Hospitals and
Community Emergency Response
What You Need to Know
Hospitals and Community
Emergency Response --
What You Need to Know
Emergency Response Safety Series
U.S. Department of Labor
Occupational Safety and Health Administration
OSHA 3152
1997
This informational booklet is intended to provide a generic, nonexhaustive
overview of a particular standards-related topic. This publication does not
itself alter or determine compliance responsibilities, which are set forth
in OSHA standards themselves and the Occupational Safety and Health Act.
Moreover, because interpretations and enforcement policy may change over
time, for additional guidance on OSHA compliance requirements, the reader
should consult current administrative interpretations and decisions by the
Occupational Safety and Health Review Commission and the courts.
Material contained in this
publication is in the public domain and may be reproduced, fully or partially,
without permission of the Federal Government. Source credit is requested
but not required.
This information will be made available to sensory impaired individuals
upon request.
Voice phone: (202) 219-8615; Telecommunications Device for the Deaf
(TDD) message referral phone: l-800-326-2577.
Introduction
Hospitals and Community
Emergency Response
What You Need to Know
Emergency Response Safety Series
U.S. Department of Labor
Alexis M. Herman, Secretary
Occupational Safety and Health Administration
Gregory R. Watchman, Acting Assistant Secretary
OSHA 3152
1997
Contents
Introduction
Relevant Legal Requirements
Preplanning
Elements of a Hospital Emergency Response Plan
Training Employees
Performing Emergency Drills
Documenting Training
Defining Personnel Roles
Responding to Emergencies
Selecting PPE
Selecting Respirators
Decontaminating Patients
Preparing to Receive Victims
Avoiding Cross-Contamination
Related Standards
OSHA Publications
Additional Resources
References
States with Approved Plans
OSHA Consultation Project Directory
OSHA Area Offices
OSHA Regional
Offices
Introduction
Protecting health care workers who respond to emergencies involving
hazardous substances is critical. Health care workers dealing with
emergencies may be exposed to chemical, biological, physical or radioactive
hazards. Hospitals providing emergency response services must be prepared
to carry out their missions without jeopardizing the safety and health of
their own workers. Of special concern are the situations where contaminated
patients arrive at the hospital for triage or definitive treatment
following a major incident.
In many localities, the hospital
has not been firmly integrated into the community disaster response system
and may not be prepared to safely treat multiple casualties resulting from
an incident involving hazardous substances. Increasing awareness of the
need to protect health care workers and understanding the principal
considerations in emergency response planning will help reduce the risk of
health care worker exposure to hazardous substances.
Relevant Legal Requirements
Both OSHA and EPA have regulations to help protect workers dealing with
hazardous waste and emergency operations. For example, Title III of the
Superfund Amendments and Reauthorization Act of 1986 (SARA) requires each
state to establish a State Emergencv Response Commission (SERC) that
designates and coordinates the activities of Local Emergency Planning
Committees (LEPC). The LEPCs must develop a community emergency response
plan (contingency plan) that contains emergency response methods and
procedures to be followed by facility owners, police, hospitals, local
emergency responders, and emergency medical personnel. The Environmental
Protection Agency (EPA) generates these requirements and ensures that
states implement emergency response planning programs.
In planning for emergencies,
LEPCs must designate a local hospital that has agreed to accept and treat
victims of emergency incidents. The designated local hospital, which should
have a representative participate in the LEPC or SERC, becomes part of the
community emergency response organization.
SARA also directed the
Occupational Safety and Health Administration (OSHA) to establish a
comprehensive rule to protect employee health and safety during hazardous
waste operations, including emergency responses to the release of hazardous
substances. Accordingly, OSHA published the Hazardous Waste Operations
and Emergency Response (HAZWOPER) Standard, Title 29, Code of
Federal Regulations (CFR) 1910.120, which became effective in 1990.
HAZWOPER requires employers, including hospitals, to plan for
emergencies if they expect to use their employees to handle an emergency
involving hazardous substances. A hospital designated by an LEPC to handle
hazardous substances emergency victims must have an Emergency Response Plan
(ERP), decontamination equipment, personnel protective equipment (PPE), and
trained personnel. The emergency response section of HAZWOPER (29 CFR
1910.120(q)) outlines required ERP elements which allow emergency responders
to use the local community emergency response plan or the state emergency
response plan or both as part of the hospital's emergency response plan. This
plan must meet Joint Commission on Accreditation of Healthcare
Organizations (JCAHO) guidelines.
To learn more about HAZWOPER or other OSHA standards, contact your
Area or Regional OSHA office listed elsewhere in this publication.
Preplanning
Ideally, employers within the community will have coordinated emergency
response planning with the hospital prior to any emergency event. However,
the hospital may need to treat contaminated victims of emergency incidents
without the benefit of pre-emergency planning. Both scenarios need to be
addressed in the hospital's Emergency Response Plan, along with plans for
responding to a hazardous substance incident that occurs in the hospital
itself.
The hospital should prepare an
Emergency Response Plan even if community coordination has not been
initiated or completed. The hospital's Emergency Response Plan must be
prepared in writing and established prior to an actual emergency. All
employees and affiliated personnel expected to be involved in an emergency
response including physicians and nurses, as well as maintenance workers
and other ancillary staff should be familiar with the details of the plan.
________________________________________________
Elements of a
Hospital Emergency Response Plan
This Emergency Response Plan is
intended for hospitals involved in a community response to a hazardous
substance incident. The plan should address the following elements:
- pre-emergency
drills implementing the hospital's emergency response plan;
·
practice sessions using the
Incident Command System (ICS) with other
local emergency response organizations;
·
lines of authority and
communication between the incident site and hospital personnel regarding
hazards and potential contamination;
·
designation of a decontamination
team, including emergency department physicians, nurses, aides and support
personnel;
·
description of the hospital's
system for immediately accessing information on toxic materials;
·
designation of alternative
facilities that could provide treatment in case of contamination of the
hospital's Emergency Department;
·
plan for managing emergency
treatment of non-contaminated patients;
·
decontamination procedures and
designation of decontamination areas (either indoors or outdoors);
·
hospital staff use of PPE based
on routes of exposure, degree of contact, and each individual's specific
tasks;
·
prevention of
cross-contamination of airborne substances via the hospital's ventilation
system;
·
air monitoring to ensure that
the facility is safe for occupancy following treatment of contaminated
patients; and
·
post-emergency critique of the
hospital's emergency response.
When a hospital has been
designated by the LEPC, it must prepare to fullfill its role in community
emergency response. This is accomplished by engaging in emergency response
planning activities that involve all segments of the community (i.e.,
employers, other emergency response organizations, local government, and
the emergency medical community). With this in mind, the hospital should
consider the following:
- The
hospital must define its role in community emergency response by
pre-planning and coordinating with other local emergency response
organizations, such as the fire department. In particular, the
hospital must be familiar with the ICS used by other local
organizations during emergencies and should participate in training
and practice sessions using the ICS.
·
All hospital personnel who are
expected to respond in emergencies where hazardous substances are released
must be trained in handling contaminated patients and objects including
body fluids.
·
Training must be based on the
duties and responsibilities of each employee.
·
Hospitals should have a
contingence plan for managing other patients in the emergency response
system when contaminated patients are being treated.
·
There should be communication
between other members of the ICS, the incident site, and the hospital
personnel regarding the hazards associated with potential contaminants.
·
Hospitals should have access to
a database that is compiled by the LEPC to provide immediate information to
hospital staff on the hazards associated with exposure to toxic materials
that may be used by local employers.
____________________
Training Employees
HAZWOPER requires varying levels
of training for personnel involved in hazardous material releases or
clean-up. HAZWOPER is a performance-based regulation allowing individual
employers flexibility in meeting the requirements of the regulation in the
most cost-effective manner. It is not OSHA's intent that every member of a
community's emergency response services receive high levels of specialized
hazardous materials training. The community may determine that it is
appropriate for the fire department to develop a small group of highly
trained hazardous materials technicians and specialists, called a
"HAZMAT team," or may find that the community does not require a
HAZMAT team and that less intensive training is adequate. Likewise, all
emergency medical technicians (EMTs) (e.g., ambulance corps members) do not
need to be trained to treat contaminated victims.
To determine the appropriate
level and type of training under HAZWOPER, community response agencies will
need to consider the hazards in their community, and determine what
capabilities will be required to respond effectively to those hazards. This
determination is to be based on worst-case scenarios. All individuals must
be adequately trained to perform their anticipated job duties without
endangering themselves or others.
Medical personnel who will
decontaminate victims must be trained to the First Responder Operations
Level(1) with emphasis on the use of PPE
and decontamination procedures. (Refer to 29 CFR 1910.120(q)(6)). The
employer must certify that personnel are trained to safely perform their
job duties and responsibilities. This includes a minimum of 8 hours of
training or demonstrated competencies and an annual refresher. Hospitals
may develop an in-house training course on decontamination and PPE use and
measures to prevent the spread of contamination to other portions of the
hospital, or provide additional training in decontamination and PPE use
after sending personnel to a standard First Responder Operations Level
course.
EMS personnel are often the
first on the scene and should be given First Responder Awareness Level(2) training as a minimum. There is no specific hourly minimum
required but the training must be sufficient or the employees must have
proven experience in specific competencies with an annual refresher. EMS
personnel who have received only Awareness Level training should not be involved
in the transport or treatment of contaminated patients. EMS personnel who
might be exposed to hazardous substances because they are expected to
transport or treat contaminated patients at the release area should be
trained to the First Responder Operations Level.
Individuals who develop the
decontamination procedures and select PPE for the workers who help
decontaminate patients, must be trained to the First Responder Operations
Level with additional training in decontamination procedures, but such individuals
would not need the lengthy specialized training required for a hazardous
materials technician.
Every member of the emergency
room clinical staff, plus any employee who might be exposed to hazardous
substances during an emergency response incident, should (1) be familiar
with how the hospital intends to respond to hazardous substance incidents,
(2) be trained in the appropriate use of PPE, and (3) be required to
participate in scheduled drills. Such a pre-designated decontamination team
might consist of emergency physicians, emergency department nurses and
aides, and other support personnel such as respiratory therapists,
security, and maintenance personnel.
Under life-threatening emergency
situations, other hospital personnel may need to enter the decontamination
area to monitor and treat the victim. These employees may be considered Skilled
Support Personnel.(3)
All hospital employees,
including ancillary personnel such as housekeeping and laundry staff, must
be adequately trained to perfom their assigned job duties in a safe and
healthful manner. If ancillary personnel will be expected to clean up the
decontamination area they must be trained in accordance with 29 CFR
1910.120(q)(11), and have access to Material Data Safety Sheets (MSDSs),
for those chemicals that may be used to decontaminate equipment and area. Coordination
with community resources for clean-up assistance is included in the
contingency plan.
____________________________
Performing
Emergency Drills:
Emergency response drills are
considered part of "Pre-emergency planning" and can be used to
evaluate HAZWOPER compliance. Drills are required under SARA Title III as
part of the local contingency plan, and under 29 CFR 1910.120 for hazardous
waste sites. Emergency medical responders should be involved in drills
through the LEPC.
JCAHO requires accredited
hospitals to implement their response plan, twice a year, either to reply
to an actual emergency or in a planned drill [1]. These drills may be
combined to fulfill dual requirements.
_______________________
Documenting
Training
Employees need not necessarily
receive a certificate, but the employer must certify training with some
form of documentation. It is considered good practice to provide employees
with a training certificate as well as to document the training in the
employer's records. The hospital also must document its training plan for
personnel who respond to hazardous substance incidents and contaminated victims
in its ERP.
_________________________
Defining Personnel
Roles
Personnel roles and
responsibilities, including who will be in charge of directing the
response, training, and communications must be included in the hospital's
overall ERP. The ERP should also have an evacuation plan and identify
alternative facilities that could provide treatment in the event that
patients would need to be rerouted due to contamination of the Emergency
Department. The plan should identify PPE including type, quantity,
location, and use, and specific decontamination procedures, materials, and
equipment.
It should also cover plans for
critique and follow-up of drills and actual emergencies.
Responding to
Emergencies
Once an emergency actually
occurs, the benefits of pre-planning will be immediately apparent,
especially in identifying the hazardous substances involved. Pre-planning
with the LEPC identifies known chemical hazards in the community; this
includes information gathered from MSDSs. First Responder Awareness Level
and Hazard Communication training enables responders to determine the
presence or release of a hazardous substance. Data from those at the scene
of the incident may identify or help identify hazards. Resources including
printed reference materials, computer databases, and telephone hotlines are
available to help identify hazards not immediately recognized. (DOT
requires a 24-hour a day telephone number to be available from the chemical
producer or shipper to assist the emergency response community in getting
accurate information on chemical hazards.)
________________
Selecting PPE
Personnel who will be involved in decontamination must be equipped
with PPE that is appropriate for the hazardous substances expected to be
encountered.
- Reference
guidebooks, database networks, MSDS's, and telephone hotlines may also
be useful in determining suitable PPE.
·
Communication with those at the
scene of the incident will be helpful in identifying the type of PPE that
will be required to prevent secondary contamination of the hospital
personnel.
Factors to be considered in the
selection of PPE include toxicity routes of exposure, degree of contact,
and the specific task assigned to the user [2]. The primary routes of
exposure are inhalation, ingestion, and direct contact.
Types of PPE range from gloves
to chemical protective clothing to a self-contained breathing apparatus
(SCBA) when the highest level of respiratory protection is required [2]. The
proper use of PPE requires considerable training by a competent person,
such as an industrial hygienist, and is required under OSHA's standard on
personal protective equipment, 29 CFR 1910.132. Wearing PPE without proper
training can be extremely dangerous and potentially fatal. Persons should
not be assigned to tasks requiring the use of respirators unless it has
been deterimed that they are physically able to perform the work and use
the equipment. The local physician shall determine what health and physical
conditions are pertinent.
_______________________
Selecting Respirators
To determine which respirator is
needed, hospitals can consult OSHA's respiratory protection standard, 29
CFR 1910.134.
The standard includes
requirements covering training in the use of respiratory protective
equipment and development of a written respiratory protection program that
addresses fit testing of respirators and inspection and maintenance
procedures.
__________________________
Decontaminating
Patients
Ideally, when medically
appropriate, patients should be decontaminated before reaching the
hospital, preferably at the incident site. However, complete on-site
decontamination of victims may not be possible due to the medical
conditions of the employees, training and skills of emergency responders,
weather conditions, and equipment availability. Therefore, the hospital
should have designated decontamination areas.
Although areas dedicated solely
to decontamination need not be set aside, hospitals need to take
appropriate precautions to prevent the spread of contamination to other areas
within the hospital. Decontamination should be performed in areas of the
facility that will minimize any exposures to uncontaminated employees,
other patients, or equipment. Morgues are often used as decontamination
rooms because of the preexisting drainage and ventilation system. Morgues
often have ventilation isolation to prevent mixing of airflow with other
area systems.
An alternative to an indoor
decontaminiation area would be an outside or portable decontamination
facility. This might include wading pools or outdoors showers, along with
bags for disposal of contaminted clothes.
Preparing to Receive Victims
Once word reaches the hospital of a hazardous substance incident, all
hospital personnel engaged in the response should be notified of the nature
of the emergency and the type of chemical contamination expected. Then the
hospital should outfit all necessary personnel with appropriate PPE.
All persons along the route from
the emergency entrance to the decontamination area need to be relocated. This
area may need to be protected by plastic or paper sheeting [3], and the
area outside the emergency department entrance set up to direct the flow of
contaminated patients to the decontamination area.
____________________________
Avoiding
Cross-Contamination
Airborne contaminants may be
transported via the hospital's ventilation system. Therefore, ventilation
in the decontamination area should be separate from the rest of the
hospital. Morgues, with an isolated ventilation system, are often used as
decontamination rooms.
If a contaminated victim is
emitting airborne contaminants, the ventilation system in the
decontamination area should be turned off. However, not all chemicals will
be volatile enough to cause off-gassing. Because Emergency Department
personnel could be at risk if the ventilation system is shut off during
decontamination in an enclosed area, ambient air should be monitored using
appropriate direct-reading instruments, and the plan should provide means
of supplementary or auxiliary ventilation. Prior to restarting the
ventilation system, air monitoring with appropriate direct-reading
instruments is advised to assure the atmosphere is safe for circulation. The
use of direct reading instruments to evaluate air quality must be made by
an individual who has been properly trained in the use of the instruments.
Related Standards
For further information on applicable standards refer to:
29 CFR 1910.120 - Hazardous Waste Operations and Emergency
Response
29 CFR 1910.1030 - Bloodborne Pathogens
29 CFR 1910.1200 - Hazard Communication (Appendix A- Health
Hazard definition; Appendix B-Hazard Determination; Appendix C-Information
Sources)
29 CFR 1910.38 - Employee Emergency Plans and Fire Prevention
Plans
29 CFR 1910.132 - Personal Protective Equipment
29 CFR 1910.134 - Respiratory
Protection
OSHA
Publications
The following is a partial listing of OSHA publications.
To obtain a free copy, mail or fax your request to:
OSHA Publications Office
P.O. Box 3735
Washington, DC 20013-7535
Phone (202)219-4667, Fax (202)219-9266
(Available on the World Wide Web at http:// www.OSHA.gov/
3077 - Personal Protective Equipment
3079 - Respiratory Protection
3084 - Chemical Hazard Communication
3088 - How to Prepare for Workplace Emergencies
3114- Hazardous Waste and Emergency Response
3130 - Occupational Exposure to Bloodborne Pathogens:
Precautions for Emergency Responders
Additional documents may purchased from the Government Printing
Office by mailing your request and payment (check, Visa, or Mastercard) to:
Superintendent of Documents
U.S. Government Printing Office
Washington, DC 20402
Phone (202)783-3238, Fax (202)512-2250
(Available on the World Wide Web at http://www.gpo.gov/su_docs)
3104 - Hazard Communication-A Compliance Kit, Order
#929-016-00147-6, $18.00.
3111 - Hazard Communication Guidelines for Compliance,
Order #029-016-00127-1, $1.00.
3122 - Principal Emergency Response and Preparedness
Requirements in OSHA Standards and Guidance for Safety and Health Programs,
Order #029-016-00136-1, $2.50.
Framework for a Comprehensive Health and Safety
Program in the Hospital Environment, Order
#029-016-00149-2, $3.50.
Additional Resources
Emergency Planning and Community Right to Know (EPCRA) Hotline:
Phone 1-800-535-0202 Fax (703)412-3333
Joint Commission on Accreditation of Healthcare Organizations,
JCAHOStandards Division Phone (708) 916-5600 (Available on the World Wide
Web at http://www.jcaho.org)
References
1. Joint Commission on
Accreditation of Healthcare Organizations. "Emergency Services
Chapter" and "Plant, Technology, and Safety Management
Chapter." The 1993 Joint Commission Accreditation Manual for
Hospitals, Vol. 1 Standards. Oakbrook Terrace, Illinois, 1993.
2. U.S. Department of Health and
Human Services. Public Health Service, Agency for Toxic Substances and
Disease Registry. Emergency Medical Services: A Planning Guide for the
Management of Contaminated Patients. Atlanta, Georgia: 1990,78 pp.
3. U.S. Department of Health and
Human Services. Public Health Service, Agency for Toxic Substances and
Disease Registry. Managing Hazardous Materials Incidents, Volume II. Hospital
Emergency Departments: A Planning Guide for the Management of Contaminated
Patients. Atlanta, Georgia: 1990,76 pp.
4. Public Law No. 99-499, "The
Superfund Amendments and Reauthorization Act of 1986," Title III.
5. State of California Emergency
Medical Services Authority. Hazardous Materials Medical Management
Protocols. Sacramento, California, 1991.
6. "CDC Recommendations for
Civilian Communities Near Chemical Weapons Depots: Guidelines for Medical
Preparedness," Federal Register 60 (123): 3308-June 27, 1995.
Documents #1 and #5 are available from:
Emergency Response and Consultation Branch (E57)
Division of Health Assessment and Consultation
Agency for Toxic Substances and Disease Registry
1600 Clifton Road, N.E.
Atlanta, Georgia 30333
(404) 639-6360
(Document #l is available on the World Wide Web at
http://atsdr1.cdc.gov.8080/atsdrhome.html)
Document #2 is available from:
Commission on Accreditation of Healthcare Organizations JCAHO
Standards Division
One Renaissance Blvd.
Oakbrook Terrace, IL 60181
(708) 916-5600
Document #4 is available from:
California Emergency Services Authority
1030 15th Street, Suite 302
Sacramento, CA 95814
(916) 322-2300
Document #6 is available on the World Wide Web at
http:\\www.access.gpo.govsu_docs
States with Approved Plans
Commissioner
Alaska Department of Labor
1111 West 8th Street
Room 306
Juneau, AK 99801
(907) 465-2700
Director
Industrial Commission of Arizona
800 W. Washington
Phoenix, AZ 85007
(602) 542-5795
Director
California Department of Industrial Relations
45 Fremont Street
San Francisco, CA 94105
(415) 972-8835
Commissioner
Connecticut Department of Labor
200 Folly Brook Boulevard
Wethersfield, CT 06109
(203) 566-5123
Director
Hawaii Department of Labor and Industrial Relations
830 Punchbowl Street
Honolulu, HI 96813
(808) 586-8844
Commissioner
Indiana Department of Labor
State Office Building
402 West Washington Street
Room W195
Indianapolis, IN 46204
(317) 232-2378
Commissioner
Iowa Division of Labor Services
1000 E. Grand Avenue
Des Moines, IA 50319
(515) 281-3447
Secretary
Kentucky Labor Cabinet
1047 U.S. Highway, 127 South,
Suite 2
Frankfort, KY 40601
(502) 564-3070
Commissioner
Maryland Division of Labor and Industry
Department of Labor Licensing and Regulation
501 St. Paul Place, 2nd Floor
Baltimore, MD 21202-2272
(410) 333-4179
Director
Michigan Department of Consumer and Industry Services
4th Floor, Law Building
P.O. Box 30004
Lansing, MI 48909
(517) 373-7230
Commissioner
Minnesota Department of Labor and Industry
443 Lafayette Road
St. Paul, MN 55155
(612) 296-2342
Director
Nevada Division of Industrial Relations
400 West King Street
Carson City, NV 89710
(702) 687-3032
Secretary
New Mexico Environment Department
1190 St. Francis Drive
P.O. Box 26110
Santa Fe, NM 87502
(505) 827-2850
Commissioner
New York Department of Labor
W. Averell Harriman State Office Building - 12
Room 500
Albany, NY 12240
(518) 457-2741
Commissioner
North Carolina Department of Labor
319 Chapanoke Road
Raleigh, NC 27603
(919) 662-4585
Administrator
Department of Consumer and Business Services
Occupational Safety and Health Division (OR-OSHA)
Labor and Industries Building
Room 430
Salem, OR 97310
(503) 378-3272
Secretary
Puerto Rico Department of Labor and Human Resources
Prudencio Rivera Martinez
Building
505 Munoz Rivera Avenue
Hato Rey, PR 00918
(809) 754-2119
Commissioner
South Carolina Department of Labor, Licensing and Regulation
3600 Forest Drive
P.O. Box 11329
Columbia, SC 29211-1329
(803) 734-9594
Commissioner
Tennessee Department of Labor
Attention: Robert Taylor
710 James Robertson Parkway
Nashville, TN 37243-0659
(615) 741-2582
Commissioner
Industrial Commission of Utah
160 East 300 South, 3rd Floor
P.0. Box 146600
Salt Lake City, UT 84114-6600
(801) 530-6898
Commissioner
Vermont Department of Labor and Industry
National Life Building - Drawer 20
120 State Street
Montpelier, VT 05620
(802) 828-2288
Commissioner
Virgin Islands Department of Labor
2131 Hospital Street
P.O. Box 890
Christiansted,St. Croix, VI 00820-4666
(809) 773-1994
Commissioner
Virginia Department of Labor and Industry
Powers-Taylor Building
13 South 13th Street
Richmond, VA 23219
(804) 786-2377
Director
Washington Department of Labor and Industries
General Administration Building
P.O. Box 44001
Olympia, WA 98504-4001
(360) 902-4200
Administrator
Workers' Safety and Compensation Division (WSC)
Wyoming Department of Employment
Herschler Building
2nd Floor East
122 West 25th Street
Cheyenne, WY 82002
(307) 777-7786
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(360) 902-5638
|
West
Virginia
|
(304) 558-7890
|
Wisconsin
|
(608) 266-8579 (H)
(414) 521-5063 (S)
|
Wyoming
|
(307) 777-7700
|
|
|
(H) Health
(S) Safety
OSHA Area Offices
Area
|
Telephone
|
Albany,
NY
|
(518) 464-6742
|
Albuquerque,
NM
|
(505) 248-5302
|
Allentown,
PA
|
(215) 776-0592
|
Anchorage,
AK
|
(907) 271-5152
|
Appleton,
WI
|
(414) 734-4521
|
Austin,
TX
|
(512) 916-5783
|
Avenel,
NJ
|
(908) 750-3270
|
Baltimore,
MD
|
(410) 962-2840
|
Bangor,
ME
|
(207) 941-8177
|
Baton
Rouge, LA
|
(504) 389-0474
|
Bayside,
NY
|
(718) 279-9060
|
Bellevue,
WA
|
(206) 553-7520
|
Billings,
MT
|
(406) 247-7494
|
Birmingham,
AL
|
(205) 731-1534
|
Bismarck,
ND
|
(701) 250-4521
|
Boise,
ID
|
(208) 334-1867
|
Bowmansville,
NY
|
(716) 684-3891
|
Braintree,
MA
|
(617) 565-6924
|
Bridgeport,
CT
|
(203) 579-5581
|
Calumet
City, IL
|
(708) 891-3800
|
Carson
City, NV
|
(702) 885-6963
|
Charleston,
WV
|
(304) 347-5937
|
Cincinnati,
OH
|
(513) 841-4132
|
Cleveland,
OH
|
(216) 522-3818
|
Columbia,
SC
|
(803) 765-5904
|
Columbus,
OH
|
(614) 469-5582
|
Concord,
NH
|
(603) 225-1629
|
Corpus
Christi, TX
|
(512) 888-3420
|
Dallas,
TX
|
(214) 320-2400
|
Denver, CO
|
(303) 844-5285
|
Des
Plaines, IL
|
(847) 803-4800
|
Des Moines,
IA
|
(515) 284-4794
|
Englewood,
CO
|
(303) 843-4500
|
Erie,
PA
|
(814) 833-5758
|
Fort
Lauderdale, FL
|
(305) 424-0242
|
Fort
Worth, TX
|
(817) 581-7303
|
Frankfort,
KY
|
(502) 227-7024
|
Harrisburg,
PA
|
(717) 782-3902
|
Hartford,
CT
|
(203) 240-3152
|
Hasbrouck
Heights, NJ
|
(201) 288-1700
|
Guaynabo,
PR
|
(787) 277-1560
|
Honolulu,
HI
|
(808) 541-2685
|
Houston,
TX (South)
|
(713) 286-0583
|
Houston,
TX (North)
|
(713) 591-2438
|
Indianapolis,
IN
|
(317) 226-7290
|
Jackson,
MS
|
(601) 965-4606
|
Jacksonville,
FL
|
(904) 232-2895
|
Kansas
City, MO
|
(816) 483-9531
|
Lansing,
MI
|
(517) 377-1892
|
Little
Rock, AR
|
(501) 324-6291
|
Lubbock,
TX
|
(806) 743-7681
|
Madison,
WI
|
(608) 264-5388
|
Marlton,
NJ
|
(609) 757-5181
|
Methuen, MA
|
(617) 565-8110
|
Milwaukee, WI
|
(414) 297-3315
|
Minneapolis, MN
|
(334) 664-5460
|
Mobile, AL
|
(334) 441-6131
|
Nashville,
TN
|
(615) 781-5423
|
New
York, NY
|
(212) 466-2482
|
Norfolk, VA
|
(804) 441-3820
|
North Aurora, IL
|
(630) 896-8700
|
Oklahoma
City, OK
|
(405) 231-5351
|
Omaha, NE
|
(402) 221-3182
|
Parsippany, NJ
|
(201) 263-1003
|
Peoria,
IL
|
(309) 671-7033
|
Philadelphia,
PA
|
(215) 597-4955
|
Phoenix,
AZ
|
(602) 640-2007
|
Pittsburgh,
PA
|
(412) 644-2903
|
Portland, OR
|
(503) 326-2251
|
Providence,
RI
|
(401) 528-4669
|
Raleigh,
NC
|
(919) 856-4770
|
Salt
Lake City, UT
|
(801) 524-5080
|
San Francisco, CA
|
(415) 744-7120
|
Savanna, GA
|
(912) 652-4393
|
Smyrna, GA
|
(404) 984-8700
|
Springfield,
MA
|
(413) 785-0123
|
St.
Louis, MO
|
(314) 425-4249
|
Syracuse,
NY
|
(315) 451-0808
|
Tampa,
FL
|
(813) 626-1177
|
Tarrytown,
NY
|
(914) 524-7510
|
Toledo, OH
|
(419) 259-7542
|
Tucker, GA
|
(770) 493-6644
|
Westbury,
NY
|
(516) 334-3344
|
Wichita,
KS
|
(316) 269-6644
|
Wilkes-Barre,
PA
|
(717) 826-6538
|
Wilmington,
DE
|
(302) 573-6115
|
OSHA Regional
Offices
Region I
(CT,* MA, ME, NH, RI, VT*
JFK Federal Building
Room E-340
Boston, MA 02203
Telephone: (617) 565-9860
Region II
(NJ, NY,* PR,* VI*
201 Varick Street
Room 670
New York, NY 10014
Telephone: (212) 337-2378
Region III
(DC, DE, MD,* PA, VA,* WV)
Gateway Building, Suite 2100
3535 Market Street
Philadelphia, PA 19104
Telephone: (215) 596-1201
Region IV
(AL, FL, GA, KY,* MS, NC, SC,* TN*)
Atlanta Federal Center
61 Forsyth Street, S.W., Room 6T50
Atlanta, GA 30303
Telephone: (404) 562-2300
Region V
(IL, IN,* MI,* MN,* OH, WI)
230 South Dearborn Street
Room 3244
Chicago, IL 60604
Telephone: (312) 353-2220
Region VI
(AR, LA, NM,* OK, TX)
525 Griffin Street
Room 602
Dallas, TX 75202
Telephone: (214) 767-4731
Region VII
(IA,* KS, MO, NE)
City Center Square
1100 Main Street Suite 800
Kansas City, MO 64105
Telephone: (816) 426-5861
Region VIII
(CO, MT, ND, SD, UT,* WY*)
1999 Broadway Suite 1690
Denver, CO 80202-5716
Telephone: (303) 844-1600
Region IX
(American Samoa, AZ,* CA,* Guam,
HI,* NV,* Trust Territories of the Pacific)
71 Stevenson Street
Room 420
San Francisco, CA 94105
Telephone: (415) 975-4310
Region X
(AK,* ID, OR,* WA*)
1111 Third Avenue
Suite 715
Seattle, WA 98101-3212
Telephone: (206) 553-5930
Footnote* These
states and territories operate their own OSHA-approved job safety and
health programs (Connecticut and New York plans cover public employees
only). States with approved programs must have a standard that is identical
to, or at least as effective as, the federal standard. (Back to text)
Footnote**ICS is
an organized approach to effectively control and manage operations at an
emergency incident. (Back to text)
Footnote(l)
Operations level training, enables employees to respond initially to a
hazardous substance release and to take defensive action to protect people,
property, and the environment. (Back to text)
Footnote(2)
Awareness level training enables employees to recognize an emergency event
and to begin responding. (Back to text)
Footnote(3) Skilled
Support Personnel must be given an initial briefing, at the time of the
incident, including instruction in the wearing of appropriate personal
protective equipment, what hazards are involved, and what duties are to be
performed.(Back to text)
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