June 2, 1993

Ms. Diane Nix
Griffin Construction Company
610 Towson Avenue
Fort Smith, Arkansas 72902

Dear Ms. Nix:

This is in further response to our letter of October 23, 1992 in which we answered your August 14, 1992 letter requesting the Occupational Safety and Health Administration (OSHA) to clarify the requirements in 29 CFR 1926.50.

Since our October response, we have had occasion to revisit the question and have revised our position with respect to the maximum response times. A maximum limit of fifteen minutes is now recognized by OSHA as appropriate. However, conditions at each workplace must be evaluated when a first aid program is developed to ensure that it is adequate to meet anticipated needs. For example, the first aid program requirements for a construction workplace will differ from those for an office environment such as at a home office.

Where a medical facility is near the workplace, 29 CFR 1926.50(a) requires the employer to insure the following:

a. In areas where accidents resulting in suffocation, severe bleeding or other life threatening injury or illness can be expected, a 3 to 4 minute response time is required. In other circumstances, i.e., where a life-threatening injury is an unlikely outcome of an accident, a longer response time of up to 15 minutes is acceptable.

b. If employees work in areas where emergency transportation is not available, the employer must make provisions for acceptable emergency transportation.

We apologize for any inconvenience our earlier letter may have caused you.

If you have any questions, please contact either myself or Mr. Dale Cavanaugh of my staff at (202) 219-8136.

Sincerely,



Roy F. Gurnham, Esq., P.E.
Director
Office of Construction and Maritime
Compliance Assistance




October 23, 1992

Ms. Diane Nix
Griffin Construction Company
610 Towson Avenue
Fort Smith, Arkansas 72902

Dear Ms. Nix:

This is in response to your August 14 letter requesting the Occupational Safety and Health Administration (OSHA) to clarify the application of 29 CFR 1926.50. I apologize for the delay in responding to your request.

The requirements set forth in 1926.50 are applicable to a wide range of construction activities and locations. Consequently, there is no one correct time or distance measure specified in the requirements. Therefore the phrase "reasonably accessible" is used to emphasize the desirability of prompt assistance when an injury or illness occurs. As a general rule, we recommend that a person trained in first aid be available on the site whenever professional medical attention is more than eight minutes away from any point on the site. However, the conditions present on any particular job site may make this eight-minute guide line inadequate.

If employees are working with materials that could adversely affect their respiration, or are subject to electrical shock that could cause loss of the breathing function, the eight-minute time period is too long. Irreversible brain damage can result in four minutes due to the lack of oxygen. Furthermore, death can occur from stoppage of breathing or severe arterial bleeding depending on the type and location of the injury. Accordingly, if hazards likely to cause such injuries are present and professional medical attention is not available within four minutes of the onset of the condition, then the employer must comply with the requirement for a person trained in first aid to be available at the worksite.

When the hazards on a worksite are of a less critical nature, the travel time factor becomes less critical also. But we recommend that the eight minute travel time be considered as the maximum.

An employer must decide what action to take to achieve compliance with the cited standard. We would add that the changing conditions on a construction site make it necessary for the employer to review these decisions periodically to assure that the safety and health measures are continuing to provide the necessary protection for the employees.

If you have any further questions, please do not hesitate to contact me or Mr. Dale Cavanaugh of my staff at (202) 219-8136.

Sincerely,



Roy F. Gurnham, Esq., P.E.
Director
Office of Construction and Maritime
Compliance Assistance