TWA guidelines can be crunk

I was talking with my niece Jordan last week, and I needed a dictionary for the new slang in each sentence that came out of her mouth.

Th Twa Guidelines 01
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by Noel Kelsch, RDHAP
n.kelsch@sbcglobal.net

I was talking with my niece Jordan last week, and I needed a dictionary for the new slang in each sentence that came out of her mouth. She said she gave her friend a prop (a compliment, praise) in front of a perspective boo (boyfriend) and that they had crunk (extreme fun) faffing about (wasting time).

The Occupational Safety and Health Administration’s (OSHA) goal is protection of employees. They want you to be able to return home at the end of the day unharmed. Most dental health-care professionals are aware of the guidelines for bloodborne pathogens, but there are many who are like me while talking with Jordan; they are just trying to understand many of the other standards.

One of the most important OSHA standards is the Hazard Communication Standard (HazCom). The purpose of the HazCom standard is to ensure that hazards of all chemicals produced or imported be evaluated and that employers transmit the information concerning such hazards directly to employees. Information is conveyed through a comprehensive hazard communication program. The program includes a written clinic/office program manual, container labeling, other forms of warning (such as in Material Safety Data Sheets), and employee training.

One of the most important standards on the forefront today is the time weighted average, or TWA.

To define TWA, OSHA states it is the average concentration for a normal eight-hour workday and a 40-hour workweek to which nearly all workers can be repeatedly exposed to a chemical without adverse health effects. The Centers for Disease Control and Prevention (CDC) Guideline for Disinfection and Sterilization in Healthcare Facilities (2008) states: “…an average of all the concentrations of a chemical to which a worker has been exposed during a specific sampling time, reported as an average over the sampling time. For example, the permissible exposure limit for ethylene oxide is 1 ppm as an 8-hour TWA. Exposures above the ppm limit are permitted if they are compensated for by equal or longer exposures below the limit during the 8-hour workday as long as they do not exceed the ceiling limit; short-term exposure limit; or, in the case of ethylene oxide, excursion limit of 5 ppm averaged over a 15-minute sampling period.”

The National Institute for Occupational Safety and Health (NIOSH) develops recommended exposure limits (REL), which help protect workers’ health over a working lifetime. This limit is frequently expressed as a 40-hour TWA exposure for up to 10 hours per day during a 40-hour workweek. These exposure limits are designed for inhalation exposures. Irritant and allergic effects can occur below the exposure limits, and skin contact can result in dermal effects or systemic absorption without inhalation. OSHA enforces those standards.

So what does every office have to do?

  • Establish a program for monitoring occupational exposure to regulated chemicals that follows federal, state, and local regulations. This must include the key factors to assess the risks of chemical exposure including duration, intensity, and route of exposure.
  • Ensure that no employee is ever overexposed to the TWA.
  • Material and Safety Data Sheet (MSDS) information must be available for all products that are in the dental setting. MSDS sheets include information on TWA.
  • All employees must be educated, and the purpose of the HazCom standard is to ensure that hazards of all chemicals produced or imported be evaluated and that employers transmit the information concerning such hazards directly to employees. Information is conveyed through a comprehensive hazard communication program. The program includes a written clinic/office program manual, container labeling and other forms of warning, Material Safety Data Sheets (MSDSs), and employee training.

For a great template for implementing this program go to: http://www.doa.state.wi.us/docs_view2.asp?docid=2518.

I may never understand the meaning of my niece’s slang, but it is clear that it is vital for all dental health-care providers to understand HazCom.

A special thanks to the Organization for Safety and Asepsis Procedures (OSAP.org) and OSHA for the information in this article.

About the Author

Noel Brandon Kelsch, RDHAP, is a freelance cartoonist, writer, and speaker. She has received many national awards including Colgate Bright Smiles Bright Futures and Sunstar/RDH Award of Distinction. Her family lives in Moorpark, Calif.

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