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SAFETY AND HEALTH PROGRAM IN THE PUBLIC HEALTH SETTING

General Policy Statement

Employee and client safety is of utmost importance to the health department, the citizensof the county and to the county's governing body.

The safety of citizens and clients is addressed by the agency's active participation in thecounty emergency plan, the ability to respond in the event of fire or medical emergency,and an awareness of the safety of the physical environment in which services are provided.

The safety of employees is addressed by promoting joint administrative and employeeresponsibility for ongoing education/training related to personal, environmental, andmedical emergency safety issues.

This document is provided as a compliance aid, but does not constitute a legal interpretation of OSHA Standards, nor does it replace the need to be familiar with, and follow, the actual OSHA Standards (including any North Carolina specific changes.)

Though this document is intended to be consistent with OSHA Standards, if an area is considered by the reader to be inconsistent, the OSHA standard should be followed.

The North Carolina Department of Labor OSH Consultative Services Bureau can be contacted for further assistance such as helping you set up your individual program and even with on-site surveys.

The following policies, procedures, and checklist are provided as samples only and are intended to assist the health department with the establishment of agency-specific information related to safety policies and appropriate orientation and documentation of these policies.

These samples should be revised as needed to meet individual agency needs and to address specific aspects of the health department's role relative to the county's unique structure and management. Sample policies and/or forms from local agencies are also provided.

Suggested Procedure

1. Employees shall be oriented to all policies and procedures identified for safety and health management at the time of initial employment. Continued training and inservice shall be provided on a regular schedule in accordance with the employee's work site and job responsibilities preferably annually.

2. The Agency should identify a responsible person for ensuring that each referenced policy is current, reviewed at least annually, revised as needed, and appropriately distributed.

3. Documentation that the employee has completed the orientation review and documentation of the employee's in-service and training attendance should be maintained.

4. In order to maintain compliance, the following is an example of how a checklist could be developed to ensure compliance:

Agency Policy

Designated individual

responsible for Policy Development

and Distribution

Date of Next

Policy Review

Policy Location

Emergency Contact / Phone Number

Safety and Health Responsibilities

Manager Responsibilities

1. Insure that an agency wide or county wide safety committee is formed and is carrying out its responsibilities as described in this program.

2. Insure that sufficient employee time, supervisor support, and funds are budgeted for safety equipment, training and to carry out the safety program.

3. Insure that supervisors are carrying out their responsibilities described in this program.

4. Insure that incidents are fully investigated and corrective action taken to prevent the hazardous conditions or behaviors from happening again.

5. Insure that a record of injuries and illnesses is maintained and posted as described in this program.

6. Set a good example by following established safety rules and attending required training.7. Report unsafe practices or conditions to the supervisor of the area where the hazard was

observed.

(Customize by adding any additional management responsibilities that you may have and/ordeleting any that do not apply to your agency.)

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Supervisor Responsibilities

1. Insure that each employee you supervise has received an initial orientation before beginning work.

2. Insure that each employee you supervise is competent or receives on-the-job training on safe operation of equipment or tasks before starting work on that equipment, project, or any new work assignment.

3. Insure that each employee receives required personal protective equipment (PPE) before starting work on a project requiring PPE, and that he/she is trained on any new PPE.

4. Do a daily walk-around safety-check of the work area. Promptly correct any hazards you find.

5. Observe the employees you supervise working. Promptly correct any unsafe behavior. Provide training and take corrective action as necessary. Document employee evaluations.

6. Set a good example for employees by following safety rules and attending required training.7. Investigate all incidents in your area and report your findings to management.8. Inform other employers/subcontractors of our safety/health program requirements prior to

commencing work. Inform the Safety Coordinator whenever outside contractors will have employees on site.

9. Talk to management about changes to work practices or equipment that will improve employee safety.

(Customize by adding any additional supervisor responsibilities that you may have and/or deleting any that do not apply to your agency.)

Employee Responsibilities

1. Follow safety rules described in this program, OSHA safety standards and training you receive.

2. Report unsafe conditions or actions to your supervisor or safety committee representative promptly.

3. Report all injuries to your supervisor promptly regardless of how serious.4. Report all near-miss incidents to your supervisor promptly.5. Always use personal protective equipment (PPE) in good working condition where it is

required. 6. Do not remove or defeat any safety device or safeguard provided for employee protection.7. Encourage co-workers by your words and example to use safe work practices on the job.8. Make suggestions to your supervisor, safety committee representative or management about

changes you believe will improve employee safety.

Employees are expected to use good judgment when doing their work and to follow established safety rules. We have established a disciplinary policy to provide appropriate consequences for failure to follow safety rules. This policy is designed not so much to punish as to bring unacceptable behavior to the employee's attention in a way that the employee will be motivated to make corrections.

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The following consequences apply to the violation of the same/similar rule or the same/similar unacceptable behavior:

First Instance verbal warning, notation in employee file, and instruction onproper actions

Second Instance written reprimand, and instruction on proper actionsThird Instance 1-5 day suspension without pay, written reprimand, and instruction

on proper actionsFourth Instance Termination of employment.

An employee may be subject to immediate termination when a safety violation places the employee or co-workers at risk of permanent disability or death.

(The above rules are included as an example only. You must customize this program by adding any disciplinary rules that you may have and/or deleting any that do not apply to your agency.)

Management Commitment

Safety Policy Template

(Customize by adding your agency name here) places a high value on the safety of its employees.

(Customize by adding your agency name here) is committed to providing a safe workplace for all employees and has developed this program for injury prevention to involve management, supervisors, and employees in identifying and eliminating hazards that may develop during our work process.

It is the basic safety policy of this agency that no task is so important that an employee must violate a safety rule or take a risk of injury or illness in order to get the job done.

The time during which employees are participating in training and education activities shall be considered as hours worked for purposes of wages, benefits, and other terms and conditions of employment. The training and education shall be provided at no cost to the employees. Members of the Safety/Health Committee will be allowed reasonable time to exercise the rights of the committee without any loss of pay or benefits.

Employees are required to comply with all agency safety rules and are encouraged to actively participate in identifying ways to make our agency a safer place to work.

Supervisors are responsible for the safety of their employees and as a part of their daily duties must check the workplace for unsafe conditions, watch employees for unsafe actions and take prompt action to eliminate any hazards.

Management will do its part by devoting the resources necessary to form a safety committee composed of management and elected employees. We will develop a system for identifying and correcting hazards. We will plan for foreseeable emergencies. We will provide initial and ongoing training for employees and supervisors. And, we will establish a disciplinary policy to insure that company safety policies are followed.

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The Safety/Health Coordinator for ___________________________is__________________________.

Safety is a team effort – Let us all work together to keep this a safe and healthy workplace.

Signature of Top Management Official_________________________________________________Title_____________________________________Date________________

(Customize by adding any additional policy items that you may have and/or deleting any that do not apply to your agency.)

Employee Participation

Safety and Health Committee

We have formed a safety/health committee to help employees and management work together to identify safety problems, develop solutions, review incident reports and evaluate the effectiveness of our safety/health program—all in accordance with NCGS 95-251 and 252. The Safety Coordinator shall facilitate the selection process and all committee activities.

w Half the committee is made up of non-management employees and in representative numbers as required by the Statute. Non-management representatives shall be selected by and from among this group, and in accordance with any contract that may exist between a collective bargaining unit(s) and __________________________________(Insert agency name).

w Elected representatives will serve for at least one year, and shall not be allowed to succeed themselves in the same position more than once. Terms may be staggered. Vacancies shall be filled in accordance with one of the procedures in the Statute under .0604.

w The committee shall be co-chaired by the Safety/Health Coordinator and a committee representative selected by members of the committee.

w The Safety/Health Committee shall, within reasonable limits and in a reasonable manner, exercise the following rights:

Review the safety/health program upon establishment and yearly thereafter. Review incidents involving work-related fatalities, injuries/illnesses, near-miss

incidents and safety/health complaints. Review agency work injury/illness records (other than personally identifiable medical

information), and other reports/documents relating to occupational safety/health. Conduct inspections at least quarterly and in response to employee/committee

complaints. Conduct interviews with employees during inspections. Conduct meetings at least quarterly and keep written minutes.

w The regularly scheduled meeting time is __________________at the ________________room. This may be changed by vote of the committee.

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w A committee member will be designated at each meeting to keep minutes. A copy may be posted on the employee bulletin board after each meeting. After being posted for one month, the minutes will be filed for two years by the Safety Coordinator.

Annual Site Survey & Audit - Once a year an inspection team made up of members of the safety committee will do a wall-to-wall walk through inspection of the entire worksite. They will write down any safety hazards or potential hazards they find. The results of this inspection will be used to eliminate or control obvious hazards, target specific work areas for more intensive investigation, assist in revising the checklists used during regular quarterly safety inspections and as part of the annual review of the effectiveness of our accident prevention program. All written programs will be reviewed and a written statement of findings and remedial actions shall be kept for two years.

Periodic Change Survey – The Safety Coordinator (or a team) will look at any changes we make to identify safety issues. Changes include new equipment, new PPE, changes to production processes or a change to the building structure. A team is made up of maintenance, production, and safety committee representatives. It examines the changed conditions and makes recommendations to eliminate or control any hazards that were or may be created as a result of the change.

Quarterly Safety Inspection - Each quarter, before the regularly scheduled safety committee meeting, safety committee representatives will inspect their areas for hazards using the standard safety inspection checklist. They will talk to co-workers about their safety concerns. Committee members will report any hazards or concerns to the whole committee for consideration. The results of the area inspection and any action taken will be posted in the affected area for one month and a copy filed for two years. Occasionally, committee representatives may agree to inspect each other's area rather than their own. This brings a fresh pair of eyes to look for hazards.

Job Hazard Analysis -- As a part of our on-going safety program, we will use a “Job Hazard Analysis” form to look at each type of job task our employees do. This analysis will be done by the supervisor of that job task with the Safety Coordinator and/or a member of the safety committee. We will change how the job is done as needed to eliminate or control any hazards. We will also check to see if the employee needs to use personal protective equipment (PPE) while doing the job. Employees will be trained in the revised operation and to use any required PPE. The results will be reported to the safety committee. Each job task will be analyzed at least once every _____years (Customize), whenever there is a change in how the task is done or if there is a serious injury while doing the task.

(Customize by adding any additional safety self-inspection policies that you may have and/or deleting any that do not apply to your agency.)

Employee Safety Meetings

All employees are encouraged to attend a safety meeting. This meeting is to help identify safety problems, develop solutions, review incidents reports, provide training and evaluate the

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effectiveness of our safety program. Written minutes will be kept on file for two years by the Safety Coordinator.

(Customize by adding any additional Employee Safety Meeting information that you may have and/or deleting any that do not apply to your agency.)

Hazard Prevention and Control

Eliminating Workplace Hazards

(Customize by adding your agency name here) is committed to eliminating or controlling workplace hazards that could cause injury or illness to our employees. We will meet the requirements of state safety standards where there are specific rules about a hazard or potential hazard in our workplace. Whenever possible we will design our facilities and equipment to eliminate employee exposure to hazards. Where these engineering controls are not possible, we will write work rules that effectively prevent employee exposure to the hazard. When the above methods of control are not possible or are not fully effective we will require employees to use personal protective equipment (PPE) such as safety glasses, hearing protection, foot protection etc.

Basic Safety Rules

The following basic safety rules have been established to help make our agency a safe and efficient place to work. These rules are in addition to safety rules that must be followed when doing particular jobs or operating certain equipment. Those rules are listed elsewhere in this program. Failure to comply with these rules will result in disciplinary action.

Never do anything that is unsafe in order to get the job done. If a job is unsafe, report it to your supervisor or safety committee representative. We will find a safer way to do that job.

Do not remove or disable any safety device! Keep guards in place at all times on operating machinery.

Never operate a piece of equipment unless you have been trained and are authorized. Use your personal protective equipment whenever it is required. Obey all safety warning signs. Working under the influence of alcohol or illegal drugs or using them at work is prohibited. Do not bring firearms or explosives onto company property. Smoking is only permitted outside the building away from any entry or ventilation intake. Horseplay, running and fighting are prohibited Loose clothing, jewelry and hair longer than shoulder length shall not be worn around

moving machinery. Clean up spills immediately. Replace all tools and supplies after use. Do not allow scraps to

accumulate where they will become a hazard. Good housekeeping helps prevent injuries.

(Customize by adding any additional safety policies that you may have and/or deleting any that do not apply to your agency.)

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Job Related Safety Rules

We have established safety rules and personal protective equipment (PPE) requirements based upon a hazard assessment for each task listed below: (List specific job titles/positions and PPE and Safety rules that apply for each position within your agency.)

Job Title/Classification Work Rules PPE

Safety and Health Training and Education

Safety Training

Training is an essential part of our plan to provide a safe work place at (Customize by adding your agency name here). To insure that all employees are trained before they start a task that requires training, we have a Safety Coordinator whose name is posted on the safety bulletin board. (Customize by inserting the name or title of the person responsible.)

The Safety Coordinator is responsible to verify that each employee has received an initial orientation (plus retraining whenever new hazards, chemicals, tasks or PPE are introduced) by his/her supervisor, has received any training needed to do the job safely, and that the employee file documents the training.

The Safety Coordinator will make sure that an outline and materials list is available for each training course we provide and that written compliance plans are in place and current. Agency training requirements may follow this plan:

(Customize by adding or deleting positions within your agency.)

Course Who must attend*Basic Orientation All employees Program Specific All employeesSafe Lifting Any employee who lifts more than 20 poundsChemical Hazards (General) All employeesFire extinguisher safety All employeesRespirator Training Employees who use a respiratorPPE Training Employees who use PPE Chemical Hygiene Plan Employees who work in laboratories

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Bloodborne Pathogens Employees potentially exposed to BBP, medical staff or agency may prefer all staff

Accident/Incident Investigation Safety/Health Committee, SupervisorsHazard Identification/Surveys Safety/Health Committee, SupervisorsRights/Responsibilities Safety/Health Committee, Supervisors, ManagementRecordkeeping Safety/Health Committee, Supervisors, ManagementCommon on-the-job accidents Safety/Health Committee, SupervisorsCommon safety violations Safety/Health Committee, Supervisors

*Note: Safety/Health Committee members must be trained, based upon the scope of the committee’s duties, in all of the areas above, as applicable.

(Customize by adding additional training required in your agency and deleting any of the above training that does not apply.)

Record Keeping and Review

Employees are required to report any injury or work related illness to their immediate supervisor regardless of how serious. Minor injuries such as cuts and scrapes can be entered on the Minor Injury Log posted (Customize by adding location of the Log). The employee must use an "Employee's Injury/Illness Report Form" to report more serious injuries.

The supervisor will: Investigate a serious injury or illness using procedures in the "Incident Investigation" section

below. Complete an "Incident Investigation Report" form. Give the “Employee’s Report” and the “Incident Investigation Report” to (Add the name or

title of the person to whom this information will be given. This may be an agency representative or county representative.).

(Add the name or title of the responsible person) will:

Determine from the Employee’s Report, Incident Investigation Report, and any claim form associated with the incident, whether it must be recorded on the OSHA 300 Injury and Illness Log and Summary according to the instructions for that form.

Enter a recordable incident within seven days after the company becomes aware of it. If the injury is not recorded on the OSHA log, add it to a separate incident report log, which

is used to record non-OSHA recordable injuries and near misses. Before the scheduled safety committee meeting, make any new injury reports and

investigations available to the safety committee for review, along with an updated OSHA and incident report log.

The safety committee may review the log for trends and may decide to conduct a separate investigation of any incident.

(Add the name or title of the responsible person) will post a signed copy of the OSHA log summary for the previous year on the safety bulletin board each February 1 until April 30. The

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log will be kept on file for at least 5 years. Any employee can view an OSHA log upon request at any time during the year.

(Customize by adding any additional Hazard Recognition policies that you may have and/or deleting any that do not apply to your agency.)

Hazard Recognition and Emergency Planning

In Case of Fire

An evacuation map for the building is posted (Customize by adding location, if this applies to your agency). It shows the location of exits, fire extinguishers, first aid kits, and where to assemble outside (Customize by adding meeting location for your agency). A copy of the map is attached to this program.

All employees will receive training on how to use fire extinguishers. A fire evacuation drill will be conducted once a year. (Customize by adding fire drill and fire extinguisher training information as it pertains to your agency.)

� If you discover a fire: Tell another person immediately. Call or have them call 911 and a supervisor.

� If the fire is small (such as a wastebasket fire) and there is minimal smoke, you may try to put it out with a fire extinguisher.

� If the fire grows or there is thick smoke, do not continue to fight the fire.

� Tell other employees in the area to evacuate. � Go to the designated assembly point outside the building. � If you are a supervisor notified of a fire in your area: Tell your employees to evacuate to the

designated assembly location. Check that all employees have been evacuated from your area.

� Verify that 911 has been called.� Determine if the fire has been extinguished. If the fire has grown or there is thick smoke,

evacuate any employees trying to fight the fire.� Tell supervisors in other areas to evacuate the building.· Go to the designated assembly point and check that all your employees are accounted for. If

an employee is missing, do not re-enter the building! Notify the responding fire personnel that an employee is missing and may be in the building.

(Customize the above rules by adding procedures in case of fire as it pertains to your agency.)

In Case of Injury

� A first aid kit is kept (Customize by adding the location of first aid supplies in your agency). Also, each agency vehicle is equipped with a first aid kit located in the glove box or under the driver's seat. These kits are checked (Customize according to your agency) by members of the safety committee. An inventory of each kit is taped to the inside cover of the box. If you are injured, promptly report it to any supervisor. (Customize by adding any additional

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locations of first aid supplies or deleting the above information if it does not apply to your agency.)

� Supervisors or other employees may be first-aid/CPR certified. A list of current first aid and CPR certified supervisors and employees are posted within the agency along with the expiration dates of their cards. (Customize by adding the location of first aid trained personnel in your agency, if any)

� In case of serious injury, do not move the injured person unless absolutely necessary. Only provide assistance to the level of your training and authorization. Call for help. If there is no response, call 911.

Aids/HIV and Hepatitis B are the primary infectious diseases of concern in blood. All blood should be assumed to be infectious. These diseases can both be deadly. In the event of a bleeding injury where first aid is needed, use gloves if possible to prevent exposure to blood or other potentially infectious materials. The injured person can often help by applying pressure to the wound. Gloves and a mouth barrier for rescue breathing are available in the first aid kits or crash carts. If you are exposed to blood while giving first aid wash immediately with soap and water and report the incident to a supervisor. The appropriate follow-up procedures will be initiated. Refer to the agency Bloodborne Pathogen Exposure Plan.

Hazard Prevention Awareness and Measures

Ergonomics

Ergonomics is the study of how to improve the fit between the physical demands of the workplace and the employees who perform the work.

That means considering the variability in human capabilities when selecting, designing, or modifying equipment, tools, work tasks, and the work environment.

Employees’ abilities to perform physical tasks may vary because of differences in age, physical condition, strength, gender, stature, and other factors.

Ergonomics aids in increasing productivity, efficiency, and quality while reducing work-related musculoskeletal disorders and therefore workers compensation costs.

Musculoskeletal Disorders or MSDs include injuries to the nerves, tendons, muscles and supporting structures of the hands, wrists, elbows, shoulders, neck and low back.

Contributing factors are aspects of work tasks which can lead to fatigue, musculoskeletal disorder (MSD) symptoms and injuries, or other types of problems. These factors may be present in one or more of the tasks employees must perform to accomplish their jobs.

(Customize by adding any additional Hazard policies that you may have and/or deleting any that do not apply to your agency.)

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Sprains and Strains

Sprains and strains are two types of musculoskeletal disorders (MSDs).

In the work environment, strains and sprains are caused by excessive reaching, bending, lifting, gripping, squatting, or twisting of hands, shoulders or body.

Any work performed with high force, with many repetitions, or in a position that feels awkward is risky. Even a motion that is harmless like stretching out the arm to grasp an object or squeezing a tool, may put the worker at risk of injury if it is repeated over and over. .

A sprain is a stretch or tear of a ligament (a band of fibrous tissue that connects two or more bones at a joint). One or more ligaments may be injured at the same time. The severity of the injury will depend on the extent of the injury (whether the tear is partial or complete) and the number of ligaments involved. A sprain can result from a fall, a sudden twist or blow to the body that causes a joint to move out of its normal position and stretches or tears the ligaments supporting that joint. Common sites in the body where sprains occur are the ankle, knees and wrist.

A strain is an injury to a muscle or tendon (a fibrous cord of tissue that connects a muscle to a bone). Depending on the severity of the injury, a strain can be as simple as an overstretching of a muscle or tendon, or it can be the result of a partial or complete tear. A strain is caused by twisting or pulling a muscle or tendon. Strains can be either acute or chronic. An acute strain is associated with a recent injury or trauma. It can also occur following improperly lifting heavy objects or overstressing the muscles.

Aspects of work tasks that can lead to fatigue, musculoskeletal disorder (MSD) symptoms and injuries, or other types of problems may be present in one or more tasks that employees must perform to accomplish their jobs.

The contributing factors that employers and employees should be aware of include: • Awkward postures • Repetitive motions • Forceful exertions • Pressure points (e.g., local contact stress) • Vibration There are environmental factors (such as temperature extremes) associated with the workplace which can contribute to the problem.


Ergonomic Improvements

Engineering improvements may include rearranging, modifying, or redesigning workstations, packaging, parts, processes, products, or materials.

For example, a computer keyboard with an ergonomic design helps the user avoid carpal tunnel syndrome and/or wrist pain by placing the hands in the proper position.

Additionally, providing a hoisting device to lift heavy loads may eliminate back injuries.

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Administrative Improvements may include: Alternating heavy tasks with light tasks Providing variety in jobs to eliminate or reduce repetition (i.e., overuse of the samemuscle groups). Adjusting work schedules, work pace, or work practices. Providing recovery time (e.g., short rest breaks). Modifying work practices so that workers perform work within their power zone (i.e., above the knees, below the shoulders, and close to the body).

Rotating workers through jobs that use different muscles, body parts, or postures.

Administrative improvements, such as job rotation, can help reduce workers’ exposures to risk factors by limiting the amount of time workers spend on “problem jobs.” However, these measures may still expose workers to risk factors that can lead to injuries.

For these reasons, the most effective way to eliminate “problem jobs” is to change them.

This can be done by putting into place the appropriate engineering improvements and modifying work practices accordingly.


Floor Maintenance and Housekeeping

Slips and falls in the workplace are a leading cause of on-the-job injuries. Agencies should provide information and put practices into place to minimize the risk of accidents. All employees are expected and required to comply with the agency policy. Employees should take precautions when working in assigned area that may be wet or slippery. Barriers or signs should be used to indicate a wet or slippery floor surface. Footwear worn should not be safe and not enhancing slips, stumbles or falls. Adequate lighting shall be maintained in all work/walking areas. Walking and Working Surfaces (e.g., floors) shall be kept clean and dry. Water and other spills shall be removed from the floor immediately using mops, buckets, squeegees, rags, etc.

Main aisles/exits shall be kept clear and in good repair, free of obstructions, holes, and/or trip hazards such as cords and hoses. In the case of temporary obstructions, employees shall use pylons or similar methods to mark the hazard(s). The use of overhead hose coils, ramping over floor cords/hoses, etc., shall be implemented as appropriate as an engineering solution.

The agency shall establish a program to ensure the daily maintenance of all areas in a neat and orderly condition. Documented inspections of housekeeping conditions shall be conducted on a regular basis. Any deficiencies shall be reported to management for timely corrective action.

Exit routes must be kept free of explosive or highly flammable furnishings or other decorations.

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Exit routes must be arranged so that employees will not have to travel toward a high hazard area, unless the path of travel is effectively shielded from the high hazard area by suitable partitions or other physical barriers.

Exit routes must be free and unobstructed. No materials or equipment may be placed, either permanently or temporarily, within the exit route. The exit access must not go through a room that can be locked, such as a bathroom, to reach an exit or exit discharge, nor may it lead into a dead-end corridor. Stairs or a ramp must be provided where the exit route is not substantially level.

Safeguards designed to protect employees during an emergency (e.g., sprinkler systems, alarm systems, fire doors, exit lighting) must be in proper working order at all times.

Lighting and marking must be adequate and appropriate.

Each exit route must be adequately lighted so that an employee with normal vision can see along the exit route.

Each exit must be clearly visible and marked by a sign reading "Exit."

Each exit route door must be free of decorations or signs that obscure the visibility of the exit route door.

If the direction of travel to the exit or exit discharge is not immediately apparent, signs must be posted along the exit access indicating the direction of travel to the nearest exit and exit discharge. Additionally, the line-of-sight to an exit sign must clearly be visible at all times.

Each doorway or passage along an exit access that could be mistaken for an exit must be marked

"Not an Exit" or similar designation, or be identified by a sign indicating its actual use (e.g., closet).

Each exit sign must be illuminated to a surface value of at least five foot-candles (54 lux) by a reliable light source and be distinctive in color. Self-luminous or electroluminescent signs that have a minimum luminance surface value of at least .06 footlamberts (0.21 cd/m2) are permitted.

Each exit sign must have the word "Exit" in plainly legible letters not less than six inches (15.2 cm) high, with the principal strokes of the letters in the word "Exit" not less than three-fourths of an inch (1.9 cm) wide.

Exit routes must be maintained during construction, repairs, or alterations.

During new construction, employees must not occupy a workplace until the exit routes required by this subpart are completed and ready for employee use for the portion of the workplace occupy.

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During repairs or alterations, employees must not occupy a workplace unless the exit routes required by this subpart are available and existing fire protections are maintained, or until alternate fire protection is furnished that provides an equivalent

New employees shall be trained on this policy during their initial job orientation. It is recommended that follow-up training shall be conducted at least annually or as necessary


Workplace Violence and Prevention

Unlawful conduct. – Unlawful conduct means the commission of one or more of the following acts upon an employee, but does not include acts of self-defense or defense of others:

a. Attempting to cause bodily injury or intentionally causing bodily injury. b. Willfully, and on more than one occasion, following, being in the presence of, or otherwise harassing, as defined in G.S. 14-277.3A, without legal purpose and with the intent to place the employee in reasonable fear for the employee's safety. c. Willfully threatening, orally, in writing, or by any other means, to physically injure the employee in a manner and under circumstances that would cause a reasonable person to believe that the threat is likely to be carried out and that actually causes the employee to believe that the threat will be carried out. (2004-165, s. 1; 2009-58, s. 7.)


Laboratory Standard Training

The following information should be included in the training for laboratory personnel. Customize this template to include your agency protocols.

I. Occupational exposure to hazardous chemicals in laboratories standard (29 CFR 1910.1450):A. Content of the standard and appendices;B. Location and explanation of the chemical hygiene plan;C. Location of reference materials and material safety data sheets (MSDS); andD. Details of access to medical consultation and management system.

II. Physical Hazards:A. Combustible liquids;B. Compressed gas;C. Explosive;D. Flammable;E. Organic peroxide;F. Pyrophoric;G. Unstable (reactive); andH. Water reactive.

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III. Health Hazards:A. Local

a. Irritants, andb. Corrosives.

B. Systemic:1. Toxics: Acute/Chronic;

a. Nervous System Effects;b. Respiratory System Effects; andc. Reproductive System Effects.

2. Sensitizers; and3. Carcinogens.

IV. Route of Exposure:A. Inhalation;B. Skin Absorption; andC. Ingestion.

V. Amount of Absorption:A. Gases/Vapors;B. Particulates:

1. Dust2. Mist3. Fume

VI. Dose:A. Work Practices;B. Personal Hygiene;C. Weight;D. Personal Protective Equipment; andE. Environmental Controls.

VII. Duration of Exposure

VIII. Exposure Limits Including PELs:A. Definition;B. Established by:

1. Chemical Similarity;2. Animal Studies; and3. Human Studies.

IX. Air SamplingA. Required by OSHA;B. Employee Reports of Illness;C. Confined Space Work; andD. Other.

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X. Response:A. Age;B. Gender;C. Body Size;D. Health Status;E. Personal Habits; andF. Other Exposures.

XI. Employee Concerns:A. Symptoms Limited/Many Causes;B. Documentation;C. Referral; andD. Refusal to Work.

XII. Company Specific Standard Operating Procedures

Laboratory Rules Summary1910.1450

All laboratories where there is the potential for employee exposure to a hazardous chemical are covered.

Exposure monitoring must be conducted to assure compliance with OSHA Permissible Exposure Limits (PELs).

The employer must notify the employee to air sampling results within 15 days of receipt of results.

A written Chemical Hygiene Plan must be developed and implemented and shall include:

Methods used to keep exposure below the PELs;

Standard Operating Procedures (SOPs) for health and safety;

Control measures and protective equipment;

Fume hood inspection and maintenance;

Medical consultation and exams;

Designating a Chemical Hygiene Officer and/or committee;

Employee notification and training; and

Additional employee protection measures.

Employee Information and Training – Information and training must be provided to employees ensuring them of:

Hazards present in their work area;

The contents of the standard;

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The Chemical Hygiene Plan;

PELs for materials in the lab;

Reference materials on chemical safety;

MSDS location and availability;

Protective measures; and

Signs and symptoms of chemical exposure.

Medical Surveillance – Medical consultation and exams must be provided:

Whenever an employee displays signs and/or symptoms of chemical exposure;

When exposure monitoring exceeds an action level or PEL that requires medical surveillance; and

Following a spill or leak or other emergency.

Hazard Identification – With respect to labels and MSDSs:

Incoming labels must not be removed or defaced;

MSDSs received with incoming shipments must be maintained and accessible;

Employer must determine if a material produced in the laboratory is hazardous; and

Material produced in the lab and shipped must meet the Hazard Communication Standard for MSDS and labeling.

Respirators – When respirator protection is required, the OSHA respirator standard (29 CFR 1910.134) must be followed.

Recordkeeping – All exposure monitoring and medical surveillance data must be maintained in accordance with the OSHA standard for recordkeeping (29 CFR 1910.1020).

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HAZARD COMMUNICATION PROGRAM

Introduction

The North Carolina Department of Labor has adopted the federal OSHA Hazard Communication Standard 29 CFR (Code of Federal Regulation) 1910.1200. The Hazard Communication Standard became effective on May 25, 1986 for North Carolina manufacturing employers and for state and local government agencies, which have one or more employers who are exposed to hazardous chemicals. The standard became effective to non-manufacturing employers on May 25, 1987. This regulation also covers North Carolina construction employers per 1926.59 which now reference the use of 1910.1200 for applicable construction work.

The goal of the Hazard Communication Standard is to reduce the occurrence of workplace illnesses and injuries caused by hazardous chemicals. The standard is designed to achieve this goal by providing information and training for employees who work with hazardous chemicals.

All employers subject to the standard must have a written hazard communication program.

The written program must:

(1) Describe how the criteria specified in the standard will be met for labels and other forms of warning for material safety data sheets and for employee information and training;

(2) Include a list of hazardous chemicals know to be present using the chemical or common name that appears on the appropriate material safety data sheet;

(3) Identify the methods used to inform employees of the hazards of non-routine tasks and those hazards associated with chemicals in unlabeled pipes in their work areas; and

(4) Describe methods used to inform any contractor with employees in the workplace of hazards that may be exposed to and appropriate protective measures.

The written hazard communication program must be made available upon request to employees; designated employee representatives; and authorized representatives of the North Carolina Commissioner of Labor.

This guide is provided to assist employers in developing a written hazard communication program that meets the requirements of paragraph (e) of the standard. Although this guide does not address the specific circumstances in each workplace, it can be adapted to meet the needs of most employers. Advice and assistance in preparing the written program is available from the Bureau of Consultative Services, Division of Occupational Safety and Health, North Carolina Department of Labor, 1101 Mail Service Center, Raleigh, NC 27699-1101, (919) 807-2899.

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Agency Hazard Communication Plan

_______________________________________________(Agency Name)

I. This program will describe how intends to protect the safety and health of our employees who are exposed to hazardous chemicals in the workplace, and to comply with the provisions of 29 CFR 1910.1200.

II. has been assigned the title of Hazard Communication Program Monitor and is responsible for monitoring all related activities to ensure compliance with both the intent and specifics of this program.

Each supervisor will be held responsible for strict adherence to these policies and will closely monitor all activities involving hazardous chemicals.

Each employee will carefully follow established work practices and promptly report observed or potential problems to supervision.

There is no job at so vital or urgent as to justify the risk of employee overexposure to a hazardous chemical. Ask when in doubt. Proceed with a job only after being satisfied that it is safe for you to do so.

III. A list of all hazardous chemicals for each workplace has been made and is readily available, upon request, to any employee, working on any shift. It is located at ________________________________.

IV. A Material Safety Data Sheet (MSDS) for each hazardous chemical on the list referenced

above is on file at _____________________________________.

MSDS Manuals are located throughout the agency in the following areas: _________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

The MSDS are accessible during each work shift for any employee to review. If you have further questions about the MSDS program, contact your supervisor.

V. is responsible to ensure that the list of hazardous chemicals is kept current and that a current MSDS for each hazardous chemical used is on hand. A chemical that is not shown on the current list will not be ordered without prior

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coordination with ___________________________________________________________.

VI. All containers of hazardous chemicals in each workplace will be conspicuously labeled with the identity of the chemical (same as on the applicable MSDS), and the appropriate hazard warnings. If the chemical is a known or suspected cancer causing agent (carcinogen), or if it is known to affect a specific organ of the body, this information will also be placed on the container label. The person having supervisory responsibility for the storage or use of each hazardous chemical will ensure that such labels are not defaced and that they remain legible at all times.

______________________________will ensure that an adequate supply of labels is kept on hand and made available to the responsible supervisors.

VII. is responsible for anticipating, as much as possible, the hazards that would be present for non-routine tasks, such as chemical spill or container rupture. Clean-up procedures and proper personal protective equipment shall be considered and adequate training for such tasks shall be addressed.

VIII. When an outside contractor will be used, it will be the responsibility of ________________________ is to advise the contractor of any hazardous chemicals to which their employees may be exposed and the appropriate protective measures to be taken. Conversely, it will be the same persons responsibility to determine if the contractor will be using any hazardous chemicals during this work that would expose employees. Appropriate training and protective measures must be taken in order to protect employees. Prior to any work being performed by an outside contractor involving hazardous chemicals, _____________________ is to be advised.

IX. All employees exposed to any hazardous chemicals will complete an information and training program which includes at least the subjects listed below. New employees must complete similar instruction before initial exposure to any hazardous chemical in the workplace.

Adequate training of all employees exposed to hazardous chemicals will be given by ______________ assisted as needed by the Hazard Communication Program Monitor.

Employee information for this program will include:

(1) The purpose and need for such a program, including the basic concept that gives every employee the right to know about hazardous chemicals with which they work.

(2) The location and availability of the written Hazard Communication Program, plus the list of hazardous chemicals and their corresponding MSDSs.

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(3) The identity upon request, of any chemical to which the employee is exposed. In the case of a trade secret chemical, the name shown on the MSDS will be provided.

Employee training shall include at least the following:

(1) Methods and observations used to detect the presence or release of a hazardous chemical in the work area such as monitoring devices, appearance or odor.

(2) The physical and health hazards associated with each chemical, as specified in the MSDS.

(3) Action that employees can take to protect their own safety and health, including specific procedures that have been established for normal work practices, emergency procedures, and policies on the use of personal protective equipment.

(4) Details of the Hazard Communication Program, including an explanation of the labeling system used on in-house containers of hazardous chemicals. Also, details of how employees can obtain and use information contained in the MSDS.

X. It is the intent of management to protect the safety and health of each employee, our most valuable and valued asset. By following correct procedures, no employee should experience any harmful effects from working with chemicals in their workplace.

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HAZARDOUS WASTE OPERATIONSEMERGENCY RESPONSE PLAN DEVELOPMENT GUIDELINES

(Elements of an Emergency Response Plan)1910.120(q)(2)

( i) Pre-emergency Planning and Coordination with outside parties

Facilities are required in the Superfund Amendments and Reauthorization Act (SARA) title III to

coordinate their activities with outside response organizations and emergency response

organizations.

The emergency response plan (ERP) should address coordination with outside emergency response organizations, such as fire departments and ambulance/hospital emergency room services and privately operated emergency response companies.

The employer should notify the organizations listed that they are part of the company’s ERP, and should detail their expected involvement in the event of an incident. Note that employee involvement and required training will be minimized where involvement by outside response teams is maximized.

Phone numbers and contact personnel must be readily available and correct.

(ii) Personnel roles, lines of authority, training and communication

Response roles should be clearly defined by naming individuals and their projected role in emergency response operations. Although specific HAZWOPERtitles are not required, there should be parallel positions that are identifiable and are trained

in accordance with 1910.120(q)(6). A minimum where response activities exceed the defensive

action stage, there must be an on-scene incident commander and two hazardous material

technicians identified.

Lines of authority must also be clearly spelled out. Initial communication channels should be directed to the on-scene incident commander quickly in the event of an emergency. Although first responder awareness level respondents may be expected to inform their supervisors (as opposed to the on-scene incident commander or hazmat response team) in the event of an emergency, the supervisor should be trained to inform the emergency response personnel.

Training - Once an incident has been determined to require an emergency response by an appropriately trained individual (i.e. first responder awareness level or above) the incident should

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not be investigated further without the coordinated effort of trained emergency responders. However, if untrained individuals report an incident to their supervisor, and the supervisor is trained to at least the first responder awareness level, the supervisor may investigate the incident, limiting his/her actions to those for which he/she has been appropriately trained.

Provisions for employee training should be incorporated into the emergency response plan. This might include the training course outline for each of the various levels of emergency responder included in the ERP. The plan should also address the required refresher training schedule and refresher course content. Training certifications should be renewed based upon employee duties and functions.

Lines of communication need to be clearly delineated in the emergency response plan. Essentially all employees that may encounter the uncontrolled release of hazardous substance that requires an emergency response should be addressed in the ERP. The employees must understand to whom they are to report a release. These preordained lines of communication need not be developed for each individual employee, but rather can be developed for different groups of employees from different areas within a facility which report to the same individual in the event of an emergency.

Means of communication to be used during an emergency response must be established and written into the emergency response plan. This might include dedicated radio frequencies, hand signals and siren blasts.

A system to communicate evacuations of all potentially affected employees who are not designated as emergency responders must be developed, consistent with 29 CFR 1910.38 (a).

(iii) Emergency Recognition and Prevention

This is an extremely important issue because it is here that the question of incidental releases and emergency responses must be addressed and clearly defined. There is a continuum of releases that may occur. Some are clearly incidental, i.e. a liter of paint thinner, limited quantity of dilute acid, etc. Regardless of where this spill occurs it simply does not pose a safety and health hazard that would require a coordinated response from personnel outside of the release area.

On the other end of the spectrum, there are releases that require an emergency regardless of other circumstances surrounding the incident.

In the middle of the continuum are releases that may or may not require an emergency response. In this gray area, the distinction becomes a function of the sophistication of the personnel in the immediate release area, their understanding of the hazards and the equipment they have on hand. The emergency response plan must define exactly what may be handled as an incidental release and what type of release requires an emergency response.

The employer has the option of developing a full HAZMAT emergency response program (1910.120(q)) or using Hazard Communication (1910.1200) to deal with simple spills/mishaps and total evacuation under 1910.38(a), if the situation exceeds the scope and intent of the hazard

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communication standard. When the employer selects the hazard communication/evacuation compliance approach, all employees must be trained to the level of first responder awareness level. The competencies to be demonstrated are given in paragraph 1910.120(q)(6)(i). The written hazard communication program and the training program must include this information to be in compliance. Also, all employees must be able to demonstrate competency at the first responder awareness level.

Employees may be required to shut down processes, close emergency valves and otherwise secure operations before evacuating in the event of an emergency (note: 1910.120 requires the evacuation of all non essential personnel in the event of an emergency). These procedures need to be carefully delineated, and employees must be trained to be able to perform these pre-evacuation procedures safely. Employees instructed to evacuate during an emergency (i.e. not trained in compliance with 1910.120) may not perform pre-evacuation procedures in the “danger area”.

Emergency responders may take action in the danger area necessary to stop the incident from increasing in severity (first responder operations level) before the emergency response team arrives, only if they have informed the incident command structure of the emergency incident and have adequate personal protective equipment and training and employ the buddy system. This kind of response must be addressed and examined in detail with ERP and emergency responders must act within the capabilities of their training and equipment, have clear guidance and training in this determination, and be clearly told that they may evacuate without employer penalty if they subjectively believe it is beyond their capabilities.

This action assumes that the emergency response team is en route, and that the action taken is immediately necessary to prevent the incident from increasing in severity drastically (i.e. to prevent a catastrophe or an environmental disaster). It is important that employers make clear to employees that they should evacuate when they lack the capabilities to respond to an emergency; failure to do so is a frequent cause of employee death.

(iv) Safe distance and places of refuge

The ERP should contain a site map with safe places of refuge identified for each section of the facility. Ideally the map should contain the location of all buildings, structures, equipment, emergency apparatus, first aid station, routes of entry and exit, emergency exit routes, staging areas and safe places of refuge.

The safe places of refuge will be the areas in which accounting of all employees will be performed. This can be critically important for identifying individuals that did not get out and estimating where they may be in the facility. Allowances should be made to ensure that this information is given to the emergency response organization in a timely fashion.

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(v) Site safety and control

Areas surrounding the danger area need to be controlled during emergencies by prohibiting unauthorized personnel from entering the exclusion zone, or hot zone. Methods of excluding areas and defining various zone need to be addressed in the ERP.

Emergency responses need to be coordinated from a command post some safe distance from the exclusion zone. Creation of a command post must be addressed in the plan.

(vi) Evacuation routes and procedures

All employees that are not trained in emergency response and who will not serve as response employees during the response operation need to be evacuated from the exclusion zone. This aspect of the emergency response plan must be in compliance with 1910.38 (a) as described above.

(vii) Decontamination

The ERP must contain provisions for decontamination of emergency responders leaving the exclusion zone. Individuals who will assist the responders as they leave the exclusion area must be trained in decontamination procedures. These individuals should wear personal protective equipment at the same level or one level below the emergency responders they are supporting.

Accidental contamination of response personnel should also be addressed in the plan including the location and availability of showers, water hoses and eye flushes.

Decontamination of response equipment and the contaminated area may be handled in the post-emergency response and therefore decontamination procedures for these areas do not necessarily need to be part of the emergency response plan. However, if emergency responders are expected to decontaminate their own equipment or the contaminated area then the procedures to be followed must be included in the emergency response plan.

(viii) Emergency medical treatment and first aid

This section of the emergency response plan should list all qualified emergency medical technicians on site, their certifications and how to best contact them during an emergency. Additionally, hospitals that are capable of receiving or responding to accident victims that may arrive contaminated, must be listed.

Where indicated by the notice of hazards at the worksite, arrangements must be made for the handling of contaminated victims with ETM’s on site, or community EMT’s and area hospital facilities. If victims must be decontaminated at an area hospital, coordination with the hospital is required prior to the emergency in order to ensure the hospital has personal protective

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equipment, methods of containing the hazardous material waste water, etc., and staff trained to at least the operations level who are capable of performing decontamination.

(ix) Emergency alerting and response procedures

This section of the emergency response plan should address how employees will be informed that an emergency exists, and how they should respond. There are two important questions that need to be addressed: (1) Who needs to be made aware of the emergency?, and (2) What do they need to be told to do? The alarm systems must inform all affected personnel that a potential emergency exists and what their immediate response should be.

Depending on plant size and the magnitude of the potential emergency “all affected employees” may include all employees, or just employees from a limited area. If the facility intends to evacuate employees from limited areas in response to emergencies, it must have alerting procedures in place that can communicate to those employees that must evacuate and to only those employees.

The following information is critical to inform employees of what their immediate response should be:

1. Notification Making the existence of the emergency situation known.

2. Level & Type The required response based on the extent and type of of Response emergency.

3. Nature of the The type of emergency condition (fire, explosion, vapor Emergency release, chemical spill, medical).

4. Location Critically important in large facilities.

5. Ambient Environmental factors that influence evacuation or Conditions response procedures (wind speed and direction).

(x)Critique of response and follow-up

Emergency response plans are based on site specific needs and experience. It is important to consider previous accidents in preparing a facility’s emergency response plan. It is just as important to consider new information, experience and incidents with the goal of enhancing the emergency response plan and keeping it current.

Formalized procedures for the critique of an emergency response must be written into the emergency response plan. Appropriate changes should be made in the emergency response plan in accordance with the results of a critique of a specific incident.

Time spent by emergency response employees critiqueing incidents can be credited towards their refresher training requirements.

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(xi) Personal protective equipment and emergency equipment

This section of the emergency response plan should list the facility’s inventory of personal protective equipment (PPE) and emergency response equipment. The ERP should include instructions on how the PPE and equipment is to be used, their limitations, and when emergency responders should use them.

HAZWOPER requires emergency responders to be trained in selection of proper PPE, and the incident commander must be aware of the equipment and PPE available during an emergency. However, it is important that the emergency response plan pre-arrange the use of PPE.

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ACCIDENT & INJURY REPORTS

EMERGENCY ACTION PLAN (Sample: Customize to meet your agency needs)

_______________________________________(Agency Name)

(Ref: 1910.38)Introduction:

This document is a plan to prepare for workplace emergencies. By auditing the workplace, training employees, obtaining and maintaining the necessary equipment, and by assigning responsibilities, human life and company resources will be preserved. The intent of this plan is to ensure all employees a safe and healthful workplace. Those employees assigned specific duties under this plan will be provided the necessary training and equipment to ensure their safety. This plan applies to emergencies that could be reasonably expected in our agency such as fire/smoke, tornadoes, bomb threats, leaks, etc.

Emergency Plan Coordinators:

Building/Department Name/Title Phone #

Plan Outline/Description:

I. Means of Reporting Emergencies: All fires and emergencies will be reported by one or more of the following means as appropriate:a. Verbally to the Coordinator during normal working hours.b. By telephone if after hours/weekends.c. By the building alarm system.

Note: The following numbers will be posted throughout the facility:

FIRE: _____________ POLICE: __________ AMBULANCE: __________

II. *Alarm System or Announcement Requirements: Alarm system or announcement requirements for notifying employees during an emergency are as follows:

a. Provides warning for safe escape.b. Can be perceived by all employees.c. Alarm or announcement is distinctive and recognizable.d. Employees have been trained on the alarm or announcement system.e. Emergency phone numbers are posted.f. Emergency alarms have priority over all other communications.g. Alarm and announcement system is properly maintained and controlled.

III. Sounding the Alarm or Announcement: The signal for immediate evacuation of the facility will be __________________. The alternate means of notification will be__________________.

IV. Evacuation Plans: Emergency evacuation escape route plans are posted in key areas of the facility. All employees shall be trained on primary and secondary evacuation routes. Each evacuation route will also identify a designated meeting point.

V. Employee Accountability: In the event of an evacuation, all occupants shall promptly exit the building via the nearest exit. Go to your designated assembly point and report to your supervisor. Each supervisor (or designee) will account for each assigned employee via a head count. All supervisors shall report their head count to ___________________who will be located at _________________ and accessible via cell phone # __________.

VI. Building Re-Entry: Once evacuated, no one shall re-enter the building. Once the Fire Department or other responsible agency has notified us that the building is safe to re-enter, then personnel shall return to their work areas.

VII. Hazardous Weather: A hazardous weather alert consists of ______________________.When a hazardous weather alert is made, all employees shall immediately report to the closest tornado refuge area. Each work area within your agency has a designated refuge area assigned. Stay in this area until given the all-clear sign which is a ________________.

VIII. Training: The personnel listed below have been trained to assist in the safe and orderly emergency evacuation of employees. These individuals are designated as Safety Coordinators within the agency.

Task Building/Department Name/Title/Phone#Fire Extinguisher/HosesEvacuation AssistantEmergency Shut-down

Employee training is provided when this plan is initiated, when employees required responsibilities change, when the plan changes, initially for new hires, and annually for all employees. Subjects to be covered include but not limited to:

a. Emergency escape procedures/routesb. Fire extinguisher locations and proper usec. Head count proceduresd. Major facility fire hazardse. Fire prevention practicesf. Means of reporting fires/emergencies (use of alarm systems)g. Names/titles of Coordinatorsh. Availability of the plan to employeesi. Housekeeping practicesj. No smoking areask. Hazardous weather proceduresl. Special duties as assigned to Coordinators and those listed above.

Written records shall be maintained of all Emergency Action Plan training.

FIRE PREVENTION PLAN(Sample: Customize to meet your agency needs)

__________________________________________(Agency Name)

(Ref: 1910.39I. Introduction:

It is the policy of to provide to employees the safest practical workplace free from areas where potential fire hazards exist. The primary goal of this fire protection program is to reduce or eliminate fire in the agency by heightening the fire safety awareness of all employees. Another goal if this plan is to provide all employees with the information necessary to recognize hazardous conditions and take appropriate action before such conditions result in a fire emergency..

This plan details the basic steps necessary to minimize the potential for fire occurring in the agency. Prevention of fires in the workplace is the responsibility of everyone employed by the agency but must be monitored by each supervisor overseeing any work activity that involves a major fire hazard. Every effort will be made by the agency to identify those hazards that might cause fires and establish a means for controlling them.

The fire prevention plan will be administered by who will compile a list of all major workplace fire hazards, the names or job titles of personnel responsible for fire control and prevention equipment maintenance, names or job titles of personnel responsible for control of fuel source hazards and locations of all fire extinguishers in the workplace. The plan administrator, or safety officer, must also be familiar with the behavior of employees that may create fire hazards as well as periods of the day, month, and year in which the agency could be more vulnerable to fire.

This fire prevention plan will be reviewed annually and updated as needed to maintain compliance with applicable regulations and standards and remain up-to-date with the state of the art in fire protection. Agency inspection reports and fire incident reports will be maintained and used to provide corrections and improvements to the plan.

This plan will be available for employee review at any time during all normal working hours.

II. Classification:

Fire is a chemical reaction involving the rapid oxidation or burning of a fuel. It needs four elements to occur as illustrated below in the tetrahedron. This is described by the following illustration:

Heat

Oxygen Fuel

Chemical Reaction

The first component of the tetrahedron is fuel. Fuel can be any combustible material such as: solid (such as wood, paper, or cloth), liquid (such as gasoline) or gas (such as acetylene or propane). Solids and liquids generally convert to gases or vapors before they will burn.

Another component of the tetrahedron is oxygen. Fire only needs an atmosphere with at least 16% oxygen.

Heat is also a component of the tetrahedron. Heat is the energy necessary to increase the temperature of the fuel source to a point in which sufficient vapors are emitted for ignition to occur.

The final side of the tetrahedron represents a chemical chain. When these components are brought together in the proper conditions and preparations, fire will develop. Take away any one of these elements, and the fire cannot exist or will be extinguished if it was already burning.

Fires are classified into four groups according to sources of fuel: Class A, B, C, and D based on the type of fuel source. Table 1 below describes the classifications of fire which can be used in making hazard assessment.

Class A Ordinary combustible materials such as paper, wood, cloth and some rubber and plastic materials.

Class B Flammable or combustible liquids, flammable gases, greases and similar materials, and some rubber and plastic materials

Class C Energized electrical equipment and power supply circuits and related materials.Class D Combustible metals such as magnesium, titanium, zirconium, sodium, lithium and

potassium

III. Determining Fire Hazards: This section consists of two steps: first, identifying the existing fire hazards in the agency and, second, taking action to resolve them. The agency should develop an inspection checklist, that provides a guide for precise fire-safe practices that must be followed. The checklist should also list the personnel responsible for the maintenance of the equipment and systems installed to prevent or control fires.

Material hazards shall be identified, as evident on the specific Material Safety Data Sheets (MSDS), and labeled on containers as soon as they arrive in the workplace. The identification system shall also include incorporation into the agency’s hazard communication program.

IV. Storage and Handling Procedures:

The storage of material shall be arranged such that adequate clearance is maintained away from heating surfaces, air ducts, heaters, flue pipes, and lighting fixtures. All storage containers or areas shall prominently display signs to identify the material stored within. Storage of chemicals shall be separated from other materials in storage, from handling operations, and from incompatible materials. All individual containers shall be identified as to their contents.

Flammable Materials

Small quantities (limited to amount necessary to perform an operation for one working shift) of flammable liquids shall be stored in, and also dispensed from, approved safety containers equipped with vapor-tight, self-closing caps, screens or covers.

Flammable liquids shall be stored away from sources that can produce sparks.

Flammable liquids shall only be used in areas having adequate and, if feasible, positive ventilation. If the liquid is highly hazardous, the liquid shall only be used in areas with a local exhaust ventilation.

Flammable liquids shall never be transferred from one container to another by applying air pressure to the original container. Pressurizing such containers may cause them to rupture, creating a serious flammable liquid spill.

When dangerous liquids are being handled, a warning sign will be posted near the operation, notifying other employees and giving warning that open flames are hazardous and are to be kept away.

V. Potential Ignition Sources:

Ensure that utility lights always have some type of wire guard over them. Don’t misuse fuses. Never install a fuse rated higher than specified for the circuit. Investigate any appliance or equipment that smells strange. Space heaters,

microwave ovens, hot plates, coffee makers and other small appliances shall be rigidly regulated and closely monitored.

The use of extension cords to connect heating devices to electric outlets shall be prohibited. If a hot or under inflated tire is discovered, it should be moved well away from the vehicle.

Table 2 below lists common sources of ignition that cause fires in the workplace, gives examples in each case, and suggests preventive measures.

Sources of Ignition Examples Preventive Measures

Electrical equipment Electrical defects, generally due Use only approved equipmentto poor maintenance, mostly in Follow National Electrical

wiring, motors, switches, lamps, Code regular maintenance and hot elements.

Friction Hot bearings, misaligned or broken Follow a regular schedule of machine parts, poor adjustment. inspection maintenance and

lubrication.

Open flames Cutting and welding torches, gas Follow established weldingpre-oil burners, misuse of gasoline precautions. Keep

burners and torches properly adjusted Do not use open

flames near combustibles.

Smoking and matches Dangerous near flammable liquids Smoke only in permittedand in areas where combustibles are areas. Make sure matches

stored or used. are out. Use appropriate receptacles.

Static electricity Occurs where liquid flows from Ground equipment. Use Pipes. Static eliminators.

Humidify the atmosphere.

Hot surfaces Furnaces, electric lamps or irons Provide ample circulation Check heating

Apparatus prior to

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Leaving unattended.VI. Housekeeping Preventive Techniques:

The following are housekeeping techniques and procedures to prevent occurrences of fire.

Keep storage and working areas free of trash. Place oily rags in covered containers and dispose of daily. Do not use gasoline or other flammable solvent or finish to clean floors. Use noncombustible oil-absorptive materials for sweeping floors. Dispose of materials in noncombustible containers that are emptied daily. Remove accumulation of combustible dust. Don’t refuel gasoline-powered equipment in a confined space, especially in the presence

of equipment such as furnaces or water heaters. Don’t refuel gasoline-powered equipment while it is hot. Follow proper storage and handling procedures. Ensure combustible materials are present only in areas in quantities required for the work

operation. Clean up any spill of flammable liquids immediately. Ensure that if a worker’s clothing becomes contaminated with flammable liquids, these

individuals change their clothing before continuing to work. Post “No Smoking” caution signs near the storage areas. Report any hazardous condition, such as old wiring, worn insulation and broken electrical

equipment, to the supervisor. Keep motors clean and in good working order. Don’t overload electrical outlets. Ensure all equipment is turned off at the end of the work day. Maintain the right type of fire extinguisher available for use. Use the safest cleaning solvents (nonflammable and nontoxic) when cleaning electrical

equipment. Ensure that all passageways and fire doors are unobstructed. Stairwell doors shall never

be propped open, and materials shall not be stored in stairwells. Periodically remove over spray residue from walls, floors, and ceilings of spray booths

and ventilation ducts. Remove contaminated spray booth filters from the building as soon as replaced, or keep

immersed in water until disposed. Don’t allow material to block automatic sprinkler systems, or to be piled around fire

extinguisher locations. To obtain the proper distribution of water, a minimum of 18 inches of clear space must be maintained below sprinkler deflectors. If there are no sprinklers, a 3 foot clearance between piled material and the ceiling must be maintained to permit use of hose streams. These distances must be doubled when stock is piled higher than 15 feet.

Check daily for any discard lumber, broken pallets or pieces of material stored on site and remove properly.

Re-pile immediately any pile of material which falls into an aisle or clear space. Use weed killers that are not toxic and do no pose a fire hazard.

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VII. Fire Protection Equipment:

Every building will be equipped with an electrically managed, manually operated fire alarm system. When activated, the system will sound alarms that can be heard above the ambient noise levels throughout the workplace. The fire alarm will also be automatically transmit to the fire department. Any fire suppression or fire detection system will automatically actuate the building alarm system.

The automatic sprinkler system, if applicable, will adhere to NFPA 13, Standard for the Installation of Sprinkler Systems. The sprinkler system and components will be electrically supervised to ensure reliable operation. This includes gate valve tamper switches with a local alarm at a constantly attended site when the valve is closed. If a single water supply is provided be a connection to the city mains, a low pressure monitor is included. If pressure tanks are the primary source of water, air pressure, water level, and temperature shall be supervised. If fire pumps are provided to boost system pressure, supervision will monitor loss of pump power, pump running indication, low system pressure, and low pump suction pressure.

Portable fire extinguishers are placed in the agency. Fire extinguishers must be kept fully charged and in their designated places. The extinguishers will not be obstructed or obscured from view. A list indicating the locations of all fire extinguishers for this agency is located below:_______________________________________________.

The fire extinguishers will also be inspected by _______________________ , at least monthly, to make sure that they are in their designated places, have not been tampered with or actuated, and are not corroded or otherwise impaired. Attached inspection tags shall be initialed/dated each month.

The location of all hydrants, hose houses, portable fire extinguishers, or other fire protective equipment should be properly marked with arrows and signs painted on the pavement.

VIII. Training:

All employees shall be instructed on the locations and proper use of fire extinguishers in their work areas. Employees shall also be instructed as to how to operate the building’s fire alarm system, and be familiar with evacuation routes. The training of all employees shall include the locations and types of materials and/or processes which pose potential fire hazards. The training program shall also emphasize the following:

1. Use and disposal of smoking materials2. The importance of electrical safety3. Proper use of electrical appliances and equipment4. Unplugging heat-producing equipment and appliances at the end of each work

day5. Correct storage of combustible and flammable materials6. Safe handling of compressed gases and flammable liquids (where appropriate)

Ongoing training shall include regularly scheduled fire drills. Training documentation shall be maintained.

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EXAMPLES OF INSPECTION LOGS

FIRE PREVENTION CHECKLISTThis checklist should be reviewed regularly and kept up-to-date.

ELECTRICAL EQUIPMENT FRICTION_ No makeshift wiring __Machinery properly lubricated_ Fuse and control boxes clean and closed __Machinery properly adjusted _ Extension cords serviceable and/or aligned_ Circuits properly fused or otherwise protected_ Motors and tools free of dirt and grease

_ Equipment approved for use in hazardous areas (if OPEN FLAMESrequired) __Kept away from spray

rooms _ Lights clear of combustible materials _Portable torches clear of flammable _ Safest cleaning solvents used services

__No gas leaksSPECIAL FIRE-HAZARD MATERIALS_ Storage of special flammable isolated_ Nonmetal stock free of tramp metal

PORTABLE HEATERS_ Set up with ample horizontal and overhead clearances_ Safely mounted on noncombustible surfaces_ Secured against tipping or upset_ Use of steel drums prohibited_ Combustibles removed or covered_ Not used as rubbish burners

HOT SURFACES_ Hot pipes clear of combustible materials_ Soldering irons kept off combustible surfaces_ Ample containers available and serviceable_ Ashes in metal containers

SMOKING AND MATCHES_ “No smoking” and “smoking” areas clearly marked_ No discarded smoking materials in prohibited areas_ Butt containers available and serviceable

SPONTANEOUS IGNITION_ Flammable waste material in closed, metal containers_ Piled material, dry, and well ventilated_ Flammable waste material containers emptied frequently_ Trash receptacle emptied daily

13

STATIC ELECTRICITY_ Flammable liquid dispensing vessels grounded and bonded_ Proper humidity maintained_ Moving machinery grounded

HOUSEKEEPING_ No accumulation of rubbish_ Premises free of unnecessary combustible materials_ Safe storage of flammables

_ No leaks or dripping of flammables and floor free of spills

_ Passageways clear of obstacles

_ Fire doors unblocked and operating freely

_ Automatic sprinklers unobstructed

FIRE PROTECTION_ Proper type of fire extinguisher_ Extinguishing system in working order_ Fire extinguishers in proper locations---

List locations for each extinguisher:

Building: Service Area:_________________________ ___________________________

_________________________ ____________________________

_________________________ ____________________________

_________________________ ____________________________

_________________________ _____________________________

_ Service date current_ Access to fire extinguishers unobstructed_ Personnel trained in use of equipment_ Access to fire extinguishers clearly marked_ Personnel exits unobstructed and maintained_ Fire protection equipment turned on

14

AGENCY MONTHLY BUILDING INSPECTION FORM

Building: _________________ Inspector: _______________ Date: _________

OK Not ok Description Identified Location with Comments/Action(s)

Electric cord attached to building surface or run through door/ceiling/wall.Electric cord frayed, cut, or damaged. Light-duty 2-prong extension cord used.Ground pin missing from cord.Empty opening (knockout) in electric box.Exposed live electrical parts.Ungrounded equipment.Storage within 3' of electric panels.Circuit breakers/disconnects not labeled.Fire extinguishers blocked/obscured.Fire extinguishers w/o monthly check.Exit doors blocked/locked.Exit signs/arrows not in place and visible.Emergency evacuation lights not tested.Storage >5' w/o stepstool or ladder.Storage within 18"of sprinkler heads.Storage within 3' of heater/heat source.Storage aisles <28"wide.Storage stacks lean/unstable.Compressed gas not capped/chainedExcessive flammables outside of cabinets.Incompatible chemicals stored together.Chemicals not labeled with name/hazards.Material Safety Data Sheets not available.Emergency shower/eyewash not tested weekly.Housekeeping not up to standards.Wet/slippery floors not marked/corrected.Trip hazards in floor, stairs, sidewalks etcFirst-aid kit and PPE not available.Burned out or missing light bulbs.Oily/greasy rags not in covered metal can.Machinery guards in placePPE provided and properly usedGuardrails and stair-rails in place as neededOther:Other:

JOBSITE INSPECTION CHECKLIST

DATE:__________

INSPECTED BY:_____________________________________________

Instructions: This is a guideline only. Any recognized hazard shall be corrected ASAP and interim protection provided for any serious hazards not readily corrected. Note corrective actions taken on the back of this form, and keep completed forms on file.

OK NOT OK

DESCRIPTION OF ITEM(S) TO BE CHECKED:

First-aid kit fully stocked & accessible (protective gloves provided?)NCDOL Poster and “911” posted?Fire extinguisher(s) present, > “2A”, inspected monthly & yearly?Haz-Com Program, MSDSs and inventory list on site?PPE: worn when needed?Flammable Liquids: Properly stored in metal cans & labeled?Temporary Lights: Bulbs installed; plastic guards, hung by loop?Fall Protection: No Obstructions; wet/slippery areas;Stairs: UnobstructedStairs with >4 risers: At least 1 handrail, and stairrail (top and midrail) on each unprotected open side? Landing at door openings?Vehicles: , horns & lights working? Seat belts used?Other:

AGENCY SELF-INSPECTION CHECKLIST

Employer Posting Is the required OSHA workplace poster displayed in a prominent location where all employees are

likely to see it?

Are emergency telephone numbers posted where they can be readily found in case of emergency?

Where employees may be exposed to any toxic substances or harmful physical agents, has appropriate information concerning employee access to medical and exposure records and material safety data sheets (MSDS) been posted or otherwise made readily available to affected employees?

Are signs concerning “Exiting from buildings,” room capacities, floor loading, biohazards, exposures to X-ray, microwave, or other harmful radiation or substances posted where appropriate?

Is the summary of occupational injuries andillnesses posted in the month of February?

Recordkeeping Are all occupational injuries and illnesses, except minor injuries requiring only first aid, being

recorded as required on the OSHA 300 log?

Are employee medical records and records of employee exposure to hazardous substances or harmful physical agents up-to-date and in compliance with current OSHA standards?

Are employee training records kept and accessible for review by employees, when required by OSHA standards?

Have arrangements been made to maintain required records for the legal period of time for each specific type of record? (Some records must be maintained for at least 40 years.)

Are operating permits and records up-to-date for such items as elevators, air pressure tanks, liquefied petroleum gas tanks, etc.?

Safety and Health Program Do you have an active safety and health program in operation that deals with general safety and

health program elements as well as the management of hazards specific to your worksite?

Is one person clearly responsible for the overall activities of the safety and health program?

Do you have a safety committee or group made up of management and employee representatives that meets regularly and reports in writing on its activities?

Do you have a working procedure for handling in-house employee complaints regarding safety and health?

Are you keeping your employees advised of the successful effort and accomplishments you and/or your safety committee have made in ensuring they will have a workplace that is safe and healthful?

Medical Services and First Aid Is there a hospital, clinic or infirmary for medical care in proximity of your workplace?

If medical and first aid facilities are not in proximity of your workplace, is at least one employee on each shift currently qualified to render first aid?

Have all employees who are expected to respond to medical emergencies as part of their work*

(1) received first aid training; (2) had hepatitis B vaccination made available to them; (3) had appropriate training on procedures to protect them from bloodborne pathogens, including universal precautions; and (4) have available and understand how to use appropriate personal protective equipment to protect against exposure to bloodborne diseases?

Where employees have had an exposure incident involving bloodborne pathogens, did you provide an immediate post-exposure medical evaluation and follow-up?

Are medical personnel readily available for advice and consultation on matters of employees’ health?

Are emergency phone numbers posted?

Are first aid kits easily accessible to each work area, with necessary supplies available, periodically inspected and replenished as needed?

Have first aid kit supplies been approved by a physician, indicating that they are adequate for a particular area or operation?

Are means provided for quick drenching or flushing of the eyes and body in areas where corrosive liquids or materials are handled?

Fire Protection Is your local fire department well acquainted with your facilities, its location and specific hazards?

If you have a fire alarm system, is it certified as required?

If you have a fire alarm system, is it tested at least annually?

If you have interior stand pipes and valves, are they inspected regularly?

If you have outside private fire hydrants, are they flushed at least once a year and on a routine preventive maintenance schedule?

Are fire doors and shutters in good operating condition?

Are fire doors and shutters unobstructed and protected against obstructions, including their counterweights?

Are fire door and shutter fusible links in place?

Are automatic sprinkler system water control valves, air and water pressure checked weekly/periodically as required?

Is the maintenance of automatic sprinkler systems assigned to responsible people or to a sprinkler contractor?

Are sprinkler heads protected by metal guards, when exposed to physical damage?

Is proper clearance maintained below sprinkler heads?

Are portable fire extinguishers provided in adequate number and type?

Are fire extinguishers mounted in readily accessible locations?

Are fire extinguishers recharged regularly and noted on the inspection tag?

Are employees periodically instructed in the use of extinguishers and fire protection procedures?

Personal Protective Equipment and Clothing

Are protective goggles or face shields provided and worn where there is any danger of flying particles or corrosive materials?

Are approved safety glasses required to be worn at all times in areas where there is a risk of eye injuries such as punctures, abrasions, contusions or burns?

Are employees who need corrective lenses (glasses or contacts) in working environments having harmful exposures required to wear only approved safety glasses or protective goggles or use other medically approved precautionary procedures?

Are protective gloves, aprons, shields or other means provided and required where employees could be cut or where there is reasonably anticipated exposure to corrosive liquids, chemicals, blood or other potentially infectious materials? (See 29 CFR 1910.1030(b) for the definition of “other potentially infectious materials.”)

Is appropriate foot protection required where there is the risk of foot injuries from hot, corrosive, poisonous substances, falling objects, crushing or penetrating actions?

Are approved respirators provided for regular or emergency use where needed?

Is all protective equipment maintained in a sanitary condition and ready for use?

Do you have eye wash facilities and a quick drench shower within the work area where employees are exposed to injurious corrosive materials?

Where special equipment is needed for electrical workers, is it available?

Where food or beverages are consumed on the premises, are they consumed in areas where there is no exposure to toxic material, blood or other potentially infectious materials?

Are adequate work procedures, protective clothing, and equipment provided and used when cleaning up spilled toxic or otherwise hazardous materials and liquids?

Are there appropriate procedures in place for disposing of or decontaminating personal protective equipment contaminated with, or reasonably anticipated to be contaminated with, blood or other potentially infectious materials?

General Work Environment Are all worksites clean, sanitary, and orderly?

Are work surfaces kept dry or appropriate means taken to ensure the surfaces are slip-resistant?

Are all spilled hazardous materials or liquids, including blood and other potentially infectious materials, cleaned up immediately and according to proper procedures?

Are combustible scrap, debris and waste stored safely and removed from the worksite promptly?

Is all regulated waste, as defined in the OSHA bloodborne pathogens standard (29 CFR 1910.1030), discarded according to federal, state and local regulations?

Are the minimum number of toilets and washing facilities provided?

Are all toilets and washing facilities clean and sanitary?

Are all work areas adequately illuminated?

Are pits and floor openings covered or otherwise guarded?

Walkways Are aisles and passageways kept clear?

Are aisles and walkways marked as appropriate?

Are wet surfaces covered with nonslip materials?

Are holes in the floor, sidewalk or other walking surfaces repaired properly, covered or otherwise made safe?

Are materials or equipment stored in such a way that sharp projectives will not interfere with the walkway?

Are spilled materials cleaned up immediately?

Are changes of direction or elevation readily identifiable?

Are aisles or walkways that pass near moving or operating machinery, welding operations, or similar operations arranged so employees will not be subjected to potential hazards?

Is adequate headroom provided for the entire length of any aisle or walkway?

Are standard guardrails provided wherever aisle or walkway surfaces are elevated more than 30 inches above any adjacent floor or the ground?

Floor and Wall Openings Are floor openings guarded by a cover, guardrail or equivalent on all sides (except at entrance to

stairways or ladders)?

Are toeboards installed around the edges of permanent floor openings (where people may pass below the opening)?

Are skylight screens of such construction and mounting that they will withstand a load of at least 200 pounds?

Is the glass in the windows, doors, glass walls, etc., which are subject to human impact, of sufficient thickness and type for the condition of use?

Are grates or similar type covers over floor openings such as floor drains of such design that foot traffic or rolling equipment will not be affected by the grate spacing?

Are floor or wall openings in fire-resistive construction provided with doors or covers compatible with the fire rating of the structure and provided with a self-closing feature when appropriate?

Stairs and Stairways Are standard stair rails or handrails on all stairways having four or more risers?

Are all stairways at least 22 inches wide?

Do stairs have landing platforms not less than 30 inches in the direction of travel and extend 22 inches in width at every 12 feet or less of vertical rise?

Do stairs angle no more than 50 and no less than 30 degrees?

Are stairs of hollow-pan type treads and landings filled to the top edge of the pan with solid material?

Are step risers on stairs uniform from top to bottom?

Are steps on stairs and stairways designed or provided with a surface that renders them slip resistant?

Are stairway handrails located between 30 and 34 inches above the leading edge of stair treads?

Do stairway handrails have at least 3 inches of clearance between the handrails and the wall or surface they are mounted on?

Where doors or gates open directly on a stairway, is there a platform provided so the swing of the door does not reduce the width of the platform to less than 21 inches?

Are stairway handrails capable of withstanding a load of 200 pounds, applied within 2 inches of the top edge, in any downward or outward direction?

Where stairs or stairways exit directly into any area where vehicles may be operated, are adequate barriers and warnings provided to prevent employees stepping into the path of traffic?

Do stairway landings have a dimension measured in the direction of travel at least equal to the width of the stairway?

Is the vertical distance between stairway landings limited to 12 feet or less?

Elevated Surfaces Are signs posted, when appropriate, showing the elevated surface load capacity?

Are surfaces elevated more than 30 inches above the floor or ground provided with standard guardrails?

Are all elevated surfaces (beneath which people or machinery could be exposed to falling objects) provided with standard 4-inch toeboards?

Is a permanent means of access and egress provided to elevated storage and work surfaces?

Is required headroom provided where necessary?

Is material on elevated surfaces piled, stacked or racked in a manner to prevent it from tipping, falling, collapsing, rolling or spreading?

Are dock boards or bridge plates used when transferring materials between docks and trucks or rail cars?

Exiting or Egress Are all exits marked with an exit sign and illuminated by a reliable light source?

Are the directions to exits, when not immediately apparent, marked with visible signs?

Are doors, passageways or stairways that are neither exits nor access to exits and which could be mistaken for exits appropriately marked “NOT AN EXIT,” “TO BASEMENT,” “STOREROOM,” etc.?

Are exit signs provided with the word “EXIT” in lettering at least 5 inches high and the stroke of the lettering at least 1/2-inch wide?

Are exit doors side-hinged?

Are all exits kept free of obstructions?

Are at least two means of egress provided from elevated platforms, pits or rooms where the absence of a second exit would increase the risk of injury from hot, poisonous, corrosive, suffocating, flammable or explosive substances?

Are there sufficient exits to permit prompt escape in case of emergency?

Are special precautions taken to protect employees during construction and repair operations?

Is the number of exits from each floor of a building, and the number of exits from the building itself, appropriate for the building occupancy load?

Are exit stairways that are required to be separated from other parts of a building enclosed by at least two-hour fire-resistive construction in buildings more than four stories in height, and not less than one-hour fire-resistive construction elsewhere?

Where ramps are used as part of required exiting from a building, is the ramp slope limited to 1 foot vertical and 12 feet horizontal?

Where exiting will be through frameless glass doors, glass exit doors, storm doors, etc., are the doors fully tempered and do they meet the safety requirements for human impact?

Exit Doors Are doors that are required to serve as exits designed and constructed so that the way of exit travel is

obvious and direct?

Are windows that could be mistaken for exit doors made inaccessible by means of barriers or railings?

Are exit doors openable from the direction of exit travel without the use of a key or any special knowledge or effort when the building is occupied?

Is a revolving, sliding or overhead door prohibited from serving as a required exit door?

Where panic hardware is installed on a required exit door, will it allow the door to open by applying a force of 15 pounds or less in the direction of the exit traffic?

Where exit doors open directly onto any street, alley or other area where vehicles may be operated, are adequate barriers and warnings provided to prevent employees stepping into the path of traffic?

Are doors that swing in both directions and are located between rooms where there is frequent traffic provided with viewing panels in each door?

Portable Ladders Are all ladders maintained in good condition, joints between steps and side rails tight, all hardware

and fittings securely attached, and moveable parts operating freely without binding or undue play?

Are nonslip safety feet provided on each ladder?

Are nonslip safety feet provided on each metal or rung ladder?

Are ladder rungs and steps free of grease and oil?

Is it prohibited to place a ladder in front of doors opening toward the ladder except when the door is blocked open, locked or guarded?

Is it prohibited to place ladders on boxes, barrels or other unstable bases to obtain additional height?

Are employees instructed to face the ladder when ascending or descending?

Are employees prohibited from using ladders that are broken, missing steps, rungs, or cleats, broken side rails, or other faulty equipment?

Are employees instructed not to use the top step of ordinary stepladders as a step?

When portable rung ladders are used to gain access to elevated platforms, roofs, etc., does the ladder always extend at least 3 feet above the elevated surface?

Is it required that when portable rung or cleat type ladders are used, the base is so placed that slipping will not occur, or it is latched or otherwise held in place?

Are portable metal ladders marked with signs reading “CAUTION—Do Not Use Around Electrical Equipment” or equivalent wording?

Are employees prohibited from using ladders as guys, braces, skids, gin poles, or for other than their intended purposes?

Are employees instructed to only adjust extension ladders while standing at a base (not while standing on the ladder or from a position above the ladder)?

Are metal ladders inspected for damage?

Are the rungs of ladders uniformly spaced at 12 inches, center to center?

Hand Tools and Equipment Are all tools and equipment (both company- and employee-owned) used by employees at their

workplace in good condition?

Are appropriate safety glasses, face shields, etc., used while using hand tools or other equipment that might produce flying materials or be subject to breakage?

Portable (Power-Operated) Tools and Equipment Are all cord-connected, electrically operated tools and equipment effectively grounded or of the

approved double-insulated type?

Are portable fans provided with full guards or screens having openings 1/2 inch or less?

Machine Guarding Is there a training program to instruct employees on safe methods of machine operation?

Is there adequate supervision to ensure that employees are following safe machine operating procedures?

Is there a regular program of safety inspection of machinery and equipment?

Is all machinery and equipment kept clean andproperly maintained?

Is sufficient clearance provided around and between machines to allow for safe operations, set up and servicing, material handling, and waste removal?

Are equipment and machinery securely placed and anchored when necessary to prevent tipping or other movement that could result in personal injury?

Is there a power shut-off switch within reach of the operator’s position at each machine?

Can electric power to each machine be locked out for maintenance, repair or security?

Lockout/Block out Procedures Is all machinery or equipment capable of movement required to be de-energized or disengaged and blocked or locked out during cleaning, servicing, adjusting or setting up operations, whenever required?

Where the power disconnecting means for equipment does not also disconnect the electrical control circuit:

Are the appropriate electrical enclosures identified?

Is means provided to ensure the control circuit can also be disconnected and locked out?

Is the locking out of control circuits in lieu of locking out main power disconnects prohibited?

Are all equipment control valve handles provided with a means for locking out?

Does the lockout procedure require that stored energy (mechanical, hydraulic, air, etc.) be released or blocked before equipment is locked out for repairs?

Are appropriate employees provided with individually keyed personal safety locks?

Are employees required to keep personal control of their key(s) while they have safety locks in use?

Is it required that only the employee exposed to the hazard place or remove the safety lock?

Is it required that employees check the safety of the lockout by attempting to start up after making sure no one is exposed?

Are employees instructed to always push the control circuit stop button prior to re-energizing the main power switch?

Is there a means provided to identify any or all employees who are working on locked-out equipment by their locks or accompanying tags?

Are a sufficient number of accident preventive signs or tags and safety padlocks provided for any reasonably foreseeable repair emergency?

When machine operations, configuration or size requires the operator to leave his or her control station to install tools or perform other operations and that part of the machine could move if accidentally activated, is such element required to be separately locked or blocked out?

In the event that equipment or lines cannot be shut down, locked out and tagged, is a safe job procedure established and rigidly followed?

Are signs reading “DANGER—NO SMOKING, MATCHES OR OPEN LIGHTS,” or the equivalent, posted?

Is suitable fire extinguishing equipment available for immediate use?

Are work and electrode lead cables frequently inspected for wear and damage and replaced when needed?

Do means for connecting cable lengths have adequate insulation?

Is it required that eye protection helmets, hand shields and goggles meet appropriate standards?

Environmental Controls Are all work areas properly illuminated?

Are employees instructed in proper first aid and other emergency procedures?

Are hazardous substances, blood and other potentially infectious materials that may cause harm by inhalation, ingestion, or skin absorption or contact identified?

Are employees aware of the hazards involved with the various chemicals they may be exposed to in their work environment, such as ammonia, chlorine, epoxies, caustics, etc.?

Is employee exposure to chemicals in the workplace kept within acceptable levels?

Are the safest methods and products being used?

Are caution labels and signs used to warn of hazardous substances (e.g., asbestos) and biohazards (e.g., bloodborne pathogens)?

Is vacuuming with appropriate equipment used whenever possible rather than blowing or sweeping dust?

Is personal protective equipment provided, used and maintained wherever required?

Are there written standard operating procedures for the selection and use of respirators where needed?

Are restrooms and washrooms kept clean and sanitary?

Is all water provided for drinking, washing and cooking potable?

Are all outlets for water not suitable for drinking clearly identified?

Are employees’ physical capacities assessed before being assigned to jobs requiring heavy work?

Are employees instructed in the proper manner of lifting heavy objects?

Where heat is a problem, have all fixed work areas been provided with spot cooling or air conditioning?

Are employees screened before assignment to areas of high heat to determine if their health condition might make them more susceptible to having an adverse reaction?

Are employees working on streets and roadways where they are exposed to the hazards of traffic required to wear high visibility or reflective warning vests?

Are exhaust stacks and air intakes so located that contaminated air will not be recirculated within a building or other enclosed area?

Is equipment producing ultraviolet radiation properly shielded?

Are universal precautions observed where occupational exposure to blood or other potentially infectious materials can occur and in all instances where differentiation of types of body fluids or potentially infectious materials is difficult or impossible?

Are fire extinguishers selected and provided for the types of materials in areas where they are to be used?

Class A Ordinary combustible material fires.

Class B Flammable liquid, gas or grease fires.

Class C Energized electrical equipment fires.

Are appropriate fire extinguishers mounted within 75 feet of outside areas containing flammableliquids and within 10 feet of any inside storage area for such materials?

Are extinguishers free from obstructions or blockage?

Are all extinguishers serviced, maintained and tagged at intervals not to exceed one year?

Are all extinguishers fully charged and in theirdesignated places?

Where sprinkler systems are permanently installed, are the nozzle heads so directed and arranged that water will not be sprayed into operating electrical switch boards and equipment?

Are “NO SMOKING” signs posted where appropriate in areas where flammable or combustible materials are used or stored?

Are safety cans used for dispensing flammable or combustible liquids at a point of use?

Are all spills of flammable or combustible liquids cleaned up promptly?

Are storage tanks adequately vented to prevent the development of excessive vacuum or pressure as a result of filling, emptying or atmosphere temperature changes?

Are storage tanks equipped with emergency venting that will relieve excessive internal pressure caused by fire exposure?

Are “NO SMOKING” rules enforced in areas involving storage and use of hazardous materials?

Hazardous Chemical Exposure Are employees trained in the safe handling practices of hazardous chemicals, such as acids and

caustics?

Are employees aware of the potential hazards involving various chemicals stored or used in the workplace, such as acids, bases, caustics, epoxies, phenols, etc.?

Is employee exposure to chemicals kept within acceptable levels?

Are eye wash fountains and safety showers provided in areas where corrosive chemicals are handled?

Are all containers, such as vats, storage tanks, etc., labeled with their identity and hazards?

Are all employees required to use personal protective clothing and equipment when handling chemicals (gloves, eye protection, respirators, etc.)?

Are flammable or toxic chemicals kept in closed containers when not in use?

Have standard operating procedures been established and are they being followed when cleaning up chemical spills?

Where needed for emergency use, are respirators stored in a convenient, clean and sanitary location?

Are respirators intended for emergency use adequate for the various uses for which they may be needed?

Are employees prohibited from eating in areas where hazardous chemicals are present?

Is personal protective equipment provided, used and maintained whenever necessary?

Are there written standard operating procedures for the selection and use of respirators where needed?

If you have a respirator protection program, are your employees instructed on the correct usage and limitations of the respirators? Are the respirators NIOSH approved for this particular application? Are they regularly inspected and cleaned, sanitized and maintained?

If hazardous substances are used in your processes, do you have a medical or biological monitoringsystem in operation?

Are you familiar with the threshold limit values or permissible exposure limits of airborne contaminants and physical agents used in your workplace?

Have control procedures been instituted for hazardous materials, where appropriate, such as respirators, ventilation systems, handling practices, etc.?

Whenever possible, are hazardous substances handled in properly designed and exhausted booths or similar locations?

Do you use general dilution or local exhaust ventilation systems to control dusts, vapors, gases, fumes, smoke, aerosols or mists that may be generated in your workplace?

Is ventilation equipment provided for removal of contaminants from such operations as production, grinding, buffing, spray painting and/or vapor degreasing and is it operating properly?

Do you monitor employees to make sure there are no complaints about dizziness, headaches, nausea, irritation or other discomfort when they use solvents or other chemicals?

Do you watch for employee health problems such as dryness, irritation or sensitization of the skin?

Have you considered the use of an industrial hygienist or environmental health specialist to evaluate your operation?

If internal combustion engines are used, is carbon monoxide kept within acceptable levels?

Is vacuuming used, rather than blowing or sweeping dusts, whenever possible for cleanup?

Are materials that give off toxic, asphyxiant, suffocating or anesthetic fumes stored in remote or isolated locations when not in use?

Respiratory Protection ProgramIn any workplace where respirators are necessary to protect the health of the employee or whenever respirators are required by the employer, has a written respiratory protection program with worksite-specific procedures been established and implemented? The program must be updated as necessary to reflect those changes in workplace conditions that affect respirator use. You must include in the program the following provisions asapplicable:

Procedures for selecting respirators for use in the workplace. Medical evaluations of employees required to use respirators. Fit testing procedures for tight-fitting respirators. Procedures for proper use of respirators in routine and reasonably foreseeable emergency situations. Procedures and schedules for cleaning, disinfecting, storing, inspecting, repairing, discarding and

otherwise maintainingrespirators.

Procedures to ensure adequate air quality, quantity and flow of breathing air foratmosphere-supplying respirators.

Training of employees in the respiratory hazards to which they are potentially exposed during routine and emergency situations.

Training of employees in the proper use of respirators, including putting on and removing them, any limitations on their use, and their maintenance.

Procedures for regularly evaluating the effectiveness of the program.

Hazardous Substances Communication Is there a list of hazardous substances used in your workplace?

Is there a current written exposure control plan for occupational exposure to bloodborne pathogens and other potentially infectious materials, where applicable?

Is there a written hazard communication program dealing with material safety data sheets (MSDS), labeling and employee training?

Is each container for a hazardous substance (including vats, bottles and storage tanks) labeled with product identity and a hazard warning (communication of the specific health hazards and physical hazards)?

Is there a material safety data sheet readily available for each hazardous substance used?

Is there an employee training program for hazardous substances?

This program needs to include: An explanation of what an MSDS is and how to use and obtain one. MSDS contents for each hazardous substance or class of substances. Explanation of “right to know.” Identification of where employees can see the employer’s written hazard communication program

and where hazardous substances are present in their work areas. Physical and health hazards of substances in the work area and specific protective measures to be

used. Details of the hazard communication program, including how to use the labeling system and

MSDSs.

The employee training program on the bloodborne pathogens standard needs to contain the following elements:

An accessible copy of the standard and an explanation of its contents. A general explanation of the epidemiology and symptoms of bloodborne diseases. An explanation of the modes of transmission of bloodborne pathogens. An explanation of the employer’s exposure control plan and the means by which employees can

obtain a copy of the written plan. An explanation of the appropriate methods for recognizing tasks and other activities that may

involve exposure to blood and other potentially infectious materials. An explanation of the use and limitations of methods that will prevent or reduce exposure, including

appropriate engineering controls, work practices and personal protective equipment. Information on the types, proper use, location, removal, handling, decontamination and disposal of

personal protective equipment. 1An explanation of the basis for selection of personal protective equipment. Information on the hepatitis B vaccine. Information on the appropriate actions to take and people to contact in an emergency involving

blood or other potentially infectious materials. An explanation of the procedure to follow if an exposure incident occurs, including the methods of

reporting the incident and the medical follow-up that will be made available. Information on post-exposure evaluations and follow-up. An explanation of signs, labels and color coding.

Are employees trained in the following: How to recognize tasks that might result in occupational exposure?

How to use work practice and engineering controls and personal protective equipment and to know their limitations?

How to obtain information on the types, selection, proper use, location, removal, handling, decontamination and disposal of personal protective equipment?

Who to contact and what to do in an emergency?

Electrical Do you specify compliance with OSHA standards for all contract electrical work?

Are all employees required to report as soon aspracticable any obvious hazard to life or property observed in connection with electrical equipment or lines?

Are employees instructed to make preliminary inspections and/or appropriate tests to determine what conditions exist before starting work on electrical equipment or lines?

When electrical equipment or lines are to be serviced, maintained or adjusted, are necessary switches opened, locked out and tagged whenever possible?

Are portable electrical tools and equipment grounded or of the double-insulated type?

Are electrical appliances such as vacuum cleaners, polishers and vending machines grounded?

Do extension cords being used have a grounding conductor?

Are multiple-plug adapters prohibited?

Are ground-fault circuit interrupters installed on each temporary 15 or 20 ampere, 120 volt ACcircuit at locations where construction, demolition, modifications, alterations or excavations are being performed?

Are exposed wiring and cords with frayed or deteriorated insulation repaired or replaced promptly?

Are flexible cords and cables free of splices or taps?

Are clamps or other securing means provided on flexible cords or cables at plugs, receptacles, tools and equipment, and is the cord jacket securely held in place?

Are all cord, cable and raceway connections intact and secure?

In wet or damp locations, are electrical tools and equipment appropriate for the use or location or otherwise protected?

Is the location of electrical power lines and cables (overhead, underground, underfloor, other side of walls) determined before digging, drilling or similar work is begun?

Are metal measuring tapes, ropes, handlines or similar devices with metallic thread woven into the fabric prohibited where they could come in contact with energized parts of equipment of circuit conductors?

Is the use of metal ladders prohibited in areas where the ladder or the person using the ladder could come in contact with energized parts of equipment, fixtures or circuit conductors?

Are all disconnecting switches and circuit breakers labeled to indicate their use or equipment served?

Are disconnecting means always opened before fuses are replaced?

Do all interior wiring systems include provisions for grounding metal parts of electrical raceways, equipment and enclosures?

Are all electrical raceways and enclosures securely fastened in place?

Are all energized parts of electrical circuits and equipment guarded against accidental contact by approved cabinets or enclosures?

Is sufficient access and working space provided and maintained about all electrical equipment to permit ready and safe operations and maintenance?

Are all unused openings (including conduit knockouts) in electrical enclosures and fittings closed with appropriate covers, plugs or plates?

Are electrical enclosures such as switches, receptacles, junction boxes, etc., provided with tight-fitting covers or plates?

Are employees who regularly work on or around energized electrical equipment or lines instructed in cardiopulmonary resuscitation (CPR)?

Fueling Is it prohibited to fuel an internal combustion engine with a flammable liquid while the engine is

running?

Are fueling operations done in such a manner that the likelihood of spillage will be minimal?

When spillage occurs during fueling operations, is the spilled fuel washed away completely, evaporated, or other measures taken to control vapors before restarting the engine?

Are fuel tank caps replaced and secured before starting the engine?

In fueling operations, is there always metal contact between the container and the fuel tank?

Are fueling hoses of a type designed to handle the specific type of fuel?

Is it prohibited to handle or transfer gasoline in open containers?

Are open lights, open flames, or sparking or arcing equipment prohibited near fueling or transfer of fuel operations?

Is smoking prohibited in the vicinity of fueling operations?

Are fueling operations prohibited in buildings or other enclosed areas that are not specifically ventilated for this purpose?

Where fueling or transfer of fuel is done through a gravity flow system, are the nozzles of the self-closing type?

Materials Handling Is there safe clearance for equipment through aisles and doorways?

Are aisleways designated, permanently marked and kept clear to allow unhindered passage?

Are motorized vehicles and mechanized equipment inspected daily or before use?

Are vehicles shut off and brakes set before loading or unloading?

Are containers of combustibles or flammables, when stacked while being moved, always separated by dunnage sufficient to provide stability?

Are hooks with safety latches or other arrangements used when hoisting materials so that slings or load attachments will not accidentally slip off the hoist hooks?

Are securing chains, ropes, chockers or slings adequate for the job to be performed?

When hoisting material or equipment, are provisions made to ensure no one will be passing under the suspended loads?

Are material safety data sheets available to employees handling hazardous substances?

Transporting Employees and Materials Do employees who operate vehicles on public

thoroughfares have valid operator’s licenses?

When seven or more employees are regularly transported in a van, bus or truck, is the operator’s license appropriate for the class of vehicle being driven?

Is each van, bus or truck used regularly to transport employees equipped with an adequate number of seats?

When employees are transported by truck, are provisions provided to prevent their falling from the vehicle?

Are vehicles used to transport employees equipped with lamps, brakes, horns, mirrors, windshields and turn signals in good repair?

Are transport vehicles provided with handrails, steps, stirrups or similar devices, so placed and arranged that employees can safely mount and dismount?

Are employee transport vehicles equipped at all times with at least two reflective type flares?

When cutting tools or tools with sharp edges are carried in passenger compartments of employee transport vehicles, are they placed in closed boxes or containers that are secured in place?

Are employees prohibited from riding on top of any load that can shift, topple or otherwise become unstable?

Sanitizing Equipment and Clothing Is personal protective clothing or equipment that employees are required to wear or use of a type

capable of being cleaned easily and disinfected?

Are employees prohibited from interchangingpersonal protective clothing or equipment unless it has been properly cleaned?

Are machines and equipment that process, handle or apply materials that could be injurious to employees cleaned and/or decontaminated before being overhauled or placed in storage?

Are employees prohibited from smoking or eating in any area where contaminants that could be injurious if ingested are present?

When employees are required to change from street clothing into protective clothing, is a clean change room with separate storage facility for street and protective clothing provided?

Are employees required to shower and wash their hair as soon as possible after a known contact has occurred with a carcinogen?

When equipment, materials or other items are taken into or removed from a carcinogen regulated area, is it done in a manner that will not contaminate nonregulated areas or the external environment?

EXAMPLES OF INCIDENT REPORTS

EMPLOYEE’S REPORT OF INJURY FORM

Instructions : Employees shall use this form to report all work related injuries, illnesses, or “near miss” events (which could have caused an injury or illness) – no matter how minor. This helps us to identify and correct hazards before they cause serious injuries. This form shall be completed by employees as soon as possible and given to a supervisor for further action.

I am reporting a work related: Injury Illness Near miss Your Name:

Job title:

Supervisor:Have you told your supervisor about this injury/near miss? Yes NoDate of injury/near miss: Time of injury/near miss:

Names of witnesses (if any):

Where, exactly, did it happen?

What were you doing at the time?

Describe step by step what led up to the injury/near miss. (continue on the back if necessary):

What could have been done to prevent this injury/near miss?

What parts of your body were injured? If a near miss, how could you have been hurt?

Did you see a doctor about this injury/illness? Yes NoIf yes, whom did you see? Doctor’s phone number:

Date: Time:Has this part of your body been injured before? Yes No If yes, when? Supervisor:

Your signature: Date:

SUPERVISOR’S ACCIDENT INVESTIGATION REPORT

Name of Injured Person _________________________________________________

Date of Birth _________________ Telephone Number ____________________

Address ______________________________________________________________

City _____________________________ State_______ Zip _____________

(Circle one) Male Female

What part of the body was injured? Describe in detail.

_____________________________________________________________________________

______________________________________________________________________________

What was the nature of the injury? Describe in detail.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Describe fully how the accident happened? What was employee doing prior to the event? What equipment, tools being using? _____________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Names of all witnesses: __________________________________________________________

Date of Event ______________________ Time of Event _____________________________

Exact location of event ___________________________________________________________

______________________________________________________________________________

What caused the event? __________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Were safety regulations in place and used? If not, what was wrong?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

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Employee went to doctor/hospital? Doctor’s Name ____________________________________

Hospital Name __________________________________________

Recommended preventive action to take in the future to prevent reoccurrence.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_________________________________________________ _______________________

Supervisor Signature Date

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Incident Investigation Report

Instructions: Complete this form as soon as possible after an incident that results in serious injury or illness. (Optional: Use to investigate a minor injury or near miss that could have resulted in a serious injury or illness.)

This is a report of a: Death Lost Time Dr. Visit Only First Aid Only Near Miss

Date of incident: This report is made by: Employee Supervisor Team Other_________

Step 1: Injured employee (complete this part for each injured employee)

Name: Sex: Male Female Age:

Department: Job title at time of incident:

Part of body affected: (shade all that apply) Nature of injury: (most serious one) Abrasion, scrapes Amputation Broken bone Bruise Burn (heat) Burn (chemical) Concussion (to the head) Crushing Injury Cut, laceration, puncture Hernia Illness Sprain, strain Damage to a body system: Other ___________

This employee works: Regular full time Regular part time Seasonal Temporary

Months with this employer

Months doing this job:

Step 2: Describe the incident

Exact location of the incident: Exact time:

What part of employee’s workday? Entering or leaving work Doing normal work activities During meal period During break Working overtime Other___________________

Names of witnesses (if any):

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Number of attachments:

Written witness statements: Photographs: Maps / drawings:

What personal protective equipment was being used (if any)?

Describe, step-by-step the events that led up to the injury. Include names of any machines, parts, objects, tools, materials and other important details.

Description continued on attached sheets:

Step 3: Why did the incident happen?

Unsafe workplace conditions: (Check all that apply) Inadequate guard Unguarded hazard Safety device is defective Tool or equipment defective Workstation layout is hazardous Unsafe lighting Unsafe ventilation Lack of needed personal protective equipment Lack of appropriate equipment / tools Unsafe clothing No training or insufficient training Other: _____________________________

Unsafe acts by people: (Check all that apply) Operating without permission Operating at unsafe speed Servicing equipment that has power to it Making a safety device inoperative Using defective equipment Using equipment in an unapproved way Unsafe lifting Taking an unsafe position or posture Distraction, teasing, horseplay Failure to wear personal protective equipment Failure to use the available equipment / tools Other: __________________________________

Why did the unsafe conditions exist?

Why did the unsafe acts occur?

Is there a reward (such as “the job can be done more quickly”, or “the product is less likely to be damaged”) that may have encouraged the unsafe conditions or acts? Yes No If yes, describe:

Were the unsafe acts or conditions reported prior to the incident? Yes No

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Have there been similar incidents or near misses prior to this one? Yes No

Step 4: How can future incidents be prevented?What changes do you suggest to prevent this incident/near miss from happening again?

Stop this activity Guard the hazard Train the employee(s) Train the supervisor(s)

Redesign task steps Redesign work station Write a new policy/rule Enforce existing policy Routinely inspect for the hazard Personal Protective Equipment Other: ____________________

What should be (or has been) done to carry out the suggestion(s) checked above?

Description continued on attached sheets:

Step 5: Who completed and reviewed this form? (Please Print)Written by:

Department:

Title:

Date:

Names of investigation team members:

Reviewed by: Title:

Date:

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