August 28, 1995

Mr. Barry Nechis
President
Rescue Technology
P.O. Box 908
Larchmont, New York 10538

Dear Mr. Nechis:

Thank you for your letter of March 25, 1994, concerning the Occupational Safety and Health Administration's (OSHA) Hazardous Waste Operations and Emergency Response (HAZWOPER) regulation, 29 CFR 1910.120. We regret the long delay in providing this response.

Your questions request clarification on training requirements for private sector Emergency Medical Services (EMS) personnel. You state that you have received an interpretation from the New York State Public Employee Safety and Health (PESH) program. As you are probably aware, State Occupational Safety and Health (OSH) Programs are required to be at least as protective as Federal OSHA, but are free to be more stringent. Further, it is the individual employer, not OSHA, who must determine the expected job duties of their workers, and ensure that they are competent to perform these assigned duties safely. This memorandum provides only Federal OSHA's interpretation for the questions you have raised.

HAZWOPER does not necessarily apply to every incident in which an individual requiring medical treatment is contaminated with hazardous substance. OSHA can not require HAZWOPER training for incidents outside the scope of the standard, although such training may be beneficial. The first scenario described in your letter, of an individual overcome by pesticide in an apple orchard, would not be considered a HAZWOPER emergency, and therefore, would not be covered by the HAZWOPER standard. Your set of scenarios relating to a motor vehicle accident involving a truck displaying a Department of Transportation (DOT) hazardous materials placard would all be considered potential emergencies, and, therefore, responses to such incidents would be covered by HAZWOPER. Where there is no damage or release of the hazardous cargo, the incident can be quickly classed as a non-emergency and outside the scope of the standard. Likewise, your final scenario of an overturned car leaking gasoline should initially be treated as a potential HAZWOPER emergency, but in many cases could be quickly classed as a non-emergency.

You inquired specifically about First Responder Awareness Level and First Responder Operations Level training under the HAZWOPER standard. To be certified at these two responder levels, HAZWOPER requires that certain competencies be met, but does not require a training course per se. Workers must have sufficient prior training or experience to be able to "objectively demonstrate competency" in the skill areas specified in paragraphs (q)(6)(i) and (q)(6)(ii). OSHA expects that in many cases EMS personnel will already be able to meet many of the competency requirements for these responder levels.

First Responder Awareness Level is intended for workers who are likely to encounter a hazardous substance emergency or potential emergency in the course of their job duties. This level enables workers to recognize the presence of hazardous conditions, stay away from the danger area, and call for additional, more highly skilled assistance. State troopers who are likely to come upon a transportation accident involving a hazardous materials tank truck would be trained to the First Responder Awareness Level.

First Responder Awareness Level certification would not be sufficient for EMS personnel to enter the danger area to perform rescue or provide medical treatment as you describe in your second set of scenarios. EMS personnel designated to enter the danger area to perform rescue or treat contaminated victims must be certified at the First Responder Operations Level. This designation is the responsibility of the EMS employer, and is not necessarily required for all EMS personnel. Also note that EMS personnel who provide treatment after victims have been removed from the danger area and decontaminated would not require HAZWOPER training. Standard emergency medical practice dictates that EMS personnel are to survey the accident scene and remain away from the hazard area until it is safe to approach. In the case of a HAZWOPER roadway emergency, the incident needs to be brought under control by more highly skilled emergency responders before it would be permissible for EMS personnel, including those certified at the Operations Level, to enter to perform rescue or provide medical treatment. Please refer to the enclosed page from the preamble to the HAZWOPER standard, which discusses this type of scenario.

First Responder Operations Level certification would also be required for EMS personnel designated to treat contaminated patients outside the danger area at a HAZWOPER emergency response, as described in your third scenario where a HAZMAT team member is injured and contaminated. However, EMS employers are only required to designate workers to treat contaminated patients if the EMS employer has agreed to be designated to provide this service in a site, facility, or community emergency response plan. Hazardous waste sites, hazardous waste treatment, storage, and disposal facilities, and facilities with a potential for an emergency release of a hazardous substance are all required to plan for emergency medical treatment. These sites may request that an EMS provider agree to be designated in their emergency response plan. State Emergency Response Commissions and Local Emergency Planning Committees are also charged with the responsibility to consider the hazards present in their communities and plan accordingly. Local emergency planning is typically coordinated through the fire department. If an EMS organization has not agreed to be designated, then the EMS organization may not have any obligation to train workers under the HAZWOPER standard.

HAZWOPER does have provisions for scenarios where EMS services have not been planned for. If an EMS service which has not agreed to be designated is called upon to stand by at a HAZWOPER emergency response, EMS providers can be considered "skilled support personnel," described in paragraph (q)(4) of the standard. Skilled support personnel are to be given on-the-spot instruction on the hazards and on the use of any necessary, protective measures or equipment prior to treating contaminated victims. This briefing is generally provided by an individual from the hazardous waste site, or at an emergency response by a member of the responding HAZMAT team. If an EMS organization is not designated in any emergency response plan, but finds that they are repeatedly called upon to treat accident victims contaminated from a HAZWOPER incident, these workers can not be considered skilled support personnel, and the EMS employer must train and designate workers to the First Responder Operations Level.

We hope this information is helpful. If you have any further questions please contact us at (202) 219-8036.

Sincerely,



John B. Miles Jr., Director
Directorate of Compliance Programs




March 25, 1994

U.S. Department of Labor
Occupational Safety & Health Administration
200 Constitution Avenue
Washington D.C. 20210
Attn: Technical Support, Rm N3636

Rescue Technology is a training and consulting firm, many of our customers are EMS (Emergency Medical Services) agencies within the private sector. Questions regarding the level of employee training under 29 CFR 1910.120 concerning EMS personnel has been raised.

My question concerns EMS personnel and centers on the need for their personnel to be trained to the First Responder Awareness level or the First Responder Operations level. The EMS personnel in question are those who fall under the private sector. Given the following scenarios for the above described EMS personnel, what level of response would you suggest that the employees come under:

1. An ambulance responds to a call for a person who is lying on the ground in an apple orchard. This person was spraying the apple trees prior to becoming ill and is covered with a white powder. Upon arrival he is treated and found to be covered with a pesticide that is a class A poison. The EMS personnel remove the victims clothing and discovers the pesticide container lying nearby. The victim is loaded into the ambulance and transported to the hospital. The EMS personnel were exposed to the poison and were contaminated by the hazardous material labeled as a poison.

2A. Below Situation with no damage or release of the hazardous cargo.

2B. Below Situation with an unknown fluid leaking from the cargo area.

2C. Below Situation with an unknown Vapor Cloud leaking from the cargo area.

An ambulance responds to a call for a motor vehicle accident involving a truck that is displaying a hazardous material placard. There is a considerable amount of debris from the truck in the area and the truck driver is still trapped inside the cab of the truck. The EMS personnel enter the cab of the truck to provide medical care to the trapped driver and awaits the fire department to extricate the trapped driver. After the driver is removed from the truck he is transported to a hospital. The EMS personnel was well within the area called the "Hot Zone" of an incident that was identified through the placard on the truck as a potential hazardous materials incident.

3. An Ambulance is called to an incident to standby where a fire department is operating at a hazardous materials incident and will be using two hazardous materials teams to control the incident. After the arrival of the ambulance an unforeseen action causes the materials at the incident to shift and a drum of acid falls on a hazardous materials team member. The injured team member is removed from under the drum by the other team members, quickly washed him off and removed his special suit. The accident caused the chemical protective suit to tear and the acid to contaminate and burn the hazardous material team member. The EMS personnel provided medical attention to the injured member and transported him to a hospital for further medical attention and decontamination. The EMS personnel came into contact with victims clothing and the parts of the victims body that suffered burns from the hazardous material.

4. An ambulance responds to an automobile accident with persons trapped inside the car. The car is upside down and leaking gasoline in and about the area where the EMS personnel will be attending to the victims trapped in the car. The fire department is protecting the EMS personnel with hose lines in case of ignition of the gasoline and also assisting in the removal of the trapped victims. The EMS personnel work in the area of strong gasoline vapors and step into the fuel as they remove the victims. The smell of the gasoline, the leak of the gasoline from the punctured gasoline tank and the presence of a liquid under the automobile are all indications that the emergency responders are operating in a dangerous environment and one that has the presence of a hazardous material as identified by the Federal Department of Transportation in 49 CFR.

All six scenarios listed above are realistic incidents where EMS personnel would be expected to respond and operate. Any clarification as to what level of response the employer should designate the responding EMS personnel at and which level of training would be expected to be provided such as First Responder Awareness level or at First Responder Operations level would be greatly appreciated.

In New York State some EMS personnel are covered under PESH. We have already received answers to the above questions from them regarding EMS personnel. We will continue our effort to support the needs of emergency responders and provide them with training that is not only informative, interesting, and cost effective, but also meets their OSHA training requirements.

Thank you for your time and effort to provide guidance on the level of response for the four EMS scenarios.

Sincerely,



Barry Nechis
President, Rescue Technology