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RISK MANAGEMENT (4)
, The FPE Group I : .3687 Mt. Diablo Blvd., Ste. 200, Lafayette, CK'94549 (415)283-8860 FaX: (415)283-5727 ,: July 27, 1990 .- File No. 905047 Ms. Barbara-Brenner I Hazardous M_aterials Plannin9 Technician Bakersfield [ire Bepartment Hazardous Materials Division 2101 H Street Bakersfield, ¢^ 93301 Oxide Risk Information For San Subject: Requested Ethylene Analysis Joaquin Community Hospital .. Dear Ms. Brenner: The potential for human error during delivery and set up of 12% EtO cylinders that may damage..the system due a lack of space in the sterilizer~ room is medium. The possible exposure to a person in the sterilizer room at the time of the accident is'~to medium, i.e., EtO is expected to mov into the surrounding environment i~ concentrations sufficient to cause serious injury only for exposure over extended periods or when individual personal health conditions create complications. This places the San Joaquin Community Hospital EtO risk in the white area, lower righthand \ ~0~ corner of the EPA Risk Analysis Matrix and indicates no further action or concern. See Figure I attached. There is a low probability of leaks in the lines, regulators, and fittings AMSCO service technician checks these crucial and conducts as an fittings preventive maintenance every other month. In addition, Gas Monitoring, Inc., checks the sterilizer and associated plumbing for leaks with an infrared spectrophotometer. The possibility of building air supply contamination if the vent pipe ruptured before it reached the roof is low in that the supply air is ducted~_ and therefore to enter it would have to find its way into the general air return air supply of the hospital, be ~ntroduced into the mixing plenum ~r ^ .-^,~'~ The 12% ethylene oxide in dichlorodifluromethane is not capable of propagating a 'flame in the vapor state either pure or mixed with any proportion of air at temperatures up to 130°F. Additionally, the fact that dichlorodifluromethane is 2-3/4 times as dense as ethylene oxide migh~ be a serious concern except that a number of tests in spaces up to 2000 ft~ The FPE Group Ms. Barbara Brenner Page 2 July 27, 1990 of dichlorodifluromethane to EtO did not revealed the ratio _ drop below the ratio in the formulation, 'but tended to increase somewhat.1 Enclosed please find the air dispersion modeling for EtO which I did for the original draft of the RMPP; I have corrected for the average wind speed in Bakersfield. Please address all future communicai~ion to Mr. Kenneth Gibb, Vice President of Finance, at San Joaquin Community Hospital as I do not Have any authority or budget to proceed further with this project. Thank you for your hel)~ and assistance with this matter. Si ncerel y , Anne C. Harrington, RN, MPH~_C~XH '~[~ i.;~. Senior Consultant-- ~ I Industrial Hygiene & Environmental Health ~,~ E~pires:6.30.91 ACH/sdk ' ~,x~_~>., ach/905047/1 tr/Ri skanal ysi s Enclosures cc:Kenneth Gibb Billy Martin I m I I I I 1 Haenni, et al, Industrial and Engineering Chemistry,51,685-688 (1959). I I I FIGURE 1 I ~ RISK ANALYSIS MATRIX , .- I HIGH I '" to:HM Release : ..... i ~ Analysis that Identify I ~'-/~'//,,,Z,,,~J of Considerable Concern ~ Combinations of Concern which may Require Planning for I Credible Events (Modified from EPA Technl~al Guidance for Hazards An~lysis) B - 7 ¸II I I 4 I 2 I I SAN JOAQU!N COMMUNITY' HOSPITAL I i Blower and Manifold Assembly 2 Gas Capture Funnel 3 Door,s) Vent Adapter(.s) I 4 Flexible Hose Ducting 5 Exhaust Vent Adapter System 6 Safety Valve ! The FPE Group --- 3687 Mt. Diablo Blvd., Ste. 200, Lafayette, CA 94549 (415) 283-8860 Fax: (415) 283-5727 SAN JOAQUIN COMMUNITY HOSPITAL Ethylene Oxide Risk Management and Prevention Program Job Number 905047 San Joaquin Community Hospital was identified by the Bakersfield Fire Department as a handler of ethylene oxide which is an acutely hazardous material (AHM). The City of Bakersfield's Fire Department determined that SJCH's operations could pose an acutely hazardous materials accident risk, therefore it would be required to submit a Risk Management and Prevention Program (RMPP) pursuant to section 25534 of the Health and Safety Code. The purpose of a RMPP is to establish and maintain a comprehensive management program to assess and prevent, to the greatest degree possible, the'risk of a release of acutely hazardous materials , in a manner which might'cause harm to the safety and health of the community and the environment. San Joaquin Community Hospital is a 162 bed facility and employs approximately 500 employees. The main hospital is 133,289 square feet. The Central Service Department is located in the basement of the main hospital and is 2,160 square feet in area. m A. Storage and Quantities Used mCurrently, SJCH uses Penngas, a 12 percent ethylene oxide (EtO) 88 mpercent dichlorodifluoromethane gas (CFC-12) for sterilization purposes. CFC-12 is used as a dilutent to render the 12/88 mixture non-flammable and non-explosive. The gas mixture is supplied by m Pennsylvania Engineering Company and is shipped in 140 pound 12" by 38" high cylinders as a liquid under 70 psig. San Joaquin Community Hospital Ethylene Oxide RMPP -1- June 27, 1990 . The FPE Group The hospital uses approximately one 140 lb. 12:88 EtO cylinder every three weeks, or approximately 17 cylinders a year. This amounts to approximately 1.4 pounds of EtO used daily and for our purposes discharged daily. Annual use of EtO is calculated to be approximately 500 pounds. mAt any one time there is a maximum of four full cylinders (67.2 pounds of EtO) on hospital property: two behind the sterilizer in the mbasement in Central Supply and two outside the main hospital in a covered, fenced, and locked, storage area approximately 300 feet away. The cylinders are chained to prevent accidental falls and the m valves are recessed to'prevent accidental release during a fall. The two EtO cylinders in the outside storage area should be relocated as mthis area is located directly across from hospital's on-site daycare facility where approximately 15 small children attend and also to mensure storage in an area which does not exceed 100 °F. mOne of the EtO cylinders in Central is "on-line" and connected to the gas sterilizer. About every three weeks Central Supply notifies engineering the tanks need to be changed, an engineer picks up a m r eserve tank form the outside storage area with a dolly, transports it to Central and exchanges the tanks in the area behind the msterilizer unit. m B. Sterilization Process and Emission Releases m The sterilization process involves EtO gas, relative humidity (moisture), proper exposure time, and temperature. The relationship m depends.on sterilizer and materials to be of these four elements the sterilized. After the materials are humidified and gasified, excess mgases and moisture are eliminated by vacuum, exhaust, and purge cycles. SJCH has one AMSCO sterilizer Model No. 2045 which has a 24 mcubic foot capacity and an AMSCO Aerator. The AMSCO sterilizer is mSan Joaquin Community Hospital Ethylene Oxide RMPP -2- June 27, 1990 m The FPE Group six years old and it and the aerator are is serviced every other month by an AMSCO service technician. In addition to this service the hospital has Gas Monitoring, Inc. come out quarterly and check the AMSCO sterilizer and AMSCO Aerator for leaks with Miran IA Spectrophotometer during operation. The hospital currently runs one sterilization load a day for a total cycle period of 4 hours (actual sterilization time is 1.75 hrs.), crack the sterilizer door for 15 mins., load it into the aerator for 12 hours and then prepare it for redistribution. Emissions of EtO occur primarily during the latter part of the 1.75-h°ur sterilization cycle and during transfer of the load to the aerator. ~. Construction workers working in the vicinity of the sterilizer were '~recently monitored for EtO exposures. All results were well below the current Cal/OSHA permissible exposure limit (PEL)_.~_~r0~Part per million (ppm). Central Supply employees past short-term exposure /leve s (STEL).to EtO are in the range of 0.~9 to 0.75 ppm which is ~elllbelow the Cal/OSHA 15 min. STELof 5 ppm. -, C. EtO and General Ventilation The hospital is noW in the process of modifying the exhaust ventilation system which services the sterilizer area. For your reference addended to this report you will find the reduced blueprints of the modifications to the mechanical system servicing Central Supply. Basically, the exhaust will now become a dedicated system for Central Supply and a new canopy hood type .exhaust will be installed to keep the sterilizer, aerator and gas cylinders under negative pressure at all times. A 12" round exhaust duct will be run up through the first three floors will be directly exhausted to the outside through a blower with a 14" square duct outlet through the San Joaquin Community HosPital Ethylene Oxide RMPP -3- June 27, 1990 m The FPE Group third floor roof at least 25 feet away from any outside intake, operable windows or personnel passage. When completed the central supply room will have 13 air changes per hour and the sterilizer room will have 22 ach/hr. (ach/hr) equipment Additionally, an alarm relay system has been installed which alerts personnel in Central to the fact that the sterilizer equipment cannot be operated if the non-recirculating mechanical exhaust system is not operating. D. Accidental Releases mSJCH has an EtO Gastech Alarm with 4 sensors which alarms at levels greater than 5 ppm. SJCH has had no accidents within the last three myears with EtO. However, on 2/26/90, Sensors~#1 & 3 alarmed. The AMSCO technician was called and found no leaks. The Gastech alarm is not specific for EtO or Freon but also reacts to alcohols, perfume, and auto exhaust and that is what apparently happened on this day. m With all the safety features being installed in SCJH~s Central Supply Area accidental releases of EtO will be unlikely. The EtO cylinders mare designed to resist breakage and leakage. The sterilizer and aerator cannot operate if the mechanical exhaust system fails. A m G astech Alarm system with four remote sensors alarms if leaks of EtO are detected and the hospital then notifies the AMSCO Service mRepresentative to find out if in fact there is a leak or not. Employees who may be potentially'exposed to ethylene oxide are m trained at the time of initial assignment and at least annually on the proper .use of the sterilizer, handling techniques and mprecautions, emergency procedures, and the right to medical surveillance. Attached to this report is a copy of San Joaquin mCommunity Hospital's "Ethylene Oxide: Employee Training and mSan Joaquin Community Hospital Ethylene Oxide RMPP -4- June 27, 1990 m The FPE Group Communications Program" which is just a small part of their ongoing HAZARD MATERIAL MANAGEMENT PROGRAM. In fact, even though ethylene oxide is widely used, serious systemic poisonings from EtO are rare in the literature. The Immediately Dangerous to Life and Health (IDLH) level for humans for EtO is 800 ppm. High concentrations of EtO gas are both irritating to the mucous membranes and depressing to the central nervous system. G~_u_~!nea pigs exposed to 51,000. to 64,000 ppm of EtO for 10 minutes died within 24 hours of lung edema. Ethylene oxide is carcinogenic in animal studies and is a suspect human carcinogen. If a rupture of one full cylinder occurred in the sterilizer equipment room after the canopy exhaust hood is installed then, theoretically because the room will be under negative pressure, all [tO would be 'exhausted to the outside with negligible adverse effects to the outside population. ^ concentration of 0.52 ppm would present at a downwind distance of 0.05 miles (or 264 feet). See attached air dispersion modeling. m (.if a cylinder ruptured and the alarm not working which would was % \result in a total release {because the main valve had not been shut m off) and the ventilation system wasn't operating and the EtO was x~confined to Central Supply {volume of area is 21,16Q, ft3}, the m would produce a hazardous condition. Thus immediate evacuation and isolation of the area (most likely the entire basement} would be m ~mperative until the area could be aerated. No one would be able to ehter the area without the use of a self-contained breathing m apparatus {SCBA) and impervious protective clothing (such as polychlorinated ethylene) as EtO is quite irritating to the skin. m This is the worst case scenario from an employee and patient exposure standpoint. ! m san Joaquin Community Hospital Ethylene Oxide RMPP -5- June 27, 1990 m m The FPE Group mSOCH has a standby Survivair SCBA outside the immediate Central Supply Area. In order to assure that this emergency equipment is m used properly during an EtO spill or rupture; personnel on all three shifts will need to be trained to respond to acutely hazardous m materials emergencies by learning how to don protective equipment an operate an SCBA. This first responder hazardous materials training mshould be at least 24 hours and be repeated annually. m E. Catastrophic Releases m in the event of an 8.3 earthquake several different scenarios are possible. We have used an EPI CodeTM software program to evaluate the m atmospheric release of EtO using air dispersion modeling. In the first scenario all four of the cylinders could rupture {2 in the m hospital and 2 outside) and volatilize to the environment. Based on"~ a wind speed condition of 6.4 mph and an instantaneous ground level release of 67 pounds of Et0 over a 150 foot radius area; the peak\! ·· ra' of EtO w uld be 23 ppm at a distance of .01 miles (52.8) concent t~on o feet). I In the second scenario two cylinders rupture in the hospital, the m ventilation system doesn't work and a total of 33.6 pounds of EtO is dispersed directly into the Central Supply Area the EtO concentration m ~o~ be 83 ppm at a distance of .05 miles and 850 at O.~31;!le. mm It is clear from this air dispersion modeling that in the event of an m 8.3 earthquake; ethylene oxide exposure to the hospital patients, the employees and the children attending the daycare would be of some mhealth bUt it is there would be loss of concern very unlikely any life and a very slight increase in the risk of developing cancer in m the future from this one-time high exposure. m ach/905047/rpt i san doaquin Community Hospital Ethylene Oxide RMPP -6- June 27, 1990 ' ' .'."-'"."'""..-': ' ' '- .:" ' ""." ' . . D.O.T. ~$ 1040"' ' ' "".".".".".".".".".".".".".".".".".".".t'"."..'."."."."."."."."."..'.'..'..'."."..'."."..'.t'~ OXIRANE Synonyms ,~ II,INI,II'INI'II~I'I/'I/'I/'I/'I!'II'II'II,II,II,I/'II,I/,II, IN!,II. IN/,I;~ HEALTN : 2 1,2-EPOXYETHANE : ~ FLAMMABILITY: 4 D IMETHYLENE OXIDE ~ ~ : ~ REACTIVITY : 3 ~ H Al Al I,I I'I I,I I'I I,I I,I I,I I, II,! I,I I,! I,II,I I,I I,I I.II. II.I Al I~I I,I I,! I,I I,I I,I (- F'USH "RETURN" KEY TO CONTINUE SUBSTANCE I.D. : ETHYLENE OXIDE CAS Number: [~.-.zl-8] Molecular Weight : 44.o5 oram/mole TWA : 1.O'ppm TWA : 1.8 mg/m'""3 IDL.H : 800 ppm D. O. T. AREA, CONTINUOUS : 5.6E-01 poUnd/rain DEPOSITION VELOCITY: 0. 100 em/second NE IGHT-EFFECT IVE : 50 Feet ~RA.D-I-US--OF--SOORCE : 'I~0~~~ STABILITY CLA~.S : WORST CASE (A - F TERRAIN : STANDARD DOWNWIND LOCATION OF MAXIMUM CONCENTRATION Distance : < 0.06 Mi L. evel : > 9.4E--01 mg/m'""3 5.2E-01 PPM ETHtLENE OXIDE CAS Number: E7~-~1--~] ~'HA : 1.O ppirm TWA : 1.8 ~g/lii'""3 EPIcode 4. LO IDLH : 800 ppm (1990:L. IBRARY) DOWNW I ND CONCENTRAT I ON ARR I V'"~.L. -I "ll ¥1c.~''' St ab Di mtan~e-Mi mg/ m'""3 ppm hours: mi nutes Cl. SJCH - Page 1 O. 06~ 0.~0 0.1~ 0.0~2 1.00 0. 10 O. C>== 2~00 0.043 0 )z4. : 6 F 4.00 0. o ~ 9 0. o ~ o 8.00 0.00~0 0. 0050 : 25 F OU7._ O. 0040 : 51 F 20.0 0.0039 0.0022 1: 1 F PUSH ANY KEY TO CONTINUE ETHYLENE OXIDE CAS Number: [75-21-8] TWA': 1.0 ppm TWA : 1.8 mg/m"3 EPIcode 4.0 IDLH : 800 ppm (1990:LIERAR~ DOWNWIND CONCENTRATION ARRIVAL TIME Stabi 1 i ty X-Mi Y-Mi mg / m"'3 ppm hour s: mi nut es C1 ass DDDDDD DDDDDD DDDDDDD DDDDDDDD DDDDDDDDDDDDD _DDDDDDDD 0.01 0. 000 6.7E-04 3.7E--04 : 0 A 0.01 0.000 1. IE-IO 5.9E-11 : 0 A Enter X-Mi Y-Mi and Push "RETURN .... RE]'URN" w/o data t.o I G'D 1. OE-O 1 '~' ....... '~"~74~'~'~' !. ()E-03 G'3::~3~3337:333:33333~3~33333333~3~:3:3~3:333:33:33:3333:3:3:];33:33:::~: D6, SJCH - Page 2 ,~.'- .~,,,t,~: '~,~.~ :~,.'-~ ' ~" ': .'. ,' .... "- '.. :,': ' .~ ~' ' DOWNWIND DISTANCE - ~il ~ ' .x., . ,., ,,. ~..4' ' ETHYLENE' O~IDE'" L~tmbility: WORST CASE (A - F) R 450 GD 3 .3 D6 0 400 GD D6 ~ Z50 GD D~ · S Z00 GD D6 ' .W : I 200 N 150 G~ ~E. O 100 G 33 ~ 333.33 ~ 3 .~ ~ 6 Feet 0.0 ' I -150 GD D6 S -200 GD D6 T -250 GDDD DDD6 A -500 GD D6 N -350 GD D6 C -400 GD D6 E -450 GD , J J D~ . I .3 .6 I 3 6 10 30 60 100 IDLH: 8.0E+0~ ppm DOWNWIND DISTANCE - Miles · -~'~ 3 : Grea~er ~han 0. 1 TWA ~ : Grea~er than ]'WA I : Greater {han IDLH : SDBS~A~C~. I.D. : ~B~ OXID~ : : C~S ~be~: [75-~1-8] ~olec~l~ Wei~b~ : ~.05 ~/~ole : : IDb~ : 800 DD~ (1990:BIB~) : : D.O. L~~~MM~MM~~MMM~~ : Release Duration: ~3.0E+01 Mi~ : : SURFACE WIND SPEED : 6.4 Mil~hour : I~~~~~; : DEPOSITION VELOCITY: 0.I00 cm/second : : HEALTH : 2 : : HEIGHT-EFFECTIVE : 0 Feet : : : : : TERR~IR : ST~RD~D : : ~TIVITY : 3 : : : I : ~GEPTOR HEIGHT : 0 Fee~ : H~~~~~~~< DO~R~I~D hOG~TIOR OF ~I~H GORGE~T~TIO~ ' : D~s~ance : < 0.0~ ~ : : Bevel : > 1.~E+O1 mg/m~3 O.~E+O0 PP~ : I TWA": ~.''" '1 fl' ~nm ' TWA' : '.. '." ] 8. m~/m 3 ::~,' .EPIcode .~.:4~0~:~..: ...... ~.~:'. -IDLH : 800 ppm " · " ........ :' ':"?' [':. ":' (1990:LIBBY) '.~' ~WNWII~I'~ , · ' ' ' ' . ARRIVAL ,TI~ ,..,.-. Stabil'~ty..~:: Diitan ce-Mi mg/m~ 3 CONCENT~T ION ~" ' ~.,.. p~m. : "~'"". ~::~ ''~ -hours :' minutes ::. DDDDDDDDDDD ' - DDDDDDDDD ' , DDDDDDDDDD .-].~ DDDDDDDDDDDDD '.. ~.',-' :~' DDDDDDDD.~¢f '0 05 19 '" 11':". ' ' ,-' ' ' :'"0' '" ::"]::'~:~':"":?;?F 0.,10 11 .6.2 ' " : 1 ' '"":~;" F "' 0.20 5.9 3.2 : 2 F ' 0.30 3.8 2.~ : 3 F 0.50 2.2 1.2 : 5 F 0.60 1.8 1.0 : 6 F 0.70 ~.5 0.82 : 7 F 0.80 1.3 ~ 0.70 : 8 F 0.90 1.1 0.61 : 8 F 1.00 1.0 0.54 : 9 F 2.00 0.43 O. 24 : 19 F 4.00 0.20 0.11 :38 F 6.00 0.13 0.074 : 56 F 8.00 0.10 0.056 1:15 F 10.0 0.082 0,045 1:34 F 20.0 0.045 0.025 3: 8 F PUSH A~ ~Y TO CONTINUE ET~BERE OXIDE C~S ~umber: [75-21-8] T~ : 1.0 ppm T~A : 1.g mg/m~3 EPIcode 4.0 IDLH : 800 ppm ( 1990 LIBRARY) DOWNWIND CONCENT~TION ARRIVAL T I~ Stability X-Mi Y-Mi mg/m~ 3 ppm hours: minutes Class DDDDDD DDDDDD DDDDDDD DDDDDDDD DDDDDDDDDDDDD ._DDDDDDDD 0.01 0.000 42 23 : 0 F 0.02 0.000 32 18 : 0 F 0.03 0.000 26 15 : 0 F 0.04 0.000 22 12 : 0 F Enter X-Mi Y-Mi and Push "RETURN". "RETURN" w/o data to QUIT IMMMMMMMMMMQMM ETHYLENE OXIDE Stability: WORST CASE (A - F) M; :2 :2222222 :22222222222 I G2222222222222222 D6 :22222222222222223333 :222222222222222233333333 :22222222222222223333333333333 1.OE-O1 G2~22z2~22~2z2z~2._33333333333333333 D6 :22222222222222223333333333333333333333 PPH :222222222222222233333333333._303333333333.:,33..~ :2222222222222222333333333333333333333333333333333 1.0E-02 G222222222222~2~33333333.33.~3333333._oo.J.:,3333333.~333333.. .. :22222222222222223333333333333333333333333333333333333333333 SJCH - Page 4 -- : 2222: ~. 0E-03' G2222"-:'< 0.06': Hi :,~.:~:~:;?l:?-¢::.?~:fj:': t333333333333333333333333333333'3333336:1} :2222 :> 9.1E+00.PPM"':'::::::'333333333333333333333333333333333333: :2222 H~~< 333333333333333333333333333333333333: : 222222g222222222gggg3gg3gg333333333333333333333ggg3333933gg3: Bess ~han T~ 2 : ~roa~er ~han T~ 1 : ~rea~er ghan IDh~ I MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM; PLUME WIDTH RESOLUTION : GDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD6 : ENTER SELECTION NUMBER : : : : 1: AUTO SCALE : : 2:0 TO 500 feet : : 3: 0 TO 1000 feet : : 4: 0 TO 5000 feet : : 5: 0 TO 5 miles : : 6: 0 TO 10 miles : : 7: 0 TO 20 miles : : : Q: QUIT : HMMMMMMMMM~MMMMMMMMMMMMMM~MMMMMMMM~< ETHYLENE OXIDE Stability: WORST CASE (A - F) C 2000 IMMMMMMMMMMQMMMMQMMMMQMMMMMMMMMQMMMMMQMM~MQMFLMMMMMMMQMMMMQMMMM; GD 3 3 D6 R 1800 O 1600 GD D6 S 1400 GD D6 S 1200 GD D6 W 1000 GDDD DDD6 I 800 GD D6 N 600 GD 33333333 D6 D 400 G3333333333333333333333333333333 D6 200 G22222222222233333333333333333333 [)6 Feet 0.0 G22222222222222233333333333333333 6 -200 G2Z2Z~2Z22Z~Z33333333333333333333 D6 D -400 G3333333333333333333333333333333 D6 I -600 GD 33333333 D6 S -800 GD D6 T -1000 GDDD DDD6 A -1200 GD D6 D6 N -1400 GD C -1600 GD D6 E -1800 GD 3 3 D6 -2000 HMMMMMMMMMMOMMMMOMMMMOMMMMMMMMMOMMMMMOMMMOMMMMMMMMMOMMMMOMMMM< .]. .3 .6 1 3 6 10 30 60 100 SOCH - Page 5 : Greater 'than' 0~. 1'~ TWA-'/2 :~-Greater 'than'~ TWA~,?~?'~]i-'~':! ii~,: ~Greater than IDLH SUBSTANCE I, D ~' : ~ ETHYLENE OXIDE' ' '-'~' >.~' . ,~,'? ' '~ i~i'~'' ".,. , · ' ~" · : - ' Molecular Weight~ :' 44.05 gram/mole · CAS Number: [75-21-8] TWA : 1,0 ppm 'TWA : 1.8 mg/m^3 : : IDLH : .800 ppm " (1990:LIBRARY) : D.O.T. ~ 1040 : AREA, TERM : 3.4E+O1 pounds : Release Duration : 3.0E+01 Min : SURFACE WIND SPEED : 6.4 Miles/hour : I~; DEPOSITION VELOCITY: '0.100 cm/second : : HEALTH : 2 : ~ HEIGHT-EFFECTIVE : 0Feet : : : P~D1J3S-OF~_~DI3RCE~~5~-~OE:~OO~-F~.~ : : FLAMMABILITY: 4 ~ :. STABILITY CLASS : WORST CASE (A - F) : : : TERRAIN : STANDARD : : REACTIVITY : 3 : : H < RECEPTOR HEIGHT' : 0 Feet : < DOWNWIND LOCATION OF MAXIMUM CONCENTRATION ~ ; Distance : < 0.06 Mi : Level : > 1.0E+02 mg/m^3 5.8E+01 PPM : HMMM~~~~< PUSH "RETURN" TO CONTINUE ETHYLENE OXIDE CAS Number: [75-21-8] TWA : 1.0 ppm TWA : 1.8 mg/m^3 EPIcode 4.0 IDLH : 800 ppm (1990:LIBRARY) DOWNWIND CONCENTRATION ARRIVAL TIME Stability Distance-Mi mg/m^3 ppm hours:minutes Class DDDDDDDDDDD DDDDDDDDD DDDDDDDDDD DDDDDDDDDDDDD _DDDDDDDD 0.05 150 83 : 0 F 0,10 46 25 : 1 F 0,20 13 7.4 : 2 F 0.30 6.4 3.5 : 3 F ' 040 3,8' 2.1 :4 F 0 5O 2.6 0 60 1.9 1.0 : 6 F 0 70 1,5 0.80 : 7 F 0 80 1.2 0.64 : 8 F 0 90 1.0 0.53 : 8 F 1 00 0.80 0.45 : 9 F 2 00 0.28 0.16 :19 F 4 O0 0.11 0.064 :38 F 6 00 0.073 0.040 :56 F 8 00 0.054 0.030 1:15 F 10.0 0.043 0.024 1:34 F 20.0 0.023 0.013 3: 8 F PUSH ANY KEY TO CONTINUE ETHYLENE OXIDE CAS Number: [75~21-8] TWA : 1.0 ppm TWA : 1.8 mg/m^3 EPIcode 4.0 IDLH : 800 ppm (1990:L~BRARY) DOWNWIND CONCENTRATION ARRIVAL TIME Stability X-Mi Y-Mi mg/m^3 ppm hours:minutes' Class SJCH - Page 6 DD DDDD ..':';i iCC :.~"C';i::i,/' :' ' [ DDDDDDDDDDDD 'i~, _DDDDDDDD ' ' .... "'"' ' '":':"~'.. '~"~'" ~:"":" ...... "'"' .... "'"'":" "': 8,50 : .... "': ?:'::'('-: 0 ' ':?::"" "'"" 0.01 0.000 '. -' . :.. 1500 F 0.02 0.000 · 620 340' : 0 F 0.03. 0.000 340 190 : 0 F 0.04 0 000 220 120 : 0 F 0.05 0.000 150 83 : 0 F Enter X-Mi Y-Mi. and Push "RETURN". "RETURN" w/o data t.o QUIT IF~QMM ETHYLENE OXIDE Stability: WORST CASE (A - F) M; 100 GD D6 : : :22 10 G22222 D6 : 2222222 : 22222222222 : 2222222222222 1 G22222222222222223 D6 : 2222222222222222333 PPM : 2222222222222222333333 : 22222222222222223333333333 1. OE-01 G222222222222222233333333333333 D6 : 222222222222222233333333333333333 : 2222 IMMaMMMM~MMMMMMMM; 33333333333333 :2222 : MAXIMUM : 3333333333333333333 lo0E-02 G2222 :< 0.06 Mi : 3333333333333333333333333 D6 :2222 :> 5.8E+01 PPM : 33333333333333.333333333333333 : 2222 HMMMMMMMMMFAMMMMaMM< 3333333333333333333333333333333333 : 222222222222222233333333333333333333333333333333333333333333 1.0E-03 HMMMMMMMMMMOMMMMOMMMMOMMMMMMMMMOMMMMMOMMMOMMMMMMMMMOMMMMOMMMM < .1 .3 .6 1 3 , 6 10 30 60 100 DOWNWIND DISTANCE - Miles 3 : Less than TWA 2 : Greater than TWA 1 : Greater than IDLH ETHYLENE OXIDE Stability: WORST CASE (A - F) C 2000 I MMMMMMMMMMQMMMMQMMMMQ~MMMMMMMMQMMMMMQMMMQMMMMMMMMMQMMMM©MMMM R 1800 GD 3 3 D6 O 1600 GD D6 S 1400 GD D6 S 1200 GD D6 W 1000 GDDD DDD6 I 800 GD 1)6 N 600 GD D6 D 400 GD D6 200 G3333333333333333333333333333 · : ])6 Feet, 0.0 G2222222222222223333333333333 -200 G3333333333333333333333333333 D6 SJCH - Page 7 D6 JJ ' I . 'i: ..,-600'' GD '. '' ' D6 mi S , . .'~800.' GD' . ' ' . D6 '" T ::",/'."~1000 GDDD '' '~ DDD6 ~ A ' -1200 GD , - D6 ', 1~ ~ -1400 GD : D6 C -1600 GD D6 ~,~ ...... E -1800 GD 3 3 D6 .1 .3 .6 1 3 6 l0 30 60 100 [D~: 8.0E+02 ppm DOWNWIND DISTANCE - Niles 3' : Greater than 0.1 TWA 2 : Greater than TWA 1 : Greater than ID~ I ! I SJCH - Page 8 POLICY M~u~ N~r ~~ NAZARD ~%TERIAL MANAGEMENT ~e~veDa~ S~ject SAN.IOAOUlN ETHYLENE OXIDE: ClOW/~/UJV/T~ EMPLOYEE TRAINING AND COMMUNICATION PROGRAM PHRPOSE: The Ethylene Oxide Program has been developed to ensure the health and safety of employees Who are potentially exposed to Ethylene Oxide. This program covers all aspects of dealing with Ethylene Oxide: Proper usage, handling techniques and precautions, medical surveillance, and communication signs and labels. I. INFORMATION AND TRAINING Upon an offer of employment and before beginning his/her first day of work in Central Service, each employee will be informed of the fact that Central Service uses Ethylene Oxide as a means of sterilization and each employee may be potentially exposed. At the time of ±nitial assignment and at least annually thereafter each employee shall be provided with information and training on Ethylene Oxide. This training will include the proper use of the ster±lizer, handling techniques and precautions, emergency procedures, and the right to medical surveillance. II. EMPLOYEE MONITORING San Joaquin Community Hospital shall employ an ongoing exposure monitoring program. If the monitoring reveals employee exposure, at or above the action level, but at or below the 8 hour T.W.A., the employer shall repeat such monitoring for each such employee at least every six months. Monitoring results shall be kept in a file in the C.S. Office, and shall be accessible to affected employees. 8~0-601 I POLICY I Numar M~ud ~~ HAZARD MATERIAL MANAGEMENT ~f~c Da2 R. 0 ~dew Da~ s~jec~ ~q~Ol/l~ ETHYLENE OXIDE: i ' EMPLOYEE TRAINING AND 4~uNrrF' COMMUNICATION PROGR/~ ~FF~ mse of 2 3 I I III. EMERGENCY SPILL OR LEAl In the event of a spill or leak, the following procedures I are provided as a guide to proper handl±ng of an emergency: A. Turn the master switch on gas autoclave to off. I B. Evacuate all personnel. ¢. Notify the Maintenance Department. The maintenance i Department will notify the Fire Department. D. Notify the following personnel: C.S. Manager, i Security/Safety director, and Assistant Administrator. A respirator is located on the east wall behind the entrance to C.S. clean area. A Material Safety Data Sheet on Ethylene Oxide is located in the MSDS Manual in the C.S. Office, and is accessible to each employee. There is a Gas Alarm System located on the south wall in the clean area. I IV. MEDICAL SURVEILLANCE I Community Hospital will employ a Medical San Joaquin Surveillance program for all employees who are or may be exposed to Ethylene Oxide at or above the action level for I at least 30 days per year. Medical exams and consultations are available to each employee prior to assignment and at least annually and at termination of employment or re- I assignment to an area where exposure to Ethylene Oxide is not at.or above the action level for at least 30 days per year. I V. SIGNS AND LABELS I Legible signs communicating ethylene oxide hazards to employees are posted in the following places: I POLICY Number M~nud HAZARD MATERIAL MANAGEMENT 18.0 ~~ Effective Dat~ Re~cw Da~ 8 / 1 / 8 8 ~~~JN ETH3~LENE OXIDE: ~/~N/~y EMPLOYEE TRAINING AND COMMUNICATION PROGRAM 3 3 A. In the C.S. clean area directly in front of the sterilizers. B. On the door entrance way to the area behind the sterilizers. C. On the door entrance to the Maintenance boiler room. PREVENTIVE MAINTENANCE San Joaquin Community Hospital has a preventive maintenance contract with the Amsco Company. Routine inspection of the Gas Sterilizer is conducted bi-monthly. /" c~o~v~,. .~/~ '" co~z~c/IZ-- ~~ ' To ~I~" .~IC~ ~. [ ~0~ ~/ ~HHO~ ~ E~- 7~1- 208 -08. ~7 C~ EX~LOS/OH-P~OOFJ~NCTiOH INLET ~ O~TLST ~~lH. _~ ~ SE~ OF~ T~ A V - A CIO V~N~ ' ' ',',,, ' MIN. VE~IFY L HHGTH TO IN~U~ C~ EA~AMCE ~.~~~,~' A gD/m/O~ 4 INFDRMA T/OH'. ' - · .. ~. P~OV/DE 4~ ?HICK CONTINUOUS CONC~ET~ ... :,. - .~/ ~5 ~ /~" ~ C, ~A. WA ~