Construction Safety – Flashcards

• Overexertion • Impact accidents • Falls • Bodily reaction (to chemicals) • Compression • Motor vehicle accidents • Exposure to radiation/caustics • Rubbing or abrasions • Exposure to extreme temperatures

Contractors, as the owners of the company, bear the ultimate responsibility for safety and health on their job sites. Contractors are responsible for the following: 1) setting a pro-safety tone for the company, 2) establishing a complete commitment to safety and health from the top down, and 3) ensuring that sufficient resources are provided to support a comprehensive, company-wide safety effort. By letting their managers and supervisors know that they expect safe and healthy job sites, contractors set a tone for the company which ensures that safety and health will be high priorities. By including safety and health in the company's strategic plan, contractors can establish the necessary commitment on the part of all employees. By providing the resources necessary to support company-wide safety and health programs, contractors ensure that the safety and health program is properly staffed and sufficiently funded.

Managers and other professionals are responsible for setting a positive example relating to safety and health and for translating the commitment of the contractor into everyday practice. This is accomplished by the following types of actions: 1) developing job descriptions that make safety and health part of every employee's job; 2) developing performance appraisal forms that contain safety and health criteria; 3) rewarding safe behavior on the job by making it an important factor in promotions and pay raises; 4) developing work procedures that emphasize safety and health; 5) recognizing safe work behavior as a part of company incentive programs; 6) ensuring that the company has a comprehensive, effective safety and health program; 7) keeping up to date with the latest OSHA standards and regulations relating to construction; and 8) effectively communicating safety and health information to all employees and subcontractors.

The Safety and Health Manager is responsible for establishing, implementing, and managing the company's overall safety and health program who reports to the CEO. Specific duties include the following: • Establish and maintain a comprehensive company-wide safety and health program. • Assess and analyze all jobs, processes, and materials for potential hazards. • Work with appropriate personnel to develop, implement, monitor, and evaluate accident prevention/hazard control strategies. • Ensure company-wide compliance with all applicable laws, standards, and codes. • Coordinate the activities of all members of the company's safety and health program. • Plan, implement, and broker, as appropriate, safety and health-related training. • Maintain all required safety and health-related records and reports. • Conduct accident investigations as necessary. • Develop and maintain a company-wide Emergency Action Plan (EAP). • Establish and maintain an ongoing safety promotion effort. • Analyze the Company's products from the perspectives of safety, health, and liability.

• Apply to the Board of Certified Safety Professionals 1. Meet an academic requirement 2. Meet a professional safety experience requirement 3. Pass the Safety Fundamentals Examination 4. Pass the Comprehensive Practice Examination

This is how Heinrich's theory of accident causation works. According to Heinrich, there are five factors in the sequence of events leading up to an accident. These factors can be summarized as follows: 1. Ancestry and social environment. Negative character traits that may lead people to behave in an unsafe manner can be inherited (ancestry) or acquired as a result of the social environment. 2. Fault of person. Negative character traits, whether inherited or acquired, are why people behave in an unsafe manner and why hazardous conditions exist. 3. Unsafe act/mechanical or physical hazard. Unsafe acts committed by people and mechanical or physical hazards are the direct causes of accidents. 4. Accident. Typically, accidents that result in injury are caused by falling or being hit by moving objects. 5. Injury. Typical injuries resulting from accidents include lacerations and fractures. Heinrich's study laid the foundation for his Axioms of Industrial Safety and his theory of accident causation, which came to be known as the domino theory. So much of Heinrich's theory has been discounted by more contemporary research that it is now considered outdated. However, since some of today's more widely accepted theories can be traced back to Heinrich's theory, students of construction safety should be familiar with his work.

Heinrich's theory has two central points: 1) Injuries are caused by the action of preceding factors; and 2) removal of the central factor (unsafe act/hazardous condition) negates the action of the preceding factors and, in so doing, prevents accidents and injuries.

The human factors theory of accident causation attributes accidents to a chain of events ultimately caused by human error. It consists of three broad factors that lead to human error: overload, inappropriate response, and inappropriate activities. These factors are explained in the following paragraphs. Overload Overload amounts to an imbalance between a person's capacity at any given time and the load that person is carrying in a given state. A person's capacity is the product of such factors as his or her natural ability, training, state of mind, fatigue, stress, and physical condition. The load that a person is carrying consists of tasks for which he or she is responsible and added burdens resulting from environmental factors (noise, distractions, and so on), internal factors (personal problems, emotional stress, and worry), and situational factors (level of risk, unclear instructions, and so on). The state in which a person is acting is the product of his or her motivational arousal levels. Inappropriate Response/Incompatibility How a person responds in a given situation can cause or prevent an accident. If a person detects a hazardous condition but does nothing to correct it, he or she has responded inappropriately. If a person disregards an established safety procedure, he or she has responded inappropriately. Such responses can lead to accidents. In addition to inappropriate responses, this component includes tool and equipment incompatibility. The incompatibility of a person's tools and equipment with regard to size, force, reach, feel, and similar factors can lead to accidents and injuries. Inappropriate Activities Human error can be the result of inappropriate activities. An example of an inappropriate activity is a person who undertakes a task that he or she doesn't know how to do. Another example is a person who misjudges the degree of risk involved in a given task and proceeds based on that misjudgment. Such inappropriate activities can lead to accidents and injuries.

Epidemiology is the study of causal relationships between environmental factors and disease. The epidemiological theory holds that the models used for studying and determining these relationships can also be used to study causal relationships between environmental factors and accidents or diseases. Figure 3-4 illustrates the epidemiological theory of accident causation. The key components are predispositional characteristics and situational characteristics. These characteristics, taken together, can either result in or prevent conditions that may result in an accident. For example, if an employee who is particularly susceptible to peer pressure (predisposition characteristic) is pressured by his co-workers (situational characteristic) to speed up his work, the result will be an increased probability of an accident.

A system is a group of regularly interacting and interrelated components that together form a unified whole. This definition is the basis for the systems theory of accident causation. This theory views a situation in which an accident may occur as a system comprised of the following components: person (host), machine (agency), and environment. The likelihood of an accident occurring is determined by how these components interact. Changes in the patterns of interaction can increase or reduce the probability of an accident. For example, an experienced employee who operates a crane may take a two-week vacation. Her temporary replacement may be less experienced. This change in a component of the system (person/host) increases the probability of an accident. Such a simple example is easily understood. However, not all changes in patterns of interaction are this simple. Some are so subtle that their analysis may require a team of people, each with a different type of expertise. The primary components of the systems model are the person/machine/environment, information, decisions, risks, and the task to be performed. Each of the components has a bearing on the probability that an accident will occur.

There are seven basic principles of BBS: • Intervention that is focused on employee behavior. • Identification of external factors that will help understand and improve employee behavior. • Direct behavior with activators or events antecedent to the desired behavior, and motivation of the employee to behave as desired with incentives and rewards that will follow the desired behavior. • Focus on the positive consequences that will result from the desired behavior as a way to motivate employees. • Application of the scientific method to improve attempts at behavioral interventions. • Use of theory to integrate information rather than to limit possibilities. • Planned interventions with the feelings and attitudes of the individual employee in mind

Morality refers to the values that are subscribed to and fostered by society in general.

Ethics is the study of morality within a context established by cultural and professional values, social norms, and accepted standards of behavior.

The role of construction professionals with regard to ethics has three parts. First, they are responsible for setting an example of ethical behavior. Second, they are responsible for helping fellow employees make the right decision when facing ethical questions. Finally, construction professionals are responsible for helping employees follow through and actually undertake the ethical option once the appropriate choice has been identified. In carrying out their roles, construction professionals can adopt one of the following approaches, the best-ratio approach, the black-and-white approach, or the full-potential approach.

A company's role in ethics can be summarized as 1) creating an internal environment that promotes, expects, and rewards ethical behavior; and 2) setting an example of ethical behavior in all external dealings.

No person will serve long as a construction professional without confronting an ethical dilemma. How then should one proceed? There are three steps (Figure 4-4): 1. Apply the various guidelines presented earlier in this chapter for determining what is ethical. 2. Select one of the three basic approaches to handling ethical questions. 3. Proceed in accordance with the approach selected, and proceed with consistency.

1. Purpose. Individuals see themselves as ethical people who let their conscience be their guide and in all cases want to feel good about themselves. 2. Pride. Individuals apply internal guidelines and have sufficient self-esteem to make decisions that may not be popular with others. 3. Patience. Individuals believe right will prevail in the long run, and they are willing to wait when necessary. 4. Persistence. Individuals are willing to stay with an ethical course of action once it has been chosen and see it through to a positive conclusion. 5. Perspective. Individuals take the time to reflect and are guided by their own internal barometer when making ethical decisions.

Has the issue or problem been thoroughly and accurately defined? Have all dimensions of the problem (productivity, quality, cost, safety, health, and so on) been identified? Who will be affected by your decision and in what way? In the short term? In the long term?

Workers' compensation represents a compromise between the needs of employees and the needs of employers. Employees give up their right to seek unlimited compensation for pain and suffering through legal action. Employers award the prescribed compensation (typically through insurance premiums) regardless of the employee's negligence. The theory is that in the long run both employees and employers will benefit more than either would through legal action.

)Replacement of Income Employees injured on the job lose income if they are unable to work. For this reason, workers' compensation is intended to replace the lost income adequately and promptly. Adequate income replacement is viewed as replacement of current and future income (minus taxes) at a ratio of two-thirds (in most states). Workers' compensation benefits are required to continue even if the employer goes out of business. 2)Rehabilitation of the Injured Employee A basic premise of workers' compensation is that the injured worker will return to work in every case possible, although not necessarily in the same job or career field. For this reason, a major objective of workers' compensation is to rehabilitate the injured employee. The rehabilitation program is to provide the needed medical care at no cost to the injured employee until he or she is pronounced fit to return to work. The program also provides vocational training or retraining as needed. Both components seek to motivate the employee to return to the labor force as soon as possible. 3)Accident Prevention Preventing future accidents is a major objective of workers' compensation. The theory underlying this objective is that employers will invest in accident prevention programs to hold down compensation costs. The payoff to employers comes in the form of lower insurance premiums that result from fewer accidents (theoretically). 4)Cost Allocation The potential risks associated with different occupations vary. For example, working as a roofer is generally considered more hazardous than working as an architect. The underlying principle of cost allocation is to spread the cost of workers' compensation appropriately and proportionately among industries ranging from the most to the least hazardous. The costs of accidents should be allocated in accordance with the accident history of the industry so that high-risk industries pay higher workers' compensation insurance premiums than do low-risk industries. Construction is a high-risk industry.

Once a workers' compensation claim is filed, an appropriate settlement must be reached. Three approaches can be used to settle a claim: • Direct settlement • Agreement settlement • Public hearing

According to the Department of Labor, OSHA's mission and purpose can be summarized as follows: • Encourage employers and employees to reduce workplace hazards. • Implement new safety and health programs. • Improve existing safety and health programs. • Encourage research that will lead to innovative ways of dealing with workplace safety and health problems. • Establish the rights of employers regarding the improvement of workplace safety and health. • Establish the rights of employees regarding the improvement of workplace safety and health. • Monitor job-related illnesses and injuries through a system of reporting and record keeping. • Establish training programs to increase the number of safety and health professionals and to improve their competence continually. • Establish mandatory workplace safety and health standards and enforce those standards. • Provide for the development and approval of state-level workplace safety and health programs. • Monitor, analyze, and evaluate state-level safety and health programs.

OSHA issues both standards and regulations. Construction professionals need to know the difference between the two. OSHA standards address specific hazards such as working in confined spaces, handling hazardous waste, or working with dangerous chemicals. Regulations are more generic in some cases than standards and more specific in others. However, even when they are specific, regulations do not apply to specific hazards. Regulations do not require the rigorous review process that standards go through. This process is explained in the next section.

A citation informs the employer of OSHA violations. Penalties are typically fines assessed as the result of citations. The types of citations are as follows: • Other-than-serious violation. A violation that has a direct relationship to job safety and health, but probably would not cause death or serious physical harm. A proposed penalty for each violation is discretionary. A penalty for an other-than-serious violation may be adjusted downward by as much as 95 percent, depending on the employer's good faith (demonstrated efforts to comply with the act), history of previous violations, and size of business. • Willful violation. A violation that the employer intentionally and knowingly commits. The employer either knows that what he or she is doing constitutes a violation or is aware that a hazardous condition exists and has made no reasonable effort to eliminate it. A proposed penalty for a willful violation may be adjusted downward, depending on the size of the business and its history of previous violations. Usually, no credit is given for good faith. If an employer is convicted of a willful violation of a standard that has resulted in the death of an employee, the offense is punishable by a court-imposed fine or by imprisonment for up to six months, or both. • Repeat violation. A violation of any standard, regulation, rule, or order where, upon re-inspection, a substantially similar violation is found. To be the basis of a repeat citation, the original citation must be final; a citation under contest may not serve as the basis for a subsequent repeat citation. • Failure to correct prior violation. Failure to correct a prior violation may bring a civil penalty that increases each day the violation continues beyond the prescribed abatement date.

The following list of employer responsibilities under the OSHAct is adapted from OSHA 2056. Employers must do the following: • Meet the general duty responsibility to provide a workplace free from hazards that are causing or are likely to cause death or serious physical harm to employees and to comply with standards, rules, and regulations issued under the OSHAct. • Be knowledgeable of mandatory standards and make copies available to employees for review upon request. • Keep employees informed about OSHA. • Continually examine workplace conditions to ensure that they conform to standards. • Minimize or reduce hazards. • Make sure employees have and use safe tools and equipment (including appropriate personal protective equipment) that is properly maintained. • Use color codes, posters, labels, or signs as appropriate to warn employees of potential hazards. • Establish or update operating procedures and communicate them so that employees follow safety and health requirements. • Provide medical examinations when required by OSHA standards. • Provide the training required by OSHA standards. • Report to the nearest OSHA office within 48 hours any fatal accident or one that results in the hospitalization of five or more employees. • Keep OSHA-required records of injuries and illnesses and post a copy of the totals as required. • At a prominent location within the workplace, post OSHA Poster 2203 informing employees of their rights and responsibilities. • Provide employees, former employees, and their representatives access to the Log and Summary of Work-Related Injuries and Illnesses. • Give employees access to medical and exposure records. • Give the OSHA compliance officer the names of authorized employee representatives who may be asked to accompany the compliance officer during an inspection. • Not discriminate against employees who properly exercise their rights under the act. • Post OSHA citations at or near the work site involved. Each citation or copy must remain posted until the violation has been abated or for three working days, whichever is longer. • Abate cited violations within the prescribed period.

Section 11(c) of the OSHAct delineates employee rights. These rights are actually protection against punishment for employees who exercise their right to pursue any of the following courses of action: • Complain to an employer, union, OSHA, or any other government agency about job safety and health hazards. • File safety or health grievances. • Participate in a workplace safety and health committee or in union activities concerning job safety and health. • Participate in OSHA inspections, conferences, hearings, or other OSHA-related activities. • Expect employers to make review copies available of OSHA standards and requirements. • Ask employers for information about hazards that may be present in the workplace. • Ask employers for information on emergency procedures. • Receive safety and health training. • Be kept informed about safety and health issues. • Anonymously ask OSHA to conduct an investigation of hazardous conditions at the work site. • Be informed of actions taken by OSHA as a result of a complaint. • Observe during an OSHA inspection and respond to the questions asked by a compliance officer. • See records of hazardous materials in the workplace. • See their medical record. • Review the annual Log and Summary of Work-Related Injuries. • Have an exit briefing with the OSHA compliance officer following an OSHA inspection. • Anonymously ask NIOSH to provide information about toxicity levels of substances used in the workplace. • Challenge the abatement period given employers to correct hazards discovered in an OSHA inspection. • Participate in hearings conducted by the Occupational Safety and Health Review Commission. • Be advised when an employer requests a variance to a citation or any OSHA standard. • Testify at variance hearings. • Appeal decisions handed down at OSHA variance hearings.

a)Ethical Factors b) regulatory factors c) economical factors d)practical factors

It is necessary to have a goal relating to fatalities because no company wants to have a fatal accident, yet such accidents are always a possibility. Since this is the case, the only acceptable goal relating to fatalities is "zero." Few construction executives are going to want to publish a safety and health plan that implies acceptance of even one fatal accident. Reduction of job-related injuries should also be considered a mandatory goal. Few construction companies are going to maintain a perfect safety record over time. As long as there are people working together to meet deadlines, there will be accidents and injuries. The question, then, becomes "how many"? The answer has got to be "as few as possible." The percent of reduction that accompanies this goal depends on the company's current safety record and how much it can be realistically improved if the company is appropriately challenged. This same rule of thumb applies to goals relating to lost time for accidents, workers compensation claims, and near miss accidents. With all of these goals, it is important to avoid both the "low-ball" and the "pie-in-the-sky" syndromes. Striking a realistic balance between being sufficiently challenging on the one hand and fully credible on the other is the key. If, for example, the company had 100 workers compensation claims last year, reducing this number by 75% might be unrealistic. On the other hand, reducing it by 40% would be challenging and might be sufficiently realistic. Goals relating to training are similar to those relating to fatal accidents. If a company is going to set a goal in this area, it must be set high. Otherwise, the wrong message is sent. A 100% participation rate is not necessarily required, but to set the goal much lower is to say that the company accepts the fact that employees might be working in a potentially hazardous situation without the proper training.

Management's responsibilities include the following: 1) establishing and maintaining the company's commitment to safety and health; 2) developing safety and health policies; 3) setting goals; 4) providing the necessary resources; 5) setting a positive example; 6) organizing, directing, controlling, evaluating, and revising the overall safety and health program.

Supervisors play a key role in maintaining a quality work environment. They represent the level of management closest to employees and subcontractors on a day-to-day basis. Consequently, supervisors carry the primary responsibility for ensuring that employees do the following: 1) comply with all applicable rules and regulations; 2) put safety ahead of other factors (without using it as an excuse for not getting the job done); 3) attend periodic safety meetings/discussions; 4) participate in safety training; 5) properly use personal protective equipment; 6) promptly report accidents and near misses; 6) do the necessary "housekeeping" chores everyday; 7) maintain a positive attitude toward safety; and 8) speak out when other employees are engaging in unsafe practices.

Employees may play the most important role of all in maintaining a quality work environment. This role involves working safely themselves and insisting that their fellow employees do the same. Specifically, employees are responsible for doing the following: 1) complying with all applicable safety rules and regulations; 2) following instructions from managers, supervisors, and safety professionals; 3) asking questions to clarify when in doubt about a course of action; 4) calling hazardous conditions to the attention of the supervisor or safety professional; 5) reporting all accidents and near misses to the supervisor or safety professional; 6) reporting damage to company property and equipment to the supervisor; 7) performing all necessary housekeeping chores promptly and regularly; and 8) projecting a positive attitude toward safety.

What follows are strategies that can be used to communicate with employees about the safety and health plan: Face-to-face meetings,Bulletin board notices, "Chalktalks" convened by supervisors at the beginning of a shift,New employee orientations,Audio tapes that can be played while driving to and from work,Videotapes,Newsletters, memorandums, and bulletins,signs and posters,Setting a positive example (the best way to communicate the importance of safety)

A hazard is a condition or combination of conditions that, if left uncorrected, may lead to an accident, illness, or property damage.

A preliminary hazard analysis (PHA) is conducted to identify potential hazards and prioritize them according to the 1) likelihood of an accident or injury being caused by the hazard; and 2) severity of injury, illness, and /or property damage that could result if the hazard caused an accident.

Risk analysis is an analytical methodology normally associated with insurance and investments. However, risk analysis can be used to analyze the workplace, identify hazards, and develop strategies for overcoming these hazards. The risk analysis process focuses on two key questions: 1. How frequently does a given event occur? 2. How severe are the consequences of a given event?

A comprehensive accident report can help construction professionals pinpoint the cause of the accident. This information can then be used to prevent future accidents, which is the primary purpose of accident investigation.

.Isolate the Accident Scene The accident scene should be isolated until all pertinent evidence has been collected or observed. The purpose is to maintain as closely as possible the conditions that existed at the time of the accident. Record All Evidence Make a permanent record of all pertinent evidence as quickly as possible. Photograph or Videotape the Scene Photographic and videotaping technology has simplified the task of observing and recording evidence. Identify Witnesses It is important to compile a witness list of three categories: primary witnesses, secondary witnesses, and tertiary witnesses. Interview Witnesses Every witness on the list should be interviewed in the order of the above categories.

The purpose of the report is to record the findings of the accident investigation, the cause or causes of the accident, and recommendations for corrective action. The purpose of the report is to record the findings of the accident investigation, the cause or causes of the accident, and recommendations for corrective action.

emergency is a potentially life-threatening situation, usually occurring suddenly and unexpectedly. Emergencies may be the result of natural and/or human causes.

The emergency response professionals quickly organize, stabilize, and administer. Their ability to respond in this manner is the result of preparation. A quick and proper response—which results because of proper preparation—can prevent panic, decrease the likelihood of injury and damage, and bring the situation under control in a timely manner. Since no workplace is immune to emergencies, preparing for them is critical. An important component of preparation is planning.

A company's designated safety and health professional is the obvious person to organize and coordinate emergency responses. However, regardless of who is designated, it is important that: (1) one person in charge; (2) everyone involved know who is in charge; and (3) everyone who has a role in responding to an emergency be given ample opportunities to practice in simulated conditions that come as close as possible to real conditions.

. Emergency planning 2. Emergency notification 3. Information Requirements 4. Toxic Chemical Release Reporting

OSHA standards do play a role in emergency prevention and should be considered when developing emergency plans. For example, 29 CFR 1926.35 contains requirements for "Employee Emergency Action Plans." Such plans are required to be in writing (except in the case of companies with 10 or fewer employees) and to cover the actions employers and employees must take to ensure employee safety during emergencies. Six elements must be included in the plan at a minimum.

A company's designated safety and health professional is the obvious person to organize and coordinate emergency responses. However, regardless of who is designated, it is important that one person in charge, everyone involved know who is in charge, everyone who has a role in responding to an emergency be given ample opportunities to practice in simulated conditions that come as close as possible to real conditions.

Trauma is psychological stress. It typically results from exposure to a disaster or emergency that is so shocking it impairs a person's sense of security or well-being. Trauma left untreated can manifest itself as post-traumatic stress disorder.

The job of the TRT is to intervene as early as possible, help employees acknowledge what they have experienced, and give them opportunities to express how they feel about it to people who are qualified to help. The qualified to help aspect is very important. TRT members who are not counselors or mental health professionals should never attempt to provide care they are not qualified to give. Part of the trauma training that construction professionals receive involves recognizing the symptoms of employees who need professional care and referring them to qualified care providers.

29 CFR 1926 is the OSHA standard that applies specifically to construction. It is divided into subparts numbered from A to Z. Each subpart covers a specific area of concern. Subpart A covers purpose, scope, variances from safety and health standards, and enforcement of the standards. A major focus of this subpart is the right of the U.S. Secretary of Labor or the designated representative of the Secretary to enter any jobsite that falls under the jurisdiction of the Contract Work Hours and Safety Standards Acts (Section 107). The principal message contained in this subpart is that the Secretary has the right to conduct on-site inspections to determine if a construction company is complying with applicable standards. There is also a detailed explanation of the rules governing administrative adjudication of cases when violations are noted by an inspector in the process of enforcing the OSHA standards. Subpart A contains the following sections: • 1926.1 Purpose and scope • 1926.2 Variations from safety and health standards • 1926.3 Inspections - right of entry • 1926.4 Rule of practice for administrative adjudication's for enforcement of safety and health standards

Key issues relating to subpart A are as follows: 1) Does the company have contract that are subject to the Contract Work Hours and Safety Standards Act (Section 107)?; 2) Do the regulations in 29 CFR 1926 apply to the company?; 3) Does the company need a variance from a given safety and health standard?; 4) Has an OSHA inspector ever visited one of the company's job sites?; and 5) Has the company ever undergone administrative adjudication for violation of an OSHA regulation?

Basic First Aid • Cardiopulmonary resuscitation • Severe bleeding • Broken bones and fractures • Burns • Choking on an obstruction • Head injuries/concussion • Cuts and abrasions • Electric shock • Heart attack • Stroke recognition • Moving an injured person • Drug overdose • Unconscious victim • Eye injuries • Chemical burns • Rescue

Training employees in first aid techniques is an important part of preparing for emergencies. However, there is more to being prepared to administer first aid than just training. In addition, it is important to do the following: 1. Have well-stocked first aid kits available. First aid kits should be placed at all job sites in clearly visible, easily accessible locations. They should be properly and fully stocked and periodically checked to ensure that they stay fully stocked. Figure 7-2 lists the minimum recommended contents for a workplace first aid kit. 2. Have appropriate personal protective devices available. With the concerns about AIDS and hepatitis, administering first aid has become more complicated than in the past. The main concerns are with bleeding and other body fluids. Consequently, a properly stocked first aid kit should contain rubber surgical gloves and facemasks or mouthpieces for CPR. 3. Post emergency telephone numbers. The advent of 911 service has simplified the process of calling for medical care, police, or fire-fighting assistance. If 911 services are not available, emergency numbers for ambulance, hospital, police, fire department, LEPC, and appropriate internal personnel should be posted at clearly visible locations near all telephones at all job sites. 4. Keep all employees informed. Some companies require all employees to undergo first aid training; others choose to train one or more employees in each department. Regardless of the approach used, it is important that all employees be informed and kept up to date concerning basic first aid information.

• Continuous noise - Noise of a constant level measured over at least one second using the "slow" setting on a sound level meter. Note that an intermittent noise (e.g., on for over a second and then off for a period) is both variable and continuous. • Exchange rate - The relationship between intensity and dose. OSHA uses a 5-dB exchange rate. Thus, if the intensity of an exposure increases by 5 dB, the dose doubles. This may also be referred to as the doubling rate. The U.S. Navy uses a 4-dB exchange rate; the U.S. Army and U.S. Air Force use a 3-dB exchange rate. • Hearing threshold level - The hearing level, above a reference value, at which a specified sound or tone is heard by an ear in a specified fraction of the trials. Hearing threshold levels have been established so that dB HTL reflects the best hearing of a group of persons. • Noise-induced hearing loss - A sensorineural hearing loss that is attributed to noise and for which no other etiology can be determined. • Time-weighted average - A value computed so that the resulting average is equivalent to an exposure resulting from a constant noise level over an eight-hour period.

A number of different factors affect the risk of hearing loss associated with exposure to excessive noise. The most important of these are: • Intensity of the noise (sound pressure level) • Type of noise (wide band, narrow band, or impulse) • Duration of daily exposure • Total duration of exposure (number of years) • Age of the individual • Coexisting hearing disease • Nature of environment in which exposure occurs • Distance of the individual from the source of the noise • Position of the ears relative to the sound waves

Typical engineering controls involve: • Reducing noise at the source (e.g., installing a muffler) • Interrupting the noise path (e.g., erecting acoustical enclosures and barriers) • Reducing reverberation (e.g., installing sound-absorbing material) • Reducing structure-borne vibration (e.g., installing vibration mounts and providing proper lubrication)

Training and education Failures or deficiencies in hearing loss prevention programs can often be traced to inadequacies in the training and education of noise-exposed workers and those who conduct elements of the program. • Has training been conducted at least once a year? • Was the training provided by a qualified instructor? • Was the success of each training program evaluated? • Is the content revised periodically? • Are managers and supervisors directly involved? • Are posters, regulations, handouts, and employee newsletters used as supplements? • Are personal counseling sessions conducted for employees having problems with hearing protection devices or showing hearing threshold shifts? Supervisor involvement Data indicate that employees who refuse to wear hearing protection devices or who fail to show up for hearing tests frequently work for supervisors who are not totally committed to the hearing conservation program. • Have supervisors been provided with the knowledge required to supervise the use and care of hearing protectors by subordinates? • Do supervisors wear hearing protectors in appropriate areas? • Have supervisors been counseled when employees resist wearing protectors or fail to show up for hearing test? • Are disciplinary actions enforced when employees repeatedly refuse to wear hearing protectors? Noise measurements Noise measurements, to be useful, should be related to noise exposure risks or the prioritization of noise control efforts, rather than merely filed away. In addition, the results should be communicated to the appropriate personnel, especially when follow-up actions are required. • Were the essential/critical noise studies performed? • Was the purpose of each noise study clearly stated? Have noise-exposed workers been notified of their exposures and apprised of auditory risks? • Are the results routinely transmitted to supervisors and other key individuals? • Are results entered into health/medical records of noise-exposed workers? • Are results entered into shop folders? • If noise maps exist, are they used by the proper staff? • Are noise measurement results considered when contemplating procurement of new equipment? Modifying the facility? Relocating workers? • Have there been changes in areas, equipment, or processes that have altered noise exposure? Have follow-up noise measurements been conducted? • Are appropriate steps taken to include (or exclude) workers in the hearing loss prevention programs whose exposures have changed significantly? • Engineering and administrative controls Controlling noise by engineering and administrative methods is often the most effective means of reducing or eliminating the hazard. In some cases, engineering controls will remove requirements for other components of the program, such as audiometric testing and the use of hearing protectors. • Have noise control needs been prioritized? • Has the cost-effectiveness of various options been addressed? • Are workers and supervisors apprised of plans for noise control measures? • Are they consulted on various approaches? • Will in-house resources or outside consultants perform the work? • Have workers and supervisors been counseled on the operation and maintenance of noise control devices? • Are noise control projects monitored to ensure timely completion? • Has the full potential for administrative controls been evaluated? Are noisy processes conducted during shifts with fewer employees? Do workers have noise-protected lunch or break areas? Monitoring audiometry and record keeping The skills of audiometric technicians, the status of the audiometer, and the quality of audiometric test records are crucial to the success of hearing loss prevention programs. Useful information may be ascertained from the audiometric records as well as from those who actually administer the tests. • Has the audiometric technician been adequately trained, certified, and re-certified as necessary? • Do on-the-job observations of the technicians indicate that they perform a thorough and valid audiometric test, instruct and consult the worker effectively, and keep appropriate records? • Are records complete? • Are follow-up actions documented? • Are hearing threshold levels reasonably consistent from test to test? If not, are the reasons for inconsistencies investigated promptly? • Are the annual test results compared to baseline to identify the presence of an OSHA standard threshold shift? • Is the annual incidence of standard threshold shift greater than a few percent? If so, are problem areas pinpointed and remedial steps taken? • Are audiometric trends (deteriorations) being identified, both in individuals and in groups of employees? • Do records show that appropriate audiometer calibration procedures have been followed? • Is there documentation showing that the background sound levels in the audiometer room were low enough to permit valid testing? • Are the results of audiometric tests being communicated to supervisors and managers as well as to workers? • Has corrective action been taken if the rate of no-shows for audiometric test appointments is more than about five percent? • Are workers incurring significant threshold shift notified in writing within at least 21 days? Referrals Referrals to outside sources for consultation or treatment are sometimes in order, but they can be an expensive element of the hearing loss prevention program and should not be undertaken unnecessarily. • Are referral procedures clearly specified? • Have letters of agreement between the company and consulting physicians or audiologists been executed? • Have mechanisms been established to ensure that workers needing evaluation or treatment actually receive the service (i.e., transportation, scheduling, reminders)? • Are records properly transmitted to the physician or audiologist, and back to the company? • If medical treatment is recommended, does the worker understand the condition requiring treatment, the recommendation, and methods of obtaining such treatment? • Are workers being referred unnecessarily? Hearing protection devices When noise control measures are not feasible, or until such time as they are installed, hearing protection devices are the only way to prevent hazardous levels of noise from damaging the inner ear. Making sure that these devices are worn properly requires continuous attention on the part of supervisors and program implementers as well as noise-exposed employees. • Have hearing protectors been made available to all employees whose daily average noise exposures are 85 dBA or above? • Are workers given the opportunity to select from a variety of appropriate protectors? • Are workers fitted carefully with special attention to comfort? • Are workers thoroughly trained, not only initially but at least once a year? • Are the protectors checked regularly for wear or defects and replaced immediately if necessary? • If workers use disposable hearing protectors, are replacements readily available? • Do workers understand the appropriate hygiene requirements? • Have any workers developed ear infections or irritations associated with the use of hearing protectors? Are there any workers who are unable to wear these devices because of medical conditions? Have these conditions been treated promptly and successfully? • Have alternative types of hearing protectors been considered when problems with current devices are experienced? • Do workers who incur noise-induced hearing loss receive intensive counseling? • Are those who fit and supervise the wearing of hearing protectors competent to deal with the many problems that can occur? • Do workers complain that protectors interfere with their ability to do their jobs? Do they interfere with spoken instructions or warning signals? Are these complaints followed promptly with counseling, noise control, or other measures? • Are workers encouraged to take their hearing protectors home if they engage in noisy non-occupational activities? • Are potentially more effective protectors considered as they become available? • Is the effectiveness of the hearing protector program evaluated regularly? • Have at-the-ear protection levels been evaluated to ensure that either over- or underprotection has been adequately balanced according to the anticipated ambient noise levels? • Is each hearing protector user required to demonstrate that he or she understands how to use and care for the protector? Are the results documented? Administration Keeping organized and current on administrative matters will help the program run smoothly. • Have there been any changes in federal or state regulations? Have hearing loss prevention program's policies been modified to reflect these changes? • Are copies of company policies and guidelines regarding the hearing loss prevention program available in the offices that support the various program elements? Are those who implement the program elements aware of these policies? Do they comply? • Are necessary materials and supplies being ordered with a minimum of delay? • Are procurement officers overriding the hearing loss prevention program implementor's requests for specific hearing protectors or other hearing loss prevention equipment? If so, have corrective steps been taken? • Is the performance of key personnel evaluated periodically? If such performance is found to be less than acceptable, are steps taken to correct the situation? • Has the failure to hear warning shouts or alarms been tied to any accidents or injuries? If so, have remedial steps been taken?