[Federal Register Volume 59, Number 200 (Tuesday, October 18, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-24498]


[[Page Unknown]]

[Federal Register: October 18, 1994]


_______________________________________________________________________

Part VI





Department of Transportation





_______________________________________________________________________



Federal Aviation Administration



_______________________________________________________________________



14 CFR Parts 121, 125, and 135




Protective Glove Requirement; Final Rule
DEPARTMENT OF TRANSPORTATION

Federal Aviation Administration

14 CFR Parts 121, 125, and 135

[Docket No. 27926 Amendment No. 121-242; 125-22; 135-53]
RIN 2120-AF37

 
Protective Glove Requirement

AGENCY: Federal Aviation Administration, DOT.

ACTION: Final rule; request for comment.

-----------------------------------------------------------------------

SUMMARY: This amendment requires that disposable latex gloves, or 
equivalent nonpermeable gloves, be located onboard aircraft operated in 
air carrier, air taxi, and commercial operations. This amendment 
responds to the concerns of the FAA and some members of the aviation 
industry that a potential health risk exists to crewmembers and 
passengers from the possibility of incidental exposure to blood borne 
pathogens. This amendment would lessen the possibility of that exposure 
and therefore increase the level of safety for both passengers and 
crewmembers.

DATES: Effective date December 2, 1994.
    Comments must be received on or before December 2, 1994.

ADDRESSES: Send or deliver comments on the rule in duplicate to: 
Federal Aviation Administration, Office of the Chief Counsel, Attn: 
Rules Docket (AGC-204), Room 916, 800 Independence Avenue SW., 
Washington, DC 20591. Comments may be examined in the Rules Docket 
weekdays, except Federal holidays, between 8:30 a.m. and 5:00 p.m.

FOR FURTHER INFORMATION CONTACT:
Daniel V. Meier Jr., Regulatory Branch (AFS-240), Air Transportation 
Division, Flight Standards Service, Federal Aviation Administration, 
800 Independence Avenue SW., Washington, DC 20591, telephone: (202) 
267-3749.

SUPPLEMENTARY INFORMATION:

Background

    The Association of Flight Attendants (AFA) stated in a 1990 
petition for rulemaking that flight attendants face many hazards in 
their work environment. Among these hazards it listed medical 
emergencies that involve bleeding, such as nose-bleeds, cuts, and 
childbirth, that could expose flight attendants to blood borne diseases 
such as Hepatitis B. AFA noted that some carriers currently provide 
barrier devices.
    The FAA recognizes that crewmembers (usually flight attendants), 
passengers, and health care professionals are sometimes called upon to 
provide assistance to ill or injured people on aircraft. Providing such 
assistance may cause such persons to come into contact with the body 
fluids of persons infected with a blood borne pathogen such as the 
human immunodeficiency virus (HIV) or the hepatitis B virus (HBV). 
Blood is the single most important source of HIV, HBV, and other blood 
borne pathogens in the occupational setting. Infection control efforts 
for these blood borne pathogens must focus on preventing persons from 
being exposed to blood. Medical research indicates that the risk of 
transmission of HIV and HBV from other body fluids and materials such 
as nasal secretions, sputum, sweat, tears, urine, vomitus and feces is 
extremely low or nonexistent. Where blood is visible in these 
substances, however, there is a risk of exposure to blood borne 
pathogens. The use of protective gloves is the most effective manner in 
which to prevent passengers and crewmembers from being exposed to 
contaminated blood and other fluids.
    The possibility of crewmembers contracting HIV or HBV in their 
working environment is remote; nevertheless, the FAA is concerned about 
the possibility of unnecessary exposure to blood borne pathogens. The 
risk of exposure is greatest among flight attendants because they come 
into contact with and assist passengers more frequently than other 
crewmembers. However, passengers who are health care professionals, and 
flight crewmembers, may also be exposed, when they assist an injured or 
ill person on an aircraft. The FAA intends to lessen exposure to blood 
borne pathogens and provide a higher level of protection for 
crewmembers and any medical volunteer who may need to use the required 
aircraft first aid or medical kits. Therefore, the FAA has determined 
that it is necessary to require operators to aircraft used in 
operations under parts 121, 125, and 135 to install protective gloves 
on board those aircraft. This requirement applies to cargo-only as well 
as passenger-carrying aircraft. However, it does not apply to operators 
that are not required to have a first aid kit on board the aircraft.
    Specifically, the rule contains the following requirements: (1) 
part 121 operators would be required to install one pair of protective 
gloves in the emergency medical kits of all of their aircraft; (2) part 
121 operators are also required to distribute pairs of protective 
gloves, equal to the number first aid kits on the airplane, as evenly 
as practicable throughout the cabin of their aircraft; and (3) part 125 
and 135 operators would be required to provide one pair of protective 
gloves on their aircraft either in the first aid kit or in a location 
that is readily accessible to crewmembers.
    Because a crewmember in part 121 operations may need to provide 
assistance when the other items of the first aid kit are not needed, 
the FAA does not require that the protective gloves be placed in the 
first aid kits; rather the rule requires that the gloves be located in 
places that are readily accessible for use by crewmembers in the cabin 
of the aircraft. This will encourage the use of gloves whenever a 
crewmember is required to assist a person and when there is the 
possibility of exposure to a body fluid. In reviewing the number of in-
flight emergencies, the FAA has found that the number of first aid kits 
is appropriate to the treatment of injuries likely to occur in flight. 
The FAA also finds that requiring pairs of protective gloves in a 
number equal to the number of first aid kits on board is sufficient. 
Readers are reminded that this is a minimum requirement and operators 
may provide more gloves if they so elect.
    Part 125 and 135 operators are only required to have first aid kits 
on board the aircraft. Part 125 and 135 operators may elect to put the 
gloves in the first aid kits, or as an alternative, may locate the 
gloves in a place that is readily accessible to crewmembers. Because 
operations conducted under part 135 are usually of a much shorter 
flight duration, multiple pairs of gloves are not required by this 
amendment. As with the part 121 operators, multiple pairs of gloves may 
be provided if the operator so elects.
    The protective gloves required by this amendment must be the 
equivalent of latex gloves commonly found in hospitals and other 
medical facilities. Operators are expected to maintain and dispose of 
the gloves in accordance with acceptable procedures.
    This rule does not include new language specifically requiring 
additional training for the use of latex gloves or their equivalent. 
However, under 14 CFR 121.415(a)(3) and 121.417(b)(3)(iv), part 121 
operators are required to include in a training program ``Illness, 
injury, or other abnormal situations involving passengers or 
crewmembers to include familiarization with the emergency medical kit * 
* *.'' Since protective gloves will be required in the medical kit, 
part 121 operators will be required to provide training as to their 
use. Likewise, 14 CFR 135.331(b)(2)(ii) and 135.331(b)(3)(iv) require 
that part 135 operators provide training in ``First aid equipment and 
its proper use.'' As the gloves will be required equipment in the first 
aid kit on board part 135 operations, part 135 operators will be 
required to provide training in the use of the gloves. The FAA does not 
intend that this training be accomplished in a special training session 
but rather as part of the normal training cycle. Part 125 does not have 
training requirements, but rather has testing requirements. The FAA 
does not find it necessary to test crewmembers serving in part 125 
operations on the use of the gloves or on blood-borne pathogens. 
Information on blood-borne pathogens and use of the gloves will be made 
available to these operators in a revised AC 120-44, and the agency 
finds this source sufficient.
    Each part 121 and 135 operator must include as a part of such 
training information about blood borne pathogens and the proper use and 
disposal of the protective gloves. This training may be accomplished in 
a number of ways to include video tapes, computer based instruction, or 
pamphlets. Advisory Circular 120-44 is being revised to include 
discussion of the various options available to operators to ensure that 
an infectious disease awareness program is included in each approved 
training program.

Trade Impact Statement

    The FAA finds that this amendment will have no impact on 
international trade.

Economic Summary

    Changes to Federal regulations are required to undergo several 
economic analyses. First, Executive Order 12866 directs each Federal 
agency to propose or adopt a regulation only upon a reasoned 
determination that the benefits of the intended regulation justify its 
costs. Second, the Regulatory Flexibility Act of 1980 requires agencies 
to analyze the economic effect of regulatory changes on small entities. 
Third, the Office of Management and Budget directs agencies to assess 
the effect of regulatory changes on international trade. With respect 
to this final rule, the FAA has determined that it: (1) Will generate 
benefits that justify its costs and is not ``a significant regulatory 
action'' as defined in the Executive Order; (2) is not significant as 
defined in the Department of Transportation's Regulatory Policies and 
Procedures; (3) will not have a significant impact on a substantial 
number of small entities; and (4) will not constitute a barrier to 
international trade. Therefore, a full regulatory analysis, which 
includes the identification and evaluation of cost reducing 
alternatives to this rule, has not been prepared. Instead, the agency 
has prepared a more concise analysis of this final rule which is 
presented in the following paragraphs.

Costs

    The FAA estimates the total cost of the final rule amending parts 
121.309(d), 125.207(a) and 135.177(a) to include protective gloves will 
be approximately $1.1 million in 1993 dollars ($750,000, discounted) 
over the 10-year period 1995-2004. This final rule requires, at a 
minimum, (1) part 121 operators to install one pair of protective 
gloves in the emergency medical kits of their aircraft; (2) part 121 
operators to provide pairs of protective gloves equal in number to the 
first aid kits on each of their aircraft; and (3) parts 125 and 135 
operators to provide, either in the first aid kit or in a readily 
accessible location, one pair of protective gloves for each aircraft.
    In addition to the cost of the gloves, the FAA has estimated the 
incremental labor cost required for the breaking down of the part 121 
emergency medical kits to install protective gloves, the supplying of 
gloves throughout part 121 aircraft cabins, the supplying of protective 
gloves aboard aircraft operated under parts 125 and 135, and the 
required record keeping associated with these activities. The FAA has 
also imputed an incremental cost for the containment and disposal of 
the gloves after use in keeping with current air carrier, air taxi and 
commercial aircraft policies on waste material. Finally, as one option 
available to operators to provide infectious disease awareness, the FAA 
has also estimated the cost for awareness materials (pamphlets) in 
accordance with the anticipated revisions to Advisory Circular 120-44.
    The total $1.1 million estimated cost of this final rule for the 
1995-2004 time period is comprised of the following components 
expressed in 1993 dollars: (1) $242,000 ($160,000, discounted) for part 
121 operators to install protective gloves in each aircraft's medical 
kit (cost of gloves plus labor) including a cost imputation to reflect 
the incremental cost to provide for the in-flight disposal of used 
gloves and to provide for their replacement as needed; (2) $174,000 
($122,000, discounted) for part 121 operators to provide protective 
gloves equal to the number of first aid kits on each aircraft (cost of 
gloves plus labor) including a cost imputation to reflect the 
incremental cost to provide for the in-flight disposal of used gloves 
and to provide for their replacement as needed; (3) $25,000 ($17,000, 
discounted) for parts 125 and 135 operators to install one pair of 
protective gloves in each aircraft's first aid kit (cost of gloves plus 
labor) including a cost imputation to reflect the incremental cost to 
provide for the in-flight disposal of used gloves and to provide for 
their replacement as needed; and (4) $620,000 ($428,000, discounted) 
estimated materials cost to provide to all affected crew members with 
infectious disease awareness training and training in the proper use of 
the gloves in accordance with Secs. 121.415(a)(3), 121.417(b)(3)(iv), 
135.311(b)(2)(ii), and 135.331(b)(3)(iv).

Benefits

    The FAA has no recorded incidents in which a crewmember or 
passenger sustained serious illness or death as a result of attending 
to a passenger with resulting exposure to bloodborne pathogens. 
However, based on information obtained from various sources, the FAA 
can reasonably approximate the risk involved in attending to a carrier 
of the bloodborne pathogens HIV or HBV.
    According to information provided by OSHA and the Centers for 
Disease Control, the estimated numbers of HIV and HBV carriers in the 
general population (255 million) in 1992, were respectively, 1.0 
million and 1.2 million. The probability of contact of any kind with a 
carrier of either HIV or HBV is approximately 0.004 and 0.005, 
respectively; the probability of contact with a person who is a carrier 
of either HIV or HBV is 0.00898 adjusted for the probability that the 
person is a carrier of both pathogens. Data contained in an FAA study 
reports that 1,150 in-flight medical emergencies, e.g., those requiring 
the use of the ``doctors only'' medical kit, occur annually (``A Study 
of In-Flight Medical Occurrences''; FAA AFS-200, July 1994). In a 1-
year exhaustive study at a major airport, twenty percent of the in-
flight medical emergencies were for lacerative, vomitous or obstetric 
conditions, conditions which could potentially result in exposure of 
persons to bloodborne pathogens (Richard O. Cummins and Jessica 
Schubach, Frequency and Types of Medical Emergencies Among Commercial 
Air Travelers; Journal of American Medicine, Vol. 261, No. 9 (1989). 
Statistically, this data suggests that at a minimum the frequency of 
in-flight medical emergencies each year which could potentially result 
in exposure to bloodborne pathogens is two (1,150*0.2*0.00898). Thus, 
over a 10-year period, the FAA estimates that care-givers attending to 
a person in an in-flight medical emergency will be at risk of being 
exposed to bloodborne pathogens on twenty occasions.

International Trade Impact Analysis

    This rule will have no effect on the sale of foreign aviation 
products or services in the U.S. or on the sale of U.S. products or 
services in foreign countries.

Regulatory Flexibility Determination

    The Regulatory Flexibility Act of 1980 (RFA) ensures that 
government regulations do not needlessly and disproportionately burden 
small businesses. The RFA requires the FAA to review each rule that may 
have ``a significant economic impact on substantial number of small 
entities.'' FAA criteria define ``a substantial number'' as not less 
than 11 nor more than one-third of the small entities subject to the 
rule. Among air carriers, a small entity is defined as one which owns, 
but does not necessarily operate, nine or fewer aircraft. The criteria 
define ``a significant impact'' as $102,000 for scheduled air carriers 
with 60 or more seats and $57,000 for scheduled air carriers with fewer 
than 60 seats. The final rule's amendments will impose a negligible 
annual cost burden (about $16 per aircraft) on all air carrier, air 
taxi and commercial aircraft operators. This cost burden is not 
expected to exceed threshold levels.

Federalism Implications

    The regulation adopted herein would not have substantial direct 
effects on the states, on the relationship between the states, or on 
the distribution of power and responsibilities among the various levels 
of government. Therefore, in accordance with Executive Order 12612, it 
is determined that this regulation would not have sufficient federalism 
implications to warrant the preparation of the Federalism Assessment.

International Civil Aviation Organization and Joint Aviation 
Regulations

    In keeping with U.S. obligations under the Convention on 
International Civil Aviation, it is FAA policy to comply with ICAO 
Standards and Recommended Practices (SARP) to the maximum extent 
practicable. For this final rule, the FAA was unable to discover an 
ICAO requirement for protective gloves.
    Likewise, the Joint Aviation Regulations do not specifically list 
items required for the first aid or medical kits but do specify that 
all items must be serviceable for their intended purpose.

Paperwork Reduction

    The current paperwork requirements for part 121 have been approved 
under OMB Control No. 2120-008, for part 135 under Control No. 2120-
0039, and for part 125 under Control No. 2120-0085. This proposal adds 
no new paperwork requirements.

Good Cause for Immediate Adoption

    The FAA finds that notice and public comment for this rulemaking is 
impracticable and contrary to the public interest. Because this rule 
will lessen a potential health risk to passengers and crewmembers, 
those persons should not be further subjected to that potential risk by 
a delay in issuing a final rule.
    In light of the current wide-spread use of protective gloves by 
operators, the agency expects little or no adverse comment on the final 
rule. Comments on the amendment are invited, however, and the 
Administrator may amend or rescind the rule in view of public comment. 
Comments should identify the Docket No. 27926 and be submitted in 
triplicate to the address provided above. All comments will be 
available for public review, both before and after the closing date for 
comments.

Conclusion

    For the reasons discussed in the preamble and based on the findings 
in the Regulatory Flexibility Determination and the International Trade 
Impact Analysis, the FAA has determined that this regulation is not a 
significant regulatory action under Executive Order 12866. In addition, 
the FAA has determined that this regulation will not have a significant 
economic impact, positive or negative, on a substantial number of small 
entities under the criteria of the Regulatory Flexibility Act. This 
regulation is not considered significant under DOT Regulatory Policies 
and Procedures (44 FR 11034; February 26, 1979).

List of Subjects in 14 CFR Parts 121, 125, 135

    Air safety, Air transportation, Aviation safety, Safety, 
Transportation, Cabin safety, Medical kits, First-aid kits.

The Amendment

    Accordingly, 14 CFR parts 121, 125, and 135 are amended as follows:

PART 121--CERTIFICATION AND OPERATIONS: DOMESTIC, FLAG, AND 
SUPPLEMENTAL AIR CARRIERS AND COMMERCIAL OPERATORS OF LARGE 
AIRCRAFT

    1. The authority citation for part 121 continues to read as 
follows:

    Authority: 49 U.S.C. App. 1354(a), 1355, 1356, 1357, 1401, 1421-
1430, 1472, 1485, and 1502; 49 U.S.C. 106(g) (revised, Pub.L. 97-
449, January 12, 1983).

    2. Section 121.309(d) is revised to read:


Sec. 121.309  Emergency equipment.

* * * * *
    (d) First aid and emergency medical equipment and protective 
gloves.(1) Approved first aid kits and, on passenger flights, an 
emergency medical kit for treatment of injuries or medical emergencies 
that might occur during flight time or in minor accidents must be 
provided and must meet the specifications and requirements of appendix 
A of this part
    (2) Pairs of protective latex gloves, or equivalent nonpermeable 
gloves, equal in number to the number of first aid kits on board the 
aircraft. These gloves must be distributed as evenly as practicable 
throughout the cabin of the aircraft.
* * * * *
    3. Appendix A of part 121 is amended by revising item 3 under 
``Emergency Medical Kits'' to read as follows:

Appendix A to Part 121--First Aid Kits and Emergency Medical Kits

* * * * *

Emergency Medical Kits

* * * * *
    (3) The approved emergency medical kit must contain, as a minimum, 
the following appropriately maintained contents in the specified 
quantities:

------------------------------------------------------------------------
                           Contents                             Quantity
------------------------------------------------------------------------
Sphygmomanometer.............................................          1
Stethoscope..................................................          1
Airways, oropharyngeal (3 sizes).............................          3
Syringes (sizes necessary to administer required drugs)......          4
Needles (sizes necessary to administer required drugs).......          6
50% Dextrose injection, 50cc.................................          1
Epinephrine 1:100, single dose ampule or equivalent..........          2
Diphenhydramine HCI injection, single dose ampule or                    
 equivalent..................................................          2
Nitroglycerin tablets........................................         10
Basic instructions for use of the drugs in the kit...........          1
Protective latex gloves or equivalent nonpermeable gloves....       \1\1
------------------------------------------------------------------------
\1\Pair.                                                                

* * * * *

PART 125--CERTIFICATION AND OPERATIONS: AIRPLANES HAVING A SEATING 
CAPACITY OF 20 OR MORE PASSENGERS OR A MAXIMUM PAYLOAD CAPACITY OF 
6,000 POUNDS OR MORE

    4. The authority citation for part 125 continues to read as 
follows:

    Authority: 49 U.S.C. App. 1354, 1421 through 1430, and 1502; 49 
U.S.C. 106(g) (Revised Pub. L. 97-449, January 12, 1983.)

    5. Section 125.207 is amended by revising paragraph (a)(1)(iii) and 
adding paragraph (a)(1)(iv) to read as follows:


Sec. 125.207  Emergency equipment requirements.

* * * * *
    (a)(1)(iii) Except as provided in paragraph (a)(1)(iv) of this 
section, at time of takeoff, each first aid kit must contain at least 
the following or other contents approved by the Administrator:

------------------------------------------------------------------------
                           Contents                             Quantity
------------------------------------------------------------------------
Adhesive bandage compressors, 1 in...........................         16
Antiseptic swabs.............................................         20
Ammonia inhalants............................................         10
Bandage compressors, 4 in....................................          8
Triangular bandage compressors, 40 in........................          5
Burn compound, \1/8\ oz or an equivalent of other burn remedy          6
Arm splint, noninflatable....................................          1
Leg splint, noninflatable....................................          1
Roller bandage, 4 in.........................................          4
Adhesive tape, 1-in standard roll............................          2
Bandage scissors.............................................          1
Protective latex gloves or equivalent nonpermeable gloves....       \1\1
------------------------------------------------------------------------
\1\Pair.                                                                

    (iv) Protective latex gloves or equivalent nonpermeable gloves may 
be placed in the first aid kit or in a location that is readily 
accessible to crewmembers.
* * * * *

PART 135--AIR TAXI OPERATORS AND COMMERCIAL OPERATORS

    6. The authority citation for part 135 continues to read as 
follows:

    Authority: 49 U.S.C. App. 1354(a), 1355(a), 1421 through 1431, 
and 49 U.S.C. 106(g) (Revised Pub. L. 97-449, January 12, 1993).

    7. Section 135.177 is amended by revising paragraph (a)(1)(iii) and 
adding paragraph (a)(1)(iv) to read as follows:


Sec. 135.177  Emergency equipment requirements for aircraft having a 
passenger seating configuration of more than 19 passengers.

* * * * *
    (a)(1)(iii) Except as provided in paragraph (a)(1)(iv) of this 
section, at time of takeoff, each first aid kit must contain at least 
the following or other contents approved by the Administrator:

------------------------------------------------------------------------
                           Contents                             Quantity
------------------------------------------------------------------------
Adhesive bandage compressors, 1 in...........................         16
Antiseptic swabs.............................................         20
Ammonia inhalants............................................         10
Bandage compressors, 4 in....................................          8
Triangular bandage compressors, 40 in........................          5
Burn compound, \1/8\ oz or an equivalent of other burn remedy          6
Arm splint, noninflatable....................................          1
Leg splint, noninflatable....................................          1
Roller bandage, 4 in.........................................          4
Adhesive tape, 1-in standard roll............................          2
Bandage scissors.............................................          1
Protective latex gloves or equivalent nonpermeable gloves....       \1\1
------------------------------------------------------------------------
\1\Pair.                                                                

    (iv) Protective latex gloves or equivalent nonpermeable gloves may 
be placed in the first aid kit or in a location that is readily 
accessible to crewmembers.
* * * * *
    Issued in Washington, DC, on September 26, 1994.
David R. Hinson,
Administrator.
[FR Doc. 94-24498 Filed 10-17-94; 8:45 am]
BILLING CODE 4910-13-M