In addition, premiums for individual firms are unlikely to be specifically related to that firm's risk environment. Building-related illnesses are often potentially severe and are often traceable to a specific contaminant source such as ETS, microbial growth, and a host of other chemical or biologic substances which must be attended to mitigate degradation of indoor air quality. This risk was raised to 1.76 when asthmatics, who may be medicated, were excluded from the analysis. Several studies have also demonstrated a positive relationship between self-reported exposure to ETS and cotinine in serum [Exs. Relevant reproductive effects include menstrual irregularities and birth defects and are associated with exposure to formaldehyde [Exs. Some of the published categories, in addition to the terms sick or well are: problem buildings and non-problem buildings, healthy buildings; buildings with high and low rates of IAQ related complaints; sick building syndrome (SBS). Standards of HVAC maintenance vary and sometimes are deficient where untrained personnel are designated to maintain complex systems. 4-195]. Dibenzo (a,i)pyrene In other words, nonsmokers experienced ETS exposure in break areas more than in general work areas. The scheduled benefits are significantly less than the actual losses to the injured workers, and recovery is often very difficult in the case of occupational diseases. Nonsmokers had more pronounced changes in eye blinking rates (a measure of eye irritation), expired carbon monoxide, increased heart rate and systolic blood pressure. For example, the average duration of exposure to homemakers was approximately 2 hours a day, for workers the average duration of exposure was approximately 3 hours a day. (4) OSHA has preliminarily determined that the direct costs of compliance with this standard will not unduly harm small entities. Given this perspective, although changes in pulmonary function tests may truly occur as a result of exposure to ETS over a number of years, the actual clinical impact may not be apparent in the healthy, young individual. The savings have been estimated at about $500 per smoker per year (3). This technology is widespread currently and can be used to achieve compliance with the proposed standard. 4-234]. To address these issues, OSHA is proposing to require that each facility have written operations and management information whose aim is twofold. (Any information not contained on disk, e.g., studies, articles, etc., must be submitted in quadruplicate.) Depending on the condition of the HVAC equipment, inspection and maintenance may include simple housekeeping of equipment and air transport pathways and/or catastrophic failure maintenance to repair/replace failed equipment. The risk of developing COPD appears to be increased in passive smokers with lifelong exposures to ETS. U.S. Bureau of the Census, County Business Patterns, 1990. In evaluating the use of cotinine as a biomarker of ETS exposure, two kinds of uncertainty must be considered. Results of population based surveys show that 88 percent of nonsmokers are aware of the negative health consequences of ETS. Your child’s surgeon will decide how long he or she will have an epidural catheter. In humans, cotinine is the major degradation product of nicotine metabolism and has a serum half-life of about 17 hours compared to two hours for the parent compound, nicotine [Exs. C. Data Sources The following is a partial list of available data sources which building owners/agents of employers may wish to consult to help identify, characterize, and reduce sources of indoor air pollutants in office work environments. OSHA has a long history of enforcing OSHA standards in multi-employer worksites. (5) Calculate the Sum of the Ranges. Individuals with underlying pulmonary disease, such as asthma, are more susceptible than others to acute exposure to these indoor air contaminants and experience coughing and wheezing at low levels of exposure. The nature of an informal rulemaking hearing is established in the legislative history of section 6 of the OSH Act and is reflected by OSHA's rules of procedure for hearings (29 CFR 1911.15(a)). Building enclosures had lower insulating values and allowed more infiltration. 3-55], "is notorious for poor air quality and employee respiratory illness and cancer." This chapter examines projected economic and environmental impacts on those industries. The pectus bar will be removed in approximately 2 to 4 years. - Coal This moldy smell is often associated with microbial contamination and is a result of VOCs released during microbial growth on environmental substrates [Ex. Mendell estimated relative risks for several building related symptoms and a subset of these estimates are shown in Table IV-11. 7. Section 1910.1033 shall apply to the exposure of every employee in every employment covered by 1910.16. 4-10]. (b) Metabolism. 4-172, 4-262, 4-315]. The partitioning data for cotinine, determined by Gabrelsson and Bondesson [Ex. Any such preemption is to be limited to the extent possible. 4-214]. What are the unit costs associated with the implementation of each control (capital and labor)? 4-33]. Effects such as eye irritation and nasal stuffiness were reported to OSHA in comments to the docket [Exs. [Ex. OSHA assessed the potential economic impacts and has preliminarily determined that the standard is economically feasible for each of the major industry groups that will be affected. By applying the lower and upper ranges of exposure, OSHA estimates that the number of nonsmoking employees exposed to ETS to be 13.9 to 36.1 million employees. First, evidence on occupational health hazards in general suggests that in the absence of immediate or clear-cut danger, employees and employers have little incentive to seek or provide information on the potential long-term effects of exposure. For most industry groups, OSHA averaged data for three years. Dibenzo (a,h)pyrene 3-14, 4-33]. 4-263]. As noted by Meridian Research in their 1988 report, ". All government buildings were considered single tenant buildings. Analysis of Uncertainty - Sulfur dioxide Application of Pharmacokinetic Modeling for Eye irritation was reported by 52 out of 167 workers. 4-160], Acetaldehyde Chromium VI Therefore, perhaps the best indicator that workplace exposure may play a role in the symptoms reported by an individual is the observation that symptoms worsen during the work day, and disappear shortly after leaving work. [Ex. They exposed Sprague-Dawley rats of both sexes, nose only, to "aged and diluted sidestream smoke" (ADSS) at 0.1, 1 or 10 mg of particulates per meter for 14 days and found "slight to mild" epithelial hyperplasia and inflammation in the most rostral part of the nasal cavity in the 10 mg group only. A salivary fluid compartment could also be added to either model if desired. The Agency believes that establishment of "designated smoking areas" is necessary to prevent employee exposure to ETS in workplaces where smoking is not prohibited. These anatomical and physiological differences, aside from the subchronic exposure, may partially account for absence of any lung tumors in the study by Coggins et al. Number of establishments include 50% of all establishments in SIC 58 (Eating and Drinking places) and 70 (Hotels). When considered over a working lifetime, this translates into an excess death rate of approximately between 7 and 16 cases of heart disease per thousand attributed to workplace exposure to ETS. From this information, it is apparent that similar tumor cell types are induced by ETS exposure as are induced by active smoking. 3-61, 4-43] and some case reports show it to be associated specifically with humidifier use. - Cases Avoided of Occupationally Developed, Number of non-smoking Employee Exposed to, Footnote(1) OSHA estimate of occupational coronary heart disease risk for lower and upper bound exposure of 7 to 16 per 1,000 employees over a working life of 45 years, Footnote(2) OSHA estimate of occupational lung cancer risk for lower and upper bound exposure of 0.4 to 0.9 per 1,000 employees over a working life of 45 years, Table VI-7. These effects include mucous membrane irritation, decrease in respiratory system performance, adverse effects on the cardiovascular system, reproductive effects, and cancer. Containment may be checked by using smoke-trails at the door undercut to verify direction of airflow. Clearly the upper respiratory effects and severe headaches associated with poor indoor air quality are of the type that interfere with the performance of work. Sidestream (SS) smoke was collected by a moving column of air spiked every minute with a puff of fresh mainstream (MS) smoke. Finally, paragraph (f)(3) proposes to require notification of employees in the vicinity of renovation and remodeling activities who may be subject to incidental exposure to emissions produced during such activities (Ex. The Digit Span test consists of the subject being allowed to view a series of random digits for a short period of time; the numbers are then covered up and the subject asked to repeat the sequence backwards. Putman et al. Tort liability laws and Workers' Compensation provide some protection, but due to market imperfections they have not been sufficient. 653, 655, 657; Walsh-Healey Act, 41 U.S.C. The determining factor in the decision to perform a quantitative risk assessment is the availability of suitable data for use in such an assessment. Since changes in building ventilation systems will be made by landlords, employers may have to negotiate agreements to ensure that they can meet the OSHA standard. The irritation effects present as sensory irritation of the skin and upper airways, irritation of eye, nose and throat, dry mucous membranes, erythema, headache, and abnormal taste [Ex. OSHA estimates that approximately between 5,583 and 32,502 cancer deaths and 97,700 to 577,818 coronary heart disease deaths related to occupational exposure to ETS will be prevented over the next 45 years. What methods are available to detect indoor air contaminants? (1), Irritant, cardiovascular, and nervous systems. Humidifier fever, a less serious variant of hypersensitivity pneumonitis, also is caused by exposure to microorganisms contained in an aerosol. Children's Hospital's main campus is located in the Lawrenceville neighborhood. 4-40] demonstrates that the platelet activating capabilities of ETS are more prominent in nonsmokers than in smokers. 4-104]). This check should conform with the proposals of paragraph (d)(2) which requires an inspection and maintenance of the building systems. In developing a final rule, OSHA would like to consider the use of a physiologically based pharmacokinetic (PBPK) model in an effort to develop a clear and complete picture of factors that may affect environmental exposure measurements, internal dose estimates and ultimately estimates of expected risk attributed to ETS exposure at the workplace. In addition, ETS exposure may cause platelets to become less sensitive to the anti-clotting regulatory substances in the blood and therefore increase the tendency of the blood to clot. Others have reported [Ex. Leuchtenberger and Leuchtenberger [Ex. What should this additional training consist of and why? Styrene (b) Workers' Compensation. A difficulty associated with the use of CO or HbCO as a biomarker for ETS effects is the presence of other sources of CO in the workplace. IX. Footnote(1) Raw figures from 1992 show approximately 1300 cases of Legionella reported although this is most certainly a gross under-estimation of the scope of the problem, since the disease resembles others and is frequently misdiagnosed. 4-9] and Aronow et al. This paragraph proposes to require that the employer take certain actions to maintain acceptable indoor air quality. F. Economic Impact and Regulatory Flexibility Analysis Supplemental content provided by Healthwise, Incorporated. 4-25, 4-196]. The Agency invites the submission of written data, views and comments on all regulatory provisions proposed in this notice, and on all relevant issues pertinent to those provisions. 4-12], sudden death, and arterial thrombosis occur more frequently in cigarette smokers as opposed to nonsmokers [Exs. Therefore, this required visual inspection will help identify those deficiencies that would otherwise be missed, such as microbial contamination in cooling coil condensate drip pans. In order to assess the overall economic impact of the rule, OSHA also estimated the cost savings to employers, or cost savings that will result from the implementation of the proposed standard. - Radon Bulk paper stores have been found to release formaldehyde [Ex. Number of establishments included represent 50 percent of large establishments in buildings with 3 or more floors and with floor space greater than 100,000 sq. Both are large, population-based studies whose results can be generalized to the general public. It appears that at least two of several conditions traditionally considered essential components of perfect markets are absent from the environment in which employees are exposed to hazards associated with exposure to indoor pollutants: (1) Perfect employee knowledge of risks and (2) perfect employee mobility between jobs. 4-41, 4-144, 4-214]. ft. X 14,000 sq. (c) Possible Mechanisms of Effect. (c) Training for HVAC Maintenance Workers and 3-438, 4-92, 4-132, 4-174, 4-208, 4-273, 4-285, 4-287, 4-299]. Cummings et al. In approximately 500 indoor air quality investigations conducted in the late 1970's and early 1980's, the National Institute for Occupational Safety and Health (NIOSH) found that the primary causes of indoor air quality problems were inadequate ventilation (52%), contamination from outside the building (10%), microbial contamination (5%), contamination from building fabric (4%) and unknown sources (13%) [56 FR 47892]. Cardiovascular Effects As the insured firm has paid an insurance company to assume some of the risks, that firm has less reason to exercise the diligence necessary to avoid losses. 4-229]. Comment 3-104 continued that "[p]assive tobacco smoke (PTS) is the principal indoor air contaminant in my office building in Rockefeller Center. These effects are associated with exposure to combustion gases such as carbon monoxide [Exs. Buildings system design, maintenance and operation can, and regularly do, provide acceptable indoor environments. For this risk assessment, OSHA defines "heart disease" to be coronary heart disease excluding strokes, as defined in the Framingham study [Ex. The second issue associated with the use of cotinine as a biomarker is the possibility that there is a longer half-life for the elimination of cotinine at very low biological concentrations, associated with the slow release of nicotine from binding sites [Exs. The purpose of this section is to discuss the use of cotinine, a metabolite of nicotine, as an internal biomarker for inhalation exposure to nicotine, and, as such, its usefulness as a metric for the health effects of ETS. Human activity pattern studies utilize random samples of human activity patterns using questionnaires and time-diary data to provide detailed generalizable data about human behavior. Table VI-6 presents estimates of the incidence of work-related cases avoided of lung cancer and heart disease following either the banning of smoking in the workplace or limiting smoking to designated smoking areas. OSHA has considered all data submitted in response to the Request for Information, as well as other scientific data which has been made a part of the record in this proceeding in arriving at these proposed provisions regarding regulation of indoor air quality. Most building cooling systems are designed to remove the heat generated by office machines, employees and light. OSHA developed quantitative estimates of the economic impact of the proposed standard on the affected industries. Specific deficiencies that produce air quality problems include inadequate outside air supply, poor air distribution, poor air mixing (and therefore poor ventilation efficiency), inadequate control of humidity, insufficient maintenance of the ventilation system, inadequate HVAC system capacity and inadequate exhaust from occupied areas. 1990. For example, the wage costs for the trainer could represent from 50 percent of the trainee labor costs (if there are only two in the class) to 5 percent if there are 20 trainees in a class. Consequently, the selection process for one of the smoking policy alternatives for a particular workplace must consider both the physical limitations of the building or firm and the building's use. 3501 et seq. Infarct size nearly doubled following only 180 hours of ETS exposure distributed over a six week period. 3-745]. Your child will be able bathe regularly in 5 to 7 days. 5. Introduction Issues on which comments were requested in the RFI included health effects attributable to poor IAQ, ventilation systems performance, exposure assessment, and abatement methods. Section and Appendix "G" of ASHRAE Standard 62-1989 [Ex. 333; sec. Comment 3-630 from a union reported that "[a]fter surveying thousands of workers across the country, SEIU compiled actual survey responses that list adverse health effects caused by indoor air pollution. Also, if inadequate outside air is provided, regardless of the age of the building, chemical and biological contaminants will build up to levels that can cause health effects in some workers. These results imply that persons who experience symptoms of SBS may have a lower threshold for certain health effects compared to nonreactive people. Based on OSHA's percentage of problem buildings (30 percent), OSHA assumed that 30 percent of employees working indoors are exposed to poor indoor air quality. And, as soon as the door is opened, the dense smoke accumulation within the office is diffused to all adjacent work areas. There is no secondary spread of symptoms to others outside the building who are exposed to the occupants (unlike the situation faced by many chemical and asbestos workers). In response to the RFI, over 1,200 comments were submitted by interested persons, groups, unions, and industries. The published Plowchalk model does not include this feature, but a forearm compartment has since been added to provide a similar function [Ex. OSHA believes that requiring record retention for 3 years of building-related illnesses which occur in nonindustrial environments is reasonable. Based on results adjusted for nonresponse and weighted to reflect national estimates, 18.81 percent of nonsmokers reported exposure to smoke in their immediate work area as shown in Table IV-8. 4-264] adopts the World Health Organization's definition of health: "Health refers to a state of complete physical, mental, and social well being, and not just the absence of disease or infirmity." Together office and mercantile buildings represent almost 40 percent of all buildings and floorspace. (4) American Lung Association, 1740 Broadway, New York, New York 10019, (212) 245-8000. OSHA preliminarily estimates that the proposed standard will prevent 3.0 million severe headaches and 4.5 million upper respiratory symptoms over the next 45 years. June 1991, Table VI-2. (2) Is the proposed definition of "building systems" sufficiently descriptive to indicate which systems the employer must attend to in order to assure acceptable indoor air quality? 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