Industrial Program

Chapter 14 INDUSTRIAL HYGIENE PROGRAM MANAGEMENT

SANDRA PARKER-, CIH,* and JOHN W. YASALONIS, CIH†

INTRODUCTION

HISTORY

ORGANIZATION OF THE INDUSTRIAL HYGIENE PROGRAM

PRACTICING ARMY INDUSTRIAL HYGIENE The Department of Defense Model Army-Specific Requirements Defense Occupational and Environmental Readiness System Industrial Hygiene Metrics

SUMMARY

*Program Manager, Occupational Health Sciences, Army Public Health Center, 5158 Blackhawk Road, Aberdeen Proving Ground, Maryland 21010 †Formerly, Lieutenant Colonel, US Army; Industrial Hygiene Consultant to The US Army Surgeon General, Headquarters, Department of the Army, 5109 Leesburg Pike, Falls Church, Virginia

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INTRODUCTION

The intent of this chapter is to describe how the industrial hygienists couple their scientific knowledge Army applies the art and science of industrial hy- with the art of industrial hygiene, they perform true giene in its unique and challenging environment. The preventive : eliminating before they theory and practice of industrial hygiene is relatively cause harm. At all Army installations, industrial hy- consistent in private industry and the public sector. gienists help protect the health and welfare of civilians Both the American Industrial Hygiene Association and soldiers by reducing workplace . Controlling (AIHA)1 and the American Conference of Governmen- hazards, such as degreasing solvents, , or carbon tal Industrial Hygienists (ACGIH)2 define industrial monoxide, helps ensure the soldier is in a state of hygiene as “the science and art devoted to the antici- maximum combat readiness. pation, recognition, evaluation, and control of those In this chapter, the term industrial hygienist denotes environmental factors or stresses, arising in or from a qualified professional. The US Army’s in- the workplace, which may cause sickness, impaired dustrial hygienists are /engineer health and well-being, or significant discomfort and officers (area of concentration 72D). The Office of inefficiency among workers or among the citizens of Personnel Management classifies civilian industrial the .” hygienists as general schedule (GS) 690 and industrial A fully competent industrial hygienist requires an hygiene technicians as GS 640 (health aide and techni- interdisciplinary covering the basic sciences, cian). Defense contractors may also provide industrial toxicology, ergonomics, and physiology. When Army hygiene support.

HISTORY

The US Army became seriously involved in the dustrial maintenance operations. The laboratory development of industrial hygiene practice during concentrated on four technical and scientific areas: World I, when workers in military gas mask field survey, chemical sampling analysis, engineer- manufacturing plants needed protection from chemi- ing design, and medicine/toxicology. Compared to cal agent gases and typical industrial, chemical, and World War I, fatalities caused by occupational dis- physical hazards: varying (and various) gas concen- eases were brought to extraordinarily low numbers trations, solvents, dust, and noise.3 Both government- during World War II, and the fact that industrial and contractor-operated received industrial hygiene personnel identified hazards and recom- hygiene evaluations during World War I, but those mended control requirements played a significant efforts ceased with the war’s end. role in reducing the rates. In October 1942, the Department of the Army The Army Industrial Hygiene Laboratory was tran- (DA) established the US Army Industrial Hygiene sitioned into the US Army Environmental Hygiene Laboratory at Johns Hopkins University to conduct Agency, then the US Army Center for Health Promo- occupational health surveys and investi- tion and Wellness, then the US Army Public Health gations at Army industrial plants, arsenals, and Command, and finally the Army Public Health Center depots.4 Workers at these facilities had potentially (APHC), the de facto provider of industrial hygiene hazardous exposures to military-unique and in- consultation to the Army today.

ORGANIZATION OF THE INDUSTRIAL HYGIENE PROGRAM

The Army occupational safety and health program components, units, and installations. is divided organizationally and financially at the DA The Army occupational health program is divided level into occupational safety and occupational health. into two main functional areas: industrial hygiene and The safety program (defined in Army Regulation [AR] occupational healthcare (which includes medicine and 385-10, The Army Safety Program5) is managed and ex- ). DA Pamphlet 40-5037 describes the Army ecuted by safety personnel at Army commands, service industrial hygiene program, which includes support components, direct reporting units, and installations. of occupational healthcare personnel by: The occupational health program is a medical program (defined in AR 40-5, Preventive Medicine6) executed • quantitatively defining the level of worksite primarily by medical department activity and medi- exposures to hazardous materials, allowing cal center personnel, who support all the commands, clinic personnel to (a) make informed patient

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care decisions regarding medical surveillance • industrial hygienists are mainly concerned and (b) target the hazards most likely to cause with factors at the worksite that cause chronic health effects on workers; or acute illness, , or to personnel. • recommending controls for existing hazards that, when implemented, can eliminate or The programs are most effective when staff of both greatly reduce medical surveillance require- work together to execute their responsibilities. For ments; and example, if acid bubbles out of a lead acid battery on • operating the Defense Occupational and high charge and burns a worker’s unprotected hands, it Readiness System is an occupational safety issue; however, if the worker (DOEHRS), a comprehensive health database inhales the resulting acid mist, and consequently sus- that provides exposure and other worksite tains respiratory illness, these are industrial hygiene data to occupational healthcare personnel in and occupational healthcare issues. an easily accessible and usable form. Personal protective equipment (PPE) also involves dual medical and safety responsibilities. For example, The primary differences between the safety and the issue and use of respiratory protective equipment industrial hygiene missions are that: has traditionally been the domain of supervisors and occupational safety personnel. However, selecting • occupational safety personnel are mainly the proper respirator requires a detailed industrial concerned with the prevention and control hygiene exposure evaluation, and the potential user of traumatic injury to personnel, and with must be medically evaluated before being required to accidents that result in loss of material, and wear a respirator.

PRACTICING ARMY INDUSTRIAL HYGIENE

The Department of Defense Exposure Assessment The elements of the exposure assessment in Figure Model 14-1 outline the sequence used by industrial hygienists. The process is sequential, with information from earlier Army industrial hygienists provide information steps essential to completing later steps, as follows: on the mission and health impact of health to commanders, who can then make decisions that minimize risk. Industrial hygienists collect informa- START tion on potential hazard sources; exposure pathways; and magnitude, frequency, and duration of worker exposures. They analyze this information to identify the risk of negative health effects from these expo- Define Scope of Reporting & sures; determine options for controlling the sources, Support & Revaluation Recording pathways, and exposures; and quantify the risk. In- Resources dustrial hygienists also provide exposure information to staff and other healthcare professionals to support medical surveillance. This exposure information contributes to the longitudinal Assess Exposures Basic & Provide Control . Characterization In 2000, the Army collaborated with the military ser- Plan vices and other DoD components to create a common industrial hygiene business practice that incorporated the best practices of industry and professional asso- Develop ciations. The result was the DoD industrial hygiene Characterize 8 Establish SEGs Workplace exposure assessment model (Figure 14-1). This model Exposures Monitoring Plan describes the industrial hygiene exposure assess- ment process to collect and evaluate exposure data, including exposures at any workplace where Army personnel are employed. Workplaces vary from fixed Figure 14-1. Department of Defense industrial hygiene ex- installations during peacetime operations to wartime posure assessment model. deployments. SEG: similar exposure group

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Step 1. Define scope of support and resources. ◦ geographic location or event (eg, space with heat stress, base camp on an old fuel • Through data collection, , and inter- spill, downwind of an uncontrolled chemi- views, identify to be served and cal release); or the scope of the industrial hygiene services ◦ work operation and task (eg, needed. Develop a schedule with required paint removal, sanding, solvent cleaning). resources for providing services. Step 4: Develop a workplace monitoring plan. Step 2. Perform basic characterization. • The industrial hygienist develops a workplace • Anticipate and identify potential exposures. monitoring plan with the following objectives: Identify the types of operations performed and ◦ monitoring performance of the exposure exposure situations, and the types of hazards controls (eg, static pressure in ventilation that require assessment at each exposure loca- duct, interlocks on x-ray rooms, testing for tion, by reviewing results of previous workplace carbon monoxide in fuel-heated spaces); assessments, reviewing medical surveillance and ◦ collecting exposure data to monitor ef- injury/illness events and summaries, and meeting fectiveness of controls (eg, using exposure with the supervisor and employee representa- control charts); tive. Identify the hazard sources using Material ◦ collecting additional data to improve the Safety Data Sheets or equipment inventories. accuracy of exposure estimates (eg, re- • Assess the hazard sources. Describe their duced standard deviation); and operating characteristics (eg, power settings ◦ complying with periodic monitoring re- used for an electrical generator) and existing quired by regulatory agencies (eg, Occu- controls (eg, , PPE, administra- pational Safety and tive). Then qualitatively assess whether or [OSHA] regulations on cadmium). not there are significant personnel exposures • The information needed in the monitoring to toxic chemicals and/or harmful physical plan includes: agents based on all available information. ◦ hazard and SEG being monitored; ◦ purpose of monitoring (eg, monitor con- Step 3: Establish similar exposure groups. trols, exposure trends, improve exposure estimate); • A similar exposure group (SEG) is a tool to ef- ◦ procedures for measuring exposures or fectively and accurately use limited industrial controls; hygiene resources. The industrial hygienist ◦ number of measurements; groups similarly exposed workers into an ◦ type of sample or measurement (eg, breath- SEG, performs a of all hazards ing zone, general area sample, peak noise and exposures for the SEG, and administra- level, full-shift, duration of task, air veloc- tively assigns the exposures and controls to all ity in duct); members of the SEG. A worker may belong to ◦ location type (eg, general area, breathing more than one SEG (eg, one SEG for exposures zone, source zone); from arc welding, and another SEG for expo- ◦ location description (eg, center of base sure to kerosene-fueled heaters from living camp, representative living quarters); in a tent). This allows the industrial hygienist ◦ conditions required during monitoring (eg, to leverage scarce resources and still collect, doors open or closed); analyze, and archive quality information. ◦ standards used to compare to results (eg, • The industrial hygienist establishes SEGs at ventilation baseline criteria, occupational a level of detail needed to separately identify exposure limit [OEL]); and and evaluate exposures. The hygienist may ◦ data analysis procedures (eg, pass/fail choose to group more workers together into criteria, run-chart trend analysis). a single SEG to save time, or separate work- ers into smaller groups to more accurately Step 5: Characterize exposures. identify workers needing training, protective equipment, and medical surveillance. The • The industrial hygienist uses state-of-the art hygienist may establish SEGs by: sampling and monitoring techniques to char- ◦ unit organizational structure, treating an acterize worker exposures. This may be done organization or sub-unit as one SEG; by what is often a sequential process:

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◦ directly measure exposures (eg, air sam- Step 8: Reevaluate. pling, noise dosimetry); ◦ record information on person sampled (eg, • The exposure assessment process is cyclical. name, employee identification number, job It is often necessary to repeat the exposure as- title, job series identification number); sessment process with the goal of improving ◦ record sample type and location (eg, previous assessments, and thereby continuing personal breathing zone, general area, to reduce risk. dosimetry, bulk, wipe); ◦ record PPE worn by person sampled (eg, Army-Specific Requirements respirators, gloves, , face and body protection); The Army implements the DoD to reduce, to ◦ record environmental conditions (eg, in- as low as reasonably achievable, health risks to each doors or outdoors, doors open or closed, employee from recognized chemical, physical, or bio- ambient temperature, pressure, logical hazards that cause or are likely to cause death, speed and direction); illness, injury, or reduced mission effectiveness. The ◦ submit the samples for analysis; and lowest OEL for the vast majority of occupational health ◦ determine the time-weighted average or hazards are listed by the American Conference of Gov- other exposure level and compare to OELs. ernmental Industrial Hygienists (ACGIH) in TLVs and BEIs (threshold limit values and biological exposure Step 6: Assess exposures and provide control plan. indices).9 This reference is updated annually based on current science, and the guidelines are developed • Industrial hygienists compare the documented to assist in the control of health hazards. They are not exposures to appropriate OELs to determine developed for use as legal standards. the need for corrective actions and follow-up The permissible exposure levels (PELs) developed surveillance. They calculate and assign priori- by OSHA are legally binding. Because the standard tization codes to all potential exposures in an promulgation process is so lengthy and new standards SEG. They evaluate effectiveness of controls for are subject to administration stays and legal actions, each potential route of exposure (eg, breath- the OSHA PELs are often less stringent than ACGIH ing zone levels with local ventilation opera- TLVs. The Army believes that its soldiers and civilians tions, noise attenuation of hearing protection, are best served by the most stringent standards, afford- chemical permeation of gloves). They develop ing them the best protection in the workplace, so it is options for controlling exposures, considering Army policy to use the most stringent OEL available.7 inherent effectiveness and reliability of the Within the Army, there are many military-unique controls. Control options include: workplaces, operations, types of equipment, and ◦ eliminating or modifying the process; systems. Army personnel are engaged in testing ◦ material substitution within the existing and maintenance of military-unique equipment and process; systems such as military weapons, military-unique ◦ (isolation, interception); aircraft, military-unique ships, missiles, early warning ◦ PPE; and systems, military space systems, ordnance, and tactical ◦ (including training, vehicles. They also perform operations such as peace- physical security of hazard source). keeping missions; field maneuvers; combat training; • And finally, the industrial hygienist deter- military flight and missile operations; military-unique mines if periodic monitoring of the hazardous research, development, test, and evaluation activities; agent or the controls is required. and actions required under national defense contin- gency conditions. Often the Army must develop a Step 7: Report and record. military-unique OEL because an appropriate level does not exist, as well as accompanying sampling and • Army industrial hygienists use DOEHRS to analysis protocols. collect, analyze, and archive all information For example, after elevated concentrations of ortho- relevant to occupational exposures. The in- chlorobenzylidene malononitrile (commonly referred dustrial hygienist uses many means of com- to as CS or tear gas) were found during mask confi- munication (eg, memoranda, email, meetings) dence training (MCT) at a basic training site, the Army to convey information to decision-makers, developed procedures for capsule dispersal to establish workers, supervisors, safety managers, and an initial CS training concentration in the chamber and occupational medicine providers. maintain that concentration. Also, a new requirement

239 Occupational Health and the Service Member was established for industrial hygienists to conduct only provides a longitudinal exposure record for semiannual monitoring and hazard assessments for all workers, it also allows for data analysis. Analytical sites that conduct MCT using CS in test chambers. The review of the data can answer questions about the organization responsible for the chamber had to imple- prevalence of hazards (eg, how many soldiers are ment a periodic cleaning schedule using wet methods exposed to beryllium); prevalence of risk (eg, how to reduce the residual CS build-up in the chamber. many workplaces have high risk assessment codes); Personnel tasked with cleaning the CS chambers were and the accomplishments of local industrial hygiene required to wear full-face respirators approved by the programs. National Institute of Occupational Safety and Health for CS exposure, water-resistant disposable coveralls Industrial Hygiene Metrics with a hood, water-resistant protective footwear, and gloves. Industrial hygienists assist with respirator To ensure timely delivery of quality industrial hy- fit-testing and selection of appropriate protective giene services, the Army conducts frequent reviews of equipment. their programs by assessing program workload, health outcomes, management effectiveness, and resource uti- Defense Occupational and Environmental Readi- lization. Reviews include program assistance visits and ness System self-reported metrics. A program review involves an organization such as APHC assessing a local program, The Army and all DoD components must collect noting deficiencies, and making recommendations for and analyze health information to support the risk improvement. management process during all phases of military DoD Instruction (DoDI) 6055.5, Occupational and En- operations.10,11 They must also maintain and control vironmental Health,8 lists several metric measurements access to personnel exposure and medical surveillance that provide insight into the effectiveness of the local records for the duration of employment plus 30 years.12 industrial hygiene program. The reduction of work- DOEHRS is used to carry out this directive. The data related occupational and environmental exposures is collection modules in DOEHRS follow the steps in the a real measure of success. The metrics include: exposure assessment model, including a method for establishing SEGs and assessing the statistical validity • percentage of shop hazard characterizations of exposure monitoring. completed, DOEHRS data collected at the garrison level, • index of unacceptable exposures, in the field, or on deployments is routinely added • percentage of hazards by risk level, and to an Army corporate database. This database not • percentage completion of the monitoring plan.

SUMMARY

The fundamental goal of Army industrial hygiene maintain a scientific edge, they must also embrace is to ensure the health and welfare of the soldier and new technologies, effectively communicate risk and civilian in an increasingly complex and fast-paced risk remediation, and leverage scarce resources to ac- world. Army industrial hygienists must not only complish the mission.

REFERENCES

1. American Industrial Hygiene Association website. http://www.aiha.org. Accessed October 27, 2016.

2. American Conference of Governmental Industrial Hygienists website. http://www.acgih.org. Accessed October 27, 2016.

3. Bayne-Jones S. The Evolution of Preventive Medicine in the Army, 1607–1939. Washington, DC: US Depart- ment of the Army, Office of The Surgeon General; 1968.

4. Heaton LD, Anderson RS, Hoff EC, eds. Preventive Medicine in World War II. Vol 9, Special fields. Washington, DC: US Department of the Army, Office of The Surgeon General; 1969.

5. US Department of the Army. The Army Safety Program. Washington, DC: DA; 2010. Army Regulation 385-10.

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6. US Department of the Army. Preventive Medicine. Washington, DC: DA; 2007, Army Regulation 40-5.

7. US Department of the Army. The Army Industrial Hygiene Program. Washington, DC: DA; 2013. DA Pamphlet 40-503.

8. US Department of Defense. Occupational and Environmental Health. Washington, DC: DoD; 2008. DoD Instruction 6055.05.

9. American Conference of Governmental Industrial Hygienists. TLVs and BEIs: Threshold Limit Values for Chemical Sub- stances and Physical Agents. Cincinnati, OH: ACGIH; 2016.

10. US Department of Defense. DoD Safety and Occupational Health (SOH) Program. Washington, DC: DoD; 1998. DoD Instruction 6055.1.

11. National Science and Technology Council. Improving the Health of Our Military, Veterans, and Their Families. Washing- ton, DC: Executive Office of the President, Office of Science and Technology Policy; August 1998. Presidential Review Directive 5.

12. 29 CFR, Part 1910.1020. Access to employee exposure and medical records.

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