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31 FACT SHEET MEDICAL AND EXPOSURE RECORD ACCESS THE OSHA ACCESS TO EMPLOYEE EXPOSURE AND MEDICAL RECORDS STANDARD OPENS THREE TYPES OF VALUABLE DOCUMENTS TO WORKERS: Medical Records The worker is assured access to his or her medical records maintained by their employers or by outside contractors. Medical records include: Medical and employment questionnaires or histories (including job description and occupational exposures). Results of medical examinations (pre-employment, pre-assignment, periodic or episodic) and laboratory tests (including X-ray examinations and all biological monitoring). Medical opinions, diagnoses, progress notes and recommendations. Descriptions of treatment and prescriptions. Employee medical complaints. The worker has the option, under this Standard of having his/her medical record sent to them in writing, or having it explained by a company physician. A limited restriction to the worker's access denies direct access to information "regarding specific diagnosis of a terminal illness or a psychiatric condition which could be detrimental to the worker's health." However, the worker's designated representative (such as a personal physician) can obtain this information, and may then give it to the worker. Exposure Records The worker has the right to examine and copy five types of exposure records: Industrial hygiene sampling data from personal, area, grab, wipe, bulk, or other forms of sampling for: - chemicals - bacteria, virus, fungus, etc. -noise - heat, cold - vibration -pressure -radiation 32 Results of biological monitoring on blood, urine, breath, hair, etc. for toxic chemicals Material Safety Data Sheets (MSDS). In the absence of MSDS, any other record which reveals the identity of a toxic substance or harmful physical agent. Exposure records of other employees with similar past or present job duties or working conditions. Exposure records of workplace conditions to which the worker is to be assigned or transferred. Facility Studies Any study or analysis using exposure or medial records concerning the employee's working conditions or environment, will be made available to the worker upon request. Facility Duties Inform workers once a year of the existence and location of medical and exposure records Tell workers once a year who the facility representative responsible for providing access is Provide a copy of the Access to Employee Exposure and Medical Records Standard to each worker requesting it Provide that access is provided in a reasonable manner of time, but in not event later than 15 days Provide access at times and places convenient to workers When workers request copies of records, the facility must make certain that: - a copy is provided, or - copying facilities are made available, or - the records are loaned out to enable copies to be made The first time a record is provided, the company must pay all expenses. After that they may make reasonable search and copy charges. Employers must maintain exposure records for 30 years after they are made; medical records for the duration of employment plus 30 years. Transfer all records to the successor employer if the company goes out of business. If there is no successor, NIOSH must be given the opportunity to take the records. 33 OSHA Rights OSHA has immediate rights to all worker exposure and medical records. If medical records contain personally identifiable information, the written consent of the worker must be obtained. However, OSHA is subject to stringent safeguards to preserve the confidentiality of medical records. Union Rights Collective bargaining agents shall be automatically treated as designated representatives of all workers. They may: Examine, copy and share information contained in the exposure records of all workers. Examine and copy information in the medical records of workers who have signed a written consent form giving the union access. Examine, copy and share analyses which use exposure or medical records. Individual Worker Rights - How To Use Them To qualify to use the regulation a worker must believe that he or she has been or is being exposed to a toxic substance or physical agent. The regulation applies to workers, former workers, and the representatives of dead workers. If you think you have been exposed, you may: Request access to your exposure and/or medical records or Grant permission to the union for access to your medical and/or exposure records by signing a written consent form. This permission can be limited in scope, and you may revoke it in writing at any time. Date your request for access and have it notarized. You or your representative may then: Examine, copy and share information contained in your medical records. Examine, copy and share information contained in your exposure records, and the exposure records of others if they are relevant. Examine, copy and share analyses which use exposure or medical records. When you have examined your records you will better understand which health and safety controls are needed in your workplace. 34 STATE EMPLOYEES ASBESTOS PROGRAM SUMMARY OF MAJOR POLICIES TRAINING - All new Level II employees or employees who transfer into Level II positions must be trained during their probationary period in a Level II training program approved by the Department of the Environment (MDE). - No employee shall work with asbestos until he/she has been trained by the MDE and has passed the written examination. - If training is not provided, the employee has the right to refuse the assignment. - All Level II automotive employees must be retrained annually by their Agency Safety & Health Specialist. - A standardized written examination will be provided at the end of both the initial and refresher training. These exams are administered and retained confidentially for five years by MDE. DEFINITIONS LEVEL I WORKER - Any worker with the potential for asbestos exposure because of work-related activities, but who does not normally break, cut into, tear out, or otherwise disturb asbestos or asbestos-containing materials. LEVEL II WORKER - Any worker whose job activity causes him/her to break, cut into, tear out, grind, or otherwise disturb asbestos or asbestos-containing materials, or who must work in areas where this activity takes place or who must enter an area restricted due to asbestos contamination. INCIDENTAL JOB ACTIVITIES - Those job activities which happen as a result of, or in connection with, the performance of an employee's normal duties that are unavoidable because of the nature of that job activity. 35 MEDICAL MONITORING - Post-probationary Level II employees who cannot be medically approved for respirator use will be reassigned, within classification, to other available work not involving Level II activities. - All Level II workers will be provided pre-placement and periodic, examinations by the medical monitoring contractor. Termination examinations will be offered when the employee leaves Level II work. - All Level II employees must participate in the Medical Monitoring process. Level II employees are not to perform Level II asbestos duties until their Medical Monitoring exam approves them to use respiratory protective equipment. - An employee who participates in the medical monitoring program, but refuses any components of the examination, will be advised that the refusal may compromise his health status. - All Level II new hires shall meet the prerequisites for both Medical Monitoring and Training during the Probationary Period. The probationary period can be extended if necessary. - If an employee refuses to work with asbestos, he will not be eligible for medical monitoring. This refusal will be documented. - If an employee can document previous Level II exposure as a State employee and no longer works with asbestos, he shall be entitled to medical monitoring on a voluntary basis. - Confidentiality of all medical records will be assured by maintaining medical records separately from personnel records and limiting access to medical personnel, the employee, and the employee's designated representative. 36 WORK PRACTICES - State employees will be assigned work with Asbestos only when it is incidental, but necessary for the performance of their normal job functions. - Employees found to be unable to wear respirators, or otherwise unfit for potential asbestos exposure, shall not be permitted to work with asbestos. - Protective clothing shall be provided and worn when performing Level II activities. - State employees can volunteer to perform non-incidental work with notification to and approval by their Agency Safety & Health Specialist. - Negative pressure half-face air purifying respirators with P100 cartridges are to be used only when performing brake-repairs using an vacuum enclosure system or an approved wet system. PAPRs are to be used when the brake or clutch enclosure or wet system is not possible and when changing vacuum filters. - Facial hair which prevents direct contact of bare skin with the respirator sealing surface is prohibited by The State Employees Asbestos Program. - All occupants in the vicinity of an asbestos-relatedjobshallbe evacuatedtoanother area. - All non-essential movable objects shall be decontaminated as necessary and removed from the work site. All electrical equipment, outlets and ventilation systems shall be properly prepared for the project (i.e., covered, locked out, etc.) - A clean uncontaminated change area must be set up on all asbestos-related jobs. - OSHA warning signs must be posted on all asbestos related jobs. - An asbestos work differential of 50% will be paid to Level II employees in 1/10 hour increments, for time spent by the employee performing asbestos-related activities, and for time spent changing into and removing specified clothing and equipment. - Upon completion of initial Level II training (i.e., the old 2 day class), each employee hired prior to March 15, 1985 has 15 days to decide his/her option to sign a formal work refusal form and turn it into their maintenance/automotive supervisor. Failure to turn in this form implies a consent to perform Level II work if required. - Employees who were hired after March 15, 1985 do not have the option to refuse to work with asbestos when such employees have been duly informed of Level II job requirements via the consent form and have been trained, medically monitored, respirator fit tested, and provided with appropriate safety equipment. 37 STATE OF MARYLAND ASBESTOS SAFETY AND HEALTH PROGRAM AUTOMOTIVE ASBESTOS PAY DIFFERENTIAL SCHEDULE FEBRUARY 19, 1988 38 AUTOMOTIVE ASBESTOS PAY DIFFERENTIAL SCHEDULE Asbestos pay differential will be paid when the following automotive work is performed: ♦ Brake repair and replacement ♦ Brake overhaul ♦ Brake inspection ♦ Clutch repair and replacement ♦ Non-associated under vehicle suspension work requiring the use of impact or motorized tools and equipment. Definition: ♦ Light duty vehicles - automobiles, trucks that are less than 10,000 lbs. gross vehicle weight, trailers and off-road vehicles with a gross vehicle weight less than 10,000 lbs. ♦ Medium and Heavy duty - all motorized vehicles and construction equipment with a gross vehicle weight that exceeds 10,000 lbs., all towed and off road equipment that exceeds 10,000 lbs. gross vehicle weight. Time Rate Schedule - the time recognized within the industry, through after market publications/flat rate manuals, to complete a given task. An example: Chilton, Mitchell, and Motor Parts and Rate Schedules. (Factory time rate schedules are not recommended) Pay Rate Schedule: Light Duty Medium and Heavy Duty Brake Repair and Replacement - 1.5 Hrs. per axle Break Repair and Replacement - 2.0 Hrs. per axle Brake Overhaul - 3.0 Hrs. per axle Break Overhaul - 4.0 Hrs. per axle *Brake Inspection - .5 Hrs. per axle *Break Inspection - 1.0 Hrs. per axle **Clutch Repair and Replacement - Time Rate Schedule plus .5 Hrs. **Clutch Repair and Replacement - Time Rate Schedule plus .5 Hrs. **Non - associated under vehicle suspension work requiring the use of impact or motorized tools and equipment - Time rate Schedule plus .5 Hrs. **Non - associated under vehicle suspension work requiring the use of impact or motorized tools and equipment - Time rate Schedule plus .5 Hrs. * Inspection time is not tabulated when brake work is performed. ** When the Time Rate Schedule is used to compute the pay differential, the additional 0.5 Hrs. will be added for the purpose of preparation and clean-up activities including changing into and out of program specified equipment and clothing. 39 TAPING PROCEDURE FOR PROTECTIVE CLOTHING 1. Tape zipper &crotch area. 2. Tape cuffs snugly at sleeve. 3. Tape shoe covers securely to suit with pants legs tucked inside.* 4. Respirator face piece must be in place before donning hood. 5. Seal hood securely with tape to suit. * If not secured/bought with hood and booties attached. 40 REMOVAL PROCEDURE FOR PROTECTIVE CLOTHING 1. Remove tape hood under chin. 2. Roll hood down (inside out). 3. Loosen tape from sleeve. 4. Remove tape from zipper, unzip, and continue to roll suit firmly inside out. 5. Pull sleeves inside-out. [...]... belt Continue to roll suit firmly inside-out Respirator should remain in place until suit is completely removed and disposed of with Asbestos Waste 41 RESPIRATORS AND PROTECTIVE CLOTHING Respirators There are two types of respirators that an Automotive Worker who works with asbestos can use The POWERED AIR PURIFYING RESPIRATOR and the NEGATIVE PRESSURE 1/2 FACED AIR PURIFYING RESPIRATOR The negative pressure... out schedule Air Supplying Respirators Air supplying respirators provide workers with clean oxygen or air (1) Airline Respirators - supply the worker with air by attaching the free end of a hose to a stationary compressed air source (2) Self Contained Breathing Apparatus (SCBA) - supply the worker with air from tanks carried by the worker CAUTION: Only (SCBA's) can be used in areas where the air is immediately... and health Air line devices can be cut, leaving the worker without protection Fit Testing OSHA requires that all workers who must wear respirators be fit tested annually Fit testing is a procedure used to determine whether leaks exist in the seal between the respirator and face There are two types of fit testing: (1) Quantitative fit testing - the worker is placed in a room while wearing a respirator... "TC" This "TC" number can be looked up in the "NIOSH Certified Equipment" publication to determine what the respirator is approved for Respirator Training Employee respirator training is required by OSHA For the safe use of any respirator both the supervisor and worker should be instructed concerning the following points: 1 Instructed concerning what type of hazard they are exposed to Does overexposure... particulate inside the respirator to that outside the respirator the degree of leakage (if any) can be found (2) Qualitative fit testing - workers are asked if they detect irritant smoke or other test substances when it is passed three inches from the respirator seal If the worker can detect the substance the respirator does not fit Qualitative fit testing gives a gross "yes" or "no" answer to the fit test,... be a permanent means of limiting the amount of a dangerous chemical a worker may breathe Engineering controls such as installing ventilation ducts to suck the harmful materials out of the air are much more preferable These engineering controls should be placed where the air contamination is produced so it can be drawn away from the worker before it enters the breathing air Respirators should be worn... Respirators are used to protect against inhalation hazards They put a barrier between the contaminated air and the worker' s lungs Types of Respirators There are two major classes of respirators Air Purifying Respirators clean the air that is inhaled while Air Supplying Respirators provide workers with their own source of air or oxygen Air Purifying Respirators There are four types of air purifying respirators... 3 A discussion of why this is the proper type of respirator for the particular purpose 4 A discussion of the respirator's capabilities and limitations 5 Instruction and training in actual use of respirator 49 6 Classroom and field training to recognize and cope with emergency situations Types of Respirators and Their Limitations Mechanical filtering respirators will protect against dusts, fumes, and... free of oil aerosols, an N100 filter would be protective In a work setting that may contain or does contain oil aerosols, an R100 or P100 filter would be protective 42 It is strongly recommended that for asbestos work a P100 filter be selected because of the moisture, etc in the abatement area According to OSHA, the powered air purifying respirator will afford protection up to 100x the P.E.L of 0.1f/cc... hazard will determine the kind of respirator that should be used Listed below are the types of hazards: 1.Dusts are solid particles produced by processes such as grinding, crushing and mixing Example: Asbestos 2.Mists are tiny liquid droplets given off when liquids are sprayed, mixed or agitated in processes such as dipping, painting, and machining Example: Spray paint 3.Fumes are tiny metallic particles . otherwise disturb asbestos or asbestos- containing materials. LEVEL II WORKER - Any worker whose job activity causes him/her to break, cut into, tear out, grind, or otherwise disturb asbestos or asbestos- containing. equipment. 37 STATE OF MARYLAND ASBESTOS SAFETY AND HEALTH PROGRAM AUTOMOTIVE ASBESTOS PAY DIFFERENTIAL SCHEDULE FEBRUARY 19, 1988 38 AUTOMOTIVE ASBESTOS PAY DIFFERENTIAL SCHEDULE Asbestos pay differential. initial and refresher training. These exams are administered and retained confidentially for five years by MDE. DEFINITIONS LEVEL I WORKER - Any worker with the potential for asbestos exposure because