FORMS

Question 1

According to WHAT FORM DO I FILL OUT, when should you fill out a Medical Exposure Report?

Answer 1

• if you are in contact with a patient possibly having a communicable disease (HIV, Hep C, TB, large amounts of blood)
• if significant (blood in eye, coughed on call Designated Officer

Question 2

According to WHAT FORM DO I FILL OUT, when should you fill out a HAZMAT Exposure Report?

Answer 2

Any time you are in contact with a hazmat (house fire, pot on stove, care fire, asbestos, unknown odour)

Question 3

According to What Form do I fill Out, when should a Workplace Injury/Illness Report be filled out?

Answer 3

Every time you get hurt at work (cut finger doing dishes, slipping on ice getting out of car, hurt back lifting patient.

Question 4

According to What Form Do I Fill Out, in addition to filling out the Workplace Injury Report, when must a Casualty Report be completed?

Answer 4

The Office of the Fire Marshall Incident and Casualty Reporting Manual requires a CASUALTY REPORT be completed for any injury sustained by a fire fighter in responding to and during any type of incident.

Question 5

According to What Form Do I Fill Out, what are the 7 conditions for completing a MAF (non-occupational Injury) ?

Answer 5

1) off work 3 days, coming back to work - for 24hr shift this = 36 hrs or more and coming back to work
2) coming to modified duties after an off the job injury
3) returning to full duties after off the job injury
4) returning to full duties after chest pains
5) returning to full duties from modified due to off-job injury
6) submitted monthly if off
7) submitted monthly if on modified

Question 6

According to What Form Do I Fill Out, what are the 3 conditions for filling out a Functional Abilities Form (FAF - Occupational Injury)?

Answer 6

1) coming back to full duties after a work place injury
2) for every Workplace Injury resulting in lost time/medical care
3) if RETURNING or NOT RETURNING to modified after a workplace injury - AND monthly after the 1st Doctor Visit (competed by DR)

Question 7

According to What Form Do I Fill Out, what is the purpose of the Physical Demands Analysis (PDA) document?

Answer 7

It may be brought to a Dr when completing a FAF or MAF. It is to assist the member in describing the demands of firefighting to the Dr. This is useful when the Dr is deciding appropriate return to work date or modified duties restrictions.

Question 8

According to WHMIS legislating, what are the 3 ways in which information will be provided to you?

Answer 8

1) Labels
2) MSDS
3) worker training

Question 9

According to WHMIS, what are the 5 pieces of legislation that implement WHMIS in Canada?

Answer 9

1) Hazardous Products Act
2) Controlled Products Regulation
3) Ingredient Disclosure List
4) Hazardous Material Information Review Act
5) Hazardous Materials Information Review Regulations

Question 10

According to WHMIS, what are the 2 pieces of Provincial Legislation that implement WHMIS in Ontario?

Answer 10

1) Occupational Health And Safety Act - places duties on employers where hazardous materials are used
2) WHMIS Regulation, sets out in detail the employer duties, respecting labels, MSDS, and worker education

Question 11

According to WHMIS, what 3 responsibilities does the Supplier have?

Answer 11

1) determine which hazmat for workplace are controlled products, this is “classification step”
2) label all controlled products as condition of sale or import
3) to provide MSDS as a condition of sale

Question 12

According to WHMIS, what are the 4 responsibilities of an employer in charge of a worksite where controlled products are used?

Answer 12

1) ensure that controlled products are labelled or identified
2) obtain MSDS for controlled products
3) educate workers
4) ensure MSDS are readily available to workers and to joint H&S

Question 13

According to WHMIS, what are the 2 Supervisor responsibilities?

Answer 13

1) advise workers of chem hazards, handling procedures and PPE
2) ensure workers use and wear necessarry PPE

Question 14

According to WHMIS, what are the 4 worker responsibilities?

Answer 14

1) follow safe handling procedure and wear PPE
2) not interfere with WHMIS labels
3) work in compliance with WHMIS
4) report any non-compliance of WHMIS regulation

Question 15

According to WHMIS, what are the 6 classes of chemical hazards?

Answer 15

1) class A - compressed gas
2) class B - flammable and combustible materials
3) class C - oxidizers
4) class D - Immediately Toxic, Other Toxic Effects, Bio-Hazard
5) class E - corrosive
6) class F - dangerously reactive

Question 16

According to WHMIS, a label provides immediate info that you need to handle a hazmat safely, what 3 things does the label provide?

Answer 16

1) alerts you to the hazards the given product represents
2) informs you of all risks the product presents and precautions to be taken when handling or storing it
3) refers to MSDS for more detailed hazard info

Question 17

According to WHMIS what 8 items of information must the supplier label contain?

Answer 17

1) product identifier
2) applicable hazard symbol
3) risk phrases
4) precautionary measures
5) first-aid measures
6) supplier/manufacturer identifier
7) reference to MSDS
8) bilingual

Question 18

According to WHMIS, what 3 pieces of information are required on a workplace label?

Answer 18

1) product identifier
2) info on safe handling of hazmat
3) reference to MSDS for additional info

Question 19

According to WHMIS, hazardous materials can enter the body in what 4 ways?

Answer 19

1) inhalation
2) skin/eye contact
3) ingestion
4) injection

Question 20

According to the WIIR Part A, what sections are to be filled out by the Captain / Immediate Supervisor?

Answer 20

Sections 1-5

Question 21

According to the WIIR Part A form, what is to be done upon completion of sections 1-5?

Answer 21

The employee and supervisor shall sign the form (which is Part 6) and the form shall be forwarded to Admin, within 24 hours.