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HAZARD COMMUNICATION Hazard Communication # 1

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1 HAZARD COMMUNICATION Hazard Communication # 1
Course Title: Hazard Communication Presentation Time: 8 Hours This training has been developed to address the requirements of 29 CFR , which requires that training be provided when a new hazard is introduced, not a new chemical. Employees exposed to a limited number of chemicals may receive training that addresses each chemical to which they are exposed; employees exposed to a large number of chemicals or employees in work areas where the chemicals change more frequently should receive training that addresses each hazard. The Hazard Communication Standard is based on a simple concept - that employees have both a need and a right to know the hazards and identities of the chemicals they are exposed to when working. Employees also need to know what protective measures are available to prevent adverse effects from occurring. This training is designed to provide VA employees the information they need. Note: The training should include a “walk-around” the facility so that the locations and safety features of the VAMC associated with flammable liquid storage (such as flammable liquid storage cabinets, inside storage rooms, and cut off rooms) are pointed out and discussed with the participants. # 1

2 Introduction Objectives Purpose
To increase knowledge of hazardous chemicals in the workplace To reduce the number and severity of accidents, injuries, and illnesses resulting from chemicals To increase understanding of protective measures required by exposure to hazardous chemicals Purpose To provide information required to work safely with chemicals To comply with requirements of 29 CFR , Hazard Communication Standard This slide lists the purpose and the objectives for this training. The presenter should revise this slide to emphasize any purpose or objectives that are facility specific. The effectiveness of hazard communication training is directly related to the attitude and ability of the person presenting the information to the workers. The presenter should convey the impression that this training is important and necessary, or the program will not be effective. OSHA Hazard Communication Standard (in Appendix E) says, “For any safety and health program, success depends on commitment at every level of the organization. This is particularly true for hazard communication, where success requires a change in behavior. This will only occur if management officials understand the program and are committed to its success, and if employees are motivated by the people presenting the information to them.” # 2

3 Purpose of Hazard Communication Standard (29 CFR 1910.1200)
To ensure that the hazards of all chemicals produced or imported are evaluated To ensure that comprehensive material safety data sheets (MSDSs) are developed by the manufacturer or importer for every hazardous chemical To ensure that information concerning the hazards associated with hazardous chemicals is transmitted to employers and employees OSHA Hazard Communication Standard achieves its purpose by an integrated program consisting of three parts. First, chemical manufacturers and importers must review available scientific evidence concerning the physical and health hazards of the chemicals they produce or import to determine if the chemicals are hazardous. Second, for every chemical found to be hazardous, the manufacturer or importer must develop comprehensive material safety data sheets (MSDSs) and warning labels (for containers) and provide both of these to the users of the chemicals. Third, all employers must develop a written hazard communication program and provide information and training to employees about the hazardous chemicals in their workplace. Because there are so many chemicals used in modern healthcare, it is impossible to provide detailed training for all of those chemicals. For this reason, it is important that all employees review the manufacturer’s literature (labels, material safety data sheets, etc.) for the chemicals in the workplace. Employees should contact their supervisors or other appropriate facility personnel, if they have any questions concerning the chemicals they use. # 3

4 Goals of the Hazard Communication Standard
Reduce exposures Substitute less hazardous materials Establish proper work practices Prevent work-related illnesses and injuries caused by chemicals The goals of OSHA Hazard Communication Standard are listed on this slide. No one person or group (particularly the safety office) can ensure that these goals are achieved. It is the responsibility of the persons working with the chemicals and their supervisors to ensure that they are aware of: (1) the hazards associated with the chemicals being used, and (2) the proper work practices, including protective actions. Completing this training by itself will not ensure that these goals are met. All employees working with chemicals must read the labels and material safety data sheets (MSDSs), must consult employee health personnel concerning the health hazards associated with the chemicals, and must follow safe work procedures at all times. When new chemicals are introduced or the chemicals are used differently, employees must ensure that they have reviewed the labels, MSDSs, etc., to assure that they understand the precautions associated with the new chemical or procedure. # 4

5 Scope Chemical manufacturers, importers - Assess hazards of chemicals
Distributors - Transmit required information to employers Employers - Provide information to their employees about the hazardous chemicals to which they are exposed This slide summarizes the scope of the Hazard Communication Standard. The most important portion of the scope is that the employer is required to provide information to the employees about the hazardous chemicals to which the employees are exposed. This training is a portion of the information required to be provided. The information given on the label, on the MSDS, and provided by employee health personnel is critical to the employees. It is provided by the VA in an effort to comply with the purpose of this standard. OSHA Interpretation, dated March 31, 1989, states that office workers who encounter hazardous chemicals only in isolated instances are NOT covered by the Hazard Communication standard (see Appendix A). Intermittent or occasional use of a copying machine does NOT result in coverage under the standard. The Hazard Communication standard is performance oriented. If any material (e.g., consumer products) causes serious injury or illness or has the potential to cause such injuries or illnesses, then that material (chemical substance) must be addressed by the Hazard Communication program. Employers must be careful since a product used at work may result in a significantly greater exposure than when used at home. OSHA Interpretation, dated March 21, 1995, clarifies the criteria used by OSHA when using the Hazard Communication Standard to cite an employer for exposure to consumer products (see Appendix A). # 5

6 Related Regulations FIFRA (Federal Insecticide, Fungicide, and Rodenticide Act) - Pesticides TSCA (Toxic Substance Control Act) - Toxic Substances FFDCA (Federal Food, Drug, and Cosmetic Act), Virus-Serum Toxin Act of Food, food additives, color additives, drugs, cosmetics, or medical or veterinary devices or products, including ingredients in such products (e.g., flavors, fragrances) Federal Alcohol Administration Act - Distilled Spirits SWDA (Solid Waste Disposal Act) - Hazardous Waste This slide and the next one list related regulations that apply to hazardous materials. They are included in this presentation for information purposes only. Attendees should be aware of these related regulations and the fact that they could impact specific hazardous materials. It is outside the scope of these training to address specific requirements of these regulations. Attendees who work with the chemicals addressed by these regulations may be required to complete training specific to the chemicals listed. Slides 6 and 7 could be deleted, if the presenter feels that the attendees will not be required to know this information and the information on these slides will not be of interest to them. # 6

7 Related Regulations (Contd.)
Consumer Product Safety Act and Federal Hazardous Substances Act - Consumer Products or Hazardous Substances Federal Seed Act - Agricultural or Vegetable Seeds Treated with Pesticides CERCLA (Comprehensive Environmental Response, Compensation and Liability Act) - Hazardous Substances Slides 6 and 7 could be deleted, if the presenter feels that the attendees will not be required to know this information and the information on these slides will not be of interest to them. # 7

8 Hazard Communication: Program Elements
Written Program Hazardous Chemical Inventory Training Labeling MSDS (Material Safety Data Sheet) Documentation Program Maintenance This slide introduces the elements of a facility level hazard communications program [29 CFR (e)]. Each facility should have a hazard communications program that addresses each of the elements listed. A copy of the facility’s program or appropriate portions of the program should be handed out. The presenter should discuss applicable portions. # 8

9 Written Program Insert date of facility written program
Insert how to obtain copies of the written program Insert who to contact to propose changes to the written program Hazardous Chemicals Brought on Site By Contractors, etc. Contracts require submission of MSDSs Insert facility contact The presenter must revise this slide so that facility specific information is included. Presenters are encouraged to provide attendees a copy of the facility’s program or portions of the program that will be discussed during the training. Written hazard communication programs must address: labeling [29 CFR (f)]; material safety data sheets [paragraph (g)]; employee information and training [paragraph (h)] methods the employer will use to inform employees of the hazards of non-routine tasks and the hazards associated with chemicals contained in unlabeled pipes in their work areas. hazardous chemicals that are used throughout the facility. See Appendix B for an example of a Hazard Communication Program developed by a VA medical center. # 9

10 Hazardous Chemical Inventory
A list of hazardous chemicals known to be present May be compiled for the workplace as a whole or for individual work areas Identified in accordance with appropriate MSDS Required to be part of the written program 29 CFR (e)(1)(i) requires that a hazardous chemical inventory be included in the written hazard communication program of the facility. At a minimum, this inventory should address the presence in the facility of any chemicals that are either listed in 29 CFR , or in the American Conference of Government Industrial Hygienist’s (ACGIH’s) Threshold Limit Values. A copy or appropriate portions of the facility’s hazardous chemical inventory should be provided to attendees and discussed by the presenter. If the training is provided to specific groups of employees (e.g., dietetics), that portion of the hazardous chemical inventory most appropriate for the attendees should be provided and discussed. See Appendix B for an example of a hazardous chemical inventory developed by a VA medical center. OSHA Interpretation, dated August 5, 1994, clarifies the requirements concerning the list of hazardous chemicals (see Appendix A). # 10

11 Training Initial assignment Whenever a new HAZARD is introduced
By chemical (if few chemicals are used) By hazard (if many chemicals are used) Whenever a new HAZARD is introduced Employers are required to provide employees with information and training on hazardous chemicals in the work area: (1) at the time of the initial assignment (before being exposed to the hazard(s) presented by the chemical); and (2) whenever a new HAZARD is introduced into their work area. Hazard communication training can either address each chemical to which employees are exposed; or the hazards to which employees are exposed. When chemicals change frequently, it may be more appropriate to train employees to control the hazards associated with the chemicals used, rather than addressing individual substances. For instance, if a new chemical is flammable and the employer has already trained employees concerning flammability, no retraining is required. If a new chemical is carcinogenic, and that hazard was not addressed in the employer’s training, then retraining is required. # 11

12 Labeling Requirements Requirements (Contd.) Voluntary
Each container must be labeled, tagged, or marked Legible Prominently displayed Identity of chemical Appropriate hazard warnings Requirements (Contd.) Name and address of chemical manufacturer, importer, or other responsible party Voluntary Emergency telephone numbers First aid procedures Leak and spill procedures The presenter should have examples of labels used throughout the facility. This could be accomplished by slides, photographs, or the actual containers. If containers are used, presenter should ascertain that the containers are empty and safe to be handled by attendees. Labels are not intended to include all information either on the properties of a chemical, or details for handling it under various conditions. Such information is more appropriately provided through other means, such as MSDS, technical bulletin, training, or other communication intended to enhance and supplement the label. Chemical manufacturers, importers, and distributors [29 CFR (f)(1)] and the employer [29 CFR (f)(5)] must comply with labeling requirements. Chemicals can be identified by a common or trade name; or a chemical name. There are no specific requirements for size, color, or any specified text. The most important aspect associated with labeling of chemicals is that employees should periodically read the label. For products that are being shipped, label is certain the only source of information for people handling the container. Therefore, the label must provide enough information, so that special training is not required. Where only sealed containers are handled (warehouses or loading docks), it is not necessary to have access to the MSDS. OSHA Interpretation, dated June 14, 1993, clarifies labeling requirements of hazardous chemicals (see Appendix A). # 12

13 Labeling Exceptions Portable containers into which hazardous chemicals are transferred from labeled containers intended for immediate use by employee who transfers chemicals Drugs dispensed by pharmacy to healthcare provider for direct administration to patient If any chemical is transferred from a manufacturer’s original labeled container to another container; the second container must be labeled appropriately unless it comes under the exceptions listed on this slide. The presenter should review the facility policies associated with labeling of containers (both as provided by the manufacturer and as repackaged by personnel at the facility). Precautionary labels are neither intended to include all information on the properties of a chemical, nor the complete details of its handling under all conditions. This training package only addresses manufacturer’s labels. The presenter should discuss responsibilities for labeling of facility containers, for accepting shipments of containers of chemicals, and any facility labeling system or procedure implemented. Any facility specific labeling program should be addressed by additional slides or additional training, as appropriate. Facility labeling systems will be judged during compliance inspections in the context of the effectiveness of the entire hazard communication program. . # 13

14 Labeling NOT Required Pesticides Tobacco or tobacco products
Food or alcoholic beverages (sold, used, or prepared in a retail establishment) Wood or wood products Drugs or cosmetics Ionizing and non-ionizing radiation Biological hazards The hazard communication standard (29 CFR ) does not apply to labels for the materials listed on this slide. # 14

15 Labeling Systems National Fire Protection Association (NFPA) - Fire diamonds Red - Fire Hazard Blue - Health Hazard Yellow - Reactivity White - Special information Higher the number, the more hazardous the chemical Hazardous Materials Identification System (HMIS) - Rectangular with horizontal strips Copyright of the National Paint and Coating Association Similar to NFPA White - Letters designate personal protective equipment (ppe) Container labels include information on the potential hazards of a chemical; proper use, storage and handling procedures; and safe work practices. This information is important for the decisions an employee makes concerning the use of the chemicals and the work practices to follow. By reading the label an employee will have the knowledge needed to make the right decisions concerning how to handle the chemical in the workplace. Labeling systems have been created by different industries to meet their needs. This presentation addresses the four most widely used labeling systems: National Fire Protection Association (NFPA) Hazardous Materials Identification System (HMIS) American National Standards Institute (ANSI) Department of Transportation (DOT) system NFPA is concerned with identifying the flammability and reactivity of a substance for emergency response. All labels are required to include the identity or the name of the chemical, physical or health hazard warnings, and the name and address of the manufacturer or importer. The number assigned represents the degree of hazard. Zero or one means no or minimal hazard and a four represents a high or severe hazard. Personal protective equipment is generally required when a two, three, or four appears in any of the label’s sections. See NFPA’s Recommended System for the Identification of the Fire Hazards of Materials (NFPA 704) # 15

16 Labeling Systems (Contd.)
Department of Transportation Color-coded diamonds Red - Flammable liquid or gas Orange - Explosive Green - Compressed gas Black and white - Corrosive Yellow - Oxygen or oxidizer base Yellow and white - Radioactive White - Toxic or poison gas Attached to hazardous materials being shipped Includes a four digit number (the United Nations identification code) American National Standards Institute (ANSI) Upper Left Side DANGER WARNING CAUTION The DOT labeling system is intended to clearly identify the potential hazards of chemicals being transported from one place to another and are often seen on trucks. The key words on the diamond represent the hazard class created by DOT that best identifies the hazard. The number at the bottom of the diamond represents the hazard class or division (NOT the degree of the hazard). Department of Transportation also uses: Blue Reactive Red Striped Solid - Flammable Red Spontaneously Combustible The ANSI labeling system uses words to identify the level of the hazard. DANGER Serious hazard WARNING Less hazardous, but still severe CAUTION Moderate hazard, but still of concern Other sections of the ANSI label list the physical and health hazards, including the target organ effects; first aid measures; storage requirements; and procedures in case of a spill or fire. The ANSI label often contains the DOT diamond. The American National Standards Institute’s (ANSI’s) Standard for Precautionary Labeling (Z129.1) includes guidance for labeling that complies with OSHA’s Hazard Communication Standard. # 16

17 Material Safety Data Sheets (MSDSs)
Manufacturers and importers must obtain or develop an MSDS for each hazardous chemical they produce or import Employers shall have an MSDS in the workplace for each hazardous chemical which they use (29 CFR (g)) Material safety data sheet (MSDS) is a written or printed material describing a hazardous chemical in accordance with 29 CFR (g). See Appendix C for examples of material safety data sheets discussed in this training. Separate requirements apply to (1) manufacturers, importers, and distributors and to (2) employers. There is no specified format for MSDS. OSHA has developed a non-mandatory format, OSHA Form 174 (see Appendix D). MSDSs must be readily accessible to employees when they are in their work areas during their workshifts. The presenter should discuss how the facility has made MSDSs accessible to the attendees. If MSDSs are computerized and employees are expected to obtain access to the MSDSs via computer, training should be provided so that the attendees can access the MSDS computer database. Electronic access, microfiche, and other alternatives to maintaining paper copies of the MSDSs are permitted as long as such options do not pose any barriers to employee access in each workplace. OSHA Interpretation dated, May 15, 1997, clarifies the requirements for MSDSs (see Appendix A). See Appendix D for: (1) Portions from OSHA 3104, Hazard Communication A Compliance Kit - Material Safety Data Sheet (MSDS), Material Safety Data Sheet Checklist, OSHA 174, OSHA-7, and MSDS Glossary; (2) Portions of OSHA Technical Manual on Chemical and Physical Agents; (3) Hazardous Material Labeling Chart - DOT; (4) Hazardous Material Placarding Chart - DOT. # 17

18 MSDSs (Contd.) General Information Ingredients Name of chemical
Name and address of manufacturer Emergency telephone number Date of preparation and review Ingredients Listed by percentage of content OSHA permissible exposure limit ACGIH threshold limit value CAS Number Note: Several MSDSs are included in this training package (see Appendix C). Presenters may discuss all of them as part of this training, or they may select only those that are specific to the needs of the attendees. If attendees need information concerning the “Ingredients” section of the MSDS, particularly those listed below, they should contact the facility Occupational Safety and Health Office: It is important to remember that the attendees for this training are not required either to understand the technical concepts associated with the information found on the MSDS, or with the 29 CFR ; however, they are required to recognize hazards associated with the chemicals they work with as well as the actions and the equipment required to protect themselves. Permissible Exposure Limit: The level of exposure above which no employee is exposed (time-weighted average concentrations that must not be exceeded during any 8-hour work shift of a 40-hour workweek). Threshold Limit Value: Generally 8-hour time-weighted average concentrations not to be exceeded as recommended by the American Conference of Governmental Industrial Hygienists (ACGIH). CAS Number: CAS (Chemical Abstracts Service) assigns scientific designations and numbers for chemicals in accordance with a nomenclature and numbering system for the purpose of conducting a hazard evaluation. # 18

19 MSDSs (Contd.) Physical/Chemical Characteristics
Appearance and odor Physical data Fire and Explosion Hazard Data Extinguishing media Disposal Data Reactivity Conditions to avoid Materials to avoid Transportation Data DOT requirements Labeling for shipping Label Data Signal word (e.g., Danger) Special precautions This slide lists information that is commonly provided as part of the MSDS. Limitations of MSDSs: MSDSs serve a multitude of purposes, being directed to employees, health professionals, and communities. Language is sometimes too technical to properly communicate the necessary information, even though OSHA recommends that the reading level of MSDS be appropriate for a worker (generally at a sixth to eighth grade reading level). The format of MSDS often “buries” the information that is of most concern to workers (such as hazard information and protective measures). Note: A complete discussion of all sections of the MSDS for isopropyl alcohol is included on slides For the rest, only the general information and the health hazards listed on the MSDS are addressed as part of this training. (See Introduction, page iv). # 19

20 MSDSs - Health Hazards Routes of entry Health hazards Carcinogenicity
Acute Chronic Carcinogenicity Signs/symptoms of overexposure Emergency/first aid Medical conditions aggravated by exposure Spill response Waste disposal Storage requirements Other precautions The Health Hazards section of the MSDS addresses health hazards associated with the chemical. The information contained in this section is subjective and often not based on adequate testing. The terms “acute” and “chronic” are used to delineate between health effects on the basis of severity or duration. Acute health effects usually occur rapidly as a result of short-term exposures and are of short duration. Acute health effects, such as irritation, corrosivity, sensitization, and lethal dose, do not adequately cover the considerable range of acute effects which may occur as a result of occupational exposure. Chronic health effects generally occur as a result of long-term exposure, and are of long duration. Chronic health effects, such as carcinogenicity, teratogenicity, and mutagenicity, do not adequately cover the area of chronic effects. Attendees should be reminded to discuss any health effects associated with chemicals that they use with employee health personnel or facility safety and health personnel. Carcinogen describes a chemical evaluated and determined to cause or potentially cause cancer. # 20

21 MSDSs - Control Measures
Respiratory Protection Ventilation Protective Gloves Eye Protection Other Protective Equipment Hygienic Work Practices Supplementary Safety and Health Data The Control Measures section of the MSDS addresses control measures associated with the chemical. It is the VA and facility policy that all control measures recommended by the chemical manufacturer be followed. Attendees should be familiar with the specific control measures associated with the chemicals they use. # 21

22 Other Considerations Procedure to follow when chemicals are delivered to the facility and an MSDS is not provided/available Procedure to update the facility’s list of chemicals This slide should be revised by the presenter to address facility specific procedures to be followed : when chemicals are delivered and an MSDS is not included when MSDS is not available at the facility when a chemical not included on the facility chemical inventory is identified as necessary for use at the facility # 22

23 Laboratory Requirements
Labels on incoming containers of hazardous chemicals must not be removed or defaced MSDSs for hazardous chemicals must be maintained MSDSs must be readily accessible to laboratory employees during each workshift Appropriate information and training must be provided A written hazard communication plan is NOT required for laboratories; however, a chemical hygiene plan is required. A separate training program for laboratory personnel has been developed by the Employee Education System Little Rock Center. OSHA Hazard Communication Standard limits coverage of laboratories by simply requiring that: Labels be kept on containers that are received labeled, MSDSs be kept and maintained that are received and employees have access to them Employees receive training similar to that contained in this training package # 23

24 General Preventive Actions
Specific Procedures Implemented by Facility Work practices Emergency procedures PPE Reduce the hazard, substitute a less hazardous chemical, if possible Facility procedure Methods to minimize exposure Know emergency response procedures The presenter must revise this slide to list any facility procedures concerning work practices, emergency procedures, etc. Additionally, attendees should be informed of the procedures to follow if they have suggestions concerning the substitution of hazardous chemicals or ways to minimize exposure. If facility policies associated with minimizing exposure include reassignment of personnel to other tasks that do not require exposure, then those policies should be discussed here. # 24

25 Preventive Actions (Contd.)
Know the chemical with which you are working Read the label before use Review the MSDS Obtain additional training Use proper ventilation Make sure fume hoods and other safeguards are operating properly Wear appropriate PPE Handle and dispose of chemicals properly Don’t smoke, drink, use drugs, or cosmetics around hazardous chemicals Let other workers know where you are/work as a team Consult employee health or EAP, if symptoms develop Practice good housekeeping This slide continues the listing of preventive actions. Let other workers know where you are/Work as a team. Facility specific policies should be discussed. Consult employee health or EAP, if symptoms develop. Employees should be encouraged to consult employee health or the Employee Assistance Program (EAP) personnel, if appropriate. Employees should be encouraged to use these resources appropriately. It is better that health hazards are identified early, when appropriate medical care is most beneficial. The presenter may want the employee health and EAP personnel to discuss briefly the services available. # 25

26 Spill Response Procedure
Attend to any medical emergencies Isolate area Leave immediate area of spill Close windows and doors, if possible Warn others to stay out of area Notify appropriate personnel Supervisors Safety professionals Develop and implement specific clean-up procedure Consult MSDS for spill procedure, if necessary Put on appropriate PPE, if it varies from that being worn Clean up spill and area in accordance with facility and manufacturer’s guidance Dispose of cleaning materials properly This slide should be revised to address the facility’s procedure for spills. If medical care is required, attendees should be informed of the procedure to be followed to obtain such care. If emergency response personnel are to be notified, the facility’s procedure for notification should be discussed. The spill response procedure may require that workers in the area of the spill work together to assure that the impact of the spill is minimized. For instance, one worker may be required to assist an injured employee, while another worker isolates the area. # 26

27 Emergency Response Determine who notifies emergency response personnel
Sound Alarm Move to a safe area Assist the emergency response personnel Provide any technical information available Follow instructions This slide should be revised to address the facility procedure for emergency response. For instance, how do facility employees notify the emergency response personnel, who is permitted to notify emergency response personnel, etc. If a spill (or other chemical-related emergency) exceeds the response capability of the workers in the immediate area of the spill, facility emergency response procedures should be implemented. Even if the attendees are NOT part of the emergency response team, it is important that they be familiar with what happens when the emergency response personnel respond and what they (the attendees) are expected to do (e.g., vacate the area, remain nearby to assist the emergency response personnel). For instance, in an emergency situation involving ethylene oxide, self-contained breathing apparatus and full protective clothing will be required. Only emergency response personnel would have the appropriate training and access to such equipment. # 27

28 General First Aid Procedures
Promptly obtain medical help for all medical emergencies Inhalation Move to fresh air If breathing has stopped, give artificial respiration If breathing and pulse have stopped, perform CPR - if properly trained Provide oxygen Skin Immediately flush exposed skin with water Remove contaminated clothing Do NOT scrub exposed skin Do NOT apply ointments or neutralizing solutions Eyes - Immediately flush exposed eye for 15 minutes This slide and the next three slides summarize the first aid procedures that are often recommended by chemical manufacturers. The MSDS for the specific chemical should be consulted to determine the recommended first aid. All attendees should be encouraged to learn CPR. # 28

29 First Aid Procedures - Shock
Check for symptoms Clammy, pale skin Rapid, faint pulse Quick, irregular breathing Weakness or nausea Treat other injuries If unconscious, place victim on side Keep victim quiet and lying down - feet slightly elevated Cover with a blanket Do NOT move victim (unless absolutely necessary), if there is the potential for a neck or spine injury # 29

30 First Aid Procedures - Ingestion
Give water, Do NOT induce Vomiting Benzene Toluene Xylene Give Water, Induce Vomiting Acetone Formaldehyde Freon Phenol Give Salt Water, Induce Vomiting Chloroform Methyl alcohol Trichloroethylene The purpose for including this slide is to emphasize the importance of easy access to MSDSs and the need to consult MSDS to determine the proper first aid procedure to be followed. First aid procedures vary and it is not possible to memorize the procedures for all probable situations. It is important to consult the MSDS to determine the proper procedure to be followed. Time is critical in rendering first aid. If an MSDS is not available or it takes a long time to locate it, proper treatment may be delayed. # 30

31 Obtain Medical Aid Provide First Aid - Do NOT leave injured employee alone Contact Employee Health Personnel Insert Telephone Number Insert Room Number Give Water, Induce Vomiting Acetone Formaldehyde Freon Phenol Give Salt Water, Induce Vomiting Chloroform Methyl alcohol Trichloroethylene This slide should be revised to list specific information for the facility. # 31

32 Hazardous Chemical Any chemical that is a physical hazard or a health hazard A hazard is an inherent property of a chemical and exists no matter what quantity of the chemical is present Chemical: Any element, chemical compound, or mixture of elements and/or chemical compounds [29 CFR (c)]. If a hazardous chemical presents health risks to employees, the chemical is always covered by OSHA’s Hazard Communication Standard. The Hazard Communication Standard applies to any chemical that is known to be present in the workplace in such a manner that employees may be exposed under normal conditions of use or in a foreseeable emergency. Physical hazards (slides 33-60) and health hazards (slides 61-92) will be discussed in detail. There are 9 physical hazards and 14 health hazards (or a total of 23 hazards) as defined by OSHA’s Hazard Communication Standard. Each one of these hazards will be addressed in the training. These hazards are often not distinct categories and exposure to most hazardous chemicals creates several hazards. While many hazardous chemicals are also used at places other than the workplace (e.g., at home), quantities used at workplace are usually much larger and pose a different potential exposure situation than where smaller quantities are stored or used. However, the training received here is applicable to the hazards presented regardless of the location of the exposure. Radiation and biological hazards have never been considered by OSHA to be covered by the Hazard Communication Standard (they are specifically exempted by 29 CFR (b)(6)(xi) and (xii)). If a chemical presents either of these hazards and one of the hazards specifically addressed by the Hazard Communication Standard that hazard (or chemical) must be addressed by the facility’s written program and training. Radiation and biological hazards are addressed in Health Effects of Physical, Chemical, and Biological/Infectious Hazards, Employee Education System Little Rock Center. If attendees are not (and are not anticipated to be) exposed to a specific hazard, that hazard could be omitted from the training. OSHA Interpretation, dated May 15, 1997, clarifies the definition of a hazardous chemical ( see Appendix A ). # 32

33 Physical Hazards Combustible liquids Flammables Explosives Pyrophorics
Aerosols Gases Solids Explosives Pyrophorics Compressed gases Organic peroxides Oxidizers Unstable (reactive) Water-reactive A chemical is considered as creating a physical hazard, if there is scientifically valid evidence that it meets one of the requirements listed on this slide. Each of the hazards listed will be addressed in detail. Combustible and flammable liquids are examples where the distinction between physical hazard categories can be extremely close. Note: There is a technical distinction between “combustible” and “flammable” liquids. However, both classes burn readily and intensely, are explosive under certain conditions, and if not properly contained can spread fire rapidly and uncontrollably. The terms flammable, nonflammable, and combustible are difficult to delimit. Since, any material that will burn at any temperature is combustible by definition, it follows that “combustible” covers all such materials, irrespective of their ease of ignition. # 33

34 Combustible and Flammable Liquids
Combustibles (flashpoint at or above 100° F) Acetic Acid Glacial Formalin (with Methanol) Formaldehyde (37% solution) Hydraulic fluid Kerosene (Fuel Oil No. 1) Linseed Oil Mineral Oil Transformer Oil Flammables (flashpoint less than 100° F) Acetone Carbon Disulfide Ethylene Oxide Ethyl Ether Isopropyl Alcohol Methyl Ethyl Ether Toluene Turpentine Xylene This slide should be revised to list those combustible or flammable liquids that are of interest to the attendees. The presenter should have examples of the signage used to identify combustible and flammable liquids. Combustible Liquid: Any liquid having a flashpoint (the lowest temperature at which a liquid releases enough vapor to start burning) at or above 100° F but below 200° F, except any mixture having components with flashpoints of 200° F or higher, the total volume of which make up 99% or more of the total volume of the mixture (29 CFR (c)). Combustible liquids are labeled as Class II, IIIA, or IIIB; NFPA Hazard Identification Diagram: 2 or 1 in the RED block DOT Identification: COMBUSTIBLE sign. (DOT defines combustible liquids as liquids having a flash point above 80 °F.) Flammable Liquid: Any liquid having a flashpoint below 100° F, except any mixture having components with flashpoints of 100° F or higher, the total of which make up 99% or more of the total volume of the mixture [29 CFR (c)]. Flammable liquids are labeled as Class IA, IB, or IC; NFPA Hazard Identification Diagram: 4 or 3 in the RED block DOT Identification: FLAMMABLE LIQUID sign Vapors of flammable and combustible liquids are heavier than air and can spread far from the liquid itself. Fires can occur even though a liquid and the ignition source are far apart. # 34

35 Isopropyl Alcohol General Information
Quantity - Not identified Physical/Chemical Characteristics Colorless liquid Slight odor of rubbing alcohol Fire and Explosion Hazard Extinguishing agents Alcohol foam Dry chemical Carbon dioxide Water may be ineffective Reactivity - Stable This slide and the next three slides summarize the information contained on the MSDS for isopropyl alcohol (see Appendix C). A review of an MSDS can identify problems with the MSDS itself. Such problems should be addressed before working with the chemical. In this case, the MSDS does not contain an emergency telephone number. Users should contact the manufacturer to find the emergency telephone number before using this product. Isopropyl alcohol is a flammable liquid and must be stored and handled appropriately. The second MSDS for isopropyl alcohol (Atlantic Chemical) describes the odor as sweet. A user should always use an MSDS that was developed for the particular product. Because of variations in manufacturing process and composition, hazards associated with a chemical can alter significantly. Note: The discussions concerning a specific MSDS included as part of this training initiative are intended to give attendees a general overview of the chemical. Attendees should not try to memorize any of the specific information listed here. However, they should be aware of the type of information that is included on MSDSs and of where that information (e.g., MSDSs) can be obtained at the facility. All MSDSs referenced in this training package are included in Appendix C. They are arranged alphabetically by name. # 35

36 Isopropyl Alcohol (Contd.)
Health Hazard Data Carcinogenic - No Target Organs Eyes Skin Respiratory System Central Nervous System (Ingestion) Levels NOT to be exceeded 400 ppm (8 hours) 500 ppm (15 minutes) Effects of Overexposure Inhalation Nausea/Vomiting Dizziness Drowsiness Irritation of Respiratory Tract Pulmonary Edema Loss of Consciousness Skin - Dermatitis Eye - Temporary Corneal Damage This slide summarizes the health hazards associated with isopropyl alcohol and lists the effects of overexposure that may result. Employees should be familiar with the effects of overexposure of chemicals they use frequently, so that they can identify when they occur and take appropriate corrective action. Also, employees often develop conditions such as dermatitis, that are not clearly identified as the result of an “occupational” exposure. If employees are aware of the health effects of the chemicals with which they work, those effects can be identified earlier and minimized. Employees do not need to receive extensive training in monitoring or concerning concepts such as PEL (permissible exposure limits), STEL (short term exposure limits), TLV (threshold limit values), and TWA (time weighted averages); however, they should be aware that specific levels are not to be exceeded and they should be aware of the actions to take (contact their supervisor or the safety office and request that monitoring be performed), if they feel that these levels are being exceeded. # 36

37 Isopropyl Alcohol (Contd.)
Protective Equipment Ventilation - General or local exhaust Respiratory Protection - Chemical cartridge respirator with organic vapor cartridge Eye/Skin Protection - Safety goggles, uniform, apron, neoprene gloves First Aid Eyes - Flush with water for 15 minutes Skin - Flush Ingested - do not induce vomiting Inhalation Remove to fresh air If not breathing, give artificial respiration If breathing is difficult, give oxygen The information contained on this slide and the previous slide complement each other. They show how the hazard and the effects of overexposure are minimized through the use of protective equipment and first aid. It is important that attendees understand that it is the hazard that dictates what protective equipment should be used and what first aid should be given. # 37

38 Isopropyl Alcohol (Contd.)
Storage and Handling Bond/ground containers when transferring liquid Keep container tightly closed Store in cool, dry, well-ventilated flammable liquid storage area Disposal Procedure In accordance with Federal, state, and local environmental regulations Spill Procedures Wear suitable protective clothing Shut off ignition sources No flares, smoking, etc. Stop leak if possible Use water spray to reduce vapors Take up with sand or other non-combustible absorbent material Flush area with water This slide lists the guidance for storage and handling, disposal, and spills. Sometimes the information contained on the MSDS is not adequate. Users of isopropyl alcohol must determine the Federal, state, and local regulations that apply to its disposal before using it - the MSDS does not clearly state what the applicable regulations are. Additionally, “suitable protective clothing” should be identified by facility personnel. Sand and other non-combustible absorbent material should be available in the work area. The presenter should discuss the facility specific procedures: protective equipment to be worn, procedures to follow, location of sand and other non-combustible absorbent material, etc. # 38

39 Preventive Actions Reduce the hazard, substitute a less flammable liquid, if possible Store properly Use proper ventilation Eliminate possible sources of ignition Dispose of properly Know proper extinguishing methods Know emergency response procedures Personal Protection Avoid skin contact Don’t breathe the vapors Protect your eyes Do NOT eat, drink, etc. in areas where hazardous chemicals are used Eliminate possible sources of ignition: Smoking materials, hot surfaces, hot particles and embers, sparks, static electricity, etc. can ignite combustible and flammable liquids. Facility policies, such as those that prohibit smoking in combustible and flammable liquid storage areas, should be discussed. A very dangerous ignition source is the STATIC ELECTRICITY which builds up when liquids are transferred from one container to another. Sparks resulting from static electricity can be prevented by BONDING AND GROUNDING. Bonding is done by electrically connecting the containers with a flexible bonding conductor - a bonding strap or wire. Grounding is done by providing a path for static charge to drain off to the earth (by strap or wire connections to water pipes, grounded metal building framework, and metallic underground gas piping systems). Dispose of properly: Facility specific procedures should be discussed. Never pour combustible or flammable liquids into sinks or drains which go to sewer facilities or storm drains where they may explode or burn. Know proper extinguishing methods: Water may be an ineffective method of extinguishing many flammable liquid fires and may in fact result in spreading the fire. Combustible or flammable liquid fires can be extinguished with a class B fire extinguisher. Note: If time and resources allow, the presenter may include a demonstration of extinguishing methods. Personal Protection: Fire is not the only danger associated with combustible and flammable liquids - many can be hazardous to your health. Avoid skin contact. Most combustible and flammable liquids will remove the oils from the skin and cause irritation, cracking, rashes, or infection. Wear protective gloves and aprons, if there is a chance of skin contact. Always wash combustible or flammable liquids from your skin with non-abrasive soap or hand cleaners. Avoid breathing the vapors of combustible and flammable liquids. Use them only in well ventilated areas. If ventilation is not possible, use an approved respirator. Be especially cautious when working in confined spaces. Protect your eyes - always wear safety glasses or goggles when pouring combustible or flammable liquids. If you spray these liquids, or if there is a chance of liquid splashing in your face, wear a full face shield. Similar preventive actions apply to all of the physical and health hazards discussed as part of this training and will not be repeated for each hazard. Consult the MSDS for specific preventive actions. # 39

40 Storage of Combustible and Flammable Liquids
Healthcare: 360 gallons in flammable liquid storage cabinets Health-related Labs: Outside approved storage cabinets gallons Industrial: 480 gallons in flammable liquid storage cabinets, if proper separation provided Offices: Prohibited, except for maintenance and operation needs Keep combustible and flammable liquids in closed containers when not in use. Leakage and spillage should be cleaned up and disposed of promptly and safely. Use combustible and flammable liquids only where there are no open flames or other sources of ignition within 50 feet. # 40

41 Proper Storage Containers Storage Cabinets Must be approved
Individual capacity cannot exceed 60 gallons Construction One gallon or less - Original container or metal safety can More than one gallon - Metal safety can Storage Cabinets Labeled: FLAMMABLE - KEEP FIRE AWAY The right column of this slide should be revised to list the actual locations of flammable liquid storage cabinets at the facility. For storage, the type of container (glass, metal, safety cans, metal drums, approved portable tanks, or polyethylene) depends upon the class and amount of the combustible or flammable liquid. See NFPA 30 (Flammable and Combustible Liquids Code) for details. Storage cabinets are designed to protect any container of combustible or flammable liquids from involvement in a “standard” room fire for up to 10 minutes. Note: This slide does not address storage cabinet requirements such as listing, capacity, or venting - since it is not necessary for employees working with chemicals to be aware of these requirements. Making sure that these requirements are satisfied is the responsibility of facility management and safety personnel. However, employees should be aware of these design features and the reasons behind them, particularly so that attendees can recognize when the safety design features have been compromised. Such design features should be pointed out during the walk-through portion of the training. # 41

42 Flammables Aerosols Gases Solids Personal Protection
Spray paint cans Gases Acetylene Solids Zinc Personal Protection Avoid skin contact Don’t breathe the vapors Protect your eyes Preventive Actions Reduce the hazard, substitute a less flammable chemical, if possible Store and dispose of properly Use proper ventilation Eliminate possible sources of ignition Know proper extinguishing methods and emergency response procedures This slide should be revised to list all flammable aerosols, gases, and solids that are used at the facility. The definitions listed below are included for the presenter. It is not required that the attendees know these technical definitions. Flammable Aerosol: An aerosol that, when tested in accordance with a standardized procedure, yields a flame projection exceeding 18 inches at full valve opening, or a flashback (a flame extending back to the valve) at any degree of valve opening. Flammable Gas: A gas that, at ambient temperature and pressure, (1) forms a flammable mixture with air at a concentration of thirteen percent by volume or less or (2) forms a range of flammable mixtures with air wider than twelve percent by volume, regardless of the lower limit. Flammable Solid: A solid, other than a blasting agent or explosive [29 CFR (a)], that is liable to cause fire through friction, absorption of moisture, spontaneous chemical change, or retained heat from manufacturing or processing, or which can be ignited readily and when ignited burns so vigorously and persistently as to create a serious hazard, when tested by a standardized procedure. # 43

43 Flammable Aerosols - Spray Paint
General Information Krylon Spray Paint Carcinogen - No Spray can burns like blowtorch Contains Propane/Isobutane Hexane/Heptane Toluene Naphtha Hazards Eyes - Irritation Inhalation Dizziness Confusion Weakness Fire Can burst violently in a fire Releases toxic and irritating compounds, if burned This slide summarizes the MSDS for aerosol cans of spray paint (see Krylon Fluorescent Spray Paint, Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in spray paint, the presenter may want to expand this discussion. # 44

44 Flammable Gas - Acetylene
General Information Acetylene Oxygen Co. Colorless gas Distinctive garlic-like odor Health Hazards Flammable Gas Can act as asphyxiant Symptoms - Dizziness and Loss of Consciousness Specific Guidance Store cylinders upright Do NOT store near oxygen Cylinders can rupture violently if not kept cool Under pressure can explode even without air or oxygen Can accumulate in confined spaces (lighter than air) Several fatalities occurred when used to fill balloons or plastic bags (“playing”) This slide summarizes the MSDS for acetylene (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in acetylene, the presenter may want to expand this discussion. Safe handling procedures for compressed gas cylinders are described in the Compressed Gas Association pamphlet P-1 (see Appendix E). # 45

45 Flammable Solid - Zinc General Information Health Hazards
Fisher Scientific Odorless Blue solid Powder or liquid is pyrophoric Health Hazards Eyes - Mechanical irritation Skin - Irritation, dermatitis Ingestion Liver damage Perforation of digestive tract Severe pain, nausea, vomiting, diarrhea, and shock Inhalation - Metal fume fever This slide summarizes the MSDS for zinc (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in zinc, the presenter may want to expand this discussion. Metal fume fever is characterized by flu-like symptoms with metallic taste, fever, chills, cough, weakness, chest pain, muscle pain and increased white blood cell count. # 46

46 Explosives and Pyrophorics
Picric acid Pyrophoric Magnesium diamide This slides lists the two separate categories of explosives and pyrophorics. Explosive: Causes a sudden, almost instantaneous release of pressure, gas, and heat when subjected to sudden shock, pressure, or high temperatures. Pyrophoric: Will ignite spontaneously in air at a temperature of 130 °F or below. Compounds containing the following functional groups tend to be sensitive to heat and shock - acetylide, azide, diazo, halamine, nitroso, ozonide, and peroxide. Compounds containing nitro groups may be highly reactive, especially if other substituents such as halogens are present. Perchlorates, chlorates, nitrates, bromates, chlorites, and iodates, whether organic or inorganic, should be treated with respect, especially at higher temperatures. Explosive chemicals decompose under conditions of mechanical shock, elevated temperature, or chemical action with forces that release large volumes of gases, heat, toxic vapors, or combinations thereof. Pyrophorics should not be confused with pyrotechnics (the art of making fireworks). If attendees do not work with explosives or pyrophorics, this part can be deleted. # 47

47 Prevention of Explosive and Pyrophoric Hazards
Minimize amounts used Store properly Follow proper procedures Shields, barricades, and guards should be used Wear proper protective gloves and clothing Do not drop or shake This slide should be revised to address any precautions associated with explosives or pyrophoric hazards at the facility. # 48

48 Explosive - Picric Acid
General Information Fisher Scientific Yellow in color Odor - Not available Flammable solid Shock sensitive and thermally unstable Health Hazards Eye - Irritation, conjunctivitis Skin - Irritation, dermatitis, sensitization, destruction, and ulceration Ingestion Kidney damage Acute hepatitis Gastrointestinal irritation with nausea, vomiting, and diarrhea Inhalation - Respiratory tract irritation, kidney damage This slide summarizes the MSDS for picric acid (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in picric acid, the presenter may want to expand this discussion. # 49

49 Compressed Gases Examples Preventive Actions Oxygen Nitrous oxide
Ethylene oxide Acetylene Propane Helium Hydrogen Liquefied Petroleum Gas Preventive Actions Store and use properly Secure cylinders in accordance with manufacturer’s guidance and facility policy Use carts, hand trucks, and other devices to move OSHA regulations concerning compressed gas cylinders are contained in 29 CFR Compressed Gas: A gas or mixture of gases (1) having an absolute pressure exceeding 40 psi at 70° F, or (2) having an absolute pressure exceeding 104 psi at 130° F regardless of the pressure at 70° F, or (3) a liquid having a vapor pressure exceeding 40 psi at 100° F as determined by ASTM D DOT Definition: Any material or mixture having in the container either an absolute pressure greater than 276 KPa (40lbf/in2) at 21° C or an absolute pressure greater than 717 KPa (104 lbf/in2) at 54° C or both or any liquid flammable material having a Reid vapor pressure greater than 276 KPa (40 lbf/in2) at 38° C. Compressed gas cylinders should be stored in well-ventilated, dry areas. Storage rooms should be fire-resistant construction and above ground. If cylinders are stored outside, air circulation must not be restricted and the bottom of the cylinders must be protected from corrosion. Cylinders should NOT be stored near sources of ignition, should not be exposed to heat (near radiators, steam pipes, boilers, etc.), or where they may be exposed to corrosive chemicals or vapors. Cylinders should be stored upright and secured, protected from damage, separated by type, and signs should identify the gases present. Full and empty cylinders should be stored separately. Cylinder caps to protect the container withdrawal valve should be in place at all times during storage and movement. Secure gas cylinders to transport carts, where the cylinders are to be used, and where they are to be stored. Compressed gas cylinders should be labeled in accordance with DOT and NFPA requirements, which will be discussed later. Note: The proper methods to secure compressed gas cylinders could be demonstrated as part of the walk around portion of this training (see slide 100). Safe handling procedures for compressed gas cylinders are described in the Compressed Gas Association pamphlet P-1 (see Appendix E). # 50

50 Compressed Gas - Oxygen
General Information Air Products and Chemicals Carcinogen - NO Colorless and odorless Supports and vigorously accelerates combustion Nontoxic under most conditions Necessary to support life Precautions Store cylinders in well ventilated areas Do NOT store near flammable/combustible materials Do NOT store in heavy traffic areas Valve caps should remain on when not connected Never lubricate valves/caps Continued from previous slide: DOT has established codes that specify the materials to be used for the construction and the capacities, test procedures, and service pressures of the cylinders in which compressed gases are stored. Compressed gas cylinders should be clearly identified. No compressed gas cylinder should be accepted that does not legibly identify its contents by name. If the labeling on a cylinder becomes so unclear that the contents cannot be identified, the cylinder should be marked “contents unknown” and returned to the manufacturer or supplier. This slide summarizes the MSDS for oxygen (see Oxygen Gas Mixtures, Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in oxygen, the presenter may want to expand this discussion. Although, oxygen is necessary to support life, it still can present hazards in a medical center. Oxygen should be stored in an area that is at least 20 feet away from any flammable or combustible materials (especially oil and grease) or separated from them by a noncombustible barrier at least 5 feet high and having a fire-resistive rating of at least 1/2 hour. Note: Even if attendees do not work directly with oxygen cylinders, this information should be reviewed because oxygen is widely used throughout medical centers and all healthcare workers should be minimally familiar with safe handling procedures. # 51

51 Organic Peroxide Types of compounds known to form peroxides
Aldehydes Ethers Compounds containing benzylic hydrogen atoms Compounds containing the allylic structure, including most alkenes Vinyl and vinylidene compounds (vinyl acetate and vinylidene chloride) Specific chemicals that can form dangerous concentrations of peroxides on exposure to air Cyclohexene Cyclooctene Decalin (decahydronaphthalene) p-Dioxane Diethyl ether Diisopropyl ether Tetrahydrofuran (THF) Tetralin (tetrahydronaphthalene) Organic peroxide: An organic compound that contains the bivalent O-O structure and which may be considered to be a structural derivative of hydrogen peroxide where one or both of the hydrogen atoms have been replaced by the organic radical. Organic peroxides are a special class of compounds that have unusual stability problems that make them among the most hazardous substances normally handled in a laboratory. They are low-power explosives, hazardous because of their extreme sensitivity to shock, sparks, or other forms of accidental ignition. These compounds are sensitive to heat, friction, impact, and light, as well as to strong oxidizers and reducing agents. All organic peroxides are highly flammable. The presenter may delete the slide, if none of the attendees works with organic peroxides. # 52

52 Prevention of Hazards Associated with Organic Peroxides
Minimize the amount of organic peroxides used Unused peroxides should not be returned to the original container Use ceramic or wooden spatulas, NOT metal ones Smoking, open flames, and heat should NOT be permitted near organic peroxides Clean up spills immediately (vermiculite can absorb solutions) Friction, grinding, and all forms of impact should be avoided near peroxides (especially solids) Use polyethylene bottles with screw-caps, NOT glass bottles with screw-cap lids or glass stoppers Store at lowest possible temperature consistent with solubility or freezing point Dispose of properly The sensitivity of most peroxides to shock and heat can be reduced by dilution with inert solvents, such as aliphatic hydrocarbons. However, toluene is known to induce the decomposition of diacyl peroxides. Solutions of peroxides in volatile solvents should not be used under conditions in which the solvent might be vaporized, because this will increase the peroxide concentration in the solution. Contamination of peroxides by metals can lead to explosive decontamination. Liquid or solutions of peroxides should not be stored at, or lower than the temperature at which the peroxide freezes or precipitates because peroxides in these forms are extremely sensitive to shock and heat. Pure peroxides should never be disposed of directly. Peroxides must be diluted before disposal. If peroxides are handled, the presenter should review the facility procedures for disposal. # 53

53 Organic Peroxide - Ethyl Ether
General Information Fisher Scientific Carcinogen - No Color - Not available Sweet, aromatic odor Vapors may form explosive mixture with air Not stable during routine use and handling Health Hazards Eyes - Irritation Skin - Irritation, burns, defatting, dermatitis Ingestion - Central nervous system depression, chemical pneumonitis (may be fatal) Inhalation - Respiratory tract irritation, seizures, blood abnormalities Psychic abnormalities - anxiety, depression, excitability (chronic exposure) This slide summarizes the MSDS for ethyl ether (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in ethyl ether, the presenter may want to expand this discussion. Ethyl ether may form explosive peroxides. Vapors can travel to a source of ignition and flash back. Will readily ignite at room temperature. Water may be an ineffective extinguishing media. Fire may be spread by the use of water. Empty containers retain product residue (liquid and/or vapor) and can be dangerous. If peroxide formation is suspected, do NOT open or move container. Store in a cool, dry, well ventilated area away from incompatible substances (e.g., strong acids, oxidizers) and light, ignition sources and exposure to air. When working with ethyl ether use explosion-proof ventilation equipment. # 54

54 Organic Peroxide - Isopropyl Ether
General Information Fisher Scientific Carcinogen - No Clear, colorless liquid Ethereal odor Explosive peroxides may form on concentration Health Hazards Eyes - Mild irritation Skin - Irritation, defatting, dermatitis Ingestion - Digestive tract irritation, central nervous system depression, respiratory failure (fatal) Inhalation - Respiratory tract irritation, headache, dizziness, unconsciousness, coma This slide summarizes the MSDS for isopropyl ether (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in isopropyl ether, the presenter may want to expand this discussion. Many similar precautions listed for ethyl ether also apply to isopropyl ether. # 55

55 Oxidizers Examples Preventive Actions Chlorine Calcium hypochlorite
Chromic acid Oxygen (Gaseous) Perchloric acid Fluorine Iodine Hydrogen peroxide (3 to 90 %) Preventive Actions Store in well ventilated areas Keep chemicals as cool as possible Store and use in glass or other inert containers (preferably unbreakable) Do not use corks or rubber stoppers with oxidizers Reaction vessels containing oxidizers should be heated using fiberglass mantles or sand baths Oxidizer: A chemical, other than a blasting agent or explosive [29 CFR (a)], that initiates or promotes combustion in other materials, thereby causing fire either by itself or through the release of oxygen or other gases. The presenter may delete this slide, if none of the attendees works with oxidizers. # 56

56 Oxidizer - Chlorine General Information
Fisher Scientific Pale yellow liquid Distinct odor Do NOT induce vomiting - Give milk or water Health Hazards Eyes - Irreversible eye injury, conjunctivitis Skin - Severe burns and ulceration, dermatitis Ingestion - Severe digestive tract burns Inhalation - Severe irritation Teeth - Erosion (chronic) This slide summarizes the MSDS for chlorine (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in chlorine, the presenter may want to expand this discussion. Potential VA Locations: Water treatment, research, laboratories, recreation therapy (pools) # 57

57 Unstable (reactive) Acrolein-Acrylonitrile Preventive Actions
Refrigerate Use immediately Unstable (reactive): A chemical in the pure state or as produced or transported that will vigorously polymerize, decompose, condense, or become self-reactive under conditions of shocks, pressure, or temperature. The presenter can delete this slide, if none of the attendees works with unstable (reactive) chemical acrolein-acrylonitrile. If attendees work with unstable (reactive) chemicals other than the one listed, then that should be identified on this slide. An MSDS for acrolein-acrylonitrile is NOT included. Acrolein-Acrylonitrile should be refrigerated and used immediately. Note: Preventive actions for other unstable (reactive) chemicals may not be the same as those listed for acrolein-acrylonitrile. # 58

58 Water-reactive Examples Preventive Actions Carbon tetrafluoride
Iodine chloride Lithium Potassium Sodium metal Sodium hydride Sulfamic acid Preventive Actions Avoid contact with water or other liquids Water-reactive: A chemical that reacts with water to release a gas that is either flammable or presents a health hazard. Water Reactive Material (Solid): Any solid substance (including sludge and pastes) which, by interaction with water, is likely to become spontaneously flammable or to give off flammable or toxic gases in dangerous quantities (EPA). The presenter can delete this slide, if none of the attendees works with water-reactive chemicals. Some chemicals react with water to evolve heat and flammable or explosive gases. Storage facilities for water-sensitive chemicals should be constructed so as to prevent accidental contact with water. Storage areas for water-reactive chemicals should be of fire-resistant construction. Combustible materials should NOT be stored in the same area with water-reactive chemicals. Areas where large quantities of water-sensitive chemicals are stored should NOT have automatic sprinkler systems. # 59

59 Water-reactive - Sulfamic Acid
General Information Fisher Scientific Carcinogen - No White solid Odor - Not available Health Hazards Eyes - Severe irritation, burns Skin - Irritation, possible burns, if skin wet Ingestion - Severe irritation gastrointestinal tract, nausea, vomiting, possible burns Inhalation - Respiratory tract irritation, burning pain in nose and throat, coughing, shortness of breath, pulmonary edema This slide summarizes the MSDS for sulfamic acid (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in sulfamic acid, the presenter may want to expand this discussion. # 60

60 Health Hazards Carcinogens Toxic agents Highly toxic agents
Reproductive toxins Irritants Corrosives Sensitizers Hepatotoxins (Liver) Nephrotoxins (Kidneys) Neurotoxins (Nervous System) Agents which damage the lungs, pulmonary system Agents that act on the hematopietic (blood) system Cutaneous hazards Eye hazards Health Hazard: A chemical for which there is statistically significant evidence based on at least one study conducted in accordance with established scientific principles that acute or chronic health effects may occur in exposed employees [29 CFR (c)]. Each one of the 14 health hazards listed on the slide will be discussed in detail. The health hazards listed are specifically identified by OSHA Hazard Communication Standard (29 CFR ). The presenter may delete the slide associated with the hazard to which the attendees are not exposed. Corrosive: chemicals that cause visible destruction of, or irreversible alterations in living tissue (exposure period of 4 hours) by chemical action at the site of contact. Irritant: chemicals that cause reversible inflammatory effect on living tissue (exposure period of 4 hours) by chemical action at the site of contact. Sensitizer: chemicals that cause a substantial proportion of exposed people or animals to develop an allergic reaction in normal tissue after repeated exposure to the chemical. # 61

61 Multiple Health Hazards
A single substance can have several kinds of adverse effects, depending on the route and level of exposure. Some effects of exposure to chemicals are listed on this slide. The slide shows the multiple health hazards for several chemicals. . # 62

62 Carcinogens Examples Preventive Actions Asbestos Chlordane Chloroform
DDT Dioxane Formaldehyde Saccharin Soot Toluene Urethane Vinyl chloride Preventive Actions If synergistic, do NOT smoke, drink, use drugs Specialized medical testing for the exposure as part of medical surveillance provided by facility Carcinogen: A chemical is considered a carcinogen if (a) it has been evaluated by the International Agency for Research on Cancer (IARC), and found to be a carcinogen or potential carcinogen; or (b) it is listed as a carcinogen or potential carcinogen in the Annual Report on Carcinogens published by the National Toxicology Program (NTP) (latest edition); or (c) it is regulated by OSHA as a carcinogen. Cancer is a complex group of diseases (characterized by the rapid and uncontrolled growth of aberrant cells into malignant tumors) whose causes are not yet fully understood. There is evidence that some chemicals can cause or promote certain types of tumors in animals and humans. Preventive actions include specialized medical testing dependent upon the exposure. In the case of asbestos, periodic x-ray examination is performed. Asbestos is synergistic (works together) with smoking to increase the chances of developing asbestos-related diseases. A worker that smokes and works with asbestos has an increased chance of developing disease over a worker who does not smoke, but works with asbestos. # 63

63 Carcinogen - Chloroform
General Information Fisher Scientific Carcinogen - Potential Clear, colorless liquid Sweet odor Toxicity increased by alcohol, steroids, and ketones Health Hazards Eyes - Irreversible eye damage (vapors or liquid) Skin - Burning, itching, redness, dermatitis Ingestion - Chemical pneumonitis (fatal) Inhalation - Depression of central nervous system, kidney and liver damage Adverse reproductive and fetal effects This slide summarizes the MSDS for chloroform (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in chloroform, the presenter may want to expand this discussion. Chloroform is a potential carcinogen based on animal studies; however, review of the MSDS shows that chloroform is considered a carcinogen by the state of California. Potential carcinogens must be handled with the same care as carcinogens. Potential VA Locations: Surgery, research, laboratories # 64

64 Toxic and Highly Toxic Agents
Orally Acrylamide Barium Isopropyl Ether Continuous Contact Dioxane Ethylene Dibromide Hydrazine Continuous Inhalation Chlorine Phenol Tert-Butyl Hydroperoxide Highly Toxic Agents Orally Hydrogen cyanide Sodium azide Sodium cyanide Continuous Contact None identified Continuous Inhalation Hydrogen sulfide Phosgene Toxic Agent: A chemical that has a median lethal dose (a) of more than 50 milligrams per kilogram but not more than 500 milligrams per kilogram of body weight when administered orally to albino rats weighing between 200 and 300 grams each; or (b) of more than 200 milligrams per kilogram but not more than 1,000 milligrams per kilogram of body weight when administered by continuous contact for 24 hours (or less if death occurs within 24 hours) with the bare skin of albino rabbits weighing between two and three kilograms each; or (c) in air of more than 200 parts per million but not more than 2,000 parts per million by volume of gas or vapor, or more than two milligrams per liter but not more than 20 milligrams per liter of mist, fume, or dust, when administered by continuous inhalation for one hour (or less if death occurs within one hour) to albino rats weighing between 200 and 300 grams each. Highly Toxic Agent: A chemical that has a median lethal dose (a) of 50 milligrams or less per kilogram of body weight when administered orally to albino rats weighing between 200 and 300 grams each; or (b) of more than 200 milligrams or less per kilogram of body weight when administered by continuos contact for 24 hours (or less if death occurs within 24 hours) with the bare skin of albino rabbits weighing between two and three kilograms each; or (c) in air of more than 200 parts per million by volume or less of gas or vapor, or two milligrams per liter or less of mist, fume, or dust, when administered by continuous inhalation for one hour (or less if death occurs within one hour) to albino rats weighing between 200 and 300 grams each. The toxicity of chemicals depends on the dose ( the amount of chemical contacted or absorbed each day) and on the length of exposure (number of days, weeks, or years). Individuals are not identical and usually do not respond identically to equal exposures to a chemical. These variations are generally not well understood. For this reason it is important to identify any subgroups (males, blacks, etc.) that may have greater sensitivity to these chemicals than the general population. Note: Acetic acid (glacial) is slightly above the limits to be classified as a toxic; the MSDS for sulfuric acid does not include this information (see Appendix C). # 65

65 Highly Toxic (Oral) - Sodium Cyanide
General Information Fisher Scientific Carcinogen - No White solid Slightly bitter-almond odor when moist Must have cyanide antidote kit available Wash thoroughly after handling/before eating Health Hazards Eyes - Severe irritation, burns Skin - Severe irritation, burns, absorbed through skin, dermatitis, necrosis, ulceration Ingestion - Severe gastrointestinal tract irritation (may be fatal), central nervous system damage Inhalation - Severe respiratory tract irritation, effects similar to ingestion Continued from previous slide: The toxic effects of any chemical may be due to its interference with some important cellular reaction, but the details will vary with each individual chemical. For instance, red blood cells contain hemoglobin, a chemical specialized for the binding and release of oxygen molecules. Carbon monoxide is a chemical that is sufficiently similar to oxygen that it may substitute for oxygen and bind with hemoglobin. Hemoglobin molecules that bind a molecule of carbon monoxide are thus rendered unable to carry their normal product oxygen. Death may result from oxygen starvation of the cells. Nitrite is a chemical that has a similar result, but involves a different mechanism. Hemoglobin contains one atom of iron, and this is in a particular form (ferrous ion). Nitrite reacts with this ferrous ion changing it to ferric ion. This change completely destroys the ability of hemoglobin to carry oxygen and as with carbon monoxide, death may result from oxygen starvation at the cellular level. No matter how toxic a chemical may be, it cannot cause an effect on a living organism unless it comes into contact with that organism - referred to as exposure. There are two key aspects of exposure that determine the effect of the chemical on the employee - site of contact (eyes, skin, lungs, gastrointestinal tract) and amount of chemical making contact (concentration). Preventive actions are similar to those discussed previously. This slide summarizes the MSDS for sodium cyanide. All portions of the MSDS are NOT addressed. If the attendees have a specific interest in sodium cyanide, the presenter may want to expand this discussion. Necrosis: condition or process of tissue dying in a live body # 66

66 Reproductive Toxins Proven - Human Studies Anesthetic gases Lead
Organic mercury Polychlorinated biphenyls (PCBs) Radiation Ribavirin Suspected - Human Studies Carbon monoxide Cytotoxic drugs Ethylene oxide Organic solvents Suspected - Animal Studies Cadmium Organochlorine pesticides Reproductive toxins: Chemicals that affect the reproductive capabilities including chromosomal damage (mutations) and effects on fetuses (teratogenesis). Mutagenesis is the induction of changes in genetic material that are transmitted during cell division. If mutations are present in the genetic material of eggs or sperm, the fertilized ovum may not be viable. Teratology is defined as the study of functional or physical defects induced during development of an animal from the time of conception to birth. # 67

67 Prevention of Reproductive Effects
Request to be assigned to another area that does not require working with reproductive toxins Verbally In writing Notify supervisor Facility procedure to resolve differences The presenter should revise this slide to address the facility policy concerning reassignment of personnel for eliminating/minimizing the risk of exposure to reproductive toxins. Other preventive actions are similar to those discussed previously. # 68

68 Reproductive Toxins - Nitrous Oxide
General Information Air Products and Chemicals Carcinogen - NO Appearance and odor Not available Supports and accelerates combustion of flammables Simple asphixiant Use safe handling procedures for gas cylinders Health Hazards Eye/Skin - Contact with liquid or cold gas causes cryogenic burns Inhalation Headache Nausea/Drowsiness Other signs of oxygen starvation Hysteria (high concentrations, short exposure) “Laughing gas” can be abused This slide summarizes the MSDS for nitrous oxide (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in nitrous oxide, the presenter may want to expand this discussion. Research has shown that female anesthesiologists, nurse-anesthetists, and other staff personnel are at an increased risk of miscarriage during their first trimester of pregnancy after having worked in operating rooms for a year. Surviving babies of female workers so exposed, have an increased risk of congenital abnormalities. Studies have also shown that there is a higher incidence of miscarriage among the wives of male operating-room personnel. Workers exposed to anesthetic gases should have complete medical histories on file, including family, genetic, and work histories, and the outcomes of all pregnancies of female workers or of the wives of male workers. Potential VA Locations: Operating rooms, dental operatories, emergency rooms, outpatient clinics, veterinary operating rooms # 69

69 Irritants and Corrosives
Chloroform Formaldehyde Freon Glutaraldehyde Hydrogen peroxide Iodine Isopropyl alcohol Toluene Xylene Corrosives Acetic acid glacial Ammonia Chlorine Fluorine Hydrochloric acid Hydrofluoric acid Hydrogen chloride Nitric acid Sulfuric acid Irritant: A chemical that causes a reversible inflammatory effect on living tissue by chemical action at the site of contact, not a corrosive. Corrosive: A chemical that causes visible destruction of, or irreversible alterations in living tissue by chemical action at the site of contact. The major classes of corrosive chemicals are strong acids (nitric acid, chromic acid, and hydrofluoric acid) and bases (potassium hydroxide, sodium hydroxide, and ammonia), dehydrating agents (concentrated sulfuric acid, sodium hydroxide, phosphorus pentoxide, and calcium oxide), and oxidizing agents (perchloric acid and chromic acid). Some chemicals, such as sulfuric acid, belong to more than one class. Inhalation of vapors or mists of these chemicals, such as ammonia, can cause severe bronchial irritation. These chemicals erode the skin and the respiratory epithelium and are particularly damaging to the eyes. Preventive actions are similar to those discussed previously and should be routinely in place before working with corrosive chemicals. Specific actions related to an individual chemical of interest to the attendees should be addressed by the presenter. Proper handling procedures may vary from chemical to chemical. Because much heat is generated when dehydrating agents are mixed with water, mixing should always be done by adding the agent to water to avoid violent reaction and splattering. # 70

70 Corrosive - Ammonia General Information Health Hazards
Bower Ammonia and Chemical Carcinogen - No Colorless liquid Pungent odor Wear goggles, if wearing contact lenses Health Hazards Eyes - Irritation Skin - Burns Ingestion - Symptoms NOT identified Inhalation Headache Coughing Severe lung congestion This slide summarizes the MSDS for ammonia (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in ammonia, the presenter may want to expand this discussion. Although, the MSDS referenced for this slide includes emergency/first aid procedures for ingestion, signs or symptoms resulting from overexposure are not identified. Therefore, before ammonia is used at the facility, the signs and symptoms resulting from overexposure should be determined. If the signs and symptoms are not made available in advance, the correct emergency or first aid response may be delayed. Potential VA Locations: Environmental management, laboratories, research # 71

71 Sensitizers Sensitizers Preventive Actions Natural latex Formaldehyde
Diazomethane Chromium Nickel Bichromates Isocyanates Certain phenols Methyl Methacrylate Preventive Actions Minimize exposure Substitute products that do not contain sensitizers, if possible Wear appropriate hand protection when contacting Wash thoroughly when task is completed Minimize exposure to unknown chemicals Sensitizer: A chemical that after repeated exposures causes a substantial proportion of exposed people or animals to develop an allergic reaction in normal tissue. A wide variety of chemicals can produce skin and lung sensitivity. Slides for both formaldehyde and methyl methacrylate are included in this training package. See Appendix A for the DASHO Letter 00S-97-6, Occupational Latex Allergies that discusses sensitivities that result from exposure to natural rubber latex. Sensitization may occur days, weeks, or months after the first exposure. Sensitized workers may experience eye or upper respiratory irritation or an asthmatic reaction at levels or exposure that are too low to cause symptoms in most people. Reactions may be quite severe with swelling, itching, wheezing, and chest tightness. Preventive actions for sensitizers include minimizing the exposure (even inadvertent exposures, such as the airborne powder created by the use of powdered latex gloves), substituting products that do not contain sensitizers, washing thoroughly when the task involving sensitizers is completed, and minimizing exposure to unknown chemicals # 72

72 Sensitizer - Formaldehyde
General Information Fisher Scientific Carcinogen - Potential Appearance - Not available Has caused adverse reproductive and fetal effects in animals Finger nail decay Health Hazards Eyes - Irritation Skin - Irritation, thickening, sensitization, discoloration Ingestion - May be fatal, blindness Inhalation Effects central nervous system Asthmatic attacks due to allergic sensitization This slide summarizes the MSDS for formaldehyde (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in formaldehyde, the presenter may want to expand this discussion. Formaldehyde is a sensitizer affecting both the skin and of the respiratory system. Formaldehyde causes delayed effects that are NOT appreciably eased by eye washing. Potential VA locations: Autopsy rooms, surgical pathology laboratories, renal dialysis units, laboratories, research # 73

73 Sensitizer - Methyl Methacrylate
General Information Fisher Scientific Carcinogen - Yes Colorless liquid Sweet, sharp odor Reproductive and fetal effects Health Hazards Eyes - Severe irritation, burns Skin - Severe irritation, sensitization, dermatitis, destruction, ulceration Ingestion - Depression, kidney and liver damage, gastrointestinal irritation, allergic reaction Inhalation - Allergic respiratory reaction, effects similar to ingestion Potential VA Locations: Operating rooms, dental laboratories, clinics # 74

74 Hematopoietic Damage Hematopoietic Toxins (Blood) Preventive Actions
Benzene Carbon Monoxide Ethylene oxide Lead Picric acid Xylene Preventive Actions Hematopoietic Toxins: Chemicals that act on the blood or hematopoietic system. Preventive actions for hematopoietic toxins require that medical surveillance for exposed workers include a review of family history to include blood and genetic diseases and several blood tests (complete blood count, differential white blood cell count), in addition to the preventive actions previously discussed. # 75

75 Hematopoietic Toxin - Ethylene Oxide
General Information 3M Carcinogen - Suspected Colorless gas Sweet odor Will burn without presence of air or other oxidizers Do NOT incinerate cartridges Health Hazards Eyes - Severe injury Skin - Irritation, dermatitis, and chemical blisters Inhalation Respiratory tract irritation Cumulative lung, liver, and kidney damage Mutagen/Suspect carcinogen Neurotoxic This slide summarizes the MSDS for ethylene oxide (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in ethylene oxide, the presenter may want to expand this discussion. The MSDS for ethylene oxide included in the training package was developed January 1, This MSDS may have been updated since then. It is included here to point out the need for periodically updating MSDS files to assure that the information available is current. The emergency telephone number is not included here and that creates a serious problem in case of an emergency. The facility should not use a chemical until all needed information has been obtained and is available for developing safe work procedures and emergency response. Although the MSDS does not identify any hematopoietic effects, at high concentrations ethylene oxide destroys red blood cells. Chromosomal abnormalities and spontaneous abortion have also been identified as potential hazards by recent research. Sensitization and cataract development can be the result of ethylene oxide exposure. Ethylene oxide also causes spontaneous abortions and birth defects. Potential VA Locations: Supply, Processing, and Distribution (SPD) See Appendix A for the DASHO Letter 00S-95-2, Accidental/Emergency Release of Ethylene Oxide. # 76

76 Liver Damage Hepatotoxins Preventive Actions Chloroform DDT
p-Dichlorobenzene Ethylene oxide Inorganic arsenic Phenol (hydroxybenzene) Picric acid Toluene Xylene Preventive Actions Medical surveillance emphasizes liver function Avoid activities known to damage the liver (e.g., heavy drinking) Hepatotoxins: Chemicals that produce liver damage. Liver damage is a frequent response to exposures to toxic chemicals. The liver is a vital organ which has considerable reserve capacity. For this reason effects on the liver may not be apparent until the liver is extensively damaged. Preventive actions are similar to those discussed previously. Additionally, medical surveillance for hepatotoxins includes extensive testing and evaluation of liver function (liver profile, etc.). Activities known to damage the liver, such as heavy drinking, should be avoided. # 77

77 Hepatotoxin - Xylene General Information Health Hazards
Fisher Scientific Carcinogen - Yes Clear, colorless liquid Aromatic odor Neurotoxic effects include permanent brain and nervous system damage Health Hazards Eyes - Severe irritation Skin - Irritation, defatting, dermatitis Ingestion - Central nervous system damage, kidney and liver damage, chemical pneumonitis (can be fatal) Inhalation - Respiratory tract irritation, chemical pneumonitis, pulmonary edema This slide summarizes the MSDS for xylene (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in xylene, the presenter may want to expand this discussion. Female workers appear more susceptible to the health effects of solvents, such as xylene. Xylene should be used in well ventilated areas, particularly when spray painting. Note: Xylene is more toxic than toluene; however, some research indicates otherwise. These varying findings may indicate the existence of a dose-activity relationship with an inversion point (i.e., at low doses toluene is more hazardous and at high doses xylene is more hazardous). Potential VA Locations: Laboratories, paint shops # 78

78 Hepatotoxin - Xylene (Contd.)
General Information No manufacturer listed Emergency Telephone None available Carcinogen - Colorless liquid Sweet, pleasant odor Ingestion or inhalation may be fatal Chronic effects include kidney and/or liver damage Health Hazards Eyes - Irritation Skin - Irritation Ingestion Gastro-intestinal irritation Blurred vision Lowering blood pressure Inhalation Respiratory tract irritation Narcosis Headache, nausea, etc. This slide is included to point out the differences between MSDSs developed by different manufacturers. While some of the differences may be the result of different ingredients and manufacturing process, other differences may result from updated information. For example, the previous slide contains more recent and therefore, more reliable information. # 79

79 Kidney Damage Nephrotoxins Preventive Actions
Chemicals listed as hepatotoxins Cadmium Turpentine Mercury Lead Preventive Actions Medical surveillance emphasizes kidney function Reduce the hazard, substitute a less hazardous chemical, if possible Nephrotoxins: Chemicals which produce kidney damage. Liver and kidney damage are often associated with the same chemicals. The chemicals listed as hepatotoxins are also nephrotoxins. However, in the case of turpentine, mercury, and lead, while kidney damage does occur, liver damage does not. Therefore, employees cannot simply rely upon the fact that a chemical damages one system of the body, so it must also damage a related system. The MSDS is the most accurate way to identify the health hazards associated with a chemical. Fluorine has been determined to cause both liver and kidney damage in animals. Preventive actions are similar to those discussed previously. Additionally, medical surveillance for nephrotoxins includes extensive testing and evaluation of kidney function (renal profile, urinalysis, etc.). # 80

80 Nephrotoxin - Toluene General Information Health Hazards
Fisher Scientific Carcinogen - Yes Colorless liquid Sweetish, pleasant, aromatic odor Causes adverse reproductive and fetal effects in animals Health Hazards Eyes - Irritation (vapors), corneal injury Skin - Irritation, dermatitis Ingestion - Digestive tract irritation, chemical pneumonitis (can be fatal) Inhalation Respiratory tract irritation Cardiac sensitization and severe heart abnormalities Liver and kidney damage This slide summarizes the MSDS for toluene (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in toluene, the presenter may want to expand this discussion. Potential VA Locations: Laboratories # 81

81 Neurotoxins (Nervous System Damage)
Benzene sec-Butyl alcohol Carbon Monoxide DDT 1,2-Dichloroethylene Ethyl ether Ethylene oxide Iodine Lead LPG Methyl Methacrylate Mercury Propane Toluene Xylene Neurotoxins: Chemicals that produce their primary toxic effects on the nervous system. The nervous system is of special toxicological concern, since chemical-induced injury to nerve cells is often irreversible and may lead to adverse health effects. Many paints contain solvents that are neurotoxins. Applying paint can generate vapors that can impair a worker’s ability to function and may lead to accidents, such as falling off a ladder. DDT - Dichlorodiphenyltrichloroethane LPG - Liquefied Petroleum Gas # 82

82 Neurotoxins - Acrylamide
General Information Fisher Scientific Carcinogen - Yes White solid Odorless Health Hazards Eyes - Irritation, burns Skin - May be absorbed through skin, sensitizer Ingestion - Nervous system damage Inhalation - Respiratory tract irritation This slide summarizes the MSDS for acrylamide (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in acrylamide, the presenter may want to expand this discussion. Exposure to acrylamide can cause: Central nervous system effects - abnormal fatigue, memory difficulties, and dizziness Peripheral neuropathy symptoms - Muscular weakness, paresthesia, numbness in hands, feet, lower legs, and lower arms, unsteadiness, and difficulties walking and standing Autonomic nervous system symptoms - Excessive sweating, peripheral vasodilation and other difficulties Effects of skin absorption, ingestion, and inhalation are similar. # 83

83 Pulmonary System Toxins (Respiratory System Damage)
Acetic acid* Ammonia* Asbestos* Benzene n-Butyl alcohol Cadmium Chlorine p-Dichlorobenzene 1,2-Dichloroethylene Ethyl acetate Ethylene oxide* Ethyl ether Fluorine Formaldehyde* Glutaraldehyde* Hexane Hydrogen peroxide Inorganic Arsenic Iodine LPG Isopropyl alcohol* Methyl Methacrylate* Mercury* Nitric acid Phosphoric acid Portland cement* Sulfuric acid Toluene* Pulmonary system toxins: Chemicals which irritate or damage pulmonary tissue or the respiratory system. The presenter should revise the slide to address any chemicals in this category that are of interest to attendees. The presenter may want to discuss the chemicals marked with an asterisk (*) in more detail, since these chemicals are used widely throughout healthcare facilities. Portland cement is also underlined to emphasize the fact that some materials generally not considered chemicals, can have health hazards associated with them. Preventive action often includes that respiratory protection (dust, fume, mist; air-purifying; powered air-purifying; air-supplied; and self-contained breathing apparatus) be worn, particularly when the exposure is above specified requirements. The substitution of non-pulmonary system toxins and the use of respiratory protection is probably the most significant preventive action available to minimize pulmonary system toxins. Effective exhaust ventilation is required in areas where pulmonary system toxins are used. Note: Respiratory protection training is outside the scope of this training program. VA has developed a separate respirator training program for employees required to wear a respirator (Health Care Worker Respirator Protection Training, Employee Education System Little Rock Center). Proper use and operation of fume hoods should be demonstrated as part of the walk around portion of this training (see Slide 100). # 84

84 Respiratory Toxins - Glutaraldehyde
General Information Fisher Scientific Carcinogen - No Colorless to light yellow liquid Pungent, sharp odor Causes adverse reproductive and fetal effects in animals Health Hazards Eyes - Severe irritation Skin - Sensitizer, dermatitis Ingestion - Digestive tract irritation, hemorrhaging, permanent damage to esophagus, digestive tract Inhalation Respiratory tract irritation Asthmatic attacks Liver abnormalities This slide summarizes the MSDS for glutaraldehyde (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in glutaraldehyde, the presenter may want to expand this discussion. If employees have pre-existing asthma or have developed sensitization to glutaraldehyde, they should be prevented from exposure to glutaraldehyde by: substituting a non-glutaraldehyde disinfection system re-assignment to a no-risk exposure task requiring the use of a respirator when exposed to glutaraldhyde Sensitization of the respiratory tract can occur even if exposure levels are maintained below mandated levels. All employees handling glutaraldehyde, even if kept well below the OSHA limit, should be included in pre-exposure, annual, and termination symptom surveillance. Proper skin protection for glutaraldehyde requires the use of neoprene or butyl rubber gloves instead of less protective gloves. Potential VA Locations: Laboratories, pulmonary physiology units, nurse’s stations, endoscopy suites # 85

85 Cutaneous Hazards (Skin Damage)
Acetic acid* Benzene n-Butyl alcohol Chloroform DDT p-Dichlorobenzene Ethyl Acetate Ethyl Ether Fluorine Formaldehyde* Freon* Glutaraldehyde* Hexane Hydrogen peroxide Inorganic Arsenic Iodine Isopropyl alcohol* Methyl Methacrylate Mercury Nitric acid Phenol (hydroxybenzene) Phosphoric acid Picric acid Portland cement* Ribavirin* Toluene Sulfuric acid Xylene Cutaneous Hazards: Chemicals which affect the dermal layer of the body. The presenter should revise the slide to address any chemicals in this category that are of interest to attendees. The presenter may want to discuss the chemicals marked with an asterisk (*) in more detail, since these chemicals are used widely throughout healthcare facilities. This slide lists chemicals used in healthcare facilities that can damage the skin. This list is NOT complete. # 86

86 Prevention of Chemical Injuries to Skin
Wear appropriate protective clothing Gloves Lab coat Apron Face Shield Hood Remove protective clothing properly Dispose or launder protective clothing properly Thoroughly wash hands and skin immediately after completion of task The presenter should demonstrate how to use an emergency shower as part of the walk around portion of this training (see Slide 100). This slide lists additional preventive actions recommended for chemicals that are hazardous to the skin. # 87

87 Cutaneous - Sulfuric Acid
General Information Fisher Scientific Carcinogen - Yes Colorless liquid Odorless Remove contaminated clothing immediately Emergency response time is of the essence Get medical aid immediately Health Hazards Eyes - Severe burns, conjunctivitis, irreversible injury Skin - Severe burns Ingestion - Chemical burns to respiratory tract Inhalation - Chemical burns to respiratory tract, nosebleeds, perforation of nasal septum Teeth - Erosion This slide summarizes the MSDS for sulfuric acid (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in sulfuric acid, the presenter may want to expand this discussion. The MSDS for sulfuric acid contains specific precautions to minimize the effects of skin contact, such as removing contaminated clothing immediately, the need to respond quickly, and to obtain medical aid immediately. Appropriate personal protective equipment and clothing must be worn when working with sulfuric acid. # 88

88 Eye Hazards # 89 Acetic acid* Ammonia* Benzene n-Butyl alcohol
sec-Butyl alcohol Chloroform p-Dichlorobenzene 1,2-Dichloroethylene Ethyl Ether Ethyl Acetate Ethylene oxide* Freon* Nitric acid Formaldehyde* Glutaraldehyde* Fluorine Hexane Hydrogen peroxide Iodine Isopropyl alcohol* Methyl Methacrylate* Mercury Phosphoric acid Picric acid Portland cement Ribavirin Sulfuric acid Xylene Eye Hazards: Chemicals which affect the eye or visual capacity. This slide lists chemicals used in healthcare facilities that can cause damage to an employees eyes. This list is NOT complete. The presenter should revise the slide to address any chemicals in this category that are of interest to attendees. The presenter may want to discuss the chemicals marked with an asterisk (*) in more detail, since these chemicals are used widely throughout healthcare facilities. Portland cement is also underlined to emphasize the fact that some materials generally not considered chemicals, can have health hazards associated with them. Note: The presenter should demonstrate how to use an emergency eye wash as part of the walk around portion of this training. All types of eye washes used at the facility should be demonstrated. # 89

89 Prevention of Chemical Injuries to Eyes
Wear appropriate eye protection Safety glasses Goggles Face Shield Hood Work near an eyewash Make sure eyewash is operational Avoid working alone This slide lists additional preventive actions recommended for chemicals that are hazardous to the eyes. Knowing emergency procedures is extremely important in the case of eye injury, because an injured worker may not be able to read the label or the MSDS. # 90

90 Eye Hazard - Acetic Acid
General Information Fisher Scientific Carcinogen - No Colorless liquid Pungent, vinegar-like odor Flush eyes for 15 minutes, occasionally lifting the upper and lower eyelids Get medical aid immediately Health Hazards Eyes - Severe irritation, irreversible damage (vapors and liquid) Skin - Burns, dermatitis Ingestion - Severe pain, permanent damage to digestive tract Inhalation - Chemical burns to respiratory tract, chronic bronchitis Teeth - Erosion This slide summarizes the MSDS for acetic acid (see Appendix C). All portions of the MSDS are NOT addressed. If the attendees have a specific interest in acetic acid, the presenter may want to expand this discussion. The MSDS for acetic acid (glacial) contains specific precautions to minimize the effects of eye hazards. Notice the special guidance concerning emergency response and the method for flushing eyes. # 91

91 Other Health Hazards Teeth/Gums Cardiovascular System Lymphatic System
Acetic acid Lead Nitric acid Sulfuric acid Cardiovascular System Cadmium Carbon Monoxide Chloroform Freon Iodine Lymphatic System Inorganic Arsenic Peripheral Nervous System DDT Freon Bones/Bone Marrow Benzene Cadmium Gastrointestinal Tract Lead Xylene Mucous Membranes/Throat Glutaraldehyde Methyl Methacrylate This slide lists additional health hazards that are associated with the chemicals listed. In general, these health hazards are not separately identified by OSHA Hazard Communication Standard; however, they are sometimes listed by chemical hazard references and may be of interest to attendees. The presenter may delete this slide or may revise the slide to address only those health hazards that are of particular interest to attendees. # 92

92 Hazardous Pharmaceuticals
If an MSDS cannot be obtained, the facility must document the efforts to obtain the MSDS See Appendix A for the DASHO Letter 00S-91-5, Applicability of OSHA’s Hazard Communication Standard to Drugs and Medications and for the OSHA Interpretation dated January 3, 1994 that discusses the requirements associated with hazardous pharmaceuticals. Containers of drugs dispensed by a pharmacist to the healthcare provider to be given to a patient are exempt from the requirements of the hazard communication standard to label the container. The presenter may expand this discussion for attendees that are responsible for drugs and medication at the facility. This slide can be deleted if attendees are not exposed to or are not responsible for drugs and medication. # 93

93 Detecting Effects of Hazardous Chemicals
Monitoring Conducted periodically Continuous monitoring devices Visual appearance Odor Documentation Exposure records Medical records This slide should summarize the monitoring performed at the facility to assure the safe use of hazardous chemicals. The presenter should emphasize that odor is not a valid indicator of the hazard. (Ethylene oxide has an odor threshold of about 700 ppm; however, exposure at 200 ppm may cause irritation of the eyes and upper respiratory system.) The presenter should tell attendees how they can obtain copies of any monitoring performed at the facility. Employees have the right to “examine and copy” employee exposure and medical records (29 CFR ). Exposure records: Upon request, the employer must provide the employee, or the employee’s designated representative, access to employee exposure records. If no record exists, then the employer must provide records of other employees with job duties similar to those of the employee. Access to these records does not require a written consent of other employees. These records must indicate the identity, amount, and nature of the toxic substances or harmful physical agents to which the employee has been exposed. Union representatives must indicate an occupational health need for requested records when seeking access to exposure records without the written authorization of the employee(s) involved. Medical records: The employer must provide employees, or their designated representatives, access to medical records relevant to the employee. Access to the medical records of another employee may be provided only with the specific written consent of that employee. Physicians are encouraged to discuss with employees the contents of the employee’s medical records; physicians also may recommend ways of disclosing medical records other than by direct employee access. # 94

94 Program Maintenance Safety committee reviews - Annually
Safety office updates - As necessary Submit comments to (insert) Revised as necessary List - Other facility procedures The presenter should revise this slide to list facility procedures to update the facility hazard communication program. # 95

95 Exposure of Family Members
Contaminants can cause health effects among worker’s families Arsenic Asbestos Asthmagens and allergens Cadmium Chlorinated hydrocarbons Fibrous glass Infectious agents Lead Mercury Pesticides Preventive actions Reduce exposure - Use good safety practices Leave soiled clothes at work Store work clothes away from nonwork clothes Change work clothes before leaving work Launder work clothes separately Shower before leaving work, if possible Do not take tools, scrap, packaging, etc. home This slide lists chemicals that are sometimes used in medical centers and that have been identified by the National Institute for Occupational Safety and Health (NIOSH) as causing health effects in worker’s families (see appendix F). The preventive actions listed on this slide are summarized from those recommended by NIOSH and may not be appropriate for all employees The presenter should revise this slide to list those chemicals and preventive actions that are appropriate for the facility. # 96

96 CHEMTREC Emergency Telephone 800-424-9300
Spill control and fire fighting information Emergency medical treatment information Manufacturer, shipper, carrier contact Chemical information from data base of 1.5 million MSDSs Non-emergency inquires (9 a.m. - 6 p.m. EST) CHEMTREC: The Chemical Transportation Emergency Center is a 24 hour public service of the chemical industry that provides immediate emergency response, information and assistance during emergencies involving chemicals. # 97

97 Summary Review facility’s written program and inventory
Review health hazard information periodically Ensure fume hoods and storage areas are effective Wear appropriate PPE Reduce the hazard, substitute a less hazardous chemical, if possible Read label and MSDS, be able to quickly locate Follow manufacturer’s guidance for chemical Handle and dispose of chemicals properly Store chemicals properly Assure safety committee effectively addresses chemical hazards and hazard communication requirements Note: The presenter should emphasize the items listed here that are considered most important at the facility and to the attendees. The list of items is continued on the next slide. Assure health hazard information periodically: Attendees should be encouraged to keep the handout materials for this training and to periodically review those portions that are most applicable for their job. Reduce the hazard, substitute a less hazardous chemical, if possible: One last opportunity to reiterate the facility procedure to follow if a less hazardous chemical can be substituted. Assure safety committee effectively addresses chemical hazards and hazard communication requirements: Employees should be encouraged to participate in safety committee activities (e.g., volunteering for subcommittees, reviewing documentation), even attending meetings if a topic of interest is being discussed. If the facility inventory is not current or the written program is out of date, employees should bring this to the attention of the safety committee or management officials. # 98

98 Summary (Contd.) Chemicals may have multiple health hazards and can be synergistic Review personal monitoring and medical records periodically Visit employee health and employee assistance personnel, when necessary Know facility emergency response procedures Know facility policies concerning re-assignment Do not inadvertently expose your family to workplace chemicals Continued from previous slide: Note: The presenter should emphasize the items listed here that are considered most important at the facility and to the attendees. The list of items is continued on the next slide. Assure health hazard information periodically: Attendees should be encouraged to keep the handout materials for this training and to periodically review those portions that are most applicable for their job. Reduce the hazard, substitute a less hazardous chemical, if possible: One last opportunity to reiterate the facility procedure to follow if a less hazardous chemical can be substituted. Assure safety committee effectively addresses chemical hazards and hazard communication requirements: Employees should be encouraged to participate in safety committee activities (e.g., volunteering for subcommittees, reviewing documentation), even attending meetings if a topic of interest is being discussed. If the facility inventory is not current or the written program is out of date, employees should bring this to the attention of the safety committee or management officials. # 99

99 Walk Around Portion of Training
Flammable Liquid Storage Storage Cabinet Inside Storage Room Cut Off Room Outside Storage Area Emergency Shower Emergency Eye Wash Proper storage of compressed gas cylinders Ventilation - Fume Hoods Continued from previous slide:. Supervisors in the areas to be visited must be notified well in advance. Supervisors in these areas could demonstrate the safety features being discussed (e.g., emergency showers, emergency eye wash), bonding/grounding procedures for flammable liquids). The presenter must determine that such demonstrations are safe and do not present any hazard(s) to the supervisor, the attendees or the presenter. # 100


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