monitoring (measuring) data will be available to the public. The 1990 Clean Air Act ordered EPA to set up clearinghouses to collect and give out technical information. Typically, these clearinghouses will serve the public as well as state and other air pollution control agencies.
See the list at the end of this summary for organizations to contact for additional information about air pollution and the Clean Air Act.
Market approaches for reducing air pollution; economic incentives
The 1990 Clean Air Act has many features designed to clean up air pollution as efficiently and inexpensively as possible, letting businesses make choices on the best way to reach pollution cleanup goals. These new flexible programs are called market or market-based approaches. For instance, the acid rain clean-up program offers businesses choices as to how they reach their pollution reduction goals and includes pollution allowances that can be traded, bought and sold.
The 1990 Clean Air Act provides economic incentives for cleaning up pollution. For instance, gasoline refiners can get credits if they produce cleaner gasoline than required, and they can use those credits when their gasoline doesn't quite meet clean-up requirements.
Cleaning up air pollution: the programs in the 1990 Clean Air Act
Smog and other "criteria" air pollutants
A few common air pollutants are found all over the United States. These pollutants can injure health, harm the environment and cause property damage.
EPA calls these pollutants criteria air pollutants because the agency has regulated them by first developing health-based criteria (science-based guidelines) as the basis for setting permissible levels. One set of limits (primary standard) protects health; another set of limits (secondary standard) is intended to prevent environmental and property damage. A geographic area that meets or does better than the primary standard is called an attainment area; areas that don't meet the primary standard are called nonattainment areas.
Although EPA has been regulating criteria air pollutants since the 1970 CAA was passed, many urban areas are classified as nonattainment for at least one criteria air pollutant. It has been estimated that about 90 million Americans live in nonattainment areas.
How Smog is Formed
What we typically call smog is primarily made up of ground-level ozone. Ozone can be good or bad depending on where it is located. Ozone in the stratosphere high above the Earth protects human health and the environment, but ground-level ozone is the main harmful ingredient in smog.
Ground-level ozone is produced by the combination of pollutants from many sources, including smokestacks, cars, paints and solvents. When a car burns gasoline, releasing exhaust fumes, or a painter paints a house, smog-forming pollutants rise into the sky.
Often, wind blows smog-forming pollutants away from their sources. The smog-forming reactions take place while the pollutants are being blown through the air by the wind. This explains why smog is often more severe miles away from the source of smog-forming pollutants than it is at the source.
The smog-forming pollutants literally cook in the sky, and if it's hot and sunny, smog forms more easily. Just as it takes time to bake a cake, it takes time to cook up smog-several hours from the time pollutants get into the air until the smog gets really bad.
Weather and geography determine where smog goes and how bad it is. When temperature inversions occur (warm air stays near the ground instead of rising) and winds are calm, smog may stay in place for days at a time. As traffic and other sources add more pollutants to the air. the smog gets worse.
Since smog travels across county and state lines, when a metropolitan area covers more than one state (for instance, the New York metropolitan area includes parts of New Jersey and Connecticut), their governments and air pollution control agencies must cooperate to solve their problem. Governments on the East Coast from Maine to Washington, D.C., will have to work together in a multistate effort to reduce the area's smog problem.
Here's how the 1990 Clean Air Act reduces pollution from criteria air pollutants, including smog.
First, EPA and state governors cooperated to identify nonattainment areas for each criteria air pollutant. Then, EPA classified the nonattainment areas according to how badly polluted the areas are. There are five classes of nonattainment areas for smog, ranging from marginal (relatively easy to clean up quickly) to extreme (will take a lot of work and a long time to clean up).
The 1990 Clean Air Act uses this new classification system to tailor clean-up requirements to the severity of the pollution and set realistic deadlines for reaching clean-up goals. If deadlines are missed, the law allows more time to clean up, but usually a nonattainment area that has missed a clean-up deadline will have to meet the stricter clean-up requirements set for more polluted areas.
Not only must nonattainment areas meet deadlines, states with nonattainment areas must show EPA that they are moving on clean-up before the deadline-making reasonable further progress.
States will usually do most of the planning for cleaning up criteria air pollutants, using the permit system to make sure power plants, factories and other pollution sources meet their clean-up goals.
The comprehensive approach to reducing criteria air pollutants taken by the 1990 Act covers many different sources and a variety of clean-up methods. Many of the smog clean-up requirements involve motor vehicles (cars, trucks, buses). Also, as the pollution gets worse, pollution controls are required for smaller sources.
Other criteria pollutants: carbon monoxide and particulates
The carbon monoxide (CO) and particulate matter (PM-10) clean-up plans are set up like the plan for smog, but only two pollution classes are identified for each (instead of the five for ozone). Getting rid of particulates (soots, dusts, smoke) will require pollution controls on power plants and restrictions on smaller sources such as wood stoves, agricultural burning, and dust from fields and roads. Because so many homes have woodstoves and fireplaces, this summary of the Clean Air Act includes a section on Woodstoves and fireplaces, providing information on how the Clean Air Act will affect these home heating systems.
1997 Changes to the Clean Air Act
EPA recently reviewed the current air quality standards for ground-level ozone (commonly known as smog) and particulate matter (or PM). Based on new scientific evidence, revisions have been made to both standards. At the same time, EPA is developing a new program to control regional haze, which is largely caused by particulate matter.
Offsets
What if a company wants to expand or change a production process or otherwise increase its output of a criteria air pollutant? If an owner or operator of a major source wants to release more of a criteria air pollutant, an offset (a reduction of the criteria air pollutant by an amount somewhat greater than the planned increase) must be obtained somewhere else, so that permit requirements are met and the nonattainment area keeps moving toward attainment. The company must also install tight pollution controls. An increase in a criteria air pollutant can be offset with a reduction of the pollutant from some other stack at the same plant or at another plant owned by the same or some other company in the nonattainment area. Since total pollution will continue to go down, trading offsets among companies is allowed. This is one of the market approaches to cleaning up air pollution in the Clean Air Act.
Criteria air pollutants in gasoline and consumer products
Volatile organic compounds (VOCs), important smog-forming chemicals, are found in gasoline and many consumer products, from hair spray to charcoal starter fluid to plastic popcorn packaging. This summary includes a section on Consumer Products; see that section for information on how the Clean Air Act will affect products you use every day. Information on changes in gasoline will be found in the section on Mobile Sources.
Hazardous air pollutants
Some air pollutants can cause cancer, problems with having children and other very serious illnesses as well as environmental damage. Air pollutants have killed people swiftly when large quantities were released; the 1984 release of methyl isocyanate at a pesticide-manufacturing plant in Bhopal, India, killed approximately 4,000 people and injured more than 200,000.
EPA refers to chemicals that cause serious health and environmental hazards as hazardous air pollutants (HAPs) or air toxics.
Air toxics are released from sources throughout the country and from motor vehicles. For example, gasoline contains toxic chemicals. Gases escape from liquid gasoline and form a vapor in a process called vaporization or evaporation. When you put gas in your car, you can often see wavy lines in the air at the pump nozzle and you can smell gasoline; that tells you gasoline vapors are in the air.
Cars & Stores
When cars and trucks burn gasoline, air toxics come out of the tailpipes. (These air toxics are combustion products--chemicals that are produced when a substance is burned.)
Air toxics are released from small stationary sources, such as dry cleaners and auto paint shops Large stationary sources, such as chemical factories and incinerators, also release hazardous air pollutants. The 1990 Clean Air Act deals more strictly with large sources than small ones, but EPA must regulate small sources of hazardous air pollutants as well.
To reduce air toxics pollution, EPA must first identify the toxic pollutants whose release should be reduced. The 1970 Clean Air Act gave EPA authority to list air toxics for regulation and then to regulate the chemicals. The agency listed and regulated seven chemicals through 1990. The 1990 Act includes a list of 189 hazardous air pollutants selected by Congress on the basis of potential health and/or environmental hazard; EPA must regulate these listed air toxics. The 1990 Act allows EPA to add new chemicals to the list as necessary.
To regulate hazardous air pollutants, EPA must identify categories of sources that release the 189 chemicals listed by Congress in the 1990 Clean Air Act. Categories could be gasoline service stations, electrical repair shops, coal-burning power plants, chemical plants, etc. The air toxics producers are to be identified as major (large) or area (small) sources.
Once the categories of sources are listed, EPA will issue regulations. In some cases, EPA may have to specify exactly how to reduce pollutant releases, but wherever possible companies will have flexibility to choose how they meet requirements. Sources are to use Maximum Available Control Technology (MACT) to reduce pollutant releases; this is a very high level of pollution control.
EPA must issue regulations for major sources first, and must then issue regulations to reduce pollution from small sources, setting priorities for which small sources to tackle first, based on health and environmental hazards, production volume, etc.
If a company wishes to increase the amount of air toxics coming out of an operating plant, the company may choose to offset the increases so that total hazardous air pollutant releases from the plant do not go up. Otherwise, they may choose to install pollution controls to keep pollutants at the required level.
If a company reduces its releases of a hazardous air pollutant by about 90 percent before EPA regulates the chemical, the company will get extra time to finish cleaning up the remaining 10 percent. This early reduction program is expected to result in a speedy reduction of the levels of several important hazardous air pollutants.
Under the 1990 Clean Air Act, EPA is required to study whether and how to reduce hazardous air pollutants from small neighborhood polluters such as auto paint shops, print shops, etc. The agency will also have to look at air toxics pollution after the first round of regulations to see whether the remaining health hazards require further regulatory action.
Cars, trucks, buses and other mobile sources release large amounts of hazardous air pollutants like formaldehyde and benzene. Cleaner fuels and engines and making sure that pollution control devices work should reduce hazardous air pollutants from mobile sources.
The Bhopal tragedy inspired the 1990 Clean Air Act requirement that factories and other businesses develop plans to prevent accidental releases of highly toxic chemicals. The Act establishes the Chemical Safety Board to investigate and report on accidental releases of hazardous air pollutants from industrial plants. The Chemical Safety Board will operate like the National Transportation Safety Board (NTSB), which investigates plane and train crashes.
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AREA III C: ERGONOMICS
OSHA's Approach to Ergonomics
A Four-Pronged, Comprehensive Approach
In April 2002, Secretary of Labor Elaine L. Chao unveiled a comprehensive approach to ergonomics designed to quickly and effectively address musculoskeletal disorders (MSDs) in the workplace. OSHA developed a four-pronged ergonomics strategy to meet this goal through a combination of industry-specific and task-specific guidelines, outreach, enforcement, and research.
Since the ergonomics strategy was announced, OSHA has made significant progress in each of the four areas of emphasis to reduce ergonomic injuries. Some highlights of OSHA's accomplishments are summarized below.
Guidelines
• OSHA's first ergonomic guidelines were released on March 13, 2003, and covered the nursing home industry; the guidelines followed public comment and a stakeholder meeting on the draft guidelines.
• OSHA published final Ergonomic Guidelines for Retail Grocery Stores on May 28, 2004 following public comment and a stakeholder meeting on draft guidelines.
• OSHA published final Ergonomic Guidelines for the Poultry Processing Industry on September 2, 2004 following public comment. No Stakeholder meeting was held for this guideline because stakeholders felt that their written comments were sufficient to communicate their concerns.
• OSHA announced in the spring of 2003 that it will develop ergonomic guidelines for shipyards. Work continues on these complex guidelines and anticipates publication of the Draft Guidelines for Shipyards early in 2005.
• OSHA is encouraging other industries to develop ergonomic guidance to meet their specific needs. For example, the State of North Carolina and the American Furniture Manufacturers Association worked together to develop ergonomic guidance for the furniture manufacturing industry.
• As part of their alliances with OSHA, several printing industry associations and the Society of the Plastics Industry, Inc., are developing ergonomic guidance for their respective industries.
Enforcement
• OSHA has issued 16 General Duty Clause violations for ergonomic hazards with more cases under evaluation for citation.
• OSHA conducted a National Emphasis Program (NEP) for the nursing home industry from July 2002 through September 30, 2003. The agency conducted 1,225 inspections under this NEP.
• OSHA has conducted 994 ergonomics inspections in industries other than nursing homes (from January 1, 2002 through January 31, 2005).
• A cross-cutting OSHA ergonomics response team evaluates and screens all inspection cases prior to issuing a citation.
• OSHA sent 361 hazard alert letters to notify employers of ergonomic problems in their facilities. Follow-up inspections at a sample of these facilities will be scheduled to evaluate the progress of response to the hazard alert letters.
• Four Regional Emphasis Programs and six Local Emphasis Programs are underway across the country, focusing on ergonomic hazards in meat processing, health care, hotels, and warehousing industries.
• OSHA named ergonomic coordinators for each of its 10 regional offices to assist staff, employers, employees, and other stakeholders with ergonomic issues.
• OSHA currently has six ergonomists throughout the country-in regional offices, the national office, an area office, the OSHA Training Institute and the Salt Lake Technical Center.
• The OSHA Training Institute has added a class to teach field personnel policies and procedures for ergonomics enforcement under the Secretary's four-pronged approach.
Outreach and Assistance
• OSHA currently has 24 strategic partnerships with an emphasis on ergonomics.
• OSHA has signed 27 national ergonomic Alliances and 17 regional ergonomic Alliances which are working with OSHA on a number of projects. Several Alliance Program participants, including the American Apparel and Footwear Association, the Airline Industry Alliance and the National Telecommunications Safety Panel are working on industry-developed ergonomics manuals. Another Alliance Program participant, the American Academy of Orthopedic Surgeons is working to develop guidance on worker-related upper extremity musculoskeletal disorders. The Dow Chemical Company helped develop an extensive case study of its successful approach to ergonomics.
• OSHA's Website features eight eTools that address ergonomics for a number of industries and occupations, including baggage handling, beverage delivery, computer workstations, grocery warehousing, health care, poultry processing and sewing. Through the Alliance Program, the Graphic Arts Coalition, which includes representatives from several printing industry trade associations, is working with OSHA to develop an ergonomic eTool for the printing industry.
• OSHA staff serves as adjunct members on the American Industrial Hygiene Association's Ergonomics Committee.
• VPP sites are required to identify and control hazards, including ergonomic hazards, as part of their overall safety and health management system.
• The OSHA Training Institute Education Centers conducted 29 ergonomic classes for 394 students in FY2004 and have scheduled several ergonomics classes in FY2005.
• OSHA provided ergonomic workstation training and evaluation assistance to several government agencies, including the IRS and the Defense Contract Audit Agency.
• OSHA's Ergonomics Safety and Health Topics webpage reflects the Agency's four-pronged strategy to reduce ergonomic injuries. The webpage provides information on ergonomics guidelines, enforcement actions, the National Advisory Committee on Ergonomics, eTools, cooperative programs, a library of 42 success stories from a variety of industries, and case studies.
• OSHA signed a Memorandum of Understanding with the U.S. Small Business Administration, Office of Advocacy, and the U.S. Small Business Administration, Office of the Small Business and Agriculture Regulatory Enforcement Ombudsman, to distribute ergonomics information to small businesses.
• OSHA and the U.S. Chamber of Commerce jointly developed a webcast on the willingness and ability of businesses to adopt and implement ergonomics policies.
• In FY 2004, OSHA awarded more than $480,000 in Susan Harwood Training Program Grants to three organizations to develop and conduct training on ergonomics in the retail grocery, nursing home, and auto supply manufacturing industries. OSHA awarded more than $1.2 million to ten organizations to conduct training in new industry-specific ergonomics guidelines in FY2003.
National Advisory Committee on Ergonomics
• OSHA established a 15-member National Advisory Committee on Ergonomics (NACE), with representatives from industry, academia, labor, and the legal and medical professions. More than 250 people were nominated in response to a Federal Register announcement seeking nominations to NACE.
• The first NACE meeting took place in January 2003. Subsequent meetings were held in May 2003, September 2003, January 2004 and May 2004, and November 2004.
• Discussion at the meetings has centered on task-specific guidelines, research needs and efforts, and outreach and assistance methods to communicate the value of ergonomics.
• Based upon a recommendation of the NACE research discussion group, OSHA sponsored a symposium entitled Musculoskeletal and Neurovascular Disorders - The State of Research Regarding Workplace Etiology and Prevention for published researchers on work-related musculoskeletal disorders to examine their studies and the methodologies used. This symposium was held in conjunction with the January 2004 NACE meeting.
• The NACE Charter ended in November 2004. A complete list of NACE'S recommendations can be found at:
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ERGONOMICS: AN INTRODUCTION
In 1996, more than 647,000 American workers experienced serious injuries due to overexertion or repetitive motion on the job. These work-related musculoskeletal disorders (MSDs) account for 34 percent of lost workday injuries. MSDs cost employers an estimated $15 to $20 billion in workers' compensation costs in 1995 and $45 to $60 billion more in indirect costs.
A compelling customer satisfaction story
Sysco Food Services of Houston, Texas had serious ergonomic problems when OSHA inspected the company. In 1996, Sysco had 210 injuries with 3,638 lost workdays. Back injuries accounted for 40 percent of the injuries and more than half the cost. An OSHA inspector issued Sysco a citation and $7,000 fine for failing to protect its employees from ergonomic hazards and set out an abatement plan for the company to follow.
Today, after implementing a formal ergonomics program under the direction of Sandra Carson, an occupational health nurse, Sysco's injury compensation costs have fallen by almost 75 percent, and major back injuries have dropped from 76 a year to 21.
Ms. Carson says the $7,000 penalty "was one of the best investments the company has made." Along with the citation, Ms. Carson says Sysco "received an analysis of our problem jobs as well as alternative controls to consider." The health and safety improvements have made Ms. Carson's branch one of Sysco's most profitable.
What are work-related musculoskeletal disorders (MSDs)?
Musculoskeletal disorders include a group of conditions that involve the nerves, tendons, muscles, and supporting structures such as intervertebral discs. They represent a wide range of disorders, which can differ in severity from mild periodic symptoms to severe chronic and debilitating conditions. Examples include carpal tunnel syndrome, tenosynovitis, tension neck syndrome, and low back pain.
Work-related Musculoskeletal Disorders are caused or made worse by the work environment. MSDs can cause severe and debilitating symptoms such as:
• pain, numbness, and tingling
• reduced worker productivity
• lost time from work
• temporary or permanent disability
• inability to perform job tasks, and
• an increase in workers compensation costs
MSDs are often confused with ergonomics. Ergonomics is the science of fitting workplace conditions and job demands to the capabilities of workers.
In other words, MSDs are the problem and ergonomics is a solution.
What are the risk factors for MSDs?
Risk factors for MSDs include;
• repetitive, forceful, or prolonged exertions of the hands
• frequent or heavy lifting, pushing, pulling, or carrying of heavy objects
• prolonged awkward postures, and
• vibration contribute to MSDs
Jobs or working conditions that combine risk factors will increase the risk for musculoskeletal problems. The level of risk depends on how long a worker is exposed to these conditions, how often they are exposed, and the level of exposure.
How common are MSDs?
MSDs of any cause are among the most prevalent medical problems, affecting 7% of the population and accounting for 14% of physician visits and 19% of hospital stays.
When looking specifically at work-related MSDs, the Bureau of Labor Statistics (BLS) reports that in 1995, 62% (308,000) of all illness cases were due to disorders associated with repeated trauma. This figure does not include back injuries. BLS also reports that the number of cases of repeated trauma has increased significantly, rising from 23,800 cases in 1972 to 332,000 cases in 1994—a fourteen-fold increase. In 1995, the number of cases decreased by 7% to 308,000 reported cases, but this number still exceeds the number of cases in any year prior to 1994.
When looking specifically at cases involving days away from work, for which more detailed information is available, BLS reports that in 1994, approximately 32% or 705,800 cases were the result of overexertion or repetitive motion. This figure includes back injuries.
NIOSH research and prevention
The National Institute for Occupational Safety and Health (NIOSH) is the only federal agency mandated to conduct research and train professionals to identify and prevent workplace hazards. The Institute is part of the Centers for Disease Control and Prevention. NIOSH conducts and funds a substantial amount of research on musculoskeletal disorders, currently a total of 80 projects on work-related MSD-related topics. A directory of all these projects has been published by NIOSH (DHHS [NIOSH] Publication No. 97-109). For more information on work-related MSDs or on other workplace safety and health issues call: 1-800-35-NIOSH (1-800-356-4674).
What this course is about
This internet course has been developed to help you
• Evaluate the potential for workplace musculoskeletal disorders, and
• Develop an effective ongoing ergonomics program
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Ergonomics: Part of a company safety and health program
Fred A. Manuele, author of On the Practice of Safety, considers occupational ergonomics to be "the art and science of designing the work to fit the worker to achieve optimum productivity and cost efficiency, and minimum risk of injury." To best fulfill the goal to achieve these benefits through ergonomics, a sound program should be developed: A program that includes a written plan, education and training, and effective procedures to identify, analyze and evaluate work for ergonomic risk factors.
Ergonomics programs should not be regarded as separate from those intended to address other workplace hazards. Aspects of hazard identification, case documentation, assessment of control options, and health care management techniques that are used to address ergonomic problems use the same approaches directed toward other workplace risks of injury or disease. Although many of the technical approaches described in this course are specific to ergonomic risk factors and MSDs, the core principles are the same as efforts to control other workplace hazards.
Reactive vs. Proactive approaches
Proactive ergonomics activities emphasize efforts at the design stage of work processes to recognize needs for avoiding risk factors that can lead to musculoskeletal problems. The goal is to design operations that ensure proper selection and use of tools, job methods, workstation layouts, and materials that impose no undue stress and strain on the worker.
Essential considerations
Ergonomics issues are identified and resolved in the planning process. In addition, general ergonomic knowledge, learned from an ongoing ergonomics program, can be used to build a more prevention-oriented approach.
Management commitment and employee involvement in the planning activity are essential. For example, management can set policy to require ergonomic considerations for any equipment to be purchased, and production employees can offer ideas on the basis of their past experiences for alleviating potential problems.
Planners of new work processes involved in the design of job tasks, equipment, and workplace layout, must become more aware of ergonomic factors and principles. Designers must have appropriate information and guidelines about risk factors for MSDs and ways to control them. Studying past designs of jobs in terms of risk factors can offer useful input into their design strategies.
Expressions of management commitment
Management commitment is a key and perhaps the most important controlling factor in determining whether any worksite hazard control effort will be successful. Management commitment can be expressed in a variety of ways. Lessons learned from NIOSH case studies of ergonomic hazard control efforts in the meatpacking industry emphasize the following points regarding evidence of effective management commitment:
Policy statements are issued that:
• treat ergonomic efforts as furthering the company's strategic goals,
• expect full cooperation of the total workforce in working together toward realizing ergonomic improvements,
• assign lead roles to designated persons who are known to "make things happen,"
• give ergonomic efforts priority with other cost reduction, productivity, and quality assurance activities, and
• have the support of the local union or other worker representatives.
• allow full discussion of the policy and the plans for implementation.
• set concrete goals that address specific operations and give priority to the jobs posing the greatest risk.
Resources are committed to:
• train the workforce to be more aware of ergonomic risk factors for MSDs,
• Provide detailed instruction to those expected to assume lead roles or serve on special groups to handle various tasks,
• bring in outside experts for consultations about start-up activities and difficult issues at least until in-house expertise can be developed, and
• implement ergonomic improvements as may be indicated.
• provide release time or other compensatory arrangements during the workday for employees expected to handle assigned tasks dealing with ergonomic concerns.
It's important to furnish information to all those involved in or affected by the ergonomic activities. Misinformation or misperceptions about such efforts can be damaging: If management is seen as using the program to gain ideas for cutting costs or improving productivity without equal regard for employee benefits, the program may not be supported by employees. For example, management should be up-front regarding possible impacts of the program on job security and job changes. All injury data, production information, and cost considerations need to be made available to those expected to make feasible recommendations for solving problems.
Employee involvement Promoting employee involvement in efforts to improve workplace ergonomic conditions has several benefits. They include
• enhanced worker motivation and job satisfaction,
• added problem-solving capabilities,
• greater acceptance of change, and
• greater knowledge of the work and organization.
Worker involvement in safety and health issues means obtaining worker input on several issues.
• The first input is defining real or suspected job hazards.
• Another is suggesting ways to control suspected hazards.
• A third involves working with management in deciding how best to put controls into place.
Employee participation in an organization's efforts to reduce work-related injury or disease and ergonomic problems may take the form of direct or individual input. A common involvement process is participation through a joint labor-management safety and health committee, which may be company-wide or department-wide in nature. Membership on company-wide committees includes union leaders or elected worker representatives, department heads, and key figures from various areas of the organization.
Two factors are critical to the different forms of worker involvement. One is the need for training both in hazard recognition and control and in group problem solving. The second is that management must share information and knowledge of results with those involved.
No single form or level of worker involvement fits all situations or meets all needs. Much depends on the nature of the problems to be addressed, the skills and abilities of those involved, and the company's prevailing practices for participative approaches in resolving workplace issues.
Who should participate?
Ergonomic problems typically require a response that cuts across a number of organizational units. Hazard identification through job task analyses and review of injury records or symptom surveys, as well as the development and implementation of control measures, can require input from
• safety and hygiene personnel,
• health care providers,
• human resource personnel,
• engineering personnel,
• maintenance personnel, and
• ergonomics specialists.
In addition, worker and management representatives are considered essential players in any ergonomics program effort.
In small businesses, two or more of the functions noted on this list may be merged into one unit, or one person may handle several of the listed duties. Regardless of the size of the organization, persons identified with these responsibilities are crucial to an ergonomics program. Purchasing personnel in particular should be included, since the issues raised can dictate new or revised specifications on new equipment orders.
Gathering and examining evidence of MSDs
Once a decision has been made to initiate an ergonomics program, a necessary step is to gather information to determine the scope and characteristics of the problem or potential problem. A variety of techniques and tools have been used; many provide the basis for developing solutions to identified problems.
• Following up of worker reports
• Reviewing OSHA 200 logs
• Conducting symptom surveys
• Using periodic medical examinations
• Identifying Risk Factors in Jobs
o Screening jobs for risk factors
o Performing job analyses
o Setting priorities
Conditions and Symptoms
What are some of the clues that MSDs are a real or possible workplace problem? Some signs are obvious while others are more subtle.
• OSHA Form 300 logs or workers compensation claims show cases of MSDs such as carpal tunnel syndrome, tendonitis, tenosynovitis, epicondylitis, and low back pain. Sometimes these records contain nonspecific entries like "hand pain," which may be an indicator of a significant health problem if severe or persistent.
• Certain jobs or work conditions cause worker complaints of undue strain, localized fatigue, discomfort, or pain that does not go away after overnight rest.
• Workers visiting the clinic make frequent references to physical aches and pains related to certain types of work Exercises.
• Job tasks involve at risk activities such as repetitive and forceful exertions; frequent, heavy, or overhead lifts; awkward work positions; or use of vibrating equipment.
If you uncover signs like these in your workplace, it might be a good idea to request a confidential evaluation by OSHA or insurer ergonomics consultant. Ergonomic evaluations may uncover significant problems and be very helpful in correcting them.
Other sources that could alert employers to potential problems include the following:
• Trade publications, insurer newsletters, or references in popular literature indicating risks of MSDs
• Cases of MSDs found among competitors or in similar businesses
• Proposals for increasing line speed, retooling, or modifying jobs to increase individual worker output and overall productivity
Following up on Worker Reports
Assuring that employees feel free to report, as early as possible, symptoms of physical stress is a key component of any ergonomics program. Early reporting makes it possible to begin corrective measures before the effects of a job problem worsen. When employees feel comfortable reporting their symptoms or other concerns, it indicates a high level of trust between labor and management.
As mentioned earlier, individual worker concerns that certain jobs cause undue physical fatigue, stress, or discomfort may be signs of ergonomic problems. Following up on these reports, particularly reports of MSDs, is essential. Such reports indicate a need to evaluate the jobs to identify ergonomic risk factors.
Reviewing OSHA Logs and other existing records
Inspecting OSHA 300 logs and plant medical records, as well as workers compensation claims, insurance claims, absentee records, and job transfer applications can yield information about the nature of MSDs. Finding workers in certain departments or operations experiencing more of these problems than others would suggest some immediate areas for study with regard to possible risk factors.
Jobs with elevated rates of low back musculoskeletal disorders often also have higher risks for acute injuries due to slips and trips or other safety hazards. In these cases, acute musculoskeletal injuries may also be an important problem.
Conducting symptoms surveys
Interviews or symptom surveys can be used to identify possible MSDs that might otherwise go unnoticed. In addition to questions about the type, onset, and duration of symptoms, symptom survey forms may include a body map. The employee is asked to locate and rate the level of discomfort experienced in different areas of his or her body. The assumption is that any discomfort or symptoms may be associated with some increased risk for MSDs.
Using periodic medical examinations
A disadvantage of using OSHA logs or company medical information to identify possible cases of MSDs is the lack of specific or uniform medical information. This limitation may make identifying MSDs difficult. One optional approach to overcome this limitation is to have each worker undergo a periodic standard examination that includes a history and physical examination. Such an examination program should be designed and administered by a health care provider.
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Screening for Risk Factors
Screening jobs for physical and psychological risk factors is very proactive, and should involve one or more of the following:
• Walk-through observational surveys of the work facilities to detect obvious risk factors
• Interviews with workers and supervisors to obtain the above information and other data not apparent in walk-through observations, such as time and workload pressures, length of rest breaks, etc.
• Checklists for scoring job features against a list of risk factors
A great deal of research has been conducted to identify workplace factors that contribute to the development of musculoskeletal disorders. NIOSH has recently summarized the epidemiological studies that show a relationship between specific work activities and the development of musculoskeletal disorders.
According to the scientific literature, the following are recognized as important risk factors for musculoskeletal disorders, especially when occurring at high levels and in combination.
Physical risk factors include:
• Awkward postures
• Forceful exertions
• Repetitive motions
• Duration of exposure
• Frequency of exposure
• Contact stresses
• Vibration
• Other conditions
Let's take a closer look at each of these risk factors.
Awkward postures
Body postures determine which joints and muscles are used in an activity and the amount of force or stresses that are generated or tolerated. For example, more stress is placed on the spinal discs when lifting, lowering, or handling objects with the back bent or twisted, compared with when the back is straight. Manipulative or other tasks requiring repeated or sustained bending or twisting of the wrists, knees, hips, or shoulders also impose increased stresses on these joints. Activities requiring frequent or prolonged work over shoulder height can be particularly stressful.
Forceful exertions (including lifting, pushing, and pulling)
Tasks that require forceful exertions place higher loads on the muscles, tendons, ligaments, and joints. Increasing force means increasing body demands such as greater muscle exertion along with other physiological changes necessary to sustain an increased effort. Prolonged or recurrent experiences of this type can give rise to not only feelings of fatigue but may also lead to musculoskeletal problems when there is inadequate time for rest or recovery. Force requirements may increase with:
• increased weight of a load handled or lifted,
• increased bulkiness of the load handled or lifted,
• use of an awkward posture,
• the speeding up of movements, increased slipperiness of the objects handled (requiring increased grip force),
• the presence of vibration (e.g., localized vibration from power handtools leads to use of an increased grip force),
• use of the index finger and thumb to forcefully grip an object (i.e., a pinch grip compared with gripping the object with your whole hand), and use of small or narrow tool handles that lessen grip capacity.
Repetitive motions
If motions are repeated frequently (e.g., every few seconds) and for prolonged periods such as an 8-hour shift, fatigue and muscle-tendon strain can accumulate. Tendons and muscles can often recover from the effects of stretching or forceful exertions if sufficient time is allotted between exertions. Effects of repetitive motions from performing the same work activities are increased when awkward postures and forceful exertions are involved. Repetitive actions as a risk factor can also depend on the body area and specific act being performed.
Duration
Duration refers to the amount of time a person is continually exposed to a risk factor. Job tasks that require use of the same muscles or motions for long durations increase the likelihood of both localized and general fatigue. In general, the longer the period of continuous work (e.g., tasks requiring sustained muscle contraction), the longer the recovery or rest time required.
Frequency
Frequency refers to how many times a person repeats a given exertion within a given period of time. Of course, the more often the exertion is repeated, the greater the speed of movement of the body part being exerted. Also, recovery time decreases the more frequently an exertion is completed. And, as with duration, this increases the likelihood of both localized and general fatigue.
Contact stresses
Repeated or continuous Contact with hard or sharp objects such as non-rounded desk edges or unpadded, narrow tool handles may create pressure over one area of the body (e.g., the forearm or sides of the fingers) that can inhibit nerve function and blood flow.
Vibration
Exposure to local vibration occurs when a specific part of the body comes in Contact with a vibrating object, such as a power handtool. Exposure to whole-body vibration can occur while standing or sitting in vibrating environments or objects, such as when operating heavy-duty vehicles or large machinery.
Other conditions Workplace conditions that can influence the presence and magnitude of the risk factors for MSDs can include
o cold temperatures,
o insufficient pauses and rest breaks for recovery,
o machine paced work, and unfamiliar or unaccustomed work.
Psychological Risk Factors
In addition to the above conditions, other aspects of work may not only contribute to physical stress but psychological stress as well. As long as we believe we have adequate control over all aspects of our job, we may experience normal stress. However, if we believe we have little control over job demands, we may suffer from distress with accompanying ill health and possible irrational behaviors. Under distress, the probability of an accident increases greatly.
Research is examining work factors such as performance monitoring, incentive pay systems, and unreasonable management production demands to determine whether these factors have a negative effect on the musculoskeletal system. Another related area of research is to determine which personal, work, or societal factors contribute to acute musculoskeletal disorders developing into chronic or disabling problems.
Using a checklist
The checklist is a formal and orderly procedure for screening jobs. Numerous versions of checklists exist in ergonomics manuals. When checklist data are gathered by persons familiar with the job, task, or processes involved, the quality of the data is generally better. This checklist illustrates three processes:
• Assessment - identify to determine if something is present.
• Analysis - take it apart to determine what it looks like, how it works.
• Evaluation - judge it against the best.
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Ergonomics Job Hazard Analysis
Efforts to identify jobs or tasks having known risk factors for musculoskeletal problems can provide the groundwork for changes aimed at risk reduction. Even without clear medical evidence, screening jobs for musculoskeletal risk factors can offer a basis for early interventions.
An effective identification method is the Ergonomics Job Hazard Analysis which breaks a job into its various elements or actions, describes them, measures and quantifies the ergonomics risk factors inherent in the elements, identifies conditions contributing to the risk factors, and determines corrective measures.
Job analyses are usually done by persons with considerable experience and training in these areas. While most job analyses have common approaches, such as a focus on the same set of risk factors described above, no "standard" protocol exists for conducting a job analysis to assess ergonomic hazards.
Most job analyses have several common steps:
• A complete description of the job is obtained.
• Employees are often interviewed in order to determine if the way the job is done changes over time.
• During the job analysis, the job is divided into a number of discrete tasks.
• Each task is then studied to determine the specific risk factors that occur during the task.
• Sometimes each risk factor is evaluated in terms of its magnitude, the number of times it occurs during the task, and how long the risk factor lasts each time it occurs.
The tasks of most jobs can be described in terms of:
• The tools, equipment, machinery and materials used to perform the job. Their design can have enormous impact on the risk of injury.
• The workstation layout and physical environment. Establishes parameters and constraints on our posture, movement, etc.
• The task demands and organizational climate in which the work is performed. Works schedules, production quotas, psychosocial support can create fatigue, anxiety, and low morale that may increase the probability of injury or illness.
More definitive procedures for collecting information on these components can include the following:
• Observing the workers performing the tasks in order to furnish time-activity analysis and job or task cycle data; videotaping the workers is typically done for this purpose
• Still photos of work postures, workstation layouts, tools, etc., to illustrate the job
• Workstation measurements (e.g., work surface heights, reach distances)
• Measuring tool handle sizes, weighing tools and parts, and measuring tool vibration and part dimensions
• Determining characteristics of work surfaces such as slip resistance, hardness, and surface edges
• Measuring exposures to heat, cold, and whole body vibration
• Biomechanical calculations (e.g., muscle force required to accomplish a task or the pressure put on a spinal disc based on the weight of a load lifted, pulled, or pushed)
• Physiological measures (e.g., oxygen consumption, heart rate)
• Special questionnaires, interviews, and subjective rating procedures to determine the amount of perceived exertion and the psychological factors influencing work performance
Setting Priorities
Jobs associated with cases of musculoskeletal problems deserve the highest consideration in follow-up efforts to identify ergonomics risk factors and implement control actions. Jobs in which current cases have been identified should receive immediate attention, followed by those in which past records have noted a high incidence or severity of MSDs despite the lack of current cases.
Priority for job analysis and intervention should be given to those jobs:
• In which most people are affected or in which work method changes are going to be taking place anyway.
• Associated with employee reports of fatigue and discomfort.
• Where screening efforts suggest the presence of significant risk factors for musculoskeletal disorders.
Ratings of high or extreme levels of risk factors, especially occurring in combination, may indicate a need for control actions. While appearing last in the priority order, taking steps to reduce apparent risk factors for musculoskeletal disorders is an important proactive approach.
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Controlling Ergonomic Hazards
Controlling MSDs through engineering controls
The preferred approach to prevent and control MSDs is to design the job including:
• the workstation layout
• selection and use of tools
• work methods to take account of the capabilities and limitations of the work force
A good match, meaning that the job demands pose no undue stress and strain to the person doing the job, helps ensure a safe work situation.
Engineering control strategies to reduce ergonomic risk factors include the following:
• Changing the way materials, parts, and products can be transported . For example, using mechanical assist devices to relieve heavy load lifting and carrying tasks or using handles or slotted hand holes in packages requiring manual handling
• Changing the process or product to reduce worker exposures to risk factors. Examples include maintaining the fit of plastic molds to reduce the need for manual removal of flashing, or using easy-connect electrical terminals to reduce manual forces Modifying containers and parts presentation, such as height-adjustable material bins.
• Changing workstation layout. Examples might include using height-adjustable workbenches or locating tools and materials within short reaching distances.
• Changing the way parts, tools, machinery and materials are to be manipulated. Examples include using fixtures (clamps, vise-grips, etc.) to hold work pieces to relieve the need for awkward hand and arm positions or suspending tools to reduce weight and allow easier access.
• Changing tool designs. For example, pistol handle grips for knives to reduce wrist bending postures required by straight-handle knives or squeeze-grip-actuated screwdrivers to replace finger-trigger-actuated screwdrivers.
• Changes in materials and fasteners. For example, lighter-weight packaging materials to reduce lifting loads.
• Changing assembly access and sequence. For example, removing physical and visual obstructions when assembling components to reduce awkward postures or static exertions.
Controlling MSDs through work-practice and administrative controls
Work practice and administrative controls are closely related attempts to change behaviors. They are management-dictated work practices and policies to reduce or prevent exposures to ergonomic risk factors. Work practice and administrative control strategies include:
• changes in job rules and procedures such as scheduling more rest breaks
• rotating workers through jobs that are physically tiring
• training workers to recognize ergonomic risk factors and to learn techniques for reducing the stress and strain while performing their work tasks
Although engineering controls are preferred, work practice and administrative controls can be helpful as temporary measures until engineering controls can be implemented or when engineering controls are not technically feasible. Since work practice and administrative controls do not eliminate hazards, management must assure that the practices and policies are followed.
Common examples of administrative control strategies for reducing the risk of MSDs are as follows:
• Reducing shift length or curtailing the amount of overtime
• Rotating workers through several jobs with different physical demands to reduce the stress on limbs and body regions
• Scheduling more breaks to allow for rest and recovery
• Broadening or varying the job content to offset certain risk factors (e.g., repetitive motions, static and awkward postures)
• Adjusting the work pace to relieve repetitive motion risks and give the worker more control of the work process
• Training in the recognition of risk factors for MSDs and instruction in work practices that can ease the task demands or burden
Personal protective equipment
One of the most controversial questions in the prevention of MSDs is whether the use of personal equipment worn or used by the employee (such as wrist supports, back belts, or vibration attenuation gloves) is effective. Some consider these devices to be personal protective equipment (PPE).
In the field of occupational safety and health, PPE generally provides a barrier between the worker and the hazard source. Respirators, ear plugs, safety goggles, chemical aprons, safety shoes, and hard hats are all examples of PPE. Whether braces, wrist splints, back belts, and similar devices can be regarded as offering personal protection against ergonomic hazards remains open to question.
Although these devices may, in some situations, reduce the duration, frequency, or intensity of exposure, evidence of their effectiveness in injury reduction is inconclusive. In some instances they may decrease one exposure but increase another because the worker has to "fight" the device to perform his or her work. An example is the use of wrist splints while engaged in work that requires wrist bending.
On the basis of a review of the scientific literature completed in 1994, NIOSH concluded that insufficient evidence existed to prove the effectiveness of back belts in preventing back injuries related to manual handling job tasks [NIOSH 1994]. A recent epidemiological study credits mandatory use of back belts in a chain of large retail hardware stores in substantially reducing the rate of low back injuries [Kraus 1996]. Although NIOSH believes this study provides evidence that back belts may be effective in some settings for preventing back injuries, NIOSH still believes that evidence for the effectiveness of back belts is inconclusive..
Less controversial types of personal equipment are vibration attenuation gloves [NIOSH 1989] and knee pads for carpet layers [Bhattacharya et al. 1985]. But even here, there can be concerns. For example, do the design and fit of the gloves make it harder to grip tools?
There you have it? Almost everything you need to know about ergonomic control strategies, right? Well, not quite, but you do have a good introduction to them. Remember, ergonomics control strategies may not be immediately obvious. If you can't figure out an effective solution, don't forget to take advantage of an outside expert. Participating in the consultation process with an ergonomist is a real win-win for your company and an excellent education for you.
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Medical Management
Company health care management strategies and policies, and coordination with health care providers are important parts of the overall ergonomics program.
In general, medical management emphasizes the prevention of impairment and disability through early detection, prompt treatment, and timely recovery. Medical management responsibilities fall on employers, employees, and health care providers.
Employer responsibilities
The employer can create an environment that encourages early evaluation by a health care provider by:
• Providing education and training to employees regarding the recognition of the symptoms and signs of MSDs and the employers procedures for reporting MSDs
• Encouraging employees to report symptoms early so prompt evaluation by an appropriate health care provider can be provided
• Giving health care providers the opportunity to become familiar with jobs and job tasks
• Modifying jobs or accommodating employees who have functional limitations secondary to MSDs as determined by a health care provider
• Ensuring, to the extent permitted by law, employee privacy and confidentiality regarding medical conditions identified during an assessment
Employee responsibilities
Employees should participate in the health care management process by:
• following applicable workplace safety and health rules,
• following work practice procedures related to their jobs, and
• reporting early signs and symptoms of MSDs.
Employees may be faced with conflicting job demands or requirements. Safe work practices or rules may conflict with pressures or incentives to be more productive.
Health Care Provider Responsibilities
The health care provider can support the employer's ergonomics program by:
• Acquiring experience and training in the evaluation and treatment of MSDs
• Seeking information and review materials regarding employee job activities
• Ensuring employee privacy and confidentiality to the fullest extent permitted by law
• Evaluating symptomatic employees including:
o medical histories with a complete description of symptoms
o descriptions of work activities as reported by the employees
o physical examinations appropriate to the presenting symptoms and histories
o initial assessments or diagnoses
o opinions as to whether occupational risk factors caused, contributed to, or exacerbated the conditions
o examinations to follow up symptomatic employees and document symptom improvements or resolutions
Job Familiarity and Job Placement Evaluations
Health care providers who evaluate employees, determine their functional capabilities, and prepare opinions regarding work relatedness should be familiar with employee jobs and job tasks. With specific knowledge of the physical demands involved in various jobs and the physical capabilities or limitations of employees, the health care provider can match the employee's capabilities with appropriate jobs. Being familiar with employee jobs not only assists the health care provider in making informed case management decisions but also assists with the identification of ergonomic hazards and alternative job tasks.
One of the best ways for a health care provider to become familiar with jobs and job tasks is by periodic plant walk-throughs. Once familiar with plant operations and job tasks, the health care provider should periodically revisit the facility to remain knowledgeable about changing working conditions. Other approaches that may help the health care provider to become familiar with jobs and job tasks include reviewing job analysis reports, detailed job descriptions, job safety analyses, and photographs or videotapes that are accompanied by narrative or written descriptions of the jobs.
Early Reporting and Access to Health Care Providers
Employees reporting symptoms or signs of potential MSDs should have the opportunity for prompt evaluation by a health care provider. In general, the earlier symptoms are identified and treatment is initiated, the less likely a more serious disorder will develop. Employers should not establish policies that discourage employees from reporting symptoms. For example, programs that link a manager's earnings to the number of employees reporting symptoms may discourage supervisors from allowing symptomatic employees to be evaluated by the health care provider. Employees should not fear discipline or discrimination on the basis of such reporting.
Treatment
• Health care providers are responsible for determining the physical capabilities and work restrictions of the affected workers.
• The employer is responsible for giving an employee a task consistent with these restrictions.
• Until effective controls are installed, employee exposure to ergonomic stressors can be reduced through restricted duty and/or temporary job transfer.
• Complete removal from the work environment should be avoided unless the employer is unable to accommodate the prescribed work restrictions.
• Immobilization devices, such as splints or supports, can provide relief to the symptomatic area in some cases. These devices are especially effective off-the-job, particularly during sleep. They should not be used as prophylactic PPE to prevent the development of MSDs. Therefore, these devices should be dispensed to individuals with MSDs only by health care providers who have knowledge of the benefits and possible negatives of these devices.
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Ergonomics Training
Identifying and solving workplace MSD problems require some level of ergonomic knowledge and skills. Recognizing and filling different training needs is an important step in building an effective program.
For ergonomics, the overall goal of training is to enable managers, supervisors, and employees to identify aspects of job tasks that may increase a worker's risk of developing MSDs, recognize the signs and symptoms of the disorders, and participate in the development of strategies to control or prevent them.
The educational component of ergonomics training ensures employees are well informed about ergonomic hazards so they can actively participate in identifying and controlling exposures. To be "well informed," includes knowing why using ergonomically safe procedures is important.
Employers may opt to have outside experts conduct ergonomics education and training. If so, the outside instructors should first become familiar with company operations and relevant policies and practices before starting to present the training. Tailoring the instruction to address specific concerns and interests of the worker groups can enhance learning.
Ergonomics awareness training
The objectives for ergonomics awareness training are as follows:
• Recognize workplace risk factors for musculoskeletal disorders and understand general methods for controlling them.
• Identify the signs and symptoms of musculoskeletal disorders that may result from exposure to such risk factors, and be familiar with the company's health care procedures.
• Know the process the employer is using to address and control risk factors, the employee's role in the process, and ways employees can actively participate.
• Know the procedures for reporting risk factors and musculoskeletal disorders, including the names of designated persons who should receive the reports.
Training in job analyses and control measures
The objectives for training in job analyses and control measures are as follows:
• Demonstrate the way to do a job analysis for identifying risk factors for musculoskeletal disorders
• Select ways to implement and evaluate control measures
Training in problem solving
The objectives for training in problem solving are as follows:
• Identify the departments, areas, and jobs with risk factors through a review of company reports, records, walk-through observations, and special surveys.
• Identify tools and techniques that can be used to conduct job analyses and serve as a basis for recommendations.
• Develop skills in team building, consensus development, and problem solving.
• Recommend ways to control ergonomic hazards based on job analyses and pooling ideas from employees, management, and other affected and interested parties.
Special considerations and precautions
Training objectives are not intended to have workers, supervisors, or managers diagnose or treat MSDs. Rather, the purpose is to instill an understanding of what type of health problems may be work related and when to refer employees for medical evaluation. The training should include what is known about work and nonwork causes of musculoskeletal disorders and the current limitations of scientific knowledge.
Training should be understandable to the target audience. Training materials used should consider the participants educational levels, literacy abilities, and language skills. This may mean, for example, providing materials, instruction, or assistance in Spanish rather than English.
Open and frank interactions between trainers and trainees, especially those in affected jobs, are especially important. Employees know their own jobs better than anyone else and often are the source of good ideas for ways to improve them. At a minimum, employees must be given an opportunity to discuss ergonomic problems in their jobs as they see them and engage in relevant problem-solving exercises during the training.
THE SEVEN STEP SAFE OJT TRAINING MODEL
Source: Steven Geigle, CSHM
Step 1. Introduction. State and discuss the learning objectives and answer any questions the employee may have. Discuss the acceptable standards of knowledge and performance. Tell the trainee what you’re going to train. Emphasize the importance of the procedure to the success of the production/service goals. Invite questions. Emphasize the natural and system consequences of their performance. The natural consequences describe the hurt or health that automatically results. The system consequences are those consequences the organization applies as a result of an employee's performance; discipline or positive recognition.
Step 2. Trainer shows and tells. In this step the trainee becomes familiar with each work practice and why it is important. Review the initial conditions for the procedure. Demonstrate the process, carefully explaining each step as you go. Answer questions and continue to demonstrate and explain until the employee understands what to do, when and why to do it, and how to do it.
|[pic] |Trainer: |EXPLAINS and PERFORMS each step. |
|[pic] |Learner: |OBSERVES each step and QUESTIONS the trainer. |
Step 3. Leaner tells - Trainer shows. This step is necessary when exposure to hazards inherent in the procedure could cause serious harm. It protects the trainee because the trainer performs the procedure. The trainee explains the procedure to the trainer, while the trainer does it. This gives the trainer an opportunity to discover whether there were any misunderstandings in the previous step. The trainee also responds to trainer questions.
|[pic] |Learner: |EXPLAINS each step and RESPONDS to questions. |
|[pic] |Trainer: |PERFORMS each step and QUESTIONS the trainee. |
Step 4. Leaner shows and tells. The trainer has the trainee do it. The trainee explains the step, gets permission to perform the stem and then carries out the step. This step is very important when training tasks that might result in serious physical injury or death if not performed correctly. The learner may try to perform the task too quickly, increasing the probability of an injury. Requiring permission helps prevent this from happening.
|[pic] |Learner: |EXPLAINS the step, gets PERMISSION and then PERFORMS each step. |
|[pic] |Trainer: |Gives PERMISSION and OBSERVES each step, ask QUESTIONS as the trainee performs. |
Step 5. Conclusion. Recognize accomplishment - “Good job!” Reemphasize the importance of the procedure and how it fits into the overall process. Tie the training again to accountability by discussing the natural and system consequences of performance.
Step 6. Document. Training documentation should be more than an attendance sheet. See the sample training certification document on the next page. It represents one possible way to document training. Strong documentation includes:
• Trainee’s and trainer’s name.
• Date of training.
• Subject(s) being trained - procedures, practices, related policies, rules, etc.
• Certification - trainee and trainer signatures.
• Trainee statement of understanding and intent to comply.
• Trainee statement that he/she was provided opportunity to practice.
• Trainer statement that testing of knowledge and skills was conducted.
• Trainer statement that student demonstrated adequate knowledge and skill.
Step 7. Validate. At some point in time after the conclusion of the OJT session, observe and question the employee to validate that the training has been successful and that the employee has developed a proper attitude related to the work.
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Model Ergonomics Plan
I. Purpose of the program
A. The Ergonomics Protection Program is established to prevent the occurrence of work-related musculoskeletal disorders, primarily those in the back, upper and lower extremities. To do this the program employs various strategies:
1. Informs employees about musculoskeletal disorders and the risk factors that can cause or aggravate them.
2. Promotes continuous improvement in workplace ergonomic protection.
3. Encourages new technology and innovation in ergonomic protection.
4. Identifies design principles that prevent exposure to risk factors.
5. Ensures ongoing and consistent management leadership and employee involvement.
B. _________________________ (person and position) is responsible for managing the Ergonomic Protection Plan. The ergonomic program health care provider, supervisors and the safety committee will assist in monitoring the effectiveness of the program.
II. Worksite analysis
A. Supervisor, with assistance from the program manager or a consultant, will conduct an ergonomic hazard analysis for each task in his or her area of responsibility. The purpose of worksite analysis is to recognize and identify existing ergonomic risk factors in the workplace. The analysis will include the use of an ergonomic checklist and employee questionnaire. Periodic surveys of the workplace will be conducted at appropriate intervals to evaluate changes in risk factors and effectiveness of work practices and engineering controls.
B. The OSHA 200 log will be reviewed to determine whether any musculoskeletal disorders have occurred during the last two years. If musculoskeletal disorders have occurred in the past two years, the supervisor will further analyze and evaluate the associated "at risk" work areas for ergonomic hazards
C. Each "at risk" task will be videotaped for the purpose of documenting work procedures, tools and materials used, and hazardous conditions encountered. The supervisor will analyze the task for ergonomic related hazard that could result in injury or illness. (See program description for instructions on videotaping) The following risk factors should be considered in your analysis:
1. Performance of the same motions or motion pattern every few seconds for more than two hours at a time. Questions to ask:
• What is the task or cycle frequency per shift?
• Is the task continuous or sporadic?
• Does the worker perform the task for the entire shift or rotate with other workers?
2. Fixed or awkward work postures for more than a total of two hours: for example, overhead work, twisted or bent back, bent wrist, kneeling, stooping, or squatting. Questions to ask:
• What is the height of the workbench?
• What is the maximum reach to parts bins, etc.?
• What is the chair height?
• Is movement restricted due to confined workspace?
3. Use of hand tools. Questions to ask:
• What is the weight of tool being used?
• Are vibrating or impact tools and/or equipment used for more than a total of two hours?
• Is there air exhaust onto the worker’s hand?
4. Manual handling of objects more than 25 pounds more than once each work shift.
5. The type of handwear being used. Questions to ask:
• Is handwear slippery?
• Do the gloves fit properly?
6. No worker control over work pace (e.g., work is mechanically or electronically paced) for more than four hours at a time (exclusive of regular breaks.)
7. Work performed in cold environment.
D. The use of outside ergonomics consultants to evaluate areas identified is encouraged. Their assistance may be extremely valuable in conducting the initial analysis. Coordinate with the program manager to request assistance.
III. Correct Actions
A. The supervisor with assistance from the program manager will determine the surface and root causes for all hazards (ergonomic and general) related to a task being analyzed. The following control strategies will be used to reduce or eliminate those hazards:
1. Engineering controls should be designed by a qualified ergonomist and may include workstation redesign, tool and handle redesign, and change of work methods. The goal is to make the job fit the person.
2. Work practice controls to include proper work techniques, new employee conditioning, and monitoring and modifications as necessary to reduce ergonomic stressors.
3. Administrative controls to reduce the duration, frequency, and severity of exposure to ergonomic stress. These controls may include job rotation, reduction of repetitions, and preventive maintenance of related equipment.
4. Personal protective equipment (PPE) may be used if appropriate. However, in all cases, if employees are not properly trained, or are reluctant to accept change, reducing ergonomic injuries and illnesses may be difficult at best.
IV. Employee involvement and training
A. Management will be involved in all stages of identifying, assessing, and controlling ergonomics hazards. Managers and supervisors will work closely with employees to determine hazards. Training in ergonomic awareness and safe work practices will be essential in ultimately reducing injuries and illnesses, and involving employees in this training will improve the interest and quality of the training
B. All supervisors and employees will be educated on the early signs and symptoms of ergonomic injury and illness..
C. Further ergonomics training will be conducted for all "at risk" employees and supervisors, and will include specific information on the hazards associated with their jobs, reporting procedures, the risks of developing cumulative trauma disorders, symptoms of exposure, and how to prevent the occurrence of cumulative trauma disorders. The supervisor’s training program will also be implemented to allow recognition of the signs of cumulative trauma disorders and to reinforce the ergonomics program. After training is completed, supervisors will provide regular feedback on work practices to their employees.
D. The training program will be conducted by a qualified health care provider.
V. Medical management
A. A medical management program will be established under the guidance of an appropriately qualified health professional. Appropriately trained health care providers will be available at all times, and on an ongoing basis as required. They will be knowledgeable in the prevention, early recognition, evaluation, treatment and rehabilitation of CTDs, and in the principles of ergonomics, physical assessment of employees, and OSHA recordkeeping requirements.
B. Program health care providers will conduct monthly, systematic workplace walk-through to remain knowledgeable about operations and work practices, identify risk factors for CTDs in the workplace, identify potential light duty jobs, and maintain close contact with employees. Findings and recommendations will be documented and reported to the safety committee as soon as possible after the walk-through is completed.
C. Program managers will develop a symptoms survey to measure the extent of symptoms of work-related disorders for each area of the plant, to determine which jobs are exhibiting problems and to measure progress of the ergonomic program. Body diagrams should be used to facilitate the gathering of this information. Employee identities and medical records, including surveys will remain confidential.
D. All employees who report pain or other symptoms possibly related to musculoskeletal disorders will be promptly evaluated by a health care provider, and appropriate treatment and follow-up will be provided.
E. Where an employee states that the injury or illness is work-related, and the case otherwise meets the criteria for recording, the case will be entered on the OSHA log pending final determination of the cause.
E. The employee will be monitored until he or she is able to perform work without restrictions. The idea is to detect any problem as early as possible to reduce the severity of the injury and associated costs.
F. The program health care provider will compile a list of light duty jobs with the lowest ergonomic risk. For such jobs, ergonomic risk(s) will be described.
G. New and current employees who are assigned to at risk jobs or tasks will be given a baseline survey by the health care provider to establish a base against which changes in health status can be evaluated. The baseline survey is not for the purpose of precluding people from performing particular jobs.
VI. Program Evaluation
A. The Ergonomics Protection Program will be evaluated by the program manager and safety committee annually for its ability to identify, assess, and eliminate ergonomic hazards in the workplace. Reductions in ergonomics related injuries and illness should ideally be experienced soon after the program is implemented.
B. Findings of the evaluation will be reported directly to the CEO.
Certification _____________________________ ______________________
Reviewed by (Signature) Date
_______________________________ ______________________
Approved by (Signature) Date
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Sample Ergonomic Hazard Analysis
The following is an example of a checklist to aid in an ergonomic hazard analysis of a specific job or workstation. It is designed to be used as a supplement to close visual observation or videotaping of the job/workstation.
Person performing analysis _________ Date ________ Job location ______ Bldg ____ Floor _______
Job name __________________ Department _________________Job description____________________
Number of employees on job _________ line speed ____________ (pieces/minute)
Jobs rotated with ____________ Rotation schedule _____________ Break schedule ________________
Workstation:
____ 1. Are there any sharp edges?
____ 2. What is the height of the work table? __________________
____ 3. Adjustability:
____ Can tools be moved around in the workplace?
____ Can the work surface height be adjusted vertically?
____ Can fixtures be tilted or rotated?
____ 4. What is the worker standing on? ______________________________
(e.g., grate, mat, concrete floor)
____ 5. Is the floor or platform slippery? _______________
Postural
____ 1. Can worker change postures (sit-to-stand or stand-to-sit)?
____ 2. What are the maximum reach distances in inches? Vertical ___ Horizontal ___
Tools
____ 1. Name of tool ______________________
____ 2. Type: Torque ______ reciprocating or vibrating _________ Other ___________
____ 3. What is the weight of the tool? ____________ lbs.
____ 4. Size of the handle: Span ____ inches, length ____ inches material _________
____ 5. What is the source of power? _____________ (e.g., air, electric)?
____ 6. If air, is the exhaust away from the hand? _____________
____ 7. Is the tool counterbalanced? ____________
Manual or hand tools
____ 1. Name of tool _____________________
____ 2. Weight ____________ lbs.
____ 3. Size of the handle: Span ____ inches, length ____ inches material _________
____ 4. Is there a place for tools in the workplace? ___________ (e.g., holster, fixture)
Miscellaneous
____ 1. Are other objects or materials handled? _________
____ 2. What are they and what do they weigh? Name _____ Weight ________lbs.
____ 3. What is the temperature of the work environment? _______ degrees (C./F.)
____ 4. What personal protective equipment is used ?______ (e.g., gloves, hard hats, aprons)
____ 5. Can the worker stop or control line speed?
____ 6. Are there opportunities for micro rest pauses? If so, how many seconds? ______
____ 7. Estimate exertion or effort required to do the job (1 to 5) ____ 1=low, 5=high
Ergonomic Protection Program Audit
Written Program
____ 1. Has a written ergonomics program been established?
____ 2. Is there a person assigned to manage the program?
Survey
____ 1. Are ergonomic surveys being conducted according to a regular schedule?
____ 2. Do surveys determine the presence of ergonomic related injuries and illnesses: for example, musculoskeletal injuries to the neck, back, shoulders, arms, hands, fingers?
____ 3. Are copies of survey being maintained?
Company procedures
____ 1. Are managers, supervisors, and all employees who may be exposed to hazardous ergonomic conditions knowledgeable of signs and symptoms of CTD?
____ 2. Does your employer have procedures for employees who report pain or other signs and symptoms related to ergonomic injury or illness?
____ 3. Are supervisors instructed on procedures when employees report pain or other symptoms of ergonomic injury or illness?
____ 4. Are employee reports of pain or other symptoms of ergonomic injury or illness being recorded?
____ 5. Are incentive programs in place that deter employees from reporting problems?
Evaluation
____ 1. Are the company’s injury and illness logs evaluated on a regular basis for evidence of ergonomic related injuries and illnesses?
____ 2. Is the information gathered from evaluating logs used to identify, assess and control ergonomic hazards?
____ 3. Is there an effective medical protocol for evaluating and treating employees for complaints of upper extremity discomfort or back pain?
____ 4. Are trained health care providers available to diagnose and treat early stages of CTD?
____ 5. Following early detection of CTD symptoms or treatment, is the amount of time prescribed or allowed off work, and/or allotted for restricted activity, appropriate?
Treatment procedures
____ 1. Are medical restrictions being followed?
____ 2. Have ergonomic hazard analyses been conducted for all alternative work assignments (e.g., light or restricted duty jobs) for CTD potential?
____ 3. Are health care providers familiar with the jobs being used for alternative work assignments.
____ 4. Is job reassignment appropriate so as not to further exacerbate the condition or create another condition?
____ 5. Does your employer document all instances where a reassignment did not help or actually worsen the CTD with explanation for the reason.
____ 6. Do health care providers track and follow up the symptom process of all reassigned and/or treated employees?
____ 7. Are appointments made for follow-up required and kept?
____ 8. Has any decrease in employee pay or loss of overtime been an impediment to timely medical care resulting in CTD surgery.
Application of controls
____ 1. Is your employer installing engineering controls: such as, equipment replacement or redesign.
____ 2. Is your employer implementing administrative controls: such as, job rotation, rest periods, etc.
____ 3. Are control strategies effective in reducing the incidence of ergonomic related injuries and illnesses?
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Ergonomics Case Study
Source: OSHA
The Dow Chemical Company's
Use of the "Six Sigma" Methodology
May 15, 2004
The Problem
Reducing Musculoskeletal Disorders:
Ergonomics-related injuries, including musculoskeletal disorders (MSDs) caused by repetitive strains, continue to be a serious problem for employers. In 2002, ergonomics-related injuries accounted for a third of all workplace injuries involving missed work time, with an average absence of nine days per injury. The resulting worker injury claims and loss of productivity are estimated to cost $13 to $20 million per year for U.S. employers. As computer workstation users spend more and more time at desktops, the risk of MSDs occurring has increased. Yet, as illustrated below, in many companies there are inherent difficulties and concerns associated with addressing this increased ergonomics risk.
For example, Tricia, the Environmental, Health and Safety (EH&S) Leader for the Specialty Chemicals Business of The Dow Chemical Company, wants to reduce MSDs among computer workstation users throughout her business’ various divisions and operations. Before she can understand what changes to make in either the workstations or the work practices in those divisions, she must identify the root causes of MSDs among the operators. Although she has some theories, Tricia does not know for sure what factors are causing or contributing to the employees’ MSD complaints. Only by knowing the root causes can she implement with confidence controls that would achieve positive results.
Tricia also suspects, but is not sure, that many of the root causes of MSDs are the same across the different operations and divisions in her business. Because of constraints on both her budget and time, Tricia would like to design one basic program that is flexible enough to implement company-wide. She also knows that any reductions achieved under the new program must be sustained over the long term, and she is concerned that over time employees and managers will "backslide" on their commitment to the program and return to their ergonomically risky behaviors.
Fortunately for Tricia, she could refer to a similar project successfully undertaken by the Design and Construction function of The Dow Chemical Company, which is discussed in the case study below. This project, which utilized a problem-solving methodology called "Six Sigma," offered an innovative way to address Tricia’s concerns for the development and implementation of a sustainable program to reduce MSDs throughout her business.
The Solution
The Dow Chemical Company’s Innovative Use of "Six Sigma":
Avoiding ergonomics-related injuries is an important component of The Dow Chemical Company’s ("Dow" or "the Company") overall emphasis on safety and health. Dow is a science and technology company that develops, manufactures and provides various chemical, plastic and agricultural products and services for customers in over 180 countries. In 1994, Dow adopted a set of voluntary 10-year EH&S goals to dramatically improve the Company’s performance by 2005. These goals call for a reduction in the Company’s reportable injury and illness rate by 90 percent to 0.24.
In 2000, the company identified an opportunity to improve its injury rate within the Dow Design and Construction business unit. Dow Design and Construction ("DDC") is responsible for managing the design and construction of Dow’s facilities worldwide. Because DDC’s approximately 1,250 workers (including employees and contractors) work primarily at desktop workstations, where they spend the majority of their time working at computer keyboards, they were increasingly susceptible to ergonomics injuries. While the rate of ergonomics-related injuries among the DDC workers was low (only three were reported in 1999), the Company chose to make proactive improvements before ergonomic injuries increased in number or severity.
Dow’s EH&S function decided to address ergonomic injuries at DDC using the "Six Sigma" problem solving methodology. Six Sigma is a disciplined, process-oriented approach to problem solving, adopted by Dow and many other companies, which emphasizes the reduction of defects in processes, products and services by applying a four-step improvement methodology. Because Six Sigma emphasizes sustainable results over short-term fixes, Dow has found it particularly useful for EH&S projects. Following the steps prescribed under Six Sigma, Dow developed a Six Sigma project team, which first defined the primary contributing factors to MSDs in the DDC function, and then sought to reduce the those factors by 70 percent. While each of the four steps of the Six Sigma project are outlined below, a more detailed discussion of the Six Sigma methodology appears at the end of this case study.
Step 1: Measure
Once the Six Sigma project team developed its charter and defined its task, it then began by defining the current process. First, the team outlined the sequence of events from workstation assignment to task performance and potential injury. They next identified a series of key variables affecting the process outcome that included:
• user attributes (such as daily time at workstations);
• user behaviors (including posture, force, and duration of use); and
• environmental factors.
In this phase of the Six Sigma method, the "defect" – a measurable outcome of the process for which improvement is desired – is defined. While the true "defect" for this process would be the occurrence of an ergonomic injury, there were so few at the start of the project that measuring a statistically significant improvement was going to be difficult. Therefore, the key process variables identified were taken as the "defect," and a goal of 70% improvement (reduction) in the baseline level was set for the project. Scored surveys of DDC workstation users were developed and conducted on the variables identified and used to measure the baseline defect level.
Step 2: Analyze
Accurately identifying the root causes of a problem, which in turn leads to more effective improvements, is an essential function of the Six Sigma methodology. Therefore, the project team next analyzed the collected survey data to determine differences in the workstations, work environments, user training, and behavior at the different DDC sites. The team then identified possible root causes underlying these variables using several of the Six Sigma tools and methodologies, including brainstorming, ‘fishbone’ diagramming, a work performance matrix, and Antecedent-Behavior-Consequence and Balance of Consequences analyses. After developing a list of possible root causes, the team used additional Six Sigma tools and methodologies to identify probable root causes and validate them. For example, one possible root cause identified was a failure of the employee to recognize the importance of ergonomics compliance to his or her personal well-being. This root cause was validated by the employee survey, in which many of the employees expressed an attitude of "it won't happen to me."
Other key root causes validated through this process were the lack of adjustable furniture at some worksites and a lack of "ownership" in personal safety on the part of the employee. The team also determined that ergonomics was not emphasized by DDC to the same extent as other, more immediate, safety issues such as the use of personal protective equipment in hazardous environments.
Step 3: Improve
After determining the most significant root causes through analysis and validation, the project team developed a series of improvements to correct the identified root causes, including both work-related and personal risk factors. Workstation deficiencies were easily addressed by implementing a workstation upgrade plan. Elevating workstation ergonomics to the same level of importance as other personal safety and health issues was a more challenging improvement. However, the team elevated the focus on workstation ergonomics by improving awareness on the part of management and employees and by altering employee behavior and work habits through increased accountability.
The project team developed a novel approach to raising employee awareness by collecting a series of personal testimonials from other employees and posting them on the Company’s intranet site. These testimonials were supplemented by more traditional communications, including regular work group safety meetings, training, and increased ergonomics resources. At each facility, the company also designated Ergonomic Focal Points and Ergonomic Contacts, DDC workers who volunteered to receive specialized training and be available as a first point of contact for ergonomic concerns and questions. The team addressed employee behavior by providing feedback to individuals, creating a specific channel for early reporting of discomfort, and developing a health assessment program to address the early warning signs of potential MSDs. Employee personal accountability was addressed by implementing a "Safety First" mentality that stressed ergonomics as a key issue in personal safety and not a separate stand-alone topic.
These improvements are not static, but are a part of an ongoing ergonomics safety and health process. For example, while furniture improvements have been implemented, it is understood that the workstations will continually evolve to meet the employees’ changing needs.
Step 4: Control
After the immediate improvements were implemented, the project team developed a long-term control plan designed to sustain the achievements. The control plan took the sequence of events which might contribute to an injury, as outlined in the Measure step, and added a series of performance standards, measures, responsibilities, and contingency plans. For example, in the original sequence, an employee was instructed to attend ergonomics training when starting a job, but there was no control measure to ensure this took place. Under the control plan, the employee is now required to attend the training within 30 days of job assignment, and the designated Ergo Contact at the job site is alerted and follows up with the employee if the employee fails to attend within that timeframe. Each step in the sequence has a similar control, ensuring that the improved process is followed long after the conclusion of the project.
Results of the Project:
DDC made immediate improvements in the identified risk factors, which have been reduced 64% since the baseline measurement and by more than 45% overall. These improvements have been well received by the DDC’s management and workers, and employees are proactive in addressing discomfort and have a better understanding of the personal benefits of ergonomics. As improvements like these have been repeated throughout the Company, the severity of ergonomics injuries has declined. In 2001, 53% of the Company's ergonomic injuries resulted in lost work time or advanced medical treatment. However, in 2003, only 30% of ergonomic injuries were this severe; the remaining 70% of cases required only first aid or precautionary measures. This result, in turn, has contributed to Dow’s 2005 goal of reducing the Company’s reportable injury and illness rate by 90 percent to 0.24.
Moreover, by virtue of the Six Sigma Methodology’s emphasis on long-term control, the project has developed an ongoing process that will help the DDC sustain its immediate results and continue to improve. The positive results of this project have been shared with Tricia and other EH&S managers at other business units, leading to similar projects throughout the company.
Dow believes that using Six Sigma for EH&S projects such as these enables employers to develop program improvements based on measurement and analysis, rather than speculation, resulting in a more cost-efficient and sustainable fix that will yield benefits indefinitely. Rather than undertaking costly trial and error attempts at solutions, the Company was able to identify the root causes of ergonomic injuries with confidence and make improvements to the ergonomics program in a systematic and sustainable way.
Sidebar: Six Sigma Methodology
The Greek letter sigma (s) is used in mathematics to represent standard deviation, or how much a process varies from its average value. Under the Six Sigma methodology, deficiencies are described in terms of "defects" per million opportunities, with the score of 6s equal to 3.4 defects per million opportunities. Six Sigma uses the following four-step process known as MAIC (Measure, Analyze, Improve, Control) to significantly reduce defects in processes, products, and/or services:
Step 1: Measure - clearly define the process to be improved and the "defect" for the project, and identify a clear and appropriate measure for the "defect"
Step 2: Analyze - determine the root causes of the defect
Step 3: Improve - develop solutions to address the root causes and validate process improvement
Step 4: Control - implement a long-term strategy to ensure that the improvements are sustained.
The methodology can be applied to any process that allows the measurement of benefits and improvements in defect reduction, whether in the manufacture of a product, the delivery of a service, the control of costs, or the management of injuries and illnesses.
Dow has adopted the Six Sigma methodology to accelerate the company’s improvement in quality and productivity. Dow has expanded the use of the Six Sigma approach to help manage aspects of the Company’s operations beyond production and quality, including the safety and health of its workforce. Some of the projects to which Dow has applied the Six Sigma methodology include:
• reduction of repetitive stress injuries;
• reduction of motor vehicle accidents;
• improved safety for visitors (especially contractors);
• site logistics risk reduction; and
• off-the-job safety process improvement.
These projects have been key components of Dow’s 2005 Environmental, Health and Safety Goals, which include reducing Dow's reportable injury and illness rate by 90% to 0.24.
As the example in our case study illustrates, Dow’s Environmental Health and Safety (EHS) function has found the Six Sigma methodology particularly useful in identifying and validating root causes that are hard to discern because of their subjectivity, and in focusing improvements to an ergonomics program in ways that caused measurable improvements. Moreover, since the Six Sigma process includes implementation of controls to ensure that achievements are sustained over a long-term period, the Company expects to realize the benefits of its efforts for years to come.
References
1 March 2004 U.S. Department of Labor News Release regarding Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses.
2 "A Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and Low Back," The National Institute for Occupational Safety and Health.
3 This case study was developed from information provided by Karen Kearns, Industrial Hygiene Specialist, and Mark Spence, Manager, North American Health and Safety Regulatory Affairs, The Dow Chemical Company.
This product was funded under GS 35F 5544H for the U.S. Department of Labor, Occupational Safety and Health Administration. The views expressed herein do not necessarily represent the official position or policy of the U.S. Department of Labor.
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Ergonomics Questions and Answers
What is an "ergonomic injury?
Input from the recent ergonomics forums demonstrated to OSHA that there are a wide variety of opinions on how the Agency should define an ergonomic injury and that the definition adopted by OSHA depends on the context. Ergonomic injuries are often described by the term "musculoskeletal disorders" or "MSDs." This is the term of art in scientific literature that refers collectively to a group of injuries and illnesses that affect the musculoskeletal system; there is no single diagnosis for MSDs. As OSHA develops guidance material for specific industries, the agency may narrow the definition as appropriate to address the specific workplace hazards covered. OSHA will work closely with stakeholders to develop definitions for MSDs as part of its overall effort to develop guidance materials.
Are all MSDs work-related?
No. MSDs can and do develop outside the workplace.
How do you determine whether MSDs are work-related?
The determination of whether any particular MSD is work-related may require the use of different approaches tailored to specific workplace conditions and exposures. Broadly speaking, establishing the work-relatedness of a specific case may include:
-- taking a careful history of the patient and the illness;
-- conducting a thorough medical examination; and
-- characterizing factors on and off the job that may have caused or contributed to the MSD.
Why aren't you doing another rule?
Congress passed, and the President signed, Senate Joint Resolution 6, which rescinded the original ergonomics rule, and under the Congressional Review Act, prohibits the agency from issuing a rule that is substantially the same as the former one.
There are a number of reasons why guidelines are preferable to doing a rule. OSHA must follow certain criteria in doing a rule - any rule. In terms of ergonomics, there are factors that make doing a rule very difficult:
• There are a variety of different hazards and combinations of different hazards to be addressed;
• Exposure to the hazards is not readily measured in some cases;
• The exposure-response relationship is not well understood;
• Cost and feasibility of abatement measures may be uncertain and may be very high in some cases; and
• It is very difficult, except in the most general terms, to prescribe remedies for abating such hazards in a single rule.
These considerations make it very difficult to develop simple criteria for compliance that can apply to a broad range of industries.
On the other hand, industry and task specific guidelines can be developed more quickly and are more flexible, and can provide specific and helpful guidance for abatement to assist employees and employers in minimizing injuries. Guidelines are the most effective method available for reducing injuries quickly.
How do you expect OSHA's guidelines to reduce injuries and illnesses related to MSDs?
Injuries and illnesses related to MSDs have consistently declined over the last 10 years, even though there has not been a standard addressing them. Guidelines, such as OSHA's Meatpacking Guidelines, and voluntary industry efforts have been successful in reducing the injury and illness rates for these disorders. For example, on a national basis, rates for carpal tunnel injuries with days away from work have gone down by 39 percent from 1992 to 1999. For the same time period, rates for strains and sprains with days away from work have also gone down by 39 percent, and rates for back injuries with days away from work have gone down by 45 percent. In the meatpacking industry, with industry-specific guidelines and focused OSHA enforcement, rates of carpal tunnel injuries with days away from work have gone down 47 percent from 1992 to 1999. Over the same time period, rates of strains and sprains with days away from work have gone down by 61 percent, and rates for back injuries with days away from work have gone down by 64 percent. OSHA expects that industry-or-task-specific guidelines will further reduce injuries and illnesses as they are completed and implemented. OSHA's VPP (Voluntary Protection Program) participants, who have implemented safety and health programs, have injury and illness rates 53 percent below the average for their respective SIC codes.
What is a guideline and how does it differ from a standard?
A guideline is a tool to assist employers in recognizing and controlling hazards. It is voluntary. Failure to implement a guideline is not itself a violation of the General Duty Clause of the OSH Act. Guidelines that OSHA develops will provide information to help employers identify ergonomic hazards in their workplaces and implement feasible measures to control those hazards.
Guidelines are more flexible than standards. They can be developed quickly and can be changed easily as new information becomes available with scientific advances. Guidelines make it easier for employers to adopt innovative programs to suit their workplaces, rather than inflexible, one-size-fits-all solutions to issues that may be unique to the industry or facility.
Does having guidelines mean that OSHA is excluding a regulatory approach in the future?
OSHA will regularly review the injury and illness rates for MSDs and make decisions based on the best-available information about what approach to take to protect workers from MSDs. OSHA believes that guidelines currently offer the best method of continuing to bring down injury and illness rates for MSDs.
What industries will these guidelines cover?
OSHA will develop industry-or-task-specific guidelines for a select number of industries, taking into account injury and illness incidence rates as well as available information on what is known to work. These guidelines will be developed with input from others. As industry-or-task-specific guidelines are drafted, we will make public announcements and share the information as broadly as possible.
Will the guidelines cover agriculture, construction and maritime?
Guidelines offer the flexibility to go beyond general industry. The previous administration's ergonomics standard was limited in scope to general industry. In addition to the industry-specific guidelines that OSHA plans to develop, the agency will encourage other industries to develop their own guidelines to reduce MSDs.
Will OSHA use the new guidelines as a basis for enforcement?
No. An employer's failure to implement the new guidelines will not be a violation of the General Duty Clause of the OSH Act. Rather, OSHA intends that the guidelines will provide information to help employers identify ergonomic hazards in their workplaces and implement feasible measures to control such hazards. For this reason, OSHA anticipates that there would likely be no basis for a Section 5(a)(1) citation for employers with ergonomic hazards who effectively implement the ergonomics guidelines or other appropriate measures. OSHA will not be focusing its enforcement efforts on employers who have implemented effective ergonomic programs or who are making good-faith efforts to reduce ergonomic hazards.
What if I am an employer in an industry for which OSHA does not develop industry-specific guidelines?
Even if there are no guidelines specific to your industry, as an employer you still have an obligation under the General Duty Clause, Section 5(a)(1) to keep your workplace free from recognized serious hazards, including ergonomic hazards. OSHA will cite for ergonomic hazards under the General Duty Clause or issue ergonomic hazard letters where appropriate as part of its overall enforcement program. OSHA encourages employers where necessary to implement effective programs or other measures to reduce ergonomic hazards and associated MSDs. A great deal of information is currently available from OSHA, NIOSH, and various industry and labor organizations on how to establish an effective ergonomics program, and OSHA urges employers to avail themselves of these resources.
Does this mean OSHA will not use the General Duty Clause to cite for ergonomic hazards?
OSHA will use the General Duty Clause to cite employers for ergonomic hazards. Under the OSH Act's General Duty Clause, employers must keep their workplaces free from recognized serious hazards, including ergonomic hazards. This requirement exists whether or not there are voluntary guidelines.
What will the OSHA enforcement program entail?
OSHA has been assessing MSD-related issues in complaints, referrals, and targeted inspections. OSHA will continue to evaluate the findings of its inspections and issue General Duty Clause citations or hazard alert letters for ergonomics hazards where appropriate. OSHA will do the same when responding to worker complaints.
OSHA will conduct inspections for ergonomic hazards and issue citations under the General Duty Clause and issue ergonomic hazard alert letters where appropriate. OSHA will conduct follow-up inspections or investigations within 12 months of certain employers who receive ergonomic hazard alert letters.
OSHA will initiate a National Emphasis Program in the nursing home industry to guide inspections of nursing homes, and to focus significant effort on addressing ergonomic hazards related to patient lifting.
OSHA will conduct specialized training of appropriate staff on ergonomic hazards and abatement methods and designate 10 regional ergonomic coordinators and involve them in enforcement and outreach.
What about construction?
Where appropriate in the construction industry, OSHA will continue to evaluate MSD-related issues through targeted inspections and response to worker complaints.
Will OSHA notify employers who have high rates of MSDs?
Yes. As an adjunct to the Site Specific Targeting (SST), OSHA annually notifies employers in the OSHA Data Initiative who report high Lost Workday Injury and Illness rates at their establishment(s), and recommends that they seek assistance in addressing these workplace hazards. If employers report high rates of injuries which in some cases may be related to ergonomic issues, they will also be urged to seek assistance to address those hazards.
________________________________________________________________________________________
Area III D: Toxicology
NATIONAL LIBRARY OF MEDICINE
TOXICOLOGY TUTOR I
Toxicology Tutor I is the first in a set of three tutorials on toxicology produced by the Toxicology and Environmental Health Information Program of the National Library of Medicine, U.S. Department of Health and Human Services. It covers Basic Principles of toxicology and is written at the introductory college student level. The Toxicology Tutors are intended to provide a basic understanding of toxicology as an aide for users of toxicology literature contained in the National Library of Medicine's Chemical and Toxicological databases. Toxicology Tutor II covers Toxicokinetics while Toxicology Tutor III will pertain to Cellular Effects and Biochemistry.
What is Toxicology?
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The traditional definition of toxicology is "the science of poisons." As our understanding of how various agents can cause harm to humans and other organisms, a more descriptive definition of toxicology is "the study of the adverse effects of chemicals or physical agents on living organisms".
These adverse effects may occur in many forms, ranging from immediate death to subtle changes not realized until months or years later. They may occur at various levels within the body, such as an organ, a type of cell, or a specific biochemical. Knowledge of how toxic agents damage the body has progressed along with medical knowledge. It is now known that various observable changes in anatomy or body functions actually result from previously unrecognized changes in specific biochemicals in the body.
The historical development of toxicology began with early cave dwellers who recognized poisonous plants and animals and used their extracts for hunting or in warfare. By 1500 BC, written recordings indicated that hemlock, opium, arrow poisons, and certain metals were used to poison enemies or for state executions.
With time, poisons became widely used and with great sophistication. Notable poisoning victims include Socrates, Cleopatra, and Claudius. By the time of the Renaissance and Age of Enlightenment, certain concepts fundamental to toxicology began to take shape. Noteworthy in this regard were the studies of Paracelsus (~1500AD) and Orfila (~1800 AD).
Paracelsus determined that specific chemicals were actually responsible for the toxicity of a plant or animal poison. He also documented that the body's response to those chemicals depended on the dose received. His studies revealed that small doses of a substance might be harmless or beneficial whereas larger doses could be toxic. This is now known as the dose-response relationship, a major concept of toxicology. Paracelsus is often quoted for his statement: "All substances are poisons; there is none which is not a poison. The right dose differentiates a poison and a remedy."
Orfila, a Spanish physician, is often referred to as the founder of toxicology. It was Orfila who first prepared a systematic correlation between the chemical and biological properties of poisons of the time. He demonstrated effects of poisons on specific organs by analyzing autopsy materials for poisons and their associated tissue damage.
The 20th century is marked by an advanced level of understanding of toxicology. DNA (the molecule of life) and various biochemicals that maintain body functions were discovered. Our level of knowledge of toxic effects on organs and cells is now being revealed at the molecular level. It is recognized that virtually all toxic effects are caused by changes in specific cellular molecules and biochemicals.
Xenobiotic is the general term that is used for a foreign substance taken into the body. It is derived from the Greek term xeno which means "foreigner." Xenobiotics may produce beneficial effects (such as a pharmaceuticals) or they may be toxic (such as lead).
As Paracelsus proposed centuries ago, dose differentiates whether a substance will be a remedy or a poison. A xenobiotic in small amounts may be non-toxic and even beneficial but when the dose is increased, toxic and lethal effects may result.
Some examples that illustrate this concept are:
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The development of Toxicology Tutor was based on the concepts presented in the University of Maryland's introductory course on toxicology, Essentials of Toxicology. These basic principles of toxicology are similar to those taught in other major university programs and are well described in the literature. The volume of literature and textbooks pertaining to toxicology is quite extensive and a listing of all the excellent textbooks is beyond the scope of this tutorial.
While other references were selectively used, the textbooks listed below have served as the primary resources for this tutorial. They are quite comprehensive and among those texts widely used in basic toxicology training courses.
[pic] [pic]
Casarett and Doull's Toxicology (C. Klaassen, M. Amdur, and J. Doull, eds.)
Principles and Methods of Toxicology (A. W. Hayes, ed.)
Basic Environmental Toxicology (L. Cockerham and B. Shane, eds.)
Industrial Toxicology (P. Williams and J. Burson, eds.)
Dose
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Dose by definition is the amount of a substance administered at one time. However, other parameters are needed to characterize the exposure to xenobiotics. The most important are the number of doses, frequency, and total time period of the treatment.
For example:[pic] [pic]
• 650 mg Tylenol as a single dose[pic]
• 500 mg Penicillin every 8 hours for 10 days[pic]
• 10 mg DDT per day for 90 days[pic]
There are numerous types of doses, e.g., exposure dose, absorbed dose, administered dose and total dose.
[pic]
Fractionating a total dose usually decreases the probability that the total dose will cause toxicity. The reason for this is that the body often can repair the effect of each subtoxic dose if sufficient time passes before receiving the next dose. In such a case, the total dose, harmful if received all at once, is non-toxic when administered over a period of time. For example, 30 mg of strychnine swallowed at one time could be fatal to an adult whereas 3 mg of strychnine swallowed each day for ten days would not be fatal.
The units used in toxicology are basically the same as those used in medicine. The gram is the standard unit. However, most exposures will be smaller quantities and thus the milligram (mg) is commonly used. For example, the common adult dose of Tylenol is 650 milligrams.
The clinical and toxic effects of a dose must be related to age and body size. For example, 650 mg is the adult dose of Tylenol. That would be quite toxic to young children, and thus Children's Tylenol tablets contain only 80 mg. A better means to allow for comparison of effectiveness and toxicity is the amount of a substance administered on a body weight basis. A common dose measurement is mg/kg which stands for mg of substance per kg of body weight.
Another important aspect is the time over which the dose is administered. This is especially important for exposures of several days or for chronic exposures. The commonly used time unit is one day and thus, the usual dosage unit is mg/kg/day.
Since some xenobiotics are toxic in much smaller quantities than the milligram, smaller fractions of the gram are used, such as microgram (µg). Other units are shown below:
[pic]
Environmental exposure units are expressed as the amount of a xenobiotic in a unit of the media.[pic] [pic] [pic]
• mg/liter (mg/l) for liquids[pic]
• mg/gram (mg/g) for solids[pic]
• mg/cubic meter (mg/m3) for air[pic]
Smaller units are used as needed, e.g., µg/ml. Other commonly used dose units for substances in media are parts per million (ppm), parts per billion (ppb) and parts per trillion (ppt).
Dose Response
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The dose-response relationship is a fundamental and essential concept in toxicology. It correlates exposures and the spectrum of induced effects. Generally, the higher the dose, the more severe the response. The dose-response relationship is based on observed data from experimental animal, human clinical, or cell studies.
Knowledge of the dose-response relationship:[pic] [pic] [pic]
• establishes causality that the chemical has in fact induced the observed effects[pic]
• establishes the lowest dose where an induced effect occurs - the threshold effect[pic]
• determines the rate at which injury builds up - the slope for the dose response.
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[pic] [pic] [pic]
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Within a population, the majority of responses to a toxicant are similar; however, a wide variance of responses may be encountered, some individuals are susceptible and others resistant. As demonstrated above, a graph of the individual responses can be depicted as a bell-shaped standard distribution curve.
[pic] [pic] [pic]
[pic]
[pic]
Dose responses are commonly presented as mean + 1 S.D. (standard deviation), which incorporates 68% of the individuals. The variance may also be presented as two standard deviations, which incorporates 95% of the responses. A large standard deviation indicates great variability of response. For example, a response of 15+8 mg indicates considerably more variability than 15+2 mg.
[pic] [pic] [pic]
[pic]
[pic]
The dose-response curve normally takes the form of a sigmoid curve. It conforms to a smooth curve as close as possible to the individual data points. For most effects, small doses are not toxic. The point at which toxicity first appears is known as the threshold dose level. From that point, the curve increases with higher dose levels. In the hypothetical curve above, no toxicity occurs at 10 mg whereas at 35 mg 100% of the individuals experience toxic effects.
A threshold for toxic effects occurs at the point where the body's ability to detoxify a xenobiotic or repair toxic injury has been exceeded. For most organs there is a reserve capacity so that loss of some organ function does not cause decreased performance. For example, the development of cirrhosis in the liver may not result in a clinical effect until over 50% of the liver has been replaced by fibrous tissue.
[pic]
[pic]
Knowledge of the shape and slope of the dose-response curve is extremely important in predicting the toxicity of a substance at specific dose levels. Major differences among toxicants may exist not only in the point at which the threshold is reached but also in the percent of population responding per unit change in dose (i.e., the slope). As illustrated above, Toxicant A has a higher threshold but a steeper slope than Toxicant B.
Dose Estimates of Toxic Effects
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Dose-response curves are used to derive dose estimates of chemical substances. A common dose estimate for acute toxicity is the LD50 (Lethal Dose 50%). This is a statistically derived dose at which 50% of the individuals will be expected to die. The figure below illustrates how an LD50 of 20 mg is derived.
[pic]
[pic]
Other dose estimates also may be used. LD0 represents the dose at which no individuals are expected to die. This is just below the threshold for lethality. LD10 refers to the dose at which 10% of the individuals will die.
For inhalation toxicity, air concentrations are used for exposure values. Thus, the LC50 is utilized which stands for Lethal Concentration 50%, the calculated concentration of a gas lethal to 50% of a group. Occasionally LC0 and LC10 are also used.
Effective Doses (EDs) are used to indicate the effectiveness of a substance. Normally, effective dose refers to a beneficial effect (relief of pain). It might also stand for a harmful effect (paralysis). Thus the specific endpoint must be indicated. The usual terms are:
[pic]
Toxic Doses (TDs) are utilized to indicate doses that cause adverse toxic effects. The usual dose estimates are listed below:
[pic] [pic] [pic]
[pic]
[pic]
The knowledge of the effective and toxic dose levels aides the toxicologist and clinician in determining the relative safety of pharmaceuticals. As shown above, two dose-response curves are presented for the same drug, one for effectiveness and the other for toxicity. In this case, a dose that is 50-75% effective does not cause toxicity whereas a 90% effective dose may result in a small amount of toxicity.
Therapeutic Index
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The Therapeutic Index (TI) is used to compare the therapeutically effective dose to the toxic dose. The TI is a statement of relative safety of a drug. It is the ratio of the dose producing toxicity to the dose needed to produce the desired therapeutic response. The common method used to derive the TI is to use the 50% dose-response points. For example, if the LD50 is 200 and the ED50 is 20 mg, the TI would be 10 (200/20). A clinician would consider a drug safer if it had a TI of 10 than if it had a TI of 3.
The use of the ED50 and LD50 doses to derive the TI may be misleading as to safety, depending on the slope of the dose-response curves for therapeutic and lethal effects. To overcome this deficiency, toxicologists often use another term to denote the safety of a drug - the Margin of Safety (MOS).
The MOS is usually calculated as the ratio of the dose that is just within the lethal range (LD01) to the dose that is 99% effective (ED99). The MOS = LD01/ED99. A physician must use caution in prescribing a drug in which the MOS is less than 1.
[pic] [pic] [pic]
[pic]
[pic]
Due to differences in slopes and threshold doses, low doses may be effective without producing toxicity. Although more patients may benefit from higher doses, this is offset by the probability that toxicity or death will occur. The relationship between the Effective Dose response and the Toxic Dose response is illustrated above.
[pic]
[pic]
Knowledge of the slope is important in comparing the toxicity of various substances. For some toxicants a small increase in dose causes a large increase in response (toxicant A, steep slope). For other toxicants a much larger increase in dose is required to cause the same increase in response (toxicant B, shallow slope).
NOAEL and LOAEL
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Two terms often encountered are No Observed Adverse Effect Level (NOAEL) and Low Observed Adverse Effect Level (LOAEL). They are the actual data points from human clinical or experimental animal studies.
[pic] [pic]
[pic]
Sometimes the terms No Observed Effect Level (NOEL) and Lowest Observed Effect Level (LOEL) may also be found in the literature. NOELs and LOELs do not necessarily imply toxic or harmful effects and may be used to describe beneficial effects of chemicals as well.
The NOAEL, LOAEL, NOEL, and LOEL have great importance in the conduct of risk assessments.
Toxic Effects
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Toxicity is complex with many influencing factors; dosage is the most important. Xenobiotics cause many types of toxicity by a variety of mechanisms. Some chemicals are themselves toxic. Others must be metabolized (chemically changed within the body) before they cause toxicity.
Many xenobiotics distribute in the body and often affect only specific target organs. Others, however, can damage any cell or tissue that they contact. The target organs that are affected may vary depending on dosage and route of exposure. For example, the target for a chemical after acute exposure may be the nervous system, but after chronic exposure the liver.
Toxicity can result from adverse cellular, biochemical, or macromolecular changes. Examples are:
• cell replacement, such as fibrosis[pic]
• damage to an enzyme system
• disruption of protein synthesis
• production of reactive chemicals in cell
• DNA damage
[pic]
Some xenobiotics may also act indirectly by:
[pic] [pic] [pic]
• modification of an essential biochemical function
• interference with nutrition
• alteration of a physiological mechanism
Factors Influencing Toxicity
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The toxicity of a substance depends on the following:
[pic] [pic] [pic]
• form and innate chemical activity
• dosage, especially dose-time relationship
• exposure route
• species
• age
• sex
• ability to be absorbed
• metabolism
• distribution within the body
• excretion
• presence of other chemicals
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The form of a substance may have a profound impact on its toxicity especially for metallic elements. For example, the toxicity of mercury vapor differs greatly from methyl mercury. Another example is chromium. Cr3+ is relatively nontoxic whereas Cr6+ causes skin or nasal corrosion and lung cancer.
The innate chemical activity of substances also varies greatly. Some can quickly damage cells causing immediate cell death. Others slowly interfere only with a cell's function. For example:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|hydrogen cyanide binds to cytochrome oxidase resulting in cellular hypoxia and rapid|
| |c] |death |
|[pic] |
| |[pi|nicotine binds to cholinergic receptors in the CNS altering nerve conduction and |
| |c] |inducing gradual onset of paralysis |
|[pic] |
The dosage is the most important and critical factor in determining if a substance will be an acute or a chronic toxicant. Virtually all chemicals can be acute toxicants if sufficiently large doses are administered. Often the toxic mechanisms and target organs are different for acute and chronic toxicity. Examples are:
[pic]
Exposure route is important in determining toxicity. Some chemicals may be highly toxic by one route but not by others. Two major reasons are differences in absorption and distribution within the body. For example:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|ingested chemicals, when absorbed from the intestine, distribute first to the liver|
| |c] |and may be immediately detoxified |
|[pic] |
| |[pi|inhaled toxicants immediately enter the general blood circulation and can |
| |c] |distribute throughout the body prior to being detoxified by the liver |
|[pic] |
Frequently there are different target organs for different routes of exposure.
Toxic responses can vary substantially depending on the species. Most species differences are attributable to differences in metabolism. Others may be due to anatomical or physiological differences. For example, rats cannot vomit and expel toxicants before they are absorbed or cause severe irritation, whereas humans and dogs are capable of vomiting.
Selective toxicity refers to species differences in toxicity between two species simultaneously exposed. This is the basis for the effectiveness of pesticides and drugs. Examples are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|an insecticide is lethal to insects but relatively nontoxic to animals |
| |c] | |
|[pic] |
| |[pi|antibiotics are selectively toxic to microorganisms while virtually nontoxic to |
| |c] |humans |
|[pic] |
Age may be important in determining the response to toxicants. Some chemicals are more toxic to infants or the elderly than to young adults. For example:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|parathion is more toxic to young animals |
| |c] | |
|[pic] |
| |[pi|nitrosamines are more carcinogenic to newborn or young animals |
| |c] | |
|[pic] |
Although uncommon, toxic responses can vary depending on sex. Examples are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|male rats are 10 times more sensitive than females to liver damage from DDT |
| |c] | |
|[pic] |
| |[pi|female rats are twice as sensitive to parathion as male rats |
| |c] | |
|[pic] |
The ability to be absorbed is essential for systemic toxicity to occur. Some chemicals are readily absorbed and others poorly absorbed. For example, nearly all alcohols are readily absorbed when ingested, whereas there is virtually no absorption for most polymers. The rates and extent of absorption may vary greatly depending on the form of the chemical and the route of exposure. For example:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|ethanol is readily absorbed from the gastrointestinal tract but poorly absorbed |
| |c] |through the skin |
|[pic] |
| |[pi|organic mercury is readily absorbed from the gastrointestinal tract; inorganic lead|
| |c] |sulfate is not |
|[pic] |
Metabolism, also known as biotransformation, is a major factor in determining toxicity. The products of metabolism are known as metabolites. There are two types of metabolism - detoxification and bioactivation. Detoxification is the process by which a xenobiotic is converted to a less toxic form. This is a natural defense mechanism of the organism. Generally the detoxification process converts lipid-soluble compounds to polar compounds. Bioactivation is the process by which a xenobiotic may be converted to more reactive or toxic forms.
The distribution of toxicants and toxic metabolites throughout the body ultimately determines the sites where toxicity occurs. A major determinant of whether or not a toxicant will damage cells is its lipid solubility. If a toxicant is lipid-soluble it readily penetrates cell membranes. Many toxicants are stored in the body. Fat tissue, liver, kidney, and bone are the most common storage depots. Blood serves as the main avenue for distribution. Lymph also distributes some materials.
The site and rate of excretion is another major factor affecting the toxicity of a xenobiotic. The kidney is the primary excretory organ, followed by the gastrointestinal tract, and the lungs (for gases). Xenobiotics may also be excreted in sweat, tears, and milk.
A large volume of blood serum is filtered through the kidney. Lipid-soluble toxicants are reabsorbed and concentrated in kidney cells. Impaired kidney function causes slower elimination of toxicants and increases their toxic potential.
The presence of other chemicals may decrease toxicity (antagonism), add to toxicity (additivity), or increase toxicity (synergism or potentiation) of some xenobiotics. For example:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|alcohol may enhance the effect of many antihistamines and sedatives |
| |c] | |
|[pic] |
| |[pi|antidotes function by antagonizing the toxicity of a poison (atropine counteracts |
| |c] |poisoning by organophosphate insecticides) |
Systemic Toxic Effects
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Toxic effects are generally categorized according to the site of the toxic effect. In some cases, the effect may occur at only one site. This site is referred to as the specific target organ. In other cases, toxic effects may occur at multiple sites. This is referred as systemic toxicity. Following are types of systemic toxicity:
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| |[pic] |Acute Toxicity |
|[pic] |
| |[pic] |Subchronic Toxicity |
|[pic] |
| |[pic] |Chronic Toxicity |
|[pic] |
| |[pic] |Carcinogenicity |
|[pic] |
| |[pic] |Developmental Toxicity |
|[pic] |
| |[pic] |Genetic Toxicity (somatic cells) |
|[pic] |
Acute Toxicity
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Acute toxicity occurs almost immediately (hours/days) after an exposure. An acute exposure is usually a single dose or a series of doses received within a 24 hour period. Death is a major concern in cases of acute exposures. Examples are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|In 1989, 5,000 people died and 30,000 were permanently disabled due to exposure to |
| |c] |methyl isocyanate from an industrial accident in India. |
|[pic] |
| |[pi|Many people die each year from inhaling carbon monoxide from faulty heaters. |
| |c] | |
|[pic] |
Non-lethal acute effects may also occur, e.g., convulsions and respiratory irritation.
Subchronic Toxicity
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Subchronic toxicity results from repeated exposure for several weeks or months. This is a common human exposure pattern for some pharmaceuticals and environmental agents. Examples are:
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|ic|c] | |
|] | | |
| |[pi|Ingestion of coumadin tablets (blood thinners) for several weeks as a treatment for |
| |c] |venous thrombosis can cause internal bleeding. |
|[pic] |
| |[pi|Workplace exposure to lead over a period of several weeks can result in anemia. |
| |c] | |
|[pic] |
Chronic Toxicity
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Chronic toxicity represents cumulative damage to specific organ systems and takes many months or years to become a recognizable clinical disease. Damage due to subclinical individual exposures may go unnoticed. With repeated exposures or long-term continual exposure, the damage from these subclinical exposures slowly builds-up (cumulative damage) until the damage exceeds the threshold for chronic toxicity. Ultimately, the damage becomes so severe that the organ can no longer function normally and a variety of chronic toxic effects may result.
Examples of chronic toxic affects are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|cirrhosis in alcoholics who have ingested ethanol for several years |
| |c] | |
|[pic] |
| |[pi|chronic kidney disease in workmen with several years exposure to lead |
| |c] | |
|[pic] |
| |[pi|chronic bronchitis in long-term cigarette smokers |
| |c] | |
|[pic] |
| |[pi|pulmonary fibrosis in coal miners (black lung disease) |
| |c] | |
|[pic] |
Carcinogenicity
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Carcinogenicity is a complex multistage process of abnormal cell growth and differentiation which can lead to cancer. At least two stages are recognized. They are initiation in which a normal cell undergoes irreversible changes and promotion in which initiated cells are stimulated to progress to cancer. Chemicals can act as initiators or promoters.
The initial neoplastic transformation results from the mutation of the cellular genes that control normal cell functions. The mutation may lead to abnormal cell growth. It may involve loss of suppresser genes that usually restrict abnormal cell growth. Many other factors are involved (e.g., growth factors, immune suppression, and hormones).
A tumor (neoplasm) is simply an uncontrolled growth of cells. Benign tumors grow at the site of origin; do not invade adjacent tissues or metastasize; and generally are treatable. Malignant tumors (cancer) invade adjacent tissues or migrate to distant sites (metastasis). They are more difficult to treat and often cause death.
Developmental Toxicity
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Developmental Toxicity pertains to adverse toxic effects to the developing embryo or fetus. This can result from toxicant exposure to either parent before conception or to the mother and her developing embryo-fetus. The three basic types of developmental toxicity are:
[pic]
Chemicals cause developmental toxicity by two methods. They can act directly on cells of the embryo causing cell death or cell damage, leading to abnormal organ development. A chemical might also induce a mutation in a parent's germ cell which is transmitted to the fertilized ovum. Some mutated fertilized ova develop into abnormal embryos.
Genetic Toxicity
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Genetic Toxicity results from damage to DNA and altered genetic expression. This process is known as mutagenesis. The genetic change is referred to as a mutation and the agent causing the change as a mutagen. There are three types of genetic change:
[pic]
If the mutation occurs in a germ cell the effect is heritable. There is no effect on the exposed person; rather the effect is passed on to future generations. If the mutation occurs in a somatic cell, it can cause altered cell growth (e.g. cancer) or cell death (e.g. teratogenesis) in the exposed person.
Organ Specific Toxic Effects
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Types of organ specific toxic effects are:
|[pic]|[pic] |[pic] |
| |[pic] |Blood/Cardiovascular Toxicity |
|[pic] |
| |[pic] |Dermal/Ocular Toxicity |
|[pic] |
| |[pic] |Genetic Toxicity (germ cells) |
|[pic] |
| |[pic] |Hepatotoxicity |
|[pic] |
| |[pic] |Immunotoxicity |
|[pic] |
| |[pic] |Nephrotoxicity |
|[pic] |
| |[pic] |Neurotoxicity |
|[pic] |
| |[pic] |Reproductive Toxicity |
|[pic] |
| |[pic] |Respiratory Toxicity |
|[pic] |
Blood and Cardiovascular Toxicity
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Blood and Cardiovascular Toxicity results from xenobiotics acting directly on cells in circulating blood, bone marrow, and heart. Examples of blood and cardiovascular toxicity are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|hypoxia due to carbon monoxide binding of hemoglobin preventing transport of oxygen |
| |c] | |
|[pic] |
| |[pi|decrease in circulating leukocytes due to chloramphenicol damage to bone marrow |
| |c] |cells |
|[pic] |
| |[pi|leukemia due to benzene damage of bone marrow cells |
| |c] | |
|[pic] |
| |[pi|arteriosclerosis due to cholesterol accumulation in arteries and veins |
| |c] | |
|[pic] |
Dermal Toxicity
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Dermal Toxicity may result from direct contact or internal distribution to the skin. Effects range from mild irritation to severe changes, such as corrosivity, hypersensitivity, and skin cancer. Examples of dermal toxicity are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|dermal irritation due to skin exposure to gasoline |
| |c] | |
|[pic] |
| |[pi|dermal corrosion due to skin exposure to sodium hydroxide (lye) |
| |c] | |
|[pic] |
| |[pi|dermal hypersensitivity due to skin exposure to poison ivy |
| |c] | |
|[pic] |
| |[pi|skin cancer due to ingestion of arsenic or skin exposure to UV light |
| |c] | |
|[pic] |
Eye Toxicity
[pic]
Eye Toxicity results from direct contact or internal distribution to the eye. The cornea and conjunctiva are directly exposed to toxicants. Thus, conjunctivitis and corneal erosion may be observed following occupational exposure to chemicals. Many household items can cause conjunctivitis. Chemicals in the circulatory system can distribute to the eye and cause corneal opacity, cataracts, retinal and optic nerve damage. For example:
|[p|[pic|[pic] |
|ic|] | |
|] | | |
| |[pic|acids and strong alkalis may cause severe corneal corrosion |
| |] | |
|[pic] |
| |[pic|corticosteroids may cause cataracts |
| |] | |
|[pic] |
| |[pic|methanol (wood alcohol) may damage the optic nerve |
| |] | |
|[pic] |
Hepatotoxicity
[pic]
Hepatotoxicity is toxicity to the liver, bile duct, and gall bladder. The liver is particularly susceptible to xenobiotics due to a large blood supply and its role in metabolism. Thus it is exposed to high doses of the toxicant or its toxic metabolites. The primary forms of hepatotoxicity are:
[pic]
Immunotoxicity
[pic]
Immunotoxicity is toxicity of the immune system. It can take several forms: hypersensitivity (allergy and autoimmunity), immunodeficiency, and uncontrolled proliferation (leukemia and lymphoma). The normal function of the immune system is to recognize and defend against foreign invaders. This is accomplished by production of cells that engulf and destroy the invaders or by antibodies that inactivate foreign material. Examples are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|contact dermatitis due to exposure to poison ivy |
| |c] | |
|[pic] |
| |[pi|systemic lupus erythematosus in workers exposed to hydrazine |
| |c] | |
|[pic] |
| |[pi|immunosuppression by cocaine |
| |c] | |
|[pic] |
| |[pi|leukemia induced by benzene |
| |c] | |
|[pic] |
Nephrotoxicity
[pic]
The kidney is highly susceptible to toxicants for two reasons. A high volume of blood flows through it and it filtrates large amounts of toxins which can concentrate in the kidney tubules. Nephrotoxicity is toxicity to the kidneys. It can result in systemic toxicity causing:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|decreased ability to excrete body wastes |
| |c] | |
|[pic] |
| |[pi|inability to maintain body fluid and electrolyte balance |
| |c] | |
|[pic] |
| |[pi|decreased synthesis of essential hormones (e.g., erythropoietin) |
| |c] | |
|[pic] |
Neurotoxicity
[pic]
Neurotoxicity represents toxicant damage to cells of the central nervous system (brain and spinal cord) and the peripheral nervous system (nerves outside the CNS). The primary types of neurotoxicity are:
|[pic|[pic] |[pic] |
|] | | |
| |[pic] |neuronopathies (neuron injury) |
|[pic] |
| |[pic] |axonopathies (axon injury) |
|[pic] |
| |[pic] |demyelination (loss of axon insulation) |
|[pic] |
| |[pic] |interference with neurotransmission |
|[pic] |
Reproductive Toxicity
[pic]
Reproductive Toxicity involves toxicant damage to either the male or female reproductive system. Toxic effects may cause:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|decreased libido and impotence |
| |c] | |
|[pic] |
| |[pi|infertility |
| |c] | |
|[pic] |
| |[pi|interrupted pregnancy (abortion, fetal death, or premature delivery) |
| |c] | |
|[pic] |
| |[pi|infant death or childhood morbidity |
| |c] | |
|[pic] |
| |[pi|altered sex ratio and multiple births |
| |c] | |
|[pic] |
| |[pi|chromosome abnormalities and birth defects |
| |c] | |
|[pic] |
| |[pi|childhood cancer |
| |c] | |
|[pic] |
Respiratory Toxicity
[pic]
Respiratory Toxicity relates to effects on the upper respiratory system (nose, pharynx, larynx, and trachea) and the lower respiratory system (bronchi, bronchioles, and lung alveoli). The primary types of respiratory toxicity are:
|[pic] |[pic] |[pic] |
| |[pic] |pulmonary irritation |
|[pic] |
| |[pic] |asthma/bronchitis |
|[pic] |
| |[pic] |reactive airway disease |
|[pic] |
| |[pic] |emphysema |
|[pic] |
| |[pic] |allergic alveolitis |
|[pic] |
| |[pic] |fibrotic lung disease |
|[pic] |
| |[pic] |pneumoconiosis |
|[pic] |
| |[pic] |lung cancer |
Interactions
[pic]
Humans are normally exposed to several chemicals at one time rather than to an individual chemical. Medical treatment and environment exposure generally consists of multiple exposures. Examples are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|hospital patients on the average receive 6 drugs daily |
| |c] | |
|[pic] |
| |[pi|home influenza treatment consists of aspirin, antihistamines, and cough syrup taken |
| |c] |simultaneously |
|[pic] |
| |[pi|drinking water may contain small amounts of pesticides, heavy metals, solvents, and |
| |c] |other organic chemicals |
|[pic] |
| |[pi|air often contains mixtures of hundreds of chemicals such as automobile exhaust and |
| |c] |cigarette smoke |
|[pic] |
| |[pi|gasoline vapor at service stations is a mixture of 40-50 chemicals |
| |c] | |
|[pic] |
Normally, the toxicity of a specific chemical is determined by the study of animals exposed to only one chemical. Toxicity testing of mixtures is rarely conducted since it is usually impossible to predict the possible combinations of chemicals that will be present in multiple-chemical exposures.
Xenobiotics administered or received simultaneously may act independently of each other. However, in many cases, the presence of one chemical may drastically affect the response to another chemical. The toxicity of a combination of chemicals may be less or it may be more than would be predicted from the known effects of each individual chemical. The effect that one chemical has on the toxic effect of another chemical is known as an interaction.
Types of Interactions
[pic]
There are four basic types of interactions. Each is based on the expected effects caused by the individual chemicals. The types of interactions are:
[pic]
This table quantitatively illustrates the percent of the population affected by individual exposure to chemical A and chemical B as well as exposure to the combination of chemical A and chemical B. It also gives the specific type of interaction:
[pic]
The interactions described can be categorized by their chemical or biological mechanisms as follows:
|[pi|[pic|[pic] |
|c] |] | |
| |[pic|chemical reactions between chemicals |
| |] | |
|[pic] |
| |[pic|modifications in absorption, metabolism, or excretion |
| |] | |
|[pic] |
| |[pic|reactions at binding sites and receptors |
| |] | |
|[pic] |
| |[pic|physiological changes |
| |] | |
|[pic] |
Additivity
[pic]
Additivity is the most common type of drug interaction. Examples of chemical or drug additivity reactions are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|Two central nervous system (CNS) depressants taken at the same time, a tranquilizer |
| |c] |and alcohol, often cause depression equal to the sum of that caused by each drug. |
|[pic] |
| |[pi|Organophosphate insecticides interfere with nerve conduction. The toxicity of the |
| |c] |combination of two organophosphate insecticides is equal to the sum of the toxicity |
| | |of each. |
|[pic] |
| |[pi|Chlorinated insecticides and halogenated solvents both produce liver toxicity. The |
| |c] |hepatotoxicity of an insecticide formulation containing both is equivalent to the |
| | |sum of the hepatotoxicity of each. |
|[pic] |
Antagonism
[pic]
Antagonism is often a desirable effect in toxicology and is the basis for most antidotes. Examples include:
[pic]
Potentiation
[pic]
Potentiation occurs when a chemical that does not have a specific toxic effect makes another chemical more toxic. Examples are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|The hepatotoxicity of carbon tetrachloride is greatly enhanced by the presence of |
| |c] |isopropanol. Such exposure may occur in the workplace. |
|[pic] |
| |[pi|Normally, warfarin (a widely used anticoagulant in cardiac disease) is bound to |
| |c] |plasma albumin so that only 2% of the warfarin is active. Drugs which compete for |
| | |binding sites on albumin increase the level of free warfarin to 4% causing fatal |
| | |hemorrhage. |
|[pic] |
Synergism
[pic]
Synergism can have serious health effects. With synergism, exposure to a chemical may drastically increase the effect of another chemical. Examples are:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|Exposure to both cigarette smoke and radon results in a significantly greater risk |
| |c] |for lung cancer than the sum of the risks of each. |
|[pic] |
| |[pi|The combination of exposure to asbestos and cigarette smoke results in a |
| |c] |significantly greater risk for lung cancer than the sum of the risks of each. |
|[pic] |
| |[pi|The hepatotoxicity of a combination of ethanol and carbon tetrachloride is much |
| |c] |greater than the sum of the hepatotoxicity of each. |
|[pic] |
Different types of interactions can occur at different target sites for the same combination of two chemicals. For example, chlorinated insecticides and halogenated solvents (which are often used together in insecticide formulations) can produce liver toxicity with the interaction being additive.
The same combination of chemicals produces a different type of interaction on the central nervous system. Chlorinated insecticides stimulate the central nervous system whereas halogenated solvents cause depression of the nervous system. The effect of simultaneous exposure is an antagonistic interaction.
Toxicity Testing Methods
[pic]
Knowledge of toxicity is primarily obtained in three ways:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|by the study and observation of people during normal use of a substance or from |
| |c] |accidental exposures |
|[pic] |
| |[pi|by experimental studies using animals |
| |c] | |
|[pic] |
| |[pi|by studies using cells (human, animal, plant) |
| |c] | |
|[pic] |
Most chemicals are now subject to stringent government requirements for safety testing before they can be marketed. This is especially true for pharmaceuticals, food additives, pesticides, and industrial chemicals.
Exposure of the public to inadequately tested drugs or environmental agents has resulted in several notable disasters. Examples include:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|severe toxicity from the use of arsenic to treat syphilis |
| |c] | |
|[pic] |
| |[pi|deaths from a solvent (ethylene glycol) used in sulfanilamide preparations (one of |
| |c] |the first antibiotics) |
|[pic] |
| |[pi|thousands of children born with severe birth defects resulting from pregnant women |
| |c] |using thalidomide, an anti-nausea medicine |
|[pic] |
By the mid-twentieth century, disasters were becoming commonplace with the increasing rate of development of new synthetic chemicals. Knowledge of potential toxicity was absent prior to exposures of the general public.
The following Federal regulatory agencies were established to assure public safety:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|Food and Drug Administration |
| |c] | |
|[pic] |
| | |for pharmaceuticals, food additives, and medical devices |
|[pic] |
| |[pi|Environmental Protection Agency |
| |c] | |
|[pic] |
| | |for agricultural and industrial chemicals released to environment |
|[pic] |
| |[pi|Consumer Product Safety Commission |
| |c] | |
|[pic] |
| | |for toxins present in consumer products |
|[pic] |
| |[pi|Department of Transportation |
| |c] | |
|[pic] |
| | |for the shipment of toxic chemicals |
|[pic] |
| |[pi|Occupational Safety and Health Administration |
| |c] | |
|[pic] |
| | |for exposure to chemicals in the workplace |
Clinical Investigations
[pic]
Knowledge of toxicity of xenobiotics to humans is derived by three methods:
[pic]
Clinical investigations are a component of the Investigational New Drug Applications (IND) submitted to FDA. Clinical investigations are conducted only after the non-clinical laboratory studies have been completed.
Toxicity studies using human subjects require strict ethical considerations. They are primarily conducted for new pharmaceutical applications submitted to FDA for approval.
Generally, toxicity found in animal studies occurs with similar incidence and severity in humans. Differences sometimes occur, thus clinical tests with humans are needed to confirm the results of non-clinical laboratory studies.
FDA clinical investigations are conducted in three phases. Phase 1 consists of testing the drug in a small group of 20-80 patients. Information obtained in Phase 1 studies is used to design Phase 2 studies. In particular to:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|determine the drug's pharmacokinetics and pharmacological effects |
| |c] | |
|[pic] |
| |[pi|elucidate its metabolism |
| |c] | |
|[pic] |
| |[pi|study the mechanism of action of the drug |
| |c] | |
|[pic] |
Phase 2 studies are more extensive involving several hundred patients and are used to:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|determine the short-term side effects of the drug |
| |c] | |
|[pic] |
| |[pi|determine the risks associated with the drug |
| |c] | |
|[pic] |
| |[pi|evaluate the effectiveness of the drug for treatment of a particular disease or |
| |c] |condition |
|[pic] |
Phase 3 studies are expanded controlled and uncontrolled trials conducted with several hundred to several thousand patients. They are designed to:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|gather additional information about effectiveness and safety |
| |c] | |
|[pic] |
| |[pi|evaluate overall benefit-risk relationship of the drug |
| |c] | |
|[pic] |
| |[pi|provide the basis for the precautionary information that accompanies the drug |
| |c] | |
Epidemiology Studies
[pic]
Epidemiology studies are conducted using human populations to evaluate whether there is a causal relationship between exposure to a substance and adverse health effects.
These studies differ from clinical investigations in that individuals have already been administered the drug during medical treatment or have been exposed to it in the workplace or environment.
Epidemiological studies measure the risk of illness or death in an exposed population compared to that risk in an identical (e.g., same age, sex, race, social status, etc.), unexposed population.
There are four primary types of epidemiology studies. They are:
[pic]
Cohort studies are the most commonly conducted epidemiology studies. They frequently involve occupational exposures. Exposed persons are easy to identify and the exposure levels are usually higher than in the general public. There are two types of cohort studies:
[pic]
To determine if epidemiological data are meaningful, standard, quantitative measures of effect are employed. The most commonly used are:
[pic]
There are a number of aspects in designing an epidemiology study. The most critical are appropriate controls, adequate time span, and statistical ability to detect an effect.
The control population used as a comparison group must be as similar as possible to that of the test group, e.g., same age, sex, race, social status, geographical area, and environmental and lifestyle influences.
Many epidemiology studies evaluate the potential for an agent to cause cancer. Since most cancers require long latency periods, e.g., 20 years, the study must cover that period of time.
The statistical ability to detect an effect is referred to as the power of the study. To gain precision, the study and control populations should be as large as possible.
Epidemiologists attempt to control errors that may occur in the collection of data. These errors, known as bias errors, are of three main types:
[pic]
Animal Testing for Toxicity
[pic]
Animal tests for toxicity are conducted prior to human clinical investigations as part of the non-clinical laboratory tests of pharmaceuticals. For pesticides and industrial chemicals, human testing is rarely conducted. Animal test results often represent the only means by which toxicity in humans can be effectively predicted.
With animal tests:
|[pi|[pic|[pic] |
|c] |] | |
| |[pic|chemical exposure can be precisely controlled |
| |] | |
|[pic] |
| |[pic|environmental conditions can be well-controlled |
| |] | |
|[pic] |
| |[pic|virtually any type of toxic effect can be evaluated |
| |] | |
|[pic] |
| |[pic|the mechanism by which toxicity occurs can be studied |
| |] | |
|[pic] |
Methods to evaluate toxicity exist for a wide variety of toxic effects. Some procedures for routine safety testing have been standardized. Standardized animal toxicity tests are highly effective in detecting toxicity that may occur in humans. Concern for animal welfare has resulted in tests that use humane procedures and only the number of animals needed for statistical reliability.
To be standardized, a test procedure must have scientific acceptance as the most meaningful assay for the toxic effect. Toxicity testing can be very specific for a particular effect, such as dermal irritation, or it may be general, such as testing for unknown chronic effects.
Standardized tests have been developed for the following effects:
|[pic] |[pic] |[pic] |
| |[pic] |Acute Toxicity |
|[pic] |
| |[pic] |Subchronic Toxicity |
|[pic] |
| |[pic] |Chronic Toxicity |
|[pic] |
| |[pic] |Carcinogenicity |
|[pic] |
| |[pic] |Reproductive Toxicity |
|[pic] |
| |[pic] |Developmental Toxicity |
|[pic] |
| |[pic] |Dermal Toxicity |
|[pic] |
| |[pic] |Ocular Toxicity |
|[pic] |
| |[pic] |Neurotoxicity |
|[pic] |
| |[pic] |Genetic Toxicity |
|[pic] |
Species selection varies with the toxicity test to be performed. There is no single species of animal that can be used for all toxicity tests. Different species may be needed to assess different types of toxicity. In some cases, it may not be possible to use the most desirable animal for testing because of animal welfare or cost considerations. For example, use of monkeys and dogs is restricted to special cases, even though they represent the species that may react closest to humans.
Rodents and rabbits are the most commonly used laboratory species due to their availability, low costs in breeding and housing, and past history in producing reliable results.
The toxicologist attempts to design an experiment to duplicate the potential exposure of humans as closely as possible. For example:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|The route of exposure should simulate that of human exposure. Most standard tests |
| |c] |use inhalation, oral, or dermal routes of exposure. |
|[pic] |
| |[pi|The age of test animals should relate to that of humans. Testing is normally |
| |c] |conducted with young adults, although newborn or pregnant animals may be used in |
| | |some cases. |
|[pic] |
| |[pi|For most routine tests, both sexes are used. Sex differences in toxic response are |
| |c] |minimal, except for toxic substances with hormonal properties. |
|[pic] |
| |[pi|Dose levels are normally selected so as to determine the threshold as well as |
| |c] |dose-response relationship. Usually, a minimum of three dose levels are used. |
|[pic] |
Acute Toxicity
[pic]
Acute toxicity tests are generally the first tests conducted. They provide data on the relative toxicity likely to arise from a single or brief exposure. Standardized tests are available for oral, dermal, and inhalation exposures. Basic parameters of these tests are:
[pic]
Subchronic Toxicity
[pic]
Subchronic toxicity tests are employed to determine toxicity likely to arise from repeated exposures of several weeks to several months. Standardized tests are available for oral, dermal, and inhalation exposures. Detailed clinical observations and pathology examinations are conducted. Basic parameters of these tests are:
[pic]
Chronic Toxicity
[pic]
Chronic toxicity tests determine toxicity from exposure for a substantial portion of a subject's life. They are similar to the subchronic tests except that they extend over a longer period of time and involve larger groups of animals. Basic parameters of these tests include:
[pic]
Carcinogenicity
[pic]
Carcinogenicity tests are similar to chronic toxicity tests. However, they extend over a longer period of time and require larger groups of animals in order to assess the potential for cancer. Basic parameters of these tests are:
[pic]
Reproductive Toxicity
[pic]
Reproductive toxicity testing is intended to determine the effects of substances on gonadal function, conception, birth, and the growth and development of the offspring. The oral route is preferred. Basic parameters of these tests are:
[pic]
Developmental Toxicity
[pic]
Developmental toxicity testing detects the potential for substances to produce embryotoxicity and birth defects. Basic parameters of this test are:
[pic]
Dermal Toxicity
[pic]
Dermal toxicity tests determine the potential for an agent to cause irritation and inflammation of the skin. This may be the result of direct damage to the skin cells by a substance. It may also be an indirect response due to sensitization from prior exposure. There are two dermal toxicity tests:
[pic]
Ocular Toxicity
[pic]
Ocular toxicity is determined by applying a test substance for one second to the eyes of 6 test animals, usually rabbits. The eyes are then carefully examined for 72-hours, using a magnifying instrument to detect minor effects. The ocular reaction may occur on the cornea, conjunctiva, or iris. It may be simple irritation that is reversible and quickly disappears or the irritation may be severe and produce corrosion, an irreversible condition.
The eye irritation test is commonly known as the "Draize Test." This test has been targeted by animal welfare groups as an inhumane procedure due to pain that may be induced in the eye. The test allows the use of an eye anesthetic in the event pain is evident. The Draize Test is a reliable predictor of human eye response. However, research to develop alternative testing procedures that do not use live animals is underway. While some cell and tissue assays are promising, they have not as yet proved as reliable as the animal test.
Neurotoxicity
[pic]
A battery of standardized neurotoxicity tests has recently been developed to supplement the delayed neurotoxicity test in domestic chickens (hens). The hen assay determines delayed neurotoxicity resulting from exposure to anticholinergic substances, such as certain pesticides. The hens are protected from the immediate neurological effects of the test substance and observed for 21 days for delayed neurotoxicity. Other neurotoxicity tests include measurements of:
[pic]
Genetic Toxicity
[pic]
Genetic toxicity is determined using a wide range of test species including whole animals and plants (e.g., rodents, insects, and corn), microorganisms, and mammalian cells. A large variety of tests have been developed to measure gene mutations, chromosome changes, and DNA activity. The most common gene mutation tests involve:
[pic]
Chromosomal effects can be detected by a variety of tests, some involving whole animals (in vivo). Some use cell systems (in vitro). Several assays are available to test for chemically induced chromosome aberrations in whole animals. The most common tests are:
[pic]
Additional in vivo chromosomal assays are:
[pic]
In vitro tests for chromosomal effects involve the exposure of cell cultures and microscopic examination for chromosome damage. The most commonly used cell lines are Chinese Hamster Ovary (CHO) cells and human lymphocyte cells. The CHO cells are easy to culture, grow rapidly, and have a low chromosome number (22) which makes for easier identification of chromosome damage.
Human lymphocytes are more difficult to culture. They are obtained from healthy human donors with known medical histories. The results of these assays are potentially more relevant to determine effects of xenobiotics which induce mutations in humans.
Two widely used genotoxicity tests measure DNA damage and repair which is not mutagenicity. DNA damage is considered the first step in the process of mutagenesis. The most commonly used test for unscheduled DNA synthesis (UDS) involves exposure of mammalian cells in culture to a test substance. UDS is measured by the uptake of tritium-labeled thymidine into the DNA of the cells. Rat hepatocytes or human fibroblasts are the common mammalian cell lines used.
Another assay to detect DNA damage involves the exposure of repair-deficient E. coli or B. subtilis. DNA damage can not be repaired so the cells die or their growth may be inhibited.
Risk Assessment
[pic]
For many years the terminology and methods used in human risk or hazard assessment were not consistent. This led to confusion among scientists and the public. In 1983, the National Academy of Sciences (NAS) published standard terminology and concepts for risk assessments.
The following terms are routinely used in risk assessments:
[pic]
Four basic steps in the risk assessment process as defined by the NAS are:
[pic]
|[pic] |[pic] |[pic] |
| | |[pic] |
|[pic] |
Risk management decisions follow the identification and quantification of risk which are determined by risk assessments. During the regulatory process, risk managers may request that additional risk assessments be conducted to justify the risk management decisions. As indicated in the figure above, the risk assessment and risk management processes are intimately related.
This section will describe only the risk assessment process. Risk assessments may be conducted for individual chemicals or for complex mixtures of chemicals. In cases of complex mixtures, such as hazardous waste sites, the process of risk assessment itself becomes quite complex. This complexity results from:
|[p|[pi|[pic] |
|ic|c] | |
|] | | |
| |[pi|simultaneous exposure to many substances with the potential for numerous chemical |
| |c] |and biological interactions |
|[pic] |
| |[pi|exposures by multiple media and pathways (e.g., via water, air, and soil) |
| |c] | |
|[pic] |
| |[pi|exposure to a wide array of organisms with differing susceptibilities (e.g., |
| |c] |infants, adults, humans, animals, environmental organisms) |
|[pic] |
[pic]
Conducting scientifically sound risk assessments is of great national importance. An error in undercalculating risk probabilities could lead to overexposure of the population. On the other hand, an overcalculation of risk could result in unwarranted costs to the public. As illustrated above, the cost to clean-up a hazardous waste site varies greatly with the degree of clean-up required which is determined by risk assessments.
Hazard Identification
[pic]
In this initial step, the potential for a xenobiotic to induce any type of toxic hazard is evaluated. Information is gathered and analyzed in a weight-of-evidence approach. The types of data usually consist of:
|[pic] |[pic] |[pic] |
| |[pic] |human epidemiology data |
|[pic] |
| |[pic] |animal bioassay data |
|[pic] |
| |[pic] |supporting data |
|[pic] |
Based on these results, one or more toxic hazards may be identified (such as cancer, birth defects, chronic toxicity, neurotoxicity). The primary hazard of concern is one in which there is a serious health consequence (such as cancer) that can occur at lower dosages than other serious toxic effects. The primary hazard of concern will be chosen for the dose-response assessment.
Human epidemiology data are the most desirable and are given highest priority since they avoid the concern for species differences in the toxic response. Unfortunately, reliable epidemiology studies are rarely available. Even when epidemiology studies have been conducted, they usually have incomplete and unreliable exposure histories. For this reason, it is rare that risk assessors can construct a reliable dose-response relationship for toxic effects based on epidemiology studies. More often, the human studies can only provide qualitative evidence that a causal relationship exists.
In practice, animal bioassay data are generally the primary data used in risk assessments. Animal studies are well-controlled experiments with known exposures and employ detailed, careful clinical, and pathological examinations. The use of laboratory animals to determine potential toxic effects in humans is a necessary and accepted procedure. It is a recognized fact that effects in laboratory animals are usually similar to those observed in humans at comparable dose levels. Exceptions are primarily attributable to differences in the pharmacokinetics and metabolism of the xenobiotics.
Supporting data derived from cell and biochemical studies may help the risk assessor make meaningful predictions as to likely human response. For example, often a chemical is tested with both human and animal cells to study its ability to produce cytotoxicity, mutations, and DNA damage. The cell studies can help identify the mechanism by which a substance has produced an effect in the animal bioassay. In addition, species differences may be revealed and taken into account.
A chemical's toxicity may be predicted based on its similarity in structure to that of chemical for which the toxicity is known. This is known as a structure-activity relationship (SAR). The SAR has only limited value in risk assessment due to exceptions to the predicted toxicity.
Dose-Response Assessment
[pic]
The dose-response assessment step quantitates the hazards which were identified in the hazard evaluation phase. It determines the relationship between dose and incidence of effects in humans. There are normally two major extrapolations required. The first is from high experimental doses to low environmental doses and the second from animal to human doses.
The procedures used to extrapolate from high to low doses are different for assessment of carcinogenic effects and non-carcinogenic effects. Carcinogenic effects are not considered to have a threshold and mathematical models are generally used to provide estimates of carcinogenic risk at very low dose levels.
Noncarcinogenic effects (e.g. neurotoxicity) are considered to have dose thresholds below which the effect does not occur. The lowest dose with an effect in animal or human studies is divided by Safety Factors to provide a margin of safety.
Cancer Risk Assessment
[pic]
Cancer risk assessment involves two steps. The first step is a qualitative evaluation of all epidemiology studies, animal bioassay data, and biological activity (e.g., mutagenicity). The substance is classified as to carcinogenic risk to humans based on the weight of evidence. If the evidence is sufficient, the substance may be classified as a definite, probable or possible human carcinogen.
The second step is to quantitate the risk for those substances classified as definite or probable human carcinogens. Mathematical models are used to extrapolate from the high experimental doses to the lower environmental doses.
The two primary cancer classification schemes are those of the Environmental Protection Agency (EPA) and the International Agency for Research on Cancer (IARC). The EPA and IARC classification systems are quite similar.
The EPA's cancer assessment procedures have been used by several Federal and State agencies. The Agency for Toxic Substances and Disease Registry (ATSDR) relies on EPA's carcinogen assessments. A substance is assigned to one of six categories as shown below:
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The basis for sufficient human evidence is an epidemiology study that clearly demonstrates a causal relationship between exposure to the substance and cancer in humans. The data are determined to be limited evidence in humans if there are alternative explanations for the observed effect. The data are considered to be inadequate evidence in humans if no satisfactory epidemiology studies exist.
An increase in cancer in more than one species or strain of laboratory animals or in more than one experiment is considered sufficient evidence in animals. Data from a single experiment can also be considered sufficient animal evidence if there is a high incidence or unusual type of tumor induced. Normally, however, a carcinogenic response in only one species, strain, or study, is considered as only limited evidence in animals.
When an agent is classified as a Human or Probable Human Carcinogen, it is then subjected to a quantitative risk assessment. For those designated as a Possible Human Carcinogen, the risk assessor can determine on a case-by-case basis whether a quantitative risk assessment is warranted.
The key risk assessment parameter derived from the EPA carcinogen risk assessment is the cancer slope factor. This is a toxicity value that quantitatively defines the relationship between dose and response. The cancer slope factor is a plausible upper-bound estimate of the probability that an individual will develop cancer if exposed to a chemical for a lifetime of 70 years. The cancer slope factor is expressed as mg/kg/day.
Mathematical models are used to extrapolate from animal bioassay or epidemiology data to predict low dose risk. Most assume linearity with a zero threshold dose.
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EPA uses the Linearized Multistage Model (LMS) illustrated above to conduct its cancer risk assessments. It yields a cancer slope factor, known as the q1* (pronounced Q1-star) which can be used to predict cancer risk at a specific dose. It assumes linear extrapolation with a zero dose threshold from the upper confidence level of the lowest dose that produced cancer in an animal test or in a human epidemiology study.
Other models that have been used for cancer assessments include:
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Estimated drinking water concentrations for chlordane that will cause a lifetime risk of one cancer death in a million persons, derived from different cancer risk assessment models, vary as illustrated below:
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PB-PK models are relatively new and are being employed when biological data are available. They quantitate the absorption of a foreign substance, its distribution, metabolism, tissue compartments, and elimination. Some compartments store the chemical (bone and adipose tissue) whereas others biotransform or eliminate it (liver or kidney). All these biological parameters are used to derive the target dose and comparable human doses.
Non-carcinogenic Risk Assessment
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Historically, the Acceptable Daily Intake (ADI) procedure has been used to calculate permissible chronic exposure levels for humans based on non-carcinogenic effects. The ADI is the amount of a chemical to which a person can be exposed each day for a long time (usually lifetime) without suffering harmful effects. It is determined by applying safety factors (to account for the uncertainty in the data) to the highest dose in human or animal studies which has been demonstrated not to cause toxicity (NOAEL).
The EPA has slightly modified the ADI approach and calculates a Reference Dose (RfD) as the acceptable safety level for chronic non-carcinogenic and developmental effects. Similarly the ATSDR calculates Minimal Risk Levels (MRLs) for noncancer end points.
The critical toxic effect used in the calculation of an ADI, RfD, or MRL is the serious adverse effect which occurs at the lowest exposure level. It may range from lethality to minor toxic effects. It is assumed that humans are as sensitive as the animal species unless evidence indicates otherwise.
In determining the ADIs, RfDs or MRLs, the NOAEL is divided by safety factors (uncertainty factors) in order to provide a margin of safety for allowable human exposure.
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When a NOAEL is not available, a LOAEL can be used to calculate the RfD. An additional safety factor is included if an LOAEL is used. A Modifying Factor of 0.1-10 allows risk assessors to use scientific judgment in upgrading or downgrading the total uncertainty factor based on the reliability and quality of the data. For example, if a particularly good study is the basis for the risk assessment, a modifying factor of < 1 may be used. If a poor study is used, a factor of >1 can be incorporated to compensate for the uncertainty associated with the quality of the study.
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A dose response curve for non-carcinogenic effects is illustrated above which also identifies the NOAEL and LOAEL. Any toxic effect might be used for the NOAEL/LOAEL so long as it is the most sensitive toxic effect and considered likely to occur in humans.
The Uncertainty Factors or Safety Factors used to derive an ADI or RfD are:
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The modifying factor is used only in deriving EPA Reference Doses. The number of factors included in calculating the ADI or RfD depend upon the study used to provide the appropriate NOAEL or LOAEL.
The general formula for deriving the RfD is:
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The more uncertain or unreliable the data becomes, the higher will be the total uncertainty factor that is applied. An example of an RfD calculation is provided below. A subchronic animal study with a LOAEL of 50 mg/kg/day was used. Thus the uncertainty factors are: 10 for human variability, 10 for an animal study, 10 for less than chronic exposure, and 10 for use of an LOAEL instead of a NOAEL.
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In addition to chronic effects, RfDs can also be derived for other long term toxic effects, including developmental toxicity.
While ATSDR does not conduct cancer risk assessments, it does derive Minimal Risk Levels (MRLs) for noncancer toxicity effects (such as birth defects or liver damage). The MRL is defined as an estimate of daily human exposure to a substance that is likely to be without an appreciable risk of adverse effects over a specified duration of exposure. For inhalation or oral routes, MRLs are derived for acute (14 days or less), intermediate (15-364 days), and chronic (365 days or more) durations of exposures.
The method used to derive MRLs is a modification of the EPA's RfD methodology. The primary modification is that the uncertainty factors of 10 may be lower, either 1 or 3, based on scientific judgment. These uncertainty factors are applied for human variability, interspecies variability (extrapolation from animals to humans), and use of a LOAEL instead of NOAEL. As in the case of RfDs, the product of uncertainty factors multiplied together is divided into the NOAEL or LOAEL to derive the MRL.
Risk assessments are also conducted to derive permissible exposure levels for acute or short term exposures to chemicals. Health Advisories (HAs) are determined for chemicals in drinking water. HAs are the allowable human exposures for one day, ten days, longer-term, and lifetime durations. The method used to calculate HAs is similar to that for the RfD's using uncertainty factors. Data from toxicity studies with durations of length appropriate to the HA are being developed.
For occupational exposures, Permissible Exposure Levels (PELs), Threshold Limit Values (TLVs), and NIOSH Recommended Exposure Levels (RELs) are developed. They represent dose levels that will not produce adverse health effects from repeated daily exposures in the workplace. The method used to derive is conceptually the same. Safety factors are used to derive the PELs, TLVs, and RELs.
Animal doses must be converted to human dose equivalents. The human dose equivalent is based on the assumption that different species are equally sensitive to the effects of a substance per unit of body weight or body surface area.
Historically, FDA used a ratio of body weights of humans to animals to calculate the human dose equivalent. EPA has used a ratio of surface areas of humans to animals to calculate the human dose equivalent. The animal dose was multiplied by the ratio of human to animal body weight raised to the 2/3rd power (to convert from body weight to surface area). FDA and EPA have agreed to use body weight raised to the 3/4th power to calculate human dose equivalents in the future.
The last step in risk assessment is to express the risk in terms of allowable exposure to a contaminated source. Risk is expressed in terms of the concentration of the substance in the environment where human contact occurs. For example, the unit risk in air is risk per mg/m3 whereas the unit risk in drinking water is risk per mg/L.
For carcinogens, the media risk estimates are calculated by dividing cancer slope factors by 70 kg (average weight of man) and multiplying by 20 m3/day (average inhalation rate of an adult) or 2 liters/day (average water consumption rate of an adult).
Exposure Assessment
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Exposure assessment is a key phase in the risk assessment process since without an exposure, even the most toxic chemical does not present a threat. All potential exposure pathways are carefully considered. Contaminant releases, their movement and fate in the environment, and the exposed populations are analyzed.
Exposure assessment includes three steps:
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| |[pic|characterization of the exposure setting (e.g., point source) |
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| |[pic|identification of exposure pathways (e.g., groundwater) |
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| |[pic|quantification of the exposure (e.g., µg/L water) |
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The main variables in the exposure assessment are:
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| |[pi|exposed populations (general public or selected groups) |
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| |[pi|types of substances (pharmaceuticals, occupational chemicals, or environmental |
| |c] |pollutants) |
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| |[pi|single substance or mixture of substances |
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| |[pi|duration of exposure (brief, intermittent, or protracted) |
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| |[pi|pathways and media (ingestion, inhalation, and dermal exposure) |
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All possible types of exposure are considered in order to assess the toxicity and risk that might occur due to these variables.
The risk assessor first looks at the physical environment and the potentially exposed populations. The physical environment may include considerations of climate, vegetation, soil type, ground-water and surface water. Populations that may be exposed as the result of chemicals that migrate from the site of pollution are also considered.
Subpopulations may be at greater risk due to a higher level of exposure or because they have increased sensitivity (infants, elderly, pregnant women, and those with chronic illness).
Pollutants may be transported away from the source. They may be physically, chemically or biologically transformed. They may also accumulate in various media. Assessment of the chemical fate requires knowledge of many factors including:
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| |[pic|organic carbon and water partitioning at equilibrium (Koc) |
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| |[pic|chemical partitioning between soil and water (Kd) |
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| |[pic|partitioning between air and water (Henry's Law Constant) |
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| |[pic|solubility constants |
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| |[pic|vapor pressures |
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| |[pic|bioconcentration factors |
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These factors are integrated with the data on sources, releases and routes of the pollutants to determine the exposure pathways of importance.
Exposure pathways may include:
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| |[pic] |groundwater |
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| |[pic] |surface water |
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| |[pic] |air |
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| |[pic] |soil |
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| |[pic] |food |
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| |[pic] |breast-milk |
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Since actual measurements of exposures are often not available, exposure models may be used. For example, in air quality studies, chemical emission and air dispersion models are used to predict the air concentrations to downwind residents. Residential wells downgradient from a site may not currently show signs of contamination. They may become contaminated in the future as chemicals in the groundwater migrate to the well site. In these situations, groundwater transport models may estimate when chemicals of potential concern will reach the wells.
Exposure Standards and Guidelines
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Exposure standards and guidelines are developed by governments to protect the public from harmful substances and activities that can cause serious health problems. Only standards and guidelines relating to protection from the toxic effects of chemicals follow.
Exposure standards and guidelines are the products of risk management decisions. Risk assessments provide regulatory agencies with estimates of numbers of persons potentially harmed under specific exposure conditions. Regulatory agencies then propose exposure standards and guidelines which will protect the public from unacceptable risk.
Exposure standards and guidelines usually provide numerical exposure levels for various media (such as food, consumer products, water and air) that cannot be exceeded. Alternatively, these standards may be preventive measures to reduce exposure (such as labeling, special ventilation, protective clothing and equipment, and medical monitoring).
Exposure standards and guidelines are of two types:
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Federal and state regulatory agencies have the authority to issue permissible exposure standards and guidelines. They include the following categories:
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| |[pic|Consumer Product Exposure Standards and Guidelines |
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| |[pic|Environmental Exposure Standards and Guidelines |
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Consumer Product Exposure Stds/Guidelines
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Manufacturers of new pharmaceuticals are required to obtain formal FDA approval before their products can be marketed. Drugs intended for use in humans must be tested in humans (in addition to animals) to determine toxic dose levels as a part of the new drug application (NDA).
The NDA covers all aspects of a drug's effectiveness and safety, including:
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| |[pic]|pharmacokinetics and pharmacological effects |
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| |[pic]|metabolism and mechanism of action |
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| |[pic]|associated risks of the drug |
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| |[pic]|intended uses and their effectiveness |
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| |[pic]|benefit-risk relationship |
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| |[pic]|basis for package inserts supplied to physicians |
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The FDA does not issue exposure standards for drugs. Instead, FDA approves an NDA which contains guidance for usage and warnings concerning effects of excessive exposure to the drug. The manufacturer is required to provide this information to physicians prescribing the drug as well as to the others that may purchase or use the drug. Information on a drug's harmful side effects is provided in three main ways:
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| |[pi|labeling and package inserts that accompany a drug and explain approved uses, |
| |c] |recommended dosages, and effects of overexposure |
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| |[pi|publication of information in the Physicians' Desk Reference (PDR) |
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| |[pi|information dissemination to physicians via direct mailing or by publications in |
| |c] |medical journals |
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The package insert labels and the PDR contain information pertaining to the drugs:
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| |[pic] |description |
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| |[pic] |clinical pharmacology |
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| |[pic] |indications and usage |
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| |[pic] |contraindications |
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| |[pic] |warnings |
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| |[pic] |precautions |
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| |[pic] |adverse reactions |
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| |[pic] |interactions |
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| |[pic] |overdosage |
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| |[pic] |available forms |
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The FDA is responsible for the approval of food additives. Standards are different depending on whether they are direct food additives or indirect food additives. Direct food additives are intentionally added to foods for functional purposes. Examples of direct food additives are processing aids, texturing agents, preservatives, flavoring and appearance agents, and nutritional supplements. Approval usually designates the maximum allowable concentrations (e.g., 0.05%) in a food product.
Indirect food additives are not intentionally added to foods and they are not natural constituents of foods. They become a constituent of the food product from environmental contamination during production, processing, packaging and storage. Examples of indirect food additives are antibiotics administered to cattle, pesticide residues remaining after production or processing of foods, and chemicals that migrate from packaging materials into foods. Exposure standards indicate the maximum allowable concentration of these substances in food.
New direct food additives must undergo stringent review by FDA scientists before they can be approved for use in foods. The manufacturer of a direct food additive must provide evidence of the safety of the food additive in accordance with specified uses. The safety evaluation is conducted by the toxicity testing and risk assessment procedures previously discussed with derivation of the ADI. In contrast to pharmaceutical testing, virtually all toxicity evaluations are conducted with experimental laboratory animals.
In 1958, with an amendment to the Food, Drug and Cosmetic Act (FDCA), FDA was required to approve all new food additives. The law at that time decided that all existing food additives were generally recognized as safe (known as GRAS) and no exposure standard was developed. Many of these GRAS substances have more recently been re-evaluated and maximum acceptable levels have been established.
The FDA re-evaluation of GRAS substances requires that specific toxicity tests be conducted based on the level of the GRAS substance in a food product. For example, the lowest level of concern is for an additive used at 0.05 ppm in the food product. Only short-term tests (a few weeks) are required for those compounds. In contrast, a food additive used at levels higher than 1.0 ppm must be tested for carcinogenicity, chronic toxicity, reproductive toxicity, developmental toxicity, and mutagenicity.
The 1958 amendment to the FDCA law for FDA is known as the Delaney Clause. This clause prohibits the addition of any substance to food that has been shown to induce cancer in man or animals. The implication is that any positive result in an animal test, regardless of dose level or mechanism, is sufficient to prohibit use of the substance. In this case, the allowable exposure level is zero.
Consumer exposure standards are developed for hazardous substances and articles by the Consumer Product and Safety Commission (CPSC). Their authority under the Federal Hazardous Substance Act pertains to substances other than pesticides, drugs, foods, cosmetics, fuels, and radioactive materials. The CPSC requires a warning label on a consumer product which is toxic, corrosive, irritant, or sensitizer. Highly toxic substances are labeled with DANGER; less toxic substances are labeled with WARNING or CAUTION.
The basis for highly toxic is death in laboratory rats at an oral dose of 50 mgs, an inhaled dose in rats of 200 ppm for one hour, and a 24-hour dermal dose in rabbits of 200 mg/kg. A substance is corrosive if it causes visible destruction or irreversible damage to the skin or eye. If it causes damage which is reversible within 24 hours, it is designated an irritant. An immune response from a standard sensitization test in animals is sufficient for designation as a sensitizer.
Environmental Exposure Standards/Guidelines
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The Environmental Protection Agency is responsible for several laws that require determination and enforcement of exposure standards. In addition, they have the authority to prepare recommended exposure guidelines for selected environmental pollutants.
The EPA is responsible for developing exposure standards for:
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| |[pic] |pesticides |
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| |[pic] |water pollutants |
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| |[pic] |air pollutants |
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| |[pic] |hazardous wastes |
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Pesticides can not be marketed until they have been registered by the EPA in accordance with the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA). In order to obtain registration, a pesticide must undergo an extensive battery of toxicity tests, chemistry analyses, and environmental fate tests.
In cases where the toxicity warrants, a pesticide may be approved for restricted uses. A primary exposure standard for pesticides is the pesticide tolerance for food use. This standard specifies the amount of pesticide that is permitted on raw food products (e.g., tolerance for chlorpyrifos on corn).
Water pollutants are regulated by two laws, the Safe Drinking Water Act (SDWA) and the Clean Water Act (CWA). Under the SDWA, the EPA conducts risk assessments and issues maximum contaminant levels (MCLs) for chemicals in drinking water. The MCL is the acceptable exposure level which, if exceeded, requires immediate water treatment to reduce the contaminant level. For example, the MCL for trichloroethylene is 0.005 mg per liter of water.
In addition to establishing MCLs, the EPA can propose recommended exposure guidance for drinking water contamination. As an interim procedure, maximum contaminant level goals (MCLGs) may be recommended for long term exposures to contaminants in drinking water. Generally, no allowable exposure can be recommended for a carcinogenic chemical. When the MCL is issued, an acceptable exposure level based on a cancer risk assessment may be proposed for the MCL. For example, the MCLG for chlordane is 0 mg/L whereas the MCL is 0.002 mg/L.
EPA prepares health advisories (HAs) as voluntary exposure guidelines for drinking water contamination. The HAs provide exposure limits for 1-day, 10-day, longer-term, or lifetime exposure periods. They pertain only to non-carcinogenic risks. The formula used to derive a health advisory differs from that for the ADI or RfD in that the HAs pertain to short-term as well as long-term exposures. In addition, human body weight and drinking water consumption are included in the formula. The basic formula for an HA (in mg/L) is:
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The durations and exposure route (oral) of the toxicology studies to be employed for HA assessments must conform to the human exposures covered by the HAs. For example, the NOAEL or LOAEL for derivation of a 10-day HA would be obtained from an animal toxicology study of approximately 10 days duration (routinely 7-14 day toxicity studies).
A longer-term HA applies to humans drinking contaminated water for up to 7 years (10% of a human's 70-year lifespan). Since 90 days is about 10% of a rats expected lifespan, the 90-day subchronic study with rats is appropriate for derivation of the longer-term HA assessment.
A life-time HA (representing lifetime exposure to a toxicant in drinking water) is also determined for non-carcinogens. The procedure uses the RfD risk assessment with adjustments for body weight of an adult human (70 kg) and drinking water consumption of 2 L/day.
In addition to drinking water standards, the EPA is authorized under the Clean Water Act (CWA) to issue exposure guidance for control of pollution in ground water. The intent is to provide clean water for fishing and swimming rather than for drinking purposes. It provides a scheme for controlling the introduction of pollutants into navigable surface water. The recommendations for ground water protection are known as ambient water quality criteria.
The ambient water quality criteria are intended to control pollution sources at the point of release into the environment. While these criteria may be less restrictive than the drinking water standards, they usually are the same numeric value. For example, the MCL (for drinking water) and the ambient water quality criteria (for ground water) for lead are the same (0.05 mg per liter of water).
Air emission standards are issued by EPA under the Clean Air Act (CAA). The CAA authorizes the issuance of national ambient air quality standards (NAAQS) for air pollution. There are two types of NAAQS. Primary NAAQS pertain to human health, whereas secondary NAAQS pertain to public welfare (such as crops, animals, and structures).
NAAQS have been established for the following major atmospheric pollutants: carbon monoxide, sulfur oxide, oxides of nitrogen, ozone, hydrocarbons, particulates, and lead. When air emissions exceed the NAAQS levels, the polluting industry must take control measures to reduce emissions to the acceptable level.
Hazardous wastes are regulated under the Resource Conservation and Recovery Act (RCRA) and the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), commonly known as Superfund. RCRA regulates hazardous chemical waste produced by industrial processes, medical waste and underground storage tanks.
The main purpose of CERCLA is to clean up hazardous waste disposal sites. EPA has established standards known as Reportable Quantities (RQs). Companies must report to EPA any chemical release that exceeds the RQ. The RQ for most hazardous substances is one pound.
ATSDR derives Minimal Risk Levels (MRLs) for noncancer toxic effects. MRLs are estimates of daily human exposures that are likely to be without an appreciable risk of adverse effects over a specified duration of exposure. MRLs are derived for acute (14 days or less), intermediate (15-364 days), and chronic (365 days or more) exposures for inhalation or oral routes.
Occupational Exposure Standards/Guidelines
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Legal standards for workplace exposures are established by the Occupational Safety and Health Administration (OSHA). These standards are known as Permissible Exposure Limits (PELs). Most OSHA PELs are for airborne substances with allowable exposure limits averaged over an 8-hour day, 40-hour week. This is known as the Time-Weighted-Average (TWA) PEL. Adverse effects should not be encountered with repeated exposures at the TWA PEL.
OSHA also issues Short Term Exposure Limit (STELs) PELs, Ceiling Limit PELs, and PELs that carry a skin designation. PEL STELs are concentration limits of substances in the air that a worker may be exposed to for 15 minutes without suffering adverse effects. The 15 minute STEL is usually considerably higher than the 8-hour TWA exposure level. For example, for trichloroethylene the PEL-STEL is 200 ppm whereas the PEL-TWA is 50 ppm.
Ceiling Limit PELs are concentration limits for airborne substances that should never be exceeded. A skin designation indicates that the substance can be readily absorbed through the skin, eye or mucous membranes, and substantially contribute to the dose that a worker receives from inhalation of the substance.
Theoretically, an occupational substance could have PELs as TWA, STEL, and Ceiling Limit, and with a skin designation. This is rare however. Usually, a OSHA regulated substance will have only a PEL as a time-weighted average. About 20% of the OSHA regulated substances have PEL-STELs and only about 10% have skin notations. In a few cases, a substance may have a PEL-Ceiling but not a PEL-TWA.
An occupational exposure guideline developed by the OSHA Standards Completion Program is the Immediately Dangerous to Life and Health (IDLH). This represents a maximum level that a human could be exposed to for up to 30 minutes and escape from without any serious health effects.
When OSHA was formed in 1971, it immediately adopted existing occupational heath guidelines for its PELs. These guidelines were those of the American National Standards Institute (ANSI), American Conference of Governmental Industrial Hygienists (ACGIH), and National Institute for Occupational Safety and Health (NIOSH). OSHA also developed health standards for over 30 other workplace hazards based on risk assessments that they conducted.
The guidelines issued by the ACGIH are known as Threshold Limit Values (TLVs). NIOSH guidelines are designated as NIOSH Recommended Exposure Limits (RELs). Three types of TLVs exist as previously described for OSHA PELs. They are: Threshold Limit Value Time-Weighted Average (TLV-TWA), TLV as a Short-Term Exposure Limit (TLV-STELs), and Threshold Limit Value as a Ceiling Limit (TLV-C). The NIOSH RELs are also designated as time-weighted average, short-term exposure limits and ceiling limits.
To continue with Toxicology Tutor II and III go online to and select Note 5 in Area III D.
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Glossary of Terms
accelerator. A chemical used to increase the speed of a chemical reaction in the production of rubber or plastics.
ACGIH. American Conference of Governmental Industrial Hygiene.
acute-moderate syndrome. The onset is acute, but not life threatening. For chemicals, the length of exposure is less than 24 hours. The patient is likely to be seen in a clinic or emergency room, but not admitted to the hospital.
acute-severe syndrome. The onset is acute, severe, and life threatening. For chemicals, the length of exposure is less than 24 hours. The patient is likely to be admitted to the hospital.
aerosol. Small particles, usually in the range of 0.01 to 100 micrometers, dispersed in air; includes liquid (mist) and solid particles (dust).
AIHA. American Industrial Hygiene Association.
alveoli. Tiny sacs at the ends of bronchioles in the lungs; oxygen and carbon dioxide gas exchange takes place here with red blood cells in adjacent capillaries.
anemia. Decreased hemoglobin or number of red blood cells.
anesthesia. Temporary loss of consciousness induced by high concentrations of organic solvents.
antibiotic. A drug used in medicine to inhibit or kill microorganisms.
antibody. Proteins produced by the body's immune system in response to specific antigens.
antigen. A foreign substance that can induce the body to produce antibodies.
aplastic anemia. One type of anemia caused by injury to blood forming tissues and associated with occupational exposure to TNT, benzene, and ionizing radiation.
aromatic. An organic chemical (hydrocarbon) characterized by the presence of a benzene ring.
asthma. Reversible bronchoconstriction (narrowing of bronchioles) initiated by the inhalation of irritating or allergenic agents.
BEI. Biological Exposure Indices (ACGIH)
benign. 1) Refers to a tumor that does not invade other tissues and does not metastasize to other parts of the body. 2) Refers to an interstitial lung disease without any apparent symptoms or detectable changes in pulmonary function, e.g., siderosis caused by iron oxide.
bioaccumulation. Progressive increase of a poison in the body; occurs because the rate of intake exceeds the rate of elimination.
bronchiole. Bronchioles are the narrowest airways that branch from the bronchi of the trachea.
bronchitis. Chronic bronchitis is a persistent cough and the production of phlegm for at least 3 months out of the year for at least two successive years. (American Thoracic Society)
burn. Burns are characterized by: 1st degree-- redness; 2nd degree-- blisters; and 3rd degree--ulcers that heal by scarring.
carbamates. The carbamate insecticides are poisons that interrupt nerve conduction. These compounds cause the accumulation of acetylcholine at nerve endings by reversibly binding with the acetycholinesterase enzyme.
carcinogen. A chemical that can increase the incidence of cancer in exposed populations. Chemicals are classified by the International Agency for Research on Cancer (IARC) as known; probable, and possible human carcinogens based on available epidemiologic and toxicological evidence.
CAS #. Chemical Abstracts Service registry number, a unique number for each chemical in the format xxx-xx-x.
CBD. Chronic Beryllium Disease.
Ceiling. "The concentration that should not be exceeded during any part of the working exposure." (ACGIH)
CFR. Code of Federal Regulations.
chemical asphyxiant. A poison that blocks either the transport or use of oxygen by living organisms.
chloracne. A skin disease resembling acne that is caused by exposure to dioxin, pentachlorophenol, PCBs, and other chlorinated hydrocarbon compounds.
chronic syndrome. The onset of symptoms is gradual over a period longer than 2 months. A chronic syndrome induced by chemicals may represent 1) A cumulative exposure with a long latency, or 2) Adverse effects that persist two months or longer after a brief high exposure.
CNS. Central Nervous System.
CNS solvent syndrome. Organic solvents can affect the central nervous system both acutely (increased reaction time and anesthesia) and chronically (permanent brain damage).
confined space. "A space that is large enough and so configured that an employee can bodily enter and perform work. Confined spaces have limited or restricted means for entry or exit and are not designed for continuous occupancy. Confined spaces include storage tanks, bins, boilers, ventilation and exhaust ducts, pits, manholes, vats, and reactor vessels."
contact dermatitis. Dermatitis caused by contact with irritating or allergenic chemicals or biological agents.
corrosive. Pertaining to chemicals that can induce severe burns at the site of contact.
CWP. Coal Workers’ Pneumoconiosis.
dermatotoxin. A chemical that can cause skin disease.
dose-response relationship. Relationship between the dose of a toxic chemical and the incidence of an adverse effect. This is a fundamental law of toxicology expressed as, "The dose makes the poison." For any poison, there exists a threshold dose below which adverse effects do not occur.
edema. Increased intercellular fluid in tissues. In pulmonary edema, there is increased fluid in lung tissues.
EEGL. Emergency Exposure Guidance Level. (NRC)
elastomer. A plastic or synthetic rubber with elastic properties at room temperature.
engineering controls. Methods put in place (engineered) to control the source of worker exposure, e.g., exhaust ventilation systems or glove-box enclosures.
EPA. Environmental Protection Agency.
fibrogenic. Inducing tissue injury and fibrosis (scarring).
flammability. NFPA flammability code: 0 = will not burn; 1 = must be preheated; 2 = high ambient temp required; 3 = may ignite at ambient temp; 4 = burn readily.
gastrointestinal. Pertaining to the organs of the digestive system, including the stomach, liver, and intestines.
half-life. Time required to reduce by one half the amount of a chemical absorbed by the body. Half-life can be calculated accurately only for those substances eliminated linearly, independent of concentration. For linearly eliminated substances, it takes approximately 3.5 half-lives to eliminate 90% of the substance. [LaDou, p.174]
hard metal disease. Interstitial lung disease caused by repeated inhalation of cobalt dusts or fume. Exposure may occur during the manufacturing or use of hard metal tools containing cobalt and tungsten carbide.
hematotoxin. A chemical that is toxic to blood or blood-forming tissues.
hemoglobin. Proteins in red blood cells that carry oxygen.
hemolytic anemia. One type of anemia induced by chemicals in which the red blood cell membrane becomes fragile and lyses.
hepatotoxin. The chemical is toxic to the liver: 1) occupational hepatotoxin (principal effect); 2) secondary hepatotoxin (a) from occupational exposure (secondary effect) or (b) in animal studies or in humans after ingestion.
High-resolution computerized tomography (HRCT). An x-ray procedure used to diagnose lung diseases.
histopathological. Pertaining to the microscopic study of diseased cells and tissues.
hypersensitivity pneumonitis. An interstitial lung disease caused by repeated inhalation of organic dusts, e.g., Farmer’s lung.
hypoxia. Deficiency of oxygen available to living tissues.
IARC. International Agency for Research on Cancer; classifies chemicals as established (1), probable (2a), or possible (2b) human carcinogens.
IDLH. Immediately Dangerous to Life or Health.
inhalation fever. An acute, flu-like illness that begins a few hours after a heavy inhalation exposure to the causative dust or mist, e.g., zinc oxide fumes (metal fume fever) or organic dusts (organic dust toxic syndrome).
interstitial pulmonary fibrosis. Asbestos, coal, and silica dusts induce scar formation in interstitial lung tissue. The interstitium is the supporting lung tissue adjacent to pulmonary airways and blood vessels.
isomers. Chemicals with the same composition and molecular weight but different physical or chemical properties.
known carcinogen. Human carcinogen: sufficient evidence of carcinogenicity. [IARC]
lachrymator (lacrimator). A substance that irritates the eyes and induces the flow of tears.
latency. The latency for an occupational disease is the time lag between exposure to the toxin and detection of the disease.
LC50. Lethal concentration in 50% of animals tested.
Lower Explosive Limit (LEL). Lower Explosive Limit; the minimum concentration below which combustion will not occur.
Lowest-Observed-Adverse-Effect Level (LOAEL). "The lowest exposure level of a chemical in a study, or group of studies, that produces statistically or biologically significant increases in frequency or severity of adverse effects between the exposed population and its appropriate control." [ATSDR]
lung cancer. Cancer of the lung caused by occupational exposures-all of these agents are in the IARC Group 1 (known human carcinogens).
MAC (MAK). Maximum Allowable Concentration (Federal Republic of Germany).
methemoglobinemia. The presence of increased methemoglobin in the blood; chemicals are classified as either Primary (Methemoglobinemia is the primary toxic effect.) or Secondary.
mg/m3. Milligrams per cubic meter of air.
mmHg. Millimeters of mercury; at sea level the earth's atmosphere exerts a pressure of 760 mmHg. 1 mmHg = 1 Torr.
mppcf. Millions of particles per cubic foot of air.
MSDS. Material Safety Data Sheet.
MSHA. Mine Safety and Health Administration.
NAERG. North American Emergency Response Guidebook.
narcosis. Temporary sleepiness induced by high concentrations of organic solvents.
nephrotoxin. The chemical is toxic to the kidneys in the occupational setting; this is a primary toxic effect of the chemical.
neuropathy. Impairment of sensory and/or motor nerve function (slowing of conduction) caused by injury to peripheral nerves.
neurotoxin. Toxic to nerve cells; includes peripheral neuropathy (predominantly motor or sensorimotor), Parkinsonism, solvent syndrome (acute or chronic), and other CNS neurotoxins. [Rom, p. 697-707; LaDou, p. 366-74]
NFPA/ National Fire Protection Agency; see “flammability.”
NIOSH. National Institute for Occupational Safety and Health.
No-Observed-Adverse-Effect Level (NOAEL). "The dose of a chemical at which there were no statistically or biologically significant increases in frequency or severity of adverse effects seen between the exposed population and its appropriate control." [ATSDR]
NRC. National Research Council.
NTP. National Toxicology Program
odor threshold. The lowest concentration at which a substance can be detected or recognized using the sense of smell.
organochlorines. The organochlorine insecticides, including DDT and chlordane, persist in the environment and in animal tissues.
organophosphates. The organophosphate insecticides are poisons that interrupt nerve conduction. These compounds cause the accumulation of acetylcholine at nerve endings by irreversibly binding with the acetycholinesterase enzyme.
OSHA. Occupational Safety and Health Administration.
other CNS neurotoxin. Cyanide, organic tin, and other chemicals can cause a type of central nervous system injury different from neuropathy, Parkinson's syndrome, and solvent syndrome.
PACD. Photoallergic contact dermatitis.
paresthesia. Tingling or numbness.
Parkinson's syndrome. A degenerative central nervous system disorder with 4 characteristic features: slowness and poverty of movement, muscular rigidity, resting tremor, and postural instability.
PEL. Permissible exposure limit. (OSHA)
personal protective equipment. Respirators, gloves, eye protection, and other equipment used to protect workers from hazards when engineering controls fail to completely eliminate the potential for exposure.
pesticide. A substance used to kill pests including: algae (algicide), aphids (aphicide), fungi (fungicide), plants (herbicide), insects (insecticide), larvae (larvacide), molluscs (molluscicide), eggs (ovicide), rodents (rodenticide), and slime-producing organisms (slimicide).
photoallergic contact dermatitis (PACD). A type of allergic contact dermatitis caused by skin contact with an allergen that becomes active only after it absorbs UV light.
photoirritant contact dermatitis (PICD). A type of irritant contact dermatitis caused by skin contact with an irritant that becomes active only after it absorbs UV light.
pleura. A thin membrane that covers the lungs (visceral pleura) and thorax adjacent to the lungs (parietal pleura).
pneumoconiosis. Chronic scarring lung disease caused by the accumulation of asbestos, coal, silica, and other fibrogenic dusts.
pneumonitis. Inflammation of the lungs induced by inhalation of metal fumes or toxic gases and vapors.
possible carcinogen. Possible human carcinogen: limited epidemiological evidence and the absence of sufficient evidence in experimental animals. [IARC]
PPE. Personal protective equipment.
ppm. Parts per million.
probable carcinogen. Probable human carcinogen: limited epidemiological evidence, but sufficient evidence in experimental animals. [IARC]
pulmonary. Pertaining to the lung.
RD50. Concentration producing a 50% decrease in respiratory rate in experimental animals following a 10-minute exposure.
REL. Recommended exposure limit. (NIOSH)
renal. Pertaining to the kidneys.
reproductive toxin. A chemical that is toxic to the reproductive system, including defects in the progeny and injury to male and female reproductive function.
Restricted Use. Regulations that have banned or restricted the use of the agent.
route of exposure. Route of entry. For occupational exposures, poisons are usually absorbed through inhalation or skin contact. Significant occupational lead absorption can occur through ingestion.
sensitizer. An agent that can induce an allergic reaction in the skin or lungs.
serum. "Watery proteinaceous portion of the blood that remains after clotting." [Glossary for Chemists of Terms Used in Toxicology,"]
sign. Objective evidence of a disease as determined by laboratory results, an x-ray finding, or the physician's physical examination.
simple asphyxiant. A gas or vapor that can cause asphyxiation by displacing oxygen, but has no other significant adverse effects.
skin designation. "Danger of cutaneous absorption." (ACGIH)
SPEGL. Short-term public emergency guidance level. (NRC)
STEL. Short-term exposure limits. (ACGIH)
subacute syndrome. The onset of symptoms is gradual over a period of time less than 2 months. The syndrome may be a cumulative exposure with short latency, e.g., lead poisoning.
threshold limit value. "Concentration in air of a substance to which it is believed that most workers can be exposed daily without adverse effect (the threshold between safe and dangerous concentrations). These values are established (and revised annually) by the American Conference of Governmental Industrial Hygienists and are time-weighted concentrations for a 7 or 8-hour workday and a 40-hour workweek. For most substances the value may be exceeded, to a certain extent, provided there are compensatory periods of exposure below the value during the workday (or in some cases the week). For a few substances (mainly those that produce a rapid response) the limit is given as a ceiling concentration (maximum permissible concentration - designated by "C") that should never be exceeded." [Glossary for Chemists of Terms Used in Toxicology," ]
TIH. Toxic inhalation hazard. (NAERG)
TLV. Threshold limit value. (ACGIH)
TWA. Time-Weighted Average, the concentration of a chemical averaged or weighted over an 8-hour workday.
uncoupler. A chemical like pentachlorophenol that can cause a hypermetabolic state by poisoning cellular respiration (uncoupling oxidative phosphorylation).
vapor pressure (VP). A measure of a chemical’s volatility at 68 degrees F.
Source: National Institutes of Health (NIH)
AREA III E: EPIDEMIOLOGY
Epidemiology
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Philip S. Brachman, M.D.
Rollins School of Public Health, Emory University
Reprinted with permission of the Author
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General Concepts
Definitions
Epidemiology is the study of the determinants, occurrence, and distribution of health and disease in a defined population. Infection is the replication of organisms in host tissue, which may cause disease. A carrier is an individual with no overt disease who harbors infectious organisms. Dissemination is the spread of the organism in the environment.
Chain of Infection
There are three major links in disease occurrence: the etiologic agent, the method of transmission (by contact, by a common vehicle, or via air or a vector), and the host.
Epidemiologic Methods
Epidemiologic studies may be (1) descriptive, organizing data by time, place, and person; (2) analytic, incorporating a case-control or cohort study; or (3) experimental. Epidemiology utilizes an organized approach to problem solving by: (1) confirming the existence of an epidemic and verifying the diagnosis; (2) developing a case definition and collating data on cases; (3) analyzing data by time, place, and person; (4) developing a hypothesis; (5) conducting further studies if necessary; (6) developing and implementing control and prevention measures; (7) preparing and distributing a public report; and (8) evaluating control and preventive measures.
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INTRODUCTION
This chapter reviews the general concepts of epidemiology, which is the study of the determinants, occurrence, distribution, and control of health and disease in a defined population. Epidemiology is a descriptive science and includes the determination of rates, that is, the quantification of disease occurrence within a specific population. The most commonly studied rate is the attack rate: the number of cases of the disease divided by the population among whom the cases have occurred. Epidemiology can accurately describe a disease and many factors concerning its occurrence before its cause is identified. For example, Snow described many aspects of the epidemiology of cholera in the late 1840s, fully 30 years before Koch described the bacillus and Semmelweis described puerperal fever in detail in 1861 and recommended appropriate control and prevention measures a number of years before the streptococcal agent was fully described. One goal of epidemiologic studies is to define the parameters of a disease, including risk factors, in order to develop the most effective measures for control. This chapter includes a discussion of the chain of infection, the three main epidemiologic methods, and how to investigate an epidemic (Table 9-1).
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Proper interpretation of disease-specific epidemiologic data requires information concerning past as well as present occurrence of the disease. An increase in the number of reported cases of a disease that is normal and expected, representing a seasonal pattern of change in host susceptibility, does not constitute an epidemic. Therefore, the regular collection, collation, analysis, and reporting of data concerning the occurrence of a disease is important to properly interpret short-term changes in occurrence.
A sensitive and specific surveillance program is important for the proper interpretation of disease occurrence data. Almost every country has a national disease surveillance program that regularly collects data on selected diseases. The quality of these programs varies, but, generally, useful data are collected that are important in developing control and prevention measures. There is an international agreement that the occurrence of three diseasescholera, plague, and yellow feverwill be reported to the World Health Organization in Geneva, Switzerland. In the United States, the Centers for Disease Control and Prevention (CDC), U.S. Public Health Service, and the state health officers of all 50 states have agreed to report the occurrence of 51 diseases weekly and of another 10 diseases annually from the states to the CDC. Many states have regulations or laws that mandate reporting of these diseases and often of other diseases of specific interest to the state health department.
The methods of case reporting vary within each state. Passive reporting is one of the main methods. In such a case, physicians or personnel in clinics or hospitals report occurrences of relevant diseases by telephone, postcard, or a reporting form, usually at weekly intervals. In some instances, the report may be initiated by the public health or clinical laboratory where the etiologic agent is identified. Some diseases, such as human rabies, must be reported by telephone as soon as diagnosed. In an active surveillance program, the health authority regularly initiates the request for reporting. The local health department may call all or some health care providers at regular intervals to inquire about the occurrence of a disease or diseases. The active system may be used during an epidemic or if accurate data concerning all cases of a disease are desired.
The health care provider usually makes the initial passive report to a local authority, such as a city or county health department. This unit collates its data and sends a report to the next highest health department level, usually the state health department.
The number of cases of each reportable disease are presented weekly, via computer linkage, by the state health department to the CDC. Data are analyzed at each level to develop needed information to assist public health authorities in disease control and prevention. For some diseases, such as hepatitis, the CDC requests preparation of a separate case reporting form containing more specific details.
In addition, the CDC prepares and distributes routine reports summarizing and interpreting the analyses and providing information on epidemics and other appropriate public health matters. Most states and some county health departments also prepare and distribute their own surveillance reports. The CDC publishes Morbidity and Mortality Weekly Report, which is available for a small fee from the Massachusetts Medical Society. The CDC also prepares more detailed surveillance reports for specific diseases, as well as an annual summary report, all of which can also be obtained through the Massachusetts Medical Society.
Infection is the replication of organisms in the tissue of a host; when defined in terms of infection, disease is overt clinical manifestation. In an inapparent (subclinical) infection, an immune response can occur without overt clinical disease. A carrier (colonized individual) is a person in whom organisms are present and may be multiplying, but who shows no clinical response to their presence. The carrier state may be permanent, with the organism always present; intermittent, with the organism present for various periods; or temporary, with carriage for only a brief period. Dissemination is the movement of an infectious agent from a source directly into the environment; when infection results from dissemination, the source, if an individual, is referred to as a dangerous disseminator.
Infectiousness is the transmission of organisms from a source, or reservoir (see below), to a susceptible individual. A human may be infective during the preclinical, clinical, postclinical, or recovery phase of an illness. The incubation period is the interval in the preclinical period between the time at which the causative agent first infects the host and the onset of clinical symptoms; during this time the agent is replicating. Transmission is most likely during the incubation period for some diseases such as measles; in other diseases such as shigellosis, transmission occurs during the clinical period. The individual may be infective during the convalescent phase, as in diphtheria, or may become an asymptomatic carrier and remain infective for a prolonged period, as do approximately 5% of persons with typhoid fever.
The spectrum of occurrence of disease in a defined population includes sporadic (occasional occurrence); endemic (regular, continuing occurrence); epidemic (significantly increased occurrence); and pandemic (epidemic occurrence in multiple countries).
Chain of Infection
The chain of infection includes the three factors that lead to infection: the etiologic agent, the method of transmission, and the host (Fig. 9-1). These links should be characterized before control and prevention measures are proposed. Environmental factors that may influence disease occurrence must be evaluated.
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FIGURE 9-1 Summary of important aspects involved in the chain of any infection.
Etiologic Agent
The etiologic agent may be any microorganism that can cause infection. The pathogenicity of an agent is its ability to cause disease; pathogenicity is further characterized by describing the organism's virulence and invasiveness. Virulence refers to the severity of infection, which can be expressed by describing the morbidity (incidence of disease) and mortality (death rate) of the infection. An example of a highly virulent organism is Yersinia pestis, the agent of plague, which almost always causes severe disease in the susceptible host.
The invasiveness of an organism refers to its ability to invade tissue. Vibrio cholerae organisms are noninvasive, causing symptoms by releasing into the intestinal canal an exotoxin that acts on the tissues. In contrast, Shigella organisms in the intestinal canal are invasive and migrate into the tissue.
No microorganism is assuredly avirulent. An organism may have very low virulence, but if the host is highly susceptible, as when therapeutically immunosuppressed, infection with that organism may cause disease. For example, the poliomyelitis virus used in oral polio vaccine is highly attenuated and thus has low virulence, but in some highly susceptible individuals it may cause paralytic disease.
Other factors should be considered in describing the agent. The infecting dose (the number of organisms necessary to cause disease) varies according to the organism, method of transmission, site of entrance of the organism into the host, host defenses, and host species. Another agent factor is specificity; some agents (for example, Salmonella typhimurium) can infect a broad range of hosts; others have a narrow range of hosts. S typhi, for example, infects only humans. Other agent factors include antigenic composition, which can vary within a species (as in influenza virus or Streptococcus species); antibiotic sensitivity; resistance transfer plasmids (see Ch. 5); and enzyme production.
The reservoir of an organism is the site where it resides, metabolizes, and multiplies. The source of the organism is the site from which it is transmitted to a susceptible host, either directly or indirectly through an intermediary object. The reservoir and source can be different; for example, the reservoir for S typhi could be the gallbladder of an infected individual, but the source for transmission might be food contaminated by the carrier. The reservoir and source can also be the same, as in an individual who is a permanent nasal carrier of S aureus and who disseminates organisms from this site. The distinction can be important when considering where to apply control measures.
Method of Transmission
The method of transmission is the means by which the agent goes from the source to the host. The four major methods of transmission are by contact, by common vehicle, by air or via a vector.
In contact transmission the agent is spread directly, indirectly, or by airborne droplets. Direct contact transmission takes place when organisms are transmitted directly from the source to the susceptible host without involving an intermediate object; this is also referred to as person-to-person transmission. An example is the transmission of hepatitis A virus from one individual to another by hand contact. Indirect transmission occurs when the organisms are transmitted from a source, either animate or inanimate, to a host by means of an inanimate object. An example is transmission of Pseudomonas organisms from one individual to another by means of a shaving brush. Droplet spread refers to organisms that travel through the air very short distances, that is, less than 3 feet from a source to a host. Therefore, the organisms are not airborne in the true sense. An example of a disease that may be spread by droplets is measles.
Common-vehicle transmission refers to agents transmitted by a common inanimate vehicle, with multiple cases resulting from such exposure. This category includes diseases in which food or water as well as drugs and parenteral fluids are the vehicles of infection. Examples include food-borne salmonellosis, waterborne shigellosis, and bacteremia resulting from use of intravenous fluids contaminated with a gram-negative organism.
The third method of transmission, airborne transmission, refers to infection spread by droplet nuclei or dust. To be truly airborne, the particles should travel more than 3 feet through the air from the source to the host. Droplet nuclei are the residue from the evaporation of fluid from droplets, are light enough to be transmitted more than 3 feet from the source, and may remain airborne for prolonged periods. Tuberculosis is primarily an airborne disease; the source may be a coughing patient who creates aerosols of droplet nuclei that contain tubercle bacilli. Infectious agents may be contained in dust particles, which may become resuspended and transmitted to hosts. An example occurred in an outbreak of salmonellosis in a newborn nursery in which Salmonella-contaminated dust in a vacuum cleaner bag was resuspended when the equipment was used repeatedly, resulting in infections among the newborns.
The fourth method of transmission is vector borne transmission, in which arthropods are the vectors. Vector transmission may be external or internal. External, or mechanical, transmission occurs when organisms are carried mechanically on the vector (for example, Salmonella organisms that contaminate the legs of flies). Internal transmission occurs when the organisms are carried within the vector. If the pathogen is not changed by its carriage within the vector, the carriage is called harborage (as when a flea ingests plague bacilli from an infected individual or animal and contaminates a susceptible host when it feeds again; the organism is not changed while in the flea). The other form of internal transmission is called biologic. In this form, the organism is changed biologically during its passage through the vector (for example, malaria parasites in the mosquito vector).
An infectious agent may be transmitted by more than one route. For example, Salmonella may be transmitted by a common vehicle (food) or by contact spread (human carrier). Francisella tularensis may be transmitted by any of the four routes.
Host
The third link in the chain of infection is the host. The organism may enter the host through the skin, mucous membranes, lungs, gastrointestinal tract, or genitourinary tract, and it may enter fetuses through the placenta. The resulting disease often reflects the point of entrance, but not always: meningococci that enter the host through the mucous membranes may nonetheless cause meningitis. Development of disease in a host reflects agent characteristics (see above) and is influenced by host defense mechanisms, which may be nonspecific or specific.
Nonspecific defense mechanisms include the skin, mucous membranes, secretions, excretions, enzymes, the inflammatory response, genetic factors, hormones, nutrition, behavioral patterns, and the presence of other diseases. Specific defense mechanisms or immunity may be natural, resulting from exposure to the infectious agent, or artificial, resulting from active or passive immunization (see Ch. 8).
The environment can affect any link in the chain of infection. Temperature can assist or inhibit multiplication of organisms at their reservoir; air velocity can assist the airborne movement of droplet nuclei; low humidity can damage mucous membranes; and ultraviolet radiation can kill the microorganisms. In any investigation of disease, it is important to evaluate the effect of environmental factors. At times, environmental control measures are instituted more on emotional grounds than on the basis of epidemiologic fact. It should be apparent that the occurrence of disease results from the interaction of many factors (Table 9-2). Some of these factors are outlined here.
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Epidemiologic Methods
The three major epidemiologic techniques are descriptive, analytic, and experimental. Although all three can be used in investigating the occurrence of disease, the method used most is descriptive epidemiology. Once the basic epidemiology of a disease has been described, specific analytic methods can be used to study the disease further, and a specific experimental approach can be developed to test a hypothesis.
Descriptive Epidemiology
In descriptive epidemiology, data that describe the occurrence of the disease are collected by various methods from all relevant sources. The data are then collated by time, place, and person. Four time trends are considered in describing the epidemiologic data. The secular trend describes the occurrence of disease over a prolonged period, usually years; it is influenced by the degree of immunity in the population and possibly nonspecific measures such as improved socioeconomic and nutritional levels among the population. For example, the secular trend of tetanus in the United States since 1920 shows a gradual and steady decline.
The second time trend is the periodic trend. A temporary modification in the overall secular trend, the periodic trend may indicate a change in the antigenic characteristics of the disease agent. For example, the change in antigenic structure of the prevalent influenza A virus every 2 to 3 years results in periodic increases in the occurrence of clinical influenza caused by lack of natural immunity among the population. Additionally, a lowering of the overall immunity of a population or a segment thereof (known as herd immunity) can result in an increase in the occurrence of the disease. This can be seen with some immunizable diseases when periodic decreases occur in the level of immunization in a defined population. This may then result in an increase in the number of cases, with a subsequent rise in the overall level of herd immunity. The number of new cases then decreases until the herd's immunity is low enough to allow transmission to occur again and new cases then appear.
The third time trend is the seasonal trend. This trend reflects seasonal changes in disease occurrence following changes in environmental conditions that enhance the ability of the agent to replicate or be transmitted. For example, food-borne disease outbreaks occur more frequently in the summer, when temperatures favor multiplication of bacteria. This trend becomes evident when the occurrence of salmonellosis is examined on a monthly basis (Fig. 9-2).
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FIGURE 9-2 An example of a disease showing a seasonal trend. Reported human Salmonella isolations, by 4-week average, in the United States from 1968 to 1980.
The fourth time trend is the epidemic occurrence of disease. An epidemic is a sudden increase in occurrence due to prevalent factors that support transmission.
A description of epidemiologic data by place must consider three different sites: where the individual was when disease occurred; where the individual was when he or she became infected from the source; and where the source became infected with the etiologic agent. Therefore, in an outbreak of food poisoning, the host may become clinically ill at home from food eaten in a restaurant. The vehicle may have been undercooked chicken, which became infected on a poultry farm. These differences are important to consider in attempting to prevent additional cases.
The third focus of descriptive epidemiology is the infected person. All pertinent characteristics should be noted: age, sex, occupation, personal habits, socioeconomic status, immunization history, presence of underlying disease, and other data.
Once the descriptive epidemiologic data have been analyzed, the features of the epidemic should be clear enough that additional areas for investigation are apparent.
Analytic Epidemiology
The second epidemiologic method is analytic epidemiology, which analyzes disease determinants for possible causal relations. The two main analytic methods are the case-control (or case-comparison) method and the cohort method. The case-control method starts with the effect (disease) and retrospectively investigates the cause that led to the effect. The case group consists of individuals with the disease; a comparison group has members similar to those of the case group except for absence of the disease. These two groups are then compared to determine differences that would explain the occurrence of the disease. An example of a case-control study is selecting individuals with meningococcal meningitis and a comparison group matched for age, sex, socioeconomic status, and residence, but without the disease, to see what factors may have influenced the occurrence in the group that developed disease.
The second analytic approach is the cohort method, which prospectively studies two populations: one that has had contact with the suspected causal factor under study and a similar group that has had no contact with the factor. When both groups are observed, the effect of the factor should become apparent. An example of a cohort approach is to observe two similar groups of people, one composed of individuals who received blood transfusions and the other of persons who did not. The occurrence of hepatitis prospectively in both groups permits one to make an association between blood transfusions and hepatitis; that is, if the transfused blood was contaminated with hepatitis B virus, the recipient cohort should have a higher incidence of hepatitis than the nontransfused cohort.
The case-control approach is relatively easy to conduct, can be completed in a shorter period than the cohort approach, and is inexpensive and reproducible; however, bias may be introduced in selecting the two groups, it may be difficult to exclude subclinical cases from the comparison group, and a patient's recall of past events may be faulty. The advantages of a cohort study are the accuracy of collected data and the ability to make a direct estimate of the disease risk resulting from factor contact; however, cohort studies take longer and are more expensive to conduct.
Another analytic method is the cross-sectional study, in which a population is surveyed over a limited period to determine the relationship between a disease and variables present at the same time that may influence its occurrence.
Experimental Epidemiology
The third epidemiologic method is the experimental approach. A hypothesis is developed and an experimental model is constructed in which one or more selected factors are manipulated. The effect of the manipulation will either confirm or disprove the hypothesis. An example is the evaluation of the effect of a new drug on a disease. A group of people with the disease is identified, and some members are randomly selected to receive the drug. If the only difference between the two is use of the drug, the clinical differences between the groups should reflect the effectiveness of the drug.
Epidemic Investigation
An epidemic investigation describes the factors relevant to an outbreak of disease; once the circumstances related to the occurrence of disease are defined, appropriate control and prevention measures can be identified. In an epidemic investigation, data are collected, collated according to time, place, and person, and analyzed and inferences are drawn.
In the investigation, the first action should be to confirm the existence of the epidemic by noting from past surveillance data the number of cases suspected and comparing this with the number of cases initially reported. Additionally, the investigator should discuss the occurrence of the disease with physicians or others who have seen or reported cases after examining patients and reviewing laboratory and hospital records. These diagnoses should then be verified. A case definition should be developed to differentiate patients who represent actual cases, those who represent suspected or presumptive cases, and those who should be omitted from further study. Additional cases may be sought or additional patient data obtained, and a rough case count made.
This initial phase consists basically of collecting data, which then must be organized according to time, place, and person. The population at risk should be identified and a hypothesis developed concerning the occurrence of the disease. If appropriate, specimens should be collected and transported to the laboratory. More specific studies may be indicated. Additional data from these studies should be analyzed and the hypothesis confirmed or altered. After analysis, control and prevention measures should be developed and, as far as possible, implemented. A report containing this information should be prepared and distributed to those involved in investigating the outbreak and in implementing control and/or prevention measures. Continued surveillance activities may be appropriate to evaluate the effectiveness of the control and prevention measures.
In the United States, the CDC assists state health departments by providing epidemiologic and laboratory support services on request. Its assistance supports disease investigations and diagnostic laboratory activities and includes various training programs conducted in the states and at the CDC. A close working relationship exists between the CDC and state health departments. Additionally, physicians frequently consult with CDC personnel on a variety of health-related problems and attend public health training programs.
The use of epidemiology to characterize a disease before its etiology has been identified is exemplified by the initial studies of acquired immune deficiency syndrome (AIDS). The first cases came to the attention of the CDC late in 1981 when an increase was observed in requests for pentamidine for treatment of Pneumocystis carinii pneumonia. This initiated specific surveillance activities and epidemiologic studies that provided important information about this newly diagnosed disease.
Initial symptoms include fever, loss of appetite, weight loss, extreme fatigue, and enlargement of lymph nodes. A severe immune deficiency then develops, which appears to be associated with opportunistic infections. These infections include P carinii pneumonia, diagnosed in 52 percent of cases; Kaposi sarcoma in 26 percent of cases; and both P carinii pneumonia and Kaposi sarcoma in 7 percent of cases. The remaining 15 percent of AIDS patients have other parasitic, fungal, bacterial, or viral infections associated with immunodeficiencies. Among the first 2,640 cases reported to the CDC, there were 1,092 deaths, a case-fatality rate of 41 percent. Approximately 95 percent of the cases were male; 70 percent were 20 to 49 years of age at the time of diagnosis. Approximately 40 percent of the cases were reported from New York City, 12 percent from San Francisco, 8 percent from Los Angeles, and the remainder from 32 other states. Cases were reported from at least 16 other countries. Among the 90 percent of patients who were categorized according to possible risk factors, those at highest risk were homosexuals or bisexuals (70 percent), intravenous drug abusers ( 17 percent), Haitian entrants into the United States (9.5 percent), and persons with hemophilia (1 percent).
Analysis of these initial data, collected before the etiologic agent of AIDS was identified, supported the hypothesis that transmission occurred primarily by sexual contact, receipt of contaminated blood or blood products, or contact with contaminated intravenous needles. Spread through casual contact did not seem likely. The epidemiologic data indicated that AIDS was an infectious disease. It has now been determined that AIDS results from infection with a retrovirus of the human T cell leukemia/lymphoma virus family, which has been designated human immunodeficiency virus type I (HIV-l). The initial hypotheses have been proven as shown by analysis of data subsequently collected.
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Beaglehole R, Bonita R, Kjellstrom T: Basic Epidemiology. World Health Organization, Geneva, Switzerland, 1993
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Bennett JV, Brachman PS: Hospital Infections. 3rd Ed., Little, Brown, Boston, 1992
Evans AS, Brachman PS: Bacterial Infections of Humans. Epidemiology and Control.2nd Ed. Plenum New York, 1991
Fox JP, Hall CE, Elveback LR: Epidemiology, Man and Disease. Macmillan, New York, 1970
Hennekens CH, Buring JE: Epidemiology in Medicine. Little, Brown, Boston, 1987
Langmuir AD: The surveillance of communicable diseases of national importance. N Engl J Med 268: 182, 1963
Lilienfeld DE, Stolley PD: Foundations of Epidemiology. 3rd Ed. Oxford University Press, New York, 1994
MacMahon B, Pugh TF: Epidemiology Principles and Methods. Little, Brown, Boston, 1970
Mandell GL, Douglas RG, Jr, Bennett JE: Principles and Practice of Infectious Diseases, 3rd Ed. Churchill Livingstone, New York, 1990
Smith DM, Haupt BJ: Hospital discharge data used as feedback in planning research and education for primary care. Public Health Rep 98:457, 1983
World Health Organization: The surveillance of communicable diseases. WHO Chron 22:439, 1968
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Epidemiology
From Wikipedia, the free encyclopedia.
Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems (Last 2001). Epidemiology is the scientific study of factors affecting the health and illness of individuals and populations, and, in this capacity, it serves as the foundation and logic of interventions made in the interest of the public’s health. The acting epidemiologist works on issues from the practical, such as outbreak investigation, environmental exposure, and health promotion, to the theoretical, including the development of statistical, mathematical, philosophical, and biological theory. To this end, epidemiologists employ a range of study designs from the observational to experimental with the purpose of revealing the unbiased relationships between exposures such as nutrition, HIV, stress, or chemicals to outcomes such as disease, wellness, and health indicators.
Epidemiological studies are generally categorized as descriptive, analytic (aiming to examine associations, commonly hypothesized causal relationships), and experimental (a term often equated with clinical or community trials of treatments and other interventions).
Epidemiologists work in a variety of settings. Some epidemiologists work "in the field", i.e., in the community, commonly in a public health service, and are at the forefront of investigating and combating disease outbreaks.
Epidemiology as causal inference
Although epidemiology is sometimes viewed as a collection of statistical tools used to elucidate the associations of exposures to health outcomes, a deeper understanding of this science is that of discovering causal relationships. This conceptualization of epidemiology is difficult to grasp because our internal notions of causation are often poorly developed, frequently being predicated on the notion of a one-to-one relationship. For example, almost everyone would agree that gravity causes a dropped ball to fall towards the ground, but would most agree that drinking one glass of milk a day will cause weight loss? Even very heavy smokers know that their vice causes lung cancer, but only 10% of life-long smokers will get lung cancer. How can this be?
The answer is complex and delves into the philosophical notions of causality, induction, deduction, logic and other dense topics. It is nearly impossible to say with perfect accuracy how even the most simple physical systems will behave, much less the complex field of epidemiology that draws on biology, sociology, mathematics, statistics, anthropology, psychology, and policy. However, for the epidemiologist the key is in the term inference. As epidemiologists, we use gathered data and a broad range of bio-medical and psycho-social theories in an iterative way to generate or expand theory, to test hypotheses, and to make educated, informed assertions about which relationships are causal and exactly how they are causal.
Epidemiology as advocacy
An alternative aspect of an epidemiologist’s duty is to advocacy for the health of populations, bearing in mind the outpost perspective they have over factors that affect a whole population. In this capacity the epidemiologist is not limited by the strict requirements for scientific accuracy. This of course does not mean that the epidemiologist can advocate for whatever position they please independent of the data, but presentation of the data can take more artistic modes to engender behavior or perspective change. For example, consider these two alternative admonishments against smoking:
1. smoking has been consistently linked to health problems such as lung cancer and coronary heart disease in several large prospective studies, this link has been deemed causal by a complex process of induction, consensus, and modeling.
2. Smoking will kill you. Although statement one is more accurate, statement two has an air of finality and explicit causation that may help to reduce the rate of smoking, albeit scientific and philosophically questionable.
The best epidemiologist as advocate will consider the broader intellectual landscape beyond the epidemiology and public health literature to render judgment on a course of action for a population, in this manner they are employing a different analytical framework than the Cartesian framework that is more common in scientific epidemiology. However, it is rare for one person to wield the skills and embody the features required to be a leader in both the scientific and advocacy aspects of epidemiology.
Measures
1. Measures of occurrence
1. Incidence measures
1. Incidence density (also known as Incidence rate) (Szklo & Nieto, 2000)
2. Hazard rate
3. Cumulative incidence
2. Prevalence measures
1. Point prevalence
2. Period prevalence
2. Measures of association
1. Relative measures
1. Risk ratio
2. Rate ratio
3. Odds ratio
4. Hazard ratio
2. Absolute measures
1. Risk/rate/incidence difference
2. Attributable risk
1. Attributable risk in exposed
2. Percent attributable risk
3. Levin’s attributable risk
History of epidemiology
Dr. John Snow is famous for the suppression of an 1854 outbreak of cholera in London's Soho district. He identified the cause of the outbreak as a public water pump on Broad Street and had the handle removed, thus ending the outbreak. (It has been questioned as to whether the epidemic was already in decline when Snow took action.) This has been perceived as a major event in the history of public health and can be regarded as the founding event of the science of epidemiology.
Other pioneers include Danish physician P.A. Schleisner, who in 1849 related his work on the prevention of the epidemic of tetanus neonatorum on the Vestmanna Islands in Iceland. Another important pioneer was Hungarian physician Ignaz Semmelweis, who in 1847 brought down infant mortality at Vienna hospital by instituting a disinfection procedure. His findings were published in 1850, but his work was ill received by this colleagues, who discontinued the procedure. Disinfection did not become widely practiced until British surgeon Joseph Lister "discovered" antiseptics in 1865 in light of the work of Louis Pasteur.
In the early 20th century, mathematical methods were introduced into epidemiology by Ronald Ross, Anderson Gray McKendrick and others. Another breakthrough was the 1956 publication of the results of a British doctor's study, which lent statistical support to the suspicion that tobacco smoking was linked to lung cancer.
References
• Last JM (2001). "A dictionary of epidemiology", 4th edn, Oxford: Oxford University Press.
• Nutter FW Jr (1999) "Understanding the Interrelationships Between Botanical, Human, and Veterinary Epidemiology: The Ys and Rs of It All. Ecosystem Health 5 (3): 131-140".
• Szklo MM & Nieto FJ (2002). "Epidemiology: beyond the basics", Aspen Publishers, Inc.
Analyzing Multiple
Risk Factors [pic]
The Event
Listed below are some of the initial steps that take place in an outbreak investigation. This section will provide you with a basis of information to complete this module.
Background Information
Recently, a national political action committee (PAC) held a fundraising event at a Hotel & Convention Center in Washington, D.C. to select which candidate they would support by providing contributions to the candidate's campaign.
The candidate would be selected by a popular vote that was scheduled to occur at the completion of the annual meeting, which took place during August 28--31. Upon arrival at the meeting, members of the PAC attended a banquet to recognize the accomplishments of the group during the previous calendar year.
Within 24 hours of the banquet, a number of diners had become ill with diarrhea and at least one of the following symptoms:
• Headache
• Fever
• Abdominal pain
• Nausea
• Vomiting
At this point, the local public health department has been notified and is onsite to conduct an investigation.
Identifying an Outbreak
Often, health departments are alerted of a potential outbreak by a health-care provider or the general public. It is your responsibility to identify whether the event is truly an outbreak or a series of unrelated cases.
Establishing a Case Definition
A case definition is a "set of standard criteria for deciding whether a person has a particular disease or health-related condition, by specifying clinical criteria and limitations on time, place, and person" (1). In the beginning of an investigation, the case definition can be fairly general, but as information is gathered, the epidemiologist may use a more specific description.
Initial Case Definition
An illness with diarrhea and at least one of the following symptoms: headache, fever, abdominal pain, nausea, and/or vomiting. Onset of illness or symptoms occurred during August 28--31.
Identification of Cases
Often, the initial cases identified in an investigation represent only a fraction of the affected population. Therefore, it is important to detect and identify other cases through interviews, questionnaires, surveys of health care facilities, newspaper articles, and other means.
During the next part of the outbreak investigation, the team obtained an occupancy list of all of the guests who were registered at the hotel.
Using an adapted version of the foodborne outbreak investigation questionnaire developed by CDC, which contained questions pertaining to demographics, clinical information, exposure information, and a 72-hour meal history, the team divided the list and began to collect data in an effort to identify affected cases and systematically organize key information.
The team established that 105 of the 435 hotel guests had become acutely ill and exhibited many of the symptoms listed in the initial case definition. All of these persons were members of the PAC.
Formulating Hypotheses
The next step in an investigation is to develop an initial hypothesis, based upon the information collected during early interviews and other information provided by health-care facilities or medical institutions that treated the patients.
Initial Hypothesis
Onset of diarrheal illness of an unknown origin occurred during August 28--31. The potential exposure to the unknown agent could have occurred at the PAC banquet at Hotel A in Washington, D.C.
Evaluating the Hypothesis
In order to identify the source of the epidemic, investigators must evaluate the relationships between exposures and the disease in question. The following information will be helpful in evaluating the hypothesis presented on the following pages.
Additional Information
A descriptive analysis of the information gathered from the interviews and questionnaires identified the following characteristics of the distribution of the disease in question.
• Person - members of the PAC
• Place - the PAC banquet on August 28
• Time - the banquet occurred at 6:00 p.m., and the first onset of illness surfaced at 6:00 a.m. on August 29
This information suggests that attendance at the banquet was the common exposure, and the reported symptoms sound like an outbreak of gastroenteritis, which is commonly caused by food contamination.
Next, we will discuss methods to organize the data in an effort to begin to make epidemiologic associations.
Potential Exposures
The team was able to determine from the interviews that the potential exposures in this outbreak include all the items served at the banquet:
• Turkey
• Gravy
• Ham
• Mashed potatoes
• Green beans
• Chocolate sorbet
• Strawberry sorbet
We need to discover, each of the potential exposures, which is associated with becoming ill.
Risk Factors
All of the potential exposures cited in the scenario so far could be classified as risk factors, which can be defined as "an aspect of personal behavior, lifestyle, or environmental exposure...which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent".(1)
Since we are trying to determine what factors are associated with the illness, we must analyze the data in order to measure the frequencies with which a potential exposure can be associated with the illness. Measures of association may be expressed in several ways.
Attack Rates
One of the most commonly used measures expresses how many diseases are a consequence of a certain factor. It can be expressed as an attack rate, which measures the proportion of people in a well-defined population that develop an illness of interest during a limited period of time.
These rates can be calculated by dividing the number of new cases among the population during the limited time period (X) by the population at risk at the beginning of the period (Y). This number is then multiplied by (100) to obtain a percentage. The formula can be expressed as:
[pic]
As you can see, attack rates measure the probability or risk for becoming a case. So the greater the difference between attack rates for those exposed to a particular risk factor and those not exposed, the higher the probability that the risk factor caused the outbreak.
Let's look at our previous example to calculate the attack rate for the entire population who attended the PAC banquet:
X = the number of ill persons who attended the banquet = 105
Y = the total number of persons who attended the banquet = 235
[pic]
Risk Ratio
Before we can make any conclusions, we must also calculate the attack rates for the unexposed population (i.e., the population that did not eat the menu item). In the table below, we have provided you with the attack rate of both the exposed and unexposed population so that we will be able to calculate the risk ratio. The risk ratio compares the amount of disease risk in the exposed population to the amount of risk in the unexposed population. The formula can be expressed as:
[pic]
Risk ratios can be evaluated by using the following criteria:
• RR = 1.0 indicates identical risk in both groups
• RR > 1.0 indicates an increased risk for the exposed group compared to the unexposed group
• RR < 1.0 indicates a decreased risk for the exposed group compared to the unexposed group
Selecting a Reference Group
Selection of an appropriate reference or comparison group is critical to determining whether an association exists between the exposure and illness. Typically, the reference group is the population of individuals that has had no exposure to the risk factor being analyzed. Ideally, the exposed and unexposed populations should be similar, with the exception of the exposure. Thus, if no direct association exists between the exposure and the illness, the attack rates will be relatively similar.
Unfortunately, the analysis of food-specific attack rates did not clearly point to any one of the menu items as the source of the outbreak.
However, one of the epidemiologists pointed out that eight persons arrived late to the banquet and were able to eat only dessert. All of these persons became ill.
Of these eight dessert-only diners:
• four ate chocolate sorbet
• four ate strawberry sorbet
In addition, the outbreak investigation team realized through their analysis of the data that ten persons who ate the main course of the meal did not eat dessert. Of these ten non-dessert diners, only two became ill.
Analyses of Multiple Risk Factors
"It is important to note that when several risk factors are being considered simultaneously, the non-exposed group should be defined as those with none of the risk factors under evaluation".(2) In this case, the reference group is the population of individuals that were not exposed to (did not eat) the risk factors being analyzed.
We have established the group that ate no dessert as the "risk-free" reference group, as they have many of the same characteristics of the exposed population but did not eat any of the dessert items.
Previously, when the risk ratios were calculated for the two dessert items, they were 1.32 for chocolate sorbet and 1.07 for strawberry sorbet. There is a difference between these figures and those calculated above (2.25 for chocolate sorbet and 2.00 for strawberry sorbet). There are several reasons for this discrepancy listed below.
• Two high-risk populations were compared because the comparison (unexposed) group included all those who ate the other implicated food item (minus those who ate both items).
• The resulting attack rate for the comparison (unexposed) group was relatively similar to the attack rate for the exposed population.
• Therefore, the risk ratios were relatively low and did not appear to be statistically significant.
Bottom of Form
Knowing when to refocus and reanalyze like this is not easy; it is something that investigators generally learn from judgment and experience. It is also essential to stay open and alert to clues. A key clue was that among a small number of people who ate nothing but dessert, all became ill, and among a small number who ate no dessert, few became ill.
Further Investigation
After a thorough analysis of the data, the investigation team hypothesized that the primary contributing factors to the illness were associated with eating chocolate sorbet or strawberry sorbet.
Early in the investigation, stool specimens had been taken from several persons. In addition, the team also took stool samples from all of the kitchen staff on duty during the preparation of the food for the banquet. All of the samples were sent to the local health department lab to be cultured for enteric pathogens.
Revising the Hypothesis
Once you have characterized the outbreak by time, place, and person and analyzed the data to determine risk factors associated with the disease, it is helpful to revisit the initial hypothesis and to determine if any changes need to be made on the basis of the information gathered so far. Much of this information can be derived from descriptive epidemiology and the analyses of the individual risk factors.
For instance, we are able to deduce that the vehicles for transmission of the illness were chocolate sorbet and strawberry sorbet. Unfortunately, at this point the causative agent (such as a microorganism, chemical substance, or form of radiation, whose presence, excessive presence, or relative absence is essential for the occurrence of a disease) is still unknown, and additional data will therefore need to be gathered after the revised hypothesis is developed.
Our revised hypothesis could read "The illness was caused by consumption of either chocolate sorbet and/or strawberry sorbet consumed at the Political Action Committee Banquet at 6 p.m. on August 28.
When the results were returned from the lab, the results indicated that:
• No kitchen staff tested positive for any enteric pathogens,
• Stool cultures from the early onset cases tested positive for Salmonella Typhimurium,
• Cultures from the leftover chocolate sorbet and strawberry sorbet yielded the identical strain of Salmonella to the persons tested at the banquet.
Based upon this new information, the investigation team revised their case definition to read:
• An illness with diarrhea (multiple loose bowel movements within a 24-hour period) and at least one of the following symptoms: headache, fever, abdominal pain, nausea, and/or vomiting
OR
• A positive stool culture for Salmonella Typhimurium
AND
• Onset of illness or symptoms occurred during August 28--31 and the patient attended the PAC banquet.
In addition, local sanitarians also conducted an environmental analysis of the kitchen facility and found no indication of Salmonella Typhimurium on any of the equipment or utensils that were used in the storage, preparation, and service of the meal. In addition, they also found that the kitchen staff practiced good hygiene and safe food-handling practices.
Understanding the Outbreak
Many outbreak investigations are not straightforward, and this one is no exception. Another aspect of evaluating a hypothesis is to review reference material on the disease or illness to determine whether the situation is similar to other reported incidents. Often, the Emerging Infectious Diseases (EID) journal is a valuable resource for finding incidents, trends, and specific disease information. (EID is available at: .
Some of the areas that will help with the investigation are:
• Typical signs and symptoms
• Modes of transmission
• Exposures
In the example of the PAC Banquet, the majority of ill persons interviewed met the established symptoms of Salmonella Typhimurium, such as:
• Diarrhea, fever, and abdominal cramps
• Incubation period of 6 -- 72 hours after infection
• Illness usually lasts 4 -- 7 days
• Transmitted through contaminated food, water, or contact with infected animals
However, the fact that Salmonella Typhimurium is not typically found in the ingredients used in chocolate sorbet and strawberry sorbet led the investigation team to consider the possibility of deliberate tampering.
When the investigators first suspected intentional food tampering, they contacted local law enforcement officials, who in turn notified the Federal Bureau of Investigation (FBI).
Information obtained in the ensuing investigation revealed that a supporter of one of the candidates owned the company that supplied desserts to many of the food service facilities in the area. This person later admitted to trying to sabotage the election by inoculating Salmonella Typhimurium into the desserts in an attempt to alter the results of the popular vote for funding. The saboteur and colleagues skipped the banquet and had planned to show up for the vote while others were ill.
If you recall, there were two persons reported that they did not eat the dessert. As it turns out, when asked again, they indicated that they forgot to mention taking a "few bites" from their spouses' desserts.
Also, four hotel employees who were not employed in the kitchen, were identified as having Salmonella Typhimurium. These employees became ill after they ate desserts that had been left over from the banquet.
In the end, all of the cases were accounted for and associated with either chocolate sorbet or strawberry sorbet.
Summary
Many outbreak investigations are not straightforward, and therefore it is important to look for clues that will help you identify what factors are associated with the illness in question. To accomplish this, you should select an appropriate reference group and analyze the data for measures of association. The following is a brief description of the steps involved in this process.
Selecting a Reference Group
Selection of an appropriate reference or comparison group is critical to determining whether an association exists between the exposure and illness. Typically, the reference group is the population of individuals that has had no exposure to the risk factor being analyzed. Ideally, the exposed and unexposed populations should be similar, with the exception of the exposure. Thus, if no direct association exists between the exposure and the illness, the attack rates will be relatively similar.
Calculating Rates and Ratios
To determine what factors are associated with the illness, we must analyze the data to measure the frequencies with which a potential exposure can be associated with the illness. There are several ways to express measures of association in cohort studies.
• Attack rates are calculated by dividing the number of new cases among the population during the limited time period (X) by the population at risk at the beginning of the period (Y). This number is then multiplied by (100) to express in a percentage. The formula can be expressed as:
[pic]
• Risk ratios compare the amount of risk associated with an event such as a disease or death in the exposed population to the amount of risk in the unexposed population. As a result, they are calculated by dividing the attack rate in the exposed population by the attack rate in the unexposed population. The formula can be expressed as:
[pic]
Analyzing Multiple Risk Factors
When several risk factors are being considered simultaneously, it is often necessary to establish an experimental control, where there is an absence of exposure to all of the risk factors being analyzed. By establishing an experimental control, a uniform denominator is created and the resulting risk ratios can be compared. The following can assist with comparison of risk ratios.
• RR = 1.0 indicates identical risk in both groups
• RR > 1.0 indicates an increased risk for the exposed group compared to the unexposed group
• RR < 1.0 indicates a decreased risk for the exposed group compared to the unexposed group
Identifying the correct association will the illness does not always occur on the first attempt and knowing when to refocus and reanalyze often requires experience and judgment and might require advanced analysis. Often, investigations are an iterative process in which a hypothesis is established, tested, and revised several times before association(s) can be established. Overall, it is also essential to stay open and be alert to clues
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Glossary
AGE-ADJUSTED MORTALITY RATE. A mortality rate statistically modified to eliminate the effect of different age distributions in the different populations.
AGENT. A factor, such as a microorganism, chemical substance, or form of radiation, whose presence, excessive presence, or (in deficiency diseases) relative absence is essential for the occurrence of a disease.
AGE-SPECIFIC MORTALITY RATE. A mortality rate limited to a particular age group. The numerator is the number of deaths in that age group; the denominator is the number of persons in that age group in the population.
ANALYTIC EPIDEMIOLOGY. The aspect of epidemiology concerned with the search for health-related causes and effects. Uses comparison groups, which provide baseline data, to quantify the association between exposures and outcomes, and test hypotheses about causal relationships.
ANALYTIC STUDY. A comparative study intended to identify and quantify associations, test hypotheses, and identify causes. Two common types are cohort study and case-control study.
APPLIED EPIDEMIOLOGY. The application or practice of epidemiology to address public health issues.
ASSOCIATION. Statistical relationship between two or more events, characteristics, or other variables.
ATTACK RATE. A variant of an incident rate, applied to a narrowly defined population observed for a limited period of time, such as during an epidemic.
ATTRIBUTABLE PROPORTION. A measure of the public health impact of a causative factor; proportion of a disease in a group that is exposed to a particular factor which can be attributed to their exposure to that factor.
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B
BAR CHART. A visual display of the size of the different categories of a variable. Each category or value of the variable is represented by a bar.
BIAS. Deviation of results or inferences from the truth, or processes leading to such systematic deviation. Any trend in the collection, analysis, interpretation, publication, or review of data that can lead to conclusions that are systematically different from the truth.
BIOLOGIC TRANSMISSION. The indirect vector-borne transmission of an infectious agent in which the agent undergoes biologic changes within the vector before being transmitted to a new host.
BOX PLOT. A visual display that summarizes data using a ``box and whiskers'' format to show the minimum and maximum values (ends of the whiskers), interquartile range (length of the box), and median (line through the box).
[pic]
C
CARRIER. A person or animal without apparent disease that harbors a specific infectious agent and is capable of transmitting the agent to others. The carrier state may occur in an individual with an infection that is inapparent throughout its course (known as asymptomatic carrier), or during the incubation period, convalescence, and postconvalescence of an individual with a clinically recognizable disease. The carrier state may be of short or long duration (transient carrier or chronic carrier).
CASE. In epidemiology, a countable instance in the population or study group of a particular disease, health disorder, or condition under investigation. Sometimes, an individual with the particular disease.
CASE-CONTROL STUDY. A type of observational analytic study. Enrollment into the study is based on presence (``case'') or absence (``control'') of disease. Characteristics such as previous exposure are then compared between cases and controls.
CASE DEFINITION. A set of standard criteria for deciding whether a person has a particular disease or health-related condition, by specifying clinical criteria and limitations on time, place, and person.
CASE-FATALITY RATE. The proportion of persons with a particular condition (cases) who die from that condition. The denominator is the number of incident cases; the numerator is the number of cause-specific deaths among those cases.
CAUSE OF DISEASE. A factor (characteristic, behavior, event, etc.) that directly influences the occurrence of disease. A reduction of the factor in the population should lead to a reduction in the occurrence of disease.
CAUSE-SPECIFIC MORTALITY RATE. The mortality rate from a specified cause for a population. The numerator is the number of deaths attributed to a specific cause during a specified time interval; the denominator is the size of the population at the midpoint of the time interval.
CENSUS. The enumeration of an entire population, usually with details being recorded on residence, age, sex, occupation, ethnic group, marital status, birth history, and relationship to head of household.
CHAIN OF INFECTION. A process that begins when an agent leaves its reservoir or host through a portal of exit, and is conveyed by some mode of transmission, then enters through an appropriate portal of entry to infect a susceptible host.
CLASS INTERVAL. A span of values of a continuous variable which are grouped into a single category for a frequency distribution of that variable.
CLUSTER. An aggregation of cases of a disease or other health-related condition, particularly cancer and birth defects, which are closely grouped in time and place. The number of cases may or may not exceed the expected number; frequently the expected number is not known.
COHORT. A well-defined group of people who have had a common experience or exposure, who are then followed up for the incidence of new diseases or events, as in a cohort or prospective study. A group of people born during a particular period or year is called a birth cohort.
COHORT STUDY. A type of observational analytic study. Enrollment into the study is based on exposure characteristics or membership in a group. Disease, death, or other health-related outcomes are then ascertained and compared.
COMMON SOURCE OUTBREAK. An outbreak that results from a group of persons being exposed to a common noxious influence, such as an infectious agent or toxin. If the group is exposed over a relatively brief period of time, so that all cases occur within one incubation period, then the common source outbreak is further classified as a point source outbreak. In some common source outbreaks, persons may be exposed over a period of days, weeks, or longer, with the exposure being either intermittent or continuous.
CONFIDENCE INTERVAL. A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable. The specified probability is called the confidence level, and the end points of the confidence interval are called the confidence limits.
CONFIDENCE LIMIT. The minimum or maximum value of a confidence interval.
CONTACT. Exposure to a source of an infection, or a person so exposed.
CONTAGIOUS. Capable of being transmitted from one person to another by contact or close proximity.
CONTINGENCY TABLE. A two-variable table with cross-tabulated data.
CONTROL. In a case-control study, comparison group of persons without disease.
CRUDE MORTALITY RATE. The mortality rate from all causes of death for a population.
CUMULATIVE FREQUENCY. In a frequency distribution, the number or proportion of cases or events with a particular value or in a particular class interval, plus the total number or proportion of cases or events with smaller values of the variable.
CUMULATIVE FREQUENCY CURVE. A plot of the cumulative frequency rather than the actual frequency for each class interval of a variable. This type of graph is useful for identifying medians, quartiles, and other percentiles.
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D
DEATH-TO-CASE RATIO. The number of deaths attributed to a particular disease during a specified time period divided by the number of new cases of that disease identified during the same time period.
DEMOGRAPHIC INFORMATION. The ``person'' characteristics--age, sex, race, and occupation--of descriptive epidemiology used to characterize the populations at risk.
DENOMINATOR. The lower portion of a fraction used to calculate a rate or ratio. In a rate, the denominator is usually the population (or population experience, as in person-years, etc.) at risk.
DEPENDENT VARIABLE. In a statistical analysis, the outcome variable(s) or the variable(s) whose values are a function of other variable(s) (called independent variable(s) in the relationship under study).
DESCRIPTIVE EPIDEMIOLOGY. The aspect of epidemiology concerned with organizing and summarizing health-related data according to time, place, and person.
DETERMINANT. Any factor, whether event, characteristic, or other definable entity, that brings about change in a health condition, or in other defined characteristics.
DIRECT TRANSMISSION. The immediate transfer of an agent from a reservoir to a susceptible host by direct contact or droplet spread.
DISTRIBUTION. In epidemiology, the frequency and pattern of health-related characteristics and events in a population. In statistics, the observed or theoretical frequency of values of a variable.
DOT PLOT. A visual display of the actual data points of a noncontinuous variable.
DROPLET NUCLEI. The residue of dried droplets that may remain suspended in the air for long periods, may be blown over great distances, and are easily inhaled into the lungs and exhaled.
DROPLET SPREAD. The direct transmission of an infectious agent from a reservoir to a susceptible host by spray with relatively large, short-ranged aerosols produced by sneezing, coughing, or talking.
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E
ENDEMIC DISEASE. The constant presence of a disease or infectious agent within a given geographic area or population group; may also refer to the usual prevalence of a given disease within such area or group.
ENVIRONMENTAL FACTOR. An extrinsic factor (geology, climate, insects, sanitation, health services, etc.) which affects the agent and the opportunity for exposure.
EPIDEMIC. The occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time.
EPIDEMIC CURVE. A histogram that shows the course of a disease outbreak or epidemic by plotting the number of cases by time of onset.
EPIDEMIC PERIOD. A time period when the number of cases of disease reported is greater than expected.
EPIDEMIOLOGIC TRIAD. The traditional model of infectious disease causation. Includes three components: an external agent, a susceptible host, and an environment that brings the host and agent together, so that disease occurs.
EPIDEMIOLOGY. The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.
EVALUATION. A process that attempts to determine as systematically and objectively as possible the relevance, effectiveness, and impact of activities in the light of their objectives.
EXPERIMENTAL STUDY. A study in which the investigator specifies the exposure category for each individual (clinical trial) or community (community trial), then follows the individuals or community to detect the effects of the exposure.
EXPOSED (GROUP). A group whose members have been exposed to a supposed cause of disease or health state of interest, or possess a characteristic that is a determinant of the health outcome of interest.
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F
FREQUENCY DISTRIBUTION. A complete summary of the frequencies of the values or categories of a variable; often displayed in a two column table: the left column lists the individual values or categories, the right column indicates the number of observations in each category.
FREQUENCY POLYGON. A graph of a frequency distribution with values of the variable on the x-axis and the number of observations on the y-axis; data points are plotted at the midpoints of the intervals and are connected with a straight line.
[pic]
G
GRAPH. A way to show quantitative data visually, using a system of coordinates.
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H
HEALTH. A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
HEALTH INDICATOR. A measure that reflects, or indicates, the state of health of persons in a defined population, e.g., the infant mortality rate.
HEALTH INFORMATION SYSTEM. A combination of health statistics from various sources, used to derive information about health status, health care, provision and use of services, and impact on health.
HIGH-RISK GROUP. A group in the community with an elevated risk of disease.
HISTOGRAM. A graphic representation of the frequency distribution of a continuous variable. Rectangles are drawn in such a way that their bases lie on a linear scale representing different intervals, and their heights are proportional to the frequencies of the values within each of the intervals.
HOST. A person or other living organism that can be infected by an infectious agent under natural conditions.
HOST FACTOR. An intrinsic factor (age, race, sex, behaviors, etc.) which influences an individual's exposure, susceptibility, or response to a causative agent.
HYPERENDEMIC DISEASE. A disease that is constantly present at a high incidence and/or prevalence rate.
HYPOTHESIS. A supposition, arrived at from observation or reflection, that leads to refutable predictions. Any conjecture cast in a form that will allow it to be tested and refuted.
HYPOTHESIS, NULL. The first step in testing for statistical significance in which it is assumed that the exposure is not related to disease.
HYPOTHESIS, ALTERNATIVE. The hypothesis, to be adopted if the null hypothesis proves implausible, in which exposure is associated with disease.
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I
IMMUNITY, ACTIVE. Resistance developed in response to stimulus by an antigen (infecting agent or vaccine) and usually characterized by the presence of antibody produced by the host.
IMMUNITY, HERD. The resistance of a group to invasion and spread of an infectious agent, based on the resistance to infection of a high proportion of individual members of the group. The resistance is a product of the number susceptible and the probability that those who are susceptible will come into contact with an infected person.
IMMUNITY, PASSIVE. Immunity conferred by an antibody produced in another host and acquired naturally by an infant from its mother or artificially by administration of an antibody-containing preparation (antiserum or immune globulin).
INCIDENCE RATE. A measure of the frequency with which an event, such as a new case of illness, occurs in a population over a period of time. The denominator is the population at risk; the numerator is the number of new cases occurring during a given time period.
INCUBATION PERIOD. A period of subclinical or inapparent pathologic changes following exposure, ending with the onset of symptoms of infectious disease.
INDEPENDENT VARIABLE. An exposure, risk factor, or other characteristic being observed or measured that is hypothesized to influence an event or manifestation (the dependent variable).
INDIRECT TRANSMISSION. The transmission of an agent carried from a reservoir to a susceptible host by suspended air particles or by animate (vector) or inanimate (vehicle) intermediaries.
INDIVIDUAL DATA. Data that have not been put into a frequency distribution or rank ordered.
INFECTIVITY. The proportion of persons exposed to a causative agent who become infected by an infectious disease.
INFERENCE, STATISTICAL. In statistics, the development of generalizations from sample data, usually with calculated degrees of uncertainty.
INTERQUARTILE RANGE. The central portion of a distribution, calculated as the difference between the third quartile and the first quartile; this range includes about one-half of the observations in the set, leaving one-quarter of the observations on each side.
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LATENCY PERIOD. A period of subclinical or inapparent pathologic changes following exposure, ending with the onset of symptoms of chronic disease.
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MEAN, ARITHMETIC. The measure of central location commonly called the average. It is calculated by adding together all the individual values in a group of measurements and dividing by the number of values in the group.
MEAN, GEOMETRIC. The mean or average of a set of data measured on a logarithmic scale.
MEASURE OF ASSOCIATION. A quantified relationship between exposure and disease; includes relative risk, rate ratio, odds ratio.
MEASURE OF CENTRAL LOCATION. A central value that best represents a distribution of data. Measures of central location include the mean, median, and mode. Also called the measure of central tendency.
MEASURE OF DISPERSION. A measure of the spread of a distribution out from its central value. Measures of dispersion used in epidemiology include the interquartile range, variance, and the standard deviation.
MEDIAN. The measure of central location which divides a set of data into two equal parts.
MEDICAL SURVEILLANCE. The monitoring of potentially exposed individuals to detect early symptoms of disease.
MIDRANGE. The halfway point or midpoint in a set of observations. For most types of data, it is calculated as the sum of the smallest observation and the largest observation, divided by two. For age data, one is added to the numerator. The midrange is usually calculated as an intermediate step in determining other measures.
MODE. A measure of central location, the most frequently occurring value in a set of observations.
MORBIDITY. Any departure, subjective or objective, from a state of physiological or psychological well-being.
MORTALITY RATE. A measure of the frequency of occurrence of death in a defined population during a specified interval of time.
MORTALITY RATE, INFANT. A ratio expressing the number of deaths among children less than one year of age reported during a given time period divided by the number of births reported during the same time period. The infant mortality rate is usually expressed per 1,000 live births.
MORTALITY RATE, NEONATAL. A ratio expressing the number of deaths among children from birth up to but not including 28 days of age divided by the number of live births reported during the same time period. The neonatal mortality rate is usually expressed per 1,000 live births.
MORTALITY RATE, POSTNEONATAL. A ratio expressing the number of deaths among children from 28 days up to but not including 1 year of age during a given time period divided by the number of lives births reported during the same time period. The postneonatal mortality rate is usually expressed per 1,000 live births.
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N
NATURAL HISTORY OF DISEASE. The temporal course of disease from onset (inception) to resolution.
NECESSARY CAUSE. A causal factor whose presence is required for the occurrence of the effect (of disease).
NOMINAL SCALE. Classification into unordered qualitative categories; e.g., race, religion, and country of birth as measurements of individual attributes are purely nominal scales, as there is no inherent order to their categories.
NORMAL CURVE. A bell-shaped curve that results when a normal distribution is graphed.
NORMAL DISTRIBUTION. The symmetrical clustering of values around a central location. The properties of a normal distribution include the following: (1) It is a continuous, symmetrical distribution; both tails extend to infinity; (2) the arithmetic mean, mode, and median are identical; and, (3) its shape is completely determined by the mean and standard deviation.
NUMERATOR. The upper portion of a fraction.
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O
OBSERVATIONAL STUDY. Epidemiological study in situations where nature is allowed to take its course. Changes or differences in one characteristic are studied in relation to changes or differences in others, without the intervention of the investigator.
ODDS RATIO. A measure of association which quantifies the relationship between an exposure and health outcome from a comparative study; also known as the cross-product ratio.
ORDINAL SCALE. Classification into ordered qualitative categories; e.g., social class (I, II, III, etc.), where the values have a distinct order, but their categories are qualitative in that there is no natural (numerical) distance between their positive values.
OUTBREAK. Synonymous with epidemic. Sometimes the preferred word, as it may escape sensationalism associated with the word epidemic. Alternatively, a localized as opposed to generalized epidemic.
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P
PANDEMIC. An epidemic occurring over a very wide area (several countries or continents) and usually affecting a large proportion of the population.
PATHOGENICITY. The proportion of persons infected, after exposure to a causative agent, who then develop clinical disease.
PERCENTILE. The set of numbers from 0 to 100 that divide a distribution into 100 parts of equal area, or divide a set of ranked data into 100 class intervals with each interval containing 1/100 of the observations. A particular percentile, say the 5th percentile, is a cut point with 5 percent of the observations below it and the remaining 95% of the observations above it.
PERIOD PREVALENCE. The amount a particular disease present in a population over a period of time.
PERSON-TIME RATE. A measure of the incidence rate of an event, e.g., a disease or death, in a population at risk over an observed period to time, that directly incorporates time into the denominator.
PIE CHART. A circular chart in which the size of each ``slice'' is proportional to the frequency of each category of a variable.
POINT PREVALENCE. The amount of a particular disease present in a population at a single point in time.
POPULATION. The total number of inhabitants of a given area or country. In sampling, the population may refer to the units from which the sample is drawn, not necessarily the total population of people.
PREDICTIVE VALUE POSITIVE. A measure of the predictive value of a reported case or epidemic; the proportion of cases reported by a surveillance system or classified by a case definition which are true cases.
PREVALENCE. The number or proportion of cases or events or conditions in a given population.
PREVALENCE RATE. The proportion of persons in a population who have a particular disease or attribute at a specified point in time or over a specified period of time.
PROPAGATED OUTBREAK. An outbreak that does not have a common source, but instead spreads from person to person.
PROPORTION. A type of ratio in which the numerator is included in the denominator. The ratio of a part to the whole, expressed as a ``decimal fraction'' (e.g., 0.2), as a fraction (1/5), or, loosely, as a percentage (20%).
PROPORTIONATE MORTALITY. The proportion of deaths in a specified population over a period of time attributable to different causes. Each cause is expressed as a percentage of all deaths, and the sum of the causes must add to 100%. These proportions are not mortality rates, since the denominator is all deaths, not the population in which the deaths occurred.
PUBLIC HEALTH SURVEILLANCE. The systematic collection, analysis, interpretation, and dissemination of health data on an ongoing basis, to gain knowledge of the pattern of disease occurrence and potential in a community, in order to control and prevent disease in the community.
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R
RACE-SPECIFIC MORTALITY RATE. A mortality rate limited to a specified racial group. Both numerator and denominator are limited to the specified group.
RANDOM SAMPLE. A sample derived by selecting individuals such that each individual has the same probability of selection.
RANGE. In statistics, the difference between the largest and smallest values in a distribution. In common use, the span of values from smallest to largest.
RATE. An expression of the frequency with which an event occurs in a defined population.
RATE RATIO. A comparison of two groups in terms of incidence rates, person-time rates, or mortality rates.
RATIO. The value obtained by dividing one quantity by another.
RELATIVE RISK. A comparison of the risk of some health-related event such as disease or death in two groups.
REPRESENTATIVE SAMPLE. A sample whose characteristics correspond to those of the original population or reference population.
RESERVOIR. The habitat in which an infectious agent normally lives, grows and multiplies; reservoirs include human reservoirs, animal reservoirs, and environmental reservoirs.
RISK. The probability that an event will occur, e.g. that an individual will become ill or die within a stated period of time or age.
RISK FACTOR. An aspect of personal behavior or lifestyle, an environmental exposure, or an inborn or inherited characteristic that is associated with an increased occurrence of disease or other health-related event or condition.
RISK RATIO. A comparison of the risk of some health-related event such as disease or death in two groups.
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S
SAMPLE. A selected subset of a population. A sample may be random or non-random and it may be representative or non-representative.
SCATTER DIAGRAM. A graph in which each dot represents paired values for two continuous variables, with the x-axis representing one variable and the y-axis representing the other; used to display the relationship between the two variables; also called a scattergram.
SEASONALITY. Change in physiological status or in disease occurrence that conforms to a regular seasonal pattern.
SECONDARY ATTACK RATE. A measure of the frequency of new cases of a disease among the contacts of known cases.
SECULAR TREND. Changes over a long period of time, generally years or decades.
SENSITIVITY. The ability of a system to detect epidemics and other changes in disease occurrence. The proportion of persons with disease who are correctly identified by a screening test or case definition as having disease.
SENTINEL SURVEILLANCE. A surveillance system in which a pre-arranged sample of reporting sources agrees to report all cases of one or more notifiable conditions.
SEX-SPECIFIC MORTALITY RATE. A mortality rate among either males or females.
SKEWED. A distribution that is asymmetrical.
SPECIFICITY. The proportion of persons without disease who are correctly identified by a screening test or case definition as not having disease.
SPORADIC. A disease that occurs infrequently and irregularly.
SPOT MAP. A map that indicates the location of each case of a rare disease or outbreak by a place that is potentially relevant to the health event being investigated, such as where each case lived or worked.
STANDARD DEVIATION. The most widely used measure of dispersion of a frequency distribution, equal to the positive square root of the variance.
STANDARD ERROR (OF THE MEAN). The standard deviation of a theoretical distribution of sample means about the true population mean.
SUFFICIENT CAUSE. A causal factor or collection of factors whose presence is always followed by the occurrence of the effect (of disease).
SURVEILLANCE. see PUBLIC HEALTH SURVEILLANCE
SURVIVAL CURVE. A curve that starts at 100% of the study population and shows the percentage of the population still surviving at successive times for as long as information is available. May be applied not only to survival as such, but also to the persistence of freedom from a disease, or complication or some other endpoint.
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T
TABLE. A set of data arranged in rows and columns.
TABLE SHELL. A table that is complete except for the data.
TRANSMISSION OF INFECTION. Any mode or mechanism by which an infectious agent is spread through the environment or to another person.
TREND. A long-term movement or change in frequency, usually upwards or downwards.
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U
UNIVERSAL PRECAUTIONS. Recommendations issued by CDC to minimize the risk of transmission of bloodborne pathogens, particularly HIV and HBV, by health care and public safety workers. Barrier precautions are to be used to prevent exposure to blood and certain body fluids of all patients.
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V
VALIDITY. The degree to which a measurement actually measures or detects what it is supposed to measure.
VARIABLE. Any characteristic or attribute that can be measured.
VARIANCE. A measure of the dispersion shown by a set of observations, defined by the sum of the squares of deviations from the mean, divided by the number of degrees of freedom in the set of observations.
VECTOR. An animate intermediary in the indirect transmission of an agent that carries the agent from a reservoir to a susceptible host.
VEHICLE. An inanimate intermediary in the indirect transmission of an agent that carries the agent from a reservoir to a susceptible host.
VIRULENCE. The proportion of persons with clinical disease, who after becoming infected, become severely ill or die.
VITAL STATISTICS. Systematically tabulated information about births, marriages, divorces, and deaths, based on registration of these vital events.
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Y
YEARS OF POTENTIAL LIFE LOST. A measure of the impact of premature mortality on a population, calculated as the sum of the differences between some predetermined minimum or desired life span and the age of death for individuals who died earlier than that predetermined age.
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Z
ZOONOSES. An infectious disease that is transmissible under normal conditions from animals to humans.
The definitions given are valid as they are used in this publication but different definitions may be used in other contexts. A Dictionary of Epidemiology, Second Edition, edited by J.M. Last for the International Epidemiological Association and published by Oxford University Press, 1988, was helpful in providing a number of the definitions.
AREA III F: INDUSTRIAL HYGIENE
What is Industrial Hygiene?
Source: OSHA
Industrial hygiene is the science of anticipating, recognizing, evaluating, and controlling workplace conditions that may cause workers' injury or illness. Industrial hygienists use environmental monitoring and analytical methods to detect the extent of worker exposure and employ engineering, work practice controls, and other methods to control potential health hazards.
There has been an awareness of industrial hygiene since antiquity. The environment and its relation to worker health was recognized as early as the fourth century BC when Hippocrates noted lead toxicity in the mining industry. In the first century AD, Pliny the Elder, a Roman scholar, perceived health risks to those working with zinc and sulfur. He devised a face mask made from an animal bladder to protect workers from exposure to dust and lead fumes. In the second century AD, the Greek physician, Galen, accurately described the pathology of lead poisoning and also recognized the hazardous exposures of copper miners to acid mists.
In the Middle Ages, guilds worked at assisting sick workers and their families. In 1556 the German scholar, Agricola, advanced the science of industrial hygiene even further when, in his book De Re Metallica, he described the diseases of miners and prescribed preventive measures. The book included suggestions for mine ventilation and worker protection, discussed mining accidents, and described diseases associated with mining occupations such as silicosis.
Industrial hygiene gained further respectability in 1700 when Bernardo Ramazzini, known as the "father of industrial medicine," published in Italy the first comprehensive book on industrial medicine, De Morbis Artificum Diatriba (The Diseases of Workmen). The book contained accurate descriptions of the occupational diseases of most of the workers of his time. Ramazzini greatly affected the future of industrial hygiene because he asserted that occupational diseases should be studied in the work environment rather than in hospital wards.
Industrial hygiene received another major boost in 1743 when Ulrich Ellenborg published a pamphlet on occupational diseases and injuries among gold miners. Ellenborg also wrote about the toxicity of carbon monoxide, mercury, lead, and nitric acid.
In England in the 18th century, Percival Pott, as a result of his findings on the insidious effects of soot on chimney sweepers, was a major force in getting the British Parliament to pass the Chimney-Sweepers Act of 1788. The passage of the English Factory Acts beginning in 1833 marked the first effective legislative acts in the field of industrial safety. The Acts, however, were intended to provide compensation for accidents rather than to control their causes. Later, various other European nations developed workers' compensation acts, which stimulated the adoption of increased factory safety precautions and the establishment of medical services within industrial plants.
In the early 20th century in the U. S., Dr. Alice Hamilton, led efforts to improve industrial hygiene. She observed industrial conditions first hand and startled mine owners, factory managers, and state officials with evidence that there was a correlation between worker illness and their exposure to toxins. She also presented definitive proposals for eliminating unhealthful working conditions.
At about the same time, U.S. federal and state agencies began investigating health conditions in industry. In 1908, the public's awareness of occupationally related diseases stimulated the passage of compensation acts for certain civil employees. States passed the first workers' compensation laws in 1911. And in 1913, the New York Department of Labor and the Ohio Department of Health established the first state industrial hygiene programs. All states enacted such legislation by 1948. In most states, there is some compensation coverage for workers contracting occupational diseases.
The U.S. Congress has passed three landmark pieces of legislation relating to safeguarding workers' health: (1) the Metal and Nonmetallic Mines Safety Act of 1966, (2) the Federal Coal Mine Safety and Health Act of 1969, and (3) the Occupational Safety and Health Act of 1970 (Act). Today, nearly every employer is required to implement the elements of an industrial hygiene and safety, occupational health, or hazard communication program and to be responsive to the Occupational Safety and Health Administration (OSHA) and the Act and its regulations.
How Are OSHA and Industrial Hygiene Related?
Under the Act, OSHA develops and sets mandatory occupational safety and health requirements applicable to the more than 6 million workplaces in the U.S. OSHA relies on, among many others, industrial hygienists to evaluate jobs for potential health hazards. Developing and setting mandatory occupational safety and health standards involves determining the extent of employee exposure to hazards and deciding what is needed to control these hazards, thereby protecting the workers. Industrial hygienists, or IHs, are trained to anticipate, recognize, evaluate, and recommend controls for environmental and physical hazards that can affect the health and well-being of workers. More than 40 percent of the OSHA compliance officers who inspect America's workplaces are industrial hygienists. Industrial hygienists also play a major role in developing and issuing OSHA standards to protect workers from health hazards associated with toxic chemicals, biological hazards, and harmful physical agents. They also provide technical assistance and support to the agency's national and regional offices. OSHA also employs industrial hygienists who assist in setting up field enforcement procedures, and who issue technical interpretations of OSHA regulations and standards. Industrial hygienists analyze, identify, and measure workplace hazards or stressors that can cause sickness, impaired health, or significant discomfort in workers through chemical, physical, ergonomic, or biological exposures. Two roles of the OSHA industrial hygienist are to spot those conditions and help eliminate or control them through appropriate measures.
What is a Worksite Analysis?
A worksite analysis is an essential first step that helps an industrial hygienist determine what jobs and work stations are the sources of potential problems. During the worksite analysis, the industrial hygienist measures and identifies exposures, problem tasks, and risks. The most effective worksite analyses include all jobs, operations, and work activities. The industrial hygienist inspects, researches, or analyzes how the particular chemicals or physical hazards at that worksite affect worker health. If a situation hazardous to health is discovered, the industrial hygienist recommends the appropriate corrective actions.
How do IH's Recognize and Control Hazards?
Industrial hygienists recognize that engineering, work practice, and administrative controls are the primary means of reducing employee exposure to occupational hazards. Engineering controls minimize employee exposure by either reducing or removing the hazard at the source or isolating the worker from the hazards.
Engineering controls include eliminating toxic chemicals and replacing harmful toxic materials with less hazardous ones, enclosing work processes or confining work operations, and installing general and local ventilation systems.
Work practice controls alter the manner in which a task is performed. Some fundamental and easily implemented work practice controls include (1) following proper procedures that minimize exposures while operating production and control equipment; (2) inspecting and maintaining process and control equipment on a regular basis; (3) implementing good house-keeping procedures; (4) providing good supervision and (5) mandating that eating, drinking, smoking, chewing tobacco or gum, and applying cosmetics in regulated areas be prohibited.
Administrative controls include controlling employees' exposure by scheduling production and workers' tasks, or both, in ways that minimize exposure levels. For example, the employer might schedule operations with the highest exposure potential during periods when the fewest employees are present.
When effective work practices and/or engineering controls are not feasible to achieve the permissible exposure limit, or while such controls are being instituted, and in emergencies, appropriate respiratory equipment must be used. In addition, personal protective equipment such as gloves, safety goggles, helmets, safety shoes, and protective clothing may also be required. To be effective, personal protective equipment must be individually selected, properly fitted and periodically refitted; conscientiously and properly worn; regularly maintained; and replaced as necessary.
What Are Some Examples of Job Hazards?
To be effective in recognizing and evaluating on-the-job hazards and recommending controls, industrial hygienists must be familiar with the hazards' characteristics. Major job risks can include air contaminants, and chemical, biological, physical, and ergonomic hazards.
Air Contaminants
These are commonly classified as either particulate or gas and vapor contaminants. The most common particulate contaminants include dusts, fumes, mists, aerosols, and fibers. Dusts are solid particles that are formed or generated from solid organic or inorganic materials by reducing their size through mechanical processes such as crushing, grinding, drilling, abrading or blasting.
Fumes are formed when material from a volatilized solid condenses in cool air. In most cases, the solid particles resulting from the condensation react with air to form an oxide.
The term mist is applied to a finely divided liquid suspended in the atmosphere. Mists are generated by liquids condensing from a vapor back to a liquid or by breaking up a liquid into a dispersed state such as by splashing, foaming or atomizing. Aerosols are also a form of a mist characterized by highly respirable, minute liquid particles.
Fibers are solid particles whose length is several times greater than their diameter.
Gases are formless fluids that expand to occupy the space or enclosure in which they are confined. Examples are welding gases such as acetylene, nitrogen, helium, and argon; and carbon monoxide generated from the operation of internal combustion engines or by its use as a reducing gas in a heat treating operation. Another example is hydrogen sulfide which is formed wherever there is decomposition of materials containing sulfur under reducing conditions.
Liquids change into vapors and mix with the surrounding atmosphere through evaporation. Vapors are the volatile form of substances that are normally in a solid or liquid state at room temperature and pressure. Vapors are the gaseous form of substances which are normally in the solid or liquid state at room temperature and pressure. They are formed by evaporation from a liquid or solid and can be found where parts cleaning and painting takes place and where solvents are used.
Chemical Hazards
Harmful chemical compounds in the form of solids, liquids, gases, mists, dusts, fumes, and vapors exert toxic effects by inhalation (breathing), absorption (through direct contact with the skin), or ingestion (eating or drinking). Airborne chemical hazards exist as concentrations of mists, vapors, gases, fumes, or solids. Some are toxic through inhalation and some of them irritate the skin on contact; some can be toxic by absorption through the skin or through ingestion, and some are corrosive to living tissue.
The degree of worker risk from exposure to any given substance depends on the nature and potency of the toxic effects and the magnitude and duration of exposure.
Information on the risk to workers from chemical hazards can be obtained from the Material Safety Data Sheet (MSDS) that OSHA'S Hazard Communication Standard requires be supplied by the manufacturer or importer to the purchaser of all hazardous materials. The MSDS is a summary of the important health, safety, and toxicological information on the chemical or the mixture's ingredients. Other provisions of the Hazard Communication Standard require that all containers of hazardous substances in the workplace have appropriate warning and identification labels.
Biological Hazards
These include bacteria, viruses, fungi, and other living organisms that can cause acute and chronic infections by entering the body either directly or through breaks in the skin. Occupations that deal with plants or animals or their products or with food and food processing may expose workers to biological hazards. Laboratory and medical personnel also can be exposed to biological hazards. Any occupations that result in contact with bodily fluids pose a risk to workers from biological hazards.
In occupations where animals are involved, biological hazards are dealt with by preventing and controlling diseases in the animal population as well as proper care and handling of infected animals. Also, effective personal hygiene, particularly proper attention to minor cuts and scratches, especially those on the hands and forearms, helps keep worker risks to a minimum.
In occupations where there is potential exposure to biological hazards, workers should practice proper personal hygiene, particularly hand washing. Hospitals should provide proper ventilation, proper personal protective equipment such as gloves and respirators, adequate infectious waste disposal systems, and appropriate controls including isolation in instances of particularly contagious diseases such as tuberculosis.
Physical Hazards
These include excessive levels of ionizing and nonionizing electromagnetic radiation, noise, vibration, illumination, and temperature.
In occupations where there is exposure to ionizing radiation, time, distance, and shielding are important tools in ensuring worker safety. Danger from radiation increases with the amount of time one is exposed to it; hence, the shorter the time of exposure the smaller the radiation danger.
Distance also is a valuable tool in controlling exposure to both ionizing and non-ionizing radiation. Radiation levels from some sources can be estimated by comparing the squares of the distances between the worker and the source. For example, at a reference point of 10 feet from a source, the radiation is 1/100 of the intensity at 1 foot from the source.
Shielding also is a way to protect against radiation. The greater the protective mass between a radioactive source and the worker, the lower the radiation exposure.
Nonionizing radiation also is dealt with by shielding workers from the source. Sometimes limiting exposure times to nonionizing radiation or increasing the distance is not effective. Laser radiation, for example, cannot be controlled effectively by imposing time limits. An exposure can be hazardous that is faster than the blinking of an eye. Increasing the distance from a laser source may require miles before the energy level reaches a point where the exposure would not be harmful.
Noise, another significant physical hazard, can be controlled by various measures. Noise can be reduced by installing equipment and systems that have been engineered, designed, and built to operate quietly; by enclosing or shielding noisy equipment; by making certain that equipment is in good repair and properly maintained with all worn or unbalanced parts replaced; by mounting noisy equipment on special mounts to reduce vibration; and by installing silencers, mufflers, or baffles.
Substituting quiet work methods for noisy ones is another significant way to reduce noise, for example, welding parts rather than riveting them. Also, treating floors, ceilings, and walls with acoustical material can reduce reflected or reverberant noise. In addition, erecting sound barriers at adjacent work stations around noisy operations will reduce worker exposure to noise generated at adjacent work stations.
It is also possible to reduce noise exposure by increasing the distance between the source and the receiver, by isolating workers in acoustical booths, limiting workers' exposure time to noise, and by providing hearing protection. OSHA requires that workers in noisy surroundings be periodically tested as a precaution against hearing loss.
Another physical hazard, radiant heat exposure in factories such as steel mills, can be controlled by installing reflective shields and by providing protective clothing.
Ergonomic Hazards
The science of ergonomics studies and evaluates a full range of tasks including, but not limited to, lifting, holding, pushing, walking, and reaching. Many ergonomic problems result from technological changes such as increased assembly line speeds, adding specialized tasks, and increased repetition; some problems arise from poorly designed job tasks. Any of those conditions can cause ergonomic hazards such as excessive vibration and noise, eye strain, repetitive motion, and heavy lifting problems. Improperly designed tools or work areas also can be ergonomic hazards. Repetitive motions or repeated shocks over prolonged periods of time as in jobs involving sorting, assembling, and data entry can often cause irritation and inflammation of the tendon sheath of the hands and arms, a condition known as carpal tunnel syndrome.
Ergonomic hazards are avoided primarily by the effective design of a job or jobsite and better designed tools or equipment that meet workers' needs in terms of physical environment and job tasks. Through thorough worksite analyses, employers can set up procedures to correct or control ergonomic hazards by using the appropriate engineering controls (e.g., designing or re-designing work stations, lighting, tools, and equipment); teaching correct work practices (e.g., proper lifting methods); employing proper administrative controls (e.g., shifting workers among several different tasks, reducing production demand, and increasing rest breaks); and, if necessary, providing and mandating personal protective equipment. Evaluating working conditions from an ergonomics standpoint involves looking at the total physiological and psychological demands of the job on the worker.
Overall, industrial hygienists point out that the benefits of a well-designed, ergonomic work environment can include increased efficiency, fewer accidents, lower operating costs. and more effective use of personnel.
In sum, industrial hygiene encompasses a broad spectrum of the working environment. Early in its history OSHA recognized industrial hygiene as an integral part of a healthful work setting. OSHA places a high priority on using industrial hygiene concepts in its health standards and as a tool for effective enforcement of job safety and health regulations. By recognizing and applying the principles of industrial hygiene to the work environment, America's workplaces will become more healthful and safer.
AREA III G: CONSTRUCTION
Construction Safety and Health Management
Historically, the construction industry suffers the highest injury and fatality rates of any economic sector in the United States except mining. Consequently, it's important that management fulfill its safety responsibilities. Management should:
• analyze compliance and accident statistics by contractor(including subcontractors), by facility, and by project
• review safety performance by tracking accident costs-- both direct and indirect.
• evaluate the accident records of all bidders during the course of the procurement process to avoid the use of high-risk contractors and subcontractors.
Due to the dynamic nature of construction work, management's role may be even more important than in general industry. The various phases of a construction project make continuous proactive management involvement critical throughout the life of each project. For instance, daily worksite safety inspections are necessary on most construction sites.
Employers should initiate and maintain programs necessary to ensure safe working conditions. It is the employer's responsible for initiating and maintaining a safe and health program that help protect all employees, other contractors, sub-contractors, visitors and the public.
The general contractor should prepare and submit a written incident/accident plan for approval before work is initiated. General contractor should also prepare a comprehensive written safety and health program addressing all aspects of on-site construction operations. A detailed review of the contractor's written safety and health program should be conducted during the preconstruction safety meeting. A copy of the pertinent provisions of the contractor's safety and health program should be given to new employees.
Safety and Health Programs and Plans
The starting point for the development of an effective safety and health program at construction work sites is the commitment of management. The employer should consider employee safety as the company's a primary, non-negotiable value and be willing to spend time and money on program development, safety equipment, and employee training.
One of the best ways management can demonstrate its commitment to safety is to develop a performance-oriented written safety and health plan that is comprehensive, yet general enough to cover the various types of projects conducted by the company or organization. This safety and health plan should establish and communicate a clear goal for the program and define objectives for meeting that goal. Copies of the plan should be distributed to all employees. The plan should be informative by including information on the use of personal protective equipment, the proper use of tools and power equipment, safe work procedures and practices, and any company safety and health policies. The plan should also outline procedures for formally evaluating plan's effectiveness at least once a year.
Worksite Safety and Health Plan
A worksite-specific safety plan should be kept at each worksite. At a minimum, the plan should include information on the following subjects as appropriate:
|• safety responsibilities |• emergency procedures |• inspections |
|• incident and accident prevention |• hazard communication |• housekeeping |
|• record keeping |• grounded electrical systems |• personal protective equipment |
|• demolition |• hoisting and rigging |• scaffolding |
Plans should also be directive. They need to assign responsibilities to individuals for carrying out safety responsibilities such as administrative procedures, controlling and coordinating the work of subcontractors, inspections, etc. However, merely assigning responsibility not enough. Each person should be held accountable for the decisions they make that result in safe behaviors, activities, and performance. Each employee assigned safety responsibilities should be given adequate authority and resources to meet their responsibilities.
Although some companies require that the recordable injury rate for each supervisor be factored into annual review and promotion decisions and others use a formal tracking system that allows supervisors with good safety records to earn bonuses, it's best to measure and recognize supervisor activities such as frequency of inspections, quality of identifying and correcting hazards, quality of training, etc. Supervisors have control over these activities. They do not have control over the number of accidents at the worksite.
Employees should be held accountable for complying with safety policies and procedures. When the employer is justified, employees who violate safety procedures should be subject to disciplinary action. The company's overall program should include a progressive disciplinary component that is clearly written and communicated. The program should establish a hierarchy of disciplinary measures, beginning with verbal and written warnings, followed by suspension, and termination.
The safety and health plan should consider the need to make adjustments to the plan required to take account of progress of the work or any changes that might occur. The project safety plan should be communicated and made readily available to all employees at the work site. The project safety and health plan should be specific and applicable to the scope of the work being performed at the worksite. Each contractor is responsible to develop, implement, monitor, and enforce their safety and health program. This requirement is especially important if a contractor has established a pattern of non-compliance with the project safety and health program and/or laws and regulations. Responsibilities for various managers include:
• Construction manager should approve a written project safety plan prior to commencement of any activity on the worksite.
• Senior Project Supervisor has final authority and responsibility for the Project Safety and Health program
• Senior Contractor Supervisor has the final authority and responsibility for the Contractor Safety and Health Program
• Project Constructor is responsible for assessing qualifications and performance of Senior Project Supervisor and Senior Contractor Supervisor.
• Project Constructor should establish disciplinary policy to comply with program
• Safety manager appointed by management to be responsible for loss control.
Employee Involvement
Employees should be involved in conducting Job Safety Analyses and Activity Hazard Analyses. Employees should be consulted during preparation of pre-phase accident prevention plans. Safety and Health Plans should be discussed with the employees who will perform the work
Employee involvement can take variety of forms including participation in:
• development of safety and health programs
• workplace inspections and program audits
• membership on joint labor/management committees
• making suggestions for improvement
• incident/accident investigations.
Safety and health committees with representation from both management and labor should be established. Both management and labor should participate in the worksite safety committee meetings. Employees and/or their representatives should be informed of all safety and health activities and measures taken on the construction site. Safety committees should perform in a consultative mode, writing recommendations for improvement in worksite safety and health.
Many construction companies actively encourage employee participation. It's good business. The International Labour Organization (ILO), the Council of the European Communities (EC), the Corps of Engineers, the Department of Energy, and the ANSI standard for multi-employer work sites all stress the importance of employee involvement. However, there are no specific requirements for employee involvement in Federal OSHA's construction standards. Some OSHA State Plans (such as Oregon) do require employee participation in safety committees.
Fitness for Duty
The employer should allow only those employees qualified by training or experience to operate equipment and machinery on the worksite. Employees must be physically, mentally, medically, and emotionally qualified to perform the duties to which they are assigned.
Preventing alcohol and drug abuse on the job should always be addressed in the Safety and Health Program. All worksite orientations should include a discussion of drug and alcohol abuse policy. Employees found to be under the influence of or consuming alcohol, drugs, etc. should be removed from the worksite immediately.
Equipment operators should be able to read and understand signs, signals, and operating instructions. Physical examinations are should required for heavy equipment operators and must be required for crane and hoisting equipment operators. Divers should be required to demonstrate driving ability in the equipment they will be operating and only qualified employees should be allowed to operate heavy equipment.
Hazard identification
Identifying hazards begins with analyses of the specific anticipated and actual hazards expected to exist at various work sites. An analysis of all work site conditions and each employee's job and each major phase of activity, will help identify the specific safety, health, and ergonomic hazards associated with a particular project. Analyses of the tasks performed by employees may be conducted by any or all of the following processes:
• Job Hazard Analysis (JHA) or "Job Safety Analysis"(JSA)
• Activity Hazard Analysis, (AHA)
• Preliminary Hazard Analysis (PHA)
The standards and codes of practice ANSI and other agencies require each contractor responsible for conducting a particular phase of work (e.g., trenching, concrete work, and masonry) develop an operation- or phase-specific PHA describing the hazards associated with that phase of the project, methods of reducing or eliminating them, equipment to be used and inspection requirements for equipment, and phase-specific training requirements. OSHA has no corresponding requirements.
Hazard Analysis
A Preliminary Hazard Analysis (PHA) should be conducted and finalized before the start of work on a construction project; the PHA should identify:
• Anticipated construction phases;
• Types of hazards associated with anticipated operations or phases of the project; and
• Operations or phases requiring further analysis or the design of special protective measures.
An Activity Hazard Analysis (AHA) should be prepared by the contractor prior to the beginning of each major phase of work. The AHA:
• Identifies phase-specific hazards;
• Includes drawings and/or documentation of any corrective measures needing to be designed by a PE or other component person;
• Identifies qualifications of competent person, or other individual who will conduct inspection required by DOE standards or construction project documents.
When warranted by the nature of the hazards of a job, a Job Hazard Analysis (JHA) should be prepared and documented. The JHA should be conducted when a construction project is first initiated and at critical stages of work:
• Pre-phase Job Hazard Analysis (JHA) should be conducted for work operations performed by contractors;
• Pre-phase JHA should be developed by the contractor filed supervisory personnel who will actually be running the job that is being pre-planned; and
• Under no circumstances should work be allowed to begin before the JHA has been approved by the Project Constructor
Hazard Prevention and Control
To ensure worksite equipment is being maintained and that site conditions pose no unnecessary risks, hazard prevention and control require careful planning, analysis of the hazards associated with:
• each major phase of the project
• the design and application of the controls
• necessary to eliminate or mitigate identified hazards
• routine inspections of the work site
• enforcement of safety rules
Although 29 CFR 1926 addresses hazard preventing and controlling hazards indirectly when discussing inspections and housekeeping requirements. Most of the standards specifically directly address this requirement were developed later by other organizations.
Any machinery, tools, materials, or equipment not in compliance with OSHA requirements should not be used on the worksite. Non-compliant machine tools, materials, or equipment should either be tagged or locked out or should be physically removed from work site.
Inspection reports should identify safety and health issues and deficiencies, and the actions, timetable, and responsibility for correcting those deficiencies. Conduct follow-up inspections to ensure abatement and adequate documentation of identified deficiencies. Employees should not be required or instructed to work in surroundings under conditions that are unsafe or dangerous to health.
The contractor should make sure all activities, equipment, and facilities comply with applicable standards. During the preconstruction safety meeting, contractors should discuss, in detail, measures to control hazards the might develop during all major phases of work under contract.
A system should be developed and maintained for tracking the status of all hazards for which immediate abatement is not possible or that fall outside of the project scope.
If feasible, all identified hazards should be immediately corrected or eliminated. If this is not possible:
• Interim control measures should be devised and implemented
• Warning signs should be posted by the hazard
• Employees should be informed of the hazard's location and interim control measures
• Work practices, procedures, and scheduling should be adjusted as needed
Worksite supervisors, foremen, and construction safety and health managers should stop work that could place employees, equipment, or property in imminent danger.
Noncompliance with safety and health standards, project safety and health programs, and hazardous conditions should be formally reported to the Senior Project Supervisor. The Senior Project Supervisor should make sure all hazardous conditions are abated in compliance with the safety and health program.
Self-Inspections
Frequent work site inspections should be conducted by competent persons and should include inspections of equipment and all materials to be used in construction. Employee should be required to report unsafe conditions to their supervisors promptly, and any unsafe practices identified should be immediately corrected.
Safety and health programs should require frequent (daily) and regular (weekly or monthly) inspections of job sites, buildings, plants, material, equipment, tools and surrounding environment. Safety inspections should be conducted only by competent and qualified personnel. Follow-up inspections should be conducted and documented. Detailed written inspection records should be maintained.
At least weekly, the worksite supervisor or construction manager should conduct worksite safety inspections. The project manager should conduct weekly project inspections for all projects valued at more than $500,000 and at least monthly for projects valued at less than $500,000.
Companies that have developed the most effective safety and health programs require daily inspections because of the possibility of rapid change on construction sites. Companies should also require documentation of the results, along with immediate correction of identified hazardous conditions and unsafe work practices.
Emergency Action/Response Plans
Work is continuous and fast on the construction site. Hazards may develop quite quickly and accidents may involve more than one employee. Therefore, emergency response planning is essential. It is important to make sure the safety and health plan specifically address foreseeable emergencies. They should also require all employees at the site:
• be made aware of appropriate emergency procedure
• be trained in these procedures and that the procedures
• conduct drills or other exercises to ensure effectiveness of procedures
The contractor's safety and health program should consider and incorporate provisions for safely and expeditiously handling possible emergency situations. A written Emergency Response Plan (ERP) should be developed and communicated to all affected employees. The ERP should specify procedures for handling serious injuries, fatalities, structural failures, or other emergencies, including administration of first-aid and other medical treatment. The ERP should be tested to ensure effectiveness. Firefighting and other emergencies should be reviewed during new employee orientation. Emergency telephone numbers and reporting instructions should be posted at the work-site
ERP responsibilities assigned and proper training provided to all employees assigned to handle emergencies. Warning systems should be installed and tested and emergency telephone numbers and reporting instructions posted at the job-site.
At the start of each job, Post the names and locations of nearby emergency medical facilities that should be contacted. All supervisors should be knowledgeable about emergency procedures. Worker training should include training in emergency procedures and location of first-aid facilities.
Accident Investigation, Reporting, and Analysis
Most safety and health plans for construction sites emphasize the importance of accurate analysis of incidents/accidents to identify trends and determine the root causes of workplace accidents. Some employers require subcontractors to submit historical data related to accidents. The failure to break down injury statistics by contractor and subcontractor can obscure poor safety performance. Maintaining separate statistics for contractors and subcontractors is increasingly practiced in the construction industry. It is also important that a consistent definition of lost-time injuries.
First Aid/Medical Requirements
Employer should make sure medical personnel are available to provide advice and consultation. Plans to provide prompt medical attention should be developed and implemented prior to project startup. First aid and medical requirements should be addressed in orientation of all employees. First aid supplies should be accessible when required. When medical attention by emergency medical technicians or other professional health care providers can not be given within five minutes, a group of 2 or more employees should be first-aid and CPR certified.
First-aid equipment needs will vary by size and location of job. Individuals who work alone in remote areas should be trained in first-aid. Where the project employs fewer than 100 workers/shift, consider first-aid supplies in the form of one 16-unit kit/25 employees, and at least one employee certified in first-aid per shift. Where 300-1,000 workers are employed, an infirmary equipped to handle outpatient treatment and staffed by nurse or EMT full time. Where more than 1,000 workers are employed, infirmary equipped to handle short-term inpatient care, with ambulance service, and staffed by full-time physician and adequate nursing staff.
Accident Investigation, Reporting, and Analysis
All non-injury incidents and accidents, no matter how minor, should be investigated at the worksite. All OSHA 300 recordable injuries and illnesses should be thorough analyzed for root causes.
Employees should be held accountable for reporting injuries and illnesses to the supervisor as soon as possible. Procedures for reporting accidents and incidents are addressed in the orientation for all employees. Supervisor should report injuries and illnesses according to the following suggested schedule:
• Report and investigate serious accidents immediately. Contractor should conduct a complete, and submit written report of findings.
• Report and investigate non-serious incidents and accidents as soon a possible. A comprehensive narrative report should be submitted within 3 working days.
• Report and investigate potentially serious accidents immediately. The equipment and/or work site involved should be secured until an investigation has been completed by the contractor.
• Report serious injuries to OSHA within 24 hrs when employees have been admitted overnight to a hospital for treatment of injuries.
• Report fatalities to OSHA within 8 hours.
The safety and health program should contain procedures for investigating, recording and reporting incidents in accordance with OSHA requirements. Procedures for investigating job-related accidents and illness should include root cause analysis. Only a qualified person (safety manager, staff) should be designated to review incident/accident reports to make sure they are accurate and complete.
The senior project supervisor should maintain all accident and illness records for entire project, including records for each Contractor. This should be kept in a daily Project Safety and Health Log. The senior contractor supervisor, or representative, should also ensure all accidents ate investigated and measures implemented to prevent recurrence.
Training/Safety Meetings
The construction employer should make sure construction safety training programs are provided as required by OSHA regulations. The employer should be responsible for employee safety and health training. This should include:
• Supervisory Training. Supervisors should be competent instructors and should be given supervisory training.
• Safety Staff. Safety delegates and safety and health committee members should be trained.
• New-Hire Training. Employees should receive orientation in company's safety policies, craft training, and job-specific training.
• Job and Site-specific training. Held on a regular basis for review of accidents and hazardous conditions. Pre-Job Meeting: Management and safety staff discuss safety after bid documents are received. Start of Job Meeting: Supervisory personnel review safety plans and delegate responsibilities for safety.
• Safety meetings. Held regularly with employees for review of safe methods, accidents, and near accidents.
The employer should provide job-specific training. Employees should receive orientation and continuing technical training. Pre-phase training, based on the AHA for that phase, should be conducted and documented for all employees on the affected work crews. When training hazardous procedures and practices, employees should certified as having adequate knowledge and skills to perform. Employees should be allowed to practice the procedure or practice before exposure to hazards.
The intent of OSHA law is that individual knowledge and skills must be determined. To accomplish this written tests should be administered and employees should be given an opportunity to practice skills and demo All safety and health programs, documents, and labels should be provided in the employee's primary language. Each employee should receive training to recognize and avoid job-specific hazards prior to starting a job assignment. On-site training should be provided to those handling specific hazardous materials or tools. Minimum contents of training include, but are not limited to:
• General contractor safety policies and rules
• Incident/accident reporting requirements;
• Emergency response and medical treatment procedures and reporting;
• Potential and actual worksite hazard reporting and methods to correct
• Job-specific hazards and control measures.
Weekly safety "tool-box," or "tail-gate" meetings to inform, review and update employees on worksite safety issues should be held and documented. A record of attendance should be adequate for safety meetings. However, technical training should be documented with a formal certification. Monthly safety meetings for supervisors, foremen, and managers should be conducted to cover management-related safety issues.
All safety meetings should include safety and health training, review of past activities, and planning for new/changed operations. Monthly safety meetings should review the effectiveness of the contractor's safety effort, to resolve safety and health problems, and provide a forum for planning safe future construction activities;
On-site supervisors, including foremen, should receive at least an annual 4-hour general review of applicable safety and health requirements. The contractor should provide first-aid training for all contractor foremen so that they maintain current first-aid certification.
All training records should be maintained by the construction contractor on the construction work site
Joint Safety Committees
Construction employers should establish joint management/labor safety committees. Safety committee should be tasked with helping the employer identify, analyze, and evaluate the employer's safety and health programs, plans, procedures, practices. The safety committee should function as an internal consultative team, providing written recommendations for corrective actions and program improvement as necessary.
Safety committees usually carry out regular inspections of the construction site and make recommendations for hazard control. For joint committees to be successful, they should encourage open and candid two-way discussion of health and safety issues. It's important that safety committees have direct-line communications with top management. They should conduct regularly-scheduled committee meetings, use agendas and keep minutes. Committees should communicate safety and health information to employees regularly.
Contractor/Subcontractor Relationship for Safety and Health
The general contractor and subcontractor may make their own arrangements with respect to obligations with the understanding that they are jointly responsible for worksite safety. In no case should the general contractor be relieved of overall responsibility for compliance with OSHA requirements. To the extent that a subcontractor of any tier agrees to perform any part of the contract, he also assumes control and responsibility for complying with OSHA standards. Thus, the general contractor assumes the entire responsibility, and subcontractor assumes responsibility with respect to his portion of the work.
The general contractor should include subcontracted work in Safety and Health Plan as well as measures contractor will take to control worksite hazards. The general contractor should coordinate and control subcontractor work and should specify requirements for subcontractor to carry out Safety and Health Program. The plan should be job-specific and include work performed by subcontractors and measures to control hazards associated with materials, etc., provided by suppliers. The general contractor should review subcontractor safety and health program and history before bidding and during construction to include subcontractor areas in inspections and audits, and to require subcontractors to correct any recognized hazards.
Contractors should include provisions for compliance with OSHA requirements in the terms and conditions of all contracts, subcontracts, and supply contracts. To help do this, the general contractor should:
• Hold a pre-phase planning meeting for all affected contractors to coordinate and assign responsibility for all activities.
• Evaluate contractor safety and health programs and monitor their implementation
• Ensure contractor compliance with ANSI and OSHA standards and abatement of hazardous conditions; and
• Audit contractor safety and health documents at least monthly.
Contractual and working relationships among employers, contractors, subcontractors and individuals may be quite complex, and lines of authority, reporting relationships, and work activities should be carefully understood by all parties. Efficient and effective coordination is the goal to make sure appropriate attention is paid to worker safety and health. Greater general contractor responsibility for subcontractor performance in this area is being emphasized lately because on a typical multi-employer construction project it is important that safe practices be required and enforced in a uniform and consistent manner.
General contractors are more likely going to review subcontractor safety and health records. Some contractors require subcontractors to have experience modification rates (MOD) of less than 1.0 to be considered during the bid process. The General contractor may also develop a project-specific safety plan that is binding on all subcontractors. Weekly safety talks with various subcontractor work crews are a common occurrence. Another effective strategy has the general contractor conducting frequent inspections of subcontractor work areas. If work is found to be seriously deficient, the general may actually stop work.
The safety and health manager should monitor and coordinate implementation of general and subcontractor safety and health plans, and ensure that the principles of safety and prevention are applied in a consistent manner. The safety and health manager/coordinator should ensure cooperation between employers, including successive employers on the same site, with a view toward protecting workers and preventing accidents and occupational health hazards.
Source: Various
______________________________________________________________________________________
1926 Subpart C
Safety and Health Program Management Guidelines
Effective management of worker safety and health protection is a decisive factor in reducing the extent and severity of work-related injuries and illnesses and related costs. In 1982, OSHA began to approve worksites with exemplary safety and health management programs for participation in Voluntary Protection Programs (VPP). More information on VPP can be obtained from your OSHA Regional or Area Office listed at the end of this publication. In 1989, OSHA issued recommended guidelines for the effective management and protection of worker safety and health. These guidelines are summarized in the following paragraphs.(1)
General
Employers are advised and encouraged to institute and maintain in their establishments a program that provides adequate systematic policies, procedures, and practices to protect their employees from, and allow them to recognize, job-related safety and health hazards.
An effective program includes provisions for the systematic identification, evaluation, and prevention or control of general workplace hazards, specific job hazards, and potential hazards that may arise from foreseeable conditions.
Although compliance with the law, including specific OSHA standards, is an important objective, an effective program looks beyond specific requirements of law to address all hazards. It will seek to prevent injuries and illnesses, whether or not compliance is at issue.
The extent to which the program is described in writing is less important than how effective it is in practice. As the size of a worksite or the complexity of a hazardous operation increases, however, the need for written guidance increases to ensure clear communication of policies and priorities as well as a consistent and fair application of rules.
Major Elements
An effective occupational safety and health program will include the following four main elements: management commitment and employee involvement, worksite analysis, hazard prevention and control, and safety and health training.
1. Management Commitment and Employee Involvement
The elements of management commitment and employee involvement are complementary and form the core of any occupational safety and health program. Management's commitment provides the motivating force and the resources for organizing and controlling activities within an organization. In an effective program, management regards worker safety and health as a fundamental value of the organization and applies its commitment to safety and health protection with as much vigor to other organizational goals.
Employee involvement provides the means by which workers develop and/or express their own commitment to safety and health protection for themselves and for their fellow workers.
In implementing a safety and health program, there are various ways to provide commitment and support by management and employees. Some recommended actions are described briefly as follows:
• State clearly a worksite policy on safe and healthful work and working conditions, so that all personnel with responsibility at the site (and personnel at other locations with responsibility for the site) fully understand the priority and importance of safety and health protection in the organization.
• Establish and communicate a clear goal for the safety and health program and define objectives for meeting that goal so that all members of the organization understand the results desired and measures planned for achieving them.
• Provide visible top management involvement in implementing the program so that all employees understand that management's commitment is serious.
• Arrange for and encourage employee involvement in the structure and operation of the program and in decisions that affect their safety and health so that they will commit their insight and energy to achieving the safety and health program's goal and objectives.
• Assign and communicate responsibility for all aspects of the program so that managers, supervisors, and employees in all parts of the organization know what performance is expected of them.
• Provide adequate authority and resources to responsible parties so that assigned responsibilities can be met.
• Hold managers, supervisors, and employees accountable for meeting their responsibilities so that essential tasks will be performed.
• Review program operations at least annually to evaluate their success in meeting the goals and objectives so that deficiencies can be identified and the program and/or the objectives can be revised when they do not meet the goal of effective safety and health protection.
2. Worksite Analysis
A practical analysis of the work environment involves a variety of worksite examinations to identify existing hazards and conditions and operations in which changes might occur to create new hazards. Unawareness of a hazard stemming from failure to examine the worksite is a sign that safety and health policies and/or practices are ineffective. Effective management actively analyzes the work and worksite to anticipate and prevent harmful occurrences. The following measures are recommended to identify all existing and potential hazards:
• Conduct comprehensive baseline worksite survey for safety and health and periodic comprehensive update surveys and involve employees in this effort.
• Analyze planned and new facilities, processes, materials, and equipment.
• Perform routine job hazards analyses.
• Assess risk factors of ergonomics applications to workers' tasks.
• Conduct regular site safety and health inspections so that new or previously missed hazards and failures in hazard controls are identified.
• Provide a reliable system for employees to notify management personnel about conditions that appear hazardous and to receive timely and appropriate responses and encourage employees to use the system without fear of reprisal. This system utilizes employee insight and experience in safety and health protection and allows employee concerns to be addressed.
• Investigate accidents and "near miss" incidents so that their causes and means of prevention can be identified.
• Analyze injury and illness trends over time so that patterns with common causes can be identified and prevented.
3. Hazard Prevention and Control
Where feasible, workplace hazards are prevented by effective design of the job site or job. Where it is not feasible to eliminate such hazards, they must be controlled to prevent unsafe and unhealthful exposure. Elimination or control must be accomplished in a timely manner once a hazard or potential hazard is recognize. Specifically, as part of the program, employers should establish procedures to correct or control present or potential hazards in a timely manner. These procedures should include measures such as the following:
• Use engineering techniques where feasible and appropriate.
• Establish, at the earliest time, safe work practices and procedures that are understood and followed by all affected parties. Understanding and compliance are a result of training, positive reinforcement, correction of unsafe performance, and if necessary, enforcement through a clearly communicated disciplinary system.
• Provide personal protective equipment when engineering controls are infeasible.
• Use administrative controls, such as reducing the duration of exposure.
• Maintain the facility and equipment to prevent equipment breakdowns.
• Plan and prepare for emergencies, and conduct training and emergency drills, as needed, to ensure that proper responses to emergencies will be "second nature" for all persons involved.
• Establish a medical program that includes first aid onsite as well as nearby physician and emergency medical care to reduce the risk of any injury or illness that occurs.
4. Safety and Health Training
Training is an essential component of an effective safety and health program. Training helps identify the safety and health responsibilities of both management and employees at the site. Training is often most effective when incorporated into other education or performance requirements and job practices. The complexity of training depends on the size and complexity of the worksite as well as the characteristics of the hazards and potential hazards at the site.
Employee Training
Employee training programs should be designed to ensure that all employees understand and are aware of the hazards to which they may be exposed and the proper methods for avoiding such hazards.
Supervisory Training
Supervisors should be trained to understand the key role they play in job site safety and to enable them to carry out their safety and health responsibilities effectively. Training programs for supervisors should include the following topics:
• Analyze the work under their supervision to anticipate and identify potential hazards.
• Maintain physical protection in their work areas.
• Reinforce employee training on the nature of potential hazards in their work and on needed protective measures through continual performance feedback and, if necessary, through enforcement of safe work practices.
• Understand their safety and health responsibilities.
Source: OSHA
AREA III: QUESTIONS WITH KEY
Introduction
This part of the CSHM Preparation Guide presents approximately 2000 questions representative of those that can be expected on the CSHM exam. Do not attempt to memorize these questions as a strategy for study. Rather, focus on being familiar with the various subject areas.
An enormous amount of information is presented that closely mirrors the subject matter within the exam. Answering these questions, as one form of study, may be quite helpful in determining your academic strengths and weaknesses.
Certification Examinations
The Institute’s CSHM certification examination is administered nation-wide a minimum of three times a year. Examination application deadlines and dates are posted at the Institutes website (.). The examination consists of 150 multiple-choice questions, each with four possible answers. Three hours are allotted to complete the examination. A passing or cut score is determined using the expert judgments of a standards setting panel. This score will vary depending on the actual examination form utilized.
The certification examination measures an individual’s mastery of the body of knowledge deemed appropriate as a result of a Job Practice Analysis conducted by the Institute. Preparation for the examination is best accomplished by mastering the body of knowledge recognized as appropriate for safety managers. The Institute uses exclusively four option multiple-choice items in its certification examinations for a number of reasons:
• 1. They are flexible and adaptable.
• 2. They tend to be more reliable than other formats.
• 3. They can accommodate a wide range of skills, knowledge and abilities to be measured.
• 4. They provide good sampling.
• 5. They have low chance scores.
• 6. They can be machine scored.
Multiple-choice items consist of three parts:
1. Stem - The stem states the problem or question to be answered.
2. Correct Answer - The correct answer is one of four potential options which represents the only correct response or the best correct response. (“Best” means a panel of experts would agree to this judgment.)
3. Distractors - Three distracters serve as incorrect responses. They are plausible, yet wrong, or not the best possible option.
The following is an example of the parts of a multiple-choice item:
|Stem: Typically, the most unreliable tool utilized in the selection process is a(n): |
| |Correct Answer: |A. employment interview |
| |Distractor: |B. selection test |
| |Distractor: |C. physical examination |
| |Distractor: |D. background check |
Items used on the Institute’s certification examinations were developed by certified safety and health managers who volunteer their services. A final review of each examination form was conducted by the Institute’s Board of Directors. Each examination form is carefully evaluated by the Board before being certified for use.
The three-step process of item development, item review and validation and examination review ensures that items are:
• clear, unambiguous and grammatically proper
• technically correct
• appropriate in terms of fairness--geographically, ethnically or culturally
• important for human resource professionals to know, and
• correctly coded to the ISHM Content Outline
Examination Preparation Methods, Strategies, and Resources
An important issue for examinees is preparation. There are a number of methods available in preparing for the ISHM examination. The selection of a method is a matter of individual preference based upon what best fits into one’s lifestyle. In the future, methods will range from the highly informal individual self-study to highly structured courses and workshops offered by professional organizations such as the National Safety Council, American Society of Safety Engineers, OSHA Training Network, and the National Safety Management Society.
Likewise, the strategy used to prepare for the certification examinations is equally important. Just like a world class athlete must “peak” at the precise moment of competition, so must an examinee on examination day. In addition to being able to master the safety management body of knowledge, the examinee should be both mentally and physically prepared to sit for the examination. Strategy is a critical element of preparation. The resources used to prepare are also critical elements of preparation. Sometimes the resources utilized will be a function of the preparation method selected. Other times, the potential examinee will have to select an appropriate resource from a wide range of possibilities. A mistake in selecting resources can significantly impact an examinee’s score.
Source: ISHM Electronic Certification Guide
Area III. Topic A. Compliance Management
1. Which of the following criteria is not used by OSHA to demonstrate that a hazard is or should have been recognized by the employer?
a. industry recognition
b. employer recognition
c. employee recognition
d. common sense recognition
2. This Part of the Code of Federal Regulations (CFR) describes occupational safety and health requirements for marine terminals:
a. 1904
b. 1917
c. 1926
d. 1928
3. Which category of OSHA standards apply to a particular industry or to particular operations, practices, conditions, processes, means, methods, equipment or installations: (OSHA FIRM CPL 2.103 Sec 7)
a. horizontal standards (specific)
b. vertical standards (general)
c. universal standards (horizontal)
d. specific industry standards (vertical)
4. The Occupational Safety and Health Act was passed in what year?
a. 1907
b. 1970
c. 1977
d. 1997
5. Whether exposed persons are employees of an employer depends on several factors, the most important of which is: (OSHA FIRM CPL 2.103 Sec 7)
a. relationship between the employee and employer
b. employee workloads and schedules
c. who controls the manner in which the employees perform assigned work
d. the manner in which the employer delegates work to the employee
6. Which category of OSHA standards below apply when a condition is not covered by a specific industry standard: (OSHA FIRM CPL 2.103 Sec 7)
a. horizontal standards (specific)
b. vertical standards (general)
c. universal standards (horizontal)
d. specific industry standards (vertical)
7. This Part of the Code of Federal Regulations (CFR) describes occupational safety and health requirements for general industry:
a. 1904
b. 1910
c. 1926
d. 1938
8. The employer's requirement to comply with an OSHA standard may be modified through granting of a: (OSHA FIRM CPL 2.103 Sec 7)
a. extension
b. variance
c. modification
d. special exception
9. An employer will not be subject to an OSHA citation if the observed condition is in compliance with either the standard or a: (OSHA FIRM CPL 2.103 Sec 7)
a. extension
b. variance
c. modification
d. special exception
10. This Part of the Code of Federal Regulations (CFR) describes occupational safety and health requirements for shipyard employment:
a. 1904
b. 1915
c. 1926
d. 1938
11. Where an OSHA standard requires engineering or administrative controls (including work practice controls), employee exposure shall be cited: (OSHA FIRM CPL 2.103 Sec 7)
a. if PPE is not appropriate for the use
b. unless suitable PPE can be immediately provided
c. if personal protective equipment is not being used
d. regardless of the use of PPE
12. Where employee exposure to a hazardous condition is not observed, witnessed, or monitored by the OSHA compliance officer during an inspection, unobserved employee exposure may be established if: (OSHA FIRM CPL 2.103 Sec 7)
a. exposure is determined through witness statements
b. exposure is determined through other evidence
c. exposure is determined through prediction
d. answer a and b above
13. An OSHA citation may be issued when the possibility exists that potential employee exposure to a hazard exists. Potential exposure may be established using any of the following criteria, except: (OSHA FIRM CPL 2.103 Sec 7)
a. witnesses and other evidence
b. past circumstances or anticipated work requirements
c. exposure can be reasonably predicted by the compliance officer
d. employee work patterns
14. Under OSHA law employers must protect employees from all of the following, except:
a. near miss
b. injury
c. illness
d. death
15. The purpose of the National Institute of Occupational Safety and Health (NIOSH) is to: (NIOSH)
a. conduct research and educate employers on best practices in safety and health
b. conduct research and make recommendations that improve OSHA standards
c. conduct research and make recommendations that prevent work-related injury and illness
d. conduct research and publish warnings regarding unsafe work practices
16. This inspection focuses on certain potentially hazardous areas, operations, conditions or practices at the establishment, but may be expanded based on information gathered by the OSHA compliance officer during the inspection process.
a. routine inspection
b. comprehensive inspection
c. programmed inspection
d. partial inspection
17. This type of violation shall be cited in situations where the most serious injury or illness that would be likely to result from a hazardous condition cannot reasonably be predicted to cause death or serious physical harm to exposed employees but does have a direct and immediate relationship to their safety and health: (OSHA FIRM CPL 2.103 Sec 7)
a. De Minimis
b. Other-than-serious
c. Serious
d. Statutory
18. The first states occupational safety and health laws in this country were enacted during what time period? (Grimaldi & Simonds, 36)
a. early 1800's
b. late 1800's
c. early 1900's
d. mid 1900's
19. This Part of the Code of Federal Regulations (CFR) requires employers to record and report work-related fatalities, injuries and illnesses:
a. 1904
b. 1910
c. 1926
d. 1938
20. The OSHA Act established all of the following agencies, EXCEPT:
a. OSHA
b. OSHRC
c. NSC
d. NIOSH
21. This type of violation exists if there is a substantial probability that death or serious physical harm could result from a condition which exists, or from one or more practices, means, methods, operations, or processes which have been adopted or are in use, in such place of employment unless the employer did not, and could not with the exercise of reasonable diligence, know of the presence of the violation.: (OSHA FIRM CPL 2.103 Sec 7)
a. De Minimis
b. Other-than-serious
c. Serious
d. Statutory
22. A serious violation is issued by OSHA if there is a substantial probability that death or serious physical harm could result from a condition which exists, or from one or more practices, means, methods, operations, or processes which have been adopted or are in use, in such place of employment unless: (OSHA FIRM CPL 2.103 Sec 7)
a. the employer corrects the violation prior to the conclusion of the inspection
b. the employer exercising reasonable diligence, did or could not know about the violation
c. the employer is able to establish the intent to comply with the violated rule
d. the employer is exercises reasonable diligence in correcting the hazard
23. Which of the following criteria is not considered by an OSHA compliance officer to determine if a serious violation exists? (OSHA FIRM CPL 2.103 Sec 7)
a. the type of accident or health hazard exposure
b. the most serious injury or illness expected
c. whether the injury or illness could include death or serious physical harm
d. whether the employee was under undue pressure to accomplish a task
24. This Part of the Code of Federal Regulations (CFR) describes occupational safety and health requirements for construction:
a. 1904
b. 1910
c. 1926
d. 1938
25. Under OSHA standards, employers are required to maintain all of the following, except: (OSHA Fact Sheet)
a. exposure records
b. hazard assessment records
c. training records
d. equipment certification records
26. This Part of the Code of Federal Regulations (CFR) describes occupational safety and health requirements for longshoring:
a. 1904
b. 1918
c. 1926
d. 1928
27. The National Institute of Occupational Safety and Health (NIOSH) has a primary research facility which includes research/field study Divisions: Division of Safety Research (DSR), Division of Respiratory Disease Studies (DRDS), and Health Effects Laboratory Division (HELD). What is the location of this facility? (NIOSH)
a. Washington DC
b. Cleveland OH
c. Pittsburgh PA
d. Morgantown WV
28. This OSHA standard requires each employer furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees: (OSHA FIRM CPL 2.103 Sec 7)
a. Section 7(a)(1) - Universal Employer Duty Clause
b. Section 5(a)(1) - General Duty Clause
c. Section 1(a)(1) - Universal Employer Requirement
d. Section 1(a)(1) - General Employer Duty
29. In general, Review Commission and court precedent has established that the following elements are necessary to prove a violation of the general duty clause, EXCEPT: (OSHA FIRM CPL 2.103 Sec 7)
a. the hazard was recognized and corrected prior to the conclusion of the inspection
b. the hazard was causing or likely to cause death or serious physical harm
c. the employer failed to keep the workplace free of a hazard to which employees were exposed
d. there was a feasible and useful method to correct the hazard
30. An OSHA general duty citation must involve the following: (OSHA FIRM CPL 2.103 Sec 7)
a. an employee and employer relationship
b. a workplace hazard and employee exposure
c. employee exposure
d. workplace hazard
31. For the purpose of citing employers, which of the following is false concerning OSHA's definition of a workplace hazard? (OSHA FIRM CPL 2.103 Sec 7)
a. it must affect the employer's employee
b. it is not a failure to abate
c. it is not an accident
d. it need not be necessarily be recognized
32. The maximum OSHA penalty for a serious violation is:
a. $3,000
b. $4,000
c. $5,000
d. $7,000
33. Employer recognition of a hazard is established if any of the following criteria is met, except: (OSHA FIRM CPL 2.103 Sec 7)
a. industry recognition
b. employer recognition
c. common sense
d. employee recognition
34. OSHA considers industry recognition may be established when the following criteria is met: (OSHA FIRM CPL 2.103 Sec 7)
a. recognition by employer's industry
b. general recognition by any industry
c. general recognition by companies three-digit SIC
d. general recognition by companies in four-digit SIC
35. OSHA considers employer recognition has been established when any of the following exists, except: (OSHA FIRM CPL 2.103 Sec 7)
a. written statements by employer
b. oral statements by supervisor
c. oral statements by employee to compliance officer
d. employee clearly calls hazard to employer's attention
36. In which of the following cases will OSHA use common-sense recognition to establish a violation? (OSHA FIRM CPL 2.103 Sec 7)
a. serious
b. flagrant
c. high-death
d. unusual
37. In which of the following cases will OSHA use common-sense recognition to establish a violation? (OSHA FIRM CPL 2.103 Sec 7)
a. serious
b. flagrant
c. high-death
d. unusual
38. Even though, as a result of the exercise of professional judgment, not all potentially hazardous conditions, operations and practices within those areas are inspected during this inspection, this type of OSHA inspection is defined as a substantially complete inspection of the potentially high hazard areas of an establishment:
a. routine inspection
b. comprehensive inspection
c. programmed inspection
d. focused inspection
39. The common-sense criteria to argue that a hazard should have been recognized by an employer will be used by OSHA: (OSHA FIRM CPL 2.103 Sec 7)
a. whenever other criteria is insufficient
b. only in flagrant cases
c. when employees identify the hazards
d. as directed by the Review Commission
40. Exposure is generally defined as: (OSHA FIRM CPL 2.103 Sec 7)
a. event or occurrence
b. condition, relative position
c. behavior, condition
d. activity, predetermined event
41. These violation OSHA standards have no direct or immediate relationship to safety or health and are not included in citations: (OSHA FIRM CPL 2.103 Sec 7)
a. De Minimis
b. General
c. Serious
d. Willful
42. This violation will be issued by OSHA if the employer has been cited previously for a substantially similar condition and the citation has become a final order:(OSHA FIRM CPL 2.103 Sec 7)
a. Repeat
b. General
c. Serious
d. Willful
43. This department is authorized to enforce the OSHAct of 1970.
a. Department of Occupational Safety and Health (DOSH)
b. Department of Labor (DOL)
c. Department of Justice (DOJ)
d. Environmental Protection Administration (EPA)
44. Section 5(b) of the Act states: 'Each employee shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to the Act which are applicable to his own actions and conduct.' All of the following are true concerning this Act, except: (OSHA FIRM CPL 2.103 Sec 7)
a. The Act does not propose penalties against employees
b. The Act does not provide for the issuance of citations against employees,
c. Employers are not responsible for employee compliance
d. Employers are responsible for employee compliance
45. In cases where the OSHA compliance officer determines that employees are systematically refusing to comply with a standard applicable to their own actions and conduct, the OSHA compliance officer will: (OSHA FIRM CPL 2.103 Sec 7)
a. propose penalties against the employee
b. issue a citation against the employee,
c. consult with the Area Director
d. review compliance with the employer
46. This Part of the Code of Federal Regulations (CFR) describes occupational safety and health requirements for inspections, citations, and proposed penalties:
a. 1903
b. 1917
c. 1926
d. 1928
47. If the employer is able to establish this defense, OSHA will excuse the violation which was otherwise proved by the OSHA compliance officer (OSHA FIRM CPL 2.103 Sec 7)
a. Due diligence
b. De Minimis,
c. Affirmative
d. Absolute
48. Common examples of employer affirmative defense include all of the following, except: (OSHA FIRM CPL 2.103 Sec 7)
a. unpreventable employee misconduct
b. compliance would create greater hazard,
c. alternative methods exist
d. compliance is functionally impossible
49. Inspections, either programmed or unprogrammed, fall into one of two categories depending on the scope of the inspection. Which of the following describe these two categories?(OSHA FIRM CPL 2.103 Sec 6)
a. comprehensive and partial
b. complete and focused,
c. area and department
d. safety and health
50. The minimum and maximum OSHA penalties for a willful violation is:
a. $2,000 to $30,000
b. $3,000 to $40,000
c. $4,000 to $50,000
d. $5,000 to $70,000
51. When OSHA conducts a substantially complete inspection of the potentially high hazard areas of the establishment, it is called a/an: (OSHA FIRM CPL 2.103 Sec 6)
a. area inspection
b. focused inspection,
c. partial inspection
d. comprehensive inspection
52. Developed in cooperation with Canada and Mexico, this system represents one of the most profound changes for statistical programs focusing on emerging economic activities:
a. North American Industry Classification System (NAICS)
b. National Industrial Classification (NIC)
c. Primary Industrial Survey (PIS)
d. Standard Industrial Classification (SIC)
53. When OSHA conducts an inspection whose focus is limited to certain potentially hazardous areas, operations, conditions or practices at the establishment, it is called a/an: (OSHA FIRM CPL 2.103 Sec 6)
a. area inspection
b. focused inspection,
c. partial inspection
d. comprehensive inspection
54. As a general rule, OSHA inspections:
a. target specific high hazard industries, workplaces or occupations
b. always result in follow up inspections
c. include of injury and illness records reviews
d. focus on scope of the comprehensive safety program
55. A partial OSHA inspection may be expanded based on information gathered by the compliance officer during the inspection process. The compliance officer must use professional judgment to determine the necessity for expansion of the inspection scope and will base this judgment on all of the following, except: (OSHA FIRM CPL 2.103 Sec 6)
a. walk-around inspection
b. program review information,
c. records review information
d. subjective impression
56. This Part of the Code of Federal Regulations (CFR) describes occupational safety and health requirements for agriculture:
a. 1904
b. 1915
c. 1926
d. 1928
57. Section 8 of the Act provides that OSHA compliance officers may enter without delay and at reasonable times any establishment covered under the Act for the purpose of conducting an inspection. The employer may not refuse to allow the compliance officer entry when any of the following recognized exceptions exist: ( (OSHA FIRM CPL 2.103 Sec 6)
a. consent
b. open field,
c. plain view
d. time restraint
58. Under OSHA standards, employers are required to maintain all of the following, except: (OSHA Fact Sheet)
a. exposure records
b. hazard assessment records
c. training records
d. equipment certification records
59. Complaints about discrimination must be filed to OSHA as soon as possible within _____ days of the alleged reprisal for most complaints:
a. 30 days
b. 60 days
c. two weeks
d. three weeks
60. Unless the circumstances constitute a recognized exception the employer may: (OSHA FIRM CPL 2.103 Sec 6)
a. refuse entry by an OSHA compliance officer to conduct of the inspection
b. refuse entry by an OSHA compliance officer without a warrant
c. refuse entry by an OSHA compliance officer with police escort
d. refuse entry by an OSHA compliance officer without legal council
61. The Occupational Safety and Health Act (William-Steigers Act) was enacted in what year?
a. 1907
b. 1970
c. 1977
d. 1997
62. Examples of employer interference with OSHA compliance inspections includes all of the following examples, except: (OSHA FIRM CPL 2.103 Sec 6)
a. refusal to permit the walk-around inspection
b. not allowing examination of records essential to the inspection,
c. refusing OSHA compliance officer entry without a warrant
d. refusing to allow the taking of essential photos
63. Which of the following is TRUE concerning employee workplace rights?
a. negotiate the corrective actions
b. appeal the citation penalty
c. require a warrant
d. contest the abatement date
64. When an apparent refusal to permit entry or inspection is encountered upon presenting the warrant, the CSHO shall specifically inquire whether the employer is refusing to comply with the warrant. If the employer refuses to comply or if consent is not clearly given, the CSHO will do all of the following, except: (OSHA FIRM CPL 2.103 Sec 6)
a. enter with a U.S. Federal Marshall
b. leave the premises,
c. not attempt to conduct the inspection
d. notify the Assistant Area Director
65. This system has served for decades as the structure for the collection, aggregation, presentation, and analysis of the US economy:
a. North American Industry Classification System (NAICS)
b. National Industrial Classification (NIC)
c. Primary Industrial Survey (PIS)
d. Standard Industrial Classification (SIC)
66. Employers who participate in these programs may be exempted from programmed OSHA inspections: (OSHA FIRM CPL 2.103 Sec 6)
a. preferred worker programs
b. voluntary compliance programs,
c. voluntary nondisclosure programs
d. OSHA 300 Survey Program
67. To protect the health and safety of persons working in the coal mining industry, the Federal Coal Mine Health and Safety Act passed. In what year was the Act enacted? (MSHA)
a. 1909
b. 1919
c. 1969
d. 1996
68. The Lost Workday Case Incident Rate (LWDI) may, in the OSHA compliance officer's discretion, be used in determining trends in injuries and illnesses. The LWDI rate is calculated according to the following formula: (OSHA FIRM CPL 2.103 Sec 6)
a. (# LWDI's x 1 million)/# employee hours worked
b. (# LWDI's x 200,000)/# employee hours worked
c. (# employee hours worked x 1 million)/200,000
d. (# employee hours worked x 200,000)/# LWDI's
69. Apparent OSHA violations will be brought to the attention of employer and employee representatives at the time they are documented during an inspection. Compliance officers are required to record at a minimum all of the following, except: (OSHA FIRM CPL 2.103 Sec 6)
a. employee's knowledge of the hazard
b. the employer's knowledge of the condition
c. the identity of the exposed employee
d. the hazard to which the employee was exposed
70. OSHA defines the hospitalization for treatment of three or more employees resulting from a work-related incident, accident or illness as a/an: (OSHA FIRM CPL 2.103 Sec 6)
a. serious accident
b. catastrophe
c. multiple injury accident
d. eight-hour reportable event
71. This Act was most recently enacted in 1977:
a. Toxic Substances Control Act
b. Occupational Safety and Health Act
c. Federal Mine Safety and Health Act
d. Walsh Healy Act
72. Section 17(e) of the Act provides criminal penalties for an employer who is convicted of having willfully violated an OSHA standard, rule or order when that violation: (OSHA FIRM CPL 2.103 Sec 6)
a. occurred in the employer's workplace
b. caused the death of an employee
c. resulted in multiple injuries
d. was a repeat
73. Occupational Safety and Health Act was passed under this president's administration?
a. Roosevelt
b. Kennedy
c. Nixon
d. Reagan
74. Any conditions or practices in any place of employment which are such that a danger exists which could reasonably be expected to cause death or serious physical harm immediately or before the imminence of such danger can be eliminated through enforcement procedures is referred to as: otherwise provided by this Act. (OSHA FIRM CPL 2.103 Sec 6)
a. immediately dangerous to life or limb (IDLL)
b. a high risk environment
c. imminent danger
d. a hazardous workplace
75. The OSHA 300 Log must be prepared for OSHA each year, but the most effective use of the summary is to:
a. Provide statistical analysis data
b. Ensure compliance with OSHA
c. Provide justification to fund safety
d. Prove due diligence
76. Days Away Restricted & Transferred (DART) incidence rate is expressed as: (OSHA FIRM CPL 2.103 Sec 6)
a. (# Days away from work, restricted work or transfer x 1 million)/# actual employee workhours)
b. (# Days away from work, restricted work or transfer x 200,000)/# actual employee workhours
c.(# actual employee workhours x 200,000)/# Days away from work, restricted work or transfer
d. # Days away from work, restricted work or transfer/(# actual employee workhours x 200,000)
77. Under the OSHA Guidelines, states may administer their own safety and health rules as long as:
a. state rules are at least as effective
b. states remit a portion of the penalties
c. state plans mirror the federal plan
d. state rules are adopted after 180 days
78. The Occupational Safety and Health Act (William-Steigers Act) was enacted in what year?
a. 1907
b. 1970
c. 1977
d. 1997
79. The maximum OSHA penalty a repeat violation is:
a. $3,000
b. $5,000
c. $7,000
d. $9,000
80. Warning signs, hazardous material labels and other forms of warnings must be in:
a. English and Spanish
b. English
c. Primary language of employee
d. English and French
81. The National Institute for Occupational Safety and Health (NIOSH) is located within what federal agency?
a. Department of Labor
b. Health and Human Services/CDC
c. Secretary of Labor
d. Secretary of Health and Human Services
82. Which of the following relationships is MOST correct?
a. NIOSH is an agency of OSHA
b. OSHA reports to NIOSH
c. NIOSH is an agency within CDC
d. CDC reports to NIOSH
83. OSHA encourages companies to develop and maintain a comprehensive safety and health program, and has established this program that recognizes this effort:
a. QSHP, Quality Safety and Health Program
b. VPP, Voluntary Protection Program
c. ESHM, Excellent Safety and Health Management Program
d. VOIP, Voluntary OSHA Inspection Program
84. OSHA encourages States to develop and operate their own job safety and health programs. OSHA approves and monitors State plans. For the states to assume, develop and operate their own OSHA laws, they must:
a. develop and forward a plan to OSHA
b. must meet 100% staffing levels
c. show worker protection is as effective as OSHA's
d. all of the above
85. This 1970 act is considered by most safety professionals to be the most significant safety legislation of the last century:
a. Taft-Hartley Act
b. Williams-Steiger Act
c. Gramm-Rudman Act
d. Steiger-Mannington Act
86. This Federal agency responsible for conducting research and making recommendations for the prevention of work-related disease and injury:
a. Department of Labor (DOL)
b. National Institutes of Safety and Health (NIOSH)
c. Occupational Safety and Health Administration (OSHA)
d. Department of Health and Human Services (HHS)
87. When any workplace fatality or accident that results in the hospitalization of three or more employees, employers are required to report to the nearest OSHA office within:
a. 8 hours
b. 24 hours
c. 36 hours
d. 48 hours
88. Which of the following must be posted at a prominent location within the workplace informing employees of their rights and responsibilities?
a. Form 301
b. OSHA summary
c. OSHA poster
d. Form 300A
89. The maximum OSHA penalty per day for failure to correct a prior violation is:
a. $3,000
b. $5,000
c. $7,000
d. $9,000
90. The employer must provide employees, former employees and their representatives access to the Log of Work-Related Injuries and Illnesses, also called the:
a. OSHA Form 301
b. OSHA Form 300
c. OSHA poster
d. Form summary
91. Name an independent agency that tests, certifies and provides other safety technical services. : (Brauer, 41)
a. OSHA
b. Industry Mutual System
c. Underwriters Laboratory (UL)
d. American National Standards Institute (ANSI)
92. Which of the following is NOT an example of a voluntary consensus standard? (Brauer, 40)
a. OSHA 1910.1200
b. ANSI Z490.1
c. ASTM A34/A34M-01
d. NFPA 70
93. Which of the following is a voluntary consensus standard that establishes guidelines for health and safety management systems? (AIHA)
a. OSHA 1910.1200
b. ANSI Z490.1
c. ANSI Z10
d. NFPA 70
94. Identify the agency that does not certify or approve health or safety related products: (OSHA)
a. OSHA
b. UL
c. NIOSH
d. FM
95. Which of the following acts was enacted most recently? (OSHA)
a. The Occupational Safety and Health Act
b. Federal Mine Safety and Health Act
c. Homeland Security Act
d. The Toxic Substances Control Act
96. Where would one usually not look to determine what agencies in a state are responsible for safety function and codes? (Brauer, 39)
a. OSHA directories
b. U.S.Code
c. Internet
d. State directories
97. The Occupational Safety and Health Administration is headed by _____________. (Dept. of Labor)
a. Vice President
b. Assistant Secretary of Labor
c. Secretary of Labor
d. Secretary of Health and Human Services
98. What is the primary responsibility of the Occupational Safety and Health Review Commission? (Dept. of Labor)
a. Conduct research, experiments, and demonstrations
b. Conduct educational programs
c. Adjudicate disputes
d. Promulgate standards
99. Congress provides grants to the States to assist in all of the following, EXCEPT: (OSHA)
a. Improving administration and enforcement
b. Evaluating labor-management relations
c. Identifying their needs and responsibilities
d. Developing plans in accordance with the OSHAct
100. OSHA has a right to Promulgate, modify and revoke standard, conduct inspection, require employers to keep records and to approve or reject state plans for programs under the act. They may also: (OSHA)
a. Dictate requirements for US plants in foreign countries.
b. Shut down a plant on evidence received in a complaint.
c. Provide training to employers and employees.
d. All of the above.
101. OSHA encourages management to manage their safety and health program. One OSHA program for this purpose is called the __________. (OSHA)
a. VPP Voluntary Protection Program (VPP)
b. EESP, Employer, Employee Safety Program (EESP)
c. ESHP, Employer Safety and Health Policy (ESHP)
d. VSIP, Voluntary Safety Inspection Program (VSIP)
102. There are many organizations that promulgate standards besides OSHA. In fact OSHA refers to some of them in the OSHA standards. Good Safety Management includes and understanding and use of these standards. Which of the following apply to safety and health? (OSHA)
a. API, American Petroleum Institute
b. The Fertilizer Institute
c. ANSI, American National Standards Institute
d. All of the above
103. OSHA encourages the states to assume the fullest responsibility for administering and enforcing their own OSHA laws. However, in order to assume this responsibility, such states must: (OSHA)
a. Develop and submit a plan to OSHA.
b. Have standards pertinent to their own state.
c. Develop a program and tell OSHA.
d. Develop, submit and receive plan approval from OSHA.
104. The responsibility for research to determine criteria requirements and to provide more advanced occupational safety and health implementation methods in general, is assigned to the National Institute for Occupational Safety and Health (NIOSH), which is under the ______: (OSHA)
a. Department of Labor
b. Department of Health and Human Services
c. National Institutes of Health
d. Occupational Safety and Health Administration
105. Which of the following is NOT a stated strategy to achieve the goals outlined in OSHA's strategic plan? (OSHA)
a. Assist employers to promote a safe culture
b. Directly intervene to reduce occupational hazards
c. Introduce common sense regulatory reform
d. Strengthen capabilities and infrastructure
106. OSHA believes it _______: (OSHA)
a. is caught between worker and employer organizations
b. cannot achieve goals through enforcement alone
c. has a mandate to enforce only
d. can achieve its mission through enforcement alone
107. OSHA has developed a variety of intervention tools and strategies for achieving its strategic goals. This multifaceted approach includes all of the following, except? (OSHA)
a. Initiating focused inspections
b. Legislating standard safety values
c. Penalty adjustments tied to the quality
d. Strengthening partnership efforts
108. OSHA makes use of research studies and data to proactively assess changes in the workplace environment and the workforce to _____________: (OSHA)
a. identify trends in injuries, illnesses, and deaths
b. determine the underlying reasons why injuries occur
c. determine employer liability
d. a and b above
109. OSHA will write new standards and guidance materials __________, in order to make safety and health requirements more understandable to those affected: (OSHA)
a. in plain language
b. using a revised indexing protocol
c. regularly
d. in standardized volumes
110. OSHA provides a strong enforcement presence to _______________________: (OSHA)
a. assure a culture of accountability
b. act as an effective deterrent
c. prevent private sector noncompliance
d. comply with DOL policy
111. OSHA will increase the number of high-impact cases (e.g., significant, egregious, and corporate-wide settlement agreements) through ______________: (OSHA)
a. enhanced targeting
b. revised reporting procedures
c. improved case preparation
d. all of the above
112. Which one of the following would NOT be considered a benefit of partnering with OSHA? (OSHA)
a. technical assistance
b. focused inspections
c. penalty reductions
d. reduced publicity
113. OSHA's compliance assistance programs include all of the following, except: (OSHA)
a. Informal training classes
b. Consultation Program
c. Voluntary Protection Programs
d. Outreach initiatives
114. This program recognizes worksites with excellent safety and health programs: (OSHA)
a. Employer Excellence Program (EEP)
b. Voluntary Protection Program (VPP)
c. Safety and Health Recognition Program (SHRP)
d. Employer Safety Excellence Program (ESEP)
115. OSHA has developed a broad-based training and educational effort for external outreach including all of the following, except: (OSHA)
a. Employer Ride-a-long Program
b. Training grant program
c. Training aids and lesson plans
d. Technology-based delivery systems
116. NIOSH performs all of the following activities, except: (OSHA)
a. Investigate potentially hazardous working conditions
b. Make recommendations on preventing injury and illness
c. Provide training to safety and health professionals
d. Promulgate pending OSHA legislation
117. Section 18 of the Occupational Safety and Health Act of 1970 ________ States to develop and operate their own job safety and health programs. (OSHA)
a. mandates
b. encourages
c. requires
d. forces
118. The organization of officials in the 26 States that operate OSHA-approved State Plans is called: (OSHA)
a. State Plan OSHA Association (SPOSHA)
b. State Occupational Safety and Health Association (SOSHA)
c. Occupational Safety and Health State Plan Association (OSHSPA)
d. Occupational State Safety Plan Association (OSPPA)
119. States must set job safety and health standards that are __________ federal standards: (OSHA)
a. at least as effective as
b. identical to
c. not in addition to
d. not otherwise addressed in
120. The Occupational Safety and Health Review Commission (OSHRC) __________: (OSHA)
a. reviews pending legislation for legal sufficiency
b. is an independent agency of the U.S. Government
c. is a consortium of private and public sector associations
d. monitors and approves employer disputes
121. The Occupational Safety and Health Review Commission's only function is to _________: (OSHRC)
a. ensure OSHA adheres to STD-1
b. conduct hearings
c. review OSHA law
d. resolve disputes
122. The Occupational Safety and Health Review Commission employs _______________ to hear cases: (OSHRC)
a. former enforcement officers
b. Administrative Law Judges
c. trial attorneys
d. hearings officers
123. This organization is composed of officials operating OSHA-approved State Plans: (OSHRC)
a. OSHAHC
b. OSHSPA
c. IRSPA
d. SPAM
124. Which of the following criteria is NOT used by OSHA to demonstrate that a hazard is or should have been recognized by the employer? (OSHA)
a. industry recognition
b. employer recognition
c. employee recognition
d. common sense recognition
125. The common sense criteria to argue that a hazard should have been recognized by an employer will be used ______: (OSHA)
a. whenever other criteria is insufficient
b. only in flagrant cases
c. when employees identify the hazards
d. as directed by the Oregon DOJ
126. Each of the below are types of OSHA standards except? (OSHA)
a. national consensus standards
b. permanent standards
c. temporary review standards
d. emergency temporary standards
127. These rules represent the most common type of OSHA regulation: (OSHA)
a. Consensus
b. Emergency
c. Temporary
d. Permanent
128. Why does OSHA rarely issue Emergency Temporary Standards (ETS)? (OSHA)
a. The need for ETS's has significantly decreased.
b. ETS's remain in effect for only six months.
c. Courts do not allow most ETS's to become effective.
d. Funding for ETS's has been cut off by Congress.
129. Before issuing a permanent standard, OSHA must find that a significant risk exists in the workplace. How does OSHA determine risk? (OSHA)
a. legal writ
b. regulatory standard
c. OSHA 200 Log results
d. workplace and other studies
130. All of the following Acts have placed restraints on OSHA's rulemaking ability, EXCEPT: (OSHA)
a. Regulatory Flexibility Act
b. Business Liability Act
c. Paperwork Reduction Act
d. Small Business Regulatory Enforcement Fairness Act
131. The general duty clause is breached when a firm's employees are exposed to hazards that meet all of the following requirements, EXCEPT: (OSHA)
a. The hazard is recognized as harmful by the individual employer.
b. The hazard is also covered by an adequate specific rule.
c. The hazard is recognized as harmful by industry.
d. The hazards is likely to cause death or serious harm.
132. Which of the following is not considered a successful employer defense against alleged OSHA violations? (OSHA)
a. Compliance poses a financial burden
b. Compliance is infeasible
c. Lack of control on a multi-employer worksite.
d. Unpreventable employee conduct
133. An employer may be able to defend against an OSHA violation by demonstrating all of the following, EXCEPT: (OSHA)
a. employee breached safety rules
b. safety rules were effectively conveyed
c. safety rules are uniformly enforced
d. the unsafe practice did not cause injury
134. All of the following are OSHA penalty classifications except? (OSHA)
a. willful
b. de minimis
c. general
d. serious
135. Which of the following is not a consideration the Secretary of Labor must consider in proposing penalties? (OSHA)
a. good faith
b. prior violation history
c. employer size
d. employer ability to pay
136. The Secretary has unreviewable prosecutorial discretion to do all of the following, EXCEPT: (OSHA)
a. nullify rules
b. withdraw citations
c. reach settlements
d. characterize violations
137. At an administrative hearing, both OSHA and the employer may _________: (OSHA)
a. cross examine
b. call witnesses
c. introduce evidence
d. all of the above
138. OSHA can seek criminal penalties in all of the following instances, EXCEPT: (OSHA)
a. someone falsely reports information to OSHA
b. willful violations of specific standards
c. willful violations of the general duty clause
d. someone provides advance notice of an OSHA inspection
139. Employees enjoy a right to do all of the following, EXCEPT: (OSHA)
a. challenge the abatement remedy
b. file a complaint with OSHA
c. accompany inspectors
d. review relevant standards
140. To prove discrimination has occurred against an employee, the Secretary must show that exercise of protected rights was a ______________ cause for an employee's adverse treatment: (OSHA)
a. sole
b. substantial
c. primary
d. secondary
141. OSHA regulations also grant employees a right to know all of the following, EXCEPT? (OSHA)
a. trade secret information
b. exposure information
c. hazardous substances on the job
d. medical records
142. 29 U.S.C. 666(e) of the OSH Act provides for criminal penalties when all of the following criteria are met, EXCEPT: ((29 U.S.C. Section 666(e))
a. There is a violation of a specific regulation
b. The violation is willful
c. The employer refused consultative services
d. An employee was killed
143. Which of the following criteria is not included in consideration of criminal penalties as specified in 29 U.S.C. 666(e) of the OSH Act? (29 U.S.C. Section 666(e))
a. The violation was a repeat
b. There is a causal relationship between the violation and the death
c. There is a violation of a specific regulation
d. An employee was killed
144. An employer may be assessed a civil penalty for willfully or repeatedly committing any of the following OSH Act violations, EXCEPT: (29 U.S.C. Section 666(a))
a. violates requirements of section 5
b. violates a standard, rule, or order promulgated in section 6
c. willfully or repeatedly violates any section of the OSHact
d. willfully or repeatedly violates prescribed OSH regulations
145. Any employer who willfully or repeatedly violates the requirements of section 5 of the OSH Act, any standard, rule, or order promulgated pursuant to section 6 of the OSHAct, or regulations prescribed pursuant to the OSH Act, may be assessed a civil penalty of not more than _____ for each violation, but not less than _____ for each willful violation. (29 U.S.C. Section 666(a))
a. $7,000, $500
b. $17,000, $1500
c. $70,000, $5,000
d. $170,000, $50,000
146. Since 1970, workplace fatalities have been reduced by: (OSHA)
a. 10%
b. 25%
c. 50%
d. 75%
147. Occupational injury and illness rates have been declining for the past six years, dropping in ____ to the lowest level on record: (OSHA)
a. 1978
b. 1983
c. 1998
d. 2003
148. Nationally, nearly ______ American workers are injured every minute: (OSHA)
a. 4
b. 17
c. 35
d. 50
149. Nationally, almost ____ workers die each day. : (OSHA)
a. 4
b. 17
c. 35
d. 50
Area III. Topic B. Environment
1. This Act gave the Environmental Protection Agency (EPA) authority to establish standards related to the discharge of pollutants from motor vehicles and industry: (NSC, APM-A&P, 107)
a. The Atmospheric Quality Act (AQA) of 1978
b. The Environmental Quality Control Act (EQCA) of 1970
c. Air Quality Act (AQA) of 1956
d. Clean Air Act (CAA) of 1967
2. The Clean Air Act (CAA) of 1967 gave this agency authority to establish standards related to the discharge of pollutants from motor vehicles and industry: (NSC, APM-A&P, 107)
a. The Environmental Protection Agency (EPA)
b. Occupational Safety and Health Administration (OSHA)
c. National Geologic Survey (NGS)
d. Department of Environmental Protection (DEP)
3. The Clean Air Act (CAA) of 1967 gave the Environmental Protection Agency (EPA) authority to do which of the following? (NSC, APM-A&P, 107)
a. regulate the discharge of pollutants from motor vehicles
b. establish air quality standards
c. regulate the discharge of pollutants from industry
d. all of the above
4. The Clean Air Act (CAA) of 1970 gave the Environmental Protection Agency (EPA) additional authority to: (NSC, APM-A&P, 107)
a. regulate the discharge of pollutants from motor vehicles
b. set and review National Ambient Air Quality Standards (NAAQS)
c. regulate the discharge of pollutants from industry
d. regulate the discharge of pollutants into outdoor ambient air
5. Which of the following define maximum concentrations of certain air pollutants allowable in ambient air to protect public health and welfare: (NSC, APM-A&P, p 107)
a. National Ambient Air Quality Standards (NAAQS)
b. National Emissions Standards for Hazardous Air Pollutants (NESHAPs)
c. American National Ambient Air Standards (ANAAS)
d. New Source Performance Standards (NSPS)
6. Under the Clean Air Act (CAA) the Environmental Protection Agency (EPA) identified primary air quality standards for all of the following, EXCEPT: (NSC, APM-A&P, 107)
a. ozone
b. silicon
c. carbon monoxide
d. particulate matter
7. Under the Clean Air Act (CAA) the Environmental Protection Agency (EPA) identified primary air quality standards for all of the following, EXCEPT: (NSC, APM-A&P, 107)
a. sulfur dioxide
b. silver monoxide
c. nitrogen dioxide
d. lead
8. Which of the following define allowable emissions limits for various stationary sources set by the Environmental Protection Agency (EPA)? (NSC, APM-A&P, 107)
a. National Ambient Air Quality Standards (NAAQS)
b. National Emissions Standards for Hazardous Air Pollutants (NESHAPs)
c. American National Ambient Air Standards (ANAAS)
d. New Source Performance Standards (NSPS)
9. These standards are set by the Environmental Protection Agency (EPA) for pollutants for which no ambient air quality standards exist: (NSC, APM-A&P, 107)
a. National Ambient Air Quality Standards (NAAQS)
b. National Emissions Standards for Hazardous Air Pollutants (NESHAPs)
c. American National Ambient Air Standards (ANAAS)
d. New Source Performance Standards (NSPS)
10. Under the National Emissions Standards for Hazardous Air Pollutants (NESHAPs) the Environmental Protection Agency (EPA) identified standards for all of the following pollutants, EXCEPT: (NSC, APM-A&P, 107)
a. arsenic
b. benzene
c. asbestos
d. lead
11. Under the National Emissions Standards for Hazardous Air Pollutants (NESHAPs) the Environmental Protection Agency (EPA) identified standards for all of the following pollutants, EXCEPT: (NSC, APM-A&P, 107)
a. anthrax
b. mercury
c. radionuclides
d. vinyl chlorides
12. This Act modified some of the National Emissions Standards for Hazardous Air Pollutants (NESHAPs) due compensate for shifts energy sources caused by the Middle East oil embargo: (NSC, APM-A&P, 107)
a. The NESHAPs Revision Act (NRA) of 1978
b. The Environmental Quality Control Act (EQCA) of 1970
c. Energy Supply and Environmental Coordination Act (ESECA) of 1974
d. Clean Air Act (CAA) of 1967
13. In 1977, Congress enacted amendments to the Clean Air Act (CAA) that resulted in all of the following, EXCEPT: (NSC, APM-A&P, 107)
a. restrictions on new pollution sources where ambient air quality standards have not been met
b. restrictions on industrial expansion to prevent deterioration in ambient air quality
c. restrictions on motor vehicle biodiesel fuel emissions
d. a and b above
14. State governments measure air quality standards and define ways to meet National Ambient Air Quality Standards (NAAQS) via this plan: (NSC, APM-A&P, 107)
a. State Emergency Management Plan (EMP)
b. State NAAQS Plan (SNP)
c. State Implementation Plan (SIP)
d. State Emergency Implementation Plan (SEIP)
15. All of the following is true concerning State Implementation Plans (SIP), EXCEPT: (NSC, APM-A&P, 108)
a. the SIP must be developed by the EPA and state governments
b. the SIP must be approved by the EPA, municipal and state governments
c. the SIP becomes part of both state and federal law
d. the SIP can be enforced by the EPA and state regulatory agencies
16. The Clean Air Amendments of 1990 contained the largest and most complex changes to air pollutant regulations since 1970. These amendments affected all of the following, EXCEPT: (NSC, APM-A&P, 108)
a. nonattainment areas
b. mobile sources
c. air toxic chemicals
d. chemtrail pollutants
17. The Clean Air Amendments of 1990 contained the largest and most complex changes to air pollutant regulations since 1970. These amendments affected all of the following, EXCEPT: (NSC, APM-A&P, 108)
a. emissions from watercraft
b. permits
c. cholorofluorocarbons
d. acid rain
18. The Clean Air Amendments of 1990 contained the largest and most complex changes to air pollutant regulations since 1970. These amendments affected all of the following, EXCEPT: (NSC, APM-A&P, 108)
a. underwater volcano emissions
b. permits
c. enforcement
d. acid rain
19. Which of the following is true concerning the Clean Air Amendments of 1990? (NSC, APM-A&P, 108)
a. identifies 189 air toxic chemicals controlled with Maximum Achievable Control Technology (MACT)
b. regulates based on the maximum exposed individual
c. removes the grandfather exemption limiting the need for emissions permits
d. all of the above
20. Which of the following is true concerning the Clean Air Amendments of 1990? (NSC, APM-A&P, 108)
a. identifies 189 air toxic chemicals controlled with Maximum Achievable Control Technology (MACT)
b. regulates based on the maximum exposed individual
c. removes the grandfather exemption limiting the need for emissions permits
d. all of the above
21. All of the following are true concerning the Clean Water Act (CWA) of 1972, EXCEPT: (NSC, APM-A&P, 108)
a. identifies toxic chemicals controlled with Maximum Achievable Control Technology (MACT)
b. Developing criteria is assigned to the Environmental Protection Agency (EPA)
c. Its purpose is to restore and maintain the chemical, physical, and biological integrity of the Nation's waters
d. States are responsible to develop water quality management programs
22. Under the Clean Water Act (CWA) of 1972, the Environmental Protection Agency (EPA) is responsible for develop criteria for all of the following, EXCEPT: (NSC, APM-A&P, 108)
a. water quality standards
b. technology-based effluent limitation guidelines
c. allowed additives control standards
d. pretreatment standards
23. This system incorporates and applies effluent limitations in individual permits for municipal and industrial dischargers: (NSC, APM-A&P, 109)
a. Waterway Effluent Discharge Permit System (WEDPS)
b. American Effluent Permit System (AEPS)
c. National Pollutant Discharge Elimination System (NPDES)
d. North American Waterway Permit System (NAWPS)
24. In 1990, the EPA published these rules to regulate industrial facilities discharging stormwater into the waters of the United States: (NSC, APM-A&P, 109)
a. Stormwater Discharge Regulations
b. American Effluent Discharge Regulations
c. National Discharge Elimination Standards
d. North American Waterway Discharge Standards
25. This Act, passed in 1976, was the first statutory framework designed to provide comprehensive federal and state hazardous-waste management: (NSC, APM-A&P, 109)
a. Clean Air Act (CAA)
b. Clean Water Act (CWA)
c. Resource Conservation and Recovery Act (RCRA)
d. Hazardous Waste Recovery and Conservation Act (HWRCA)
26. This Act requires industry to identify and list all hazardous wastes and to note the toxicity, persistence, degradability in nature, and the potential for accumulation in tissue: (NSC, APM-A&P, 109)
a. Clean Air Act (CAA)
b. Clean Water Act (CWA)
c. Resource Conservation and Recovery Act (RCRA)
d. Hazardous Waste Recovery and Conservation Act (HWRCA)
27. Which of the following must be listed by industry under the Resource Conservation and Recovery Act (RCRA)? (NSC, APM-A&P, 109)
a. hazardous waste toxicity
b. hazardous waste persistence
c. hazardous waste degradability in nature
d. all of the above
28. Under the Resource Conservation and Recovery Act (RCRA), all of the following must be listed by industry, EXCEPT: (NSC, APM-A&P, 109)
a. potential for accumulation of hazardous wastes in tissues
b. resistance of hazardous waste to controls
c. degradability of hazardous wastes in nature
d. toxicity of hazardous wastes
29. Under the Resource Conservation and Recovery Act (RCRA), all of the following must be accomplished by hazardous waste generators, EXCEPT: (NSC, APM-A&P, 109)
a. maintain recordkeeping
b. accomplish container labeling
c. train hazardous waste workers
d. comply with component disclosure
30. Under the Resource Conservation and Recovery Act (RCRA), all of the following must be accomplished by hazardous waste generators, EXCEPT: (NSC, APM-A&P, 109)
a. use of a manifest system to track hazardous waste movement
b. report to OSHA
c. accomplish container labeling
d. comply with component disclosure
31. The Resource Conservation and Recovery Act (RCRA) regulates: (NSC, APM-A&P, 109)
a. hazardous waste generators
b. hazardous waste treatment facilities
c. hazardous waste storage facilities
d. all of the above
32. Which of the following is not regulated by the Resource Conservation and Recovery Act (RCRA)? (NSC, APM-A&P, 109)
a. hazardous waste manufacturers
b. hazardous waste treatment facilities
c. hazardous waste disposal facilities
d. hazardous waste generators
33. Under the Resource Conservation and Recovery Act (RCRA), hazardous waste generators and treatment, storage and disposal (TSD) facilities must operate under the conditions in a/an: (NSC, APM-A&P, 109)
a. hazardous waste plan
b. controlled environment
c. RCRA Permit
d. hazard communication and control plan
34. Under the Hazardous Waste and Solid Waste Amendments (HSWA), treatment, storage and disposal (TSD) facilities must: (NSC, APM-A&P, 109)
a. take corrective action for releases of hazardous wastes
b. take corrective action for releases of constituents from any solid waste management unit (SMWU)
c. take corrective action regardless of when the waste was placed in the SWMU
d. all of the above
35. The Hazardous Waste and Solid Waste Amendments (HSWA), authorizes EPA and authorized states to issue orders requiring a firm to take corrective action when: (NSC, APM-A&P, 109)
a. a hazardous waste release occurs at a permitted facility
b. a hazardous waste release occurs at a TSD facility pending permit approval
c. a hazardous waste release occurs at an interim status facility
d. all of the above
36. This law outlines how to develop and implement a program to regulate underground storage tanks (USTs) that store petroleum and other substances defined as hazardous: (NSC, APM-A&P, 109)
a. Underground Petroleum Storage Tank Amendment (UPSTA)
b. National Underground Storage Tank Act (NUST)
c. Subtitle I, Regulation of Underground Story Tanks (USTs)
d. Underground Storage Tank Control Act (USTC)
37. The Hazardous and Solid Waste Amendment employs all of the following strategies to protect groundwater, EXCEPT: (NSC, APM-A&P, 110)
a. technological standards for land disposal facilities
b. volunteer compliance and cooperation
c. requirements for managing and treating small quantities of hazardous waste
d. regulations for controlling USTs
38. The Hazardous and Solid Waste Amendment employs all of the following strategies to protect groundwater, EXCEPT: (NSC, APM-A&P, 110)
a. technological standards for land disposal facilities
b. upgraded performance and design criteria for disposing solid waste in landfills
c. requirements for disposal of hazardous waste at remote locations
d. restrictions on land disposal of many untreated hazardous wastes
39. Several incidents of uncontrolled, dangerous disposal of toxic chemicals resulted in Congress passing this Act: (NSC, APM-A&P, 110)
a. Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA)
b. Resource Conservation and Recovery Act of 1976 (RCRA)
c. Superfund Amendments and Reauthorization Act of 1986 (SARA)
d. National Hazardous Waste Recovery and Liability Act of 1988 (NHWRLA)
40. This event inspired the 1990 Clean Air Act requirement that factories and other businesses develop plans to prevent accidental releases of highly toxic chemicals: (EPA)
a. Bhopal Tragedy
b. New York Trade Center Tragedy
c. Great Chicago Fire
d. Three Mile Island
41. This Act gave the Environmental Protection Agency (EPA) authority to establish standards related to the discharge of pollutants from motor vehicles and industry: (NSC, APM-A&P, 107)
a. The Atmospheric Quality Act (AQA) of 1978
b. The Environmental Quality Control Act (EQCA) of 1970
c. Air Quality Act (AQA) of 1956
d. Clean Air Act (CAA) of 1967
Area III. Topic C. Ergonomics
1. Which of the following best describes carpal tunnel syndrome?
a. Elbow and shoulder swelling and inflammation
b. Inflammation of the channel in the wrist
c. Raynaud's syndrome of the hand and wrist
d. White finger
2. Carpal tunnel syndrome include all of the following symptoms, except:
a. Numbness in the little finger
b. Pain in the wrist upon exertion
c. Pain in the second and third finger
d. Inflammation and swelling of the wrist
3. Lateral epicondylitis is also called:
a. Trigger finder
b. Roffer's wrist
c. Carpenter's elbow
d. Rotator cuff
4. This agency publishes the Work Practices Guide for Manual Lifting:
a. OSHA
b. ANSI
c. NIOSH
d. ASSE
5. An injury of the median nerve inside the wrist is known as:
a. Carpal Tunnel Syndrome
b. Osteoarthritis
c. DeQuarvain's Disease
d. Reynold's Syndrome
6. This field of study is interested in the physical and behavioral interaction between humans and their environment on and off the job: (Brauer, p. 483)
a. Ergonomics
b. Anthropometrics
c. Biomechanics
d. Biobehavioral Systems
7. The most common of the work related musculoskeletal disorders, and in economic terms, the most costly is:
a. Back pain
b. Carpal Tunnel Syndrome
c. Trigger finger
d. Tennis elbow
8. Grasping a pencil or pen between the thumb and distal joints of the fingers is referred to as:
a. Power grip
b. Hook grip
c. Precision grip
d. Relaxed grip
9. Which grip produces the maximum force that can be developed by the hand?
a. Power grip
b. Hook grip
c. Precision grip
d. Relaxed grip
10. What is the normal line of sight at rest?
a. 10 degrees upward
b. 10 degrees downward
c. 15 degrees upward
d. 15 degrees downward
11. The application of mechanical principles to biological problems is known as:
a. Kinesiology
b. Physiology
c. Biomechanics
d. Ergonomics
12. Ergonomics, as a field of study, is best described as: (Brauer, p. 483)
a. The science that deals with causal factors
b. The measure of negative entropy in a system
c. The study of mechanics of biological systems
d. The man-machine relationship
13. An MSD is an ergonomics acronym for:
a. Material Safety Data
b. Musculoskeletal Disorders
c. Machine System Design
d. Muskulo-Safe Determination
14. Which of the following is most likely produced by a cumulative trauma disorder?
a. Hearing loss
b. Vision loss
c. Tennis elbow
d. Loss of memory
15. This category of vibration is a commonly experienced by truck drivers:
a. back vibration
b. segmental vibration
c. whole-body vibration
d. neck vibration
16. Ergonomics is derived from two Greek words meaning: (Brauer, p. 483)
a. Work and Law
b. Cumulative and Trauma
c. Work and Disease
d. Trauma and Law
17. The science of measuring the body is called:
a. physiometry
b. anthropometry
c. ergonomics
d. socionoics
18. Force can be defined by all of the following, except:
a. an external load
b. expressed in newtons or pounds
c. capacity to do work or cause physical change
d. a vector quantity that tends to produce a deceleration
19. All of the following are considered ergonomics risk factors associated with a task, except: (NSC, APM-BIET, p.107)
a. Fitness
b. Repetitive motion
c. Weight
d. Point of operation
20. Which of the following is not considered in study of ergonomics?
a. Physiological demands
b. Psychological demands
c. Physical demands
d. Emotional demands
21. Work-related MSDs of the neck, shoulder, and upper limb are referred to as:
a. Cumulative trauma injuries (CTI)
b. Carpal Tunnel Syndrome
c. Repetitive Strain Injuries (RSI)
d. Upper limb syndrome
22. Which of the following is not an important ergonomics consideration?
a. Safe lift techniques
b. Repetitive motion risk factors
c. Exposure to blood-borne pathogens
d. Exposure to excessive vibration or extreme temperatures
23. Which of the following is the least strategy to increase employee involvement in ergonomics?
a. Effective reporting
b. Prompt responses to concerns
c. Using employee ideas on program development
d. Ignore employee concerns and ideas
24. Which of the following is not an effective manual material handling principle?
a. Lift loads between knees and shoulders
b. Keep the travel distance less than 10 feet
c. Twist as you lift from the floor
d. Keep the load close to the body
25. A proactive approach to ergonomics would emphasize:
a. reduction in injury costs
b. early return to work programs
c. workstation design
d. aggressive accident investigation
26. Which of the following is not an effective ergonomics program policy?
a. give ergonomics efforts high priority
b. further strategic goals
c. allow full discussion and cooperation
d. discourage union involvement
27. Each of the following is a way management can demonstrate commitment to an ergonomics program, except:
a. conduct awareness training
b. encourage compliance
c. bring in outside experts
d. carry out ergonomic improvements
28. Which of the strategies below are counter-productive to effective ergonomics?
a. Ignoring employees registering complaints
b. Training in ergonomic risk factor awareness
c. Sharing information and results
d. Incentives for involvement
29. Which of the following is the least effective technique in developing concrete ergonomics solutions?
a. reviewing OSHA logs
b. brainstorming
c. periodic medical exams
d. screening jobs for risk factors
30. If you uncover signs and symptoms of possible MSDs in your workplace, the most effective strategy would be to:
a. implement a training program
b. assess for signs and symptoms
c. request a confidential evaluation
d. Purchase safety belts
31. Once a decision has been made to initiate an ergonomics program, what is your next step?
a. identify players
b. determine risk factors
c. determine scope of the problem
d. identify costs
32. The purpose of the walk-through ergonomics observational survey is to:
a. interview safety committee members
b. detect obvious risk factors
c. score unsafe behaviors
d. conduct in-depth analysis
33. The quality of checklist data collected during an ergonomics inspection is generally better when:
a. interviews cover supervisors as well as workers
b. data is expressed as percentages
c. employees providing data do not feel intimidated
d. persons are familiar with the job, task, or process
34. Activities requiring frequent or prolonged work can be particularly stressful in all of the following situations, except:
a. work requiring sustained bending or twisting
b. work requiring sustained or repeated work above the shoulders
c. work requiring sustained or repeated work at chest level
d. work requiring sustained or repeated work below the knees
35. Force requirements may increase with:
a. increasing speed of movements
b. pinch grip
c. decreased slipperiness
d. vibration
36. To determine possible negative effects on the musculoskeletal system, research is conducted all of the following areas, except:
a. group dynamics
b. performance monitoring
c. production demands
d. incentive pay systems
37. An effective ergonomics job hazard analysis would never do which of the following?
a. identify conditions contributing to risk factors
b. measure and quantify ergonomic risk factors
c. break down task into individual steps
d. exclude employee involvement in the analysis
38. Which of the following procedures is least likely to be used for collecting information on the ergonomic components of a job?
a. videotaping
b. observation
c. investigation
d. measurements
39. Which of the following procedures is least effective proactive strategy for collecting information on the ergonomic components of a job?
a. biomechanical calculations
b. physiological measures
c. investigation
d. interviews
40. Jobs in which current cases have been identified should receive ____________ attention, followed by those in which past records have noted a high incidence or ________ of MSDs despite the lack of current cases.
a. planned, probability
b. some, number
c. immediate, severity
d. primary, type
41. Priority for ergonomics job analysis and intervention should be given to those jobs:
a. employees complain of discomfort
b. in which most people are affected
c. significant risk factors exist
d. all of the above
42. Which of the three ergonomics control strategies is most effective in eliminating risk factors?
a. Technical Controls
b. Engineering Controls
c. Work Practice Controls
d. Interim Measures
43. Which ergonomics control strategy below has as its primary purpose to limit exposure to the hazard?
a. Technical Controls
b. Engineering Controls
c. Work Practice Controls
d. Interim Measures
44. Which of the following is not considered a component of proper computer workstation design to maintain proper posture?
a. the printer
b. the work surface
c. the keyboard
d. the chair
45. Effective procedures should incorporate each of the following ergonomics goals, except:
a. decrease recovery time
b. maintain neutral postures
c. reduce duration of exposure
d. reduce frequency of exposure
46. What is the purpose of the testing and evaluation phase of an ergonomics program implementation?
a. verifies duties and responsibilities
b. verifies proposed solutions
c. identifies additional enhancements
d. identifies additional modifications
47. What of the following is not considered a purpose of the follow-up ergonomics evaluation?
a. new risk factors do not exist
b. controls reduce risk factors
c. controls eliminate risk factors
d. controls are identified
48. Long-term indicators of the effectiveness of an ergonomics program can include:
a. reduced severity rates
b. reduced incidence rates
c. increased product quality
d. reduced productivity
49. In general, the medical management process in an ergonomics program emphasizes the prevention of impairment and disability through all of the following, except:
a. Early return to work
b. Prompt treatment
c. Early detection
d. Timely recovery
50. It is not appropriate for employers to provide ergonomics training to employees regarding which of the following?
a. signs and symptoms of MSDs
b. methods of self-treating MSDs
c. procedures for reporting MSDs
d. importance of reporting MSDs
51. It is not appropriate for employees or supervisors to:
a. be aware of signs and symptoms of MSDs
b. diagnose signs and symptoms
c. report signs and symptoms of MSDs
d. thank employees for reporting possible MSDs
52. One of the best ways for a health care provider to become familiar with jobs and job tasks is by:
a. formal communication
b. periodic plant tours
c. medical exams
d. accident record reviews
53. The least effective goal of ergonomics training is to enable managers, supervisors, and employees to do all of the following except:
a. Comply with mandatory OSHA rules
b. Identify job tasks that may increase risk of MSDs
c. Recognize signs and symptoms of MSDs
d. Develop control and prevention strategies
54. One of the primary objectives for ergonomics awareness training is to recognize workplace risk factors for _________ and understand general methods for controlling them:
a. environmental injuries
b. musculoskeletal disorders
c. psychosocial factors
d. ergonomic awareness
55. Musculoskeletal disorders can result when there is a mismatch between the physical _______ of the job and the physical ________ of the worker:
a. demands, requirements
b. requirements, capacity
c. requirements, requirements
d. demands, demands
56. Workers are likely to develop MSDs when they:
a. work in an awkward position
b. use a great deal of force
c. repeatedly lift heavy objects
d. Any of the above
57. Which of the following is not considered one the three areas within which ergonomics risk factors exist?
a. the worker
b. the procedure
c. the task
d. the environment
58. Musculoskeletal disorders are among the most prevalent medical problems in the U.S., affecting _____ of the entire population:
a. 3 percent
b. 7 percent
c. 40 percent
d. 72 percent
59. MSDs include a group of conditions that involve all of the following, except:
a. nerves
b. tendons
c. muscles
d. skin
60. All of these factors may contribute to MSDs, except:
a. vibration
b. unique motions
c. awkward postures
d. forceful exertions
61. Which of the following is not considered a critical risk factor leading to cumulative trauma disorders (CTDs) as well as other musculoskeletal disorders?
a. force
b. duration
c. capacity
d. frequency
62. By the age _____, most people have had their first episode of back pain:
a. 25
b. 35
c. 45
d. 55
63. The amount of effort in performing a task depends on a number of factors. Which of the factors below is not one of those factors?
a. Type of grip
b. Object weight
c. Object dimensions
d. Fatigue
64. The amount of effort in performing a task depends on a number of factors. Which of the factors below is not one of those factors?
a. repetition
b. duration
c. environment
d. slipperiness
65. All of the following are common locations of injury due to exerting excessive force, except:
a. neck/shoulder
b. foot/ankle
c. upper back
d. wrist/hand
66. What condition exists when any part of your body presses against an external object and the resulting sustained force has caused too much mechanical stress on tissues?
a. Mechanical trauma
b. Recovery trauma
c. Force trauma
d. Contact trauma
67. This grip strategy to manipulate objects requires much greater muscle strength so it is more likely going to cause an injury:
a. pinch grip
b. power grip
c. sustained grip
d. intermittent grip
68. This form of exertion combines force, posture, and duration to create a condition that quickly fatigues our muscles which increases the chances of acquiring a cumulative trauma disorder (CTD):
a. intermittent exertion
b. repetitive exertion
c. static exertion
d. forceful exertion
69. This term describes a measure of the rest (or low stress activity) period available to the muscle group between similar exertions:
a. rest period
b. recovery time
c. degree of recovery
d. muscle group rest time
70. Awkward postures typically include all of the following, except:
a. squatting
b. working overhead
c. bending
d. standing
71. ____ is the speed at which the body part moves and ____ is the rate of change of the speed at which the body part moves:
a. angular velocity, acceleration
b. acceleration, angular velocity
c. angular acceleration, velocity
d. velocity, angular acceleration
72. Heat stress can result in:
a. Heat exhaustion
b. Heat cramps
c. Dehydration
d. All of the above
73. Heat stress is made even more dangerous in the presence of ______ due to the reduced ability of the body to cool itself:
a. low humidity
b. high humidity
c. greater exertion
d. higher force
74. This condition may result if the worker is exposed to an environment so cold that the body cannot maintain adequate deep core temperature:
a. hyperthermia
b. hypothermia
c. hyperthermitis
d. hypothermitis
75. Which of the following is not one of the symptoms brought on by cold stress?
a. pulmonary pain
b. dilated pupils
c. ventricular fibrillation
d. shivering
76. The body's response to vertical vibration will be greatest between ____ Hz:
a. 2 and 4
b. 4 and 8
c. 8 and 10
d. 10 and 12
77. Factors influencing the adequacy and effectiveness of illumination include the following, except:
a. freedom from diffusion
b. freedom from glare
c. freedom from concentration
d. freedom from glare
78. To create a healthy work environment that reduces the risk of ergonomics injuries, management should do all of the following, except:
a. understand roles
b. allow participation
c. threaten for noncompliance
d. conduct adequate training
79. Which of the following are least likely to result in work-related MSDs?
a. intensified workload
b. limited job control
c. monotonous work
d. poor labor-management relations
80. For proper work surface design, all of these factors should be considered, except:
a. deep enough
b. wide enough
c. high enough
d. flat enough
Area III. Topic D. Toxicology
1. What term refers to the science that studies the poisonous, or toxic, properties of substances? (Plog, 123)
a. bacteriology
b. epidemiology
c. toxicology
d. virology
2. A toxic effect is: (Plog, 123)
a. any reversible noxious effect on the body
b. any permanent noxious effect on the body
c. any irreversible noxious effect on the body
d. a and c above
3. A toxic effect is the result of: (Plog, 123)
a. contact with a harmful substance
b. exposure to harmful substances
c. interaction with a harmful substance
d. influence of a harmful substance
4. According to Plog, toxic effects may be the result of all of the following, EXCEPT: (Plog, 123)
a. contact with a harmful substance
b. side effects of medication
c. side effects of vaccinations
d. contact with biological mutagens
5. The capacity of a chemical to harm or injure a living organism by other than mechanical means is called: (Plog, 123)
a. dose
b. lethality
c. toxicity
d. carcinogenicity
6. The toxicity of a chemical depends on: (Plog, 123)
a. the dose
b. degree of exposure
c. its lethality
d. acute threshold
7. An important responsibility of the industrial toxicologist is to: (Plog, 124)
a. define how substance much is too much
b. consider types of exposure
c. consider effects of substances on workers
d. all of the above
8. What term is used by toxicologists to describe the ability of a substance to produce an unwanted effect when the chemical has reached a sufficient concentration at a certain site in the body? (Plog, 124)
a. exposure
b. toxicity
c. hazard
d. dose
9. What term is used by toxicologists to describe the probability that a chemical will reach a sufficient concentration in the body at a certain site to cause an unwanted effect? (Plog, 124)
a. exposure
b. toxicity
c. hazard
d. dose
10. Factors that contribute to determining the degree of hazard include all of the following, EXCEPT: (Plog, 124)
a. route of entry
b. dosage
c. environmental variables
d. exposure
11. This term is commonly used by toxicologists in comparing one chemical agent with another: (Plog, 124)
a. exposure
b. toxicity
c. hazard
d. dose
12. A chemical stimulus can be considered to have produced a toxic effect when it satisfies all of the following criteria, EXCEPT: (Plog, 124)
a. an observable physiological deviation produced in any organ
b. the stimulus has changed chemical markers
c. the observed change can be repeated
d. the stimulus has impaired a protective mechanism
13. A chemical stimulus can be considered to have produced a toxic effect when it satisfies all of the following criteria, EXCEPT: (Plog, 124)
a. the effect is unique and specific
b. the effect is reversible or attenuated when stimulus is removed
c. the effect does not occur or is infrequent without a stimulus
d. the observation is noted and reproducible by others
14. A chemical stimulus can be considered to have produced a toxic effect when it satisfies all of the following criteria, EXCEPT: (Plog, 124)
a. physiological change reduces the efficiency of an organ or function
b. the effect is reversible or attenuated when stimulus is removed
c. the effect does not occur or is infrequent without a stimulus
d. the observation is unique to the observer
15. Which of the following statements is true regarding the toxicity of a chemical? (Plog, 124)
a. Toxic effects are predictable and constant
b. Toxicity does not vary under normal conditions
c. Toxicity is not a physical constant
d. Toxicity is a physical constant, similar to vapor pressure
16. In addition to determining toxicity, evaluation of a chemical hazard involves all of the following, EXCEPT: (Plog, 124)
a. duration of exposure
b. amount of exposure
c. physiological characteristics of the chemical
d. conditions under which exposure occurs
17. In addition to determining toxicity, evaluation of a chemical hazard involves all of the following, EXCEPT: (Plog, 124)
a. duration of exposure
b. amount of the hazard
c. physical characteristics of the substance
d. conditions under which exposure occurs
18. All of the following may have a significant influence the toxic potency of a substance, EXCEPT: (Plog, 124)
a. toxic content of the substance
b. effects of other substances in combined exposure
c. physical characteristics of the substance
d. conditions under which exposure occurs
19. This physical characteristic of a chemical substance may indicate its potential as an inhalation hazard: (Plog, 124)
a. melting point
b. vapor pressure
c. boiling point
d. temperature
20. This is a primary source of information on the hazardous properties of chemical products: (Plog, 146)
a. primary container label from the manufacturer
b. OSHA's Chemical Hazards Information System (OCHIS)
c. NIOSH Chemical Hazards Database
d. Material Safety Data Sheet (MSDS)
21. What is the term used to describe an injury that results from direct tissue contact with an irritant? (Plog, 124)
a. local injury
b. system injury
c. direct injury
d. primary injury
22. Injury to the lining of the trachea and lungs from inhaling toxic vapors is an example of this kind of injury: (Plog, 124)
a. local injury
b. system injury
c. direct injury
d. primary injury
23. For industrial exposures, this route of entry is considered most important because they are the most common: (Plog, 125)
a. ingestion
b. absorption
c. injection
d. inhalation
24. Only particles smaller than this are likely to enter an alveolar sac: (Plog, 125)
a. .5µm
b. 1µm
c. 5µm
d. 10µm
25. Contact of a substance with skin results in all of the following possible actions, EXCEPT: (Plog, 125)
a. The skin can act as an effective barrier
b. The substance can cause tissue irritation and/or destruction
c. The substance can result in unusual behavioral actions
d. The substance can cause skin sensitization
26. Contact of a substance with skin results in all of the following possible actions, EXCEPT: (Plog, 125)
a. The skin will prevent exposure
b. The substance can cause tissue irritation and/or destruction
c. The substance can penetrate the skin and enter the bloodstream
d. The substance can cause skin sensitization
27. The rate of cutaneous absorption of some organic compounds will vary with: (Plog, 125)
a. activity and location
b. skin type and activity
c. temperature and perspiration
d. temperature and duration
28. What properties of a material mainly determine whether a material is absorbed through the skin? (Plog, 125)
a. physiological
b. physiochemical
c. physical
d. physiosystemic
29. Important properties of a material that determine whether a material is absorbed through the skin include all of the following, EXCEPT: (Plog, 125)
a. pH
b. extent of ionization
c. solubility
d. location
30. Important properties of a material that determine whether a material is absorbed through the skin include all of the following, EXCEPT: (Plog, 125)
a. humidity
b. extent of ionization
c. solubility
d. molecular size
31. Relative to inhalation toxicity, oral toxicity is generally: (Plog, 125)
a. higher
b. about the same
c. the same
d. lower
32. For a given substance, oral toxicity is generally _____ then inhalation toxicity: (Plog, 125)
a. higher
b. about the same
c. the same
d. lower
33. This is an important systemic defense process to reduce the toxic effects of a chemical: (Plog, 126)
a. lymphatic system
b. remuneration
c. detoxification
d. deterioration
34. All of the following occur as part of the body's detoxification process, EXCEPT: (Plog, 126)
a. the liver degrades the toxin
b. the toxin is converted to a non-toxic water-soluble compound
c. attack by macrophages
d. transportation to kidneys and excreted
35. Which of the following is not an area into which a toxic substance may be injected? (Plog, 126)
a. the bloodstream
b. the duodenal sac
c. the peritoneal cavity
d. the pleural cavity
36. There is increased attention to prevention of skin puncture and injection injuries due to all of the following bloodborne pathogens, EXCEPT: (Plog, 126)
a. pneumococcus
b. HIV
c. hepatitis C
d. hepatitis B
37. All toxicological considerations are based on the: (Plog, 126)
a. dosage-toxic constant
b. dose-response relationship
c. toxic-absorption constant
d. toxicological relationship
38. What is the point on a dose-response curve in which a lethal response occurs to half of the animals administered a chemical agent? (Plog, 126)
a. LD0
b. LD5.0
c. LD50
d. LD100
39. Which of the following are the two variables used to determine the dose-response relationship? (Plog, 126)
a. concentration (C) and frequency (F) of exposure
b. temperature (T) and duration (D) of exposure
c. duration (D) and frequency (F) of exposure
d. concentration (C) and duration (T) of exposure
40. Regulatory exposure limits are set such that these two variables are theoretically below levels that produce injury: (Plog, 126)
a. concentration (C) and frequency (F) of exposure
b. temperature (T) and duration (D) of exposure
c. duration (D) and frequency (F) of exposure
d. concentration (C) and duration (T) of exposure
41. What is the term used to describe the relationship between the dose of a chemical and the response produced in a biological system? (Plog, 126)
a. dose-response relationship
b. toxic potency
c. threshold relationship
d. dosage threshold
42. The harmfulness of a material depends on all of the following, EXCEPT: (Plog, 127)
a. chemical composition
b. type and degree of exposure
c. route of entry
d. fate of the material in the body
43. Which of the following can be calculated when death is the only variable being measured in response to exposure to a toxic chemical? (Plog, 127)
a. lethal dose (LD)
b. fatality rate (FR)
c. exposure-dose relationship (EDR)
d. dose-response relationship (DRR)
44. This designation is defined as the lowest concentration of toxic chemical that will kill all exposed animals: (Plog, 127)
a. LD0
b. LD5.0
c. LD50
d. LD100
45. If the slope of a dose-response curve is steep, the margin of safety is: (Plog, 127)
a. great
b. slight
c. not determined
d. constant
46. The relationship between slope and margin of safety on a dose-response curve is: (Plog, 127)
a. directly proportional
b. inversely proportional
c. not proportional
d. unpredictable
47. The designation used for airborne materials to indicate the dose-response relationship is: (Plog, 127)
a. dose-duration level (DL)
b. exposure-dose concentration (EDC)
c. lethal dose (LD)
d. lethal concentration (LC)
48. The duration of exposure to a toxic chemical through inhalation has what kind of effect on lethal concentration (LC)? (Plog, 127)
a. no effect
b. usually little effect
c. some effect
d. possible significant effect
49. When evaluating the response of exposure to a toxic substance, it's important to examine the organs removed from exposed animals for all of the following reasons, EXCEPT: (Plog, 128)
a. reveals the site of action
b. reveals the route of entry
c. reveals the mode of action
d. reveals the cause of death
50. The toxic action of substances can be divided into which two categories? (Plog, 128)
a. predictable, unpredictable
b. variable, constant
c. expected, unexpected
d. acute, chronic
51. Which of the following terms describes short-term high concentrations and immediate results such as illness, irritation or death? (Plog, 129)
a. acute effects
b. chronic effects
c. stat effects
d. prolonged effects
52. These exposures are typically sudden and severe and involve rapid absorption of the offending material: (Plog, 129)
a. acute
b. chronic
c. physical
d. environmental
53. Which of the following terms describes long-term symptoms of disease or their frequent recurrence? (Plog, 129)
a. acute effects
b. chronic effects
c. stat effects
d. prolonged effects
54. These exposures result in symptoms that usually last for years: (Plog, 129)
a. acute
b. chronic
c. physical
d. environmental
55. Which of the following is not one of the three general classes of air contaminants? (Plog, 129)
a. irritants
b. asphyxiants
c. CNS depressants
d. avoidants
56. These toxic substances interfere with oxygenation of the tissues and affected individual may suffocate: (Plog, 131)
a. irritants
b. asphyxiants
c. CNS depressants
d. avoidants
57. These toxic substances can produce unconsciousness by preventing the brain and spinal cord from doing their normal job: (Plog, 132)
a. irritants
b. asphyxiants
c. CNS depressants
d. avoidants
58. This term describes any agent that can produce or accelerate the development of malignant or potentially malignant tumors or malignant neoplastic proliferation of cells: (Plog, 134)
a. mutagen
b. carcinogen
c. teratogen
d. osteogen
59. This term describes any agent that affects the genetic material of the exposed organism, and can cause cancer, birth defects, or undesirable effects in later generations: (Plog, 135)
a. mutagen
b. carcinogen
c. teratogen
d. paragen
60. This term describes any agent that interferes with normal embryonic development, and may produce malformations of the fetus without inducing damage to the mother: (Plog, 136)
a. mutagen
b. carcinogen
c. teratogen
d. paragon
61. Which agency administers the Toxic Substances Control Act of 1976? (Plog, 139)
a. Occupational Safety and Health Administration (OSHA)
b. Environmental Protection Agency (EPA)
c. Centers for Disease Control (CDC)
d. Department of Labor (DOL)
62. NIOSH develops this and it represents a time-weighted average (TWA) concentration for up to a 10-hour workday during a 40-hour workweek: (Plog, 140)
a. Threshold Limit Value (TLV)
b. Recommended Exposure Limit (REL)
c. Ceiling Value (CV)
d. Permissible Exposure Limit (PEL)
63. OSHA sets this regulatory limit which is based on an 8-hour time weighted average (TWA) exposure: (OSHA)
a. Threshold Limit Value (TLV)
b. Recommended Exposure Limit (REL)
c. Ceiling Value (CV)
d. Permissible Exposure Limit (PEL)
64. This regulatory limit on the amount or concentration of a substance in the air. They may also contain a skin designation and they are enforceable: (OSHA)
a. Threshold Limit Value (TLV)
b. Recommended Exposure Limit (REL)
c. Ceiling Value (CV)
d. Permissible Exposure Limit (PEL)
65. These values are issued by the American Conference of Governmental Industrial Hygienists and are the most widely accepted: (Plog, 140)
a. Threshold Limit Values (TLV)
b. Recommended Exposure Limits (REL)
c. Biological Exposure Indices (BEI)
d. Permissible Exposure Limits (PEL)
66. Where are the measurements to determine Threshold Limit Values (TLV)? (Plog, 140)
a. within eight feet of the work zone
b. generally where work is being conducted
c. within the breathing zone of a worker
d. anywhere in the workplace
67. Although this measurement does not necessarily predict the amount of a substance that will be absorbed, it does measure the amount that can be inhaled during a workday: (Plog, 141)
a. Threshold Limit Value (TLV)
b. Time Weighted Average (TWA)
c. Ceiling Value (CV)
d. Permissible Exposure Limit (PEL)
68. What is the usual span of time over which TWA measurements are taken? (Plog, 141)
a. 2 hours
b. 6 hours
c. 8 hours
d. 10 hours
69. What is the designation given by the TLV committee that indicates it is not advisable to permit concentrations substantially above the recommended TWA? (Plog, 141)
a. A
b. B
c. C
d. D
70. This designation indicates the level at which a slightly higher will cause irritation by the most sensitive individuals: (Plog, 141)
a. upper control limit (UCL)
b. self-rescue emergency exposure limit (SREC)
c. ceiling value (C)
d. lower control limit (LCL)
71. TLV values for suspended particulates are expressed as: (Plog, 141)
a. parts per million (PPM)
b. milligrams per cubic meter (mg/m3)
c. milligrams per cubic liter (mg/L3)
d. parts per million per cubic meter (ppm/m3)
72. TLV values for gases and vapors are expressed as: (Plog, 141)
a. parts per million (PPM)
b. milligrams per cubic meter (mg/m3)
c. milligrams per cubic liter (mg/L3)
d. parts per million per cubic meter (ppm/m3)
73. When two or more hazardous substances that act on the same body organ system are present, what primary measure should be considered? (Plog, 142)
a. their combined effect
b. their additive effect
c. their separate effects
d. their multiplied effects
74. When using the formula in determining combined effects of hazardous substances, if the sum of the fractions (observed concentration each substance divided by its TLV) is greater than one, then the TLV for the combined substances has: (Plog, 142)
a. not been reached
b. been reached
c. been exceeded
d. been multiplied
75. TLV values are based on all of the following data, EXCEPT: (Plog, 143)
a. labor-management negotiation
b. animal toxicological studies
c. morbidity and mortality data
d. environmental data
76. This sampling method is used to test for levels of metabolites of toxic agents: (Plog, 145)
a. Blood analysis
b. Urine tests
c. Breath analysis
d. Stomach content analysis
77. This sampling method is considered the best method to test for exposure to lead: (Plog, 145)
a. Blood analysis
b. Urine tests
c. Breath analysis
d. Stomach content analysis
78. Biological sampling data may be used: (Plog, 144-146)
a. as a substitute for air sampling
b. in addition to air sampling
c. only if air sampling data isn't available
d. instead of air sampling
79. This is a primary source of information on the hazardous properties of chemical products: (Plog, 146)
a. primary container label from the manufacturer
b. OSHA's Chemical Hazards Information System (OCHIS)
c. NIOSH Chemical Hazards Database
d. Material Safety Data Sheet (MSDS)
80. The ACGIH has adopted a set of advisory biological limit values called the: (Plog, 146)
a. Biological Limit Values (BLV)
b. Biological Exposure Indices (BEI)
c. ACGIH Chemical Hazards Database
d. Material Safety Data Sheet (MSDS)
81. This designation is used to indicate the lowest published lethal concentration: (Brauer, 365)
a. LD
b. LC
c. TLD
d. TLC
82. This designation is used to indicate the lethal concentration for inhalation of toxic substances: (Brauer, 365)
a. LD
b. LC
c. TLD
d. TLC
83. This designation is used to indicate the lethal dose by ingestion, injection, or other means of contact with toxic substances: (Brauer, 365)
a. LD
b. LC
c. TLD
d. TLC
84. This designation is used to indicate the lowest published lethal dose: (Brauer, 365)
a. LD
b. LC
c. TLD
d. TLC
85. If 50% of the test animal population died as a result of contact with a toxic substance through inhalation, the designation used to indicate this data would be: (Brauer, 365)
a. LD50
b. LC50
c. TLD50
d. TLC50
86. If 50% of the test animal population died as a result of contact with a toxic substance through ingestion or injection, the designation used to indicate this data would be: (Brauer, 365)
a. LD50
b. LC50
c. TLD50
d. TLC50
87. The period of time between exposure with a toxic substance and the first signs of the effects of that exposure is called the: (Brauer, 365)
a. dormant period
b. toxic delay
c. latency period
d. response delay
88. When a pharmaceutical substance appears to have high benefit and relatively little risk, this agency may approve testing on human subjects: (Brauer, 365)
a. CDC
b. OSHA
c. NIH
d. FDA
89. When a pharmaceutical substance appears to have high benefit and relatively little risk, this agency may approve testing on human subjects: (Brauer, 365)
a. CDC
b. OSHA
c. NIH
d. FDA
90. Toxicity studies on animal species include all of the following factors, EXCEPT: (Brauer, 365)
a. the physiology of species varies
b. meaningfulness is the same regardless of species
c. standard tests and methods help estimate effects
d. controlled breeding improves reliability of results
91. Air samples are inherently problematic for all of the following reasons, EXCEPT: (Plog, 141)
a. it is difficult to obtain a representative sample
b. they are difficult to schedule into the normal workday
c. the extent of absorption is difficult to determine
d. samples may be accidentally contaminated
92. Air samples are inherently problematic for all of the following reasons, EXCEPT: (Plog, 141)
a. it is difficult to obtain a representative sample
b. misleading information due to variation in particles
c. the extent of absorption is difficult to determine
d. cooperation by workers may not occur
Area III. Topic E. Epidemiology
1. Which of the following is not one of the three types of epidemiological data? (Plog, 138)
a. Descriptive
b. Retrospective
c. Prospective
d. Proactive
2. These epidemiological studies identify a change or difference in the prevalence of a disease in a subgroup of the population: (Plog, 138)
a. Descriptive studies
b. Retrospective studies
c. Prospective studies
d. Proactive studies
3. These epidemiological studies reveal a relationship between a chemical and a certain effect caused by exposure that occurred months or years before the initiation of data collection: (Plog, 138)
a. Descriptive or cross sectional studies
b. Retrospective or control group studies
c. Prospective or cohort studies
d. Proactive or reactive studies
4. These epidemiological studies can define more precisely the time relationship and the magnitude of risk: (Plog, 138)
a. Descriptive studies
b. Retrospective studies
c. Prospective studies
d. Proactive studies
5. These epidemiological studies are present and future continuing studies that measure health effects as the exposures occur in work areas: (Plog, 138)
a. Descriptive studies
b. Retrospective studies
c. Prospective studies
d. Proactive studies
6. Analysis that reveals the relationship between time of occurrence of an adverse effect and age at the time of first exposure: (Plog, 138)
a. Descriptive analysis
b. Retrospective analysis
c. Prospective analysis
d. Epidemiological analysis
7. What should the removal of a chemical from the environment be followed by: (Plog, 138)
a. documentation that the chemical has been safely removed
b. evidence of a decline in the frequency of the effect
c. assurance that the chemical will not be reintroduced
d. public relations campaign
8. What should the removal of a chemical from the environment be followed by: (Plog, 138)
a. documentation that the chemical has been safely removed
b. evidence of a decline in the frequency of the effect
c. assurance that the chemical will not be reintroduced
d. public relations campaign
9. Which of the following is not considered one of the three primary reasons for underreporting of work-associated infections? (Plog, 406)
a. employee fear of reporting
b. issues of liability
c. rewards for underreporting
d. employer refusal to report
10. Surveys have revealed that the most common routes of exposure to be all of the following, EXCEPT: (Plog, 406)
a. percutaneous inoculation
b. inhalation of aerosols generated by work practices
c. ingestion of contaminated food
d. contact between hands and contaminated material
11. Surveys have revealed that the most common routes of exposure to be all of the following, EXCEPT: (Plog, 406)
a. subcutaneous absorption
b. inhalation of aerosols generated by accidents
c. ingestion of contaminated material
d. contact between mucous membranes and contaminated material
12. Studies indicate that people engaged in these activities have acquired the greatest number of infections: (Plog, 406)
a. construction
b. healthcare
c. research
d. agriculture
13. Which one of the following is not one of the most frequently reported laboratory-acquired infections, according to the Pike studies? (Plog, 406)
a. brucellosis
b. Q fever
c. hepatitis
d. HIV
14. Which one of the following is not one of the most frequently reported laboratory-acquired infections, according to the Pike studies? (Plog, 406)
a. brucellosis
b. Q fever
c. hepatitis
d. HIV
15. Which of the following infections is an emerging virus found in the workplace? (Plog, 406)
a. brucellosis
b. Q fever
c. hepatitis
d. HIV
16. This method of evaluating the nature and severity of hazards reviews literature of a population-based research that may provide information about adverse health effects not yet noticed in a small work force: (Plog, 454)
a. Process or operation analysis
b. Variability of response
c. Epidemiological and risk assessment
d. Interviews and maintenance activities
17. According to Leon Gordis, each of the following is an important objective of the science of epidemiology, EXCEPT: (Gordis, 4)
a. To provide a foundation for developing regulations
b. To discover the etiology of an occupational disease,
c. Determine the extent to which the disease if found in the workplace
d. Evaluate the degree to which occupational disease impacts productivity
18. According to Leon Gordis, each of the following is an important objective of the science of epidemiology, EXCEPT: (2) , (3) to study the natural history and prognosis of a disease, (4) , and (5) provide a foundation for developing regulations. (Gordis, 4)
a. To study the natural history and prognosis of a disease
b. To discover the etiology of an occupational disease,
c. Determine the extent to which the animals mirror human etiology
d. Evaluate existing and new therapeutic and preventive measures
Area III. Topic F. Industrial Hygiene
1. Industrial hygiene includes the development of corrective measures in order to control health hazards by reducing or eliminating: (Plog, 4)
a. injuries
b. exposures
c. hazards
d. risks
2. Industrial hygiene exposure control measures may include all of the following, except: (Plog, 4)
a. substitution of toxics
b. ventilation
c. changing work procedures
d. rule enforcement
3. Industrial hygiene exposure control measures may include all of the following, except: (Plog, 4)
a. training
b. ventilation
c. changing work procedures
d. personal protective equipment
4. An effective industrial hygiene program involves: (Plog, 4)
a. sound claims management
b. anticipation of health hazards
c. evaluation and measurement
d. hazard control
5. These hazards arise from excessive airborne concentrations of mists, vapors, gases, or solids in the form of dusts or mists: (Plog, 7)
a. chemical hazards
b. biological hazards
c. ergonomic hazards
d. physical hazards
6. These hazards include excessive levels of non-ionizing and ionizing radiations, noise, vibration and extremes of temperature and pressure: (Plog, 7)
a. chemical hazards
b. biological hazards
c. ergonomic hazards
d. physical hazards
7. These hazards are any living organism or its properties that can cause an adverse response in humans: (Plog, 7)
a. chemical hazards
b. biological hazards
c. ergonomic hazards
d. physical hazards
8. These hazards include improperly designed tools, work areas, or work procedures: (Plog, 7)
a. chemical hazards
b. biological hazards
c. ergonomic hazards
d. physical hazards
9. The effects of noise on humans include all of the following, except: (Plog, 11)
a. psychological effects
b. interference with communications
c. physiological effects
d. physical effects
10. Which of the following is not considered a factor that can influence the effect of noise exposure? (Plog, 11)
a. variation in receptivity
b. total energy of the sound
c. frequency distribution of the sound
d. total duration of exposure
11. Which of the following is not considered a factor that can influence the effect of noise exposure? (Plog, 11)
a. variation in individual susceptibility
b. intermittent energy of the sound
c. length of employment in the noise environment
d. total duration of exposure
12. Which of the following is not a nontechnical guideline to determine whether the work area has excessive noise levels? (Plog, 11-12)
a. Is it necessary to speak loudly or shout into the ear?
b. Have employees complained of ringing in their ears after work?
c. Are employees volunteering to wear earplugs or muffs?
d. Do employees complain that speech or music is muffled?
13. Which of the following is one of the first signs of oxygen deficiency? (Plog, 23)
a. increased heart beat
b. dizziness
c. increased breathing rate
d. decreased focus
14. To produce an index of general contamination the industrial hygienist take: (Plog, 27)
a. area samples at fixed locations
b. samples taken by following the operator
c. samples from various non-fixed locations
d. samples located throughout a process
15. What is a finely divided liquid suspended in the atmosphere? (Plog, 22)
a. mist
b. smoke
c. gas
d. aerosol
16. What is the 8-hour TWA limit for noise exposure? (CFR 1910.95 Plog, 12)
a. 80 dBA
b. 85 dBA
c. 90 dBA
d. 95 dBA
17. What is the 4-hour TWA limit for noise exposure? (CFR 1910.95, Plog, 12)
a. 80 dBA
b. 85 dBA
c. 90 dBA
d. 95 dBA
18. What instrument is used to measure electric fields at frequencies above 100 kHz: (Plog, 292)
a. magnets resonance meter
b. dipole antenna
c. multi-meter
d. radio frequency detector
19. What is the employer required to do first if permissible limits for noise exposure are exceeded? (Plog, 12)
a. initiate a hearing conservation program
b. use engineering and administrative controls
c. ensure personal protective equipment is used
d. limit work near the source of exposure
20. Dust particles more than this size usually do not remain airborne: (Plog, 22)
a. 1 µm
b. 5 µm
c. 10 µm
d. 15 µm
21. What is the employer required to do first if engineering and administrative controls fail to adequately reduce exposure to sound? (Plog, 12)
a. initiate a hearing conservation program
b. control duration of exposure
c. ensure personal protective equipment is provided
d. limit work near the source of exposure
22. The capacity of a material to produce injury or harm when the chemical has reached a sufficient concentration at a certain site in the body is defined as: (Plog, 11)
a. toxicity
b. severity
c. exposure
d. hazard
23. Controlling exposure to electric fields may be accomplished by: (Plog, 285)
a. placing an ungrounded resistance between the field and person
b. placing a grounded resistance between the field and person
c. placing a grounded conductor between the field and person
d. placing an ungrounded conductor between the field and person
24. This form of unwanted vibration conducted through solids, liquids, or gases is referred to as: (Plog, 11)
a. hertz
b. hard rock
c. frequency
d. noise
25. Biological effects of optical radiation result from: (Plog, 296)
a. thermal and photochemical mechanisms
b. mechanical and kinetic mechanisms
c. ionizing and non-ionizing mechanisms
d. frequency and duration mechanisms
26. All of the following factors can influence the effect of noise exposure, except: (Plog, 11)
a. total time since exposure occurred
b. total daily duration of exposure
c. total energy of the sound
d. frequency distribution of the sound
27. This condition is caused by exposure to an environment in which the body is unable to cool itself sufficiently? (Plog, 12)
a. heatstroke
b. heat stress
c. heat exhaustion
d. heat cramps
28. What instrument is used to measure electric fields at frequencies above 100 kHz: (Plog, 292)
a. magnets resonance meter
b. dipole antenna
c. multi-meter
d. radio frequency detector
29. All of the following factors can influence the effect of noise exposure, except: (Plog, 11)
a. total time since exposure occurred
b. total daily duration of exposure
c. total energy of the sound
d. frequency distribution of the sound
30. All of the following are factors to consider for radiation safety, except: (Plog, 14)
a. potential for damage to living tissue
b. the different kinds of radiation
c. ways radiation can present a hazard
d. sources of radiation
31. These are the volatile form of substances that are normally in the solid or liquid state at room temperature and pressure: (Plog, 23)
a. vapors
b. smoke
c. gasses
d. aerosols
32. The harmfulness of a material depends on all of the following, except: (Plog, 127)
a. chemical composition
b. type and rate of exposure
c. fate of the material in the body
d. half-life of the chemical
33. Biological effects of optical radiation result from: (Plog, 296)
a. thermal and photochemical mechanisms
b. mechanical and kinetic mechanisms
c. ionizing and non-ionizing mechanisms
d. frequency and duration mechanisms
34. All of the following are factors to consider for radiation safety, except: (Plog, 14)
a. potential for damage to living tissue
b. the different kinds of radiation
c. ways radiation can present a hazard
d. sources of radiation
35. All of the following are one of the five types of radioactivity, except: (Plog, 14)
a. alpha-particles
b. beta-radiation
c. charlie-waves
d. gamma-rays
36. The dose rate, or the rate at which energy is transferred to tissue is called the: (Plog, 288)
a. basic absorption rate (BAR)
b. average absorption rate (AAR)
c. specific absorption rate (SAR)
d. technical absorption rate (TAR)
37. Occupational dermatitis can be caused by all of the following, except: (Plog, 28)
a. chemical agents
b. biological agents
c. plant poisons
d. psychosocial environment
38. All of the following are one of the five types of radioactivity, except: (Plog, 14)
a. alpha-particles
b. beta-radiation
c. delta-waves
d. neutrons
39. Which of the following is not a part of an electromagnetic device? (Plog, 279)
a. receiver
b. transmission path
c. source
d. output
40. Radioactive material can get inside the body through all of the following pathways, except: (Plog, 14)
a. inhalation
b. ingestion
c. absorption
d. penetration
41. This meter is used to measure beta-, gamma-, and x-rays: (Plog, 15)
a. radmeters
b. Geiger-Muller
c. Geigle-Mueller
d. Dosimeters
42. A film badge used to measure accumulated amounts of radiation is called a: (Plog, 15)
a. radmeter
b. Geiger-Muller
c. Geigle-Mueller
d. Dosimeters
43. Which of the following strategies for controlling occupational health hazards serves to reduce or eliminate exposure to the hazard? (Plog, 29)
a. Inspections and audits
b. Engineering controls
c. Administrative controls
d. Personal Protective Equipment
44. This radiation is so weak it can not penetrate paper: (Plog, 15)
a. alpha-particles
b. beta-radiation
c. gamma-rays
d. neutrons
45. The action of a substance can be arbitrarily divided into which two effects? (Plog, 128)
a. acute and chronic
b. lethal and nonlethal
c. expected and unexpected
d. minor and major
46. The harmful effects of non-ionizing radiation on the body depend largely on: (Plog, 15)
a. frequency
b. duration
c. intensity
d. variation
47. Substituting or replacing a toxic material with a harmless one is a very practical: (Plog, 30)
a. industrial control
b. engineering control
c. administrative control
d. technical control
48. This invisible low frequency radiation, found in radar, communications, cooking, and diathermy applications is called: (Plog, 15)
a. ultraviolet
b. microwave
c. laser
d. infrared
49. This invisible low frequency radiation cannot penetrate below the superficial layer of the skin: (Plog, 15)
a. ultraviolet
b. microwave
c. laser
d. infrared
50. This form of radiation can be found around electric arcs and requires opaque shielding: (Plog, 16)
a. ultraviolet
b. microwave
c. laser
d. infrared
51. This form of coherent radiation is produced by a single frequency: (Plog, 16)
a. ultraviolet
b. microwave
c. laser
d. infrared
52. This predecessor to the laser emits microwaves instead of coherent light: (Plog, 16)
a. multiplex
b. microwave
c. maser
d. ultralizer
53. This body organ is most vulnerable to injury by laser: (Plog, 16)
a. ear
b. eye
c. prostate
d. skin
54. These body parts are all vulnerable to hyperbaric pressure, except: (Plog, 17)
a. ear
b. sinuses
c. teeth
d. skin
55. Unequal distribution of pressure can cause this form of tissue damage: (Plog, 16)
a. barotrauma
b. hyperbaria
c. baroitis
d. hyperbaroemia
56. When employees are subjected to sound that exceeds permissible limits, what must the employer do in response? (Plog, 12)
a. use engineering and administrative controls to reduce exposure
b. ensure employees use proper personal protective equipment
c. schedule employees to reduce exposure to noise levels
d. change work procedures to keep employees away from the source
57. Which of the following conditions may exist due to worker exposure to hyperbaric atmospheres? (Plog, 17)
a. the bends
b. pain and congestion in the ears
c. partial hearing loss
d. any of the above
58. All of the following are typical entry routes of chemical compounds, except: (Plog, 21)
a. inhalation
b. absorption
c. ingestion
d. penetration
59. All of the following types of chemical airborne contaminants may enter the body via inhalation, absorption or ingestion, except: (Plog, 21)
a. mists
b. allergens
c. gasses
d. dusts
60. All of the following types of chemical airborne contaminants may enter the body via inhalation, absorption or ingestion, except: (Plog, 21)
a. vapors
b. microbes
c. gasses
d. fumes
61. Solid particles generated by handling, crushing, grinding, impact, detonation, and decrepitation are called: (Plog, 21)
a. vapors
b. particulates
c. mists
d. dusts
62. Which of the following describes the diameter of a dust particle? (Plog, 21)
a. 0.1-10 µm
b. 0.1-15 µm
c. 0.1-20 µm
d. 0.1-25 µm
63. These are formed when the material from a volatized solid condenses in cool air: (Plog, 22)
a. vapors
b. mists
c. gasses
d. fumes
64. These consist of carbon or soot particles less and result from the incomplete combustion of carbonaceous materials: (Plog, 22)
a. vapors
b. smoke
c. gasses
d. fumes
65. The strength of a magnetic field and the strength of the electric field are related to each other, and the ratio between the two is set according to: (Plog, 277)
a. Hertz's Law
b. Ohm's Law
c. Faraday's Law
d. Darwin's Law
66. These liquid droplets or solid particles remain dispersed in air for a prolonged period of time: (Plog, 22)
a. vapors
b. smoke
c. gasses
d. aerosols
67. These are suspended liquid droplets generated by the condensation of liquids from a vapor back to the liquid state, or by breaking up of a liquid into a dispersed state: (Plog, 22)
a. mists
b. smoke
c. gasses
d. aerosols
68. What is a formless fluid that expands to occupy the space or enclosure in which they are confined? (Plog, 22)
a. mist
b. smoke
c. gas
d. aerosol
69. Respiratory hazards can be broken down into which two main groups? (Plog, 23)
a. Atmospheric pressure
b. Oxygen deficiency
c. Air that contains harmful or toxic contaminants
d. b and c above
70. What is the normal oxygen level of normal air at sea level? (Plog, 23)
a. 19 percent
b. 20 percent
c. 21 percent
d. 22 percent
71. Which of the following is not one of the three general categories of airborne contaminants that may adversely affect the lungs? (Plog, 24)
a. toxic mists affecting upper area of the lung
b. toxic vapors and gases that affect lung tissue
c. toxic aerosols or gases that pass through the lungs and affect other organs
d. particulate aerosols deposited in the lungs
72. This exposure guideline established by the ACGIH for airborne concentrations is referred to as the : (Plog, 25)
a. Threshold Exposure Limit (TEL)
b. Permissible Exposure Limit (PEL)
c. Permissible Limit Value (PLV)
d. Threshold Limit Value (TLV)
73. The TLV-TWA is the time weighted average concentration for: (Plog, 25)
a. 15-minute exposure
b. 8-hour exposure
c. averaged 24-hour exposure
d. averaged 48-hour exposure
74. This is the airborne contaminant concentration that should not be exceeded during any part of the working exposure: (Plog, 25)
a. TLV-TWA
b. TLV-STEL
c. TLV-C
d. TLV-MWD
75. This is the maximum airborne contaminant concentration for a continuous 15-minute exposure: (Plog, 25)
a. TLV-TWA
b. TLV-STEL
c. TLV-C
d. TLV-MWD
76. To recognize hazardous environmental factors or stresses in the workplace the safety and health manager must first know the raw materials used and the nature of the products manufactured. To do this the safety professional would consult: (Plog, 27)
a. MSDSs
b. TLV-STEL
c. OSHA 300 Summary
d. NAIC Codes
77. Which of the following is not considered a factor influencing the degree of hazard from exposure to a harmful environment? (Plog, 27)
a. Nature of the material or energy involved
b. Degree of probability of exposure
c. Intensity of the exposure
d. Duration of the exposure
78. All of the following are extremely important considerations for air sampling, except: (Plog, 27)
a. sampling location
b. proper time to sample
c. sequence of sampling
d. number of samples taken
79. Which of the following are general types of dermatitis? (Plog, 28)
a. Primary irritation dermatitis
b. Localized dermatitis
c. Sensitization dermatitis
d. a and c above
80. Why are many workplaces today presenting nontraditional occupational health hazards? (Plog, 29)
a. Downsizing
b. A shift from manufacturing to service
c. Jobs are moving overseas
d. Ever-increasing exposure to exotic substances
81. Strategies for controlling occupational health hazards include all of the following, except: (Plog, 29)
a. Inspections and audits
b. Engineering controls
c. Administrative controls
d. Personal Protective Equipment
82. Which of the following strategies for controlling occupational health hazards serves to reduce or eliminate the hazard? (Plog, 29)
a. Inspections and audits
b. Engineering controls
c. Administrative controls
d. Personal Protective Equipment
83. Which of the following strategies is considered the first line of defense for controlling occupational health hazards? (Plog, 29)
a. Inspections and audits
b. Engineering controls
c. Administrative controls
d. Personal Protective Equipment
84. Which strategy may be necessary when it is not feasible to render the working environment completely safe? (Plog, 31)
a. Inspections and audits
b. Engineering controls
c. Administrative controls
d. Personal Protective Equipment
85. What is the science that studies the poisonous, or toxic, properties of substances? (Plog, 123)
a. Virology
b. Toxicology
c. Epidemiology
d. Pharmacology
86. The calculated dose of a substance that is expected to kill 50 percent of a defined experimental animal population when exposure occurs through any route other than inhalation is called the: (Plog, 127)
a. KR50
b. LD50
c. Lethal Dose Limit
d. Lethal Dose Ratio
87. TLVs and PELs are published by which of the following agencies? (Plog, 12)
a. NIOSH and OSHA
b. ACGIH and MSHA
c. ACGIH and OSHA
d. OSHA and MSHA
88. The dominant standard for laser safety in the United States is: (Plog, 301)
a. NIOSH Pub. 456
b. LIA/ANSI Z136.1
c. ACGIH 1910.95
d. CFR 1904.1200
89. Symptoms of this condition are fatigue, weakness, blurred vision, dizziness and headache? (Plog, 323)
a. heat stress
b. dehydration
c. heat exhaustion
d. heat stroke
90. This is the preferred method of air sampling to evaluate worker exposure to airborne chemicals? (Plog, 485)
a. personal
b. area
c. grab
d. integrated
91. Which of the following is not considered a factor that can influence the effect of noise exposure? (Plog, 11)
a. variation in receptivity
b. total energy of the sound
c. frequency distribution of the sound
d. total duration of exposure
92. Which of the following is not considered a factor that can influence the effect of noise exposure? (Plog, 11)
a. variation in individual susceptibility
b. intermittent energy of the sound
c. length of employment in the noise environment
d. total duration of exposure
93. Which of the following is not a nontechnical guideline to determine whether the work area has excessive noise levels? (Plog, 11-12)
a. Is it necessary to speak loudly or shout into the ear?
b. Have employees complained of ringing in their ears after work?
c. Are employees volunteering to wear earplugs or muffs?
d. Do employees complain that speech or music is muffled?
94. When employees are subjected to sound that exceeds permissible limits, what must the employer do in response? (Plog, 12)
a. use engineering and administrative controls to reduce exposure
b. ensure employees use proper personal protective equipment
c. schedule employees to reduce exposure to noise levels
d. change work procedures to keep employees away from the source
95. Which of the following is not commonly measured in heat stress studies? (Plog, 13)
a. work energy
b. metabolism
c. air movement
d. caloric intake
96. Which of the following is used to measure air temperature? (Plog, 13)
a. anemometer
b. dry bulb thermometer
c. wet bulb thermometer
d. psychrometer
97. The NIOSH heat stress control program recommends all of the following work practices, EXCEPT (Plog, 13)
a. stretching
b. acclimation periods
c. work and rest regimens
d. provision for water intake
98. The NIOSH heat stress control program recommends all of the following work practices, EXCEPT (Plog, 13)
a. regular breaks of at least one hour
b. protective clothing
c. distribution of work over time
d. audiometric testing
99. This heat stress index combines air temperature (dry bulb), humidity (wet bulb), and air movement: (Plog, 13)
a. average temperature index
b. combined temperature index
c. effective temperature index
d. dry-wet temperature index
100. General hypothermia is an acute problem resulting from which two conditions? (Plog, 14)
a. acute exposure to cold and prolonged heat exposure
b. prolonged heat loss and exposure
c. prolonged cold exposure and heat loss
d. acute heat loss and prolonged cold exposure
101. All of the following are examples of ionizing radiation, EXCEPT: (Plog, 14)
a. alpha; particles
b. gamma-rays
c. neutrons
d. electrons
102. Which of the following forms of ionizing radiation is least dangerous? (Plog, 14)
a. alpha-particles
b. beta-radiation
c. neutrons
d. gamma-rays
103. Which of the following forms of ionizing radiation has the greatest penetration ability? (Plog, 14)
a. alpha-particles
b. beta-radiation
c. neutrons
d. gamma-rays
104. Which of the following forms of ionizing radiation is not usually used in manufacturing operations? (Plog, 14)
a. x-rays
b. beta-radiation
c. alpha-particles
d. neutrons
105. The amount of energy a particular kind of radioactive material possesses is defined in terms of: (Plog, 15)
a. BeA (billion electron amps)
b. MeV (million electron volts)
c. Kev (thousand electron volts)
d. MeO (million electron ohms)
106. Radiation that has various effects on the body, depending largely on wavelength of the radiation involved, is called: (Plog, 15)
a. ionizing radiation
b. non-ionizing radiation
c. beta-radiation
d. alpha-emitting radiation
107. All of the following are examples of low frequency non-ionizing radiation that can cause general heating of the body, EXCEPT: (Plog, 15)
a. broadcast radio
b. power line transmissions
c. MRI transmissions
d. short-wave radio
108. The degree of body heating from low frequency non-ionizing radiation depends on three factors. Which of the following is not one of those factors?: (Plog, 15)
a. orientation of the wave front
b. wavelength
c. power intensity
d. duration of exposure
109. This form of radiation can only penetrate below the superficial layer of skin, so it is not considered a significant health hazard: (Plog, 15)
a. ultraviolet
b. infrared
c. visible
d. microwave
110. Electric arcs produce this type of harmful radiation: (Plog, 16)
a. ultraviolet
b. infrared
c. visible
d. microwave
111. This device emits coherent radiation of a single color or wavelength and frequency: (Plog, 16)
a. maser
b. laser
c. light sword
d. LED
112. This device is the predecessor of the laser and emits microwave radiation of a single color or wavelength and frequency: (Plog, 16)
a. LED
b. quasar
c. light sword
d. maser
113. Which of the following is NOT a factor affecting the degree of eye injury from exposure to laser light? (Plog, 16)
a. divergence of the laser light
b. pigmentation of the eye
c. distance from the source of energy
d. presence of focusing media in the light path
114. This environment is encountered when work is conducted in watertight structures and by divers who work under water: (Plog, 16)
a. hypobaric
b. hyperbaric
c. hypothermic
d. hyperthermic
115. Tissue damage resulting from the unequal distribution of air pressure in the lungs, sinuses, and the middle ear: (Plog, 16)
a. barotrauma
b. hypertrauma
c. hypothermia
d. hyperthermia
116. This condition results from the release of nitrogen bubbles into the circulation and tissues: (Plog, 17)
a. nitroneuoma
b. helium high
c. decompression sickness
d. compression illness
117. One of the most common troubles encountered by workers under compressed air is: (Plog, 17)
a. pain in lungs
b. pain and congestion in the ears
c. pain and pressure in the GI track
d. painful area behind the eye
118. the customs, habits, and laws of work literally means: (Plog, 17)
a. ergonomics
b. job analysis
c. culture
d. best practices
119. the customs, habits, and laws of work literally means: (Plog, 17)
a. ergonomics
b. job analysis
c. culture
d. best practices
120. Ergonomics considers which of the following? (Plog, 17)
a. physical health requirements
b. psychological health maintenance
c. physiological and psychological demands
d. psychosocial support mechanisms
121. A very effective tool to deal with the functioning of the structural elements of the body and the effects of external and internal forces on the various parts of the body is called: (Plog, 18)
a. Anthropometry
b. Biomechanics
c. NIOSH Model
d. Ergonomics
122. How many biological agents, such as infectious microorganisms, allergens, and toxins are know to produce infections, allergic, toxic and carcinogenic reactions in workers? (Plog, 20)
a. 200
b. 300
c. 400
d. 500
123. Which of the following occupations has not been identified as most at risk to occupational biohazards? (Plog, 20)
a. agricultural
b. medical
c. nursing homes
d. laboratory work
124. This clinically diagnosed disease in one or building occupants: (Plog, 20)
a. building-related illness (BRI)
b. sick-building syndrome (SBS)
c. Building-related syndrome
d. sick-building illness
125. This condition exists when building occupants exhibit nonspecific symptoms that cannot be associated with an identifiable cause: (Plog, 20)
a. building-related illness (BRI)
b. sick-building syndrome (SBS)
c. Building-related syndrome
d. sick-building illness
126. The three major routes of entry of compounds in the form of liquids, gases, mists, dusts, fumes, and vapors include all of the following, EXCEPT: (Plog, 21)
a. inhalation
b. ingestion
c. absorption
d. abrasion
127. This route of entry is particularly important due to the rapidity in which toxic material can be absorbed: (Plog, 21)
a. inhalation
b. ingestion
c. absorption
d. abrasion
128. All of the following can cause systemic poisoning by direct contact with the skin, EXCEPT: (Plog, 21)
a. TNT
b. lead oxide
c. cyanides
d. phenols
129. Solid particles generated by handling, crushing, grinding, rapid impact, detonation, and decrepitation of organic or inorganic materials are called: (Plog, 21)
a. gases
b. smoke
c. fumes
d. dusts
130. Dusts larger than this usually do not remain airborne: (Plog, 22)
a. 5µm
b. 10µm
c. 15µm
d. 20µm
131. Dusts smaller than this can actually reach the alveoli sacs in the lung: (Plog, 22)
a. 5µm
b. 10µm
c. 15µm
d. 20µm
132. What is the smallest size dust particle can a worker with normal vision detect? (Plog, 22)
a. 35µm
b. 40µm
c. 45µm
d. 50µm
133. These are produced when the material from volatized solid condenses in cool air: (Plog, 22)
a. gases
b. smoke
c. fumes
d. dusts
134. This oxide, if mechanically dispersed into the air, it can produce a severe lead-poisoning hazard: (Plog, 22)
a. gross
b. dross
c. fossgil
d. arcus
135. What is the safety strategy to prevent lead-oxide from being dispersed into the air? (Plog, 22)
a. misting air around the point of operation
b. aggressive positive ventilation
c. scrupulously clean housekeeping
d. blowers and negative pressure ventilators
136. These are formless liquids that expand to occupy the space or enclosure in which they are confined: (Plog, 22)
a. gases
b. smoke
c. fumes
d. dusts
137. These are suspended liquid droplets generated by condensation of liquids from the vapor back to the liquid state: (Plog, 22)
a. gases
b. mists
c. aerosols
d. dusts
138. These are liquid droplets or solid particles of fine enough particle size to remain dispersed in air for a prolonged period of time: (Plog, 22)
a. gases
b. mists
c. aerosols
d. dusts
139. These are suspended liquid droplets generated by breaking up a liquid into a dispersed state, such as by splashing, foaming, or atomizing: (Plog, 22)
a. gases
b. mists
c. aerosols
d. dusts
140. These are the volatile form of substances that are normally in the solid or liquid state at room temperature: (Plog, 23)
a. gases
b. mists
c. aerosols
d. vapors
141. Terms used by industrial hygienists to describe the degree of exposure include all of the following, EXCEPT: (Plog, 23)
a. ppm - parts per million
b. mppcf - millions of particles of a particulate per cubic foot of air
c. mg/l - milligrams per liter of a liquid
d. mg/m3 - milligrams of a substance per cubic meter of air
142. Which of the following are main categories of respiratory hazards? (Plog, 23)
a. helium-nitrogen deficiency
b. oxygen deficiency
c. toxic contaminants in the air
d. b and c above
143. What is the percentage of oxygen normally found in the atmosphere at sea level? (Plog, 23)
a. 21 percent
b. 32 percent
c. 42 percent
d. 79 percent
144. What is the percentage of nitrogen and other inert gases normally found in the atmosphere at sea level? (Plog, 23)
a. 21 percent
b. 32 percent
c. 42 percent
d. 79 percent
145. What is the partial pressure of oxygen normally found at sea level when the barometric pressure of 760 mm Hg? found in the atmosphere at sea level? (Plog, 23)
a. 36 mm Hg (760 mm Hg/21)
b. 160 mm Hg (760 mm Hg x .21)
c. 1596 mm Hg (760 mm Hg x 2.1)
d. 3619 mm Hg (760 mm Hg/.21)
146. Oxygen may be deficient in confined spaces for all of the following reasons, EXCEPT: (Plog, 23)
a. consumed by chemical reactions
b. replaced by inert gases
c. relocated to areas of lower pressure
d. absorbed by porous surfaces
147. Inert gases that may replace oxygen in confined spaces include all of the following, EXCEPT: (Plog, 23)
a. propane
b. argon
c. nitrogen
d. carbon dioxide
148. What are the first physiological signs of oxygen deficiency? (Plog, 23)
a. a giddy feeling and forgetfulness
b. dizziness and euphoria
c. increased depth and rate of breathing (anoxia)
d. confusion and giddiness
149. Which of the following is not one of the three ways inhaled contaminants may adversely affect the lungs? (Plog, 23)
a. Aerosols that damage lung tissue
b. Toxic vapors and gases the damage lung tissue
c. Aerosols or gases that affect oxygen-carrying capacity
d. Mists that enter and damage lung tissue
Area III. Topic G. Construction
1. Most contractors divide their bids five ways. Which of the following is not one of those ways? (NSC, APM-ET, 32)
a. material
b. labor
c. safety
d. overhead
2. Most contractors divide their bids five ways. Which of the following is not one of those ways? (NSC, APM-ET, 32)
a. plant
b. labor
c. profit
d. schedule
3. Who was the source of the following law? If a builder builds a house for a man and does not make his construction firm and the house he has built collapses and causes the death of the householder, the builder shall be put to death. (Hislop, 7) ?
a. OSHA circa 1970 CE
b. Attila the Hun circa 728 CE
c. King Hammurabi, 2200 BCE.
d. King Solomon, 1300 BCE
4. If a contractor fails to comply with safety requirements, what effect might that failure have on the host employer? (Hislop, 9) ?
a. No effect. The host has no responsibility
b. It may affect the ability of the host to continue operations
c. It may have a negative impact on construction costs
d. b and c above
5. According the studies conducted by the Business Roundtable, accidents account for an average of ______ of total project costs where effective safety programs are NOT in place: (Hislop, 10) ?
a. 6.9 %
b. 8.5%
c. 15%
d. 19.5%
6. According the studies conducted by the Business Roundtable, accidents account for an average of ______ of total project costs where effective safety programs are in place: (Hislop, 10)
a. .9 %
b. 2.5%
c. 4%
d. 5.3%
7. Under this theory, the employer has an obligation to exercise reasonable care and prudence in the conduct of their work: (Hislop, 10) ?
a. non-negligence
b. accountability
c. due diligence
d. reasonable care
8. The amount of insurance placed in a construction bid is a percentage of all of the following, EXCEPT: (NSC, APM-ET, 32)
a. cost of materials
b. cost of labor
c. profit
d. plant
9. The amount of insurance placed in a construction bid is a percentage of all of the following, EXCEPT: (NSC, APM-ET, 32)
a. cost of materials
b. cost of labor
c. profit
d. plant
10. Under the concept of due diligence, the employer must do all of the following, EXCEPT: (Hislop, 16)
a. develop a documented safety program
b. train and educate employees
c. train supervisors
d. provide incentives
11. Under the concept of due diligence, the employer must do all of the following, EXCEPT: (Hislop, 16)
a. investigate and report accidents
b. develop a safety committee
c. train supervisors
d. monitor the workplace
12. Which of the following is not a criteria for prioritizing job safety analyses? (Hislop, 23)
a. frequency of accidents and injuries
b. severity of accidents and injuries
c. type of accidents and injuries
d. potential for severe injuries
13. The construction safety manager should consider all of the following criteria for prioritizing job safety analyses, EXCEPT: (Hislop, 23)
a. frequency of accidents and injuries
b. probability for accidents
c. new or modified tasks
d. infrequently performed tasks
14. The obligation to carry out assigned duties defines this term: (Hislop, 23)
a. responsibility
b. accountability
c. due diligence
d. leadership
15. A competent person is generally defined as an individual, who as the result of training and/or experience, is capable of: (Hislop, 27)
a. identifying or predicting hazardous situations
b. authority to discipline for noncompliance
c. authorizing prompt corrective actions
d. correcting hazardous conditions
16. A competent person at an excavation site should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. structural ramps
b. water removal equipment
c. soil conditions
d. machine guarding
17. A competent person at an excavation site should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. biological hazards
b. water removal equipment
c. hazardous atmospheres
d. shoring requirements
18. A competent person responsible for work on a scaffold should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. scaffold assembly
b. structural integrity
c. soil conditions
d. fall protection
19. A competent person responsible for work on a scaffold should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. tie points
b. structural integrity
c. safe access
d. weather effects
20. A competent person responsible for work on a scaffold should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. tie points
b. evaluation of training
c. modifications/alterations
d. selection of assemblers
21. A competent person responsible for work requiring fall protection should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. certifying nets
b. personal fall arrest systems
c. monitoring requirements
d. selection of back belts
22. A competent person responsible for work involving derricks and cranes should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. certifying workers
b. all machinery prior to use
c. annual inspections
d. equipment following trial lifts
23. A competent person responsible for work involving hazardous chemicals should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. identity of hazardous chemicals on site
b. establishing regulated areas
c. annual inspections of chemicals
d. monitoring exposure
24. A competent person responsible for work involving underground construction should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. evaluating haulage and hoisting equipment
b. establishing regulated areas
c. drilling equipment
d. ventilation, air monitoring and compressed air
25. A competent person responsible for work involving underground construction should be knowledgeable about, and be able to identify and correct hazards related to all of the following, EXCEPT: (Hislop, 28)
a. soil and rock conditions
b. personal protective equipment
c. verifying employee training
d. ventilation, air monitoring and compressed air
26. This person should monitor job-site activities under their control to assess the effectiveness of their safety plan implementation: (Hislop, 30)
a. on-site supervisor
b. field engineer
c. employee
d. contractor
27. This regulation details OSHA standards specifically for the construction industry: (OSHA)
a. 29 CFR 1904
b. 29 CFR 1910
c. 29 CFR 1926
d. 29 CFR 1940
28. Which of the following is not usually included in an worksite orientation? (Hislop, 32)
a. introduction to the jobsite
b. site safety rules and regulations
c. parking zones
d. HAZCOM information
29. On a multi-employer worksite, who is legally responsible for compliance with all safety and health protection requirements for employees? (OSHA)
a. only the contractor
b. both contractor and subcontractor
c. site safety supervisor
d. all of the above
30. Each contractor/subcontractor is responsible for compliance with all safety and health protection requirements for their employees. A single safety and health plan for multi-employer worksites may be used by contractors/subcontractors if: (OSHA)
a. if it addresses health hazards
b. it addresses their activity
c. if addresses safety hazards
d. all of the above
31. In general a worksite plan organized as a single document, with component sections/appendices coverall tasks, operations, and contractors/contractors may: (OSHA)
a. promote use efficiency
b. enhance clarity of duties and responsibilities
c. enhance coordination among all affected parties
d. all of the above
32. Pre-work meetings held at the start of each day should be short and include at least all of the following, EXCEPT: (Hislop, 33)
a. review the previous day's work
b. new work assignments
c. safety issues
d. bonus for beating work schedules
33. Which of the following is not considered a reasonable advantage of the weekly toolbox talk? (Hislop, 34-35)
a. can talk about anticipated safety issues
b. can new work assignments
c. able to review lessons learned from accidents
d. they are short
34. These are the most common cause of accidents on a construction worksite: (Hislop, 35)
a. overexposure
b. electrical
c. slips, trips, falls
d. bodily reaction
35. According to the Center for the Protection of Workers' Rights, _____ of construction workers report to work under the influence of some behavior modifying substance: (Hislop, 35)
a. 10%
b. 20%
c. 30%
d. 40%
36. Which of the following does not occur during the Engineering and Design Phase (Step 1) of the construction process? (Hislop, 40-42)
a. Conceptualize project
b. identification of coordinating engineer
c. develop the bid package
d. initial cost and schedule estimate
37. Which of the following does not occur during the Engineering and Design Phase (Step 1) of the construction process? (Hislop, 40-42)
a. Conceptualize project
b. Award contract
c. conduct a baseline review
d. 90% Design and Constructability Review
38. Which of the following does not occur during the Engineering and Design Phase (Step 1) of the construction process? (Hislop, 40-42)
a. specific work-site safety briefing
b. Award contract
c. conduct a baseline review
d. pre-work planning
39. In the Engineering and design phase of the construction process, this person identifies the need for a new installation or modification to existing facility: (Hislop, 40)
a. originator
b. planner
c. engineer
d. decision-maker
40. Which of the following is not considered a key responsibility of the safety representative during the design and planning stage? (Hislop, 40-43)
a. Give advice on provisions for safety features in the design
b. Assist with the conduct of the ESH Baseline review
c. Coordinate involvement in the 90% design review
d. Provide guidance on selection of contractors
41. In the Engineering and design phase of the construction process, this person identifies the need for a new installation or modification to existing facility: (Hislop, 40)
a. originator
b. planner
c. coordinating engineer
d. designer
42. This position coordinates the development of the project design: (Hislop, 40)
a. originator
b. planner
c. coordinating engineer
d. designer
43. The purpose of this process during the engineering and design phase is to identify as many of the safety hazards as possible associated with use of the space in which the project will be built: (Hislop, 41)
a. worksite audit
b. site walk-through
c. project hazard analysis
d. baseline safety review
44. Each of the following is an objective of the baseline safety review, EXCEPT: (Hislop, 41)
a. identify existing and potential hazards
b. provide guidance in selecting contractors
c. consider occupancy requirements
d. consider maintenance requirements
45. Each of the following is an objective of the baseline safety review, EXCEPT: (Hislop, 41)
a. identify existing and potential hazards
b. provide guidance in selecting contractors
c. consider occupancy requirements
d. consider maintenance requirements
46. This position helps keep the project safe by defining the configuration and components of the work through the plans and specifications: (Hislop, 42)
a. originator
b. planner
c. coordinating engineer
d. designer
47. This position defines the configuration and components of the work through the plans and specifications: (Hislop, 40)
a. originator
b. planner
c. coordinating engineer
d. designer
48. This position defines the configuration and components of the work through the plans and specifications: (Hislop, 40)
a. originator
b. planner
c. coordinating engineer
d. designer
49. This is the final step in the engineering and design phase: (Hislop, 45)
a. specific work-site safety briefing
b. award contract
c. statement of work
d. pre-work planning
50. Each of the following is accomplished in the Procurement/Contracting Phase of a project, EXCEPT: (Hislop, 45-46)
a. specific work-site safety briefing
b. bid package
c. pre-bid meeting
d. invitation to bid
51. Each of the following is accomplished in the Procurement/Contracting Phase of a project, EXCEPT: (Hislop, 45-46)
a. bid review, evaluation, and contractor selection
b. bid package
c. contract award
d. pre-work planning
52. Each of the following is accomplished in the Procurement/Contracting Phase of a project, EXCEPT: (Hislop, 45-46)
a. pre-construction meeting
b. pre-work release meeting
c. hazard communication briefing
d. safety program and job safety analysis review
53. During the procurement and contracting phase, the safety representative accomplishes all of the following, EXCEPT: (Hislop, 47)
a. provides guidance for the selection of contractors
b. train contractors during the pre-work release meeting
c. assists the field engineer in evaluating risks
d. assists coordinating engineer in evaluating hazards
54. During the procurement and contracting phase, the safety representative accomplishes all of the following, EXCEPT: (Hislop, 47)
a. provides guidance for the selection of contractors
b. train contractors during the pre-work release meeting
c. assists the field engineer in evaluating risks
d. assists coordinating engineer in evaluating hazards
55. Which of the following is not conducted in the Work/Construction Phase (Step 3) of a project? (Hislop, 47-52)
a. contractor equipment inspection
b. specific work site safety briefing
c. general worksite and hazcom briefing
d. safety program and job safety analysis review
56. Which of the following is not conducted in the Work/Construction Phase (Step 3) of a project? (Hislop, 47-52)
a. contract award
b. inspections and audits
c. contractor progress reports
d. job specific training
57. Which of the following is not conducted in the Work/Construction Phase (Step 3) of a project? (Hislop, 47-52)
a. progress and coordination meetings
b. baseline safety review
c. permits
d. contract closeout
58. Which of the following is not a primary safety responsibility of the host employer during the Procurement/Contracting Phase (Step 2) of a project? (Hislop, 45)
a. conduct progress and coordination meetings
b. develop the safety and health program for the project
c. consider safety and health in the invitation to bid
d. verify selected contractors have an appropriate safety and health program
59. Which of the following is not a primary safety responsibility of the contractor during the Work/Construction Phase (Step 3) of a project? (Hislop, 47)
a. provide safety information on hazard created during work
b. develop and implement a site-specific safety and health program
c. give advice, as needed to the coordinating engineer
d. call attention to hazards that might affect others
60. A contractor may be required to submit all of the following reports to the host employer during the Work/Construction Phase (Step 3) of a project, EXCEPT: (Hislop, 51)
a. safety committee agendas
b. material certifications
c. conformance to code statement
d. man-hour and injury reports
61. This person must clearly define their safety expectations to the project designers and the construction manager: (Hislop, 57)
a. client
b. architect
c. coordinating engineer
d. host employer
62. Which of the following is most likely the reason designers generally do not address construction worker safety? (Hislop, 57)
a. they are not typically educated and trained in safety
b. they claim they do not have the tools or information
c. they are advised not to address safety to minimize liability
d. they leave the design of safety into the project to the safety representative
63. This person may be held liable, even if no contractual obligation exists, to bring a hazard to the attention of the exposed party: (Hislop, 59)
a. client
b. architect
c. coordinating engineer
d. engineer
64. Construction engineers must understand it is there obligation to issue a ______ order if a serious hazard exists: (Hislop, 59)
a. Stop-Work
b. reprimand
c. red tag
d. citation
65. This position is retained to act on the owner's behalf to oversee the development and construction of a project and is responsible for the coordination of the safe execution of all work on the project: (Hislop, 60)
a. construction manager (CM)
b. construction engineer (CE)
c. safety engineer (SE)
d. safety manager (SM)
66. All of the following may complicate the ability of the construction manager (CM) to give attention to project safety: (Hislop, 60)
a. concern over liability issues
b. hiring the CM after the start of the project
c. the absence of a competent safety engineer
d. coordinating numerous project issues
67. The client may make the mistake of assigning responsibility to the construction manager (CM) but not giving him or her authority to do any of the following, EXCEPT: (Hislop, 61)
a. stop work
b. hiring a safety manager to enforce safety policies
c. withhold payment
d. enforce safety policies and rules
68. This position is expected to supply the labor and tools to complete the work as scheduled and within defined specifications: (Hislop, 61)
a. construction manager (CM)
b. subcontractor
c. coordinating engineer
d. general contractor (GC)
69. This position is responsible for defining safety practices of the means and methods to be implemented, and to make sure subcontractors implement those practices: (Hislop, 61)
a. construction manager (CM)
b. subcontractor
c. coordinating engineer
d. general contractor (GC)
70. The construction manager (CM) and client should not delegate the decision regarding standards to be met to this position: (Hislop, 61)
a. construction manager (CM)
b. subcontractor
c. coordinating engineer
d. general contractor (GC)
71. Which of the following describes why the construction manager (CM) and client should not delegate the decision regarding standards to be met to the general contractor? (Hislop, 61)
a. may cause discord among workers and subcontractors
b. will result in a broad disparity in safety program implementation
c. safe work practices may be circumvented
d. all of the above
Answer Key
Area III. Topic A. Compliance Management
1. c. employee recognition
2. b. 1917
3. d. specific industry standards (vertical)
4. b. 1970
5. c. who controls the manner in which the employees perform assigned work
6. c. universal standards (horizontal)
7. b. 1910
8. b. variance
9. b. variance
10. b. 1915
11. d. regardless of the use of PPE
12. d. answer a and b above
13. a. witnesses and other evidence
14. a. near miss
15. c. conduct research and make recommendations that prevent work-related injury and illness
16. d. partial inspection
17. c. Serious
18. b. late 1800's
19. a. 1904
20. c. NSC
21. c. Serious
22. b. the employer exercising reasonable diligence, did or could not know about the violation
23. d. whether the employee was under undue pressure to accomplish a task
24. c. 1926
25. d. equipment certification records
26. b. 1918
27. d. Morgantown WV
28. b. Section 5(a)(1) - General Duty Clause
29. a. the hazard was recognized and corrected prior to the conclusion of the inspection
30. b. a workplace hazard and employee exposure
31. d. it need not be necessarily be recognized
32. d. $7,000
33. d. employee recognition
34. a. recognition by employer's industry
35. c. oral statements by employee to compliance officer
36. b. flagrant
37. b. flagrant
38. b. comprehensive inspection
39. b. only in flagrant cases
40. b. condition, relative position
41. a. De Minimis
42. a. Repeat
43. b. Department of Labor (DOL)
44. c. Employers are not responsible for employee compliance
45. c. consult with the Area Director
46. a. 1903
47. c. Affirmative
48. c. alternative methods exist
49. a. comprehensive and partial
50. d. $5,000 to $70,000
51. d. comprehensive inspection
52. a. North American Industry Classification System (NAICS)
53. c. partial inspection
54. c. include of injury and illness records reviews
55. d. subjective impression
56. d. 1928
57. d. time restraint
58. d. equipment certification records
59. a. 30 days
60. b. refuse entry by an OSHA compliance officer without a warrant
61. b. 1970
62. c. refusing OSHA compliance officer entry without a warrant
63. d. contest the abatement date
64. a. enter with a U.S. Federal Marshall
65. b. National Industrial Classification (NIC)
66. b. voluntary compliance programs,
67. c. 1969
68. b. (# LWDI's x 200,000)/# employee hours worked
69. a. employee's knowledge of the hazard
70. b. catastrophe
71. c. Federal Mine Safety and Health Act
72. b. caused the death of an employee
73. c. Nixon
74. c. imminent danger
75. a. Provide statistical analysis data
76. b. (# Days away from work, restricted work or transfer x 200,000)/# actual employee workhours
77. a. state rules are at least as effective
78. b. 1970
79. c. $7,000
80. b. English
81. b. Health and Human Services/CDC
82. c. NIOSH is an agency within CDC
83. c. ESHM, Excellent Safety and Health Management Program
84. d. all of the above
85. b. Williams-Steiger Act
86. b. National Institutes of Safety and Health (NIOSH)
7. a. 8 hours
88. c. OSHA poster
89. c. $7,000
90. b. OSHA Form 300
91. c. Underwriters Laboratory (UL)
92. a. OSHA 1910.1200
93. b. ANSI Z10
94. a. OSHA
95. c. Homeland Security Act
96. b. U.S.Code
97. b. Assistant Secretary of Labor
98. c. Adjudicate disputes
99. b. Evaluating labor-management relations
100. c. Provide training to employers and employees.
101. a. VPP Voluntary Protection Program (VPP)
102. d. All of the above
103. d. Develop, submit and receive plan approval from OSHA.
104. b. Department of Health and Human Services
105. c. Introduce common sense regulatory reform
106. b. cannot achieve goals through enforcement alone
107. b. Legislating standard safety values
108. d. a and b above
109. a. in plain language
110. b. act as an effective deterrent
111. d. all of the above
112. d. reduced publicity
113. a. Informal training classes
114. b. Voluntary Protection Program (VPP)
115. a. Employer Ride-a-long Program
116. d. Promulgate pending OSHA legislation
117. b. encourages
118. c. Occupational Safety and Health State Plan Association (OSHSPA)
119. a. at least as effective as
120. b. is an independent agency of the U.S. Government
121. d. resolve disputes
122. b. Administrative Law Judges
123. b. OSHSPA
124. c. employee recognition
125. b. only in flagrant cases
126. c. temporary review standards
127. a. Consensus
128. c. Courts do not allow most ETS's to become effective.
129. d. workplace and other studies
130. b. Business Liability Act
131. b. The hazard is also covered by an adequate specific rule.
132. a. Compliance poses a financial burden
133. d. the unsafe practice did not cause injury
134. c. general
135. d. employer ability to pay
136. a. nullify rules
137. d. all of the above
138. c. willful violations of the general duty clause
139. a. challenge the abatement remedy
140. b. substantial
141. a. trade secret information
142. c. The employer refused consultative services
143. a. The violation was a repeat
144. c. willfully or repeatedly violates any section of the OSHact
145. c. $70,000, $5,000
146. c. 50%
147. c. 1998
148. d. 50
149. b. 17
Area III. Topic B. Environment
1. d. Clean Air Act (CAA) of 1967
2. a. The Environmental Protection Agency (EPA)
3. d. all of the above
4. d. regulate the discharge of pollutants into outdoor ambient air
5. a. National Ambient Air Quality Standards (NAAQS)
6. b. silicon
7. b. silver monoxide
8. d. New Source Performance Standards (NSPS)
9. b. National Emissions Standards for Hazardous Air Pollutants (NESHAPs)
10. d. lead
11. a. anthrax
12. c. Energy Supply and Environmental Coordination Act (ESECA) of 1974
13. d. a and b above
14. c. State Implementation Plan (SIP)
15. a. the SIP must be developed by the EPA and state governments
16. d. chemtrail pollutants
17. a. emissions from watercraft
18. a. underwater volcano emissions
19. d. all of the above
20. d. all of the above
21. a. identifies toxic chemicals controlled with Maximum Achievable Control Technology (MACT)
22. c. allowed additives control standards
23. c. National Pollutant Discharge Elimination System (NPDES)
24. a. Stormwater Discharge Regulations
25. c. Resource Conservation and Recovery Act (RCRA)
26. c. Resource Conservation and Recovery Act (RCRA)
27. d. all of the above
28. b. resistance of hazardous waste to controls
29. c. train hazardous waste workers
30. b. report to OSHA
31. d. all of the above
32. a. hazardous waste manufacturers
33. c. RCRA Permit
34. d. all of the above
35. d. all of the above
36. c. Subtitle I, Regulation of Underground Story Tanks (USTs)
37. b. volunteer compliance and cooperation
38. c. requirements for disposal of hazardous waste at remote locations
39. a. Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA)
40. a. Bhopal Tragedy
41. d. Clean Air Act (CAA) of 1967
Area III. Topic C. Ergonomics
1. a. Elbow and shoulder swelling and inflammation
2. b. Pain in the wrist upon exertion
3. c. Carpenter's elbow
4. c. NIOSH
5. a. Carpal Tunnel Syndrome
6. a. Ergonomics
7. a. Back pain
8. c. Precision grip
9. a. Power grip
10. b. 10 degrees downward
11. c. Biomechanics
12. d. The man-machine relationship
13. b. Musculoskeletal Disorders
14. c. Tennis elbow
15. c. whole-body vibration
16. a. Work and Law
17. b. anthropometry
18. d. a vector quantity that tends to produce a deceleration
19. a. Fitness
20. d. Emotional demands
21. c. Repetitive Strain Injuries (RSI)
22. c. Exposure to blood-borne pathogens
23. d. Ignore employee concerns and ideas
24. c. Twist as you lift from the floor
25. c. workstation design
26. d. discourage union involvement
27. b. encourage compliance
28. a. Ignoring employees registering complaints
29. b. brainstorming
30. c. request a confidential evaluation
31. c. determine scope of the problem
32. b. detect obvious risk factors
33. d. persons are familiar with the job, task, or process
34. c. work requiring sustained or repeated work at chest level
35. c. decreased slipperiness
36. a. group dynamics
37. d. exclude employee involvement in the analysis
38. c. investigation
39. c. investigation
40. c. immediate, severity
41. d. all of the above
42. b. Engineering Controls
43. c. Work Practice Controls
44. a. the printer
45. a. decrease recovery time
46. b. verifies proposed solutions
47. d. controls are identified
48. d. reduced productivity
49. a. Early return to work
50. b. methods of self-treating MSDs
51. b. diagnose signs and symptoms
52. b. periodic plant tours
53. a. Comply with mandatory OSHA rules
54. b. musculoskeletal disorders
55. c. requirements, requirements
56. d. Any of the above
57. b. the procedure
58. b. 7 percent
59. d. skin
60. b. unique motions
61. c. capacity
62. b. 35
63. d. Fatigue
64. c. environment
65. c. upper back
66. d. Contact trauma
67. a. pinch grip
68. c. static exertion
69. b. recovery time
70. d. standing
71. a. angular velocity, acceleration
72. d. All of the above
73. b. high humidity
74. b. hypothermia
75. a. pulmonary pain
76. b. 4 and 8
77. c. freedom from concentration
78. c. threaten for noncompliance
79. d. poor labor-management relations
80. d. flat enough
Area III Topic D. Toxicology
1. c. toxicology
2. d. a and c above
3. a. contact with a harmful substance
4. d. contact with biological mutagens
5. c. toxicity
6. b. degree of exposure
7. d. all of the above
8. b. toxicity
9. c. hazard
10. d. exposure
11. b. toxicity
12. b. the stimulus has changed chemical markers
13. a. the effect is unique and specific
14. d. the observation is unique to the observer
15. c. Toxicity is not a physical constant
16. c. physiological characteristics of the chemical
17. b. amount of the hazard
18. a. toxic content of the substance
19. b. vapor pressure
20. d. Material Safety Data Sheet (MSDS)
21. a. local injury
22. a. local injury
23. d. inhalation
24. c. 5µm
25. c. The substance can result in unusual behavioral actions
26. a. The skin will prevent exposure
27. c. temperature and perspiration
28. b. physiochemical
29. d. location
30. a. humidity
31. d. lower
32. d. lower
33. c. detoxification
34. c. attack by macrophages
35. b. the duodenal sac
36. a. pneumococcus
37. b. dose-response relationship
38. c. LD50
39. d. concentration (C) and duration (T) of exposure
40. d. concentration (C) and duration (T) of exposure
41. b. toxic potency
42. c. route of entry
43. a. lethal dose (LD)
44. d. LD100
45. b. slight
46. b. inversely proportional
47. d. lethal concentration (LC)
48. d. possible significant effect
49. b. reveals the route of entry
50. d. acute, chronic
51. a. acute effects
52. a. acute
53. b. chronic effects
54. b. chronic
55. d. avoidants
56. b. asphyxiants
57. c. CNS depressants
58. b. carcinogen
59. a. mutagen
60. c. teratogen
61. b. Environmental Protection Agency (EPA)
62. b. Recommended Exposure Limit (REL)
63. d. Permissible Exposure Limit (PEL)
64. d. Permissible Exposure Limit (PEL)
65. a. Threshold Limit Values (TLV)
66. c. within the breathing zone of a worker
67. b. Time Weighted Average (TWA)
68. c. 8 hours
69. c. C
70. c. ceiling value (C)
71. b. milligrams per cubic meter (mg/m3)
72. a. parts per million (PPM)
73. a. their combined effect
74. c. been exceeded
75. a. labor-management negotiation
76. b. Urine tests
77. a. Blood analysis
78. b. in addition to air sampling
79. d. Material Safety Data Sheet (MSDS)
80. b. Biological Exposure Indices (BEI)
81. d. TLC
82. b. LC
83. a. LD
84. c. TLD
85. b. LC50
86. a. LD50
87. c. latency period
88. d. FDA
89. d. FDA
90. b. meaningfulness is the same regardless of species
91. b. they are difficult to schedule into the normal workday
92. d. cooperation by workers may not occur
Area III. Topic E. Epidemiology
1. d. Proactive
2. a. Descriptive studies
3. b. Retrospective or control group studies
4. c. Prospective studies
5. c. Prospective studies
6. d. Epidemiological analysis
7. b. evidence of a decline in the frequency of the effect
8. b. evidence of a decline in the frequency of the effect
9. c. rewards for underreporting
10. d. contact between hands and contaminated material
11. a. subcutaneous absorption
12. c. research
13. d. HIV
14. d. HIV
15. c. Epidemiological and risk assessment
16. d. Evaluate the degree to which occupational disease impacts productivity
17. a. To determine effects of toxins on control populations of animals
18. c. Determine the extent to which the animals mirror human etiology
Area III. Topic F. Industrial Hygiene
1. c. hazards
2. d. rule enforcement
3. a. training
4. a. sound claims management
5. a. chemical hazards
6. d. physical hazards
7. b. biological hazards
8. c. ergonomic hazards
9. d. physical effects
10. a. variation in receptivity
11. b. intermittent energy of the sound
12. c. Are employees volunteering to wear earplugs or muffs?
13. c. increased breathing rate
14. a. area samples at fixed locations
15. a. mist
16. c. 90 dBA
17. d. 95 dBA
18. b. dipole antenna
19. b. use engineering and administrative controls
20. b. 5 µm
21. c. ensure personal protective equipment is provided
22. a. toxicity
23. c. placing a grounded conductor between the field and person
24. d. noise
25. a. thermal and photochemical mechanisms
26. a. total time since exposure occurred
27. a. heatstroke
28. b. dipole antenna
29. a. total time since exposure occurred
30. d. sources of radiation
31. a. vapors
32. d. half-life of the chemical
33. a. thermal and photochemical mechanisms
34. d. sources of radiation
35. c. charlie-waves
36. c. specific absorption rate (SAR)
37. d. psychosocial environment
38. c. delta-waves
39. d. output
40. d. penetration
41. b. Geiger-Muller
42. d. Dosimeters
43. c. Administrative controls
44. a. alpha-particles
45. a. acute and chronic
46. a. frequency
47. b. engineering control
48. b. microwave
49. d. infrared
50. a. ultraviolet
51. c. laser
52. c. maser
53. b. eye
54. d. skin
55. a. barotrauma
56. a. use engineering and administrative controls to reduce exposure
57. d. any of the above
58. d. penetration
59. b. allergens
60. b. microbes
61. d. dusts
62. d. 0.1-25 µm
63. d. fumes
64. b. smoke
65. b. Ohm's Law
66. d. aerosols
67. a. mists
68. c. gas
69. d. b and c above
70. c. 21 percent
71. a. toxic mists affecting upper area of the lung
72. d. Threshold Limit Value (TLV)
73. b. 8-hour exposure
74. c. TLV-C
75. b. TLV-STEL
76. a. MSDSs
77. b. Degree of probability of exposure
78. c. sequence of sampling
79. d. a and c above
80. b. A shift from manufacturing to service
81. a. Inspections and audits
82. b. Engineering controls
83. b. Engineering controls
84. d. Personal Protective Equipment
85. b. Toxicology
86. b. LD50
87. c. ACGIH and OSHA
88. b. LIA/ANSI Z136.1
89. c. heat exhaustion
90. c. grab
91. a. variation in receptivity
92. b. intermittent energy of the sound
93. c. Are employees volunteering to wear earplugs or muffs?
94. a. use engineering and administrative controls to reduce exposure
95. d. caloric intake
96. b. dry bulb thermometer
97. a. stretching
98. d. audiometric testing
99. c. effective temperature index
100. c. prolonged cold exposure and heat loss
101. d. electrons
102. a. alpha-particles
103. c. neutrons
104. d. neutrons
105. b. MeV (million electron volts)
106. b. nonionizing radiation
107. c. MRI transmissions
108. a. orientation of the wave front
109. b. infrared
110. a. ultraviolet
111. a. maser
112. a. LED
113. d. presence of focusing media in the light path
114. b. hyperbaric
115. a. barotrauma
116. c. decompression sickness
117. b. pain and congestion in the ears
118. a. ergonomics
119. a. ergonomics
120. c. physiological and psychological demands
121. b. Biomechanics
122. a. 200
123. c. nursing homes
124. a. building-related illness (BRI)
125. b. sick-building syndrome (SBS)
126. d. abrasion
127. a. inhalation
128. b. lead oxide
129. d. dusts
130. a. 5µm
131. a. 5µm
132. d. 50µm
133. c. fumes
134. b. dross
135. c. scrupulously clean housekeeping
136. a. gases
137. b. mists
138. c. aerosols
139. b. mists
140. d. vapors
141. c. mg/l - milligrams per liter of a liquid
142. d. b and c above
143. a. 21 percent
144. d. 79 percent
145. b. 160 mm Hg (760 mm Hg x .21)
146. c. relocated to areas of lower pressure
147. a. propane
148. c. increased depth and rate of breathing (anoxia)
149. d. Mists that enter and damage lung tissue
Area III. Topic G. Construction
1. c. safety
2. d. schedule
3. c. King Hammurabi, 2200 BCE.
4. d. b and c above
5. a. 6.9 %
6. a. .9 %
7. c. due diligence
8. c. profit
9. c. profit
10. d. provide incentives
11. b. develop a safety committee
12. c. type of accidents and injuries
13. b. probability for accidents
14. a. responsibility
15. b. authority to discipline for noncompliance
16. d. machine guarding
17. a. biological hazards
18. c. soil conditions
19. d. weather effects
20. b. evaluation of training
21. d. selection of back belts
22. a. certifying workers
23. c. annual inspections of chemicals
24. b. establishing regulated areas
25. c. verifying employee training
26. b. field engineer
27. c. 29 CFR 1926
28. c. parking zones
29. b. both contractor and subcontractor
30. d. all of the above
31. d. all of the above
32. d. bonus for beating work schedules
33. a. can talk about anticipated safety issues
34. d. bodily reaction
35. c. 30%
36. c. develop the bid package
37. b. Award contract
38. a. specific work-site safety briefing
39. a. originator
40. d. Provide guidance on selection of contractors
41. a. originator
42. c. coordinating engineer
43. d. baseline safety review
44. b. provide guidance in selecting contractors
45. b. provide guidance in selecting contractors
46. d. designer
47. d. designer
48. d. designer
49. c. statement of work
50. a. specific work-site safety briefing
51. d. pre-work planning
52. c. hazard communication briefing
53. b. train contractors during the pre-work release meeting
54. b. train contractors during the pre-work release meeting
55. d. safety program and job safety analysis review
56. a. contract award
57. b. baseline safety review
58. b. develop the safety and health program for the project
59. c. give advice, as needed to the coordinating engineer
60. a. safety committee agendas
61. a. client
62. c. they are advised not to address safety to minimize liability
63. d. engineer
64. a. Stop-Work
65. a. construction manager (CM)
66. c. the absence of a competent safety engineer
67. b. hiring a safety manager to enforce safety policies
68. b. subcontractor
69. d. general contractor (GC)
70. d. general contractor (GC)
71. d. all of the above
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