June 14, 1991

Mr. Edward McNamara
Executive Director
Central Massachusetts Emergency
Medical Systems Corporation
Suite 208
42 Lake Avenue
Worcester, Massachusetts 01604

Dear Mr. McNamara:

This is in response to your letter of March 21, to Region I office concerning the Occupational Safety and Health Administration's (OSHA) Hazardous Waste Operations and Emergency Response final rule (29 CFR 1910.120). Please accept my apology for the delay in this reply.

Your specific question relates to the training requirements for emergency medical service personnel.

Section (q)(6) of 1910.120 discusses the training requirements for five levels of emergency responders. The specific training requirements for emergency medical service personnel depend on the duties they are expected to perform during an emergency response to a release of hazardous substance.

If the contaminated victims have been totally and thoroughly decontaminated and removed from the danger area, the emergency medical service personnel treating these victims would not have specific training requirements under 1910.120. However, these personnel should be given an initial briefing at the site prior to their participation in the emergency response.

Emergency Medical Service personnel are often the first on the scene and therefore should be given first responder awareness level training as a minimum even if they are not expected to handle contaminated victims.

If the emergency response personnel must handle victims whom have been only superficially decontaminated or have not been decontaminated at all, training to the first responder operations level as described in 1910.120 section (q)(6)(ii) would be required. The minimum amount of training required by this paragraph is 8 hours.

The emergency response plan for the jurisdiction should clearly define who will be responsible for decontaminating victims during an emergency response. The emergency medical service personnel should be trained in accordance with the responsibilities they will be expected to assume during an emergency response as described in the community emergency response plan.

We hope this information is helpful. If you have any further questions please feel free to contact [the Office of Health Enforcement at (202) 693-2190].

Sincerely,



Patricia K. Clark, Director
[Directorate of Enforcement Programs]

[Corrected 1/6/03]

Attached is a letter from a Massachusetts Emergency Medical Service (EMS) company requesting an interpretation of the application of 1910.120(q) to EMS personnel in a hazardous substance emergency response. We are forwardingthis to your office at the advice of Mary Ann Garrahan of your office, as she has informed us that you are presently developing policy on the application of 1910.120 to all the personnel in the emergency medical area.

Thank you for your assistance. If you have any questions on this matter, please contact Fred Malaby of my staff.



March 21, 1991

John B. Miles, Jr., Regional Administrator
U.S. Department of Labor - OSHA
133 Portland St., 1st Floor
Boston, MA 02114

Dear Mr. Miles:

On March 21, 1991, I called your office and spoke to a Mr. Fred Malaby, Senior Industrial Hygienist concerning requirements under SARA Title III for the training of emergency medical technicians. I specifically addressed anincident where ambulance services arrive on scene, contaminated victims are washed down initially by the fire personnel and then brought to an EMS treatment area where emergency medical technicians must treat those individuals who may conceivably still have portions of the contaminant on their bodies. My question was whether these individuals should receive the first responder level training program (3 hours) or the operational level training program (8 hours). Mr. Malaby and I both seem to agree that those individuals that must handle and treat victims of a hazardous materials spill should be trained at the 8 hour level.

I would appreciate it if you could send me a letter expressing that opinion, so that we can begin the establishment of the 8 hour programs in the Central Massachusetts service area.

If you have any questions concerning this letter, I can be reached during the day at (508) 798-0755. Thank you for your time.

Sincerely,



Edward McNamara
Executive Director



Edward McNamara, Executive Director
Central Massachusetts Emergency
Medical Systems Corporation
42 Lake Ave., Suite 208
Worcester, MA 0104

Dear Mr. McNamara,

The training required for emergency medical service personnel (EMS) at a hazardous substance emergency response would depend on the duties that these personnel are expected to perform. If the EMS must handle victims who have not been decontaminated or have only been superficially decontaminated, and/or they are near enough to the release that they could be exposed, then they would be considered operations level emergency responders and training would be required. If, however, by washing down you mean that the victims are nearly totally decontaminated and the EMS area is well away from the release, then it is conceivable that they would be skilled support personnel, and training would not be required. This would mean that other emergency responder personnel would be responsible for any necessary treatment on contaminated personnel or treatment in a contaminated zone. The emergency response plan for the jurisdiction should specify the role that the EMS are expected to perform.

I hope that this information has been of assistance. If you have any other questions, feel free to contact this office.

Yours very truly



John B. Miles, Jr.
Regional Administrator
Technical Support



April 16, 1991

Mr. Walter H. Bauer
Assistant Director
Paramedic Unit 3 - Lehigh County
418 Pearl Street
Catasauqua, PA 18032

Dear Mr. Bauer

Your letter dated March 28, 1991 to Mr. George Tomchick, our Allentown Area Director, has been forwarded to this office for response.

The three incident scenarios which you stated in your letter have been evaluated by Dr. John Barry, our regional coordinator for Hazardous Waste and Emergency Response Operations. Scenarios 1 and 2 clearly require first responder awareness level training. Scenario 3 will require first responder operations level training because your people become involved in the incident command structure.

In your letter you did not mention a fourth possible scenario; namely, treatment of victims in a contaminated area or treatment of un-decontaminated people. Such a situation would require HAZMAT specialist training.

Since your unit is an element of Lehigh County government, federal OSHA has no jurisdiction; however, under the Superfund Amendments and Reauthorization Act of 1986 (SARA), EPA is the enforcing authority. For information on EPA operations under 29 CFR 1910.120, you should contact EPA directly at:

Director
Hazardous Waste Management Division U.S.
Environmental Protection Agency
841 Chestnut Street
Philadelphia, PA 19107

MEDIC 3 PARAMEDIC UNIT - LEHIGH COUNTY

Emergency (215) 437-5252
* Business (215) 264-4000
Station Address - 418 Pearl Street, Catasauqua, PA 18032

Sincerely,


John B. Miles, Jr.
Regional Administrator
Technical Support


March 28, 1991

Mr. George Tomchick
OSHA District Supervisor
850 N. 5TH St.
Allentown, PA 18102

Mr. Tomchick:

I am writing you for clarification in regards to the OSHA standards for infection control and hazardous materials incidents. We have received copies of CFR 1910.120 and CPL 2-2.44B, but our membership seems to have different interpretations of these standards.

Medic 3 could become involved at the following levels of a hazardous materials incident.

1. Medic 3 personnel could arrive on the scene of an incident as the first unit.



 
2. Medic 3 personnel could become involved in the medical care and transportation of injured patients after the decontamination process.



 
3. Medic 3 personnel could become involved in the incident command structure of a hazardous materials incident. The paramedic, being the highest certified emergency medical service person on the scene, should be designated the EMS officer within the incident command structure.

I would like your interpretation for the level of training our personnel should be given to prepare them for operations as described above. I would also appreciate any information in regards to fines for being non-compliant or causing further contamination of other persons or facilities. I feel this information would enlighten our membership as to the appropriate actions to take.

Thank you in advance for your cooperation and input into this matter.

Respectfully,



Walter H. Bauer
Assistant Director