Thursday, May 23, 2013

First Aid requirements for hazardous waste sites

This is in response to your inquiry of December 9, concerning the Occupational Safety and Health Administration's (OSHA) Hazardous Waste Operations and Emergency Response (29 CFR 1910.120), Medical Services and First Aid (29 CFR 1910.151), and Bloodborne Pathogens (29 CFR 1910.1030) regulations.

Your question concerns clarification on first aid requirements for hazardous waste sites. Paragraph (l) of the Hazardous Waste Operations and Emergency Response (HAZWOPER) standard addresses requirements for emergency response at hazardous waste clean-up operations. Subparagraph (l)(2)(viii) requires that emergency medical treatment and first aid be addressed in the employer's emergency response plan. The standard does not specifically require that on-site personnel be designated and trained to provide first aid. However, the Medical Services and First Aid standard (29 CFR 1910.151), is applicable at hazardous waste sites, and requires that personnel be trained to render first aid whenever outside medical assistance "in near proximity to the workplace" is not available.

[For OSHA's current policy on "near proximity," please see the 01/16/2007 Letter to Mr. Brogan.]

In the case of operations at a hazardous waste site, accident victims may be located in contaminated areas of the site. If first-aiders will be expected to enter contaminated areas they must be trained under 29 CFR 1910.120(e)(3)(ii) as a minimum and equipped with personal protective equipment appropriate to the hazards of the site. Therefore the employer may find that the simplest solution is to train hazardous waste workers on-site to render first aid and CPR.

You also inquired whether this requirement to train first aiders in accordance with 29 CFR 1910.151[(b)] would mean that these personnel are covered by the Occupational Exposure to Bloodborne Pathogens Standard, 29 CFR 1910.1030. The key to the issue of coverage under the Bloodborne Pathogens rule is not whether employees have been trained in first aid, but whether they are also designated as responsible for rendering medical assistance. The employer is free to provide first aid training without designating the employee as a first-aid provider covered under the scope of 29 CFR 1910.1030. However, providing first aid training in order to comply with a specific requirement of another OSHA regulation such as 29 CFR 1910.151 would constitute a de facto designation of these employees for the purposes of coverage under the Bloodborne Pathogens rule.

Further, site employees who are neither trained nor "designated" in the site emergency response plan or site safety and health plan, and who are, nonetheless, expected or directed to render first aid during a first aid incident would also be covered under the scope of 29 CFR 1910.1030. They must likewise be provided the protection of the Bloodborne Pathogens Standard, including training, personal protective equipment, and post-exposure follow-up in the event of an exposure incident.

Please note that OSHA has recently issued a policy statement specifying that, while designated first aid providers are covered under the scope of the Bloodborne Pathogens Standard, failure to offer the hepatitis B vaccine pre-exposure to persons who render first aid only as a collateral duty will be considered a de minimis violation carrying no penalties, provided that a number of conditions are met. In many cases, hazardous waste workers trained to render first aid could meet the de minimis criteria for collateral duty first aiders. Please see the attached news release for details.

We hope this information is helpful. If you have any further questions please contact us at [(202) 693-1850].


Roger Clark, Director
Directorate of [Enforcement] Programs

[Corrected 06/13/07]

December 9, 1992

Ms. Maryanne Garrahan
U.S. Department of Labor
Occupational Safety & Health
Washington, D.C. 20210

Re: First Aid/CPR Training Requirements Under HAZWOPER

Dear Ms. Garrahan:

As per our brief discussion December 9, 1992, I am requesting interpretive information regarding the requirements for first aid/CPR under HAZWOPER. The only section that I can identify which references first aid is in section (l)(2)(viii) Emergency medical treatment and first aid. Section (l)(2) only requires that the emergency response plan "address, as a minimum" emergency medical treatment and first aid. The same does not suggest that on-site personnel be first aid trained, but rather that the need for emergency medical and first aid be addressed in the emergency response plan. Addressing this could be interpreted to mean arranging for off-site medical emergency and first aid assistance. However, the need for immediate response in any emergency coupled by the remoteness of most HAZWASTE field activities dictates that there be someone on-site who is first aid/CPR trained. How is this resolved?

Since Bloodborne Pathogens includes "designated first aid providers," training such responders for HAZWASTE type activities appears to be a disincentive if one is desirous of not having to comply with 1910.1030. Consequently, how is OSHA interpreting 1910.120 regarding the need to have someone on-site trained and designated as a first aid/CPR responder? If not specifically included in 1910.120, would the general duty clause apply? How does 1910.151 apply to HAZWASTE vs. plant environments? How does OSHA interpret the wording in 1910.151 "in near proximity to the workplace"?

In a July 1, 1992 Compliance Directive On Enforcing Bloodborne Pathogens, the term "designated" is used. What does that mean? Is it possible to train field staff in first aid/CPR, but not "designate" them, say in the site health & safety plan, as first aid responders so as to fall outside 1910.1030? If we have first aid/CPR trained field staff that have been so designated in past health & safety plans, can we now stop re-certifying them as first aid/CPR responders and also stop designating them as such

These are issues I am personally struggling with in my job. The answers to these issues will assist me in deciding whether to continue our efforts in first aid/CPR training as well as whether or not my firm must comply with 1910.1030. Your attention and response to these issues is very much appreciated.

Very truly yours,


Thursday, May 16, 2013

Heat Stress Kit

With Summer right around the corner it is imperative all workplaces are prepared to aid any employees that may have a heat related illness.  National Safety Compliance has released its Heat Stress First Aid Kit with the following contents:

Qty Description
4 Cold Pack, Certi-Cool Junior
2 Certi-Tape, Spool 1" x 10 yd.
25 Certi-Lyte Tablets, Electrolyte 2/pkg
1 Rescue Blanket, Silver in Plastic bag 52" x 84"
4 Electrolyte Replacement Mix, Makes 8 to 10 oz.
These contents come in a poly white box 10" x 7" x 3"

This kit contains the basic necessities needed to aid a heat stress victim and is ideal for all hot environment work. Comes in a sturdy plastic container that is wall mountable.

Thursday, May 9, 2013

Emergency Medical Services on Construction Sites

Re: Emergency medical services on construction sites

We are in receipt of your correspondence dated May 26 and September 21, 2004, to the Occupational Safety and Health Administration (OSHA) regarding a number of issues related to emergency medical services on construction sites.

After considering the information in your letters and additional information you provided in telephone discussions with OSHA staff, we have paraphrased your questions as follows:

I. Automatic External Defibrillators (AEDs)

Question 1: When will the rules on AEDs applicable to construction sites be finalized?

Answer: OSHA is not currently developing any construction standards regarding AEDs.

Question 2(a): Are there any OSHA requirements that prohibit an employer from terminating or threatening to terminate a licensed and insured Emergency Medical Technician ("EMT") for bringing an AED to the job site to render assistance if necessary?

Answer: First, note that there are no OSHA construction standards that specifically require an employer to provide an AED at a construction site.

Second, Section 11(c) of the Occupational Safety and Health Act ("OSH Act") prohibits employers from discharging or otherwise discriminating against an employee "because such employee has filed any complaint ... under or related to" the OSH Act. Whether the termination or the threat to terminate an EMT-certified employee for bringing an AED to a jobsite could be an 11(c) violation would depend on the specific facts involved.

Employees who believe that they have been discriminated against in violation of the OSH Act should contact the OSHA Area or Regional office serving their location (we have included OSHA's 11(c) information pamphlet for your review).

Question 2(b): Does 29 CFR 1926.50 protect an EMT from being terminated by an employer based on emergency services rendered to a worker on a construction job site?

Answer: As stated in our answer to question 2(a) above, whether such a termination would violate Section 11(c) of the Act would depend on all the relevant factors involved, which you would need to discuss with OSHA's Area or Regional office for your location.

II. 29 CFR 1926.50 - Medical services and first aid.

Question 3: Does OSHA's construction standard for medical services and first aid (§1926.50) permit a union to designate specially qualified members as first-responders for emergency medicine?

Answer: In general, the OSH Act does not address labor relations issues, including whether a union has a right to designate a particular individual for a particular job.

Question 4: I am an electrician who works on construction sites where workers are exposed on a daily basis to the risks associated with high voltage. Does 1926.50 require the presence of an individual trained in first aid on construction sites where the response time to a request for medical assistance for such workers cannot be guaranteed within four minutes?

Answer: In 29 CFR Part 1926 Subpart D (Occupational Health and Environmental Controls), §1926.50 (Medical services and first aid) provides in part:
* * *
(c) In the absence of an infirmary, clinic, hospital, or physician, that is reasonably accessible in terms of time and distance to the worksite, which is available for the treatment of injured employees, a person who has a valid certificate in first-aid training from the U.S. Bureau of Mines, the American Red Cross, or equivalent training that can be verified by documentary evidence, shall be available at the worksite to render first aid. [Emphasis added.]
* * *
Question 5: Where 50 construction employees are spread out over 25 floors (or as many as 65 floors) in a high rise, would the presence of one individual trained in first aid satisfy the requirements of §1926.50?

Answer: Section 1926.50(b) provides:
Provisions shall be made prior to commencement of the project for prompt medical attention in case of serious injury.
In CMC Electric, the court stated that the purpose of §1926.50(b) is similar to that of §1926.50(c): 1
... the purpose of §1926.50(b) is to avoid any unnecessary delay in the administration of medical attention to an injured employee, particularly in the case of serious injury, where even a few minutes can make a difference.
The court stated also that the provisions are "complementing and overlapping." In analyzing §1926.50(b)'s "prompt medical attention" requirement, the court noted:
... [the requirement] should be read to require the employer to take reasonable steps to insure that in case of serious injury, medical attention can be obtained as quickly as possible. In addition to the time it takes to reach medical attention, this analysis should include a review of a variety [of] factors, such as: where the job site was located and how many employees were involved....[Emphasis added.]
In situations where a certified first aider is required under §1926.50(b) or (c), whether more than one first aider is required at a work site spread over many floors of a multi-story structure will depend on factors such as those described above. Given the limited information that you provided, we are unable to conclusively comment on whether the single certified individual would suffice under the "prompt medical attention" criteria in a multi-floor scenario. Factors such as whether functioning elevators are in yet, extent of on-site communications, and reasonably expected travel time up and down stairs (where elevators are not available) would be relevant to the assessment.

Question 6(a): Must employers provide medical equipment in addition to the first aid kit required in 29 CFR 1926.50(d)?

Answer: Title 29 CFR 1926.50 states that:
(a) The employer shall insure the availability of medical personnel for advice and consultation on matters of occupational health.
(b) Provisions shall be made prior to commencement of the project for prompt medical attention in case of serious injury.
* * *
(d)(1) First aid supplies shall be easily accessible when required.
(2) The contents of the first aid kit shall be placed in a weatherproof container with individual sealed packages for each type of item, and shall be checked by the employer before being sent out on each job and at least weekly on each job to ensure that the expended items are replaced.
* * *
Employers must provide a first aid kit that contains the basic supplies necessary to address typical worksite first aid needs. "Medical equipment" that goes beyond basic first aid needs is not required to be included in the kit. 2

Question 6(b): Must a construction employer provide medical equipment in addition to the first aid kit required in 29 CFR 1926.50(d) as a consequence of an employee having emergency medical training that goes well beyond basic first aid training?

Answer: No, there is no such OSHA requirement.

III. 29 CFR 1926.103 - Respiratory protection

Question 7: Are all the requirements of §1926.103 in effect as of June 1, 2004? Who is responsible for the ongoing yearly training, and refitting of respirators?

Answer: The requirements of §1926.103 3 have been in effect since April 8, 1998. The standard places the responsibility on the employer to ensure that the training, yearly retraining, and fit testing is conducted.

Question 8: Does §1926.103 require that all electricians be equipped with a properly fitted respirator and that all electrical contractors are required to have available on the job site sufficient cartridges to protect their workers from known hazards?

Answer: The standard does not specifically address electricians. Section 1910.134(a)(2) requires that respirators be worn "whenever it is necessary to protect the health of the employee from contaminated or oxygen deficient air."

IV. OSHAct 5(a)(1), "General Duty Clause"

Question 9: Does Section 5(a)(1) of the Occupational Safety and Health Act (the "General Duty Clause") require general foremen on a construction site to meet any general qualifications?

Answer: Section 5(a)(1) of the OSH Act states that each employer:
... shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.
There is no general requirement under that section (the General Duty clause) for employers to ensure that, in all cases, foremen have some specified level of qualifications. 4 Note, though, that some OSHA construction standards require that a "competent person" or a "qualified person" perform certain tasks. There are definitions in those standards that describe the level of qualification for each of these designations.

Note also that §1926.21(b)(2) states:
The employer shall instruct each employee in the recognition and avoidance of unsafe conditions and the regulations applicable to his work environment to control or eliminate any hazards or other exposure to illness or injury.
Question 10: Does the General Duty Clause require employers to provide and train a designated first responder on every jobsite where five or more employees are performing construction work?

Answer: No, there is no such general requirement applicable in all cases. Note that, as discussed in questions 3-5, there are requirements regarding certified first aid personnel in §1926.50.

Therefore, an employer performing construction activities is required to provide a first aid responder on site only if there is no infirmary, clinic, hospital, or physician reasonably accessible in terms of time and distance to the worksite. The employer must ensure that the designated first aid responder has been properly trained to administer first aid (see the "valid certificate" requirement of §1926.50(c) in question 4 above).

Note also that §1926.50 is applicable irrespective of the number of employees at a particular site.

Question 11(a): Do OSHA standards require that there be a means of communication available at each worksite for summoning emergency medical assistance?

Answer: Yes. Section 1926.50(f) states:
In areas where 911 is not available, the telephone numbers of the physicians, hospitals, or ambulances shall be conspicuously posted.
The purpose of §1926.50(f) is to ensure that, where 911 is not available, the employer can rapidly contact emergency responders without wasting time trying to find the right phone number. Implicit in this requirement is that a means of communication must be available at each worksite. Having 911 available is useless if there is no way for the employer to call 911 from the worksite. Similarly, if 911 is unavailable, meeting the requirement to conspicuously post the emergency numbers at the worksite would be equally pointless.

Question 11(b): Scenario: An employer has a work rule prohibiting all employees except the employer-designated first aid responder from carrying cell phones on a worksite. An employee who is an EMT (but who is not the designated first aid responder) is also prohibited from carrying a cell phone. Would such a work rule violate any OSHA standards or the General Duty Clause?

Answer: Typically such a work rule would not violate any OSHA requirements.

V. Other Labor Laws/Immigrant Worker Training

Question 12: Where do I get information about labor laws (other than OSHA) on training requirements regarding immigrant workers?

Answer: That information can be obtained from the U.S. Department of Labor's Employment and Training Administration at 202-693-2700, or visit their website at: .