Barriers and solutions in implementing occupational health and safety services at a large nuclear weapons facility.

The Hanford Nuclear Reservation is one of the U.S. Department of Energy's largest nuclear weapons sites. The enormous changes experienced by Hanford over the last several years, as its mission has shifted from weapons production to cleanup, has profoundly affected its occupational health and safety services. Innovative programs and new initiatives hold promise for a safer workplace for the thousands of workers at Hanford and other DOE sites. However, occupational health and safety professionals continue to face multiple organizational, economic, and cultural challenges. A major problem identified during this review was the lack of coordination of onsite services. Because each health and safety program operates independently (albeit with the guidance of the Richland field operations office), many services are duplicative and the health and safety system is fragmented. The fragmentation is compounded by the lack of centralized data repositories for demographic and exposure data. Innovative measures such as a questionnaire-driven Employee Job Task Analysis linked to medical examinations has allowed the site to move from the inefficient and potentially dangerous administrative medical monitoring assignment to defensible risk-based assignments and could serve as a framework for improving centralized data management and service delivery.

Structure and function of occupational health services within selected Department of Energy sites.

The mission of the United States Department of Energy sites has recently changed from nuclear weapons production to site remediation. Considering the mass of radiological and chemical contaminants at these sites, ensuring the health and safety of workers is a major challenge. This study used the findings from a written survey to describe occupational health services at 10 Department of Energy sites. The study aims were to describe and compare: (1) the primary hazards associated with the site activities; (2) the occupational safety and health structure, including service providers; and (3) the occupational health and safety functions, including surveillance, training, and service provision. Although explosions and radiological agents were identified as the hazards with the greatest associated risks, workers at these sites were most likely to be exposed to physical hazards, ergonomic hazards, and/or chemicals, including asbestos. Physicians accounted for 2.4% of service providers, nurses for 5.5%, industrial hygienists for 12.2%, safety personnel for 11.8%, and health physicists for 64.9%. It was concluded that there is an imbalance between the most important hazards and the types of health and safety personnel at these sites.

A description of factors affecting hazardous waste workers' use of respiratory protective equipment.

This article describes the first phase of a study that was designed to gain an understanding of hazardous waste workers' attitudes and beliefs about the use of respiratory protective equipment. Exploratory, open-ended interviews were conducted among 28 respirator users at a US Department of Energy facility. Subjects were asked to describe their knowledge, attitudes, and beliefs about their risks to hazards at their worksites and to discuss their use of respiratory protective equipment. A detailed content analysis of the interviews resulted in the generation of a taxonomy of issues and concerns which fell into three general categories: 1) Knowledge, Beliefs, and Attitudes, 2) Physical and Psychological Effects, and 3) External Influences. Knowledge, Beliefs, and Attitudes included Training, Fit Testing, Medical Clearance, Work Exposures, Respirator Use, and Vulnerability to Disease. Physical and Psychological Effects included Somatic/Health Effects, Personal Comfort, Visual Effects, Fatigue, Communication, and Anxiety. External Influences included Structural Environment, Quality and Availability of Equipment, Other PPEs, Co-Worker Influence, Supervisor Influence, and Organizational Culture. The findings from this study have important implications to training and education programs. Effective respiratory protection programs depend on a knowledge of the factors that affect workers' use of equipment. This study suggests that efforts to assure equipment comfort and fit, to assist workers who see and hear less well as a result of their equipment, and to develop strategies to allay worker anxiety when wearing equipment should all be components of a program. An organizational culture that supports and abets the appropriate use of equipment is also a critical element in a successful program.