DIOSH DAY2016

Wednesday, March 2, 2016Peoria Civic Center, Peoria, Illinois

Occupational Safety and Health Administration1320 W. Commerce Drive, Suite 800

Peoria, Illinois 61615

DIOSH Day 20162

DIOSH DAY 2016— Agenda

7:00 a.m. Registration Complimentary Refreshments in Exhibit Area7:00 – 1:30 p.m. Mini Health Fair7:00 – 2:35 p.m. Exhibit Area Open9:00 – 2:00 p.m. Concession Stand8:00 - 8:50 a.m. Breakout Session 19:15 - 10:05 a.m. Breakout Session 2 10:30 - 11:20 a.m. Breakout Session 3 11:20 - 12:40 p.m. Hot Buffet Lunch12:10 p.m. Presentation of Governor’s Award12:40 - 1:30 p.m. Breakout Session 41:50 - 2:40 p.m Breakout Session 5 2:55 - 3:45 p.m. Breakout Session 6

DIOSH Day Mini Health Fair

Breakout SessionsDIOSH DAY 2016

1A Personal Productivity - Room 222AAIM Employers’ Association Do you have too much to do? Do you feel overwhelmed by the non-stop flood of emails, voicemails, meetings and interruptions? Are you paralyzed by the piles on your desk? Learn how to organize your work area, set priorities, organize your day, deal with interrup-tions, and combat procrastination and perfectionism. You’ll leave with a lot of simple, but powerful time-saving tips--and a way to reduce your stress

1B OSHA Update Program – Room 401Tom Bielema, OSHAThe Peoria Area Director will provide an update on the hot topics at OSHA that effect businesses in Illinois. If you want insight to OSHA enforcement, then this is the session for you.

7:00 a.m. – 1:30 p.m. in Exhibit Hall CBlood Pressure/Cholesterol/Blood Glucose*Spirometry - Hormone ScreeningSpinal Health Screenings - Trigger Point MassageHealthy Living Tips*Open until noon. To participate, you must fast 8-12 hours beforehand

Breakout Session 1 • 8:00 - 8:50 a.m.

Breakout Session 2 • 9:15 - 10:05 a.m.2A Safety Return on Investment – Room 222Tom Grey, Grey & AssociatesWould you spend $1 to save $2 in the future? How would you feel about $3 or $4 or $6 in future savings for every dollar you spend now? The choice may seem like an easy one, but when that first dollar becomes millions of dollars, and the savings may not be seen until years later, spending money up front can become harder to justify. This is a situation in which many occupational safety and health professionals find themselves when trying to convince up-per management that investing in training or equipment will lead to safer workplaces. But experts say the savings exist, and – armed with the right figures on the costs of injuries – safety pros should be able to successfully argue that investments in safety will result in savings down the line.

2B OSHA Emphasis Programs – Room 401Ed Marshall, Mark Rzasa, OSHAThis session will provide participants a look at OSHA’s National and local emphasis programs. Participants will learn how emphasis program inspections are selected and the types of information an OSHA inspector will ask for if a site is inspected.

2C Ergonomics: Been There, Done That, Why Isn’t It Working? – Room 220Robin Poston, SmartWork SolutionsThis session will look at “A New Approach to ‘Ergonomic’ Solutions.” Spending tens of thousands of dollars on fancy “ergo” equipment is not always the best answer to work pain problems. There is no one size fits all model to approach ergonomics. In this fun interactive presentation you will learn a practical comprehensive approach to reducing risks for work related musculoskeletal disorders.

2D Arc Flash Demonstration – Room 135-136Joshua Maestas, Loss Prevention Management ServicesWe will explore the physical properties of arc flash and how they are affected by different factors. We will discuss and demonstrate some of the various components that make up arc flash personal protective equipment (PPE), and how to select the proper equip-ment using OSHA 1910 and NFPA 70E standards. The presentation will review real world case studies involving arc flash incidents and walk through techniques that can be utilized in your work place to prevent or reduce the severity of injuries caused by arc blast.

1C SHARP Employer Program – Room 220Mica Chunes, Gerald Cunningham, Illinois OSHAThis Illinois OSHA Cooperative program SHARP (Safety and Health Achievement Recognition Program) session will cover: What is SHARP? Who is eligible to be a SHARP employer? Benefits of SHARP and the SHARP Process. The session will also include a presentation from a current SHARP employer who will share their experiences with being a SHARP company.

1D Safety Metrics: Leading & Lagging Indicators – Room 135-136Jeff Pacheco, Falcon Safety GroupLeading indicators are measures that “drive” or lead to the perfor-mance of lag measures; normally measuring intermediate process-es and activities. Lagging indicator measures focus on results at the end of a time period, normally characterizing historical perfor-mance. This session will explore leading and lagging indicators and how they help an organization establish goals for safety measure-ment and tracking accountability.

3DIOSH Day 2016

11:20 - 12:40 p.m. Hot Buffet Lunch and Presentation of Governor’s Award for Contributions in Health and Safety

Breakout Session 3 • 10:30 - 11:20 a.m.

Breakout Session 4 • 12:40 - 1:30 p.m.

3A Up-Armoring the Workforce - PPE in the 21st Century – Room 222Lee Hager, Don Garvey, 3MSafety professionals routinely require PPE be used in the work-place. However, many are unaware of the design, testing and new features that go into modern PPE. This presentation will discuss some of the current ANSI test requirements for PPE (including slo-motion action video!), basic and optional features to allow the safety professional to customize PPE to the specific worker needs and common misuse that can degrade PPE performance.

3B OSHA Enforcement in the Healthcare Industry – Room 401Joneen McElligott, OSHAJoneen will address an OSHA inspection from top to bottom at a healthcare facility. Participants will learn the types of hazards OSHA inspectors will be looking for and the safety and health programs healthcare facilities should have in place to manage and control potential hazards.

3C Census of Fatal Occupational Injuries– Room 220Gail Barnett, Alvina Chulanon, Bureau of Labor StatisticsThis session will provide a general overview of the data available (and not available) and types of output generated for Injury, Illness, and fatality data from the BLS Survey of Occupational Injuries and Illnesses and the Census of Fatal Occupational Injuries. Data is available by industries, occupations, types of injuries, events caus-ing injury and many other options. Tips will be shared on how to access and use the data.

3D Wild, Wacky & Highly Effective Safety Training– Room 135-136Mark Briggs, Safety Management Resources Corp.This program proves that safety training can be engaging, interest-ing, and yes, even FUN! Using hands-on examples, participants will be guided through the process of identifying a training need, determining how to present the necessary information in a new and exciting way, and then delivering the information in a way that ensures every trainee is engaged and learning.

Breakout Session 5 • 1:50 - 2:40 p.m.5A Caterpillar Safety Journey – Room 222Andy Schneider, CaterpillarCaterpillar made a commitment to safety in 2002 and has trans-formed their organization around the safety vision of its leaders. This presentation describes the safety journey that Caterpillar has been on for the past 10 years and the lessons they learned along the way. Learning Objectives include defining the critical success factors for a successful safety transformation, describing leader-ship’s role in driving safety improvement, describing what makes safety initiatives successful, defining the levers that can be pulled to drive change, and describing the next steps to drive further improvement.

5B OSHA Confined Spaces: Construction and General Industry – Room 401Brian Bothast, OSHAThis session will address the requirements for the new confined space entry standard for construction and compare it to the gen-eral industry standard. Brian will also take a look at best practices for implementing an effective confined space entry program.

5C Problem Solving and Root Cause Analysis – Room 220Ken Wunderlich, Illinois Manufacturing Excellence Center (IMEC)Companies are continually striving to eliminate undesirable out-comes, chronic problems and customer complaints. The tendency in many companies is generally to treat the symptom rather than the underlying fundamental cause that is actually responsible for the errant situation. Dealing with the symptom, rather than the cause, typically means that, in time, the problem or complaint returns and must be dealt with once again. Using a structured problem-solving methodology to understand why errors and prob-lems occur, allows a company to implement appropriate solutions to address the root cause(s) and, ultimately, prevent the problem from occurring again.

4A Machine Guarding – Room 222Roger Harrison, Rockford SystemsThis session will discuss the five basic Machine Safeguarding prin-ciples from ANSI B11.19: GUARDS: Point of Operation and Perim-eter; acceptable openings, interlocks; DEVICES: Light Curtains, are laser scanners, laser devices for press brakes, two-hand controls; DISTANCE: of people from hazards; LOCATION: of operator controls; OPENING: ¼” or less opening. Also discussed will be shields for cutting/turning machines (chuck shields, chip/coolant shields) and The Electrical Requirements for Industrial Machines in ANSI/NFPA 79 (Emergency-Stops, disconnects, motor starters, etc.).

4B OSHA Recordkeeping Questions & Answers – Room 401Trish Rankin, OSHATrish will provide a brief update on reporting, recording and OSHA’s expectations for tracking work related injuries and illnesses. Then the fun begins with your recordkeeping questions! Trish and Brian Bothast will work together to bring clarity to OSHA recordkeeping requirements.

4C Severe Storm Spotting and Safety – Room 220Ed Shimon, National Weather ServiceThe presentation will include an overview of severe storm spotting from a National Weather Service perspective. Topics covered will be severe thunderstorm attributes, tornado development and severe weather safety.

4D Improving Your EHS Efforts by Moving Beyond OSHA Compliance – Room 135-136Mark Briggs, Safety Management Resource Corp.This session will focus on the value of moving beyond OSHA compliance by adopting best practices and embracing consensus standards, moving your organization toward the development of an organized, priority-based approach to EHS. Participants will be introduced to many resources, including ANSI, ISO, NFPA, ASME, the British Standards Institute*, and non-regulatory information provided by OSHA. More importantly, they will learn how to easily access this incredible volume of information to improve the quality of their own safety efforts.

4 DIOSH Day 2016

PresenterBiographies

Breakout Session 6 • 2:55 - 3:45 p.m.

6A Back Health & Safety – Room 222Dr. Brad CottonAccording to the National Institute of Health, back pain is the num-ber one cause of work-related disability and lost time from work. Dr. Cotton will discuss how your neck and back work and how they can be injured. He will also demonstrate on-the-job and at-home ways to strengthen your spine and steps to decrease the likelihood of injury.

6B Carbon Monoxide: Still Lethal in the Workplace – Room 401Salvatore Cali, MPH, CIH, University of Illinois at ChicagoCarbon monoxide (CO) is a product of combustion and certain chemical reactions. Most people understand that CO represents a hazard from vehicles, heating systems and fires, but poisonings also can occur due to other sources in the workplace. Sources include gas or diesel powered tools, generators, compressors and pumps. This presentation will review several cases of CO poisoning and discuss the amount of CO produced by certain equipment, the speed at which harmful effects can occur in the presence of various air concentrations, and suggested ventilation configurations to prevent the accumulation of CO. In addition, personal and area CO alarms will be discussed. The presenter will also solicit the experi-ences of audience members for their experiences with CO.

6C Effects of Human Factors on Motor Vehicle Related Injuries and Fatalities in Illinois– Room 220Mehdi Nassirpour, Illinois Department of TransportationMotor vehicle crashes are the leading cause of death for age 4 and every age 11 through 27. In 2014, a total of 32,675 people died in motor vehicle crashes; and 2,362,000 people were injured. During the same period, a total of 924 people were killed on Illinois roads and 84,652 people were injured. The economic impact due to motor vehicle crashes is enormous. In a one-year period, the cost of medical care and productivity losses associated with injuries from motor vehicle crashes exceeded $99 billion, according to a study by the Centers for Disease Control (CDC 2012). The estimated economic costs of motor-vehicle crashes are well beyond $200 bil-lion. Over 94 percent of car crashes are caused by human error. The main focus of the session will be on the effects of behaviors like drunk driving, not wearing seat belts and texting and driving on traffic fatalities and injuries and their associated costs in Illinois.

6D Fall Protection Equipment & Regulations – Room 135-136Wise Safety & EnvironmentalThis session will include demonstrations with harnesses, lanyards, self-retracting lifelines, anchor points, etc., tie-off techniques, es-timation of free fall distance, application limits, proper anchoring, swing fall, total fall distance to prevent striking a lower level, verti-cal & horizontal lifelines, elongation, and deceleration distance.

Gail Barnett is the Regional Branch Chief for Federal State Coopera-tive Programs in Occupational Safety and Health with the Bureau of Labor Statistics (BLS) in Chicago, Illinois. She has worked with the Injuries, Illnesses, and Fatalities program for 24 years, first as a senior survey statistician working with Survey Data Collection, Technical Program Training, and Quality Assurance Analysis, and for the last three years as the region’s Chief. She is a 1983 graduate of Illinois State University with a B.S. in Math and English Education.

Tom Bielema is the Area Director for the OSHA offices in Peoria and Fairview Heights. He joined OSHA in 1995 and has worked as an Assistant Area Director and Industrial Hygienist. He has also worked as a Safety Director in private industry. Tom is a 1995 graduate of Purdue University with a B.S. in Environmental Health Science/Industrial Hygiene.

Brian Bothast is a Compliance Assistance Specialist with the Oc-cupational Safety and Health Administration (OSHA) in Peoria, Illinois. He has worked for Caterpillar in the Environmental, Health, and Safety Department and as an Industrial Hygienist with OSHA. He is a 1988 graduate of Illinois State University with a B.S. in Environmental Health

Mark Briggs serves as the Vice President of Safety Management Resources Corporation (SMRC), a full-service consulting firm deliver-ing world-class risk management and safety services, supporting the efforts of corporations and organizations around the world. Mark is a frequent keynote and session speaker for associations and corpora-tions, delivering educational, captivating, motivational, and just-plain-fun programs that participants remember and incorporate into their own professional world.

Alvina Chulanon is a senior economist for Federal State Cooperative Programs in Occupational Safety and Health with the Bureau of Labor Statistics (BLS) in Chicago, Illinois. She has worked as a National Technical Program Trainer and Quality Assurance Analyst for the past 15 years in the Injuries, Illnesses, and Fatalities program. She is a 2000 graduate of University of Illinois at Chicago with a B.A in Economics.

Mica Chunes has worked for the IL On-site Safety and Health Consul-tation Program since 1997 as an Industrial Hygiene Consultant and in 2004 became the Industrial Hygiene Supervisor for the Program. Her prior positions include TRC Environmental Consulting and IL EPA. Her Bachelor’s degree from IL State University is in Environmental Health.

Brad Cotton, D.C., has been helping people in the Peoria area with their health care needs for over 14 years. He is a graduate of Palmer College of Chiropractic and has engaged in numerous post-graduate study programs related to his field. Dr. Cotton has spoken frequently about health and wellness to local businesses and civic groups, including DIOSH Day 2012 and 2013.

Gerald Cunningham has worked with the Illinois On-site Consulta-tion program since 2000 as a safety consultant and supervisor. His prior positions include working as a safety director for Nalco Chemi-cal and Borden Chemical and as a safety training consultant for the National Safety Council. He earned a Bachelor of Science degree in Safety from the University of Wisconsin-Whitewater.

Don Garvey, CIH, CSP is an industrial hygienist with the 3M Personal Safety Division in St. Paul, MN and is the construction technical spe-cialist. Prior to 3M, Don was the construction industrial hygienist for The St. Paul Companies. Don has a masters degree in environmental health from the University of Washington, Seattle, WA. He is a past chair of the American Industrial Hygiene Association Construction Committee and is a Fellow of the Association. He has published several articles in Professional Safety and is author of the industrial hygiene chapter in the ASSE’s recently published Construction Safety Management and Engineering 2nd Ed.

5D Aerial & Scissor Lift Equipment – Room 135-136Wise Safety & EnvironmentalThis session will take a closer look at aerial & scissor lift inspection (frequent & periodic), maintenance and working requirements, re-cord keeping, safe work practices and vehicle stability and training requirements.

5DIOSH Day 2016

Tom Grey is President of Grey and Associates. He is a highly skilled trainer and coach in employer and employee development of safety performances. He has over 28 years of hands-on experience as a for-mer plant manager, human resources manager, and quality control manager in manufacturing, distribution, and trucking industries. His manufacturing experience ranges from automotive, food processing and packaging to consumer products and personal care products. He has been trained in the STOP program, Key Concept to Safety Program, OSHA Outreach, and more.

Lee Hager brings over 25 years of experience to his position as Hear-ing Conservation and Detection Specialist for 3M, including consulta-tion with Fortune 50 companies on hearing conservation program effectiveness. He is a certified occupational hearing conservationist (COHC) and has served as chair of the Council for Accreditation in Oc-cupational Hearing Conservation (CAOHC), president of the National Hearing Conservation Association (NHCA), and chair of the Noise Committee and Fellow of the American Industrial Hygiene Associa-tion (AIHA). In his role with 3M, he provides technical support on hearing protection issues and hearing protector fit testing, training in hearing loss prevention, support for communication in noise via 3M Peltor technologies, and support for 3M Detection noise, heat stress, and environmental air quality monitoring. He publishes regularly and presents internationally on noise and hearing issues. Most of all, he cares about your ears.

Roger Harrison is the Director of Training for Rockford Systems, Inc. As such, he has conducted numerous seminars on the subject of Machine Safeguarding. These include 2.5-day monthly sessions at their Rockford, Illinois Training Center as well as on-site sessions for groups across the country. Previously, Roger worked as Project Manager for V-TIP (Video Technical Instructional Programs) where he developed two performance-based video training systems: Manually-fed Press Operators and Die setters, and Coil-fed Press Operators and Die setters. He also spent time as an Educational Coordinator for the Fabricating Manufacturers Association (FMA) where he organized a wide variety of metal fabricating conferences and seminars across the country. Roger has a Bachelor of Science in Business Administration from Northern Illinois University.

Joshua Maestas’ background includes over 11 years as an Electri-cian and Operator in the Navy, serving on multiple nuclear power and propulsion plants. He was qualified as an Electrical Operator and Engineering Watch Supervisor, and is experienced on operation and maintenance of medium voltage AC and DC distribution systems and equipment. His experience includes training program development, safety, project management, and mechanical/electrical maintenance and troubleshooting. Maestas has many years training classrooms, small groups, and OJT. He has led the electrical divisions on two sepa-rate Nuclear powered submarines in a hands on capacity. Maestas is a certified IFSAC Level II Firefighter, Hazmat Level I Responder, National Registry EMT, authorized OSHA 10 and 30 Hour General Industry Instructor, and a Board Certified Occupational Health and Safety Technologist (OHST).

Ed Marshall is an Industrial Hygienist in the Peoria Area OSHA office. He is a graduate of Illinois State University with a B.S. in Environmen-tal Health and has worked for OSHA since 2007. His prior work experi-ence includes public health, clinical laboratory and military service.

Joneen McElligott is an Industrial Hygienist in the Peoria Area OSHA office. She holds a Juris Doctorate, Masters of Science in Chemistry, and Bachelor’s degrees in Chemistry and psychology. Her prior work experience includes safety, health, environmental, and hazardous materials transportation management in government research, healthcare, and agricultural facilities.

Mehdi Nassirpour is the Manager of Research and Evaluation, Division of Traffic Safety at the Illinois Department of Transporta-tion. He received his Ph.D. in Demography/Applied Statistics from the University of Illinois at Urbana-Champaign. Mehdi’s professional work experience includes over 30 years of experience in conducting research and evaluation studies, and over 23 years of his experience has been on transportation safety and traffic records and statistical analyses of highway safety projects and programs. In his current posi-tion, he initiates, designs, participates and evaluates several highway

safety projects and programs in the State, and conducts and directs several traffic safety-related studies using large administrative data and survey data. He maintains research and policy liaison with other State agencies, universities, federal government with reference to in-formation/data, and coordination of research and planning activities and serves at several national research committees at TRB and Traffic Records. He has presented several papers at national and interna-tional conferences and has published several articles and reports in the field of traffic safety and health services research.

Jeff Pacheco is the owner of Falcon Safety Group and holds an As-sociate’s Degree from Carl Sandburg College. He is an authorized OSHA outreach trainer for general industry. He holds a certification as a Certified Safety Manger with the National Association of Safety Pro-fessionals. He is certified as an Ergonomic Assessment Specialist. Jeff has over 18 years of experience in leadership, including work as a cor-porate safety director, human resource director and corporate lead trainer with fortune 200 companies. Jeff’s unique blend of experience and education has led him to help companies save millions of dollars over the years by instituting proven best practices safety programs which helped improve safety attitudes, behaviors and cultures. Under Jeff’s leadership companies have been recognized and awarded for no loss work time and no injuries in the workplace.

Robin Poston, OT/L, CEAS is an Industrial Occupational Therapist and owner of SmartWork Solutions. She has over 20 years of experi-ence in treating work related injuries. As a Certified Ergonomic Assessment Specialist and therapist, Robin has been helping clients identify risks for work pain problems and develop programs to decrease those risks as well as empower workers to reduce their own risks and prevent work pain problems.

Trish Rankin is a Safety and Health Compliance Officer with the Peoria OSHA office. She joined OSHA in 1998 and has conducted inspections in a wide variety of industries. She is a graduate of Illinois State University with a B. S. in Construction Management.

Mark Rzasa is a Safety Compliance Officer in the Peoria Area OSHA office. He is a graduate of the University of Dubuque with a B.S. in Environmental Science and has worked for OSHA since 2007. His prior work experience was as an Environmental, Health, and Safety Manager in the mining industry.

Andy Schneider is the Global Manager – Safety and Health for Caterpillar where he provides leadership and support for Caterpil-lar’s global safety and health program and also manages the North American regional EHS support program. Previously, Andy led roles such as EHS Auditing and Shared Services Manager, Corporate Safety Manager, Regional EHS Manager, and Health and Safety Program Development Manager. Prior to joining Caterpillar in 1995, Andy worked as the Assistant Area Director and an Industrial Hygienist for OSHA. Andy holds a Bachelor of Science in Biology from the Univer-sity of Arizona and a Master of Science in Industrial Hygiene from the University of Central Missouri.

Ed Shimon attained his BS in Meteorology from the University of Wis-consin Madison in 1990. He has worked for the National Weather Ser-vice for the last 21 years. His career path has taken him from Madison WI, to Duluth MN and then Lincoln IL. Throughout his career in the National Weather Service, Ed has been very active in severe weather research, training, outreach, and computer administration.

Ken Wunderlich is a Manufacturing Specialist for the Illinois Manu-facturing Excellence Center (IMEC). He has more than 19 years experience in both manufacturing and product design. He has held positions in the Quality area acquiring a diverse set of skills in manufacturing for medical devices, maintaining certifications for medical devices, as well as food component manufacturing. He has maintained quality management systems for certifications under ISO 9001:2008, ISO 13485:2003, Food Safety systems and the Illinois Department of Public Health (IMS). Ken holds a Master of Science in Industrial Management from Northern Illinois University and a Master of Science in Information Systems from DePaul University.

AAIM Employers’ Association • American Industrial Hygiene Association, Prairie Section • American Society of Safety Engineers, Central Illinois Chapter • Greater Peoria Contractors & Suppliers Association, Inc. • Illinois OSHA • IMEC • United States Occupational Safety and Health Administration, Peoria Area Office

DIOSH Day is for employers, employees, and all others interested in safety and health. Experts in the field will present a program on the most current issues in safety and health today. Many governmental agencies will have booths in the exhibit area. This is a great opportunity to get your workplace safety questions answered in a neutral setting.

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DIOSH Day

Exhibit Area

Take advantage of this opportunity to network with hundreds of other safety professionals and learn about resources available to downstate Illinois businesses and employers. In addition to governmental and nonprofit organizations, more than 40 other exhibitors will demonstrate many useful and innovative products and services to help accomplish your safety and health goals–and you can get your questions answered on the spot by knowledgeable company representatives. Be sure to bring plenty of business cards to network within the local safety and health community.Exhibit Area Hours: 7:00 a.m.-2:35 p.m.

Sponsors

Associated General Contractors of Illinois • Caterpillar Inc. • Central Illinois Builders of AGC • Central Illinois Chapter, National Electrical Contractors Association • Central Illinois Chapter of SMACNA • Central Illinois Mason Contractors Association • Grain and Feed Association of Illinois • Illinois Association of Plumbing, Heating and Cooling Contractors • Illinois Chapter, National Electrical Contractors Association • Illinois Manufacturers Association • Illinois Municipal League Risk Management Association • Illinois Society of Professional Farm Managers & Rural Appraisers • Illinois State University, Department of Health Sciences • Mid-Illini Mechanical Contractors • Northern Illinois University - National Safety Education Center • On-Site Safety and Health Consultation Program, DCEO • OSF Center for Occupational Health • Peoria Area Chamber of Commerce • Prairie Branch, APWA • Quad City Chapter, National Electrical Contractors Association • Southern Illinois Builders Association of AGC • State Farm Insurance Company • Tri-County Construction Labor-Management Council • University of Illinois Hazardous Materials Training Program • West Central Illinois Building and Construction Trades Council

In Cooperation with:

DIOSH Day 2016

Annual Governor’s Award for

Contributions in Health and Safety

This award will be presented to a person who has made significant contributions in the areas of safety and/or health through training and/or research which have had a lasting impact on workers in the downstate Illinois area.

Nominations are accepted from:1) Someone making the nomination, or2) Self-nomination.Nomination forms are available at www.dioshday.com and should be submitted no later than January 2, 2016.

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25th AnnuAl DownstAte IllInoIs occupAtIonAl sAfety AnD heAlth DAy weDnesDAy, MArch 2, 2016 • 7 A.M. - 3:45 p.M.Only one registrant per form; photocopy form for additional registrants. Please check one:___ Full Registration. Fee: $110/person($160 after February 25)—Includes morningrefreshments, mini health fair, choice of break-out sessions, handouts, entranceto the exhibit hall, and hot buffet lunch.

Please provide the following information. We must have your e-mail address in order to send confirmation and check-in information. Please print legibly.

NAME

TITLE

COMPANY

STREET

CITY STATE ZIP

Please indicate at right each breakout session you plan to attend by circling your choice next to each session. This information will be used strictly to assist in advance planning for determining classroom size. You will not be held to attend the session you indicated; you may change your mind at any time.

PHONE (____)__________________ E-MAIL _________________________________________________________

___ MasterCard ___Visa ___Discover Account #____________________________________________________

Exp. Date ________________ CVV/Security Code_________________Cardholder’s Name ____________________________________________ Signature _______________________________________________

____ Full Registration for Full-time Students. Fee: $35/person—Includes morning refreshments, Mini Health Fair, choice of breakout sessions, handouts, entrance to the exhibit hall, and hot buffet lunch.

____ Trade Show only. Fee: $10/person

DIOSH DAY 2016Early registration is encouraged, but on-site registration is available. Take advantage of a $50 discount for reservations made by February 25. Fees must be paid by cash, check, or credit card at the time of

registration. Reservations are transferable but not refundable. Confirmation and check-in information is e-mailed to each individual registrant, so it is imperative that you provide an e-mail address.

Online registrations are preferred. Registrations will also be accepted by mail or in person:

• Online at www.DIOSHDay.com• By mail (with check* or Credit Card) to: 401 NE Jefferson Avenue,

Peoria, IL 61603• In person (with cash, check*, or Credit Card) at: 401 NE Jefferson Av-

enue, Peoria, IL 61603*Make checks payable to DIOSH Day. For more information visit our website at www.DIOSHDay.com or call 1-877-DIOSH-DAY (877-346-7432). If special accommodations are needed, please notify the DIOSH registrar in advance.

Registration FormOnline Registration at www.DIOSHDay.com

___Diner’s Club ____American Express

Make your nomination for the Governor’s Health & Safety Award. Nomination form available on the DIOSH Day website.

Privacy Statement: All DIOSH Day related correspondence and materials will be emailed or mailed to the address provided on the registration form. This information will also be provided to exhibitors participating in DIOSH Day 2016. If you do NOT want your information provided to exhibitors, please check here o

Session 1: 1A 1B 1CSession 2: 2A 2B 2CSession 3: 3A 3B 3C 3DSession 4: 4A 4B 4C 4DSession 5: 5A 5B 5C 5DSession 6: 6A 6C 6D

1D

6B

2D