To ensure the protection of frontline healthcare and emergency medical workers at high risk of infection with H1N1 virus, OSHA is expected to issue a compliance directive to ensure uniform procedures when conducting inspections to identify and minimize or eliminate high to very high risk occupational exposures to the 2009 H1N1 influenza A virus.
When conducting inspections in response to complaints, OSHA inspectors will ensure that healthcare employers implement a hierarchy of controls, including source control, engineering, and administrative measures, as well as encouraging vaccinations and other work practices recommended by the CDC.
Where respirators are required to be used, inspectors will be ensuring the OSHA Respiratory Protection standard is being followed, including worker training and fit testing. The CDC recommends the use of respiratory protection that is at least as protective as a fit tested disposable N95 respirator for healthcare personnel who are in close contact (within 6 feet) with patients with suspected or confirmed 2009 H1N1 influenza.
Since a shortage of disposable N95 respirators is possible, employers are advised to monitor their supply, prioritize their use of disposable N95 respirators according to guidance provided by CDC, and to consider the use of elastomeric respirators and facemasks if severe shortages occur. Healthcare workers performing high hazard aerosol-generating procedures (e.g., bronchoscopy, open suctioning of airways, etc.) on a suspected or confirmed H1N1 patient must always use respirators at least as protective as a fit-tested N95, even where a respirator shortage exists. In addition, an employer must prioritize use of respirators to ensure that sufficient respirators are available for providing close-contact care for patients with aerosol-transmitted diseases such as tuberculosis.
Where OSHA inspectors determine that a facility has not violated any OSHA requirements but that additional measures could enhance the protection of employees, OSHA may provide the employer with a Hazard Alert Letter outlining suggested measures to further protect workers.
FDA Warns of Unapproved and Illegal H1N1 Drug Products Purchased Over the Internet
The U.S. Food and Drug Administration (FDA) is warning consumers to use extreme care when purchasing any products over the Internet that claim to diagnose, prevent, treat, or cure the H1N1 influenza virus. The warning comes after the FDA recently purchased and analyzed several products represented online as Tamiflu (oseltamivir), which may pose risks to patients.
One of the orders, which arrived in an unmarked envelope with a postmark from India, consisted of unlabeled, white tablets taped between two pieces of paper. When analyzed by the FDA, the tablets were found to contain talc and acetaminophen, but none of the active ingredient oseltamivir. The Web site disappeared shortly after the FDA placed the order. At the same time, the FDA also purchased four other products purported to diagnose, prevent, treat, or cure the H1N1 influenza virus from other websites.
These products contained various levels of oseltamivir but were not approved for use in the United States. Several of the products purchased did not require a prescription from a health care professional. Additionally, the products did not arrive in a timely enough fashion to treat someone infected with the H1N1 influenza virus, or with an immediate exposure to the virus.
“Products that are offered for sale online with claims to diagnose, prevent, mitigate, treat or cure the 2009 H1N1 influenza virus must be carefully evaluated,” said Commissioner of Food and Drugs, Margaret A. Hamburg, M.D. “Medicines purchased from Web sites operating outside the law put consumers at increased risk due to a higher potential that the products will be counterfeit, impure, contaminated, or have too little or too much of the active ingredient.”
Consumers may not know exactly what they are getting when buying such antiviral products on the Internet from an unfamiliar company. Patients who buy prescription drugs from websites operating outside the law are at increased risk of suffering life-threatening adverse events, such as side effects from inappropriately using prescription medications, dangerous drug interactions, contaminated drugs, and impure or unknown ingredients found in unapproved drugs. This may particularly be the case in the event of a public health emergency, such as an influenza outbreak, where approved treatment options would be in high demand and expensive, and where drug shortages could occur. Drugs that are in high demand are vulnerable to counterfeiting and diversion because buyers may be desperate to stock the product, and criminals capitalize on the situation.
The FDA urges consumers to only purchase FDA-approved products from licensed pharmacies located in the United States. Consumers should contact their health care provider if they have any questions or concerns about medical products or personal protective equipment.
The two antiviral drugs approved by the FDA for treatment and prophylaxis of the 2009 H1N1 influenza virus are Tamiflu (oseltamivir phosphate) and Relenza (zanamivir). Tamiflu and Relenza, in addition to their approved label, have Emergency Use Authorizations that describe specific authorized uses during this public health emergency.
The FDA actively monitors the Internet, and where appropriate, will purchase and analyze drug products.
OSHA Reminds Grain Handling Operators of Required Safety Measures to Protect Workers
After a recent increase in the number of workers killed while performing grain handling operations such as loading, emptying, and cleaning grain storage bins, OSHA is reminding employers and workers of available resources and OSHA standards that identify hazards and offer solutions to prevent fatalities.
Providing proper protection and not allowing workers to walk or stand in products piled higher than waist high, reduces the risk of workers sinking and suffocating.
Recent incidents involved workers in grain handling facilities who died from falls, suffocation, and entanglement in equipment. While suffocation and falls are the leading causes of death at these facilities, fatalities can also occur from electrocutions, fires, and explosions.
"These deaths could have been prevented if proper safety measures were used," said acting Assistant Secretary of Labor for OSHA Jordan Barab. "Employers are responsible for knowing what hazards exist in their workplaces and ensuring that workers are not exposed to risks that could result in injury or death."
The standard also requires that employers develop an emergency action plan that protects workers from fires and other emergencies, and maintain a housekeeping program that controls dust accumulation.
NIOSH Makes Three New HHE Reports Available
NIOSH has made three new Health Hazard Evaluation (HHE) reports available.
Investigators found that some dust concentrations in the air exceeded current occupational exposure limits. Investigators recommended respiratory protection for all workers with work-related asthma and, if that is ineffective, relocating those workers to lower exposure areas.
Investigators found that auto insertion operators’ noise exposures were very low. Investigators found lead on employees’ hands, on work surfaces, and in a break room. Investigators recommended improving general housekeeping and using engineering controls when removing solder dross and cleaning wave solder machines.
Investigators found that all airport terminal service employees’ carbon monoxide levels measured in the evaluation were above recommended limits but transportation security and air logistics employees’ carbon monoxide levels were not. Investigators recommended replacing fuel-driven forklifts and tugs with electric ones, reminding drivers to turn off vehicle engines when at the dock doors, increasing warehouse ventilation, and installing carbon monoxide alarms.
NIOSH Seeks Comments on Protective Measures for Workers
NIOSH is seeking comments on the following topics that have been published in recent Federal Registers:
- Increasing adoption of cost-effective roll-over protective structures (CROPS) by farmers and manufacturers.
- Temporary reassignment for healthcare workers who work with hazardous drugs.
- Potential occupational health risks from the chemicals 1-Bromopropane and glutaraldehyde.
- Proposed enhancement to the occupational health data collected among healthcare workers in the National Healthcare Safety Network. NIOSH will also hold a public meeting in the Cincinnati area as part of the project.
See the Federal Register notices for information about submitting comments.
All-Feed Processing and Packaging Receives $518,520 OSHA Fine
OSHA has cited All-Feed Processing and Packaging Inc. in Galva, Illinois, with alleged serious, repeat, willful, and failure to abate citations of federal workplace safety and health standards. The proposed fines total $518,520.
OSHA began its safety and health inspections at the pet food research and packaging facility in response to a fire in April that sent three workers to a local hospital. The resulting inspection revealed nine alleged willful, four serious, two repeat, and two failure to abate violations.
Hazards identified as willful violations addressed the lack of explosion prevention systems for combustible dust, inadequate housekeeping where dust could accumulate, insufficient PPE, training deficiencies, failure to lockout energy sources during maintenance and other lockout/tagout issues, and the lack of warning signs where combustible dust was being processed. OSHA defines a willful violation as one committed with plain indifference to or intentional disregard for employee safety and health.
Serious violations included fall hazards and issues pertaining to employees entering or working in confined spaces where a variety of hazards could be present. A serious citation is issued when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known.
The repeat violation cites the company's failure to compile a list of hazardous chemicals used at the plant and the failure to include such a list in the hazardous communication program, and for the lack of proper employee training. The company had been previously cited for these violations and had agreed to correct the problems but had not done so. The failure to abate violations included use of flexible cords as a substitute for fixed wiring and equipment and wiring was not approved for hazardous locations.
"Recent events have shown the damage that can result from the failure to control dust and dust explosions," said OSHA Area Director Nick Walters, Peoria, Illinois. "The cost of human life and health is far too great a price to pay for anyone to ignore this hazard. All of us want to see working men and women go home safe at the end of every work shift."
In business since 1997, the company has been inspected by OSHA on seven occasions since January 2000. These inspections have resulted in the issuance of 31 serious, nine willful, four repeat, and seven other-than-serious citations.
OSHA Fines CES Environmental Services Inc. $207,800 Following Fatality at Texas Worksite
OSHA has cited Houston-based CES Environmental Services Inc., with one alleged willful, 32 alleged serious, and one other-than-serious violation following the death of a worker at the company's worksite in Port Arthur.
"Hazardous chemicals and the improper handling of those chemicals have unfortunately claimed the life of a worker," said Dean McDaniel, OSHA's regional administrator in Dallas. "If this employer had followed OSHA's standards, it is possible that this tragedy could have been avoided."
OSHA's Houston South Area Office began its investigation April 14 at the company's worksite on Gulf Way Drive following the death of a worker who was exposed to hydrogen sulfide. A willful citation was issued for failing to provide a rescue team to promptly respond to an emergency when workers enter a confined space.
The investigation found 32 serious violations, including failing to evaluate the worksite for exposures to hydrogen sulfide, develop procedures for waste stream processing, develop decontamination procedures, and train workers on the hazards associated with confined space entry on barges.
The other-than-serious violation was issued for failing to remove liquid waste as often as necessary.
OSHA cited CES with proposed penalties of $16,600 in December 2008 after the investigation of a worker's death in Port Arthur; and currently OSHA has an open investigation of a July fatality that occurred at the company's Houston location.
Proposed penalties for the April 14 investigation total $207,800.
Embalming Fluid Manufacturer Facing $138,000 in OSHA Fines for Formaldehyde and Other Hazards
OSHA has cited The Dodge Co. Inc., for 41 alleged violations of workplace safety and health standards at its Cambridge, Massachusetts, production plant. The embalming fluid manufacturer faces $138,000 in fines for inadequate safeguards involving formaldehyde stored and used in manufacturing processes at the plant as well as for various chemical, mechanical, and electrical hazards identified during comprehensive OSHA inspections conducted over the past several months.
OSHA found that the plant lacked a process safety management (PSM) program and procedures to proactively assess and address hazards associated with processes and equipment using large amounts of formaldehyde and that the plant also lacked controls and other safeguards to reduce the levels of formaldehyde to which some workers were exposed.
OSHA also identified numerous deficiencies in the plant's respiratory protection, emergency response, hazardous energy control, chemical hygiene, and chemical hazard communication programs as well as electrical hazards, unguarded moving machine parts, untrained forklift operators, failure to maintain work floors in a clean condition, and use of unapproved forklifts in areas where flammable materials are used.
"Workers' exposure to excess formaldehyde levels can impact their health, while the other conditions cited here pose more acute safety hazards," said Paul Mangiafico, OSHA's area director for Middlesex and Essex counties. "All of these hazards must be effectively corrected for the safety and health of the plant's workers."
As a result, OSHA has issued the company 38 serious citations for these hazards plus four other-than-serious citations for incomplete and inadequate recordkeeping.
OSHA Cites Industrial Pipe Fittings $116,500 for Alleged Safety and Health Hazards
OSHA has cited Industrial Pipe Fittings LLC (IPF) for 47 alleged serious and four alleged other-than-serious violations following an inspection at the company's facility in Corsicana, Texas. Proposed penalties total $116,500.
OSHA's Fort Worth Area Office began its inspection on April 20 when a worker had his hand crushed in-between a rotating, unguarded drum drive wheel and pipe while performing an overwrapping operation at the drum drive wheel machine station. The serious violations include failing to provide machine guarding on lathes, drum drive wheels and saws; provide fall protective equipment, ensure workers are protected from electrical hazards, provide training for forklift operations and hazard communication.
"This company failed to provide a safe and healthful working environment for its workers," said Zachary Barnett, OSHA's area director in Fort Worth. "If OSHA's standards were followed, it is possible this serious injury could have been avoided."
The other-than-serious violations included failing to meet OSHA's respiratory requirements by informing workers of the precautions and use of wearing a respirator and failing to provide a written personal protective equipment hazard assessment. An other-than-serious violation is one that has a direct relationship to job safety and health but probably would not cause death or serious physical harm.
OSHA Cites NuStar Asphalt Refining Co. and Proposes $105,750 in Fines for Workplace Safety and Health Hazards
OSHA has cited NuStar Asphalt Refining Co. LLC for 24 alleged serious workplace safety and health violations found at its Paulsboro worksite. Penalties proposed total $105,750.
OSHA initiated the inspection on April 14 as part of its National Emphasis Program (NEP) on Petroleum Refinery Process Safety Management. The violations include an ineffective process hazard analysis; no emergency escape respirators in the control room for use in the event of a toxic gas release; operating procedures needing to be updated and not addressing certain hazards; process safety information that did not include piping and instrument diagrams; and emergency shutdown procedures that did not identify and address certain hazards.
"This company needs to rectify these violations and revamp its safety management system immediately to avoid putting its workers in further potential danger," said Paula Dixon-Roderick, director of OSHA's Marlton, New Jersey, office.
NuStar, which employs about 85 workers, refines and manufactures principally liquid asphalt for a wide variety of applications.
OSHA Cites ConocoPhillips for Repeat Workplace Safety and Health Hazards and Proposes $92,000 in Penalties
OSHA has cited ConocoPhillips’ Bayway Refinery in Linden, New Jersey, for alleged workplace safety and health violations, and is proposing a total of $92,000 in penalties.
OSHA initiated a complaint investigation on April 23, 2009, at the facility. As a result of the investigation, the company has been issued citations for three repeat violations, with a penalty of $75,000, and four serious citations, with a penalty of $17,000.
"The identified violations leave employees at the refinery at risk of accidents that could result in injury or possible death," said Patricia Jones, area director of OSHA's Avenel, New Jersey office. "Employees are entitled to a safe and healthy workplace."
The repeat violations include the company's failure to implement safe operating procedures, failure to implement inspection and testing procedures, and failure to update piping and instrumentation diagrams after process changes. OSHA issues repeat violations when it finds a substantially similar violation of any standard, regulation, rule or order issued to the same employer within the previous three years. All previous citations were issued at the Linden site.
The serious violations reflect deficiencies in the company's Process Safety Management program as well as the lack of a comprehensive safety and health management system at the facility.
The Linden, New Jersey, petroleum refinery employs 830 workers.
Roofing Contractor Faces $91,000 in OSHA Fines for Fall Hazards at New Hampshire Jobsites
OSHA has proposed a total of $91,000 in fines against Summer and Winter Construction LLC, a Pittsfield, New Hampshire, roofing contractor, for alleged fall hazards at worksites in Hanover and Manchester, New Hampshire.
OSHA opened inspections at 80 Lyme Road in Hanover and 605 Front St. in Manchester after its inspectors observed Summer and Winter Construction employees performing roofing work without fall protection at both locations. The inspections found workers exposed to falls ranging from 16 feet at the Manchester site to three stories at the Hanover site. OSHA had previously cited the contractor in November 2006 for fall hazards at a Concord worksite.
"The sizable fines we've proposed reflect the serious and recurring nature of these fall hazards," said Rosemarie Ohar, OSHA's area director for New Hampshire. "Improperly utilized fall protection equipment is just as deadly as failing to use fall protection at all. Workers who lack adequate and effective fall protection are just one slip, trip or misstep away from a potentially fatal plunge."
As a result of its inspections, OSHA has issued Summer and Winter Construction one willful citation, with a proposed fine of $70,000, for allowing employees at the Hanover site to work atop a roof without fall protection and with improperly rigged lifelines and improper equipment; and two repeat citations, with $8,000 in fines, for lack of fall protection at the Manchester site and an extension ladder that did not provide safe access to the roof at the Hanover site.
The contractor also has been issued eight serious citations, with $13,000 in fines, for lack of fall protection training, improperly worn body harnesses, an ungrounded power saw, no safety glasses for employees using nail guns in Manchester, two employees tied off to a single anchorage point, a defective ladder, employees working beneath the suspended load of an unattended fork truck, and riding without seatbelts in the back of a pickup truck in Hanover.
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