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Maintenance Module  


    

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  Hazards found in a Building Maintenance Room Spray Nozzle - Exposure to Legionnaires' Disease Hazardous Chemicals Water Systems - Water Heater  Hazards of Heat Producing Equipment - Furnace Lockout/Tagout Issues Machine Guarding Issues Electrical Outlet

The following topics relate to occupational safety and health hazards in maintenance: 



  Legionnaires' Disease

Generally occurs where water is contaminated with the legionella organism and is aerosolized and then breathed in by workers or patients. 

Hazard

Exposure to the legionella organism and Legionnaires' Disease: 

  • Hazard of breathing contaminated, aerosolized water could occur 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, 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, can lead to death.
    • Fatality rate is approximately 15%.

Example Controls

Good work practices found in the OSHA Technical Manual on Legionnaries' Disease include:

Maintenance of water systems at specified recommendations:
  • Domestic hot-water systems
    • Store Hot water at 140 degrees F and delivered at a minimum of 50°C (122°F) to all outlets. To avoid scalding problems install fail-safe scald protection equipment, such as preset thermostatic mixing valves.
    • Where building cannot be retrofitted, periodically increasing the temperature to at least 158 degrees F or chlorination followed by flushing should be considered.
    • Systems should be inspected annually to ensure equipment is functioning properly.
  • Domestic cold-water systems:
    • Maintain cold-water lines below 68 degrees F.
    • Water tanks that allow water to remain uncirculated for long periods should be eliminated or designed to reduce storage time to a day or less. They should also be covered and protected from temperature extremes.
    • Cross-contamination of the domestic cold water system with other systems shall be prevented.
    • If the cold-water lines have significant contamination, hyperchlorination can eradicate legionella
  • Cooling towers should be cleaned and disinfected at least twice a year. 
    • Periodic use of biocides is recommended to control bacteria growth.
    • Provide visual inspection and periodic maintenance of the system, to prevent buildup of scale and sediment and bio-fouling, which support legionella growth.
Legionnaires' Disease Chapter 7 Section III, OSHA Technical Chapter, Controls, Source Identification
  • Appendix III:7-5. OSHA Technical Chapter, Water Treatment Protocols for Facilities that have experienced a Legionnaires' Outbreak. 
  • Appendix III:7-1. Employee Awareness Program, to inform employees of any potential outbreaks, and to educate about the disease.

The CDC in Legionellosis: Legionnaires' Disease and Pontiac Fever recommends to limit the growth and spread of Legionella organisms by:  

  • Improving design and maintenance of cooling towers and plumbing systems.
  • Identifying the source of disease transmission and providing appropriate prevention and control measures, such as the decontamination of the water source.

Medical Awareness of Physicians and Health Care Workers (HCWs):

HCWs need to be aware that the bacteria can be present in water systems and promptly test vulnerable and/or symptomatic patients and use appropriate antibiotics quickly.
  • Legionnaires' Disease most frequently attacks individuals who have an underlying illness or weakened immune system. The most susceptible include persons who are elderly, smokers, and immunosuppressed.
  • Symptoms include: dry cough, high fever, chills, muscle aches, diarrhea, fatigue, headache, and abdominal pain.
  • Usually treated with erythromycin or a combination of erythromycin and Rifampin.
The Whirlpool/Shower module also addresses Legionnaires' Disease.

Additional Information

  • In September of 1999, the Joint Commission on Accreditation of Healthcare Organizations, (JCAHO) Committee on Healthcare Safety recognized, the need to emphasize and reduce organizational acquired illness by updating the current Environment of Care Standards which would include and address:
    • Issues of improperly designed and maintained aerosolizing water systems (controlling pathogenic biological agents such as legionella in cooling towers, domestic hot water systems, etc).

     

 

Hazardous Chemicals

Hazard

Exposure to hazardous chemicals from cleaning and maintenance work:

  • 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. 

Example Controls

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.
  • Agents with any of the following characteristics are considered hazardous: carcinogens, corrosives, toxic or highly toxic, irritants, sensitizers, or target organ effectors Hazard Communication Standard Appendix A and chemicals listed in 1910.1000 Table 2.
    • Both human and animal data are to be used in this determination. The Hazard Communication Standard Appendix B lists sources of toxicity information. 
  • There are exceptions to some of the requirements of the HCS for consumer products that are subjected to the labeling requirements of the terms as defined in the Consumer Product Safety Act and the Federal Hazardous Substances Act [1910.1200(b)(5)(v)].
  • All hazardous chemicals such as those found in some soaps, disinfectants, pesticides, must be clearly labeled as hazardous [1910.1200(f)].
  • Workers must be trained in potential chemical hazards and controls (engineering controls, work practices, PPE) necessary to prevent hazards in the work area [1910.1200(h)(3)].
  • Provide PPE (e.g., gloves, goggles, splash aprons) as appropriate when handling hazardous dishwashing detergents and chemicals [1910.132]. 
  • Medical Services and First Aid:  Where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use [1910.151(c)]. 
  • Switch to chemicals and cleaning products that are non-hazardous.

Other Recommended Good Work Practices:

  • 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.

The Utility, Dietary and Laundry modules also address Hazardous Chemicals.

Additional Information

 

 

Fire Safety

Hazard

Potential fire hazards:

  • Heat-producing equipment.
  • Storage of flammable chemicals.
Example Controls

OSHA requires:

  • Keep grill, and grill duct work clean of flammable residues and properly maintained [1910.38(b)(3) and (5)].
  • Flammable items must be stored away from heat producing equipment [1910.38(b)(3)]. 
  • A facility's fire prevention plan must address whether employees are to fight fires [1910.157]:
    • If employees are to fight fires, the employer must decide if all employees or just designated employees will fight fires, or if a fire brigade will be trained and equipped. 
    • If employees are not to fight fires, (i.e., employer relies on safe evacuation of all employees and outside services, e.g., local fire stations to fight fires). 
      • Employers must provide an Emergency Action Plan, 1910.38(a) and a Fire Prevention Plan,1910.38(b) following the requirements of 1910.38.

 

 

Lockout/Tagout

Hazard

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

Example Controls

OSHA Lockout/Tagout Standard identifies procedures necessary to shut down and lock out or tag out machines and equipment to prevent possible injury [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.
  • Service or maintenance tasks that expose workers to the unexpected release of hazardous energy are covered under this standard.

Additional Information

 

 

Electric Shock or Electrocution

Hazard

Possible electric shock and contact with electrical hazards from:
  • Maintenance equipment and machinery.
  • Using damaged receptacles and connectors.

Example Controls

Comply with OSHA Standard 1910 Subpart S-Electrical-General. The standard is comprehensive and includes the following sections:

  • Electrical equipment shall be free from recognized hazards [1910.303(b)(1)].
  • Listed or labeled equipment shall be used or installed in accordance with any instructions included in the listing or labeling [1910.303(b)(2)].

  • Sufficient access and working space shall be provided and maintained around all electric equipment to permit ready and safe operation and maintenance of such equipment [1910.303(g)(1)].

  • Ensure that all electrical service near sources of water is properly grounded [1910.304(f)(5)(v)].

  • Tag out and remove from service all damaged receptacles and portable electrical equipment [1910.334(a)(2)(ii)].

  • Repair all damaged receptacles and portable electrical equipment before placing them back into service[1910.334(a)(2)(ii)].
  • Ensure that employees are trained not to plug or unplug energized equipment when their hands are wet [1910.334(a)(5)(i)].
  • Safeguards for personnel protection. Electrical protective equipment [1910.335]. 

  • Selection and use of work practices [1910.333].

  • Hazardous Classified Locations [1910.307].

The Dietary module also addresses Electric Shock.

Additional Information

 

 

Mercury Spills

Acute exposure: Acute inhalation of mercury vapor may result in toxicity similar to metal fume fever including chills, nausea, general malaise, tightness in the chest, chest pains, dyspnea, cough, stomatitis, gingivitis, salivation, and diarrhea [ACGIH 1991; Hathaway et al. 1991].

Chronic exposure: Chronic exposure to mercury may result in weakness, fatigue, anorexia, weight loss, and disturbance of gastrointestinal function. 

Hazard

Exposure to mercury from accidental spills that can occur during repair of  broken thermometers, sphygmomanometers, barometers, gauges, and valves or during sterilization and centrifugation of thermometers in maintenance areas. Exposure to mercury occurs through inhalation or through skin contact. If spills are not promptly cleaned up, mercury may accumulate on surfaces and then vaporize and  be inhaled by unaware workers. Short exposure to high levels of mercury can produce severe respiratory irritation, digestive disturbances and marked renal damage. 

Example Controls

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

OSHA requires:

  • Exposure to mercury vapor shall not exceed an 8-hour time-weighted average limit of 1 mg/10 M3 (0.1 mg/M3) [1910.1000].
  • Employers must select and provide appropriate PPE for clean up of spills[1910.134] and [1910.132].
  • It is mandatory that no employee be allowed to consume food or beverages in an area exposed to mercury [1910.141(g)(2)].

NIOSH recommends:

  • Clean-up spills promptly with special mercury vacuum cleaners and a water-soluble mercury decontaminant.
  • Use disposable protective equipment, protective gloves, special mercury vapor respirators, and gowns, and hoods while cleaning up mercury spills.
  • Disposal according to US EPA regulations. (40 CFR 261.24).
  • Avoid carpeting or porous surfaces on floors that would make clean-up difficult.
  • All spill areas are to be clearly posted until adequate clean-up has been accomplished.
  • Medical monitoring should occur for the respiratory track, nervous system, kidneys, and skin of any worker who may be exposed to mercury.

Good Work Practice recommends:

  • Prevent the spill in the first place by replacing outdated glass thermometers, and sphygmomanometers.
  • Have spill kits available to help clean up small spills of 25 ml or less. 
  • Procedures in place that allow for isolation of the contaminated area.
  • Use a Mercury Vapor Analyzer (Jerome) to verify that the area is safe to reenter.

For more information see OSHA's Standard for Mercury, 1910.1000, Air Contaminants table Z-2.

Additional Information

 

 

Asbestos Exposure

Asbestos is a widely used, mineral-based material that is resistant to heat and corrosive chemicals. Typically, asbestos appears as a whitish, fibrous material which may release fibers that range in texture from coarse to silky; however, airborne fibers that can cause health damage may be too small to see with the naked eye.

Inhaling these airborne asbestos fibers can cause asbestosis (scarring of the lungs resulting in loss of lung function that often progresses to disability and to death); mesothelioma (cancer affecting the membranes lining of the lungs and abdomen); lung cancer; and cancers of the esophagus, stomach, colon, and rectum. 

Hazard
Maintenance workers can be exposed to asbestos from many possible areas and sources. It is often associated with boilers and piping systems or working in areas or with items that might not be expected to contain asbestos. 

Asbestos is more commonly found in buildings built in the1940's and 1950's, and can be found in many items, such as:

  • HVAC Duct Insulation
  • boiler insulation
  • pipe insulation
  • cooling towers
  • floor tile/ceiling tile
  • electrical wiring insulation
  • wall board or spackling compounds

Example Controls

A safety and health program that educates, and protects employees from the hazards of asbestos exposure in the workplace.

Permissible exposure limits (PELs) to Asbestos are set by OSHA:  

  • Asbestos Standard for General Industry [1910.1001]:
    • Sets a maximum exposure limit and include provisions for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, 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. 
  • Significant Changes in the Asbestos Standard for General Industry, 1910.1001 (through June 29, 1995). Office of Training and Education, training materials. 
    • 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 provide an asbestos awareness training course to employees who will perform housekeeping activities in an area containing ACM or PACM.

EPA regulations (40 CFR), PDF files or text. The TSCA Asbestos regulations are found in 40 CFR 763.

Additional Information

 

 


 

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