OSHA Inspection: DENTAHEALTH

Issued

1987-01-15 00:00:00

Abate by

1987-04-20 00:00:00

Penalty

Initial $180.00 · Current $125.00 Reduced

Hazardous substances 1953

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: The
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employer did not furnish employment and a place of employment which were
free from recognized hazards that were causing or likely to cause death
or serious physical harm to employees in that employees were exposed to
the hazards of waste anesthetic gas:
a) Employees were exposed to the hazards of nitrous oxide (N20) present
as a waste anesthetic gas while performing and assisting with dental
operatory procedures. The employer did not provide adequate controls
during the period of administration of N20 in order to control
occupational exposure of waste nitrous gas. The employees were
exposed to high levels of N20, thereby subjecting them to serious
health hazards of:
1) an increased incidence of liver and kidney diseases;
2) an increased rate of spontaneous abortions to females exposed to the
N20 gas;
3) an increased rate of congenital abnormalities to children born to
parents, either or both of whom were exposed to N20; and,
4) an increased rate of development of neurological diseases.
a) A dental surgeon was exposed to 370 parts per million (PPM), time
weight average (TWA) for a period of 109 minutes while performing
dental surgery on 7/1/86. Based on an 8-hour TWA, this exposure is
84 PPM or 4.3 times the acceptable limit.
b) A dental assistant was exposed to 380 PPM TWA for a period of 106
minutes while assisting with dental surgery on 7/1/86. Based on an
8-hour TWA, this exposure is 83 PPM or 4.3 times the acceptable
limit.
NIOSH's occupational exposure to nitrous oxide, when used as the sole
anesthetic agent, shall be controlled so that no worker is exposed to
TWA concentrations greater than 25 PPM during anesthetic
administration.
Some feasible and acceptable abatement methods, among others, to correct
this hazard are:
1) Leak testing both the high and low pressure N20 delivery systems to
assure tight fit of all parts and a minimum of leakage;
2) Minimizing coversation with the patient;
3) Performing preventive maintenance of anesthesia equipment at least
semi-annually;
4) Employing the air sweep when acceptable concentrations of N20 are not
achieved by other methods;
5) Assuring that the exhaust vacuum flow rate should be kept at 45 LPM;
6) Assuring that the scavenging exhaust system is vented to prevent any
recontamination of the room;
7) Increasing general room dilution ventilation rates;
8) Employ ongoing air monitoring program to prove the effectiveness of
the control measures, and;
9) Administrative control of N20 use, such as, but not limited to:
a) limiting the number of N20 surgeries per day;
b) rotation of personnel who utilize N20 during their workday.
ABATEMENT SCHEDULE
STEP 1: Submit to the Area Director a written, detailed plan of
abatement outlining a schedule for the implementation of engineering
and/or administrative measures to control employee exposure to
hazardous substances as referenced in this citation. This plan shall
include, at a minimum, target dates for the following actions which
must be consistent with the dates required by this citation:
1) Evaluation of engineering/administrative control options;
2) Selection of optimum control methods and completion of design;
3) Procurement, installation and operation of selected control measures;
4) Testing and acceptance of modification/redesign of controls.
All proposed control measures shall be approved for each particular
use by a competent industrial hygienist or other technically
qualified person.
STEP 2: Abatement shall have been completed by the implementation of
feasible engineering and/or administrative controls upon verification
of their effectiveness in achieving compliance.

Issued

1987-01-15 00:00:00

Abate by

1987-01-18 00:00:00

Issued

1987-01-15 00:00:00

Abate by

1987-01-27 00:00:00

Hazardous substances 19538210

Issued

1987-01-15 00:00:00

Abate by

1987-01-27 00:00:00

Hazardous substances 19538210