OSHA Inspection: ORAL AND MAXILLO, FACIAL SURGEONS, INC.

Issued

Aug 27, 1986

Abate by

Dec 3, 1986

Penalty

Initial $240 · Current $150 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:
Employees were exposed to the hazards of nitrous oxide (N20) present as
a waste anesthetic gas.  The employer did not provide adequate controls
during the period of administration of nitrous oxide to control the
occupational exposure of waste nitrous oxide gas to its employees in
and around the dental operatory rooms hereafter listed exposing
employees to high level concentrations of the nitrous oxide thereby
subjecting them to serious health hazards.  Those hazards being: a) an
increased incidence of liver and kidney diseases, b) an increased rate
of spontaneous abortions to females exposed to the N20 gas; c) an
increased rate of congenital abnormalities to children born to parents
either or both of whom were exposed to nitrous oxide; and d) increased
rate of development of neurological diseases.
The incidents on the day sampling were:  (a) on May 12, 1986, in
dental operatory room #4, the LPN Chair Assistant was exposed to 1100
ppm (parts per million)  TWA (time weighted average) for a period of
45 minutes.  The NIOSH and American Dental Association recommended
limit of "reasonably achievable" concentration is "as high as 50 ppm"
(b)  On the same date, in dental operatory room(s) #4, 4, 3, the Oral
Surgeon was exposed to 610 ppm TWA for 58 minutes.  The recommended
top limit is 50 ppm as above.  Based on an 8 hour TWA this exposure is
74 ppm or 1.5 times the recommended limit.
Compliance methods include but are not limited to:  a) use of various
size face masks, b) monitoring scaverging system already present for
leaks, c) evaluation of present scavenging system for adequacy,
d) limiting patient conversation after use of N20, e) As through as
possible cleansing of the system with oxygen at the end of nitrous
oxide use, f) possible use of properly installed sweep (fan) system.
Abatement shall have been completed by the implementation of feasible
engineering and/or administrative controls upon verification of their
effectiveness in achieving compliance.