• Legionnaires' Disease
• Hazardous Chemicals
• Fire Safety
• Machine Guarding
• Lockout/Tagout

• Electric Shock
• Mercury Spills
• Asbestos Exposure
• Welding Fumes

Employee exposure to the legion Ella organism and Legionnaires' Disease from breathing aerosolized water that contains the legion Ella bacteria.

• Hazard of breathing contaminated, aerosolized water while working in areas where:
  • Cooling towers, humidifiers and/or air conditioning systems or domestic hot water systems are used.
  • Spray nozzles are used: kitchens, janitorial closets, and showers.

• Can cause a mild respiratory illness (that may not require treatment) or severe pneumonia like symptoms 2 to 10 days after exposure.
  
  
  • If not detected and treated promptly with appropriate antibiotics, it can lead to death.
    
    
  • Fatality rate is approximately 15%.

For additional information, see Healthcare Wide Hazards - Legionnaires' Disease.

Employee exposure to hazardous chemicals from cleaning and maintenance work. Including exposure to paints, adhesives, pesticides, solvents used in maintenance shops, waste anesthetic gases and ethylene oxide if repairing ventilation or exhaust systems that are used to remove these gases.

• The Hazard Communication Standard is based on the concept that: Employees have both a need and a right to know the hazards and the identities of the chemicals they are exposed to when working, and what protective measures are available or needed to prevent adverse effects from occurring.

Implement a written program which meets the requirements of the Hazard Communication Standard (HCS) to provide for worker training, warning labels, and access to Material Safety Data Sheets (MSDS).

	The Hazard Communication Standard ensures employee awareness of the hazardous chemicals they are exposed to in the workplace.
	All hazardous chemicals such as those found in some soaps, disinfectants, pesticides, must be clearly labeled as hazardous [29 CFR 1910.1200(f)]. Provide PPE (e.g., gloves, goggles, splash aprons) as appropriate when handling hazardous cleaning agents and chemicals [29 CFR 1910.132(a)].

• Employers need to be aware that paints, adhesives, solvents, and cleaners may give off toxic vapors, and special ventilation and air monitoring practices may be needed.
  
  
• Never mix ammonia and chlorine in a cleaning solution and never pour both down a drain together. When mixed, these chemical form a deadly gas.

For additional information, see Healthcare Wide Hazards - Hazardous Chemicals.

Potential fire hazards for employees in engineering:

Heat-producing equipment. Storage of flammable chemicals. Faulty electrical wiring.

For additional information, see Healthcare Wide Hazards - Fire Hazards.

Maintenance employees can be exposed to possible amputations, and strangulations while performing maintenance to machines, if no machine guarding measures are utilized.

According to OSHA Machine Guarding Standard, machine guarding must be provided to protect employees from hazards [29 CFR 1910.212]:

• Machine guarding can be accomplished through the positioning of hazards so they are inaccessible to employees (i.e. provide barrier guards over dangerous equipment to prevent hazards of strangulation or amputations).
  
  
• Other methods of machine guarding:
  
  
  • Two-handed tripping devices.
    
    
  • Electronic safety devices.

• Machine Guarding. OSHA Safety and Health Topics Page.
• 29 CFR 1910.212, General requirements for all machines. OSHA Standard.

Employee injuries occurring during servicing or maintenance of machines or equipment from the unexpected release of hazardous energy.

OSHA Lockout/Tagout Standard identifies procedures necessary to shut down, isolate, and lock out or tag out machines and equipment to prevent possible injury [29 CFR 1910.147].

• Before service or maintenance is performed on machines or equipment, the machines or equipment must be turned off and disconnected from the energy source, and the energy-isolating device must be locked out or tagged out appropriately. In addition, any stored energy must be relieved or otherwise effectively controlled.
  
  
• Service or maintenance tasks that expose workers to the unexpected release of hazardous energy are covered under this standard.

• Control of Hazardous Energy (Lockout/Tagout). OSHA Safety and Health Topics Page.
• Lockout/Tagout Interactive Training Program. OSHA eTool, (1998).
• Small Business Handbook. OSHA Publication 2209-02R, (2005). Also available as a 260 KB PDF, 56 pages.
  • Lockout/Tagout Procedures
  • Electrical

Maintenance workers and engineers can be unknowingly exposed to asbestos from many possible areas and sources. Engineers can be exposed while working in furnace rooms where boilers are insulated with asbestos, or when making repairs to old piping or doing minor renovations. Significant asbestos exposures can occur when insulation in old buildings is removed during renovations. Asbestos exposure is often associated with areas or items that might not be expected to contain asbestos. Maintenance personnel may be unaware and untrained to handle these hazards.

• Asbestos is commonly found in old buildings, built in the 1940's and 1950's, and can be found in many items such as:

• Follow the requirements of the Asbestos Standard for General Industry [29 CFR 1910.1001] including:
  
  
  • Follow permissible exposure limits (PELs) and include provisions for engineering controls, respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, record keeping, and medical exams.
    
    
  • Workplace exposure is limited to 0.1 fibers per cubic centimeter of air (0.1 f/cc), averaged over an eight-hour work shift. The excursion or short-term limit is one fiber per cubic centimeter of air (1 f/cc) averaged over a sampling period of 30 minutes.
    
    
  • Whenever asbestos fibers are exposed, they present a hazard and should be removed or encapsulated so that they will not be released. Asbestos should only be removed by fully trained personnel using methods and PPE covered in 1910.1001.
    
    
  • Significant Changes in the Asbestos Standard for General Industry, 1910.1001 (through June 29, 1995) including:
    
    
    • The PEL was reduced from 0.2 fibers/cc to 0.1 fibers/cc from 0.2 fibers/cc as a TWA. The Excursion Limit remains 1.0 fibers/cc averaged over 30 minutes.
      
      
    • Asphalt and vinyl flooring material installed before 1980 also must be treated as asbestos-containing.
      
      
    • Installed thermal system insulation and sprayed-on and troweled-on surfacing materials found in buildings constructed no later than 1980 are presumed to be asbestos-containing materials (greater than 1% asbestos).
      
      
    • Sanding of asbestos-containing flooring material is prohibited.
      
      
    • Building and facility owners must determine the presence, location, and quantity of asbestos-containing material (ACM) and presumed asbestos-containing material (PACM) and keep records of ACM/PACM.
      
      
    • Building and facility owners must inform other employers, and their own employees who will perform housekeeping activities, of the presence and location of such materials.
      
      
    • Employers must post signs at entrances to mechanical rooms/areas that contain ACM/PACM and that employees may enter.
      
      
    • Employers must provide an asbestos awareness training course to employees who will perform housekeeping activities in an area containing ACM or PACM.

EPA regulations (49 CFR Title 40, Protection of the Environment). The Toxic Substances Control Act (TSCA) asbestos regulations are found in 40 CFR 763, Asbestos.

• Asbestos. OSHA Safety and Health Topics Page.
• Asbestos Bibliography (Revised). US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 97-162, (1997, September).
• Better Protection Against Asbestos in the Workplace. OSHA Fact Sheet, (2001), 88 KB PDF, 2 pages.

Possible electric shock and contact with electrical hazards from:

• Maintenance equipment and machinery.
  
  
• Using damaged receptacles and connectors.
  
  
• Ungrounded electrical service near sources of water.

Comply with OSHA Standard 29 CFR 1910 Subpart S, Electrical, General.

For additional information, see Healthcare Wide Hazards - Electrical Hazards.

Exposure to mercury from accidental spills that can occur during repair of  broken thermometers, sphygmomanometers, barometers, and gauges.

Safety and health program that provides for prompt, safe, clean-up of spills by workers trained in proper procedures.

• Prevent the spill in the first place by replacing outdated glass thermometers, and sphygmomanometers.

For additional information, see Healthcare Wide Hazards - Mercury.

Maintenance employee exposure to welding hazards and fumes as they are repairing items. Welding fumes contain particulate matter and gases and may be a health concern for workers especially if welding is taking place in confined spaces, also potential for flash burns to skin and eyes.

There are numerous health hazards associated with exposure to fumes, gases and ionizing radiation formed or released during welding, cutting and brazing, including heavy metal poisoning, lung cancer, metal fume fever, flash burns, and others. These risks vary depending upon the type of welding materials and welding surfaces.

• Comply with OSHA's 29 CFR 1910 Subpart Q, Welding, cutting, and brazing including:
  
  
  • Protective eyewear [29 CFR 1910.252(b)(2)].
    
    
  • Protective clothing [29 CFR 1910.252(b)(3)].
    
    
  • Work in confined spaces [29 CFR 1910.252(b)(4)].
    
    
  • Local exhaust or general ventilating systems shall be provided and arranged to keep the amount of toxic fumes, gases, or dusts below the maximum allowable concentration as specified in 1910.1000, [29 CFR 1910.252(c)(1)(iii)].
    
    
  • The Welding fume PEL (permissible exposure limit) in Air Contaminants, 29 CFR 1910.1000 Section 6 - VI. Health Effects Discussion and Determination of Final PEL is 5mg/m³ and applies to the total fume concentration generated during the welding of iron, mild steel, or aluminum.
    
    
    
    

Criteria for a Recommended Standard: Welding, Brazing, and Thermal Cutting. National Institute for Occupational Safety and Health (NIOSH), (1988, April). Recommends, reducing exposures to all welding emissions to the lowest feasible concentrations using state-of-the-art engineering controls, and work practices (e.g., use local exhaust ventilation units to remove fumes).	Local Exhaust Ventilation unit removing fumes.
Control Technology Assessment for the Welding Operations at Boilermaker's National Apprenticeship Training School, Kansas City, Kansas. National Institute for Occupational Safety and Health (NIOSH) In-Depth Report, (1997, June 27). Identifies, observes, and evaluates engineering control measures that may reduce the amount of fume a worker is exposed to during welding.	Local Exhaust Ventilation Unit.