OSHA Inspection: ROBERT G. WYLIE, DDS

Issued

Feb 19, 2010

Abate by

Mar 24, 2010

Penalty

Initial $1,050 · Current $1,050

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970:  The
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 HAZARD OF OVEREXPOSURE TO NITROUS OXIDE:
(a)At the Wylie Dental Office, on or about 01/15/2010: the employer did not
furnish a place of employment free from recognized hazards that were
causing or
likely to cause serious physical harm to employees in that employees
performing or
assisting in dental procedures where nitrous oxide was administered to
patients as
an anesthetic gas, were exposed to the waste nitrous oxide gas in levels
measured at
91.0 PPM 8-hour TWA and 57.0 PPM 8-hour TWA, exceeding the recommended
exposure level (REL) of 25 parts per million (PPM) as an 8-hour time
weighted
average (TWA).
The REL was established by the National Institute of Occupational Safety
and
Health (NIOSH), U.S. Department of Health and Human Services to protect
employees from the harmful health effects of nitrous oxide including
reduced
fertility, spontaneous abortions, and neurologic, renal, and liver
disease.
Air monitoring conducted on 01/15/2010 indicated employee exposure to
airborne
nitrous oxide as listed in the following table:
A Dental Assistant adjacent to N2O scavenger, exposed for 163 minutes,
with an 8
hour TWA of 91.0 PPM nitrous oxide. This level is approximately four times
the
REL of 25 PPM.  This exposure was derived from one sample collected over
the 163
minute sampling period, with a zero increment added for the 317 minutes not
sampled.
A Dental Assistant in the operatory across hall from N2O scavenger,
exposed for 165
minutes, with an 8 hour TWA of 47.4 PPM nitrous oxide. This level is
approximately two times the REL of 25 PPM.  This exposure was derived from
one
sample collected over the 165 minute sampling period, with a zero
increment for the
315 minutes not sampled.
Feasible and effective abatement methods can include, but are not limited
to the
following:
Engineering Controls: 1.Perform additional monitoring of nitrous oxide
levels,
including monitoring of air from the workers personal breathing zone.
2.Leak test
all equipment, including cylinder connections, distribution and recovery
(scavenger)
lines, seals, etc. Exposure to nitrous oxide and repeated sterilization
can degrade
rubber and plastic components. 3.If not completed, install a nitrous waste
gas
scavenger system. 4.Supply scavenging mask in a variety of sizes so that
the maskfits correctly over the patients face, forming a comfortable and
secure fit. 5.Make
sure that the scavenging system exhaust rates (flow rates) are
approximately 45 liters
per minute (L/min) to minimize nitrous oxide flow rate with a flowmeter
that is:-
Validated to measure air flow within 5 L/min of actual air flow,
-Permanently
connected to the scavenging system vacuum line, and -Positioned so that it
is always
visible to the operator. 6.Vent nitrous oxide from all scavenging pumps to
the
outside of the building away from any fresh air intakes, windows, or
walkways.
7.Increase the air flow into the room(s) or increase the percentage of
outside air to
allow for more air mixing and further dilution of the anesthetic gas.
Maintain a
balanced air supply and exhaust system so that nitrous does not contaminate
adjacent areas. 8.Consider the use of supplementary local ventilation
(such as a vent
hood) in conjunction with a scavenging system to reduce nitrous exposures
in
the
operatory. The effectiveness of this type of ventilation may depend on its
location
with respect to the patient and the airflow rates. Do not work between the
patient
and the exhaust duct, where contaminated air would be drawn through the
workers
breathing zone.
Work Practice Controls: 1.Do not turn on the nitrous delivery system
until: -The
vacuum system scavenging unit is operating at a flow rate of at least 45
L/min, and -
The scavenging mask is securely over the patient's nose or face. 2.Assure
the mask
is fastened according to the manufacturers instructions to reduce leakage.
3.Flush
the system of nitrous after the procedure by administering oxygen to the
patient
through the anesthetic equipment for at least 5 minutes before
disconnecting the gas
delivery system. 4.Encourage the patient to minimize talking and
mouth-breathing
during dental procedures.
Respiratory Protection: If levels can not be maintained below 25 parts per
million
as an 8 hour time weighted average, and until such time as these
modifications are
put into place, the employees should be provided with: 1.Wearing air
supplied
respirators. If respirators are used, the employer must comply with the
provisions
of the OSHA Respiratory Protection Standard, 29CFR 1910.134.
Abatement Disclaimers: 1.The employer is not limited to the abatement
methods
suggested by OSHA. 2.The abatement methods explained are general, and may
not
be effective in all cases. 3.The employer is responsible to selecting and
carrying out
an applicable abatement method.
Abatement certification must be submitted for this item.

Issued

Feb 19, 2010

Abate by

Feb 24, 2010

Penalty

Initial $750 · Current $750

Issued

Feb 19, 2010

Abate by

Feb 24, 2010

Penalty

Initial $600 · Current $600

Issued

Feb 19, 2010

Abate by

Mar 24, 2010

Penalty

Initial $1,050 · Current $1,050

Issued

Feb 19, 2010

Abate by

Feb 24, 2010

Issued

Feb 19, 2010

Abate by

Feb 24, 2010

Issued

Feb 19, 2010

Abate by

Feb 24, 2010

Penalty

Initial $1,500 · Current $1,500

Issued

Feb 19, 2010

Abate by

Feb 24, 2010

Issued

Feb 19, 2010

Abate by

Mar 24, 2010

Penalty

Initial $600 · Current $600

Issued

Feb 19, 2010

Abate by

Mar 22, 2010