Document YjkV92wOrM5z1g21L2mqzbL0O

TEN 7991 71:0001 TCI MEDICAL MANUAL PAGE TAB SECTION 71 - STANDARDS Preamble ............................................... ........................................................................... 71:0101 Digest of OSHA-Medical and Environmental Surveillance Requirements ................................................................................................................ 71:1001 Standards: General - Adopted Air Contaminants (29CFR1910.1000) .................................................................. 71:2101 Access to Employee Exposure and Medical Records (29CFR1910.20) ....................................................................................................... 71:2201 Rules of Agency Practice and Procedure Concerning OSHA Access to Employee Medical Records (29CFR1913.10) ........................ 71:2207 Medical Services and First Aid (29CFR1910.151) ................................. 71:2401 Personal Protective Equipment (29CFR1910 Subpart I) ........................ 71:2601 Carcinogens - "The OSHA Cancer Policy" - Identification, Classification, and Regulation of Potential Occupational Carcinogens (29CFR1990) ..................................................................................... 71:2701 Standards: Specific - Adopted Asbestos (1910.1001) .............................................................................................. 71:4101 4-Nitrobiphenyl (1910.1003) ................................................................................ 71:4121 alpha-Naphthylamine (1910.1004) ....................................................................... 71:4131 bis-Chloromethyl ether (1910.1008) .............................................................. 71:4151 beta-Naphthylamine (1910.1009) ....................................................................... 71:4161 Benzidine (1910.1010) ............................................................................................... 71:4171 Vinyl Chloride (1910.1017) ................................................................................ ' 71:4201 Arsenic (1910.1018) ................................................................................................... 71:4301 Lead (1910.1025) ........................................................................................................ 71:4401 Benzene (1910.1028) ................................................................................................... 71:4501 Acrylonitrile (1910,1045) ..................................................................................... 71:4601 Noise (1910.95) ............................................... ............................................................. 71:4701 03-31-81(3)(R) TEN 7992 71:0002 TCI MEDICAL MANUAL TAB SECTION 71 - STANDARDS (Cont'd.) Standards: Proposed Hazards Identification (Labeling Standard) (29 CFR Part 1910) ............................................................................ Mercury Guidelines - NIOSH Criteria Document (# HSM73-11024) ............................................................. PAGE 60A(B01-18) TEN 7993 71:0101 STANDARDS PREAMBLE This Tab Section will contain, almost exclusively. Health Standards appli cable under the Occupational Safety and Health Act of 1970 (OSHA), promulgated and enforced by the Department of Labor. Occupational health standards or regulations promulgated under other federal statutes (TSCA, etc.) and enforced by HEW, DOL, or other agencies may be also included if deemed to be relevant and appropriate. Examples of the latter might be the Rule under Section 8(e) of TSCA (which is under EPA of HEW) on the Reporting of Substances Presenting a Substantial Risk to Health or Environment; or the proposed Rule on Access to Medical Records, under OSHA. Copies of Safety Standards or Environmental Standards under OSHA will generally not be incorporated, as these are usually more appropriately addressed by Industrial Hygiene or Safety and these sources may be consulted for copies or information. However, certain topics or standards of particular importance will be noted in this section. Examples of this type of standard would be those on Personal Protective Equipment, Sanitation, Ventilation, etc. On the other hand, a standard in this category may be included. Representative of this would be the current Noise Standard (29CFR1910.95) and the proposed revision, because of the prime importance of the medical implications and requirements of this standard. Of course, copies of or reference to any standards of relevance or signi ficance can and should be obtained via the Federal Register, the Occupa tional Safety and Health Reporter (published by the Bureau of National Affairs) and other related publications. Assistance can be provided by the Corporate Medical Department, the TCI or other library, and other available sources. Occupational safety and health standards adopted under the Occupational Safety and Health Act and enforced by the Labor Department appear in Title 29, Chapter XVII, Part 1910 of the Code of Federal Regulations (CFR). The standards are subdivided into 20 subparts--A through Z--with some sections reserved. Subpart Z was added for standards relating to toxic and hazardous substances. Pertinent OSHA Standards may also appear in other parts of the CFR. For example, the proposed "Generic Carcinogen Standard" - "Identification, Classification, and Regulation of Certain Toxic Substances" has been placed in a newly created Part 1990 to be added to the CFR; Recordkeeping and Reporting of Occupational Injuries and Illnesses is in 29 CFR Part 1904; and certain administrative rules pertaining to OSHA are in 29 CFR Part 1913, etc. Still other standards from other laws have been adopted and are enforceable under OSHA, and occasionally one may want to consult them. Some of these are Construction Safety Standards (Title 29, Chapter XVII, Part 1926 of the Code of Federal Regulations with Subparts A through X); Longshore Safety Standards (29 CFR Parts 1915, 1916, 1917, 1918); Public Contracts Acts Standards, e.g., Walsh-Healey (CFR, Title 41, Chapter 50 Part 50-204); Coal Mine Standards (CFR Title 30, Chapter I, Subchapter 0); etc. TEN 7994 71:0102 In addition to OSHA Standards (Final or Proposed), certain OSHA Advance Notice of Intended Rulemaking or Guidelines, NIOSH Regulations, Guidelines or Requests for Information may be included in this Section if felt to be of sufficient import at that stage. The first Subsection consists of the most current edition of the Digest of OSHA Medical and Environmental Surveillance Specifications published by Occupational Health Associates, Pittsburgh, Pennsylvania. This digest compiles, selects, summarizes, and consolidates information from all adopted and proposed OSHA Standards and NIOSH Criteria Documents. The required or recommended medical and environmental surveillance, studies, values, etc., recordkeeping provisions, and communications are organized and listed in a concise, brief format for ready reference. The digest presents a ready reference on these health regulations in a form that can be readily used by in-plant medical personnel, outside medical personnel, plant management, personnel functionaries, etc. with savings in time and effort and the enhancement of administrative efficiency. Revised editions of this resource will be published periodically. These initially are included in all manuals. However, revisions will automatically be supplied only to "key" holders of the Medical Manual. This will consist of all In-House and Contract Medical Personnel and at least one to each TCI location. Others who find this useful and wish to receive this service should contact the Corporate Medical Office at Saddle Brook. The Standards Section will be subdivided into at least three other Sub sections. These will be (1) Standards: General - Adopted, (2) Standards: Specific - Adopted, and (3) Standards: Proposed. The Standards: General - Adopted Subsection will contain complete copies or reference to standards of broad, general or basic application to most workplaces; such as Air Contaminants, Occupational Noise Exposure, Personal Protective Equipment, Sanitation, Medical and First Aid, etc. Generic Standards will be included in this Subsection after final promulgation. The Standards: Specific - Adopted Subsection will provide copies of stan dards or regulations which have been promulgated, as distinguished from proposed, by OSHA and are applicable to specific substances, processes, or workplaces. The Standards - Proposed Subsection will contain important, "benchmark," or standards with broad implications while still in the proposed stage. This Subsection will also contain certain other documents such as OSHA Guidelines, NIOSH Regulations, Guidelines, or Information from Criteria Documents, etc. as noted above. Initially, all manuals issued will contain the principal standards (general and specific - adopted or proposed) that have been published by OSHA and are applicable to any TCI location(s). A few others will also be included as prototypes and for the information of the user(s). In the future, and for the most part, adopted or certain proposed standards will only be sent as applicable to the specific location(s) and/or appropriate site or personnel involved. Every effort will be made to provide these on a timely basis, but this should not be construed as obviating site management and other personnel of their responsibilities in regard to the various regulations. TEN 7995 71:0103 Scope and Application of a Standard Some standards developed under OSHA or corresponding state laws are applicable to individual hazards or exposures; others apply to a group of related hazards or exposures. Both types of standards may be applicable to some plants and workplaces and not to others. Many standards begin with a paragraph titled "Scope and Application" which is written in very specific terms. In other standards this paragraph may not be included and scope and application must be discerned from the context. Each member of a plant medical staff should know the scope and text of the standards which are applicable to the workplaces and the employees which that medical staff serves. Exposure Limits OSHA standards for occupational exposure to toxic substances define as precisely as possible the limits of exposure to which an employee may be subjected within a given period of time. The limit is expressed as a Permissible Exposure Limit (PEL) or as a "Time-Weighted Average" (TWA), which indicates the allowable exposure averaged over a given number of hours, usually eight. In certain toxic substance standards, employee exposure is also limited by a level not to be exceeded--Maximum Allowable Concentration (MAC), or a Ceiling Concentration (C) not to be exceeded at any time. The Medical staff should also be familiar with the "Action Level" defined by an OSHA Standard. The term "Action Level" is used to indicate a measured level of the presence of a certain toxic substance at which some kinds of protective action, usually including medical surveillance and recordkeeping, is required to be taken by the employer. The Action Level is usually one-half the PEL. Medical Examinations Some OSHA Standards require that medical examinations be conducted either before or when an employee is assigned to a job involving exposure to a particular toxic substance or material. In addition, periodic examination may be required in order to maintain medical surveillance of the health of employees working on such affected operations. The full implementation of these requirements of an OSHA standard is the responsibility of the plant physician and those working under his supervision. OSHA Standards frequently specify procedures to be included in the medical examination. The standards do not prohibit additional procedures, but specify the minimum. These medical examination procedures or studies are identified in specific standards incorporated in this Standards Section 71 and as outlined in the Protocol Section - 61 of this Manual. Other requirements of OSHA Standards for medical personnel to be familiar with are medical records, information required to and from the physician, the physician's statement of employee suitability, training, protective clothing and equipment, and OSHA/NIOSH inspection procedures. These are detailed in appropriate standards. (24-W)B10-12 10/23/79 TEN 7996