First Aid for Chemical Exposure Incidents
Every second counts when someone is exposed to harmful chemicals. That's why it is critical to be prepared, have a comprehensive first aid plan in place, and make sure that workers know what to do when an exposure incident takes place.
In a perfect world, implementing hazard controls would be sufficient to keep all workers safe from harmful chemicals. In reality, however, an unplanned chemical event is less a matter of "if" than "when."
None of us want to think about our employees, our coworkers, or ourselves getting hurt. But being prepared for this eventually can substantially decrease the severity of the harm incurred.
Emergency response for chemical exposure incidents will almost always include first aid. And knowing how to properly administer that first aid is a critical safety skill. To help you get prepared for this eventuality, we'll go over what should be included in your first aid plan and what steps to consider for specific types of chemical exposures.
First Aid Response Planning
Unfortunately, there is no single type of chemical exposure emergency. The specifics of each incident will vary based on a number of factors, including the substance in question, the mode and duration of exposure, and any catalysts involved.
With this variability in mind, here are some elements you should consider when planning your first aid response.
Compile a Hazardous Materials Inventory
A quick response makes all the difference when administering first aid. One of the first steps, then, is to put together an inventory of all the hazardous substances in your workplace, and to do it long before an unplanned event occurs.
Once you've completed this list, you can cross-reference it with the National Institute for Occupational Safety and Health’s (NIOSH) Pocket Guide to Chemical Hazards to gather information that will be essential in developing substance-specific first aid training.
Ensure Trained Responders Are Present
There should be an adequate number of first aid responders for each shift. The minimum number and type of responders will be determined by state or provincial law, although it is advisable to go beyond that minimum.
Keep in mind that a first aid responder could themselves be the victim of a chemical exposure. For that reason, there should be more than one employee trained in first aid available in all critical areas where a speedy response can make a substantial difference to the outcome.
(Learn about Lone Worker First Aid Must-Haves)
Provide Adequate Training
Commercially available first aid training courses tend to be generic and might not cover specific responses for the chemicals in your workplace. You should, therefore, consider expanding this general first aid training with specialized substance-specific training.
The training should include some hands-on learning, including how to use eyewash stations or operate emergency showers if they are a part of your workplace. It should also cover how and where to get immediate medical attention for the affected employee. There might be specific hospitals or clinics in your area that are equipped to deal with the types of emergencies you might encounter. The phone numbers for those facilities should be widely available and easy to find - include them in the first aid kit, on the safety board, and anywhere else your first aid responders might look.
Stock First Aid Supplies
Your workplace likely already has first aid kits. A standard kit, however, won't have the specialized supplies you might need when responding to a chemical emergency. Depending on the chemicals in your workplace, you may also need specialized bandages or ointments for burns, activated charcoal, calcium gluconate, or oxygen tanks.
Be sure to check the regulations that apply in your jurisdiction to ensure that first aid responders are allowed to administer these specialized supplies and treatments. In some cases, they can only be administered by medical personnel or when advised by someone with the proper medical authority.
Be Prepared for Moving Unconscious Workers
Some chemical incidents can leave a worker unconscious and unresponsive. When that happens, their coworkers will need a way to move them if needed. This could include coveralls with built-in hooks to more easily drag them out of a hazardous area or a stretcher with sufficient personnel available to lift and carry someone on it.
Keep Eyewash Stations and Emergency Showers in Good Worker Order
OSHA’s 29 CFR 1910.151 standard stipulates that "Where the eyes or body of any worker may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use."
Eyewash stations and emergency showers should be available in the immediate proximity of the area where chemicals are handled. Access to them should also be kept unobstructed. When the window to avoid severe injury is measured in seconds, no worker should have to go through an obstacle course - especially if their vision is impaired.
Access to clean water is also required, both for washing the exposed area and for drinking if consuming water is recommended to reduce the severity of the exposure.
There should also be a program in place for inspecting and testing every eyewash station and emergency shower in the facility. It should ensure that they are in good working order, clean and sanitary, and in compliance with the ANSI Z358.1-2014 standard. They should also be included in your formal inspections along with all other safety equipment.
Keep in mind that some eyewash fluids should be replaced at specific intervals (generally every 120 days), even with preservative and clean water.
A first aid response should always be appropriate for the injury. In the case of chemical exposure, this means taking into account the chemical involved in the incident, the exposure pathway, the severity of the exposure, and the state of the affected individual.
(Learn about The Top 4 Pathways for Chemical Exposure)
As with other emergencies, the first consideration is stopping contact with the hazard. Remove the affected worker from direct contact with the substance, its fumes, or airborne particles. This will ensure that the affected individual's condition does not aggravate beyond its current state.
Although not strictly a first aid response, attention should also be given to other elements of the emergency response plan, such as shutting down a leaking installation to prevent further injuries.
If there is a risk to the first responder, they must don adequate personal protective equipment (PPE) before providing assistance. If the worker’s clothes or PPE are contaminated with the chemical, these clothing and accessories should be removed.
First Aid by Exposure Pathway
Inhaling chemicals in the form of a gas, dust, or mist can lead to a variety of symptoms, including nausea, confusion, dizziness, difficulty breathing, and loss of consciousness.
If it is safe to do so, the first action should be to remove the affected employee from the area and move them to one with fresh, uncontaminated air.
If the worker is conscious, stay with them and keep them at rest. Help them remain calm and comfortable.
If the employee has stopped breathing, initiate artificial respiration.
Once the affected individual feels better or when emergency services have arrived, take them to see a physician.
When to Administer Oxygen
Administering oxygen is recommended if the affected employee has inhaled any of the following:
- Gases that displace the oxygen in the air (e.g. helium, argon, methane, carbon dioxide, nitrogen)
- Chemicals that can cause a severe asthma attack (e.g. isocyanates and some dyes)
- Chemicals which lead to liquid build up in the lungs (e.g. ammonia and chlorine)
- Chemicals that can reduce oxygen in the blood (e.g. carbon monoxide and methylene chloride)
- Chemicals that inhibit the body’s ability to use oxygen (e.g. cyanide and hydrogen sulfide)
Oxygen should only be administered, however, if the following conditions are met:
- Administering oxygen is considered more vital than the risk of worsening the condition of people with chronic obstructive pulmonary disease
- State or provincial legislation allows for trained first aid providers to administer oxygen
- You are trained to administer oxygen (a procedure not covered in generic first aid training)
Contact with the Skin
When chemicals come into contact with the skin, the first concern is minimizing the time of exposure. The sooner you start pouring water over the affected area, the more you will limit tissue damage and absorption into the bloodstream.
If the affected area is small and easily accessed, washing can be done under a regular tap. Otherwise, use the nearest emergency shower.
Wash off the chemicals using lots of water for at least 15 minutes. If dealing with a substance that is quickly absorbed or flammable, the washing should last longer - generally 30 to 60 minutes.
After thoroughly washing the skin, take the affected employee to a physician. Be sure to bring information about the chemical so the physician knows exactly what they are dealing with.
Contact with the Eyes
First aid response when chemicals come into contact with the eyes starts with getting the injured employee to the nearest eyewash station. Ideally, it should be located within ten seconds from the work area.
When using the eyewash station, follow these steps:
- Remove contact lenses
- Turn on the water
- Move the head so that the eye(s) are in the fluid stream
- If only one eye is affected, make sure no fluid is transferred to the unaffected eye (tilt the head so the water runs from the affected eye to the ear)
- Hold the eye(s) open wide using your fingers to ensure the fluid gets under the eyelids
- Roll the eyes up and down, left and right to ensure the water reaches every part of the eye
- Flush for at least 15 minutes or longer depending on the substance:
- Moderate to severe irritants: 15 to 20 minutes
- Chemicals with acute toxicity: 15 to 20 minutes
- Corrosive chemicals: 30 minutes
- Strong alkalis: 60 minutes
If the injured person is unable to stand, there are two options for flushing their eyes:
- A co-worker or several co-workers can support the injured employee so they can stand at the eyewash station and flush their eyes
- Allow the worker to lie on their back while a co-worker continuously pours water over their eyes
After properly flushing the eyes, make sure the affected employee sees a physician as soon as possible.
Inducing vomiting is only recommended in some cases of chemical ingestion. As such, that information is critical and should be readily available. It can be part of the emergency response plan, affixed to the safety board, and included in the Safety Data Sheet (SDS).
If the product's label or SDS lists an antidote and the first aid responders have been trained in administering it, have it ready and provide it to the affected employee. This is simpler in a plant environment where it is known beforehand what substances might be involved.
If the SDS does not advise against using activated charcoal, it is generally safe to assume that it can be administered to the affected individiual. This is especially helpful within an hour of ingesting the hazardous subtance, since the activated charcoal can bind the chemical and prevent its absorption.
According to the Canadian Centre for Occupational Health and Safety (CCOHS), “the American Heart Association and American Red Cross recommend that people should not take anything by mouth for an ingested poison unless specifically told to do so by a doctor or the Poison Control Centre.” So unless advised by these or by the SDS, refrain from providing the affected worker with water or other beverages.
If the affected individual loses consciousness before emergency services arrive onthe scene, lay them on their side to ensure they do not choke on their vomit.
After providing the first aid measures indicated in the SDS or the product label, take the affected individual (and information about the chemical they ingested) to the hospital.
Being prepared for chemical emergencies is common industry practice and an important part of due diligence. The speed of the response can make a substantial difference to the survivability rate and the extent of the temporary or permanent consequences of the exposure.
In places where chemical exposure is likely, like chemical plants or processing facilities, employers should be aware of the presence of these chemicals, their risks, and the proper first aid response procedures. They should also provide all the equipment, supplies, and training required to administer adequate first aid.
Even if the affected individual fully recovers as a result of the first aid procedures, it is always advisable to follow up with a physician to ensure that they are provided with the best care and that all possible negative outcomes are minimized.