April 22, 2003

Mr. Mike Bolt
Construction Manager, Decontamination Team Supervisor
Novant Health
3333 Silas Creek Parkway
Winston-Salem, NC 27103

Dear Mr. Bolt:

On July 16, 2002, you sent a letter to the Occupational Safety and Health Administration's (OSHA's) Directorate of Enforcement Programs requesting an interpretation of the Hazardous Waste Operations and Emergency Response standard, 29 CFR 1910.120. On September 26 our office responded to you; a copy of that letter is enclosed. After reviewing our letter we have decided to clarify our answer to your first question. This letter provides the clarification of our September 2002 letter to you in the form of italicized and bracketed wording added to our response to the first question.

This letter constitutes OSHA's interpretation only of the requirements discussed and may not apply to any question not delineated within your original correspondence. You had questions about Hazardous Waste Operations and Emergency Response (HAZWOPER) training requirements for hospital employees who may have to decontaminate patients who were exposed to hazardous materials incidents. Your questions and our responses are listed below.

Question 1: Can hospitals that train employees to decontaminate victims of hazardous materials incidents modify their training programs to be specific to the employees' anticipated job duties and hazards? These employees do not respond to hazardous materials releases within the hospital.

Response: Yes. HAZWOPER is a performance-based regulation allowing employers flexibility in meeting the requirements of the regulation in the most cost-effective manner. However, the appropriate level and type of training must be based on [reasonably predictable] worst-case scenarios. All employees must be adequately trained to perform their anticipated job duties without endangering themselves or others.

Question 2: What is OSHA's opinion of our suggested modification of the required competencies for First Responder Operations Level for "Hospital-based victim decontamination personnel"?

Response: We compared your list of suggested competencies to the requirements in 29 CFR 1910.120(q)(6)(ii) and have the following comments. Your proposed training fails to include the following:

• At least eight hours of training or demonstration of the required competencies. [1910.120(q)(6)(ii)]
• The competency, "the ability to recognize the presence of hazardous substances in an emergency." This competency is different from knowing what hazardous substances are and their risks and may include knowing how to detect hazardous substances by smell, appearance, and/or with instruments. Employees who perform decontamination must know when the hazardous substance is present or absent. [1910.120(q)(6)(i)(C)]
• The competency, "the ability to identify the hazardous substances, if possible." As discussed with you by telephone, a person assigned to decontaminate victims of hazardous substance incidents may not need to know how to read DOT placards. However, he/she should know how to identify the probable contaminants so that the correct decontamination methods are used and the correct personal protective equipment is selected. [1910.120(q)(6)(i)(D)]
• The competency, "An understanding of the role of the first responder awareness individual in the employer's emergency response plan including site security and control and the U.S. Department of Transportation's Emergency Response Guidebook." The emergency response plan may not be the hospital's plan, but if hospital employees have a role in a community emergency response plan, they must be trained in that role. A hospital employee who performs decontamination may not need to be familiar with the rail and road trailer chart, but he/she should know how to use the DOT Emergency Response Guidebook to select personal protective equipment. [1910.120(q)(6)(i)(E)]
• The competency, "An understanding of basic hazardous materials terms." [1910.120(q)(6)(ii)(C)]
• The competency, "Know how to perform basic control, containment and/or confinement operations within the capabilities of the resources and personal protective equipment available with their unit." Although your hospital decontamination employees will not actively control, contain, or confine a spill at the incident location, they should know these concepts in order to control both the spread of contamination and the decontamination chemicals. Employees must know their capabilities so they can determine when their training and equipment is not adequate to handle a situation. [1910.120(q)(6)(ii)(D)]

Question 3: Are the eight (8) hours of training required for the First Responder Operations Level included in the time spent in the training for the First Responder Awareness Level, and is this training part of the required competencies for the First Responder Operations Level?

Response: Yes. For example, if you spend two hours training employees in the required competencies for First Responder Awareness Level as described in 29 CFR 1910.120(q)(6)(i)(A)-(F), then you would need to spend at least six additional hours training employees in the required competencies for First Responder Operations Level as described in 29 CFR 1910.120(q)(6)(ii)(A)-(F). Depending on the employees' job duties and prior education and experience, more than eight hours of training may be needed. Please note that employees with sufficient experience may objectively demonstrate the required competencies instead of completing eight hours of training. The employer must certify in writing the comparable training or demonstrated competencies.

As you may be aware, the North Carolina Department of Labor administers an OSHA-approved state occupational safety and health program for both private and public sector employers and employees in North Carolina. State plans are required to implement regulations that are "at least as effective" as the federal standards. If you would like further information regarding North Carolina occupational safety and health requirements, you may contact the North Carolina Department of Labor at the following address:

Cherie Berry, Commissioner
North Carolina Department of Labor (NCDOL)
4 West Edenton Street
Raleigh, North Carolina 27601-1092
Phone: (919) 807-2900
Fax: (919) 807-2855

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA requirements are set by statute, standards, and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at http://www.osha.gov. If you have any further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.

Sincerely,



Richard E. Fairfax, Director
Directorate of Enforcement Programs