Medical Services and First Aid for General Industry and Construction

MIOSHA

Michigan Occupational Safety and Health Administration

Department of Labor and Economic Opportunity

AGENCY

INSTRUCTION

DOCUMENT IDENTIFIER:

MIOSHA-STD-08-3R5

DATE:

December 2, 2020

SUBJECT: Medical Services and First Aid for General Industry and Construction

I. Purpose. This instruction establishes policies and provides clarifications to ensure

uniform enforcement and interpretation of MIOSHA standards requiring medical services

and first aid.

II. Scope. This instruction applies agency wide.

III. References.

A. American National Standards Institute (ANSI)/International Safety Equipment

Association (ISEA) Z308.1-2015 Minimum Requirements for Workplace First

Aid Kits and Supplies.

B. Construction Safety Standards Part 1. /R408.40132 et seq., General Rules.

C. MIOSHA-300 Log of Work Related Injuries and Illnesses.

D. MIOSHA Field Operations Manual (FOM), as amended.

E. Michigan Department of Labor and Economic Opportunity (LEO) Michigan

Occupational Safety and Health Administration (MIOSHA), Consultation

Education and Training (CET) Division, Publication #5230 – Bloodborne

Infectious Diseases Sample Exposure Control Plan (Limited Exposure).

F. Occupational Health Standards Part 472. /R325.47201 et seq., Medical Services

and First Aid.

G. Occupational Health Standards Part 554. /R325.70001 et seq., Bloodborne

Infectious Diseases.

IV. Distribution. MIOSHA Staff; Federal OSHA; S-drive Accessible; MIOSHA Messenger;

and Internet Accessible.

V. Cancellations. All previous versions of this agency instruction.

VI. Next Review Date. To be reviewed in three (3) years from date of issuance

VII. History: History of previous versions include:

MIOSHA-STD-08-3R4, June 2, 2020

MIOSHA-STD-08-3R3, October 13, 2016

MIOSHA-STD-08-3R2, January 17, 2012

MIOSHA-STD-08-3R1, December 3, 2008

MIOSHA-STD-08-3, October 1, 2008

VIII. Contact. Barton G. Pickelman, Director

IX. Originator. Barton G. Pickelman, Director

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

X. Significant Changes.

A. Delete language in XII. A. 2. for construction only, a worksite located within or in

close proximity to a functional infirmary, clinic or hospital is considered to have

met this requirement.

B. Updated Section XV. Guidelines for First Aid Kits.

XI. General Industry Requirements.

A. Occupational Health Standards Part 472, Medical Services and First Aid.

1. The employer shall ensure the ready availability of medical personnel for

advice and consultation on matters of plant health. [Part 472. Rule

325.47201(1)]

a) The necessity for consultation is determined by the types of

hazards (chemical, physical) found in the workplace and an

ongoing analysis of the employer’s MIOSHA-300 (Log of Work

Related Injuries and Illnesses), workers’ compensation data, and

workplace safety and health surveys.

b) To meet the Michigan occupational health standard requirements,

first aid care shall be readily available to employees during all

working hours. However, this standard does not necessarily

require first aid facilities in all places of employment.

2. In the absence of an infirmary, clinic, or hospital in near proximity to the

workplace, an employer shall ensure the ready availability of a person or

persons who are adequately trained to render first aid. To determine

“near proximity,” MIOSHA will consider the following:

a) In areas where serious accidents may occur such as those involving

falls, electric shock, amputations, or severe chemical exposures

that could result in suffocation, severe bleeding, or other life-

threatening injury or illness, a maximum three- to four-minute

response time is required.

b) In other circumstances where a life-threatening injury is unlikely

(e.g., low hazard workplaces such as offices), a maximum 15-

minute response time is acceptable.

3. Where a remote location or a single employee worksite exists, an

employer shall develop and implement a written plan that provides for and

assures the prompt medical treatment of employees working at such

locations. Methods for assuring prompt medical attention in the event of

an emergency may include, but are not limited to the following:

a) Provide employee(s) with a means of communication such as a cell

phone, two-way radio, or panic button alert system that could be

activated to summon emergency services.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

b) Implement a wellness verification procedure where the employee

would periodically check in with a centrally staffed location on a

set schedule.

c) Install a video monitoring system.

d) Train exposed and responding employees on the exact procedure to

execute in the event of an injury.

4. An employer shall ensure the ready availability of first aid supplies in the

workplace.

a) Consideration shall be given to the following when selecting the

contents, number, and placement of first aid kits at a worksite: the

size of the worksite, the type of work, the number of employees,

and past experience.

b) A first aid kit that contains items appropriate for the worksite will

be considered in compliance with the rule.

B. All Other General Industry Standards with First Aid Requirements. See

Appendix A and Appendix B for other general industry-related standards with

specific first aid requirements.

XII. Construction Requirements.

A. Construction Safety Standards Part 1, General Rules.

1. An employer shall ensure the availability of medical personnel for advice

and consultation on matters of occupational health. The necessity for

consultation is predicated by the types of hazards (chemical, physical)

found in the workplace and through an ongoing analysis of the employer’s

MIOSHA-300 (Log of Work Related Injuries and Illnesses), workers’

compensation data, and worksite safety and health surveys.

2. A person who has a valid certificate in first aid training shall be present at

the worksite to render first aid. A certificate is valid if the requirements

necessary to obtain the certificate for first aid training meet or exceed the

requirements of the United States Bureau of Mines, the American Red

Cross, or an equivalent training program that can be verified by

documented evidence.

3. Although cardiopulmonary resuscitation (CPR) training is not a

requirement, MIOSHA encourages employers to provide CPR training

along with first aid training. A good share of construction accidents are

not addressed in the basic first aid courses. A victim of an electric shock

whose breathing and/or heart has stopped must receive immediate

assistance from a CPR trained person or death is imminent within three to

four minutes. Other types of construction accidents, such as falls,

drowning, and cave-ins may also require CPR. The safety

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

officer/industrial hygienist (SO/IH) shall encourage employers to include

CPR training along with any first aid training that may be provided.

4. Where a remote location or a single employee worksite exists, an

employer shall develop and implement a written plan that provides for and

assures the prompt medical treatment of employees working at such

locations. The plan shall be communicated to all affected employees.

This means the employer must have a written plan in place prior to

initiating such projects. Methods for assuring prompt medical attention in

the event of an emergency may include, but are not limited to:

a) Provide employee(s) with a means of communication such as a cell

phone, two-way radio, or panic button alert system that could be

activated to summon emergency services.

b) Implement a wellness verification procedure where the employee

would periodically check in with a centrally staffed location on a

set schedule.

c) Install a video monitoring system.

5. An employer shall ensure that there are first aid supplies at each jobsite

and that the supplies are readily accessible.

a) Consideration shall be given to the following when selecting the

contents, number, and placement of first aid kits at a worksite: the

size of the jobsite, the type of work, the number of employees, and

past experience.

b) A first aid kit that contains items appropriate for the worksite will

be considered in compliance with the rule.

c) First aid kit supplies shall be sealed in individual packages, stored

in a weatherproof container, and inspected by an employer or

designated representative prior to being sent out on each job and at

least weekly thereafter. Depleted supplies shall be promptly

replaced.

6. Where serious accidents such as falls, electric shocks, amputations, or

severe chemical exposures could result in suffocation, severe bleeding, or

other life-threatening injuries or illnesses, the employer shall put measures

in place to assure the prompt transport and medical treatment of injured

personnel.

a) The employer must also provide a communication system for

contacting the necessary emergency service.

b) The telephone numbers of a physician, hospital, or emergency

service shall be conspicuously posted at the jobsite.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

B. Other Construction Standards with First Aid Requirements. See Appendix C for

other construction-related standards with specific first aid requirements.

XIII. Citation Guidelines.

A. Serious. The SO/IH shall consider a serious violation after evaluating the

following:

1. When a SO/IH encounters a workplace containing hazards or exposures

that could result in a life-threatening injury or illness, the employer has

made no arrangements for first aid or medical treatment, and an incident

has occurred, the SO/IH shall recommend a serious violation.

2. For other combinations of hazards, exposures, or lack of preparation, the

SO/IH may contact their supervisor prior to recommending a serious

violation. Before contacting their supervisor, the SO/IH shall evaluate the

employer’s efforts with regard to the following:

a) Identify and assess workplace risks that have potential to cause

worker injury or illness.

b) Identify emergency medical services and availability for all times

of the day when employees are working. Response times for

treatment must be planned taking into consideration normally

anticipated delays such as auto or train traffic. Plans for response

time must be reevaluated when conditions change.

c) Designate available trained first aid providers and readily

accessible location of first aid supplies.

d) Communicate and make readily accessible contact personnel and

phone numbers. Ensure this information is current.

e) Instruct all workers about the first aid program, including what

workers should do if a coworker is injured or ill.

B. Other-than-serious. The SO/IH shall consider an other-than-serious violation only

after evaluation of the following:

1. A first aid violation has been determined and no incident has occurred.

2. Work activities that fall under the scope of a vertical standard that require

first aid and the employer is in compliance with the requirements of that

standard.

3. There are extenuating circumstances that affect the employer’s ability to

comply (such as community-wide emergency conditions).

C. Grouping. Violations may be grouped where there are violations of multiple

rules/standards involving the same hazard (e.g., first aid requirements, bloodborne

infectious diseases requirements, and/or recordkeeping requirements). Violations

shall be grouped in accordance with the MIOSHA FOM.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

XIV. Bloodborne Infectious Disease Program.

A. Employees with assigned first aid duties in general industry are required to be

protected by compliance with the MIOSHA bloodborne infectious disease

standard.

The bloodborne infectious diseases standard does not apply to the construction

and agriculture industries. For those industries that do not fall within the scope of

the bloodborne infectious diseases standard, and a recognized hazard involving

bloodborne infectious diseases has been identified, consideration shall be given to

citing Section 11(a) of the Michigan Occupational Safety and Health Act, Act 154

of the Public Acts of 1974, as amended (MIOSH Act). Section 11(a) of the

MIOSH Act (The General Duty Clause) provides that “an employer shall furnish

to each employee, employment and a place of employment which is free from

recognized hazards that are causing, or are likely to cause, death or serious

physical harm to the employee.” Section 11(a) citations must meet the

requirements outlined in the MIOSHA FOM, Chapter VI. Failure to implement

all or any part of R325.70001 et seq. can be used as the basis for a general duty

citation in the construction and agricultural industries. However, R325.70001 et

seq. should never be referenced in a general duty citation. The requirements of

R325.70001 et seq. may be listed in a general duty citation.

B. The employer must develop a written exposure control plan that covers:

- exposure determination - regulated waste disposal

- universal precautions - laundry

- engineering controls - vaccination & post exposure follow-up

- work practices - communication of hazards to employees

- personal protective equipment - recordkeeping

- housekeeping - training

CET handout MIOSHA-CET-5230 provides a model written program for those

situations where employees are expected to have limited (e.g., first aid)

exposures.

C. If first aid is a "collateral duty," for example a production employee who may, on

occasion, be called upon to provide first aid as a trained first aid team member,

the employer may postpone the hepatitis B vaccination until such time the

employee performs first aid where blood or other potentially infectious materials

are present.

XV. Guidelines for First Aid Kits. ANSI /ISEA Z308.1-2015 “Minimum Requirements for

Workplace First Aid Kits and Supplies” classifies first aid kits as “A” or “B” and requires

one or the other based on how populated, high-risk, or complex a work environment is.

The kits must contain minimum quantities of supplies within a Type I-IV container with

an appropriate label. The ANSI standard is a consensus standard and viewed as guidance

but not enforced by MIOSHA.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

Classes of First Aid Kits and Required Supplies

First Aid Supply

Minimum Quantity

Minimum Size or Volume

Class A Kits

Class B

Kits

(US)

(metric)

Adhesive Bandage

1 x 3 in

2.5 x 7.5 cm

Adhesive Tape

2.5 yd (total)

2.3 m

Antibiotic Application

1/57 oz

0.5 g

Antiseptic

1/57 oz

0.5 g

Breathing Barrier

Burn Dressing

4 x 4 in

10 x 10 cm

Burn Treatment

4 x 4 in

10 x 10 cm

Cold Pack

4 x 5 in

10 x 12.5 cm

Eye Covering, with

means of attachment

2.9 sq in

19 sq cm

Eye/Skin Wash

1 fl oz

4 fl oz

29.6 ml / 118.3 ml

First Aid Guide

Hand Sanitizer

1/32 oz

0.9 g

Medical Exam Gloves

2 pair

4 pair

Roller Bandage 2 inch

2 in x 4 yd

5 cm x 3.66 m

Roller Bandage 4 inch

4 in x 4 yd

10 cm x 3.66 m

Scissors

Splint

4 x 24 in

10.2 x 61 cm

Sterile Pad

3 x 3 in

7.5 x 7.5 cm

Tourniquet

1 in (width)

2.5 cm (width)

Trauma Pad

5 x 9 in

12.7 x 22.9 cm

Triangular Bandage

40 x 40 x 56 in

101 x 101 x 142

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

Appendix A

General Industry Safety Standards with First Aid or Medical Service

Requirements or References

Part 6. Fire Exits

R 408.10623 Employee emergency plans.

Rule 623(3)(e): Rescue and medical duties for those employees who are trained to

perform them.

Part 50. Telecommunications

1910.268(b) General.

Paragraph 268(b)(3): Readily accessible, adequate, and appropriate first aid supplies.

1910.268(c) Training.

Paragraph 268(c)(2) and (3): Train and certify in procedures pertaining to emergency

situations and first aid training, including instruction in artificial respiration.

1910.268(o) Underground lines.

Paragraph 268(o)(1)(ii): While working in a manhole, a person with basic first aid

training shall be immediately available to render assistance if there is cause for believing

that a safety hazard exists.

Paragraph 268(o)(3): While working in a manhole occupied jointly by an electric utility

and a telecommunication utility, an employee with basic first aid training shall be

available in the immediate vicinity to render emergency assistance as may be required.

The employee . . . is not to be precluded from occasionally entering a manhole to provide

assistance other than in an emergency.

Part 51. Logging

R 408.15114 Injuries, first aid, and first aid training.

Rule 5114(1): First aid kits are required at each worksite where trees are being cut, at

each active landing, and on each employee transport vehicle.

Rule 5114(2): The number and content of first aid kits is reviewed and approved.

Rule 5114(3): The contents of each first aid kit are maintained in a serviceable condition.

Rule 5114(4): Not less than 1 employee at a jobsite is trained in Red Cross first aid or

equivalent.

Rule 5114(5): Assure that each employee, including supervisors, receives or has received

first aid and cardiopulmonary resuscitation (CPR) training.

Rule 5114(6): Each employee receives first aid training at least once every 3 years and

CPR training at least annually.

Rule 5114(7): Assure that first aid and CPR training or certificate of training, or both,

remain current.

Rule 5114(8): All training shall be conducted by a designated person.

Rule 5114(9): Training is presented in a manner that the employee is able to understand,

and is appropriate in content.

Rule 5114(10): The contents and numbers of first aid kits shall be adequate for the size

and operations being conducted.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

Rule 5114(11): First aid and CPR training: methods, length, and demonstrable ability.

Rule 5114(12): Minimum content of first aid and CPR training.

Part 63. Pulp and Paper

R 408.16321 Illumination.

Rule 6321(3): Provide emergency lighting in all plant first aid and medical facilities.

Part 74. Fire Fighting

R 408.17411 Duties of employer.

Rule 7411(1)(d): Develop procedures for the treatment and transport of injured

employees from the emergency scene to a medical facility.

Rule 7411(1)(e): Provide first aid supplies/kits appropriate for the hazard history.

Part 77. Grain Handling Facilities

1910.272(d) Emergency action plan.

Paragraph 272(d): The employer shall develop and implement an emergency action plan

meeting the requirements contained in 29 CFR 1910.38.

Part 86. Electric Power Generation, Transmission, and Distribution

1910.269(b) Medical services and first aid.

Paragraph 269(b): Provide medical services and first aid as required in 1910.151. In

addition:

Paragraph 269(b)(1)(i) and (ii): Persons trained in first aid shall be available for field

work and for fixed work locations such as substations.

Paragraph 269(b)(2): First aid supplies shall be in weatherproof containers if exposed to

the weather.

Paragraph 269(b)(3): Maintain, inspect, and replenish first aid kits and make them readily

available for use.

1910.269(e) Enclosed spaces.

Paragraph 269(e)(7): While work is being performed in the enclosed space, a person with

first aid training shall be immediately available outside the enclosed space.

1910.269(t) Underground electrical installations.

Paragraph 269(t)(3)(i): While work is being performed in a manhole or vault containing

energized electric equipment, an employee with first aid training shall be available on the

surface to render emergency assistance.

Part 90. Permit-Required Confined Spaces

1910.146(k) Rescue and emergency services.

Paragraph 146(k)(2)(iii): Employees designated to provide permit space rescue and

emergency services shall be trained in basic firstaid and CPR with current certification.

Part 92. Hazard Communication

1910.1200(g) Safety data sheets.

Paragraph 1200(g)(2)(iv): Safety data sheets shall include first-aid measures.

1910.1200(i) Trade secrets.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

Paragraph 1200(i)(2): Where a medical emergency exists, the chemical manufacturer,

importer, or employer shall immediately disclose the specific chemical identity of a trade

secret chemical to that treating physician or nurse, regardless of the existence of a written

statement of need or a confidentiality agreement.

Paragraph 1200(i)(3)(ii)(D): In non-emergency situations, a chemical manufacturer,

importer, or employer shall, upon request, disclose a specific chemical identity to a health

professional providing medical or other occupational health services to exposed

employee(s), and to employees or designated representatives, if needed to provide

medical treatment to exposed employees.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

Appendix B

Occupational Health Standards with First Aid or Medical Services

Requirements or References

GI = General Industry

C = Construction

AO = Agricultural Operations

Part 306. Formaldehyde (GI & C)

1910.1048(l) Medical surveillance.

Paragraph 1048(l)(1)(ii): Provide medical surveillance as soon as possible to employees

exposed to formaldehyde in an emergency.

Part 350. Carcinogens (GI)

1910.1003(e)(4) Training and indoctrination.

Paragraphs 1003(e)(4)(i)(H) and (I): An employer shall ensure that each authorized

employee, before entering a regulated area and annually, receives training that includes,

but is not limited to the purpose and application of specific first aid procedures and

practices.

Part 430. Hazard Communication (GI & C)

1910.1200(g) Safety data sheets.

Paragraph 1200(g)(2)(iv): Safety data sheets shall include first-aid measures.

1910.1200(i) Trade secrets.

Paragraph 1200(i)(2): Where a medical emergency exists, the chemical manufacturer,

importer, or employer shall immediately disclose the specific chemical identity of a trade

secret chemical to that treating physician or nurse, regardless of the existence of a written

statement of need or a confidentiality agreement.

Paragraph 1200(i)(3)(ii)(D): In non-emergency situations, a chemical manufacturer,

importer, or employer shall, upon request, disclose a specific chemical identity to a health

professional providing medical or other occupational health services to exposed

employee(s), and to employees or designated representatives, if to provide medical

treatment to exposed employees.

Part 432. Hazardous Waste Operations and Emergency Response (GI & C)

1910.120(l)(2) Elements of an emergency response plan.

Paragraph 120(l)(2)(vii): The emergency response plan shall address emergency medical

treatment and first aid.

1910.120(m) Illumination.

Paragraph 120(m): Table H-120.1 specifies minimum illumination requirements for first

aid stations and infirmaries.

1910.120(p)(8)(ii) Elements of an emergency response plan.

Paragraph 120(p)(8)(ii)(H): The emergency response plan shall address emergency

medical treatment and first aid.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

1910.120(q)(2) Elements of an emergency response plan.

Paragraph 120(q)(2)(vii): The emergency response plan shall address emergency medical

treatment and first aid.

1910.120 - Appendix E – Training Curriculum Guidelines – (Non-mandatory).

Part 474. Sanitation (GI)

1910.141(b)(1) Potable water.

Paragraph 141(b)(1): The employer shall ensure that potable water is provided in all

places of employment, for drinking, washing of the person, cooking, washing of foods,

washing of cooking or eating utensils, washing of food preparation or processing

premises, and personal service rooms (including first aid and medical services).

1910.141(b)(2) Non-potable water.

Paragraph 141(b)(2)(i): The employer shall ensure that outlets for nonpotable water,

such as water for industrial or firefighting purposes, are posted or otherwise marked in a

manner that will indicate clearly that the water is unsafe and is not to be used for

drinking, washing of the person, cooking, washing of food, washing of cooking or eating

utensils, washing of food preparation or processing premises, or personal service rooms

(including first aid and medical services), or for washing clothes.

Part 490. Permit-Required Confined Spaces (GI)

1910.146(k) Rescue and emergency services.

Paragraph 146(k)(2)(iii): Employees designated to provide permit space rescue and

emergency services shall be trained in basic firstaid and CPR with current certification.

Part 504. Diving Operations (GI & C)

1910.410(a) General.

Paragraph 410(a)(3): All dive team members shall be trained in cardiopulmonary

resuscitation and first aid (American Red Cross standard course or equivalent).

1910.421(c) First aid supplies.

Paragraph 421(c)(1): A first aid kit appropriate for the diving operation and approved by

a physician shall be available at the dive location.

Paragraph 421(c)(2): When used in a decompression chamber or bell, the first aid kit

shall be suitable for use under hyperbaric conditions.

Paragraph 421(c)(3): In addition to any other first aid supplies, an American Red Cross

standard first aid handbook or equivalent, and a bag-type manual resuscitator with

transparent mask and tubing shall be available at the dive location.

Appendix C Alternative Conditions Under § 1910.401(A)(3) for Recreational Diving

Instructors and Diving Guides (Mandatory).

Paragraph 8(c)(i): Before each day’s diving operations, the employer must ensure that at

least two attendants, either employees or non-employees, qualified in first-aid and

administering O

treatment, are available at the dive site to treat diving-related medical

emergencies; and

(ii): Verify their qualifications for this task.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

Part 511. Temporary Labor Camps (GI & AO)

1910.142(k) “First aid.”

Paragraph 142(k)(1): Adequate first aid facilities approved by a health authority shall be

maintained and made available in every labor camp for the emergency treatment of

injured persons.

Paragraph 142(k)(2): Facilities shall be in charge of a person trained to administer first

aid and shall be readily accessible for use at all times.

Part 526. Dipping And Coating Operations (GI)

1910.124 General requirements for dipping and coating operations.

Paragraph 124(f): What first aid procedures must my employees know? First aid

procedures that are appropriate for the hazards.

Paragraph 124(h): What treatment and first aid must I provide? When your employees

work with liquids that may burn, irritate, or otherwise harm their skin, you must provide:

Paragraph 124(h)(2): Treatment by a properly designated person of any small skin

abrasion, cut, rash, or open sore.

Paragraph 124(h)(3): Appropriate first aid supplies located near the dipping and coating

operation.

Part 529. Welding, Cutting, And Brazing (GI)

1910.252(c)(13) First-aid equipment.

Paragraph 252(c)(13): First-aid equipment shall be available at all times. All injuries

shall be reported as soon as possible for medical attention. Firstaid shall be rendered

until medical attention can be provided.

Part 665. Underground Construction Caissons, Cofferdams and Compressed Air (C)

1926.803 Compressed air.

Paragraph 803(b): Medical attendance, examination, and regulations.

Paragraph 803(b)(1): There shall be retained one or more licensed physicians familiar

with and experienced in the physical requirements and the medical aspects of compressed

air work and the treatment of decompression illness. He shall be available at all times

while work is in progress in order to provide medical supervision of employees employed

in compressed air work. He shall himself be physically qualified and be willing to enter a

pressurized environment.

Paragraph 803(b)(7): A fully equipped first aid station shall be provided at each tunnel

project regardless of the number of persons employed. An ambulance or transportation

suitable for a litter case shall be at each project.

Paragraph 803(b)(8): Where tunnels are being excavated from portals more than 5 road

miles apart, a first aid station and transportation facilities shall be provided at each portal.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

Appendix C

Construction Safety Standards that have First Aid or Medical Service

Requirements or References

Part 1. General Rules

R 408. 40132 Medical services and first aid.

Rule 132(1): Medical personnel availability.

Rule 132(2): Prompt medical attention.

Rule 132(3): First aid certification.

Rule 132(4): Written plan requirements, remote locations, or single employee worksite.

Rule 132(5): Jobsite first aid supplies.

Rule 132(6): Contents of first aid kit.

Rule 132(7): Transport of injured person and communication requirements.

R 408.40133 Illumination.

Rule 133(3): Illumination intensity of 50 footcandles shall be provided for first aid

stations and infirmaries.

Part 13. Mobile Equipment

1926.604 Site clearing.

Paragraph 604(a)(1): General requirements. Employees engaged in site clearing shall be

protected from hazards of irritant and toxic plants and suitably instructed in the first aid

treatment available.

1926.605 Marine operations and equipment.

Paragraph 605(d)(2): First-aid and lifesaving equipment. The employer shall ensure that

there is in the vicinity of each barge in use at least one U.S. Coast Guard-approved 30-

inch lifering with not less than 90 feet of line attached, and at least one portable or

permanent ladder which will reach the top of the apron to the surface of the water. If the

above equipment is not available at the pier, the employer shall furnish it during the time

that he is working the barge.

Paragraph 605(d)(3): First-aid and lifesaving equipment. Employees walking or working

on the unguarded decks of barges shall be protected with U.S. Coast Guard-approved

work vests or buoyant vests.

Part 14. Tunnels, Shafts, Caissons, and Cofferdams

R 408.41463 Emergency provisions; plans; equipment; rescue crews.

Rule 1463(10)(h): The employer shall provide the following minimum rescue equipment

at the top of a shaft: One first aid kit as prescribed in Construction Safety Standard Part 1

“General Rules,” as referenced in R 408.41410.

Part 16. Power Transmission and Distribution

1926.951 Medical Services and First Aid.

Paragraph 951(a): General. The employer shall provide medical services and first aid as

required in §1926.50.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction

Paragraph 951(b): First-aid training. In addition to the requirements of §1926.50, when

employees are performing work on, or associated with, exposed lines or equipment

energized at 50 volts or more, persons with first-aid training shall be available as follows:

Paragraph 951(b)(1): Field work. For field work involving two or more employees at a

work location, at least two trained persons shall be available.

Paragraph 951(b)(2): Fixed work locations. For fixed work locations such as substations,

the number of trained persons available shall be sufficient to ensure that each employee

exposed to electric shock can be reached within 4 minutes by a trained person. However,

where the existing number of employees is insufficient to meet this requirement (at a

remote substation, for example), each employee at the work location shall be a trained

employee.

Part 35. Confined Space in Construction

1926.1211 Rescue and Emergency Services.

Paragraph 1211(b)(3): Employees designated to provide permit space rescue and

emergency services shall be trained in basic first aid and CPR with current certification.

Part 30. Telecommunications for Construction

1910.268(b) General.

Paragraph 268(b)(3): Readily accessible, adequate, and appropriate first aid supplies.

1910.268(c) Training.

Paragraph 268(c)(2) and (3): Train and certify in procedures pertaining to emergency

situations and first aid training, including instruction in artificial respiration.

1910.268(o) Underground lines.

Paragraph 268(o)(1)(ii): While working in a manhole, a person with basic first aid

training shall be immediately available to render assistance if there is cause for believing

that a safety hazard exists.

Paragraph 268(o)(3): While working in a manhole occupied jointly by an electric utility

and a telecommunication utility, an employee with basic first aid training shall be

available in the immediate vicinity to render emergency assistance as may be required.

The employee . . . is not to be precluded from occasionally entering a manhole to provide

assistance other than in an emergency.

Part 42. Hazard Communication

1910.1200(g) Safety data sheets.

Paragraph 1200(g)(2)(iv): Safety data sheets shall include first-aid measures.

1910.1200(i) Trade secrets.

Paragraph 1200(i)(2): Where a medical emergency exists, the chemical manufacturer,

importer, or employer shall immediately disclose the specific chemical identity of a trade

secret chemical to that treating physician or nurse, regardless of the existence of a written

statement of need or a confidentiality agreement.

Paragraph 1200(i)(3)(ii)(D): In non-emergency situations, a chemical manufacturer,

importer, or employer shall, upon request, disclose a specific chemical identity to a health

professional providing medical or other occupational health services to exposed

employee(s), and to employees or designated representatives, if to provide medical

treatment to exposed employees.

MIOSHA-STD-08-3R5

December 2, 2020

Medical Services and First Aid for General Industry and Construction