April 12, 2001

The Federal Aviation Administration (FAA) today issued a final rule requiring U.S. airlines to carry automated external defibrillators (AEDs) and enhanced emergency medical kits (EMKs) on all domestic and international flights within three years. The rule, which responds to the Aviation Medical Assistance Act of 1998, affects airplanes that weigh more than 7,500 pounds each and have at least one flight attendant.

An estimated 350,000 Americans are struck by cardiac arrest each year. Cardiac arrest stops effective pumping of blood to the heart. An abnormal heart rhythm called "ventricular fibrillation" is the most common form of treatable cardiac arrest. Chances of survival can be as high as 90 percent if defibrillation -- electrical shocks that stimulate the heart to resume normal beating -- is provided during the first minutes following collapse.

"Nine airlines either currently carry AEDs and enhanced kits or have made a commitment to do so," said FAA Administrator Jane F. Garvey. "Our rule will ensure that all airline passengers have access to this potentially life-saving device."

The FAA rule also expands the EMK by adding medications that may help passengers who suffer an in-flight medical event. The following items will be added to each EMK:

  • oral antihistamine
  • non-narcotic analgesic
  • aspirin
  • atropine
  • bronchodilator inhaler
  • lidocaine and saline
  • IV administration kit with connectors
  • AMBU bag (to assist respiration following defibrillation)
  • CPR masks

An EMK is already equipped with:

  • sphygmomanometer (measures blood pressure)
  • stethoscope
  • three sizes of oral airways (breathing tubes)
  • syringes
  • needles
  • 50 percent dextrose injection (for hypoglycemia or insulin shock)
  • epinephrine (for asthma or acute allergic reactions)
  • diphenhydramine (for allergic reactions)
  • nitroglycerin tablets (for cardiac-related pain)
  • basic instructions on the use of the drugs
  • latex gloves

All crewmembers will receive initial training on the EMK and on the location, function, and intended operation of an AED. Flight attendants will receive initial and recurrent training in CPR and on the use of AEDs.

Medical personnel are frequently onboard and can assist fellow passengers during an in-flight medical event. In addition, a "Good Samaritan" provision in the Aviation Medical Assistance Act of 1998 limits the liability of air carriers and non-employee passengers unless the assistance is grossly negligent or willful misconduct is evident.

The total estimated cost to the airline industry over 10 years for equipment, medications, and initial and recurrent crew training is $16 million.


"The United States enjoys what I believe is the safest and the best transportation system in the world. However, we face safety and capacity challenges," Secretary Mineta said. "The funding requested in the 2002 budget will help us to address those challenges and save lives, relieve congestion, reduce environmental impacts, and provide greater mobility for all Americans."

The $59.5 billion budget represents a 6 percent increase over fiscal 2001 when last year's one-time projects, which total over $2.8 billion, are subtracted, Secretary Mineta said.

The budget includes full funding for highway and transit guarantees under the Transportation Equity Act for the 21st Century (TEA-21), with highway funding increased by 6 percent from 2001 and transit up by nearly 8 percent. Funding for programs under the Wendell H. Ford Aviation Investment and Reform Act for the 21st Century (AIR-21) would increase by 6 percent.

In addition, the budget includes $521 million for Amtrak capital programs, and $145 million for the President's New Freedom Initiative to ensure transportation alternatives for people with disabilities.

Secretary Mineta stressed that safety is the department's number one priority, and that the budget includes over $7 billion for safety programs, including a total of $400 million to reduce motor carrier fatalities. The proposed budget includes an increased investment of $88 million for state and federal enforcement activities and inspection infrastructure to support opening the southern border.

The budget funds activities to implement the Transportation Recall Enhancement, Accountability, and Documentation (TREAD) Act, which requires updating tire safety standards, increasing crash data collection, developing dynamic rollover tests and improving the safety of child restraints.

In an effort to reach the goal of an 80 percent reduction in fatal U.S. aviation accidents by 2007, aviation safety funding would increase 4 percent to over $4 billion, including $112 million -- up 13 percent from 2001 -- to prevent runway incursions.

Funding for rail safety programs would increase 9 percent to $154 million, the U.S. Coast Guard's search and rescue programs 12 percent to over $1 billion, and pipeline safety 15 percent to $54 million.

The budget provides resources to ease transportation congestion, which is caused by the gap between demand for transportation and the capacity of transportation infrastructure. Total investment in transportation infrastructure would reach almost $43 billion in 2002, up 39 percent from the average annual investment between 1994 and 2001. A total of $2.9 billion is proposed for aviation capital modernization, including funding for delay reduction initiatives such as better weather systems and improved automation aids. In addition, the budget includes $253 million for Intelligent Transportation Systems, up 32 percent.

A total of $6.6 billion is proposed to lessen the environmental effects of transportation, including the Coast Guard's response to oil spills and the Maritime AdministrationÆs disposal of obsolete vessels.

In support of the President's drug control strategy, funding for the Coast Guard's drug law enforcement activities increases 19 percent to $759 million.


The U.S. Department of Transportation's National Highway Traffic Safety Administration (NHTSA) today announced the availability of a computer CD-ROM containing summaries of 400 motor vehicle trauma cases investigated by nine Crash Injury Research and Engineering Network (CIREN) Centers around the country.

CIREN was established in 1996 and is a multi-center research program involving clinicians and engineers in hospitals, universities, industry, and government. CIREN's mission is to improve the treatment and rehabilitation of motor vehicle crash injuries and to prevent and reduce deaths, disabilities, and human and economic costs of highway crashes.

Nine Level 1 Trauma Centers are linked together through a computer network associated with this research program. Level 1 Trauma Centers are traditionally teaching institutions associated with a university. Of these existing centers, seven are funded by NHTSA, one by Mercedes-Benz, and one by Ford. Together, they are studying crashes, injuries, and treatments to improve processes and outcomes. Researchers can review data and share expertise, which could lead to the design of safer vehicles.

Each center collects detailed crash and medical data on approximately 50 motor vehicle crashes per year. After the necessary coding and quality control takes place, the information is added to a database on the computer network linking the centers. The CIREN database, as currently configured, consists of multiple discrete fields of data concerning these crashes, including crash reconstruction and medical injury profiles. Personal and location identifiers and highly sensitive medical information have been removed from the public files to protect patient confidentiality.

There are about 133 cases, extending back to 1996, for which coding and quality control have been completed, and these are now available for viewing at the NHTSA public access workstation. Additional cases will be released to the public as they become available. The CIREN website is expected to contain 600 cases by Sept. 30, 2001.

The CD-ROM also contains a Microsoft Excel spreadsheet of selected variables that can be used to narrow a search. These variables were selected to provide a range of search capabilities that should prove helpful to auto safety investigators and medical researchers. The CD-ROM can be purchased for $57 from the National Crash Analysis Center, 20101 Academic Way, Suite 203, Ashburn, VA 20147. The telephone number is (703) 726-8236 and the fax number is (703) 726-8358.


Effective last Friday, textile manufacturers that use an improved method of washing raw cotton to eliminate the risk of byssinosis are exempt from all provisions of the OSHA cotton dust standard except the requirements for recordkeeping and medical surveillance.

On Dec. 7, 2000, OSHA published a direct final rule amending its cotton dust standard to include the "batch kier" cotton washing method among other procedures exempted from portions of the cotton dust standard. At that time, the agency announced that if no adverse comments were received within 60 days, the changes would take effect on April 6, 2001. No comments were received.

In partially exempting the batch kier method from the cotton dust standard, OSHA was following the recommendations of the Task Force for Byssinosis Prevention. The task force includes OSHA, the National Institute for Occupational Safety and Health, the Department of Agriculture, the National Cotton Council, the American Textile Manufacturers Institute and the Union of Needletrades, Industrial and Textile Employees.

OSHA's 1978 cotton dust standard was amended in 1985 to partially exempt cotton washed in a continuous flow system. Washing raw cotton before it is spun and woven eliminates the risk of byssinosis, commonly known as "brown lung," for workers exposed to cotton dust. The earlier exemptions did not apply to the batch kier method-in which raw cotton is repeatedly washed in a giant kettle-since this method had not been demonstrated to eliminate the bioactivity of cotton dust. More recent research and testing evaluated by the task force indicated that advances made in the batch kier method are sufficient to protect workers against byssinosis.

OSHA chose the direct rule approach since the changes had received universal support from labor and industry. This procedure saves regulatory resources by eliminating the notice and comment portion of the rulemaking, which is unnecessary if there is no opposition to a rule.

Notice of the partial exemption from the cotton dust standard for the batch kier washing method appeared in the April 6, 2001 Federal Register.


OSHA has issued a willful citation, serious citation and other-than-serious citation to the Laidlaw Transit Services district office in Commerce City, Colo. The citations carry a total of $123,000 in proposed penalties for alleged job safety violations at Boise Urban Stages in Boise, Idaho.

The citations were issued following an investigation by OSHA's Boise Area Office in response to an employee complaint, according to Ryan Kuehmichel, area director for the Boise office.

Laidlaw Transit Services' willful citation stated that equipment, wiring methods and installations of equipment in hazardous locations were not safe or approved for those locations.

The serious citation noted the following violations: the company did not provide a workplace free from the recognized hazards and employees were exposed to the hazard of fire and explosion from an inadequately maintained Compressed Natural Gas Compression System; employees were exposed to being struck or crushed by an inadequately designed and installed crane; trapdoor floor openings were not guarded by floor opening covers; compressed gas cylinders were not inspected regularly; fall protective equipment was not provided; the employer did not provide a written respiratory protection program or an energy control procedure or training; machine guarding was not provided; and there was a lack of material safety data sheets for each hazardous chemical used and lack of information and training on hazardous chemicals used in the workplace.

The other-than-serious citation stated that the floor-rated load capacity was not determined or posted at the overhead storage mezzanine area; and there was a lack of a written emergency actiit plan and lack of training on the use of portable fire extinguishers for employees.

According to Kuehmichel, the company has 15 working days to contest the citations.

A willful violation is defined by OSHA as one in which an employer knew that a condition constituted a violation or was aware that a hazardous condition existed and made no reasonable effort to correct it.

A serious violation is defined by OSHA as one in which there is substantial probability that death or serious physical harm could result, and the employer knew or should have known of the hazard.


OSHA cited Spiral Industry, Inc., a Birmingham manufactured home builder, and fined the company $79,600 following investigation of a fatal accident.

An employee was critically injured on Oct. 12 when he was caught between two sections of a double-wide mobile home as they were being pushed together. The victim died a month later after surgery in connection with his injuries.

Following an investigation of the accident, OSHA cited Spiral Industry for 12 serious and five repeat safety violations.

The 12 serious citations, with penalties totaling $47,600, included:

  • failure to protect employees from potential crushing hazards when mobile home sections are moved;
  • failure to protect workers from fall hazards by properly guarding suspended platforms and ensuring they remain free of debris;
  • neglecting to install toe boards on suspended platforms to protect employees from overhead hazards;
  • exposing employees to fire and explosion hazards by failing to protect a gasoline tank from vehicular damage during refueling operations;
  • failure to provide workers with proper personal protective equipment;
  • failure to properly label hazardous chemicals;
  • lack of a workplace hazard assessment, and
  • unguarded belts and pulleys.

The remaining penalty of $32,000 was proposed for violations which were categorized as repeat because the company had been cited for the same or similar hazards previously. These included failure to install adequate guarding at suspended platforms; allowing suspended platforms to be cluttered with debris; failure to properly identify exits; unguarded saw blades, and failure to identify circuits and disconnects which could cause electrical shocks.

"This employer did not take necessary precautions to safeguard workers from crushing hazards while joining two halves of a double-wide home," said Paul Alvarado, OSHA's acting area director in Birmingham. "Several safety lapses contributed to the fatal accident, including failing to ensure that the mobile home sections were unoccupied before they were pushed together; not notifying nearby employees of the planned movement, and reassigning æspotters' to help push the motor home sections rather than ensuring that they remained at their stations to look out for the safety of other employees."

Alvarado added, "Other protective measures were also lacking. Workers on a suspended platform without guardrails were placed at substantial risk of injury from falls and others working with unguarded saws were exposed to potential cuts and amputations."

Spiral Industry, which employs approximately 120 workers, has 15 working days to contest OSHA's citations and proposed penalties before the independent Occupational Safety and Health Review Commission.