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HHE Search Results
1056 HHE reports were found based on your search terms. Reports are listed in order of year published with the most recently published reports listed first.
Year Published and Title
(2024) Exposures and health concerns in a dental clinic. (Click to open report) Request: We received a management request for a health hazard evaluation at a dental clinic. The request stated concerns about idiopathic pulmonary fibrosis (IPF). IPF is a serious long term lung disease that can cause permanent scarring in the lungs. IPF was first identified in a cluster of dentists reported in 2018. In response to the request, we performed an air sampling survey in August 2022 to evaluate potential exposures to respirable dust, respirable crystalline silica, respirable metals,... (Click to show more)Request: We received a management request for a health hazard evaluation at a dental clinic. The request stated concerns about idiopathic pulmonary fibrosis (IPF). IPF is a serious long term lung disease that can cause permanent scarring in the lungs. IPF was first identified in a cluster of dentists reported in 2018. In response to the request, we performed an air sampling survey in August 2022 to evaluate potential exposures to respirable dust, respirable crystalline silica, respirable metals, and volatile organic compounds (VOCs). We also assessed the existing ventilation systems in the dental clinic. Workplace: The dental clinic provides dental care services to patients. General dentistry services and procedures are performed at the clinic and clinic laboratory. The dental clinic is housed on the second floor of a two-story medical clinic on an academic campus. At the time of our survey, eight staff were onsite, including two dentists, two dental hygienists, three dental assistants, and one administrative staff. Our Approach We conducted a site visit in August 2022 to assess possible exposures during routine dental care, assess the ventilation systems in use, and informally interview clinic staff. We conducted opening and closing meetings with employees and management to share background information about NIOSH and this health hazard evaluation. We also described the purpose of our survey, activities that would be performed while onsite, and actions that would be taken after we concluded our survey. During our onsite survey, we: a) Collected full-shift personal air samples on dental clinic employees for respirable dust and respirable crystalline silica. b) Collected full-shift area air samples in multiple locations in the dental clinic for respirable dust, respirable crystalline silica, respirable metals, and volatile organic compounds (VOCs). c) Collected instantaneous air samples for VOCs during various tasks and procedures. d) Collected real-time measurements of respirable aerosols in and just outside of the laboratory. e) Assessed the heating, ventilation, and air-conditioning (HVAC) systems in use. f) Informally interviewed clinic staff to learn about any health concerns potentially related to exposures at work. Our Key Findings: All personal air samples were below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) and the American Conference of Governmental Industrial Hygienists (ACGIH®) threshold limit value (TLV®) for respirable dust. All personal air samples for respirable crystalline silica were below the NIOSH recommended exposure limit (REL) and OSHA PEL. All area air samples for respirable dust, respirable crystalline silica, and respirable metals were low; some metals were measured in all or most areas of the clinic. Some VOCs were higher in some locations or during specific tasks and procedures. Ethanol and isopropyl alcohol were the highest measurements collected during full-shift area sampling and during task or source sampling and were likely due to cleaning and disinfecting tasks. Treatment rooms (dental operatories) and staff offices did not receive adequate outdoor air from existing mechanical ventilation systems, and the clinic was unable to maintain temperatures in the clinic recommended by ASHRAE. LEV controls in the laboratory were not consistently used. When no LEV was used, higher levels of air contaminants were measured in the laboratory and adjacent hallway. Respirable aerosol generated in the laboratory migrated to adjacent areas. Employees reported no work-related symptoms. Our Recommendations: 1: Reduce risk of entrainment of air from the laboratory into adjacent spaces. 2: Encourage employees to utilize local exhaust ventilation (LEV) controls in the laboratory area during grinding, trimming, or soldering tasks. 3: Consider using LEV controls such as high-volume evacuation (HVE) and voluntarily using N95® filtering facepiece respirators (or other air-purifying particulate respirators) when performing dental procedures with nickel or silica (e.g., restorative procedures). 4: Improve ventilation so that all areas receive adequate outdoor air and maintain appropriate temperatures and comfortable humidity levels. 5: Make NIOSH-approved N95 filtering facepiece respirators (or other air-purifying particulate respirators) available for voluntary use and train employees on proper use of respiratory protection. 6: Ensure employees understand the hazards associated with working in a dental clinic and how to protect themselves. 7: Encourage employees to report any new, persistent, or worsening respiratory symptoms, particularly those with a work-related pattern, to their healthcare providers and, as instructed by their employer, to a designated individual at their workplace.
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(2023) Exposures to dust and noise at a pharmaceutical manufacturing facility. (Click to open report) Management at a pharmaceutical manufacturing facility requested a health hazard evaluation of employees' exposures to pharmaceutical dust and noise during pharmaceutical manufacturing. During our visit to the facility, we observed work processes, work practices, and conditions; measured particulates in air during pharmaceutical manufacturing and packaging; took personal noise exposure measurements from workers involved in manufacturing and packaging pharmaceuticals; and measured sound levels thr... (Click to show more)Management at a pharmaceutical manufacturing facility requested a health hazard evaluation of employees' exposures to pharmaceutical dust and noise during pharmaceutical manufacturing. During our visit to the facility, we observed work processes, work practices, and conditions; measured particulates in air during pharmaceutical manufacturing and packaging; took personal noise exposure measurements from workers involved in manufacturing and packaging pharmaceuticals; and measured sound levels throughout the manufacturing and packaging areas of the facility. We found that none of the average particle mass concentrations from the activities measured exceeded the OSHA PEL for total or respirable dust or ACGIH guidelines for respirable dust. However, particle concentrations reached these levels for short periods of time during tablet pressing when scooping powder by hand into the hopper. We recommend reducing airborne dust exposure as much as practicable by reducing or eliminating hand scooping of powder, reducing powder transport distance from containers to hoppers, eliminating use of compressed air to blow dust and powder off clothing, and minimizing use of compressed air to clean equipment. We also found that employees in the bottling room had the highest full-shift noise exposures. However, noise exposures did not exceed noise exposure limits. Noise in the bottling room and other areas where compressed air is used could potentially be reduced by using compressed air nozzles designed to produce less noise. We recommend continuing to use hearing protection during activities that generate sound levels above 85 dBA.
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(2023) Occupational exposures and indoor environmental quality in an underground cavern workplace. (Click for full summary) An employer representative of a warehouse facility, located in a former underground limestone quarry, requested a health hazard evaluation concerning employees' exposures to carbon monoxide, wood dust and other airborne particles, noise, and radon. During our visits, we (1) observed work processes, practices, and workplace conditions, and spoke with employees; (2) measured carbon monoxide, carbon dioxide, temperature, and relative humidity, and radon; (3) collected air samples for wood dust, oth... (Click to show more)An employer representative of a warehouse facility, located in a former underground limestone quarry, requested a health hazard evaluation concerning employees' exposures to carbon monoxide, wood dust and other airborne particles, noise, and radon. During our visits, we (1) observed work processes, practices, and workplace conditions, and spoke with employees; (2) measured carbon monoxide, carbon dioxide, temperature, and relative humidity, and radon; (3) collected air samples for wood dust, other airborne particles, and noise; (4) used tracer gas to measure the air exchange rate in the workspace; (5) took sound level measurements when powered woodworking equipment and tools were used; and (6) measured illumination levels at various locations throughout the space. We found employees' noise exposures in the woodshop exceeded the NIOSH recommended exposure limit due to noise generated during the use of powered woodworking equipment. Wood dust exposures in the woodshop could exceed occupational exposure limits depending on how much time woodworking equipment was used. Carbon monoxide and radon levels were well below occupational exposure limits. The air exchange was very low as the warehouse as there was not a mechanical ventilation system to bring outdoor air into workspace. Temperature and relative humidity levels were within ASHRAE guidelines. Our measurements indicated that illumination could be improved in some areas of the workspace. We recommended including woodshop employees in a hearing loss prevention program, which includes audiometric testing, proper hearing protection use, and employee training; improving wood dust capture at the saws; increasing lighting in various areas of the workspace; and adding a portable toilet, handwashing station, emergency eyewash, and drinking water within the work area.
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Contact us to obtain a copy of report HHE-2018-0181-3389.
(2021) Coccidioides exposure and coccidioidomycosis infections among warehouse and distribution employees. (Click to open report) The Health Hazard Evaluation Program received a request from management of a warehouse and distribution facility concerned about the potential for work-related coccidioidomycosis, also known as Valley fever or "cocci." Several employees developed coccidioidomycosis in recent years. The warehouse and distribution facility consisted of multiple buildings on several hundred acres mostly surrounded by farmland. We interviewed employees about work characteristics, time spent outdoors at and outside o... (Click to show more)The Health Hazard Evaluation Program received a request from management of a warehouse and distribution facility concerned about the potential for work-related coccidioidomycosis, also known as Valley fever or "cocci." Several employees developed coccidioidomycosis in recent years. The warehouse and distribution facility consisted of multiple buildings on several hundred acres mostly surrounded by farmland. We interviewed employees about work characteristics, time spent outdoors at and outside of work, residence in areas where Coccidioides has been found, and personal health; observed work practices and conditions; assessed the ventilation systems; reviewed policies and procedures; and identified cases of coccidioidomycosis among employees. We found that employees could possibly breathe in dust during indoor and outdoor work. We identified at least 10 cases of coccidioidomycosis among facilities during January 2014-April 2019. However, it was not possible to determine whether this represented an excess risk of coccidioidomycosis at this workplace or whether exposure to Coccidioides occurred at work or outside of work. Most employees reported performing job activities outdoors or handling materials that were dusty from being outdoors. Housekeeping practices varied in the buildings we visited. Some areas used dry sweeping, which can generate dust. While the facility's respiratory protection plan outlined that an exposure assessment was to be performed to determine required or voluntary respirator use, an exposure assessment for airborne dust was not documented in the respiratory protection plan we reviewed. Although management reported that respirator use for dust was voluntary, communications to employees were unclear on whether respirator use was voluntary or required during excessive wind conditions. We recommended reducing airborne dust exposure by keeping warehouse bays, doors, and windows closed; using a wet sweeping method or a filtered vacuum to capture dust; choosing machinery with closed cabs and increased filtration when replacing equipment; and cleaning and maintaining window air-conditioning units in warehouse breakrooms. We also recommended conducting exposure assessment(s) to determine whether respirator use to prevent dust exposure should be required or voluntary, instructing employees voluntarily wearing N95 filtering facepiece respirators on how to wear them properly, and improving communication with employees about Coccidioides exposure and coccidioidomycosis.
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(2021) Exposure to lead during residential water line replacement activities. (Click to open report) The Health Hazard Evaluation (HHE) Program received a request from the employer of a city water department concerning lead exposure among crews replacing lead water lines servicing residential homes. This occurred after two employees received blood tests indicating elevated lead levels. In response to these findings, the employer implemented some measures to minimize lead exposures among employees and submitted an HHE request. In response to this request, we conducted confidential medical interv... (Click to show more)The Health Hazard Evaluation (HHE) Program received a request from the employer of a city water department concerning lead exposure among crews replacing lead water lines servicing residential homes. This occurred after two employees received blood tests indicating elevated lead levels. In response to these findings, the employer implemented some measures to minimize lead exposures among employees and submitted an HHE request. In response to this request, we conducted confidential medical interviews; collected personal air samples for lead; conducted colorimetric wipe sampling for lead on the hands of employees; collected wipe samples inside the surfaces of work gloves, work trucks, and areas at the main pump station; and determined whether lead particulate was expelled from the old lead pipe during a removal process. All air samples were below the occupational exposure limit for lead; however, we found lead on various surfaces and on the hands of some employees. Specific job titles such as crew leader and maintenance worker appear to have a higher potential for exposure via all routes than other job titles. We detected lead on the hands of employees who handled the lead pipe during removal activities, and lead on the inside of some work gloves after the job was completed. The task of using compressed air to blow a string through the lead piping produced a large amount of lead aerosol being ejected from the pipe. We observed incorrect respirator usage and some cases where nitrile gloves were not worn underneath work gloves when handling lead pipe. The company had a written lead monitoring and control program, a hazard communication program, and a job-hazard analysis for tasks associated with lead line replacement. While the employer had implemented multiple measures to minimize lead exposures to employees, there appears to be opportunities for potential lead exposure among employees during residential water line replacement activities. We recommended improving (1) lead surveillance, training, and work practices; (2) personal protective equipment use and training; (3) procedures for employees to keep their hands clean and free of lead during different tasks; and (4) cleaning procedures to reduce lead exposure.
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(2021) Exposures to metals and a perceived excess of cancer cases in a train maintenance facility. (Click to open report) The Health Hazard Evaluation Program received a request from a union at a train maintenance facility concerning employee exposure to metals and a perceived excess of cancer. We visited the facility twice and focused our evaluation on first shift employees working in six shops (truck, wheel, motor, electronics, contactor, and tin) that worked on different maintenance and repair tasks. We observed work processes, work practices, and conditions; spoke informally to employees in each shop about heal... (Click to show more)The Health Hazard Evaluation Program received a request from a union at a train maintenance facility concerning employee exposure to metals and a perceived excess of cancer. We visited the facility twice and focused our evaluation on first shift employees working in six shops (truck, wheel, motor, electronics, contactor, and tin) that worked on different maintenance and repair tasks. We observed work processes, work practices, and conditions; spoke informally to employees in each shop about health and safety concerns; measured employee exposures to metals in air; administered medical surveys; and measured blood lead levels of employees in the electronics shop. Our air sampling showed that there were no exposures to metals above relevant occupational exposure limits; however, employees remained concerned about potential exposures to metals and dust. Blood lead levels were all below the CDC reference level of 5 micrograms per deciliter. We found that training and hazard communication could be improved. For example, employees expressed concern about potential exposures to varnish chemicals and cadmium. However, management ceased the vacuum pressure impregnation process for applying varnish and enclosed the cadmium-containing contactors. Employees were also concerned about their health, specifically their respiratory health and a perceived excess risk of cancer. The results from our evaluation were not consistent with the reported cancers being caused by a work-related exposure. We recommended providing periodic training and communication around concerns about chemical exposures, visible dust in the facility, cadmium in the contactor shop, personal protective equipment requirements, and the perceived excess of cancer cases. We recommended reinforcing the importance of daily and weekly cleaning of commonly used areas of all workstations and break areas. We also recommended using wet methods or high efficiency particulate air filter vacuums to clean metal dust; ways to improve the spray-painting process; removing latex gloves from the facility; and consuming food and beverages away from production areas.
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(2020) Exposures and health concerns in a dental clinic. (Click to open report) Request: We received a management request for a health hazard evaluation at a dental clinic. The request stated concerns about possible exposure to mercury vapors from amalgam, a metal alloy used for dental fillings. Workplace: The dental clinic provides dental care services to patients. Services include general dentistry, family dentistry, cosmetic dentistry, restorative dentistry, full-mouth reconstruction, and oral surgery services. At the time of our survey, the clinic employed 17 staff, inc... (Click to show more)Request: We received a management request for a health hazard evaluation at a dental clinic. The request stated concerns about possible exposure to mercury vapors from amalgam, a metal alloy used for dental fillings. Workplace: The dental clinic provides dental care services to patients. Services include general dentistry, family dentistry, cosmetic dentistry, restorative dentistry, full-mouth reconstruction, and oral surgery services. At the time of our survey, the clinic employed 17 staff, including three dentists, dental hygienists, dental assistants, administrative staff, and a business administrator. In June 2019, we conducted a site visit to assess possible exposures during routine dental care, assess the ventilation systems in use, and informally interview clinic staff. During our survey in June 2019, we 1) Collected full-shift time-weighted average (TWA) samples on dental clinic employees while they performed their regular job duties and analyzed for elemental mercury content. 2) Collected full-shift TWA area samples in multiple locations in the dental clinic and analyzed for respirable dust, respirable silica, respirable metals, and volatile organic compound (VOC) concentrations. Full-shift TWA areas samples for VOCs were collected with two different samplers, placed side-by-side. 3) Collected instantaneous task-based and area air samples for VOCs during various tasks and procedures. 4) Assessed the heating, ventilation, and air-conditioning (HVAC) systems in use. 5) Informally interviewed clinic staff to learn about any health concerns potentially related to exposures at work. Our Key Findings: 1) All personal air samples for elemental mercury were below the NIOSH recommended exposure limit (REL) of 50 micrograms per cubic meter of air (ug/m3). 2) All area air samples for respirable dust, respirable silica, and respirable metals were low. 3) Some VOCs were higher in some locations or during specific tasks or procedures. 4) The laboratory area was under positive pressure relative to adjacent areas and could serve as a source of air contaminants. 5) Some employees reported eye and nose symptoms that were better when away from work. Our Recommendations: Recommendation 1: Reduce risk of entrainment of air from the laboratory into adjacent spaces. Recommendation 2: Encourage employees to minimize walking through the laboratory area while grinding or sandblasting tasks are being performed. Recommendation 3: Make N95 filtering-face piece respirators available for voluntary use and train employees on proper use of respiratory protection. Recommendation 4: Encourage employees to report any new, persistent, or worsening respiratory symptoms, particularly those with a work-related pattern, to their healthcare providers and, as instructed by their employer, to a designated individual at their workplace.
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(2020) Exposures and respiratory health at a coffee roasting, flavoring, and packaging facility. (Click to open report) Physicians at a university medical center diagnosed obliterative bronchiolitis, a serious, often disabling lung disease, in five former employees of the coffee roasting, flavoring, and packaging facility. In April 2012, the National Institute for Occupational Safety and Health's Health Hazard Evaluation Program received a confidential employee request from a coffee roasting, flavoring, and packaging facility with approximately 85 employees. The requestors had concerns about respiratory symptoms,... (Click to show more)Physicians at a university medical center diagnosed obliterative bronchiolitis, a serious, often disabling lung disease, in five former employees of the coffee roasting, flavoring, and packaging facility. In April 2012, the National Institute for Occupational Safety and Health's Health Hazard Evaluation Program received a confidential employee request from a coffee roasting, flavoring, and packaging facility with approximately 85 employees. The requestors had concerns about respiratory symptoms, lung disease, and eye irritation related to the manufacturing of coffee products, including ingredients used in the flavoring process. In July/August 2012, we conducted an initial walk-through site visit at the facility. In September 2012, we conducted a medical survey; we administered a questionnaire, performed breathing tests, and measured antibodies in blood. In November 2012, we conducted an industrial hygiene survey and ventilation assessment at the facility. The industrial hygiene survey consisted of collecting personal breathing zone and area air samples for alpha-diketones (i.e., diacetyl and 2,3-pentanedione) and dust. Bulk samples of whole bean green and roasted coffee, ground roasted coffee, and liquid flavorings were collected to evaluate the potential for emission of diacetyl and 2,3-pentanedione. We used continuous monitoring instruments to measure total volatile organic compounds, carbon monoxide, carbon dioxide, temperature, and relative humidity in specific areas and during tasks. We evaluated respiratory health and airborne exposures to alpha-diketones (diacetyl, 2,3-pentanedione, and 2,3-hexanedione), dust, other volatile organic compounds, carbon monoxide, and carbon dioxide during coffee roasting, grinding, flavoring, and packaging. Diacetyl and 2,3-pentanedione were detected in a majority of full-shift personal breathing zone air samples. During the November 2012 visit, the maximum concentration of diacetyl was 166.0 parts per billion in a personal sample from a packaging employee while the maximum 2,3-pentanedione concentration was 199.0 parts per billion from a personal sample collected on an employee in the flavoring room. In April 2017, personal samples from employees in the flavoring room gave maximum concentrations of 163.8 parts per billion diacetyl and 899.6 parts per billion 2,3-pentanedione. In November 2012, 58 of 59 full-shift personal samples exceeded the NIOSH recommended exposure limit for diacetyl of 5 parts per billion and 42 of 59 samples exceeded the NIOSH recommended exposure limit for 2,3-pentanedione of 9.3 parts per billion. In April 2017, 28 of 29 full-shift personal samples exceeded the NIOSH recommended exposure limits for diacetyl and 2,3-pentanedione. The production volume in April 2017 was approximately 70% higher than our first visit which likely contributed to the higher concentrations measured in some areas. During the medical survey, eye and nose symptoms were the most commonly reported symptoms; 1.6-fold excess of employees reported shortness of breath compared to the U.S. population with a similar demographic distribution, and 2.7 times as many employees as expected had spirometric obstruction than in the U.S. population. We recommend installing local exhaust and dilution ventilation and implementing administrative controls such as modification of work practices. Until engineering and administrative controls are in place, we recommend respiratory protection to reduce exposures to alpha-diketones. The choice of respirator should be guided by personal exposure sampling for diacetyl and 2,3-pentanedione and be made only by qualified personnel. We also recommended continuing the medical surveillance program.
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(2020) Exposures at a coffee roasting, flavoring, and packaging facility. (Click to open report) The Health Hazard Evaluation Program of the National Institute for Occupational Safety and Health received a request from management at a coffee roasting, flavoring, and packaging facility regarding concerns about potential health effects from exposure to diacetyl, 2,3-pentanedione, and other alpha-diketones during coffee roasting, grinding, and flavoring of coffee. In April 2019, we conducted an industrial hygiene survey at the facility. The industrial hygiene survey consisted of the collection... (Click to show more)The Health Hazard Evaluation Program of the National Institute for Occupational Safety and Health received a request from management at a coffee roasting, flavoring, and packaging facility regarding concerns about potential health effects from exposure to diacetyl, 2,3-pentanedione, and other alpha-diketones during coffee roasting, grinding, and flavoring of coffee. In April 2019, we conducted an industrial hygiene survey at the facility. The industrial hygiene survey consisted of the collection of air samples for the analysis of diacetyl, 2,3-pentanedione, and 2,3-hexanedione. We used continuous monitoring instruments to monitor total volatile organic compounds, carbon monoxide, and carbon dioxide in specific areas and during tasks. All full-shift personal samples collected during the industrial hygiene survey exceeded the recommended exposure limits of 5 parts per billion for diacetyl or 9.3 parts per billion for 2,3-pentanedione in 13 of 13 samples. Grinding roasted coffee beans, flavoring roasted beans, and packaging roasted coffee beans resulted in relatively higher air concentrations of diacetyl and 2,3-pentanedione than other tasks. We observed high instantaneous levels of diacetyl and 2,3-pentanedione during grinding of unflavored coffee. Continuous air sampling for carbon monoxide identified peak exposures during grinding of roasted coffee. Area carbon monoxide measurements were higher near the main grinder and in the roasted bean storage/off-gassing and staging area compared with other work areas. Carbon dioxide levels were below occupational exposure limits throughout the facility. We recommend implementing local exhaust ventilation on the grinders, and training employees about workplace hazards. We also recommend providing respiratory protection for diacetyl and 2,3-pentanedione to reduce exposures to alpha-diketones until engineering and administrative controls are in place.
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(2020) Silica exposures during dowel drilling. (Click to open report) Management from a dowel drilling company requested a NIOSH health hazard evaluation (HHE) concerning employee exposure to respirable crystalline silica during dowel drilling activities. Dowel drilling is one step in the process of repairing a road. The work on this HHE took place on a state road construction site. During our visit, we observed work processes and work practices, estimated the amount of water used to control dust, collected air samples for respirable crystalline silica and respira... (Click to show more)Management from a dowel drilling company requested a NIOSH health hazard evaluation (HHE) concerning employee exposure to respirable crystalline silica during dowel drilling activities. Dowel drilling is one step in the process of repairing a road. The work on this HHE took place on a state road construction site. During our visit, we observed work processes and work practices, estimated the amount of water used to control dust, collected air samples for respirable crystalline silica and respirable dust, and collected bulk samples of the slurry produced from drilling to determine its silica content. Our air sampling showed that the drill rig operation led to concentrations of respirable crystalline silica above relevant occupational exposure limits; however, the drill rig operator was wearing appropriate respiratory protection. Concentrations of respirable dust were below relevant occupational exposure limits for all samples. The slurry bulk samples contained 10%-13% quartz. The drill rig operator was required to wear a respirator, but there was no written respiratory protection program, medical clearance, or annual respiratory training. However, the respirator was put on and taken off correctly, cleaned after each shift, and stored appropriately. Other health and safety issues we identified during our evaluation included leaving the slurry and dust on the drill rig to dry overnight, high visibility vests not being used consistently, stepping into the live traffic lane while filling and covering patches, and not having enough vehicle spacing in between crews. We recommended developing a written respiratory protection program, sending drill rig operators for medical respirator clearance, and providing employees training about respirator use and maintenance. We also made recommendations to address other health and safety issues we identified during our evaluation.
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