[Federal Register Volume 77, Number 240 (Thursday, December 13, 2012)]
[Notices]
[Pages 74193-74194]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-30080]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention (CDC)

[CDC-2012-0012; NIOSH-254]


Request for Information on Edel-Kindwall Caisson Tables for 
Preventing Decompression Illness in Construction Workers

AGENCY: National Institute for Occupational Safety and Health (NIOSH) 
of the Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice of public comment period.

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SUMMARY: The National Institute for Occupational Safety and Health 
(NIOSH) of the Centers for Disease Control and Prevention (CDC) invites 
comments and information on decompression tables used for protecting 
tunneling (caisson) workers from developing decompression illnesses.
    Public Comment Period: Comments must be received by March 29, 2013.

ADDRESSES: Written comments, identified by CDC-2012-0012 and docket 
number NIOSH-254, may be submitted by any of the following methods:
     Federal erulemaking portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: NIOSH Docket Office, Robert A. Taft Laboratories, 
MS-C34, 4676 Columbia Parkway, Cincinnati, OH 45226.
     Email: [email protected].
    All information received in response to this notice will be 
available for public examination and copying at the NIOSH Docket 
Office, 4676 Columbia Parkway, Cincinnati, Ohio 45226. The document and 
instructions for submitting comments can be found at: http://www.regulations.gov. NIOSH includes all comments received without 
change in the docket, including any personal information provided. All 
electronic comments should be formatted as Microsoft Word. Please make 
reference to CDC 2012-0012 and docket number NIOSH-254.

FOR FURTHER INFORMATION CONTACT: Frank J. Hearl, PE, Chief of Staff, 
National Institute for Occupational Safety and Health, Centers for 
Disease Control and Prevention, Patriots Plaza, Suite 9200, 395 E St. 
SW., Washington, DC 20201. Telephone: (202) 245-0625 (this is not a 
toll-free number).

SUPPLEMENTARY INFORMATION: High pressure tunneling operations are used 
for some underground infrastructure projects. Compressed air is used to 
prevent seepage of water or to stabilize unstable soil conditions. 
Caisson work (a water-tight structure that allows underwater 
construction to be performed) can also involve elevated pressure 
worksites. This hyperbaric environment created by ambient pressure and 
compressed air effects exposes caisson and tunnel workers to the risks 
of decompression sickness (DCS) such as the ``bends.'' DCS is related 
to intravascular or extravascular bubbles formed during reduction of 
environmental pressure (decompression). The release of nitrogen bubbles 
into blood or tissues can result in obstruction of blood flow or 
pressure effects. Clinical manifestations of DCS include (but are not 
limited to) joint pain (``bends''), lytic lesions of bones (dysbaric 
osteonecrosis), cutaneous disorders (cutis marmorata), spinal cord and 
brain disorders (stroke, paralysis, paresthesias, bladder dysfunction, 
etc.), and cardiopulmonary disorders (shortness of breath ``chokes''), 
arterial gas embolism.
    In order to prevent DCS, workers in higher hyperbaric environments 
must be safely brought back to the non-work environmental ambient 
pressure (decompressed) in decompression areas.
    Decompression tables generally utilize stepwise (staged) 
progressions of gradually decreasing pressure at varying time intervals 
based on work exposure pressures and length of work shift.
    In 1971, the Washington State Decompression Tables that were used 
in multiple states became the federal code enforced by the Occupational 
Health and Safety Administration (OSHA) and remain, unchanged, as the 
decompression tables in force today. The maximum worksite pressures 
allowed by OSHA (1926 Subpart S, Appendix A) and addressed by the OSHA 
decompression tables is 50 pounds per square inch (psi) (~3.45 bar 
gauge) [1]. They are considered inadequate for ``efficiently 
eliminating nitrogen from the body'' at pressures in excess of 36.5 psi 
[2].
    The Edel-Kindwall Caisson Tables were developed for NIOSH in 1981. 
They are based on advances in hyperbaric research and are considered to 
be more protective of worker health than the OSHA tables. As a result, 
these tables have been used for variances to the OSH standard. NIOSH is 
making these tables more easily accessible to construction users by 
posting them to a new Web page at the NIOSH Web site at http://www.cdc.gov/NIOSH/topics/Decompression/.
    However, the Edel-Kindwall tables are inadequate for dealing with 
pressures greater than 50 psi. Many modern projects using Tunnel Boring 
Machines involve pressures greater than 50 psi. There is a need for up-
to-date decompression tables.
    NIOSH is thus requesting information on the following: (1) 
Information on types of projects where the Edel-Kindwall Tables have 
been used, (2) Published and unpublished reports and findings relating 
to the use of the Edel-Kindwall Tables, including information on 
possible health effects or lack of observed health health effects in 
tunnel/caisson workers who were

[[Page 74194]]

decompressed with data from the Edel-Kindwall Tables,(3) Information on 
related control measures (e.g., engineering controls, work practices, 
personal protective equipment) in use in workplaces where decompression 
is required, and (4) Information on alternative tables and approaches 
being used to protect tunneling workers from higher pressures greater 
than 50 psi.

References

1. Hamilton RW, Bill Kay E. (2008) Boring deep tunnels. Third 
conference on U.S.-Japan panel on aerospace-diving physiology & 
technology and hyperbaric medicine.
2. Downs GJ, Kindwall EP. (1986) Aseptic necrosis in caisson 
workers: A new set of decompression tables. Aviat Space & Environ 
Med 57:569-574.


    Dated: December 4, 2012.
John Howard,
Director, National Institute for Occupational Safety and Health, 
Centers for Disease Control and Prevention.
[FR Doc. 2012-30080 Filed 12-12-12; 8:45 am]
BILLING CODE 4163-19-P