Document DRrKm5NDeZdjLz3X8ya7pEdd

AMERICAN OCCUPATIONAL MEDICAL ASSOCIATION 150 NORTH WACKER DRIVE CHICAGO, ILLINOIS 60506 OSHA ISSUES APPENDICES TO LEAD STANDARD; OUTLINES MEDICAL SURVEILLANCE Three appendices elaborat ing on t he Occupat ional Saf et y and Healt h Administ rat ion's lead st andard, and giving medical surveillance guidelines, were published in t he Federal Regist er on Oct ober 23 (pp. 60980-60995). According t o OSHA, t he appendices provide addit ional informat ion and are not int ended t o creat e any obligat ions not ot herwise imposed by t he st andard. It should be not ed, how ever, t hat employers are provided 60 days from publicat ion before t hey must comply wit h requirement s based on t he appendices. The main provisions of t he lead st andard, which ult imat ely lowers permissible worker exposure to 50 pg/ m'3 of air averaged over an eight -hour workday, have been in effect since March 1, but t hose governing engineering and work pract ice cont rols, and some ot her minor provisions, have been st ayed pending j udicial review. Appendix A ident ifies t he various met al compounds covered and t heir uses and lists permissible worker exposure limit s, ways in which t he met al ent ers t he body, and out lines t he damage caused t o reproduc t ive, nervous and ot her body systems by)Overexposure. Appendix B is a summary for employees which spells out key provisions of t he st andard such as monit oring requirement s, medical surveillance, medical removal prot ect ion, informat ion and t raining, and employers' responsibilit ies, as well as exposure limit s. (. Appendix C, det ails a program of biological monit oring and medical surveillance t o be made available t o all employees exposed t o lead above t he act ion level of 30 gg/ m3 TWA (t ime-weight ed average) for more t han 30 days each year. This program consist s of periodic blood sampling and medical evaluat ion to be performed on a schedule which is defined by previous laborat ory result s, worker complaint s or con cerns, and t he cl inical assessment of t he examining physician. . Medical guidelines for t he t emporary removal of an exposed employee and his or her subsequent ret urn t o work in an exposure area are an import ant part of Appendix C. Under t he st andard's ult imat e worker removal crit eria, a worker is t o be removed from any work having any eight hour TWA exposure to lead of 30 pg/ m'3 or more whenever eit her of t he f ollowing circumst ances apply: (1) a blood lead level of 60 pg/ 100 g or great er is obt ained and confirmed by a second f ollow-up blood lead level performed wit h in t wo weeks aft er t he employer receives t he results of t he first blood sampling test, or (2) t he average of t he previous t hree blood lead det erminat ions or t he average of all blood lead det erminat ions conduct ed during the previous six mont hs, whichever encompasses t he longest time period, equals or exceeds 50 pg/ 100 g. An except ion applies when an employee's last blood sample indicat es a blood lead level at or below 40 pg/ 100 g. During t he first t wo years t hat t he ult imat e removal crit eria are being phased in, t he ret urn crit eria have been set t o assure that a worker's blood lead level has subst ant ially declined during t he period of removal. From March 1, 1979, t o March 1, 1980, t he blood lead level requiring employee medical removal is 80 pg/ 100 g. Workers found t o have a confirmed blood lead at t his level or great er need Workers so removed are to be ret urned to work when t heir blood lead levels are at or below 60 pg/ 100 g of whole blood. From March 1, 1980 t o March 1, 1981, the blood lead level requiring medical removal Is 70 pg/ 100 g. During t his period workers need only be removed from Jobs having a daily 8 hour TWA exposure to lead at or above 50 pg/ m^ and are t o be ret urned t o work when a level of 50 pg/ 100 g is achieved. Beginning March 1, 1981, return depends on a worker's blood lead level declining to 40 ug/ 100 g of whole blood. Recommendations of the examining physician may be more st ringent t han the specif ic provisions of the st andard. The physician is given broad f l exibil it y t o t ailor special prot ect ive procedures to the needs of individual employees. The physical examinat ion should emphasize t he neurological, gast roint est inal, and cardiovascular systems. The following laborat ory st udies are required: (1) blood lead level; (2) hemoglobin and hemat ocrit det erminat ions, red cell indices, and examinat ion of t he peripheral blood smear t o evaluat e red blood cell morphology; (3) blood urea nit rogen; (4) serum creat inine; and (5) rout ine urinalysis wit h microscopic examinat ion. The zinc prot oporphyrin test, which measures an ad verse met abolic effect of lead and as such is a better indicat or of lead t oxicit y t han t he level of blood lead It self, is not required due t o pending lit igat ion. Because of its relat ively recent development and t he lack of ext ensive dat a concerning its interpret at ion, t he ZPP current ly remains an ancillary test. Prophylact ic chelat ion is prohibit ed and diagnost ic and t herapeut ic chelat ion are permit ted only under t he supervision of a licensed physician wit h appropriat e medical monit oring in an accept able cl inical set t ing. Copies of t he st andard and the appendices are available wit hout charge by writ ing or call ing t he OSHA Of f ice of Publicat ions, Room S-1212, U. S. Dept , of Labor, Washingt on, DC 20210; t elephone: (202) 523- 6138. OSHA CLARIFIES EXTENT OF MEDICAL REMOVAL PROTECTION UNDER LEAD STANDARD > The medical removal prot ect ion provisions of t he Occupat ional Saf et y and Healt h Administ rat ion's st andard for worker exposure t o lead applies t o t hose employees who, at t he time t he lead st andard became eff ect ive (March 1, 1979), were t emporarily removed from t heir obs due t o high blood lead levels. This clarif icat ion by Eula Bingham, Assist ant Secret ary of Labor and Direct or of OSHA, means that t hose employees are ent it led t o medical prot ect ion removal benefit s (no loss in pay, seniorit y, or ot her employment right s) for up to 18 mont hs. Dr. Bingham added that t his would be t he case whet her t he employer's removal crit eria were equal t o or more st ringent than t hose of t he OSHA st andard, and regardless of what benefit s or insurance t he employee received prior to March 1. NEW REGISTRY OF TOXIC EFFECTS OF CHEMICAL SUBSTANCES NOW AVAILABLE Dist ribut ion of t he first copies of the 1978 Regist ry of Toxic Effect s of Chemical Subst ances (RTECS) was made by t he Nat ional Inst it ut e for Occupat ional Saf et y and Healt h lat e in Oct ober. This publicat ion, which supersedes all previous print ed edit ions of t he Regist ry, is a compendium of t oxicit y dat a ab st ract ed from the scient if ic lit erat ure. The 1978 edit ion cont ains 124, 247 name ent ries -- 33, 929 of t hese are subst ances list ed by t heir prime names and accompanied by associat ed t oxicit y dat a; t he ot her 90, 318 name ent ries are synonyms. This represents an increase of approximat ely 7, 500 more subst ances t han were listed in t he 1977 Regist ry. The 1978 edit ion also includes, for t he first t ime, primary skin and eye irrit at ion dat a. In the 1978 Regist ry, ail subst ances are listed in alphabet ical order. Each prime name is ident if ied by a unique RTECS accession number (two letters and seven numerals) that varies direct ly wit h the alphabet ic sequence of t he name, e. g. , t oluene has a higher number than benzene. Each synonym is cross-referenced to its appropriat e prime name accession number. For each such number t he f ollow ing dat a are provided when available: the subst ance prime name and synonyms; CAS number; molecu-