hazard communication program - mystericycle.com · © 2010 stericycle, inc. rev.(1/10) hazard...

Hazard Communication Program

Hazard

Comm

unication Program

Hazard Communication Standard© 2010 Stericycle, Inc. Rev.(1/10)

Hazard CommuniCation Program

table of Contents

Safety Plan Review Sign-In Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .2

Hazard Communication Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .3

Hazard Communication Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .4

Hazardous Chemical Inventory Master List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .5

Material Safety Data Sheets (MSDS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .6

Proper Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .8

Hazard/PPE ID Poster and Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .9

Non-Routine Tasks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .10

Hazard Communication Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .11

Contractor Employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .15

Workplace Hazard Assessment/PPE Selection and Certification . . . . . . . . . . . . . . 4 .16

Personal Protective Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .17

Certification of PPE Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .19

4 .1

Hazard Communication Standard

© 2010 Stericycle, Inc. Rev.(1/10) 4 .2

Safety Plan Review Sign-In SheetFor: Hazard Communication StandardOur Plan has been reviewed by:

Reviewer’s Name (print) Title

Signature of Reviewer Date

Sign below to indicate that you have read and reviewed the plan listed above and that you have been given the opportunity to ask questions to management to ensure a complete understanding of the employer’s plan:

Print Name Title Signature Date

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Hazard Communication Standard

The OSHA Hazard Communication Standard has a simple intent; employees have both a need and a right to know what chemical hazards they are potentially exposed to so that they can properly protect themselves .

The Hazard Communication Standard requires:

• Establishment of a master chemical inventory list – this is a list of all hazardous chemical products at our facility .

• Maintenance of Material Safety Data Sheets (MSDS) – An MSDS provides details on the chemical components of a product, the physical and health hazards, recommended personal protective equipment (PPE), emergency first aid procedures, spill response, etc. We maintain an MSDS for every hazardous chemical product listed on our inventory.

• Primary container labeling – manufacturers are required to provide labels on all chemical products . These labels must contain the identity of the hazardous chemical(s), appropriate hazard warnings (both physical and health hazard), and name and address of the manufacturer or other responsible party .

• Secondary container labeling – if a chemical is transferred from its original container into a secondary container, a chemical label must be applied to the secondary container . Similarly, if the original container’s label is missing or defaced, it must be replaced with a secondary label as well . Secondary labels must contain the identity of the hazardous chemical(s) and the appropriate hazard warnings (both physical and health hazards) .

• Employee training is required and provided so that all employees know how to determine what chemicals they are potentially exposed to and what precautions need to be taken .

• A qualified administrator who is knowledgeable about the chemicals present and about the Hazard Communication Standard must be selected to administer the Hazard Communication Program .

• A written program – the Hazard Communication Program must be in writing.

What is a Hazardous Chemical?OSHA defines a hazardous chemical as one that presents either a physical hazard, a health hazard, or both. The Standard exempts consumer products if that product is used as a consumer would at home . For example, if you use a desk cleaner in the proper way for the standard duration of time, just as you would at home, then the OSHA Standard does not cover the product . However, if an employee’s job is to use the cleaner to clean desks all day long, then the product is covered by the Standard because it is no longer being used as a consumer would use it . OSHA uses three criteria to determine if a consumer product is being used on the job the way it would be used at home by any other consumer: 1 . Is it being used for the same purpose? 2 . Is it being used for the same duration of time? 3 . Is it being used with the same frequency of use? If the answer to all three questions is yes, and the product is a consumer product, then it is exempt. You are, however, still free to maintain an MSDS for such exempt products even though it is not strictly required .

4 .3


Hazard Communication Program

Hazard Communication in our FacilityOur Hazard Communication Program Administrator

Name Location Phone

This person has overall responsibility for the program and will review and update the program as necessary . Copies of the written program may be obtained from the Hazard Communication Program Administrator .

In this facility we work with a variety of chemicals, some of which are considered potentially hazardous . It is important that we are aware of the hazardous chemicals in our workplace and understand the labeling and communication about these chemicals so that we can safely manage their use .

Under this program, you will be informed of the contents of the Hazard Communication Standard, the hazardous properties and characteristics of chemicals with which you work, safe handling procedures, and measures to take to protect yourself from these chemicals . You will also be informed of the hazards associated with non-routine tasks .

4 .4


Hazardous Chemical inventory master List

Name Location Phone

is responsible for this list of hazardous chemicals and related work practices used at this location and will update the list as necessary .

Following is the master list of these hazardous chemicals. Our list of chemicals identifies all of the chemicals used in our work process .

Each list also identifies the corresponding MSDS. Use additional sheets if needed.

Many facilities like to store each MSDS in a notebook and assign a simple numerical sequence numbering system to them for ease of location between the master list and the position of the MSDS in the notebook. This is simply a number you assign; it is not an “official” number that you must look for.

Product Name Location of Use/Storage MSDS Name/Number

4 .5


material Safety data Sheets (mSdS)

Materials Safety Data Sheets (MSDS) - Other than the manufacturer’s primary label, your second source of information about a chemical is the MSDS. An MSDS provides detailed information about a specific chemical product . They contain the following information:

• Identity (name of substance)

• Physical Hazards (target organ)

• Health Hazards

• Routes of Exposure (entry into the body)

• Permissible Exposure Limits (PEL)

• Carcinogenic Factors (cancer causing)

• Safe-Handling Procedures

• Control Measures (personal protective equipment)

• Emergency First Aid Procedures (emergency telephone number)

• Contact Information

• Special Instructions

We should never use a hazardous chemical covered by the Standard that does not have an MSDS, a label, or some other form of warning .

Our MSDS location

You should use an MSDS whenever you need additional information about a hazardous chemical that is not included on the product label. Our MSDS copies are accessible in the work area during all operating shifts .

If an employee may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use .

See Weekly Eye Wash Station Inspection Checklist & Log found in MASTER FORMS Section.

4 .6

© 2010 Stericycle, Inc. Rev.(1/10)Hazard Communication Standard

An MSDS provides us with specific information on the materials we use in our workplace.

mSdS on File

Name Location Phone

will maintain an MSDS for every hazardous chemical in our workplace for which an MSDS is required. We will ensure that access to MSDS files is provided in the work area during the work shift.

mSdS updates

Name Location Phone

is responsible for acquiring and updating MSDS files. He/she will contact the manufacturer or vendor if additional research is necessary or if an MSDS has not been supplied with an initial shipment.

To obtain an MSDS, please contact the manufacturer of the material. See MSDS Request Form found in MASTER FORMS Section.

For Steri•SafeSM Select and Preferred customers the Steri•SafeSM online MSDS System is now available: Call (866) STERI•CALL or (866) 783-7422 for more info .i

4 .7


i

Proper Labeling

Labeling – Your most immediate source for information can be found on labels attached to containers that hold various chemicals .

Name Location Phone

will ensure that all hazardous chemicals in the workplace are properly labeled and updated as necessary .

• Primary Container labeling – manufacturers are required to provide labels on all chemical products . These labels must contain the identity of the hazardous chemical(s), appropriate hazard warnings (both physical and health hazard), and name and address of the manufacturer or other responsible party .

• Secondary Container labeling – if a chemical is transferred from its original container or the original label is missing or defaced, a secondary chemical label must be applied to the container . The label must contain the identity of the hazardous chemical(s) and appropriate hazard warnings (both physical and health hazards) .

Secondary Container Labels can be abbreviated, but they must contain enough information so that the user can know how to reference it to its MSDS.

If hazardous chemicals are transferred from a labeled container to a portable container intended only for your own immediate use (single-use only), no labels are required on the portable container provided it is not used for more than one shift and is not left unattended . Pipes or piping systems will not be labeled but their contents will be described in the training sessions .

Remember: Do not use products which are unlabeled or have defaced labels . Report such incidences to the Hazard Communication Program Administrator .

If you are a Steri•SafeSM Select or Preferred Customer, this Manual will include secondary chemical labels and a corresponding hazard identification poster.

4 .8


This poster, used in conjunction with the Steri•SafeSM Hazard/Personal Protective Equipment ID Labels, is intended to identify hazardous materials that occur in your workplace, as well as the measures you may employ to protect yourself from such hazards. Each orange icon depicts a type of hazard, while each blue icon displays a type of personal protective equipment that may be appropriate to protect against the hazards. For more detailed instructions, please consult the Steri•SafeSM OSHA Compliance Program Manual or SteriSafe.com.

Biohazardous Materials: Biohazardous materials that are potentially infectious are identified by this icon. Always store these materials in impermeable, leakproof color-coded/labeled containers. This symbol is also used to identify “sharps,” those items which have the potential of puncturing or cutting. Specially designated, puncture-resistant sharps containers, color-coded red/labeled, should always be used to dispose of all sharps. Proper use of sharps containers can prevent accidental “sticks” that can be associated with exposure to bloodborne pathogens.

Protective Gloves: Use of protective gloves is indicated when this icon is used. Gloves are used to protect the hands from temperature extremes, cuts, abrasions, burns, chemical exposure and biohazards. Gloves are an essential element of personal safety. Before choosing a pair, consider the job to be performed, as there are literally hundreds of types available. The fit, material, gripping surface, and length are important in choosing the right gloves for the task. Exam gloves provide the wearer only limited protection and should not be used in place of utility gloves or when other specialty gloves are required.

Corrosive Materials: Corrosive materials are identified by this icon. These materials, either an acid (a pH-below 7) or a base (a pH-above 7) not only present a hazard by themselves, but they can also react to create a hazard if the two are accidentally combined. All necessary personal protective equipment, such as corrosive-resistant gloves and safety glasses, must be worn when handling corrosive materials. Glass or plastic containers must be used to store corrosive materials. Always dispose of corrosive materials and wastes in accordance with all Federal, State and local regulations.

Lab Coat: Use of an impermeable lab coat is indicated when this icon is used. This type of lab coat acts as a protective barrier between your body and hazardous materials. A splash apron or other protective clothing may be used instead of an impermeable lab coat if the task being performed so indicates. Because there are many types of protective clothing available, choose the type that offers the best protection from the material with which you are working. Proper sizing is critical to assuring your protection.

Flammable Materials: Flammable materials are identified by this icon. All flammables must be kept away from open flames. Most of the flammable materials used are liquids that evaporate quickly. The danger of vapor buildup is a concern best addressed by storing flammable materials and liquids in air-tight containers. Waste containing flammable materials must be collected in proper containers for disposal by a registered hazardous waste hauler.

Safety Glasses: Use of safety glasses is indicted when this icon is used. ANSI-Z87.1 approved glasses with side-shields are standard, but are not the only type of eye and face protection available. The protection you are using must also be appropriate for the task being performed. When pouring chemicals, for example, you will need goggles to guard against splashes. When selecting your protection, be sure to choose the type that fits the task you are performing.

Toxic Materials: Toxic materials are identified by this icon. Because they can cause serious illness or death, extreme caution must be exercised whenever using toxic materials. The effects of exposure to toxic materials can be both acute (immediate harmful effects) and/or chronic (damage occurring over time). Exposure can occur from skin contact, ingestion, and inhalation. When disposing of toxic materials and wastes, use a registered hazardous waste hauler to assure that all Federal, State and local regulations are satisfied.

Surgical Mask or Respirator: Use of a surgical mask or respirator is indicated when this icon is used. Surgical masks are primarily designed for patient protection. They are also suitable for your protection from incidental splashes of body fluids. For protection against TB or toxic chemicals (vapor or dusts) a NIOSH approved particulate or organic vapor respirator specifically designed for your protection is needed. The respirator selected must be chosen based on the degree of protection required and on the specific hazard to be protected against. Never substitute a full-face shield as a replacement for a surgical mask or respirator, as it will allow passage of airborne pathogens and chemicals to your breathing zone.

HAZARD IDENTIFICATION SYSTEM PERSONAL PROTECTIVE EQUIPMENT GENERAL OSHA COMPLIANCE GUIDELINES

Call Steri•SafeSM customer service to order additional Hazardous Materials Identification and Personal Protective Equipment Poster and Labels.

(866) STERI•CALL(866) 7 8 3 - 7 4 2 2

Emergency Contacts

__________________________________Fire, Police, Medical:

________________________________________Gas Leak:

________________________________________For Issues With Our Building Call:

Required OSHA PostingOSHA requires all work places to post the OSHA Labor poster in order to inform your employees of their rights under the OSH Act. An OSHA Labor poster is available in the Steri•SafeSM OSHA Compliance Manual or SteriSafe.com Program Folder.

Required OSHA Programs & RecordkeepingWritten Programs and Training – OSHA requires many written programs and training sessions, including Bloodborne Pathogens, Hazard Communication and Personal Protective Equipment. Forms and instructions for creating these programs are available in the Steri•SafeSM OSHA Compliance Program Manual or on SteriSafe.com.

Recordkeeping – OSHA requires all employers who employ 11 or more employees to maintain the OSHA 300 Recordkeeping logs. OSHA also requires certain employers covered by their Bloodborne Pathogen regulations to maintain a separate sharps injury log. Forms and instructions for the OSHA 300 records and sharps injury log are available in the Steri•SafeSM OSHA Compliance Program Manual or on SteriSafe.com.

STC_SAFEPSTR_0610©2010 Stericycle, Inc.

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STC-OSHA Safety Poster.indd 1 7/28/10 11:09 AM

The requirement under 29CFR 1910.1200(f)(5) of the Hazard Communication Standard states: Except as provided in paragraphs (f)(6) and (f)(7) of this section, the employer shall ensure that each container of hazardous chemicals in the workplace is labeled, tagged or marked with the following information: (i) Identity of the hazardous chemical(s) contained therein; and, (ii) Appropriate hazard warnings, or alternatively, words, pictures, symbols, or combination thereof, which provide at least general information regarding the hazards of the chemicals, and which in conjunction with the other information immediately available to employees under the hazard communication plan, will provide employees with specific information regarding the physical and health hazards for the hazardous chemical.

©2001 Stericycle, Inc. Rev. (7/07)

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You may want to display all posters of the Steri•Safe Compliance program, in a common area accessible to all employees . You may also consider duplicating this and other Steri•Safe posters for inclusion in new employee orientation materials .

4 .9


From time to time there may be occasions when employees are required to perform non-routine tasks that cause them to work with a hazardous chemical with which they do not routinely work . Prior to any such assignment, our Hazard Communication Program Administrator will ensure that all such employees have been provided with the necessary information, training, PPE, engineering controls, etc., that may be required. Examples of such non-routine tasks, if any, may be listed below.

non-routine tasks

4 .10


Hazard Communication training

Purpose – to provide information and training on chemical products used within the workplace, and how our Hazard Communication Program can be used to protect our employees from chemical hazards .

Instructor’s Note: The following training information may be provided to all employees upon assignment and whenever a new material or procedure is implemented .

Hazard Communication Principals and terminology Physical Hazards Physical hazards threaten your physical safety . The most common types are:

• Fire

• Explosion

• Chemical Reactivity

Flammables - Ignite easily and burn rapidly . Liquid flammables have a flashpoint (temperature at which they will burn) under 100 degrees Fahrenheit .

Combustibles (similar to flammables, but they do not ignite as easily .) - Liquid combustibles have a flash point above 100 degrees Fahrenheit .

Pyrophoric (spontaneous combustion) - Materials that can burst into flames on their own at temperatures below 130 degrees Fahrenheit .

Explosives Materials - Release a tremendous amount of energy in the form of heat, light and expanding pressure within a very short period of time .

Water Reactives - React with water and may explode, or they may release a gas, which is flammable .

Unstable Reactives - Chemicals that can react or can become self-reactive when subjected to shock, pressure or temperature .

Health Hazards Health Hazards are capable of causing physiological harmful changes in the human body . The changes may be acute or chronic, reversible or permanent .

Toxicity vs. Hazard

The term toxicity is used to describe the ability of a substance to cause a harmful effect. Everything is toxic at some dose. Even water!

Toxicity vs. Dose

Dose is the amount of something you are exposed to, or come in contact with . The less the toxicity, the greater the dose you can tolerate without ill effects . The greater the toxicity, the less dose you can tolerate without becoming sick .

4 .11


High Toxicity - Low Dose

Acetone is a highly toxic chemical . However, you can work safely with it if you avoid skin contact and have adequate ventilation (low dose) .

Low Toxicity - High Dose

Nitrogen gas has a low toxic rating . It is found in great amounts in the air we breathe . However, if you were in a confined space that had only nitrogen (a very high dose), you would soon die because of the lack of oxygen .

Safe Exposure Limits

Much research has been done by government agencies and groups to establish safe exposure limits for the chemicals used in the workplace. These limits are based upon a Time Weighted Average or TWA. TWAs have been established to limit the average amount of a chemical you can be exposed to over an eight-hour day. The most common TWAs used in the United States are OSHA’s Permissible Exposure Limits or PELs and the American Conference of Governmental Hygienists, ACGIH, Threshold Limit Values, or TLVs .

acute vs. Chronic Acute Health Hazards - Hazards where the effects occur immediately or soon after you come in contact with a hazardous chemical .

For example, you accidentally spill a strong acid on your hand . The acid will begin to burn your hand immediately . Or you begin to work with a paint solvent in a closed area, and the vapors make you feel dizzy .

Chronic Health Hazards - on the other hand are those, where the effects can take years or decades to occur after many exposures .

An example of a chronic health hazard is asbestos . The dangerous effects for people who have been exposed to asbestos take years to appear and have been linked to a number of fatal lung diseases .

routes of ExposureIt’s important to remember that hazardous chemicals present a health hazard only when they come into contact with the body . Chemicals can enter the body in four ways:

• Inhalation

• Skin Contact

• Eye Contact

• Ingestion

4 .12


Inhalation - Inhalation is the most common route of exposure for most health hazards . This includes breathing in dust, fumes, oil mists, gases and vapors .

Skin Contact - Some chemicals are absorbed into the body through the skin . If a chemical is readily absorbed into the skin, then the notation “skin” will appear along with the occupational exposure limits on the MSDS. Corrosive chemicals can cause burns and tissue destruction. Extra care must be taken to prevent skin contact with these chemicals . This is why wearing aprons, gloves, and other protective clothing is important when working with some chemicals . Other materials can cause allergic reactions .

Eye contact - If a chemical is splashed in the eye, one may experience burning, irritation and potentially serious side effects (blindness) . To avoid eye contact, you should wear protective eyewear . You will receive better splash protection by wearing goggles or a face shield versus safety glasses .

Ingestion - Some chemicals when swallowed will be absorbed through the GI tract. To avoid ingesting harmful chemicals you must avoid hand to mouth contact whenever your hands are contaminated . In addition, you should never eat, drink, or smoke in areas where hazardous chemicals exist .

Health/Physical EffectsCorrosives/Acids - Cause tissue damage and burns on contact with the skin or eyes .

Primary Irritants - Cause intense redness or swelling of the skin or eyes on contact, but with no permanent tissue damage .

Sensitizers - Cause an allergic skin or lung reaction .

Acutely Toxic Materials - Cause an adverse effect, even at a very low dose .

Carcinogens - May cause cancer.

Teratogens - May cause birth defects.

Organ Specific Hazards - May cause damage to specific organ systems, such as the blood, liver, lungs, or reproductive system .

4 .13


training CommitmentWe Promise: Everyone who works with or is potentially exposed to hazardous chemicals will receive initial training on the Hazard Communication Standard and the safe use of those chemicals .

Our Hazard Communication Compliance Administrator is

Name Location Phone

The Administrator will review the employee training program and ensure that we meet any training or retraining needs . Retraining is required whenever a hazard may change or a new hazard or chemical is introduced into the workplace . Some states require Hazard Communication training annually . It will be our policy to provide retraining as required to ensure the effectiveness of the program and that we remain in compliance. Also, new employees will be trained initially upon hire. We will obtain input from employees regarding the training they have received, and their suggestions for improving it .

Name Location Phone

is available to answer any questions from workers on the program or the products in use . The training program will emphasize these items:

• Summary of the OSHA Hazard Communication Standard and this program.

• Chemical and physical properties of hazardous chemicals (e.g., flash point, reactivity) and methods that can be used to detect the presence or release of chemicals .

• Physical hazards of chemicals (e.g. potential for fire, explosion, etc.).

• Health hazards, including signs and symptoms of chemical exposure and discussion of any medical condition known to be aggravated by exposure to the chemical .

• Procedures to protect against hazards (e.g., personal protective equipment required, proper use, maintenance, work practices, or methods to assure proper use and handling of chemicals and procedures for emergency response) .

• Work procedures for cleaning hazardous chemical spills and leaks to ensure employee protection.

• Where MSDS files are located in our facility; how to read and interpret the information on both labels and an MSDS; how employees may obtain additional information.

A generic form for documenting any safety training can be found in the MASTER FORMS section.

4 .14


Contractor Employees

We want to ensure that the safety and health of our employees are not compromised when outside contractors bring hazardous materials into our workplace . At the same time, we are committed to providing a safe and healthful working environment to outside contractors who might encounter hazardous materials while working on our premises .

In our workplace, it is the responsibility of

Name Location Phone

to advise outside contractors of any hazards they may encounter while on our premises. We will communicate the labeling system that is in use, the protective measures required, and the safe handling procedures . In addition we will notify these individuals of the location and availability of relevant MSDS files.

Each contractor bringing hazardous materials into our workplace must provide us with the appropriate hazard information on these substances, including the labels used and the precautionary measures to be taken in working with these materials .

4 .15

Hazard Communication Standard© 2010 Stericycle, Inc. Rev.(1/10) 4 .16

Workplace Hazard assessment

OSHA requires employers to assess the work environment to determine if hazards are present which necessitate the use of Personal Protective Equipment, PPE. When PPE is needed to protect employees from hazards, we are required to specify the correct PPE and its usage.

To accomplish this,

Name Location Phone

is our PPE coordinator and will ensure that the following requirements are met.

❏ A hazard assessment is accomplished to identify hazards .

❏ The appropriate PPE is assigned to the potential hazard.

❏ PPE is provided.

❏ Properly fitted PPE is maintained and available.

❏ Employees are trained on PPE usage: how to use it, when it is required, and what are its limitations .

❏ PPE selection decisions and criteria will be communicated to employees.

❏ The employer must also certify that the workplace hazard assessment and PPE selection has been performed .

PPE Selection and Certification Form

Task Hazard PPEExample: stripping porcelain from dental casting hydrofluoric acid utility gloves, eye shield, face shield as needed

This is to certify that I have performed an assessment of our workplace tasks and procedures, and that the hazards found are listed above along with the PPE to be used.

Name Signature Date

Hazard Communication Standard© 2010 Stericycle, Inc. Rev.(1/10) 4 .17

Personal Protective Equipment

Based on our hazard assessments, the types of PPE selected and made available to our employees are as follows (check all that apply):

Gloves

❏ Latex Exam (powdered or powder-free) circle one or both if used

❏Vinyl Exam

❏Sterile Surgical

❏Utility gloves

❏Nitrile

❏Neoprene

❏___________________

❏___________________

Respiratory Protection

❏N95 respirators

❏Other respirators

❏___________________

❏___________________

Eye and Face Protection

❏Safety Glasses with sideshields

❏Splash goggles

❏Face Shield

❏Face Masks

❏___________________

❏___________________

Hearing Protection

❏Ear Plugs

❏Ear Muffs

❏___________________

❏___________________

Other

❏___________________

❏___________________

❏___________________

Protective Clothing

❏Lab Coats

❏Gowns

❏Smocks

❏Bouffants

❏Bootiesi Helpful Internet Links to more information can be found in the

RESOURCE GUIDE section.

Keep in mind that whenever respirator use is required, it also triggers implementation of the provisions of the Respiratory Protection Standard (see SUPPLEMENTARY WORkPLACE CONCERNS section of this manual for further information) .


We can find our PPE location(s) at

Location

and may be obtained through

Name Location Phone

who is responsible for evaluating and maintaining the supply and distribution of our PPE.

• Used PPE may be disposed of in

List appropriate containers for storage, laundering, decontamination, or disposal .

Handling PPEDisposable PPE is discarded after use. If it is visibly bloody, it is discarded in Regulated Medical Waste. If it is not visibly bloody, it may be discarded in regular solid waste or it may be overclassified and still disposed of in Regulated Medical Waste.

If our facility uses any PPE that is not disposable, however, then the procedures for cleaning it and otherwise handling it will be inserted below .

The procedures for handling used PPE are as follows: (reference specific procedures by title or number and/or description such as how and where to decontaminate face shields, eye protection, resuscitation equipment, etc .)

PPE/Number Handling Procedures

4 .18


Sample

Certification of PPE training

The affected employees listed below have been trained on the PPE selected for this facility as the result of our Workplace Hazard Assessment .

Items of PPE for which training has been provided:

_______________________ _______________________ _____________________ ______________________

_______________________ _______________________ _____________________ ______________________

_______________________ _______________________ ______________________ ______________________

_______________________ _______________________ ______________________ ______________________

_______________________ _______________________ ______________________ ______________________

Employees trained on the above items of PPE:

Name Date(s) of Training PPE Item for which Training was Provided (If different from items already listed above)

____________________________ ______________________________ ________________________________________

____________________________ ______________________________ ________________________________________

____________________________ ______________________________ ________________________________________

____________________________ ______________________________ ________________________________________

____________________________ ______________________________ ________________________________________

____________________________ ______________________________ ________________________________________

____________________________ ______________________________ ________________________________________

____________________________ ______________________________ ________________________________________

This is to certify that the employees listed above have been trained on the PPE indicated above and that they understand when that PPE is necessary, what PPE is necessary, how to properly don (put on), doff (remove), adjust, and wear the PPE, the limitations of the PPE, and the proper care, maintenance, useful life, and disposal of the PPE.

Printed Name Signature Date

4 .19

David Walker David Walker 1/15/10

John

Mary

Sue

Joseph

Sandy

Disposable gloves

Face masks

Eye protection

Disposable gowns

Reusable utility gloves

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