10 12 26 30

ETHICS PROFESSIONAL DEVELOPMENT FEATURE FEATURE

Updates to the The Importance Respirator Use at Exercising Judgment
Code of Ethics of NORA High Altitudes with Office Furniture

January 2020

Advances in
Understanding
NOISE
EXPOSURES
Key Findings from the
National Occupational
Research Agenda for
Hearing Loss Prevention

AIHA | Protecting Worker Health. www.aiha.org

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 JANUARY 2020

FEATURES

20
ADVANCES IN UNDERSTANDING NOISE EXPOSURES
KEY FINDINGS FROM THE NATIONAL OCCUPATIONAL RESEARCH
AGENDA FOR HEARING LOSS PREVENTION
The new NIOSH agenda for hearing loss prevention
research contains significant new insights from the
latest science concerning hearing loss, which impacts
communication in the workplace. The document also
presents critical new information regarding age correction
and vulnerable populations.
BY VERONICA STANLEY

26
RESPIRATOR USE AT HIGH ALTITUDES
EXAMINING A COMMON MISUNDERSTANDING ABOUT
ATMOSPHERE-SUPPLYING RESPIRATORS
Does an SCBA (self-contained breathing apparatus)
respirator protect wearers from oxygen-deficient
atmospheres due to increasing altitude? The answer
may surprise you.
BY ROY T. MCKAY

30
EXERCISING JUDGMENT WITH OFFICE FURNITURE
ARE “ACTIVE WORKSTATIONS” THE SOLUTION TO EXCESSIVE
SITTING?
More employees are requesting to incorporate treadmills,
stationary bicycles, exercise balls, and sit-stand desks into
workstations. While the health benefits of these “active”
workstations may appear obvious, occupational health
and safety professionals need to consider their potential
impacts on workplace safety and productivity.
BY PENNEY M. STANCH, MARJORIE WERRELL, ALBERT MOORE, AND STEPHEN W. HEMPERLY

CONTRIBUTORS
VERONICA STANLEY, FEATURE AUTHOR ROY T. MCKAY, FEATURE AUTHOR PENNEY M. STANCH, FEATURE AUTHOR
Veronica Stanley, MSPH, CIH, CSP, CESCP, works as adjunct faculty Roy T. McKay, PhD, is professor emeritus with the University of Penney M. Stanch, CIH, CSP, CPE, is a senior consultant with Baer
in Workforce Development at Harrisburg Area Community College. Cincinnati. Engineering and Environmental Consulting, Inc., in Austin, Texas.

| January 2020 4
 JANUARY 2020

Volume 31 Number 1

EDITOR IN CHIEF
Ed Rutkowski: erutkowski@aiha.org

COLUMNS & DEPARTMENTS SENIOR EDITOR

Kay Bechtold: kbechtold@aiha.org

8 PRESIDENT’S MESSAGE 14 NEWSWATCH DESIGNER

Janelle Welch, 2 Hounds Media
Progress in International OEHS and Industry News
Collaboration PRODUCTION MANAGER
BY KATHLEEN S. MURPHY 18 ADVERTISERS’ INDEX Jim Myers: jmyers@aiha.org

10 ETHICS 35 PRODUCT FEATURES ADVERTISING REPRESENTATIVE

MCI | USA
Updates to the Code of Ethics
Holly Klarman: holly.klarman@mci-group.com
BY ALAN LEIBOWITZ 36 COMMUNITY
AIHA News CHIEF EXECUTIVE OFFICER
12 PROFESSIONAL DEVELOPMENT Lawrence D. Sloan, CAE: lsloan@aiha.org
The Importance of NORA 38 BY THE NUMBERS
BY EMILY J.K. NOVICKI AND PAUL J. MIDDENDORF Driver Fatigue
The Synergist® is a copyrighted publication of the American Industrial
Hygiene Association, 3141 Fairview Park Drive, Suite 777, Falls Church,
VA 22042; (703) 849-8888; e-mail synergist@aiha.org. No part of The
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Submission of articles or letters to the editor are welcome, but AIHA
and The Synergist will determine what to publish and reserve the right to
edit all submissions for content, style, length and clarity.

The Synergist (USPS #009-332) is published monthly except a combined

June/July issue by the American Industrial Hygiene Association, 3141
Fairview Park Drive, Suite 777, Falls Church, VA 22042 for $50 per year
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EDITORIAL ADVISORY BOARD MEMBERS

Jeff Behar, California Institute of Technology
Patricia Crawford, Consultant
COMING IN FEBRUARY: M. Cathy Fehrenbacher, U.S. EPA
Bloodborne Pathogens Outside Healthcare Settings | Combustible Dust: Conducting a Dust Hazard Analysis | Don Garvey, 3M Co.
Trends in Remote Health Monitoring Stephen Hemperly, Hitachi GST
Hank Muranko, Muranko & Associates
Derek Popp, Wisconsin Occupational Health Laboratory
The Synergist’s mission is to provide AIHA members with news and information about
Doris Reid, Goodrich Corporation
the occupational and environmental health and safety fields and the industrial hygiene John Rekus, John F. Rekus & Associates Ltd.
profession. The Synergist focuses on industry trends and news, government and regulatory
activities, key issues facing the profession, appropriate technical information and news on
association events and activities.
The Synergist’s objective is to present information that is newsworthy and of general
interest in industrial hygiene. Opinions, claims, conclusions, and positions expressed in this
publication are the authors’ or persons’ quoted and do not necessarily reflect the opinions
of the editors, AIHA, or The Synergist.

| January 2020 6
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 PRESIDENT'S MESSAGE

Progress in International
KATHLEEN S. MURPHY, CIH,
is AIHA president and director of Global
Collaboration
Regulatory Affairs at Sherwin Williams in
BY KATHLEEN S. MURPHY, AIHA PRESIDENT
Cleveland, Ohio. She can be reached at

I
kathleen.murphy@sherwin.com.
nn 2018, AIHA was honored to host the International Occupational
Send feedback to synergist@aiha.org. Hygiene Association’s International Scientific Conference in Washing- INCREASING OHS AWARENESS
ton, D.C., the first time the event was held in the United States. The Making the general public aware of
opportunity to establish closer ties with occupational hygienists from occupational health and safety may
around the world encouraged the AIHA Board of Directors to reexamine not yield immediate measurable
our strategy for international engagement. You can read about the returns, but it’s necessary to grow
strategy in the March 2019 Synergist at http://bit.ly/synintlreset. This month, the profession and lay the founda-
I’ll provide an update on progress toward our goals for international engagement: tion for protecting future workers.
developing professionals, fostering community, and increasing awareness of Our strategy calls for AIHA to work
occupational health and safety. through IOHA to influence activities
in organizations such as the United
Nations, the World Bank, the World
DEVELOPING PROFESSIONALS FOSTERING COMMUNITY Health Organization, and the Inter-
AIHA continues to collaborate effec- Last year, AIHA introduced a new Vir- national Labor Organization. We’re
tively with sister organizations in other tual Section and a companion Virtual also leveraging our involvement in
countries. For example, AMHI, the Section en Español to serve areas that the Center for Safety and Health Sus-
Mexican Industrial Hygiene Associ- don’t have local sections. To promote tainability to promote AIHA’s mission
ation, is translating into Spanish the membership in these new commu- where appropriate.
first module of AIHA’s 2019 virtual nities, we offered discounted access Another way to increase aware-
conference on exposure assessment to members of our sister organiza- ness is through AIHA’s Standards
strategies. We’re also in discussions tions. As of September 2019, CIHA had Advisory Panel, which identifies
with Chinese representatives to trans- recruited 21 members in India and opportunities for AIHA to play a
late the fourth edition of A Strategy SCHO an additional 18 members in role in international standards. Cur-
AIHA contin-
for Assessing and Managing Occupa- Colombia. rently, AIHA has a representative
ues to collaborate tional Exposures. The two occupational Early returns are positive regard- on the committee that developed
effectively with hygiene organizations in Colombia, ing our efforts to increase inter- the ISO 45001 standard for occu-
sister organiza- SCHO and ACHO, have expressed national membership following pational health and safety manage-
interest in having Certified Industrial passage of a bylaws amendment ment systems. We’re also exploring
tions in other
Hygienists who live in the country teach in 2018 that expanded the defini- the possibility of participating in the
countries. 500-level courses from the Occupa- tion of “international member.” ISO 45003 standard on psycho-social
tional Hygiene Training Association. Our international membership rose health.
And next month, I’m heading to Delhi to more than 30 percent from 110 in
deliver the keynote address at the Cen- 2017 to 145 through the first nine A BETTER FUTURE
tral Industrial Hygiene Association’s months of 2019. The vital importance of engaging with
annual meeting and to promote the Also to support membership recruit- our counterparts in other countries
value of the CIH credential on behalf ment, this year AIHA representatives is what motivated the Board to revisit
of ABIH. These efforts help enhance will attend the Pan American occupa- AIHA’s international strategy in 2018.
the existing base of OH technicians and tional hygiene conference and the 2020 So far, thanks to the International
create new OH professionals. CIHA conference. In addition, we’re Affairs Committee and the Inter-
To fund training in other countries, taking advantage of the travel required national Advisory Group's efforts to
AIHA launched our micro-grants pro- for staff of the AIHA Laboratory Accred- refine our strategy and select targeted
gram in 2019. Managed by the Interna- itation Programs, LLC, who recently opportunities, we’re making measur-
tional Affairs Committee, the program attended a meeting in Colombia and able progress toward a future where
awarded $20,000 in grants to five recip- discussed ways AIHA can support occu- workers around the world have similar
ients. We’ve budgeted $25,000 for 2020. pational hygienists there. protections.

| January 2020 8
Have your voice heard...

community.aiha.org
Learn how you can invest in
your own success.

Join the dialogue about

hot topics affecting the
industry... and get help
from peers about how
to overcome your own
workplace challenges.

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VALUE of AIHA MEMBERSHIP: BY THE NUMBERS

Updates to the
ALAN LEIBOWITZ, CIH, CSP, FAIHA, is the
president of EHS Systems Solutions LLC,
a member of the Joint Industrial Hygiene
Code of Ethics
Ethics Education Committee, a current Introducing a Unified Code from the Board for Global EHS Credentialing
ABIH Board member, and a past
Board member of AIHA.
BY ALAN LEIBOWITZ
Send feedback to synergist@aiha.org.
E
arlier this year, the
American Board of
Industrial Hygiene
announced the
creation of a new,
high-level umbrella
organization called the Board for Global
EHS Credentialing, or BGC, to more
accurately reflect its enhanced creden-
tial offerings. BGC credentials include
the Certified Industrial Hygienist (CIH);
the Qualified Environmental Profession-
al (QEP) and Environmental Professional
In-Training (EPI) adopted from the
Institute of Professional Environmen-
tal Practice (IPEP); and the Certified
Professional Product Steward (CPPS),
currently in development.
A key part of establishing this new
structure is to unify the existing codes
of ethics for the individual credentials.
The unified code is now available at
CIHs will see
http://bit.ly/bgcunifiedcode (PDF). For
much that they CIHs, QEPs, and EPIs, the unified code
recognize in the will become effective on July 1, 2020,
new unified code replacing the existing codes for those
professionals. For CPPSs, who did not
since the core
previously have a code of ethics, the
elements were unified code is effective immediately.
drawn from the CIHs will see much that they recog-
existing ABIH nize in the new unified code since the
core elements were drawn from the
code.
existing ABIH code. Over the years,
the ABIH code was developed based
on real-world issues, both legal and
professional. This update focused on
ensuring that each requirement is
measurable and represents an essen-
tial expectation of our credentialed
professionals.
| January 2020
ETHICS
KEY CHANGES
The introductory section to the new
unified code clarifies that it applies to
all existing and upcoming BGC cre-
dentials. In the preamble, language
has been added to clarify that com-
pliance with the code is required “in
order to retain” all recognized BGC
credentials.
The section of the unified code that
identifies responsibilities to clients,
employers, employees, and the public
has a few changes that CIHs should
note. The ABIH code included an obli-
gation for CIHs to “make a reasonable
effort to provide appropriate profes-
sional referrals when [they are] unable
to provide competent professional
assistance.” In the new unified code,
this obligation has been removed. CIHs
may continue to provide referrals, but
the main obligation is to conduct only
those industrial hygiene-related activ-
ities that an individual CIH is qualified
to perform.
The unified code also addresses
potential new signifiers of certifica-
tion such as electronic badging. BGC
is considering offering certificants
these new options as technology and
professional practice require. Let BGC
know if you have interest in methods to
acknowledge your certification beyond
the currently offered rubber stamps,
embossers, and certificates by email-
ing info@ehscredentialing.org.
The unified code allows the creden-
tialed professional to sign documents
that they have “fully reviewed and
approved.” CIHs will recognize a slight
difference here from the existing ABIH
10
code, which specifies that individuals
who are “under [the certificant’s] direc-
tion and control” may affix or autho-
rize the use of the CIH seal, stamp, or
signature to documents that describe
work to be performed for clients. The
unified code emphasizes that creden-
tialed professionals must review and
approve any such authorization and
clarifies that this authorization does
not represent BGC’s endorsement of
the work under consideration.
A new responsibility concerning
communication has been added to
the unified code. CIHs now are obli-
gated to “communicate clearly, to cli-
ents and/or employers, the potential
consequences if professional deci-
sions or judgments are overruled or
disregarded.”
Finally, a new conclusion reinforces
that the code is key to retaining cre-
dentials: “Any violation of the preceding
numbered requirements may result
in sanctions up to and including the
suspension or removal of credentials
awarded by the BGC.”
CREDENTIALING ISSUES
Remember that the code applies only
to credentialing issues and does not
supersede any other legal or other
regulatory obligations you might have.
A link to the new code appears in the
ABIH document library at http://bit.
ly/abihdocuments. The library also
contains several other relevant doc-
uments. Please feel free to contact
BGC with any comments or questions
at (517) 321-2638 or info@ehscreden
tialing.org.
SDS Label Authoring Registry
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us authoring SDSs. Becoming an SDSRP gave me
the skills and confidence to write SDSs well.”
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EMILY J.K. NOVICKI, MA, MPH, is a
health scientist at NIOSH in Atlanta and
coordinates NORA. She can be reached at
noracoordinator@cdc.gov.
PAUL J. MIDDENDORF, PhD, CIH, is
deputy associate director for science at
NIOSH in Atlanta. He can be reached at
pkm2@cdc.gov.
Send feedback to synergist@aiha.org.
Editor’s note: The feature article on page
20 of this issue discusses information
from the NIOSH National Occupational
Research Agenda for Hearing Loss
Prevention, which was published in
July 2019. The article focuses on items
of interest to industrial hygienists and
those managing work-related hearing
conservation programs.
| January 2020
PROFESSIONAL DEVELOPMENT
The Importance of NORA
Why Practitioners Should Care About Research
BY EMILY J.K. NOVICKI AND PAUL J. MIDDENDORF
P
ractitioners need the best information and tools to protect its research, but the agency’s plan for
workers. Effective practice requires knowledge of what issues to 2019–2023 (see http://bit.ly/niosh
target, tools to develop, and controls to implement. It’s import- strategicplan) draws on the agendas
ant to remember that occupational safety and health is a system developed under NORA.
that includes practice, surveillance, and research. Each part of Councils also share information,
the system works most effectively when the other parts are fully develop partnerships, and promote
engaged and interactive; none of them are effective in a vacuum. evidence-based solutions. For exam-
ple, the NORA Manufacturing Sector
Council recently published a web page
As a practitioner, you have knowledge assistance; manufacturing; mining; on hazardous energy control at http://
that’s critical to developing research oil and gas extraction; services; public bit.ly/hazardousenergy. Members of
agendas to help improve workers’ safety; transportation, warehousing, the council compiled, reviewed, and
well-being. You know the issues you’re and utilities; and wholesale and retail adapted resources to help companies
facing, and you know the limitations of trade. NORA’s cross-sectors include and businesses start or improve and
the tools you’re using. It’s important cancer, reproductive, cardiovascular, maintain their existing lockout pro-
that your voice is heard and that your and other chronic disease prevention; gram. Another example comes from the
needs are represented in your coun- hearing loss prevention; immune, Respiratory Health Council, which cre-
try’s research agenda. In the United infectious, and dermal disease pre- ated a series of four short videos called
States, the National Occupational vention; musculoskeletal health; “Faces of Work-Related COPD” (see
Research Agenda process is a good respiratory health; traumatic injury http://bit.ly/facescopd). The videos fea-
place to start. prevention; and healthy work design ture interviews with patients diagnosed
and well-being. with work-related chronic obstructive
WHAT IS NORA? pulmonary disease who discuss occu-
NORA is a partnership program HOW DOES NORA WORK? pational exposures, their quality of life
intended to stimulate innovative The work of NORA is carried out by with COPD, and ways to minimize the
research and improved workplace councils, one for each sector and risks of getting the disease.
practices. Through NORA, diverse cross-sector. Council members rep-
parties such as stakeholders from uni- resent the diverse mix of stakeholders HOW DO I PARTICIPATE?
versities, large and small businesses, from business, labor, government, and NORA councils are open to anyone
professional societies, government academia. Meetings are held both vir- with an interest in occupational safety
agencies, and worker organizations tually and in person, creating a national and health. Council members ben-
come together to create a research venue for individuals and organizations efit by hearing about cutting-edge
framework for the nation. NIOSH with common interests in occupational research findings, learning about evi-
serves as the steward of NORA. safety and health to come together. dence-based ways to improve safety
NORA is organized into 10 sectors Each council has developed a and health efforts in their organization,
to prioritize occupational safety and research agenda to guide or promote and forming new partnerships. In turn,
health research by major areas of the high-priority research efforts on a members share their knowledge and
U.S. economy and seven cross-sec- national level. These agendas (see experiences with others and recip-
tors according to the major health http://bit.ly/noraagendas) include rocate partnerships. Visit www.cdc.
and safety issues affecting the U.S. research conducted by various entities gov/nora to learn more or contact the
working population. The 10 sectors such as government, higher educa- NORA Coordinator at noracoordinator
are agriculture, forestry, and fishing; tion, and the private sector. NIOSH @cdc.gov if you are interested in par-
construction; healthcare and social has its own strategic plan that guides ticipating.
12
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www.AIHce2020.org

WORKPLACE INSPECTIONS
OSHA PUBLISHES
“SIGNIFICANT CHANGES”
TO FIELD OPERATIONS
MANUAL
OSHA recently made “significant
changes” to its Field Operations
Manual, a reference document for
the agency’s field personnel that
covers enforcement policies and
procedures for conducting OSHA
investigations. The updates,
which went into effect on Sept.
13, 2019, are intended to help
inspectors more effectively pro-
tect workers from occupational
hazards. Updates were made to
sections related to enforcement
follow-up, inspection scope,
general penalty policy, civil
penalties, fatality and catastro-
phe investigations, and citable
program elements. OSHA has
also updated the section on
“walkaround representatives,”
who are designated to accompa-
ny OSHA Compliance Safety and
Health Officers, or CSHOs, during
walkaround inspections. During
these inspections, CSHOs seek
to identify potential safety and
health hazards in a workplace.
Further details are available
in a PDF download from OSHA’s
website at http://bit.ly/osha
fieldmanual.
| January 2020
NEWSWATCH
EPA Identifies “Unreasonable”
Risks to Workers, Consumers
from NMP Use
A
new draft risk evalua-
tion published by EPA
in November identifies
“unreasonable risks
associated with acute and chronic
inhalation and dermal exposure” to
N-methylpyrrolidone, or NMP. The
draft document, which is available as
a PDF at http://bit.ly/epadraftnmp,
describes how workers and con-
sumers could be adversely affected
by NMP under certain conditions of
use. EPA reviewed 30 potential uses
of NMP to develop its draft risk eval-
uation. These potential uses include
adhesives, sealants, arts and craft
paints, paint and coating removers,
adhesive removers, and degreasers.
The agency did not find risk to the
environment, occupational non-us-
ers, or workers in the general area
of NMP use.
EPA urges workers who use prod-
ucts containing NMP to follow label
instructions and applicable workplace
regulations and to use appropriate
personal protective equipment such
as protective gloves. According to the
agency, a variety of alternatives to
NMP—including other chemical prod-
ucts and mechanical methods—are
available for paint and coating removal.
EPA intends to perform additional work
to identify whether alternatives exist for
other uses of NMP.
A previous EPA risk assessment
of NMP completed in 2015 indicates
that both duration of use and a prod-
uct’s concentration of NMP affect risk
RISK ASSESSMENT
associated with NMP use. According to incorporate NMP use in the risk
to EPA’s 2015 risk assessment (see evaluation for the chemical.
http://bit.ly/epanmp2015), short-term EPA’s new draft risk evaluation
exposures (1–2 hours) to products of NMP is the sixth that the agency
containing 25 percent or less of NMP has published under the amended
result in no risk. However, products Toxic Substances Control Act legis-
containing higher concentrations of the lation. As amended by the Frank R.
chemical presented risks to users from Lautenberg Chemical Safety for the
acute and chronic exposures. 21st Century Act, which was signed
NMP is a common alternative to the into law in June 2016, TSCA requires
solvent methylene chloride, which is EPA to complete risk evaluations for
used in a variety of industries, includ- 10 chemicals, including NMP, within
ing paint and coating removal, plas- three years, or by December 2019.
EPA urges workers who use products
containing NMP to use appropriate
personal protective equipment such as
protective gloves.
tic processing, metal cleaning and TSCA allows for a single six-month
degreasing, and adhesive manufac- extension of this deadline.
turing. A draft risk evaluation pub- EPA is accepting comments on its
lished by EPA in October describes new draft risk evaluation until Jan.
“adverse health risks associated with 6, 2020. Instructions for submitting
acute and chronic inhalation expo- comments are available in the Federal
sure” to methylene chloride under Register at http://bit.ly/epafrnmp.
some conditions of use, and an EPA The Science Advisory Committee
ban on retail distribution of methy- on Chemicals—a federal advisory
lene chloride to consumers went into committee charged with providing
effect on Nov. 22. When EPA originally scientific advice, information, and
proposed the ban, it also proposed recommendations to EPA on chem-
to regulate NMP in paint and coat- icals regulated under TSCA legisla-
ing removal, but the agency did not tion—reviewed the draft risk evalua-
finalize its proposed determination tion during a meeting that was held
of “unreasonable risk” for NMP in in December. Information about the
paint and coating removal through meeting can be found at http://bit.
regulatory action. Instead, EPA chose ly/peerreviewnmp.
14

NIOSH to Develop IDLH Values for Six Chemicals
NIOSH intends to develop new or
updated Immediately Dangerous to Life
or Health values for six chemicals: allyl
alcohol, bromine chloride, hydrogen
bromide, hydrogen iodide, propylene
imine, and lewisite, a chemical warfare
agent. The agency’s IDLH values are
established to ensure workers’ ability
to escape from a contaminated envi-
ronment in the event that their respi-
ratory protection equipment fails. IDLH
values are also intended to represent a
maximum level above which workers
should not be exposed without highly
reliable respiratory protection.
As part of the process for develop-
OSHA: Training Needed for Temp Workers in
Shipyards
A new bulletin published by OSHA
focuses on hazards in shipyards and
safety of temporary workers. The bul-
letin is part of a series of guidance
documents developed under OSHA’s
Temporary Worker Initiative, which
is intended to help host employers
and staffing agencies understand
their responsibilities for protecting
temporary workers. According to the
new publication, shipyard workers
are exposed to hazards associated
with industrial operations such as
steel fabrication, welding, abrasive
blasting, electrical work, and coating
applications. Workers face additional
hazards related to the operation and
servicing of complex machinery and
equipment. Many shipyards are multi-
ple-employer worksites, and shipyard
employees, crew members, tempo-
rary workers, contractors, and sub-
contractors often work together on
the same ship at the same time. OSHA
NEWSWATCH
ing IDLH values, NIOSH will evaluate
scientific data for the six chemicals.
The agency asks stakeholders to
submit published and unpublished
reports and research findings to eval-
uate the possible acute health risks of
occupational exposure to the chem-
icals. Reports of acute animal toxic-
ity studies, acute human toxicology
studies, and mode of action studies
are additional examples of the type
of information NIOSH is requesting.
Further details, including instruc-
tions for submitting information, are
available in the Federal Register at
http://bit.ly/idlhvalues.
warns that this can complicate the
safe coordination of work activities.
“Many fatal incidents occurred
when workers, particularly tem-
porary workers, were not provided
Shipyard workers are exposed to hazards
associated with industrial operations
such as steel fabrication, welding,
abrasive blasting, electrical work, and
coating applications.
timely training necessary to do their
job safely,” OSHA’s bulletin states.
OSHA stresses that both staffing
agencies and host employers share the
responsibility for training temporary
workers. Staffing agencies and host
employers should also jointly assess all
worksites for potential hazards to which
temporary workers might be exposed
15
OCCUPATIONAL EXPOSURE LIMITS
NIOSH updated its method for
determining IDLH values in 2013
via Current Intelligence Bulletin 66:
Derivation of Immediately Dangerous
to Life or Health (IDLH) Values, or CIB
66 (see http://bit.ly/nioshcib66). The
document notes that occupational
health and safety professionals have
incorporated IDLH values into risk
management plans for operations
in high-risk environments such as
confined spaces, and in guidance for
emergency responders.
More information on IDLH values
can be found on the NIOSH website
at http://bit.ly/nioshidlh.
COMMUNICATION AND TRAINING
during assigned work. The new bulletin
includes example scenarios intended
to illustrate what can happen when
temporary workers are not adequately
trained and when host employers and
staffing agencies do not coordinate
appropriately to protect workers.
The bulletin on shipyard hazards is
available as a PDF on OSHA’s website
at http://bit.ly/osha3981. More infor-
mation can be found on the agency’s
web page on protecting temporary
workers, http://bit.ly/oshatemp
workers.
www.aiha.org |
RADIATION
REVISED OSHA PAGE
FOCUSES ON IONIZING
RADIATION HAZARDS
OSHA recently announced revi-
sions to its web page on ionizing
radiation hazards, http://bit.ly/
ionizingradiation. Highlights
of the revised page include
an online tool that focuses on
radiation hazards and controls
in the healthcare setting and a
quiz that allows users to test
their knowledge of radiation
exposure, protection, and
related OSHA standards. OSHA
intends the revised page to be a
starting point for technical and
regulatory information regarding
the recognition, evaluation, and
control of workplace health
hazards associated with ionizing
radiation. The page focuses on
ionizing radiation hazards that
workers may encounter on a day-
to-day basis.
Ionizing radiation sources can
be found in occupational settings
such as medical and dental
offices, nuclear power plants,
and air and space travel and
transport operations. According
to OSHA, exposure to ionizing
radiation—especially at higher
doses—increases the risk of
developing health effects, which
can include blood cell changes,
skin burns, radiation sickness,
cancer, and death.

PERSONAL PROTECTIVE
EQUIPMENT
NIOSH UPDATES
STANDARD TESTING
PROCEDURE FOR
N95 SERIES FILTERS
NIOSH has updated the standard
testing procedure for the
determination of particulate
filter efficiency for N95 series
filters against solid particulates
for non-powered, air-purifying
respirators. According to the
agency, these filters or filter
cartridges may be integral to
respirator construction; mounted
individually or in sets of up to
three; used in conjunction with
cartridges and canisters for
chin-style, front-mounted, and
back-mounted gas masks; or
used in combination with gas-
and-vapor or atmosphere-
supplying respirators. The pur-
pose of the update is to establish
the procedure for ensuring that
the particulate filtering effi-
ciency level of N95 series filters
used on non-powered respirators
submitted to NIOSH for approval
or extension of approval meet
minimum certification stan-
dards.
A PDF copy of the revised
procedure, dated Oct. 31, 2019, is
available from NIOSH at http://
bit.ly/n95update. More infor-
mation on standard respirator
testing procedures is avail-
able from the NIOSH National
Personal Protective Technology
Laboratory website at http://bit.
ly/nioshnpptl.
| January 2020
NEWSWATCH
EPA Proposes Changes to Agricultural Worker
Protection Standard
EPA has announced proposed
changes to the application exclusion
zone requirements of its agricultural
worker protection standard, which
was most recently revised in 2015.
The requirements related to appli-
cation exclusion zones, or AEZs, are
intended to reduce the number of
incidents where workers or others
are exposed to pesticides during
agricultural pesticide applications.
EPA is proposing to revise the provi-
sion requiring employers to suspend
a pesticide application if workers or
others are in the AEZ. As currently
described in the standard, the AEZ
can extend beyond the boundaries
of agricultural establishments. EPA’s
proposal is to limit the AEZ so that it
International Organizations Launch Global
Coalition on Occupational Safety and Health
The Global Coalition on Occupational
Safety and Health was launched on
Nov. 12, 2019, at the Vision Zero
Summit in Helsinki, Finland. The coa-
lition is intended to implement com-
mitments related to worker health and
safety that have been made in global
forums during the last decade. These
forums include the United Nations
Sustainable Development Goals; the
Group of 7, or G7, an intergovernmen-
tal economic organization compris-
ing Canada, France, Germany, Italy,
Japan, the United Kingdom, and the
United States; the Group of 20, or G20,
an international forum for the govern-
ments and central bank governors
from 19 countries and the European
Union; and the EU OSH Strategy.
is applicable and enforceable only on
a farm owner’s property. The agency
notes that bystanders who are not on
farm property “would still be protected
from pesticide applications thanks to
the existing ‘do not contact’ require-
ment that prohibits [pesticide] use in
a manner that would contact unpro-
tected individuals.” EPA also proposes
to exempt immediate family members
of farm owners from all aspects of the
AEZ requirement.
“The targeted updates would
improve enforceability for state reg-
ulators and reduce regulatory burdens
for farmers,” EPA states on its web-
site at http://bit.ly/epaaezupdates.
“It would also maintain public health
protections for farm workers and
According to the Finnish Institute of
Occupational Health, the coalition was
established on Finland’s initiative with
a group of founding partners including
the International Labor Organization,
the International Commission on
Occupational Health, the European
The coalition is intended to implement
commitments related to worker health
and safety that have been made in global
forums during the last decade.
Commission, the European Agency
for Safety and Health at Work, and the
Ministry of Manpower of Singapore.
The World Health Organization will
16
PESTICIDES
other individuals near agricultural
establishments that could be exposed
to agricultural pesticide applications.”
The 2015 revision of the standard
requires employers to keep work-
ers and others out of certain areas
around pesticide application equip-
ment during ongoing applications.
Employers are also currently required
to suspend a pesticide application if
workers or others are in the AEZ.
EPA is accepting comments on
its proposed changes until Jan. 30,
2020. Further information is available
in the Federal Register at http://bit.ly/
epaaezfr and on an agency web page,
http://bit.ly/epaaezupdates, which
focuses on AEZ requirements in the
worker protection standard.
PUBLIC POLICY
participate as an observer.
ILO will chair the steering com-
mittee of the coalition. The coalition
also includes representatives from
the EU, the International Commission
on Occupational Health, and several
countries, including Chile, Croatia,
Iraq, South Africa, and Portugal.
A recording of the coalition’s launch
is available online at http://bit.ly/coa
litionrecording.
 NEWSWATCH
REGULATION AND LEGISLATION

866-736-8347
www.RaecoRents.com
OSHA Rules on Emergency Protect Workers from Hearing Loss
Response, Workplace Violence New TSI Quest Edge4+ cordless personal noise
Remain Stalled dosimeters with Bluetooth. Monitor noise exposure
without interrupting worker activities.
OSHA rulemaking activities related to emergency response and workplace
violence remain in the pre-rule stage on the agency’s fall 2019 regulatory
agenda, which was released in November.
OSHA previously acknowledged that current agency standards do not
address the full range of hazards or concerns currently faced by emergency
responders and do not reflect “major changes” in performance specifications
for protective clothing and equipment. According to the latest regulatory
agenda (see http://bit.ly/fall2019emres), the agency is still considering
updating these standards. The next step in the federal rulemaking process,
convening a panel to consider an emergency response standard’s potential
impact on small businesses, was originally scheduled to take place in October
2018. The previous regulatory agenda pushed that step back to May 2019,
while the new agenda states that a panel will be convened in August 2020.
The projected date for convening a small-business panel on an OSHA
standard focused on the prevention of workplace violence in healthcare
and social assistance has been delayed again until January 2020. OSHA
Daily, weekly, and long-term rentals. Free UPS Ground
first published an RFI in December 2016 to gather information on workplace
round-trip shipping on every rental order $500 or larger.
violence and prevention strategies from healthcare employers, workers, and
other subject matter experts. A broad coalition of labor unions and National
Nurses United, the largest organization of registered nurses in the U.S.,
separately petitioned OSHA for a standard to prevent workplace violence in
healthcare. OSHA granted the petitions in January 2017. More information
about agency actions related to this rulemaking is available at http://bit.ly/
fall2019wpviolence.
In late November, the U.S. House of Representatives passed the Work-
place Violence Prevention for Health Care and Social Service Workers Act,
or H.R. 1309. The bill would require the Department of Labor to promulgate
an occupational safety and health standard to require certain employers
in the healthcare and social service industries to develop and implement
a comprehensive workplace violence prevention plan. As this issue of The
Synergist went to press, H.R. 1309 was headed to the Senate, where its fate
was less certain.
For more information, view the entire fall 2019 agency rule list for the
Department of Labor at http://bit.ly/fall2019dol.

Recent webinars include:

Correction • Advanced FR/AR Concepts: A Deeper Look into FR/AR Protection
• EHS Air Quality Monitoring
In the article "Cost Estimates for OEHS Recommendations," which • Why Is FR/AR Compliance So Difficult?
appeared in the November 2019 issue, a sentence on page 31 refers • Challenges to Consider When Pursuing Laboratory Inventory
to "$160 per year" as the operating and maintenance costs of a new Management
HVAC filter system. The cost should have been presented as $160 per
month. The digital version of the article at http://bit.ly/oehscostest
imates has been corrected.
View archive at aiha.webvent.tv
17 www.aiha.org |
 NEWSWATCH
European Agency Proposes OEL for Lead,
Notations for Diisocyanates
New scientific reports published by the European
Chemicals Agency include ECHA’s recommen-
dations regarding occupational exposure limits
for lead and its compounds (see http://bit.ly/
echalead) and for diisocyanates (see http://bit.ly/
echadiisocyanates). The agency proposes a bio-
facebook.com/RutgersTraining logical limit value, or BLV, of 150 µg Pb/L in blood
for inorganic and for organic lead compounds. To
@RutgersTraining help achieve blood lead levels below the proposed
#RutgersTraining BLV, ECHA proposes to establish an OEL for inor-
ganic compounds and organic compounds—or
alkyl lead compounds—of 30 μg/m3 as an 8-hour
time-weighted average. For comparison, OSHA’s
permissible exposure limit and NIOSH’s rec-
ommended exposure limit for lead are both
50 µg/m3 as an 8-hour TWA. OSHA also has an
action level for lead of 30 µg/m3, at which an
employer must begin specific compliance activ-
ities. ECHA’s report concludes that no 15-minute
short-term exposure limit can be derived.
“ECHA does not propose a STEL because the
leading toxic effects for lead and inorganic com-
pounds are chronic systemic effects and there is
no evidence of acute effects at these levels,” the
OSHA Announces Changes to Nationally
ADVERTISERS’ INDEX Recognized Testing Laboratory Program
ADVERTISER PAGE In November, OSHA announced the addition
DataChem Software 19 of a new test standard to the Nationally Rec-
ognized Testing Laboratory Program’s list of
Inside Front
EMSL Analytical appropriate test standards. The agency also
Cover
updated the scopes of recognition of several
Kinetics Noise Control 19 NRTLs. OSHA’s NRTL Program recognizes orga-
RAECO Rents LLC 17 nizations that provide product-safety testing
and certification services to manufacturers.
Rutgers School of Public
18 The program is intended to ensure that certain
Health
products meet the requirements of OSHA’s elec-
Inside Back trical standards—both construction and general
SKC Inc.
Cover industry. Effective Nov. 5, the agency added UL
TSI Incorporated 3 61010-2-020, Standard for Safety Requirements
Zefon International Back Cover for Electrical Equipment for Laboratory Use; Part
2-020: Particular Requirements for Laboratory
See this month’s Product Features on page 35. Equipment for Laboratory Centrifuges, to the
NRTL Program's list of appropriate test stan-
| January 2020 18
OCCUPATIONAL EXPOSURE LIMITS
report (PDF, http://bit.ly/echaleadreport) states.
ECHA is not proposing an OEL for diisocy-
anates, which the agency says are the most
common group of isocyanates used in the
workplace. Instead, ECHA recommends that the
Committee for Risk Assessment, which supports
the European Commission by giving scientific
opinions on OELs, focus on “further [developing]
the approach to derive an exposure response and
then establish an OEL.”
“ECHA considers that the data available do
not allow identification of a threshold average
exposure concentration below which no cases
of asthma would occur among those workers
where the induction of respiratory sensitization
to diisocyanates has already taken place,” the
agency’s report (PDF, http://bit.ly/diisocyanates
report) explains.
ECHA is proposing skin sensitization, respi-
ratory sensitization, and skin notations for diiso-
cyanates.
More information on ECHA's OEL proposals
is available on the agency’s website at http://
bit.ly/oelsecha.
LABORATORIES
dards. This standard replaces UL 61010A-2-
020—Electrical Equipment for Laboratory Use;
Part 2: Particular Requirements for Laboratory
Equipment for Laboratory Centrifuges, which was
previously withdrawn.
This change affects the scopes of recognition
for several of the laboratories in the program:
the Canadian Standards Association; Intertek
Testing Services, NA; TUV SUD America, Inc.;
and Underwriters Laboratory, Inc. OSHA has
updated the scopes of recognition for each of
these laboratories to delete the test standard
UL 61010A-2-020, Part 2, and replace it with UL
61010-2-020, Part 2-020.
More information about these modifications is
available in the Federal Register at http://bit.ly/
nrtlmodifications.
 NEWSWATCH
CHEMICAL AND MATERIAL HAZARDS

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fire burning in a chemical disposal vat. According to NIOSH’s health hazard ■ CHMMprep ■ CITprep
evaluation report on the incident, it was unclear what was in the vat due to ■ OHSTprep ■ ASPprep
missing or incomplete labeling and inventory documentation. Some of the
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building, while others became ill after leaving. Several firefighters reported ■ CSPprep ■ Safety in
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equipment used in the response.
NIOSH’s response included confidential medical interviews with 46 fire-
fighters. Agency staff also reviewed firefighter medical records, departmental
incident reports, the fire department’s hazardous material and decontami-
nation protocols, chemical inventory records of the company, and laboratory
analysis of solid and liquid samples collected from the location of the fire.
NIOSH’s investigation found that many firefighters who responded to the
chemical fire reported symptoms during or shortly after the response. The
most common immediate symptoms they reported included dry cough,
shortness of breath, fatigue, and throat irritation. Thirteen of the 26 fire-
fighters who reported immediate symptoms told NIOSH staff that they had
ongoing symptoms about one month after the fire. When agency investiga-
tors conducted a second round of interviews about four months after the
incident, seven firefighters reported persistent respiratory symptoms such
as cough, trouble breathing, wheeze, chest tightness, or being awoken by
cough or shortness of breath.
The fire department determined that an alkaline substance was present
at the chemical manufacturer, but NIOSH could not determine the exact
exposures to firefighters participating in this response. The agency explains
that the unpredictable mixtures and unknown products of combustion present
during chemical fires make exposure reconstruction challenging.
“[The company’s] incomplete documentation and labeling practices, the
nature of these types of fires, along with the minimal sampling conducted
after the fire contributed to these unquantifiable and unidentifiable expo-
sures,” NIOSH’s report concludes. “Due to these factors, the exact chemicals
encountered by responding firefighters will likely remain unknown.”
NIOSH urges the fire department to audit its practices and procedures
for chemical fire responses and HAZMAT situations. Further recommen-
dations from the agency are available in the PDF report at http://bit.ly/
hhechemicalfire.

19 www.aiha.org |
 Advances in
Understanding

NOISE
EXPOSURES

Key Findings from the

National Occupational
Research Agenda for
Hearing Loss Prevention
BY VERONICA STANLEY
iLexx/Getty Images

| January 2020 20
O
n July 30, 2019, NIOSH released the National
Occupational Research Agenda for Hearing
Loss Prevention. The document identifies
research objectives intended to meet needs
for new knowledge related to important issues
in worker health protection. It also contains
significant new insights from the latest science
concerning hearing loss, which impacts communication
ability for many individuals in the workplace.
This article primarily highlights information in the
NORA document of interest to IHs and those who manage
work-related hearing conservation programs, as required
for compliance with the OSHA regulation (29 Code of Fed-
eral Regulations 1910.95, occupational noise exposure).
This article also discusses some additional information
helpful for a more complete understanding of the issues
identified in the NORA document, which contains consid-
erably more information than can be covered here, even via
summary.
Interestingly, as indicated in the NORA document, not all
types of hearing loss seem to have been identified. But what
is striking is evidence of the likelihood that the many types of
hearing loss are not accurately measured via current, stan-
dard audiometry testing. Our understanding of the impact
of each type of damage, and of combinations of damages, is
limited. Thus, despite critical advances, the field still has a
way to go.
The NORA document also presents critical new informa-
tion regarding age correction and vulnerable populations that
may make you think harder about what constitutes
21 www.aiha.org |
 Figure 1. Comparison of hearing ability between a 25-year-old tones could explain why some individuals report hearing
carpenter and a 50 year old who has not been exposed to noise. trouble that hasn’t been identified on pure-tone audiom-
Adapted from NIOSH, http://bit.ly/noisecarpenter. etry testing. If new animal research can directly apply to
0 humans, an important finding was made regarding the type
25-year-old
carpenter of neurons tested in pure-tone audiometry; according to
10 the NORA document, it is likely that “pure-tone threshold
Hearing Threshold Level (dB HL)

testing cannot evaluate the response of neurons most at

Normal
20 risk for synaptic damage.”
Hearing Limit 50-year-old male
no noise exposure
30 NOT ALL LOSS IS THE SAME
It has been known for a while that individuals can expe-
40 40 years exposure rience a loss of hearing acuity, which reduces sensitivity,
100 dBA noise
and a loss in clarity, which distorts what is heard and is
50
not helped by amplification. The underlying factors that
affect acuity and clarity are still not adequately understood;
60
55-year-old the lack of detailed exposure histories seems to be a major
carpenter factor in the pace of progress. But the NORA document
70
500 1000 2000 3000 4000 6000 describes useful insights gained from research. Damage at
Frequency (Hz) the connection of auditory neurons to cochlear hair cells,
called synaptopathy, is now considered “hidden” from the
Figure 2. Progression of hearing loss with age for a carpenter. pure-tone audiogram. Researchers theorize that the symp-
Adapted from NIOSH, http://bit.ly/noisecarpenter2. toms of synaptopathy include problems understanding
0 speech while in a noisy environment. Scientists are trying
to understand the effects of the location of damage and
Age
10 effects from multiple types of damage on overall response.
Hearing Threshold Level (dB HL)

25 For example, it is thought that damage to outer hair cells

Normal may also result in difficulty understanding speech while
20
Hearing Limit in a noisy environment. Better understanding needs to
30 35
be developed for the impact from each type of loss or
combination.
40 Useful information provided in the NORA document
45 is that not all neurons associated with hearing function
respond the same. Some require more stimulus than others
50
to be triggered. More sensitive neurons are relied upon for
55 hearing low-level signals in quiet environments but can
60
become overwhelmed in noisy environments. New evidence
provides reason to suspect that the neurons relied upon
70
500 1000 2000 3000 4000 6000 to assist with hearing in noisy environments are not only
Frequency (Hz) more susceptible to damage but also cannot be evaluated
by pure-tone testing.
appropriate regulation and how workplace programs New evidence also suggests that damage at the connec-
should be modified. For example, the document identi- tion of the inner hair cell to the auditory neurons may be
fies diabetes, a common medical condition, as making the “earliest site of noise-induced morphologic damage,”
workers more vulnerable to illness from noise exposure. according to the NORA document.

AUDIOGRAM DEFICIENCY POSSIBILITIES FOR EARLY DETECTION OF DAMAGE

Different types of neurons are used in hearing. Thus, the
location of damage matters.
While the pure-tone audiogram—a measurement
of a hearing threshold through observation of patient
responses to sounds with a sinusoidal waveform—remains
the gold-standard test of hearing ability, the hearing loss
prevention community has also accepted that individuals
with similar pure-tone audiograms cannot be expected to
have the same functional hearing ability. Functional deficit
can exist that is not evident on the pure-tone audiogram.
Between-frequency losses, known as “hidden hearing
loss,” are a new focus for research. Having losses between
Scientists are hoping to know if testing recognition of
speech in the presence of background noise, already used
to distinguish between loss of acuity and clarity, can be
used for early detection of damage. In addition, extending
testing to higher frequencies—10,000 Hz and above—is
another possibility for early detection of damage when
measured over a long period. Interpretation could be
confounded by age-related decreases in hearing ability.
This indicator requires more research to be of practical
application.
New information from NIOSH regarding the age-related
decline raises the question, how much decline is normal?

| January 2020 22
Figure 1, from NIOSH, shows that the average 25-year-old
carpenter has a similar audiogram to a non-noise-exposed
50-year-old, lacking an indication of a severe “notch” at the
higher frequencies. In Section III, Chapter 5, of the OSHA
Technical Manual, OSHA states that “[a]udiograms often
display a 4,000-Hz ‘notch’ in patients who are developing
the beginning stages of sensorineural hearing loss.” Figure
1 also shows that the average carpenter develops severe
hearing loss, depicted via the development of severe notch-
ing by age 55, while no notching is seen in those who do
not have noise exposure even by age 55. Figure 2 shows
progression of hearing loss with age, to develop the notch-
ing for the average carpenter. Remember also that even
before we had this new information, the OSHA Technical
Manual said the notch at the 8,000 Hz frequency in the
audiogram often indicates age-related loss as opposed to
noise-induced loss. This indicates OSHA’s understanding
that there needs to be an analysis of any loss to determine
possible causes. Thus, the default interpretation even now
cannot be to assume the loss is age-related.
Likely a bit further off is research that will expand the
science of auditory brainstem response. This method has
been applied to research of high-level firearm discharge,
but the science needs to be further expanded for applica-
tion to populations with chronic exposures at frequencies
where progressive accumulation of damage is the concern.
BETTER PREDICTION OF HAZARD
Many IHs will probably attest to witnessing situations
that seem to have different risk but whose final calculated
values for OSHA compliance purposes are similar because
of the equal-energy model OSHA uses. This simplistic
model, in widespread use, is appropriate for steady-state
noise but does not adequately quantify risk for complex
noise profiles with impulse or impact noise.
For those curious about the possibilities of improved
technology, information about use of “kurtosis” may be
of interest. According to the NORA document, kurtosis
“describes the distribution of amplitudes of noise expo-
sure.” Adjustment with the concept of kurtosis is used to
correct measurements of sound pressure levels to account
for the more harmful impulse noise embedded in steady-
state noise. Kurtosis-corrected measurement of sound
pressure levels is not a new concept, but it has not gained
widespread use. Including the concept of kurtosis would
better predict hearing loss.
AGE CORRECTION
In 1998, NIOSH revised the criteria for a recommended
standard for occupational noise exposure. One of the
agency’s revisions was that it no longer recommended age
correction. The document informs that age correction cur-
rently in use does not represent the ethnicity and gender of
the current United States population, was based on a small
sample size, and lacked audiometric data for workers older
than 60 years.
While the NORA document indicates that more
research is needed, it provides new information related
More about NORA
See page 12 for an article about the NIOSH
National Occupational Research Agenda.
to ethnicity and gender: non-Hispanic blacks have better
hearing than non-Hispanic whites, and women have better
hearing than men. Different methods for age correction
were recommended as research topics.
SENSITIVE POPULATIONS
Additional protective action, for extended durations, is
recommended for vulnerable workers who have certain
medical conditions and are exposed to hazardous noise.
Key information reported in the NORA document is that
“increased vulnerability to noise may last long beyond the
end of the therapeutic treatment.” The document states
that medical conditions such as “diabetes, hypertension,
renal disease, compromised immune systems, or condi-
tions that require use of pharmaceuticals, can increase the
vulnerability of the audio-vestibular system.” Training for
those at risk is advised.
TOXICOLOGIC INTERACTIONS
The NORA document suggests that recommended expo-
sure limits may need to be lowered to account for effects on
hearing from multiple hazards at once. Of the 22 million
noise-exposed workers, it is reported that between 5 and
10 million are also exposed to the ototoxic organic solvents
toluene, xylene, styrene, trichloroethylene, and carbon
disulfide. Heavy metals and asphyxiants are ototoxic chem-
icals, which have synergistic interactions with noise.
FIT TESTING
Using information from three studies published between
2007 and 2016, the NORA document informs that about
half of U.S. workers—11 million—“achieve less than 5 to 15
dB of attenuation without training.” Incorporation of fit
testing for individual hearing protection into hearing loss
prevention programs is a need NIOSH identified decades
ago. The NORA document recognizes that fit testing of
individual hearing protection is “[t]he only way to more
precisely identify the specific at-risk population.” The
result of the fit test is a personal attenuation rating, or
PAR, which describes how well an individual can fit hear-
ing protection. PAR is not referenced much on the OSHA
website—the only current mention is a published stake-
holder meeting summary report from 2011 on preventing
occupational hearing loss available at http://bit.ly/hear
inglossmeeting—but the NORA document suggests that
the term may make a comeback.
Also on the OSHA website is a 2017 standard interpre-
tation from OSHA to 3M regarding a personal fit-testing
system (see http://bit.ly/osha3mfittest). In its inter-
pretation, OSHA indicates that the personal fit-test system
is considered appropriate to determine initial fitting, as
required by 29 CFR 1910.95(i)(5), but reiterates that the
23 www.aiha.org |
 regulation codified methods for determining adequacy
of attenuation in Appendix B. Thus, it appears the
regulation would need to be changed to allow for new
technology like the PAR to be used to determine ade-
quacy of attenuation. OSHA currently approves these new
technologies to train workers.
The fact that more than half of hearing protection
users achieve less than half of the labelled attenuation is a
serious issue when considering that OSHA does not force
employers to follow the hierarchy of controls to protect
workers from noise. In an August 2018 OSHA standard
interpretation, the agency states that “29 CFR 1910.95(b)
(1) allows employers to rely on personal protective equip-
ment and a hearing conservation program, rather than
engineering and/or administrative controls, when hearing
protectors will effectively attenuate the noise to which
employees are exposed to acceptable levels” (see http://
bit.ly/osharobley).
NEED FOR IMPROVED DOSIMETRY
According to the NORA document, “Preliminary research
suggests that the attenuation of a hearing protector may
underestimate the level of protection provided.” The docu-
ment recommends acoustic standards for in-ear dosimetry,
recognizes in-the-ear noise monitoring as feasible, and
acknowledges problems with the accuracy of traditional
dosimetry.
Information in the document supports a case for
expanding dosimetry to those at the margins of the defi-
nition for inclusion in hearing conservation programs.
Consider the following quotes:
• “Workers who are highly mobile and those whose noise
RESOURCES
CDC: National Health and Nutrition Examination Survey, Audiometry Procedures Manual, http://bit.ly/
nhnesaudiometry (PDF, January 2003).
NIOSH: National Occupational Research Agenda for Hearing Loss Prevention, http://bit.ly/norahearing (July
2019).
NIOSH: Noise and Hearing Loss Prevention, Facts and Statistics, http://bit.ly/noisecarpenter and http://
bit.ly/noisecarpenter2.
OSHA: Hearing Conservation, http://bit.ly/oshahearingcon (2002).
OSHA: Occupational Health and Safety Standards, Methods for Estimating the Adequacy of Hearing Protector
Attenuation, http://bit.ly/attenuationappb.
OSHA: Occupational Health and Safety Standards, Occupational Noise Exposure, http://bit.ly/29cfr1910.
OSHA: OSHA Technical Manual, Section III, Chapter 5, “Noise,” http://bit.ly/otmnoise.
OSHA: Stakeholder Meeting on Preventing Occupational Hearing Loss, http://bit.ly/hearinglossmeeting
(November 2011).
OSHA: Standard Interpretations, Ear Plug Personal Fit-Testing Systems That Measure Real-Time Noise
Reduction, http://bit.ly/osha3mfittest (October 2017).
OSHA: Standard Interpretations, Hearing Conservation Program, http://bit.ly/osharobley (August 2018).
The Journal of the Acoustical Society of America: “The Value of a Kurtosis Metric in Estimating the Hazard to
Hearing of Complex Industrial Noise Exposures” (May 2013).
The Journal of the Acoustical Society of America: “Kurtosis Corrected Sound Pressure Level as a Noise Metric
for Risk Assessment of Occupational Noises,” http://bit.ly/jasakurtosis (March 2011).
| January 2020
exposures hover around the margins of required hearing
protection use may be more prone to unprotected noise
exposures than workers who are stationary or who remain
in consistently high noise levels.”
• “Noise exposures that are close to noise exposure limits or
of short duration pose inherent risk because they might
not be perceived as risky or the long-term effects of over-
exposure are not realized.”
OSHA-DEFINED HEARING LOSS
Currently, OSHA regulations mandate only baseline and
annual audiograms. A standard threshold shift, or STS, is
a loss determined by comparing values measured at the
baseline with subsequent (that is, annual) audiograms at
defined frequencies only. Specifically, OSHA guidance on
hearing conservation defines an STS as “an average shift
in either ear of 10 dB or more at 2,000, 3,000, and 4,000
hertz” (see http://bit.ly/oshahearingcon).
Most octave frequencies tend to be tested for work-
related audiograms, with some inter-octave frequencies
tested at frequencies of higher risk. For example, the
inter-octave frequencies 3,000 and 6,000 Hz are also
often tested. As explained in a CDC manual for audiometry
procedures, the shape of the human ear causes increased
amplification in the 2,000–3,000 Hz range, resulting in
increased risk around these ranges.
THE COMPLETE PICTURE
Where do we go with these new insights?
OSHA already recognizes that most noise is not pure
tone. While we may have to wait for changes to OSHA reg-
ulation until better quantification is possible, the NORA
document provides IHs with actionable information. For
example, we are now aware of hidden losses that cannot
yet be measured but can at least be acknowledged. We also
have information about effects on sensitive populations
that can be put into practical use in policies and programs.
It’s true that we wish we had more details, but that’s usually
the case in our field.
Since now we know that an audiogram may not be the
complete picture, perhaps we should put more stock into
qualitative information such as reports and observations
from workers. We need to admit that when insufficient
tools exist to quantify what workers are experiencing, we
must supplement with qualitative information. When, and
to what extent, we rely on qualitative information is a sub-
ject for further exploration.
Let us hope for speedy advancement on this important
topic. Science will continue to provide finer details as tech-
nology improves the ability to investigate the microscopic
functions of the human body.
VERONICA STANLEY, MSPH, CIH, CSP, CESCP, works as
adjunct faculty in Workforce Development at Harrisburg
Area Community College and is a PhD student at Indiana
University of Pennsylvania. She can be reached at veinfi@
gmail.com and www.linkedin.com/in/veriia.
Send feedback to synergist@aiha.org.
24
 eLearning …members access
content when and where
they want to, earning CIH/CSP
points. This is a very valuable
resource for our AIHA Local Section!
– ANDY PERKINS,
MS, CIH, CSP, Alabama Local
AIHA Section

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 RESPIRATOR USE AT

HIGH
ALTITUDES
BY ROY T. MCKAY

D
oes an SCBA (self-contained breathing
apparatus) respirator protect wearers from
oxygen-deficient atmospheres due to increas-
ing altitude? Absolutely not. This answer
probably surprises many readers, so let’s be
certain we understand the question.
In this situation, the respirator is a fully
functional, NIOSH-approved, tight-fitting,
full-facepiece, pressure-demand SCBA. This is the most protec-
tive respirator generally available for workplaces. The oxygen
deficiency is due solely to a decrease in available oxygen as
elevation above sea level increases. No airborne contaminants
are present to displace or consume oxygen; there’s simply less
oxygen to breathe when ascending to higher elevations. Given
Examining a Common these conditions, wearers of SCBAs are not protected from
oxygen deficiency.

Misunderstanding
You might wonder whether a supplied air respirator (SAR)
connected to a nearly unlimited supply of Grade D breathing air
is protective in these conditions. Again, the answer may surprise

about Atmosphere- you: absolutely not.

Supplying Respirators
BACKGROUND
Around the globe, regardless of where you go, the oxygen con-
centration in atmospheric air is 20.95 percent by volume. From
sea level to Mount Everest, the percentage of oxygen and other
gaseous components remains the same, notably nitrogen (78.09
percent), argon (0.92 percent), carbon dioxide (0.04 percent),
and trace amounts of other gaseous components. Only water

| January 2020 26
EpicStockMedia/Getty Images, davepeetersphoto/Getty Images
vapor varies due to changing meteorological conditions.
However, for our purposes, we will ignore water vapor and
assume dry air.
What does change with increasing altitude is baro-
metric pressure. With increasing altitude there are fewer
molecules within any given volume of air (that is, air
becomes thinner). Consequently, the partial pressure of all
gases, including oxygen partial pressure (PO2), decreases
with increasing altitude. Partial pressure is the pressure a
specific gas exerts within a mixture of gases and is calcu-
lated as the product of the fractional concentration of a gas
and the atmospheric (barometric) pressure expressed in
millimeters of mercury (mmHg):
Fractional Concentration • Barometric Pressure in
mmHg = Partial Pressure
For example, at sea level, average barometric pressure
is 760 mmHg. Therefore, the partial pressure of oxygen is:
0.2095 • 760 mmHg = 159.2 mmHg
At 7,500 feet, average barometric pressure is 570
mmHg. At this elevation the partial pressure of oxygen is:
0.2095 • 570 mmHg = 119.4 mmHg
From a physiological standpoint, it’s the partial pres-
sure of oxygen in air that becomes biologically important.
Although the exact partial pressure of oxygen that causes
various physiologic effects can be debated, the earliest
effects of decreasing oxygen partial pressure are loss of
visual acuity at night and a reduction in the ability to sus-
tain maximal physical exertion (exercise). This becomes
noticeable for persons who live at sea level and travel to
Denver, Colo., where the elevation is 5,280 feet, the baro-
metric pressure is 620 mmHg, and PO2 is 130 mmHg.
As elevation increases above 6,000 feet, unacclimated
individuals may begin to experience increased pulmo-
nary ventilation and cardiac output, incoordination, and
impaired attention and cognitive function, according to
ACGIH’s 2017 TLVs and BEIs book. As altitude increases,
persons with preexisting coronary heart disease, circula-
tory problems, or certain respiratory conditions, as well
as older individuals or persons in poor physical condition,
may notice shortness of breath earlier than persons who are
healthy.
RECOMMENDATIONS FOR RESPIRATORY PROTECTION
Previous Synergist articles have discussed respirator selec-
tion for oxygen-deficient atmospheres; see http://bit.ly/
synergisto2deficiency and http://bit.ly/synrevis
itingo2. This article, intended as a complement to those
articles, addresses a specific scenario—an oxygen deficiency
caused solely by increased altitude. Oxygen deficiencies due
to displacement by other gases or consumption of oxygen
are different matters, not addressed in this article.
The definition of oxygen-deficient atmospheres in ANSI/
ASSE Z88.2-2015, Practices for Respiratory Protection, is
based upon the partial pressure of oxygen. Section 7.1.1.4.1
of Z88.2 defines an atmosphere that has an oxygen partial
pressure less than 122 mmHg as oxygen-deficient IDLH
(immediately dangerous to life and health). For these
atmospheres, Z88.2 requires either a full-facepiece,
pressure-demand SCBA or full-facepiece, pressure-demand
SAR with self-contained auxiliary air supply (an escape
bottle). Section 7.1.1.4.2 states that atmospheres with par-
tial pressures of oxygen between 122 and 148 mmHg are
oxygen deficient non-IDLH. For these atmospheres, any
atmosphere-supplying respirator is permitted.
Z88.2 includes a table that summarizes respirator selec-
tion for the effect of altitude alone (that is, when oxygen
concentration is maintained at 20.9 percent) as well as the
combined effects of altitude with reductions in oxygen
concentration (for atmospheres with less than 19.5 per-
cent oxygen as well as those with less than 16.0 percent
oxygen). This table—designated as “Table 1” in Z88.2—is
intended for persons not acclimated to altitude. Acclima-
tion requires about four weeks’ residence for the body’s
respiratory, cardiovascular, and hematopoietic systems
to adapt. In all cases, Z88.2 requires that the source of
any reduction in oxygen be understood and controlled.
In addition, a footnote to Z88.2, Table 1, notes that
“acclimated” workers can continue to perform their work
without any atmosphere-supplying respirators up to alti-
tudes of 14,000 feet, provided the oxygen concentration
remains above 19.5 percent. Inspection of Z88.2, Table
1, column 1, reveals that in the absence of any airborne
contaminants (in atmospheres where the oxygen concen-
tration remains 20.9 percent), an SAR is recommended
for unacclimated individuals above 2,000 feet. Above
7,000 feet, a pressure-demand, tight-fitting, full-facepiece
SCBA or combination SAR/SCBA is recommended.
Other organizations have similar recommendations to
define oxygen-deficient atmospheres. For example, the
NIOSH Respirator Decision Logic established an
oxygen-deficient atmosphere based upon “alveolar” par-
tial pressures of oxygen. When “alveolar” partial pressure
falls below 60 torr (1 torr is essentially equal to 1 mmHg),
adverse physiologic effects can occur. An alveolar partial
pressure of 60 torr has an equivalent atmospheric partial
pressure of approximately 132 mmHg. ACGIH also defines
oxygen deficiency as an atmospheric oxygen partial pres-
sure of less than 132 torr. To keep this in perspective, 132
torr is equivalent to an altitude slightly lower than
Denver’s (5,280 feet).
SHORTNESS OF BREATH AT 6,000 FEET
Given this information, let’s say a 55-year-old, mildly over-
weight but otherwise healthy employee who normally lives
and works at an altitude of 1,000 feet is asked to respond
to a work request at a site with an altitude of 6,000 feet.
Shortly after arriving at the worksite, the employee expe-
riences shortness of breath and compensates by working
at a much slower pace. Prior to returning to the worksite
on the second day, the employee informs his supervisor of
the shortness of breath. The supervisor reaches out to both
the safety department and employee health services for
assistance. Together, they recognize that altitude decreases
oxygen partial pressure, and that this can be responsible
for the employee’s shortness of breath on exertion. They
inspect Z88.2, Table 1, column 1 for unacclimated indi-
viduals and identify 6,000 feet as an oxygen-deficient
atmosphere having an oxygen partial pressure of 127
mmHg. This table permits the use of a supplied-air res-
pirator. They also read footnote number 3, which states:
“For oxygen partial pressure equal to or greater than 122
and less than 148 mmHg, airline respirators may be worn
if the source of the oxygen reduction is understood and
controlled.”
Feeling confident that the source of the oxygen
| January 2020 28
reduction is understood and controlled, they issue an SAR.
The employee, previously trained on and medically cleared
for use of an SAR, returns to the worksite at 6,000 feet.
After donning the SAR, the employee develops shortness
of breath more quickly than the day before. Why? Because
the SAR does not provide additional oxygen. Consequently,
it does not protect from oxygen-deficient atmospheres due
to increasing elevation. In this case, the respirator does not
provide any benefit to the wearer. Furthermore, the SAR
adds physiological stress (increased breathing resistance,
weight, and workload due to the need to continuously pull
a heavy hose, among other factors). Wearing the SAR either
exacerbates intolerance to altitude, causes an adverse
response to the use of the respirator itself, or both.
In this example, the safety department and employee
health services mistakenly relied solely on the information
in Z88.2 Table 1.
HOW PRESSURE-DEMAND REGULATORS WORK
To understand why SAR and SCBA respirators with
breathing air provide no benefit to the wearer requires an
understanding of respiratory physiology and how these
respirators work.
OSHA’s respiratory protection standard (29 Code of
Federal Regulations, Part 1910.134) defines an SCBA as
an atmosphere-supplying respirator for which the source
of breathing air is designed to be carried by the user. The
agency defines a pressure-demand respirator as a
positive-pressure, atmosphere-supplying respirator that
admits breathing air to the facepiece when the positive
pressure is reduced inside the facepiece by inhalation. To
maintain this positive pressure, the pressure-demand reg-
ulator utilizes a spring-like device to hold the admission
valve in a slightly open position, theoretically allowing a
continual flow of air into the facepiece. However, working
in conjunction with the regulator is an additional spring-
like exhalation valve on the facepiece. This spring on the
exhalation valve prevents air from escaping out of the
facepiece until the in-facepiece back pressure exceeds a
critical positive pressure. When in-mask pressure decreases
during inhalation, the admission valve fully opens, and
air begins flowing into the facepiece. Working together,
these two valves prevent air from continuously emptying
from the facepiece (that is, the valves maintain a slight
positive pressure inside the facepiece) and avoid pre-
mature emptying of the cylinder. (For a full explanation
of pressure-demand respirators, see the NIOSH Guide
to Industrial Respiratory Protection.) Although a pres-
sure-demand, tight-fitting, full-facepiece SCBA is intended
to maintain a positive pressure within the facepiece, these
can go negative for short periods of time, such as during
periods of strenuous activity when the wearer inhales faster
than the rate of delivery or when there is damage or face-
seal leakage due to poor fit.
For pressure-demand SCBA certification, NIOSH
conducts a series of performance tests. My understand-
ing of these tests is based on conversations with NIOSH
personnel and respirator manufacturers. One of the tests
incorporates a breathing machine set to 40 liters per
minute (lpm) using a cyclic breathing frequency of 24
breaths per minute (bpm). At the point of maximum inspi-
ration, the in-mask pressure must not go negative. Typical
pressures during maximum inspiration are approximately
+0.10 inches of water, which are just slightly above ambi-
ent pressures. During maximum expiration, the in-mask
pressure must not exceed +3.5 inches of water. Modern
pressure-demand regulators typically achieve maxi-
mum pressures between +2.5 and +3.0 inches of water
during expiration. During testing, in-mask pressures
are measured in units of water. However, guidelines for
oxygen-deficient atmospheres are expressed in units of
mmHg. One inch water gauge is approximately equal to
1.868 mmHg. Therefore, in the best-case scenario, the
maximum in-mask pressure during expiration is +6.5
mmHg above ambient pressure (3.5 inches H2O • 1.868
mmHg/inch H20). Since breathing is cyclic, the length of
time in-mask pressure is near the maximum expiratory
pressure is very short. For a nearly equal but short length
of time during maximum inspiration, in-mask pressures
are just above ambient. During the breathing cycle, most of
the time in-mask pressures are between the minimum and
maximum pressures.
PRESSURE-DEMAND REGULATORS AT ALTITUDE
The performance of a pressure-demand regulator is rela-
tive to the atmosphere of its environment. Although not
tested during the certification process, pressure-
demand regulators have a linear response with atmo-
spheric pressure. In other words, the in-mask pressures
will not exceed ambient pressure by more than 6.5
mmHg; usually, the exceedance is less than 6.5 mmHg.
Table A shows calculated ambient and in-mask pressures,
if certification testing was conducted at two locations. The
first location is Cincinnati, Ohio, which has an elevation
of 460 feet above sea level and an average barometric
pressure of 747 mmHg. The second location is a ski resort
near Park City, Utah, with an elevation of 7,500 feet
and a barometric pressure of 570 mmHg. Also shown
in the table are the ambient and in-mask oxygen partial
pressures for both locations. Results shown are for a pres-
sure-demand SCBA.
When wearing a pressure-demand respirator, the
in-mask pressures are just slightly above the atmospheric
pressure, regardless of location. This is because the exha-
lation valve opens, which prevents in-mask pressures from
becoming too high. This slight increase in positive pressure
is not able to compensate for the much larger decrease
in oxygen partial pressure with increasing altitude. Fur-
thermore, in-mask pressures shown in Table A represent
the most protective scenario. Because breathing is cyclic,
maximum pressures are only achieved for a short fraction
of time (that is, during exhalation). For the majority of the
breathing cycle (inhalation and pauses between inhalation
and exhalation), in-mask pressures and oxygen partial
pressures are lower than the maximum values shown in
Table A. In addition, typical pressure-demand regulators
Table A. Ambient and In-Mask Pressures for a Pressure Demand SCBA
at Point of Maximum Expiration (Units of mmHg)*
Location and Ambient Atmo- Maximum In- Ambient Oxygen In-Mask Oxygen
Altitude spheric Pressure mask Pressure Partial Pressure Partial Pressure
Cincinnati, OH 747 753.5 156.5 157.9
460 feet
Park City, UT 570 576.5 119.4 120.8**
7,500 feet
*This table presents the author’s calculations.
**An in-mask oxygen partial pressure of 120.8 mmHg is defined by Z88.2 as an oxygen
deficient IDLH atmosphere (that is, < 122 mmHg).
maintain pressures below the maximum values required
during certification testing.
A MEDICAL DECISION
Atmosphere-supplying respirators (SARs and SCBAs)
do not overcome oxygen-deficient atmospheres due to
increasing altitude. These respirators only add phys-
iologic stress to the wearer. In these cases, providing
an atmosphere-supplying, positive-pressure industrial
respirator is not helpful and may make things worse.
A worker, whether acclimated or not, who experiences
physiologic effects at altitude should undergo medical
evaluation. (Again, note that displacement of oxygen by
other gases or consumption of oxygen are not covered in
this article.) A potential solution for oxygen deficiency
due solely to altitude could be supplemental oxygen via a
nasal cannula, which may resolve or mitigate reductions
in oxygen partial pressure due to altitude. However, the
decision to provide supplemental oxygen should be made
and prescribed by a competent physician or other licensed
healthcare provider. Prior to using supplemental oxygen,
health and safety personnel would need to reassess the
workplace to ensure no flammability or explosion poten-
tial exists or is introduced. Training of the worker will also
be necessary. Substituting another worker who is accli-
mated to the altitude may be another option.
Ever wonder why high-altitude mountain climb-
ers don’t carry industrial SCBA respirators? Now you
know.
ROY T. MCKAY, PhD, is professor emeritus with the
University of Cincinnati and a member of the ANSI/ASSP
Z88.2 committee. He can be reached at roy.mckay@uc.edu.
Send feedback to synergist@aiha.org.
RESOURCES
ACGIH: 2017 TLVs and BEIs (2017).
American National Standards Institute: ANSI/ASSP Z88.2-2015, Practices for Respiratory Protection
(2015).
NIOSH: NIOSH Guide to Industrial Respiratory Protection, http://bit.ly/nioshindrespguide (1987).
NIOSH: NIOSH Respirator Decision Logic, http://bit.ly/nioshresplogic87 (1987).
OSHA: Occupational Health and Safety Standards, Personal Protective Equipment, Respiratory
Protection, http://bit.ly/osharespstandard (1998).
29 www.aiha.org |
 ARE “ACTIVE WORKSTATIONS” THE
SOLUTION TO EXCESSIVE SITTING?
EXERCISING
JUDGMENT
with Office Furniture
BY PENNEY M. STANCH, MARJORIE WERRELL, ALBERT MOORE,
AND STEPHEN W. HEMPERLY
S
o many jobs today are sedentary, involving
primarily computer use and other office
automation that we handle most tasks with-
out leaving our desks. Between email and
telephones, we seldom leave our desks to
communicate with colleagues down the hall.
Conference calls, webinars, and Skype allow us to meet with
colleagues across the country as we sit at our desks.
Perhaps due to concerns about the health effects of all
that sitting, more employees, in our experience, are request-
ing to incorporate treadmills, stationary bicycles, exercise
balls, and sit-stand desks into workstations. While the
health benefits of these “active” workstations may appear
obvious, occupational health and safety professionals need
to consider their potential impacts on workplace safety and
productivity.
STANDARDS
When confronted with a workplace hazard, occupational
health and safety professionals typically look for an appli-
cable standard to determine the established practices and
procedures for protecting the workforce. Currently, OSHA
has no specific regulations regarding ergonomics. The
agency does offer guidelines such as the OSHA Computer
Workstations eTool (http://bit.ly/oshaworkstation
setool). Nonregulatory standards are provided by the
American National Standards Institute (ANSI), the Human
| January 2020 30
Factors and Ergonomics Society (HFES), and the Business
and Institutional Furniture Manufacturers Association
(BIFMA).
ANSI maintains several standards regarding the design
and engineering of computer workstations and related office
furniture. HFES compiles the latest scientific data into the
volume ANSI/HFES 100-2007 Human Factors Engineer-
ing for Computer Workstations, providing requirements
and guidance on the design, configuration, and installation
of workstations focused on the human-machine interface.
BIFMA publishes the BIFMA G1-2013 Ergonomics Guide-
line for Furniture Used in Office Work Spaces Designed
for Computer Use with guidance on function and range
of adjustments for office furniture. BIFMA also manages
the ANSI/BIFMA standards for workplace furniture, with
separate standards for each type of furniture (for example,
ANSI/BIFMA X5.1 – 2017, Office Chairs and ANSI/BIFMA
X5.5 – 2014, Desk Products). In addition to comfort, these
standards include requirements for safety, sustainability,
and durability.
Purchasing ANSI-, HFES-, and BIFMA-compliant furni-
ture alone does not ensure employees will be protected from
work-related musculoskeletal disorders. But this furniture
should increase the likelihood that the workstation can be
configured and adjusted to meet the needs of the individual
employee and task. The latest updates to these standards
incorporate guidance for performing computer operations
while standing as well as sitting; however, there are currently
no standards for exercise/office furniture such as a treadmill
desk or bicycle chair.
EFFECTS OF EXERCISE ON PRODUCTIVITY
Examples of office furniture that combine exercise equip-
ment with typical desks and chairs include height-adjustable
sit-stand workstations, treadmill desks, cycle chairs, under-
desk cycles, and exercise ball chairs. These products purport
to offer some of the same health benefits as exercise without
requiring workers to leave their desk. Employers that offer
this equipment also assume that employees can be just as
productive while exercising as when working in traditional
office furniture.
Today’s exercise furniture attempts to integrate “modi-
fied” exercises into computer workstations. The research we
reviewed suggests that treadmill and cycle desk exercises
fail to mimic the same aerobic activity as running. Nor do
these exercises substitute for strength training such as lifting
weights.
Ball chairs may provide therapeutic exercise targeting
specific muscle groups in the gym, but they do not pro-
vide the stability needed for long-term seated office work.
Employees are unable to maintain a strong core posture
throughout the day. One study published in Applied Ergo-
nomics in 2009 found constant lower-back muscle and trunk
activation while using a ball chair, which leads to fatigue and
AndreyPopov/depositphotos
can place the worker at risk for assuming awkward postures
over time. Compression of the soft tissue of the posterior
surface of the thigh may also cause discomfort over time
versus a standard chair that distributes the weight safely to
the ischial tuberosities (the sit bones), according to studies in
Human Factors and Clinical Biomechanics.
Studies on the quality of exercise provided by treadmill
desks yield varied results. Two studies in the Journal of
Physical Activity and Health (JPAH) showed an increase in
energy expenditure and an increase in heart rate and blood
pressure. But a separate study in JPAH, as well as research
published in Obesity, showed no significant change in either
of these health components.
The use of exercise furniture may affect productivity as
well as health. In a review of twelve studies that appeared
in Occupational and Environmental Medicine in 2019,
treadmill and cycling workstations were found to require
more physical activity than sit-stand workstations, with a
greater potential for health benefits. In addition, use of the
treadmill and cycling workstations increased arousal and
decreased boredom. However, motor task performance (for
example, the speed and accuracy of typing, mouse pointing,
and combined keyboard/mouse tasks) suffered during use of
the treadmill desk and under-the-desk cycle when compared
to a sit-stand desk. The researchers’ analysis suggested that
because treadmill workstations require users to stabilize gait
and posture, the fine motor skills required for keyboarding,
31 www.aiha.org |
 mouse pointing, and typing are adversely affected. Sim-
ilar performance decrements when using a treadmill desk
were identified in research published in Human Factors
and JPAH in 2009. A study published in PLoS ONE in
2015 showed a decline in cognitive tasks such as recall,
memory, and concentration, as well as a decline in typing
speed and accuracy, while walking on the treadmill. In
addition, some studies have found that mousing and
keying can be more difficult while moving on a treadmill,
resulting in increased errors and tension in the hands.
Another systematic review that appeared in the Inter-
national Journal of Environmental Research and Public
Health in 2018 found similar mixed results regarding
workplace productivity and performance when using active
workstations, with one important addition: “It appears that
In our view, research does not
suggest a strong health benefit
that would justify utilizing exercise
furniture as standard practice.
phokin/Getty Images
using a sit-stand workstation has no effect on productivity
when the person is standing,” the researchers wrote, “indi-
cating that alternating between standing and sitting may not
have any detrimental effect on the amount and quality of
work being produced.”
ERGONOMIC AND SAFETY IMPACTS
In our view, research does not suggest a strong health bene-
fit that would justify utilizing exercise furniture as standard
practice. In addition, use of such furniture can increase the
risk of an MSD by permitting or even requiring non-neutral
postures. With neutral posture, the body is aligned to follow
natural curves and balanced to minimize stress on muscles
and joints. Appropriate office furniture is designed to permit
and support neutral posture for the entire body for each
task. It is critical for workstations to minimize ergonomic
risk factors such as awkward postures, repetitive or long-du-
ration tasks, and the need for excessive force.
Awkward postures involve more than not standing
straight. Poor posture is a risk factor that makes the body
work harder when joints are misaligned. Poor posture can
also increase the amount of force necessary to work if joints
are not in the midrange of motion. Office work in particular
has the added risk factor of static posture—that is, holding
the same posture for lengthy durations. Adjustable furniture
| January 2020 32
like a sit-stand workstation can adapt the monitor and
keyboard height to obtain neutral computing postures and
allow those postures to change over the workday.
While exercise furniture might address static postures,
its use may have unintended consequences. For example,
a ball chair is not height adjustable, so a position too close
to the floor could mean that the user must reach up to the
keyboard, creating stress on forearms and wrists, and look
up at the monitor, increasing visual demands and requiring
poor neck posture (especially for wearers of bifocals or tri-
focals). Both the ball chair and the cycle chair lack armrests
and lumbar support. Unsupported arms increase the risk of
wrist, elbow, and shoulder problems. Users may be tempted
to use the desk as an armrest as they tire, which means
they will no longer be maintaining neutral lumbar posture.
Falling and tripping are major safety risks as the transition
between sitting and standing is less stable than with a con-
ventional chair. Some ball chairs use a frame with lumbar
support, eliminating some of the instability of sitting on the
ball alone. But the stability of the frame defeats the purpose
of the ball chair. A worker might as well sit in a conventional
desk chair (with conventional support and stability).
Under-desk cycles are used with regular office chairs, so
adjustability and stability are not affected. However, other
risk factors can result in less-than-ideal posture. When not
in use, the pedals get in the way of leg room under the work
surface. Seated chair height can often be compromised to
accommodate knee clearance while pedaling, which results
in poor working postures of elevated upper extremities and
increases the reach and force necessary to perform tasks.
Similar concerns arise with treadmill desks. Walking can
induce extra head and eye movements to read the screen.
Walking while using voice recognition software could
decrease accuracy due to increased breathing rate. Increased
overall body fatigue is a concern as well. Treadmill desks
pose acute risks that a stationary workstation does not:
specifically, slips, trips, or falls from “distracted walking.”
Treadmill desks need numerous safety features such as a
safety tether, handrails, and speed limitations as well as
proper clothing, particularly shoes. Whether using an exer-
cise ball as a chair or a treadmill desk, users will eventually
get tired and need to use a regular chair at some point
during the workday.
At the same time, a basic risk factor for MSDs is static
work posture. Thus, changing positions throughout the
day is critical, more frequently than just taking a walk
or hitting the gym at lunch time. Altering work postures
throughout the day is key to reducing musculoskeletal dis-
comfort. Ideally, workers will change postures as often as
every thirty minutes. A 2014 study in Ergonomics in Design
demonstrated that combining the sit-stand workstation
with software-generated reminders to switch positions
reduced discomfort without negative effects on productivity
when performing tasks such as keyboarding, mousing, and
making phone calls. Whether the worker is sitting or stand-
ing, proper ergonomic principles must be applied in relation
to the position of the keyboard, monitor, input device, and
document.
FACILITY AND CORPORATE IMPACTS
Typically, to provide good indoor air quality as well as
thermal comfort, air handling systems serving office
spaces are designed with the capacity to meet certain
criteria for temperature, relative humidity, minimum
outside air uptake, and airflow rate. If computer work-
stations equipped with exercise bicycles or treadmills are
introduced into office environments, then the heating,
ventilating, and air-conditioning (HVAC) systems serv-
ing those environments would have to be modified at
increased cost to account for the additional heat load that
exercising personnel produce.
The introduction of exercise furniture will also require
more space per person since it will need to fit alongside con-
ventional office furniture. Conventional furniture will still
be necessary for employees to use when they get tired. Many
office facilities may not have the space necessary to allow
every worker to have a treadmill desk, for example, raising
questions of fairness and the need for criteria to determine
who can or should have such a workstation. Employers
may be forced to require a “fitness for duty” medical exam
or a legal waiver of liability as well as other administrative
controls. Office layouts in which some workstations are
exercise-capable and others are not will not be uniform,
which may detract from their overall appearance, and the
use of such workstations will likely add another source of
distraction to open office areas. Sit-stand workstations are
the exception: these are designed to take the same space as a
conventional desk and utilize conventional seating when the
user gets tired of standing.
A HEALTHY CULTURE
The bottom line is that definitive benefits from the use of
exercise equipment as office furniture have yet to mate-
rialize. Research suggests that such use results in limited
energy expenditure and frequently in diminished work per-
formance. Studies rarely address the risks of slips, falls, and
MSDs, much less the potential for workers’ compensation
claims.
A recommended approach for defining the office furni-
ture permitted in the workplace is to look to the standards.
Industrial hygienists perform hazard assessments of pro-
cedures, tasks, and equipment including furniture. The
process of controlling the hazard starts with a review of cur-
rent regulations, standards, and guidelines. For respiratory
protection, hygienists look to OSHA regulations, NIOSH
guidelines, and non-regulatory Threshold Limit Value
standards. For office furniture, hygienists have the ANSI/
HFES and ANSI/BIFMA standards. When enough research
is available on how to build a safe treadmill desk or bicycle
chair, BIFMA will likely add a standard for them. Until then,
we recommend developing a workplace culture that invites
employees to adopt healthy workplace practices to limit sed-
entary behavior at work. Such practices are simple and easily
incorporated into the workday:
• Stand during meetings, while on the phone, or reading.
• Take frequent micro-breaks at the desk to stand and
stretch.
• Take a brief walking break, perhaps a lap around the build-
ing or the floor.
• Walk down to a colleague’s desk rather than call or email.
• Use the stairs rather than the elevator.
• Participate in lunchtime exercise classes, if offered.
These behaviors accomplish the same purpose as exer-
cise equipment—a change in posture and movement—and
minimize the risk of MSDs. None of them need an “exercise
device” to be effective. An important part of this culture is
reminding employees, coworkers, and managers that taking
a break is not wasted time, but rather a healthy and produc-
tive practice.
PENNEY M. STANCH, PT, CPEE, CIE, is a senior consultant
with Baer Engineering and Environmental Consulting, Inc.,
in Austin, Texas. She can be reached at pstanch@baereng.
com.
MARJORIE WERRELL, PT, CPEE, CIE, is president of
Ergoworks Consulting in Gaithersburg, Md. She can be
reached at marj@ergoworksconsulting.com.
ALBERT MOORE, MS, CIH, CPE, CLSO, is a PhD student
with Industrial & Systems Engineering at Virginia Tech in
Blacksburg, Va. He can be reached at amoore@vt.edu.
STEPHEN W. HEMPERLY, MS, CIH, CSP, CLSO, FAIHA, is
an advisory industrial hygienist with Western Digital in San
Jose, Calif. He can be reached at steve.hemperly@wdc.
com.
Send feedback to synergist@aiha.org.
RESOURCES
Clinical Biomechanics: “Sitting on a Chair or an Exercise Ball: Various Perspectives to Guide Decision
Making” (May 2006).
Ergonomics in Design: “Stand Up and Move; Your Musculoskeletal Health Depends on It” (July 2015).
Human Factors: “Stability Ball Versus Office Chair: Comparison of Muscle Activation and Lumbar Spine
Posture During Prolonged Sitting” (2006).
Human Factors: “The Effects of Walking and Cycling Computer Workstations on Keyboard and Mouse
Performance” (December 2009).
International Journal of Environmental Research and Public Health: “The Impact of Active Workstations on
Workplace Productivity and Performance: A Systematic Review” (February 2018).
Journal of Physical Activity and Health: “Cognitive Function During Low-Intensity Walking: A Test of the
Treadmill Workstation” (May 2014).
Journal of Physical Activity and Health: “Effect of Using a Treadmill Workstation on Performance of
Simulated Office Work Tasks” (2009).
Journal of Physical Activity and Health: “Metabolic Cost and Speech Quality While Using an Active
Workstation” (March 2011).
Obesity: “Treadmill Desks: A 1-Year Prospective Trial” (April 2013).
Occupational and Environmental Medicine: “Health and Productivity at Work: Which Active Workstation for
Which Benefits: A Systematic Review” (May 2019).
PLoS ONE: “Cognitive and Typing Outcomes Measured Simultaneously with Slow Treadmill Walking or
Sitting: Implications for Treadmill Desks” (April 2015).
Preventative Medicine: “A Systematic Review of Standing and Treadmill Desks in the Workplace”
(January 2015).
33 www.aiha.org |
 Powering the
Profession
American Industrial Hygiene Foundation
TM

The Impact of AIHF

Since 1982, the Foundation has contributed
over $2 million towards the education of over
750 students studying industrial hygiene and
related disciplines. Our scholarships enable “I am a single mother and unfortunate-
talented students to complete their education ly my living costs far exceed the living
and encourage promising scholars to enter or costs for most graduate students. For
remain in the IH/OEHS profession. this reason, I am infinitely grateful for
individuals like you who donate money
for scholarships to give to students
like me. I am grateful to have my hard
work recognized and my story heard.”
Our sincere thanks — Misha Griffis
Clyde M. Berry Memorial Scholarship
to all 2019 donors.
Please consider making a monthly gift to fund a
student scholarship in 2020! Contact us today
to learn how you can catalyze the future of the
profession! tla@aiha.org

AIHFOUNDATION.ORG
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35 www.aiha.org |

Call for Volunteers:
AIHA Finance
Committee
The AIHA Finance Committee
is a standing committee that
works with AIHA’s Board of
Directors, chief executive offi-
cer, and chief financial officer
to monitor the finances of the
association. There is currently
one opening on the Finance
Committee for a three-year
term beginning June 2020.
If you are interested in serving
on the Finance Committee,
please review the roles and
responsibilities (PDF, http://
bit.ly/aihafc2020roles) and
submit your application by Jan.
31, 2020. The application is
available as a PDF at http://
bit.ly/aihafc2020form. Once
your application is received, you
will be contacted to set up an
appointment for a 30-minute
phone interview with a member
of the AIHA Board.
Email Belinda D’Agostino at
bdagostino@aiha.org or call
(703) 846-0721 with questions.
| January 2020
COMMUNITY
IOHA CHOOSES THOMAS P. FULLER
AS PRESIDENT-ELECT
T
he International Occupa- has 36 member organizations that and other professional and phil-
tional Hygiene Associa- represent more than 20,000 occu- anthropic organizations, expand-
tion board of directors has pational hygienists worldwide. IOHA’s ing recognition of the occupational
elected Thomas P. Fuller, mission is to “enhance the inter- hygiene profession, publishing timely
ScD, CIH, CSP, MSPH, MBA, as IOHA’s national network of occupational information on the IOHA website,
president-elect. IOHA is the umbrella hygiene associations that promotes, and expanding IOHA’s guidance to
organization for industrial and occu- universities regarding curricula for
pational hygiene organizations around “For me, IOHA is a associate, master’s, and bachelor’s
the world. Fuller, who has served as means to reach the degree programs.
AIHA’s representative to IOHA for two most people, who Other areas of focus for IOHA are to
years, will become IOHA’s president advance the international standards
later this year, and will serve as IOHA
need the most help, of educational and training assess-
past president in 2021–2022. through an ever- ment, and to help educational orga-
IOHA’s current president is Rene improving network.” nizations understand the importance
Leblanc of Canada. of educational assessment.
“Millions of workers around the develops, and improves occupational In 2018, AIHA hosted IOHA’s pres-
world are still in need of safe and hygiene worldwide, providing a safe tigious International Scientific Con-
healthy working conditions,” Fuller and healthy working environment for ference in Washington, D.C., the first
said in an email. “For me, IOHA is all,” according to the organization’s time the conference had ever been
a means to reach the most people, website. held in the United States. The 2020
who need the most help, through an Fuller identified several priorities International Scientific Conference will
ever-improving network of collabora- for his time in IOHA’s leadership, be held Oct. 17–22 in Daegu, Korea.
tion, communication, and education.” including coordinating educational For more information, visit www.
Created in 1987, IOHA currently initiatives between IOHA members ioha2020.org and www.ioha.net.
AIHF Launches President’s Leadership Award
The American Industrial Hygiene Foundation announced lishment of this award as the 'gift that keeps on giving' to
on Oct. 29, 2019, the establishment of the President's the working women and men around the world in ensuring
Leadership Award. This award, to be given annually by their health and safety."
AIHF, will be the foundation's highest scholarship and To qualify for the President's Leadership Award, appli-
professional development honor. The award consists of a cants must demonstrate scientific, literary, and research
considerable scholarship and a professional development acumen in industrial hygiene, environmental, and occu-
opportunity to attend a meeting of the British Occupational pational health disciplines. Applicants must be graduate
Hygiene Society or the Australian Institute of Occupational students with a focus in IH or exposure science. Students
Hygienists, or a comparable international conference on must also demonstrate strong propensity toward lead-
occupational health and safety. The President's Leadership ership, volunteerism, and problem-solving. Most notably,
Award is made possible thanks to a generous $150,000 applicants must show genuine passion for using their
endowment and annual donation by John Henshaw, MPH, knowledge, experience, and talents to make a tangible
CIH, FAIHA, who served as president of AIHA in 1990–91. and positive impact on worker health and safety.
"This is a way for me to give back to the profession by More information about the President's Leadership
helping others as others have helped me in my career as Award is available on AIHF’s website at http://bit.ly/aihf
an industrial hygienist,” Henshaw said. “I see the estab- leadership.
36

Cast Your Ballot in the 2020 AIHA Board Election
AIHA has partnered with eBallot to
provide a safe, secure web-based
voting system during the 2020 Board
of Directors election cycle. Instruc-
tions on how to vote in the election,
which will run from Feb. 15 to March
6, 2020, will be emailed to members
in February.
Members who require a paper
ballot must submit their request by
In Memoriam
Raj Ganapathy, CIH, passed away on
Oct. 10, 2019. He was 56. Ganapathy
most recently worked as a senior
industrial hygienist at Washington
River Protection Solutions in Rich-
land, Wash. He earned a bachelor’s
degree in chemistry and a master’s
in environmental chemistry at the
University of Madras in India, and
later achieved a master’s in environ-
mental science at Southern Illinois
University. His full obituary is avail-
able at http://bit.ly/rajganapathy.
Students: AIHF Scholarship Applications Are Due Jan. 31
The American Industrial Hygiene
Foundation is accepting scholarship
applications for the 2020–2021 aca-
demic year. Students are evaluated
on academic record, extracurricular
activities, future goals as an indus-
Dates and Deadlines
JANUARY 15
Deadline to submit nominations
for AIHA awards. Visit http://bit.ly/
awardsnoms.
JANUARY 23
AIHA webinar: “An Introduction to
Big Data and Data Analytics.” Visit
http://bit.ly/aihawebinars.
JANUARY 27
Deadline to submit AIHF scholar-
ship applications for the 2020–2021
academic year.
COMMUNITY
email to nominations@aiha.org no
later than Wednesday, Jan. 22. The
paper ballot will be mailed by early
February and must be returned
postmarked no later than Friday,
Feb. 21, to be counted in the election.
Nominations by petition are
due soon. In addition to nomina-
tions made by AIHA’s Nominating
Committee, nominations for officers
Thomas C. Goob, MPH, MBA, CSP,
CIH, passed away on Sept. 11, 2019.
He was 48. Goob was vice president
of quality, safety, and risk manage-
ment at Diagnostic Laboratory Ser-
vices, Inc. He served as president of
the Hawaii Local Section in 2003 and
was previously a member of AIHA’s
Healthcare Working Group. His full
obituary is available online at http://
bit.ly/thomasgoob.
Kim Douglas Merritt passed
away on Oct. 24, 2019. He was 51.
trial hygienist, and potential for lead-
ership in the industrial hygiene pro-
fession. Several AIHF scholarships
have specific criteria, and schools or
students who meet those criteria will
be given first consideration.
JANUARY 31
Deadline to submit applications for
the AIHA Finance Committee.
MARCH 9–13
Comprehensive Industrial Hygiene
Review course in Ann Arbor, Mich.
Co-sponsored by the Michigan
Industrial Hygiene Society. Visit
http://bit.ly/cihrmarch2020.
JUNE 1–3
AIHce EXP 2020 in Atlanta, Ga. Visit
www.aihce2020.org.
37
Awards Nominations
and directors may be made by peti- Due Soon
tion of not less than two percent of
AIHA is accepting nominations for the
members who are eligible to vote.
2020 AIHA awards until 11:59 p.m. ET on
Petitions must be submitted to the
Jan. 15, 2020. AIHA’s awards honor indi-
chair of the Nominating Committee
viduals who provide significant contri-
at nominations@aiha.org by Feb. 4.
butions to the IH and OEHS professions.
Important information about AIHA
More information on AIHA awards and
governance is available online at
honors, including links to nominations
http://bit.ly/governanceaiha. Email
forms, is available on AIHA's website at
questions to nominations@aiha.org.
http://bit.ly/awardsnoms.
The award recipients will be recognized
during the Mark of Excellence Awards
Merritt was an active volunteer Breakfast at AIHce EXP 2020
and previously served in several in Atlanta, Ga.
leadership roles, including chair,
for AIHA’s Nonionizing Radiation
Committee. In 2015–16, he was 2020 Consultants Listing
president of the Tidewater Local Coming Soon
Section. Merritt worked with the
The Consultants Listing is a comprehen-
Safety and Quality Assurance Alli-
sive print and online directory of IH
ance at NASA Langley Research
and OEHS companies across the nation
Center in Hampton, Va., for 17 years
that is requested by some of the top
until his retirement in 2018. His full
organizations in the industry. The latest
obituary is available at http://bit.ly/
edition of the Consultants Listing will be
kimmerritt.
published in February. If you missed
the opportunity to purchase a listing,
you can still get an online-only listing.
For more information, contact Wanda
All application materials must
Barbour at wbarbour@aiha.org or
be submitted by Jan. 31, 2020. For
(703) 846-0782.
more information on AIHF scholar-
ships and eligibility requirements, The Consultants Listing is also
please visit the foundation's website available online at www.
at http://bit.ly/aihfscholarshipinfo. consultantslisting.org.
Subscribe to SynergistNOW
For a complete list of events, visit
The SynergistNOW blog offers ideas,
www.aiha.org/calendar.
insights, and perspectives on important
topics affecting industrial hygiene
professionals, written by and for expe-
rienced IHs, researchers, academics,
and AIHA leaders. Launched in 2016,
SynergistNOW features two new posts
per week. The blog is available to every-
one with an interest in the IH and OEHS
fields, but even AIHA members must
subscribe. Visit SynergistNOW online at
http://bit.ly/synergistnow.
www.aiha.org |
 BY THE NUMBERS

From CDC’s web page on
drowsy driving:
“Studies have shown that
going too long without sleep
can impair your ability to drive
the same way as drinking too
much alcohol. . . . Additionally,
drowsiness increases the effect
of even low amounts of alcohol.”
DRIVER FATIGUE
A new page on the NIOSH website focuses on how to prevent driver fatigue on the job. Driver
fatigue can be caused by being awake for many consecutive hours, not getting enough sleep
over multiple days, and monotonous tasks or long periods of inactivity. Time of day and health
factors like sleep disorders or medications that cause drowsiness can also contribute to driver
fatigue. Fatigued drivers may nod off or react more slowly to changing road conditions. NIOSH
encourages employers to use a fatigue risk management system to help reduce the risks of
driver fatigue. According to NIOSH, an FRMS can promote alertness among workers, identify
tasks that are prone to fatigue, and lessen fatigue and its potential consequences. Information
from NIOSH’s new web page on fatigue appears below.

0.05 In terms of impairment, the blood-alcohol

content equivalent to 17 consecutive hours
of wakefulness. 17

In terms of impairment, the blood-alcohol

0.1 content equivalent to 24 consecutive hours
of wakefulness. 24

SOURCES:
CDC: “Drowsy Driving,” http://bit.ly/
37
Percentage of U.S.
20
Maximum percentage
30
Maximum length of
workers who get of fatal vehicle time, in seconds, of
cdcdrowsydriving. less than the crashes in the “microsleeps,”
recommended general population or brief sleep
NIOSH: “Motor Vehicle Safety at Work: minimum of that involve driver episodes that
Driver Fatigue on the Job,” http://bit.ly/ 7 hours of sleep fatigue. fatigued drivers
nioshdriverfatigue. per night. may experience.

| January 2020 38