[Federal Register Volume 61, Number 188 (Thursday, September 26, 1996)]
[Rules and Regulations]
[Pages 50432-50436]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-24720]
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DEPARTMENT OF LABOR
Mine Safety and Health Administration
30 CFR Parts 56 and 57
RIN 1219-AA97
Safety Standards for First Aid at Metal and Nonmetal Mines
AGENCY: Mine Safety and Health Administration, Labor.
ACTION: Final rule.
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SUMMARY: This final rule revises existing standards at metal and
nonmetal mines, requiring first aid capability to be available in the
event a miner is injured. The final rule provides operators more
flexibility and clarifies requirements for persons trained in first
aid.
EFFECTIVE DATE: December 26, 1996.
FOR FURTHER INFORMATION CONTACT: Patricia W. Silvey, Director; Office
of Standards, Regulations, and Variances, MSHA; 703-235-1910 (voice),
703-235-5551 (facsimile), [email protected] (Internet e-mail).
SUPPLEMENTARY INFORMATION:
I. Rulemaking Background
Sections 56/57.18010, requiring first aid training, were originally
promulgated as advisory standards on July 31, 1969, and made mandatory
on August 29, 1973. MSHA issued Program Policy Letter (PPL) No. P94-IV-
2 on October 3, 1994, to underscore the first aid requirements. MSHA
withdrew the PPL by notice in the Federal Register (60 FR 9986) on
February 22, 1995, and began a new procedure for formulating certain
policies with increased participation by the mining community. MSHA
asked the mining community to comment on the issues and to help with
development of a policy for the first aid standard.
By letter of August 25, 1995, the National Mining Association (NMA)
petitioned the Secretary of Labor requesting that MSHA institute
rulemaking, rather than develop policy on the first aid issue, and
suggested language for a new standard. The NMA recommended that MSHA
develop a new rule to require that an individual capable of providing
first aid be available on all shifts and that first aid training be
made available to all interested miners. The recommendation from NMA
addressed mutual concerns of MSHA and the mining industry.
In lieu of finalizing a first aid policy, MSHA used NMA's
recommendation as the basis for a proposed first aid rule published in
the Federal Register (60 FR 55150) on October 27, 1995. MSHA received
comments from organized labor, industry associations, mining
contractors, and medical personnel first aid trainers, all of which
were considered in developing the final rule. MSHA also reviewed and
considered written comments previously submitted to the Agency on its
draft policy letter. One request for a public hearing was received, but
it was subsequently withdrawn.
II. Discussion and Summary of the Final Rule
A. General Discussion
Mining has historically experienced one of the highest rates of
severe injuries among its employees of any major industry group in
America. Despite significant long-term improvements in safety and
health, in the three-year period from 1993 through 1995, mine operators
and independent contractors reported 226 amputations among the
approximately 225,000 miners in the metal and nonmetal industry. During
the same period, over 500 burns; 1500 fractures; and 1200 cuts,
lacerations, or punctures resulted in time lost from work. The
frequency and severity of injuries in the mining industry and the
remoteness of many operations and working places require a skilled
first aid response, the first level of care for many injured miners.
First aid is basic emergency treatment rendered on-site as soon as
possible
[[Page 50433]]
after an injury occurs and is intended to help a victim until medical
care arrives. In severe instances, first aid typically precedes two
subsequent care levels: a secondary level often performed by
paraprofessionals, such as emergency medical technicians (EMT's), and
full medical care performed by professionals, such as physicians and
nurses.
Existing MSHA standards at Secs. 56/57.18010 provide that:
``Selected supervisors shall be trained in first aid. First aid
training shall be made available to all interested employees.'' The
primary purpose of these standards is to assure that a responsible
person, trained to provide first aid, is available to render assistance
in the event a miner is injured. An additional purpose is to encourage
first aid education among miners so that they are able to help an
injured co-worker or even provide self-treatment.
The existing standards identify supervisors as the persons required
to receive first aid training. Supervisors are typically more mobile
than other workers. Companies often provide transportation to
supervisors so they can quickly access areas of the mine in the
performance of their duties. Traditionally, supervisors are present
where work is performed and injuries are most likely to occur.
Since the existing standards were first promulgated, however, there
has been significant progress in emergency response care and conditions
in the mining industry. At a number of mines, medical paraprofessionals
or professionals are members of mine workforces and able to render
skilled help at mine properties. This rulemaking takes into account
these developments.
B. Discussion of Final Rule
Final Secs. 56/57.18010 require that an individual capable of
providing first aid be available on all shifts. This individual must be
currently trained and have the skills to perform patient assessment and
artificial respiration; control bleeding; and treat shock, wounds,
burns, and musculoskeletal injuries. Operators must make first aid
training available to all interested miners.
The final rule adopts the proposal with two changes: it expressly
requires that the individual be currently trained and it deletes the
requirement for transportation and handling skills. MSHA received
comments that addressed many aspects of the proposal as discussed
below.
Individual With First Aid Skills
The final rule requires that operators have an individual capable
of providing first aid. Some commenters suggested that operators should
be allowed to use any medical personnel and paraprofessionals, such as
nurses or EMT's, to satisfy the first aid standard whether or not that
person is a supervisor. Another commenter said that the term
``individual'' should be interpreted to refer to any miner, even if the
miner is not a professional medical service provider. One commenter
asked whether a security guard could fulfill the requirements of the
proposal.
A primary reason for this rulemaking is to broaden the scope of the
rule to permit any person, regardless of title, to provide first aid.
Under the final rule, operators will have the flexibility to use anyone
who meets the requirements.
One commenter raised a concern that a miner could become an agent
of the company when the miner is available to provide first aid. The
final rule requires that operators have a capable individual available
who can perform first aid. The operator has the responsibility to
arrange for this first aid coverage. An individual's assignment for
purposes of this coverage does not make that person an ``agent'' in the
sense of being empowered to act as a representative of the operator.
Capability
One commenter was concerned that the proposed requirement for an
individual ``capable'' of performing first aid would be open to
subjective interpretation. This commenter asked how MSHA would
interpret such a requirement. Commenters generally pointed to training
as the means to establish capability and raised the issue of what type
of training was contemplated. While the existing rule requires that
supervisors ``be trained,'' the proposal contained no expressed
training requirement other than that first aid training be made
available to interested miners.
The final rule expressly provides that the individual must be
``currently trained'' and have certain specified first aid skills. The
individual who is so trained and skilled is ``capable.'' To be
``currently trained'' means that the individual must have received in-
depth first aid training which covers the specific skills in the final
regulation and that such training be up-to-date. Persons, such as
EMT's, nurses, and physicians, with current licenses or certifications
to practice, are considered ``currently trained'' under the final rule.
One commenter suggested that first aid training be provided
annually. Organizations with histories of successfully training
individuals in first aid skills differ in the frequency, breadth, and
depth of the retraining required to maintain competence. Some, such as
the American Red Cross, use a different interval from annual retraining
to maintain certification of competence. The American Red Cross's
current standard course is initially an 8-hour program to receive
certification. It requires retraining every three years to maintain a
current certification. Training offered by similar organizations, such
as local fire departments, also has varying retraining components.
Rather than exclude or constrain programs that have effectively
prepared individuals for rendering first aid, the final rule does not
incorporate an annual retraining requirement. MSHA will accept the
retraining requirements prescribed by the organization providing the
initial training.
One commenter said that first aid training taken to meet the
existing requirements of 30 CFR part 48 should qualify individuals as
``capable''. The commenter stated that part 48 training allows ample
time for adequate first aid training.
Part 48 training, however, may not automatically qualify an
individual as capable since part 48 is a different type of training
provision from the final rule. Part 48 requires basic first aid
training for all miners. The final rule for Secs. 56/57.18010 requires
that certain persons, trained and skilled in first aid, be available
and that the more in-depth first aid training to acquire those skills
be made available to interested miners.
Part 48 was promulgated in 1978. It implements Section 115 of the
Federal Mine Safety and Health Act of 1977 (Mine Act) 30 U.S.C. 825
which was intended by Congress to prevent miners from being put to work
before having received some safety and health training, including basic
first aid.
Part 48 requires training in many health and safety subjects. The
24-hour training required of new surface miners must cover at least
eleven other subjects besides first aid. The 8-hour annual refresher
training must cover at least ten other subjects. Operators have sought
flexibility to adjust the time spent on any one subject, particularly
during annual refresher training, according to the accident experience
and safety and health needs of the mine and the miners. An operator
with a high number of back injuries, for example, may determine that
miners need more training on proper lifting. To allocate
[[Page 50434]]
more time to lifting, first aid training might be curtailed. Under
these circumstances, a brief review of first aid would not adequately
train persons to maintain skills as required by Secs. 56/57.18010.
MSHA will accept part 48 training for compliance with the final
rule if it is sufficiently in-depth to develop the capability to
perform the necessary first aid skills. In all instances, training that
complies with this rule would satisfy the new miner training
requirements for first aid under part 48 and annual refresher training
requirements for the year in which it was received.
Availability
Commenters asked that MSHA clarify the meaning of the terms
``available'' and ``on all shifts.'' The concept of availability is
critical to the purpose of the final rule and is intended to have its
ordinary meaning--present and ready for use or at hand.
The final rule requires that, if an injury occurs, a person skilled
in first aid must be present at the site and must be able to be at the
scene quickly. Individuals on-site are able to respond sooner because
they are closer to the scene of an accident and know the mine. The
likelihood of survival for a seriously injured miner would be greatly
diminished if first aid treatment were not administered before off-site
medical personnel could provide it. Operators also will have to plan to
assure that this on-site coverage is provided during absences and
vacations.
One commenter questioned whether the person capable of providing
first aid would be required underground and, if so, must the person be
trained to go underground. The final rule revises current Sec. 57.18010
and expressly applies to underground mines where first aid availability
is a critical element of injury response planning. To be available, the
first aid person must be prepared to provide first aid to injured
miners promptly. An individual capable of first aid and located on the
surface at an underground mine would not be available for miners
underground in many cases because the time required to reach the
injured person would be too long. For example, reaching some areas of
an old underground mine may require traveling through a mile or more of
old workings and could take an hour or more, depending on the
availability of transportation. In those few cases where a first aid
person on the surface is available to miners injured underground, such
as some small adit mines, that person would have to be trained to go
underground to the extent required by other MSHA standards.
Similarly, to ensure availability under conditions of difficult
access and remote work areas, an underground mine operator may be
required to have more than one first aid person underground. This
concept of availability also applies to surface mines where miners may
be working in remote areas.
One commenter suggested that the term ``readily'' be inserted in
the standard before ``available'' to ensure a prompt response.
``Available'' is commonly defined to mean present and ready for use or
at hand. Adding the term ``readily'' would not increase miner
protection and, therefore, this suggestion is not adopted in the final
rule.
Another commenter suggested that availability be established either
by having the person present on-shift or reachable through radio
contact. While such factors as communication, transportation, and
presence on-shift help determine availability, they do not make a
person available to provide first aid. For example, radio communication
without the ability to reach an accident scene quickly would not meet
the requirements of the final rule.
The final rule provides that an individual skilled in first aid be
available ``on all shifts.'' Commenters questioned which shifts need to
be covered. One commenter said that only ``production'' shifts should
be covered. Another commenter stated that the standard should apply
``to all shifts where two or more miners are engaged in production,
extraction, or maintenance activities.''
Under the Mine Act, mining includes activities beyond those
suggested by the comments. Production (excavation, extraction, and
milling), development, stripping, construction, dismantling,
maintenance, and abandonment comprise mining activities according to
the Mine Act. All of these activities involve exposure to hazards that
may require the application of first aid skills. The final rule retains
the ``on all shifts'' wording to convey the breadth of these activities
while keeping the language as simple as possible. The final rule does
not apply, however, in the few instances when no mining activities
occur, for example, when only security, sales, or office work is
performed.
Independent Contractors
One commenter suggested that independent contractors should be
solely responsible for compliance with the rule for their own
employees. Another commenter said that the rule's requirements should
not apply when independent contractors are performing explosives-
related work, such as shot service, which can involve a single
employee.
Under the final rule, independent contractors will be treated the
same as under other MSHA safety and health standards. Independent
contractors working on mine property are responsible for compliance
with MSHA regulations. In some instances, the mine operator and
independent contractor are isolated from one another and a single
individual capable of first aid could not be available for both. In
those situations, each would be responsible for their own coverage. In
other instances, the mine operator and independent contractor work in
such close proximity that one can choose to provide first aid coverage
for the other. In those situations, it is the mine operator's and
independent contractor's responsibility to agree on the coverage and to
coordinate and communicate its implementation. Consistent with MSHA's
enforcement of the existing standard, mine operators and independent
contractors have the flexibility to use anyone at the mine with the
necessary skills and availability, regardless of employer.
Mining activity can present hazards to an employee whether the
employee is working alone or with another person. If an employee is
alone and becomes injured, the ability to provide self-treatment could
be critical to survival. The final rule, therefore, does not include an
exception for miners or contractor employees working alone.
First Aid Skills
Several commenters addressed the proposed first aid skills needed
to establish capability. One commenter suggested that the required
skills for those other than EMT's be limited to ``basic first aid such
as for breathing, bleeding, and shock.'' This recommendation would
exclude patient assessment and treatment of wounds, burns, breaks,
sprains, and strains. MSHA's experience is that the injuries that occur
in mines require assessment and treatment skills; the final rule,
therefore, retains the proposed skill requirements, except as discussed
below.
This commenter also said that a good procedure for obtaining
``outside medical assistance'' should be emphasized. Separate existing
standards, however, already require operators to have suitable
emergency communications and arrangements for obtaining medical
assistance (Secs. 56/57.18012, 18014).
One commenter suggested that cardiopulmonary resuscitation (CPR) be
[[Page 50435]]
added to the list of required skills. The commenter suggested that
firefighting, extrication, and evacuation also be included. The ability
to perform CPR competently can require additional patient assessment
skills, physical dexterity, and endurance. Traditionally, CPR training
has been a supplement to first aid training and is not always offered
with first aid.
The final rule does not require that first aid skills include CPR.
Mine operators are encouraged, however, to add skills which are
considered appropriate to their workforce and environment. Likewise,
the final rule does not include the suggestion that persons be
specially trained in firefighting, extrication, or evacuation. This
suggestion exceeds the scope of first aid. In addition, existing
standards require operators to train miners in these areas.
One commenter recommended that the individuals capable of providing
first aid be able to treat injuries from hazardous liquids and gases.
The final rule requires skills for treatment of injuries from any
source or cause. Skills in patient assessment and artificial
respiration and treatment of shock and burns would have direct
application to injuries from hazardous liquids and gases.
The proposed rule would have required an individual to have the
skills to handle and transport injured persons. One commenter stated
that transportation is no longer taught in the American Red Cross's
basic first aid course. The commenter pointed out that when
transporting an injured person, particularly one with a neck or spinal
injury, there is the potential to cause greater harm and possible
paralysis. The commenter suggested that the handling and transportation
of injured persons be deleted from the required skills under the final
rule.
MSHA agrees that mishandling and improper transportation of a
victim with a serious neck or spinal injury presents a high potential
to exacerbate the injury. The American Red Cross does not currently
include separate instruction on transportation and handling of the
injured in its standard first aid course, although it furnishes
guidance about these subjects in an informational section of its
textbook. The American Red Cross teaches that one of the most dangerous
threats to any seriously injured victim is unnecessary movement.
Further, the National Safety Council's course emphasizes that injured
persons should be moved only if they are in immediate danger from their
environment.
Special training, experience, dexterity, and strength are often
required to successfully handle or transport a victim with an injured
spine. Emergency medical personnel have the skills to successfully
handle and transport victims in these cases. Improvements in
transportation and communications, and the widespread availability of
emergency service present an alternative that MSHA believes is more
protective of miner safety. Under current regulations at Secs. 56/
57.18014, operators must make advance arrangements for obtaining
transportation for injured persons and emergency medical assistance
beyond first aid. The final rule, therefore, does not include the skill
requirements for transportation and handling of injured persons
contained in the proposal.
Interested Miners
The second sentence of the existing standard is revised in the
final rule to require that training be available to all interested
``miners'' rather than all interested ``employees.'' This is not a
substantive change and merely conforms the rule's terminology with
other MSHA standards. To comply with the rule, operators must inform
miners of the training in advance, so the miners can plan to attend.
One commenter questioned whether the operator must pay for first
aid training. Consistent with the existing standard, the final rule
requires the operator to make the training available to all interested
miners. Therefore, to encourage the miners' attendance at the course,
the operator must pay ordinary course expenses. The final rule, like
the existing rule, does not address the issue of compensation for the
miner's time.
III. Executive Order 12866 and the Regulatory Flexibility Act
Executive Order 12866 requires that regulatory agencies assess both
the costs and benefits of intended regulations. MSHA has determined
that this rulemaking is not a significant regulatory action
representing additional costs in excess of $100 million to a segment of
the economy and, therefore, has not prepared a separate analysis of
costs and benefits. The Regulatory Flexibility Act requires regulatory
agencies to consider a rule's impact on small entities. For the purpose
of the Regulatory Flexibility Act, MSHA policy defines a small entity
as an operation employing fewer than 20 employees. This final rule
would not have a significant economic impact on a substantial number of
small entities. The analysis contained in this preamble meets MSHA's
responsibilities under Executive Order 12866 and the Regulatory
Flexibility Act.
A few commenters were concerned that the rule would expand training
and personnel requirements beyond part 48 and existing Secs. 56/
57.18010. One commenter stated that MSHA should prepare a regulatory
analysis before proceeding further with the rulemaking.
Operators are currently required to provide supervisors trained in
first aid who, by virtue of their position, work with and are available
to the workforce. There may be some operators, however, who have not
provided this first aid coverage for the miners on all shifts under the
existing rule. These operators may incur some additional costs to
comply with the final rule. These costs, however, would be minimal and
offset by the flexibility provided in the final rule.
The final rule incorporates the National Mining Association's
petition for rulemaking and broadens the scope of persons who can
provide the first aid capability required by the standard. A mine
operator can rely on existing, non- supervisory personnel who possess
these special skills. Accordingly, MSHA has determined that this rule
will not result in any significant costs to the mining industry.
IV. Paperwork Reduction Act
This final rule contains no information collection or paperwork
requirements subject to the Paperwork Reduction Act of 1995. The
compiling and maintaining of records or other documentation of a
miner's first aid training is incurred by mine operators in the normal
course of their business activities. The burden associated with such
usual and customary business records are excluded from the information
collection burden under 5 CFR 1320.3(b)(2) (60 FR 44985).
One commenter maintained that the rule would represent a
significant burden by virtue of increased paperwork. It was suggested
that MSHA accept a certification by the mine operator as sufficient
evidence of the training. Currently, MSHA determines compliance with
the existing requirements by reviewing documentation already kept by
the mine operator, particularly course records. MSHA accepts available
documentation, such as course completion certificates, diplomas,
letters from a qualified instructor, or similar evidence. Under the
final rule, MSHA would continue this practice.
V. Unfunded Mandates Reform Act
Title II of the Unfunded Mandates Reform Act of 1995, Pub. L. 104-
4,
[[Page 50436]]
requires each Federal agency to assess the effects of Federal
regulatory actions on state, local, and tribal governments and the
private sector, other than to the extent such actions merely
incorporate requirements specifically set forth in a statute, and to
determine if the rule might significantly or uniquely affect small
governments. MSHA has concluded that small governmental entities are
not significantly or uniquely impacted by this regulation. The final
rule will impact about 10,800 metal and nonmetal mining operations of
which about 400 sand and gravel or crushed stone operations are run by
state, local, or tribal governments for the construction and repair of
highways and roads. These entities may incur some additional costs to
comply with the final rule. These costs, however, would be minimal and
offset by the flexibility provided in the final rule. Notwithstanding
this conclusion, MSHA will mail a copy of the final rule to these 400
entities.
List of Subjects in 30 CFR Parts 56 and 57
Emergency medical services, Metal and nonmetal mines, Mine safety
and health.
Dated: September 18, 1996.
J. Davitt McAteer,
Assistant Secretary for Mine Safety and Health.
Parts 56 and 57, subchapter N, chapter I, title 30 of the Code of
Federal Regulations are amended as follows:
PART 56--[AMENDED]
1. The authority citation for part 56 continues to read as follows:
Authority: 30 U.S.C. 811.
2. Section 56.18010 is revised to read as follows:
Sec. 56.18010 First aid.
An individual capable of providing first aid shall be available on
all shifts. The individual shall be currently trained and have the
skills to perform patient assessment and artificial respiration;
control bleeding; and treat shock, wounds, burns, and musculoskeletal
injuries. First aid training shall be made available to all interested
miners.
PART 57--[AMENDED]
3. The authority citation for part 57 continues to read as follows:
Authority: 30 U.S.C. 811.
4. Section 57.18010 is revised to read as follows:
Sec. 57.18010 First aid.
An individual capable of providing first aid shall be available on
all shifts. The individual shall be currently trained and have the
skills to perform patient assessment and artificial respiration;
control bleeding; and treat shock, wounds, burns, and musculoskeletal
injuries. First aid training shall be made available to all interested
miners.
[FR Doc. 96-24720 Filed 9-25-96; 8:45 am]
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