August 28, 2017
OSHA Docket Office
U.S. Department of Labor, Room N-2625
200 Constitution Avenue, N.W.
Washington, DC 20210
Docket No. OSHA–H005C–2006–0870
To Whom It May Concern:
The American College of Occupational and Environmental Medicine (ACOEM) would like to thank the Occupational Safety and Health Administration (OSHA) for the opportunity to comment on the proposed rule — Occupational Exposure to Beryllium. ACOEM has previously commented on earlier versions of this proposed rule in a letter dated November 14, 2015, and those comments continue to be relevant to the current proposal.
ACOEM vigorously encourages OSHA to retain the medical surveillance, medical removal, and other ancillary standards for both construction and shipyard workers whenever airborne or dermal exposure to beryllium is a significant possibility, as defined in the OSHA standard for other industries. The experience of the Department of Energy facilities has clearly demonstrated that individuals in the building trades can be affected by beryllium. Multiple studies have demonstrated risk for workers who are considered dust disturbers, including those involved in demolition. Research has also shown that the risk applies to individuals across the full range of beryllium forms, including beryllium oxides, alloys, and salts, as fumes and as dust. It makes no sense to diminish the protections for certain employment sectors against beryllium disease.
OSHA Question 2: In particular, what is the incremental benefit if OSHA keeps the medical surveillance requirements for construction and shipyards described in the January 9, 2017 final rule, but revokes the other ancillary provisions?
OSHA has acknowledged that workers in the construction and shipbuilding industries are at risk even under the lower PEL in this proposed standard. Chronic beryllium disease (CBD) is an immunologically mediated condition for which medical testing is available to detect early signs. The proposed lower PEL is insufficient protection by itself. Thus, while the OSHA is correct in stating that the new PEL will reduce the burden of disease, it is also correct in stating that it does not eliminate the disease risk. The ancillary provision for medical surveillance for exposed workers has been proven to be a ‘safety net’ for detecting beryllium sensitization and CBD at early stages of illness. Exposed workers deserve the opportunity to know, based on medical assessment, when they are at increased personal risk of CBD or have early signs of disease. Without medical surveillance, at-risk workers may continue to be exposed and unknowingly increase their likelihood of serious, even fatal, disease. Additionally, by conducting medical surveillance, it becomes possible for companies, industries, and OSHA to assess the effectiveness of the construction and shipbuilding protections. This will be especially important if OSHA should decide to exempt these industries from the full set of ancillary provisions.
ACOEM further suggests that, to minimize harm to exposed workers, the trigger for medical surveillance should be the action level (AL) and not the PEL. Both sensitization to beryllium and CBD have been demonstrated at or below this lower level of exposure, and the use of the AL as a trigger for medical surveillance would be consistent with most other OSHA standards.
The medical removal protections provided to workers in general industry under the proposed rule should be extended to the construction and shipbuilding sectors. Medical removal protection provides an avenue for individuals with a beryllium-related condition to transition to jobs that eliminate or mitigate their risk of disease. The burden to the employer is time-limited, and the benefit to the affected worker is substantial.
OSHA Question 1: OSHA has proposed revoking the ancillary provisions for the construction and shipyard sectors while retaining the new (lower) PEL of 0.2 mg/m3 and STEL of 2.0 mg/m3 for those sectors. Does this provide adequate protection to the workers in construction and shipyard sectors considering the other standards that apply? Should OSHA keep any or all of the ancillary provisions of the January 9, 2017 final rule for construction and shipyards? If so, which ones?
ACOEM has addressed above the insufficiency of the PEL/STEL alone in protecting workers in this case. ACOEM submits that the unusual nature of the beryllium hazard that justifies the application of the ancillary standards in general industry applies by the same logic to construction and shipbuilding. These standards include exposure monitoring, regulated areas (and competent person in construction), a written exposure control plan, protective equipment and work clothing, hygiene areas and practices, housekeeping, and worker training. Given the extremely low levels at which beryllium can cause sensitization, extra measures to contain and minimize the hazard are warranted. For example, it would be incorrect that the application of the OSHA ventilation standard offers sufficient protection from beryllium, given that respirators offer only a protection factor and are rarely used 100% by workers. Beryllium has been shown to cause sensitization and disease even in workers assigned to use respiratory protection. An integrated package of protections, as provided by the ancillary standards, offers the best option to minimize exposure consistent with the unique beryllium hazard.
Thank you for your consideration of our comments. Please do not hesitate to contact me or Patrick O’Connor, ACOEM’s Director of Government Affairs, at 703/351-6222, should you have any questions.
Charles M. Yarborough III, MD, MPH, FACOEM