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What
is a transition program and what elements should
I include in my transition program?
A transition program is
recommended for facilities in which anthrax contamination
has been identified and normal work operations
are conducted. Three examples of this situation
include the following:
- Normal work activities were resumed in a
contaminated facility following decontamination
and clearance sampling efforts.
- Original sampling identified low levels of
surface and air contamination and therefore
occupancy is permitted.
- Occupancy is permitted outside an established
exclusion zone in which decontamination is
being performed.
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| The duration of the program
would generally be dictated by sampling results
obtained during the transitional period. Site-specific
transitional elements should be developed for
each facility and incorporated as part of the
regular site health and safety plan (HASP).
It is recommended that an industrial hygienist
develop these elements or at a minimum provide
input during the development phase. Transitional
Program elements to be included in the HASP include
some or all of the following elements, as applicable:
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| Hazard
Awareness Training |
Hazard
awareness training is intended to communicate
information concerning hazards of anthrax
and appropriate protective measures to
employees. This program may include, but
is not limited to:
- Elements of the transition program.
- The health hazards of anthrax, including
routes of entry, signs and symptoms
of exposure, synergistic effects,
and any medical conditions which would
place employees at increased risk (i.e.,
immunocompromised individuals).
- Operations in the work area where anthrax
has been identified.
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- Dissemination of sampling results to employees,
including information on how to gain access
to such results.
- Any applicable control measures, such as
appropriate engineering controls, work practices,
housekeeping, or personal
protective equipment (PPE).
- Implementation of interim standard operating
procedures to control anthrax exposure during
operations, maintenance, cleaning, etc.
- Frequent updates regarding any on-going anthrax
sampling, decontamination, control, medical
surveillance, and related activities being
performed at the facility, as applicable.
Additional detailed information
may be found at the following site:
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| Medical
Surveillance |
A medical
surveillance program is necessary to ensure
that employees receive appropriate preventive
care. Medical surveillance includes, but
is not limited to:
- Identification of employee population
at risk and establishment of controls
for such employees (such as work reassignment, PPE,
prophylactic medication, etc.).
- Administrative follow-up on absentees
(such as sick leave, etc.).
- Selection of prophylactic medication,
as appropriate.
- Response to symptoms reported by employees.
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Additional detailed information may be found at
the following sites:
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| Transitional
Sampling |
Transitional sampling
is conducted to confirm that the occupied areas
remain safe for occupancy. Sampling during this
period is continued until repeatable results
demonstrate that contamination remains below
an established target level. Additional information
can also be found in the chapter on sampling. Elements
of transitional sampling include, but are not
limited to, the following:
- Determination of appropriate sampling
techniques. Recommended techniques include
non-aggressive high-volume air sampling,
aggressive HEPA vacuum surface sampling,
and if appropriate bulk sampling (such
as bulk samples from HEPA vacuum bags
used to clean surfaces).
- Use of high-volume air sampling as
an essential tool in order to characterize
levels of anthrax in the air and provide
inhalational exposure information to
employees.
- Identification of specific locations
and frequency of sampling.
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Additional detailed information may be found at
the following site:
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| Personal
Protective Equipment |
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workplace must be reassessed in order to
select and use appropriate personal
protective equipment (PPE) to protect
employees from the anthrax hazards present.
The specific types of PPE utilized would
be dependant on the actual operation in
question and results from the reassessment.
Examples of work operations where modifications
to PPE may be necessary are as follows: |
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- Operating equipment or working on surfaces
where anthrax was previously identified.
- Performing maintenance tasks, such as cleaning
equipment or changing HEPA vacuum filters.
Additional detailed information
may be found at the following site:
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| Personal
Hygiene |
A personal
hygiene program should be implemented to
limit exposures and control the spread
of anthrax contamination. Procedures that
may be required include the following:
- Assuring that food or beverage is not
present or consumed, tobacco products
are not present or used, and cosmetics
are not applied.
- Regular washing of the hands and/or
face, and before eating, drinking, using
tobacco, or applying cosmetics.
- Showering as necessary.
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| Interim
Standard Operating Procedures |
Interim standard operating
procedures (SOPs) must be developed to address
special work activities necessary under the transitional
program. Affected employees should receive training
on the interim SOPs. These SOPs may include,
but are not limited to, the following topics:
- Maintenance and housekeeping procedures
developed or modified to control the
spread of contamination and protect employees.
Examples of procedures include:
- Use of HEPA vacuums for cleaning
surfaces instead of sweeping or other
methods,
- Cleaning, maintenance, and filter
and bag removal for HEPA vacuums,
- Maintenance and cleaning of facility
equipment,
- Cleaning of floors and other surfaces,
and
- Handling and disposal of wastes.
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- Changes to regular work operations and equipment,
as applicable.
- Modifications to facility-wide mechanical
systems, particularly heating, ventilation,
and air-conditioning (HVAC) systems. Examples
of HVAC modifications include:
- Increase in ventilation rates (air changes
per hour)
- Increase in percentage of outside air
- Use of HEPA filters to collect dust in
circulated air
- Other applicable major elements being implemented
as part of the transitional program, as described
previously (such as training, medical surveillance,
sampling, PPE, and hygiene).
Additional detailed information
may be found at the following site:
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