November 15, 2001

A Talladega, Ala. underground utility contractor has agreed to pay $73,000 in penalties after being cited for exposing employees to trenching hazards.

OSHA cited Phipps Construction Company, Inc., for alleged willful and repeat violations of trench safety standards after inspecting a Lincoln job site where the company was performing boring operations in connection with sewer pipe installation.

"The potential for tragedy at this site was real," said Robert Sanchez, OSHA's Birmingham area director. "Excavation walls that are not sloped, shored, or otherwise protected can collapse without notice burying and killing workers trapped within. "

Acting under a Trenching National Emphasis Program which allows self-referrals, OSHA compliance officers initiated an inspection April 24 when they observed employees working in an unprotected trench. Failure to provide a protective system for employees working in the excavation, which was greater than six feet deep, resulted in one alleged willful citation; one alleged repeat citation was issued for failing to perform daily inspections of the trench.

"We cited Phipps Construction in 1999 and 2000 for trenching violations, and again earlier in April 2001 for similar violations on two nearby job sites," said Sanchez. "We found the same kinds of violations again during this inspection. In fact, two days after the inspection was completed, employees continued to enter excavations without protection against potential cave-in."

The company agreed to settle the remaining two OSHA cases completed in April 2001 for an additional $32,000.

OSHA defines a repeat violation as one which occurs when an employer has been cited previously for a similar condition and the citation has become a final order of the Occupational Safety and Health Review Commission.


Failure to provide all required safeguards, including the Hepatitis B vaccine, to protect employees against bloodborne pathogens, has resulted in $60,100 in proposed fines against a Salem, Massachusetts-based ambulance service.

Following inspections conducted in response to employee complaints, OSHA has cited Northshore Ambulance for alleged willful and serious violations at its facilities in Salem, Peabody, Swampscott and Beverly, Mass.

"To protect workers who are exposed to bloodborne pathogens, employers must follow stringent procedures. Our inspection found that key health standards were not being met," said Richard Fazzio, OSHA area director for Northeastern Massachusetts.

"Northshore Ambulance did not supply employees with Hepatitis B vaccine in a timely manner and also failed to dispose of regulated waste in accordance with health regulations," he said. "As an ambulance carrier, this employer knew these requirements yet apparently chose to ignore them. Therefore, we are issuing a willful citation and proposing a $44,000 fine."

OSHA defines a willful violation as one committed with an intentional disregard of, or plain indifference to, the requirements of the Occupational Safety and Health Act and regulations.

A fine of $16,100 is proposed for 11 alleged violations classified as serious, including failure to provide workers with initial bloodborne pathogen training, lack of decontamination procedures, failure to supply face shields and protective clothing, failure to launder contaminated uniforms, lack of containers or areas to dispose of contaminated materials and failure to review its exposure control plan. A serious violation is defined as one in which there is a substantial probability that death or serious physical harm could result, and the employer knew, or should have known, of the hazard.

The company has 15 working days from receipt of the citations and proposed penalties to either elect to comply with them, to request and participate in an informal conference with the OSHA area director, or to contest them before the independent Occupational Safety and Health Review Commission.


As first responders in communities across the U.S. contend with actual and suspected cases of anthrax exposure, the nonprofit NFPA has created a page on its Web site to provide free and simplified access to its hazardous materials response standards and other relevant information. In addition to anthrax threats, first responders also face daily encounters with common chemicals that can be even deadlier. Regardless of the type of chemical or bio-hazard, all first responders must be adequately informed for their own safety and well-being.

Widely adopted and used internationally by fire and emergency service workers, the three model consensus documents have been posted as free Adobe Acrobat PDF downloads. They are NFPA 471, Recommended Practice for Responding to Hazardous Materials Incidents; NFPA 472, Professional Competence of Responders to Hazardous Materials Incidents; and NFPA 473, Professional Competence of Emergency Medical Responders to Hazardous Materials Incidents. In addition, NFPA is offering PDF files of supplemental materials taken from their Hazardous Materials Response Handbook.

"NFPA's goal is to support the public safety mandate of first responders while at the same time reinforcing the importance of their own safety from occupational hazards," says NFPA's public fire protection chief Gary Tokle. "Chemical and biological terrorism are high-profile topics today; yet fire and emergency response personnel deal with common hazardous materials on the job every day. It is essential that they understand and adhere to the established standards of haz-mat response."


OSHA has issued a safety and health guide to help employers provide a safer workplace for workers exposed to metalworking fluids.

The publication of "Metalworking Fluids: Safety and Health Best Practices Manual" is the culmination of four years of work by the Metalworking Standards Advisory Committee, whose goal was to help reduce the adverse health effects of working with metalworking fluids.

"Millions of workers in the manufacturing industry work with these types of fluids daily," said OSHA Administrator John L. Henshaw. "There is extensive scientific evidence that continued occupational exposure to metalworking fluids can have serious health risks. We believe this guide is an important first step in arming employers with viable preventative measures to help reduce those risks."

Metalworking fluids include a complex mixture of oils, detergents, lubricants and other potentially toxic ingredients, and are used mainly for their coolant, lubricating and corrosion resistant properties during machining operations. Occupational exposure to these fluids can have harmful health effects and has been associated with skin problems such as contact dermatitis, and various respiratory diseases including bronchitis. A number of epidemiological studies has found evidence that exposures to metalworking fluids can cause substantially elevated risk of cancer of the pancreas, bladder, larynx, scrotum and rectum.

The manual provides general information about metalworking fluids and recommends a systems management approach to control exposure and minimize contact with the fluid. That strategy includes engineering and work practice controls such as machine enclosure, ventilation and the use of personal protective equipment.

The guide also recommends employers establish a fluid management program that includes designating responsibility of the system to one or more persons knowledgeable in the chemistry involved in metalworking processes. The program should also include standard operating procedures for testing fluids, a data collection and tracking system, employee participation in setting up and operating the overall system, and a continuing training program.

Also included in the guide are recommendations for instituting an exposure monitoring program (air sampling) on, at minimum, an annual basis. The manual recommends that employee exposures be reevaluated whenever there are significant changes in production, equipment, or processes that may cause new or additional exposures to metalworking fluids. Finally, the manual recommends a proactive medical monitoring program for exposed employees that will help identify early evidence of respiratory impairment or skin disease. That early identification will prompt corrective action, which will help reduce the incidence and severity of metalworking fluid-associated diseases.

The Metalworking Fluids Best Practices Manual is not a new standard or regulation, and it creates no new legal obligations. It is advisory in nature, informational in content, and is intended for use by employers in providing a safe and healthful workplace for workers exposed to metalworking fluids. 


OSHA has announced a special national emphasis program that is aimed at reducing amputations in general industry workplaces.

The National Emphasis Program on Hazardous Machinery Associated With Amputations expands the existing national emphasis program on mechanical power presses. This new initiative targets all types of power presses, including press brakes, saws, shears, slicers, and slitters.

"Operating this type of equipment can be very dangerous. Injuries involving these machines are often fatal or result in permanent disability," said OSHA Administrator John L. Henshaw. "This new program will help us identify and guard against the workplace hazards that are likely to cause amputations."

The program applies to general industry workplaces where these machines are present. Companies with fewer than ten employees are also included, except those industries exempted from programmed inspections.

The method to calculate amputation rates has changed. Rates for each industry are now figured using the number of employees in each SIC code. In the past, industries were targeted by the number of amputations, not taking into consideration the actual size of the industry. This new information will allow greater flexibility for regions and area offices to target and inspect the most hazardous workplaces.

Outreach programs will be carried out by the regional and area offices to identify, reduce and eliminate workplace hazards associated with these machines. Programs may involve employers, professional associations, and local unions, or other activities designed to involve employee and management stakeholders in the identification and elimination of hazards associated with such equipment.

The twenty-four states and two territories that operate their own OSHA programs are encouraged, but not required, to adopt a similar emphasis program. 


An NIH Clinical Center researcher, in collaboration with physicians in Maryland and Washington DC, has published a detailed assessment of the fatal cases of inhalation anthrax that occurred in two District of Columbia postal workers. 

"These results are presented in an effort to make doctors aware of what to look for when diagnosing suspected anthrax patients," said Dr. Luciana Borio, lead author of the paper. Borio, who is fellow in the Critical Care Medicine Department of the NIH Clinical Center and researcher at the Johns Hopkins Center for Civilian Biodefense Studies, published the findings in collaboration with physicians at the Greater Southeast and Southern Maryland Hospitals, and the DC and Maryland Medical Examiners Office. An accompanying editorial by Anthony S. Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases (NIAID) and H. Clifford Lane, MD, NIAID Clinical Director, is also posted on the JAMA website.

Because the symptoms in these two cases were nonspecific, they were initially misidentified as flu or other common infections. However, a later review of the laboratory data showed pathology different from common infections, according to Borio. Both patients' blood tests showed increased white blood-cell counts and concentrated red blood-cell counts. Neither finding would normally be seen in flu patients, said Borio. In addition, blood cultures quickly showed long chains of the distinctive anthrax bacilli.

"Laboratory tests should be ordered if there is any suspicion of anthrax," Borio stressed. "Both cases show the importance of testing by microbiology laboratories with staff experienced in growing and identifying these unusual organisms."

Both postal workers also developed fluid build up in the chest and infiltrates in the lungs that resembled pneumonia on radiological images. "It would have been easy to misdiagnose these cases as pneumonia, and thus rule out anthrax, if doctors had relied on the x-rays alone," said Borio.

"It's essential that doctors are familiar with how anthrax presents in order to distinguish it from more common infections," said Borio. "Both patients were sick enough to seek medical help," she said, "but neither had symptoms that would normally require further tests or hospitalization, so they were initially sent home."

The two anthrax victims were among five postal workers who worked at the Brentwood postal facility in Washington who contracted anthrax in October. One had gastrointestinal symptoms, including nausea, vomiting and stomach pain. The other had flu-like symptoms, including muscle ache, discomfort and fatigue. Both developed chest pain and breathing difficulty, eventually requiring a respirator.

Doctors made a working diagnosis of anthrax after the media reported two other postal workers from the same facility were diagnosed with anthrax. Although both were treated with antibiotics, both died within 24 hours of hospitalization.

"Without warning that anthrax was present in the community, doctors would be unlikely to consider such a rare condition," said Dr. Henry Masur, chief of critical care medicine at the NIH Clinical Center. "The analysis and prompt publication of these findings will help doctors avoid such tragic consequences in the future."