Occupational And Environmental Health Site Assessment
U.S. NAVYU.S. AIR FORCEU.S. ARMYNTRP 4-02.9AFTTP 3-2.82 IPATP 4-02.82OCCUPATIONAL ANDENVIRONMENTAL HEALTHSITE ASSESSMENTEDITION APRIL 2012DISTRIBUTION RESTRICTION: APPROVED FOR PUBLIC RELEASE;DISTRIBUTION IS UNLIMITEDNAVY WARFARE DEVELOPMENT COMMAND1528 PIERSEY STREET BLDG O-27NORFOLK VA 23511-2723URGENT CHANGE/ERRATUM RECORDNUMBERDATEENTERED BYPRIMARY REVIEW AUTHORITY:NAVY AND MARINE CORPS PUBLICHEALTH CENTERDEPARTMENT OF THE NAVYOFFICE OF THE CHIEF OF NAVAL OPERATIONS HEADQUARTERS,U.S. MARINE CORPS, U.S. AIR FORCE, AND U.S. ARMY0411LP11291581APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82INTENTIONALLY BLANKAPR 20122
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.823A P R 2 0 12
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82INTENTIONALLY BLANKAPR 20124
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.825APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82INTENTIONALLY BLANKAPR 20126
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82April 2012PUBLICATION NOTICEROUTING1. NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82 (APR 2012), OCCUPATIONAL ANDENVIRONMENTAL HEALTH SITE ASSESSMENT, is available in the NavyWarfare Library. It is effective upon receipt.2. Summary.a. This publication describes processes for conducting an occupational andenvironmental health site assessment (OEHSA) for deployed forces.b. The scope includes current doctrine and tactics, techniques, and procedures for theconduct of an OEHSA.c. The intended audience includes tactical level military Service preventive medicinepersonnel preparing for and conducting OEHSAs at military deployment locations.Navy Warfare Library CustodianNavy Warfare Library publications must bemade readily available to all users and otherinterested personnel within the U.S. Navy.Note to Navy Warfare Library CustodianThis notice should be duplicated for routing to cognizant personnel to keep them informed of changes to this publication.7APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82INTENTIONALLY BLANKAPR 20128
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82CONTENTSPageNo.CHAPTER 1—BACKGROUND1.1GENERAL .1-11.2OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENT .1-11.3CONCEPTUAL SITE MODEL .1-21.4OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITEASSESSMENT APPROACH .1-21.5OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITEASSESSMENT ACTIVITIES .1-3CHAPTER 2—OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENTPHASE I: PREDEPLOYMENT ACTIVITIES2.1GENERAL .2-12.2PREDEPLOYMENT ACTIVITIES .2-1CHAPTER 3—OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENTPHASE II: DEPLOYMENT ACTIVITIES3.1GENERAL .3-13.23.2.13.2.2SITE INTERVIEWS AND RECONNAISSANCE .On-Site/Off-Site Interviews .On-Site/Off-Site Reconnaissance .3-13-23-43.3PATHWAY SCREENING.3-53.4BUILD CONSOLIDATED CONCEPTUAL SITE MODEL .3-73.5OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENTREPORT. 3-9Service Preventive Medicine Personnel with Access to Defense Occupationaland Environmental Health Readiness System . 3-9Service Preventive Medicine Personnel without Access to Defense Occupational andEnvironmental Health Readiness System . 3-9Peer Review. 3-103.5.13.5.23.5.39APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82PageNo.CHAPTER 4—OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENTPHASE III: ADDITIONAL DATA COLLECTION4.1GENERAL . 4-14.2OCCUPATIONAL AND ENVIRONMENTAL HEALTH SAMPLING . 4-1CHAPTER 5—OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENTPHASE IV: OCCUPATIONAL AND ENVIRONMENTAL HEALTH RISKASSESSMENTAPPENDIX A—JOINT SERVICE: OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITEASSESSMENT TEMPLATEAPPENDIX B—EXAMPLE OCCUPATIONAL AND ENVIRONMENTAL HEALTH THREATSCENARIO AND SAMPLING AND ANALYSIS PLANB.1OCCUPATIONAL AND ENVIRONMENTAL HEALTH THREAT SCENARIO . B-1B.2CONCEPTUAL SITE MODEL . B-1B.3OCCUPATIONAL AND ENVIRONMENTAL HEALTH SAMPLING ANDANALYSIS PLAN .Ambient Air: Sampling and Analytical Method(s) .Soil: Sampling and Analytical Method(s) .Occupational and Environmental Health Sampling and Analysis Plan Site Map .B.3.1B.3.2B.3.3B-2B-2B-2B-2APPENDIX C—EXAMPLE DEFENSE OCCUPATIONAL AND ENVIRONMENTAL HEALTHREADINESS SYSTEM OCCUPATIONAL AND ENVIRONMENTAL HEALTHSITE ASSESSMENT REPORTC.1DEFENSE OCCUPATIONAL AND ENVIRONMENTAL HEALTH READINESSSYSTEM OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITEASSESSMENT . C-1C.2EXAMPLE SURVEY REPORT . C-1APPENDIX D—PERIODIC OCCUPATIONAL AND ENVIRONMENTAL MONITORINGSUMMARY MILITARY DEPLOYMENT EXAMPLEREFERENCESGLOSSARYLIST OF ACRONYMS AND ABBREVIATIONSAPR 201210
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82LIST OF ILLUSTRATIONSPageNo.CHAPTER 1—BACKGROUNDFigure 1-1.Figure 1-2.Figure 1-3.Occupational and Environmental Health Site Assessment Phased Approach . 1-2Conceptual Site Model Evolution . 1-4Occupational and Environmental Health Site Assessment Activity Matrix . 1-5CHAPTER 2—OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENTPHASE I: PREDEPLOYMENT ACTIVITIESFigure 2-1.Figure 2-2.Google Earth Visual Layout of Balad Air Base, Iraq . 2-5Balad Airbase Wind Rose . 2-6CHAPTER 3—OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENTPHASE II: DEPLOYMENT ACTIVITIESFigure 3-1.Figure 3-2.Figure 3-3.Figure 3-4.Figure 3-5.Joint Service Occupational and Environmental Health Site Assessment TemplateInterview Points of Contact .Decision Logic for Pathway Screening using Direct Reading Instruments .Example of a Conceptual Site Model.Guidance for Determining Severity and Probability for Qualitative Risk Rankingof Exposure Pathways .Risk Assessment Matrix.3-23-63-83-83-9CHAPTER 4—OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENTPHASE III: ADDITIONAL DATA COLLECTIONFigure 4-1.Figure 4-2.Figure 4-3.Figure 4-4.Figure 4-5.Figure 4-6.American Industrial Hygiene Agency Exposure Assessment Strategy .Department of Defense Industrial Hygiene Exposure Assessment Model .The Data Quality Objectives Process.Information Required for a Sampling and Analysis Plan for Soil .Information Required for a Sampling and Analysis Plan for Air .Information Required for a Sampling and Analysis Plan for Water .4-34-44-54-74-84-9APPENDIX A—JOINT SERVICE: OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITEASSESSMENT TEMPLATEFigure A-1.Occupational and Environmental Health Threat Categories Covered under the JointService Occupational and Environmental Health Site Assessment Template . A-1APPENDIX B—EXAMPLE OCCUPATIONAL AND ENVIRONMENTAL HEALTH THREATSCENARIO AND SAMPLING AND ANALYSIS PLANFigure B-1.Figure B-2.Figure B-3.Conceptual Site Model . B-1Ambient Air: Sampling and Analytical Method(s) . B-3Soil Sampling and Analytical Methods. B-511APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82PageNo.Figure B-4.Occupational and Environmental Health Sample and Analysis Plan Site Map . B-7APPENDIX C—EXAMPLE DEFENSE OCCUPATIONAL AND ENVIRONMENTAL HEALTHREADINESS SYSTEM OCCUPATIONAL AND ENVIRONMENTAL HEALTHSITE ASSESSMENT REPORTFigure C-1.Occupational and Environmental Health Site Assessment Survey Report Example . C-2APPENDIX D—PERIODIC OCCUPATIONAL AND ENVIRONMENTAL MONITORINGSUMMARY MILITARY DEPLOYMENT EXAMPLEFigure D-1.APR 2012Periodic Occupational and Environmental Monitoring Summary MilitaryDeployment Example. D-112
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82PREFACENTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82 (APR 2012), Occupational and Environmental Health SiteAssessment provides guidance to deployed Service preventive medicine personnel who plan to conductoccupational and environmental health site assessments (OEHSAs) on military installations in a theateroperational environment. This publication provides specific tactical references to facilitate the execution of anOEHSA to identify and document occupational and environmental health (OEH) threat conditions that may affectthe current and future health of deployed military personnel.Use of trademarked name(s) does not imply endorsement by any Department of Defense component, but isintended only to assist in identification of a specific product.PURPOSEThe purpose of this publication is to facilitate the implementation of deployment occupational and environmentalhealth surveillance requirements outlined in Department of Defense instruction (DODI) 6490.03 (Aug2006),Deployment Health, and the Joint Chiefs of Staff memorandum MCM 0028-07 (Nov2007), Procedures forDeployment Health Surveillance. In addition, this publication is intended to provide a standardized methodologyfor the military Services to support organic preventive medicine assets in successfully accomplishing an OEHSAin various deployed environments.APPLICATIONThis publication is designed for use at the tactical level. The document supports and applies to preventivemedicine personnel across all military Services that are preparing for and conducting OEHSAs at militarydeployment locations.IMPLEMENTATION PLANParticipating Service command offices of primary responsibility will review this publication, validate theinformation, and reference and incorporate it in Service and command manuals, regulations, and curricula asfollows:1. Army. The United States Army (USA) will incorporate the procedures in this publication in Army trainingand doctrinal publications as directed by the commander, United States Army Training and DoctrineCommand Distribution is according to the Department of the Army Form 12-99-R, Initial DistributionRequirements for Publications.2. Marine Corps. The United States Marine Corps (USMC) will incorporate the procedures in this publicationin USMC training and doctrinal publications as directed by the Commanding General, Marine CorpsCombat Development Command. Distribution is according to the USMC publications distribution system.3. Navy. The United States Navy (USN) will incorporate procedures from this publication where appropriate.Nothing in this publication will supersede existing Service-specific policy. Distribution is according to theDepartment of the USN publications distribution system.4. Air Force. The United States Air Force (USAF) will incorporate the procedures in this publication inUSAF training and doctrinal publications as directed by the Air Staff. USAF strategic objective is“Garrison equals Deployed.” Distribution is according to the Department of the USAF publicationsdistribution system.13APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82USER INFORMATIONThe United States Navy and Marine Corps Public Health Center (NMCPHC) developed this publication incooperation with the Joint Environmental Surveillance Working Group and participation of the approving Servicecommands.We encourage recommended changes for improving this publication. Please reference changes by specific pageand paragraph, and provide a rationale for each recommendation. Send comments and recommendations to:COMMANDERNAVY WARFARE DEVELOPMENT COMMANDATTN: DOCTRINE1528 PIERSEY STREET BLDG O-27NORFOLK VA 23511-2723NWDC NRFK FLEETPUBS@NAVY.MILORDERING DATAOrder printed copies of a publication using the print-on-demand (POD) system. A command may requisition apublication using the standard military standard requisitioning and issue procedure (MILSTRIP) processes on theNaval Supply Systems Command Web site called the Naval Logistics Library (https://nll.ahf.nmci.navy.mil). Anapproved requisition is forwarded to the specific Defense Logistics Agency (DLA) site at which the publication’selectronic file is officially stored. Currently, two copies are printed at no cost to the requester.CHANGE RECOMMENDATIONSProcedures for recommending changes are provided below.WEB-BASED CHANGE RECOMMENDATIONSRecommended changes to this publication may be submitted to the Navy Doctrine Library System, accessiblethrough the Navy Warfare Development Command (NWDC) Web site at: http://ndls.nwdc.navy.smil.mil orhttps://ndls.nwdc.navy.mil.URGENT CHANGE RECOMMENDATIONSWhen items for changes are considered urgent, send this information by message to the primary review authority,info NWDC. Clearly identify and justify both the proposed change and its urgency. Information addressees shouldcomment as appropriate. See the sample for urgent change recommendation format on page 16.ROUTINE CHANGE RECOMMENDATIONSSubmit routine recommended changes to this publication at any time by using the routine change recommendationletter format on page 17. Mail it to the address below or post the recommendation on the Navy Doctrine LibrarySystem site.COMMANDERNAVY WARFARE DEVELOPMENT COMMANDATTN: DOCTRINE1528 PIERSEY STREET BLDG O-27NORFOLK VA 23511-2723APR 201214
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82CHANGE BARSRevised text is indicated by a black vertical line in the outside margin of the page, like the one printed next to thisparagraph. The change bar indicates added or restated information. A change bar in the margin adjacent to thechapter number and title indicates a new or completely revised chapter.WARNINGS, CAUTIONS, AND NOTESThe following definitions apply to warnings, cautions, and notes used in this manual:An operating procedure, practice, or condition that may result in injury or death if notcarefully observed or followed.An operating procedure, practice, or condition that may result in damage to equipmentif not carefully observed or followed.NoteAn operating procedure, practice, or condition that requires emphasis.WORDINGWord usage and intended meaning throughout this publication are as follows:“Shall” indicates the application of a procedure is mandatory.“Should” indicates the application of a procedure is recommended.“May” and “need not” indicate the application of a procedure is optional.“Will” indicates future time. It never indicates any degree of requirement for application of a procedure.15APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82FM ORIGINATORTO (Primary Review Authority)//JJJ//INFO COMNAVWARDEVCOM NORFOLK VA//COMUSFLTFORCOM NORFOLK VA//JJJ//COMUSPACFLT PEARL HARBOR HI//JJJ//(Additional Commands as /GENADMIN/(Organization ID)//SUBJ/URGENT CHANGE RECOMMENDATION FOR (Publication Short Title)//REF/A/DOC/NTTP 1-01//POC/(Command Representative)//RMKS/ 1. IAW REF A URGENT CHANGE IS RECOMMENDED FOR (Publication Short Title)2. PAGE ART/PARA NO LINE NO FIG NO3. PROPOSED NEW TEXT (Include classification)4. JUSTIFICATION.BTEnsure that actual message conforms to MTF requirements.Urgent Change Recommendation Message FormatAPR 201216
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82DEPARTMENT OF THE NAVYNAME OF ACTIVITYSTREET ADDRESSCITY, STATE XXXXX-XXXX5219Code/SerialDateFROM:TO:(Name, Grade or Title, Activity, Location)(Primary Review Authority)SUBJECT:ROUTINE CHANGE RECOMMENDATION TO (Publication Short Title,Revision/Edition, Change Number, Publication Long Title)ENCL:(List Attached tables, figures, etc.)1. The following changes are recommended for NTTP X-XX, Rev. X, Change X:a.CHANGE: (page 1-1, paragraph 1.1.1, line 1)Replace “ the National Command Authority President and Secretary of Defense establishesprocedures for the ”REASON: SECNAVINST ####, dated ####, instructing the term “National Command Authority”be replaced with “President and Secretary of Defense.”b.ADD: (page 2-1, paragraph 2.2, line 4)Add sentence at end of paragraph “See figure 2-1.”REASON: Sentence will refer reader to enclosed illustration.Add figure 2-1 (see enclosure) where appropriate.REASON: Enclosed figure helps clarify text in paragraph 2.2.c.DELETE: (page 4-2, paragraph 4.2.2, Line 3)Remove “Navy Tactical Support Activity.”“ Navy Tactical Support Activity, and the Navy Warfare Development Command are isresponsible for ”REASON: Activity has been deactivated.2. Point of contact for this action is (name, grade or title, telephone, e-mail address).(SIGNATURE)NAMECopy to:COMUSFLTFORCOMCOMUSPACFLTCOMNAVWARDEVCOMRoutine Change Recommendation Letter Format17APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP/ATP 4-02.82INTENTIONALLY BLANKAPR 201218
NTRP 4-02.9/AFTTP 3-2.82 IP /ATP 4-02.82CHAPTER 1Background1.1 GENERALAccording to the Joint Chiefs of Staff memorandum MCM 0028-07 (Nov2007), Procedures for DeploymentHealth Surveillance, “force health protection (FHP) provides the conceptual framework for optimizing forcehealth readiness and protecting Department of Defense (DOD) personnel from occupational and environmentalhealth (OEH) threats associated with deployments and military Service.” Deployment health surveillance is acritical component of health risk management and FHP. Deployment health surveillance includes identifying andassessing OEH threats, recognizing potential exposure pathways for deployed populations, documenting andreporting health risk, and implementing preventive measures to reduce the health risk posed by those OEH threats.The occupational and environmental health site assessment (OEHSA) is the key information organizing processand report that supports OEH risk management activities on military installations in an operational environment.The OEHSA documents environmental conditions, identifies potential OEH threats, guides OEH data collectionactivities and further risk assessments, and summarizes acute or immediate risk mitigation actions. Health riskassessment (HRA) and health risk management are critical parts of deployment health surveillance. The OEHSAis the first step of the process that supports data collection and risk assessments over time. HRAs anticipate,identify, prioritize, and assess health threats and compare residual risks across potential controls andcountermeasures. OEHSAs are a key element of the HRA process and assist Service preventive medicinepersonnel to adequately support FHP and local commanders’ risk management decisions concerning OEH threats.1.2 OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENTAn OEHSA is an iterative process used to identify and provide recommendations to manage OEH threats andtheir sources at a particular deployment site (e.g., base camp, airbase, forward operating base (FOB)) withcomplete or potentially complete exposure pathways to a current or future deployed population. The OEHSA is acomprehensive baseline assessment followed by periodic reassessments. The OEHSA and subsequentreassessments are documented in the Defense Occupational and Environmental Health Readiness System(DOEHRS). The Joint Service (JS) OEHSA template (see appendix A) is a tool to help collect OEHSA data.Reassessments serve to validate complete and potentially complete exposure pathways previously recognized andidentify new sources and exposure pathways resulting from site expansion, mission change, etc. Each iteration ofthe OEHSA is a snapshot in time of the current status of the site and provides the key operational tool for Servicepreventive medicine personnel to prioritize and manage all OEH threat assessments and to guide allocation of onsite preventive medicine resources.The source is a point or non-point origin of a health threat (e.g., field of buried drums, burn pit, bulk chemicalstorage, incinerator, radio frequency emitters, fugitive emission from off-site industries, on-site sanding/paintingoperations, transportation route). The more specific the source information the Service preventive medicinepersonnel provides, the better.In the timeframe between these iterative OEHSA reports, personnel collecting any occupational or environmentalsamples should always document (on the field data sheet and in the DOEHRS wherever possible) the rationale forthe type and location of a sample as it relates to the conceptual site model (CSM) noted in the most currentOEHSA. If the samples are for a new exposure pathway, this information should be used to update the nextOEHSA.1-1APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP /ATP 4-02.82The OEHSA takes time to fully develop. Service preventive medicine personnel should initiate the OEHSA asearly as possible to meet FHP mandates. The goal is for the OEHSA to be initiated at a site before it is occupiedby United States (U.S.) forces as a part of a preliminary hazard assessment (PLHA); however, operationalrequirements may dictate otherwise. For all permanent and semi-permanent sites (those open for more than 30days) the initial OEHSA will be initiated within 30 days and the first iteration completed within 90 days(MCM 0028-07).1.3 CONCEPTUAL SITE MODELThe cornerstone of the OEHSA is the CSM. The CSM concisely describes what is known about a site, how thesite may lead to OEH exposures, and the data gaps that must be filled to support informed health risk managementdecisions. As such, the CSM guides all environmental sampling for the site and provides the contextualinformation necessary for interpreting sampling data and using it in subsequent risk assessments. Finally, theCSM serves as a communication tool between successive Service preventive medicine personnel by defining thebasis for sample collection and keeping them focused on data needs.1.4 OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENT APPROACHThe iterative nature of the OEHSA process requires a multi-phase approach to fully assess all OEH threats,develop the CSM, and facilitate health risk assessment. Figure 1-1 outlines a phased approach to complete andcontinually update the OEHSA as new data are ascertained in the later phases of the process. Each phase and itsrespective steps will be described in detail in subsequent chapters of this document.PREDEPLOYMENT ACTIVITIESPhaseActivityObjectivesPLANNINGIGather site background and intelligenceinformationIdentify potential OEH threatsourcesEnd Product(s)Preliminary CSMInitial OEHSA planPrepare preliminary CSMDEPLOYMENT ACTIVITIESPhaseActivityObjectivesEnd Product(s)OEHSA1–Site interviews and reconnaissance2–Update CSM3–Screen exposure points4–Finalize CSM5–Rank hazardsII6–Control acute hazards7–Information managementGather more site-specificinformationIdentify new exposure pathwaysand OEH threat sourcesScreen hazard presence atexposure points and determineexposure pathway viabilityValidate or revise preliminary CSMRank hazards and pathways byrelative risk and prioritize for furtherassessmentInitial OEHSAreport–updated CSM–hazards ranked–acute hazards–controlledOEHSA entered inthe DOEHRSMitigate high/acute health risksimmediatelyDocument OEHSA on JS templateFigure 1-1. Occupational and Environmental Health Site Assessment Phased Approach (Sheet 1 of 2)APR 20121-2
NTRP 4-02.9/AFTTP 3-2.82 IP /ATP 4-02.82PhaseDEPLOYMENT ACTIVITIES (continued)ActivityObjectivesEnd Product(s)ADDITIONAL DATA COLLECTION1–Prepare OEH sampling and analysisplan (SAP)2–Sample exposure points or pointsalong CSM exposure pathwaysIIIDevelop sampling strategies to obtaindata representative of CSM exposurepathways at priority exposure pointlocations3–Monitor environmental conditionsGenerate new data from samplingand analysis4–Improve characterization of populationactivities and exposuresEvaluate data usability per the CSM5–Sampling and analysis and datagenerationProduce actionable environmentaldata to support health riskassessment/management6–Information ManagementRecord valid and relevant data onpopulation exposure patterns relativeto exposure pointsOEH SAPOEHSA datareport(s)Samples andsurveys entered inthe DOEHRS orsubmitted to theMilitary ExposureSurveillanceLibrary (MESL)when DOEHRSaccess is notavailableDocument exposure assumptionsIVOEH RISK ASSESSMENT1–Perform health risk assessment2–Recommend/refine control measures3–Repeat phase II and III over time andas necessary4–Information managementComplete formal quantitative orsemi-quantitative health riskassessmentsUnderstand residual health riskrelative to available control optionsDocument health risk assessmentand management summariesOEH riskassessment(s)Periodicoccupational andenvironmentalmonitoringsummaries(POEMSs)All reportsarchived in theDOEHRSFigure 1-1. Occupational and Environmental Health Site Assessment Phased Approach (Sheet 2 of 2)This phased approach highlights how the CSM is developed and refined throughout the entire OEHSA process.Figure 1-2 is a graphical representation of the CSM evolution. At the conclusion of Phase II of the OEHSAprocess, Service preventive medicine personnel will create a CSM for all complete and potentially completeexposure pathways.1.5 OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE ASSESSMENT ACTIVITIESAlthough the OEHSA process remains constant, the specific activities or the tactical execution in support of thatprocess may change depending on the mission and location associated with the OEHSA. For example, if the locationis a bare site (i.e., without existing infrastructure or U.S. forces present) intended for establishing a FOB, Servicepreventive medicine personnel are more apt to focus on identifying only the existing OEH threats in order to providethe chain of command site layout recommendations that are intended to minimize future OEH health risks (e.g.,preventing tent city build-up adjacent to a landfill) when the site is established. Any sampling taken during thisscenario would be for source identification only, in order to characterize the site based on existing OEH threats.Figure 1-3 provides a summary of specific OEHSA activities that should be performed during phases I and II of theOEHSA process. Completion of Phase II and entering the OEHSA in the DOEHRS fulfills the commander’srequirement for completing the OEHSA. Further characterization of exposure pathways by environmental and/orpersonal sampling in Phase III supports risk assessment/management and future deployment site reassessmentduring Phase IV.1-3APR 2012
NTRP 4-02.9/AFTTP 3-2.82 IP /ATP 4-02.82Figure 1-2. Conceptual Site Model EvolutionAPR 20121-4
NTRP 4-02.9/AFTTP 3-2.82 IP /ATP 4-02.82PHASE IDeployedSite cation (noinfrastructureand nopopulation atrisk (PAR))Use, concept ofoperations, operationalplans, unit/operationalenvironmental engineerand intelligence assetsor other predeploymentplanning documents tobegin to collect dataneeds for CSMdevelopment, includingpopulationcharacteristics,operational activities,deployment schedules,and other missionspecific information thatmay impact who will bedeployed, what they willbe doing, how long theywill be there, loymentactivities might belimited to open sourceinternet search andcontacting the UnitedStates Air Force Schoolof Aerospace medicine(USAFSAM), NationalCe
u.s. navy ntrp 4-02.9 u.s. air force afttp 3-2.82_ip u.s. army atp 4-02.82 occupational and environmental health site assessment . risk assessment matrix . 3-9 chapter 4—occupational and environmental health site asse
Documentation of occupational therapy services is necessary whenever professional services are provided to a client. Occupational therapists and occupational therapy assistants1 determine the appropriate type of documentation structure and then record the services provided within their scope of practice. This document, based on the Occupational .File Size: 540KBPage Count: 9Explore furtherDocumentation & Reimbursement - AOTAwww.aota.orgNEW OT Evaluation and Reevaluation - AOTA Guidelinestherapylog.typepad.comWriting progress notes in occupational therapy jobs .www.aureusmedical.comDocumentation & Data Collection For Pediatric Occupational .www.toolstogrowot.comSOAP Note and Documentation Templates & Examples Seniors .seniorsflourish.comRecommended to you b
1When the term occupational therapy practitioner is used in this document, it refers to both occupational therapists and occupational therapy assistants (AOTA, 2015b). Occupational therapists are responsible for all aspects of occupational therapy service delivery and are accountable for the safety and effectiveness of the occupational therapy .
Occupational therapists around the world are obligated to promote occupational rights as the actualization of human rights. This obligation requires addressing occupational injustices, initially named as occupational deprivation, occupational imbalance, occupational marginalisation, and occupational alienation (Wilcock & Townsend, 2000 .
403-1 Occupational health and safety management system 403-2 Hazard identification, risk assessment, and incident investigation 403-3 Occupational health services 403-4 Worker participation, consultation, and communication on occupational health and safety 403-5 Worker training on occupational health and safety 403-6 Promotion of worker health
2.14. P ercent of Occupational NYS OHCN Patients, by Major Occupational Group and Patient Type .21 2.15. Percent of Occupational NYS OHCN Patients, by Major Occupational Group and Geographic Region .22 2.16. P ercent of Occupational NYS OHCN Patients,
Scope of the Environmental Scan on Work and Health The three areas of focus of the Occupational Health Clinics for Ontario Workers Inc. (OHCOW) are occupational disease, workplace mental health, and occupational health issues. These priorities are viewed through the lenses of vulnerable workers, aging workers, small business, young workers, new
This Occupational Safety and Health Manual implements one of the elements of the National Weather Service (NWS) Occupational Safety and Health Program defined in NWS Policy Directive NWSPD-50-11, Occupational Safety and Health. The manual includes 32 safety procedures developed in accordance with Occupational Safety and Health Administration
How are you currently supporting your local tourism ADVENTURE INDUSTRY RESPONDENTS: OVERVIEW businesses concerning COVID-19? Tourism boards are primarily supporting the local industry through open communication, and by providing tools, resources and information to help members weather the crisis. % Percentage of respondents . 29 ORGANIZATIONAL CONCERNS (Tourism Boards) ATTA 2020 29. Q36 .
