The insurance premiums paid by a firm under the Workers' Compensation system are generally not experience rated; that is, they do not reflect the individual firm's job safety and health record. (3) Is the term "building-related illness" sufficiently descriptive and inclusive of the medical conditions that can arise from poor indoor air quality? Mean Nicotine Levels in Home and, Leaderer and Hammond 1991, homes, NY State, 9-hour average workshift (nonsmoker's air; smoking allowed on premises). For investigating some of the concerns associated with the use of cotinine as a biomarker, however, a physiologically based pharmacokinetic (PBPK) description would be preferred. As noted earlier, the Agency believes that development of written compliance plans are essential to implementation of a successful IAQ program. Why? 4-8]. Mycotoxins (toxins produced as secondary metabolites by many fungi) are among the most carcinogenic of known substances, and are also acutely toxic. Section 1928.21 is proposed to be amended by adding a new paragraph (a)(6) as follows: 1928.21 Applicable standards in 29 CFR Part 1910. When they exceed 800 ppm, check to make sure the HVAC system is operating as it should and correct deficiencies if necessary, (d)(6) [Exs. They also showed that sidestream smoke produced positive results in the Chinese hamster ovary cells chromosomal aberration assay and in the Chinese hamster ovary cell sister-chromatid exchange assay both with and without metabolic activation. Conclusion Cardiovascular effects resulting from exposure to ETS have been associated with carbon monoxide (CO), nicotine, and more recently with polycyclic aromatic hydrocarbons (PAHs) [Ex. Although the presiding officer is an Administrative Law Judge and questioning by interested persons is allowed on crucial issues, the proceeding is informal and legislative in type. 942; National Foundation of Arts and Humanities Act, 20 U.S.C. Exposure The Nuss procedure is painful for the first few days after the surgery. The study focused on time spent in activities such as cooking or playing sports, but more specifically targeted activities and environments that had implications for air pollution exposure, such as the presence of smokers, use of cooking equipment or solvents. [Ex. Susceptibility is influenced by host factors, such as age and immune system status. 3-446, 3-500]. If not, why not? Finally, proposed provisions in this notice address the establishment, retention, availability, and transfer of records such as inspection and maintenance records, records of written compliance programs, and employee complaints of building-related illness. OSHA estimated that 50 percent of large establishments with floor space greater than 100,000 square feet and with more than three floors will provide designated smoking areas. The formation of DNA adducts is widely accepted as an initial step in the carcinogenesis process. Research has shown that passive exposure to tobacco smoke damages endothelial cells and increases the number of circulating anuclear carcasses of endothelial cells [Ex. This is important since many nonsmoking women continue to work throughout their pregnancies. OSHA welcomes such supportive comments, including any pertinent data and cost information which may be available, in order that the record of this rulemaking will present a balanced picture of the public response on the issues involved. This extensive amount of data increases confidence that the associations seen between ETS exposure and the development of lung cancer is externally consistent and is not due to artifacts or a product of some unidentified, indirect factors unlikely to be common to all of the studies. Some of the published categories, in addition to the terms sick or well are: problem buildings and non-problem buildings, healthy buildings; buildings with high and low rates of IAQ related complaints; sick building syndrome (SBS). The importance of these spirometry criteria is emphasized by the fact that the FEV(1) may result in being 100 to 200 ml lower than when a maximal effort is given by the subject. Despite this general awareness, exposure to ETS is pervasive [Ex. No quantitative estimates are available on the effects of indoor air on equipment. 3-689D, 4-129, 4-239]. - The results of epidemiological studies taken in the aggregate suggest that nonsmoker exposure to ETS is causally-related to the development of lung cancer. 4-311]. Nonsmokers reported more eye irritation than smokers did. As indicated in Table III-8, 51% of male and 38% of female nonsmokers reported ETS exposure at work. This definition also intends to focus on those HVAC system components whose failure, degradation, or misuse would adversely impact indoor air quality. Why? VI. ASHRAE Standard 62-1989. Footnote(10) The number of maintenance workers is based on BLS's Occupational Employment Statistics survey of 1992 and includes all maintenance workers who perform work involving two or more maintenance skills to keep machines, mechanical equipment, or structure of an establishment in repair. Scope and Application: Paragraph (a) The mainstream and the sidestream smoke were equally effective in inducing the AHH activity. This section also examines the technological feasibility of complying with proposed regulation. In order to pursue litigation successfully, there must be specific knowledge of the magnitude and duration of a worker's exposure to a hazardous substance, as well as the causal link between the disease and the occupational exposure. 4-113]. These effects are associated with exposure to carbon dioxide [Ex. 3-6, 3-14, 3-38, 3-188, 3-440A, 3-500], radon [Exs. 4-270] found a 3-fold variation in reported half-lives for cotinine. Transformation of mammalian cells was induced in several cell systems using the cigarette smoke condensate from mainstream cigarette smoke [Exs. Kauffmann et al. Nicotine has been shown to bind with plasma proteins which may interfere with elimination and thereby prolong retention in the body. To date, no careful pharmacokinetic investigation of this possibility has been performed in the human model, and adequate nicotine-specific tissue binding information does not appear to have been collected except perhaps in the brain. Condensates from both mainstream [Exs. The Agency solicits data, views, and comments on all provisions proposed in this notice. Initial costs are annualized over 20 years at a 10 percent interest rate. 4-25]. 4-310]. Even when not fatal, it is usually very severe, requiring substantial treatment or hospitalization. The mean RSP value in the presence of nicotine was 44.1 +/- 30 ug/m(3). (b) Human Activity Pattern Studies Used to Assess Workplace Exposure. These mechanisms of cardiac stress and potential injury to the heart are in agreement with accepted theories of cardiac injury. This rat model has also been scaled for use in predicting mouse and human pharmacokinetics [Ex. (7) Since the "Test Statistic," 2, is greater the 0.974 found in the table for 3 samples, the indoor air levels of carbon dioxide are significantly more than the outdoor air levels. The polyamines contained in tobacco smoke, spermidine, spermine, and their diamine precursor, putrescine, are believed to have an essential role in cellular proliferation and differentiation. The proposed IAQ standard will affect numerous small establishments and a portion of these establishments may have difficulty financing the compliance actions needed to comply depending on which alternative they choose. Insect infestation of the building was evident. As presented in Table VI-9, the one time annualized cost of compiling and developing the written IAQ compliance program is $21.2 million. Cost Savings It has been suggested that there is a longer clearance half-life for nicotine, and therefore cotinine, associated with low circulating concentrations, and that this longer half-life is due to the slower release of nicotine bound to tissues [Exs. What methods are available to detect indoor air contaminants? The centralization of services and the expanding economy have led to concentration of office space in the cities. This in OSHA's view reduces significant risk to only a small percentage of the current risk. Where this is the case, labor market negotiations are unlikely to reflect accurately the value that workers place on health. OSHA has no data on the number of establishments currently permitting smoking in designated smoking areas. Description of Pharmacokinetic Models for Nicotine Warehouses and assembly buildings both are almost as numerous as office buildings, but account for less floorspace. 4-80]. Understanding the significance of findings is complicated because studies used a variety of measures from spirometry. 4-246]. Where a decrease of 100 to 200 ml of FVC or FEV(1) may be clinically insignificant in healthy persons, such a change may be significant for workers with already impaired pulmonary function [Exs. The term "Air contaminants" refers to substances contained in the vapors from paint, cleaning chemicals, pesticides, solvents, particulates, outdoor air pollutants and other airborne substances which may cause material impairment to the health of employees working within the nonindustrial environment. 3. Damage to alveolar epithelium was more frequent for the smoke-exposed animals than the room air-exposed animals. 3-446, 3-500, 4-294], and particulates [Ex. However, OSHA does not have the data to provide such delineation at this point. Mendell and Smith [Ex. CSC assays may not, however, reveal all of the carcinogenic activity of actual cigarette smoke, because these condensates lack most of the volatile and semi-volatile components of whole smoke. Table VI-8 contains OSHA's estimates of the annualized first-year and the annual recurring costs of full compliance with the proposed rule. In addition, other physical factors such as lack of windows, noise, and inadequate lighting, and ergonomic factors involving uncomfortable furniture and intensive use of video display units, etc., will cause discomfort in occupants that may be inaccurately attributed to air quality. (IUD v. API, 448 U. S. at 655). Some typical contaminants are listed below: (a) Gases and Vapors (organic/inorganic): OSHA believes that there is a need for central responsibility in affected buildings and facilities [Exs. Atherosclerotic plaque formation is a complicated chronic process that can lead to constriction of the lumen of the blood vessels, resulting in reduced blood supply to the myocardial tissues. 7. Your child’s surgery will take place at Children’s Hospital. For the time involved in the training session, a range of costs for the instructor could be developed. 4-239]. Managing Indoor Air Quality. - Nicotine in Nonsmokers' Air: Personal Monitors(1), Table IV-1. For upper respiratory conditions, such as "stuffy nose", "runny nose", etc., the relative risks ranged from 1.4 to 1.8. A. Nervous system effects have also been produced due to exposure to poor indoor air quality. In addition, other studies substantiate the magnitude of workplace exposures. Based on the National Health Interview Survey, OSHA estimated that 74.2 million employees or 73.01 percent of the U.S. labor force covered by OSHA are nonsmokers. Why? Informal Hearing Information: Mr. Tom Hall, Division of Consumer Affairs, Occupational Safety and Health Administration, 200 Constitution Avenue, NW., room N3649, Washington, DC 20210; (202) 219-8615. Preliminary Regulatory Impact Analysis. This method takes about 4 to 6 hours, depending on the amount of cartilage that needs to be removed and the age of the child. [Ex. 4-89, 4-193] and sidestream smoke [Ex. This association of ETS exposure with work settings remained strong after controlling for the length of the activity episode, and hence was not simply a function of longer time intervals at work. Sidestream (SS) smoke was collected by a moving column of air spiked every minute with a puff of fresh mainstream (MS) smoke. Notices of intention to appear must be postmarked by June 20, 1994. Employers must comply with the standards which the Secretary promulgates. Cotinine is preferred over nicotine as an internal biomarker because of its slower clearance from the body [Ex. Air contaminants refers to substances contained in the vapors from paint, cleaning chemicals, pesticides, and solvents, particulates, outdoor air pollutants and other airborne substances which together may cause material impairment to employees working within the nonindustrial environment. However, heart disease runs the gamut from severe to disabling to fatal. This threshold is also affected by carbon monoxide levels [Exs. Benzo(b)fluoranthene Pectus excavatum occurs mostly during the early teenage years in times of rapid growth, and mostly in boys. - Fungi - Characteristics of Environmental The proposal would require affected employers to develop a written indoor air quality compliance plan and implement that plan through actions such as inspection and maintenance of building systems which influence indoor air quality. When the surgery is over, the medications will be stopped and your child will begin to wake up. Cost is annualized over 10 years at a 10 percent interest rate. [Ex. In some instances, outbreaks of SBS are identified with specific pollutant exposures, but in general only general etiologic factors related to building design, operation and maintenance can be identified [Ex. Therefore, the total number of buildings requiring maintenance is estimated at 2.3 million. In response to the RFI, over 1,200 comments were submitted by interested persons, groups, unions, and industries. Workers sighted cockroaches, silverfish, and steam bugs near the coffee shop and on back stairs. Three conditions must exist in buildings before microbial contamination can occur: high humidity (over 60%), appropriate temperatures (varies according to microbe), and appropriate growth media [Exs. Negative pressure is achieved by exhausting more air from the space than is supplied to the space. 4-172, 4-262, 4-315]. There have been numerous studies on the pharmacokinetics of nicotine in both animals and man. Informing Employees About the Indoor Air Limited existing data suggest that sidestream smoke may contain more carcinogenic activity per milligram of cigarette smoke concentrate than does mainstream smoke [Ex. 3-56]; evaluate the need to perform alterations of the HVAC system in response to employee reports of building-related illness, (d)(12); and take such remedial measures as the evaluation shows to be necessary, (d)(13). This is indicated when the data are analyzed by employed nonsmoker status. Whenever the employer ceases to do business, records that are required to be maintained by paragraph (h) of this section shall be provided to and retained by the successor employer. You may bring along a “comfort” item—such as a favorite stuffed animal or “blankie”—for your child to hold before and after the surgery. Carbon dioxide (CO(2)) sampling is one of the measurement tools used to characterize indoor air quality. Sidestream smoke was also found to be mutagenic in a system where the smoke was tested directly on the bacterial plates [Ex. The basis for this proposed action is a preliminary determination that employees working in indoor work environments face a significant risk of material impairment to their health due to poor indoor air quality, and that compliance with the provisions proposed in this notice will substantially reduce that risk. One Children’s Hospital Drive The causation of SBS by indoor air pollution was first objectively demonstrated in 1984 in a study of 62 Danish subjects suffering from "indoor climate symptoms" [Ex. The inclusion of training and information requirements reflects the Agency's conviction, as noted above, that informed employees are essential to the operation of any effective health program. In March 1992, the AFL-CIO petitioned OSHA to promulgate an overall IAQ standard. OSHA used 1.4 as an observed relative risk for upper respiratory conditions. 4-190], First [Ex. The bar is made of titanium and comes in various lengths. Section 1926.1148 also issued under 29 U.S.C. COVID-19: Safety, Testing, News Alerts, and More. There is a strong correlation between nicotine intake and plasma cotinine levels [Ex. The physical condition of this building was obviously in disrepair since the commenters reported pails of stagnant water, collected from leaks in the roof, were left in hallways. A chest tube is almost always needed after the open procedure to remove air from the chest cavity. Comments are to be submitted in quadruplicate or 1 original (hardcopy) and 1 disk (5 1/4 or 3 1/2) in WP 5.0, 5.1, 6.0 or Ascii. The designated smoking area must be under negative pressure compared to all surrounding spaces including adjoining rooms, corridors, plenums and chases. (1), Irritant, nervous system, liver, kidney. It has been suggested that a large number of these cases occur as the result of workplace exposure [Exs. The Workers' Compensation system is a result of the perceived inadequacies in liability or insurance systems to compel employers to prevent occupational disease or compensate workers fully for their losses. Burns et al. The extent to which outside air ventilation is effective in diluting indoor contaminants depends on how well outside air is mixed with indoor air and is reflected by ventilation efficiency. State, local and other business taxes have not been factored into the conversion formula. Persons desiring to participate at the informal public hearing must file a notice of intention to appear by June 20, 1994. Which workers should this training be provided to - all maintenance and building systems workers, supervisors, crew leaders? 4, 6, 8, Occupational Safety and Health Act of 1970 (29 U.S.C. ETS exposure may also contribute to the chronic formation of arterial wall plaques which are implicated in the event of an acute myocardial infarction. - Formaldehyde There are at least 32 epidemiological studies that have attempted to evaluate the carcinogenic potential of ETS. 4-311]. Mercantile and service buildings account for the greatest number and floorspace of any single activity category. 6, 8 of the Occupational Safety and Health Act, 29 U.S.C. These actions are event related as opposed to being policy related). It was reported that these effects may be part of a general immunosuppressive condition associated with the occurrence of low birthweight [Ex. This can be viewed as a way to validate misclassification results derived from surveys; (3) Evaluation of the potential impact of high affinity, low capacity binding of nicotine and cotinine in nonsmokers with low exposure to ETS; and (4) Evaluation of the potential impact of pharmacokinetic uncertainty and variability on the use of cotinine concentrations in plasma, saliva or urine to infer an individual's ETS exposure. Based on this, Woods et al. (b) Subtract the lowest sample result of the indoor samples from the highest result for the indoor samples. The work sites ranged from those with minimal restriction of smoking and high levels of exposure to work sites with extensive smoking restrictions and low exposure. 4-221]. 3-38, 3-347, 3-412, 3-415, 3-434, 3-444B, 3-500, 3-529]. The adjusted relative risk was a weighted average of the reported relative risks using the gender composition of the U.S. workforce as weights ((1.24*45.64 + 1.31*54.36/100) = 1.28). Putman et al. This medication is flavored and takes effect in 10 to 15 minutes. A total of 505 cities and counties limit smoking, specifically in restaurants. In addition, paragraph (a)(2) proposes to further extend coverage of the provisions found in paragraph (e)(1), which address exposure to tobacco smoke, to all indoor work environments under OSHA's jurisdiction. 4. Shirley J. Hansen. A variety of bars and “pins” may be used to raise the sternum in the open procedure. Any party requesting more than ten (10) minutes for presentation at the informal public hearing, or who intends to submit documentary evidence, must provide in quadruplicate the testimony and evidence to be presented at the informal public hearing. The second kind of uncertainty includes those factors which tend to broaden the confidence interval for the risk estimate. Control over the ventilation systems is a multi-faceted concept: it includes maintenance, recordkeeping and the development and implementation of the indoor air quality compliance plan. Summary statistics of additional studies on personal monitoring for nicotine are shown in Table III-11 [Ex. 655 or 29 CFR part 1911; also issued under 5 U.S.C. The average of these three samples is 680 ppm (2,040 ppm divided by 3). Introduction For which provisions should implementation periods be either decreased or increased and why? 4-166], and urine [Exs. Designated smoking areas must be areas where employees do not have to enter in the performance of normal work activities. An individual that smokes or is older may develop the more serious pneumonia [Exs. 4-56]. - Fiberglass/Mineral Wools Preliminary estimates indicate that the risk of mortality from heart disease due to ETS exposure is even greater than that of cancer. First, evidence on occupational health hazards in general suggests that in the absence of immediate or clear-cut danger, employees and employers have little incentive to seek or provide information on the potential long-term effects of exposure. In addition, ETS exposure may cause platelets to become less sensitive to the anti-clotting regulatory substances in the blood and therefore increase the tendency of the blood to clot. What other provisions, if any, should be included to limit the effects that renovation and remodeling activities may have on indoor environments? Cost includes an additional 7.5 minutes per employee to cover trainer cost. In the same survey, smaller companies were half as likely as larger ones to have a policy under consideration. (a) Evidence of Association Further, paragraph (c)(4) proposes to require that the following information also must be retained, if available, to assist in indoor air quality evaluations: as built construction documents; HVAC system commissioning reports; HVAC system testing, adjusting and balancing reports; operation and maintenance manuals; water treatment logs; and operator training materials. E. Technological Feasibility and Compliance Costs. I(p) is the U.S. population incidence rate for nonsmokers. Your child also might have an epidural catheter for a few days after surgery. 3-1183, 3-1090]. The symptoms of chronic episodes are serious respiratory symptoms such as progressive dyspnea. A number of studies have suggested that ETS exposure adversely affects the myocardial oxygen supply-demand relationship; this would predispose the heart to develop ischemia or exacerbate preexisting ischemia. The responsibility of the Administrative Law Judge is to ensure that the hearing proceeds at a reasonable pace and in an orderly manner. 4-186]. (2) Average the results of the outdoor and indoor samples. The use of a pharmacokinetic model to relate inhaled nicotine to circulating nicotine and cotinine levels is the main focus of this section. A salivary fluid compartment could also be added to either model if desired. 4-33], and pesticides [Ex. 4-137], Footnote(3) EPA: Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders, 1992. June 1991, Table VI-2. The accused firm must also pay for its defense. Similar results of mild hyperplasia were also obtained when male rats were exposed to the same concentrations for up to 13 weeks [Ex. Symptoms are relieved when the employee leaves the building and may be reduced or eliminated by modifying the ventilation system. However, Benowitz et al. Housekeeping cleaning agents or pesticides are typical of contaminants that may be released which could not be absorbed by a non-ventilated space. Many commenters particularly felt that regulation of IAQ was necessary to eliminate exposures to ETS in the workplace. Standards of maintenance vary dramatically in the HVAC industry and sometimes are deficient where untrained personnel are designated to maintain very complex systems. - Textiles/Cotton Considering the up-front efforts of these code officials, designers, and construction teams, it is reasonable from a standpoint of continuity, to require that buildings be operated and maintained to the same design intent. For example, the definition of "HVAC system" lists what OSHA believes to be typical components of such systems which directly affect indoor air quality. These substances, either alone or in synergy, have produced health effects that OSHA believes can be considered material impairment [Ex. The authority citation for subpart Z of Part 1910 would continue to read as follows: Authority: Secs. For comparison, the variation in the volume of distribution for cotinine was 5-fold, while for the half-life and volume of distribution of nicotine, the variation was 8-fold and 6-fold, respectively. In general, the observed cotinine time profiles in blood and tissues were consistent with linear kinetics, but the distribution of cotinine into all tissues appeared to be roughly three-fold greater following infusion of nicotine than following infusion of cotinine, and the clearance of cotinine following bolus and infusion dosing was significantly different. Estimating the risk from exposure to ETS requires the use of some measure of the extent of exposure. The Centers for Disease Control Prevention estimate that over 25,000 cases of the pneumonia caused by Legionella occur each year with more than 4,000 deaths. Industrial Union Department, AFL-CIO v. American Petroleum Institute, 444 U. 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