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• Safety and Health on Bridge Repair, Renovation and Demolition Projects

Safety and Health on Bridge Repair, Renovation and Demolition Projects

• Name, address, phone number of firm.
  
  
• Qualifications of the firm, including previous experience in lead abatement/removal
      project(s) or activities.
  
  
• Resumes of key personnel to be assigned to the project.
  
  
• A lump sum fee to prepare and furnish the following for the LHPP:
  
  
  • Written LHPP procedures.
    
    
  • Written records of all employees who are participating in the LHPP.
    
    
  • Procedure for instituting medical surveillance, including method and personnel involved.
    
    
  • Procedure for employee notification.
    
    
  • Procedure for employee exposure assessment with 29 CFR 1926.62 and CRISP guidelines.
    
    
  • Selection and justification of appropriate respiratory equipment and protective clothing.
    
    
  • Procedure for conducting employee training (on-site services).
    
    
  • Written hazard communication procedures.
    
    
  • Written personal hygiene procedures.
    
    
  • Monthly certification.
    
    
  • Monthly compliance report.
    
    
  • Summary report and/or annual reports.
    
    
  • A quote to provide employee training as required under the LHPP to be paid as each group of employees trained.
    
    
  • Hourly rate for on-site services performed by the CIH, the IH, and/or their supervised technicians, etc., to comply with and monitor the LHPP procedures  This includes weekly inspections and certification that respirators are being cleaned properly  Also included are investigation requirements for medical removal, intervention, and recommended implementation of intervention measures  A listing by title of those personnel to be on-site shall be furnished with copies of certified payrolls that will be in effect for the duration of the project  Overhead as documented by a CPA and profit (7 percent maximum) shall not exceed 145 percent of these payrolls and shall include all direct and indirect costs related to this work and recommended implementation of intervention measures.  Travel costs will not be paid.  Hourly rates for principals of the company shall not exceed $35/hr including overhead and profit.
    
    
  • Agreement to use the forms provided by CRISP for collecting and reporting data to ConnDOT and to CRISP.
    
    
  • Agreement to follow as a minimum the testing guidelines provided by CRISP.

The engineer will review the proposals submitted and notify the contractor in writing of the firm(s) acceptance within ten (10) calendar days of receipt of the proposals.

Definitions:

Lead Health Protection Program:

The LHPP consists of written LHPP procedures and on-site inspections, occupational air sampling, wide sampling, and reporting of the procedures by a CIH   The frequency of the on-site surveillance and monitoring shall be dependent upon the type of work to be performed and shall be detailed in the written LHPP procedures.

At the outset of a given job, the IH firm must send to CRISP and ConnDOT all written procedures under this item  If there are changes to these procedures, they shall be resubmitted.

The written LHPP procedures consist of, but are not limited to:

1.  A written record of all employees involved in work tasks that pose an airborne lead exposure risk at the work site or who may on any day have an exposure exceeding the Action Level.  Tasks where 30 µg/m³ may be exceeded include but are not limited to: welding, burning paint, flame cutting, gouging, abrasive blasting, grinding, chipping, needle gun cleaning, lead burning, manual scraping and sanding, manual demolition of structures, heat gun cleaning, peening on existing structural steel, abrasive blasting debris cleanup, using lead-containing mortar, containment moving and removal, power tool cleaning, lead removal equipment cleaning, decontamination trailer cleaning, rivet busting, etc  Those working in the vicinity of these tasks may also be exposed.

For this purpose a daily sign in/out log provided by CRISP that identifies persons by name, Social Security Number, affiliation, and work task for all employees who were at the site during the reporting period must be maintained at the work site and submitted monthly to DOT and CRISP.

All workers exposed to airborne lead at or above the Action Level on any day will be required to participate in the medical surveillance program.  The IH firm shall determine levels of airborne exposure by breathing zone air sampling for airborne lead exposure over a full representative shift  In addition, all workers except those specifically exempted from the comprehensive medical surveillance program who do have or may be anticipated to have lead exposure will be enrolled in the comprehensive medical surveillance program.  Those who are exempted from the comprehensive medical surveillance program will be enrolled in the limited medical surveillance program and the listed justification for their exemption by the site CIH will be submitted to ConnDOT and CRISP within 5 working days of the decision to exempt.

2.  Procedures for instituting a medical surveillance program in accordance with 29 CFR 1926.62(j) except as noted herein  Frequency of medical examination shall conform to 1926.62(j) except where additional testing is specified  Medical surveillance will consist of, but not be limited to, an entry/annual testing protocol, an exit testing protocol, interval and comprehensive examination testing as indicated based upon exposure and prior surveillance data blood lead level and Zinc Protoporphyrin levels  The medical surveillance data acquired under this special provision shall be collected according to current CRISP protocol and submitted by the CIH to the Department of Public Health and Addiction Services - CRISP Program Coordinator at the following address, CRISP, 150 Washington Street, Hartford, CT 06106.  The General Contractor and any and all subcontractors shall cooperate fully and in a timely manner with the project IH firm to share information regarding blood lead levels on covered employees so that results are submitted accurately and in a timely manner to CRISP.  The General Contractor and any and all subcontractors and IH firm will cooperate by identifying to the participating CRISP clinic the individuals who will be scheduling the CRISP examinations (the General Contractor or the CIH)  All medical examinations and testing will be done at a CRISP- listed medical facility using appropriate CRISP protocols and forms.

3.  An entry/annual testing protocol shall apply to workers covered under this specification and shall include the following:

4.  The medical removal requirements shall be as follows:

5.  Intervention.  For any employee with a blood lead level at or above 35 µg/dl for 1994 (30 µg/dl for 1995 and beyond), the IH firm shall be immediately informed by the responsible clinic or medical facility and shall be responsible for determining the cause of the elevated lead level and instituting additional protective and hygiene measures against lead exposure at the jobsite  A written statement of these determinations shall be sent to ConnDOT and the CRISP coordinator, with the monthly compliance report using the CRISP.

6.  Procedures for employee notification.  Within five (5) working days of receipt of the medical surveillance results, the employer shall notify all tested employees in writing of the results of their tests  Also, the employee shall be immediately notified by the employer (within 24 hours of receipt of results) of the blood lead levels that require removal from lead exposure.

7.  Employees' exposures should be assessed in accordance with OSHA Part 1926.62(d) and the current CRISP guidelines for air and wipe sampling  Airborne lead samples shall be analyzed by a laboratory accredited by the American Industrial Hygiene Association (AIHA) for the analysis of lead in air.  Wipe and chip samples may alternatively be analyzed by a laboratory meeting the proficiency requirement of the ELPAT program  The results of all testing shall be reported to the CRISP Coordinator as part of the monthly compliance report.

8.  The CIH shall determine and recommend the implementation of intervention measures based on the airborne lead exposure, wipe sampling, blood lead levels, and the observation of work practices.  The determination and recommendations should not rely solely on airborne exposure levels (See Part 1926.62(h) & (j)).

9.  Procedures for the selection of appropriate respiratory equipment and protective clothing for the particular work task shall be developed in conformance with 29 CFR 1926.62.  The minimum respiratory protective equipment required shall conform to 29 CFR 1926.62 for particular work tasks unless a higher level protection is required by the project IH firm.  If a higher level of protection is recommended, the CIH shall provide written justification of its need.  The CIH will ensure that proper testing, training, cleaning/storage, or replacement and disposal of the utilized articles will be in accordance with 29 CFR 1926.62(f) and (g), especially 29 CFR 1926.62(g)(2) (ii-viii)  The IH firm shall monitor the selection and use of respiratory equipment and protective clothing during on-site surveillance and monitoring inspections.  The IH firm will conduct weekly inspections and the CIH will certify that the respirators are being cleaned properly.  If the cleaning is found be unacceptable by the IH firm or the CIH, the Contractor will correct the situation, and the cost for reinspection by the IH firm or CIH will not be eligible for reimbursement by ConnDOT.

10.  Procedures for conducting employee training on lead hazards in accordance with 29 CFR 1926.62(l). This training will cover a minimum of, but not limited to, those topics specified in 29 CFR 1926.62(1)(2)(i-viii) and the Lead Standard 29 CFR 1926.62. Employees must be given access to 29 CFR 1926.62 and its appendices and all relevant materials.  The procedures shall define the site personnel requiring training, the frequency of training, maintenance and training records, and qualifications required of the instructor performing the training.  In addition, a blood lead level >25 µg/dl will trigger a special retraining session where the IH works with the individual to determine the cause of the elevation and another session where the IH discusses with the individual the result of that determination and the protective measures instituted.

11.  The Contractor shall establish and have available at the work site a written Hazard Communication Procedure in accordance with 29 CFR 1926.59  This written procedure shall describe how warning signs, labels, material safety data sheets, and employee training will be provided.  It must also contain proper work practices for working around hazardous materials. Also contained in this procedure will be a list of hazardous materials generated by a work task, i.e., lead fumes, lead dust, etc  Any training required to meet 1926.59 above that required of 1926.62 shall be provided.

12.  A written Personal Hygiene Procedure shall be available at the work site and must be in accordance with 29 CFR 1926.62(e)(2)(ii)(F), paragraph (h) Housekeeping and paragraph (i) Hygiene Facilities and Practices of 29 CFR 1926.62  Workers will not be allowed to eat, drink, or smoke, or apply cosmetics in areas where there is a potential for lead exposure.  The Contractor shall provide a climate-controlled decontamination facility containing washing and shower facilities with clean hot and cold water, soap, and disposable towels, which the workers will use to wash their hands and face before eating, drinking, or smoking and after each working shift  In addition, portable wash units will be provided as the site dictates for use during breaks for personal hygiene.  The Contractor shall provide a clean area for eating and drinking and a separate clothes-changing area to reduce the chance for lead cross contamination.  After employees change clothes and shower, the work clothing, shoes, and protective equipment shall remain at the jobsite until properly cleaned or disposed of.  The written plan shall also include procedures for cleaning and ensuring cleanliness of these facilities.

On a monthly basis, the CIH shall submit to CRISP and ConnDOT the following:

a) Certification that all requirements of the LHPP and CRISP guidelines and protocols, including occupational air and wipe sampling, training medical surveillance, and elevated blood lead level intervention and reporting, have been followed.

b) A monthly report including:

1. Results of all air and wipe sampling done during the past month reported on the forms or diskette using the format provided by CRISP.
   
   
2. A narrative report describing progress on the jobsite, interpreting the sampling results, and making any recommendations necessary.
   
   
3. Blood lead and Zinc Protoporphyrin levels for all employees listed by name and Social Security number and a listing of exempted workers by name with justification for exemption. Copy furnished to ConnDOT shall not include employee's name or Social Security number.
   
   
4. Reports of the investigations made subsequent to any employees having blood level at or above 25 µg/dl, including determination of cause and plan of action for remedy. Copy furnished to ConnDOT shall not include employee's name or Social Security number.
   
   
5. The daily sign in/out log of people working on the jobsite for the past month.
   
   
6. Submission of required monthly CRISP reporting forms.

Projects lasting less than 1 year will provide a project summary report at the close of lead-related work, and projects lasting more than 1 year will provide and annual report.

1. All occupational air and wipe sampling and other pertinent data gathered.
   
   
2. All blood lead level and Zinc Protoporphyrin data generated for workers and others on the site identified by name and Social Security number and presented in chronological order, in a format showing job title/activity for each worker, and describing activities undertaken to limit exposures when elevated blood lead levels are identified, and the results of those activities.  Copy furnished to ConnDOT shall not include employee’s name or Social Security number.
   
   
3. A listing of all workers who were medically removed by name and Social Security numbers and resulting actions.  Copy furnished to ConnDOT shall not include employee’s name or Social Security number.
   
   
4. Unusual and/or interesting findings on the bridge project that you have discovered/evaluated/identified that would be valuable to your colleagues, CRISP, and/or ConnDOT in the management and control of lead exposure on future bridge projects.
   
   
5. Summarize recommendations and comments that are designed to improve the capabilities of the LHPP to more efficiently and effectively control blood lead levels on ConnDOT bridge work.

Method of Measurement. This work will be measured for payment as follows:

1.  Written LHPP Procedures:  The written LHPP procedures prepared by the CIH will be measured for payment on a lump sum basis and shall include the following:

• LHPP procedures
  
  
• Records of all employees who are participating in the LHPP
  
  
• Procedure for instituting medical surveillance
  
  
• Procedure of employee notification
  
  
• Employee exposure assessment with OSHA 1926.62 and CRISP guidelines
  
  
• Procedures for selection of appropriate respiratory equipment and protective clothing
  
  
• Procedure for conducting employee training (on-site services only)
  
  
• Hazard communication procedures
  
  
• Personal hygiene procedures
  
  
• Monthly certifications
  
  
• Monthly compliance reports
  
  
• Annual reports/summary report
  
  
• All changes, updates, and modifications to LHPP required during project

2.  Employee Training Class:   Employee training classes will be measured for payment by the number of classes given by the CIH, IH and/or supervised technicians  To be considered an employee training class the class must be site specific, held at the project site, and have a minimum of five trainees  The engineer must be notified when a training class is scheduled.  If the engineer is not notified, the class will not be measured for payment.

3.  On-Site Services Performed by IH Firm:  On-site services performed by the CIH, IH and/or supervised technicians to comply with and monitor the LHPP shall be measured for payment by the number of hours worked on-site by title of person providing service  On-site services performed by the CIH, IH and/or supervised technicians for reinspection and recertification will not be measured for payment by the State.

4.  Medical Examinations and Testing by Independent Clinics: Medical examinations and testing by independent clinics required under CRISP protocol and/or other testing as required and approved by the engineer shall be measured for payment by actual cost (receipted bills) plus allowable markup  These examinations and tests shall include:

• Complete medical and occupational exposure history
  
  
• Complete medical examinations
  
  
• Lab Testing
• • Complete blood count
  • Chemistry screen
  • Blood lead level
  • Zinc Protoporphyrin
  • Spirometry
  • Urinalysis including microscopic examination
  • Other medical and/or testing approved by the engineer

5.  Equipment:   The following equipment may be measured for payment on a monthly rental basis if an acceptable rental rate can be agreed upon by the contractor and engineer.  If an acceptable rental rate cannot be agreed upon, the equipment shall be measured for payment by actual cost (receipted bills). Only new equipment will be eligible for reimbursement if rental rate cannot be agreed upon.

• Respiratory equipment, other than blast hoods, with Protection Factor of 10 or greater, excluding air supply hoses and compressor
  
  
• HEPA vacuum system
  
  
• Filtration devices utilized to provide Grade D breathing air, excluding air supply hoses and compressor

Basis of Payment: The sum of money shown on the estimate and in the itemized proposal as “estimated cost” for this work will be considered the bid price even though payment will be made as described below.  The estimated cost figure is not to be altered in any manner by the bidder  Should the bidder alter the amount shown, the altered figures will be disregarded and the original price will be used to determine the total amount for the contract   The basis of payment for this work shall be as follows:

Description:  Under this item, the contractor shall provide for the duration of the work where employees will be exposed to lead a portable handwash facility(ies)  The number of facilities to be provided will be dictated by the site and approved by the engineer  The facility will provide hot and cold clean water, hand soap or similar cleansing agents, and individual hand towels or sections made of cloth or paper, warm air blowers, or clean individual sections of continuous cloth toweling that the workers will use to wash and dry their hands, face, and any exposed skin prior to eating, drinking, smoking or applying cosmetics  The facility shall be located as close to the work site as is physically possible  Ownership of and liability for the facility shall remain with the contractor throughout the duration of the project  The facility shall comply with 29 CFR Part 1926.51.

Materials:  Materials shall be of satisfactory quality for the purpose intended and shall be approved by the engineer.

Requirements:  The portable handwash facility shall be trailer, skid, or cart-mounted and have a minimum of one sink with a fresh water tank and a holding tank  Hand soap or similar cleansing agents and individual hand towels or sections made of cloth or paper, warm air blowers, or clean individual sections of continuous cloth toweling shall be provided  The facility will also be equipped with hot water heater, eye wash station, storage cabinets, lights for night use, an electric or pneumatic water pump, and lead filtration system  Containers for the collection and disposal of refuse generated at the facility shall also be provided.

The facility shall be kept in a sanitary condition and clean as defined in the current CRISP protocol  As a minimum, the facility shall be cleaned after every shift.

Method of Measurement:  The furnishing of the portable handwash facility(ies) that are approved will be measured for payment by the number of calendar months that each facility is in place, operational, and being used by employees who are exposed to lead above the Action Level of 30 µg/m³, or have blood levels above 20 µg/dl or who have been directed by the CIH  A portable handwash facility that is in operation for only a portion of a month will be measured for payment for the entire month.

Basis of Payment:  The furnishing of the portable handwash facility will be paid for at the contract unit price per month for each “Portable Handwash Facility” as specified, which price shall include all material, equipment, labor, sampling, testing, treatment, and disposal of wastewater, cleaning, maintenance, disposal, cost of the CIH for monitoring the cleanliness of the facility, and work incidental thereto.

#603272A - DECONTAMINATION FACILITY

Description:  Under this item, the contractor shall provide for the duration of the work where employees will be exposed to lead a climate-controlled decontamination facility  The decontamination facility shall consist of a “clean” area where workers can remove and store clean street clothing when they arrive on site for work, shower room with hot and cold running water, soap and towels, and a “dirty” area where work clothing and personal protective equipment may be stored  The showers shall be located between the two areas  The facility shall be used by all employees as defined in Item “Lead Health Protection Program” who are exposed to lead above the Action Level of 30 µg/m³ or have blood levels above 20 µg/dl or who are directed by the CIH.  The facility shall have adequate clean storage for all employees who are required to use the facility to store their non-work clothing  The facility shall be located as close to the work site as is physically possible.  If the contractor is unable to locate the decontamination facility close to specific work areas, a designated shuttle vehicle shall be provided  This vehicle shall be classified as contaminated and shall remain at the jobsite in the decontamination zone  This vehicle shall be operated and maintained to eliminate any possibility of cross contamination with the support zone  The vehicle shall be cleaned as defined in the current CRISP protocol. Ownership of and liability for the facility and shuttle vehicle shall remain with the contractor throughout  The facility shall comply with 29 CFR Part 1926.51.

Materials:  Materials shall be of satisfactory quality for the purpose intended and shall be approved by the engineer.  The walls, ceiling, and floors shall be constructed of impervious material to aid in the cleaning of the facility such as, but not limited to, fiberglass and plastic.

Requirements:  The decontamination facility shall have adequate square feet of floor space to accommodate the workforce and a minimum ceiling height of 2.13 meters  Windows shall be of a type that will open and close conveniently, shall be sufficient in number and size to provide adequate light and ventilation, and shall be fitted with locking devices and screens  The entrance shall be secure, screened, and fitted with a lock.

Method of Measurement:  The furnishing of the decontamination facility and shuttle vehicle specified will be measured for payment by the number of calendar months that the facility and shuttle vehicle are in place, operational, and being used by employees who are exposed to lead above the action level of 30 µg/m³, or have blood levels above 20 µg/dl, or who have been directed by the CIH  A decontamination facility and shuttle vehicle that are in operation for only a portion of a month will be measured for payment for the entire month.

Basis of Payment:  The furnishing of the decontamination facility and shuttle vehicle will be paid for at the contract unit price per month for “Decontamination Facility” as specified, which price shall include all material, equipment, labor, cleaning, sampling, testing, treatment, and disposal of wastewater, utilities, maintenance, services, cost of CIH to perform wipe sampling, and work incidental thereto.

The cost of providing external illumination, trash removal, and snow and ice removal shall also be included in the monthly unit price bid for the item “Decontamination Facility” as specified.

CRISP

CRISP OBJECTIVES

The fundamental objective of CRISP (Connecticut Road Industry Surveillance Project) is to limit the toxicity from lead exposure in bridge repair and rehabilitation workers in the State of Connecticut  It performs this function through active surveillance of the cohort of bridge workers on bridge sites at any given moment in the State.

Clinical Protocols

The authority for medical visits and examinations is provided through Connecticut Department of Transportation (CONNDOT) bid contract specifications.  These specifications provide for a Lead Health Protection Program (LHPP) in all circumstances where lead exposure is possible on a construction site.

In general, the workers screened through this program will be painters, blasters, and ironworkers  These general groups do the most direct lead-associated work on the bridge sites.  However, since the potential exposures to lead generated by these activities are so great (10,000 µg/m³ is not uncommon in burning activities), bystander exposures are also very important  For example, a carpenter building forms near an ironworker replacing a bearing may receive substantial “bystander” exposure.

CRISP provides for five basic medical evaluations for workers in this cohort.  The forms include the following:

• Entry/Annual Evaluation
• Medical Evaluation for Respirator Use
• Interval Evaluation
• Comprehensive Evaluation
• Exit Evaluation

The ENTRY/ANNUAL EVALUATION is designed to provide baseline medical information, to identify medical conditions that might be worsened by lead exposure, and to provide for medical certification for respirator wear  It includes a section on occupational and medical history, physical examination findings, laboratory values, and recommendations  For data management purposes, the five medical evaluation forms are used to record this information and enable accurate records to be kept and data management to be undertaken. Demographic data for each worker must be completely and accurately documented. This not only includes name, address, and so forth, but also includes jobsite/work site information and employer data  This is important so that when a worker is identified with a high lead level, access to the site and worker for intervention will be expeditious  The MEDICAL EVALUATION FOR RESPIRATOR USE is completed at the time of the Entry/Annual Evaluation.

The laboratory values required under the CONNDOT specifications include the following:

• CBC
• Chemistry Screen (Chemzyme)
• Urinalysis with microscopic examination
• Blood Lead Level (BLL)
• Zinc Protoporphyrin (ZPP)
• Spirometry

The physical examination is meant to examine and report findings on those organ systems that are known to be subject to harm from elevated lead exposure (i.e., neurologic, GI, etc.).

The INTERVAL EVALUATION is conducted on a variable protocol  For all workers entered into the system (those seen by one of the participating CRISP clinics) monthly BLL and ZPP testing is required for the first 4 months and at month 6.  If, after 6 months of testing, the BLL remains below 25 µg/dl, the worker is switched to a quarterly schedule and BLL and ZPP are drawn every 3 months.  If at any time in the quarterly schedule, the BLL exceeds 25 µg/dl, the worker is switched to a monthly testing interval.

The Interval Evaluation form is designed to record the most recent BLL and ZPP levels and to update the workers' demographic/work site information and symptoms listing  Hence, the form is designed to include those sections of the Entry/Annual Evaluation form relevant to these needs  The only labs drawn at this time are the BLL and ZPP, except, of course, if the physician recommends additional work-up for an abnormal finding.

The COMPREHENSIVE EVALUATION is completed for all workers found to have lead levels in blood greater than 35 µg/dl.  Again, the format of the reporting document closely parallels the Entry/Annual Evaluation form except that the occupational history is more expansive (to include direct and more comprehensive questions regarding work history). More information is gathered regarding the workers' possible alternate and prior lead exposures, and all of the demographic and past medical history information will be updated.  Laboratories replicate those noted above except for spirometry.

These workers continue on a monthly BLL and ZPP testing interval and their lab and examination results initiate an intervention by the IH component of the project  If a lead-toxicity related finding is detected on this or other evaluations, the worker is referred for specialty follow-up to one of the academic occupational medical clinics for specialist evaluation.

The EXIT EVALUATION is completed within 5 days of the completion of a project, or after the employee's last day employed on a project, or if an employee is terminated by his/her employer  Exit Evaluation shall be required only for projects lasting 1 month or longer.  The format of the examination is similar to the Interval Evaluation but does not require information on recommendations for working conditions.  BLL and ZPP tests are performed.

In summary, the CRISP protocol includes the use of five separate documentation and reporting forms:

Finally, CRISP and the CRISP medical examination protocol are not designed nor are they intended to serve as a pre-placement examination system to evaluate workers for fitness to work, except that medical problems that would be worsened by lead exposure are identified and considered  If lead-related toxicity is detected in a worker, the CRISP system (Department of Public Health and Addiction Services and CRISP Project Director) manages the appropriate work site intervention strategy, including an IH investigation  Any worker ill as a result of lead-related toxicity will be referred to an occupational medicine diagnostic clinic for full evaluation and will usually be placed in a medical removal classification 

Changes to the CRISP Protocol for
Administrative/Management Personnel

1. Administrative/management personnel regularly involved in on-site activities (these may include several different sites) three or fewer days per week, who do not enter the restricted access work area on any of the work sites, and who are not anticipated to receive lead exposure may, but are not required to, be enrolled in the standard CRISP  medical protocol.
   
   
2. Rather, individuals meeting the criteria noted above will be required to have blood lead and Zinc Protoporphyrin levels drawn annually to serve as baseline levels and will be asked at that time to complete a questionnaire for individuals potentially involved in lead exposure work.
   
   
3. Administrative/management personnel regularly assigned to the worksite on a day-to-day basis but removed from direct contact with the lead-exposed work area may be removed from the standard CRISP medical protocol and placed on an every 3-month protocol if the following are met:
   
   
   1. The administrative/management personnel work place is located more than 500 yards and generally upwind from active bridge work;
      
      
   2. If active bridge work progresses to 500 yards or nearer to the administrative/ management personnel work place, these workers will be enrolled in the standard CRISP protocol until work progresses to greater than 500 yards away;
      
      
   3. Periodic wipe sampling is routinely conducted on surfaces in the administrative/management personnel work place, and results not meeting CRISP's industrial hygiene criteria are immediately reported to CRISPand appropriate medical evaluations are conducted; and
      
      
   4. On-site workers and others who regularly work inside the lead control area do not enter the administrative/management personnel work place without passing through the on-site decontamination facility.
      
      
4. Administrative/management personnel who elect to be medically managed utilizing the standard CRISP protocol will be allowed to be enrolled in that protocol.
   
   
5. All applicable provisions of the Interim Final Rule for Lead Exposure in Construction  (29 CFR 1926.62) apply in this setting.

CRISP

1. Contract with a CRISP Clinic to follow CRISP Medical Protocol.
   
   
2. • Under CRISP protocol, your employee will be given an Entry/Annual Evaluation before starting on the job.  There will be only one per year.  The evaluation will include a baseline medical evaluation for lead exposure and for respirator wear.
     
     
   • There will be four more Interval Evaluations scheduled, one each month and one at month six.  After month six, if the blood lead level (BLL) remains below 25 µg/dl (micrograms per deciliter of blood) he/she will go to a quarterly schedule (testing every 3 months).
     
     
   • If your employee's BLL equals or exceeds 25 µg/dl, he/she will be kept on a monthly Interval Evaluation schedule until the level drops below 25 µg/dl.
     
     
   • If at any time your employee's BLL exceeds 35 µg/dl, he/she will be given a Comprehensive Evaluation  Under Connecticut Department of Transportation (CONNDOT) Lead Health Protection Program (LHPP), the Comprehensive Evaluation is initiated when the BLL exceeds 35 µg/dl.
     
     
   • When your employee terminates from the job or the job is completed, an Exit Evaluation is given.
     
     
   • $200.00 for Entry/Annual Evaluation
   • $40.00 - $50.00 for the Interval Evaluation
   • $225.00 - $250.00 for the Comprehensive Evaluation
   • $40.00 - $50.00 for the Exit Evaluation
     
   
   If working under a CONNDOT contract that includes the LHPP specifications, the cost of Industrial Hygiene monitoring as well as the medical surveillance is reimbursed according to CONNDOT contract  Each individual construction company, however, is responsible for direct payment to the provider of medical services.
3. Although CRISP does not assign charges for the examinations, it recommends guidelines to each clinic.  These recommendations are approximately:
   
   
4. Because CRISP is a federally funded project for managing blood lead data, each lead exposed worker must sign a consent form at the clinic to allow CRISP to add the medical data to the database.
   
   
5. In case of known lead exposure from a previous worksite, the company responsible for the lead exposure should be responsible to pay the medical costs.
   
   
6. Both you and your employee will be sent blood lead level test results along with medical certification for respirator wear.
   
   
7. If you have any questions, please call CRISP at (203) 566-1454.

CRISP EXAMINATION VISIT TIMELINE
Revised 3/20/95

Biological monitoring under the OSHA Lead Rule is triggered from the time of employment  CRISP has adapted its schedule to conform with the rule  Therefore, once an employee begins a new job, he/she needs a baseline and four subsequent monthly visits, etc  The annual exam is performed to determine medical fitness for respirator use (PE, PFT) and to perform annual bloodwork to evaluate for anemia, kidney disease, etc. (UA & Micro, CBC, SMAC)  The annual exam is performed in addition to an interval screen when 12 or more months have elapsed since the last annual/entry exam.

Some examples follow:

Example 1

A worker starts a job at month 0. There are four monthly interval exams and interval exams at month 6, 9, and 12 as long as BLLs remain less than 20 µg/dl.  At month 12, an annual exam is performed since it has been 12 months since the entry exam.  If the job continues past 1 year, the cycle of biological monitoring will repeat that of the first year (monthly interval exams, interval exams at month 6, 9, and 12 as long as BLL remain less than 20 µg/dl).

First- and second-year monitoring program:

Example 2

A worker starts a job at month 0. There are monthly interval exams and an exit exam at month 6 (as long as BLL's remain less than 20 µg/dl).  There is no other monitoring if the exit BLL is less than 20 µg/dl  At month 7, the worker is hired by another employer.  This triggers four monthly interval exams from month 8 thru 11, an interval at 6 , 9, and 12 from the date of the most recent hire (13, 16, and 18 months from entry into the CRISP system).  At month 13, an annual exam is performed since it has been 12 months since the entry exam.  If the job continues past this point, revert to the first year cycle of screening.

Example 3

A worker starts at month zero  There are two monthly interval exams and then an exit exam when he/she is laid off.  There is no other monitoring if the exit BLL is less than 20 µg/dl  The worker is re-hired twice more at month 6 or 10 for one-month jobs  An entry annual exam is not needed to re-enter at month 6 or 10  Rather, interval exams are performed at these times.  At month 13, the worker starts another job  At this point, an annual (it has been 12 months since the last one) and interval (start of new monitoring schedule) exam are both needed  This new job triggers subsequent interval exams from month 14 thru 17.  An exit is performed at month 18 when the worker is laid off  There is no other monitoring if the exit BLL is less than 20 µg/dl.

Example 4

• Hands:  front and back surface of hands and fingers of both hands on one sample.
  
• Steering Wheel:  entire surface of circular wheel, not to include surface of crosspieces.
• Half-Face Respirator:  entire inside surface, as much as possible.
• Full-Face Respirator:  entire inside surface of respirator, including view plate
• Blast Helmet:  inside surface of view plate.

1. Each IH firm will be assigned a unique letter  Use this letter as the first character in all your sample numbers and use unique numbers for all your samples.
   
   
2. Enter all time values as xx:xxa or xx:xxp, that is, 7:15 am should be entered as 07:15a.
   
   
3. The field data must be entered before the laboratory results.
   
   
4. Flow rates must be entered into the Pump Calibration Form.
   
   
5. Leave the IH Firm field blank - your firm name will automatically be entered when the system prints out forms and reports.
   
   
6. When you have finished entering data onto the Personal Sampling Form's first screen (the “header”), the computer will ask if you want to save the data, type “N” in order to proceed.  At this point any sample numbers not entered in the first data entry cannot be added later.
   
   
7. You cannot use the edit function to add sample numbers to the Personal Sampling Form or the Area Sampling Form, although you can use the edit function in the Laboratory Results Form.
   
   
8. The “PROJECT NAME” field is case sensitive  Use all CAPITAL LETTERS.
   
   
9. A list of the form numbers previously entered in the database are available for the Personal Sampling Form and the Wipe Sample Form  Forms not able to produce listings are the Area Sampling Form, Pump Calibration Form, and the Laboratory Results Form.
   
   
10. The flow rate must be entered on the Pump Calibration Form for the value to be used in calculations.
    
    
11. The Laboratory Results Form has a field for lead test results in micrograms  A field for lead concentration is also provided but may be left blank and will be calculated when a report is generated.
    
    
12. To exit the CRISP program use the left pointing arrow key (<-).
    
    
13. For further information regarding this program, contact either Kathie Hammond, PhD (508-856-5730) or Bob Iden (614-431-9217).

• DOS-based operating system (version 5 or above);
  
• Windows is not required;
  
• 3.5" floppy drive;
  
• Hard drive with a minimum of 4 MB free disk space; and
  
• RAM memory of 2 MB.

1. Insert Disk 1 into drive A (or B).
   
2. Change to the A (or B) directory by typing A: (or B:).
   
3. Type INSTALL <return>
   
4. After Disk 1 is installed, follow the instructions on the screen, which will direct you to insert Disk 2 into drive A and to type INSTL <return>.
   
5. When Disk 2 is installed, follow the instructions on the screen, which will direct you to change your directory to C:1 CRISPDIR, where the program was installed, and then to type CRISP <return> to start the CRISP IH Database System.

General Information: How Do I?

• The system will print data gathering forms (Wipe Sample Form, Pump Calibration Form, Personal Sampling Form, Area Sampling Form, and Laboratory Results Form) and number each with a unique number  This was done so that if the data needs to be revised, you will be able to easily identify where to edit the information. Because of this type of tracking system, DO NOT PHOTOCOPY THESE FORMS but print them as you need them.
  
  
• In order to fit all of the information on the Area Sampling Form and Personal Sampling Form pages, set your printer to condensed type before you print these forms.

CRISP
CONNECTICUT ROAD INDUSTRY SURVEILLANCE PROJECT
150 Washington Street   Hartford, CT 06106    Tel: 203-566-1454

CRISP Industrial Hygiene (IH) Forms

A listing of the Industrial Hygiene Forms required for CRISP and where to locate the forms are explained below.

The following forms are contained on the CRISP IH Computer Data Reporting Program disks (the disks will be available at the time of contract award):

• Wipe Sample Form;
  
• Pump Calibration Form;
  
• Personal Sampling Form;
  
• Area Sampling Form; and
  
• Laboratory Results Form.

Each one of these forms is generated with unique form numbers.  The forms listed above must NOT be photocopied.

Several forms not included on the disks but required for IH monthly reporting are the following:

• Field Notes - Form for Sampling Days (2 pages);
  
• Monthly Field Notes for Equipment at Site, Respirators, Hygiene Facilities, and Protective Work Clothing and Equipment (5 pages);
  
• Report of Investigation of Individual’s Elevated Blood Lead Level; and
  
• LHPP Site Register.

These forms may be photocopied  If new forms are needed they may be obtained from the CRISP IH, Judy Sparer.

Note: Information required by the CRISP IH for inclusion in monthly reports is detailed in the Connecticut Department of Transportation’s Lead Health Protection Program (LHPP).

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