To implement a monitoring program for your employees who, as
part of their job duties, handle category I or II organophosphate
or N-methyl-carbamate pesticides with the words “DANGER”
or “WARNING” on the label.
Definition:
The terms handle and handler refer to employees who are engaged
in the job duties listed in the definition of “handler”
contained in WAC
296-307-11005, Pesticides (worker protection standard).
Important:
Whenever there is reason to believe than an employee has been
poisoned or injured by exposure to pesticides while on the job,
you need to provide the medical services required by WAC
296-307-13055.
WAC
296-307-14805 Maintain handling records for covered pesticides.
You must:
Maintain accurate records of all time that
each employee spends handling category I or II organophosphate
or N-methyl-carbamate pesticides (this includes employees who
don't meet the handling hour thresholds in WAC 296-307-14810).
Provide a completed CHOLINESTERASE MONITORING HANDLING HOURS
REPORT (F413-065-000) to the physician or other licensed health
care professional (LHCP) for each employee receiving a periodic
cholinesterase blood test and make sure the report is submittted
to the laboratory with each periodic cholinesterase test.
Provide the employee with a copy of the CHOLINESTERASE MONITORING
HANDLING HOURS REPORT upon request.
Retain pesticide handling records for 7 years.
Make sure that pesticide-handling records
are readily accessible to employees, their designated representatives,
and treating health care professionals.
WAC
296-307-14810 Implement a medical monitoring program.
You must:
Implement a medical monitoring program for
your employees who handle or will be expected to handle category
I or II organophosphate or N-methyl-carbamate pesticides for
30 or more hours in any consecutive 30-day period.
Note:
You don't need to count time spent mixing
and loading using closed systems (as defined in WAC 296-307-13045(4)(d))
in determining the need for periodic testing. Closed cabs aren't
"closed systems." Time using closed systems is still
counted for purposes of establishing coverage under this rule
and determining the need for obtaining baseline cholinesterase
levels.
The first 30 consecutive day period begins on the first day
of handling organophosphate or N-methyl-carbamate pesticides
after obtaining the baseline cholinesterase test.
There is nothing in this rule that prohibits
employers from providing cholinesterase monitoring to employees
who handle organophosphate or N-methyl-carbamate pesticides
for fewer than 30 hours in any consecutive 30-day period.
WAC
296-307-14815 Identify a physician or other licensed health care
professional.
You must:
Identify a physician or other licensed health
care professional (LHCP) who will:
- Provide baseline and periodic cholinesterase
testing through the department of health public health laboratory
or a laboratory approved by the department of Labor & Industries
- Interpret cholinesterase tests.
- Provide you with a written recommendations
for each employee's blood test and evaluation.
Obtain the LHCP's written recommendation for
each employee's blood test and evaluation (including baseline
tests) and make sure that the employee receives a copy of the
LHCP's written recommendation, either through you or directly
through the LHCP, within 5 business days after you receive the
recommendation.
Make sure the LHCP's written recommendation
for each employee's blood test and evaluation is limited to
the following information:
- The employees cholinesterase status based
on the LHCP's evaluation.
- Identification of changes in cholinesterase
levels requiring a work practive evaluation for the employee.
- Identification of changes in cholinesterase
levels requiring the employee to be removed from handling
and other exposure to organophosphate and N-methyl-carbamate
pesticides.
- Guidance on medical monitoring.
- Any other relevant information concerning
an employee's workplace exposure to organophosphate and
N-methyl-carbamate pesticides.
Note: All testing for an employee should
be conducted through the same laboratory. This will allow for
accuarate comparison between baseline and periodic tests.
You must:
Instruct the LHCP to NOT reveal in
writing or in any other communication with you any other personally
identifiable medical information.
Note: If the LHCP written recommendation
contains specific findings or diagnoses unrelated to occupational
exposure, you should send it back and obtain a revised version
without the additional information.
You must:
Make sure the LHCP is familiar with the requirements
of this rule (for example, by providing a copy of the rule or
by confirming that the provider has attended training on the
rule).
Post the name, address, and telephone number
of the LHCP you have identified at the locations where employees
usually start their work day.
Make sure written recommendations from the
LHCP are maintained for 7 years.
Note: You may also maintain the employee's
actual test results if the employee provides the LHCP with written
consent to share these results with you.
WAC
296-307-14820 Make cholinesterase testing available.
You must:
Make medical monitoring available to employees
who will meet the handling hour threshold of 30 or more hours
in any consecutive 30-day period (WAC 296-307-14810) at no cost
and at a reasonable time and place, as follows:
- Provide annual baseline red blood
cell (RBC) and serum cholinesterase tests that are taken at
least 30 days after the employee last handled organophosphate
or N-methyl-carbamate pesticides.
- Provide periodic RBC and serum cholinesterase
testing:
Within 3 days after the end of each 30-day
period where the employee meets the handling hour threshold
in WAC 296-307-14810; however, testing isn't required more
often than every 30 days;
OR
At least every 30 days for those employees
who may meet the handling hour threshold in WAC 296-307-14810.
- Follow the recommendations of the LHCP
regarding continued employee pesticide handling or removal
from handling until a 30-day exposure free baseline can be
established.
Exemption: You don't need to
provide baseline or periodic testing for those employees whose
work exposure is limited to handling only N-Methyl-carbamate pesticides.
Note:
For employees who have had exposure to organophosphate or
N-methyl-carbamate pesticides in the 30 days prior to the test
obtain a working baseline. For example, a worker who initially
declines cholinesterase testing and later chooses to participate
in testing would obtain a "working baseline."
For new employees, the LHCP may accept pervious baselines,
if they are obtained according to this rule.
You must:
Obtain a signed declination statement
from the or LHCP for each employee who declines cholinesterase
testing.
- Employees may decline cholinesterase
testing only after they receive training about cholinesterase
inhibiting pesticides and discuss the risks and benefits
of participation with the LHCP.
- An employee may change his or her mind
and elect to participate or decline to continue participation
in the testing program at any time.
Make sure the employee receives a copy of
the signed declination statement either through you or directly
through the LHCP, within 5 business days after you receive the
declination statement.
Note:If employers discourage
participation in cholinesterase monitoring, or in any way interfere
with an employee's decision to continue with this program, this
interference may represent unlawful discrimination under RCW 49.17.160,
Discrimination against employee filing, instituting proceedings,
or testifying prohibited--Procedure--Remedy.
WAC
296-307-14825 Respond to depressed cholinesterase levels.
You must:
Respond to an employee's depressed
cholinesterase levels by:
-Taking the actions required in Table
1;
AND
- Following any additional occupational
health recommendations from the or LHCP.
Table 1 - Required Responses
to an Employee's Depressed Cholinesterase Levels
When:
Action
to be taken:
Methods:
An
employee's RBC or serum cholinesterase levels fall
more than 20 percent below the baseline
Evaluate
the employee's workplace and work practices to identify
and correct potential sources of pesticide exposure
Review:
Personal protective equipment
(PPE) and its condition
Employees' PPE usage
General sanitation and decontamination
practices and availability of decontamination
facilities required by WAC 296-307-13050
Pesticide handling practices
Pesticide label requirements
An
employee's RBC cholinesterase level falls 30 percent
or more from the baseline
OR
An employee's serum cholinesterase level falls
40 percent or more from the baseline
Remove
the employee from handling and other work exposures
to organophosphate and N-methyl-carbamate pesticides
such as thinning and harvesting in recently treated
areas
AND
Evaluate the employee's work practices to identify
and correct potential sources of pesticide exposure
When available; provide the
employee with other duties that don't include
handling and other work exposures to organophosphate
and N-methyl-carbamate pesticides
Provide medical monitoring
and cholinesterase testing as recommended by the
LHCP
Provide salary and benefits as if employee was
continuing pesticide application activities
A removed
employee's cholinesterase levels return to 20 percent
or less below baseline
The
employee may return to handling class I and II organophosphate
and N-methyl-carbamate pesticides
WAC
296-307-14830 Provide medical removal protection benefits.
You must:
Provide medical removal protection benefits
for a maximum of three months on each occasion:
- An employee is temporarily removed
from work due to depressed cholinesterase levels;
OR
- Assigned to other duties due to depressed
cholinesterase levels.
Provide medical removal protection benefits
that include maintenance of the same pay, seniority and other
employment rights and benefits of an employee as though the
employee has not been removed from normal exposure to organophosphate
or N-methyl-carbamate pesticides or otherwise limited.
Note: The following are examples of
how a worker's pay could be maintained while medically removed
from exposure to cholinesterase-inhibiting pesticides:
A removed worker is assigned to work 8 hours a day but the
employer's pesticide handlers are working 10 hours a day. The
removed worker would be paid for 10 hours at the handler's pay
rate.
The farmer pays workers 2 dollars more per hour when they
are handling organophosphate or N-methyl-carbamate pesticides.
The removed worker will be paid this premium when the pesticides
are being handled on the farm; however, the worker will be paid
at their usual pay rate when the pesticides aren't being handled
on the farm.
Make sure that the following records
are maintained:
- The name, address, and telephone number
of the physician or LHCP.
- Written recommendations and opinions
received from the physician or LHCP.
- Findings of all work practice investigations.
- Dates when employees were medically
removed from their duties and dates when employees are returned
to duties that include handling organophosphate orN-methyl-carbamate
pesticides.
- Signed declination statement.
Maintain records for 7 years.
Make sure that all records are readily accessible
to the employee and his or her designated representative.
Make sure employees have received training
before initial medical monitoring. The training must include
at least the following:
-
The human health hazards and physical symptoms
of overexposure to organophosphate and N-methyl-carbamate
cholinesterase-inhibiting pesticides.
- The purpose and requirements for medical
monitoring.
Note:
Training required by this rule may be combined with other
pesticide handler training as required byWAC 296-307-13025,
Pesticide safety training--Standards for pesticide handlers.
The department will implement and complete an evaluation of this
rule by doing the following:
Organize a scientific team to oversee collection and analysis
of data collected during 2004 and 2005. L&I will select
representatives of the University of Washington, Washington
State University, as well as other interested members of the
academic and scientific communities, to participate on the team.
The team will provide an initial analysis of testing data and
any appropriate recommendations directly to L&I and to the
cholinesterase monitoring advisory committee by November 1,
2004, and a further analysis and any appropriate recommendations
by November 1, 2005. A final report and recommendations will
be completed by September 30, 2006.
Establish a cholinesterase stakeholder advisory committee
to evaluate issues related to rule implementation and provide
recommendations to the department regarding implementation of
the rule and any possible modifications to it. L&I will
invite representatives of growers, labor and affected state
agencies to participate on the advisory committee. The committee
will have an opportunity to comment on the analysis completed
by the scientific team and to make any appropriate recommendations
before December 1, 2004, and again before December 1, 2005.
In addition, the committee will review the scientific committee's
final report and recommendations and provide advice to L&I
prior to December 1, 2006.
Review reports from the scientific team and stakeholder advisory
committee, and other relevant information and make modifications
to the rule as appropriate.
Make efforts to defray the costs of medical testing during
2004.
Prepare and distribute provider guidelines.
Develop and make available a model employee training program.
Publish a list of trained providers and certified laboratories
on the internet.
Coordinate recordkeeping requirements with the department
of agriculture.
For
printing