111 W. 16th Avenue, Third FloorAnchorage, AK 99501-5109907-563-0013 Phone907-563-6713 FaxTECHNICAL MEMORANDUMDATE:June 20, 2008TO:Mr. Carey Cossaboom, Project Manager, U.S. Army Corps of Engineers, AlaskaDistrictFROM:Matthew Faust, Project Manager, Bristol EnvironmentalRemediation Services, LLCRE:Contract No. W911KB-08-P-0074Monitoring Well DecommissioningGambell, AlaskaBristol Environmental Remediation Services, LLC (Bristol) has prepared this TechnicalMemorandum (Tech Memo) at the request of the U.S. Army Corps of Engineers (USACE). TheTech Memo presents the work plan for a groundwater monitoring well decommissioning projectto be conducted at the Gambell Formerly Used Defense Site (FUDS).SITE DESCRIPTIONThe Gambell FUDS is located on the northwest tip of Saint Lawrence Island, near the village ofGambell. Gambell is located at latitude 63 degrees (°), 46 minutes ('), 49 seconds (") North, andlongitude 171° 43' 46" West, approximately 200 miles southwest of Nome, Alaska, and 700miles northwest of Anchorage, Alaska (Figure 1). The site was operated by the military as aradar and communications facility from 1948 until the late 1950s (USACE, 2005).The Gambell FUDS encompasses approximately 2.7 square miles. The site includes areasaround Troutman Lake and extends from the ocean to the top of Sevuokuk Mountain.Environmental investigation efforts have been conducted at the site from the 1980s through thepresent (USACE, 2005). Environmental remediation efforts under the FUDS program have beencompleted at the site, with the exception of final monitoring well abandonment anddecommissioning.F10AK069603_07.04_0500_a200-1fA subsidiary of Bristol Bay Native CorporationTechnical MemorandumJune 20, 2008Page 2SCOPE OF WORKThe scope of work for this project is to properly abandon and decommission all remaininggroundwater monitoring wells currently located at the Gambell FUDS in accordance withapplicable Alaska Department of Environmental Conservation (ADEC) guidance (ADEC, 1992).Approximately 21 monitoring wells are currently located at the site. Approximate monitoringwell locations are listed on Table 1 and are shown on Figure 2.PROJECT WORK ACTIVITIESAlaska Department of Environmental Conservation guidance specifies three acceptable methodsfor decommissioning monitoring wells (ADEC, 1992). One of the acceptable methods is towithdraw the casing and fill the bore hole with grout or bentonite. This is the method that Bristolwill use to decommission the monitoring wells at the Gambell FUDS.The monitoring wells at the site were constructed using 2-inch diameter schedule 40 polyvinylchloride (PVC) casing within a steel protective casing. The protective casings of the wells rangein diameter from four to 24 inches, and in depth from one to two feet below ground surface(bgs). Two of the wells were completed flush with the ground surface, while the other 19 werecompleted 1.25 to 3.5 feet above the ground surface. Total well depths range from 6.5 to 22.5feet bgs. All screens are 0.01-inch slot size and are either five or ten feet in length. Filter packsconsist of 20-40 sand. All wells were constructed with bentonite seals from the top of the filterpack to the surface.Bristol’s procedure for decommissioning the wells will be to first pull the protective steel casingfrom the ground using a chain attached to a loader bucket. Once the protective casing has beenremoved, the PVC will be removed using the same method. Given the shallow depth of themonitoring wells, Bristol does not foresee difficulties removing the casing in this manner. Oncethe PVC has been removed, the bore hole will be backfilled with bentonite chips, taking care tominimize void spaces. The bentonite will then be hydrated.Technical MemorandumJune 20, 2008Page 3PROJECT SCHEDULEFieldwork for the Gambell FUDS monitoring well decommissioning project is anticipated tobegin in mid-August 2008, and is expected to last no more than one week. The draft report,documenting the well commissioning, will be submitted within two weeks of the completion offieldwork.Schedule SummaryActivityMonitoring Well DecommissioningSubmit Draft ReportMonth/YearTentative Date(s)August 2008August 18 – 24September 2008September 7PROJECT ORGANIZATIONMr. Matthew Faust will be the Project Manager and will be responsible for ensuring project tasksare completed on schedule and within budget.Mr. Llewellyn MacDonald will be the Site Superintendent and will be responsible for executionof Bristol on-site activities in accordance with contract specifications.Mr. Carey Cossaboom is the Project Manager for USACE and is the point of contact (POC) forthe Corps. Ms. Lisa Geist shall serve as the alternate POC.Bristol will subcontract certain tasks to the Native Village of Gambell (NVG), who will providea trained field crew and necessary heavy equipment. The field crew and heavy equipmentcurrently serve the Native American Lands Environmental Mitigation Program (NALEMP), butthis work is separate from NALEMP. The NVG crew will provide labor and heavy equipmentoperation, as well as disposal of well materials accumulated during the decommissioningactivities.SITE HEALTH AND SAFETY PLANPotential hazards associated with conducting field activities include physical hazards, such asexposure to heavy equipment, noise, slips/trips/falls, and hand tool usage, and potentiallyhazardous weather.Technical MemorandumJune 20, 2008Page 4PHYSICAL HAZARDSFallsWorkers may encounter fall conditions (slipping and tripping) during field activities. Thepotential hazards related to slipping, tripping, or falling associated with this site include thefollowing:•Uneven terrain,•Buried objects, and•Slippery surface conditions caused by standing water.These hazards will be mitigated by using caution at all times.Exposure to Heavy EquipmentHeavy equipment will be used on this project to pull casing from the bore holes. There is apotential for workers to be struck by these vehicles, or to be injured by contact with exposedmechanical parts. In addition, there is a risk of vehicle accidents and of fire during refueling. Tocontrol these hazards, safe distances will be maintained between workers and mechanicalequipment.NoiseHigh noise levels may occur during heavy equipment operation. Personnel exposed to noiseassociated with heavy equipment operation will be provided with appropriate hearing protection.A physical agent data sheet (PADS) for noise is included in Attachment 1 and will be availableon site during field activities.Hand ToolsPersonnel may be utilizing hand tools during field activities. The potential hazards related tohand tools are pinch points and tools dropped onto body extremities.These hazards will be mitigated by using tools in a manner proscribed by the tool’smanufacturer.Technical MemorandumJune 20, 2008Page 5Adverse WeatherIn case of adverse weather, Bristol will determine if work can continue without sacrificing thehealth and safety of field workers. Some of the conditions to be considered prior to determiningif work should continue are listed below:•Extreme cold, and/or wind conditions,•Heavy precipitation,•Limited visibility, and•Electrical storms.PADS for heat and cold stress are included in Attachment 1 and will be available on site duringfield activities.Personal Protection Equipment (PPE)All site work will initially be conducted in Modified Level D PPE, which includes the following:•Feet protection – occupational safety boots,•Eye protection – safety glasses or goggles, and•Hand protection – latex/neoprene/nitrile gloves.Emergency Medical ServicesIn the event of an accidental injury or sudden onset of illness or injury that is beyond the normalscope of first aid, emergency medical services will be available at the Bessie A. Kaningok HealthClinic in Gambell, Alaska. The telephone number for the health clinic is (907) 985-5346.Technical MemorandumJune 20, 2008Page 6REFERENCESU.S. Army Corps of Engineers. 2005 (June). Decision Document, Gambell Formerly UsedDefense Site, F10AK0696, St. Lawrence Island, Alaska.Alaska Department of Environmental Conservation. 1992 (April). Guidance No. 001 –Recommended Practices for Monitoring Well Design, Installation, andDecommissioning.FIGURESDrawing: O:\JOBS\49003 GAMBELL MONITORING WELL DECOM\ACAD-ENVIRO\FIGURES\DWG\49003_FIG1_SVM_JUNE08.DWG - Layout: 49003_FIG1_SVM_JUNE08User: MGARCIA Jul 16, 2008 - 3:45pm Xrefs: - Images: C62168G5.TIFSiteLocationGambell Site036Scale: 1"= 6 MILESSource: USGS National Atlas Sheet Number 42-43FIGURE 1GAMBELL, ST. LAWRENCE ISLAND, ALASKAMONITORING WELL DECOMMISSIONINGVICINITY MAPBristolENVIRONMENTAL REMEDIATIONSERVICES, LLCPhone (907) 563-0013 Fax (907) 563-6713Project No: 49003DATUM:NAPROJECTION:NADATE06/20/08DWN.MTG1SCALENTSofAPPRVD.SAJ2SHEET1. Mapping taken from Chemical Data Aquisition Plan by Ecology& Environment (1993). Mapping believed to be sketchedfrom aerial photography taken in 1985. Accuracy unknown.2. Contour interval varies 5/100 ft.WESTBEACH8RUNWAY1BERING SEA8CITY LANDFILLOLD GAMBELL8OLD VILLAGE WELLARCHAEOLOGICAL SITEVILLAGE OFGAMBELLMUNICIPAL BUILDINGTROUTMAN LAKE816PUMP HOUSE1LANDFILL NO. 17HIGH SCHOOLARMYLANDFILLFORMER MAIN CAMP17WATER TRANSMISSION LINENAYVAGHAQLAKEAREA 1AARMYLANDINGAREA6UNNAMEDPONDARCHAEOLOGICAL SITESSOUTH AREA13NORTH AREA12PROPOSED WASTEACCUMULATION POINTLANDFILL NO. 2NEW VILLAGEWATER SUPPLYFORMER CABLE BURIAL AREA10PROPOSED BEESCLANDING AREA5BURIED FORMER TRAM ANCHORBERING SEAFORMER INFILTRATION GALLERY(CURRENTLY USED)2CATIONS10BLCAEROUTESUSPECTEDORDNANCE BURIALSITEFORMER MILITARY HOUSING/ OPERATIONS BURIAL SITEAREA 1B3FORMER TRANSFORMER AREAAREA 4DCOMMUNIDrawing: O:\JOBS\49003 GAMBELL MONITORING WELL DECOM\ACAD-ENVIRO\FIGURES\DWG\49003_FIG2_MWL_JUNE08.DWG - Layout: 49003_FIG2_MWL_JUNE08User: MGARCIA Jul 18, 2008 - 12:51pm Xrefs: - Images:1994 SUMMER LAKEBOUNDARYNORTHBEACHAIR FORCE LANDING AREA1FORMER COMMUNICATIONS FACILITY BURIAL AREAQUONSET HUTS10DRUMSAREA 4C10AREA 4A4ARMY TRAILAREA 4BFORMER AIR FORCE RADAR SITESEVUOKUK MTN.AIR FORCE TRAILFIGURE 2GAMBELL, ST. LAWRENCE ISLAND, ALASKAMONITORING WELL DECOMMISSIONINGMONITORING WELL LOCATIONSAPPROXIMATE MONITORING WELL LOCATIONSOURCE: U.S. ARMY ENGINEERING DISTRICT, ALASKAST. LAWRENCE ISLAND, AKFIGURE 1-3, GAMBELL REMEDIAL INVESTIGATION(SITE 5)-MWH MONTGOMERY WATSON, INC.12000600APPROXIMATE SCALE IN FEET1200BristolENVIRONMENTAL REMEDIATIONSERVICES, LLCPhone (907) 563-0013 Fax (907) 563-6713Project No: 49003DATUM:NAPROJECTION:NADATE06/20/08DWN.MTG2SCALESHOWNofSAJ2APPRVD.SHEETTABLETable 1 - Approximate Monitoring Well LocationsWell IDNorth LatitudeWest LongitudeConditionMW-163.781356°171.7149255°UnknownMW-263.781983°171.7136754°UnknownMW-363.782303°171.7167222°UnknownMW-463.782614°171.7157427°UnknownMW-563.782632°171.7142623°UnknownMW-663.781235°171.6986545°UnknownMW-763.781432°171.697668°UnknownMW-863.781016°171.6978684°Bent by ATV accidentMW-963.779763°171.6953778°UnknownMW-1063.779493°171.696521°UnknownMW-1163.779979°171.6976435°UnknownMW-1263.780023°171.6995515°UnknownMW-1363.77942°171.6999017°UnknownMW-1763.741088°171.7076646°UnknownMW-1863.741363°171.7085022°UnknownMW-1963.737655°171.7164491°UnknownMW-2063.744871°171.7115767°UnknownMW-2163.745254°171.7108938°UnknownMW-2263.744751°171.7100725°UnknownMW-2563.777664°171.7174244°Flush mount completionMW-2763.777449°171.7185506°Flush mount completionNotes:° = degreesATV = all-terrain vehicleID = identificationATTACHMENT 1Physical Agent Data Sheets (PADS)Heat StressCold StressNoisePhysical Agent Data Sheet (PADS)- Heat StressOther PADS:Cold StressHand-Arm VibrationHeatIonizing Radiation (PDF)LasersNoiseRadio WavesUltraviolet RadiationDescriptionAcclimatizationHealth EffectsHeatDisordersLessening Stressful ConditionsMedical ConditionsAggravated By Exposure toHeatPreventing Heat DisordersThermal Conditions in theWorkplaceRest AreasDrinking WaterDescriptionHeat stress is caused by working in hot environments like laundries, bakeries,or around boilers or incinerators. Four environmental factors affect the amountof heat stress felt by employees in hot work areas: temperature, humidity,radiant heat (such as from the sun or a furnace), and air velocity. How well orhow poorly an individual reacts to heat stress is dependent on personalcharacteristics such as age, weight, fitness, medical condition, andacclimatization.The body has several methods of maintaining the proper internal bodytemperature. When internal body temperature increases, the circulatorysystem reacts by increasing the amount of blood flow to the skin so the extraheat can by given off.Sweating is another means the body uses to maintain stable internaltemperatures. When sweat evaporates, cooling results. However, sweating iseffective only if the humidity level is low enough to permit evaporation and ifthe fluids and salts lost are replaced.^back to the topHealth EffectsHeat DisordersHeat stroke, the most serious health problem for workers in hot environmentsis caused by the failure of the bodys internal mechanism to regulate its coretemperature. Sweating stops and the body can no longer rid itself of excessheat. Signs include: mental confusion, delirium, loss of consciousness,convulsions or coma; a body temperature of 106 degrees Fahrenheit or higher;and hot dry skin which may be red, mottled or bluish. Victims of heat stroke willdie unless treated promptly. While medical help should be called, the victimmust be removed immediately to a cool area and his/her clothing soaked withcool water. He/she should be fanned vigorously to increase cooling. Promptfirst aid can prevent permanent injury to the brain and other vital organs.Heat exhaustion develops as a result of loss of fluid through sweating when aworker has failed to drink enough fluids or take in enough salt, or both. Theworker with heat exhaustion still sweats, but experiences extreme weakness orfatigue, giddiness, nausea, or headache. The skin is clammy and moist, thecomplexion pale or flushed, and the body temperature normal or slightlyhigher. Treatment is usually simple: the victim should rest in a cool place anddrink salted liquids. Salt tablets are not recommended. Severe cases involvingvictims who vomit or lose consciousness may require longer treatment undermedical supervision.Heat cramps, painful spasms of the bone muscles, are caused when workersdrink large quantities of water but fail to replace their bodies salt loss. Tiredmuscles, those used for performing the work, are usually the ones mostsusceptible to cramps. Cramps may occur during or after working hours andmay be relieved by taking salted liqids by mouth or saline solutionsintravenously for quicker relief, if medically determined to be required.Fainting may be a problem for the worker unacclimatized to a hot environmentwho simply stands still in the heat. Victims usually recover quickly after a briefperiod of lying down. Moving around, rather that standing still, will usuallyreduce the possibility of fainting.Heat rash, also known as prickly heat, may occur in hot and humidenvironments where sweat is not easily removed from the surface of the skinby evaporation. When extensive or complicated by infection, heat rash can beso uncomfortable that it inhibits sleep and impairs a workers performance oreven results in temporary total disability. It can be prevented by showering,resting in a cool place, and allowing the skin to dry.^back to the topMedical Conditions Aggravated By Exposure to HeatPersons with heart or circulatory diseases or those who are on "low salt" dietsshould consult with their physicians prior to working in hot environments.Preventing Heat DisordersOne of the best ways to reduce heat stress on workers is to minimize heat inthe workplace. However, there are some work environments where heatproduction is difficult to control, such as when furnaces or sources of steam orwater are present in the work area, or when the workplace itself is outdoorsand exposed to varying warm weather conditions.AcclimatizationHumans are, to a large extent, capable of adjusting to the heat. Thisadjustment to heat, under normal circumstances, usually takes about 5 to 7days, during which time the body will undergo a series of changes that willmake continued exposure to heat more endurable.On the first day of work in a hot environment, the body temperature, pulse rate,and general discomfort will be higher. With each succeeding daily exposure, allof these responses will gradually decrease, while the sweat rate will increase.When the body becomes acclimated to the heat, the worker will find it possibleto perform work with less strain and distress.Gradual exposure to heat gives the body time to become accustomed to higherenvironmental temperatures. Heat disorders in general are more likely to occuramong workers who have not been given time to adjust to working in the heator among workers who have been away from hot environments and who havegotten accustomed to lower temperatures. Hot weather conditions of thesummer are likely to affect the worker who is not acclimatized to heat.Likewise, workers who return to work after a leisurely vacation or extendedillness may be affected by the heat in the work environment. Whenever suchcircumstances occur, the worker should be gradually reacclimatized to the hotenvironment.^back to the topLessening Stressful ConditionsMany industries have attempted to reduce the hazards of heat stress byintroducing engineering controls, training workers in the recognition andprevention of heat stress, and implementing work-rest cycles. Heat stressdepends, in part, on the amount of heat the workers body produces while ajob is being performed. The amount of heat produced during hard, steady workis much higher than that produced during intermittent or light work. Therefore,one way of reducing the potential for heat stress is to make the job easier orlessen its duration by providing adequate rest time. Mechanization of workprocedures can often make it possible to isolate workers from the heat source(perhaps in an air-conditioned booth) and increase overall productivity bydecreasing the time needed for rest. Another approach to reducing the level ofheat stress is the use of engineering controls which include ventilation andheat shielding.Number and Duration of ExposuresRather than be exposed to heat for extended periods of time during the courseof a job, workers should, wherever possible, be permitted to distribute theworkload evenly over the day and incorporate work-rest cycles. Work-restcycles give the body an opportunity to get rid of excess heat, slow down theproduction of internal body heat, and provide greater blood flow to the skin.Workers employed outdoors are especially subject to weather changes. A hotspell or a rise in humidity can create overly stressful conditions. The followingpractices can help to reduce heat stress:Postponement of nonessential tasksPermit only those workers acclimatized to heat to perform themore strenuous tasks, orProvide additional workers to perform the task keeping in mindthat all workers should have the physical capacity to perform thetask and that they should be accustomed to the heat.^back to the topThermal Conditions in the WorkplaceA variety of engineering controls can be introduced to minimize exposure toheat. For instance, improving the insulation on a furnace wall can reduce itssurface temperature and the temperature of the area around it. In a laundryroom, exhaust hoods installed over those sources releasing moisture will lowerthe humidity in the work area. In general, the simplest and least expensivemethods of reducing heat and humidity can be accomplished by:Opening windows in hot work areas,Using fans, orUsing other methods of creating airflow such as exhaustventilation or air blowers.Rest AreasProviding cool rest areas in hot work environments considerably reduces thestress of working in those environments. There is no conclusive informationavailable on the ideal temperature for a rest area. However, a rest area with atemperature near 76 degrees Fahrenheit appears to be adequate and mayeven feel chilly to a hot, sweating worker, until acclimated to the coolerenvironment. The rest area should be as close to the workplace as possible.Individual work periods should not be lengthened in favor of prolonged restperiods. Shorter but frequent work-rest cycles are the greatest benefit to theworker.^back to the topDrinking WaterIn the course of a days work in the heat, a worker may produce as much as 2to 3 gallons of sweat. Because so many heat disorders involve excessivedehydration of the body, it is essential that water intake during the workday beabout equal to the amount of sweat produced.Most workers exposed to hot conditions drink less fluids than needed becauseof an insufficient thirst drive. A worker, therefore, should not depend on thirst tosignal when and how much to drink. Instead, the worker should drink 5 to 7ounces of fluids every 15 or 20 minutes to replenish the necessary fluids in thebody. There is no optimum temperature of drinking water, but most peopletend not to drink warm or very cold fluids as readily as they will cool ones.whatever the temperature of the water, it must be palatable and readilyavailable to the worker. Individual drinking cups should be provided, never usea common drinking cup.Heat acclimatized workers lose much less salt in their sweat than do workerswho are not adjusted to the heat. The average American diet containssufficient salt for acclimatized workers even when sweat production is high. If,for some reason, salt replacement is required, the best way to compensate forthe loss is to add a little extra salt to the food. Salt tablets should not be used.CAUTION: PERSONS WITH HEART PROBLEMS OR THOSE ON A "LOWSODIUM" DIET WHO WORK IN HOT ENVIRONMENTS SHOULD CONSULTA PHYSICIAN ABOUT WHAT TO DO UNDER THESE CONDITIONS.^back to the topProtective ClothingClothing inhibits the transfer of heat between the body and the surroundingenvironment. Therefore, in hot jobs where the air temperature is lower thanskin temperature, wearing clothing reduces the bodys ability to lose heat intothe air.When air temperature is higher than skin temperature, clothing helps toprevent the transfer of heat from the air to the body. The advantage of wearingclothing, however, may be nullified if the clothes interfere with the evaporationof sweat.In dry climates, adequate evaporation of sweat is seldom a problem. In a drywork environment with very high air temperatures, the wearing of clothingcould be an advantage to the worker. The proper type of clothing depends onthe specific circumstance. Certain work in hot environments may requireinsulated gloves, insulated suits, reflective clothing, or infrared reflecting faceshields. For extremely hot conditions, thermally-conditioned clothing isavailable. One such garment carries a self-contained air conditioner in abackpack, while another is connected to a compressed air source which feedscool air into the jacket or coveralls through a vortex tube. Another type ofgarment is a plastic jacket which has pockets that can be filled with dry ice orcontainers of ice.^back to the topRecommended Exposure LimitsThese Threshold Limit Values (TLVS) refer to heat stress conditions underwhich it is believed that nearly all workers may be repeatedly exposed withoutadverse health effects. The TLVs shown in Table I are based on theassumption that nearly all acclimatized, fully clothed workers with adequatewater and salt intake should be able to function effectively under the givenworking conditions without exceeding a deep body temperature of 38 degreesCelsius (100.4 degrees Fahrenheit).Since measurement of deep body temperature is impractical for monitoring theworkers heat load, the measurement of environmental factors is requiredwhich most nearly correlate with deep body temperature and otherphysiological responses to heat. At the present time, Wet Bulb GlobeTemperature Index (WBGT) is the simplest and most suitable technique tomeasure the environmental factors. WBGT values are calculated by thefollowing equations:Outdoors with solar load: WBGT = 0.7 NWB + 0.2 GT + 0.1 DBIndoors or Outdoors with no solar load: WBGT = 0.7 NWB + 0.3 GTWhere:WBGT = Wet Bulb Globe Temperature IndexNWB = Natural Wet Bulb TemperatureDB = Dry Bulb TemperatureGT = Globe TemperatureThe determination of WBGT requires the use of a black globe thermometer, anatural (static) wet-bulb thermometer, and a dry bulb thermometer.Higher heat exposures that shown in Table I are permissible if the workershave been undergoing medical surveillance and it has been established thatthey are more tolerant at work in heat than the average worker. Workersshould not be permitted to continue their work when their deep bodytemperature exceeds 38.0 degrees Celsius (100.4 degrees Fahrenheit).^back to the topTable 1Permissible Heat Exposure Threshold Limit Values(Values are given in degrees Centigrade WBGT (Fahrenheit)]Work LoadWork- Rest RegimenLightModerateHeavyContinuous work30.0(86.0)26.7(80.1)25.0(77.0)75% Work, 25%Rest/Hour30.6(87.1)28.0(82.4)25.9(78.6)50% Work, 50%Rest/Hour31.4(88.5)29.4(85.0)27.9(82.2)25% Work, 75%Rest/Hour32.2(90.0)31.1(88.0)30.0(86.0)References1. "Working in Hot Environments," US Department of Health and HumanServices, Public Health Service, Centers for Disease Control, NationalInstitute for Occupational Safety and Health, 1986.2. "Threshold Limit Values and Biological Exposure Indices for 1986 1987," American Conference of Governmental Industrial, Hygienists,6500 Glenway Avenue, Building D-7, Cincinnati, OH 45211-4438.^back to the topLabor and Workforce Development || Job Seeker || Employer || WorkerAlaska Department of Labor and Workforce DevelopmentLabor Standards and Safety3301 Eagle Street/PO Box 107022Anchorage, Alaska 99510-7022(907) 269-4955PHYSICAL AGENT DATA SHEETCOLD STRESSHYPOTHERMIAFROSTBITEAlaska Department of Labor and Workforce DevelopmentLabor Standards and Safety3301 Eagle Street/PO Box 107022Anchorage, 99510-7022(907) 269-4955Physical Agent Data SheetHYPOTHERMIAHypothermia is a temperature-related disorder. Therefore it is necessary to understandhuman physiology as it pertains to temperature stress.Man is considered a tropical animal. Normal functioning of the human animal requires abody temperature of 37 degrees Celsius (98.6 degrees Fahrenheit). The body can selfcompensate for small upward or downward variations in temperature through the activationof built-in thermoregulatory system, controlled by temperature sensors in the skin. Theresponse to an upward variation in body temperature is the initiation of perspiration, whichmoves moisture from the body tissues to the body surface. When the moisture reaches thesurface it evaporates, carrying with it a quantity of heat. The response to downwardvariation in body temperature is shivering, which is the body’s attempt to generate heat.Shivering is an involuntary contraction and expansion of muscle tissue occurring on a largescale. This muscle action creates heat through friction.THE DISORDERHypothermia is defined as a core temperature of the body less than 35 degrees Celsius (95degrees Fahrenheit). Hypothermia is also considered the clinical state of sub-normaltemperature when the body is unable to generate sufficient heat to efficiently maintainfunctions.Many variables contribute to the development of hypothermia. Age, health, nutrition, bodysize, exhaustion, exposure, duration of exposure, wind, temperature, and wetness of bodyor clothes, medication and intoxicants (alcohol) may decrease heat production or increaseheat loss.The healthy individual’s compensatory responses to heat loss via conduction, convection,radiation, evaporation and respiration may be overwhelmed by exposure. Medication mayalso interfere with heat generation or regulation. Children will have different symptomsthan adults depending on the severity of the cold.Definitions:Conduction: Direct transfer of heat by contact with a cooler objectConvection: Cool air moving across the surface of the body, heat is transferred tothe cool air warming the air.Radiation: Heat radiated outward from the warm body to the cooler environment.Evaporation: The process of losing heat from the body by vaporization of water fromthe body surface.Respiration: Inspired air raised to body temperature that is then exhaled.Each of these causes of heat loss can play a large or small role in the development ofhypothermia, depending on clothing, head cover, wind, weather, etc.Once hypothermia develops, two body compartments, the shell (skin) and the core (theremainder of the body) share the heat deficit. The skin constitutes about 10% of a 150pound mass.Hypothermia can be recognized as impending, mild, moderate and severe. Below is a briefdescription of the various stages:Impending: Person’s core temperature has decreased to 96.8 degrees Fahrenheit(36 degrees C). Individual will increase exercise in an attempt to warm up. The skinmay become pale, numb and waxy. Muscles can become tense and shivering maybegin. Fatigue and weakness may begin to show.Mild: Core temperature has dropped to 93.2 degrees Fahrenheit (34 degrees C).Intense, uncontrolled shivering has begun. The individual may still be alert and ableto help self; however, movements become less coordinated and the coldness iscausing some pain and discomfort.Moderate: Core temperature has dropped to 87.7 degrees Fahrenheit (31 degreesC). Shivering slows or stops completely, mental confusion and apathy set in.Speech is slow and slurred. Breathing becomes slow and shallow followed by withdrowsiness.Severe: Core temperature is below 87.7 degrees Fahrenheit (31 degrees C). Skinmay have a blue-gray color; iris of the eyes may be dilated, may appear drunk,denies problems and may refuse help. This leads to a gradual loss of consciousness.There may be little or no breathing, lack of response to verbal or painful stimuli andmay appear dead.(Temperatures used in above descriptions are approximate. Symptoms may startat different temperatures depending on the individual and circumstances.)Treatment PrefaceAlways act on the fact that “no one is dead until warm and dead.”Think ABCD – Airway, Breathing, Circulation and Degrees.In sudden exposure to cold water there is a greater chance for resuscitation with suddensubmersion and with prolonged exposure to cold water. Quick onset of hypothermia, easyto reverse. Slow onset, the harder to reverse the process.The sole consensus regarding prehospital treatment is that all patients at some point shouldbe rewarmed. Core first then extremities. The best way to rewarm the core is by warm airand warm IV solutions.Initial management principles emphasize prevention of further heat loss, rewarnimg as soonas is safely possible at a “successful” rate and rewarming the core before the shell, in anattempt to avoid inducing lethal side effects during rewarming. This treatment goal isimportant, since hypothermia itself may not be fatal above 77 degrees Fahrenheit (25degrees C) core temperature.The person must be handled very carefully and gently and not be allowed to exercise, asmuscular action can pump cold blood to the heart.Cold blood going to the heart can cause ventricular fibrillationHypothermia causes several reactions within the body as it tries to protect itself and retainits heat. The most important of these is vasoconstriction, which halts blood flow to theextremities in order to conserve heat in the core of the body.Treatment of HypothermiaBe able to recognize the symptoms of hypothermia in yourself and others. The victim maydeny he/she is in trouble. Even mild symptoms demand attention:Impending: Seek or build a shelter to get the person out of the cold, windy, wetenvironment.Start a fire or get a cookstove going to provide warmth. Provide the person with ahot drink (no alcohol, coffee or tea). Insulate the person with extra clothes.Mild: Remove or insulate the patient from the cold ground, protect from the wind,eliminate evaporative heat loss with a vapor barrier. Keep the head and neckcovered, remove to a warm environment. Consider covering patient’s mouth andnose with a light fabric to reduce heat loss through breathing. Provide the personwith a warm, sweetened drink (no alcohol, coffee or tea) and some high-energyfood. Limited exercise may help to generate some internal heat, but it depletesenergy reserves.Moderate: Remove the person from the cold environment, keeping the head andneck covered. Apply mild heat (comfortable to your elbow) to the head, neck chest,armpits and groin of the patient. Use hot water bottles, wrapped Thermo-pads, orwarm moist towels. Do not place the hot water bottles next to the skin, wrap incloth first. Offer sips of warm, sweetened liquids (no alcohol, coffee or tea) if thepatient is fully conscious, beginning to rewarm and is able to swallow. Patient shouldbe seen by a physician ASAP.Severe: Place person in a prewarmed sleeping bag with one or two other people.Skin to skin contact in the areas of the chest (ribs) and neck is effective. Exhalewarm air near the patient’s nose and mouth, or introduce steam into the area. Keepthe patient awake. Apply mild heat, with the aim of stopping temperature drop, notrewarming. If patient has lost consciousness be very gentle, as the heart isextremely sensitive. Check for pulse at the carotid artery. If there is any breathingor pulse, no matter how faint, do not give CPR but keep a very close watch forchanges in breathing and heart beat (vital signs). If no pulse can be found beginCPR immediately, stopping only when the heart begins to beat or the personapplying CPR cannot carry on any longer without endangering themselves.In all of the above, it is imperative that the victim be removed out of the wet and windy weather,remove all wet clothing, and put the victim into dry clothing and a warm sleeping bag.Recent research has concluded that the safest and most effective method of treating hypothermia isthrough inhalation rewarming. Equipment is available; however, out in the field, alternative methodswhich have been described must be used where equipment is lacking.Alaska Department of Labor and Workforce DevelopmentLabor Standards and Safety301 Eagle Street, PO Box 107022Anchorage, Alaska 99510-7022(907) 269-4955Physical Agent Data SheetFROSTBITEGENERAL INFORMATIONFrostbite is the freezing of some part of the body. Fingers, toes, andeven whole arms and legs can be lost as a result of frostbite. Injuriescan happen at home, in the cities and also in more isolated areas ofthe State.In extreme cold it is important to prevent heat loss from as manyareas of the body as possible. Exposed limbs and head are majorareas of heat loss, but keeping enough blood flowing to the hands andfeet is the key to preventing frostbite. The trunk and the head shouldbe warm enough so that the brain is able to command the bloodvessels in the hands and feet to open up and keep the extremitieswarm.ESSENTIAL CLOTHINGThis includes thermal underwear, insulated footwear or mukluks withliners; double mittens and a parka, preferably down-filled with a goodruff. A parka that can be opened at the neck to allow heat to escapewill prevent overheating and sweating. Quilted or skin pants arenecessary if no warm shelter is immediately available. Tight cloths,especially tight gloves or tight boots should not be worn. Thetightness interferes with good circulation in the hands and feet. Ifthere is a reduction in blood flow to these areas, then the possibility offrostbite increases as the extremity cools down.FACTORS LEADING TO FROSTBITETall thin persons are more likely to get frostbite than those of stockybuild.People in poor physical condition are more susceptible than those ingood health.Certain diseases slow down the blood flow in the hands and feetespecially in elderly people.Heavy smokers often have poor circulation in the vital organs anddecreased circulation in the arms and legs.Children and elderly people who cannot produce large amounts of bodyheat for long periods of time can experience a lowering of deep bodytemperature and frostbite.Alcohol causes the blood vessels to dilate (become larger). This leadsto a false sense of warmth. This also leads to faster loss of heat fromthe body because of dilation of blood vessels. More important, peopleact with poor judgment after drinking.Don’t touch cold metal with bare or wet hands. You will freeze to themetal and tear the skin if pulled away without proper thawing withwarm water, heat or urine.Be careful when handling gasoline, kerosene or liquids other thanwater. Contact with bare skin in cold temperatures can cause instantfrostbite.Frostbite is more likely to occur when you are injured, frightenedor careless.HOW TO RECOGNIZE FROSTBITEExposed parts of the body should be inspected routinely. This is donebest with a partner. Just before freezing, the skin, especially the facewith its many blood vessels, becomes bright red. Then small patchesof white appear, as freezing actually occurs.The loss of the sensations of touch, pressure and pain may occurwithout awareness of any numbness or other sensations. Therefore, itis important to test these sensations often. Wear clothing that is notrestrictive but loose.There may be no pain associated with frostbite if the freezing ortemperature change is slow. Only if there is a rapid change intemperature does the body register pain.The skin becomes less elastic. This is best noted in the finger pads. Iftouched or squeezed the pads will remain pitted. Any further coolingwill result in frostbite.Serious freezing is most common in the feet, followed by the handsand then the head (nose, ears). This is because of the poorercirculation in the feet and hands. Also with the poorer circulation thereis in conjunction less sensation to these areas. Exposed head areasare less likely to freeze because of a better blood supply.EARLY TREATMENT OF FROSTBITEEarly rewarming.Thawing and refreezing should always be avoided.Limbs should be rewarmed in stirred water just above normal bodytemperature (100 – 105 degrees Fahrenheit). Always use athermometer to get accurate temperatures. Never try to thaw in coldwater or snow. Since feeling is lost, fires, stoves, exhaust pipes, etc.,should never be used. Serious damage to the skin could result.Rewarming is an acutely painful experience and medication to alleviatepain should be given if available. After thawing, a deep aching painmay persist for several days, depending upon severity of the injury.Pain is a good sign; this tells us that the nerves are still alive andfunctioning.A dull purple color, swelling and/or blistering of the extremity afterthawing indicate a more serious injury and require medical attention.SUMMARYPoor circulation and poor production of body heat will lower resistanceto frostbite.Most cases of frostbite occur as a result of lack of knowledge, carelesspreparation, unavoidable accident, or the effects of alcohol onjudgment. Forethought can prevent injury.If freezing does occur, proper rewarming in warm water will givemaximum benefit. The injured limb should be handled gently and amedical judgment made of the extent of injury and the need forfurther treatment.Physical Agent Data Sheet (PADS) - NoiseOther PADS:Cold StressHand-Arm VibrationHeatIonizing Radiation (PDF)LasersNoiseRadio WavesUltraviolet RadiationDescriptionHealthEffectsHearingOtherEffectsPermissibleExposureLimitProtectiveMeasuresDescriptionSound is created when a vibrating source (like a bell, motor or astereo speaker) sends sound waves through the air to your ear.Every sound has two aspects: its pitch (frequency) and its loudness(intensity). On a stereo, frequency is determined by the bass/treblecontrol. Intensity is determined by the volume control. Noise(unwanted sound) is usually made up of many frequencies. Thedisturbing and harmful effects of noise depend both on the loudnessand the frequency of the tones making up noise.Loudness is measured in units called decibels (dB). Aconversational voice is about 65 dB. A shout is 90 dB or greater.Frequency is measured in units called Hertz (Hz). The frequency ofa locomotive horn is about 250 Hz. The frequency of a table saw isabout 4,000 Hz.^back to the top.Health EffectsExcessive noise can destroy the ability to hear, and may also putstress of other parts of the body, including the heart.For most effects of noise, there is no cure, so that prevention ofexcessive noise exposure is the only way to avoid health damage.HearingThe damage done by noise depends mainly on how loud it is and onthe length of exposure. The frequency or pitch can also have someeffect, since high-pitched sounds are more damaging than lowpitched sounds.Noise may tire out the inner ear, causing temporary hearing loss.After a period of time away from the noise hearing may be restored.Some workers who suffer temporary hearing loss may find that bythe time their hearing returns to normal, it is time for another workshift so, in that sense, the problem is "permanent."With continual noise exposure, the ear will lose its ability to recoverfrom temporary hearing loss, and the damage will becomepermanent. Permanent hearing loss results from the destruction ofcells in the inner ear, cells which can never be replaced or repaired.Such damage can be caused by long-term exposure to loud noiseor, in some cases" by brief exposures to very loud noises.Normally, workplace noise first affects the ability to hear highfrequency (high-pitched) sounds. This means that even though aperson can still hear some noise, speech or other sounds may beunclear or distorted.Workers suffering from noise-induced hearing loss may alsoexperience continual ringing in their ears, called "tinnitus." At thistime, there is no cure for tinnitus, although some doctors areexperimenting with treatment.^back to the top.Other EffectsAlthough research on the effects of noise is not complete, it appearsthat noise can cause quickened pulse rate, increased bloodpressure and a narrowing of the blood vessels over a long period oftime, these may place an added burden on the heart.Noise may also put stress on other parts of the body by causing theabnormal secretion of hormones and tensing of the muscles.Workers exposed to noise sometimes complain of nervousness,sleeplessness and fatigue. Excessive noise exposure also canreduce job performance and may cause high rates of absenteeism.^back to the top.Permissible Exposure LimitThe Action level for noise is an average noise level of 85 dB for aneight-hour day. When employees are exposed to noise levels, whichexceed the Permissible Exposure Limit, the employer must install oruse engineering or administrative controls to lower the noise levels.While these controls are being designed or installed employeesmust wear hearing protection. If the controls still do not reduce noiseexposures to below 90 dB, hearing protection must continue to beworn.^back to the top.Protective MeasuresSuitable hearing protectors (earplugs or muffs) must be madeavailable at no cost to employees who are exposed to an average of85 dB or greater for an eight-hour day. Employees must be giventhe opportunity to select from three different types of appropriatehearing protectors.Hearing tests (audiometric exams) must be given to employees whoare exposed to an average of 85 dB or greater for an eight-hour day.Hearing tests will show whether employees are experiencing anyhearing losses. Hearing tests are also useful in showing how wellthe earplugs and earmuffs are working. Hearing tests must be givenannually.Employees should also receive training in the effects of noise onhearing, an explanation of the hearing tests, and instruction on theproper fitting and care of earplugs or muffs.Noise away from work can also cause hearing loss. Hearingprotectors should be worn when operating noisy equipment or toolssuch as chain saws, brush cutters, power lawn mowers, or whenusing firearms.Refer to Alaska Administrative Code, Occupational Health andEnvironmental Control 04.0104 for specific regulations on NoiseExposure and Hearing Conservation Programs.^back to the top.Labor and Workforce Development || Job Seeker || Employer || Worker