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Workers’ Health and Safety
CAPT James Spahr, MPH, RS, DAAS Associate Director, NIOSH-OD-EPRO
Deepwater Horizon PanelUSPHS Scientific and Training Symposium
June 20, 2011
National Institute for Occupational Safety and Health
Office for Emergency Preparedness and Response
Examining NIOSH’s Health Hazard Evaluation at the Deepwater Horizon Response
Worker Risks & NIOSH Objectives Response
Objectives: To provide
opportunity for every response worker to be counted
To prevent illness and injury real-time during the event by reducing or eliminating exposures
Health & Safety Risks:
Injury and Illness Chemical
Exposures Heat Stress Work Stress Fatigue Mental Health
Federal Response Leadership
Key NIOSH Impact Activities• Technical Guidance and
Communication• Toxicity Testing• Health Surveillance• Rostering• Health Hazard Evaluations Worker repairing boom
(HHE participant)
Interim Guidance for Protecting Deepwater Horizon Response
Workers and Volunteers National Institute for Occupational Safety and Health, Centers for Disease
Control and Prevention, U.S. Department of Health and Human Services andOccupational Safety and Health Administration, U.S. Department of Labor
June 25, 2010
For more information on general disaster response, consult the NIOSH Emergency Response Topic Page at
http://www.cdc.gov/niosh/topics/emergency.html
Technical Guidance and Communication
NIOSH and OSHA Collaboration
• CDC provided health information to 14 million Gulf region residents• Posted 16 new interim guidance documents; • Posted 5 interim guidance documents with OSHA Co-branding• Cleared & released 60 unique documents & fact sheets • CDC Web pages received more than 225,000 page views
Toxicity TestingAcute animal testing (rats):
Dispersant (Nalco Corexit 9500A) Crude Oil from the source Dispersant/crude oil mixture
Inhalation studies Measuring Pulmonary, cardiovascular, and Central Nervous System outcomes
Dermal studies Assessing hypersensitivity and immune-mediated responses
Six Dispersant Abstracts: The Journal of the Federation Amer. Soc. For Experimental Biology - April 2011, Vol 25 (4)
Health Surveillance ResourcesPromoting Response “Safety
Culture”
• BP/UAC health data• Hospital Emergency Department
data• State surveillance data• Poison Control Centers, and
BioSense data• BP injury and illness data analysis• HHS/ASPR on Medic Log data• Roster worker questionnaire• HHE Health Symptom Surveys
NIOSH Injury and Illness Report of BP Incident Data
Responder Rostering Roster ≠ Registry
• Rostered over 55,500 response workers• Staging areas and training sites• Paper-based and web-based• BP employees, contractors, federal, state
employees, & volunteers
Rostering Workers in LA
27092; 51%
19360; 36%
4253; 8%
1623; 3% 1233; 2%
Race/Ethnicityfrequency, percent
Non-Hispanic whiteNon-Hispanic blackHispanic or Latino/LatinaAsianOther
NIOSH received a request from BP for a Health Hazard Evaluation of workers responding to Deepwater
Horizon Oil Spill
• Evaluate responder activities and controls
• Conduct health monitoring
Observational assessments of work activities
Health symptom surveys
• Conduct exposure assessment
Industrial hygiene monitoring
• Provide remediation recommendations
NIOSH’sHealth Hazard EvaluationProgram
When an HHE Can Help
• New hazards, exposures, or processes
• Illnesses from an unknown cause• Exposure to unregulated agents• Adverse health effects at
exposures less than the standards
• Emergency Response SituationsBP Responders being hospitalized ….
BP Request received on May 28th, and
first NIOSH team was on the ground by June 2nd.
9 HHE Reports ~ 20 Worksites Assessed Multiple Types of Workers
(n=3211)Off-Shore (41%)
– Dispersant vessels
– In-Situ Burn vessels
– Skimming vessels
– Booming– Shrimp
trawlers– Source Vessels
On-Shore (59%)– Wildlife– 67 sites of
Beach Clean-up– Decontaminati
on– Waste
Management– BP
Administration (work organization & resiliency)
–Demographics –Work History–Employer–Days on oil spill, boat–Exposures to oil, dispersant, chemicals–Symptoms: Heat stress; by organ system; job stress– Skin contact with oil– Respirator use
Roster had initially included:
• Past Medical history,• Pharmaceutical use,• Smoking History,• Training
So these things were not asked.
At the sites, we surveyed
workers
Industrial Hygiene Sampling:
Measured 111 different chemical constituents 42 on personal breathing zone air
samples92 on general area air samples
2,577 total air samples were
collected
33% were personal breathing zone air
sample points
67% were general air sample points
Occupational Exposure Limits
• Levels below which most of the working population could be exposed on a regular basis with a low risk to health– Considers a critical health effect –the one
effect at the lowest level, acute or chronic– Determines an exposure-response relationship– Considers the Acceptability of Risk and the
Extent of Uncertainty– Based on expert opinion & science & politics
Evaluation of Dispersant Use
Applied from a boat
Applied from the air
Large containers of dispersant connected to
hoses
Dispersant Vessel: on this boat, scientists evaluated the efficacy of the dispersant
breaking up the oil
Corexit®
9500ADispersant applied to surface oil
Dispersant breaking up the Oil on the Surface of the Gulf
Note the PPE* useOf the Dispersant Applicator:Impermeable suit with hood, gloves, cartridgerespirator, goggles,steel-toed boots, life vest
PPE=personal protective equipment
Chemical dispersants being released near Houma, Louisiana in the Gulf of Mexico (USCG photo)
We evaluated aerial release of dispersant from a support aircraft
Dispersant monitoring 1 hour
after aerial sprayingNote the difference in personal protection
equipment : only wrist-length gloves
• Symptom surveys given within 1 hour after
dispersant application• 4 hours later, each participant was interviewed
Health Surveys on The Dispersant Vessels
Results : workers monitored after aerial spraying reported more headaches, exhaustion, and skin symptoms compared to Dispersant ship; they wore less PPE, and were out in sun longer
Measurement Results on the Dispersant VesselsAll samples* were at non-detectable or low concentrations well below occupational exposure limits (OELs)
OELs= Occupational Environmental LimitsVOCs = volatile organic compoundsOEL: occupational exposure limits
*VOCs, 2-butoxyethanol, benzene, ethanol, ethyl benzene, naphthalene, toluene, CO, H2S, dipropylene glycols, mercury, total hydrocarbons
A pair of shrimping trawlers towed 300 feet of boom trailing and capturing floating oil, until it was about 3 mm thick.
Evaluation of In-Situ Burns
The oil would be litby an igniter
Note the burning oil plume of smoke and the proximity to the small boat
– the burn duration ranged 45 minutes to 6 hours
Health Survey at the In-Situ Burns
• 39/65 workers surveyed
• Most frequent symptoms: upper respiratory symptoms, headaches, fatigue, back pain, and feeling stressed, worried, and pressured.
Measurement Resultsat the In-Situ Burn
• Samples* were either non-detectable or well below OELs• Carbon monoxide peak exposure was above NIOSH REL ceiling limit; occurred when the gasoline powered engines idling.
OELs= Occupational Environmental LimitsOEL: occupational exposure limitsREL: recommended exposure limit
*VOCs, 2-butoxyethanol, benzene, ethanol, ethyl benzene, naphthalene, toluene, H2S, dipropylene
glycols, mercury, total hydrocarbons
Recommendations: In Situ Burns
• Vessels should stay much further away from the fire because of potential exposure to combustion products
• Workers should wear appropriate fire resistant PPE
• No need for continuous wearing of respirators…but… during emergency situations, (shifts in wind), use Escape Respirators
• Attend to idling of boats and potential CO exposure
Evaluation at the Spill Source
“The Source” above the leaking well on the ocean floor, at the Time of the NIOSH HHE
DDII:The relief well
Discoverer Enterprise:
Vessel capturing leaking oil
Source Workers on VesselsRisk of exposure to
contaminants from oil:– Proximity to the source
of the oil– Enclosed spaces– Flares created possible
exposures to combustion by‐products. However, these were full time oil rig workers, and their exposure to oil was not novel…
Health Survey on the Source Vessels
• 62/178 completed the survey • Most frequent symptoms:
– Heat Stress symptoms– Nose or eye irritation– Headaches– Stress (worried, pressured,
stressed, short tempered) on the DDII
Measurement Results at the Source
• Low concentrations of VOCs were detected on both vessels. Most abundant were C10‐C16 aliphatic hydrocarbons.
• Samples* were all well below OELs
– On DD II: 69% (90/130) below detectable levels
– On D. Enterprise: 67% (94 of 140) below detectable levels *VOCs, propylene glycol ethers, sulfides, PAHs, CO,
H2S, toluene, naphthalene, limonene, ethyl benzene, 2 -butoxyethanol
Recommendations at the Source
• No need for routine respirator use, but make respirators immediately available for uncontrolled situations
• Attend to Heat Stress Management Plan
• Consider a special emphasis follow-up with regard to Employee Assistance Program service, due to stress reported on DDII
Evaluated Barge Vacuuming of Oil
• Lack of fall protection: workers bending at 8 ft ledge• Musculoskeletal risk: from continuous bending • Noise risk: from vacuum - lack of hearing protection
Most Frequent Symptoms: Scrapes and cuts; Itchy
skin or rash; Headache or feeling faint, dizzy, or fatigued; Hand, shoulder, or back pain
Evaluated Wildlife Cleaners
Recommendations: Follow heat stress management plans; Minimize skin & mucus membrane exposures; Follow ergonomic recommendations; Provide adequate staffing & work rotation schedules
Evaluated Shore Workers
Health Survey in On-Shore Workers*
• Evaluated 1,899 workers at 67 work sites.
• Most frequently reported symptoms
Upper and lower respiratory symptomsHeat stress symptomsSkin symptomsHand, shoulder, and back painPsychosocial and stress symptoms *Located in Louisiana, Alabama, Florida, and
Mississippi.
IH Measurement Results for On-Shore Sites
• None of the individuals’ chemical exposures exceeded any OEL– Personal breathing zone sampling on 24
individuals– 154/261 (59%) samples: non-detectable– 25/107 (23%) detectable samples less
than minimum quantifiable concentration
• Workers around pressure washers likely to have exposures above NIOSH noise REL* * REL= recommended exposure limit
85 decibels, A-weighted, as an 8-hr Time-Weighted Average
On-Shore Worker Recommendations
• Minimize contact with oil through work practices and PPE
• Follow heat stress management plan, including the role PPE may add to heat stress risk
• Improve design of tools for beach cleaning• Address hearing protection and
conservation• Maintain routine reporting of illnesses and
injuries• Employ pre-placement medical evaluations
of workers
HHE Conclusions• Worker exposures to oil constituents
and dispersant chemicals well below OELs
• Concentration above OELs were known hazards (CO from idling boats, noise)
• Health surveys identified heat exposure as major worker exposure
• Targeted groups had explainable exposures and symptoms (wildlife handlers: cuts and scrapes; in-situ burns: upper respiratory; beach cleaners: back pain; source workers: stress and work pressure)
How HHEs Resolve Problems
Multi-disciplinary Approach
Confirm
Anticipate
Evaluate
Risk Management
Decision-MakingFrameworkControl
Recognize
Health and Medicine:Physician, Nurse, Vet, PsychologistsControl Measures:EngineerField & Lab Methods Development:Lab Scientist
Exposure Assessment:Industrial Hygienist
Thank You
http://www.cdc.gov/niosh/topics/oilspillresponse/gulfspillhhe.html
The NIOSH Health Hazard Evaluation Interim Reports can be found at:
Acknowledgements:Members of the Hazard Evaluation and Technical Assistance Branch and other branches of NIOSH involved in the DWH response, especially:
•Allison Tepper, PhD
•Teresa Seitz, MPH, CIH•Bruce Bernard, MD•John Gibbins, DVM• Brad King, MPH, CIH•Nancy Burton, PhD, CIH•Chad Dowell, MS, CIH•Kenny Fent, PhD•Renee Funk, DVM, MPH•John Halpin, MD, MPH•Margaret Kitt, MD, MPH
Questions?
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: [email protected] Web: http://www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
National Institute for Occupational Safety and Health
Emergency Preparedness and Response Office