If the worst happens to workers, will safety training save the day?

Employees exposed to chemical drive selves to ED

When a barrel at an East St. Louis plant was dropped containing the highly toxic chemical nitroaniline, the lid popped off. White powder spilled and coated eight workers. Instead of calling 911, however, the workers went home. When they began having breathing problems, some drove themselves to the nearest emergency departments (ED). Others waited hours before seeing medical care.

This response not only put the workers at risk for serious harm, but also put dozens of other people at risk as well. Two EDs immediately were locked down, with staff and patients quarantined and decontaminated due to possible exposure to the chemical.

The Occupational Safety and Health Administration (OSHA) is investigating whether the workers followed proper procedures, whether they had received adequate safety training, and whether they were wearing the proper safety equipment.

Willful violation can cost $70,000 plus

Fines for OSHA violations vary depending on the type of infraction and what is found during the course of an investigation. The facts of this particular case are not yet known, but if OSHA finds a willful violation, in which the employer knew that a hazardous condition existed but made no reasonable effort to eliminate it, penalties would range from $5,000 to $70,000 per violation. In addition, in a case like this, if the employees weren't told what to do and that caused an injury, the occupational health nurse possibly could be held liable, according to Karen Mastroianni, RN, MPH, COHN-S, FAAOHN, co-owner and health and safety strategist for Raleigh, NC-based Dimensions in Occupational Health & Safety.

"Worker's comp is designed to prevent lawsuits," Mastroianni says. "However, in this case, it would be highly likely that lawyers would pursue the injured and lawsuits would result."

As an occupational health professional, it's your responsibility to bring the potential for catastrophic, worst-case scenarios to upper management, says Chris Kalina, MBA, MS, RN, COHN-S/CM, FAAOHN, director of global occupational health programs and services at Wm. Wrigley Jr. Co. in Chicago.

"If this isn't done by an [occupational health nurse] or onsite safety person, then it is possible nobody will bring this to their attention," she says. "That being said, you should be at the table when people start planning and preparing for how such incidents will be addressed."

One way to get involved is by volunteering to be a member of any task groups on emergency preparedness. Mastroianni says, "I think often we wait until we're asked to assist, or for our opinion about something. This is often a mistake.

Kalina says, "The process needs to be totally mapped out, with everyone knowing their role and specific areas of responsibility and accountability." Address every aspect of managing an emergency incident, including transportation from the scene.

What your planning should include

Your planning should include establishment of a trained emergency response team on site, regular refresher training and updates for the team, practice drills, and after-drill critique sessions.

As an occupational health professional, you bring a medical expertise that no one else involved will have. "This is essential, not only to address the emergency, but also to take care of the well-being of the people involved in the emergency," says Kalina. This might include debriefings, Employee Assistance Program referrals, or follow up care, such as for employees exposed to blood or other biological hazards.

Your goal is to address the specific risks at your worksite — not just chemical exposure incidents, but also workplace violence that can occur anywhere. Work with management, human resources, safety and environmental health, and mental health professionals, advises Kalina. "Identify all risks that would potentially be found within an actual emergency incident situation," she says. "Then, develop strategies to mitigate these."


For more information on preparing employees for a workplace incident, contact:

  • Robert Emery, DrPH, Assistant Vice President, Safety, Health, Environment and Risk Management, The University of Texas Health Science Center at Houston. Phone: (713) 500-8100. E-mail: Robert.J.Emery@uth.tmc.edu.
  • Chris Kalina, MBA, MS, RN, COHN-S/CM, FAAOHN, Director, Global Occupational Health Programs and Services, Wm. Wrigley Jr. Co., Chicago. Phone: (312) 645-3770. E-mail: ckalina@wrigley.com.
  • Karen Mastroianni, RN, MPH, COHN-S, FAAOHN, Co-Owner and Health & Safety Strategist, Dimensions in Occupational Health & Safety, Raleigh, NC. Phone: (919) 676-2877 ext. 12. E-mail: karenm@dimensions-ohs.com.

Principal Emergency Response and Preparedness is a reference guide summarizing the Occupational Safety and Health Administration's general and industry-specific emergency response requirements. The cost is $29 plus $5 for shipping. To order the book, contact:

Government Institutes, 15200 NBN Way, Building B, Blue Ridge Summit, PA 17214. Phone: (800) 462-6420. Fax: (800) 338-4550. E-mail: custserv@rowman.com. To order online, go to www.govinstpress.com and type "Principal Emergency Response" in the book search box.