Updating the icrp human respiratory tract model
Employees at hospitals that do not meet the criteria shown in Tables 1 and 2 must determine whether more protective equipment is required (e.g., HAZWOPER Level B).
A higher level of protection also may be necessary for any hospital that anticipates providing specialized services (such as Hazardous Materials Response Team at the incident site).
These hospital employees, who may be termed This means that their exposures are limited to the substances transported to the hospital on victims' skin, hair, clothing, or personal effects (Horton et al., 2003).
The location and limited source of contaminant distinguishes first receivers from other first responders (e.g., firefighters, law enforcement, and ambulance service personnel), who typically respond to the incident site (i.e., the Release Zone).
*To maintain a minimum level of confidentiality, hospitals were assigned letters according to risk category, which do not reflect the alphabetical order in which they are listed above.
The following agencies and organizations reviewed and provided comments regarding OSHA's Best Practices: Healthcare workers risk occupational exposures to chemical, biological, or radiological materials when a hospital receives contaminated patients, particularly during mass casualty incidents.
During mass casualty emergencies, hospitals can anticipate little or no warning before victims begin arriving.
Additionally, first receivers can anticipate that information regarding the hazardous agent(s) would not be available immediately.
The first receiver PPE listed in Table 3 is not the only option for first receivers.
OSHA considers sound planning the first line of defense in all types of emergencies (including emergencies involving chemical, biological, or radiological substances).
By tailoring emergency plans to reflect the reasonably predictable "worst-case" scenario under which first receivers might work, the hospital can rely on these plans to guide decisions regarding personnel training and PPE (OSHA, 2003, 2002b, 1999).
These sources demonstrate appropriate caution in the face of unknown contaminants of unknown concentration.
However, OSHA believes that the substantial body of recent information on first receivers' actual experiences and probable exposure levels now allows more definitive guidance.
This risk was estimated using a scale adapted from the Hospital Corporation of America (HCA, undated): Note: This risk scale was used only to help identify a diverse group of hospitals for interviews.