[Federal Register Volume 61, Number 188 (Thursday, September 26, 1996)]
[Rules and Regulations]
[Pages 50432-50436]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-24720]


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DEPARTMENT OF LABOR

Mine Safety and Health Administration

30 CFR Parts 56 and 57

RIN 1219-AA97


Safety Standards for First Aid at Metal and Nonmetal Mines

AGENCY: Mine Safety and Health Administration, Labor.

ACTION: Final rule.

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SUMMARY: This final rule revises existing standards at metal and 
nonmetal mines, requiring first aid capability to be available in the 
event a miner is injured. The final rule provides operators more 
flexibility and clarifies requirements for persons trained in first 
aid.

EFFECTIVE DATE: December 26, 1996.

FOR FURTHER INFORMATION CONTACT: Patricia W. Silvey, Director; Office 
of Standards, Regulations, and Variances, MSHA; 703-235-1910 (voice), 
703-235-5551 (facsimile), [email protected] (Internet e-mail).

SUPPLEMENTARY INFORMATION:

I. Rulemaking Background

    Sections 56/57.18010, requiring first aid training, were originally 
promulgated as advisory standards on July 31, 1969, and made mandatory 
on August 29, 1973. MSHA issued Program Policy Letter (PPL) No. P94-IV-
2 on October 3, 1994, to underscore the first aid requirements. MSHA 
withdrew the PPL by notice in the Federal Register (60 FR 9986) on 
February 22, 1995, and began a new procedure for formulating certain 
policies with increased participation by the mining community. MSHA 
asked the mining community to comment on the issues and to help with 
development of a policy for the first aid standard.
    By letter of August 25, 1995, the National Mining Association (NMA) 
petitioned the Secretary of Labor requesting that MSHA institute 
rulemaking, rather than develop policy on the first aid issue, and 
suggested language for a new standard. The NMA recommended that MSHA 
develop a new rule to require that an individual capable of providing 
first aid be available on all shifts and that first aid training be 
made available to all interested miners. The recommendation from NMA 
addressed mutual concerns of MSHA and the mining industry.
    In lieu of finalizing a first aid policy, MSHA used NMA's 
recommendation as the basis for a proposed first aid rule published in 
the Federal Register (60 FR 55150) on October 27, 1995. MSHA received 
comments from organized labor, industry associations, mining 
contractors, and medical personnel first aid trainers, all of which 
were considered in developing the final rule. MSHA also reviewed and 
considered written comments previously submitted to the Agency on its 
draft policy letter. One request for a public hearing was received, but 
it was subsequently withdrawn.

II. Discussion and Summary of the Final Rule

A. General Discussion

    Mining has historically experienced one of the highest rates of 
severe injuries among its employees of any major industry group in 
America. Despite significant long-term improvements in safety and 
health, in the three-year period from 1993 through 1995, mine operators 
and independent contractors reported 226 amputations among the 
approximately 225,000 miners in the metal and nonmetal industry. During 
the same period, over 500 burns; 1500 fractures; and 1200 cuts, 
lacerations, or punctures resulted in time lost from work. The 
frequency and severity of injuries in the mining industry and the 
remoteness of many operations and working places require a skilled 
first aid response, the first level of care for many injured miners.
    First aid is basic emergency treatment rendered on-site as soon as 
possible

[[Page 50433]]

after an injury occurs and is intended to help a victim until medical 
care arrives. In severe instances, first aid typically precedes two 
subsequent care levels: a secondary level often performed by 
paraprofessionals, such as emergency medical technicians (EMT's), and 
full medical care performed by professionals, such as physicians and 
nurses.
    Existing MSHA standards at Secs. 56/57.18010 provide that: 
``Selected supervisors shall be trained in first aid. First aid 
training shall be made available to all interested employees.'' The 
primary purpose of these standards is to assure that a responsible 
person, trained to provide first aid, is available to render assistance 
in the event a miner is injured. An additional purpose is to encourage 
first aid education among miners so that they are able to help an 
injured co-worker or even provide self-treatment.
    The existing standards identify supervisors as the persons required 
to receive first aid training. Supervisors are typically more mobile 
than other workers. Companies often provide transportation to 
supervisors so they can quickly access areas of the mine in the 
performance of their duties. Traditionally, supervisors are present 
where work is performed and injuries are most likely to occur.
    Since the existing standards were first promulgated, however, there 
has been significant progress in emergency response care and conditions 
in the mining industry. At a number of mines, medical paraprofessionals 
or professionals are members of mine workforces and able to render 
skilled help at mine properties. This rulemaking takes into account 
these developments.

B. Discussion of Final Rule

    Final Secs. 56/57.18010 require that an individual capable of 
providing first aid be available on all shifts. This individual must be 
currently trained and have the skills to perform patient assessment and 
artificial respiration; control bleeding; and treat shock, wounds, 
burns, and musculoskeletal injuries. Operators must make first aid 
training available to all interested miners.
    The final rule adopts the proposal with two changes: it expressly 
requires that the individual be currently trained and it deletes the 
requirement for transportation and handling skills. MSHA received 
comments that addressed many aspects of the proposal as discussed 
below.
Individual With First Aid Skills
    The final rule requires that operators have an individual capable 
of providing first aid. Some commenters suggested that operators should 
be allowed to use any medical personnel and paraprofessionals, such as 
nurses or EMT's, to satisfy the first aid standard whether or not that 
person is a supervisor. Another commenter said that the term 
``individual'' should be interpreted to refer to any miner, even if the 
miner is not a professional medical service provider. One commenter 
asked whether a security guard could fulfill the requirements of the 
proposal.
    A primary reason for this rulemaking is to broaden the scope of the 
rule to permit any person, regardless of title, to provide first aid. 
Under the final rule, operators will have the flexibility to use anyone 
who meets the requirements.
    One commenter raised a concern that a miner could become an agent 
of the company when the miner is available to provide first aid. The 
final rule requires that operators have a capable individual available 
who can perform first aid. The operator has the responsibility to 
arrange for this first aid coverage. An individual's assignment for 
purposes of this coverage does not make that person an ``agent'' in the 
sense of being empowered to act as a representative of the operator.

Capability

    One commenter was concerned that the proposed requirement for an 
individual ``capable'' of performing first aid would be open to 
subjective interpretation. This commenter asked how MSHA would 
interpret such a requirement. Commenters generally pointed to training 
as the means to establish capability and raised the issue of what type 
of training was contemplated. While the existing rule requires that 
supervisors ``be trained,'' the proposal contained no expressed 
training requirement other than that first aid training be made 
available to interested miners.
    The final rule expressly provides that the individual must be 
``currently trained'' and have certain specified first aid skills. The 
individual who is so trained and skilled is ``capable.'' To be 
``currently trained'' means that the individual must have received in-
depth first aid training which covers the specific skills in the final 
regulation and that such training be up-to-date. Persons, such as 
EMT's, nurses, and physicians, with current licenses or certifications 
to practice, are considered ``currently trained'' under the final rule.
    One commenter suggested that first aid training be provided 
annually. Organizations with histories of successfully training 
individuals in first aid skills differ in the frequency, breadth, and 
depth of the retraining required to maintain competence. Some, such as 
the American Red Cross, use a different interval from annual retraining 
to maintain certification of competence. The American Red Cross's 
current standard course is initially an 8-hour program to receive 
certification. It requires retraining every three years to maintain a 
current certification. Training offered by similar organizations, such 
as local fire departments, also has varying retraining components.
    Rather than exclude or constrain programs that have effectively 
prepared individuals for rendering first aid, the final rule does not 
incorporate an annual retraining requirement. MSHA will accept the 
retraining requirements prescribed by the organization providing the 
initial training.
    One commenter said that first aid training taken to meet the 
existing requirements of 30 CFR part 48 should qualify individuals as 
``capable''. The commenter stated that part 48 training allows ample 
time for adequate first aid training.
    Part 48 training, however, may not automatically qualify an 
individual as capable since part 48 is a different type of training 
provision from the final rule. Part 48 requires basic first aid 
training for all miners. The final rule for Secs. 56/57.18010 requires 
that certain persons, trained and skilled in first aid, be available 
and that the more in-depth first aid training to acquire those skills 
be made available to interested miners.
    Part 48 was promulgated in 1978. It implements Section 115 of the 
Federal Mine Safety and Health Act of 1977 (Mine Act) 30 U.S.C. 825 
which was intended by Congress to prevent miners from being put to work 
before having received some safety and health training, including basic 
first aid.
    Part 48 requires training in many health and safety subjects. The 
24-hour training required of new surface miners must cover at least 
eleven other subjects besides first aid. The 8-hour annual refresher 
training must cover at least ten other subjects. Operators have sought 
flexibility to adjust the time spent on any one subject, particularly 
during annual refresher training, according to the accident experience 
and safety and health needs of the mine and the miners. An operator 
with a high number of back injuries, for example, may determine that 
miners need more training on proper lifting. To allocate

[[Page 50434]]

more time to lifting, first aid training might be curtailed. Under 
these circumstances, a brief review of first aid would not adequately 
train persons to maintain skills as required by Secs. 56/57.18010.
    MSHA will accept part 48 training for compliance with the final 
rule if it is sufficiently in-depth to develop the capability to 
perform the necessary first aid skills. In all instances, training that 
complies with this rule would satisfy the new miner training 
requirements for first aid under part 48 and annual refresher training 
requirements for the year in which it was received.
Availability
    Commenters asked that MSHA clarify the meaning of the terms 
``available'' and ``on all shifts.'' The concept of availability is 
critical to the purpose of the final rule and is intended to have its 
ordinary meaning--present and ready for use or at hand.
    The final rule requires that, if an injury occurs, a person skilled 
in first aid must be present at the site and must be able to be at the 
scene quickly. Individuals on-site are able to respond sooner because 
they are closer to the scene of an accident and know the mine. The 
likelihood of survival for a seriously injured miner would be greatly 
diminished if first aid treatment were not administered before off-site 
medical personnel could provide it. Operators also will have to plan to 
assure that this on-site coverage is provided during absences and 
vacations.
    One commenter questioned whether the person capable of providing 
first aid would be required underground and, if so, must the person be 
trained to go underground. The final rule revises current Sec. 57.18010 
and expressly applies to underground mines where first aid availability 
is a critical element of injury response planning. To be available, the 
first aid person must be prepared to provide first aid to injured 
miners promptly. An individual capable of first aid and located on the 
surface at an underground mine would not be available for miners 
underground in many cases because the time required to reach the 
injured person would be too long. For example, reaching some areas of 
an old underground mine may require traveling through a mile or more of 
old workings and could take an hour or more, depending on the 
availability of transportation. In those few cases where a first aid 
person on the surface is available to miners injured underground, such 
as some small adit mines, that person would have to be trained to go 
underground to the extent required by other MSHA standards.
    Similarly, to ensure availability under conditions of difficult 
access and remote work areas, an underground mine operator may be 
required to have more than one first aid person underground. This 
concept of availability also applies to surface mines where miners may 
be working in remote areas.
    One commenter suggested that the term ``readily'' be inserted in 
the standard before ``available'' to ensure a prompt response. 
``Available'' is commonly defined to mean present and ready for use or 
at hand. Adding the term ``readily'' would not increase miner 
protection and, therefore, this suggestion is not adopted in the final 
rule.
    Another commenter suggested that availability be established either 
by having the person present on-shift or reachable through radio 
contact. While such factors as communication, transportation, and 
presence on-shift help determine availability, they do not make a 
person available to provide first aid. For example, radio communication 
without the ability to reach an accident scene quickly would not meet 
the requirements of the final rule.
    The final rule provides that an individual skilled in first aid be 
available ``on all shifts.'' Commenters questioned which shifts need to 
be covered. One commenter said that only ``production'' shifts should 
be covered. Another commenter stated that the standard should apply 
``to all shifts where two or more miners are engaged in production, 
extraction, or maintenance activities.''
    Under the Mine Act, mining includes activities beyond those 
suggested by the comments. Production (excavation, extraction, and 
milling), development, stripping, construction, dismantling, 
maintenance, and abandonment comprise mining activities according to 
the Mine Act. All of these activities involve exposure to hazards that 
may require the application of first aid skills. The final rule retains 
the ``on all shifts'' wording to convey the breadth of these activities 
while keeping the language as simple as possible. The final rule does 
not apply, however, in the few instances when no mining activities 
occur, for example, when only security, sales, or office work is 
performed.
Independent Contractors
    One commenter suggested that independent contractors should be 
solely responsible for compliance with the rule for their own 
employees. Another commenter said that the rule's requirements should 
not apply when independent contractors are performing explosives-
related work, such as shot service, which can involve a single 
employee.
    Under the final rule, independent contractors will be treated the 
same as under other MSHA safety and health standards. Independent 
contractors working on mine property are responsible for compliance 
with MSHA regulations. In some instances, the mine operator and 
independent contractor are isolated from one another and a single 
individual capable of first aid could not be available for both. In 
those situations, each would be responsible for their own coverage. In 
other instances, the mine operator and independent contractor work in 
such close proximity that one can choose to provide first aid coverage 
for the other. In those situations, it is the mine operator's and 
independent contractor's responsibility to agree on the coverage and to 
coordinate and communicate its implementation. Consistent with MSHA's 
enforcement of the existing standard, mine operators and independent 
contractors have the flexibility to use anyone at the mine with the 
necessary skills and availability, regardless of employer.
    Mining activity can present hazards to an employee whether the 
employee is working alone or with another person. If an employee is 
alone and becomes injured, the ability to provide self-treatment could 
be critical to survival. The final rule, therefore, does not include an 
exception for miners or contractor employees working alone.
First Aid Skills
    Several commenters addressed the proposed first aid skills needed 
to establish capability. One commenter suggested that the required 
skills for those other than EMT's be limited to ``basic first aid such 
as for breathing, bleeding, and shock.'' This recommendation would 
exclude patient assessment and treatment of wounds, burns, breaks, 
sprains, and strains. MSHA's experience is that the injuries that occur 
in mines require assessment and treatment skills; the final rule, 
therefore, retains the proposed skill requirements, except as discussed 
below.
    This commenter also said that a good procedure for obtaining 
``outside medical assistance'' should be emphasized. Separate existing 
standards, however, already require operators to have suitable 
emergency communications and arrangements for obtaining medical 
assistance (Secs. 56/57.18012, 18014).
    One commenter suggested that cardiopulmonary resuscitation (CPR) be

[[Page 50435]]

added to the list of required skills. The commenter suggested that 
firefighting, extrication, and evacuation also be included. The ability 
to perform CPR competently can require additional patient assessment 
skills, physical dexterity, and endurance. Traditionally, CPR training 
has been a supplement to first aid training and is not always offered 
with first aid.
    The final rule does not require that first aid skills include CPR. 
Mine operators are encouraged, however, to add skills which are 
considered appropriate to their workforce and environment. Likewise, 
the final rule does not include the suggestion that persons be 
specially trained in firefighting, extrication, or evacuation. This 
suggestion exceeds the scope of first aid. In addition, existing 
standards require operators to train miners in these areas.
    One commenter recommended that the individuals capable of providing 
first aid be able to treat injuries from hazardous liquids and gases. 
The final rule requires skills for treatment of injuries from any 
source or cause. Skills in patient assessment and artificial 
respiration and treatment of shock and burns would have direct 
application to injuries from hazardous liquids and gases.
    The proposed rule would have required an individual to have the 
skills to handle and transport injured persons. One commenter stated 
that transportation is no longer taught in the American Red Cross's 
basic first aid course. The commenter pointed out that when 
transporting an injured person, particularly one with a neck or spinal 
injury, there is the potential to cause greater harm and possible 
paralysis. The commenter suggested that the handling and transportation 
of injured persons be deleted from the required skills under the final 
rule.
    MSHA agrees that mishandling and improper transportation of a 
victim with a serious neck or spinal injury presents a high potential 
to exacerbate the injury. The American Red Cross does not currently 
include separate instruction on transportation and handling of the 
injured in its standard first aid course, although it furnishes 
guidance about these subjects in an informational section of its 
textbook. The American Red Cross teaches that one of the most dangerous 
threats to any seriously injured victim is unnecessary movement. 
Further, the National Safety Council's course emphasizes that injured 
persons should be moved only if they are in immediate danger from their 
environment.
    Special training, experience, dexterity, and strength are often 
required to successfully handle or transport a victim with an injured 
spine. Emergency medical personnel have the skills to successfully 
handle and transport victims in these cases. Improvements in 
transportation and communications, and the widespread availability of 
emergency service present an alternative that MSHA believes is more 
protective of miner safety. Under current regulations at Secs. 56/
57.18014, operators must make advance arrangements for obtaining 
transportation for injured persons and emergency medical assistance 
beyond first aid. The final rule, therefore, does not include the skill 
requirements for transportation and handling of injured persons 
contained in the proposal.
Interested Miners
    The second sentence of the existing standard is revised in the 
final rule to require that training be available to all interested 
``miners'' rather than all interested ``employees.'' This is not a 
substantive change and merely conforms the rule's terminology with 
other MSHA standards. To comply with the rule, operators must inform 
miners of the training in advance, so the miners can plan to attend.
    One commenter questioned whether the operator must pay for first 
aid training. Consistent with the existing standard, the final rule 
requires the operator to make the training available to all interested 
miners. Therefore, to encourage the miners' attendance at the course, 
the operator must pay ordinary course expenses. The final rule, like 
the existing rule, does not address the issue of compensation for the 
miner's time.

III. Executive Order 12866 and the Regulatory Flexibility Act

    Executive Order 12866 requires that regulatory agencies assess both 
the costs and benefits of intended regulations. MSHA has determined 
that this rulemaking is not a significant regulatory action 
representing additional costs in excess of $100 million to a segment of 
the economy and, therefore, has not prepared a separate analysis of 
costs and benefits. The Regulatory Flexibility Act requires regulatory 
agencies to consider a rule's impact on small entities. For the purpose 
of the Regulatory Flexibility Act, MSHA policy defines a small entity 
as an operation employing fewer than 20 employees. This final rule 
would not have a significant economic impact on a substantial number of 
small entities. The analysis contained in this preamble meets MSHA's 
responsibilities under Executive Order 12866 and the Regulatory 
Flexibility Act.
    A few commenters were concerned that the rule would expand training 
and personnel requirements beyond part 48 and existing Secs. 56/
57.18010. One commenter stated that MSHA should prepare a regulatory 
analysis before proceeding further with the rulemaking.
    Operators are currently required to provide supervisors trained in 
first aid who, by virtue of their position, work with and are available 
to the workforce. There may be some operators, however, who have not 
provided this first aid coverage for the miners on all shifts under the 
existing rule. These operators may incur some additional costs to 
comply with the final rule. These costs, however, would be minimal and 
offset by the flexibility provided in the final rule.
    The final rule incorporates the National Mining Association's 
petition for rulemaking and broadens the scope of persons who can 
provide the first aid capability required by the standard. A mine 
operator can rely on existing, non- supervisory personnel who possess 
these special skills. Accordingly, MSHA has determined that this rule 
will not result in any significant costs to the mining industry.

IV. Paperwork Reduction Act

    This final rule contains no information collection or paperwork 
requirements subject to the Paperwork Reduction Act of 1995. The 
compiling and maintaining of records or other documentation of a 
miner's first aid training is incurred by mine operators in the normal 
course of their business activities. The burden associated with such 
usual and customary business records are excluded from the information 
collection burden under 5 CFR 1320.3(b)(2) (60 FR 44985).
    One commenter maintained that the rule would represent a 
significant burden by virtue of increased paperwork. It was suggested 
that MSHA accept a certification by the mine operator as sufficient 
evidence of the training. Currently, MSHA determines compliance with 
the existing requirements by reviewing documentation already kept by 
the mine operator, particularly course records. MSHA accepts available 
documentation, such as course completion certificates, diplomas, 
letters from a qualified instructor, or similar evidence. Under the 
final rule, MSHA would continue this practice.

V. Unfunded Mandates Reform Act

    Title II of the Unfunded Mandates Reform Act of 1995, Pub. L. 104-
4,

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requires each Federal agency to assess the effects of Federal 
regulatory actions on state, local, and tribal governments and the 
private sector, other than to the extent such actions merely 
incorporate requirements specifically set forth in a statute, and to 
determine if the rule might significantly or uniquely affect small 
governments. MSHA has concluded that small governmental entities are 
not significantly or uniquely impacted by this regulation. The final 
rule will impact about 10,800 metal and nonmetal mining operations of 
which about 400 sand and gravel or crushed stone operations are run by 
state, local, or tribal governments for the construction and repair of 
highways and roads. These entities may incur some additional costs to 
comply with the final rule. These costs, however, would be minimal and 
offset by the flexibility provided in the final rule. Notwithstanding 
this conclusion, MSHA will mail a copy of the final rule to these 400 
entities.

List of Subjects in 30 CFR Parts 56 and 57

    Emergency medical services, Metal and nonmetal mines, Mine safety 
and health.

    Dated: September 18, 1996.
J. Davitt McAteer,
Assistant Secretary for Mine Safety and Health.

    Parts 56 and 57, subchapter N, chapter I, title 30 of the Code of 
Federal Regulations are amended as follows:

PART 56--[AMENDED]

    1. The authority citation for part 56 continues to read as follows:

    Authority: 30 U.S.C. 811.

    2. Section 56.18010 is revised to read as follows:


Sec. 56.18010  First aid.

    An individual capable of providing first aid shall be available on 
all shifts. The individual shall be currently trained and have the 
skills to perform patient assessment and artificial respiration; 
control bleeding; and treat shock, wounds, burns, and musculoskeletal 
injuries. First aid training shall be made available to all interested 
miners.

PART 57--[AMENDED]

    3. The authority citation for part 57 continues to read as follows:

    Authority: 30 U.S.C. 811.

    4. Section 57.18010 is revised to read as follows:


Sec. 57.18010  First aid.

    An individual capable of providing first aid shall be available on 
all shifts. The individual shall be currently trained and have the 
skills to perform patient assessment and artificial respiration; 
control bleeding; and treat shock, wounds, burns, and musculoskeletal 
injuries. First aid training shall be made available to all interested 
miners.

[FR Doc. 96-24720 Filed 9-25-96; 8:45 am]
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