WAC 296-62-07460   Butadiene.  (1) Scope and application.

     (a) This section applies to all occupational exposures to 1,3-Butadiene (BD), Chemical Abstracts Service Registry No. 106-99-0, except as provided in (b) of this subsection.

     (b)(i) Except for the recordkeeping provisions in subsection (13)(a) of this section, this section does not apply to the processing, use, or handling of products containing BD or to other work operations and streams in which BD is present where objective data are reasonably relied upon that demonstrate the work operation or the product or the group of products or operations to which it belongs may not reasonably be foreseen to release BD in airborne concentrations at or above the action level or in excess of the STEL under the expected conditions of processing, use, or handling that will cause the greatest possible release or in any plausible accident.

     (ii) This section also does not apply to work operations, products or streams where the only exposure to BD is from liquid mixtures containing 0.1% or less of BD by volume or the vapors released from such liquids, unless objective data become available that show that airborne concentrations generated by such mixtures can exceed the action level or STEL under reasonably predictable conditions of processing, use or handling that will cause the greatest possible release.

     (iii) Except for labeling requirements and requirements for emergency response, this section does not apply to the storage, transportation, distribution or sale of BD or liquid mixtures in intact containers or in transportation pipelines sealed in such a manner as to fully contain BD vapors or liquids.

     (c) Where products or processes containing BD are exempted under (b) of this subsection, 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 subsection (13)(a) of this section.

     (2) Definitions: For the purpose of this section, the following definitions shall apply:

     "Action level" means a concentration of airborne BD of 0.5 ppm calculated as an 8-hour time-weighted average.

     "Director" means the director of the department of labor and industries, or authorized representatives.

     "Authorized person" means any person specifically designated by the employer, whose duties require entrance into a regulated area, or a person entering such an area as a designated representative of employees to exercise the right to observe monitoring and measuring procedures under subsection (4)(h) of this section, or a person designated under the WISH Act or regulations issued under the WISH Act to enter a regulated area.

     "1,3-Butadiene" means an organic compound with chemical formula CH(2)=CH-CH=CH(2) that has a molecular weight of approximately 54.15 gm/mole.

     "Business day" means any Monday through Friday, except those days designated as federal, state, local or company specific holidays.

     "Complete blood count (CBC)" means laboratory tests performed on whole blood specimens and includes the following: White blood cell count (WBC), hematocrit (Hct), red blood cell count (RBC), hemoglobin (Hgb), differential count of white blood cells, red blood cell morphology, red blood cell indices, and platelet count.

     "Day" means any part of a calendar day.

     "Emergency situation" means any occurrence such as, but not limited to, equipment failure, rupture of containers, or failure of control equipment that may or does result in an uncontrolled significant release of BD.

     "Employee exposure" means exposure of a worker to airborne concentrations of BD which would occur if the employee were not using respiratory protective equipment.

     "Objective data" means monitoring data, or mathematical modelling or calculations based on composition, chemical and physical properties of a material, stream or product.

     "Permissible exposure limits (PELs)" means either the 8-hour time-weighted average (8-hour TWA) exposure or the short-term exposure limit (STEL).

     "Physician or other licensed health care professional" is an individual whose legally permitted scope of practice (i.e., license, registration, or certification) allows him or her to independently provide or be delegated the responsibility to provide one or more of the specific health care services required by (k) of this subsection.

     "Regulated area" means any area where airborne concentrations of BD exceed or can reasonably be expected to exceed the 8-hour time-weighted average (8-hour TWA) exposure of 1 ppm or the short-term exposure limit (STEL) of 5 ppm for 15 minutes.

     "This section" means this 1,3-butadiene standard.

     (3) Permissible exposure limits (PELs).

     (a) Time-weighted average (TWA) limit. The employer shall ensure that no employee is exposed to an airborne concentration of BD in excess of one part BD per million parts of air (ppm) measured as an eight (8)-hour time-weighted average.

     (b) Short-term exposure limit (STEL). The employer shall ensure that no employee is exposed to an airborne concentration of BD in excess of five parts of BD per million parts of air (5 ppm) as determined over a sampling period of fifteen minutes.

     (4) Exposure monitoring.

     (a) General.

     (i) Determinations of employee exposure shall be made from breathing zone air samples that are representative of the 8-hour TWA and 15-minute short-term exposures of each employee.

     (ii) Representative 8-hour TWA employee exposure shall be determined on the basis of one or more samples representing full-shift exposure for each shift and for each job classification in each work area.

     (iii) Representative 15-minute short-term employee exposures shall be determined on the basis of one or more samples representing 15-minute exposures associated with operations that are most likely to produce exposures above the STEL for each shift and for each job classification in each work area.

     (iv) Except for the initial monitoring required under (b) of this subsection, where the employer can document that exposure levels are equivalent for similar operations on different work shifts, the employer need only determine representative employee exposure for that operation from the shift during which the highest exposure is expected.

     (b) Initial monitoring.

     (i) Each employer who has a workplace or work operation covered by this section, shall perform initial monitoring to determine accurately the airborne concentrations of BD to which employees may be exposed, or shall rely on objective data pursuant to subsection (1)(b)(i) of this section to fulfill this requirement. The initial monitoring required under this subitem shall be completed within sixty days of the introduction of BD into the workplace.

     (ii) Where the employer has monitored within two years prior to the effective date of this section and the monitoring satisfies all other requirements of this section, the employer may rely on such earlier monitoring results to satisfy the requirements of (b)(i) of this subsection, provided that the conditions under which the initial monitoring was conducted have not changed in a manner that may result in new or additional exposures.

     (c) Periodic monitoring and its frequency.

     (i) If the initial monitoring required by (b) of this subsection reveals employee exposure to be at or above the action level but at or below both the 8-hour TWA limit and the STEL, the employer shall repeat the representative monitoring required by (a) of this subsection every twelve months.

     (ii) If the initial monitoring required by (b) of this subsection reveals employee exposure to be above the 8-hour TWA limit, the employer shall repeat the representative monitoring required by (a)(ii) of this subsection at least every three months until the employer has collected two samples per quarter (each at least 7 days apart) within a two-year period, after which such monitoring must occur at least every six months.

     (iii) If the initial monitoring required by (b) of this subsection reveals employee exposure to be above the STEL, the employer shall repeat the representative monitoring required by (a)(iii) of this subsection at least every three months until the employer has collected two samples per quarter (each at least 7 days apart) within a two-year period, after which such monitoring must occur at least every six months.

     (iv) The employer may alter the monitoring schedule from every six months to annually for any required representative monitoring for which two consecutive measurements taken at least 7 days apart indicate that employee exposure has decreased to or below the 8-hour TWA, but is at or above the action level.

     (d) Termination of monitoring.

     (i) If the initial monitoring required by (b) of this subsection reveals employee exposure to be below the action level and at or below the STEL, the employer may discontinue the monitoring for employees whose exposures are represented by the initial monitoring.

     (ii) If the periodic monitoring required by (c) of this subsection reveals that employee exposures, as indicated by at least two consecutive measurements taken at least 7 days apart, are below the action level and at or below the STEL, the employer may discontinue the monitoring for those employees who are represented by such monitoring.

     (e) Additional monitoring.

     (i) The employer shall institute the exposure monitoring required under subsection (4) of this section whenever there has been a change in the production, process, control equipment, personnel or work practices that may result in new or additional exposures to BD or when the employer has any reason to suspect that a change may result in new or additional exposures.

     (ii) Whenever spills, leaks, ruptures or other breakdowns occur that may lead to employee exposure above the 8-hour TWA limit or above the STEL, the employer shall monitor (using leak source, such as direct reading instruments, area or personal monitoring), after the cleanup of the spill or repair of the leak, rupture or other breakdown, to ensure that exposures have returned to the level that existed prior to the incident.

     (f) Accuracy of monitoring.

     Monitoring shall be accurate, at a confidence level of 95 percent, to within plus or minus 25 percent for airborne concentrations of BD at or above the 1 ppm TWA limit and to within plus or minus 35 percent for airborne concentrations of BD at or above the action level of 0.5 ppm and below the 1 ppm TWA limit.

     (g) Employee notification of monitoring results.

     (i) The employer shall, within 5 business days after the receipt of the results of any monitoring performed under this section, notify the affected employees of these results in writing either individually or by posting of results in an appropriate location that is accessible to affected employees.

     (ii) The employer shall, within 15 business days after receipt of any monitoring performed under this section indicating the 8-hour TWA or STEL has been exceeded, provide the affected employees, in writing, with information on the corrective action being taken by the employer to reduce employee exposure to or below the 8-hour TWA or STEL and the schedule for completion of this action.

     (h) Observation of monitoring.

     (i) Employee observation. The employer shall provide affected employees or their designated representatives an opportunity to observe any monitoring of employee exposure to BD conducted in accordance with this section.

     (ii) Observation procedures. When observation of the monitoring of employee exposure to BD requires entry into an area where the use of protective clothing or equipment is required, the employer shall provide the observer at no cost with protective clothing and equipment, and shall ensure that the observer uses this equipment and complies with all other applicable safety and health procedures.

     (5) Regulated areas.

     (a) The employer shall establish a regulated area wherever occupational exposures to airborne concentrations of BD exceed or can reasonably be expected to exceed the permissible exposure limits, either the 8-hour TWA or the STEL.

     (b) Access to regulated areas shall be limited to authorized persons.

     (c) Regulated areas shall be demarcated from the rest of the workplace in any manner that minimizes the number of employees exposed to BD within the regulated area.

     (d) An employer at a multiemployer worksite who establishes a regulated area shall communicate the access restrictions and locations of these areas to other employers with work operations at that worksite whose employees may have access to these areas.

     (6) Methods of compliance.

     (a) Engineering controls and work practices.

     (i) The employer shall institute engineering controls and work practices to reduce and maintain employee exposure to or below the PELs, except to the extent that the employer can establish that these controls are not feasible or where subsection (8)(a)(i) of this section applies.

     (ii) Wherever the feasible engineering controls and work practices which can be instituted are not sufficient to reduce employee exposure to or below the 8-hour TWA or STEL, the employer shall use them to reduce employee exposure to the lowest levels achievable by these controls and shall supplement them by the use of respiratory protection that complies with the requirements of subsection (8) of this section.

     (b) Compliance plan.

     (i) Where any exposures are over the PELs, the employer shall establish and implement a written plan to reduce employee exposure to or below the PELs primarily by means of engineering and work practice controls, as required by (a) of this subsection, and by the use of respiratory protection where required or permitted under this section. No compliance plan is required if all exposures are under the PELs.

     (ii) The written compliance plan shall include a schedule for the development and implementation of the engineering controls and work practice controls including periodic leak detection surveys.

     (iii) Copies of the compliance plan required in (b) of this subsection shall be furnished upon request for examination and copying to the director, affected employees and designated employee representatives. Such plans shall be reviewed at least every 12 months, and shall be updated as necessary to reflect significant changes in the status of the employer's compliance program.

     (iv) The employer shall not implement a schedule of employee rotation as a means of compliance with the PELs.

     (7) Exposure goal program.

     (a) For those operations and job classifications where employee exposures are greater than the action level, in addition to compliance with the PELs, the employer shall have an exposure goal program that is intended to limit employee exposures to below the action level during normal operations.

     (b) Written plans for the exposure goal program shall be furnished upon request for examination and copying to the director, affected employees and designated employee representatives.

     (c) Such plans shall be updated as necessary to reflect significant changes in the status of the exposure goal program.

     (d) Respirator use is not required in the exposure goal program.

     (e) The exposure goal program shall include the following items unless the employer can demonstrate that the item is not feasible, will have no significant effect in reducing employee exposures, or is not necessary to achieve exposures below the action level:

     (i) A leak prevention, detection, and repair program.

     (ii) A program for maintaining the effectiveness of local exhaust ventilation systems.

     (iii) The use of pump exposure control technology such as, but not limited to, mechanical double-sealed or seal-less pumps.

     (iv) Gauging devices designed to limit employee exposure, such as magnetic gauges on rail cars.

     (v) Unloading devices designed to limit employee exposure, such as a vapor return system.

     (vi) A program to maintain BD concentration below the action level in control rooms by use of engineering controls.

     (8) Respiratory protection.

     (a) General. For employees who use respirators required by this section, the employer must provide each employee an appropriate respirator that complies with the requirements of this subsection. Respirators must be used during:

     (i) Periods necessary to install or implement feasible engineering and work-practice controls;

     (ii) Nonroutine work operations that are performed infrequently and for which exposures are limited in duration;

     (iii) Work operations for which feasible engineering controls and work-practice controls are not yet sufficient to reduce employee exposures to or below the PELs;

     (iv) Emergencies.

     (b) Respirator program.

     (i) The employer must implement a respiratory protection program as required by chapter 296-842 WAC, except WAC 296-842-13005 and 296-842-14005, which covers each employee required by this section to use a respirator.

     (ii) If air-purifying respirators are used, the employer must replace the air-purifying filter elements according to the replacement schedule set for the class of respirators listed in Table 1 of this section, and at the beginning of each work shift.

     (iii) Instead of using the replacement schedule listed in Table 1 of this section, the employer may replace cartridges or canisters at 90% of their expiration service life, provided the employer:

     (A) Demonstrates that employees will be adequately protected by this procedure;

     (B) Uses BD breakthrough data for this purpose that have been derived from tests conducted under worst-case conditions of humidity, temperature, and air-flow rate through the filter element, and the employer also describes the data supporting the cartridge- or canister-change schedule, as well as the basis for using the data in the employer's respirator program.

     (iv) A label must be attached to each filter element to indicate the date and time it is first installed on the respirator.

     (v) If NIOSH approves an end-of-service-life indicator (ESLI) for an air-purifying filter element, the element may be used until the ESLI shows no further useful service life or until the element is replaced at the beginning of the next work shift, whichever occurs first.

     (vi) Regardless of the air-purifying element used, if an employee detects the odor of BD, the employer must replace the air-purifying element immediately.

     (c) Respirator selection.

     (i) The employer must select appropriate respirators from Table 1 of this section.


Table 1. - Minimum Requirements for Respiratory Protection for Airborne BD
Concentration of Airborne BD (ppm) or condition of use Minimum required respirator
Less than or equal to 5 ppm (5 times PEL) (a) Air-purifying half mask or full facepiece respirator equipped with approved BD or organic vapor cartridges or canisters. Cartridges or canisters shall be replaced every 4 hours.
Less than or equal to 10 ppm (10 times PEL) (a) Air-purifying half mask or full facepiece respirator equipped with approved BD or organic vapor cartridges or canisters. Cartridges or canisters shall be replaced every 3 hours.
Less than or equal to 25 ppm (25 times PEL) (a) Air-purifying full facepiece respirator equipped with approved BD or organic vapor cartridges or canisters. Cartridges or canisters shall be replaced every 2 hours.
(b) Any powered air-purifying respirator equipped with approved BD or organic vapor cartridges. PAPR cartridges shall be replaced every 2 hours.
(c) Continuous flow supplied air respirator equipped with a hood or helmet.
Less than or equal to 50 ppm (50 times PEL) (a) Air-purifying full facepiece respirator equipped with approved BD or organic vapor cartridges or canisters. Cartridges or canisters shall be replaced every 1 hour.
(b) Powered air purifying respirator equipped with a tight-fitting facepiece and an approved BD or organic vapor cartridges. PAPR cartridges shall be replaced every 1 hour.
Less than or equal to 1,000 ppm (1,000 times PEL) (a) Supplied air respirator equipped with a half mask or full facepiece and operated in a pressure demand or other positive pressure mode.
Greater than 1,000 ppm (a) Self-contained breathing unknown concentration, or apparatus equipped with a fire fighting full facepiece and operated in a pressure demand or other positive pressure mode.
(b) Any supplied air respirator equipped with a full facepiece and operated in a pressure demand or other positive pressure mode in combination with an auxiliary self-contained breathing apparatus operated in a pressure demand or other positive pressure mode.
Escape from IDLH Conditions (a) Any positive pressure self-contained breathing apparatus with an appropriate service life.
(b) Any air-purifying full facepiece respirator equipped with a front or back mounted BD or organic vapor canister.

Notes: Respirators approved for use in higher concentrations are permitted to be used in lower concentrations. Full facepiece is required when eye irritation is anticipated.
     (ii) Air-purifying respirators must have filter elements certified by NIOSH for organic vapor or BD.

     (iii) When an employee whose job requires the use of a respirator cannot use a negative-pressure respirator, the employer must provide the employee with a respirator that has less breathing resistance than the negative-pressure respirator, such as a powered air-purifying respirator or supplied-air respirator, when the employee is able to use it and if it provides the employee adequate protection.

     (9) Protective clothing and equipment. Where appropriate to prevent eye contact and limit dermal exposure to BD, the employer shall provide protective clothing and equipment at no cost to the employee and shall ensure its use. Eye and face protection shall meet the requirements of WAC 296-800-160.

     (10) Emergency situations. Written plan. A written plan for emergency situations shall be developed, or an existing plan shall be modified, to contain the applicable elements specified in WAC 296-24-567, Employee emergency plans and fire prevention plans, and in WAC 296-62-3112, hazardous waste operations and emergency responses, for each workplace where there is a possibility of an emergency.

     (11) Medical screening and surveillance.

     (a) Employees covered. The employer shall institute a medical screening and surveillance program as specified in this subsection for:

     (i) Each employee with exposure to BD at concentrations at or above the action level on 30 or more days or for employees who have or may have exposure to BD at or above the PELs on 10 or more days a year;

     (ii) Employers (including successor owners) shall continue to provide medical screening and surveillance for employees, even after transfer to a non-BD exposed job and regardless of when the employee is transferred, whose work histories suggest exposure to BD:

     (A) At or above the PELs on 30 or more days a year for 10 or more years;

     (B) At or above the action level on 60 or more days a year for 10 or more years; or

     (C) Above 10 ppm on 30 or more days in any past year; and

     (iii) Each employee exposed to BD following an emergency situation.

     (b) Program administration.

     (i) The employer shall ensure that the health questionnaire, physical examination and medical procedures are provided without cost to the employee, without loss of pay, and at a reasonable time and place.

     (ii) Physical examinations, health questionnaires, and medical procedures shall be performed or administered by a physician or other licensed health care professional.

     (iii) Laboratory tests shall be conducted by an accredited laboratory.

     (c) Frequency of medical screening activities. The employer shall make medical screening available on the following schedule:

     (i) For each employee covered under (a)(i) and (ii) of this subsection, a health questionnaire and complete blood count (CBC) with differential and platelet count every year, and a physical examination as specified below:

     (A) An initial physical examination that meets the requirements of this rule, if twelve months or more have elapsed since the last physical examination conducted as part of a medical screening program for BD exposure;

     (B) Before assumption of duties by the employee in a job with BD exposure;

     (C) Every 3 years after the initial physical examination;

     (D) At the discretion of the physician or other licensed health care professional reviewing the annual health questionnaire and CBC;

     (E) At the time of employee reassignment to an area where exposure to BD is below the action level, if the employee's past exposure history does not meet the criteria of (a)(ii) of this subsection for continued coverage in the screening and surveillance program, and if twelve months or more have elapsed since the last physical examination; and

     (F) At termination of employment if twelve months or more have elapsed since the last physical examination.

     (ii) Following an emergency situation, medical screening shall be conducted as quickly as possible, but not later than 48 hours after the exposure.

     (iii) For each employee who must wear a respirator, physical ability to perform the work and use the respirator must be determined as required by chapter 296-842 WAC.

     (d) Content of medical screening.

     (i) Medical screening for employees covered by (a)(i) and (ii) of this subsection shall include:

     (A) A baseline health questionnaire that includes a comprehensive occupational and health history and is updated annually. Particular emphasis shall be placed on the hematopoietic and reticuloendothelial systems, including exposure to chemicals, in addition to BD, that may have an adverse effect on these systems, the presence of signs and symptoms that might be related to disorders of these systems, and any other information determined by the examining physician or other licensed health care professional to be necessary to evaluate whether the employee is at increased risk of material impairment of health from BD exposure. Health questionnaires shall consist of the sample forms in Appendix C to this section, or be equivalent to those samples;

     (B) A complete physical examination, with special emphasis on the liver, spleen, lymph nodes, and skin;

     (C) A CBC; and

     (D) Any other test which the examining physician or other licensed health care professional deems necessary to evaluate whether the employee may be at increased risk from exposure to BD.

     (ii) Medical screening for employees exposed to BD in an emergency situation shall focus on the acute effects of BD exposure and at a minimum include: A CBC within 48 hours of the exposure and then monthly for three months; and a physical examination if the employee reports irritation of the eyes, nose, throat, lungs, or skin, blurred vision, coughing, drowsiness, nausea, or headache. Continued employee participation in the medical screening and surveillance program, beyond these minimum requirements, shall be at the discretion of the physician or other licensed health care professional.

     (e) Additional medical evaluations and referrals.

     (i) Where the results of medical screening indicate abnormalities of the hematopoietic or reticuloendothelial systems, for which a nonoccupational cause is not readily apparent, the examining physician or other licensed health care professional shall refer the employee to an appropriate specialist for further evaluation and shall make available to the specialist the results of the medical screening.

     (ii) The specialist to whom the employee is referred under this subsection shall determine the appropriate content for the medical evaluation, e.g., examinations, diagnostic tests and procedures, etc.

     (f) Information provided to the physician or other licensed health care professional. The employer shall provide the following information to the examining physician or other licensed health care professional involved in the evaluation:

     (i) A copy of this section including its appendices;

     (ii) A description of the affected employee's duties as they relate to the employee's BD exposure;

     (iii) The employee's actual or representative BD exposure level during employment tenure, including exposure incurred in an emergency situation;

     (iv) A description of pertinent personal protective equipment used or to be used; and

     (v) Information, when available, from previous employment-related medical evaluations of the affected employee which is not otherwise available to the physician or other licensed health care professional or the specialist.

     (g) The written medical opinion.

     (i) For each medical evaluation required by this section, the employer shall ensure that the physician or other licensed health care professional produces a written opinion and provides a copy to the employer and the employee within 15 business days of the evaluation. The written opinion shall be limited to the following information:

     (A) The occupationally pertinent results of the medical evaluation;

     (B) A medical opinion concerning whether the employee has any detected medical conditions which would place the employee's health at increased risk of material impairment from exposure to BD;

     (C) Any recommended limitations upon the employee's exposure to BD; and

     (D) A statement that the employee has been informed of the results of the medical evaluation and any medical conditions resulting from BD exposure that require further explanation or treatment.

     (ii) The written medical opinion provided to the employer shall not reveal specific records, findings, and diagnoses that have no bearing on the employee's ability to work with BD.

Note: This provision does not negate the ethical obligation of the physician or other licensed health care professional to transmit any other adverse findings directly to the employee.

     (h) Medical surveillance.

     (i) The employer shall ensure that information obtained from the medical screening program activities is aggregated (with all personal identifiers removed) and periodically reviewed, to ascertain whether the health of the employee population of that employer is adversely affected by exposure to BD.

     (ii) Information learned from medical surveillance activities must be disseminated to covered employees, as defined in (a) of this subsection, in a manner that ensures the confidentiality of individual medical information.

     (12) Communication of BD hazards to employees.

     (a) Hazard communication. The employer shall communicate the hazards associated with BD exposure in accordance with the requirements of the chemical hazard communication standard, WAC 296-800-170.

     (b) Employee information and training.

     (i) The employer shall train each employee who is potentially exposed to BD at or above the action level or the STEL in accordance with the requirements of the chemical hazard communication standard, WAC 296-800-170.

     (ii) The employer shall institute a training program for all employees who are potentially exposed to BD at or above the action level or the STEL, ensure employee participation in the program and maintain a record of the contents of such program.

     (iii) Training shall be provided prior to or at the time of initial assignment to a job potentially involving exposure to BD at or above the action level or STEL and at least annually thereafter.

     (iv) The training program shall be conducted in a manner that the employee is able to understand. The employer shall ensure that each employee exposed to BD over the action level or STEL is informed of the following:

     (A) The health hazards associated with BD exposure, and the purpose and a description of the medical screening and surveillance program required by this section;

     (B) The quantity, location, manner of use, release, and storage of BD and the specific operations that could result in exposure to BD, especially exposures above the PEL or STEL;

     (C) The engineering controls and work practices associated with the employee's job assignment, and emergency procedures and personal protective equipment;

     (D) The measures employees can take to protect themselves from exposure to BD;

     (E) The contents of this standard and its appendices; and

     (F) The right of each employee exposed to BD at or above the action level or STEL to obtain:

     (I) Medical examinations as required by subsection (10) of this section at no cost to the employee;

     (II) The employee's medical records required to be maintained by subsection (13)(c) of this section; and

     (III) All air monitoring results representing the employee's exposure to BD and required to be kept by subsection (13)(b) of this section.

     (c) Access to information and training materials.

     (i) The employer shall make a copy of this standard and its appendices readily available without cost to all affected employees and their designated representatives and shall provide a copy if requested.

     (ii) The employer shall provide to the director, or the designated employee representatives, upon request, all materials relating to the employee information and the training program.

     (13) Recordkeeping.

     (a) Objective data for exemption from initial monitoring.

     (i) Where the processing, use, or handling of products or streams made from or containing BD are exempted from other requirements of this section under subsection (1)(b) of this section, or where objective data have been relied on in lieu of initial monitoring under subsection (4)(b)(ii) of this section, the employer shall establish and maintain a record of the objective data reasonably relied upon in support of the exemption.

     (ii) This record shall include at least the following information:

     (A) The product or activity qualifying for exemption;

     (B) The source of the objective data;

     (C) The testing protocol, results of testing, and analysis of the material for the release of BD;

     (D) A description of the operation exempted and how the data support the exemption; and

     (E) Other data relevant to the operations, materials, processing, or employee exposures covered by the exemption.

     (iii) The employer shall maintain this record for the duration of the employer's reliance upon such objective data.

     (b) Exposure measurements.

     (i) The employer shall establish and maintain an accurate record of all measurements taken to monitor employee exposure to BD as prescribed in subsection (4) of this section.

     (ii) The record shall include at least the following information:

     (A) The date of measurement;

     (B) The operation involving exposure to BD which is being monitored;

     (C) Sampling and analytical methods used and evidence of their accuracy;

     (D) Number, duration, and results of samples taken;

     (E) Type of protective devices worn, if any;

     (F) Name, Social Security number and exposure of the employees whose exposures are represented; and

     (G) The written corrective action and the schedule for completion of this action required by subsection (4)(g)(ii) of this section.

     (iii) The employer shall maintain this record for at least 30 years in accordance with chapter 296-802 WAC.

     (c) Medical screening and surveillance.

     (i) The employer shall establish and maintain an accurate record for each employee subject to medical screening and surveillance under this section.

     (ii) The record shall include at least the following information:

     (A) The name and Social Security number of the employee;

     (B) Physician's or other licensed health care professional's written opinions as described in subsection (11)(e) of this section;

     (C) A copy of the information provided to the physician or other licensed health care professional as required by subsection (11)(e) of this section.

     (iii) Medical screening and surveillance records shall be maintained for each employee for the duration of employment plus 30 years, in accordance with chapter 296-802 WAC.

     (d) Availability.

     (i) The employer, upon written request, shall make all records required to be maintained by this section available for examination and copying to the director.

     (ii) Access to records required to be maintained by (a) and (b) of this subsection shall be granted in accordance with chapter 296-802 WAC.

     (e) Transfer of records.

     (i) Whenever the employer ceases to do business, the employer shall transfer records required by this section to the successor employer. The successor employer shall receive and maintain these records. If there is no successor employer, the employer shall notify the director, at least three months prior to disposal, and transmit them to the director if requested by the director within that period.

     (ii) The employer shall transfer medical and exposure records as set forth in chapter 296-802 WAC.

     (14) Dates.

     (a) Effective date. This section shall become effective (day, month), 1997.

     (b) Start-up dates.

     (i) The initial monitoring required under subsection (4)(b) of this section shall be completed immediately or within sixty days of the introduction of BD into the workplace.

     (ii) The requirements of subsections (3) through (13) of this section, including feasible work practice controls but not including engineering controls specified in subsection (6)(a) of this section, shall be complied with immediately.

     (iii) Engineering controls specified by subsection (6)(a) of this section shall be implemented by February 4, 1999, and the exposure goal program specified in subsection (7) of this section shall be implemented by February 4, 2000.

     (15) Appendices.

     Appendices A, B, C, D, and F to this section are informational and are not intended to create any additional obligations not otherwise imposed or to detract from any existing obligations.


     Appendix A. Substance Safety Data Sheet For 1,3-Butadiene (Non-Mandatory)

     (1) Substance Identification.

     (a) Substance: 1,3-Butadiene (CH(2)=CH-CH=CH(2)).

     (b) Synonyms: 1,3-Butadiene (BD); butadiene; biethylene; bi-vinyl; divinyl; butadiene-1,3; buta-1,3-diene; erythrene; NCI-C50602; CAS-106-99-0.

     (c) BD can be found as a gas or liquid.

     (d) BD is used in production of styrene-butadiene rubber and polybutadiene rubber for the tire industry. Other uses include copolymer latexes for carpet backing and paper coating, as well as resins and polymers for pipes and automobile and appliance parts. It is also used as an intermediate in the production of such chemicals as fungicides.

     (e) Appearance and odor: BD is a colorless, noncorrosive, flammable gas with a mild aromatic odor at standard ambient temperature and pressure.

     (f) Permissible exposure: Exposure may not exceed 1 part BD per million parts of air averaged over the 8-hour workday, nor may short-term exposure exceed 5 parts of BD per million parts of air averaged over any 15-minute period in the 8-hour workday.

     (2) Health Hazard Data.

     (a) BD can affect the body if the gas is inhaled or if the liquid form, which is very cold (cryogenic), comes in contact with the eyes or skin.

     (b) Effects of overexposure: Breathing very high levels of BD for a short time can cause central nervous system effects, blurred vision, nausea, fatigue, headache, decreased blood pressure and pulse rate, and unconsciousness. There are no recorded cases of accidental exposures at high levels that have caused death in humans, but this could occur. Breathing lower levels of BD may cause irritation of the eyes, nose, and throat. Skin contact with liquefied BD can cause irritation and frostbite.

     (c) Long-term (chronic) exposure: BD has been found to be a potent carcinogen in rodents, inducing neoplastic lesions at multiple target sites in mice and rats. A recent study of BD-exposed workers showed that exposed workers have an increased risk of developing leukemia. The risk of leukemia increases with increased exposure to BD. OSHA has concluded that there is strong evidence that workplace exposure to BD poses an increased risk of death from cancers of the lymphohematopoietic system.

     (d) Reporting signs and symptoms: You should inform your supervisor if you develop any of these signs or symptoms and suspect that they are caused by exposure to BD.

     (3) Emergency First-Aid Procedures.

     In the event of an emergency, follow the emergency plan and procedures designated for your work area. If you have been trained in first-aid procedures, provide the necessary first aid measures. If necessary, call for additional assistance from co-workers and emergency medical personnel.

     (a) Eye and Skin Exposures: If there is a potential that liquefied BD can come in contact with eye or skin, face shields and skin protective equipment must be provided and used. If liquefied BD comes in contact with the eye, immediately flush the eyes with large amounts of water, occasionally lifting the lower and the upper lids. Flush repeatedly. Get medical attention immediately. Contact lenses should not be worn when working with this chemical. In the event of skin contact, which can cause frostbite, remove any contaminated clothing and flush the affected area repeatedly with large amounts of tepid water.

     (b) Breathing: If a person breathes in large amounts of BD, move the exposed person to fresh air at once. If breathing has stopped, begin cardiopulmonary resuscitation (CPR) if you have been trained in this procedure. Keep the affected person warm and at rest. Get medical attention immediately.

     (c) Rescue: Move the affected person from the hazardous exposure. If the exposed person has been overcome, call for help and begin emergency rescue procedures. Use extreme caution so that you do not become a casualty. Understand the plant's emergency rescue procedures and know the locations of rescue equipment before the need arises.

     (4) Respirators and Protective Clothing.

     (a) Respirators: Good industrial hygiene practices recommend that engineering and work practice controls be used to reduce environmental concentrations to the permissible exposure level. However, there are some exceptions where respirators may be used to control exposure. Respirators may be used when engineering and work practice controls are not technically feasible, when such controls are in the process of being installed, or when these controls fail and need to be supplemented or during brief, nonroutine, intermittent exposure. Respirators may also be used in situations involving nonroutine work operations which are performed infrequently and in which exposures are limited in duration, and in emergency situations. In some instances cartridge respirator use is allowed, but only with strict time constraints. For example, at exposure below 5 ppm BD, a cartridge (or canister) respirator, either full or half face, may be used, but the cartridge must be replaced at least every 4 hours, and it must be replaced every 3 hours when the exposure is between 5 and 10 ppm.

     If the use of respirators is necessary, the only respirators permitted are those that have been approved by the National Institute for Occupational Safety and Health (NIOSH). In addition to respirator selection, a complete respiratory protection program must be instituted which includes regular training, maintenance, fit testing, inspection, cleaning, and evaluation of respirators. If you can smell BD while wearing a respirator, proceed immediately to fresh air, and change cartridge (or canister) before reentering an area where there is BD exposure. If you experience difficulty in breathing while wearing a respirator, tell your supervisor.

     (b) Protective Clothing: Employees should be provided with and required to use impervious clothing, gloves, face shields (eight-inch minimum), and other appropriate protective clothing necessary to prevent the skin from becoming frozen by contact with liquefied BD (or a vessel containing liquid BD).

     Employees should be provided with and required to use splash-proof safety goggles where liquefied BD may contact the eyes.

     (5) Precautions for Safe Use, Handling, and Storage.

     (a) Fire and Explosion Hazards: BD is a flammable gas and can easily form explosive mixtures in air. It has a lower explosive limit of 2%, and an upper explosive limit of 11.5%. It has an autoignition temperature of 420 deg. C (788 deg. F). Its vapor is heavier than air (vapor density, 1.9) and may travel a considerable distance to a source of ignition and flash back. Usually it contains inhibitors to prevent self-polymerization (which is accompanied by evolution of heat) and to prevent formation of explosive peroxides. At elevated temperatures, such as in fire conditions, polymerization may take place. If the polymerization takes place in a container, there is a possibility of violent rupture of the container.

     (b) Hazard: Slightly toxic. Slight respiratory irritant. Direct contact of liquefied BD on skin may cause freeze burns and frostbite.

     (c) Storage: Protect against physical damage to BD containers. Outside or detached storage of BD containers is preferred. Inside storage should be in a cool, dry, well-ventilated, noncombustible location, away from all possible sources of ignition. Store cylinders vertically and do not stack. Do not store with oxidizing material.

     (d) Usual Shipping Containers: Liquefied BD is contained in steel pressure apparatus.

     (e) Electrical Equipment: Electrical installations in Class I hazardous locations, as defined in Article 500 of the National Electrical Code, should be in accordance with Article 501 of the Code. If explosion-proof electrical equipment is necessary, it shall be suitable for use in Group B. Group D equipment may be used if such equipment is isolated in accordance with Section 501-5(a) by sealing all conduit 1/2-inch size or larger. See Venting of Deflagrations (NFPA No. 68, 1994), National Electrical Code (NFPA No. 70, 1996), Static Electricity (NFPA No. 77, 1993), Lightning Protection Systems (NFPA No. 780, 1995), and Fire Hazard Properties of Flammable Liquids, Gases and Volatile Solids (NFPA No. 325, 1994).

     (f) Fire Fighting: Stop flow of gas. Use water to keep fire-exposed containers cool. Fire extinguishers and quick drenching facilities must be readily available, and you should know where they are and how to operate them.

     (g) Spill and Leak: Persons not wearing protective equipment and clothing should be restricted from areas of spills or leaks until clean-up has been completed. If BD is spilled or leaked, the following steps should be taken:

     (i) Eliminate all ignition sources.

     (ii) Ventilate area of spill or leak.

     (iii) If in liquid form, for small quantities, allow to evaporate in a safe manner.

     (iv) Stop or control the leak if this can be done without risk. If source of leak is a cylinder and the leak cannot be stopped in place, remove the leaking cylinder to a safe place and repair the leak or allow the cylinder to empty.

     (h) Disposal: This substance, when discarded or disposed of, is a hazardous waste according to Federal regulations (40 CFR part 261). It is listed as hazardous waste number D001 due to its ignitability. The transportation, storage, treatment, and disposal of this waste material must be conducted in compliance with 40 CFR parts 262, 263, 264, 268 and 270. Disposal can occur only in properly permitted facilities. Check state and local regulation of any additional requirements as these may be more restrictive than federal laws and regulation.

     (i) You should not keep food, beverages, or smoking materials in areas where there is BD exposure, nor should you eat or drink in such areas.

     (j) Ask your supervisor where BD is used in your work area and ask for any additional plant safety and health rules.

     (6) Medical Requirements.

     Your employer is required to offer you the opportunity to participate in a medical screening and surveillance program if you are exposed to BD at concentrations exceeding the action level (0.5 ppm BD as an 8-hour TWA) on 30 days or more a year, or at or above the 8-hr TWA (1 ppm) or STEL (5 ppm for 15 minutes) on 10 days or more a year. Exposure for any part of a day counts. If you have had exposure to BD in the past, but have been transferred to another job, you may still be eligible to participate in the medical screening and surveillance program.

     The WISHA rule specifies the past exposures that would qualify you for participation in the program. These past exposure are work histories that suggest the following:

     (a) That you have been exposed at or above the PELs on 30 days a year for 10 or more years;

     (b) That you have been exposed at or above the action level on 60 days a year for 10 or more years; or

     (c) That you have been exposed above 10 ppm on 30 days in any past year.

     Additionally, if you are exposed to BD in an emergency situation, you are eligible for a medical examination within 48 hours. The basic medical screening program includes a health questionnaire, physical examination, and blood test. These medical evaluations must be offered to you at a reasonable time and place, and without cost or loss of pay.

     (7) Observation of Monitoring.

     Your employer is required to perform measurements that are representative of your exposure to BD and you or your designated representative are entitled to observe the monitoring procedure. You are entitled to observe the steps taken in the measurement procedure, and to record the results obtained. When the monitoring procedure is taking place in an area where respirators or personal protective clothing and equipment are required to be worn, you or your representative must also be provided with, and must wear, the protective clothing and equipment.

     (8) Access to Information.

     (a) Each year, your employer is required to inform you of the information contained in this appendix. In addition, your employer must instruct you in the proper work practices for using BD, emergency procedures, and the correct use of protective equipment.

     (b) Your employer is required to determine whether you are being exposed to BD. You or your representative has the right to observe employee measurements and to record the results obtained. Your employer is required to inform you of your exposure. If your employer determines that you are being overexposed, he or she is required to inform you of the actions which are being taken to reduce your exposure to within permissible exposure limits and of the schedule to implement these actions.

     (c) Your employer is required to keep records of your exposures and medical examinations. These records must be kept by the employer for at least thirty years.

     (d) Your employer is required to release your exposure and medical records to you or your representative upon your request.


     Appendix B. Substance Technical Guidelines for 1,3-Butadiene (Non-Mandatory)

     (1) Physical and Chemical Data.

     (a) Substance identification:

     (i) Synonyms: 1,3-Butadiene (BD); butadiene; biethylene; bivinyl; divinyl; butadiene-1,3; buta-1,3-diene; erythrene; NCI-C50620; CAS-106-99-0.

     (ii) Formula: (CH(2)=CH-CH=CH(2)).

     (iii) Molecular weight: 54.1.

     (b) Physical data:

     (i) Boiling point (760 mm Hg): -4.7 deg. C (23.5 deg. F).

     (ii) Specific gravity (water = 1):0.62 at 20 deg. C (68 deg. F).

     (iii) Vapor density (air = 1 at boiling point of BD): 1.87.

     (iv) Vapor pressure at 20 deg. C (68 deg. F): 910 mm Hg.

     (v) Solubility in water, g/100 g water at 20 deg. C (68 deg. F): 0.05.

     (vi) Appearance and odor: Colorless, flammable gas with a mildly aromatic odor. Liquefied BD is a colorless liquid with a mildly aromatic odor.

     (2) Fire, Explosion, and Reactivity Hazard Data.

     (a) Fire:

     (i) Flash point: -76 deg. C (-105 deg. F) for take out; liquefied BD; Not applicable to BD gas.

     (ii) Stability: A stabilizer is added to the monomer to inhibit formation of polymer during storage. Forms explosive peroxides in air in absence of inhibitor.

     (iii) Flammable limits in air, percent by volume: Lower: 2.0; Upper: 11.5.

     (iv) Extinguishing media: Carbon dioxide for small fires, polymer or alcohol foams for large fires.

     (v) Special fire fighting procedures: Fight fire from protected location or maximum possible distance. Stop flow of gas before extinguishing fire. Use water spray to keep fire-exposed cylinders cool.

     (vi) Unusual fire and explosion hazards: BD vapors are heavier than air and may travel to a source of ignition and flash back. Closed containers may rupture violently when heated.

     (vii) For purposes of compliance with the requirements of WAC 296-24-330, BD is classified as a flammable gas. For example, 7,500 ppm, approximately one-fourth of the lower flammable limit, would be considered to pose a potential fire and explosion hazard.

     (viii) For purposes of compliance with WAC 296-24-585, BD is classified as a Class B fire hazard.

     (ix) For purposes of compliance with WAC 296-24-956 and 296-800-280, locations classified as hazardous due to the presence of BD shall be Class I.

     (b) Reactivity:

     (i) Conditions contributing to instability: Heat. Peroxides are formed when inhibitor concentration is not maintained at proper level. At elevated temperatures, such as in fire conditions, polymerization may take place.

     (ii) Incompatibilities: Contact with strong oxidizing agents may cause fires and explosions. The contacting of crude BD (not BD monomer) with copper and copper alloys may cause formations of explosive copper compounds.

     (iii) Hazardous decomposition products: Toxic gases (such as carbon monoxide) may be released in a fire involving BD.

     (iv) Special precautions: BD will attack some forms of plastics, rubber, and coatings. BD in storage should be checked for proper inhibitor content, for self-polymerization, and for formation of peroxides when in contact with air and iron. Piping carrying BD may become plugged by formation of rubbery polymer.

     (c) Warning Properties:

     (i) Odor Threshold: An odor threshold of 0.45 ppm has been reported in The American Industrial Hygiene Association (AIHA) Report, Odor Thresholds for Chemicals with Established Occupational Health Standards. (Ex. 32-28C).

     (ii) Eye Irritation Level: Workers exposed to vapors of BD (concentration or purity unspecified) have complained of irritation of eyes, nasal passages, throat, and lungs. Dogs and rabbits exposed experimentally to as much as 6700 ppm for 7 1/2 hours a day for 8 months have developed no histologically demonstrable abnormality of the eyes.

     (iii) Evaluation of Warning Properties: Since the mean odor threshold is about half of the 1 ppm PEL, and more than 10-fold below the 5 ppm STEL, most wearers of air purifying respirators should still be able to detect breakthrough before a significant overexposure to BD occurs.

     (3) Spill, Leak, and Disposal Procedures.

     (a) Persons not wearing protective equipment and clothing should be restricted from areas of spills or leaks until cleanup has been completed. If BD is spilled or leaked, the following steps should be taken:

     (i) Eliminate all ignition sources.

     (ii) Ventilate areas of spill or leak.

     (iii) If in liquid form, for small quantities, allow to evaporate in a safe manner.

     (iv) Stop or control the leak if this can be done without risk. If source of leak is a cylinder and the leak cannot be stopped in place, remove the leaking cylinder to a safe place and repair the leak or allow the cylinder to empty.

     (b) Disposal: This substance, when discarded or disposed of, is a hazardous waste according to Federal regulations (40 CFR part 261). It is listed by the EPA as hazardous waste number D001 due to its ignitability. The transportation, storage, treatment, and disposal of this waste material must be conducted in compliance with 40 CFR parts 262, 263, 264, 268 and 270. Disposal can occur only in properly permitted facilities. Check state and local regulations for any additional requirements because these may be more restrictive than federal laws and regulations.

     (4) Monitoring and Measurement Procedures.

     (a) Exposure above the Permissible Exposure Limit (8-hr TWA) or Short-Term Exposure Limit (STEL):

     (i) 8-hr TWA exposure evaluation: Measurements taken for the purpose of determining employee exposure under this standard are best taken with consecutive samples covering the full shift. Air samples must be taken in the employee's breathing zone (air that would most nearly represent that inhaled by the employee).

     (ii) STEL exposure evaluation: Measurements must represent 15 minute exposures associated with operations most likely to exceed the STEL in each job and on each shift.

     (iii) Monitoring frequencies: Table 1 gives various exposure scenarios and their required monitoring frequencies, as required by the final standard for occupational exposure to butadiene.
Table 1. -- Five Exposure Scenarios and Their Associated

Monitoring Frequencies
Action Level 8-hr TWA STEL Required Monitoring Activity
__* __ __ No 8-hour TWA or STEL monitoring required.
+* __ __ No STEL monitoring required. Monitor 8-hr TWA annually.
+ __ __ No STEL monitoring required. Periodic monitoring 8-hour TWA, in accordance with (4)(c)(iii).**
+ + + Periodic monitoring 8-hour TWA, in accordance with (4)(c)(iii)**. Periodic monitoring STEL in accordance with (4)(c)(iii).
+ __ + Periodic monitoring STEL, in accordance with (4)(c)(iii). Monitor 8-hour TWA annually.

Footnote (*) Exposure Scenario, Limit Exceeded: + = Yes, - = No.
Footnote (**) The employer may decrease the frequency of exposure monitoring to annually when at least 2 consecutive measurements taken at least 7 days apart show exposures to be below the 8-hour TWA, but at or above the action level.
     (iv) Monitoring techniques: Appendix D describes the validated method of sampling and analysis which has been tested by OSHA for use with BD. The employer has the obligation of selecting a monitoring method which meets the accuracy and precision requirements of the standard under his or her unique field conditions. The standard requires that the method of monitoring must be accurate, to a 95 percent confidence level, to plus or minus 25 percent for concentrations of BD at or above 1 ppm, and to plus or minus 35 percent for concentrations below 1 ppm.

     (5) Personal Protective Equipment.

     (a) Employees should be provided with and required to use impervious clothing, gloves, face shields (eight-inch minimum), and other appropriate protective clothing necessary to prevent the skin from becoming frozen from contact with liquid BD.

     (b) Any clothing which becomes wet with liquid BD should be removed immediately and not reworn until the butadiene has evaporated.

     (c) Employees should be provided with and required to use splash proof safety goggles where liquid BD may contact the eyes.

     (6) Housekeeping and Hygiene Facilities.

     For purposes of complying with WAC 296-800-220 and 296-800-230, the following items should be emphasized:

     (a) The workplace should be kept clean, orderly, and in a sanitary condition.

     (b) Adequate washing facilities with hot and cold water are to be provided and maintained in a sanitary condition.

     (7) Additional Precautions.

     (a) Store BD in tightly closed containers in a cool, well-ventilated area and take all necessary precautions to avoid any explosion hazard.

     (b) Nonsparking tools must be used to open and close metal containers. These containers must be effectively grounded.

     (c) Do not incinerate BD cartridges, tanks or other containers.

     (d) Employers must advise employees of all areas and operations where exposure to BD might occur.


     Appendix C. Medical Screening and Surveillance for 1,3-Butadiene (Nonmandatory)

     (1) Basis for Medical Screening and Surveillance Requirements.

     (a) Route of Entry Inhalation.

     (b) Toxicology.

     Inhalation of BD has been linked to an increased risk of cancer, damage to the reproductive organs, and fetotoxicity. Butadiene can be converted via oxidation to epoxybutene and diepoxybutane, two genotoxic metabolites that may play a role in the expression of BD's toxic effects. BD has been tested for carcinogenicity in mice and rats. Both species responded to BD exposure by developing cancer at multiple primary organ sites. Early deaths in mice were caused by malignant lymphomas, primarily lymphocytic type, originating in the thymus.

     Mice exposed to BD have developed ovarian or testicular atrophy. Sperm head morphology tests also revealed abnormal sperm in mice exposed to BD; lethal mutations were found in a dominant lethal test. In light of these results in animals, the possibility that BD may adversely affect the reproductive systems of male and female workers must be considered.

     Additionally, anemia has been observed in animals exposed to butadiene. In some cases, this anemia appeared to be a primary response to exposure; in other cases, it may have been secondary to a neoplastic response.

     (c) Epidemiology.

     Epidemiologic evidence demonstrates that BD exposure poses an increased risk of leukemia. Mild alterations of hematologic parameters have also been observed in synthetic rubber workers exposed to BD.

     (2) Potential Adverse Health Effects.

     (a) Acute.

     Skin contact with liquid BD causes characteristic burns or frostbite. BD in gaseous form can irritate the eyes, nasal passages, throat, and lungs. Blurred vision, coughing, and drowsiness may also occur. Effects are mild at 2,000 ppm and pronounced at 8,000 ppm for exposures occurring over the full workshift.

     At very high concentrations in air, BD is an anesthetic, causing narcosis, respiratory paralysis, unconsciousness, and death. Such concentrations are unlikely, however, except in an extreme emergency because BD poses an explosion hazard at these levels.

     (b) Chronic.

     The principal adverse health effects of concern are BD-induced lymphoma, leukemia and potential reproductive toxicity. Anemia and other changes in the peripheral blood cells may be indicators of excessive exposure to BD.

     (c) Reproductive.

     Workers may be concerned about the possibility that their BD exposure may be affecting their ability to procreate a healthy child. For workers with high exposures to BD, especially those who have experienced difficulties in conceiving, miscarriages, or stillbirths, appropriate medical and laboratory evaluation of fertility may be necessary to determine if BD is having any adverse effect on the reproductive system or on the health of the fetus.

     (3) Medical Screening Components At-A-Glance.

     (a) Health Questionnaire.

     The most important goal of the health questionnaire is to elicit information from the worker regarding potential signs or symptoms generally related to leukemia or other blood abnormalities. Therefore, physicians or other licensed health care professionals should be aware of the presenting symptoms and signs of lymphohematopoietic disorders and cancers, as well as the procedures necessary to confirm or exclude such diagnoses. Additionally, the health questionnaire will assist with the identification of workers at greatest risk of developing leukemia or adverse reproductive effects from their exposures to BD.

     Workers with a history of reproductive difficulties or a personal or family history of immune deficiency syndromes, blood dyscrasias, lymphoma, or leukemia, and those who are or have been exposed to medicinal drugs or chemicals known to affect the hematopoietic or lymphatic systems may be at higher risk from their exposure to BD. After the initial administration, the health questionnaire must be updated annually.

     (b) Complete Blood Count (CBC).

     The medical screening and surveillance program requires an annual CBC, with differential and platelet count, to be provided for each employee with BD exposure. This test is to be performed on a blood sample obtained by phlebotomy of the venous system or, if technically feasible, from a fingerstick sample of capillary blood. The sample is to be analyzed by an accredited laboratory.

     Abnormalities in a CBC may be due to a number of different etiologies. The concern for workers exposed to BD includes, but is not limited to, timely identification of lymphohematopoietic cancers, such as leukemia and non-Hodgkin's lymphoma. Abnormalities of portions of the CBC are identified by comparing an individual's results to those of an established range of normal values for males and females. A substantial change in any individual employee's CBC may also be viewed as "abnormal" for that individual even if all measurements fall within the population-based range of normal values. It is suggested that a flowsheet for laboratory values be included in each employee's medical record so that comparisons and trends in annual CBCs can be easily made.

     A determination of the clinical significance of an abnormal CBC shall be the responsibility of the examining physician, other licensed health care professional, or medical specialist to whom the employee is referred. Ideally, an abnormal CBC should be compared to previous CBC measurements for the same employee, when available. Clinical common sense may dictate that a CBC value that is very slightly outside the normal range does not warrant medical concern. A CBC abnormality may also be the result of a temporary physical stressor, such as a transient viral illness, blood donation, or menorrhagia, or laboratory error. In these cases, the CBC should be repeated in a timely fashion, i.e., within 6 weeks, to verify that return to the normal range has occurred. A clinically significant abnormal CBC should result in removal of the employee from further exposure to BD. Transfer of the employee to other work duties in a BD-free environment would be the preferred recommendation.

     (c) Physical Examination.

     The medical screening and surveillance program requires an initial physical examination for workers exposed to BD; this examination is repeated once every three years. The initial physical examination should assess each worker's baseline general health and rule out clinical signs of medical conditions that may be caused by or aggravated by occupational BD exposure. The physical examination should be directed at identification of signs of lymphohematopoietic disorders, including lymph node enlargement, splenomegaly, and hepatomegaly.

     Repeated physical examinations should update objective clinical findings that could be indicative of interim development of a lymphohematopoietic disorder, such as lymphoma, leukemia, or other blood abnormality. Physical examinations may also be provided on an as needed basis in order to follow up on a positive answer on the health questionnaire, or in response to an abnormal CBC. Physical examination of workers who will no longer be working in jobs with BD exposure are intended to rule out lymphohematopoietic disorders.

     The need for physical examinations for workers concerned about adverse reproductive effects from their exposure to BD should be identified by the physician or other licensed health care professional and provided accordingly. For these workers, such consultations and examinations may relate to developmental toxicity and reproductive capacity.

     Physical examination of workers acutely exposed to significant levels of BD should be especially directed at the respiratory system, eyes, sinuses, skin, nervous system, and any region associated with particular complaints. If the worker has received a severe acute exposure, hospitalization may be required to assure proper medical management. Since this type of exposure may place workers at greater risk of blood abnormalities, a CBC must be obtained within 48 hours and repeated at one, two, and three months.


     Appendix D: Sampling and Analytical Method for 1,3-Butadiene (Nonmandatory)

     OSHA Method No.: 56.

     Matrix: Air.

     Target concentration: 1 ppm (2.21 mg/m(3)).

     Procedure: Air samples are collected by drawing known volumes of air through sampling tubes containing charcoal adsorbent which has been coated with 4-tert-butylcatechol. The samples are desorbed with carbon disulfide and then analyzed by gas chromatography using a flame ionization detector.

     Recommended sampling rate and air volume: 0.05 L/min and 3 L.

     Detection limit of the overall procedure: 90 ppb (200 ug/m(3)) (based on 3 L air volume).

     Reliable quantitation limit: 155 ppb (343 ug/m(3)) (based on 3 L air volume).

     Standard error of estimate at the target concentration: 6.5%.

     Special requirements: The sampling tubes must be coated with 4-tert-butylcatechol. Collected samples should be stored in a freezer.

     Status of method: A sampling and analytical method has been subjected to the established evaluation procedures of the Organic Methods Evaluation Branch, OSHA Analytical Laboratory, Salt Lake City, Utah 84165.

     (1) Background.

     This work was undertaken to develop a sampling and analytical procedure for BD at 1 ppm. The current method recommended by OSHA for collecting BD uses activated coconut shell charcoal as the sampling medium (Ref. 5.2). This method was found to be inadequate for use at low BD levels because of sample instability.

     The stability of samples has been significantly improved through the use of a specially cleaned charcoal which is coated with 4-tert-butylcatechol (TBC). TBC is a polymerization inhibitor for BD (Ref. 5.3).

     (a) Toxic effects.

     Symptoms of human exposure to BD include irritation of the eyes, nose and throat. It can also cause coughing, drowsiness and fatigue. Dermatitis and frostbite can result from skin exposure to liquid BD. (Ref. 5.1)

     NIOSH recommends that BD be handled in the workplace as a potential occupational carcinogen. This recommendation is based on two inhalation studies that resulted in cancers at multiple sites in rats and in mice. BD has also demonstrated mutagenic activity in the presence of a liver microsomal activating system. It has also been reported to have adverse reproductive effects. (Ref. 5.1)

     (b) Potential workplace exposure.

     About 90% of the annual production of BD is used to manufacture styrene-butadiene rubber and Polybutadiene rubber. Other uses include: Polychloroprene rubber, acrylonitrile butadiene-styrene resins, nylon intermediates, styrene-butadiene latexes, butadiene polymers, thermoplastic elastomers, nitrile resins, methyl methacrylate-butadiene styrene resins and chemical intermediates. (Ref. 5.1)

     (c) Physical properties (Ref. 5.1).

     CAS No.: 106-99-0

     Molecular weight: 54.1

     Appearance: Colorless gas

     Boiling point: -4.41 deg. C (760 mm Hg)

     Freezing point: -108.9 deg. C

     Vapor pressure: 2 atm (a) 15.3 deg. C; 5 atm (a) 47 deg. C

     Explosive limits: 2 to 11.5% (by volume in air)

     Odor threshold: 0.45 ppm

     Structural formula: H(2)C:CHCH:CH(2)

     Synonyms: BD; biethylene; bivinyl; butadiene; divinyl; buta-1,3-diene; alpha-gamma-butadiene; erythrene; NCI-C50602; pyrrolylene; vinylethylene.

     (d) Limit defining parameters.

     The analyte air concentrations listed throughout this method are based on an air volume of 3 L and a desorption volume of 1 mL. Air concentrations listed in ppm are referenced to 25 deg. C and 760 mm Hg.

     (e) Detection limit of the analytical procedure.

     The detection limit of the analytical procedure was 304 pg per injection. This was the amount of BD which gave a response relative to the interferences present in a standard.

     (f) Detection limit of the overall procedure.

     The detection limit of the overall procedure was 0.60 ug per sample (90 ppb or 200 ug/m(3)). This amount was determined graphically. It was the amount of analyte which, when spiked on the sampling device, would allow recovery approximately equal to the detection limit of the analytical procedure.

     (g) Reliable quantitation limit.

     The reliable quantitation limit was 1.03 ug per sample (155 ppb or 343 ug/m(3)). This was the smallest amount of analyte which could be quantitated within the limits of a recovery of at least 75% and a precision (+/- 1.96 SD) of +/-25% or better.

     (h) Sensitivity.(1)


Footnote (1) The reliable quantitation limit and detection limits reported in the method are based upon optimization of the instrument for the smallest possible amount of analyte. When the target concentration of an analyte is exceptionally higher than these limits, they may not be attainable at the routine operation parameters.
     The sensitivity of the analytical procedure over a concentration range representing 0.6 to 2 times the target concentration, based on the recommended air volume, was 387 area units per ug/mL. This value was determined from the slope of the calibration curve. The sensitivity may vary with the particular instrument used in the analysis.

     (i) Recovery.

     The recovery of BD from samples used in storage tests remained above 77% when the samples were stored at ambient temperature and above 94% when the samples were stored at refrigerated temperature. These values were determined from regression lines which were calculated from the storage data. The recovery of the analyte from the collection device must be at least 75% following storage.

     (j) Precision (analytical method only).

     The pooled coefficient of variation obtained from replicate determinations of analytical standards over the range of 0.6 to 2 times the target concentration was 0.011.

     (k) Precision (overall procedure).

     The precision at the 95% confidence level for the refrigerated temperature storage test was +/- 12.7%. This value includes an additional +/- 5% for sampling error. The overall procedure must provide results at the target concentrations that are +/- 25% at the 95% confidence level.

     (l) Reproducibility.

     Samples collected from a controlled test atmosphere and a draft copy of this procedure were given to a chemist unassociated with this evaluation. The average recovery was 97.2% and the standard deviation was 6.2%.

     (2) Sampling procedure.

     (a) Apparatus. Samples are collected by use of a personal sampling pump that can be calibrated to within +/- 5% of the recommended 0.05 L/min sampling rate with the sampling tube in line.

     (b) Samples are collected with laboratory prepared sampling tubes. The sampling tube is constructed of silane-treated glass and is about 5-cm long. The ID is 4 mm and the OD is 6 mm. One end of the tube is tapered so that a glass wool end plug will hold the contents of the tube in place during sampling. The opening in the tapered end of the sampling tube is at least one-half the ID of the tube (2 mm). The other end of the sampling tube is open to its full 4-mm ID to facilitate packing of the tube. Both ends of the tube are fire-polished for safety. The tube is packed with 2 sections of pretreated charcoal which has been coated with TBC. The tube is packed with a 50-mg backup section, located nearest the tapered end, and with a 100-mg sampling section of charcoal. The two sections of coated adsorbent are separated and retained with small plugs of silanized glass wool. Following packing, the sampling tubes are sealed with two 7/32 inch OD plastic end caps. Instructions for the pretreatment and coating of the charcoal are presented in Section 4.1 of this method.

     (c) Reagents.

     None required.

     (d) Technique.

     (i) Properly label the sampling tube before sampling and then remove the plastic end caps.

     (ii) Attach the sampling tube to the pump using a section of flexible plastic tubing such that the larger front section of the sampling tube is exposed directly to the atmosphere. Do not place any tubing ahead of the sampling tube. The sampling tube should be attached in the worker's breathing zone in a vertical manner such that it does not impede work performance.

     (iii) After sampling for the appropriate time, remove the sampling tube from the pump and then seal the tube with plastic end caps. Wrap the tube lengthwise.

     (iv) Include at least one blank for each sampling set. The blank should be handled in the same manner as the samples with the exception that air is not drawn through it.

     (v) List any potential interferences on the sample data sheet.

     (vi) The samples require no special shipping precautions under normal conditions. The samples should be refrigerated if they are to be exposed to higher than normal ambient temperatures. If the samples are to be stored before they are shipped to the laboratory, they should be kept in a freezer. The samples should be placed in a freezer upon receipt at the laboratory.

     (e) Breakthrough.

     (Breakthrough was defined as the relative amount of analyte found on the backup section of the tube in relation to the total amount of analyte collected on the sampling tube. Five-percent breakthrough occurred after sampling a test atmosphere containing 2.0 ppm BD for 90 min. at 0.05 L/min. At the end of this time 4.5 L of air had been sampled and 20.1 ug of the analyte was collected. The relative humidity of the sampled air was 80% at 23 deg. C.)

     Breakthrough studies have shown that the recommended sampling procedure can be used at air concentrations higher than the target concentration. The sampling time, however, should be reduced to 45 min. if both the expected BD level and the relative humidity of the sampled air are high.

     (f) Desorption efficiency.

     The average desorption efficiency for BD from TBC coated charcoal over the range from 0.6 to 2 times the target concentration was 96.4%. The efficiency was essentially constant over the range studied.

     (g) Recommended air volume and sampling rate.

     (h) The recommended air volume is 3 L.

     (i) The recommended sampling rate is 0.05 L/min. for 1 hour.

     (j) Interferences.

     There are no known interferences to the sampling method.

     (k) Safety precautions.

     (i) Attach the sampling equipment to the worker in such a manner that it will not interfere with work performance or safety.

     (ii) Follow all safety practices that apply to the work area being sampled.

     (3) Analytical procedure.

     (a) Apparatus.

     (i) A gas chromatograph (GC), equipped with a flame ionization detector (FID).(2)


Footnote (2) A Hewlett-Packard Model 5840A GC was used for this evaluation. Injections were performed using a Hewlett-Packard Model 7671A automatic sampler.
     (ii) A GC column capable of resolving the analytes from any interference.(3)


Footnote (3) A 20-ft x 1/8-inch OD stainless steel GC column containing 20% FFAP on 80/100 mesh Chromabsorb W-AW-DMCS was used for this evaluation.
     (iii) Vials, glass 2-mL with Teflon-lined caps.

     (iv) Disposable Pasteur-type pipets, volumetric flasks, pipets and syringes for preparing samples and standards, making dilutions and performing injections.

     (b) Reagents.

     (i) Carbon disulfide.(4)


Footnote (4) Fisher Scientific Company A.C.S. Reagent Grade solvent was used in this evaluation.
     The benzene contaminant that was present in the carbon disulfide was used as an internal standard (ISTD) in this evaluation.

     (ii) Nitrogen, hydrogen and air, GC grade.

     (iii) BD of known high purity.(5)


Footnote (5) Matheson Gas Products, CP Grade 1,3-butadiene was used in this study.
     (c) Standard preparation.

     (i) Prepare standards by diluting known volumes of BD gas with carbon disulfide. This can be accomplished by injecting the appropriate volume of BD into the headspace above the 1-mL of carbon disulfide contained in sealed 2-mL vial. Shake the vial after the needle is removed from the septum.(6)


Footnote (6) A standard containing 7.71 ug/mL (at ambient temperature and pressure) was prepared by diluting 4 uL of the gas with 1-mL of carbon disulfide.
     (ii) The mass of BD gas used to prepare standards can be determined by use of the following equations:

     MV = (760/BP)(273+t)/(273)(22.41)

     Where:

     MV = ambient molar volume

     BP = ambient barometric pressure

     T = ambient temperature

     ug/uL = 54.09/MV

     ug/standard = (ug/uL)(uL) BD used to prepare the standard

     (d) Sample preparation.

     (i) Transfer the 100-mg section of the sampling tube to a 2-mL vial. Place the 50-mg section in a separate vial. If the glass wool plugs contain a significant amount of charcoal, place them with the appropriate sampling tube section.

     (ii) Add 1-mL of carbon disulfide to each vial.

     (iii) Seal the vials with Teflon-lined caps and then allow them to desorb for one hour. Shake the vials by hand vigorously several times during the desorption period.

     (iv) If it is not possible to analyze the samples within 4 hours, separate the carbon disulfide from the charcoal, using a disposable Pasteur-type pipet, following the one hour. This separation will improve the stability of desorbed samples.

     (v) Save the used sampling tubes to be cleaned and repacked with fresh adsorbent.

     (e) Analysis.

     (i) GC Conditions.

     Column temperature: 95 deg. C

     Injector temperature: 180 deg. C

     Detector temperature: 275 deg. C

     Carrier gas flow rate: 30 mL/min.

     Injection volume: 0.80 uL

     GC column: 20-ft x 1/8-in OD stainless steel GC column containing 20%

     FFAP on 80/100 Chromabsorb W-AW-DMCS.

     (ii) Chromatogram. See Section 4.2.

     (iii) Use a suitable method, such as electronic or peak heights, to measure detector response.

     (iv) Prepare a calibration curve using several standard solutions of different concentrations. Prepare the calibration curve daily. Program the integrator to report the results in ug/mL.

     (v) Bracket sample concentrations with standards.

     (f) Interferences (analytical).

     (i) Any compound with the same general retention time as the analyte and which also gives a detector response is a potential interference. Possible interferences should be reported by the industrial hygienist to the laboratory with submitted samples.

     (ii) GC parameters (temperature, column, etc.) may be changed to circumvent interferences.

     (iii) A useful means of structure designation is GC/MS. It is recommended that this procedure be used to confirm samples whenever possible.

     (g) Calculations.

     (i) Results are obtained by use of calibration curves. Calibration curves are prepared by plotting detector response against concentration for each standard. The best line through the data points is determined by curve fitting.

     (ii) The concentration, in ug/mL, for a particular sample is determined by comparing its detector response to the calibration curve. If any analyte is found on the backup section, this amount is added to the amount found on the front section. Blank corrections should be performed before adding the results together.

     (iii) The BD air concentration can be expressed using the following equation:

     mg/m(3) = (A)(B)/(C)(D)

     Where:

     A = ug/mL from Section 3.7.2

     B = volume

     C = L of air sampled

     D = efficiency

     (iv) The following equation can be used to convert results in mg/m(3) to ppm:

     ppm = (mg/m(3))(24.46)/54.09

     Where:

     mg/m(3) = result from Section 3.7.3.

     24.46 = molar volume of an ideal gas at 760 mm Hg and 25 deg. C.

     (h) Safety precautions (analytical).

     (i) Avoid skin contact and inhalation of all chemicals.

     (ii) Restrict the use of all chemicals to a fume hood whenever possible.

     (iii) Wear safety glasses and a lab coat in all laboratory areas.

     (4) Additional Information.

     (a) A procedure to prepare specially cleaned charcoal coated with TBC.

     (i) Apparatus.

     (A) Magnetic stirrer and stir bar.

     (B) Tube furnace capable of maintaining a temperature of 700 deg. C and equipped with a quartz tube that can hold 30 g of charcoal.(8)


Footnote (8) A Lindberg Type 55035 Tube furnace was used in this evaluation.
     (C) A means to purge nitrogen gas through the charcoal inside the quartz tube.

     (D) Water bath capable of maintaining a temperature of 60 deg. C.

     (E) Miscellaneous laboratory equipment: One-liter vacuum flask, 1-L Erlenmeyer flask, 350-M1 Buchner funnel with a coarse fitted disc, 4-oz brown bottle, rubber stopper, Teflon tape etc.

     (ii) Reagents.

     (A) Phosphoric acid, 10% by weight, in water.(9)


Footnote (9) Baker Analyzed Reagent grade was diluted with water for use in this evaluation.
     (B) 4-tert-Butylcatechol (TBC).(10)


Footnote (10) The Aldrich Chemical Company 99% grade was used in this evaluation.
     (C) Specially cleaned coconut shell charcoal, 20/40 mesh.(11)


Footnote (11) Specially cleaned charcoal was obtained from Supelco, Inc. for use in this evaluation. The cleaning process used by Supelco is proprietary.
     (D) Nitrogen gas, GC grade.

     (iii) Procedure.

     Weigh 30g of charcoal into a 500-mL Erlenmeyer flask. Add about 250 mL of 10% phosphoric acid to the flask and then swirl the mixture. Stir the mixture for 1 hour using a magnetic stirrer. Filter the mixture using a fitted Buchner funnel. Wash the charcoal several times with 250-mL portions of deionized water to remove all traces of the acid. Transfer the washed charcoal to the tube furnace quartz tube. Place the quartz tube in the furnace and then connect the nitrogen gas purge to the tube. Fire the charcoal to 700 deg. C. Maintain that temperature for at least 1 hour. After the charcoal has cooled to room temperature, transfer it to a tared beaker. Determine the weight of the charcoal and then add an amount of TBC which is 10% of the charcoal, by weight.

     CAUTION-TBC is toxic and should only be handled in a fume hood while wearing gloves.

     Carefully mix the contents of the beaker and then transfer the mixture to a 4-oz bottle. Stopper the bottle with a clean rubber stopper which has been wrapped with Teflon tape. Clamp the bottle in a water bath so that the water level is above the charcoal level. Gently heat the bath to 60 deg. C and then maintain that temperature for 1 hour. Cool the charcoal to room temperature and then transfer the coated charcoal to a suitable container.

     The coated charcoal is now ready to be packed into sampling tubes. The sampling tubes should be stored in a sealed container to prevent contamination. Sampling tubes should be stored in the dark at room temperature. The sampling tubes should be segregated by coated adsorbent lot number.

     (b) Chromatograms.

     The chromatograms were obtained using the recommended analytical method. The chart speed was set at 1 cm/min. for the first three min. and then at 0.2 cm/min. for the time remaining in the analysis.

     The peak which elutes just before BD is a reaction product between an impurity on the charcoal and TBC. This peak is always present, but it is easily resolved from the analyte. The peak which elutes immediately before benzene is an oxidation product of TBC.

     (5) References.

     (a) "Current Intelligence Bulletin 41, 1,3-Butadiene," U.S. Dept. of Health and Human Services, Public Health Service, Center for Disease Control, NIOSH.

     (b) "NIOSH Manual of Analytical Methods," 2nd ed.; U.S. Dept. of Health Education and Welfare, National Institute for Occupational Safety and Health: Cincinnati, OH. 1977, Vol. 2, Method No. S91 DHEW (NIOSH) Publ. (U.S.), No. 77-157-B.

     (c) Hawley, G.C., Ed. "The Condensed Chemical Dictionary," 8th ed.; Van Nostrand Rienhold Company: New York, 1971; 139.5.4. Chem. Eng. News (June 10, 1985), (63), 22-66.


     Appendix E: Reserved.


APPENDIX F, MEDICAL QUESTIONNAIRES, (Non-mandatory)


1,3-Butadiene (BD) Initial Health Questionnaire


DIRECTIONS:


You have been asked to answer the questions on this form because you work with BD (butadiene). These questions are about your work, medical history, and health concerns. Please do your best to answer all of the questions. If you need help, please tell the doctor or health care professional who reviews this form.


This form is a confidential medical record. Only information directly related to your health and safety on the job may be given to your employer. Personal health information will not be given to anyone without your consent.


Date:  
Name:   SSN / /    
Last   First MI
Job Title:  
Company's Name:  
Supervisor's Name:  
Supervisor's Phone No.: ( )      -    

Work History


1. Please list all jobs you have had in the past, starting with the job you have now and moving back in time to your first job. (For more space, write on the back of this page.)


Main Job Duty

Year

Company Name

City, State


Chemicals

1.

2.

3.

4.

5.

6.

7.

8.


2. Please describe what you do during a typical work day. Be sure to tell about your work with BD.

3. Please check any of these chemicals that you work with now or have worked with in the past:


benzene     
glues     
toluene     
inks, dyes     
other solvents, grease cutters     
insecticides (like DDT, lindane, etc.)     
paints, varnishes, thinners, strippers     
dusts     
carbon tetrachloride ("carbon tet")     
arsine     
carbon disulfide     
lead     
cement     
petroleum products     
nitrites     

4. Please check the protective clothing or equipment you use at the job you have now:


gloves     
coveralls     
respirator     
dust mask     
safety glasses, goggles     

Please circle your answer.


5. Does your protective clothing or equipment fit you

properly? yes no


6. Have you ever made changes in your protective clothing or equipment to make it fit better? yes no


7. Have you been exposed to BD when you were not wearing protective clothing or equipment? yes no


8. Where do you eat, drink and/or smoke when you are at work? (Please check all that apply.)


Cafeteria/restaurant/snack bar     
Break room/employee lounge     
Smoking lounge     
At my work station     

Please circle your answer.


9. Have you been exposed to radiation (like x-rays or nuclear material) at the job you have now or at past

jobs? yes no


10. Do you have any hobbies that expose you to dusts or chemicals (including paints, glues, etc.)? yes no


11. Do you have any second or side jobs? yes no

  If yes, what are your duties there?
 
 

12. Were you in the military? yes no


If yes, what did you do in the military?
 
 
 

Family Health History

1. In the FAMILY MEMBER column, across from the disease name, write which family member, if any, had the disease.


DISEASE                         FAMILY MEMBER

Cancer

Lymphoma

Sickle Cell Disease or Trait

Immune Disease

Leukemia

Anemia


2. Please fill in the following information about family health


Relative

Alive?

Age at Death?

Cause of Death?

Father

Mother

Brother/Sister

Brother/Sister

Brother/Sister


Personal Health History


Birth Date      / / Age      Sex      Height     Weight     


Please circle your answer.


1. Do you smoke any tobacco products? yes no


2. Have you ever had any kind of surgery or operation?

     yes no


     If yes, what type of surgery:


3. Have you ever been in the hospital for any other

reasons? yes no


  If yes, please describe the reason
 
 
 

4. Do you have any on-going or current medical problems

or conditions? yes no


  If yes, please describe:
 
 

5. Do you now have or have you ever had any of the following? Please check all that apply to you.
unexplained fever     
anemia ("low blood")     
HIV/AIDS     
weakness     
sickle cell     
miscarriage     
skin rash     
bloody stools     
leukemia/lymphoma     
neck mass/swelling     
wheezing     
yellowing of skin     
bruising easily     
lupus     
weight loss     
kidney problems     
enlarged lymph nodes     
liver disease     
cancer     
infertility     
drinking problems     
thyroid problems     
night sweats     
chest pain     
still birth     
eye redness     
lumps you can feel     
child with birth defect     
autoimmune disease     
overly tired     
lung problems     
rheumatoid arthritis     
mononucleosis ("mono")     
nagging cough     

Please circle your answer.


6. Do you have any symptoms or health problems that you think may be related to your work with BD? yes no

If yes, please describe:
 
7. Have any of your co-workers had similar symptoms or

problems? yes no don't know


  If yes, please describe:
 

8. Do you notice any irritation of your eyes, nose, throat, lungs, or skin when working with BD? yes no


9. Do you notice any blurred vision, coughing, drowsiness, nausea, or headache when working with BD? yes no


10. Do you take any medications (including birth control or over-the-counter)? yes no


  If yes, please list:
 

11. Are you allergic to any medication, food, or chemicals? yes no


  If yes, please list:
 

12. Do you have any health conditions not covered by this questionnaire that you think are affected by your work with

BD? yes no


  If yes, please explain:
 

13. Did you understand all the questions? yes no


              

Signature



1,3-Butadiene (BD) Health Update Questionnaire

DIRECTIONS:


You have been asked to answer the questions on this form because you work with BD (butadiene). These questions are about your work, medical history, and health concerns. Please do your best to answer all of the questions. If you need help, please tell the doctor or health care professional who reviews this form.


This form is a confidential medical record. Only information directly related to your health and safety on the job may be given to your employer. Personal health information will not be given to anyone without your consent.


Date:  
Name:   SSN / /    
Last   First MI
Job Title:  
Company's Name:  
Supervisor's Name:  
Supervisor's Phone No.: ( )      -    

1. Please describe any NEW duties that you have at your

job.                                                            

2. Please describe any additional job duties you have:
Please circle your answer.


3. Are you exposed to any other chemicals in your work

since the last time you were evaluated for exposure to

BD? yes no


If yes, please list what they are:                         
 

4. Does your personal protective equipment and clothing fit you properly? yes no


5. Have you made changes in this equipment or clothing to make if fit better? yes no


6. Have you been exposed to BD when you were not wearing protective clothing or equipment? yes no


7. Are you exposed to any NEW chemicals at home or while working on hobbies? yes no


  If yes, please list what they are:                         
 

8. Since your last BD health evaluation, have you started working any new second or side jobs? yes no


  If yes, what are your duties there?
 
 



Personal Health History


1. What is your current weight?      pounds


2. Have you been diagnosed with any new medical

conditions or illness since your last evaluation?

yes     no


  If yes, please tell what they are:                         
 

3. Since your last evaluation, have you been in the hospital for any illnesses, injuries, or surgery? yes no


  If yes, please describe:                                   
 

4. Do you have any of the following? Please place a check for all that apply to you.
unexplained fever     
anemia ("low blood")     
HIV/AIDS     
weakness     
sickle cell     
miscarriage     
skin rash     
bloody stools     
leukemia/lymphoma     
neck mass/swelling     
wheezing     
yellowing of skin     
bruising easily     
lupus     
weight loss     
kidney problems     
enlarged lymph nodes     
liver disease     
cancer     
infertility     
drinking problems     
thyroid problems     
night sweats     
chest pain     
still birth     
eye redness     
lumps you can feel     
child with birth defect     
autoimmune disease     
overly tired     
lung problems     
rheumatoid arthritis     
mononucleosis ("mono")     
nagging cough     

     Please circle your answer.


5. Do you have any symptoms or health problems that you think may be related to your work with BD? yes no

If yes, please describe:
 

6. Have any of your co-workers had similar symptoms or

problems? yes no don't know

  If yes, please describe:
 

7. Do you notice any irritation of your eyes, nose, throat, lungs, or skin when working with BD? yes no


8. Do you notice any blurred vision, coughing, drowsiness, nausea, or headache when working with BD? yes no


9. Have you been taking any NEW medications (including birth control or over-the-counter)? yes no


     If yes, please list:

   
   
10. Have you developed any new allergies to medications, foods, or chemicals? yes no


     If yes, please list:

11. Do you have any health conditions not covered by this

questionnaire that you think are affected by your work with

BD? yes no

If yes, please explain:
 

12. Do you understand all the questions? yes no


              

Signature




[Statutory Authority: RCW 49.17.010, 49.17.040, 49.17.050, 49.17.060. 09-15-145, § 296-62-07460, filed 7/21/09, effective 9/1/09; 07-03-163, § 296-62-07460, filed 1/24/07, effective 4/1/07; 05-03-093, § 296-62-07460, filed 1/18/05, effective 3/1/05; 04-10-026, § 296-62-07460, filed 4/27/04, effective 8/1/04; 03-18-090, § 296-62-07460, filed 9/2/03, effective 11/1/03. Statutory Authority: RCW 49.17.010,[49.17].040 , and [49.17].050. 01-11-038, § 296-62-07460, filed 5/9/01, effective 9/1/01; 99-10-071, § 296-62-07460, filed 5/4/99, effective 9/1/99. Statutory Authority: RCW 49.17.040, [49.17.]050 and [49.17.]060. 97-19-014, § 296-62-07460, filed 9/5/97, effective 11/5/97.]