Hazard Communication Program Manual
For Strong Memorial Hospital Nurses and Medical Care Staff
Prepared by: Environmental Health & Safety
(Revised 9/2006)
Printable file is available with Adobe Acrobat Reader:
PDF Version of Hazard Communication Program for Nurses
Table of Contents
- Introduction
- Section 1 - Requirements and Responsibilities
- Requirements
- Responsibilities
- Records
- Multi-Employer Workplace
- Section 2 - Required Employee Information and Training
- Training
- Reading and Interpreting MSDS and Labels
- Limiting Chemical Exposures
- SECTION 3 - Chemicals - Hazards and Emergency Response
- Exposure Levels
- Medical Consultations and Examinations
- Spill Control Plan
- Common Chemicals
- Closing Comments
Appendices
- Definitions
- Chemical Inventory Form
- Blank MSDS
- Reproductive Protection Policy
- Mercury Spill Clean Up Procedures
- Formaldehyde Spill Protocol
- INTRODUCTION
This manual is designed to instruct nursing and other medical care staff about the
Occupational Safety and Health Administration's (OSHA's) Hazard Communication Standard
29CFR 1910.1200 and The University of Rochester Hazard Communication Program (Haz Comm).
Nursing staff and others need to read this program and become familiar with its contents.
Personnel should use this document as an instructional program to gain a better understanding
of the hazards associated with chemicals used in the workplace and appropriate protective
measures.
It is important to recognize that OSHA’s Hazard Communication Standard, as with any safety
regulation, is designed to protect employees and is part of an overall program to provide a
healthy and safe work environment. This standard is a performance-oriented regulation that
mandates a program of evaluating potential hazards of chemicals, communicating information
concerning hazards, and implementing appropriate protective measures for employees that use
hazardous chemicals in a non-laboratory setting. Hazardous chemicals include those regulated
in 29 CFR 1910, Subpart Z, and any chemical meeting the definition of a hazardous chemical
as set forth in OSHA's Hazard Communication Standard.
The University of Rochester Haz Comm Program is designed to comply with OSHA’s Hazard
Communication Standard. The program defines responsibilities, evaluates the potential hazards
of chemicals and communicates information concerning the hazards and appropriate protective
measures for employees. It is the policy of the University of Rochester to provide an
environment free from recognized hazards that could cause injury or illness. To this end,
employees may not be exposed at or above the Permissible Exposure Limits (PEL) of OSHA, as
described in Section 3. Also any personal protective equipment (PPE) to help prevent chemical
exposures or needed for the performance of a job function is provided by the department at no
cost to the employee. Working with any chemical involves a degree of risk. Through the use
of all components of the Haz Comm, employees can work to minimize chemical hazards.
This document is divided into three sections. Section 1 outlines the specific requirements
of the standard and the manner in which the University is complying with the regulations.
Section 2 focuses on required employee training information. Section 3 provides a summary
of the hazards associated with some of the chemicals most commonly encountered by medical staff
and emergency response actions to take in the event of a spill or exposure to a chemical agent.
Because of the importance of this standard you may be interviewed during internal audits or
by OSHA inspectors to determine if your supervisor is providing you with adequate training.
You must be able to show that you have an understanding of the potential dangers of the
chemicals in your work place and the means to protect yourself from these hazards. Any
questions on the Haz Comm or its implementation should be referred to the Industrial Hygiene
Unit of Environmental Health & Safety (EH&S) at ext. 5-3241.
- SECTION 1: REQUIREMENTS AND RESPONSIBLITIES
REQUIREMENTS
The following are the requirements of the Hazard Communication Standard:
- Staff Application: The Hazard Communication Standard (Haz Comm) applies to all employees who use
hazardous chemicals. Those employees working in laboratories are covered under another OSHA standard, the "Occupational Exposure to Hazardous Chemicals in Laboratories", 29 CFR 1910.1450.
- Applicable Chemicals: The standard applies to all chemicals, which are defined as hazardous by the
standard and are used in the workplace in a manner in which employees may be exposed to
the chemicals under conditions of use or foreseeable emergencies. The standard defines
a hazardous chemical as any chemical which is a physical hazard or a health hazard.
- Physical hazards include:
- combustible liquids
- compressed gases
- explosives
- flammables
- organic peroxides
- oxidizers
- Chemicals considered health hazards fall into one of the following categories:
- carcinogen
- toxic or highly toxic
- reproductive toxin
- irritant
- corrosive
- sensitizer
- hepatotoxin
- nephrotoxin
- neurotoxin
- agents affecting the hematopoietic system
- agents which damage the lungs, skin, eyes or mucous membranes
Definitions of these categories can be found in Appendix 1.
- Written Program: The employer is required to develop and maintain a written Hazard Communication
Program, which describes how it will meet the requirements of the Standard. A copy of
the University's Written Hazard Communication Program for Nurses and Medical Care Staff is found on our web site at
www.safety.rochester.edu/ih/hazcomnurses.html. Additional copies of this document are
available from Nursing Services.
- Chemical Inventory and Material Safety Data Sheets: The employer is required to compile
a list of the hazardous chemicals present in the workplace along with corresponding Material Safety Data
Sheets. All employees must have access to this information during their work shifts. A suggested
chemical inventory form to complie the information and a sample MSDS are available in Appendixes 2 and 3. Within Strong Memorial
Hospital, all departments who are responsible for bringing chemicals onsite are responsible for maintaining department
specific chemical inventories with corresponding Material Safety Data Sheets. For example, Hospital Stores,
Material Processing and Environmental Services all maintain department specific chemical inventories. Due to the integrated
nature of Patient Care Units (i.e. staff and chemicals form various SMH departments) the following procedure will
apply:
- A centralized chemical inventory/MSDS system will be maintained by EH&S. This system is networked to provide ready access to the inventories and MSDSs location. Departments/Units may modify their inventories by contacting EH&S at ext. 5-3241.
- Patient Care Units that procure chemicals outside of SMH departments must maintain their chemical inventory as listed in the previous entry.
- EH&S is available to assist all SMH staff with locating MSDSs by calling 275-3241.
- Chemical information is available 24/7 at the Poison Control Center at
275-3232
- Labels: All containers of hazardous chemicals must be labeled with the following information:
- the identity of the hazardous chemical(s)
- the appropriate hazard warnings
- the name/address of the chemical manufacturer, importer or other
responsible party.
Exceptions to this rule include:
- containers in which chemicals are transferred from a labeled container
for immediate use by the employee performing the transfer
- alternatives to labels may also be used such as signs, placards,
process sheets, operating procedures or other written materials instead of affixing
labels to individual stationary process containers as long as the materials contain
the required labeling information
- Training: Employers (supervisors) are also required to provide information and training to
employees on this standard and the hazards of the chemicals used in
the workplace.
RESPONSIBILITIES
Responsibility for implementing the Haz Comm resides with each department where hazardous
chemicals are utilized in a non-laboratory setting. The responsibility for implementing and
fulfilling the mandates of the Haz Comm are as follows:
- Supervisors have primary responsibility for:
- Informing and training employees on potential hazards associated with the
chemicals in their work area, and when new chemical hazards are introduced
- Completing a Job Hazard Assessment
to determine the personal protective equipment needed to protect the employees, available at http://www.safety.rochester.edu/ih/jhaassess.html.
- Supervising employees in the implementation of engineering controls, safe work
practices, and Personal Protective Equipment (PPE) used to reduce potential
exposure to the lowest practical level
- Investigating and reporting incidents relating to the use of hazardous chemicals
- Selecting chemicals, supervising the use and disposal of chemicals, and
maintaining access to a current chemical inventory, and availability of the MSDS of hazardous
chemicals for all work locations under their direction
- Maintaining training records of all those in the department that have attended
training sessions relating to Haz Comm
- Employees responsibilities include:
- Awareness of the hazards associated with the chemicals used and the methods of
reducing exposures.
- Planning and using chemicals in accordance with established safe work practices
and protocols
- Using all of the appropriate PPE required for working with a chemical
- Disposing of chemicals in an appropriate manner
- Reporting unsafe conditions to their supervisor
- Reporting incidents of hazardous chemical exposure to their supervisor
- RECORDS
- Chemical inventories will be maintained by each department and maintained in the University's Chemical Inventory / MSDS System.
- Attendance records of Haz Comm sessions conducted by department supervisors are to
be retained in employee files or in an office training file.
- Injuries or chemical exposures will be documented on an SMH115 Incident Report Form. This
form is available on line at: http://www.safety.rochester.edu/SMH115.html.
- Medical records will be retained as established by University protocol.
- MULTI-EMPLOYER WORKPLACE
EH&S will provide an inventory of the chemicals and a copy of the MSDSs to outside
contractors for those hazardous chemicals used in the immediate work/construction area.
Outside contractors are required to have an MSDS for any hazardous chemical brought onto
University property and have them readily available to their employees and to the
University. Contractors using particularly hazardous materials (based on flammability,
toxicity or stench odor) must receive EH&S approval prior to use.
- SECTION 2: REQUIRED EMPLOYEE INFORMATION & TRAINING
The OSHA Hazard Communication Standard requires that employees
be informed of the requirements of the Standard, the location of the written
Hazard Communication Plan, operations in the workplace involving hazardous chemicals,
lists of hazardous chemicals used in the workplace and the location of MSDSs
for these chemicals. Review of this program and completion of the attendance
sheet and quiz meets the minimum requirement for awareness training. The supervisor
must provide documented site-specific training to all staff on the chemicals
used in the work area.
The University's Written Hazard Communication Plan is available
from EH&S (ext. 5-3241) and through the web at www.safety.rochester.edu/ih/hazcom.html.
- TRAINING
- Required Training and Frequency of Training
The University provides employees with information
and training to ensure they are mindful of the hazards of chemicals present in their
work area. Awareness Training is made available at New Hire Orientation before the
employee's initial work assignment begins. Site-specific training must be provided at
the initial job assignment. EH&S will provide additional periodic training in those
departments where special hazards have been identified.
Documentation of the training provided at New Hire Orientation and other sessions held
by EH&S will be maintained by EH&S for a period of up to 5 years. Continuing employee training for special hazards
in an employee's work area will be the responsibility of the supervisor.
The IH Unit can provide reference and/or videotape materials to assist the
supervisor in training for site specific chemicals or procedures that may introduce a
risk to the employees.
Retraining is required when a new hazard is introduced in a work area.
Supervisors may request the assistance of EH&S with the periodic retraining for their
employees.
- Purpose and Content of Training
The purpose of Hazard Communication training is to inform individuals of the risks
and hazards associated with chemical use and what to do if an emergency occurs. General
awareness training conducted by EH&S consists of an overview of:
- The existence of the Hazard Communication program (Haz Comm) and its
requirements
- How to read and understand the material found on an MSDS
- Methods to minimize employee exposure to hazardous chemicals
- Signs and symptoms associated with exposure to hazardous chemicals
- Location and availability of known reference materials, including MSDS,
outlining the hazards, safe handling, storage, and disposal of hazardous chemicals
- Proper use and limitations of personal protective equipment (PPE)
- Proper use of emergency equipment and the limitations of safety equipment
- Emergency procedures to follow in the event of a chemical spill
Site-specific training needs to be provided at the employee’s initial job assignment.
Continuing employee training for special hazards in an employee's work area will be the
responsibility of the supervisor.
- READING AND INTERPRETING MSDSs & LABELS
The two key written materials that convey information on the hazards of chemicals
are Material Safety Data Sheets (MSDSs) and labels. The Hazard Communication Standard
requires that MSDSs be available for all hazardous chemicals and that all containers of
these chemicals be labeled. This section gives valuable information on what to expect and
how to use the information on MSDSs.
- Material Safety Data Sheets (MSDSs)
A copy of the Material Safety Data Sheet
(MSDS) must be readily available for all chemicals used. MSDSs are sent by the
manufacturer/supplier for the first order of the chemical.
Departments should maintain department-specific chemical inventories and corresponding
MSDSs. On-line access to department chemical inventories will be maintained at www.safety.rochester.edu.
Departments will be responsible for providing EHS with annual updates. Any staff member may request a
copy of any MSDS from the applicable department.
Patient Care Areas will maintain access to applicable department chemical inventories. In addition, any
Patient Care Area which orders chemical products outside of SMH departments will maintain an inventory of
the chemical products from outside vendors along with copies of the Material Safety Data Sheets.
Assistance with obtaining MSDSs is available by calling EH&S at 275-3241. Chemical information is
also available 24/7 by calling the Poison Control Center at 275-3232.
Because the Hazard Communication Standard requires certain information to be included on MSDSs but not a rigid format,
variation among MSDSs will occur. The following list is a breakdown of the required
sections on an MSDS:
- Section I Manufacturer Information - Lists the manufacturer’s name, address,
telephone and provides emergency numbers.
- Section II Hazardous Ingredients/Identity Information - Provides a listing of
the chemicals found in the listed material and the allowable exposure limits.
- Section III Physical/Chemical Characteristics - Gives information including the
boiling point, solubility, melting point and other technical information of the
material.
- Section IV Fire and Explosion Hazard Data - Provides the temperature at which
product burns, type of extinguisher needed for fires and other information in case
of a fire.
- Section V Reactivity Data - Lists chemicals that are not compatible with this
material and gives hazard information.
- Section VI Health Hazard Data - Lists different ways the chemical can enter
body. For each mode of entry, the possible health effects are listed. Specific
health effects such as carcinogenicity and reproductive effects are also listed.
- Section VII Precautions for Safe Handling and Use - Gives special material
handling data and spill procedures.
- Section VIII Control Measures - Lists recommendations for PPE and if special
ventilation requirements are needed.
Appendix 3 is a blank MSDS which has been filled in with the kind of information that
would be found on an actual MSDSs. Any reproductive health hazard information will be
listed in the Health Hazard Data Section of the MSDS. Because many chemicals have not
been tested for potential reproductive health effects some MSDSs will state that the
effects are unknown.
- Labels and Signs
The hazard warnings on the label outline the
appropriate measures to be taken in the case of an emergency and give the main
hazard(s) associated with the use of the chemical. If a label is missing from a
container in which the chemical can be properly identified, a new label shall be
affixed containing the appropriate information. Never mix chemicals that do not have
proper labels. Never assume an unlabeled container is harmless. Also never remove any
label unless you immediately replace it with a new label containing the information
removed on the previous label. Labels are an important first source of information on
the chemicals used in the workplace. Labels can be seen as a condensed version of an
MSDS. The following information is required to be affixed on all containers of hazardous
chemicals:
- All purchased chemicals, purchased solutions, and in-house prepared solutions
must have identity labels showing:
- The identity of the hazardous chemical(s) with proper names.
- Appropriate hazard warnings such as FLAMMABLE or CORROSIVE etc.
- The name/address of the chemical manufacturer, importer or
responsible party.
- Abbreviations are not an acceptable method to identify the contents of a
container.
- Product labels and DOT shipping labels must be retained on all bulk quantities
of chemicals.
- Signs indicating the location of safety showers, eyewash stations, and other
safety and first aid equipment are required.
- Warnings signs are required in areas or on equipment where special or unusual
hazards exist.
- LIMITING CHEMICAL EXPOSURES
Three main methods exist to control exposure: engineering controls, safe work practices,
and personal protective equipment (PPE). Actions made when procuring, storing, and
disposing of chemicals can limit exposures.
- Engineering Controls
Engineering controls are the preferred method of reducing exposure. Engineering controls
should be used whenever the chemical hazard information on the chemical label or the MSDS
indicates a need. A common need for engineering controls is indicated when an MSDS states
“use local exhaust.” Examples of engineering controls include switching to a less hazardous
chemical, isolating the chemical by using isolation rooms or using remote equipment, and
using special local ventilation.
- Safe Work Practices
Safe work practices offer a second method to reduce exposure after the use of
engineering controls. MSDS and chemical labels should be reviewed for specific work
practice instructions before using chemicals. Additional safe work practices include not
working alone, washing hands after using chemicals, and reducing the amount of chemicals
used or stored.
- Personal Protective Equipment (PPE)
PPE should be used in addition to, but not as a substitute, for engineering controls
and safe work practices to reduce exposure. PPE may consist of respiratory protection,
eye protection, face protection, gloves, hearing protection, and protective clothing.
MSDS and chemical labels contain specific information on the proper PPE needed. The supervisor is to fill out the most recent edition of EH&S's PPE Job
Hazard Assessment Form, available on line at http://www.safety.rochester.edu/ih/jhaassess.html, to
assist in the proper selection of PPE. When PPE is selected, its use shall be in accordance with OSHA
standard 29 CRF 1910 subpart I, sections 132-139, and in consultation with the manufacturer.
Personnel must wear PPE to help prevent chemical exposures. See the University’s
Personal Protective Equipment Plan, available through EH&S or the web. Adequate PPE needed for
the performance of a job function is to be provided by the supervisor at no cost to the
employee.
- Chemical Procurement, Distribution, Storage and Disposal
- Procurement
- Before a substance is used, an MSDS with information on proper handling,
storage, and disposal shall be obtained and made available for those who will be
using the substance. No container is to be accepted without an adequate
identifying label. Manufacturers’ labels are not to be defaced or removed.
- Whenever possible, supervisors should consider using alternative chemicals for
very hazardous chemicals.
- To reduce future wastes, purchase only those quantities necessary.
- Distribution
When chemicals are transported by hand or cart, the container should be placed
within a second, larger container or bucket.
- Storage
- Periodic inventories must be conducted. An example of a chemical inventory
sheet is located in Appendix 2. Updated information is to be entered into the University's Chemical Inventory / MSDS System. The Hazardous Waste Unit must be consulted before
disposal of unneeded or excess items. At least annually a visual inspection for
replacement, deterioration, and of container integrity should be performed when
inventories are updated.
- Chemicals must be stored correctly. Consult the MSDS and product labels for
recommended storage procedures. Manufacturers should be consulted for additional
storage recommendations.
- Disposal
- All hazardous waste generated shall be disposed of in accordance with local,
state and federal regulations. The Hazardous Waste Management Unit shall be
contacted for guidance on the disposal of any chemical waste.
- Training on the proper disposal of hazardous waste is available. Contact the
Hazardous Waste Management Unit (x5-2056) for a copy of the “Learners Guide for
Responsible Hazardous Chemical Waste Management” and/or the use of a training video
on hazardous waste management.
- SECTION 3.: CHEMICALS - HAZARDS AND EMERGENCY RESPONSE
- EXPOSURE LEVELS
Minimizing exposures to chemicals is important to worker safety. Consulting the
MSDS can provide valuable information on preventing exposures to chemicals. Effects from
adverse chemical exposures can lead to long-term health effects. Exposures to chemicals
are described in many ways. Acute, or short term, exposures are exposures that occur over
a very short period of time, usually less than 15 minutes. Chronic, or long-term,
exposures occur over a long period of time, usually weeks or years.
OSHA regulates the amount of a chemical an employee can be exposed to. OSHA’s
Permissible Exposure Limits (PEL’s) for a chemical is a legal regulatory limit, time
weighted average, which cannot be exceeded over an 8-hour work period. Short Term Exposure
Limits (STEL’s) are limits that cannot be exceeded for more than 15 minutes.
The American Congress of Governmental Industrial Hygienist (ACGIH) publishes a list
of Threshold Limit Values (TLV’s) for chemicals. The TLV for a chemical is the recommended
maximum average airborne concentration of a chemical that is thought most people can be
exposed to for an 8-hour limit with no ill effects.
Methods of detecting chemicals can include:
- Monitoring by the employer
- Continuous monitoring devices
- Observation of the chemical’s appearance, odor, or other
characteristic.
- MEDICAL CONSULTATIONS AND EXAMINATIONS
Medical consultations and examinations are available for chemical exposures from
the University Health Service (UHS). In the event of a serious injury or an after hour's
emergency, care is available from Strong Memorial Hospital's Emergency Department. All
required medical examinations and consultations are performed by, and under the direct
supervision of, a licensed physician and are provided without cost to the employee.
- Consultations
Consultations and medical examinations for work-related illnesses, injuries, and
exposures are made available under the following circumstances:
- When an employee develops signs or symptoms associated with a hazardous
chemical to which he/she may have been exposed
- Where exposure monitoring reveals any exposure levels routinely above
the OSHA Action Level (AC) or Permissible Exposure Limit (PEL) for which
there are exposure monitoring and medical surveillance requirements
- Whenever an unusual event takes place in the work area such as a
spill, leak, explosion, or other occurrence resulting in the likelihood of
an exposure above the PEL.
- Chemical Exposures
- Between 8:00 AM and 4:30 PM, phone the University Health Service (UHS)
Occupational Health Nurse at ext. 5-1164 (or pager 16-4152). Identify
yourself, state that a person has been exposed to a chemical (how and
which one), what preliminary precautions have been taken, and that the
exposed patient is on the way to UHS. Send with the patient the name of
the chemical(s) exposed to and, if possible, a copy of the MSDS. UHS is
located at G-5000 of the Medical Center.
- Between 4:30 PM and 8:00 AM, call ext. 13 (Security Emergency Dispatch)
and request a MERT Response.
- For any serious situation, call ext. 13 (Security Dispatch) and request
a MERT Response.
- Pre-placement Assessments
Specific groups of employees receive pre-placement health assessments and
annual reassessments through UHS.
- Special Programs
Special medical surveillance programs are provided when indicated by a
department's or division's unique needs and are available through UHS. The
department can call UHS Occupational Health Program at ext. 5-4955 for
department charges and other information.
- SPILL CONTROL POLICY
When working with chemicals, responding to chemical spills is vital to minimize
hazards. Preplanning the spill response saves time and minimizes hazards. Small spills
are those spills, which by their small volume or low toxicity, are not deemed to present a
health hazard to trained chemical users. Small chemical spills are to be cleaned up
immediately by the chemical user. Some spills can create slippery conditions that can
lead to additional hazards. The appropriate PPE must be worn when cleaning these spills to
help prevent exposures.
Some hazardous substances necessitate special clean-up procedures to minimize
hazards to clean-up personnel. Major spills are those spills, which by their large volume
or high toxicity present a health hazard under normal conditions. Clean up of these spills
should not be attempted by employees. Appropriate emergency services should be notified
immediately to arrange for a spill response team.
Spill Emergency Plan
- Emergency preplanning to be followed before working with toxic chemicals:
- Determine the potential location of releases.
- Determine the quantities of material that may be released.
- Know the chemical and physical properties of the material
(physical state, vapor pressure, air or water reactivity).
- Know the hazardous properties of the material (toxicity,
corrosivity, flammability).
- Have the required PPE and spill kits available.
- In the event of a small spill, the following general procedures
are to be followed:
- Attend to any persons who may have been contaminated. If
personal exposure may have occurred, have the person use the eye
wash station or safety shower. Direct the person to appropriate
medical facilities.
- Notify persons in the immediate area of the spill.
- Close the door.
- Avoid breathing vapors of the spilled material.
- Leave any local exhaust ventilation on.
- Secure supplies to effect clean-up.
- During clean-up, wear the appropriate PPE.
- Place the collected waste in an appropriate container for
disposal.
- In the event of a major spill, the following procedures are to
be followed:
- Attend to any persons who may have been contaminated. If
personal exposure may have occurred, have the person use the eye
wash station or safety shower. Remove the person from the area and
seek medical assistance if needed.
- Alert others in the immediate area of the spill. Evacuate
personnel from the area.
- Confine the fumes/vapors from the spill by closing the door to
the room where the spill occurred.
- Contact Security (ext. 13) from a safe location.
- Be available for the emergency spill response personnel to
provide information concerning the spill and other hazards that
may be present in the spill area.
- COMMON CHEMICALS
This section is designed to provide information of common chemicals used by medical staff
in a clinical setting. This section might not include all chemicals used in specialty
medical areas but it is designed to cover the majority of chemicals encountered. Those
chemicals used that are not listed need to be reviewed by the supervisor so the hazards
and means of protection can be established and explained to the employees.
Several of the chemicals in this section present potential reproductive hazards to
personnel working with them. The University’s Reproductive Protection Policy, Appendix 4,
should be consulted prior to the use of these chemicals. Radionuclides, including
radioactive iodine and implanted radioactive seeds, are not covered under this program.
Contact Radiation Safety at ext. 5-3781, for information on the hazards and safety
precautions for these materials.
Information on chemicals/groups can be found in the University's Chemical Inventory/MSDS System. A brief summary of the chemicals medical staff most commonly come in contact with follows:
- Antineoplastic (chemotherapeutic) Agents
Strong Memorial Hospital Policy 7.10 entitled Antineoplastic and Other
Toxic Agents - Guidelines for Handling can be found in the SMH Policy
Manual. A copy of this manual can be found on each hospital unit. This policy is
designed to inform nurses and other staff on the precautions and handling
procedures necessary to properly work with these agents. The policy has information
regarding the routine use, administration, clean-up of spills, and disposal of
excreta from patients being treated with these agents. The policy covers all
antineoplastic agents used in the hospital and includes a cross-reference listing
for the drugs. Material Safety Data Sheets are available from the SMH Pharmacy and
from EH&S.
- Disinfecting Agents
These are used by employees to disinfect instruments, contaminated surfaces and
other items to prevent the spread of organisms and infection. Some cold
disinfecting agents contain chemicals such as glutaraldehyde, which may have
adverse health effects associated with them. Disinfectants containing chemicals
such as glutaraldehyde should be used in well-ventilated areas. These areas must be
pre-approved by Infection Control and EH&S. The potential for skin contact or
breathing vapors should be minimized. When performing duties with the potential of
creating splashes or sprays, proper eye protection must be worn to prevent eye
contact with the chemicals. Appropriate gloves and gowns / lab coats must be used
to minimize dermal exposures. Disinfecting agents should be sprayed onto a cloth
whenever possible instead of spraying directly on surfaces to minimize the amount
of chemical aerosolized.
- Housekeeping Chemicals
These are used by staff for spot cleaning or by Housekeeping or USA employees.
Environmental Services maintains MSDSs for all of the chemicals they use in SMH. In
general the majority of chemicals used by Environmental Services have a low hazard level.
Gloves are to be used to prevent dermal exposure. For those tasks where the risk of
eye exposure is possible, safety glasses, goggles, or a face shield is required.
The most hazardous chemicals, such as floor strippers, are used infrequently and
require special precautions.
- Anesthetic Gases
These gases can be found in the operating rooms, labor & delivery,
emergency department, outpatient clinics, dental surgery, and recovery rooms and
may be found much less frequently in other areas. Anesthetic gases used include
nitrous oxide, halothane, enflurane, and isoflurane. Anesthetic gases can be
released and cause exposures by the following pathways: during hook-up and
check-out of the system, gas seeping out of a patient's mask which does not fit
properly, leaks in hoses fittings and other parts of the delivery system, gas
escaping from scavenging systems (designed to capture excess and exhaled gas), and
when a post-operative patient exhales gas into the room. The hazards associated
with exposure to anesthetic gases are listed below.
- Nitrous Oxide - Acute exposure by inhalation to high concentrations of
nitrous oxide can cause central nervous system depression, drowsiness,
lightheadedness, confusion, hysteria, anesthesia and unconsciousness. Chronic
occupational exposure has been linked to neurologic problems, bone marrow
depression, and kidney and liver disorders. Spontaneous abortions and fetal
malformations have been reported in dentists and their assistants and linked
to Nitrous Oxide exposure. Skin and eye exposure with liquid nitrous oxide can
cause frostbite.
- Halogenated Anesthetic Gases - These gases include Halothane, Enflurane,
and Isoflurane. Acute exposure to these gases can cause respiratory depression,
muscle relaxation and loss of consciousness. Waste anesthetic gases are
considered chronic low-level health hazards. Suspected health effects include
hepatic and renal diseases. Studies of health care workers have linked exposure
to waste anesthetic gases with cancers, spontaneous abortions, fetal
malformations, infertility and sterility.
- Compressed Gases
These gases are considered a physical hazard by the Hazard Communication Standard
and should be treated with care. Regardless of the chemical composition of the
compressed gas, any cylinder or other container with pressurized contents presents a
significant physical hazard if the gas is released uncontrollably. Read the label of
the compressed gas cylinder to determine the contents and the possible health hazard
it may present to you. Cylinders also present a hazard to ankles, feet and toes when
they are dropped or tipped over. All cylinders shall be fastened to a sturdy object
with straps, chains or other devices. All cylinders not being used should have a
protective cap covering the cylinder valve. Also some compressed gases can present a
health hazard to you.
- Mercury
Elemental Mercury or silver mercury can be found in many types of medical care
equipment including thermometers, Cantor tubes, Coulter counters and sphygmomanometers. Although most mercury containing items are no longer used at SMH, some isolated locations may sstill be using them.
Mercury is an odorless chemical that generates vapors at room temperature. The main
route of mercury exposure is the inhalation of mercury vapors. Skin contact and
ingestion of elemental mercury should also be avoided. Short-term exposure to high
levels of mercury can cause severe respiratory irritation, digestive disturbances and
renal damage. The health hazards associated with chronic exposure to relatively low
levels of mercury vapor are significant and include central nervous systems effects,
tremors, irritability, emotional instability, gingivitis, anorexia and weight loss.
Mercury is also nephrotoxic and can cause sensitization dermatitis. Care should be
taken to avoid exposure to mercury vapors and keep all areas free of mercury
contamination.
The proper clean up and disposal of mercury in the event of a spill is outlined in the
Nursing Practice Manual E 27.0 Guidelines for Disposal of Hazardous Material -
Mercury. Nurses are responsible for the clean up of broken thermometers following
the guidelines listed in the document. The amount of mercury in a thermometer is not
enough to cause adverse health effects but must be properly cleaned up. Larger spills
or releases of mercury such as a blood pressure manometer or a cantor tube are
cleaned-up by emergency responders. Upon recognition of a broken manometer or other
large source of mercury the nurse should relocate patient (if possible) and contact
SMH Housekeeping. Quick response and clean up by properly trained staff limits the
exposure to mercury vapors and prevents lingering problems of contamination. EH&S’
Industrial Hygiene Unit monitors areas where spills of "mercury" manometers
occur to verify the clean up procedures removed all the mercury released from the
spill. Appendix 5 provides information to assist personnel in the clean up of small
mercury spills.
- Isopropyl Alcohol
This is commonly used in medical applications as both an antiseptic and a
disinfectant. In addition to being flammable, isopropyl alcohol can cause irritation
to the eyes, nose and throat. It can cause defatting of the skin, which leads to
irritation, drying and cracking. Contact dermatitis has also been noted. Exposure to
high concentrations has a narcotic effect with symptoms of drowsiness, headache,
staggering and unconsciousness.
- Formaldehyde and Formalin Solutions
These solutions are used in some other patient care areas to fix tissue samples. Formaldehyde is prepared in aqueous
solutions ranging in concentration up to 37%. Formaldehyde is considered a carcinogen
by OSHA, NTP, IARC and ACGIH. A number of cancers have been associated with exposure to
formaldehyde however the strongest associations found concern nasal and nasopharyngeal
cancer. Chronic exposure has also been associated with lung cancer in humans.
Acute exposure to formaldehyde can cause severe irritation of the skin, throat and
nose. High levels can cause tissue damage and severe respiratory tract injury.
Formaldehyde is also a pulmonary sensitizer. Specimen containers containing
formaldehyde solutions should be handled carefully. Proper protective equipment,
including gloves and gas-proof goggles, should be worn and proper ventilation is
required when there is a potential for exposure. In the event of a spill of a specimen
container, soak up the spilled liquid with paper towels and place the debris in a
sealed container for disposal as hazardous waste. Appendix 6 lists the steps to take for spills of formaldehyde containing materials.
- Prescription Drugs
Prescription drugs and other pharmaceutical agents in a liquid form can present an
opportunity for chemical exposure. Prescription drugs in solid form can present a
potential for exposure if the materials are cut, crushed, or powdered. The hazards to
personnel vary based on the concentration of the active ingredient and the mode of
entry. The MSDS for these liquid chemical agents and those agents that may be crushed
or powdered must be made available in accordance with the OSHA Hazard Communication
Standard and are available from the SMH Pharmacy, Poison Center or EH&S.
- Pentamidine
This is a drug that is administered primarily in aerosol form to patients being
treated for Pneumocystis carinii pneumonia. Acute irritation has been noted in staff
members exposed to the aerosol. Staff members administering pentamidine should make
efforts to minimize the release of aerosolized pentamidine and limit the amount of time
spent in the room where the drug is administered. Refer to the SMH’s Pentaminidine
Policy, available on the web and SMH Policy Manual. The chronic health effects and
reproductive effects are unknown at this time so care should be taken to minimize
exposure to the drug.
- Ribavirin (Virazole)
This is another drug used in aerosol form in the clinical setting. Ribavirin is
used to treat lower respiratory tract infections caused by respiratory syncytial virus
(RSV). Ribavirin is aerosolized into a tent or hood containing the patient. Exposure
occurs when staff are required to enter the tent and from passive leakage from the
tent. Health care workers exposed to ribavirin have complained of severe headaches,
eye irritation, coughing and upper respiratory tract irritation. Lung irritation,
wheezing and shortness of breath has been noted in people with asthma. Ribavirin has
also been found to be teratogenic and/or embryo lethal in studies on rodents. Currently
there is no data on reproductive effects in humans. Pregnant employees or employees
planning pregnancy should use the recommended procedures and personal protective
equipment to limit exposure.
- CLOSING COMMENTS
Information on chemicals is readily availabe to personnel through the University's Chemical Inventory / MSDS System. Product labels and MSDSs contain valuable information on using chemicals safely, first aid and
emergency procedures. In the event of a spill, call Security at
ext. 13 and request the assistance of EH&S. Should an exposure occur, personnel are to use the appropriate first aid. The Poison Center (ext. 5-3232) can provide useful information for further medical treatment that may be needed.
If this guide raises questions, problems or if
you have suggestions, please contact the Industrial Hygiene Unit at ext. 5-3241.
APPENDIX 1
DEFINITIONS OF HAZARDS
Physical Hazards:
Combustible - ignites at 100oF or above but below
200oF.
Compressed gas - gas under high pressure in a cylinder,
hazard of violent release if valve is broken off or cylinder is dropped.
Explosive - ignites suddenly and violently.
Flammable - ignites at temperature below 100oF.
Organic peroxide - explodes if shaken or shocked; some liquids
such as ether form organic peroxides after long storage times if stored improperly.
It has a chemical structure related to hydrogen peroxide.
Oxidizer - gives off oxygen and will support combustion
(Examples: sodium nitrate, sulfuric acid).
Pyrophoric - catches fire in air without needing a source
of ignition at a temperature of 130oF or below.
Unstable (reactive) - may react in air or with other chemicals,
causing explosion or heat.
Water reactive - reacts spontaneously in contact with water
giving off toxic or ignitable vapors or causing hazardous pressure increases.
Health Hazards:
Carcinogen - has been found to cause cancer in humans or
at least two experiments with animals.
Corrosive- causes burns to human tissue on contact (Examples:
sulfuric acid, lye, phenol).
Highly Toxic - contact with a small amount of the chemical
(1 teaspoon or less) may cause illness from single exposure.
Irritant - causes irritation of skin, eyes or upper respiratory
tract.
Sensitizer - may cause allergic reactions such as skin rash,
especially after repeated contact.
Target Organ Effects - chemical causes harm to a certain
organ or organs of the body.
Toxic - causes illness, but need single contact with larger
amount of the chemical than for "highly toxic" chemicals or repeated
contacts with smaller amounts.
APPENDIX 2
CHEMICAL INVENTORY
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NAME OF CHEMICAL
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MANUFACTURER & ADDRESS
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STORAGE LOCATION
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HAS MSDS BEEN RECEIVED? YES/NO
*
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PPE REQUIRED FOR USE**
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Add any chemicals whenever a new chemical is introduced in the workplace.
NAME OF PERSON COMPLETING INVENTORY:________________________
DATE OF INVENTORY: ______/______/______
* If the MSDS is not available, call the chemical supplier for a copy.
**List the PPE required for using the chemical in this column.
APPENDIX 3
BLANK MSDS
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Material Safety Data Sheet
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U.S. Dept. of Labor OSHA
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OSHA's Hazard Communication Standard, 29 CFR 1910.1200.
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(Non-Mandatory Form)
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Standard must be consulted
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Form Approved
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for specific requirements.
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OMB No. 1218-0072
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IDENTITY (As Used on Label and List)
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Note: Blank spaces are not permitted. If any item is not applicable,
or no information is available, the space must be marked to indicate that.
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Section I
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Manufacturer's Name
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Emergency Telephone Number
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Address (Number, Street, City, State, and ZIP Code)
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Telephone Number for Information
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Date Prepared
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Signature of Preparer (optional)
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Section II - Hazard Ingredients/Identity Information
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Hazardous Components (Specific Chemical Identity; Common Name(s))
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OSHA PEL
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ACGIH TLV
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Other Limits Recommended
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%(optional)
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Section III - Physical/Chemical Characteristics
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Boiling Point
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Specific Gravity (H2O = 1)
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Vapor Pressure (mm Hg.)
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Melting Point
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Vapor Density (AIR = 1)
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Evaporation Rate (Butyl Acetate = 1)
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Solubility in Water
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Appearance and Odor
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Section IV - Fire and Explosion Hazard Data
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Flash Point (Method Used)
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Flammable Limits
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LEL
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UEL
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Extinguishing Media
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Special Fire Fighting Procedures
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Unusual Fire and Explosion Hazards
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Section V - Reactivity Data
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Stability
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Unstable
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Conditions to Avoid
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Stable
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Incompatibility (Materials to Avoid)
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Hazardous Decomposition or Byproducts
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Hazardous
Polymerization
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May Occur
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Conditions to Avoid
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Will Not Occur
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Section VI - Health Hazard Data
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Route(s) of Entry:
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Inhalation?
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Skin?
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Ingestion?
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Health Hazards (Acute and Chronic)
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Carcinogenicity:
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NTP?
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IARC Monographs?
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OSHA Regulated?
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Signs and Symptoms of Exposure
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Medical Conditions Generally Aggravated by Exposure
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Emergency and First Aid Procedures
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Section VII - Precautions for Safe Handling and Use
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Steps to Be Taken in Case Material is Released or Spilled
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Waste Disposal Method
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Precautions to Be taken in Handling and Storing
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Other Precautions
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Section VIII - Control Measures
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Respiratory Protection (Specify Type)
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Ventilation
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Local Exhaust
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Special
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Mechanical (General)
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Other
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Protective Gloves
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Eye Protection
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Other Protective Clothing or Equipment
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Work/Hygienic Practices
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APPENDIX 4
REPRODUCTIVE PROTECTION POLICY
APPENDIX 4
REPRODUCTIVE
PROTECTIVE POLICY
The
following is a reprint of the University of Rochester's Policy 167, Reproductive Protection Policy, issued 5/92 by Personnel.
Subject:
Reproductive Protection Policy
Applies
to: All Faculty and Staff
- Policy: Some work locations at the
University may, because of the nature of the work, pose potential health risk
to employees during their fertile years. The University is committed to minimizing
these risks through safety education and management but realizes that some
risks may still exist. Employees need to understand those risks and be able
to make informed decisions about working in those settings.
The University will provide employees who work in areas which contain hazardous
chemicals or radiation with a copy of this policy prior to their accepting
employment or transfer opportunities. The University will advise final applicants
and employees of the known risks and assist employees in taking appropriate
precautions. While accepting employment may mean accepting some risks, the
individual (applicant or staff member) is responsible for making this decision.
- Guidelines:
- Administration of this policy
is the responsibility of Deans and Directors. Implementation of this policy
is the responsibility of the supervisor and the employee. All employees
-- both male and female -- shall be made aware of the known risks and reproductive
hazards in their work. Employees whose work involves possible exposure to
agents that are known to cause injury to the sperm, egg or fetus shall be
informed of the risks and how to minimize them.
- Technical advice is available
from the Environmental Health & Safety Office (EH&S), and medical
advice from the University Health Service Occupational Health Staff.
- As part of its compliance
with the OSHA Laboratory Safety Standard and the Hazard Communication
Standard, the University will provide written information and training
based on current scientific and medical consensus about the specific hazards
of each workplace in which chemicals are used.
- Material Safety Data Sheets
(MSDS) are available to each employee in the workplace to review. The
MSDS's describe the specific hazards, including any reproductive hazards,
of each chemical and what work practices and/or protective equipment are
necessary to reduce risks of exposure.
- Supervisors are required
to inform final applicants and candidates for transfer about the known risks
in areas which contain hazardous chemicals and/or radiation.
- Supervisors should provide
final candidates for positions with a copy of this policy.
- It is the supervisor's
responsibility continuously to train and reinforce good work practices
and safety rules to minimize risks of exposure.
- Current employees and applicants
who are offered positions have the responsibility for knowing and understanding
this policy. They also have the right to choose or refuse placement in an
area which contains hazardous chemicals and/or radiation.*
- If an eligible employee
becomes pregnant and wishes a change in duties, the supervisor, if possible,
will attempt to accommodate the employee's request. If accommodations
are not possible, the eligible employee has the choice of remaining in
the position, seeking a transfer (with no guarantees of alternate placement),
taking a leave without pay (with the approval of the supervisor), or resigning.
- If a current employee's
job changes so that he/she is placed in an area which contains hazardous
chemicals and/or radiation, the employee will be provided the opportunity
to seek a transfer. If no other positions are available, the employee
has the option of remaining in the position, or being placed on layoff.
- An internal applicant who
seeks a transfer and is offered a position in an area which contains hazardous
chemicals and/or radiation may decide to remain in his/her current position.
If the employee is placed on layoff because his/her current position is
being eliminated, the layoff policy will still be in effect.
*Departments with represented employees must consult the applicable collective
bargaining agreement and the Offices of Human Resources at the Medical
Center or River Campus.
- Procedures:
- Supervisors should provide
copies of this policy to all final candidates.
- EH&S will provide written
information and training as required.
- Departmental supervisors
are responsible for providing immediate and on-going training about the
safety precautions for specific work sites and about the hazardous chemicals
and/or radiation in the employee's workplace. Compliance with OSHA Standards
requires that employers make Material Safety Data Sheets (MSDS) readily
available in the workplace to all employees and notify employees of that
location.
- EH&S will conduct introductory
training on safety for newly hired personnel and refresher training for
current employees who will be or are assigned to areas which contain hazardous
chemicals and/or radiation. The Offices of Human Resources at the Medical
Center or River Campus will provide names of newly hired people and their
area of assignment. EH&S will notify the appropriate departments about
the time and place for the training and list the people who are required
to attend. Compliance with OSHA Standards requires that employers provide
training for all employees who work with hazardous chemicals.
- At the end of the EH&S
initial training session, EH&S Staff will ask employees to sign a
statement that they have received safety training. EH&S Staff will
forward statements which will be placed in the University's personnel
file of each individual trained.
- The Office of Human Resources
at the Medical Center or River Campus is available for assistance when offers
are being made to final candidates and for additional information.
Appendix 5
MERCURY SPILL CLEAN-UP
PROCEDURES
Although mercury should not be found in patient care areas, the following guidelines have been established
to prevent mercury exposures to personnel and prevent the release of mercury
into the environment.
The proper clean up and disposal of mercury in the event of a spill outlined
in the Nursing Practice Manual E 27.0 Guidelines for Disposal of Hazardous
Material - Mercury. Nurses are responsible for the clean up of broken thermometers
following the guidelines listed in the document. The amount of mercury in a
thermometer is not enough to cause adverse health effects but must be properly
cleaned up. Larger spills or releases of mercury such as a blood pressure manometer
or a cantor tube are cleaned-up by emergency responders. Upon recognition of
a broken manometer or other large source of mercury, nursing is to relocate
the patient and contact SMH Housekeeping. Quick response and clean up by properly
trained staff limits the exposure to mercury vapors and prevents lingering problems
of contamination. EH&S’ Industrial Hygiene Unit monitors areas where spills
of "mercury" manometers occur to verify the clean up procedures removed
all the mercury released from the spill.
Exposure to mercury is most likely through
inhalation of mercury vapors. Health effects from mercury exposures can include
kidney damage and central nervous system disorders. The small quantity of mercury
in a thermometer does not present a health hazard to personnel if immediate
action is taken when a thermometer is broken. The concentration of mercury vapors
generated immediately after a spill is very low. However, the use of personal
protective equipment is still needed to prevent exposure.
Broken Thermometers
Only a small quantity of mercury can be found in
a standard laboratory thermometer. When a thermometer breaks, some or all of
the mercury may be released. Using a 3" x 5" index card, push the
mercury into a pile. Make sure peripheral areas are checked for mercury. If
any is found, push the mercury into the pile. Using two 3" x 5" cards,
gather the mercury droplets onto one of the cards and transfer the mercury into
a small plastic bottle. A special mercury sponge can also be used to absorb
the mercury. For those droplets that cannot be picked up using either of these
methods, use one of the following actions:
- Use a syringe (no needle) to suck up the mercury
- Use "scotch" tape and press the tape onto the mercury. By carefully
lifting the tape, mercury will remain on the tape.
For each of the listed steps, place the
collected mercury into a sealable non-metallic container. Place any part of
the thermometer that still contains mercury into the container. Go over the
area a second time to ensure that all the mercury has been removed. Contact
the Hazardous Waste Management Unit (ext. 5-2056) for disposal of the collected
material as hazardous waste.
After a mercury spill is cleaned up, a
flashlight can be used to check for any beads of mercury that may remain. Turn
off the room lights and shine a flashlight at the spill area. Any mercury that
still is present will be visible when the light shines on the mercury at a glancing
angle.
Barometers and Manometers
These devices contain a large quantity of mercury.
A trained responder must be called for clean up should a mercury spill occur
from one of these devices. To reduce the possibility of airborne exposures or
tracking the mercury into other areas, personnel should not be permitted to
enter the area. Clean up of these spills requires special equipment. It is important
to clean up the spill as soon as possible. Contact appropriate emergency resources
as needed.
Special Circumstances
Occasionally, mercury is spilled onto carpeting.
The only remedy for these spills is to remove the carpeting and dispose of it
as hazardous waste.
Appendix 6
FORMALDEHYDE SPILL PROTOCOL
FOR PATIENT CARE LOCATIONS
Formaldehyde solutions are used by medical care personnel for the preservation
of specimens. Typically, the concentration of these solutions is 3.7% formaldehyde,
commonly called formalin. OSHA’s Formaldehyde Standard, 29CFR1910.1048, requires
special labels on all formaldehyde containers. Locations that store or use
formaldehyde-containing materials must have an established spill plan to comply
with the OSHA standard. This protocol has been established specifically for
those locations where specimen containers are used or stored.
Formaldehyde solutions can present a health hazard from inhalation and direct
skin contact. Acute exposures to formaldehyde solutions can cause eye and skin
irritations. Exposure to vapors can result in respiratory and eye irritation.
To minimize possible exposures, storage containers must be stored properly and
personnel must be aware of action to take should a spill occur.
STORAGE REQUIREMENTS
Minimize the number of specimen containers in a location. The following guideline
is recommended for medical care locations:
- Central storage locations are to be non-patient
care areas that are properly ventilated. The quantity stored in these locations
should be limited to a one-month’s supply for any size container. The specimen
containers should be kept in the original shipping container, if possible.
If bins are used, the containers are to be stored stacked upright in the bin
to minimize potential spills. A label is to be placed on the shelf, cabinet,
or bin to identify the formaldehyde storage location.
- Storage in patient care rooms is to be limited to one week’s supply.
A recommended location is a labeled upper cabinet or a single drawer.
SPILL PROCEDURE
The EMERGENCY 13 Flip Chart was prepared to assist personnel on the action
to take for emergency situations. Please refer to this chart for detailed information.
Additional information is available through the Industrial Hygiene Unit (x5-3241).
Commercially prepared specimen containers have tight fitting tops that have
a very little probability of leaking. The most likely spill would be from an
open specimen container. Depending upon the size of the container, the quantity
of fluid is usually low (less than 100 ml) and is considered a minor spill,
capable of being cleaned up without the assistance of safety and emergency personnel.
The following steps are to be taken:
- Inform others in the area of the minor spill.
- Wearing the appropriate personal protective
equipment to prevent exposure (minimum of gloves and an outer garment), absorb
the spilled material with paper towels. Place the paper towels into a labeled
hazardous waste container, such as a heavy-duty bag.
- Wash the contaminated area two times with some soap and water. Dry
the area with paper towels. Place these paper towels into the labeled hazardous
waste container. Seal the container to minimize the release of formaldehyde
vapors.
- Dispose of the labeled hazardous waste
container through Hazardous Waste (call x5-2056 for a pick up – for SMH on-site
locations only).
QUESTIONS? Contact the EH&S Industrial Hygiene Unit at 275-3241 or e-mail EH&S Questions.
This page last updated 3/20/2007. Disclaimer.
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