Updating OSHA standards based on national consensus standards. Direct final rule

In this direct final rule, the Agency is removing several references to consensus standards that have requirements that duplicate, or are comparable to, other OSHA rules; this action includes correcting a paragraph citation in one of these OSHA rules. The Agency also is removing a reference to American Welding Society standard A3.0-1969 ("Terms and Definitions") in its general-industry welding standards. This rulemaking is a continuation of OSHA's ongoing effort to update references to consensus and industry standards used throughout its rules.

Evaluating the Michigan SENSOR Surveillance Program for work-related asthma

BACKGROUND

Most Occupational Safety and Health Administration (OSHA) inspections are based on employee complaints or targeting of industry groupings. Limited use has been made of illness data to target inspections and evaluation of such targeting is even more limited.

METHODS

This study compared 545 Michigan OSHA (MIOSHA) inspections performed as follow up to reports of work-related asthma (WRA) with 12,268 non-disease initiated OSHA inspections performed during the same time period (1989-2002).

RESULTS

SENSOR asthma inspections were more likely to be conducted in larger, unionized employers. Although the likelihood of citations ( approximately 50%), type of citation, and monetary penalties ( approximately 30%) were not different between disease and non-disease initiated inspections, the number of citations and amount of monetary penalties were less in disease initiated inspections. Citations and penalties were more likely for small as compared to large employers, and were less likely at unionized worksites.

CONCLUSIONS

Even without the availability of specific standards for agents that cause WRA, inspections triggered by a WRA index case are very much like other inspected worksites in terms of the prevalence of violations observed at the worksite. The advisability of making referrals to OSHA and additional ways to evaluate the effectiveness of this type of intervention model are discussed.

Survey of current lead use, handling, hygiene, and contaminant controls among New Jersey industries

In 2003, a chemical handling and use survey was mailed to New Jersey employers identified as currently using lead in their industrial processes. This survey was used to ascertain characteristics about lead use, handling, and protection of employees during manufacturing operations. The survey included a diverse group of current lead users with a total lead use range from less than 1 pound to more than 63 million pounds of lead per year. The survey allowed for a comprehensive characterization of hazards and protective measures associated with this metal, still commonly used in many products and industrial processes. Forty-five surveys were returned by companies that are listed in the New Jersey Adult Blood Lead Registry, which is part of the New Jersey Adult Blood Lead Epidemiology and Surveillance (ABLES) program. This program records and investigates cases of adults with greater than 25 mu g/dL of lead in their blood; most cases are related to occupational exposures. This survey found that greater than 25% of these surveyed companies with significant potential for lead exposure did not employ commonly used and basic industrial hygiene practices. In addition, the survey found that 24% of these companies had not conducted air sampling within the last 3 years. Air sampling is the primary trigger for compliance with the Occupational Safety and Health Administration (OSHA) general industry lead standard. Only 17% of the companies have ever been cited for a violation of the OSHA lead standard, and only 46% of these companies have ever had an OSHA inspection. State-based surveillance can be a useful tool for OSHA enforcement activities. Elevated blood lead values in adults should be considered as a trigger for required compliance with an OSHA general industry lead standard.

Medical fitness evaluation for respirator users: results of a national survey of private sector employers

OBJECTIVE

To provide information on medical evaluation procedures for respirator use in private sector establishments.

METHODS

In 2001, data on respirator use and practices were collected in a survey of private sector establishments.

RESULTS

Of establishments where respirators were required, 46% did not evaluate employees' medical fitness. Evaluations for fitness increased with establishment size, ranging from 35% in small establishments (1-10 workers) to 95% in large establishments (>or=1000 workers). Questionnaire with a follow-up examination, as needed, was the most common method of evaluating medical fitness (48%).

CONCLUSIONS

Results suggest that about half of all private sector establishments where respirators are required do not comply with Occupational Safety and Health Administration requirements for medical fitness evaluations. Improved awareness among employers and workers and identification of methods to increase medical evaluation practices, especially among smaller establishments, is needed.

Confined space entry: mitigating risk in general industry

Thorough understanding of the hazards, risks, and program and regulatory requirements for confined space entry provides the framework for safe entry procedures. Permit-required confined spaces possess hazardous characteristics that have the potential to cause harm, physical injury, or death. Special procedures are required for entry into a permit-required confined space. This article provides an overview of confined space hazards, permit requirements, and entrant and attendant responsibilities. Rescue requirements and implications are discussed. Understanding the hazards of confined space entry, safe permit-entry procedures, and rescue requirements enables occupational health nurses to support the EHS team in initiating an effective confined space entry program.

Statistical issues with respect to workplace protection factors for respirators

A workplace protection factor (WPF) for a respirator wearer is the measured concentration of a contaminant outside the respirator divided by the simultaneous concentration of that contaminant inside the respirator. The Occupational Safety and Health Administration (OSHA) proposed an assigned protection factor (APF) of 10 to negative-pressure, half-facepiece, air-purifying respirators (HFAPR), based on the criterion that the 5th percentile of WPF for HFAPR be larger than the APF. This class of half-facepiece respirators includes both filtering facepiece and elastomeric half-mask respirators. Nicas and Neuhaus developed a statistical model for log-normally distributed WPF that separated between-wearer and within-wearer variation. Using results from applying this model to seven studies of HFAPR, they proposed an APF of 5 for this class of respirator, based on the criterion that the 5th percentile of the 5th percentile of individual worker WPF distributions be larger than the APF. In this article, two reasons are suggested for these differing proposals: (1) the Nicas and Neuhaus criterion is inherently more conservative than that of OSHA, and (2) substantially different databases were used to evaluate the two criteria. The Nicas and Neuhaus model is expanded to allow for differences in WPF distributions for different types of HFAPR and different contaminants and for separately estimating within-wearer variation and variation due to measurement error. Appropriate statistical methods are illustrated for implementing these models when some of inside-the-respirator measurements are nondetects. Results from applying this expanded model to two new WPF studies suggest that an APF of 10 would be sufficiently protective in these studies using the OSHA criterion but more marginally so using the Nicas and Neuhaus criterion.

Accidental needle sticks, the Occupational Safety and Health Administration, and the fallacy of public policy

BACKGROUND

Current Occupational Safety and Health Administration (OSHA) guidelines mandate the use of safety needles when allergy injections are given. Safety needles for intradermal testing remain optional. Whether safety needles reduce the number of accidental needle sticks (ANSs) in the outpatient setting has yet to be proven.

OBJECTIVE

To determine the rate of ANSs with new (safety) needles vs old needles used in allergy immunotherapy and intradermal testing.

METHODS

Allergy practices from 22 states were surveyed by e-mail.

RESULTS

Seventy practices (28%) responded to the survey. Twice as many ANSs occurred in practices giving immunotherapy when using new needles vs old needles (P < .01). The rate of ANSs was roughly the same for intradermal testing with new needles vs old needles.

CONCLUSIONS

These findings further question whether OSHA's guidelines for safety needle use in outpatient practice need revision and if allergy practices might be excluded from the requirement to use safety needles.

A university hospital's 10-year experience with tuberculin testing: value of the 2-step tuberculin skin test

BACKGROUND

The usefulness of the 2-step tuberculin skin test as a tool for monitoring tuberculosis exposure among health care workers is controversial.

OBJECTIVES

We aimed to determine the cost-effectiveness and influence of initiation of a preemployment, 2-step tuberculin skin-testing program on the annual tuberculin skin conversion rate among a university hospital's health care workers.

METHODS

The tuberculin skin test conversion rates among the recipients of 31,729 tuberculin skin tests over 10 years were retrospectively analyzed. Data from the first 6 years of this study were generated when a single preemployment tuberculin skin test was utilized. Data from the last 4 years were gathered after the advent of a preemployment 2-step program. A cost analysis of the 2-step tuberculin skin test process was performed to determine the annual cost of this program.

RESULTS

Relative risk of a conversion was 8.43 times less during the 2-step period when compared with the years when a single tuberculin skin test was given at the start of employment (P < .001). A cost analysis showed that the annual added cost of the 2-step program was approximately 9,565 US dollars.

CONCLUSION

A greater than 8-fold reduction in the number of annual tuberculin skin test conversion coincided with, but could not be attributed solely to, the initiation of a 2-step program in our hospital. The Infection Control Committee concluded that the 2-step testing program is essential to achieve the hospital's goal of a 0% annual tuberculin skin test conversion rate and that the annual cost is justified.