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Labour Minister Ricardo Berzoini (Labour cial treatment meted out to Eternit workers suffering Party) worked for a consensus view right to the from mesothelioma spasms in lower back purchase rumalaya liniment 60 ml with amex, and the company’s open-hand end muscle relaxant migraine buy 60 ml rumalaya liniment with visa, but was foiled by an alliance of the Minister edness to political parties spasms jaw buy 60 ml rumalaya liniment otc. This left came into his account spasms in neck rumalaya liniment 60 ml mastercard, he had already been dead for the President of the Republic with the nal say. Approximately a third of his compensa Civil Ofce”, the President’s staff of close ofcials tion went to pay for his funeral and headstone. But the asbestos industries also engaged in system this can only favour the status quo, and has been atic harassment of those who speak out against hailed as a victory by the asbestos industry. Eternit has brought repeated lawsuits against good reason… a Sao Paulo labour inspector, Fernanda Giannasi. While they have all been thrown out, their clear Money talks purpose was to browbeat labour inspectorate staff. Pressure from asbestos multinationals, mainly the pull her off asbestos-using plant inspections10. The murder of three tion-related activities in Brazil generate a wide-ranging propaganda campaign of playing labour inspectors and their driver on 28 January turnover of some 430 million reaisreaisreais a down, not to say denying outright, the dangers of 2004 shows the level of violence that some employ year. Also, as per usual when workers’ health ers’ circles are ready to use against a labour inspec asbestos-cement companies amounts protection is on the agenda, the employers lobby torate that they see as standing in the way of free to approximately 5 000 workers. What the Government falters while society erno adia decisao de banir amianto do campaign glossed over was that were asbestos to moves on” pais, Folha de Sao Paulo, 20 February 2005). As in Quebec, an upsurge of nationalist ment in Brazilian society to get asbestos banned. Exporting the risks to poorer countries the number of lawsuits against companies that exposed their workers to asbestos are also increas Brazil is currently the fourth world asbestos pro ing, and the amounts awarded in damages are act ducer after Russia, China and Canada18. A Brazil’s asbestos production is exported to other large number of asbestos-using rms are planning to countries. Its main markets for this killer bre are switch over to less harmful substitutes. Most spectac Thailand (28% of export sales), India (21%), Mexico ularly, Saint Gobain’s Brazilian subsidiary, Brasilit, (12%), Indonesia (9%) and Colombia (7%). Working has gone over entirely to asbestos-free production, conditions in these countries leave no room for illu investing 100 million reaisreaisreais in a factory that manu sion about what good the controlled use” of asbes factures the asbestos substitute, polypropylene, at tos will do. Asbestos use on the Brazil 850 workers and has an annual turnover of some ian home market has fallen sharply in recent years 200 million reais13, or just under half of Eternit’s (almost 50% in the six years between 1997 and turnover for asbestos-cement production. In 1997, 30% of Brazil’s Brazilian researchers have developed new processes, asbestos output was sold abroad. In 2003, that had in particular for using plant bres in the production risen to 60%, while asbestos imports were about a of building materials. While asbestos defend asbestos to the death, but behind the scenes bre exports have increased signicantly, exports of it is not ruling out reconversion. While the general asbestos-containing manufactured goods have lev press is lled with its proclamations of steadfast elled off at 59 million tonnes in 2003 against 60 loyalty to asbestos, the specialised economic press million tonnes in 1997. Brazilian government also refuses to carry out prior the government’s indecision is creating widespread information and consent procedures with the public uncertainty and obstructing an appropriate switcho authorities of the countries concerned by asbestos ver that respects asbestos workers’ interests, and exports, showing how little credence it places in the paves the way for viable, job-creating alternatives. It is too soon to and exporter South Africa is moving towards a total 7 April 2005, p. On 17 March 2005, the Speaker to under a quarter in ve years to be wound down 15 Mandl, C. This shows that there is no iron law about diversicar productos, Valor Online, lic backing to the Goias State pro-asbestos group once an asbestos producer, always an asbestos 1 December 2004. Imports 38 941 24 049 33 136 11 856 18 Brazil, Canada and Kazakhstan’s Exports 63 164 49 418 53 919 144 343 outputs are fairly close. Brazil’s place Apparent domestic consumption 184 224 147 716 151 912 98 630 varies between fourth and fth world producer, according to the year, with around 10% of the mineral market. Source: Ministerio de Minas e Energia, Departamento Nacional de Producao Mineral 20 S P E C I A L R E P O R T Asbestos in the world Contract killers go after labour inspectors On 28 January 2004, three labour inspectors and their driver were mown down by hired killers on the Unai-Buritis road in Minas Gerais State. They were on their way to inspect the working conditions of seasonal bean harvest workers on the region’s big farming estates. But they were also actively working against the forced labour and forms of slavery still found in rural Brazil. In July 2004, the federal police arrested the murderers, who admitted to carrying out the contract killing. The man who ordered it, businessman Hugo Pimenta, seemed to have no personal grudge against the murdered inspectors. But the police investigations revealed close links between his road haulage busi ness and large agricultural interests. The main suspects behind the organization of the slaying are two brothers: Norberto Manica, one of Brazil’s biggest employ ers in the bean-growing sector, and Anterio Manica, who is also a local political luminary. According to Pastoral Land Commission Chairman Tomas Balduino, the list also had theb backing of Jose Alencar, federal Vice-President and Defence Minister in the Lula government. Thec d examining magistrate’s investigations revealed that nearly a dozen businessmen and landowners had contributed to help pay for the killing. The main agricultural employers’ organization in Minas Gerais State is also keeping up its vindictive cam paign against the labour inspectorate. In a letter sent to Vice-President Jose Alencar after the inspectors’ murder, the organization complains of inspection terrorism”, and against all the evidence denies the existence of farm slavery in the State. Census data reveals that diverse communities experience a host of societal problems at higher rates than Caucasians. People of these communities are more likely to be uninsured, less likely to have a regular health care provider and, in turn, suffer from poor health. Access to and utilization of care is further affected by provider biases, poor provider-patient communication, poor health literacy, and other factors, including personal experiences. This report provides members of these communities with much needed health information that can be used in the fght against lung disease and risk factors that cause or contribute to lung disease. It provides statistics, background material and ongoing research about important lung health issues such as asthma, smoking, and clean air as they relate to racially and ethnically diverse communities. American Lung Association State of Lung Disease in Diverse Communities 2010 5 Looking at the nation as a whole, the American Lung Association State of Lung Disease in Diverse Communities 2010 fnds: • Studies have linked air pollution to heart disease, cancer, asthma, other illnesses, and even death. Communities of color are especially vulnerable as both African Americans and Hispanics have been found to be more likely than Caucasians to live in areas with high levels of air toxics and that are disproportionately located near freeways and other areas with heavy traffc. This markedly higher burden may be due to greater levels of poverty, delays in accessing care, or chronic disease levels among these populations. Among those who died from novel H1N1 infuenza, American Indians and Alaska Natives were much more likely to have had asthma or diabetes compared to other groups. This difference is most pronounced among men, as African American men are 37 percent more likely to develop and 22. African Americans with sarcoidosis are 3 times more likely than Caucasians to have a frst-degree or second degree relative with the disease. The American Lung Association State of Lung Disease in Diverse Communities: 2010 report is intended to inform local communities and organizations about these health disparities in an effort to assist them in infuencing local policy and public health practice. The American Lung Association is dedicated to being the premiere organization engaged in lung health research, education and advocacy. We fund innovative research that has the promise of impacting lung health to fnd cures and new and improved treatments that will beneft those living with lung disease. Our Awards and Grants program is unique in that it supports researchers at a critical juncture in their careers to help ensure that there will be an adequate supply of investigators dedicated to lung disease. Our Asthma Clinical Research Center, the nation’s largest not-for-proft network of clinical research centers dedicated to asthma treatment research, attracts some of the best asthma investigators worldwide to conduct large clinical trials that American Lung Association State of Lung Disease in Diverse Communities 2010 9 have a direct impact on patient care and asthma treatment. For example, the American Lung Association’s adult asthma program, Breathe Well, Live Well, helps participants increase their asthma knowledge as well as learn asthma self-management. The American Lung Association collaborates with volunteers and community organizations nationwide. Our programs are taught by local residents who help us in serving diverse communities. Policy change provides some of the fastest, most far-reaching and highest impact interventions in the fght against lung disease.

Infection around joint replacements in patients who have a renal or liver transplantation spasms on right side cheap rumalaya liniment online amex. Factors influencing the incidence and outcome of infection following total joint arthroplasty spasms small intestine best buy for rumalaya liniment. Rapid spread of carbapenem-resistant Klebsiella pneumoniae in New York City: a new threat to our antibiotic armamentarium spasms in chest order rumalaya liniment amex. Consensus: We recognize that the probability of surgical site infection correlates directly with the quantity of bacteria that reach the wound bladder spasms 4 year old generic rumalaya liniment 60 ml with visa. Accordingly we support strategies to lower particulate and bacterial counts at surgical wounds. Delegate Vote: Agree: 97%, Disagree: 2%, Abstain: 1% (Strong Consensus) Justification: Postoperative surgical site infections are believed to occur via bacterial inoculation at the time of surgery or as a result of bacterial contamination of the wound via open 1-3 pathways to the deep tissue layers. The probability of surgical site infection is reflected by 2 interaction of parameters that can be categorized into three major groups. The first group consists of factors related to the ability of bacteria to cause infection and include initial inoculation load and genetically determined virulence factors that are required for adherence, reproduction, toxin production and bypassing host defense mechanisms. The second group involves those factors related to the defense capacity of the host including local and systemic defense mechanisms. The last group are environmental determinants of exposure such as size, time and location of the surgical wound that can provide an opportunity for the bacteria to enter the surgical wound, overcome the local defense system, sustain their presence, replicate and initiate local as well as systemic inflammatory reactions of the host. However, no recommendations regarding the use of skin barriers can be made (See Workgroup 4 Question 27). Question 2: Do numbers of bacteria in the operating room environment correlate directly with the probability of surgical site infection Consensus: We recognize that airborne particulate bacteria are a major source of contamination in the operating room environment and that bacteria shed by personnel are the 115 predominant source of these particles. The focus of our recommendations is to reduce the volume of bacteria in the operating room with particular attention to airborne particles. Delegate Vote: Agree: 93%, Disagree: 5%, Abstain: 2% (Strong Consensus) 2, 4 Justification: Air is a potential source of contamination in the operating room. It has been suggested that if it was possible to measure accurately the number of bacteria present in the wound it should constitute the most precise predictor of 5 subsequent infection. Some studies have suggested that the airborne particulate count should be considered as 6 potential surrogate for airborne microbial density. Others have found correlation between the number of particulates larger than 10 micrometers with the density of viable bacteria at the site 7 of surgery (measured by colony forming units). It has been suggested that monitoring particulate count be used as a real-time proxy for increased risk of wound contamination or 7 infection. Persons in the operating room are major source of bacterial load and shed bacterial particulates. Movements of objects (personnel and/or operating room equipment including opening and closing doors) can generate significant marked air currents and increase the probability of 3, 8 bacteria being deposited in the surgical site. Consensus: We believe that arthroplasty surgery may be performed in operating theaters without laminar flow. Laminar flow rooms and other strategies that may reduce particulates in operating rooms would be expected to reduce particulate load. These are complex technologies that must function in strict adherence to maintenance protocols. This increase was found to be independent of patient characteristics, operative time, surgeon, or institution. However, there is some suggestion that 18, 19 space suits should be worn in laminar flow-fitted rooms to prevent contamination. The main personnel responsible for door openings were implant technical representatives and circulating nurses. In their series, information requests (an easily avoidable cause) was the reason for the 22 majority of door openings. Question 6: Should operating lights be controlled with a foot pedal as opposed to reaching above eye level Other strategies for light control need to be developed in the future to minimize contamination. Delegate Vote: Agree: 91%, Disagree: 4%, Abstain: 5% (Strong Consensus) Justification: Davis et al. It might be considered an adjunct but not a replacement for conventional cleaning. There is insufficient evidence to support the use of masks by patients that outweighs the benefit of airway access. A study by Lipp and Edwards included 3 controlled trials with a total of 2,113 subjects and concluded that the use of face masks had no 32 significant effect on surgical wound infections in patients undergoing clean surgery. However, this study included non-orthopaedic as well as orthopaedic procedures and followed patients for only 6 35 weeks postoperatively. Furthermore, it was not clear if orthopaedic procedures included implantation procedures. Consensus: We recommend that all personnel wear clean theatre attire including disposable head covering, when entering an operating room. Delegate Vote: Agree: 98%, Disagree: 1%, Abstain: 1% (Strong Consensus) Justification: Some aspects of the appropriate attire for surgical personnel (such as surgical gowns and gloves) have been addressed in other sections. Controversy has been raised regarding the utility of surgical masks or head coverings in the prevention of surgical site infection based on inconsistent results from experimental and clinical investigations in the field of general surgery, 36-42 gynecology and cardiology (cardiac catheterization). These secretions may contain bacterial particulates and all efforts should be made to decrease the risk of exposure of surgical wound to these particulates. Moreover, masks can also be beneficial in protecting the personnel from patients’ blood or other bodily fluids. Consensus: We recognize that portable electronic devices may be contaminated with bacteria. We also recognize that increased levels of talking are associated with higher levels of bacteria in the operating room environment. Accordingly we recommend that portable electronic device usage be limited to that necessary for patient care. We recognize that some surgeries present a marked and inescapable level of complexity that will 122 require more time. We recognize that minimizing the duration of surgery is an important goal and a cooperative effort on the base of the entire surgical team as well as the institution. We recommend that a coordinated effort be made to minimize the duration of surgery without technical compromise of the procedure. When considering the risk factors for infection, the duration of surgery was the only significant independent factor in a logistic regression model, also taking into account age, American 61 Society of Anesthesiologists’ physical status score, and level of emergency. On the other hand, there are studies 67 68 that failed to demonstrate such a correlation or even found an opposite relationship. Moreover, none of the previous studies considered the potential confounding role of repeat doses of antibiotic prophylaxis during prolonged procedures. Procedure duration may be an indicator of complexity of surgery (extensive surgical exposure and more severe tissue damage), surgical indication (previous procedures and indications other than osteoarthritis), 123 inexperienced surgical team, surgeon with slow pace, perioperative complications, inadequate 57, 69, 70 optimal standardization program, or patient’s preexisting medical conditions. Interestingly, it has also been demonstrated that procedures with a 62 longer duration are at increased risk for revision due to aseptic failure. Consensus: We recognize the concern regarding risk of infection to a clean surgery following a contaminated surgery. We recognize that studies have not demonstrated increased infection rates in clean surgery performed subsequent to contaminated cases. We recommend thorough cleaning as defined by local institutional standards, after contaminated surgery and before further surgery. Delegate Vote: Agree: 89%, Disagree: 8%, Abstain: 3% (Strong Consensus) Justification: Although performing an infected arthroplasty procedure before non-infected procedures is theoretically risky for cross-contamination between procedures, there is inadequate evidence to support or oppose this practice. Whether the practice of performing a clean arthroplasty procedure following an infected case increases the probability of infection or not has not been adequately studied. Microbiologic studies have demonstrated long-term 124 71 survivorship of common nosocomial pathogens on inanimate surfaces. This may support the theoretical risk of cross-contamination between procedures if there is no efficient preventive strategy for disinfection of these surfaces after every procedure. There are only two retrospective studies that have addressed this issue, but both had inadequate power and 72, 73 inconsistent conclusions. However, no advanced microbiological testing was performed to certify that both organisms were of identical 73 strains.

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Sometimes a head massage spasms under sternum buy rumalaya liniment line, or slowly but firmly rubbing the child’s head and shoulders with a towel prior to using the scissors or electric cutters muscle relaxant antidote buy cheap rumalaya liniment 60 ml line, can reduce the hypersensitivity of the child’s scalp spasms from anxiety purchase rumalaya liniment overnight delivery. Sometimes the problem is the intensity of the touch zoloft spasms cheap rumalaya liniment 60 ml fast delivery, where there is a greater sensitivity to light touch, while more intense physical pressure is acceptable or even enjoyed. Temple Grandin found deep pressure or squeezing was enjoyable and calming: I would pull away and stiffen when hugged, but I craved back rubs. She found the machine created a soothing and relaxing experience that gradually desensitized her. It held me safe in its black, awesome darkness and it offered me quiet – pure and effortless quiet. Entire mornings would pass me by while I swam under water for great periods of time, pushing my lungs to hold on to the quiet and dark until they forced me to find air. The request to ‘keep in touch’ may not be an invitation readily accepted by the person with Asperger’s syndrome. Over 50 per cent of children with Asperger’s syndrome have olfac tory and taste sensitivity (Bromley et al. My favourite foods were cereal – dry, with no milk – bread, pancakes, macaroni and spaghetti, potatoes, potatoes and milk. Because these were the foods I ate early in life, I found them comforting and soothing. I was supersensitive to the texture of food, and I had to touch everything with my fingers to see how it felt before I could put it in my mouth. I really hated it when food had things mixed with it like noodles with vegetables or bread with fillings to make sandwiches. The sensory stimulation of having that small piece of fruit explode in my mouth was too much to bear and I was not going to take any chances of that happening again. Carrots in a green salad and celery in a tuna fish salad are still intolerable to me because the contrast in texture between carrots or celery and salad or tuna fish is too great. Often as a child, less now, I would eat things serially, finishing one item on the plate before going on to the next. Unfortunately, the sensi tivity and subsequent avoidance of food that has a specific fibrous or ‘wet’ texture, and the combination of certain foods, can be the source of agitation for the whole family at meal times. Mothers in particular can be in a state of despair that the child will not con template any new or more nutritious food. Fortunately, most children with Asperger’s syndrome who have this type of sensitivity have been able to widen their diet as they mature, and for many children, this characteristic has almost disappeared by early adolescence. We recognize the reaction of retching when a person places a finger down his or her throat. This reaction is an automatic reflex to avoid a solid object in the throat, and the sensation is extremely unpleasant. However, a child with Asperger’s syndrome may have the same reaction to fibrous food in his or her mouth, not just the throat. Sometimes the resistance to eating a particular fruit or vegetable is due to a height ened sensitivity to specific aromas. The aroma is perceived as delicious to a typical child or adult, but the child with Asperger’s syndrome may have a greater olfactory sensitivity and range of perception, and detect certain aromas as overly pungent. When I ask children with Asperger’s syndrome who have this characteristic to describe the range of aromas they experience when eating a ripe peach, for example, they may respond with descriptions such as ‘it smells like urine’ or ‘it smells as if it is rotten. An adult said to me that he perceived perfumes as having a similar smell to insecticides. A child with olfactory sensitivity may avoid the aromas of paints and art supplies at school, the school cafeteria or rooms where a cleaner has used a particular detergent or cleaning agent. I know of several adults with Asperger’s syndrome who have combined an acute sense of smell with a special interest in wines to become celebrated wine experts and connoisseurs. As Liane Holliday Willey walked to her table at a restaurant, her acute sense of smell enabled her to warn a diner at another table that her sea food was off and would make her very ill. She also uses the ability to smell sickness in her daughters by smelling their breath (personal communication). Strategies to increase dietary diversity It is important to avoid programs of force feeding or starvation to encourage a more varied diet. The child has an increased sensitivity to certain types of food: it is not a simple behaviour problem where the child is being deliberately defiant. Nevertheless, parents will have to ensure that the child eats an appropriate range of food, and a dieti cian may provide guidance on what is nutritious but tolerable to the child in terms of texture, aroma or taste. Gradually the sensitivity diminishes, but the fear and consequent avoidance may continue. When this occurs, a program of systematic desensitization can be introduced by a clinical psychologist. The child can first be encouraged to describe the sensory experience and identify foods that are rated as some of the least unpleasant and more likely to be tolerated with encouragement. When introducing a low prefer ence food, the child initially only has to lick and taste, rather than chew or swallow, the food. When trying specific food sensations, the child should be encouraged to be relaxed, with a supportive adult present, and achieve congratulations and perhaps an appropriate reward for being brave. Nevertheless, some adults with Asperger’s syndrome continue to have a very restricted diet consisting of the same essential ingredients, cooked and presented in the same way, throughout their lives. Such children and adults report being ‘blinded by brightness’ and avoid intense levels of illumination. Extra red was added to the colour making it look orange, and it blurred upwards making it look like it was on fire. When the child with Asperger’s syndrome has a natural talent at drawing, and this is combined with the special interest and considerable drawing practice, the result can be works of art that achieve an effect of photographic realism. For example, a young child who has an interest in trains can be precocious in learning to draw railway scenes in perspective, including almost every detail of the loco motive. In contrast, the people in the scene may be drawn at an age-appropriate level of representation. There are reports of visual distortion, as described by Darren: I used to hate small shops because my eyesight used to make them look as if they were even smaller than they actually were. Liane Holliday Willey described that: Bright lights, mid-day sun, reflected lights, flickering lights, fluorescent lights; each seemed to sear my eyes. Together, the sharp sounds and the bright lights were more than enough to overload my senses. My head would feel tight, my stomach would churn, and my pulse would run my heart ragged until I found a safety zone. It produces ‘shadows’ in my vision (which were very scary when I was young) and long exposure can lead to confusion and dizziness often resulting in migraine. There have been descriptions of not being able to see something that is clearly visible and that the person is searching for (Smith Myles et al. The child may be asked to find a particular book in his or her desk or cupboard, and despite the book being easy for others to see, the child does not recognize the book he or she is looking for. For the person with Asperger’s syndrome, there can be intense pleasure in examples of visual symmetry. For young children this can be the parallel lines and sleepers or ties of a railway track, a picket fence or electricity pylons in a rural landscape. Adults with Asperger’s syndrome may extend the interest in symmetry to an appreciation of architecture. Liane Holliday Willey has a remarkable knowledge and appreciation of architecture: To this day, architectural design remains one of my most favored subjects and now that I am older I indulge my interest, giving in to the joy it brings me. When I feel tangled and tense, I get out my history of architecture and design books and set my eyes on the kinds of spaces and arenas that make sense to me; the linear, the straight lined and the level buildings that paint pictures of strong balance. Liane has explained to me that if she sees buildings that are asym metrical or, as she says, ‘jagged’ in their design, she feels nauseous and very anxious. Strategies to reduce visual sensitivity Parents and teachers can avoid placing the child in circumstances associated with intense or disturbing visual sensations: for example, not seating the child at the side of the car that receives the full glare of the sun, or at the school desk illuminated by strong sunlight. Another approach is to use sunglasses and visors indoors to avoid intense light or glare, or to have a workstation to screen out excessive visual stimulation. The child may have a natural screen, by growing long hair that acts as a curtain and barrier to visual (and social) experiences. Concern regarding the perceived intensity of colours can lead to a preference for wearing only black clothes, which is not necessarily a fashion statement. There are remedial programs that might have an effect on reducing a child’s visual sensitivity. Helen Irlen has developed the use of tinted glasses to improve visual percep tion and reduce perceptual overload and visual disturbance.

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This notification must include the location of the work site spasms trapezius discount rumalaya liniment 60 ml on line, the start and completion dates spasms or twitches purchase cheapest rumalaya liniment and rumalaya liniment, and a description of the work to be performed muscle relaxant with painkiller cheap 60 ml rumalaya liniment otc. The form is available by contacting the contact centre or printing the form from October 2012 33 Alberta Asbestos Abatement Manual Chapter 3 the Occupational Health and Safety’s web site spasms cure discount rumalaya liniment 60 ml free shipping. Receipt of the form will be acknowledged with an Asbestos Project Notification Acknowledgement form. Projects requiring notification involve operations having the potential to release fibres from asbestos containing materials. Although Human Services requires notification of all asbestos abatement projects, the Department is flexible regarding the 72-hour notification requirement where it can be demonstrated that there is a need to carry out the work immediately. An example of this type of situation would be the immediate removal of asbestos cladding on a ruptured pipe. However, delays in construction schedules resulting from the discovery of asbestos are not considered sufficient reason to reduce the notification period. For ongoing routine maintenance work involving low or moderate risk activities, projects may be granted extended project notification status” as long as workers are adequately trained and follow safe work procedures. Extended notifications may be granted for up to a year, depending on the employer’s ability to plan in advance. Types of projects that do not require notification include: (a) inspection of asbestos-containing materials as part of a management plan or asbestos assessment project; (b) sampling of asbestos-containing materials or potential asbestos-containing materials as part of an asbestos assessment project. Sampling must be performed by trained personnel in a manner that minimizes disturbance and damage to the asbestos containing materials; (c) removal and replacement of small (less than 30 centimeter diameter) manufactured asbestos products such as gaskets or valve packing; (d) short-term work in areas containing non-friable asbestos-containing materials that does not involve disturbing the asbestos-containing materials; and (e) transportation of asbestos-containing materials in sealed containers unless the materials are part of an asbestos abatement project. In the above cases, employers must take precautions to ensure that asbestos fibres are not released. Work procedures must be developed and followed to prevent potential asbestos exposure. October 2012 34 Alberta Asbestos Abatement Manual Chapter 3 Asbestos in buildings the following uses of asbestos are prohibited in new or existing buildings: (a) the use of materials containing crocidolite (blue) asbestos; (b) the use of asbestos-containing materials in a supply or return air plenum in a location or form that will allow asbestos fibres to enter the system; (c) the installation of a product that has the potential for releasing asbestos fibres in a building. Asbestos cement pipe and asbestos cement board are exceptions as long as they are not installed in a supply or return air plenum; and (d) the installation of asbestos by spray application. In existing buildings where there is a potential for the release of asbestos fibres, an unsafe condition may be declared. If an area within a building is being altered or renovated, materials that have the potential for releasing asbestos fibres in that area must be removed, enclosed or encapsulated. In buildings or parts of buildings that are being demolished, materials having the potential for releasing asbestos fibres must first be removed. These requirements are based on the potential for asbestos fibres to be released when the material is disturbed, not on the amount of asbestos in the material. However, some materials, such as vermiculite insulation, can release significant amounts of asbestos fibres into the air, even when they contain very low levels of asbestos. The employer must comply with the asbestos requirements when: the individual material in question contains more than one per cent asbestos (by weight) the material contains less than one per cent asbestos, but it is known that a restricted area” is likely to occur when it is disturbed (e. October 2012 35 Alberta Asbestos Abatement Manual Chapter 3 Materials identified as containing less than one per cent asbestos such as drywall joint compounds and stipple may not have been uniformly mixed when they were applied and could contain asbestos in concentrations greater than one per cent in sections. When dealing with large quantities of such materials, employers should take non homogeneous mixtures into consideration. It is the responsibility of the employer to conduct a hazard assessment and evaluate the likelihood of asbestos fibre release based on the material in question and the work procedures. This assessment must be documented and may need to be supported with air monitoring data. If the material contains less than one per cent asbestos and the likelihood of fibre release is low, the product may be handled as a non-asbestos material. These are explosives within the meaning of the Explosives Act; cosmetics, devices, drugs or food within the meaning of the Food and Drug Act; a control product within the meaning of the Pest Control Product Act; a nuclear substance within the meaning of the Nuclear Safety and Control Act; a product, material or substance packaged as a consumer product and in quantities normally used by the consuming public. October 2012 36 Alberta Asbestos Abatement Manual Chapter 3 For more information humanservices. Respiratory protective equipment must be provided and worn by the worker where a risk of over-exposure exists, or where a worker will be working in a restricted area. In selecting the appropriate equipment, the employer must consider: (a) the nature of the contaminant(s); (b) the concentration of contaminants; (c) the duration of worker exposure; (d) oxygen concentrations; and (e) the need for emergency escape from the work area. A different equipment testing organization’s approval will only be recognized if approved by a Director of Occupational Hygiene. October 2012 37 Alberta Asbestos Abatement Manual Chapter 3 In addition, a proper respirator fit must be obtained by each worker, workers must be clean shaven where the respirator meets the skin of the face (if their efficacy depends on a tight facial seal) and respirators must be stored, cleaned, inspected, serviced and used in accordance with the manufacturer’s specifications. The employer must ensure that the equipment itself does not create a hazard to the worker, workers use the required protective equipment and the equipment is in proper working condition. Where there is a potential danger of injury to a worker’s head, protective headwear must be worn. Where there is a danger of injury or irritation to a worker’s eyes, the employer must ensure that the worker wears suitable eye protection. October 2012 38 Alberta Asbestos Abatement Manual Chapter 3 Foot protection or limb and body protection may also be required where there is a danger of injury to the foot, hands, legs or trunk. Where there is a danger of falling from a height, appropriate fall protection equipment or methods must be used. Generally, the equipment must be installed by workers who are competent to do so, and the employer must ensure that the equipment is appropriate for the job and loads to be supported. A confined space is defined as a restricted space which may become hazardous to a worker entering it because of (a) an atmosphere that is or may be injurious by reason of oxygen deficiency or enrichment, flammability, explosivity, or toxicity, (b) a condition or changing set of circumstances within the space that presents a potential for injury or illness, or (c) the potential or inherent characteristics of an activity which can produce adverse or harmful consequences within the space”. A restricted space is defined as an enclosed or partially enclosed space, not designed or intended for continuous human occupancy, that has a restricted, limited or impeded means of entry or exit because of its construction”. Employers must develop procedures to eliminate hazards associated with confined spaces that address ventilation, presence of harmful substances in the air, oxygen deficiency, isolation from other piping and supply lines, protective equipment, rescue procedures and communication. The employer must develop a written code of practice that includes identification of the confined space, worker qualifications and training, isolation, ventilation, tests to be done prior to entry, protective equipment, rescue procedures and equipment, and identification of other hazards that may be present. Part of the Department’s mandate includes regulations for the use of building materials containing asbestos. The need for a building permit should be discussed with Alberta Municipal Affairs. A building permit is generally required prior to any work being done, including demolition. A Safety Codes Officer will review the plans and specifications submitted and sign-off on the project once the following items have been assessed: Additions/Renovations Where asbestos-containing building components are removed, equivalent replacements such as fire barriers may need to be provided. Impact on electrical systems and emergency lighting or alarm systems while the abatement project is in progress. In all cases, Alberta Human Services’s health and safety legislation must be followed. Where a building permit is obtained depends on the municipality in which the building is located. For non-accredited municipalities, an Alberta Municipal Affairs Contracted Accredited Agency will issue the permit. Accredited municipalities that issue permits and have taken responsibility for all of the Alberta Building Code issue the permit directly. In accredited municipalities that do not issue permits related to asbestos, an Alberta Municipal Affairs Contracted Accredited Agency must be contacted for the permits related only to the asbestos enclosure, removal or encapsulation. Prior to the start of work, the municipality or Alberta Municipal Affairs should be contacted to confirm where the building permit can be obtained. Alberta Environment has published Guidelines for the Disposal of Asbestos Waste”. In the guidelines, asbestos waste is defined as a waste containing more than one per cent asbestos by weight. Although asbestos waste does not require a manifest, a shipping document must accompany the waste to the landfill. This document must include the following information: (a) a document identification number that is legible and indelibly printed; (b) the date; (c) the name and address of the shipper; (d) the shipper’s signature; (e) the name and address of the receiver (landfill); (f) the name of the initial carrier (transporter of the waste); and (g) a description of the dangerous goods in the following order: (i) the proper shipping name of the product (asbestos: white for chrysotile, brown for amosite, blue for crocidolite); (ii) the dangerous goods class (9. The external surfaces of every container and of every vehicle or vessel used for the transport of asbestos waste must be free of asbestos waste. Asbestos waste must be properly secured and transported within an enclosed vehicle or covered by a tarpaulin or net if transported in a vehicle which is not enclosed. Friable asbestos waste should only be transported in vehicles equipped with emergency spill clean-up equipment that includes a shovel, a broom, wetting agent, protective clothing, a supply of six mil thick polyethylene bags, bag closures and approved respiratory protection.