Purpose: Ethylene oxide, chapter 296-62 WAC, General occupational health standards; chapter 296-855 WAC, Ethylene oxide; and chapter 296-841 WAC, Respiratory hazards; the department has rewritten and clarified requirements relating to ethylene oxide. The department has amended the rule in chapter 296-62 WAC to only apply to agriculture and adopted ethylene oxide as a new chapter for all other industries, chapter 296-855 WAC. This rule making was part of our goal to rewrite all of WISHA's general occupational safety and health rules for clarity. The department has eliminated unnecessary requirements and outdated terminology.

     Citation of Existing Rules Affected by this Order: Amending WAC 296-62-07355 Ethylene oxide and 296-841-100 Scope.

     Statutory Authority for Adoption: RCW 49.17.010, 49.17.040, 49.17.050, 49.17.060.

      Adopted under notice filed as WSR 05-10-076 on May 3, 2005.

     Changes Other than Editing from Proposed to Adopted Version: WAC 296-855-100 Scope.

•	Changed the reference in step three to reflect the correct number. Step three now reads: "You need only follow Exposure Records, WAC 296-855-20080."
•	Clarified the language in Table 1, Sections That Apply to Your Workplace. The third row now reads "Employee exposure monitoring results are above the AL and below the STEL."

WAC 296-855-20020 Exposure control areas.

•	Clarified the language in this section. The fourth primary bullet now reads: "Make sure employees entering exposure control areas have appropriate respirators available for use."

WAC 296-855-20050 Employee protective measures.

•	Deleted the language in this section.
•	Changed the heading of this section to "Exposure evaluations."
•	Moved the language from WAC 296-855-20060 into this section.
•	Changed the reference number for exposure records in the first note, it now reads: "You can use Steps three through six of this process to create a written description of the procedure used for obtaining representative employee exposure monitoring results, which is a requirement in Exposure records, WAC 296-855-20080 in this chapter."

WAC 296-855-20060 Exposure evaluations.

•	Moved the language from this section into WAC 296-855-20050.
•	Changed the heading of this section to "Notification."
•	Moved the language from WAC 296-855-20070 into this section.

WAC 296-855-20070 Notification.

•	Moved the language from this section into WAC 296-855-20060.
•	Changed the heading of this section to "Exposure records."
•	Moved the language from WAC 296-855-20080 into this section.

WAC 296-855-20080 Exposure records.

•	Added language under the first primary bullet for clarity. It now reads: "The operation being monitored for employee exposure to EtO."
•	Moved the language from this section into WAC 296-855-20070.
•	Changed the heading of this section to "Documentation records."
•	Added language to this section for clarity, it reads:
	"You must:

•	Keep documentation you develop, of the processing, use, or handling of products made from or containing EtO that conclusively demonstrates that the action level or STEL for EtO cannot be exceeded under any foreseeable conditions of use.
•	Include the following in the documentation record:

-	The product that is the subject of the documentation;
-	The source of the data;
-	Any testing protocol, results of testing, and/or analysis of the product for the release of EtO;
-	A description of the operation where the product is used and how the data support your conclusion; and
-	Other data relevant to the operations, materials, processing, or employee exposures covered by your conclusion.

•	Maintain the documentation record for as long as you rely on your conclusion that the action level and STEL cannot be exceeded."

WAC 296-855-20090 Training.

•	Added language under the third primary bullet for clarity. It now reads: "The location and availability of this chapter."

WAC 296-855-30030 Medical evaluations.

•	Changed the number of business days in step four from twenty to five to reflect the correct amount of days.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 19, Amended 2, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 19, Amended 2, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 19, Amended 2, Repealed 0.

     Date Adopted: August 23, 2005.

Gary Weeks

Director

OTS-7944.1

AMENDATORY SECTION(Amending Order 91-07, filed 11/22/91, effective 12/24/91)

WAC 296-62-07355   Ethylene oxide.   Scope and application.

Note:

The requirements in WAC 296-62-07355 through 296-62-07386 apply only to agriculture. The requirements for all other industries relating to ethylene oxide have been moved to chapter 296-855 WAC, Ethylene oxide.

     (1) WAC 296-62-07355 through 296-62-07389 applies to all occupational exposures to ethylene oxide (EtO), Chemical Abstracts Service Registry No. 75-21-8, except as provided in subsection (2) of this section.

     (2) WAC 296-62-07355 through 296-62-07389 does not apply to the processing, use, or handling of products containing EtO where objective data are reasonably relied upon that demonstrate that the product is not capable of releasing EtO in airborne concentrations at or above the action level, and may not reasonably be foreseen to release EtO in excess of the excursion limit, under the expected conditions of processing, use, or handling that will cause the greatest possible release.

     (3) Where products containing EtO are exempted under subsection (2) of this section, the employer shall maintain records of the objective data supporting that exemption and the basis for the employer's reliance on the data, as provided in WAC 296-62-07375(1).

[Statutory Authority: Chapter 49.17 RCW. 91-24-017 (Order 91-07), § 296-62-07355, filed 11/22/91, effective 12/24/91;88-23-054 (Order 88-25), § 296-62-07355, filed 11/14/88; 87-24-051 (Order 87-24), § 296-62-07355, filed 11/30/87.]

OTS-7287.3

AMENDATORY SECTION(Amending WSR 04-18-079, filed 8/31/04, effective 11/1/04)

WAC 296-841-100   Scope.   This chapter applies only if your employees:

     • Are exposed to a respiratory hazard

     OR

     • Could be exposed to one of the specific hazards listed below.

     This chapter applies to any workplace with potential or actual employee exposure to respiratory hazards. It requires you to protect employees from respiratory hazards by applying this protection strategy:

     • Evaluate employee exposures to determine if controls are needed

     • Use feasible controls. For example, enclose or confine the operation, use ventilation systems, or substitute with less toxic material

     • Use respirators if controls are not feasible or if they cannot completely remove the hazard.

     Definition:

     Exposed or exposure:

     The contact an employee has with a toxic substance, harmful physical agent or oxygen deficient condition, whether or not protection is provided by respirators or other personal protective equipment (PPE). Exposure can occur through various routes of entry, such as inhalation, ingestion, skin contact, or skin absorption.

Note:	• Examples of substances that may be respiratory hazards when airborne include:
	– Chemicals listed in Table 3
	– Any substance
	• Listed in the latest edition of the NIOSH Registry of Toxic Effects of Chemical Substances
	• For which positive evidence of an acute or chronic health hazard exists through tests conducted by, or known to, the employer
	• That may pose a hazard to human health as stated on a material safety data sheet kept by, or known to, the employer
	– Atmospheres considered oxygen deficient
	– Biological agents such as harmful bacteria, viruses or fungi
	– Examples include airborne TB aerosols and anthrax
	• Pesticides with a label requirement for respirator use
	• Chemicals used as crowd control agents such as pepper spray
	• Chemicals present at clandestine drug labs.
	• These substances can be airborne as dusts, fibers, fogs, fumes, mists, gases, smoke, sprays, vapors, or aerosols.

Reference:	• Substances in Table 3 that are marked with an X in the "skin" column may require personal protective equipment (PPE). See WAC 296-800-160, Personal protective equipment, for additional information and requirements.
	• If any of the following hazards are present in your workplace, you will need both this chapter and any of the following specific rules that apply:

Hazard	Rule that applies
Acrylonitrile	WAC 296-62-07336
Arsenic (inorganic)	WAC 296-62-07347
Asbestos	WAC 296-62-077
Benzene	Chapter 296-849 WAC ((296-62-07523))
Butadiene	WAC 296-62-07460
Cadmium	WAC 296-62-074 through 296-62-07449 or 296-155-174
Carcinogens	Chapter 296-62 WAC, Part F
Coke ovens	Chapter 296-62 WAC, Part O
Cotton dust	Chapter 296-62 WAC, Part N
1, 2-Dibromo-3- chloropropane	WAC 296-62-07342
Ethylene oxide	Chapter 296-855 WAC ((296-62-07355))
Formaldehyde	WAC 296-62-07540
Lead	WAC 296-62-07521 or 296-155-176
Methylene chloride	WAC 296-62-07470
Methylenedianiline	WAC 296-62-076 or 296-155-173
Thiram	WAC 296-62-07519
Vinyl chloride	WAC 296-62-07329

[Statutory Authority: RCW 49.17.010, 49.17.040, 49.17.050, 49.17.060. 04-18-079, § 296-841-100, filed 8/31/04, effective 11/1/04; 03-20-115, § 296-841-100, filed 10/1/03, effective 1/1/04.]

OTS-7945.4

     Definition:

     • Ethylene oxide (EtO) is an organic chemical represented by the Chemical Abstract Service (CAS) registry number 75-21-8. It is a flammable colorless gas that is commonly used to sterilize medical equipment and as a fumigant for certain agricultural products. It is also used as an intermediary in the production of various chemicals such as ethylene glycol, automotive antifreeze, and polyethylene.

     • Exposure is the contact an employee has with EtO, whether or not protection is provided by respirators or other personal protective equipment (PPE). Exposure can occur through various routes of entry such as inhalation, ingestion, or skin and eye contact.

     Some of the requirements in this chapter may not apply to every workplace with an occupational exposure to EtO. The following steps will show which requirements apply to your workplace based on employee exposure monitoring results.

Step one:	Follow requirements in the basic rules section, WAC 296-855-20010 through 296-855-20090.
Step two:	Use employee exposure monitoring results from the exposure evaluations required by, Exposure evaluations, WAC 296-855-20050, and follow Table 1 to find out which additional sections of this chapter apply to your workplace.
Step three:	You need only follow Exposure records, WAC 296-855-20070 and Medical records, WAC 296-855-30080 if you have documentation conclusively demonstrating that employee exposure for ethylene oxide and the operation where it's used, cannot exceed the AL or STEL during any conditions reasonably anticipated.
	• Such documentation can be based on observations, data, calculations, and previous air monitoring results.

Table 1
Sections That Apply to Your Workplace

If:	Then continue to follow the basic rules, and the additional requirements in:
Employee exposure monitoring results are below the AL and STEL	No additional requirements if exposures remain stable
Employee exposure monitoring results are above the PELs	• Exposure and medical monitoring, WAC 296-855-30010 through 296-855-30080;
Note: PEL refers to both the STEL and TWA	AND
	• Exposure control, WAC 296-855-40005 through 296-855-40045
Employee exposure monitoring results are above the AL;	Exposure and medical monitoring, WAC 296-855-30010 through 296-855-30080
AND
Below the STEL
When there is a possibility of an emergency release of EtO	Establish a written emergency response plan and a means of alerting potentially exposed employees as found in Exposure control plan, WAC 296-855-40005

[]

     Summary:

     Your responsibility:

     To evaluate employee exposure and protect employee from ethylene oxide.

     IMPORTANT:

     • The requirements in basic rules apply to all employers covered by the scope of this chapter, WAC 296-855-100. Additional sections may apply to you, based on employee exposure monitoring results. Turn to the Scope, WAC 296-855-100, and follow Table 1.

[]

     You must:

     • Make sure that all containers of EtO whose contents are capable of causing employee exposure above the action level or above the STEL are labeled, tagged, or marked with this warning:

Danger      Contains Ethylene Oxide      Cancer Hazard and Reproductive Hazard

     AND

     A warning stating that breathing airborne concentrations of EtO is hazardous.

     • Keep container labels free of statements that contradict or detract from the labels' hazard warning.

Note:

• EtO is highly flammable and should be kept in a tightly covered container, and in a cool, well-ventilated area away from any type of ignition source.

     You must:

     • Make sure warning labels remain on containers of EtO when these containers are transported.

Exemption:	• Reaction vessels, storage tanks, and pipes or piping systems are not considered to be containers and do not require labeling.
	• Labeling requirements do not apply when EtO:
	– Is used as a pesticide as defined by the Federal Insecticide, Fungicide, and Rodenticides Act (7 U.S.C. 136 et seq.);
	AND
	– Meets the Environmental Protection Agency labeling requirements for pesticides.

[]

     You must:

     • Establish temporary or permanent exposure control areas where airborne concentrations of ethylene oxide (EtO) exceed or could exceed the permissible exposure limits (PELs) by doing all the following:

     – Clearly identify the boundaries of exposure control areas in any way that minimizes employee access.

     – Post signs at access points to exposure control areas that:

     &sqbul; Are easy to read (for example, they are kept clean and well lit).

     AND

     &sqbul; Include this warning:

DANGER ETHYLENE OXIDE CANCER AND REPRODUCTIVE HAZARD AUTHORIZED PERSONNEL ONLY RESPIRATORS AND PROTECTIVE CLOTHING MAY BE REQUIRED TO BE WORN IN THIS AREA

     • Keep signs and areas near them free of statements that contradict or detract from their message.

Note:

• This requirement does not prevent you from posting other signs.

     You must:

     • Allow only authorized personnel to enter exposure control areas.

Note:	• When identifying the boundaries of exposure control areas you should consider factors such as:
	– The level and duration of airborne exposure.
	– Whether the area is permanent or temporary.
	– The number of employees in adjacent areas.
	• You may use permanent or temporary enclosures, caution tape, ropes, painted lines on surfaces, or other materials to visibly distinguish exposure control areas or separate them from the rest of the workplace.

     You must:

     • Make sure employees entering exposure control areas have appropriate respirators available for use.

     • Prevent all of the following activities from occurring in exposure control areas:

     – Eating food.

     – Drinking beverages.

     – Smoking.

     – Chewing tobacco or gum.

     – Applying cosmetics.

     – Storing food, beverages, or cosmetics.

[]

     You must:

     • Make sure employees wear appropriate PPE as protection from skin or eye contact with ethylene oxide (EtO), liquid EtO, or EtO solutions.

     • Provide appropriate PPE at no cost to employees.

[]

     IMPORTANT:

     This section applies when there is a potential for airborne exposure to ethylene oxide (EtO) in your workplace.

     When you conduct an exposure evaluation in a workplace where an employee uses a respirator, the protection provided by the respirator is not considered.

     Following this section will also meet the requirements to identify and evaluate respiratory hazards found in another chapter, Respiratory hazards, chapter 296-841 WAC.

     You must:

     • Conduct an employee exposure evaluation to accurately determine airborne concentrations of EtO by completing Steps one through seven of the exposure evaluation process, each time any of the following apply:

     – No evaluation has been conducted.

     – Changes have occurred in any of the following areas that may result in new or increased employee exposures:

     &sqbul; Production.

     &sqbul; Processes.

     &sqbul; Personnel.

     &sqbul; Exposure controls such as ventilation systems or work practices.

     – You have any reason to suspect new or increased employee exposure may occur.

     • Provide affected employees and their designated representatives an opportunity to observe any exposure monitoring during Step six of the exposure evaluation process.

     • Make sure observers entering areas with EtO exposure:

     – Are provided with and use the same protective clothing, respirators, and other personal protective equipment (PPE) that employees working in the area are required to use;

     AND

     – Follow all safety and health requirements that apply.

     Exposure evaluation process

Step one:	Identify all employees who have potential exposure to airborne ethylene oxide (EtO) in your workplace.
Step two:	Identify operations where employee exposures could exceed EtO's fifteen-minute short-term exposure limit (STEL) of five parts per million (ppm).
Step three:	Select employees from those working in the operations you identified in Step two who will have their STEL exposures measured.
Step four:	Select employees from those identified in Step one who will have their eight-hour exposures monitored.
	• Make sure the exposures of the employees selected represent eight-hour exposures for all employees identified in Step one including each job classification, work area, and shift.
	• If you expect all employee exposures to be below the action level (AL), you can choose to limit your selection to those employees reasonably believed to have the highest exposures. If you find these employees' exposure to be above the AL, then you'll need to repeat Step four to represent all employees identified in Step one.

Note:

You can use Steps three through six of this process to create a written description of the procedure used for obtaining representative employee exposure monitoring results, which is a requirement in Exposure records, WAC 296-855-20070.

Exemption:	• You can skip Steps four through seven if you have documentation conclusively demonstrating that employee exposure for a particular material and the operation where it's used, cannot exceed the AL or STEL during any conditions reasonably anticipated.
	• Such documentation can be based on observations, data, calculations, and previous air monitoring results. Previous air monitoring results:
	– Must meet the accuracy required by Step five.
	– May be from outside sources, such as industry or labor studies.
	– Must be based on data that represents conditions being evaluated in your workplace.

Step five:	Determine how you will obtain accurate employee exposure monitoring results. Select and use an air monitoring method with a confidence level of ninety-five percent, that's accurate to:
	• ±twenty-five percent when concentrations are potentially above the AL or eight-hour time-weighted average of one part per million (ppm).
	• ±thirty-five percent when concentrations are potentially above the AL of 0.5 ppm or the STEL of five ppm.

Note:	Here are examples of air monitoring methods that meet this accuracy requirement:
	• OSHA Method thirty found by going to: http://www.osha.gov/dts/sltc/methods/toc.html.
	• NIOSH Method thirty eight hundred found by going to: http://www.cdc.gov./niosh/homepage.html and linking to the NIOSH Manual of analytical methods.

Step six:

Obtain employee monitoring results by collecting air samples representing employees identified in Steps three and four.

	• Collect STEL samples for employees and operations selected in Step three.
	• Collect samples representing the eight-hour exposure, for at least one shift, for each employee selected in Step four.
	• Make sure samples are collected from each selected employee's breathing zone.

Note:	• You may use any sampling method that meets the accuracy specified in Step five. Examples of these methods include:
	– Real-time monitors that provide immediate exposure monitoring results.
	– Equipment that collects samples that are sent to a laboratory for analysis.
	• The following are examples of methods for collecting samples representative of eight-hour exposures.
	– Collect one or more continuous samples, such as a single eight-hour sample or four two-hour samples.
	– Take a minimum of five brief samples, such as five fifteen-minute samples, during a work shift at randomly selected times.
	• For work shifts longer than eight hours, monitor the continuous eight-hour portion of the shift expected to have the highest average exposure concentration.

Step seven:	Have the samples you collected analyzed to obtain monitoring results for eight-hour and STEL exposures.
	• Determine if employee exposure monitoring results are above or below the following values:
	– Eight-hour time-weighted average (TWA8) of one ppm.
	– Fifteen-minute short-term exposure limit (STEL) of five ppm.
	– Eight-hour action level (AL) of 0.5 ppm.

Note:	• You may contact your local WISHA consultant for help:
	– Interpreting data or other information.
	– Determining eight-hour or fifteen-minute employee exposure monitoring results.

[]

     You must:

     • Provide written notification of exposure monitoring results to employees represented by your exposure evaluation, within five business days after monitoring results become known to you.

     • In addition, when employee exposure monitoring results are above either the TWA₈ or STEL permissible exposure limit (PEL), provide written notification of all the following within fifteen business days after the results become known to you:

     – Corrective actions being taken and a schedule for completion;

     AND

     – Any reason why exposures can not be lowered to below the PELs.

Note:	• You can either notify employees individually or post the notifications in areas readily accessible to affected employees.
	• Posted notification may need specific information that allows affected employees to determine which monitoring results apply to them.
	• Notification may be:
	– In any written form, such as hand-written or e-mail.
	– Limited to the required information, such as exposure monitoring results.
	• When notifying employees about corrective actions, your notification may refer them to a separate document that is available and provides the required information.

[]

     You must:

     • Establish and keep complete and accurate records for all exposure monitoring evaluations conducted under this chapter. Make sure the record includes, at least:

     – The name, unique identifier, and job classification of:

     &sqbul; The employee sampled;

     AND

     &sqbul; All other employees represented by the sampled employee.

     – A description of the methods used to obtain exposure monitoring results and evidence of the methods' accuracy.

     – The operation being monitored for employee exposure to EtO.

     – A description of the procedure used to obtain representative employee exposure monitoring results.

     – The date, number, duration, location, and the result of each sample taken.

     – Any environmental conditions that could affect exposure concentration measurements.

     – Any personal protective equipment (PPE) worn by the employee including the type of respirator.

Note:

• You can use Steps three through six of the exposure evaluation process in Exposure evaluations, WAC 296-855-20050, to create a description of the procedure you used for obtaining representative employee exposure monitoring results.

     You must:

     • Keep exposure monitoring records for at least thirty years.

Reference:	• To see additional requirements for employee exposure records including access, and transfer requirements, go to another chapter, Employee medical and exposure records, chapter 296-802 WAC.
	• Exposure monitoring records need to be kept longer than thirty years for employees participating in medical monitoring, go to Medical records, WAC 296-849-12080.

[]

     You must:

     • Keep documentation you develop, of the processing, use, or handling of products made from or containing EtO, that conclusively demonstrates that the action level or STEL for EtO cannot be exceeded under any foreseeable conditions of use.

     • Include the following in the documentation record:

     – The product that is the subject of the documentation;

     – The source of the data;

     – Any testing protocol, results of testing, and/or analysis of the product for the release of EtO;

     – A description of the operation where the product is used and how the data support your conclusion; and

     – Other data relevant to the operations, materials, processing, or employee exposures covered by your conclusion.

     • Maintain the documentation record for as long as you rely on your conclusion that the action level and STEL cannot be exceeded.

[]

     You must:

     • Train employees who are potentially exposed above the:

     – Action level (AL) 0.5 parts per million (ppm);

     OR

     – Fifteen-minute short-term exposure limit (STEL) of five ppm.

     • Provide training:

     – At the time of initial assignment;

     AND

     – Then at least every twelve months.

     • Make sure training and information includes all of the following:

     – The requirements of this chapter.

     – The location and availability of this chapter.

     – The purpose of medical evaluations and a description of your medical evaluation program required in Medical evaluations, WAC 296-855-30030 in this chapter.

     – Monitoring procedures and observations to detect the presence or release of EtO.

     – The physical and health hazards of EtO.

     – Actions employees can take to protect themselves from EtO exposure such as work practices, emergency procedures, and PPE.

     – The details of your hazard communication program required by another chapter, Employer chemical hazard communication, WAC 296-800-170.

     – Operations in employee work areas where EtO is present.

     – The following information found in the General occupational health standards, chapter 296-62 WAC:

     &sqbul; The Substance safety data sheet, WAC 296-62-07383 Appendix A.

     &sqbul; The Substance technical guidelines, WAC 296-62-07385 Appendix B.

     &sqbul; Medical surveillance guidelines, WAC 296-62-07387 Appendix C.

[]

     Summary:

     Your responsibility:

     To monitor employee health and workplace exposures to ethylene oxide (EtO).

     IMPORTANT:

     • These sections apply when employee exposure monitoring results are either above the:

     – Action level (AL) of 0.5 parts per million (ppm);

     OR

     – Short-term exposure limit (STEL) of five ppm.

[]

Exemption:

Periodic employee exposure monitoring is not required if exposure monitoring results conducted to fulfill requirements in Exposure evaluation, WAC 296-855-20050, are below the action level (AL).

     You must:

     • Obtain employee exposure monitoring results according to the frequency specified in Table 2, Periodic Exposure Evaluation Frequencies.

Note:

• If you documented that one work shift consistently has higher exposure monitoring results than another for a particular operation, then you may limit sample collection to the work shift with higher exposures and use those results to represent all employees performing the operation on other shifts.

Table 2
Periodic Exposure Evaluation Frequencies

If employee exposure monitoring results:	Then:
Are between the:	Conduct additional exposure monitoring at least every 6 months.
• Action level (AL) of 0.5 parts per million (ppm);
AND
•TWA8 of 1 ppm
Are above the TWA8;	Conduct additional exposure monitoring at least every 3 months.
OR
Above the STEL
Have been obtained at least every 3 months;	You may decrease your evaluation frequency for the TWA8 to every 6 months.
AND
Have 2 consecutive monitoring results, taken at least 7 days apart, showing 8-hour employee exposure monitoring results that have dropped below the TWA8, but remain at or above the AL
Have 2 consecutive evaluations, taken at least 7 days apart, showing 8-hour employee exposure monitoring results that have dropped below the AL and STEL	You may stop periodic exposure evaluations.

[]

     IMPORTANT:

     Medical evaluations meeting all requirements of this section will fulfill the medical evaluation requirement found in another chapter, Respirators, chapter 296-842 WAC.

     Employees who wear respirators need to be medically evaluated to make sure the respirator will not harm them, before they are assigned work in areas requiring respirators.

     You must:

     • Make medical evaluations available to current employees:

     – Who have been, are, or may be exposed above the action level (AL) for at least thirty days in any twelve-month period.

     – Exposed to EtO during an emergency situation.

     – Wanting medical advice on EtO exposure and reproductive health.

     – Whenever the employee develops signs and symptoms commonly associated with ethylene oxide.

     – At no cost including travel costs and wages associated with any time spent obtaining the medical evaluation.

     – At reasonable times and places.

     • Complete Steps one through four of the medical evaluation process at the following times:

     – Initially, when employees are assigned to work in an area where exposure monitoring results are, or will likely be, above the action level (AL) for at least thirty days in a twelve-month period.

     – Every twelve months for employees exposed above the AL for at least thirty days in the preceding year unless the examining physician determines that they should be provided more frequently.

     – When employment with exposure ends, if the employee has not had an evaluation within the six-month period before exposure ends.

Note:	• Employees who decline to receive medical examination and testing to monitor for health effects caused by EtO are not excluded from receiving a separate medical evaluation for respirator use.
	• If employers discourage participation in medical monitoring for health effects caused by EtO, or in any way interfere with an employee's decision to continue with this program, this interference may represent unlawful discrimination under RCW 49.17.160, Discrimination against employee filing complaint, instituting proceedings, or testifying prohibited -- Procedure -- Remedy.

Helpful tool:	Declination form for nonemergency related medical evaluations
	You may use this optional form to document employee decisions to decline participation in the medical evaluation process for exposure to ethylene oxide (EtO). To see this form, go to the resources section within this chapter.

     Medical evaluation process

Step one:	Select an appropriate licensed health care professional (LHCP) who will conduct or supervise examinations and procedures.
	• If the LHCP is not a licensed physician, make sure individuals who conduct pulmonary function tests have completed a training course in spirometry sponsored by an appropriate governmental, academic, or professional institution.

Step two:	Make sure the LHCP receives all of the following information before the medical evaluation is performed:
	• A copy of:
	– This chapter.
	– The following information found in the General occupational health standards, chapter 296-62 WAC:
	&sqbul; The Substance safety data sheet, WAC 296-62-07383(1) Appendix A.
	&sqbul; The Substance technical guidelines, WAC 296-62-07385(2) Appendix B.
	&sqbul; Medical surveillance guidelines, WAC 296-62-07387(3) Appendix C.
	• A description of the duties of the employee being evaluated and how these duties relate to EtO exposure.
	• The anticipated or representative exposure monitoring results for the employee being evaluated.
	• A description of the personal protective equipment (PPE) and respirators each employee being evaluated uses or will use.
	• Information from previous employment-related examinations when this information is not available to the examining LHCP.
	• Instructions that the written opinions the LHCP provides you be limited to the following information:
	– Whether or not medical conditions were found that would increase the employee's risk for impairment from exposure to EtO.
	– Any recommended limitations for EtO exposure and use of respirators or other PPE.
	– A statement that the employee has been informed of medical results and medical conditions caused by EtO exposure requiring further examination or treatment.
Step three:	Make medical evaluations available to the employee. Make sure they include the content listed in Table 3, Content of Medical Evaluations.
Step four:	Obtain the LHCP's written opinion for the employee's medical evaluation and make sure the employee receives a copy within five business days after you receive the written opinion.
	• Make sure the written opinion is limited to the information specified for written opinions in Step two.

Note:

• If the written opinion contains specific findings or diagnoses unrelated to occupational exposure, send it back and obtain a revised version without the additional information.

Table 3
Content of Medical Evaluations

When conducting:	Include:
An initial and annual evaluation	• A work history and medical history that includes emphasis on:
	– Pulmonary, hematological, neurological, reproductive systems;
	AND
	– The eyes and skin.
	• A physical examination that includes emphasis on:
	– Pulmonary, hematological, neurological, and reproductive systems;
	AND
	– The skin and eyes.
	• A complete blood count including a:
	– White cell count with differential
	– Red cell count
	– Hematocrit
	– Hemoglobin.
	• Additional examinations the licensed health care professional (LHCP) believes appropriate based on the employee's exposure to ethylene oxide (EtO) or respirator use.
	• Additional testing:
	– Pregnancy test, and laboratory evaluation for fertility if requested by employee and approved by evaluating LHCP.
Evaluations due to termination of employment	• The same content as specified for initial and annual evaluations.
Evaluations due to reassignment to an area where EtO exposure is below the AL	• The same content as specified for initial and annual evaluations.
	• As determined by the LHCP.
Evaluations due to exposure during an emergency	• The same content as specified for initial and annual evaluations.
Evaluations triggered by employee signs and symptoms commonly associated with overexposure to EtO or a request for reproductive advice	• The content of medical examinations and consultations will be determined by the examining LHCP.
	– Pregnancy test, and laboratory evaluation for fertility if requested by employee and approved by evaluating LHCP.
Evaluations determined necessary by LHCP for exposed employees	• The content of medical examinations and consultations will be determined by the examining LHCP.

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     IMPORTANT:

     This section applies when a medical evaluation is performed, or any time a medical record is created for an employee exposed to ethylene oxide (EtO).

     You must:

     • Establish and maintain complete and accurate medical records for each employee receiving a medical evaluation for EtO and make sure the records include all the following:

     – The employee's name and unique identifier.

     – Any employee medical complaints related to EtO.

     – A description of the employee's duties.

     – A copy of the licensed health care professional's (LHCP's) written opinions.

     – The anticipated or representative employee exposure monitoring results provided to the LHCP for the employee.

     – A copy of the information required in Step two of the medical evaluation process, found in WAC 296-855-30030, except the copy of this chapter and the appendices.

     • Maintain medical records for the duration of employment plus thirty years.

Note:

• Your medical provider may keep these records for you. Other medical records, such as the employee's medical history or X rays, need to be kept as confidential records by the medical provider.

Reference:

For additional requirements that apply to employee exposure records including access and transfer requirements, go to, Employee medical and exposure records, chapter 296-802 WAC.

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     Summary:

     Your responsibility:

     To protect employees from exposure to ethylene oxide (EtO) by using feasible exposure controls and appropriate respirators.

     IMPORTANT:

     • These sections apply when employee exposure monitoring results are above either of the following permissible exposure limits (PELs):

     – The eight-hour time-weighted average (TWA₈) of one part per million (ppm);

     OR

     – The fifteen-minute short-term exposure limit (STEL) of five ppm.

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     You must:

     • Establish and implement a written exposure control plan to reduce employee exposure to EtO below both TWA₈ and the STEL by the use of feasible exposure controls. Include at least the following in your plan:

     – A schedule for periodic leak detection surveys.

     – Make sure employee rotation is not included as a method to control employee exposure.

     • Establish a written plan for emergency situations for each work area where there is a possibility of an emergency from a release of EtO. The plan must include, at a minimum:

     – Emergency escape:

     &sqbul; Procedures.

     &sqbul; Route assignments.

     – Emergency evacuation plans and procedures to account for all employees after emergency evacuation has been completed.

     – Procedures to be followed by employees who remain to operate critical plant operations before they evacuate.

     – Requirements for the use of respiratory protection as required in WAC 296-855-40045.

     – Rescue and medical duties for those employees who will perform them.

     – The preferred means of reporting fires and other emergencies.

     – Names or regular job titles of persons or departments who can be contacted for further information or explanation of duties under the plan.

     • Establish an employee alarm system that meets the requirements of Employee alarm systems, WAC 296-800-31070 in the safety and health core rules.

     – The employee alarm system must be distinctive and recognizable as a signal to perform actions designated under the emergency response plan.

     • Review your exposure control plan at least every twelve months and update as needed to reflect your current workplace conditions.

     • Provide a copy of your exposure control plan to affected employees and their designated representatives, when they ask to review or copy it.

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     IMPORTANT:

     The use of an employee rotation schedule to control employee exposure to ethylene oxide (EtO) is prohibited.

     Respirators and other personal protective equipment (PPE) are not exposure controls.

     You must:

     • Use feasible exposure controls to:

     – Reduce exposure to, or below, the permissible exposure limit (PELs);

     OR

     – To reduce exposure to the lowest achievable level above the PELs.

Reference:

Go to another chapter, Respiratory hazards, chapter 296-841 WAC for additional information on employee exposure controls.

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     IMPORTANT:

     The requirements in this section are in addition to the requirements found in another chapter, Respirators, chapter 296-842 WAC.

     Medical evaluations meeting all requirements of WAC 296-855-30030, will fulfill the medical evaluation requirement found in another chapter, Respirators, chapter 296-842 WAC.

     You must:

     • Provide respirators and require that employees use them in circumstances where exposure is above either PEL, such as when:

     &sqbul; Feasible exposure controls are being put in place.

     &sqbul; You determine that exposure controls are not feasible.

     &sqbul; Feasible exposure controls do not reduce exposures to or below the PELs.

     &sqbul; Employees are responding to emergencies.

     • Ensure all respirator use is accompanied by eye protection either through the use of full-facepiece respirators, hoods, or chemical goggles.

     • Establish a respirator program that meets the requirements of another chapter, Respirators, chapter 296-842 WAC, and include the following additional requirement:

     – Limit selection of respirators to those with a full-facepiece or another type of respirator providing eye protection for EtO.

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     Action level:

     An airborne concentration of ethylene oxide (EtO) of 0.5 parts per million, calculated as an eight-hour time-weighted average.

     Authorized personnel:

     Individuals specifically permitted by the employer to enter the exposure control area to perform necessary duties, or to observe employee exposure evaluations.

     Breathing zone:

     The space around and in front of an employee's nose and mouth, forming a hemisphere with a six- to nine-inch radius.

     CAS (Chemical Abstract Service) number:

     CAS numbers are internationally recognized and used on material safety data sheets (MSDSs) and other documents to identify substances. For more information see http://www.cas.org/about.

     Container:

     Any container, except for pipes or piping systems that contains ethylene oxide. It can be any of the following:

     &sqbul; Barrel.

     &sqbul; Bottle.

     &sqbul; Can.

     &sqbul; Cylinder.

     &sqbul; Drum.

     &sqbul; Reaction vessel.

     &sqbul; Storage tank.

     Day:

     Any part of a calendar day.

     Director:

     The director means the director of the department of labor and industries or their designee.

     Emergency:

     Any event that could or does result in the unexpected significant release of ethylene oxide. Examples of emergencies include equipment failure, container rupture, or control equipment failure.

     Ethylene oxide (EtO):

     Is an organic chemical represented by the CAS registry number 75-21-8. EtO is a flammable colorless gas and is commonly used to sterilize medical equipment and as a fumigant for certain agricultural products. It is also used as an intermediary in the production of various chemicals such as ethylene glycol, automotive antifreeze, and polyurethane.

     Exposure:

     The contact an employee has with ethylene oxide, whether or not protection is provided by respirators or other personal protective equipment (PPE). Exposure can occur through various routes of entry such as inhalation, ingestion, skin contact, or skin absorption.

     Licensed health care professional (LHCP):

     An individual whose legally permitted scope of practice allows him or her to provide some or all of the health care services required for medical evaluations.

     Permissible exposure limits (PELs):

     PELs are employee exposures to toxic substances or harmful physical agents that must not be exceeded. PELs are specified in applicable WISHA rules. The PELs for ethylene oxide (EtO) are:

     • Eight-hour time-weighted average (TWA₈) of one part per million (ppm);

     AND

     • Fifteen-minute short-term exposure limit (STEL) of five ppm.

     Short term exposure limit (STEL):

     An exposure limit averaged over a short time period (usually fifteen minutes) that must not be exceeded during any part of an employee's workday.

     Time-weighted average (TWA₈):

     An exposure limit averaged over an eight-hour period that must not be exceeded during an employee's workday.

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