P09_Combined Attached Forms.pdf

ATTACHMENT A ABOVE-THE-CEILING WORK PERMIT

Building:___________ Floor: ______ Room #: ______ Fire / Smoke Barrier: YES NO

Work Coordinator/Supervisor: Name: _____

Phone # or Extension: _____

Purpose of Work: ____________________________________

Date(s) Planned for Proposed Work: _____

Date Permit Submitted: _____

Project COR (if applicable): Name: _____

To be completed by the Work Coordinator / Responsible person prior to work beginning or a permit being issued.

Yes No

1. Did the responsible person obtain prints from FMS detailing hourly rated walls and identify the scope of work?

2. Will the proposed work open or penetrate an existing building structural element, such as a wall or floor, which is smoke-tight or fire-rated?

If YES, continue to #3.

If NO, complete bottom section, numbers 3 through 6 (no approval required)

3. Has the responsible person prepared an itemized schedule of fire/smoke walls to be penetrated?

4. Will the opening(s) or penetration(s) created by the proposed work be sealed using an available and approved UL fire stop system?

MATERIALS UTILIZED IN REPAIR

Attach installation detail sketch

Fire Stopping: _______________________________________________________________

Wall Board: _________________________________________________________________

Other: _____________________________________________________________________ Must provide documentation proving fire stopping is compatible with other fire stopping in area.

Approved by: Date: _____ NOTE: - Contact the POC when work is complete for inspection of area to ensure compliance

To be completed by the COR or designated staff Yes No

1. The proposed work area has been inspected and the proposed plan is approved.

2. A copy of the approved permit has been provided to the work coordinator/supervisor.

3. Work is complete: Every opening, penetration and joint is properly sealed to prevent the escape of fire and smoke.

4. Work is complete and

5. All work has been completed in accordance with industry practice and applicable building fire code requirements.

6. All j-boxes in the area are closed.

Closed by: Date:

to

Comments:

Complete Date and Time:

Location of Work:

HOT WORK PERMIT

THIS PERMIT IS REQUIRED FOR ANY TEMPORARY OPERATION INVOLVING OPEN FLAMES, HEAT, OR

SPARKS; SUCH AS" BRAZING, CUTTING, GRINDING OR WELDING (ANY TORCH USE).

INFORMATION

Safety personnel signing this permit must have valid 30 hour OSHA card and has verified, by his/her signature that all requirements located have been verified and completed.

REQUIRED PRECAUTIONS CHECKLIST

Available sprinklers, hose streams and

COR Final Check Name and Signature: Date:

Complete Date and Time:

Supervisor Name:

Supervisor's Signature:

Hot Work Technician VA Employee/Contractor Name:

Type of Hot Work to be Performed:

Start Date and Time:

Complete Date and Time:

HOT WORK PERMIT

THIS PERMIT IS REQUIRED FOR ANY TEMPORARY OPERATION INVOLVING OPEN FLAMES, HEAT, OR

SPARKS; SUCH AS" BRAZING, CUTTING, GRINDING OR WELDING (ANY TORCH USE).

INFORMATION REQUIRED PRECAUTIONS CHECKLIST

Available sprinklers, hose streams and extinguishers extinguishers are in service/operable? Safety personnel signing this permit must have valid 30 hour OSHA card and has verified, by his/her signature that all requirements located are in service/operable?

Hot work equipment inspected and in good repair?

Requirements within 35 ft. of work

Combustable floors wet down, covered with damp have been verified and completed.

Hot work equipment inspected and in good repair?

Hot Work Technician VA Employee/Contractor Name:

Requirements within 35 ft. of work

Combustable floors wet down, covered with damp sand or fire resistive sheets

Remove other combustables or cover with fire sand or fire resistive sheets

Remove other combustables or cover with fire blankets or curtains blankets or curtains

Wall and floor openings covered

Protect or shut down ducts that may carry sparks to Protect or shut down ducts that may carry sparks to

Location of Work: Wall and floor openings covered Work on walls, ceilings, or roofs combustable areas combustable areas

Type of Hot Work to be Performed: Work on walls, ceilings, or roofs

Construction is non-combustable Construction is non-combustable Combustables have been moved away

Work in enclosed equipment Enclosed permit quipment cleaned of all

Supervisor Name:

Supervisor's Signature:

Combustables have been moved away

Work in enclosed equipment Enclosed permit quipment cleaned of all combustables Containers purged of flammable liquids or vapors Start Date and Time: Containers purged of flammable liquids or vapors combustables Pressurized vessels/piping: isolated or vented Pressurized vessels/piping: isolated or vented Fire watch/monitoring of hot work area Complete Date and Time: Fire watch/monitoring of hot work area Fire watch shall be providedf 30 minutes after work Fire watch shall be providedf 30 minutes after work Fire watch shall be provided with extinguisher(s)

Fire watch is trained in the use of extinguishers and

Complete Date and Time: Fire watch shall be provided with extinguisher(s)

Fire watch is trained in the use of extinguishers and sounding alarm Fire watch may be required in adjoining areas to sounding alarm Complete Date and Time: Fire watch may be required in adjoining areas to Monitor hot work area for three hours after job is work work

Monitor hot work area for three hours after job is Safety Final Check and Approval Name and Signature: Date:

complete complete

Comments:

COR Final Check Name and Signature: Date:

Safety Final Check and Approval Name and Signature: Date:

Steps 1-3 Adapted with permission V Kennedy, B Barnard, St Luke Episcopal Hospital, Houston TX; C Fine CA Steps 4-14 Adapted with permission Fairview University Medical Center Minneapolis MN Forms modified /updated; provided courtesy of Judene Bartley, ECSI Inc. Beverly Hills MI 2002. Jbartley@ameritech.net Updated, 2009.

Infection Control Risk Assessment Matrix of Precautions for Construction & Renovation

Step One:

Using the following table, identify the Type of Construction Project Activity (Type A-D)

TYPE A

Inspection and Non-Invasive Activities.

Includes, but is not limited to:

• removal of ceiling tiles for visual inspection only, e.g., limited to 1 tile per 50 square feet

• painting (but not sanding)

• wallcovering, electrical trim work, minor plumbing, and activities which do not generate dust or require cutting of walls or access to ceilings other than for visual inspection.

TYPE B

Small scale, short duration activities which create minimal dust Includes, but is not limited to:

• installation of telephone and computer cabling

• access to chase spaces

• cutting of walls or ceiling where dust migration can be controlled.

TYPE C

Work that generates a moderate to high level of dust or requires demolition or removal of any fixed building components or assemblies Includes, but is not limited to:

• sanding of walls for painting or wall covering

• removal of floorcoverings, ceiling tiles and casework

• new wall construction

• minor duct work or electrical work above ceilings

• major cabling activities

• any activity which cannot be completed within a single workshift.

TYPE D

Major demolition and construction projects Includes, but is not limited to:

• activities which require consecutive work shifts

• requires heavy demolition or removal of a complete cabling system

• new construction.

Step 1:

mailto:Jbartley@ameritech.net

Steps 1-3 Adapted with permission V Kennedy, B Barnard, St Luke Episcopal Hospital, Houston TX; C Fine CA Steps 4-14 Adapted with permission Fairview University Medical Center Minneapolis MN Forms modified /updated; provided courtesy of Judene Bartley, ECSI Inc. Beverly Hills MI 2002. Jbartley@ameritech.net Updated, 2009.

Step Two:

Using the following table, identify the Patient Risk Groups that will be affected.

If more than one risk group will be affected, select the higher risk group:

Low Risk Medium Risk High Risk Highest Risk

• Office areas

• Cardiology

• Echocardiography

• Endoscopy

• Nuclear Medicine

• Physical Therapy

• Radiology/MRI

• Respiratory

Therapy

• CCU

• Emergency Room

• Labor & Delivery

• Laboratories

(specimen)

• Medical Units

• Newborn Nursery

• Outpatient Surgery

• Pediatrics

• Pharmacy

• Post Anesthesia Care

Unit

• Surgical Units

• Any area caring for immunocompromised patients

• Burn Unit

• Cardiac Cath Lab

• Central Sterile Supply

• Intensive Care Units

• Negative pressure isolation rooms

• Oncology

• Operating rooms including C-section rooms

Step 2 Step Three: Match the

Patient Risk Group (Low, Medium, High, Highest) with the planned … Construction Project Type (A, B, C, D) on the following matrix, to find the … Class of Precautions (I, II, III or IV) or level of infection control activities required.

Class I-IV or Color-Coded Precautions are delineated on the following page.

IC Matrix - Class of Precautions: Construction Project by Patient Risk

Construction Project Type

Patient Risk Group TYPE A TYPE B TYPE C TYPE D

LOW Risk Group I II II III/IV

MEDIUM Risk Group I II III IV HIGH Risk Group I II III/IV IV

HIGHEST Risk Group II III/IV III/IV IV Note: Infection Control approval will be required when the Construction Activity and Risk Level indicate that Class III or Class IV control procedures are necessary.

Step 3

Steps 1-3 Adapted with permission V Kennedy, B Barnard, St Luke Episcopal Hospital, Houston TX; C Fine CA Steps 4-14 Adapted with permission Fairview University Medical Center Minneapolis MN Forms modified /updated; provided courtesy of Judene Bartley, ECSI Inc. Beverly Hills MI 2002. Jbartley@ameritech.net Updated, 2009.

Description of Required Infection Control Precautions by Class During Construction Project Upon Completion of Project

C L

A

SS

I 1. Execute work by methods to minimize raising dust from construction operations.

2. Immediately replace a ceiling tile displaced for visual inspection

1. Clean work area upon completion of task.

A

SS

II

1. Provide active means to prevent airborne dust from dispersing into atmosphere.

2. Water mist work surfaces to control dust while cutting.

3. Seal unused doors with duct tape.

4. Block off and seal air vents.

5. Place dust mat at entrance and exit of work area

6. Remove or isolate HVAC system in areas where work is being performed.

1. Wipe work surfaces with cleaner/disinfectant.

2. Contain construction waste before transport in tightly covered containers.

3. Wet mop and/or vacuum with HEPA filtered vacuum before leaving work area.

4. Upon completion, restore HVAC system where work was performed.

A

SS

II

I

1. Remove or Isolate HVAC system in area where work is being done to prevent contamination of duct system.

2. Complete all critical barriers i.e. sheetrock, plywood, plastic, to seal area from non work area or implement control cube method (cart with plastic covering and sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins.

3. Maintain negative air pressure within work site utilizing HEPA equipped air filtration units.

4. Contain construction waste before transport in tightly covered containers.

5. Cover transport receptacles or carts. Tape covering unless solid lid

1. Do not remove barriers from work area until completed project is inspected by the owner’s Safety Department and Infection Prevention & Control Department and thoroughly cleaned by the owner’s Environmental Services Department.

2. Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction.

3. Vacuum work area with HEPA filtered vacuums.

4. Wet mop area with cleaner/disinfectant.

5. Upon completion, restore HVAC system

A

SS

IV

1. Isolate HVAC system in area where work is being done to prevent contamination of duct system.

2. Complete all critical barriers i.e. sheetrock, plywood, plastic, to seal area from non work area or implement control cube method (cart with plastic covering and sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins.

3. Maintain negative air pressure within work site utilizing HEPA equipped air filtration units.

4. Seal holes, pipes, conduits, and punctures.

5. Construct anteroom and require all personnel to pass through this room so they can be vacuumed using a HEPA vacuum cleaner before leaving work site or they can wear cloth or paper coveralls that are removed each time they leave work site.

6. All personnel entering work site are required to wear shoe covers. Shoe covers must be changed each time the worker exits the work area

1. Do not remove barriers from work area until completed project is inspected by the owner’s Safety Department and Infection Prevention & Control Department and thoroughly cleaned by the owner’s Environmental Services Dept.

2. Remove barrier material carefully to minimize spreading of dirt and debris associated with construction.

3. Contain construction waste before transport in tightly covered containers.

4. Cover transport receptacles or carts. Tape covering unless solid lid.

5. Vacuum work area with HEPA filtered vacuums.

6. Wet mop area with cleaner/disinfectant.

7. Upon completion, restore HVAC system

Steps 1-3 Adapted with permission V Kennedy, B Barnard, St Luke Episcopal Hospital, Houston TX; C Fine CA Steps 4-14 Adapted with permission Fairview University Medical Center Minneapolis MN Forms modified /updated; provided courtesy of Judene Bartley, ECSI Inc. Beverly Hills MI 2002. Jbartley@ameritech.net Updated, 2009.

Step 4. Identify the areas surrounding the project area, assessing potential impact

Unit Below Unit Above Lateral Lateral Behind Front

Risk Group Risk Group Risk Group Risk Group Risk Group Risk Group

Step 5. Identify specific site of activity e.g., patient rooms, medication room, etc.

Step 6. Identify issues related to: ventilation, plumbing, electrical in terms of the occurrence of probable outages.

Step 7. Identify containment measures, using prior assessment. What types of barriers?

(E.g., solids wall barriers); Will HEPA filtration be required?

(Note: Renovation/construction area shall be isolated from the occupied areas during construction and shall be negative with respect to surrounding areas)

Step 8. Consider potential risk of water damage. Is there a risk due to compromising structural integrity? (e.g., wall, ceiling, roof)

Step 9. Work hours: Can or will the work be done during non-patient care hours?

Step 10. Do plans allow for adequate number of isolation/negative airflow rooms?

Step 11. Do the plans allow for the required number & type of handwashing sinks?

Step 12. Does the infection prevention & control staff agree with the minimum number of sinks for this project? (Verify against FGI Design and Construction Guidelines for types and area)

Step 13. Does the infection prevention & control staff agree with the plans relative to clean and soiled utility rooms?

Step 14. Plan to discuss the following containment issues with the project team.

E.g., traffic flow, housekeeping, debris removal (how and when), Appendix: Identify and communicate the responsibility for project monitoring that includes infection prevention & control concerns and risks. The ICRA may be modified throughout the project.

Revisions must be communicated to the Project Manager.

Steps 1-3 Adapted with permission V Kennedy, B Barnard, St Luke Episcopal Hospital, Houston TX; C Fine CA Steps 4-14 Adapted with permission Fairview University Medical Center Minneapolis MN Forms modified /updated; provided courtesy of Judene Bartley, ECSI Inc. Beverly Hills MI 2002. Jbartley@ameritech.net Updated, 2009.

Infection Control Construction Permit Permit No:

Location of Construction: Project Start Date:

Project Coordinator: Estimated Duration:

Contractor Performing Work: Permit Expiration Date:

Supervisor: Telephone:

YES NO CONSTRUCTION ACTIVITY YES NO INFECTION CONTROL RISK GROUP

TYPE A: Inspection, non-invasive activity GROUP 1: Low Risk TYPE B: Small scale, short duration, moderate to high levels GROUP 2: Medium Risk

TYPE C: Activity generates moderate to high levels of dust, requires greater 1 work shift for completion

GROUP 3: Medium/High Risk

TYPE D: Major duration and construction activities Requiring consecutive work shifts

GROUP 4: Highest Risk

CLASS I 1. Execute work by methods to minimize raising dust from 3. Minor Demolition for Remodeling construction operations.

2. Immediately replace any ceiling tile displaced for visual inspection.

CLASS II 1. Provides active means to prevent air-borne dust from 6. Contain construction waste before transport in tightly dispersing into atmosphere covered containers.

2. Water mist work surfaces to control dust while cutting. 7. Wet mop and/or vacuum with HEPA filtered vacuum

3. Seal unused doors with duct tape. before leaving work area.

4. Block off and seal air vents. 8. Place dust mat at entrance and exit of work area.

5. Wipe surfaces with cleaner/disinfectant. 9. Isolate HVAC system in areas where work is being performed; restore when work completed.

CLASS III

1. Obtain infection control permit before construction begins. 6. Vacuum work with HEPA filtered vacuums.

2. Isolate HVAC system in area where work is being done to 7. Wet mop with cleaner/disinfectant prevent contamination of the duct system. 8. Remove barrier materials carefully to minimize

3. Complete all critical barriers or implement control cube spreading of dirt and debris associated with method before construction begins. construction.

9. Contain construction waste before transport in

4. Maintain negative air pressure within work site utilizing tightly covered containers.

HEPA equipped air filtration units. 10. Cover transport receptacles or carts. Tape covering.

5. Do not remove barriers from work area until complete 11. Upon completion, restore HVAC system where work project is checked by Infection Prevention & Control and was performed.

thoroughly cleaned by Environmental Services.

Date

Initial

CLASS IV

1. Obtain infection control permit before construction begins. 8. Do not remove barriers from work area until completed

2. Isolate HVAC system in area where work is being done to project is checked by Infection Prevention & Control prevent contamination of duct system. and thoroughly cleaned by Environmental. Services.

3. Complete all critical barriers or implement control cube 9. Vacuum work area with HEPA filtered vacuums.

method before construction begins. 10. Wet mop with disinfectant.

4. Maintain negative air pressure within work site utilizing 11. Remove barrier materials carefully to minimize

HEPA equipped air filtration units. spreading of dirt and debris associated with

5. Seal holes, pipes, conduits, and punctures appropriately. construction.

6. Construct anteroom and require all personnel to pass 12. Contain construction waste before transport in tightly through this room so they can be vacuumed using a HEPA covered containers.

vacuum cleaner before leaving work site or they can wear 13. Cover transport receptacles or carts. Tape covering.

cloth or paper coveralls that are removed each time they 14. Upon completion, restore HVAC system where work leave the work site. was performed.

7. All personnel entering work site are required to wear shoe covers

Date

Initial

Additional Requirements:

Date Initials Exceptions/Additions to this permit

Date Initials are noted by attached memoranda Permit Request By: Permit Authorized By:

Date: Date:

CCR/Project Lead:

Safety Official:

X

X

ILSM APPROVAL

Edward P. Boland VA Medical Center

VA Central Western Massachusetts Healthcare System 421 North Main Street

Leeds, MA 01053-9764

REQUEST FOR INFORMATION

NO.

PROJECT TITLE:

LOCATION: JOB:

CONTRACT NO.:

VA PROJECT NO.:

DATE REQUIRED:

TO: CC:

REQUEST SUBJECT:

Requested By: Date:

Signed:

RESPONSE:

This response does not constitute a change to the contract and is not an authorization to the contractor to proceed with any work that modifies the contract price or the time of performance. If the contractor believes that this response modifies any portion of the contract, the contractor shall make timely notice to the Contracting Officer and await the Contracting Officer’s direction before proceeding with any work that the contractor believes is a modification to the contract.

This response may constitute a change to the contract documents. Do not proceed with any work indicated in this response that changes the contract documents until directed in writing by the Contracting Officer.

Response By: Concur:

Signed:

Signed:

VA Project Manager

Date: Date:

Research Laboratory Safety Guidebook Volume 1:

Managing Chemical Safety

Construction Safety Guidebook

Published by

VHA Healthcare Environment and Facilities Programs (HEFP) http://vaww.hefp.va.gov/ i

Table of Contents

PREFACE

Disclaimers ................................................................................................................ xii

Executive Summary ................................................................................................. xiv

Acknowledgements ................................................................................................... xv

Update Listing .......................................................................................................... xvii

Acronyms and Abbreviations ............................................................................... xviii

1 Program Management

1.1. Introduction

1.2. Construction Safety Program

1.2.1. VHA Policy

1.2.2. Plan-Do-Check-Act

1.3. Regulations and Standards

1.3.1. FAR

1.3.2. FAR

1.3.3. VAAR

1.3.4. VHA Procurement Manual

1.3.5. OSHA

1.3.6. VA Medical Center Memorandum (MCM)

1.4. Construction Safety Responsibilities

1.4.1. Veterans Integrated Service Network (VISN) Director

1.4.2. VA Facility Director

1.4.3. Multi-Disciplinary Team (Construction Safety Committee)

1.4.4. Chief Engineer and Resident Engineer (RE)

1.4.5. Facility Safety Program Manager

1.4.6. CO and COR or Project Engineer

1.4.7. Construction Safety Officer (CSO)

1.4.8. GEMS Coordinator

1.4.9. Emergency Planning Coordinator

1.4.10. Construction Lead Person

1.4.11. Police and Security

ii

1.4.12. Infection Control Professional (ICP)

1.4.13. General Contractor

1.4.14. Subcontractor

1.4.15. Intervention Authority and Compliance

1.5. Pre-Award Period and Preconstruction

1.5.1. Responsible Prospective Contractors

1.5.2. ILSM Assessment

1.5.3. Infection Prevention and Control

1.5.4. PICRA

1.5.5. References

1.6. Post-Award and Construction Period

1.6.1. Surveillance

1.6.2. Written Site-Specific Plan

1.7. Post-Construction Period

1.8. Program Evaluation

1.9. Enclosures

2 Hazard Communication

2.1. Key Requirements

2.2. Discussion

2.2.1. Definitions

2.2.2. Certifications

2.2.3. Chemical Classifications

2.2.4. Contractor Written Hazard Communication Program

2.2.5. Employer Written Hazard Communication Program

2.2.6. Labels and Warnings

2.2.7. SDS Documents

2.2.8. Minimum Requirements of SDS Documents

2.2.9. Location and Copies of SDS

2.3. Education and Training

2.4. On-Site Review of Hazard Communication

2.5. References

2.6. Online Resources

2.7. Enclosure

3 Personal Protective Equipment

3.1. Key Requirements

iii

3.2. Discussion

3.2.1. General PPE

3.2.2. Occupational Foot Protection

3.2.3. Head Protection

3.2.4. Eye and Face Protection

3.2.5. Hearing Protection

3.2.6. Safety Belts, Lifelines and Lanyards

3.2.7. Respiratory Protection

3.2.7.a. Permissible Practice

3.2.7.b. Respiratory Protection Program

3.2.7.c. Selection of Respirators

3.2.7.d. Medical Evaluation of Employees

3.2.7.e. Medical Determination

3.2.7.f. Additional Medical Evaluations

3.2.7.g. Fit Testing Requirements

3.2.7.h. Use of Respirators

3.2.7.i. Facepiece Seal Protection

3.2.7.j. Continuing Respirator Effectiveness

3.2.7.k. Maintenance and Care of Respirators

3.2.7.l. Cleaning and Disinfection of Respirators

3.2.7.m. Storage of Respirators

3.2.7.n. Inspection of Respirators

3.2.7.o. Checklist for Respirator Inspection

3.2.7.p. Repairs to Respirators

3.2.7.q. Supplied Air Respirators

3.2.7.r. Identification of Filters, Cartridges and Canisters

3.2.7.s. Program Evaluation

3.2.7.t. Recordkeeping

3.3. Education and Training

3.3.1. Respirator Training and Information

3.4. Certifications

3.5. Formalized Written Program

3.6. References

3.7. Online Resources

3.8. Enclosures

iv

4 Asbestos

4.1. Key Requirements

4.2. Discussion

4.2.1. Definitions

4.2.2. Asbestos History

4.2.3. Initial Project Phase

4.2.4. Design Project Phase

4.2.5. Construction Project Phase

4.3. Training

4.4. Online Resources

4.5. Enclosure

5 Lead

5.1. Key Requirements

5.2. Discussion

5.2.1. Definitions

5.2.2. General

5.2.3. Environmental Lead Assessment

5.3. Education and Training

5.3.1. Certifications

5.3.2. Training

5.4. References

5.5. Online Resources

5.6. Enclosures

6 Silica

6.1. Key Requirements

6.2. Discussion

6.2.1. Definitions

6.2.2. General

6.3. Exposure Assessment

6.4. Controls

6.5. Other Provisions

6.6. Education and Training

6.7. References

6.8. Online Resources

7 Hexavalent Chromium v

7.1. Key Requirements

7.2. Discussion

7.2.1. Definitions

7.2.2. Health Effects

7.2.3. Exposure

7.2.4. Exposure Determination

7.2.5. Methods of Compliance

7.2.5.a. Engineering and Work Practice Controls

7.2.5.b. Respiratory Protection

7.2.5.c. Protective Work Clothing and Equipment

7.2.5.d. Hygiene Areas and Practices

7.2.5.e. Prohibited Activities

7.2.5.f. Medical Surveillance

7.3. Education and Training

7.4. References

7.5. Online Resources

7.6. Enclosures

8 Fire Protection/Prevention and Emergency Planning

8.1. Key Requirements

8.2. Discussion

8.2.1. Mandatory Program Elements

8.2.1.a. Fire Protection

8.2.1.b. Water Supply

8.2.1.c. Portable Fire Fighting Equipment

8.2.1.d. Fire Hose and Connections

8.2.1.e. Sprinkler Protection

8.2.1.f. Fire Alarm Devices

8.2.1.g. Ignition Hazards

8.2.1.h. Hazardous Locations

8.2.1.i. Open Yard Storage

8.2.1.j. Indoor Storage

8.2.1.k. Temporary Heaters

8.2.1.l. Weather Enclosures

8.3. Flammable and Combustible Liquids

8.3.1. Mandatory Program Elements

vi

8.4. Emergency Protection and Prevention

8.4.1. Employee Emergency Action Plans

8.4.2. Mandatory Program Elements

8.5. Education and Training

8.6. References

8.7. Online Resource

8.8. Enclosure

9 Welding and Cutting

9.1. Key Requirements

9.2. Discussion

9.2.1. Permit Authorizing Individual (PAI)

9.2.2. Hot Work Permit

9.2.3. Fire Watch

9.2.4. Gas Welding and Cutting

9.2.5. Arc Welding and Cutting

9.2.6. Welding and Cutting Precautions

9.2.7. Welding, Cutting and Heating in Way of Preservative Coatings

9.3. Education and Training

9.4. References

9.5. Online Resources

9.6. Enclosures

10 Electrical

10.1. Key Requirements

10.2. Discussion

10.2.1. General Requirements

10.2.2. Wiring Design and Protection

10.2.3. Wiring Methods, Components and Equipment for General Use

10.2.4. Specific Purpose Equipment and Installations

10.2.5. Safety Related Work Practices

10.2.6. Locking and Tagging of Circuits

10.2.7. Batteries and Battery Charging

10.3. Education and Training

10.4. References

10.5. Enclosure

11 Energy Isolation vii

11.1. Key Requirements

11.2. Discussion

11.2.1. Definitions

11.2.2. General

11.2.3. Control of Hazardous Energy

11.2.4. Forms of Hazardous Energy

11.2.5. Energy Isolation Procedures

11.2.6. Formalized Written Program Required

11.2.7. Hot Tapping

11.3. Education and Training

11.4. References

11.5. Online Resources

11.6. Enclosures

12 Confined Space Entry

12.1. Key Requirements

12.2. Discussion

12.2.1. Major OSHA Violations

12.2.2. Confined Space Identification

12.2.3. Confined Space Procedures

12.2.4. CSCP/Safety Supervisor Responsibilities

12.2.5. Confined Space Entry Written Program Elements

12.3. Education and Training

12.3.1. Rescue and Emergency Services

12.4. References

12.5. Enclosures

13 Excavation and Trenching

13.1. Key Requirements

13.2. Discussion

13.2.1. Definitions

13.2.2. Soil Testing

13.2.3. Soil Classification

13.2.4. General Protection Provisions

13.2.5. Employee Awareness Training

13.3. Formalized Written Program Required

13.4. Education and Training

viii

13.4.1. Certifications

13.5. References

13.6. Online Resource

13.7. Enclosures

14 Fall Protection

14.1. Key Requirements

14.2. Discussion

14.2.1. Definitions

14.2.2. Formalized Written Program Required

14.2.3. General

14.3. Education and Training

14.3.1. Certifications

14.4. Reference

14.5. Online Resources

14.6. Enclosure

15 Material Handling and Rigging

15.1. Key Requirements

15.2. Discussion

15.2.1. Material Storage

15.2.2. Rigging Equipment

15.2.3. Inspection Criteria

15.2.4. Alloy Steel Chains

15.2.5. Wire Ropes

15.2.5.a. Natural or Synthetic Fiber Rope

15.3. Education and Training

15.3.1. Certifications

15.4. References

15.5. Online Resources

15.6. Enclosures

16 Steel Erection

16.1. Key Requirements

16.2. Discussion

16.2.1. Definitions

16.2.2. Site Layout, Site-Specific Erection Plan and

Construction Sequence ix

16.2.3. Hoisting and Rigging

16.2.4. Structural Steel Assembly

16.2.5. Column Anchorage

16.2.6. Beams and Columns

16.2.7. Open Web Steel Joists

16.2.8. Systems-Engineered Metal Buildings

16.2.9. Falling Object Protection

16.2.10. Fall Protection

16.3. Education and Training

16.4. Reference

16.5. Online Resources

16.6. Enclosure

17 Scaffolds and Aerial Lifts

17.1. Key Requirements

17.2. Discussion

17.2.1. Definitions

17.2.2. Competent Person

17.2.3. General

17.3. Education and Training

17.4. Reference

17.5. Online Resources

17.6. Enclosures

18 Stairways and Ladders

18.1. Key Requirements

18.2. Discussion

18.2.1. Definitions

18.2.2. General

18.3. Training

18.4. References

18.5. Online Resources

18.6. Enclosures

19 Concrete and Masonry

19.1. Key Requirements

19.2. Discussion

19.2.1. Definitions

x

19.2.2. General

19.2.3. PPE and Sanitation Requirements

19.2.4. Requirements for Equipment and Tools

19.2.5. Requirements for Cast-In-Place Concrete

19.2.6. Requirements for Precast Concrete

19.2.7. Requirements for Lift-Slab Operations

19.2.8. Requirements for Masonry Construction

19.3. Education and Training

19.3.1. Certifications

19.4. References

19.5. Online Resources

19.6. Enclosures

20 Hand and Power Tools

20.1. Key Requirements

20.2. Discussion

20.2.1. General

20.2.2. Hand Tools

20.2.3. Power Tools

20.2.4. Abrasive Wheels and Tools

20.2.5. Woodworking Tools

20.2.6. Jacks: Lever and Ratchet, Screw and Hydraulic

20.2.7. Air Receivers

20.3. Education and Training

20.3.1. Certifications

20.4. Reference

20.5. Online Resources

20.6. Enclosure

21 Cranes and Load Handling Equipment

21.1. Key Requirements

21.2. Discussion

21.2.1. Definitions

21.2.2. Types of Cranes

21.2.3. Standard Lift Plan (SLP)

21.2.4. Inspection Criteria for Load Handling Equipment

21.2.5. Safety Devices and Operational Aids

xi

21.2.6. Testing

21.2.7. Operation

21.2.8. Critical Lifts

21.2.9. Environmental Considerations

21.3. Education and Training

21.3.1. Crane Operator Requirements − General

21.3.2. Crane Operator Certification, Qualification and Designation

21.3.3. Signal Person Qualifications

21.4. References

21.5. Online Resources

21.6. Enclosures

Enclosures xii

Disclaimers Endorsement

Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by the U.S. Government. The views and opinions of authors expressed herein do not necessarily state or reflect those of the U.S. Government and shall not be used for advertising or product endorsement purposes.

Hyperlinks

The appearance of external hyperlinks does not constitute endorsement by the

Department of Veterans Affairs (VA) of the linked websites or the information, products, or services contained therein. For other than authorized VA activities, the Department does not exercise any editorial control over the information you may find at these locations. All links are provided with the intent of meeting the mission of the Department and the VA website. Please let us know about existing external links that you believe are inappropriate and about specific additional external links that you believe should be included.

Liability

With respect to documents available from this server, neither the U.S.

Government nor any of its employees makes any warranty, expressed or implied, including the warranties of merchantability and fitness for a particular purpose, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately-owned rights.

Reference from this website or from any of the information services sponsored by

VA to any non-governmental entity, product, service, or information does not constitute an endorsement or recommendation by VA or any of its employees. We are not responsible for the content of any “off-site” websites referenced from the

Veterans Health Administration (VHA) Healthcare Environment Facilities

Programs (HEFP) website, electronic media, or printed media.

Guidance

VHA HEFP guidebooks are “BEST PRACTICE” resources designed to assist health care facilities implement and enhance programs and more effectively comply with current VA/VHA policy and external regulatory standards. HEFP guidebooks are NOT OFFICIAL POLICY. In accordance with VHA Directive

6330(1), Controlled National Policy/Directives Management System, official policy documents include: (1) Directives, which carry the authority to mandate

Department- or Administration-wide policies and (2) Handbooks, which carry the xiii authority to mandate procedures or operational requirements implementing policies contained in directives.

xiv

Executive Summary Safety is a philosophy and a practice that identifies and eliminates jobsite hazards throughout the lifecycle of a project and discourages work practices and equipment that place individuals at risk of injury. The Office of Occupational Safety, Health and GEMS Programs (10NA8) in the

Veterans Health Administration (VHA) Headquarters recognized the need to assist Department of Veterans

Affairs (VA) facilities in complying with safety standards and ensuring a safe environment for patients, visitors and staff.

As a result, VHA Directive 2004-012, Safety and Health

During Construction Activities, and its subsequent revisions, VHA Directive 2011-036, Safety and Health During

Construction (2011), and VHA Directive 7715, Safety and

Health During Construction (2017) established policy for consistent construction safety programs across VHA. To support the VHA Directive, the Healthcare Environment

Facilities Programs (HEFP) established a standing multi-disciplinary task group to create a functional guidebook that would be revised as needed to reflect the latest guidance for safe construction activities at VHA facilities.

The goal of this guidebook is to provide guidance for active participation in the facility Construction Safety Program. It provides safety training guidelines and will assist managers in identifying risks/hazards and establishing a process for their control, elimination and prevention. This guidebook is designed not only for program officials (e.g., Safety Officer, Chief

Engineer, etc.), but is also intended for use by all managers throughout the facility.

Questions regarding the use and application of this guidebook may be addressed to Mr. Richard Watson, HEFP Construction

Safety Product and Service Manager, at 937-268-6511, ext. 2069, or by email at

Richard.Watson@va.gov.

xv

Acknowledgements This guidebook was possible because of the devoted attention of the personnel and management of the VHA Center for Engineering & Occupational Safety and Health

(CEOSH), St. Louis, Missouri.

A special thank you is extended to the Construction Safety Professional Advisory

Group (PAG) who developed this guidebook, and to management at their respective facilities for their support.

David Birk, PE, CSP, Construction Safety Engineer, VAMC, West Haven, CT

Claudia Boutot, Construction Safety Engineer, VAMC, Bay Pines, FL

Che Buval, Safety and Occupational Health Specialist, VAMC, Temple, TX

Jerry Fox, BS, Environmental Safety Manager, VAMC, Danville, IL

*Jennifer Hamner, CHSP, MSPH, Safety Manager, VAMC, Biloxi, MS

Michael Henrickson, MPH, CHMM, CFI, Occupational Safety and Health

Manager, VISN 7, Columbia, SC

Richard Hofman, CIH, CSP, CPEA, Senior Industrial Hygienist, VHACO, Washington, DC

John Houvener, CHCM, Safety and Occupational Health Program Manager, VHACO, Washington, DC

Sean Kaminski, Contracting Officer, PCAC, Cleveland, OH

Gary Krupa, PE, Senior Electrical Engineer, VAMC, Omaha, NE

Brian Marcyjanik, CSP, CHMM, General Safety Program Manager, VHACO, Washington, DC

David McClintock, Safety Specialist, VAMC, Danville, IL

Mike Minicky, CSP, General Safety Product and Service Manager, HEFP, St.

Louis, MO

Darlene Powell, CHSP, HEM, Chief, Safety and Emergency Management, VAMC, Bay Pines, FL

Michael Reed, BSEE, CHFM, Healthcare Engineering Product and Service

Manager, HEFP, St. Louis, MO

George Stevens, PE, MPH, Chief, Safety and Emergency Management, VAMC, Phoenix, AZ

Sheila Taylor, BS, Safety Manager, VAMC, Saginaw, MI xvi

*Richard Watson, MPH, CSP, Construction Safety Product and Service

Manager, HEFP, Dayton, OH

Carl Wise, Maintenance Mechanic Leader, VAMC, Danville, IL

*Chairpersons

HEFP Publishing Staff:

Tina Beckner, Lead Technical Information Specialist, St. Louis, MO

Lesley Luscri, Technical Information Specialist, HEFP, St. Louis, MO

Melody Watts, Technical Information Specialist, HEFP, St. Louis, MO

Connie Young, Chief, Publishing Services, HEFP, St. Louis, MO xvii

Update Listing The following listing identifies online updates for this guidebook. It is designed to assist the reader in verifying the most current information available.

Table 1: Update Listing

Update

Number Date Updated Remarks Chapter xviii

Acronyms and Abbreviations Acronym/

Abbreviation

Definition μg Micrograms μg/m3 Micrograms per Cubic Meter

A2B Anti-Two Blocking Device

AC Alternate Current

ACD Allergic Contact Dermatitis

ACGIH American Conference of Governmental Industrial

Hygienists

ACI American Concrete Institute

ACM Asbestos Containing Materials

AE Architect and Engineering

AHA Activity Hazard Analysis

AHERA Asbestos Hazard Emergency Response Act

AIA American Institute of Architects

AIIR Airborne Infection Isolation Room

ANSI American National Standards Institute

API American Petroleum Institute

APIC Association for Professionals in Infection Control and

Epidemiology

APP Accident Prevention Plan

ASHARA Asbestos School Hazard Abatement Reauthorization

Act

ASHRAE American Society of Heating, Refrigerating and Air

Conditioning Engineers

ASME American Society of Mechanical Engineers

AWE Annual Workplace Evaluation

BLL Blood Lead Level xix

BLS Bureau of Labor Statistics

CAI Capital Asset Inventory

CDC Center for Disease Control

CDZ Controlled Decking Zone

CEOSH Center for Engineering & Occupational Safety and

Health

CERCLA Comprehensive Environmental Responsibility, Compensation and Liability Act

CFM Office of Construction & Facilities Management

CFR Code of Federal Regulations

CIH® Certified Industrial Hygienist cm Centimeter

CO Contracting Officer

COR Contracting Officer’s Representative

COTR Contracting Officer’s Technical Representative

CP Competent Person

CPL Compliance

CPR Cardiopulmonary Resuscitation

CPSC Consumer Product Safety Commission

CR(VI) Hexavalent Chromium

CS Construction Safety

CSE Confined Space Entry

CSCP Confined Space Competent Person

CSI Clinical-Specific Initiatives

CSO Construction Safety Officer

DART Days Away, Restricted, Transferred dBA Decibels xx

DC Direct Current

DHHS Department of Health and Human Services

D.O. Doctor of Osteopathy

DOL Department of Labor

DOT Department of Transportation

EMR Experience Modification Rate

EPA Environmental Protection Agency

E-SAFE Environmental Safety Automated Facility Evaluation

ESCBA Escape Self-Contained Breathing Apparatus f/cc Fibers per Cubic Centimeter

FAA Federal Aviation Administration

FAR Federal Acquisitions Regulations

FDA Food and Drug Administration

FGI Facilities Guidelines Institute

ft. Foot/Feet g Gram

GEMS Green Environmental Management Systems

GFCI Ground Fault Circuit Interrupters

GHS Globally-Harmonized System of Classification and

Labeling of Chemicals

GPM Gallons Per Minute

H Horizontal

HAI Healthcare Associated Infections

HCP Hazard Communication Program

HEPA

HEFP

High Efficiency Particulate Air

Healthcare Environment Facilities Programs

HVAC Heating, Ventilation and Air Conditioning xxi

HUD Housing and Urban Development

IARC International Agency for Research on Cancer

ICP Infection Control Practitioner

ICRA Infection Control Risk Assessment

ICU Intensive Care Unit

ID Identification

IDLH Immediately Dangerous to Life and Health

IH Industrial Hygienist

ILSM Interim Life Safety Measures

in. Inch

ISO International Standards Organization kPa Kilopascal kv Kilovolt

lb. Pound

LBP Lead Based Paint

LDR Land Disposal Restrictions

LFL Lower Flammable Limit

LHE Load Handling Equipment

LMI Load Moment Indicator

LOI Letter of Interpretation

LOTO Lockout/Tagout

LP Liquefied Petroleum

LWDIR Loss Work Day Incident Rate m Meter m3 Cubic Meter

M&O Maintenance and Operations

MAP Model Accreditation Plan xxii

MCM Medical Center Memorandum

M.D. Doctor of Medicine mg Milligram

MLR Multiple Lift Rigging

MMAD Mass Median Aerodynamic Diameter mppcf Millions of Particles per Cubic Foot

NAICS North American Industrial Classification System

NCCCO National Commission for the Certification of Crane

Operators

NEC National Electric Code

NESHAP National Emission Standards for Hazardous Air

Pollutants

NFPA National Fire Protection Association

NIOSH National Institute for Occupational Safety and Health

NOB Non-Friable Organically Bound

NPRCS Non-Permit-Required Confined Spaces

NRM Non-Recurring Maintenance

NRR Noise Reduction Rating

NTP National Toxicology Program

OD Optical Density

O&M Operations and Maintenance

OSH Occupational Safety and Health

OSHA Occupational Safety and Health Administration

OTI OSHA Training Institute

PACM Presumed Asbestos Containing Material

PACU Post-Anesthesia Care Unit

PAI Permit Authorizing Individual xxiii

PAPR Powered Air-Purifying Respirator

PCB polychlorinated biphenyl

PCM Phase Contrast Microscopy

PDF Personal Decontamination Facility

PEL Permissible Exposure Limit

PFAS Personal Fall Arrest System

PG Program Guide

PHSC Project Health and Safety Coordinator

PICRA Preconstruction/Infection Control Risk Assessment

PLHCP Professionally Licensed Health Care Professional

PLM Polarized Light Microscopy

PM Procurement Manual

PM&R Physical Medicine and Rehabilitation

PNOR Particulates Not Otherwise Regulated ppb Parts per Billion

PPE Personal Protective Equipment

PPM Parts Per Million

PRCS Permit Required Confined Space psf. Per Square Foot psi Pound Per Square Inch

Q&A Questions and Answers

QLFTP Qualitative Fit Testing Procedures

QNFTP Quantitative Fit Testing Procedures

QP Qualified Person

QR Qualified Rigger

RACM Regulated Asbestos-Containing Material

RCRA Resource Conservation and Recovery Act xxiv

RE Resident Engineer

REL Recommended Exposure Level

ROPS Rollover Protective Structures

RPE Registered Professional Engineer

RPM Revolutions Per Minute

RQ Reportable Quantity

RRP Renovation, Repair and Painting Rule

S Service

SAFE Safety Automated Facility Evaluation

SAR Supplied Air Respirator

SCBA Self-Contained Breathing Apparatus

SCIP Strategic Capital Investment Planning

SEG Similar Exposure Group

SI International System of Units

SiO2 Crystalline Silica

SIC Standard Industrial Classification

SJ Service Junior

SJO Service Junior with Oil Resistant Jacket

SJT Service Junior Thermoplastic

SJTO Service Junior Thermoplastic with Oil Resistant Jacket

SLP Standard Lift Plan

SO Service Oil Resistant Jacket

SOP Standard Operating Procedure

SOW Statement of Work

SPD Supply, Processing and Distribution

ST Service Thermoplastic

STO Service Thermoplastic with Oil Resistant Jacket xxv

SWL Safe Working Load

TB Tuberculosis

TC Toxicity Characteristic

TCLP Toxicity Characteristic Leaching Procedure

TEM Transmission Electron Microscopy

TIL Technical Information Library

TSI Thermal Systems Insulation tsf Tons per square foot

TWA Time-Weighted Average

UL Underwriters Laboratories Incorporated

U.S. United States

USC United States Code

USDL United States Department of Labor

V Vertical

VA Veterans Affairs

VAAR VA Acquisition Regulation

VACO VA Central Office

VAI Vermiculite Attic Insulation

VAMC VA Medical Center

VAT Vinyl Asbestos Floor Tiles

VHA Veterans Health Administration

VISN Veterans Integrated Service Network

W/EDF Waste/Equipment Decontamination Facility

WLL Working Load Limit

XRF X-ray Fluorescence Technology

ZPP Zinc-Protoporphyrin xxvi

Chapter 1 Program Management

1 Program Management

1.1. Introduction

Construction is a high hazard occupation. Over 11 million construction workers build and maintain roads, houses, workplaces and physical infrastructure. This work includes many inherently hazardous tasks and conditions such as work at height, excavations, noise, dust, power tools and equipment, confined spaces and electricity. Construction work includes about 8 percent of United States (U.S.)

workers, but accounts for 22 percent of the fatalities − the largest number of fatalities reported for any of the industry sectors according to the National Institute for Occupational Safety and Health (NIOSH).

The implementation of Construction Safety Programs is expected to reduce the potential for injuries and illnesses to Veterans Affairs (VA) patients, employees and visitors from unsafe construction activities conducted by contractors as well as VA employees, including operations and maintenance crews, permanent construction crews and temporary purchase and hire staff. Construction Safety

Programs will also reduce the potential for VA liability, lost time, added costs and other intangibles that often result from construction accidents, life safety deficiencies or infection control failures.

Historically, Infection Control Practitioners (ICPs) have had minimal involvement in construction, demolition and renovation activities in medical centers. They have always been involved in preventing infections such as urinary tract infections, pneumonias, surgical site infections and bacteremias (bloodstream infections) in hospitalized patients. It was not until the late 1990’s that ICPs and others began to see the importance of their early and continuous involvement in construction activities.

Occupational Safety and Health Administration (OSHA) and Environmental

Protection Agency (EPA) regulations, The Joint Commission requirements and

Facilities Guidelines Institute (FGI), formerly the American Institute of Architects

(AIA), guidance identify opportunities for maintaining the health and safety of VA patients, staff, visitors and contractors. OSHA and EPA regulations, in addition to requirements with VA Directive 7700, Occupational Safety and Health; Veterans

Health Administration (VHA) Directive 7701, Occupational Safety and Health

(OSH), occupational safety and health issues for employees and contractors working on VA/VHA property are addressed. The Joint Commission requirements and FGI guidance address patient safety during construction activities.

1.2. Construction Safety Program

Construction work is inherently dangerous and can result in serious injury, illness and even death. In order to protect patients, staff, volunteers, visitors and contractors from safety and health hazards associated with construction activities, strategies need to be established to control the hazards inherent in conducting construction or renovation activities. These strategies include the assignment of appropriate responsibility at all levels of the organization, establishing and maintaining the necessary expertise to manage an effective Construction Safety and Health Program, applying technical guidance and best practices to assist in managing the program and providing a Construction Safety Multi-Disciplinary

Team to oversee and enforce the application of the Construction Safety Program.

The intent of the Construction Safety Program is to reduce the potential for injury and illness resulting from unsafe construction activities conducted by contractors and VA employees. In the past, VHA has experienced several injuries, illnesses and even fatalities of patients, staff and contractors due to unsafe construction activities. According to a U.S. Department of Labor (US DOL) study (National

Census of Fatal Occupational Injuries in 2015: USDL-16-2304), fatal injuries among construction and extraction occupations rose by 2 percent to 924 cases in

2015; the highest since 2008. Several construction occupations recorded their highest fatality total in years, including construction laborers (highest since 2008);

carpenters (2009); electricians (2009); and plumbers, pipefitters and steamfitters

(2003). The current Bureau of Labor Statistics (BLS) data is available at http://www.bls.gov/news.release/cfoi.nr0.htm.

OSHA conducts half of all enforcement inspections in the construction industry and has established national emphasis programs in general construction, excavation and trenching and falls from elevation. Moreover, OSHA regional emphasis programs may include cranes, confined spaces, electrical safety and scaffolding. OSHA Title 29 Code of Federal Regulations (CFR) Part 1960 (29

CFR 1960, Basic Program Elements for Federal Employee Occupational Safety and Health Programs and Related Matters) requires each agency to develop, implement and evaluate an Occupational Safety and Health (OSH) Program to include construction safety. Federal Acquisition Regulations (FAR) require that contracts have provisions for assurance that construction contractors implement

Construction Safety and Health Programs and require Contracting Officers (COs) to enforce compliance of Federal safety and health standards. The Joint

Commission requires that hospitals have a written plan for managing the safety of patients, staff, volunteers and visitors during construction activities.

The purpose of the Construction Safety Guidebook is to provide users with strategies for reducing the potential for occupational injury or illness and decrease the risk of exposure to hazardous conditions and situations to patients, employees, volunteers and visitors. The challenge of reducing exposure, risks and injury during construction can be met by supporting on-going education, focusing on hazardous exposures and integrating the procedures outlined in this guidebook.

1.2.1. VHA Policy

The VHA policy and specific strategies for construction safety have been updated in revised VHA Directive 7715, Safety and Health During Construction.