216-RICR-20-10-4. School Health Programs (version Amendment, 08/12/2014 to 07/02/2018)

RULES AND REGULATIONS FOR SCHOOL HEALTH PROGRAMS [R16-21-SCHO] STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION DEPARTMENT OF HEALTH January 1964 As Amended: March 1979 December 1980 May 1989 December 1989 March 1993 January 2007 (re-filing in accordance with the provisions of section 42-35-4.1 of the Rhode Island General Laws, as amended) January 1996 January 2007 December 1998 January 2009 December 1999 December 2000 January 2012 (re-filing in accordance with the provisions of section 42-35-4.1 of the Rhode Island General Laws, as amended) July 2014 January 2002 (re-filing in accordance with the provisions of section 42-35-4.1 of the Rhode Island General Laws, as amended) October 2003 June 2005 i INTRODUCTION These amended Rules and Regulations for School Health Programs [(R16-21-SCHO] are promulgated pursuant to the authority conferred under RIGL Chapters 16-21, 35-4 and 23-1-18(4), and are established for the purpose of adopting prevailing standards pertaining to school health programs. Pursuant to the provisions of §42-35-3(a)(3) and § 42-35.1-4 of the General Laws of Rhode Island, as amended, the following were given consideration in arriving at these amended regulations: (1) alternative approaches to the regulations; (2) overlap or duplication with other state regulations; and (3) significant economic impact on small business. Based on the available information, no known alternative approach, overlap or duplication was identified. Professional staff at the Departments of Health and Education shall be available to provide guidance on the implementation of these Regulations, as needed. Upon promulgation of these amendments, these amended Regulations shall supersede all previous Rules and Regulations for School Health Programs [R16-21-SCHO] promulgated by the Departments of Education and Health and filed with the Secretary of State. ii TABLE OF CONTENTS Page PART I DEFINITIONS & GENERAL REQUIREMENTS 1 1.0 Definitions 1 2.0 General Requirements 7 2.8 Child Abuse/Neglect Reporting Requirements 8 2.10 Health and Wellness Subcommittee 9 PART II HEALTH EDUCATION AND PHYSICAL EDUCATION 10 3.0 Administration of the Health Education Program 10 4.0 Health Education Curriculum 11 5.0 Mandated Health Instructional Outcomes: Required Content Areas 12 6.0 Physical Education Curriculum 14 PART III HEALTH SERVICES 15 7.0 Responsibility for Services 15 8.0 School Personnel 16 9.0 Health Examinations 19 10.0 Vision Screening 20 11.0 Hearing Screening 23 12.0 Speech/Language Screening 25 13.0 Scoliosis Screening 26 14.0 Dental Health Screening 27 15.0 Health Records 28 16.0 Notification of Parents 30 17.0 School Reporting Requirements 30 18.0 First Aid and Emergencies 31 18.18 Concussions and Head Injuries in Recreational and/or Athletic Competition 36 19.0 Diabetes Care Management 36 20.0 Medication Administration 38 21.0 Immunization and Testing for Communicable Diseases 40 PART IV HEALTHFUL SCHOOL ENVIRONMENT 42 22.0 Standards for School Buildings and Approval 42 23.0 New Construction (School Building)/General Requirements 42 24.0 Existing School Buildings/General Requirements 43 25.0 Pesticide Applications and Notifications of Pesticide Applications at School 44 26.0 Asbestos 46 27.0 Lead 47 28.0 Radon 47 29.0 Latex Gloves 48 30.0 Food Service 48 30.7 Healthier Beverages and Healthier Snacks 50 31.0 Health Room 50 32.0 Sanitation 51 33.0 Housekeeping 51 34.0 Swimming Pools 52 35.0 Water Supply 52 36.0 Tobacco 52 37.0 School Safety Plans / School Safety Teams / School Crisis Response Teams / School Safety Assessments / Statewide Bullying Policy 53 37.7 Statewide Bullying Policy 57 38.0 Weapons and Firearms 59 39.0 Alcohol and Other Drugs 60 40.0 Recreational Facilities 60 41.0 Laboratories, Shops and Other Special Purpose Areas 60 41.2 Chemical Hygiene Plan 61 42.0 Vehicular and Pedestrian Traffic Safety 62 43.0 Asset Protection 62 PART V ENFORCEMENT & SEVERABILITY 63 44.0 Enforcement 63 45.0 Severability 63 REFERENCES 64 APPENDIX “A” 67 1 PART I DEFINITIONS AND GENERAL REQUIREMENTS Section 1.0 Definitions Wherever used in these rules and regulations the terms listed below shall be construed as follows: 1.1 "Added sweetener" shall mean any additive, including natural or artificial additives that enhances the sweetness of the beverage, including, added sugar, but does not include, the naturally occurring sugar or sugars that are contained within milk or fruit juice. 1.2 "Anaphylaxis" refers to a potentially fatal, acute allergic reaction to a substance (such as stinging insects, foods and medications) that is induced by an exposure to the substance. Manifestations of anaphylaxis may be cutaneous (such as hives, itchiness, swelling), cardiorespiratory (swelling of tongue, throat, wheezing, difficulty breathing, low blood pressure), central nervous system (lethargy, coma) and others. 1.3 "At school", as used in §37.0 and §38.0 of these Regulations, means in a classroom, elsewhere on or immediately adjacent to school premises, on a school bus or other school- related vehicle, at an official school bus stop, or at any school-sponsored activity or event whether or not it is held on school premises, or using property or equipment provided by the school that creates a material and substantial disruption of the education process or the orderly operation of the school. 1.4 "Audiologist" means an individual licensed in this state in accordance with the Rules and Regulations for Licensing Speech Pathologists and Audiologists (R5-48-SPA) [Reference 8] who specializes in preventing, identifying, and assessing hearing disorders, as well as providing audiologic treatment including hearing aids and other assistive listening devices. 1.5 "Audiometric aide" means an individual registered in this state in accordance with the Rules and Regulations for Licensing Speech Pathologists and Audiologists (R5-48-SPA) [Reference 8]. 1.6 "Bullying and Cyber-Bullying", as used in these Regulations, are defined by RIGL §16-21- 33 and §37.7(a) of these Regulations. 1.7 "Certified health educator" means an individual who holds the appropriate certification as a health educator in accordance with the requirements of the Rhode Island Department of Elementary and Secondary Education. 1.8 "Certified school nurse-teacher" means an individual who is licensed as a professional (registered) nurse in this state pursuant to RIGL Chapter 5-34 and is certified by the Rhode Island Department of Elementary and Secondary Education as a Certified School Nurse- Teacher. 1.9 "Community" means any city, town or regional school district established pursuant to state law and/or the Department for Children, Youth, and Families and any school operated by the state Department of Elementary and Secondary Education; provided, however, that the Department for Children, Youth and Families shall not have those administrative responsibilities and obligations as set forth in RIGL Chapter 16-2 ("Education"); provided, however, the member towns of the Chariho Regional High School District, created by RIGL 2 Chapter 55 shall constitute separate and individual communities for the purpose of determining and distributing said Foundation Level School support including state aid for non-capital excess expenses for the special education of handicapped children provided for in RIGL Chapter 16-24-6 for all grades financed in whole or in part by said towns irrespective of any regionalization pursuant to RIGL Chapter 16-7 entitled, "Foundation Level School Support." 1.10 "Confidential health care information" means all information relating to a patient's health care history, diagnosis, condition, treatment or evaluation obtained from a health care provider who has treated the patient. 1.11 "Controlled substance" means a drug, substance, or immediate precursor in schedules I--V of RIGL Chapter 21-28-1.02. 1.12 “Dating partner” means any person involved in an intimate association with another, primarily characterized by the expectation of affectionate involvement, whether casual, serious, or long-term. 1.13 “Dating violence” means a pattern of behavior wherein a person uses threats of, or actually uses, physical, sexual, verbal or emotional abuse to control his or her dating partner. 1.14 "Dental hygienist", as used in these Regulations, means an individual licensed to practice dental hygiene in the United States. 1.15 "Dentist", as used in these Regulations, means an individual licensed in the United States to practice dentistry. 1.16 "Education record" means those records that are: (1) Directly related to a student; and (2) Maintained by an educational agency or institution or by a party acting for the agency or institution. 1.17 "Emergency" means a medical or psychological condition where the absence of immediate intervention could reasonably be expected to result in placing the student's health (or another student's health) in serious jeopardy; serious impairment to bodily or psychological functions; or serious dysfunction of any bodily organ or part. 1.18 “Emergency care plan (ECP)” means a set of procedural guidelines that provides specific directions about what to do in a particular emergency situation. A student with special health care needs may have both an ECP and an individualized health care plan (IHCP). The ECP may be formulated as part of the IHCP. As used in these Regulations, “emergency care plan (ECP)” shall have the same meaning as “emergency health care plan (EHCP).” 1.19 "Epinephrine auto-injectors" refers to any device that is used for the automatic injection of epinephrine into the human body to prevent or treat anaphylaxis. 1.20 "Eye care provider", as used in these Regulations, means an individual licensed in the United States to practice optometry or medicine (i.e., ophthalmology). 3 1.21 "Follow up" means the contact with a student, parent as defined in these Regulations, and/or service provider to verify receipt of services, provide clarification and determine the need for additional assistance. 1.22 The “governing body” means the body or board or committee or individual, or the designated agent(s) or designee(s) of the aforementioned, responsible for, or who has control over, the administration of any elementary or secondary school, public or non-public, in the state of Rhode Island. 1.23 "Hazardous chemical" means a chemical for which there is statistically significant evidence based on at least one study conducted in accordance with established scientific principles that acute or chronic health effects may occur in exposed employees. The term "health hazard" includes chemicals that are carcinogens, toxic or highly toxic agents, reproductive toxins, irritants, corrosives, sensitizers, hepatotoxins, nephrotoxins, neurotoxins, agents that act on the hematopoietic systems, and agents that damage the lungs, skin, eyes, or mucous membranes. 1.24 "Health" is the quality of a person's physical, psychological, and sociological functioning that enables him or her to deal effectively with self and others in a variety of situations. 1.25 "Health care provider/agency" means any person/agency licensed by this state to provide or otherwise lawfully able to provide health care services, including, but not limited to, a physician, chiropractor, hospital, intermediate care facility or other health care facility, dentist, dental hygienist, nurse, physician assistant, nurse practitioner, optometrist, podiatrist, pharmacist, physical therapist, psychiatric/clinical social worker, mental health counselor, or psychologist and any officer, employee or agent of that provider acting in the course and scope of his/her employment or agency related to or supportive of health services. 1.26 "Health education" means comprehensive sequential K through 12 instruction that builds a foundation of health knowledge, develops the motivation and skills required of students to cope with challenges to health and provides learning opportunities designed to favorably influence health attitudes, practices and behavior that will impact lifestyles, educational performance and achievements and long range health outcomes and is in accordance with the requirements of §3.4 of these Regulations. 1.27 "Healthier beverages" shall be defined as: 1.27.1 Water, including carbonated water, flavored or sweetened with one hundred percent (100%) fruit juice and containing no added sweetener. 1.27.2 Two percent (2%) fat milk, one percent (1%) fat milk, nonfat milk, and dairy alternatives, such as fortified soy beverages; plain or flavored, with a sugar content of not more than four (4) grams per ounce. 1.27.3 One hundred percent (100%) fruit juice or fruit based drinks that are composed of no less than fifty percent (50%) fruit juice and have no added sweetener. 1.27.4 Vegetable-based drinks that are composed of no less than fifty percent (50%) vegetable juice and have no added sweetener. 1.28 "Healthier snacks" shall be defined as: 4 1.28.1 Individually sold portions of nuts, nut butters, seeds, eggs, and cheese packaged for individual sale, fruit, vegetables that have not been deep fried, and legumes. 1.28.2 Individually sold portions of low fat yogurt with not more than four (4) grams of total carbohydrates (including both naturally occurring and added sugars) per ounce and reduced fat or low fat cheese packaged for individual sale. 1.28.3 Individually sold enriched or fortified grain or grain product; or whole grain food items that meet all of the following standards based on manufacturers' nutritional data or nutrient facts labels: (i) Not more than thirty percent (30%) of its total calories shall be from fat. (ii) Not more than ten percent (10%) of its total calories shall be from saturated fat. (iii) Not more than seven (7) grams of total sugar (includes both naturally occurring and added sugars) per ounce. 1.29 "Hearing impairment" means an impairment in hearing, whether permanent or fluctuating, that affects a student's educational performance. 1.30 “Individualized health care plan (IHCP)” means a comprehensive plan for care of children with special health care needs developed by the certified school nurse teacher in collaboration with the student, parents/guardians, school staff, community, and health care provider(s), as appropriate. 1.31 “Individualized health services” means services provided to individual students who attend school within the community which are specific to the health needs of the individual student, such as medication administration, and are not included in the health examination/ screenings, record keeping and reporting requirements described in §7.1.1 of these Regulations. 1.32 "Laboratory" means a facility where the laboratory use of hazardous chemicals occurs. It is a place where relatively small quantities of hazardous chemicals are used on a non- production basis. 1.33 “Local education agency” means an educational agency at the local level that exists primarily to operate schools or to contract for educational services for elementary and secondary public and non-profit private schools. For non-profit private schools, this includes the building owner. 1.34 "Mandated instructional outcomes" are statements which indicate what health knowledge and skills students should have at the completion of a specific health unit. 1.35 “Medically accurate” means verified or supported by research conducted in compliance with accepted scientific methods and published in peer-reviewed journals, where appropriate, and recognized as accurate and objective by professional organizations and agencies with expertise in the relevant field, such as the federal Centers for Disease Control and Prevention. 5 1.36 "Medication" means any FDA-approved substance regarded as effective for the use for which it is designed in bringing about the recovery, maintenance or restoration of health, or the normal functioning of the body. 1.37 "Parent" means a natural parent, a legal guardian or an individual acting as a parent in the absence of a parent or a legal guardian. 1.38 "Physician", as used in these Regulations, means an individual licensed in the United States to practice allopathic or osteopathic medicine. Chiropractic physicians licensed under the provisions of RIGL Chapter 5-30 shall be entitled to the same services of the laboratories of the Department of Health and other institutions, and shall be subject to the same duties and liabilities, and shall be entitled to the same rights and privileges in their professional calling pertaining to public health which may be imposed or given by law or regulations upon or to physicians qualified to practice medicine by RIGL §5-37-2; provided, however, that chiropractic physicians shall not write prescriptions for drugs for internal medication nor practice major surgery. 1.39 “Population-based health services” means services provided to all students attending school within the community which are not focused on the individual health needs of the particular student but are provided to all students as part of the health examination/screenings, record keeping and reporting requirements described in §7.1.1 of these Regulations. 1.40 "Prescription" means an order for medication signed by a licensed practitioner with prescriptive authority or transmitted by the practitioner to a pharmacist by telephone, facsimile, or other means of communication and recorded in writing by the pharmacist. 1.41 "Record" means any information recorded in any way, including, but not limited to, handwriting, print, tape, electronic storage, computer diskette, film, microfilm, and microfiche. 1.42 “RIGL” means Rhode Island General Laws, as amended. 1.43 "School" means all public or privately supported schools for students in grades Kindergarten (K) through 12 in Rhode Island. In addition, a preschool program operated by or within an approved school (per the requirements of §2.1 of these Regulations) shall be considered a "school" for the purposes of these Regulations. 1.44 "School personnel" means all persons employed directly by the school or under contract to the school. 1.45 "Scoliosis screening" means screening for detection of an abnormal curvature of the spine, as defined by current American Academy of Orthopaedic Surgeons and Scoliosis Research Society standards. 1.46 "Self-administration" of medication means that the student uses the medication with parental authorization in the manner directed by the health care provider, and by following the age appropriate instructions on the OTC medication label, without additional assistance or direction. 6 1.47 "Self-carry" means that the student carries medication on his/her person, in the event that self-administration is necessary, with safety to him/herself and other students. 1.48 "Snack" means a food that is generally regarded as supplementing a meal, including, but not limited to: chips, crackers, onion rings, nachos, French fries, donuts, cookies, pastries, cinnamon rolls, and candy. 1.49 "Speech or language impairment" means a disorder in articulation, language, voice and/or fluency that adversely affects the student's educational performance. A speech and language impairment may range in severity from mild to severe; it may be developmental or acquired. A speech and language impairment may be the result of a primary disabling condition or it may be secondary to other disabling conditions. A dialect is a variation of a symbol system used by a group of individuals that reflects and is determined by shared regional, social or cultural/ethnic factors and is not considered to be a disorder of speech. 1.50 "Speech/language pathology" includes identification of students with speech or language impairments; diagnosis and appraisal of specific speech or language impairments; referral for medical or other professional attention necessary for the habilitation of speech or language impairments; provision of speech and language services for the habilitation or prevention of communicative impairments; and counseling and guidance of parents, children and teachers regarding speech and language impairments. 1.51 "Speech/language pathologist" means a professional who identifies, assesses, diagnoses, prevents, and treats speech, voice, language, communication, and swallowing disorders. 1.51.1 "Certified speech/language pathologist" means a speech/language pathologist certified by the Rhode Island Department of Elementary and Secondary Education to perform speech-language pathology services for the public school system. 1.51.2 "Licensed speech/language pathologist" means a speech/language pathologist licensed by the Rhode Island Board of Examiners in Speech Pathology and Audiology to perform speech-language pathology services in all settings outside the public school system. 1.52 "Speech/language pathology aide" means an individual registered in this state in accordance with the Rules and Regulations for Licensing Speech Pathologists and Audiologists (R5-48-SPA) [Reference 8]. 1.53 "Student" means any individual who is or has been enrolled at an educational agency or institution and regarding whom the agency or institution maintains educational records. 1.54 “These Regulations” mean all parts of Rhode Island Rules and Regulations for School Health Programs [R16-21-SCHO]. 1.55 "Vision screening," as used in these Regulations, means a limited series of tests to identify individuals who may have a vision or eye health problem. 1.56 "Visual impairments" include: (a) "Partial sight" means a visual acuity ranging from 20/70 to 20/200 in the better eye after refraction, or a significant loss of fields of vision in both eyes as a result of, but not 7 limited to, hemeralopia, glaucoma, retinitis pigmentosa, retinoschisis, or diabetes retinopathy that, with correction, affects a student's educational performance. (b) "Blindness" means a visual acuity ranging from a central visual acuity of 20/200 or less in the better eye after refraction, or a peripheral field of vision that subtends an angle no greater than twenty (20) degrees that, even with correction, affects a student's educational performance. Section 2.0 General Requirements 2.1 All schools that are approved pursuant to RIGL §§16-19-1 and 16-19-2 shall have a comprehensive school health program consisting of health education, health services and a healthful school environment, approved by the State Commissioner of Elementary and Secondary Education and the Director of Health in accordance with RIGL §16-21-7. The health education program (curriculum and personnel) for non-public schools shall be consistent with the provisions of §3.1 of these Regulations. 2.2 Each community, school district and appropriate non-public school authority (e.g. the superintendent, the headmaster, or the principal) shall be responsible for a comprehensive school health program (health education, health services, healthful school environment) and shall develop a manual of procedures (protocols) governing health education, health services and a healthful school environment. This manual shall be available at the Superintendent's office and at each school, both public and non-public, within the district. Such procedures shall pertain to no less than the statutory and regulatory requirements herein and shall furthermore include provisions pertaining to, but not limited to, the following: 2.2.1 The education of children infected with HIV/AIDS, based on the most current Rhode Island Department of Elementary and Secondary Education and the Rhode Island Department of Health Policy Guidelines on Infected Students and Employees. 2.2.2 Substance abuse, based on the Model Policy for Tobacco, Alcohol, and Other Illicit Drug Use promulgated by the Rhode Island Substance Abuse Policy Task Force and the Rhode Island Department of Elementary and Secondary Education; 2.2.3 The use of alcohol and tobacco products on school premises and at authorized school activities; 2.2.4 Suicidal behavior; 2.2.5 The prevention and management of injuries and violent behaviors for the protection and safety of students on school premises and at authorized school activities; and 2.2.6 Provisions regarding the three (3) statutory waivers for exclusion of a child from certain areas of the health education curricula (see §5.1.7.2 sexuality and family life; §5.1.8.2 HIV/AIDS; and §5.1.13.1 the characteristics, symptoms or treatment of disease). 2.3 Each community, school district and appropriate non-public school authority (e.g., the superintendent, the headmaster, or the principal) shall be responsible to provide an adequate number of personnel for a school health program (health education, health services and 8 environmental health) in accordance with the statutory requirements and the requirements of these Regulations. 2.3.1 Such personnel shall include no less than a school physician, dentist, certified school nurse-teacher and personnel as set forth in §3.3 of these Regulations. 2.4 The superintendent of each school district, and the appropriate non-public school authority (e.g., the headmaster or principal) shall designate an individual(s) or committee to be accountable for the school or school district health program (health education, health services and a healthful school environment). The names of this/these individual(s) shall be included in the annual report (see §2.5 of these Regulations). 2.5 A report pertaining to the district’s school health program (health education, health services and a healthful school environment) shall be submitted to the state Commissioner of Elementary and Secondary Education and the state Director of Health by the responsible school authority of public (the district superintendent) and non-public schools (the principal or headmaster). Such report (prepared with input from district school improvement teams, when appropriate) shall be submitted to the Commissioner of Elementary and Secondary Education and the Director of Health on forms provided by the Rhode Island Departments of Elementary and Secondary Education and Health, no later than sixty (60) days from a date established by the Departments of Education and Health. 2.6 No requirement of these Regulations shall be construed as requiring a certified school nurse- teacher or other licensed health care provider to act in a manner contrary to the provisions of the laws and regulations governing the practice of said profession. 2.7 Nothing in these Regulations is meant to preclude any student or the parents of any student from pursuing their rights to appropriate educational services and accommodations guaranteed by federal and state laws. Child Abuse/Neglect Reporting 2.8 Any person who has reasonable cause to know or suspect that any child has been abused or neglected shall report such information to the proper authorities at the Department of Children, Youth and Families, in accordance with: (1) The requirements of RIGL Chapter 40-11; (2) The Guide to Identifying and Reporting Child Abuse in the Schools, of the Rhode Island Department of Elementary and Secondary Education; and (3) The school's protocol for reporting child abuse or neglect. Said protocol shall specify the responsibilities of all school personnel related to child abuse or neglect such as identification, reporting, multidisciplinary cooperation, in-service training, and public awareness. 2.9 All health care providers licensed by this state to provide health care services and all health care facilities licensed under RIGL Chapter 23-17 shall assess patient pain in accordance with the requirements of the Rules and Regulations Related to Pain Assessment (R5-37.6- PAIN) [Reference 23]. 9 Health and Wellness Subcommittee 2.10 The school subcommittee of each school district shall establish a district-wide coordinated school health and wellness subcommittee chaired by a member of the full school committee. The subcommittee will make recommendations regarding the district's health education curriculum and instruction, physical education curriculum and instruction, and nutrition and physical activity policies to decrease obesity and enhance the health and well being of students and employees. 2.11 The school health and wellness subcommittee shall consist of members of the general public, a majority of whom are not employed by the school district, including at least one parent, and are encouraged to include teachers; administrator; students; community and school- based health professionals; business community representatives; and representatives of local and statewide nonprofit health organizations. The subcommittee will be chaired by a member of the school committee. 2.12 Nothing in §§ 2.10 through 2.14.1 (inclusive) of these Regulations shall preclude the school committee from reconstituting any existing district-wide volunteer committees as the school health and wellness subcommittee so long as said subcommittee membership meets the requirements of §§ 2.10 through 2.14.1 (inclusive) of these Regulations. 2.13 The school health and wellness subcommittee shall be responsible for, but not limited to, development of policies, strategies, and implementation plans that meet the requirements of the child nutrition and WIC Reauthorization Act of 2004. The school health and wellness subcommittee shall forward all recommendations regarding the district's health education curriculum and instruction, physical education curriculum and instruction, nutrition policies, and physical activity policies to the full school committee. 2.14 Reporting shall be consistent with requirements of RIGL §16-7.1-2(h) and as follows: 2.14.1 All strategic plans shall include strategies to decrease obesity and improve the health and wellness of students and employees through nutrition, physical activity, health education, and physical education. Said strategies shall be submitted by May 1st of each year to the Rhode Island Department of Elementary and Secondary Education and the Rhode Island Department of Health. 10 PART II HEALTH EDUCATION AND PHYSICAL EDUCATION Section 3.0 Administration of the Health Education Program 3.1 Health education as defined in §1.26 of these Regulations shall be provided in grades K through 12 in all schools approved by the Rhode Island Department of Elementary and Secondary Education in accordance with the standards in these Regulations. The health education program (curriculum and personnel) of non-public schools shall be approved if deemed substantially equivalent. 3.2 Pursuant to the provisions of RIGL §16-1-5(14), the Rhode Island Department of Elementary and Secondary Education in conjunction with the Department of Health shall provide both guidance and technical assistance in the development and adoption of school health education curricula for the provision of comprehensive school health education in accordance with the statutory requirements and the requirements of these Regulations. 3.3 An appropriately certified health educator shall be designated by the superintendent of school districts and by the appropriate non-public school authority (e.g. the superintendent, the headmaster or the principal) to administer the health education program. Pursuant to the certification requirements of the Rhode Island Department of Elementary and Secondary Education and the provisions hereunder, teachers providing health education shall consist of: 3.3.1 at the secondary level: certified school nurse-teachers, health and physical education teachers or health educators, all of whom must hold appropriate certification as health educators in accordance with the requirements of the Rhode Island Department of Elementary and Secondary Education. 3.3.2 at the elementary level: certified school nurse-teachers, health and physical education teachers or health educators, all of whom must hold appropriate certification as health educators in accordance with the requirements of the Rhode Island Department of Elementary and Secondary Education, or any certified elementary teacher. 3.4 Health education instruction shall consist of a comprehensive health education program in accordance with the Mandated Health Instructional Outcomes of §5.0, which conforms to the statutory provisions of RIGL §35-4-18, the curriculum requirements of the Rhode Island Department of Elementary and Secondary Education and other statutory and regulatory requirements herein. Health education instruction and materials shall be age-appropriate for use with students of all races, genders, sexual orientations, ethnic and cultural backgrounds, and students with disabilities. 3.5 Pursuant to the provisions of RIGL §16-22-4 and §16-1-5(14) all children in grades kindergarten (K) through twelve (12) attending public schools or such other schools as are managed and controlled by the state, shall receive therein instruction in health and physical education as prescribed and approved by the Rhode Island Department of Elementary and Secondary Education during periods which shall average at least twenty (20) minutes in each school day. Recess, free play, and after-school activities shall not be construed as physical education. No non-public instruction shall be approved by any school committee for the 11 purposes of RIGL Chapter 16-19 as substantially equivalent to that required by law of a child attending a public school in the same city and/or town unless instruction in health and physical education similar to that required in public schools is given. 3.6 Planned and ongoing in-service programs shall be established to update health educators and other relevant personnel in their knowledge of health and teaching skills, and to obtain their input regarding health curriculum, assessment and improvement. These shall be consistent with the provisions of RIGL §35-4-18 entitled, "Health education, alcohol and substance abuse prevention program", and RIGL §§ 16-1-5(14), 16-22-12, 16-22-14, and 16-22-24 pertaining to substance abuse, alcohol, suicide, teen dating violence, and such other relevant laws. 3.7 Provisions shall be made for the participation by representatives from parent groups, community agencies, professional organizations, health agencies, business, educational institutions and such other groups, to actively involve them in the planning and the implementation of the school health education program. 3.8 Teaching and learning materials that relate directly to the mandated health instructional outcomes of §5.0 of these Regulations and methods for each grade level shall be made available by the local school authorities to teaching staff (health educators) and students in the classroom. Section 4.0 Health Education Curriculum 4.1 The health education curriculum shall: 4.1.1 be sequential and comprehensive for grades Kindergarten-12; 4.1.2 be medically accurate; 4.1.3 be aligned with the Rhode Island health education standards; 4.1.4 include standards-based goals, objectives, examples of teaching and learning strategies and materials, and assessment; 4.1.5 address the mandated health instructional outcomes (§5.0 of these Regulations); and, 4.1.6 be developmentally appropriate so that all students can achieve high standards. 4.2 A curriculum team consisting of representatives from the school district teaching and administrative staff, parents, and community members shall periodically review and revise, as necessary, the health education curriculum. The health education curriculum of each school district shall be available for review by the Rhode Island Department of Elementary and Secondary Education upon request. 12 Section 5.0 Mandated Health Instructional Outcomes: Required Content Areas 5.1 The health education curriculum shall be based on the health education standards of the Rhode Island Health Education Framework: Health Literacy for All Students and consistent with the mandated health instructional outcomes therein. These outcomes shall pertain to no less than the following topics appropriate to grade or developmental level: 5.1.1 Alcohol, Tobacco and Other Substance Abuse: the causes, effects, treatment and prevention of the use of tobacco and abuse of alcohol and other drugs pursuant to RIGL §§ 16-22-3, 16-22-12, 16-1-5(14), and 35-4-18; 5.1.2 Cardiopulmonary Resuscitation (CPR): the procedures and proper techniques for CPR, automated external defibrillator (AED), and the Heimlich Maneuver, pursuant to RIGL §§ 16-22-15 and 16-22-16; 5.1.3 Child Abuse: the signs, symptoms and resources available for assistance; 5.1.4 Community Health: the significance of the relationship between the individual and the community, and the impact that individual health has on the community’s health within a framework of geographical, social, cultural, and political factors; 5.1.5 Consumer Health: the factors involved in decision-making, selecting, evaluating, accessing and utilizing health information, products and services; 5.1.6 Environmental Health: environmental factors that affect the health of individuals and society, strategies to minimize the negative effects of the environment on the community and its members, and the importance of protecting and improving all aspects of the environment; 5.1.7 Family Life and Sexuality: the responsibilities of family membership and adulthood, including issues related to reproduction, abstinence, dating and dating violence, marriage, and parenthood as well as information about sexually transmitted diseases, sexuality and sexual orientation, as part of comprehensive sexuality education. Pursuant to RIGL §16-22-18, courses in family life or sex education within this state shall include instruction on abstinence from sexual activity and refraining from sexual intercourse as the preferred method for the prevention of pregnancy and sexually transmitted diseases; 5.1.7.1 Pursuant to RIGL §16-22-18, upon written request to the school principal, a pupil not less than eighteen (18) years of age or a parent of a pupil less than eighteen (18) years of age, within one week following the date the request is received, shall be permitted to examine the health and family life curriculum program instruction materials at the school in which his/her child is enrolled. 5.1.7.2 A parent may exempt his/her child from the program by written directive to the principal of the school. No child so exempted shall be penalized academically by reason of such exemption. 5.1.8 HIV (Human Immunodeficiency Virus)/AIDS (Acquired Immune Deficiency Syndrome): the causes, effects, treatment, and prevention, including abstinence as a preferred prevention method of this disease, pursuant to RIGL §16-22-17; 13 5.1.8.1 Pursuant to RIGL §16-22-17, upon written request to the school principal, a pupil not less than eighteen (18) years of age or a parent of a pupil less than eighteen (18) years of age, within one (1) week following the date the request is received, shall be permitted to examine the HIV/AIDS curriculum program instruction materials at the school in which his/her child is enrolled. 5.1.8.2 A parent may exempt his/her child from the program by written directive to the principal of the school. No child so exempted shall be penalized academically by reason of such exemption. 5.1.9 Human Growth and Development: growth and development as a process of natural progression influenced by heredity, environment, culture, and other factors and which encompasses the continuum from conception to death; 5.1.10 Mental Health: the emotional, behavioral, and social factors that influence both mental and physical health; 5.1.11 Nutrition: the role of nutrition in the promotion and maintenance of good health; 5.1.12 Physiology and Hygiene: the basic structure and functions of the human body systems, health habits, and sanitary practices for the preservation of health, pursuant to RIGL §16-22-3. 5.1.13 Physical Activity: the relationship of physical activity to health and physical fitness; 5.1.14 Prevention and Control of Disease: the causes, effects, treatment, and prevention of chronic and communicable diseases. 5.1.14.1 A child may be excluded from instruction because of religious beliefs in accordance with RIGL §16-21-7, whereby no instruction in the characteristics, symptoms, or treatment of disease shall be given to any child whose parent or guardian shall present a written statement signed by them stating that such instructions should not be given such child because of religious beliefs. 5.1.15 Safety and Injury Prevention: the causes, effects, treatment, and prevention of behaviors that can result in unintentional or intentional injury; and 5.1.15.1 Suicide Prevention: the causes, effects, and treatment of behaviors related to suicide, pursuant to RIGL §16-22-14. 5.1.15.2 Teen Dating Violence (grades 7 through 12): defining dating violence, recognizing dating violence warning signs and characteristics of healthy relationships, as stipulated in RIGL §16-22-24, and as defined in these Regulations. 5.1.15.2.1 Additionally, students shall be provided with the school district’s dating violence policy, as provided in §37.3 of these Regulations and as provided in RIGL §16-21-30(c). 5.1.15.2.2 Upon written request to the school principal, and within a reasonable period of time after the request is made, a parent or 14 legal guardian of a pupil less than eighteen (18) years of age shall be permitted to examine the dating violence education program instruction materials at the school in which his/her child is enrolled; Section 6.0 Physical Education Curriculum 6.1 The physical education curriculum shall: 6.1.1 be sequential and comprehensive for grades Kindergarten-12; 6.1.2 be aligned with the Rhode Island physical education standards of the Rhode Island Physical Education Framework; 6.1.3 include standards-based goals, objectives, examples of teaching and learning strategies and materials, and assessment; and 6.1.4 be developmentally appropriate so that all students can achieve high standards. 6.2 A curriculum team consisting of representatives from the school district teaching and administrative staff, parents, and community members shall periodically review and revise, as necessary, the physical education curriculum. 6.3 The physical education curriculum of each school district shall be available for review by the Rhode Island Department of Elementary and Secondary Education upon request. 15 PART III HEALTH SERVICES Section 7.0 Responsibility for Services Population-Based Health Services 7.1 In accordance with RIGL Chapter 16-21-9, each community shall provide adequate and appropriate personnel to conduct mandated population-based health services, as described in these Regulations, for all school children attending public and non-public schools within its geographical boundaries. 7.1.1 Said services shall include no less than the following components: 7.1.1.1 health examinations/screenings (as described in §§ 9.0, 10.0, 11.0, 12.0, 13.0, and 14.0 of these Regulations); 7.1.1.2 record keeping requirements in accordance with §§ 15.0, 16.0, 17.0, and 18.0 of these Regulations; 7.1.1.3 reporting and management of any school-based communicable, environmental, or occupational disease as directed by a physician and in accordance with §16.0 of these Regulations. Individualized Health Services 7.2 Each public and non-public school shall provide adequate and appropriate personnel and/or equipment to render individualized health services to all students enrolled in the school. At a minimum, said services shall include those ordered by a physician, such as medication administration. 7.2.1 All personnel rendering individualized health services to students shall be duly licensed and/or certified in Rhode Island in accordance with all applicable state laws and regulations. 7.2.2 [DELETED] Students Assisted by Medical Technology 7.3 Pursuant to the provisions of RIGL §23-13-26 ("Technology-dependent Children"), certified school nurse-teachers who provide direct care for technology-dependent children, shall develop individualized health care plans (IHCPs) for such children and provide care accordingly. 7.3.1 All children assisted by medical technology and/or with other specialized health care needs, who are currently enrolled in grades K-12; entering Kindergarten; or currently attending or entering a public school-sponsored preschool, shall have as part of their permanent school health record, an individualized health care plan (IHCP) and/or an emergency care plan (ECP/ EHCP), as necessary and/or appropriate to ensure health, safety, and learning for the child while at school or at school-sponsored activities. 7.3.2 The plan shall include, but not be limited to the following: 16 (a) A description of all services that will be provided to the student, including those services related to school-sponsored transportation and off-site school-sponsored activities; (b) Persons responsible for providing each service and a description of service(s) provided in school or at school-sponsored activities; (c) Qualifications of the person(s) providing services; (d) Training requirements for person(s) providing services and locus of responsibility for providing training; (e) Supervision of person(s) providing services. 7.3.3 All school personnel who may be involved in the care of a student assisted by medical technology shall be informed of the IHCP and ECP/ EHCP, on a need-to- know basis. 7.3.4 The IHCP and ECP/EHCP shall be developed by the certified school nurse teacher or school nurse in collaboration with the medical provider, parent or guardian, student (when appropriate), principal, and other school staff, as appropriate. It shall be signed by the certified school nurse teacher, parent/guardian, and student (when appropriate). 7.3.5 The IHCP and ECP/EHCP shall be developed in addition to an Individualized Education Plan (IEP) or a 504 Plan, when appropriate. The IEP or 504 Plan may serve as the IHCP or ECP/EHCP if it meets all of the requirements stated in these Regulations. Section 8.0 School Personnel 8.1 The school superintendent with the advice and consent of the school committee of each community, school district or appropriate non-public school authority (e.g., superintendent, headmaster or principal) shall arrange for the appointment of all school health personnel necessary to implement the health services requirements described in these Regulations, pursuant to the requirements of RIGL Chapter 16-21. School Physician 8.2 Each community shall provide for the appointment and provision of direct and/or consultative services of a school physician(s) as specified in RIGL §16-21-9, to make examinations of the health of the school children, who shall report any deviation from the normal, and for the preservation of records of the examinations of the children. Qualifications and General Duties 8.2.1 The community's school physician(s) shall be licensed to practice allopathic or osteopathic medicine in Rhode Island in accordance with RIGL Chapter 5-37. 8.2.2 The school physician shall be qualified by virtue of training and experience to assume the role of a school health consultant (e.g., develops school health protocols, provides in-service training for school nurses) and/or primary care provider (e.g., 17 performs physicals, examines outbreak cases) for a wide range of comprehensive school health services. 8.2.3 The school physician shall have knowledge of all state and local laws, regulations and protocols affecting schools. The school physician shall participate actively to ensure implementation of all such laws, regulations and protocols in collaboration with the school’s administrative authorities and school health personnel. 8.2.4 The school physician shall establish a contract with the school system defining mutually agreed upon expectations and objectives and shall provide a regular report (a minimum of one (1) per year) on consultation and/or direct service activities rendered to the school system. 8.2.5 As a condition for approval of a community's school health program by the Commissioner of Elementary and Secondary Education and the Director of Health, that community's school health service plans, protocols and programs (except those developed and provided by the school dentist[s]) shall have received the prior approval of the community's school physician(s). 8.2.5.1 At a minimum, these plans shall be reviewed on an annual basis by the school physician and shall include provisions for: 1. the delivery of health services in the school environment (including screenings); 2. consultations; 3. furnishing information on health-related matters; 4. review of standing orders, protocols and procedures; and 5. reporting and management of infectious diseases and outbreaks, in accordance with the most current Department of Health recommendations related to infection control in the school environment. Certified School Nurse-Teachers Qualifications 8.3 Certified school nurse-teacher personnel shall be certified by the state Department of Elementary and Secondary Education and licensed as registered nurses in accordance with §1.7 of these Regulations. General Duties 8.3.1 In accordance with §1.7 of these Regulations, a certified school nurse-teacher shall provide population-based health services to school children in public and non-public schools in the community. In accordance with §7.2 of these Regulations, a certified school nurse-teacher shall provide individualized health services to all public school children in the community. This requirement shall not be construed as prohibiting certified school nurse-teachers from providing individualized health services to students in non-public schools. 18 Exemption from Certified Nurse-Teacher Requirement 8.3.2 In accordance with the Guidance for the Approval of Non-Public Schools in Rhode Island issued by the Rhode Island Department of Elementary and Secondary Education, non-public schools are authorized to employ registered nurses licensed in Rhode Island for the purpose of providing individualized health services, including dispensing medications, to students in the school setting. 8.3.3 These registered nurses licensed in Rhode Island (cited in §8.3.2 of these Regulations) are construed to be “substantially equivalent” in their qualifications only for the purpose of providing individualized health services, including dispensing medication, to students in the school setting, not for carrying out the population-based health services and other requirements of the school health program as described in these Regulations. Dentist/Dental Hygienist Qualifications 8.4 The school dentist(s)/dental hygienist for a community shall be licensed to practice dentistry/ dental hygiene, respectively, in Rhode Island in accordance with RIGL Chapter 5-31.1. General Duties 8.4.1 Each community shall provide for dental screenings by a dentist or a licensed dental hygienist with at least three (3) years of clinical experience as specified in RIGL §16-21-9 who shall report any suspected deviation from the normal and for the preservation of records of the screenings of the children. 8.4.2 Each community as defined in RIGL §16-7-16 shall contract only with a licensed dentist for the provision of the dental screening services required by these Regulations. Dental hygienists performing the dental screenings pursuant to the provisions of RIGL §16-21-9 shall do so under the general supervision of the dentist liable and responsible under the contract with the community. (For a definition of “general” supervision, see the Rules and Regulations Pertaining to Dentists, Dental Hygienists and Dental Assistants (R5-31-DHA) promulgated by the Rhode Island Department of Health). 8.4.3 Each school dentist or dental hygienist as specified in §14.1 of these Regulations may perform any of the required dental screenings of school children in his/her district. Each dentist shall also examine children referred to him/her by the administrator, certified school nurse-teacher, or physician for suspected dental disease. 8.4.4 The school dentist and dental hygienist, when applicable, shall be qualified by virtue of training and experience to assume the role of a school health consultant (e.g., develops school health protocols, provides in-service training for school nurses or dental hygienists) and/or service provider in accordance with the Rules and Regulations Pertaining to Dentists, Dental Hygienists and Dental Assistants (R5-31-DHA) promulgated by the Rhode Island Department of Health. 19 8.4.5 The school dentist and dental hygienist, when applicable, shall have knowledge of all relevant state and local laws, regulations and protocols affecting schools. The school dentist and dental hygienist, when applicable, shall participate actively to ensure implementation of all such laws, regulations and protocols in collaboration with the school’s administrative authorities and school health personnel. 8.4.6 The school dentist shall establish a contract with the school system defining mutually agreed upon expectations and objectives and the dentist and/or dental hygienist, when applicable, shall provide a regular report (a minimum of one (1) per year) on consultation and/or direct service activities rendered to the school system. 8.4.7 Except in emergency circumstances, referral by a dentist or dental hygienist of children screened pursuant to the provisions of RIGL §16-21-9 to a dental practice by which the dentist or dental hygienist is employed and/or which the dentist owns shall be strictly prohibited. In the event that a referral has been made in violation of this provision, the community shall terminate its contract with the dentist. In the case of an egregious violation of the referral prohibition contained in these Regulations, such conduct shall be reported to the Board of Dental Examiners at the Rhode Island Department of Health. 8.4.7.1 Referrals by a dentist or a dental hygienist to non-profit dental programs that provide oral health services on a reduced or sliding fee scale basis are exempt from the provisions of §8.4.7 of these Regulations. Section 9.0 Health Examinations General Health Examination Requirements 9.1 Every student who has not been previously enrolled in a public or non-public school in this state shall have a medical history and physical examination completed. This examination shall be conducted in the twelve (12) months preceding the date of school entry, but if not, it shall be completed within six (6) months of school entry. 9.1.1 A second general health examination and health clearance will be required upon entry to the seventh (7th) grade. This general health examination may be performed during the sixth (6th) grade, but no later than six (6) months after entry into the seventh (7th) grade. 9.1.2 Effective 1 August 2015, a third general health examination and health clearance will be required upon entry to the twelfth (12th) grade. This general health examination shall be performed after the student turns sixteen (16) years of age, and no later than six (6) months after the student enters the twelfth (12th) grade. 9.1.3 Said general health examinations shall be a complete, age-appropriate history and physical examination, assessing the health and well-being of the child and evaluating any challenges to the child’s success in school and school-related activities. 9.2 [DELETED] 20 9.3 [DELETED] 9.4 These general health examinations shall be conducted by the student's family physician, a physician's assistant under the physician's supervision, or a certified registered nurse practitioner. 9.4.1 If there is no evidence that the appropriate general health examination has been performed, the school system shall make provisions for said examination by the end of the school year in which it is required. 9.4.2 No student shall be excluded from school for failure to provide documentation of completion of a general physical examination. 9.5 For students suspected or identified as having special health needs, referrals by a certified school nurse-teacher shall be made as specified in these Regulations or in the Regulations Governing the Special Education of Children with Disabilities [Reference 9]. 9.6 Each school system may require additional health examinations, in order to ensure the mental and physical health of each child to participate in classroom, athletic, or special activities sponsored or conducted by the school. Lead Screening 9.7 In accordance with the requirements of RIGL §23-24.6-8, each public and private nursery school and kindergarten shall, prior to initial enrollment of a child, obtain from a parent of the child evidence that said child has been screened for lead poisoning according to guidelines established under RIGL §23-24.6-7, or a certificate signed by the parent stating that blood testing is contrary to that person’s beliefs. Documentation & Follow-up 9.8 General health examination results shall be documented in a standardized format with one (1) copy available from the Department of Health or in any such format that captures the same fields of information. One (1) copy of said form shall be provided to the appropriate certified school nurse-teacher and entered into the student's cumulative school health record. Electronic transmission of the information is acceptable, provided that the requirements of §15.4 and §15.5 of these Regulations are met. 9.9 As appropriate, a care plan for health problems shall be developed by the certified school nurse-teacher in conjunction with the parent, student, and other appropriate health care providers and maintained on each student, as needed. The plan shall be entered into the cumulative health record. Section 10.0 Vision Screening General Vision Screening Requirements 10.1 Upon entering kindergarten or within thirty (30) days of the start of the school year, the parent or guardian of each child shall present to school health personnel certification that the child, within the previous twelve (12) months has passed a vision screening conducted by a 21 health care professional licensed by the Department or has obtained a comprehensive eye examination performed by a licensed optometrist or ophthalmologist. 10.1.1 For children who fail to pass the vision screening and for children diagnosed with neurodevelopmental delay, proof of a comprehensive eye examination performed by a licensed optometrist or ophthalmologist indicating any pertinent diagnosis, treatment, prognosis, recommendation and evidence of follow-up treatment, if necessary, shall be provided. 10.1.2 Any person who conducts a comprehensive eye examination of a child in response to such child having failed a vision screening given in accordance with the provisions of this section shall forward a written report of the results of the examination to the school health personnel and a copy of said report to a parent or guardian of such child and the child's primary health care provider. 10.1.3 Said report shall include, but not be limited to, the following: 10.1.3.1 date of report; 10.1.3.2 name, address and date of birth of the child; 10.1.3.3 name of the child's school; 10.1.3.4 type of examination; 10.1.3.5 a summary of significant findings, including diagnoses, medication used, duration of action of medication, treatment, prognosis, whether or not a return visit is recommended and, if so, when; 10.1.3.6 recommended educational adjustments for the child, if any, which may include the following: preferential seating in the classroom, eyeglasses for full-time use in school, eyeglasses for part-time use in school, sight- saving eyeglasses or any other recommendations; 10.1.3.7 name, address and signature of the examiner. 10.2 Every student shall be given a vision screening at least upon entry to school and in the first (1st), second (2nd), third (3rd), fourth (4th), fifth (5th), seventh (7th) and ninth (9th) grades. 10.2.1 If satisfactory evidence is presented to the school physician or certified school nurse-teacher that the same screening, or series of tests, as provided for in these Regulations, has been completed within the preceding twelve (12) months by the student's ophthalmologist, optometrist, or primary care provider, the student shall be exempt from this screening requirement for that school year. 10.3 Regular reporting to the Departments of Health and Education on the results of examinations as required in these Regulations shall be made in a manner and at such intervals as prescribed from time to time in directives issued by the Director of Health or the Commissioner of Elementary and Secondary Education. 10.4 The screening shall be completed in accordance with the schedule prescribed below: 22 Function Tests Referral Criteria Comments Distance Visual Acuity (myopia screening) Snellen letters Snellen numbers Tumbling E HOTV Picture tests Allen figures LH test For Ages 3--5 Years: 1. Less than 4 of 6 correct on 20 foot line with either eye tested at 10 feet monocularity (i.e., less than 10/20 or 20/40) OR 2. Two-line difference between eyes, even within the passing range (i.e., 10/12.5 and 10/20 or 20/25 and 20/40) For Ages 6 and Older: 1. Less than 4 of 6 correct on 15 foot line with either eye tested at 10 feet monocularity (i.e., less than 10/15 or 20/30) OR 2. Two-line difference between eyes, even within the passing range (i.e., 10/10 and 10/15 or 20/20 and 20/30) 1. Tests are listed in decreasing order of cognitive difficulty. The highest test that the child is capable of performing should be used. In general, the Tumbling E or the HOTV test should be used for ages 3 through 5 years and Snellen letters or numbers for ages 6 years and older. 2. Testing distance of 10 feet is recommended for all visual acuity tests. 3. A line of figures is preferred over single figures. 4. The non-tested eye should be covered by an occluder held by the examiner or by an adhesive occluder patch applied to the eye. The examiner must ensure that it is not possible to peek with the non-tested eye. 5. Testing for distance visual acuity shall be completed for those grades noted in §10.2 of these Regulations. Near Visual Acuity (hyperopia screening) Snellen visual acuity or equivalent If using hyperopia glasses, correctly identify 4 out of 6 Testing for near visual acuity must be completed at least once per student upon entry and in either Kindergarten, 1st grade, 2nd grade, or 3rd grade; and once per student in the 4th or 5th grade; and once per student in the 7th and 9th grades. Ocular Alignment Random Dot E Stereotest at 40 cm (100 secs of arc) Less than 4 of 6 correct Testing for ocular alignment must be completed only for students in grades K, 1, and 2 and for those upon initial entry who have not been previously screened. Color vision Any standard developmentally- appropriate isochromatic color vision test Failure under conditions specified by the manufacturer Tested only once at school entry age or upon initial screening  Or other vision screening test(s) designed for special populations 23 Personnel & Training Requirements 10.5 The school vision screening shall be given by a certified school nurse-teacher, trained in the administration of these tests. 10.6 Trained volunteers or other school personnel who are directly supervised on-site by certified school nurse-teachers may be utilized in the vision screening program. Follow-up & Documentation Requirements 10.7 A child failing the screening shall be given a retest on a different day (but within one month) before the parents are notified of the results of the test. 10.7.1 Students who fail the screening criteria set shall be re-screened by the certified school nurse-teacher. 10.8 Parents of those students who fail to meet the minimal visual requirements on the second screening shall be notified, in accordance with the requirements of §16.0 of these Regulations in order to arrange for a comprehensive vision examination by an eye care provider. 10.9 If the corrected visual acuity of the child is found to be in the range of 20/70--20/200 in the better eye after rescreening, the licensed health care provider in charge of the screening shall, within 30 days, report the result of the screening to the administrator of the Division of Services for the Blind and to the Special Education Supervisor, indicating that specialized services may be indicated. 10.9.1 Students identified with a visual impairment shall be referred for specialized services and follow-up in accordance with the provisions of §4.0 of the Regulations Governing the Special Education of Children with Disabilities. [Reference 9] 10.10 A student's vision screening results shall be recorded in the "Vision Screening" section of the school health record. Section 11.0 Hearing Screening General Hearing Screening Requirements 11.1 School children in pre-kindergarten programs operated by public school districts, as well as all school children in kindergarten, first, second, and third grades and any student(s) new to a school without a prior record of a hearing screening shall be given a hearing screening test by a properly trained and qualified person in the manner and at such intervals as comports with current guidelines of the American Speech-Language-Hearing Association (ASHA). 11.2 Students who failed the hearing screening tests in previous years, repeat a grade, have a history of hearing difficulty or pathology, are enrolled in curricular or extracurricular activities where there is exposure to noise levels that meet or exceed current Occupational Safety and Health Administration (OSHA) standards Reference 19], or are suspected by school personnel of a hearing loss shall be screened as often as is necessary. 24 11.3 The "passing" criteria for the hearing screening test shall be in accordance with the most recent guidelines set forth by the State of Rhode Island Hearing Center at the Rhode Island School for the Deaf. 11.4 The screening shall consist of an initial Otoacoustic Emission hearing test. Children who fail the initial screen shall immediately be re-screened with tympanometry and pure tone according to American Speech/Language and Hearing guidelines for screening school age children. 11.5 Any student who provides documentation from a parent that a hearing screening test has been performed in accordance with §11.7 of these Regulations shall be exempt from this screening requirement. 11.5.1 In the absence of this documentation from the parent, the school shall make provisions for the screening. Equipment 11.6 All equipment utilized in the hearing screenings shall be calibrated according to current national standards, as described in Guidelines for Audiologic Screening; ANSI/ASA Specifications for Audiometers; and ANSI Specifications for Instruments to Measure Aural Acoustic Impedance and Admittance (Aural Acoustic Immittance) [References 10-12]. Personnel Requirements 11.7 A certified school nurse-teacher shall be responsible for coordinating the requirements of this section. Personnel who may perform the screening requirements of this section include: an audiologist, speech language pathologist, certified school nurse-teacher, audiometric aide under the supervision of a licensed audiologist, or a speech/language pathology assistant under the supervision of a certified speech language pathologist. 11.8 Any supporting personnel utilized by an audiologist/speech language pathologist in the hearing screening program shall meet the requirements outlined in the Rules and Regulations for Licensing Speech Pathologists and Audiologists (R5-48-SPA) [Reference 8]. Follow-up & Documentation Requirements 11.9 The parent of a student who does not meet the "passing" criteria of the hearing screening shall be notified, in accordance with the requirements of §16.0 of these Regulations, and recommended to obtain a comprehensive audiological evaluation and/or medical follow-up with the child’s primary care physician. 11.10 Children identified with a potentially educationally-significant hearing impairment shall be referred by the certified school nurse-teacher for in-school supportive accommodations, Teacher Support Team, or other educational services, as appropriate or as specified in the Regulations Governing the Special Education of Children with Disabilities [Reference 9]. 11.11 The hearing status of children referred for further evaluation shall be confirmed and noted by the certified school nurse-teacher within three (3) months of the initial referral. 25 11.12 A student's hearing screening results shall be entered into his/her school health record by the certified school nurse-teacher or the person performing the screening. 11.12.1 At a minimum, the following components shall be noted in the record: 11.12.1.1 date screening completed; 11.12.1.2 screening results; 11.12.1.3 follow-up plan, as indicated. Section 12.0 Speech/Language Screening General Speech/Language Requirements 12.1 Every elementary school student who has not been previously screened for speech/language impairments shall be screened for speech and language impairments by a trained and qualified person (as described in §§12.4 and 12.5 of these Regulations). Any student may be screened on an “as needed” basis. 12.1.1 For those students who have been previously screened, results of said screening shall be transferred to each new school in accordance with the requirements of §15.3 of these Regulations. 12.2 Any student who has never been previously enrolled in a Rhode Island school who provides documentation from a parent that a speech screening has been performed by a certified and/or licensed speech language pathologist shall be exempt from this screening requirement. 12.2.1 In the absence of this documentation from the parent, the school shall make provisions for the screening. 12.3 A speech/language screening shall consist of an assessment of the following: 12.3.1 articulation; 12.3.2 voice characteristics; 12.3.3 fluency (e.g., stuttering) and; 12.3.4 receptive/expressive language skills. Personnel Requirements 12.4 A Rhode Island Department of Elementary and Secondary Education-certified speech language pathologist shall be responsible for implementing the requirements of §12.0 of these Regulations. 12.5 Any support personnel (e.g., a speech/language pathology assistant) utilized by a speech/language pathologist shall meet the training and supervision requirements outlined in the Rules and Regulations for Licensing Speech Pathologists and Audiologists (R5-48-SPA) [Reference 8]. 26 Instruments 12.6 A school's speech screening program may be conducted utilizing commercially available kindergarten/elementary school level screening instruments. 12.7 In developing techniques for screening students ages eight (8) and above, informal items may be adapted from available tests. This informal screening would not provide standardized procedures but would yield an acceptable method of screening to determine the need for further testing. Follow-up & Documentation Requirements 12.8 A student who does not pass the speech/language screening shall be referred immediately for a comprehensive speech/language evaluation. The parent of any child who does not pass the speech screening shall be notified of the findings, in accordance with the requirements of §16.0 of these Regulations. 12.9 The speech language pathologist or the certified school nurse-teacher shall enter the results into the student's school health record. 12.9.1 The following components shall be noted in the record: 12.9.1.1 date screening completed; 12.9.1.2 screening results (i.e., pass/fail); and 12.9.1.3 follow-up plan for a student who does not pass. Section 13.0 Scoliosis Screening General Scoliosis Screening Requirements 13.1 No school-based scoliosis screening shall be conducted before students are introduced to the nature of the condition, its effects, and the nature of the scoliosis screening procedure. 13.2 The school health program shall provide for the yearly screening or examination for scoliosis of all school children in grades six (6) through eight (8) and the preservation of records of the screening or examinations of those children. 13.3 The parent of any such child may have the screening or examination conducted by a private physician and the results thereof shall be made available to the local school department. If these results are made available to the local school department, the student shall be exempt from the requirements of §13.0 of these Regulations. 13.4 The screening of male and female pupils shall be conducted separately and individually. A private, well-lit screening area should be available. 13.5 The test shall not be required of any student whose parents object on the grounds that the test conflicts with their religious beliefs. 27 Personnel Requirement 13.6 The screening shall be conducted by a certified school nurse-teacher, in accordance with the requirements of RIGL §16-21-10. Follow-up and Documentation Requirements 13.7 In accordance with the requirements of §16.0 of these Regulations, the certified school nurse-teacher shall be responsible for notifying the parent of any child who is found to have positive signs or symptoms of scoliosis, based upon current standards published by the American Academy of Orthopaedic Surgeons or the Scoliosis Research Society, in order to arrange for further evaluation or treatment, as indicated. 13.8 A student's scoliosis screening results shall be documented in the student health record. Section 14.0 Dental Health Screening General Dental Health Screening Requirements 14.1 Every student who has not been previously enrolled in a public or non-public school in this state shall be given a dental screening by a licensed dentist or a licensed dental hygienist with at least three (3) years of clinical experience. Thereafter, every student shall be given an annual dental screening by a licensed dentist or dental hygienist through the fifth (5th) grade and shall be screened at least once between the sixth (6th) and tenth (10th) grades. Dental hygienists performing the dental screenings pursuant to the provisions of this section shall do so under the general supervision of the dentist liable and responsible under the contract with the community as required under RIGL §16-21-9(b). 14.1.1 Provided, however, that dental screenings for children in kindergarten, fourth and ninth grades shall only be performed by a licensed dentist. 14.2 Students who are screened by private dentists/dental hygienists and who provide written documentation of the screening being performed at the prescribed intervals (as in §14.1 of these Regulations) shall be exempt from the requirements of this section and may elect not to be screened. 14.3 In order to screen for hard tissue disease (tooth decay), soft tissue disease (gum disease) and urgent treatment need, the school dental screening shall consist of an inspection of the student's mouth, according to the referral criteria described below. These screenings shall be totally non-invasive. Category Referral Criteria Hard tissue (dentition) 1. Suspicious tooth decay Soft tissue (gums) 1. Gross gingival inflammation 2. Soft tissue lesions (e.g., fistulas, abscesses, etc.) Treatment Urgency 1. No apparent need for care 2. Apparent need for routine, non-urgent care/ referral recommended 3. Apparent emergency need/immediate referral recommended 28 14.4 Equipment to perform the screening requirements of §14.3 of these Regulations shall include: a mirror, cotton rolls, a light source, and non-latex disposable gloves. 14.5 The initial dental screening preferably should be conducted by the child's family dentist/dental hygienist within the six (6) months preceding the date of school entry, and the succeeding screenings should be conducted by him/her at any time during the school year (including vacations) for which the screening is required. 14.5.1 Effective with the 2014-2015 school year, all such screening results shall be documented in writing using the Rhode Island Department of Health (RIDOH) standardized form and submitted to the school for all grades and to the RIDOH Oral Health Program upon screening completion for grades K, 3 and 6 (if grade 6 is the selected screening year between grades 6 and 10), or as indicated by the RIDOH. 14.5.2 The RIDOH standardized form will be made available to all schools via the RIDOH website. Follow-up and Documentation Requirements 14.6 When a school dental screening has revealed that a dental problem may exist, the parent shall be notified in writing, using the standardized form of the RIDOH, so that a dental visit may be arranged. 14.7 A student's dental screening results shall be documented on the school health record. 14.8 Each community shall provide to parents or custodians of children who require professional or skilled treatment a current list of both dental practices in the community which accept patients insured by Medical Assistance and/or RIte Care and dental practices which provide services on a sliding scale basis to uninsured individuals. 14.8.1 In accordance with RIGL §16-21-9(d), the Rhode Island Department of Human Services shall provide each community with a current list containing the addresses and telephone numbers of both dental practices which accept patients insured by Medical Assistance and/or RIte Care and dental practices which provide services on a sliding scale basis to uninsured individuals. Section 15.0 Health Records 15.1 The certified school nurse-teacher shall be responsible for the complete, cumulative school health record for each student at the school in which the student is enrolled. The student's cumulative health record is confidential and subject to the provisions of RIGL Chapter 5- 37.3-1, ("Confidentiality of Health Care Information Act") [Reference 4], and other applicable state and federal laws and rules and regulations. The record shall be stored in an appropriately secured location with convenient access by the school nurse and shall be used only in connection with the provision of treatment to the student. The record shall be maintained by the school for a minimum of five (5) years after the student turns eighteen (18) years of age or five (5) years after the student leaves the school district. 15.1.1 Such records shall include information regarding: 29 15.1.1.1 immunization status and certification; 15.1.1.2 health history, including chronic conditions and treatment plan; 15.1.1.3 screening results and necessary follow-up; 15.1.1.4 health examination reports; 15.1.1.5 documentation of traumatic injuries and episodes of sudden illness referred for emergency health care (see also requirements in "First Aid and Emergencies" §18.0 of these Regulations); 15.1.1.5.1 For a student with documented anaphylaxis, the parental authorization of a student's treatment for allergies and the physician's order to administer an epinephrine auto-injector shall be entered into the student's health record. 15.1.1.6 documentation of any nursing assessments completed; 15.1.1.7 documentation of any consultations with school personnel, students, parents, or health care providers related to a student's health problem(s), recommendations made, and any known results; 15.1.1.8 documentation of the health care provider's orders, if any, and parental permission to administer medication or medical treatment to be given in school by the certified school nurse-teacher. 15.2 Appropriate steps shall be taken for the protection of all student health records, including the provisions for the following: 15.2.1 securing records at all times, including confidentiality safeguards for electronic records; 15.2.2 establishing, documenting and enforcing protocols and procedures consistent with the confidentiality requirements described in these Regulations; 15.2.3 training school personnel who handle student school health records in security objectives and techniques. 15.3 Whenever a student transfers to another school building or school system in or out of Rhode Island, the original, a copy, or electronic version of the complete, cumulative school health record shall be transferred at the same time to the health personnel of the school building or school system to which the student is transferring. This record shall be sent in a manner consistent with the provisions of the Health Insurance Portability and Accountability Act [Reference 24] to a health care professional authorized to receive said confidential health care information at the new school or handed to the parent, as appropriate. A copy of the record (or the original) shall be maintained by the sending community for a minimum of five (5) years after the student turns eighteen (18) years of age or five (5) years after the student leaves the school district. 30 Confidentiality 15.4 Any school personnel, including health care providers, who maintain cumulative school health records containing confidential health care information shall be responsible for ensuring full confidentiality of this information as provided in RIGL §5-37.3-4 ("Confidentiality of Health Care Information Act") [Reference 4] and other applicable state and federal laws and rules and regulations. 15.5 Any school personnel, including health care providers, who release confidential health care information from cumulative school health records in accordance with RIGL §5-37.3-4 ("Confidentiality of Health Care Information Act" [Reference 4] and other applicable state and federal laws and rules and regulations, shall document each such release in the applicable cumulative school health records by indicating the following: 15.5.1 the date of release; 15.5.2 a description of the information released; 15.5.3 the name(s) of the person(s) to whom the information was released; 15.5.4 the reason for the release of information. 15.6 Violations Pertaining to Confidentiality: Any person suspected of violating the Health Care Information Act shall be reported to the Attorney General's Office for prosecution and any subsequent penalties, in accordance with statutory provisions. Section 16.0 Notification of Parents 16.1 Parents and/or guardians shall be notified, according to established local school district procedures, of any suspected deviation from normal or usual health found as a result of a screening test (e.g., vision screening), health examination, and/or school personnel observation, in accordance with all applicable state and/or federal laws and regulations. 16.2 Each school district shall develop procedures or protocols for documenting and implementing a follow-up and referral plan for students identified as needing additional services. Section 17.0 School Reporting Requirements 17.1 In accordance with the Rules and Regulations Pertaining to the Reporting of Communicable, Environmental and Occupational Diseases [Reference 1], the basic responsibility for reporting communicable, environmental and occupational diseases lies with: 1. Physicians licensed in accordance with RIGL Chapter 5-37 who are attending the case or suspected case; 2. Laboratories; 3. Other authorized health professionals working under the auspices of a physician; and 31 4. Other health care professionals authorized by law or regulation to practice independently (e.g., registered nurse practitioners). In the school setting, this requirement encompasses certified school nurse-teachers directed by a physician to report in accordance with the regulatory requirements cited above. 17.1.1 Licensed health care facilities that operate school-based health clinics shall report communicable, environmental and occupational diseases in accordance with the Rules and Regulations for the Licensing of Organized Ambulatory Care Facilities [Reference 14] and the Rules and Regulations Pertaining to the Reporting of Communicable, Environmental and Occupational Diseases [Reference 1] 17.2 In accordance with the Rules and Regulations Pertaining to the Reporting of Communicable, Environmental and Occupational Diseases, any health care provider (e.g., school physicians, certified school nurse-teachers, school dentists/dental hygienist) having knowledge of any outbreak or undue prevalence of infectious or parasitic disease or infestation (based upon his/her professional judgment), whether listed in said regulations or not, shall promptly report the facts to the Department of Health. Exotic diseases and unusual group expressions of illness that may be of public health concern should also be reported immediately. Section 18.0 First Aid and Emergencies 18.1 Each school shall have written protocols and standing orders available in the event of injuries and acute illnesses, including anaphylaxis. 18.1.1 These written protocols and standing orders shall be prepared, dated, signed, reviewed and updated, as appropriate, but at least on an annual basis by the school physician(s). 18.1.1.1 No requirement in these Regulations shall be construed as prohibiting the issuance of a standing order by a school physician for the administration of an epinephrine auto-injector by a school nurse to a student who has not been previously medically identified for the prevention or treatment of anaphylaxis. This standing order shall be reviewed in accordance with §18.1.1 of these Regulations. 18.1.2 These emergency written protocols shall be reviewed annually by all school personnel who might be involved in managing an emergency in a school, including anaphylaxis, prior to the arrival of more fully trained persons. Said personnel shall be identified by the school principal, or other designated school authority, as needing to review these emergency written protocols on an annual basis. First Aid Training - Basic First Aid Training 18.2 In-service basic first aid training shall be provided for school personnel who might be involved in managing an injury or other medical emergency. Said personnel shall be identified by the school principal, or other designated school authority, and listed in the emergency protocol described in §§ 18.1.1 and 18.1.2 of these Regulations. Subjects to be covered shall include, but not be limited to: control of major bleeding, use of 32 universal/standard precautions, management of ocular trauma and emergencies, management of burns, diabetes-related signs and symptoms, accessing the "911" emergency medical system, proper application and removal of disposable gloves and equipment, and movement and transportation of an injured person. No less than one (1) hour of basic first aid training or current certification for the allotted term of said certification in basic first aid by a nationally recognized organization shall be required of school personnel designated by the school administrator during every school year. 18.2.1 The school principal, or other authorized school personnel, shall maintain a record- keeping system documenting that the basic first aid training (as above) has been provided to all designated school personnel. 18.2.2 The training shall be delivered by a certified school nurse-teacher, or other designated instructor, utilizing a training curriculum that adheres to standards established by a nationally-recognized body. 18.2.3 Students engaged in potentially hazardous tasks (including, but not limited to, activities during normal school hours in science laboratories, industrial arts, physical education, and family/consumer science classes) should be directly supervised by teachers or instructors who are trained, as outlined in §18.2 of these Regulations in the administration of basic first aid, and who have posted and discussed safety rules with the students. First Aid Training - Basic First Aid and Cardiopulmonary Resuscitation Training 18.3 At all times, during normal school hours and at on-site school-sponsored activities, each school shall have available at least one (1) person other than the certified school nurse- teacher who is trained, competent and responsible for the administration of basic first aid, child/adult cardiopulmonary resuscitation (CPR), including emergency procedures for obstructed airways (choking) and drowning, and administration of the epinephrine auto- injector. First Aid Training - Anaphylaxis 18.4 Training shall be provided for school personnel who might administer an epinephrine auto- injector in a case of anaphylaxis. Subjects to be covered shall include (but not be limited to): signs and symptoms of anaphylactic shock, proper epinephrine auto-injector administration, adverse reactions, accessing the "911" emergency medical system, and preparation for movement and transport of the student. Response to and Treatment for Anaphylaxis 18.5 To prevent or treat a case of anaphylaxis (as defined in §1.2 of these Regulations), the certified school nurse-teacher or trained school personnel shall administer the epinephrine auto-injector to an identified student. Certified school nurse-teachers shall administer the epinephrine auto-injector in accordance with standard nursing practice. 18.6 In the event of a suspected case of anaphylaxis, school personnel may administer the emergency protocol, including an epinephrine auto-injector to a medically identified student 33 when authorized by a parent/guardian and when ordered by a physician or other licensed prescriber. 18.7 School health programs shall develop and adopt a procedure for addressing incidents of anaphylaxis and the use of the epinephrine auto-injector on previously medically identified students. Such procedures shall pertain to no less than the requirements described in these Regulations and shall include the following: 18.7.1 Parents shall provide a physician's or other licensed prescriber's order, parent authorization, and filled prescription(s) (i.e., the epinephrine auto-injector(s)) notifying the school of the student's allergy and the need to administer the epinephrine auto-injector in a case of anaphylaxis. 18.7.2 School administrators shall communicate the required medical information from the parent to the appropriate school personnel, including the certified school nurse- teacher, teachers, food service workers, and school bus drivers and bus monitors. 18.7.3 The school physician shall review these procedures on an annual basis, in accordance with the requirements of §8.2 of these Regulations. 18.7.4 Such procedures shall stipulate that the epinephrine auto-injector be used only upon the student for whom it was prescribed, in accordance with the provisions of RIGL Chapter 21-28.2, "Drug Abuse Control,". 18.7.5 Such procedures shall provide for the development of an individualized emergency care plan for a student at risk for anaphylaxis. 18.7.6 Procedures for accessing the community's emergency medical system (i.e., "911") shall be included in these procedures. 18.8 Students who are treated for anaphylaxis at the school shall be transported by a licensed ambulance/rescue service promptly to an acute care hospital for medical evaluation and follow-up. 18.9 If appropriate, a child identified as being at risk for anaphylaxis should carry the epinephrine auto-injector with him at all times. If this is not appropriate, the epinephrine auto-injector shall, if necessary for the student’s safety, as determined by the physician, or other licensed prescriber, be available in the classroom, cafeteria, physical education facility, health room and/or other areas where the epinephrine auto-injector is most likely to be used. Reasonable provisions shall be made for the availability, safekeeping and security of the epinephrine auto-injector. The school shall develop protocols and procedures related to the availability, safekeeping and security of the epinephrine auto-injector. 18.10 School personnel who have been trained in accordance with §§ 18.2, 18.3, and/or 18.4 of these Regulations are authorized to administer the epinephrine auto-injector to an identified student. If trained school personnel are not available, any willing person may administer the epinephrine auto-injector to a medically identified student. None of the requirements of these Regulations shall preclude the self-administration of an epinephrine auto-injector by a medically identified student. 34 Good Samaritan Provisions 18.10.1 No school teacher, school administrator, school health care personnel, or any other school personnel shall be liable for civil damages which may result from acts or omissions in the use of the epinephrine auto-injector which may constitute ordinary negligence. This immunity does not apply to acts or omissions constituting gross negligence or willful or wanton conduct. 18.10.2 No person who voluntarily and gratuitously renders emergency assistance to a person in need thereof shall be liable for civil damages which result from acts or omissions by such person rendering the emergency care, which may constitute ordinary negligence. This immunity does not apply to acts or omissions constituting gross negligence or willful or wanton conduct. Food Allergy Management 18.11 In all public or non-public schools, wherein a student with an allergy to peanuts/tree nuts and/or food derived from peanut/tree nuts products is in attendance, a notice shall be posted within that school building in a conspicuous place at every point of entry and within the cafeteria facility advising that there are students at said school with allergies to peanuts/tree nuts. The notice shall not identify the individual(s) with such allergy. 18.12 In all public and non-public elementary, middle or junior high schools, the school authority shall develop a policy designed to provide a safe environment for students with peanut/tree nut allergies with potentially serious health consequences while attending school or participating in school-sponsored activities. Such policy shall include, but is not limited to, the following: 18.12.1 The development of an individual health care plan (IHCP) and an emergency health care plan (EHCP) for each student with such food allergy; and 18.12.2 The development by the school of a protocol, consistent with the policy and the IHCP and EHCP, that provides the student with protections while he or she is attending school or participating in school-sponsored activities. 18.13 The student’s IHCP and EHCP shall be part of the student’s permanent school health record and be developed by the school nurse in collaboration with the student’s health care provider, the parents/guardians of the student, and the student (if appropriate). 18.13.1 The IHCP and EHCP shall be developed prior to entry into school or immediately thereafter for students previously diagnosed with an allergy. The IHCP and EHCP shall be developed immediately after the diagnosis for students already enrolled who are newly diagnosed with an allergy. 18.13.2 These plans should include both preventative measures to help avoid accidental exposure to allergens and emergency measures in case of exposure. 18.13.3 Depending on the nature and extent of the student’s allergy, the measures listed in the IHCP may include, but are not limited to:  Posting additional signs (e.g. in classroom entryways);  Prohibiting the sale of particular food items in the school; 35  Designating special tables in the cafeteria;  Prohibiting particular food items from certain classrooms and/or the cafeteria;  Prohibiting particular food items from the school or school grounds;  Educating school personnel, students, and families about food allergies; and/or  Implementing particular protocols around cleaning surfaces touched by food products, washing of hands after eating, etc. 18.13.4 The EHCP shall be consistent with applicable provisions contained in these Regulations, including, but not limited to, training, communication, plan review, Good Samaritan protections, follow-up and documentation. 18.13.5 All school personnel who may be involved in the care of a student who has been diagnosed with a peanut/tree nut allergy shall be informed of the IHCP and the EHCP, as appropriate. Follow-up & Documentation Requirements 18.14 Following a traumatic injury, an episode of anaphylaxis, or other emergency situation, a written report shall be completed and filed in the student health record and verbal notification made to the student's parents as soon as possible by the school principal or a person delegated by him/her. 18.15 Following a minor injury, the certified school nurse-teacher, or other appropriate school authority, shall make a notation of the minor injury in a log book maintained by the school specifically for this purpose. At a minimum, the following items shall be noted: 18.15.1 date and time of injury; 18.15.2 location where injury occurred; 18.15.3 chief complaint; 18.15.4 treatment administered; 18.15.5 disposition (e.g., back to class); 18.15.6 signature of responder. 18.16 For each student, emergency information shall be documented and updated on an annual basis. Such emergency information shall include no less than the following: 18.16.1 name and telephone number of the student's parent and additional contact person(s) in the event of an emergency; 18.16.2 name and telephone number of the family physician or primary care provider; 18.16.3 health insurance (optional); 18.16.4 known allergies (including drug, food, insect bite and chemical allergies); 18.16.5 medical conditions that may need attention (e.g., past surgeries, heart problems, seizure disorders, nosebleeds, diabetes); 18.16.6 current, routine prescription medications and authorized OTC medications. 36 18.17 Protocols or procedures shall be developed to require an individualized emergency care plan for a student at risk for anaphylaxis, asthmatic conditions and/or any other medical emergencies, as defined in §1.16 of these Regulations. 18.18 Concussions and Head Injuries in Recreational and/or Athletic Competition. 18.18.1 A youth athlete who is suspected of sustaining a concussion or head injury in a practice or game related to recreational and/or athletic competition shall be removed from that practice or competition at that time. 18.18.2 A youth athlete who has been removed from play may not return to play until the athlete is evaluated by a licensed physician and until the athlete receives written clearance to return to play from that licensed physician. 18.18.3 A report of a confirmed concussion and written clearance to return to play should be logged in the student’s health record. 18.18.4 All coaches, trainers and volunteers involved in youth recreational and/or athletic competition must complete a training course, and a refresher course annually thereafter, in concussions and traumatic brain injuries. 18.18.5 School districts and schools are required to use training materials of the US Center for Disease Control and Prevention entitled "Heads Up: Concussion in High School Sports/Concussion in Youth Sports" or materials substantially equivalent. Section 19.0 Diabetes Care Management 19.1 Each school district shall develop a policy or protocol that allows children who are diagnosed with diabetes to self-manage their disease whenever possible. Such policy or protocol shall be developed in collaboration with licensed health care providers, parents, students, school nurses and administrators, as appropriate. 19.2 Such policy or protocol shall require no less than the following: 19.2.1 Developing an individualized health care plan (IHCP) and an emergency care plan (ECP/EHCP); 19.2.2 Permitting self-testing in the classroom or other appropriate place(s) on the school campus or at school-sponsored activities, as designated in the IHCP; 19.2.3 Permitting healthier snacks, as defined in these Regulations, in the classroom or other appropriate place(s) on the school campus or at school-sponsored activities, as designated in the IHCP; 19.2.4 Permitting bathroom and water fountain privileges in the classroom or other appropriate place(s) on the school campus or at school-sponsored activities as designated in the IHCP, 19.2.5 Ensuring the accompaniment of a symptomatic child to a health area by a designated adult, per the IHCP and the ECP/EHCP, unless such action puts the child at increased health risk. 37 19.3 The student’s IHCP and EHCP shall be part of their permanent school health record and be developed by the school nurse in collaboration with the student’s health care provider, the parents/guardians of the student, and the student (if appropriate). Glucagon Administration 19.4 As part of the ECP/EHCP, a parent or legal guardian of any child may expressly authorize school employees or those employed on behalf of the school, for when there is no school nurse immediately available, to administer glucagon on such child in case of an emergency, while at school or school-sponsored activities. 19.4.1 A parent or legal guardian shall provide a diabetes management plan or physician's order, signed by the student's health care provider, that prescribes the care and assistance needed by the student including glucagon administration. 19.4.2 The glucagon shall be kept in a conspicuous place, readily available, but with reasonable provisions made for the safekeeping and security of the glucagon, so that the security of the medication will not be compromised. 19.4.3 Glucagon administration training may be provided by a licensed physician, physician assistant, advanced practiced registered nurse, or registered nurse, however in no case shall school nurse teachers be required to provide training. 19.4.3.1 The school administration shall allow properly trained staff to voluntarily assist with the emergency administration of glucagon when authorized by a parent or legal guardian. 19.4.3.2 A school employee, including administrative staff, shall not be subject to penalty or disciplinary action for refusing to be trained in glucagon administration. 19.4.3.3 The training and supervision of personnel, other than the school nurse, who provide emergency medical assistance to students under this section, shall be governed by performance standards and guidelines developed by the Department Rhode Island Department of Health, in conjunction with the American Diabetes Association, and the Rhode Island chapter of the American Academy of Pediatrics. Such personnel shall only be authorized to provide such assistance upon successful completion of glucagon administration training. 19.4.4 No school teacher, school administrator, school health care personnel, person employed on behalf of the school, any other school personnel, nor any local educational authority shall be liable for civil damages which may result from acts or omissions in use of glucagon which may constitute ordinary negligence. This immunity does not apply to acts or omissions constituting gross negligence or willful or wanton conduct. 19.5 All school personnel who may be involved in the care of a student who has been diagnosed with diabetes shall be informed of the IHCP and the ECP/EHCP, as appropriate. 38 Section 20.0 Medication Administration 20.1 Each public school district or non-public school authority shall develop protocols or procedures related to medication administration in schools that include, at a minimum, the following provisions: 20.2 A certified school nurse-teacher shall administer medication(s) to student(s) within the public school setting except as provided in §§ 18.10, 19.4, 20.10 , 20.14, or 20.15 of these Regulations. Such a certified school nurse-teacher shall be licensed in Rhode Island in accordance with the requirements of RIGL Chapter 5-34. He/she shall also be certified in accordance with the provisions of RIGL Chapter 16-21-8. 20.2.1 All medications, including prescription and OTC (over-the-counter), shall be administered only in accordance with a written order from a licensed health care prescriber, except as provided in §§ 18.10, 19.4, 20.10, 20.10.1, 20.14, or 20.15 of these Regulations. All medications shall be administered in keeping with safe standards of health care practice and in accordance with all applicable state and federal laws and regulations. 20.3 A certified school nurse-teacher or other registered nurse shall administer medication to student(s) in a non-public school except as provided in §§18.10, 19.4, 20.10, 20.10.1, 20.14, or 20.15 of these Regulations. Such a registered nurse shall be licensed in Rhode Island in accordance with the requirements of RIGL Chapter 5-34. 20.4 No lay person, other than a parent, shall administer medication to a student in the school setting. Exceptions: §§18.10 and 19.4 of these Regulations (related to the administration of epinephrine and glucagon). Provisions Related to Nurse Administration 20.5 Each dose of medication administered by a certified school nurse-teacher or other registered nurse shall be documented. Documentation shall include: date, time, dosage, route of administration and the signature of the certified school nurse-teacher or other registered nurse administering the medication or supervising the student in self-administration. In the event a dosage is not administered as ordered, the reason(s) therefore shall be noted. 20.6 All medications to be administered by the certified school nurse-teacher or other registered nurse, as provided in these Regulations, shall be kept in a secured cabinet. 20.7 A licensed provider's (with prescriptive privileges) order shall be obtained and verified by the certified school nurse-teacher or other registered nurse for all medications to be administered by the certified school nurse-teacher or registered nurse, including school physician standing orders. Verbal orders to the nurse and facsimile transmissions may be accepted. Verbal orders shall be followed up by a written order from the licensed prescriber within three (3) working days. Upon receipt, the orders shall be confirmed with the parent by the nurse. 39 20.8 For prescription medications, all parent authorizations and licensed provider’s orders shall be renewed no less than annually by the certified school nurse-teacher or other registered nurse. Controlled Substances 20.9 No controlled substance shall be in the possession of or administered by anyone other than a certified school nurse-teacher, other registered nurse, licensed prescriber, or parent of the child for whom the medications have been prescribed. A student may deliver his/her own medication to school in accordance with protocols or procedures developed by the school but may not self-administer the controlled substance while on school property. Exception: see §20.15 of these Regulations. Self-Carry and Self-Administration of Medication 20.10 All school districts or school authorities shall develop protocols or procedures to permit students to self-carry and/or self-administer prescription medication if the student, parent, certified school nurse-teacher or registered nurse, and licensed prescribing health care provider enter into a written agreement that specifies the conditions under which the prescription medication must be self-carried and/or self-administered. The school principal shall be informed of the existence of said agreement. 20.10.1 School districts or school authorities may develop protocols or procedures to permit students to self-carry and/or self administer medication that does not require a licensed prescriber’s note. In developing such protocols or procedures, school districts or school authorities shall give consideration to such factors as the age of the child, the duration of the need for the medication, and the ability of the child to self-administer. 20.11 The protocols or procedures related to student self-administration of medication shall include provisions for the following: 20.11.1 All medication shall be stored in its original prescription or manufacturer-labeled container. 20.11.2 For prescription medication, a licensed health care prescriber’s written order shall be provided. 20.11.3 [REMOVED] 20.12 A student shall be prohibited from sharing, transferring, or in any way diverting his/her own medication(s) to any other person. 20.13 [REMOVED] Inhalers 20.14 Each school district shall develop a procedure to allow children to carry and use prescription inhalers while in school or at a school sanctioned function or event, when prescribed by a licensed individual with prescriptive privileges. Children who need to carry said inhalers shall provide the school with medical documentation that the inhaler has been legitimately 40 prescribed and that the child needs to carry it on his/her person due to a medical condition. But no child shall be disciplined solely for failure to provide such documentation in advance. 20.14.1 No school teacher, school administrator, or school health personnel, or any other school personnel shall be liable for civil damages which may result from acts or omissions in the use of prescription inhalers by children which may constitute ordinary negligence. This immunity does not apply to acts or omissions constituting gross negligence or willful or wanton conduct. Medication Administration at Off-site School-sponsored Activities 20.15 Each school district or non-public school authority shall develop a procedure or protocol to allow students to self-carry and self-administer a day’s supply of medication for each day off-site, including a controlled substance, during an off-site school-sponsored activity. Said medication shall be supplied by the parent and shall be stored and transported in a properly labeled container. 20.15.1 Said medication shall be supplied by the parent with a parent’s written authorization for use of the medication during the off-site school-sponsored activity and shall be stored and transported in its original prescription-labeled container (in the case of a prescription medication) or its manufacturer-labeled container (in the case of a non- prescription medication). 20.15.2 In the case of a prescription medication, a licensed health care prescriber’s written order shall be provided, if it is not already on file in the school. 20.15.3 A student shall be prohibited from sharing, transferring, or in any way diverting his/her own medication(s) to any other person. 20.16 [REMOVED]. Section 21.0 Immunization and Testing for Communicable Diseases 21.1 Pursuant to the Rules and Regulations Pertaining to Immunization and Testing for Communicable Diseases [Reference 2], public and non-public schools in Rhode Island must adopt, at a minimum, the standards for immunization and communicable disease testing described therein. 21.1.1 Each student, upon initial entry to any school, and upon entry into kindergarten, 7th grade and 12th grade, shall furnish evidence of having met the standards for immunization and communicable disease testing in accordance with the Rules and Regulations Pertaining to Immunization and Testing for Communicable Diseases [Reference 2]. 21.2 It shall be the responsibility of the administrative head of any public or non-public school to secure compliance with the Rules and Regulations Pertaining to Immunization and Testing for Communicable Diseases [Reference 2]. 41 21.3 An annual immunization assessment of students shall be conducted as determined by the Department of Health to assure compliance with the Rules and Regulations Pertaining to Immunization and Testing for Communicable Diseases (R23-1-IMM) [Reference 2]. 42 PART IV HEALTHFUL SCHOOL ENVIRONMENT Section 22.0 Standards for School Building(s) and Approval 22.1 Pursuant to RIGL §16-21-3, the State Building Codes Standards Committee, the State Fire Marshall, the State Health Department, and the Department of Labor and Training, Division of Occupational Safety shall determine whether the school buildings in the several cities and towns or on state property conform to appropriate state and federal laws and regulations within their respective jurisdiction. 22.1.1 Furthermore, it shall be the responsibility of each local fire chief, local building inspector, the Director of the state Department of Health, and the Director of the state Labor and Training Department to determine and notify each local school superintendent or non-public school official by August 1 of each year as to whether the public and non-public nursery, elementary and secondary school buildings conform to appropriate state and federal laws and regulations within their respective jurisdiction. 22.1.2 In the case of those schools on state property, it shall be the responsibility of the State Building Commissioner, the State Fire Marshall, the Director of the state Department of Health, and the Department of Labor and Training to notify the department director responsible for the operation of the school as to whether these schools conform to appropriate state and federal laws and regulations. 22.2 Pursuant to RIGL §16-21-3.1, it shall be the responsibility of the school administrator, the non-public school official, in the case of state operated schools, the responsibility of the director of the state operated school, to ensure that schools are not opened until notification is received from the aforementioned agencies that the schools are in compliance with their respective codes. 22.2.1 Neglect by any superintendent, non-public school official, or director of any state operated school to comply with the statutory provisions of §22.2 of these Regulations shall be subject to the sanction as set forth in RIGL §16-21-3.1. Section 23.0 New Construction, Renovation or Conversion of Existing Buildings to Schools General Requirements 23.1 All new construction or the alteration, extension, or modification of an existing building(s) shall be subject to all applicable federal, state and local laws, codes, regulations, and ordinances, including but not limited to the following regulatory provisions enforced by the specific agency: 23.1.1 IBC-1 State Building Code, et al, RIGL Chapter 23-27.3, R.I. State Building Code Standards Committee; 23.1.2 The Uniform Federal Accessibility Standards (UFAS) and state accessibility for persons with disability standards: 23.1.2.1 RIGL Chapter 37-8-15, “Access for People with Disabilities”; 43 23.1.2.2 The Federal Rehabilitation Act of 1973, as amended, (29 U.S.C. § 791 et seq.) section 504, 34 Code of Federal Regulations, Part 104, Program Accessibility for Persons with Disabilities and the Americans with Disabilities Act of 1990 (42 U.S.C. § 12101 et seq.), 28 Code of Federal Regulations, Parts 35 and 36, Accessibility for Persons with Disabilities in Public Entities and Public Accommodations; 23.1.2.3 RIGL §42-26-13 Open Meetings-Accessibility for Persons with Disabilities; SBC-17 Accessibility of Meetings for Persons with Disabilities; 23.1.3 29 Code of Federal Regulations 1910 and 29 Code of Federal Regulations 1926, Construction, Division of Occupational Safety, Rhode Island Department of Labor and Training; 23.1.4 Section 7, Chapter 10 of the Rhode Island Fire Prevention Code, Rhode Island State Fire Marshal’s Office; and, 23.1.5 RIDE School Construction Regulations (24 May 2007) 23.1.6 Such other applicable statutory and regulatory provisions. 23.2 All architectural plans for school construction, renovations, or conversions shall be submitted to the appropriate staff at the Rhode Island Department of Elementary and Secondary Education, the Governor’s Commission on Disabilities, the State Building Commissioner and all other state or local agencies as appropriate prior to construction for review for compliance with all applicable federal, state and local laws, codes, regulations and ordinances. 23.2.1 All architectural plans for new school construction, submitted for approval shall include provisions for a health room that includes, at a minimum, a private toilet, hand washing facilities, a private area for consultation, and a waiting area. Section 24.0 Existing School Buildings/General Requirements 24.1 All existing structures shall comply with all applicable federal, state and local laws, codes, regulations, and ordinances including but not limited to the following regulatory requirements enforced by the specified agency: 24.1.1 BC-13 State Building Code Standards for Existing Schools, R.I. State Building Code Standards Committee through the local building officials or the State Building Commissioner; 24.1.2 Where applicable, the federal and state accessibility for persons with disability standards: 24.1.2.1 RIGL Chapter 37-8-15, “Access for People with Disabilities”; 24.1.2.2 The Federal Rehabilitation Act of 1973, as amended, (29 U.S.C. § 791 et seq.) section 504, 34 Code of Federal Regulations, Part 104, Program Accessibility for Persons with Disabilities and the Americans with Disabilities Act of 1990 (42 U.S.C. § 12101 et seq.), 28 Code of Federal 44 Regulations, Parts 35 and 36, Accessibility for Persons with Disabilities in Public Entities and Public Accommodations; 24.1.2.3 SBC-15 Accessibility for Individuals with Disabilities in State and Local Government Facilities, R.I. State Building Commissioner; 24.1.2.4 SBC-16 Accessibility for Individuals with Disabilities, R.I. State Building Commissioner; 24.1.2.5 RIGL §42-26-13 Open Meetings--Accessibility for Persons with Disabilities; SBC-17 Accessibility of Meetings for Persons with Disabilities, R.I. State Building Commissioner. 24.1.3 RIGL Chapter 23-24.9, "Mercury Reduction and Education Act;" 24.1.4 29 Code of Federal Regulations 1910 and 29 Code of Federal Regulations 1926, Construction, Division of Occupational Safety, R.I. Department of Labor and Training; 24.1.5 RIGL Chapter 23-28.12 and section 7, Chapters 1 through 8 and Chapters 24 through 43 of the current Rhode Island Fire Prevention Code, Rhode Island State Fire Marshal’s Office; and, 24.1.6 Such other applicable statutory or regulatory requirements. Section 25.0 Pesticide Applications and Notification of Pesticide Applications at Schools 25.1 In accordance with RIGL §23-25-37, no person other than a licensed or certified commercial applicator, as defined in RIGL §23-25-4, shall apply pesticide within any building or on the grounds of any school. This section shall not apply in the case of an emergency application of pesticide to eliminate an immediate threat to human health, where it is impractical to obtain the services of any such applicator; provided the emergency application does not involve a restricted use or state limited use pesticide. For purposes of §25.0 of these Regulations, "emergency" means a sudden need to mitigate or eliminate a pest which threatens the health or safety of a student or staff member. 25.2 At the beginning of each school year, each local school authority shall provide the staff of each school and the parents or guardians of each child enrolled in each school with a written statement of the committee's policy on pesticide application on school property and a description of any pesticide applications made at the school during the previous school year. 25.2.1 The statement and description shall be provided to the parents or guardians of any child who transfers to a school during the school year. The statement shall: (i) Indicate that the staff, parents, or guardians may register for prior notice of pesticide applications at the school; and (ii) Describe the emergency notification procedures provided for in §25.0 of these Regulations. Notice of any modification to the pesticide application policy shall be sent to any person who registers for notice under §25.0 of these Regulations. 45 25.3 Parents or guardians of children in any school and school staff may register for prior notice of pesticide application at their school. Each school shall maintain a registry of persons requesting the notice. 25.4 Prior to providing for any application of pesticide within any building or on the grounds of any school, the local school authority shall provide for the distribution of notice to parents and guardians who have registered for prior notice under this section, such that the notice is received no later than twenty-four (24) hours prior to the application. Notice shall be given by any means practicable to school staff who have registered for the notice. Notice under this subsection shall include: (1) The common or trade name and the name of the active ingredient; (2) The EPA registration number as listed on the pesticide label; (3) The target pest; (4) The exact location of the application on the school property; (5) The date of the application; and (6) The name of the school administrator, or a designee, who may be contacted for further information. 25.5 No application of pesticide may be made in any building or on the grounds of any school during regular school hours or during planned activities at any school. No child shall enter an area where the application has been made until it is safe to do so according to the provisions on the pesticide label. This section shall not apply to the use of germicides, disinfectants, sanitizers, deodorizers, antimicrobial agents, insecticidal gels, non-volatile insect or rodent bait in a tamper resistant container, insect repellants or the application of a pesticide classified by the United States Environmental Protection Agency as an exempt material under 40 CFR part 152.25. 25.6 A local school authority may make an emergency application of pesticide without prior notice under this section in the event of an immediate threat to human health, provided the board provides for notice, by any means practicable, on or before the day that the application is to take place, to any person who has requested prior notice under §25.0 of these Regulations. 25.7 Notice of any pesticide application at a school shall be given, by any means practicable, to the parents or guardians of any child enrolled at the school and to the staff of the school not later than one (1) week after the application. The notice shall include: (1) The common or trade name and the name of the active ingredient; (2) The EPA registration number as listed on the pesticide label; (3) The target pest; (4) The exact location of the application on the school property; (5) The date of the application; and (6) The name of the school administrator, or a designee, who may be contacted for further information. 46 25.8 A copy of the record of each pesticide application at a school shall be maintained at the school for a period of five (5) years. Section 26.0 Asbestos 26.1 School buildings shall be subject to the provisions of RIGL Chapter 23-24.5 and the Rules and Regulations for Asbestos Control, promulgated by the Rhode Island Department of Health. 26.2 Such requirements, as stipulated in the regulations cited in §26.1 of these Regulations include, but are not limited to, the following: 26.2.1 All schools shall be inspected for asbestos-containing building materials (ACBM). Identified ACBM shall be assessed and the appropriate response actions (repair, encapsulation, removal) shall be implemented in accordance with the regulations cited in §26.1 of these Regulations. Any uninspected building acquired for use as a school building shall be inspected within thirty (30) days after commencement of such use. 26.2.2 Each local education agency (LEA) with ACBM shall have implemented an effective and ongoing operations and maintenance program as part of a management plan to include no less than the following: 26.2.2.1 a designated person trained to oversee asbestos activities and to ensure regulatory compliance; 26.2.2.2 a two (2) hour awareness training for all members of the maintenance and custodial staff working in buildings with ACBM; 26.2.2.3 a sixteen (16) hour training for all members of maintenance and custodial staff who may conduct activities that will disturb asbestos. Such trained staff may be licensed by the Department of Health to perform spot repairs, as defined in the regulations cited in §26.1 of these Regulations; 26.2.2.4 periodic surveillance, but no less than every six (6) months; 26.2.2.5 reinspection every three (3) years by a certified inspector and management planner; 26.2.2.6 annual notifications to workers and building occupants, or their parents, regarding asbestos inspections and response actions; 26.2.2.7 mechanism(s) for informing contractors involved in remodeling or construction projects regarding the location of ACBM prior to starting any projects; 26.2.2.8 documentation of all inspections, reinspections, response actions, training, and notifications to be included with the management plan maintained at each school with ACBM and at the LEA administrative office. 26.2.3 All asbestos abatement projects larger than a spot repair shall not be initiated without prior approval of an asbestos abatement plan by the Department of Health. 47 The plan shall be prepared by a certified project designer and performed by a licensed asbestos abatement contractor. Section 27.0 Lead 27.1 Schools serving children under the age of six (6) years (e.g., kindergartens, day care sites) shall be subject to the provisions of RIGL Chapter 23-24.6 as well as the Rules and Regulations for Lead Poisoning Prevention (R23-24.6-PB) promulgated by the Rhode Island Department of Health. Section 28.0 Radon 28.1 School buildings shall be subject to the provisions of RIGL Chapter 23-61 and the Rules and Regulations for Radon Control, promulgated by the Department of Health. 28.2 Such requirements, as stipulated in the regulations cited in §28.1 of these Regulations, shall include, but are not limited to, the following: 28.2.1 All schools shall be tested for radon in the air to identify structures in which the potential exists for elevated radon concentrations. 28.2.1.1 Schedules for initial short term testing shall be submitted to the Department of Health confirming that all initial and short term testing has been completed in accordance with the regulations cited in §28.1 of these Regulations. 28.2.1.2 All short term results shall be reported to the Department of Health within thirty (30) days of receipt of results. 28.2.2 Measurement protocols, as outlined in the regulations cited in §28.1 of these Regulations, shall include no less than the following: 28.2.2.1 Measurements shall be taken by a certified radon measurement consultant; 28.2.2.2 Measurements shall be taken with acceptable measurement devices and analyzed by certified laboratories; 28.2.2.3 Short term measurements shall be taken during the months of October through March, and shall be left in place for a minimum of forty-eight (48) hours in closed building conditions. 28.2.3 Follow-up measurements shall be required when short term measurements are greater than or equal to four (4) picocuries per liter (pCi/L) to determine if areas exceed the indoor air standard of four (4) pCi/L as an annual average. Testing protocols are outlined in the regulations cited in §28.1 of these Regulations. 28.2.4 Mitigation systems shall be installed to reduce areas of school buildings that have radon levels of four (4) pCi/L or greater on an annual average. Installations of radon mitigation systems shall only be performed by individuals licensed as radon mitigation specialists. 48 28.2.5 Post-mitigation measurements shall be taken in all mitigated areas by a certified radon measurement consultant to ensure the effectiveness of the mitigation system. Section 29.0 Latex Gloves 29.1 Any school that utilizes latex gloves shall do so in accordance with the provisions of the Rules and Regulations Pertaining to the Use of Latex Gloves by Health Care Workers, in Licensed Health Care Facilities, and by Other Persons, Firms, or Corporations Licensed or Registered by the Department [Reference 21] that include but are not limited to the following: Notices 29.2 Health care providers, licensed health care facilities, and other persons, firms, or corporations licensed or registered by the Department that utilize latex gloves shall post a notice informing and warning employees and the public: (1) That natural rubber latex gloves are used; (2) That exposure to latex may result in the development of an allergy; (3) That allergic reactions to natural rubber latex can manifest by skin rash, hives, nasal and eye irritation, asthma, and shock; and (4) That should you or your family experience allergic reaction symptoms, then you should contact your health care provider. 29.3 The notice required in §29.2 of these Regulations shall include letters which are at least three-eighths (3/8) of an inch high and shall be posted in conspicuous areas (e.g., lobby, health room, employee bulletin boards) throughout the premises. 29.4 The notice required in §29.2 of these Regulations shall be posted in English, Spanish and other languages, as appropriate, to the language needs of the individuals served by the health care provider, health care facility, or other person, firm, or corporation licensed or registered by the Department. Section 30.0 Food Service 30.1 Food service in all schools, including food service facilities, shall comply with the following statutory and regulatory provisions relating to food protection including, but not limited to: 30.1.1 RIGL Chapter 21-27 and §23-1-31; 30.1.2 Food Code (R23-1,21-27-FOOD), Rhode Island Department of Health, Office of Food Protection; 30.1.3 Rules and Regulations Pertaining to Sanitary Standards for Manufacture, Processing, Storage, and Transportation of Ice, Rhode Island Department of Health; 30.1.4 Regulations Pertaining to the Sale of Foods and Beverages through Vending Machines (R23-1-VM), Rhode Island Department of Health; 49 30.1.5 Rules and Regulations Pertaining to Certification of Managers in Food Safety (R21- 27-CFS), Rhode Island Department of Health. 30.2 No less than one (1) person certified as a manager in food safety within each school shall be designated to supervise all food preparation personnel to ensure food safety. 30.3 No person shall be in the food service area (i.e., work as a food handler) who may be a health hazard to others. 30.3.1 Food employees and food employee applicants are required to report, to the person in charge, information about their health and activities (such as consuming food implicated in a food borne outbreak) as they relate to diseases that are transmissible through food and active cases of tuberculosis or measles. 30.3.2 The person in charge shall exclude a food employee from a food service facility if the food employee is diagnosed with Salmonella typhi, Shigella spp., Escherichia coli 0157:H7, or Hepatitis A virus infection, confirmed through laboratory testing, even if asymptomatic. 30.3.3 Symptoms and signs indicating exclusion or restriction from the food service area pursuant to requirements of the Food Code (R23-1, 21-27-FOOD) include but are not limited to: 30.3.3.1 diarrhea, fever, vomiting, jaundice, or abdominal cramps; 30.3.3.2 sore throat and fever, norovirus; 30.3.3.3 lesion containing pus that is open or draining, located on the hands or wrists or exposed portion of the arms and not protected with impermeable cover and glove (hands, wrists) or impermeable cover (exposed portions of arms), or dry, durable, tight fitting bandage (on other parts of the body); and 30.3.3.4 any other condition and/or communicable disease with the potential for causing foodborne illness during the infectious period. 30.4 Hand washing Facilities: Lavatory facilities shall be readily accessible to food handlers to enable them to wash their hands before starting work and as often as may be necessary while working in the food service areas. 30.4.1 Consistent with the Rhode Island Food Code, the lavatory facilities used by food service personnel shall be equipped with soap dispensers (liquid or powder soap) or bar soap, and either an adequate supply of disposable towels stocked at all times or a heated-air hand drying device. 30.4.2 The lavatory facilities used by food service personnel shall be accessible to persons with disabilities in accordance with all applicable local, state, and federal laws and regulations. 30.5 Food employees may not contact exposed, ready-to-eat food with their bare hands and shall use suitable utensils such as deli tissue, spatulas, tongs, single use non-latex gloves, or dispensing equipment. 50 30.6 In accordance with the Rhode Island Food Code, each school serving hot potentially hazardous foods shall have a written plan for assessing, monitoring, and controlling foodborne disease hazards within the facility. The plan shall include, but not be limited to, monitoring of food temperatures at the shipping and receiving end for satellite feeding operations and a plan for the restriction and exclusion of ill personnel. Healthier Beverages and Healthier Snacks 30.7 All Rhode Island schools that sell or distribute beverages and snacks on their premises, including those sold through vending machines, shall be required to offer only healthier beverages and healthier snacks, as defined in §1.27 and §1.28 of these Regulations. 30.8 Schools may permit the sale of beverages and snacks that do not comply with §30.7 of these Regulations as part of school fundraising in any of the following circumstances: 30.8.1 The items are sold by pupils of the school and the sale of those items takes place off and away from the premises of the school. 30.8.2 The items are sold by pupils of the school and the sale of those items takes place one (1) hour or more after the end of the school day. 30.8.3 The items sold during a school sponsored pupil activity after the end of the school day. Section 31.0 Health Room 31.1 Schools shall have a designated health room(s) to be utilized for health services. The room(s) shall be equipped with no less than the following accommodations: Within the health room: 31.1.1 Hand washing facilities, including warm (not to exceed 120 F [49 C]) and cold running water, soap dispensers and soap (liquid or powdered), and either disposable towels or a heated-air hand drying device; 31.1.2 A cot or other suitable area for reclining, with accommodations for privacy; 31.1.3 All supplies necessary for the disposal of biohazardous waste, including but not limited to, a sharps container that shall be managed in accordance with the requirements of Reference 20; 31.1.4 A secure medication storage area, including a locked storage site for controlled substances; 31.1.5 A telephone; Either within or adjacent to the health room: 31.1.6 A toilet; 31.1.7 A secure refrigerator for exclusive use of medications and health supplies (e.g., ice packs); 31.1.8 A secure cabinet for medical record storage; 51 31.1.9 An area for students to comfortably await services; Either within or accessible to the health room on the same floor of the building: 31.1.10 A private area for consultations that ensures that confidentiality is maintained. 31.2 The minimum lighting level for the health room shall be fifty (50) foot candles. Section 32.0 Sanitation Facilities 32.1 The premises of each school shall include an appropriate number of hand washing facilities, toilets, and drinking fountains for all students and school personnel that shall be maintained in a working and sanitary condition as determined by the Rhode Island Department of Health and in accordance with the most recent version of the Code of Federal Regulations of the Division of Occupational Safety, R.I. Department of Labor and Training. 32.1.1 Hand washing facilities: In addition, hand washing facilities shall have cold and warm (not to exceed 120 F [49 C]) running water and be stocked at all times with soap dispensers and soap (liquid or powdered) and either disposable towels or a heated-air hand drying device. An adequate number of alcohol-based personal hand washing stations for students and teachers shall also be available within school premises in accordance with Executive Order 07-01. 32.1.2 Toilets: At a minimum, the following ratios of toilets shall be accessible to students: Type of School Minimum Ratio of Toilets per Student Boys Girls Elementary School 1:40 1:35 Secondary School 1:75 1:45 Urinals 1:30 32.1.3 Showers: In those schools where shower facilities are in use, they shall be properly cleaned and maintained and supplied with cold and warm (not to exceed 120F [49 C]) running water. 32.1.4 All sanitation facilities shall be accessible to persons with disabilities in accordance with all applicable local, state and federal laws and regulations. Section 33.0 Housekeeping 33.1 Each school shall maintain a comprehensive list of all solutions, compounds and other products used in and around the school for cleaning and maintenance. This list shall include, but not be limited to, cleaning products used in all parts of the school, lawn care products used on school grounds, and products used to maintain facilities such as swimming pools. Said list shall be kept in a readily accessible location, such as the school administrative office, shall be updated regularly, and shall be provided to any individual upon request. 52 Section 34.0 Swimming Pools 34.1 Swimming pools shall be subject to the statutory provisions of RIGL Chapter 23-22 and any other applicable law relating to swimming pools and the Rules and Regulations for the Licensing of Swimming and Wading Pools, Hot Tubs and Spas [R23-22-SWI/H&S] promulgated by the Department of Health. Section 35.0 Water Supply 35.1 Each school building shall be furnished with an adequate supply of potable water meeting the standards set forth in Rhode Island’s public drinking water regulations entitled, Rules and Regulations Pertaining to Public Drinking Water (R46-13-DWQ) of the Rhode Island Department of Health. 35.1.1 Potable water shall be supplied to all food service areas, lavatories, janitorial and shower areas. 35.1.2 An adequate supply of potable drinking water shall be available for consumption through a sufficient number of well-maintained and accessible sources and in accordance with §§ 403, 404 and 411 of the Rhode Island Plumbing Code (SBC-3). 35.2 A community water system shall be used as the source of supply where available. 35.2.1 Where a community water system is unavailable the water supply system utilized by the school must meet the requirements of RIGL Chapter 46-13 and the Rules and Regulations Pertaining to Public Drinking Water [R46-13-DWQ] of the Rhode Island Department of Health, and RIGL Chapter 23-65 and the Rules and Regulations Pertaining to the Certification of Public Drinking Water Supply Treatment and Public Water Supply Transmission and Distribution Operators [R23- 65-DWQ] of the Rhode Island Department of Health. 35.3 All proposed school water systems or proposed alterations to existing school water systems shall be approved by the Department of Health. Section 36.0 Tobacco 36.1 Schools shall be subject to the provisions of RIGL Chapter 23-20.10, “Public Health and Workplace Safety Act” and RIGL Chapter 23-20.9, entitled, “Smoking in Schools.” 36.1.1 Pursuant to the requirements of RIGL §23-20.9-5, the governing body of each school in Rhode Island shall be responsible for the development of enforcement procedures to prohibit tobacco product usage by any person utilizing school facilities. All facilities, including school grounds, used by a school, whether owned, leased or rented, shall be subject to the provisions of said Chapter. Enforcement procedures shall be promulgated and conspicuously posted in each building. 36.1.2 The requirements of §36.1.1 of these Regulations and of RIGL §23-20.9-5 shall not modify, or be used as a basis for modifying, school policies or regulations in effect 53 prior to the passage of said Chapter if the existing policies or regulations prohibit tobacco product usage in said school. 36.1.3 All school areas where tobacco product usage is prohibited shall be clearly marked with “nonsmoking area” signs with bold block lettering at least three inches (3”) high stating, “Tobacco-Free School – Tobacco Use Prohibited.” There shall be at least one (1) “nonsmoking area” sign, in conformance with the above, at every building entrance and in other areas as designated by the governing body. Signs shall also be posted in every school bus and every school vehicle. Signs as detailed above shall be provided, without charge, by the Department of Health. Violations and Penalties 36.2 In accordance with the Rules and Regulations Pertaining to Smoke-Free Public Places and Workplaces promulgated by the Department of Health and RIGL Chapter 23-20.10, an employer who violates the provisions of said regulations or statute, respectively, shall be liable for a civil penalty as follows: 36.2.1 A penalty of two hundred fifty dollars ($250) for the first violation; 36.2.2 A penalty of five hundred dollars ($500) for the second violation; 36.2.3 A penalty of one thousand dollars ($1,000) for the third and subsequent violations; which shall be assessed and recovered in a civil action brought by the city or town solicitor, having jurisdiction over the licensed holder, in the city or town municipal court or any court of competent jurisdiction. Each day the violation is committed or permitted to continue shall constitute a separate offense and shall be punishable as a separate offense. One-half (1/2) of any penalty assessed and recovered in an action brought pursuant to this subsection shall be transferred to the municipality in which the civil action originated and the other one-half (1/2) of any penalty assessed and recovered shall be transferred to the General Fund. 36.2.4 In any civil action alleging a violation of RIGL §23-20.10-14, or §5.0 of the aforementioned Regulations, the Court may: 36.2.4.1 Award up to three (3) times the actual damages to a prevailing employee or prospective employee; 36.2.4.2 Award court costs to a prevailing employee or prospective employee; 36.2.4.3 Afford injunctive relief against any employer who commits or proposes to commit a violation of RIGL Chapter 23-20.10, or the Rules and Regulations Pertaining to Smoke-Free Public Places and Workplaces. Section 37.0 School Safety Plans / School Safety Teams / School Crisis Response Teams / School Safety Assessments / Statewide Bullying Policy 37.1 Consistent with the provisions of RIGL §16-21-23, each school district of each town, city, and regional school department shall conduct a school safety assessment in conjunction with local professional public safety agencies, including local law enforcement, fire, and emergency personnel, in addition to members of each district’s school safety team, as well as 54 any other qualified public safety resource utilized by each school district. The assessment shall examine the current status of each school building’s safety and shall be performed on or before July 31, 2013, and shall be undertaken on the anniversary date of the initial school safety assessment every three (3) years thereafter. All meetings regarding the school safety assessment shall be closed pursuant to the provisions of RIGL Chapter 42-46, and any documents produced relating to a school safety assessment, including, but not limited to, the school safety committee meeting minutes and the comprehensive school safety plan adopted by the districts’ school committees, shall be exempt in accordance with the provisions of RIGL Chapter 38-2. 37.2 The school committee of each town, city, and regional school department shall adopt upon completion of a school safety assessment pursuant to the provisions of §37.1 of these Regulations, a comprehensive school safety plan regarding crisis intervention, emergency response, and management. The plan shall be developed by a school safety team comprised of representatives of the school committee, representatives of student, teacher, and parent organizations, school safety personnel, school administration, and members of local law enforcement, fire, and emergency personnel. Members of the school safety team shall be appointed by the school committee of the town, city, or regional school district. In creating the school safety plan, the school safety team(s) shall be guided by the provisions of RIGL 16-21-24 and the current model school safety plan developed by the Department of Elementary and Secondary Education. 37.2.1 Each school district’s crisis response team (CRT) shall be comprised of-those selected school personnel willing to serve as members of a psychological response team to address the psychological and emotional needs of the school community. Each CRT may be guided by mental health resources maintained by the Departments of Elementary and Secondary Education and Health. Members of the CRT may coordinate the delivery of mental health services for those students and school employees affected by acts of violence in the school district communities and their schools, by means of the resources available through the Departments of Elementary and Secondary Education and Health, as well as other public and non- public mental health professional agencies and experts. 37.3 School safety plans, as required by RIGL Chapter16-21, shall address, but not to be limited to, prevention, mitigation, preparedness, response, and recovery. The school safety plans shall include, at a minimum, the following policies and procedures relating to: (1) Appropriate preparedness, prevention, mitigation, and intervention strategies which are based on data to target priority needs and-which make use of effective actions based on currently accepted best practices as well as the relevant provisions of the current state model plan published pursuant to RIGL §16-21-23.1 that include consistent, plain language and terminology; (2) Formalized collaborative arrangements with state and local professional public safety, law enforcement and emergency personnel officials, designed to ensure that school safety officers and other security personnel are adequately trained, including being trained to de-escalate potentially violent situations, and are effectively and fairly recruited; 55 (3) Emergency communication systems and protocols for assuring expeditious notification of public safety officials and the activation of the school CRT in the event of a violent incident as recommended by the current state model plan published pursuant to RIGL §16-21-23.1; (4) Communication protocol for notification of students’ parents, legal guardians and those who are in loco parentis as recommended by the current state model plan published pursuant to RIGL §16-21-23.1; (5) School building security, including where appropriate the use of school safety officers and/or security devices or procedures; (6) Annual school safety training programs for school personnel and students and review of the school crisis response plan for staff and students; (7) Protocols for school personnel and students in responding to bomb threats, hostage- takings, intrusions, and kidnappings, as recommended by the current state model plan published pursuant to RIGL §16-21-23.1; (8) Violent behavior by students, teachers, or other school personnel as well as visitors to the school, as recommended by the current state model plan published pursuant to RIGL §16-21-23.1; (9) The dissemination of informative materials regarding the early detection of potentially violent behaviors, including, but not limited to, the identification of family, community, and environmental factors, to teachers, administrators, school personnel, parents, legal guardians, those who are in loco parentis, and students appropriate to receive such information; (10) Strategies for improving communication among students and between students and staff and for the reporting of potentially violent incidents. For example the establishment of youth-run programs, peer mediation, conflict resolution, school-wide forums or mentoring initiatives regarding bullying or violence, and the establishment of anonymous reporting mechanisms for school violence; (11) Detailed description of the duties and responsibilities of school hall monitors and any other school safety personnel, including the school crisis response team, and the training requirements of all personnel acting in a school security capacity (12) Students and school personnel who are on school grounds and in school common areas and hallways during a lockdown situation. (13) Guidance for communicating threats of violence or harm to the specifically identifiable student(s) and/or school personnel who are the subject of said threats by individuals or groups. (14) Standards for determining those threats of violence or harm that meet the threshold of seriousness and reasonableness so that communication of said threats to specifically identifiable students and/or school personnel is justified; (15) Guidance for school administrators and school personnel in balancing the need to communicate information about a student's conduct, including, but not limited to, the student's prior disciplinary records, and the student’s history of violent behavior towards 56 teachers, school personnel, and school security staff and other students against the duty to such information from any further disclosure; and (16) Guidance to school administrators in determining whether any verbal threats and/or physical behavior may serve as grounds for discipline of the student. 37.4 School safety plans, as required by RIGL §16-21-23, shall further include school emergency response plans specific to each school building contained within each city, town, or regional school district., and shall be developed and approved in consultation with local professional public safety agencies, including local law enforcement, fire, and emergency personnel. The state police shall provide consultation to those school districts that do not maintain a local law enforcement agency. School emergency response plans shall include, and address, but not be limited to, the following elements: (1) Policies and procedures for the safe evacuation of students, teachers, and other school personnel as well as visitors to the school in the event of a serious violent incident or other emergency, which shall include evacuation routes and shelter sites and procedures for addressing medical needs, transportation, and emergency notification to persons in parental relation to a student. "[S]erious violent incident" means an incident of violent criminal conduct that is, or appears to be, life threatening and warrants the evacuation of students and/or staff; (2) Designation of an emergency response team comprised of school personnel, local law enforcement officials, and representatives from local regional and/or state emergency response agencies, other appropriate incident response teams including a school crisis response team, and a post-incident response team that includes appropriate school personnel, medical personnel, mental health counselors, and others who can assist the school community in coping with the aftermath of a violent incident; (3) Procedures for assuring that crisis response and law enforcement officials have access to floor plans, blueprints, schematics, or other maps of the school interior and school grounds, and road maps of the immediate surrounding area; (4) Establishment of internal and external communication systems in emergencies recommended by the current model published in accordance with RIGL §16-21-23.1; (5) Definition and formalization of the chain of command in a manner consistent with the national interagency incident management system/incident command system; (6) Procedures for review and the conduct of drills and other exercises to test components of the emergency response plan, including use of checklists as described in RIGL §16-21- 23.1; (7) Policies and procedures created in conjunction with local or state police for securing and restricting access to the crime scene in order to preserve evidence in cases of violent crimes on school property; and (8) Policies and procedures for ensuring timely access to mental health services for those students, school personnel and others directly affected by a violent incident. 57 Review of School Safety Plans 37.5 In accordance with RIGL §16-21-25, each school district safety plan and school emergency response plans shall be reviewed on an annual basis by the school committee and updated as deemed necessary. These reviews and, where applicable, updates shall be completed on or before November 1 of each year, and the Commissioner of Elementary and Secondary Education shall report, on or before December 31 of each year, to the Speaker of the House, the President of the Senate, and the Governor that such reviews or, where applicable, updates have been completed. 37.6 [DELETED] Statewide Bullying Policy 37.7 In accordance with RIGL §16-21-33 and RIGL §16-21-34, any form or degree of bullying at school is prohibited. (a) Definitions. In addition to the definitions in §1.0 of these Regulations, the following definitions are applicable to a Statewide Bullying Policy. (1) “Bullying” means the use by one or more students of a written, verbal or electronic expression or a physical act or gesture or any combination thereof directed at a student that: (i) Causes physical or emotional harm to the student or damage to the student's property; (ii) Places the student in reasonable fear of harm to himself/herself or of damage to his/her property; (iii) Creates an intimidating, threatening, hostile, or abusive educational environment for the student; (iv) Infringes on the rights of the student to participate in school activities; or (v) Materially and substantially disrupts the education process or the orderly operation of a school. The expression, physical act or gesture may include, but is not limited to, an incident or incidents that may be reasonably perceived as being motivated by characteristics such as race, color, religion, ancestry, national origin, gender, sexual orientation, gender identity and expression or mental, physical, or sensory disability, intellectual ability or by any other distinguishing characteristic. (2) “Cyber-bullying” means bullying through the use of technology or any electronic communication, which shall include, but shall not be limited to, any transfer of signs, signals, writing, images, sounds, data, texting or intelligence of any nature transmitted in whole or in part by a wire, radio, electromagnetic, photo electronic or photo optical system, including, but not limited to, electronic mail, Internet communications, instant messages or facsimile communications. For purposes of these Regulations, cyber-bullying shall also include: 58 (i) The creation of a web page or blog in which the creator assumes the identity of another person; (ii) The knowing impersonation of another person as the author or posted content or messages; or (iii) The distribution by electronic means of a communication to more than one person or the posting of materials on an electronic medium that may be accessed by one or more persons, if the creation, impersonation, or distribution results in any of the conditions enumerated in §§3.7.1(b)(1) (i) to (v) of these Regulations. (b) All school districts, charter schools, career and technical schools, approved private day or residential schools and collaborative schools must adopt the statewide bullying policy developed by the Rhode Island Department of Education. In accordance with RIGL §16- 21-34, the statewide bullying policy shall include: (1) Descriptions of and statements prohibiting bullying, cyber-bullying and retaliation at school; (2) Clear requirements and procedures for students, staff, parents, guardians and others to report bullying or retaliation; (3) A provision that reports of bullying or retaliation may be made anonymously; provided, however, that no disciplinary action shall be taken against a student solely on the basis of an anonymous report; (4) Clear procedures for promptly responding to and investigating reports of bullying or retaliation; (5) The range of disciplinary actions that may be taken against a perpetrator for bullying or retaliation; provided, however, that the disciplinary actions shall balance the need for accountability with the need to teach appropriate behavior; and provided, further: (i) A parental engagement strategy; and (ii) A provision that states punishments for violations of the bullying policy shall be determined by the school’s appropriate authority; however, no student shall suspended from school unless it is deemed a necessary consequence of the violations; (6) Clear procedures for restoring a sense of safety for a victim and assessing that victim’s needs for protection; (7) Strategies for protecting from bullying or retaliation a person who reports bullying, provides information during an investigation of bullying or witnesses or has reliable information about an act of bullying; (8) Procedures for promptly notifying the parents or guardians of a victim and a perpetrator; provided, further, that the parents or guardians of a victim shall also be notified of the action taken to prevent any further acts of bullying or retaliation; and provided, further, that the procedures shall provide for immediate notification of the 59 local law enforcement agency when criminal charges may be pursued against the perpetrator; (9) A provision that a student who knowingly makes a false accusation of bullying or retaliation shall be subject to disciplinary action; (10) A strategy for providing counseling or referral to appropriate services currently being offered by schools or communities for perpetrators and victims and for appropriate family members of said students. The plan shall afford all students the same protection regardless of their status under the law; (11) A provision that requires a principal or designee to be responsible for the implementation and oversight of the bullying policy; (12) Provisions for informing parents and guardians about the bullying policy of the school district or school shall include, but not be limited to: (i) A link to the policy prominently posted on the home page of the school district’s website and distributed annually to parents and guardians of students; (ii) A provision for notification, within twenty-four (24) hours, of the incident report, to the parents or guardians of the victim of bullying and parents or guardians of the alleged perpetrator of the bullying; (13) A school employee, school volunteer, student, parent, legal guardian, or relative caregiver who promptly reports, in good faith, an act of bullying to the appropriate school official designated in the school's policy is immune from a cause of action for damages arising from reporting bullying; (14) RIGL §16-21-34 does not prevent a victim from seeking redress under any other available law, either civil or criminal. RIGL §16-21-34 does not create or alter any tort liability; (15) Students shall be prohibited from accessing social networking sites at school, except for educational or instructional purposes and with the prior approval from school administration. Nothing in RIGL §16-21-33 or RIGL §16-21-34 shall prohibit students from using school department or school websites for educational purposes. School districts and schools are encouraged to provide in-service training on Internet safety for students, faculty and staff. Section 38.0 Weapons and Firearms 38.1 All schools shall have policies prohibiting possession of firearms and other weapons and imposing penalties for such possession in conformity with RIGL 16-21-18 and the “Gun Free Schools Act”, 20 U.S.C.A. §8921 et seq. 38.1.1 All school districts shall ensure the discipline policies regarding incidents of students in possession of weapons shall be imposed on a case-by-case basis. 60 Section 39.0 Alcohol and Other Drugs 39.1 All schools shall have policies regarding possession of alcohol and other drugs and shall have on-going prevention activities and programs as supported by the “Safe and Drug Free Schools Act”, 20 U.S.C.A. §7101 et seq. 39.1.1 All school districts shall ensure that the discipline policies regarding incidents of students in possession of alcohol or drugs shall be imposed on a case-by-case basis. Section 40.0 Recreational Facilities 40.1 All recreation facilities and areas, including gymnasiums, playgrounds, and athletic fields shall be maintained and operated in a safe manner at all times, including, at a minimum, the following provisions: 40.1.1 Playground surfaces and equipment shall demonstrate compliance with all applicable guidelines of the most recent version of the Handbook for Public Playground Safety issued by the U.S. Consumer Products Safety Commission. 40.2 In accordance with section 36 Code of Federal Regulations, Part 1191, recreational facilities, athletic fields and playgrounds shall be accessible to persons with disabilities. 40.3 Adequate, convenient, and well-maintained changing areas and facilities shall be provided for secondary school students, as needed. Section 41.0 Laboratories, Shops and Other Special Purpose Areas 41.1 Special purpose areas of school facilities that shall include, but not be limited to, the cafeteria, home economics laboratory, industrial arts and vocational laboratories, art rooms, and science laboratories shall be in compliance with the following provisions: 41.1.1 OSHA Regulations 1910: Occupational Safety and Health Standards, as filed with the Secretary of State pursuant to RIGL 28-20 by the Rhode Island Department of Labor and Training; 41.1.2 The Code of Federal Regulations, Title XXIX, General Industry Standards 1910.1200 Hazardous Communication that requires employers to maintain in the workplace copies of the required material safety data sheets for each hazardous chemical, and shall ensure that they are readily accessible during each work shift to employees when they are in their work area(s), and to provide training in accordance with state and federal regulations. 41.1.3 OSHA Regulations 1926: Safety and Health Regulations for Construction, as filed with the Secretary of State pursuant to RIGL 28-20 by the Rhode Island Department of Labor and Training; 41.1.4 RIGL Chapter 16-7-24, entitled “Minimum Appropriation By a Community for Approved School Expenses”; 41.1.5 Basic Education Program Regulations, Rhode Island Board of Regents for Elementary and Secondary Education (effective 1 July 2010). 61 Chemical Hygiene Plan 41.2 For the purposes of these Regulations, the protective measures required for employees pursuant to §1450 of OSHA Standard 1910, as incorporated by reference in §41.1.1 of these Regulations, shall extend to students. 41.3 Any school engaged in the laboratory use of hazardous chemicals as defined in these Regulations shall develop and implement a written chemical hygiene plan that sets forth procedures, equipment, personal protective equipment, and work practices that are capable of protecting employees and students from the health hazards presented by hazardous chemicals used in that particular school setting in accordance with the requirements of Section 1450 of OSHA Standard 1910, , as incorporated by reference in §41.1.1 of these Regulations. Said plan shall also include a section regarding the purchase, storage, and disposal of potentially hazardous chemicals and the training of staff and students on their use. 41.4 The written chemical hygiene plan required by these Regulations shall include a prohibition on the use of the chemicals listed in Appendix "A" of these Regulations. 41.4.1 Any chemical(s) listed in Appendix “A” of these Regulations shall not be purchased by a school. 41.4.2 All chemicals listed in Appendix “A” in these Regulations shall be prohibited from a school. 41.4.3 State-approved career and technical education programs, as governed by the Regulations of the Board of Regents Governing the Management and Operation of Area Vocational-Technical Centers in Rhode Island, shall be exempt from the chemical prohibition of §41.4 of these Regulations, but shall maintain a safe and healthy environment where risks are minimized through education, training, administrative and engineering controls, personal protective equipment, proper work practices, and the use of the safest available materials and products, in accordance with current occupational and environmental standards and regulations. 41.5 School personnel (e.g., art teachers, shop teachers, classroom teachers, maintenance staff) shall ensure compliance with §1200 of OSHA Standard 1910, as incorporated by reference in §41.1.1 of these Regulations, for those areas under their control or supervision. Safety data sheets1 for all chemicals stored, handled or used in those areas shall be reviewed with the school’s chemical hygiene officer to ensure that the chemicals are appropriately managed in accordance with school’s chemical hygiene plan. 1 The change from Material Safety Data Sheet (MSDS) to Safety Data Sheet (SDS) is part of updating the OSHA Hazard Communication Standard [29 CFR 1910.1200] for consistency with the Globally Harmonized System of Classification and Labeling of Chemicals (GHS). 62 Section 42.0 Vehicular and Pedestrian Traffic Safety 42.1 Each school shall develop written procedures or protocols, the goal of which shall be to reduce the risk of motor vehicle injuries and exposure to motor vehicle exhaust fumes among students. These procedures shall be reviewed annually by school representatives and local police authorities and shall address no less than the following issues: 42.1.1 Arrival and departure areas for busses, private automobiles, bicyclists, and pedestrians; 42.1.2 Parking and idling locations for motor vehicles, including busses; 42.1.3 Signage and crosswalks; 42.1.4 Traffic flow on and adjacent to school grounds; and, 42.1.5 Emergency procedures. Section 43.0 Asset Protection 43.1 Each public school shall be subject to the provisions of RIGL Chapter 16-7.1, entitled “The Rhode Island Student Investment Initiative”, requiring all public school districts to provide an annual asset protection plan to the Commissioner of Elementary and Secondary Education. 63 PART V ENFORCEMENT & SEVERABILITY Section 44.0 Enforcement 44.1 Pursuant to the provisions of RIGL §16-5-30, the Commissioner of Elementary and Secondary Education may for violation or neglect of law or for violation or neglect of rules and regulations in pursuance of law by any city or town or city or town officer or school committee, order the General Treasurer to withhold the payment of any portion of the public money that has been or may be apportioned to the city or town. 44.2 The General Treasurer upon the receipt in writing of the order shall hold the public money due the city or town until such time as the Commissioner by writing requests the withheld funds for the purposes of eliminating the violation or neglect of law or regulation that caused the order to be issued, or the Commissioner of Elementary and Secondary Education shall notify the Treasurer that the city or town has complied with the order as the Department shall make in the premises, in which case payment shall be made to the town forthwith. 44.3 The Board of Regents for Elementary and Secondary Education shall report to the General Assembly annually all infractions of school law which shall be brought to its attention, with a record of such action as the Department shall have taken in each instance. Section 45.0 Severability 45.1 If any provision of these Regulations or the application thereof to any facility or circumstance shall be held invalid, such invalidity shall not affect the provisions or application of the regulations which can be given effect, and to this end the provisions of these Regulations are declared to be severable. SchoolHealthPrograms_Final_July2014.doc Wednesday, 02 July 2014 64 REFERENCES 1. Rules and Regulations Pertaining to Reporting of Communicable, Environmental and Occupational Diseases (R23-10-DIS), Rhode Island Department of Health, July 2008 2. Rules and Regulations Pertaining to Immunization and Testing for Communicable Diseases (R23-1-IMM), Department of Health, April 2009 3. "Good Samaritan--Immunity from Liability", RIGL Chapter 9-1-27.1. Available online: http://www.rilin.state.ri.us/Statutes/TITLE9/9-1/9-1-27.1.HTM 4. "Confidentiality of Health Care Information Act", RIGL Chapter 5-37.3. Available online: http://www.rilin.state.ri.us/Statutes/TITLE5/5-37.3/INDEX.HTM 5. Compliance with the Americans with Disabilities Act: A Self-Evaluation Guide for Public Elementary and Secondary Schools. Washington, D.C.: U.S. Department of Education, Office for Civil Rights. Available online: http://www.bcm.edu/ilru/dlrp/html/publications/schools/general/guidcont.html 6. Public Playground Safety Handbook, U.S. Consumer Products Safety Commission, Washington, D.C. 20207. U.S. Government Printing Office Publication #325, November 2010. Available online: http://www.cpsc.gov/cpscpub/pubs/325.pdf 7. Basic Education Program Regulations, Rhode Island Board of Regents for Elementary and Secondary Education, June 2009 (effective 1 July 2010). 8. Rules and Regulations for Licensing Speech Pathologists and Audiologists (R5-48-SPA), State of Rhode Island and Providence Plantations, Department of Health, January 2008 9. Regulations Governing the Education of Children with Disabilities, Board of Regents for Elementary and Secondary Education, July 2008 (effective 1 July 2010). 10. American Speech-Language-Hearing Association (1997). Guidelines for Audiologic Screening. Available online: http://www.asha.org/docs/pdf/GL1997-00199.pdf 11. American National Standards Institute (2010). Specifications for Audiometers (ANSI/ASA 3.6- 2010). New York: ANSI. Available online: http://webstore.ansi.org/RecordDetail.aspx?sku=ANSI%2fASA+S3.6-2010 12. American National Standards Institute (2007). Specifications for Instruments to Measure Aural Acoustic Impedance and Admittance (Aural Acoustic Immittance) [ANSI 3.39-1987 (R 2007)]. New York: ANSI. Available online: http://webstore.ansi.org/RecordDetail.aspx?sku=ANSI+S3.39-1987+(R+2007) 65 13. "Family Educational Rights and Privacy", 34 Code of Federal Regulations, Part 99. Available online: http://ecfr.gpoaccess.gov/cgi/t/text/text- idx?c=ecfr&sid=f8be718f02f1330b4dd863050eecd441&rgn=div5&view=text&node=34:1.1.1.1. 34&idno=34 14. Rules and Regulations for the Licensing of Organized Ambulatory Care Facilities, Rhode Island Department of Health, September 2007 15. Postural Screening Guidelines for School Nurses, National Association of School Nurses, Inc. 8484 Georgia Avenue, Suite 420, Silver Spring, MD 2091 2004. http://www.nasn.org 16. “Screening Prior to Child Care or School Enrollment”, RIGL §23-24.6-8. Available online: http://www.rilin.state.ri.us/Statutes/TITLE23/23-24.6/23-24.6-8.HTM 17. “Screening by Health Care Providers”, RIGL Chapter 23-24.6-7. Available online: http://www.rilin.state.ri.us/Statutes/TITLE23/23-24.6/23-24.6-7.HTM 18. Guidance for the Approval of Non-Public Schools in Rhode Island (2008), Rhode Island Department of Elementary and Secondary Education. http://www.ride.ri.gov/PSI/Non%20-%20Public%20School%20Resources/1.%20%20GUIDANCE%202008.doc 19. Occupational Safety and Health Administration (OSHA): Occupational Noise Exposure Standard, 29 Code of Federal Regulations section 1910.95. Available online: http://ecfr.gpoaccess.gov/cgi/t/text/text- idx?c=ecfr&sid=4f2876cccab3d8ae2fc2ae7809425511&rgn=div8&view=text&node=29:5.1.1.1. 8.7.33.2&idno=29 20. Rules and Regulations Governing the Generation, Transportation, Storage, Treatment, Management and Disposal of Regulated Medical Waste in Rhode Island (DEM-OWM-MW-1- 2009), Rhode Island Department of Environmental Management, July 2010. 21. Rules and Regulations Pertaining to the Use of Latex Gloves by Health Care Workers, in Licensed Health Care Facilities, and by Other Persons, Firms, or Corporations Licensed or Registered by the Department (R23-73-LAT), Rhode Island Department of Health, May 2002. 22. Occupational Safety and Health Administration (OSHA): Occupational Exposure to Hazardous Chemicals in Laboratories, 29 Code of Federal Regulations section 1910.1450. Available online: http://ecfr.gpoaccess.gov/cgi/t/text/text- idx?c=ecfr&sid=4f2876cccab3d8ae2fc2ae7809425511&rgn=div8&view=text&node=29:6.1.1.1. 1.1.1.38&idno=29 23. Rules and Regulations Related to Pain Assessment (R5-37.6-PAIN), Rhode Island Department of Health, May 2003 24. Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 enacted on August 21, 1996. Available online: http://aspe.hhs.gov/admnsimp/pl104191.htm 66 The revision dates of all RI Department of Health, Department of Environmental Management and Board of Regents for Elementary and Secondary Education regulations cited above were current when these amended regulations were filed with the Rhode Island Secretary of State. The most up to date copies of all regulations issued by these agencies are available at the RI Secretary of State’s Final Rules and Regulations Database website: http://www.sos.ri.gov/rules/, and may be downloaded at no charge 67 Appendix “A”: List of Chemicals Prohibited from Use in Schools Full Chemical Name CAS # Reference 1-(2-tert-Butylperoxy isopropyl)-3-isopropenylbenzene 96319-55-0 49CFR173.225 1-(o-Chlorophenyl)thiourea 5344-82-1 EPA Acutely Toxic (P Listed) 1,1-Di-(tert-amylperoxy)cyclohexane 15667-10-4 49CFR173.225 1,1-Di-(tert-butylperoxy)-3,3,5-trimethylcyclohexane 6731-36-8 49CFR173.225 1,1-Di-(tert-butylperoxy)cyclohexane 3006-86-8 49CFR173.225 1,1'-Diazoaminonaphthalene DOT Forbidden 1,1-Dimethyl-3-hydroxybutylperoxyneoheptanoate 49CFR173.225 1,2,3-Propanetriol, trinitrate (R) 55-63-0 EPA Acutely Toxic (P Listed) 1,2,4-butanetriol trinitrate DOT Forbidden 1,2-Benzenediol, 4-[1-hydroxy-2-(methylamino)ethyl]-, (R)- 51-43-4 EPA Acutely Toxic (P Listed) 1,2-Diazidoethane DOT Forbidden 1,2-Dibromo-3-Chloropropane 96-12-8 Reproductive Toxin, Select Carcinogen 1,2-Propylenimine 75-55-8 EPA Acutely Toxic (P Listed) 1,3,4 oxadiazole IARC List of Known and Suspected Human Carcinogens 1,3-butadiene 106-99-0 OSHA Listed Chemicals 1,3-Diazopropane DOT Forbidden 1,3-dinitro-5,5-dimethyl hydantoin DOT Forbidden 1,3-Dithiolane-2-carboxaldehyde, 2,4-dimethyl-, O- [(methylamino)- carbonyl]oxime. 26419-73-8 EPA Acutely Toxic (P Listed) 1,4-Butanediol Dimethylsulfonate 55-98-1 Select Carcinogen 1,7-octadine-3, 5-diyne-1, 8-dimethoxy-9-octadecynoic acid DOT Forbidden 1,8-dihydroxy-2,4,5,7-tetranitroanthraquinone DOT Forbidden 1,9-dinitroxy pentamethylene-2,4, 6,8-tetramine DOT Forbidden 1-Acetyl-2-thiourea 591-08-2 EPA Acutely Toxic (P Listed) 1-bromo-3-nitrobenzene DOT Forbidden 2-(2-Hydroxyethoxy)-1-(pyrrolidin-1-yl)benzene-4- diazonium zinc chloride 15005-97-7 49CFR 173.224 2-(N,N-Ethoxycarbonylphenylamino)-3-methoxy-4-(N- methyl-N-cyclohexylamino)benzenediazonium zinc chloride 49CFR 173.224 2-(N,N-Methylaminoethylcarbonyl)-4-(3,4-dimethyl- phenylsulphonyl)benzene diazonium zinc chloride 49CFR 173.224 2,2'-Azodi(2,4-dimethyl-4-methoxyvaleronitrile) 49CFR 173.224 2,2'-Azodi(2,4-dimethylvaleronitrile) 4419-11-8 49CFR 173.224 2,2-Azodi(2-methylbutyronitrile) 49CFR 173.224 2,2'-Azodi(ethyl 2- methylpropionate) 49CFR 173.224 2,2'-Azodi(isobutyronitrile) 78-67-1 49CFR 173.224 2,2-Di-(4,4-di(tert-butylperoxy)cyclohexyl)propane 1705-60-8 49CFR173.225 2,2-di-(4,4-di-tert-butylperoxycyclohexyl) propane DOT Forbidden 2,2-Di-(tert-butylperoxy) butane DOT Forbidden 2,2-di-(tert-Butylperoxy)butane 2167-23-9 49CFR173.225 2,2-Di-(tert-butylperoxy)propane 1705-60-8 49CFR173.225 2,2-Dihydroperoxypropane 2614-76-8 49CFR173.225 2,2-dinitrostilbene DOT Forbidden 2,4-Dinitrophenol 51-28-5 EPA Acutely Toxic (P Listed) 2,5 Dimethyl 2,5 di-2-ethylhexanoylperoxyhexane 49CFR173.225 2,5-Diethoxy-4-(phenylsulphonyl)benzenediazonium zinc chloride 49CFR 173.224 2,5-Diethoxy-4-2,5-Diethoxy-4- morpholinobenzenediazonium zinc chloride 26123-91-1 49CFR 173.224 2,5-Diethoxy-4-morpholinobenzenediazonium tetrafluoroborate 4979-72-0 49CFR 173.224 68 Full Chemical Name CAS # Reference 2,5-Diethoxy-4-morpholinobenzenediazonium zinc chloride 26123-91-1 49CFR 173.224 2,5-Dimethoxy-4-(4-methylphenylsulphony)benzene diazonium zinc chloride 49CFR 173.224 2,5-Dimethyl-2,5-di-(3,5,5-trimethylhexanoylperoxy)hexane 49CFR173.225 2,5-Dimethyl-2,5-di-(benzoylperoxy)hexane 2618-77-1 49CFR173.225 2,5-Dimethyl-2,5-di-(tert-butylperoxy)hexane 78-63-7 49CFR173.225 2,5-Dimethyl-2,5-di-(tert-butylperoxy)hexyne-3 1068-27-5 49CFR173.225 2,5-dimethyl-2,5-dihydroperoxy hexane DOT Forbidden 2,5-Dimethyl-2,5-dihydroperoxyhexane 3025-88-5 49CFR173.225 2-acetylaminofluorene 53-96-3 OSHA Listed Chemicals 2-Acetylaminofluorine Select Carcinogen 2-Cyclohexyl-4,6-dinitrophenol 131-89-5 EPA Acutely Toxic (P Listed) 2-Diazo-1-Naphthol-4-sulphochloride 49CFR 173.224 2-Diazo-1-Naphthol-5-sulphochloride 49CFR 173.224 2-Methyllactonitrile 75-86-5 EPA Acutely Toxic (P Listed) 2-Propanone, 1-bromo- 598-31-2 EPA Acutely Toxic (P Listed) 2-Propen-1-ol 107-18-6 EPA Acutely Toxic (P Listed) 2-Propenal 107-02-8 EPA Acutely Toxic (P Listed) 3(2H)-Isoxazolone, 5-(aminomethyl)- 2763-96-4 EPA Acutely Toxic (P Listed) 3-(2-Hydroxyethoxy)-4-(pyrrolidin-1-yl)benzenediazonium zinc chloride 15005-97-7 49CFR 173.224 3,3,6,6,9,9-Hexamethyl-1,2,4,5-tetraoxacyclononane 22397-33-7 49CFR173.225 3,3-dichlorobenzidine 91-94-1 OSHA Listed Chemicals 3-3'-Dichlorobenzidine 91-94-1 Select Carcinogen 3-Azido-1, 2-Propylene glycol dinitrate DOT Forbidden 3-Chloro-4-diethylaminobenzenediazonium zinc chloride 49CFR 173.224 3-Chloroperoxybenzoic acid 937-14-4 49CFR173.225 3-Chloropropionitrile 542-76-7 EPA Acutely Toxic (P Listed) 3-Isopropylphenyl N-methylcarbamate. 64-00-6 EPA Acutely Toxic (P Listed) 3-Methyl-4-(pyrrolidin-1-yl)benzenediazonium tetrafluoroborate 36422-95-4 49CFR 173.224 3-tert-Butylperoxy-3-phenylphthalide 25251-51-8 49CFR173.225 4-(Benzyl(ethyl)amino)-3-ethoxybenzenediazonium zinc chloride 49CFR 173.224 4-(Benzyl(methyl)amino)-3-ethoxybenzenediazonium zinc chloride 49CFR 173.224 4,4'-Methylenebis (2-Chloroaniline) 95-51-2 Select Carcinogen 4,6-Dinitro-o-cresol, & salts 534-52-1 EPA Acutely Toxic (P Listed) 4-Aminobiphenyl 92-67-1 Select Carcinogen 4-Aminopyridine 504-24-5 EPA Acutely Toxic (P Listed) 4-bromo-1, 2-dinitrobenzene DOT Forbidden 4-Dimethylamino-6-(2-dimethylaminoethoxy)toluene-2- diazonium zinc chloride 49CFR 173.224 4-Dimethylaminoazobenzene 60-11-7 Select Carcinogen 4-Dipropylaminobenzenediazonium zinc chloride 49CFR 173.224 4-Methylbenzenesulphonylhydrazide 49CFR 173.224 4-Nitrobiphenyl 92-93-3 Select Carcinogen 4-Nitrosophenol 104-91-6 49CFR 173.224 4-Pyridinamine EPA Acutely Toxic (P Listed) 5-(Aminomethyl)-3-isoxazolol 2763-96-4 EPA Acutely Toxic (P Listed) 5-Azido-1-hydroxy tetrazole DOT Forbidden 5-Mercaptotetrazol-1-acetic acid 57658-36-3 DOT Explosive 5-nitrobenzotriazol 169796-98-9 DOT Explosive 7-Benzofuranol, 2,3-dihydro-2,2-dimethyl-, 1563-66-2 EPA Acutely Toxic (P Listed) 69 Full Chemical Name CAS # Reference methylcarbamate. 7-Oxabicyclo[2.2.1]heptane-2,3-dicarboxylic acid 145-73-3 EPA Acutely Toxic (P Listed) A-alpha-C [2-amino-9H-pyrido[2,3-b]indole] IARC List of Known and Suspected Human Carcinogens Acetal 105-57-7 Peroxidizable Acetaldehyde 75-07-0 Reproductive Toxin Acetaldehyde, chloro- 107-20-0 EPA Acutely Toxic (P Listed) Acetamide, 2-fluoro- 640-19-7 EPA Acutely Toxic (P Listed) Acetamide, N-(aminothioxomethyl)- 591-08-2 EPA Acutely Toxic (P Listed) Acetic acid, fluoro-, sodium salt 62-74-8 EPA Acutely Toxic (P Listed) Acetyl acetone peroxide 37187-22-7 49CFR173.225 Acetyl benzoyl peroxide 644-31-5 49CFR173.225 Acetyl cyclohexanesulfonyl peroxide 3179-56-4 49CFR173.225 acetyl peroxide 110-22-5 DOT Forbidden acetylaminofluorene, 2- IARC List of Known and Suspected Human Carcinogens acetylene silver nitrate 7761-88-8 DOT Forbidden Acrolein 107-02-8 EPA Acutely Toxic (P Listed) Acrylamide 79-06-1 Select Carcinogen Acrylonitrile 107-13-1 Select Carcinogen actinomycin D IARC List of Known and Suspected Human Carcinogens adriamycin [doxorubicin] IARC List of Known and Suspected Human Carcinogens AF-2 [2-(2-furyl)-3-(5-nitro-2-furyl)acrylamide] IARC List of Known and Suspected Human Carcinogens Aflatoxin 1402-68-2 Select Carcinogen Aflatoxin B1 1162-65-8 Select Carcinogen Aflatoxin B2 7220-81-7 Select Carcinogen Aflatoxin G1 1165-39-5 Select Carcinogen Aflatoxin G2 7241-98-7 Select Carcinogen Aflatoxin M1 6795-23-9 Select Carcinogen agaritine IARC List of Known and Suspected Human Carcinogens Aldicarb 116-06-3 EPA Acutely Toxic (P Listed) Aldicarb sulfone. 1646-88-4 EPA Acutely Toxic (P Listed) Aldrin 309-00-2 EPA Acutely Toxic (P Listed) Allyl alcohol 107-18-6 EPA Acutely Toxic (P Listed) allyl isothiocyanate IARC List of Known and Suspected Human Carcinogens allyl isovalerate IARC List of Known and Suspected Human Carcinogens alpha,alpha-Dimethylphenethylamine 122-09-8 EPA Acutely Toxic (P Listed) Alpha-Naphthylamine 134-32-7 Select Carcinogen alpha-Naphthylthiourea 86-88-4 EPA Acutely Toxic (P Listed) Aluminum phosphide (R,T) 20859-73-8 EPA Acutely Toxic (P Listed) amino-2-methylanthraquinone, 1- IARC List of Known and Suspected Human Carcinogens amino-5-(5-nitro-2-furyl)-1,3,4-thiadiazole IARC List of Known and Suspected Human Carcinogens amino-5-nitrothiazole, 2- IARC List of Known and Suspected Human Carcinogens aminoanthraquinone, 2- IARC List of Known and Suspected Human Carcinogens 70 Full Chemical Name CAS # Reference aminoazobenzene, p- IARC List of Known and Suspected Human Carcinogens aminoazotoluene, o- [solvent yellow 3] IARC List of Known and Suspected Human Carcinogens aminobipheny, 4- IARC List of Known and Suspected Human Carcinogens amitrole IARC List of Known and Suspected Human Carcinogens ammonium azide DOT Forbidden ammonium bromate DOT Forbidden ammonium chlorate 10192-29-7 DOT Forbidden ammonium fulminate DOT Forbidden ammonium nitrate 6484-52-2 DOT Explosive ammonium nitrite DOT Forbidden ammonium perchlorate 7790-98-9 DOT Explosive ammonium permanganate DOT Forbidden Ammonium picrate (R) 131-74-8 EPA Acutely Toxic (P Listed) Ammonium vanadate 7803-55-6 EPA Acutely Toxic (P Listed) androgenic (anabolic) steroids IARC List of Known and Suspected Human Carcinogens aniline IARC List of Known and Suspected Human Carcinogens anisidine hydrochloride, o- IARC List of Known and Suspected Human Carcinogens anisidine, o- IARC List of Known and Suspected Human Carcinogens anlagesic mixtures containing phenacetin IARC List of Known and Suspected Human Carcinogens anthanthrene IARC List of Known and Suspected Human Carcinogens antimony sulfide 1345-04-6 DOT Forbidden aramite IARC List of Known and Suspected Human Carcinogens Argentate(1-), bis(cyano-C)-, potassium 506-61-6 EPA Acutely Toxic (P Listed) Arsenic 7440-38-2 Reproductive Toxin, Select Carcinogen Arsenic acid H3 AsO4 7778-39-4 EPA Acutely Toxic (P Listed) Arsenic oxide As2 O3 1327-53-3 EPA Acutely Toxic (P Listed) Arsenic oxide As2 O5 1303-28-2 EPA Acutely Toxic (P Listed) Arsenic pentoxide 1303-28-2 EPA Acutely Toxic (P Listed) arsenic sulfide 56320-22-0 DOT Forbidden Arsenic trioxide 1327-53-3 EPA Acutely Toxic (P Listed) Arsine 7784-42-1 Acutely Toxic Arsine, diethyl- 692-42-2 EPA Acutely Toxic (P Listed) Arsonous dichloride, phenyl- 696-28-6 EPA Acutely Toxic (P Listed) Asbestos 1332-21-4 Select Carcinogen ascaridole DOT Forbidden auramine IARC List of Known and Suspected Human Carcinogens azacitidine IARC List of Known and Suspected Human Carcinogens azaserine IARC List of Known and Suspected Human Carcinogens Azathioprine Select Carcinogen azaurolic acid DOT Forbidden 71 Full Chemical Name CAS # Reference azido guanidine picrate DOT Forbidden azidodithiocarbonic acid DOT Forbidden azidoethyl nitrate DOT Forbidden Aziridine 151-56-4 EPA Acutely Toxic (P Listed) Aziridine, 2-methyl- 75-55-8 EPA Acutely Toxic (P Listed) Azodi(hexahydrobenzonitrile) 2094-98-6 49CFR 173.224 Azodicarbonamide formulation 123-77-3 49CFR 173.224 barium azide 18810-58-7 DOT Explosive Barium Chromate 10294-40-3 Select Carcinogen Barium cyanide 542-62-1 EPA Acutely Toxic (P Listed) barium styphnate 20236-55-9 DOT Explosive benz[a]anthracene IARC List of Known and Suspected Human Carcinogens benz[c]acridine IARC List of Known and Suspected Human Carcinogens Benzenamine, 4-chloro- 106-47-8 EPA Acutely Toxic (P Listed) Benzenamine, 4-nitro- 100-01-6 EPA Acutely Toxic (P Listed) Benzene 71-43-2 Reproductive Toxin, Select Carcinogen benzene diazonim chloride DOT Forbidden Benzene sulphohydrazide 80-17-1 49CFR 173.224 benzene triozonide DOT Forbidden Benzene, (chloromethyl)- 100-44-7 EPA Acutely Toxic (P Listed) Benzene-1,3-disulphohydrazide 49CFR 173.224 Benzeneethanamine, alpha,alpha-dimethyl- 122-09-8 EPA Acutely Toxic (P Listed) Benzenethiol 108-98-5 EPA Acutely Toxic (P Listed) Benzidine 92-87-5 Select Carcinogen benzo[a]pyrene IARC List of Known and Suspected Human Carcinogens benzo[b]fluoranthene IARC List of Known and Suspected Human Carcinogens benzo[j]fluoranthene IARC List of Known and Suspected Human Carcinogens benzo[k]fluoroanthene IARC List of Known and Suspected Human Carcinogens benzotrichloride IARC List of Known and Suspected Human Carcinogens Benzoyl (3-methylbenzoyl) peroxide 214425-85-1 49CFR173.225 benzoyl azide DOT Forbidden Benzyl chloride 100-44-7 EPA Acutely Toxic (P Listed) benzyl violet 4B IARC List of Known and Suspected Human Carcinogens beryllium & beryllium compounds (e.g. oxide or sulfate) IARC List of Known and Suspected Human Carcinogens Beryllium powder 7440-41-7 EPA Acutely Toxic (P Listed) Beta-naphthylamine 91-59-8 OSHA Listed Chemicals Beta-Propiolactone 57-57-8 Select Carcinogen bieomycins IARC List of Known and Suspected Human Carcinogens biphenyl triozonide DOT Forbidden bis(chloroethyl) nitrosourea [BCNU] IARC List of Known and Suspected Human Carcinogens bis(chloromethyl)ether [BCME] IARC List of Known and Suspected Human Carcinogens bitumens, extracts of steam and air refined IARC List of Known and Suspected Human 72 Full Chemical Name CAS # Reference Carcinogens bromine azide 13973-87-0 DOT Forbidden Bromoacetone 598-31-2 EPA Acutely Toxic (P Listed) bromosilane DOT Forbidden Brucine 357-57-3 EPA Acutely Toxic (P Listed) Butadiene 106-99-0 Peroxidizable butadiene, 1,3- IARC List of Known and Suspected Human Carcinogens butylated hydroxyanisole [BHA] IARC List of Known and Suspected Human Carcinogens butyrolactone, beta- IARC List of Known and Suspected Human Carcinogens C.I. basic red 9 monohydrochloride IARC List of Known and Suspected Human Carcinogens Cadmium and cadmium compounds Reproductive Toxin Calcium cyanide 592-01-8 EPA Acutely Toxic (P Listed) captan 133-06-2 IARC List of Known and Suspected Human Carcinogens Carbamic acid, [(dibutylamino)- thio]methyl-, 2,3-dihydro- 2,2-dimethyl- 7-benzofuranyl ester. 55285-14-8 EPA Acutely Toxic (P Listed) Carbamic acid, dimethyl-, 1-[(dimethyl-amino)carbonyl]- 5- methyl-1H- pyrazol-3-yl ester. 644-64-4 EPA Acutely Toxic (P Listed) Carbamic acid, dimethyl-, 3-methyl-1- (1-methylethyl)-1H- pyrazol-5-yl ester. 119-38-0 EPA Acutely Toxic (P Listed) Carbamic acid, methyl-, 3-methylphenyl ester. 1129-41-5 EPA Acutely Toxic (P Listed) carbazole 86-74-8 IARC List of Known and Suspected Human Carcinogens Carbofuran. 1563-66-2 EPA Acutely Toxic (P Listed) Carbon Disulfide 75-15-0 Reproductive Toxin carbon tetrachloride 56-23-5 IARC List of Known and Suspected Human Carcinogens Carbonic dichloride 75-15-0 EPA Acutely Toxic (P Listed) Carbosulfan. 55285-14-8 EPA Acutely Toxic (P Listed) carrageenan 9000-07-1 IARC List of Known and Suspected Human Carcinogens Chloramabucil Select Carcinogen chloramphenicol 56-75-7 IARC List of Known and Suspected Human Carcinogens chlorbenzilat 510-15-6 IARC List of Known and Suspected Human Carcinogens chlordane 57-74-9 IARC List of Known and Suspected Human Carcinogens chlordecone [kepone] 143-50-0 IARC List of Known and Suspected Human Carcinogens chlorendic acid 115-28-6 IARC List of Known and Suspected Human Carcinogens 73 Full Chemical Name CAS # Reference chlorinated, alpha- toluenes (benzal chloride [98- 87-3], benzotrichlor ide [98-07- 7], benzyl chloride [100-44-7]) and benzoyl chloride [98- 88-4] IARC List of Known and Suspected Human Carcinogens chlorine azide DOT Forbidden chlorine dioxide 10049-04-4 DOT Forbidden Chlorine Gas 7782-50-5 Acutely Toxic chlormadinone acetate 302-22-7 IARC List of Known and Suspected Human Carcinogens Chlornaphazine Select Carcinogen chlornaphazine [n,n-bis(2-chloroethyl)-2-naphthylamine] 494-03-1 IARC List of Known and Suspected Human Carcinogens Chloroacetaldehyde 107-20-0 EPA Acutely Toxic (P Listed) chloroacetone 78-95-5 DOT Forbidden chloroethyl)-3-cyclohexyl-1-nitrosourea, 1-(2- [CCNU] IARC List of Known and Suspected Human Carcinogens chloroform 67-66-3 IARC List of Known and Suspected Human Carcinogens chloromethyl ethyl ether 3188-13-4 IARC List of Known and Suspected Human Carcinogens Chloromethyl Methyl Ether Select Carcinogen chloro-o-phenylenediamine, 4- 95-83-0 IARC List of Known and Suspected Human Carcinogens chloro-o-toluidine, p- 95-69-2 IARC List of Known and Suspected Human Carcinogens chloro-o-toluidine, p- and its HCl salt IARC List of Known and Suspected Human Carcinogens chlorophenols IARC List of Known and Suspected Human Carcinogens chlorophenoxy herbicides IARC List of Known and Suspected Human Carcinogens Chloroprene 126-99-8 Peroxidizable chloroprene 126-99-8 DOT Forbidden chlorothalonil 1897-45-6 IARC List of Known and Suspected Human Carcinogens chlorozotocin 54749-90-5 IARC List of Known and Suspected Human Carcinogens cholesterol 57-88-5 IARC List of Known and Suspected Human Carcinogens Chromium and chromium compounds 7440-47-3 Select Carcinogen chrysene 218-01-9 IARC List of Known and Suspected Human Carcinogens cinnamyl anthranilate 87-29-6 IARC List of Known and Suspected Human Carcinogens cisplatin [trade name=platinol] 15663-27-1 IARC List of Known and Suspected Human Carcinogens 74 Full Chemical Name CAS # Reference citrus red no. 2 6358-53-8 IARC List of Known and Suspected Human Carcinogens clofibrate 637-07-0 IARC List of Known and Suspected Human Carcinogens coal tar pitch volatiles IARC List of Known and Suspected Human Carcinogens copper acetylide DOT Forbidden copper amine azide DOT Forbidden Copper cyanide 544-92-3 EPA Acutely Toxic (P Listed) copper tetramine nitrate DOT Forbidden creosotes IARC List of Known and Suspected Human Carcinogens cresidine, p- 120-71-8 IARC List of Known and Suspected Human Carcinogens Cumene 98-82-8 Peroxidizable Cumyl hydroperoxide 80-15-9 49CFR173.225 Cumyl peroxyneodecanoate 26748-47-0 49CFR173.225 Cumyl peroxypivalate 23383-59-7 49CFR173.225 cupferron 135-20-6 IARC List of Known and Suspected Human Carcinogens Cyanides (soluble cyanide salts), not otherwise specified EPA Acutely Toxic (P Listed) Cyanogen 460-19-5 EPA Acutely Toxic (P Listed) Cyanogen chloride 506-77-4 EPA Acutely Toxic (P Listed) cyanuric triazide DOT Forbidden cycasin [methylazoxmethanol] 14901-08-7 IARC List of Known and Suspected Human Carcinogens cyclamates 139-05-9 IARC List of Known and Suspected Human Carcinogens Cyclohexanone peroxide(s) [as a paste] 78-18-2 49CFR173.225 Cyclohexanone peroxide(s) [as a solution] 12262-58-7 49CFR173.225 Cyclohexene 110-83-8 Peroxidizable cyclopenta[cd]pyrene 27208-37-3 IARC List of Known and Suspected Human Carcinogens Cyclopentene 142-29-0 Peroxidizable Cyclophosphamide 50-18-0 Select Carcinogen cyclosporin 79217-60-0 IARC List of Known and Suspected Human Carcinogens cyclotetramethylene tetranitramine DOT Forbidden cyclotetramethylenetetranitramine 2691-41-0 DOT Explosive D, 2,4- (salts and esters) e.g. phenolyacetic acid 94-75-7 IARC List of Known and Suspected Human Carcinogens dacarbazine [trade name=DIC or DTIC] 4342-03-4 IARC List of Known and Suspected Human Carcinogens danthron 117-10-2 IARC List of Known and Suspected Human Carcinogens dapsone 80-08-0 IARC List of Known and Suspected Human Carcinogens daunomycin [daunorubicin] 20830-81-3 IARC List of Known and Suspected Human Carcinogens DDT 50-29-3 IARC List of Known and Suspected Human Carcinogens decabromodiphenyl oxide 1163-19-5 IARC List of Known and Suspected Human Carcinogens Decalin 91-17-8 Peroxidizable 75 Full Chemical Name CAS # Reference Di-(1-hydroxycyclohexyl)peroxide 2407-94-5 49CFR173.225 di-(1-hydroxytetrazole) DOT Forbidden Di-(2-ethoxyethyl)peroxydicarbonate 52373-74-7 49CFR173.225 Di-(2-ethylhexyl)peroxydicarbonate 16111-62-9 49CFR173.225 Di-(2-ethylhexyl)peroydicarbonate 49CFR173.225 di(2-ethylhexyl)phthalate 117-81-7 IARC List of Known and Suspected Human Carcinogens Di-(2-methylbenzoyl)peroxide 3034-79-5 49CFR173.225 Di-(2-neodecanoylperoxyisopropyl)benzene 49CFR173.225 Di-(2-phenoxyethyl)peroxydicarbonate 41935-39-1 49CFR173.225 Di-(2-tert-butylperoxyisopropyl)benzene 279671-18-0 49CFR173.225 Di-(3,5,5-trimethyl-1,2-dioxolanyl- 3)peroxide 49CFR173.225 Di-(3,5,5-trimethylhexanoyl)peroxide 49CFR173.225 Di-(3-methoxybutyl)peroxydicarbonate 52238-68-3 49CFR173.225 Di-(3-methylbenzoyl)peroxide 96436-26-9 49CFR173.225 Di-(4-methylbenzoyl)peroxide 895-85-2 49CFR173.225 Di-(4-tert-butylcyclohexyl)peroxydicarbonate 15520-11-3 49CFR173.225 di-(beta-nitroxyethyl) ammonium nitrate DOT Forbidden di-(tert-butylperoxy) phthalate DOT Forbidden Di-(tert-butylperoxy)phthalate 2155-71-7 49CFR173.225 Di-2,4-dichlorobenzoyl peroxide 133-14-2 49CFR173.225 di-2,4-dichlorobenzoyl peroxide DOT Forbidden Di-4-chlorobenzoyl peroxide 94-17-7 49CFR173.225 Diacetone alcohol peroxides 54693-46-8 49CFR173.225 Diacetyl peroxide 110-22-5 49CFR173.225 diacetylbenzidine, n,n'- 613-35-4 IARC List of Known and Suspected Human Carcinogens Diacetylene 446-86-6 Peroxidizable diallate 2303-16-4 IARC List of Known and Suspected Human Carcinogens diaminoanisole sulfate, 2,4- IARC List of Known and Suspected Human Carcinogens diaminoanisole, 2,4- 615-05-4 IARC List of Known and Suspected Human Carcinogens diaminodiphenyl ether, 4,4'- 101-80-4 IARC List of Known and Suspected Human Carcinogens diaminotoluene, 2,4- 95-80-7 IARC List of Known and Suspected Human Carcinogens diazoaminotetrazole DOT Forbidden Diazomethane 334-88-3 Acutely Toxic diazonium nitrates DOT Forbidden diazonium perchlorates DOT Forbidden dibenz[a,c]anthracene 215-58-7 IARC List of Known and Suspected Human Carcinogens dibenz[a,h]acridine 226-36-8 IARC List of Known and Suspected Human Carcinogens dibenz[a,h]anthracene 53-70-3 IARC List of Known and Suspected Human Carcinogens dibenz[a,j]acridine 224-42-0 IARC List of Known and Suspected Human Carcinogens dibenz[a,j]anthracene 224-41-9 IARC List of Known and Suspected Human Carcinogens dibenzo[a,e]fluoranthene 5385-75-1 IARC List of Known and Suspected Human Carcinogens 76 Full Chemical Name CAS # Reference dibenzo[a,e]pyrene 192-65-4 IARC List of Known and Suspected Human Carcinogens dibenzo[a,h]pyrene 189-64-0 IARC List of Known and Suspected Human Carcinogens dibenzo[a,i]pyrene 189-55-9 IARC List of Known and Suspected Human Carcinogens dibenzo[a,l]pyrene 191-30-0 IARC List of Known and Suspected Human Carcinogens dibenzo[c,g]carbazole, 7H- 194-59-2 IARC List of Known and Suspected Human Carcinogens Dibenzoyl peroxide 94-36-0 49CFR173.225 Dibenzyl peroxydicarbonate 2144-45-8 49CFR173.225 dibenzyl peroxydicarbonate DOT Forbidden Diborane 19287-45-7 Acutely Toxic dibromo-3-chloropropane, 1,2- [DBCP] 96-12-8 IARC List of Known and Suspected Human Carcinogens dibromoacetylene 624-61-3 DOT Forbidden dibromomethane, 1,2- [DBM] IARC List of Known and Suspected Human Carcinogens Dicetyl peroxydicarbonate 26322-14-5 49CFR173.225 dichloro-4,4'-diaminodiphenyl ether, 3,3'- 28434-86-8 IARC List of Known and Suspected Human Carcinogens dichloroacetylene 7572-29-4 DOT Forbidden dichlorobenzene, 1,4- 106-46-7 IARC List of Known and Suspected Human Carcinogens dichlorobenzidine, 3,3'- 91-94-1 IARC List of Known and Suspected Human Carcinogens dichloroethane, 1,2- [EDC] [ethylene dichloride] 107-06-2 IARC List of Known and Suspected Human Carcinogens dichloroethyl sulfide DOT Forbidden dichloromethane 75-09-2 IARC List of Known and Suspected Human Carcinogens Dichloromethyl ether 542-88-1 EPA Acutely Toxic (P Listed) Dichlorophenylarsine 696-28-6 EPA Acutely Toxic (P Listed) dichloropropane, 1,2- [propylene dichloride] 78-87-5 IARC List of Known and Suspected Human Carcinogens dichloropropene, 1,3- 542-75-6 IARC List of Known and Suspected Human Carcinogens dichlorovinylchloroarsine DOT Forbidden dicofol 115-32-2 IARC List of Known and Suspected Human Carcinogens Dicumyl peroxide 80-43-3 49CFR173.225 Dicyclohexyl peroxydicarbonate 1561-49-5 49CFR173.225 Dicyclopentadiene 77-73-6 Peroxidizable Didecanoyl peroxide 762-12-9 49CFR173.225 dieldrin 60-57-1 IARC List of Known and Suspected Human Carcinogens Dieldrin 60-57-1 EPA Acutely Toxic (P Listed) dienoestrol 84-17-3 IARC List of Known and Suspected Human Carcinogens diepoxybutane 1464-53-5 IARC List of Known and Suspected Human Carcinogens diethanol nitrosamine dinitrate DOT Forbidden Diethyl Ether 60-29-7 Peroxidizable 77 Full Chemical Name CAS # Reference Diethyl peroxydicarbonate 14666-78-5 49CFR173.225 diethyl sulfate 64-67-5 IARC List of Known and Suspected Human Carcinogens Diethylarsine 692-42-2 EPA Acutely Toxic (P Listed) Diethylene glycol bis(allyl carbonate) + Diisopropylperoxydicarbonate 49CFR 173.224 Diethylene Glycol Dimethyl Ether 11-96-6 Peroxidizable diethylene glycol dinitrate 693-21-0 DOT Forbidden diethyleneglycol dinitrate 628-96-6 DOT Explosive diethylgold bromide DOT Forbidden diethylhydrazine, 1,2- OR n,n'-diethylhydrazine 1615-80-1 IARC List of Known and Suspected Human Carcinogens Diethylnitrosamine Select Carcinogen Diethyl-p-nitrophenyl phosphate 311-45-5 EPA Acutely Toxic (P Listed) Diethylstilbestrol 56-53-1 Select Carcinogen diglycidyl resorcinol ether 101-90-6 IARC List of Known and Suspected Human Carcinogens dihydrosafrole 94-58-6 IARC List of Known and Suspected Human Carcinogens diiodoacetylene DOT Forbidden Diisobutyryl peroxide 3437-84-1 49CFR173.225 Diisopropyl peroxydicarbonate 105-64-6 49CFR173.225 Diisopropylbenzene dihydroperoxide 29014-32-2 49CFR173.225 diisopropylbenzene hydroperoxide DOT Forbidden Diisopropylfluorophosphate (DFP) 55-91-4 EPA Acutely Toxic (P Listed) Diisotridecyl peroxydicarbonate 49CFR173.225 Dilauroyl peroxide 105-74-8 49CFR173.225 Dimethoate 60-51-5 EPA Acutely Toxic (P Listed) dimethoxybenzidine, 3,3'- [o-dianisidine] 119-90-4 IARC List of Known and Suspected Human Carcinogens Dimethyl Sulfate 77-78-1 Select Carcinogen dimethylamino)methylimino]-5-[2-nitro-2-furyl)vinyl]- IARC List of Known and Suspected Human Carcinogens dimethylaminoazobenzene (also 4 or para-) 60-11-7 IARC List of Known and Suspected Human Carcinogens dimethylbenzidine, 3,3'- [o-toludine] 119-93-7 IARC List of Known and Suspected Human Carcinogens dimethylcarbamoyl chloride 79-44-7 IARC List of Known and Suspected Human Carcinogens dimethylhexane dihydroperoxide DOT Forbidden dimethylhydrazine, 1,1- 57-14-7 IARC List of Known and Suspected Human Carcinogens dimethylhydrazine, 1,2- 540-73-8 IARC List of Known and Suspected Human Carcinogens Dimethylmercury * 593-74-8 Acutely Toxic dimethylvinyl chloride 513-37-1 IARC List of Known and Suspected Human Carcinogens Dimetilan. 644-64-4 EPA Acutely Toxic (P Listed) Dimyristyl peroxydicarbonate 53220-22-7 49CFR173.225 Di-n-butyl peroxydicarbonate 16215-49-9 49CFR173.225 di-n-butyl peroxydicarbonate DOT Forbidden dinitroglycoluril 55510-04-8 DOT Explosive dinitrophenol 51-28-5 DOT Explosive dinitropropylene glycol DOT Forbidden 78 Full Chemical Name CAS # Reference dinitropyrene, 1,6- 42397-64-8 IARC List of Known and Suspected Human Carcinogens dinitropyrene, 1,8- 42397-65-9 IARC List of Known and Suspected Human Carcinogens dinitroresorcinol 519-44-8 DOT Explosive dinitrosobenzene 25550-55-4 DOT Explosive Di-n-nonanoyl peroxide 762-13-0 49CFR173.225 Di-n-octanoyl peroxide 762-16-3 49CFR173.225 Dinoseb 88-85-7 EPA Acutely Toxic (P Listed) Di-n-propyl peroxydicarbonate 16066-38-9 49CFR173.225 Dioxane 123-91-1 Peroxidizable dioxane, 1,4- 123-91-1 IARC List of Known and Suspected Human Carcinogens Diperoxy azelaic acid 1941-79-3 49CFR173.225 Diperoxy dodecane diacid 66280-55-5 49CFR173.225 Diphenyloxide-4,4'-disulphohydrazide 80-51-3 49CFR 173.224 Diphosphoramide, octamethyl- 152-16-9 EPA Acutely Toxic (P Listed) Diphosphoric acid, tetraethyl ester 107-49-3 EPA Acutely Toxic (P Listed) dipicryl sulfide 2217-06-3 DOT Explosive Dipropionyl peroxide 3248-28-0 49CFR173.225 dipropionyl peroxide DOT Forbidden direct black 38 1937-37-7 IARC List of Known and Suspected Human Carcinogens direct blue 6 2602-46-2 IARC List of Known and Suspected Human Carcinogens direct brown 95 16071-86-6 IARC List of Known and Suspected Human Carcinogens Di-sec-butyl peroxydicarbonate 19910-65-7 49CFR173.225 disperse blue 1 2475-45-8 IARC List of Known and Suspected Human Carcinogens Distearyl peroxydicarbonate 52326-66-6 49CFR173.225 Disuccinic acid peroxide 123-23-9 49CFR173.225 Disulfoton 298-04-4 EPA Acutely Toxic (P Listed) Di-tert-amyl peroxide 10508-09-5 49CFR173.225 Di-tert-butyl peroxide 110-05-4 49CFR173.225 Di-tert-butyl peroxyazelate 16580-06-6 49CFR173.225 Dithiobiuret 541-53-7 EPA Acutely Toxic (P Listed) Divinyl Ether 109-86-4 Peroxidizable Endosulfan 115-29-7 EPA Acutely Toxic (P Listed) Endothall 145-73-3 EPA Acutely Toxic (P Listed) Endrin 72-20-8 EPA Acutely Toxic (P Listed) Endrin, & metabolites 72-20-8 EPA Acutely Toxic (P Listed) epichlorohydrin 106-89-8 IARC List of Known and Suspected Human Carcinogens erionite 66733-21-9 IARC List of Known and Suspected Human Carcinogens estradiol 17b 50-28-2 IARC List of Known and Suspected Human Carcinogens estrone 53-16-7 IARC List of Known and Suspected Human Carcinogens Ethanedinitrile 460-19-5 EPA Acutely Toxic (P Listed) Ethanimidothioc acid, 2-(dimethylamino)-N-[[(methylamino) carbonyl]oxy]-2-oxo-, methyl ester. 23135-22-0 EPA Acutely Toxic (P Listed) Ethanimidothioic acid, 16752-77-5 EPA Acutely Toxic (P Listed) 79 Full Chemical Name CAS # Reference ethanol amine dinitrate DOT Forbidden ethidium bromide 1239-45-8 Potent mutagen ethinyloestradiol 57-63-6 IARC List of Known and Suspected Human Carcinogens ethion 563-12-2 IARC List of Known and Suspected Human Carcinogens Ethyl 3,3-di-(tert-amylperoxy)butyrate 67567-23-1 49CFR173.225 Ethyl 3,3-di-(tert-butylperoxy)butyrate 55794-20-2 49CFR173.225 ethyl acrylate 140-88-5 IARC List of Known and Suspected Human Carcinogens Ethyl cyanide 107-12-0 EPA Acutely Toxic (P Listed) ethyl hydroperoxide DOT Forbidden ethyl methanesulfonate 62-50-0 IARC List of Known and Suspected Human Carcinogens ethyl perchlorate DOT Forbidden Ethylencimine OSHA Listed Chemicals ethylene diamine diperchlorate DOT Forbidden Ethylene Dibromide 106-93-4 Select Carcinogen ethylene dichloride [1,2-dichloroethane] 107-06-2 IARC List of Known and Suspected Human Carcinogens Ethylene Glycol Dimethyl Ether 110-71-4 Peroxidizable Ethylene Glycol Monoethyl Ether 110-80-5 Peroxidizable, Reproductive Toxin Ethylene Glycol Monomethyl Ether 109-86-4 Peroxidizable, Reproductive Toxin Ethylene Oxide 75-21-8 Reproductive Toxin, Select Carcinogen ethylene thiourea 96-45-7 IARC List of Known and Suspected Human Carcinogens Ethylenimine 151-56-4 Select Carcinogen ethyl-n-nitrosourea, n- 759-73-9 IARC List of Known and Suspected Human Carcinogens ethynodiol diacetate 297-76-7 IARC List of Known and Suspected Human Carcinogens eugenol [oil of cloves] 97-53-0 IARC List of Known and Suspected Human Carcinogens Famphur 52-85-7 EPA Acutely Toxic (P Listed) Fluorine 7782-41-4 EPA Acutely Toxic (P Listed) Fluoroacetamide 640-19-7 EPA Acutely Toxic (P Listed) Fluoroacetic acid, sodium salt 62-74-8 EPA Acutely Toxic (P Listed) fluorouracil 51-21-8 IARC List of Known and Suspected Human Carcinogens Formaldehyde (Any solution or product with greater than .1%) 50-00-0 Select Carcinogen Formetanate hydrochloride. 23422-53-9 EPA Acutely Toxic (P Listed) Formparanate. 17702-57-7 EPA Acutely Toxic (P Listed) formylhydrazino)-4-(nitro-2-furyl)thiazole, 2-(2- 3570-75-0 IARC List of Known and Suspected Human Carcinogens Fulminic acid, mercury(2+) salt (R,T) 628-86-4 EPA Acutely Toxic (P Listed) Furan 110-00-9 Peroxidizable furfaltadone IARC List of Known and Suspected Human Carcinogens glu-p-1(2-amino-6methyldipyrido[1,2-a:3',2'-d]imidazole 67730-11-4 IARC List of Known and Suspected Human Carcinogens glu-p-2(2-aminodipyrido[1,2-a:3',2'-d]imidazole 67730-10-3 IARC List of Known and Suspected Human Carcinogens 80 Full Chemical Name CAS # Reference glycerol gluconate trinitrate DOT Forbidden glycerol-1, 3-dinitrate DOT Forbidden glycidaldehyde 765-34-4 IARC List of Known and Suspected Human Carcinogens griseofulvin 126-07-8 IARC List of Known and Suspected Human Carcinogens guanyl nitrosaminoguanylidene hydrazine DOT Explosive guanyl nitrosaminoguanylidene hydrazine DOT Forbidden gyromitrin [acetaldeyde formylmethylhydrazone] 16568-02-8 IARC List of Known and Suspected Human Carcinogens Heptachlor 76-44-8 EPA Acutely Toxic (P Listed) hexachlorobutadiene 87-68-3 IARC List of Known and Suspected Human Carcinogens hexachlorocyclohexane isomers [e.g. lindane] IARC List of Known and Suspected Human Carcinogens Hexaethyl tetraphosphate 757-58-4 EPA Acutely Toxic (P Listed) hexamethylene triperoxide diamine DOT Forbidden Hexamethylphosphoramide 680-31-9 Select Carcinogen hexanitroazoxy benzene DOT Forbidden hexanitrodiphenyl urea DOT Forbidden hexanitrodiphenylamine 131-73-7 DOT Explosive hexanitrostilbene 49850-40-0 DOT Explosive hydralazine 86-54-4 IARC List of Known and Suspected Human Carcinogens Hydrazine 302-01-2 Select Carcinogen hydrazine sulfate 10034-93-2 IARC List of Known and Suspected Human Carcinogens Hydrazine, methyl- 60-34-4 EPA Acutely Toxic (P Listed) Hydrazinecarbothioamide 79-19-6 EPA Acutely Toxic (P Listed) hydrazobenzene 122-66-7 IARC List of Known and Suspected Human Carcinogens Hydrocyanic acid 74-90-8 EPA Acutely Toxic (P Listed) hydrocyanic acid 74-90-8 DOT Forbidden Hydrofluoric Acid 7664-39-3 Acutely Toxic Hydrogen cyanide 74-90-8 EPA Acutely Toxic (P Listed) Hydrogen Fluoride 7664-39-3 Acutely Toxic Hydrogen phosphide 7803-51-2 EPA Acutely Toxic (P Listed) hyponitrous acid DOT Forbidden indeno[1,2,3-cd]pyrene 193-39-5 IARC List of Known and Suspected Human Carcinogens Inorganic arsenic OSHA Listed Chemicals iron dextran complex 9004-66-4 IARC List of Known and Suspected Human Carcinogens Isodrin 465-73-6 EPA Acutely Toxic (P Listed) Isolan. 119-38-0 EPA Acutely Toxic (P Listed) isonizid [isonicotinic acid hydrazide] 54-85-3 IARC List of Known and Suspected Human Carcinogens Isopropyl Ether 108-20-3 Peroxidizable Isopropylcumyl hydroperoxide 57242-90-7 49CFR173.225 isosafrole 120-58-1 IARC List of Known and Suspected Human Carcinogens kepone [chlordecone] 143-50-0 IARC List of Known and Suspected Human Carcinogens lasiocarpine 303-34-4 IARC List of Known and Suspected Human 81 Full Chemical Name CAS # Reference Carcinogens Lead and lead compounds 7439-92-1 Reproductive Toxin lead mononitroresorcinate 51317-24-9 DOT Explosive lead styphnate 15245-44-0 DOT Explosive lindane 58-89-9 IARC List of Known and Suspected Human Carcinogens Manganese dimethyldithiocarbamate. 15339-36-3 EPA Acutely Toxic (P Listed) Manganese, bis(dimethylcarbamodithioato-S,S Œ)-, 15339-36-3 EPA Acutely Toxic (P Listed) mannitol hexanitrate 15825-70-4 DOT Explosive m-Cumenyl methylcarbamate. 64-00-6 EPA Acutely Toxic (P Listed) mea-alpha-c [2-amino-3-methyl-9H-pyrido[2,3-b]indole] IARC List of Known and Suspected Human Carcinogens medroxyprogesterone acetate 71-58-9 IARC List of Known and Suspected Human Carcinogens megestrol acetate 595-33-5 IARC List of Known and Suspected Human Carcinogens Melphalan 148-82-3 Select Carcinogen melphalan [alkeran] 148-82-3 IARC List of Known and Suspected Human Carcinogens mercaptopurine, 6- 50-44-2 IARC List of Known and Suspected Human Carcinogens Mercury 7439-97-6 Reproductive Toxin mercury fulminate 628-86-4 DOT Explosive Mercury fulminate (R,T) 628-86-4 EPA Acutely Toxic (P Listed) Mercury, (acetato-O)phenyl- 62-38-4 EPA Acutely Toxic (P Listed) merphalan 531-76-0 IARC List of Known and Suspected Human Carcinogens mestranol 72-33-3 IARC List of Known and Suspected Human Carcinogens Methanamine, N-methyl-N-nitroso- 62-75-9 EPA Acutely Toxic (P Listed) Methane, isocyanato- 624-83-9 EPA Acutely Toxic (P Listed) Methane, oxybis[chloro- 542-88-1 EPA Acutely Toxic (P Listed) Methane, tetranitro- (R) 509-14-8 EPA Acutely Toxic (P Listed) Methanethiol, trichloro- 75-70-7 EPA Acutely Toxic (P Listed) Methanimidamide, N,N-dimethyl-N Œ-[2-methyl-4- [[(methylamino)carbonyl]oxy]phenyl]- 23422-53-9 EPA Acutely Toxic (P Listed) Methanimidamide, N,N-dimethyl-N Œ-[3-[[(methylamino)- carbonyl]oxy]phenyl]-, monohydrochloride. 17702-57-7 EPA Acutely Toxic (P Listed) Methiocarb. 2032-65-7 EPA Acutely Toxic (P Listed) Methomyl 16752-77-5 EPA Acutely Toxic (P Listed) methotrexate [trade name=mexate or folex] 59-05-2 IARC List of Known and Suspected Human Carcinogens methoxsalen therapy [PUVA] IARC List of Known and Suspected Human Carcinogens methoxypsoralen, 5- 484-20-8 IARC List of Known and Suspected Human Carcinogens Methyl Acetylene 74-99-7 Peroxidizable methyl bromide 74-83-9 IARC List of Known and Suspected Human Carcinogens methyl chloride 74-87-3 IARC List of Known and Suspected Human Carcinogens Methyl chloromethyl ether 107-30-2 OSHA Listed Chemicals Methyl ethyl ketone peroxide 1338-23-4 49CFR173.225 Methyl Fluorosulfate 421-20-5 Acutely Toxic 82 Full Chemical Name CAS # Reference Methyl hydrazine 60-34-4 EPA Acutely Toxic (P Listed) methyl hydrazine [monomethyl hydrazine] 60-34-4 IARC List of Known and Suspected Human Carcinogens methyl iodide 74-88-4 IARC List of Known and Suspected Human Carcinogens Methyl Isobutyl Ketone 108-10-1 Peroxidizable Methyl isobutyl ketone peroxide 28056-59-9 49CFR173.225 Methyl isocyanate 624-83-9 EPA Acutely Toxic (P Listed) methyl methanesulfonate 66-27-3 IARC List of Known and Suspected Human Carcinogens Methyl parathion 298-00-0 EPA Acutely Toxic (P Listed) methyl-1-nitroanthraquinone, 2- 129-15-7 IARC List of Known and Suspected Human Carcinogens methylaziridine, 2- [propyleneimine] 75-55-8 IARC List of Known and Suspected Human Carcinogens methylazoxymethanol and its acetate 590-96-5 and 592-62- 1 IARC List of Known and Suspected Human Carcinogens methylchrysene, 2- 3351-32-4 IARC List of Known and Suspected Human Carcinogens methylchrysene, 3- 3351-31-3 IARC List of Known and Suspected Human Carcinogens methylchrysene, 4- 3351-30-2 IARC List of Known and Suspected Human Carcinogens methylchrysene, 5- 3697-24-3 IARC List of Known and Suspected Human Carcinogens methylchrysene, 6- 1705-85-7 IARC List of Known and Suspected Human Carcinogens Methylcyclohexanone peroxide 11118-65-3 49CFR173.225 Methylcyclopentane 96-37-7 Peroxidizable methylenbis(n,n-dimethylaniline), 4,4'- 101-61-1 IARC List of Known and Suspected Human Carcinogens methylene bis(2-chloroaniline), 4,4'- [MOCA] 101-14-4 IARC List of Known and Suspected Human Carcinogens methylene bis(n,n-dimethyl)benzeneamine, 4,4'- 101-61-1 IARC List of Known and Suspected Human Carcinogens Methylene chloride 75-09-2 OSHA Listed Chemicals Methylenedianiline 101-77-9 OSHA Listed Chemicals methylenedianiline, 4,4'- 101-77-9 IARC List of Known and Suspected Human Carcinogens methyl-n'-nitro-n-nitrosoguanidine, n- [MNNG] 70-25-7 IARC List of Known and Suspected Human Carcinogens methyl-n-nitrosourethane, n- 615-53-2 IARC List of Known and Suspected Human Carcinogens methylthiouracil 56-04-2 IARC List of Known and Suspected Human Carcinogens Metolcarb. 1129-41-6 EPA Acutely Toxic (P Listed) metronidazole 443-48-1 IARC List of Known and Suspected Human Carcinogens Mexacarbamate. 315-18-4 EPA Acutely Toxic (P Listed) michler's ketone 90-94-8 IARC List of Known and Suspected Human Carcinogens mirex 2385-85-5 IARC List of Known and Suspected Human Carcinogens 83 Full Chemical Name CAS # Reference mitomycin C 50-07-7 IARC List of Known and Suspected Human Carcinogens monocrotaline 315-22-0 IARC List of Known and Suspected Human Carcinogens morpholinomethyl-3-[(5-nitrofurfurylidene)amino]-2- oxazolidinone, 5-( 3795-88-8 IARC List of Known and Suspected Human Carcinogens Mustard Gas Select Carcinogen myleran [1,4-butanediol dimethanesulfonate] 55-98-1 IARC List of Known and Suspected Human Carcinogens N,N'- Dinitrosopentamethylenetetramine 101-25-7 49CFR 173.224 N,N'-Dinitroso-N, N'-dimethyl-terephthalamide 133-55-1 49CFR 173.224 N-[[(methylamino)carbonyl]oxy]-, methyl ester EPA Acutely Toxic (P Listed) nafenopin 3771-19-5 IARC List of Known and Suspected Human Carcinogens naphthylamine, 1- 134-32-7 IARC List of Known and Suspected Human Carcinogens naphthylamine, 2- 91-59-8 IARC List of Known and Suspected Human Carcinogens n-Butyl peroxydicarbonate DOT Forbidden n-Butyl-4,4-di-(tert-butylperoxy)valerate 995-33-5 49CFR173.225 N-Formyl-2-(nitromethylene)-1,3-perhydrothiazine 49CFR 173.224 nickel and some nickel compounds 7440-02-0 IARC List of Known and Suspected Human Carcinogens Nickel Carbonyl 13463-39-3 Acutely Toxic, Select Carcinogen Nickel carbonyl Ni(CO)4, (T-4)- 13463-39-3 EPA Acutely Toxic (P Listed) Nickel cyanide 557-19-7 EPA Acutely Toxic (P Listed) Nickel cynaide Ni(CN)2 557-19-8 EPA Acutely Toxic (P Listed) Nicotine, & salts 54-11-5 EPA Acutely Toxic (P Listed) nifuradene(1-[(5-nitrofurfurylidene)amino]-2-imidazolinone) IARC List of Known and Suspected Human Carcinogens niridazole 61-57-4 IARC List of Known and Suspected Human Carcinogens nithiazide 139-94-6 IARC List of Known and Suspected Human Carcinogens Nitric oxide 10102-43-9 EPA Acutely Toxic (P Listed) nitrilotriacetic acid 139-13-9 IARC List of Known and Suspected Human Carcinogens nitro urea 556-89-8 DOT Explosive nitro-2-furyl)-2-thiazolyl]acetamide, n-[4-(5- 531-82-8 IARC List of Known and Suspected Human Carcinogens nitroacenaphthene, 5- 602-87-9 IARC List of Known and Suspected Human Carcinogens nitroanisole, o- 91-23-6 IARC List of Known and Suspected Human Carcinogens nitrobiphenyl, 4- 92-93-3 IARC List of Known and Suspected Human Carcinogens nitrocellulose 9004-70-0 DOT Explosive nitrochrysene, 6- 7496-02-8 IARC List of Known and Suspected Human Carcinogens nitrofen 1836-75-5 IARC List of Known and Suspected Human Carcinogens Nitrogen dioxide 10102-44-0 EPA Acutely Toxic (P Listed) nitrogen mustard [trade name=mustargen] 51-75-2 IARC List of Known and Suspected Human Carcinogens 84 Full Chemical Name CAS # Reference nitrogen mustard n-oxide 126-85-2 IARC List of Known and Suspected Human Carcinogens Nitrogen oxide NO 10102-43-9 EPA Acutely Toxic (P Listed) Nitrogen oxide NO2 10102-44-0 EPA Acutely Toxic (P Listed) nitrogen trichloride 10025-85-1 DOT Forbidden nitroglycerin 55-63-0 DOT Explosive Nitroglycerine (R) 55-63-0 EPA Acutely Toxic (P Listed) nitroguanidine 556-88-7 DOT Explosive nitro-ortho-anisidine, 5- 99-59-2 IARC List of Known and Suspected Human Carcinogens nitropropane, 2- 25322-01-4 IARC List of Known and Suspected Human Carcinogens nitropyrene, 1- 5522-43-0 IARC List of Known and Suspected Human Carcinogens nitropyrene, 4- IARC List of Known and Suspected Human Carcinogens nitrosoamines (chemical name includes nitroso) IARC List of Known and Suspected Human Carcinogens nitrosodiethanolamine, n- IARC List of Known and Suspected Human Carcinogens nitrosodiethylamine, n- 55-18-5 IARC List of Known and Suspected Human Carcinogens nitrosodimethylamine, p- 62-75-9 IARC List of Known and Suspected Human Carcinogens nitrosodi-n-butylamine, n- IARC List of Known and Suspected Human Carcinogens nitrosodi-n-propylamine, n- IARC List of Known and Suspected Human Carcinogens nitrosomethylamino)-1-(3-pyrdyl)-1-butanone, 4-(n- 64091-91-4 IARC List of Known and Suspected Human Carcinogens nitrosomethylamino)propionitrile, 3-(n- 60153-49-3 IARC List of Known and Suspected Human Carcinogens nitrosomethylethylamine, n- 10595-95-6 IARC List of Known and Suspected Human Carcinogens nitrosomethylvinylamine, n- 4549-40-0 IARC List of Known and Suspected Human Carcinogens nitrosomorpholine, n- 59-89-2 IARC List of Known and Suspected Human Carcinogens nitroso-n-ethylurea, n- 759-73-9 IARC List of Known and Suspected Human Carcinogens nitroso-n-methylurea, n- 684-93-5 IARC List of Known and Suspected Human Carcinogens nitrosonornicotine, n- 80508-23-2 IARC List of Known and Suspected Human Carcinogens nitrosopiperidine, n- 100-75-4 IARC List of Known and Suspected Human Carcinogens nitrosopyrrolidine, n- 930-55-2 IARC List of Known and Suspected Human Carcinogens nitrososarcosine, n- 13256-22-9 IARC List of Known and Suspected Human Carcinogens nitrostarch 9056-38-6 DOT Explosive nitrotriazolone DOT Explosive n-n'-Dichlorazodicarbonamidine DOT Forbidden N-Nitrosodimethylamine 62-75-9 EPA Acutely Toxic (P Listed) 85 Full Chemical Name CAS # Reference N-Nitrosomethylvinylamine 4549-40-0 EPA Acutely Toxic (P Listed) norethisterone 68-22-4 IARC List of Known and Suspected Human Carcinogens norethynodrel 68-23-5 IARC List of Known and Suspected Human Carcinogens O,O-Diethyl O-pyrazinyl phosphorothioate 297-97-2 EPA Acutely Toxic (P Listed) O-[(methylamino)carbonyl]oxime EPA Acutely Toxic (P Listed) O-[4-[(dimethylamino)sulfonyl]phenyl] O,O-dimethyl ester EPA Acutely Toxic (P Listed) ochratoxin A 303-47-9 IARC List of Known and Suspected Human Carcinogens Octamethylpyrophosphoramide 152-16-9 EPA Acutely Toxic (P Listed) octolite DOT Explosive octonal DOT Explosive oestradiol-17 beta IARC List of Known and Suspected Human Carcinogens oestrone 53-16-7 IARC List of Known and Suspected Human Carcinogens oil or orange SS 2646-17-5 IARC List of Known and Suspected Human Carcinogens Osmium oxide OsO4, (T-4)- 20816-12-0 EPA Acutely Toxic (P Listed) Osmium tetroxide 20816-12-0 EPA Acutely Toxic (P Listed) Oxamyl. 23135-22-0 EPA Acutely Toxic (P Listed) oxydianiline, 4,4'- 101-80-4 IARC List of Known and Suspected Human Carcinogens oxymentholone IARC List of Known and Suspected Human Carcinogens Ozone 10028-15-6 Acutely Toxic panfuran S [dihydroxymethylfuratizine] 794-93-4 IARC List of Known and Suspected Human Carcinogens Parathion 56-38-2 EPA Acutely Toxic (P Listed) p-Chloroaniline 106-47-8 EPA Acutely Toxic (P Listed) p-Diazidobenzene DOT Forbidden Peracetic acid 79-21-0 49CFR173.225 Peroxyacetic acid 79-21-0 49CFR173.225 petasitenine 60102-37-6 IARC List of Known and Suspected Human Carcinogens phenacetin 62-44-2 IARC List of Known and Suspected Human Carcinogens phenazopyridine 94-78-0 IARC List of Known and Suspected Human Carcinogens phenazopyridine hydrochloride 136-40-3 IARC List of Known and Suspected Human Carcinogens phenelzine 51-71-8 IARC List of Known and Suspected Human Carcinogens phenobarbital 50-06-6 IARC List of Known and Suspected Human Carcinogens Phenol, (3,5-dimethyl-4-(methylthio)-, methylcarbamate 2032-65-7 EPA Acutely Toxic (P Listed) Phenol, 2-(1-methylpropyl)-4,6-dinitro- 88-85-7 EPA Acutely Toxic (P Listed) Phenol, 2,4,6-trinitro-, ammonium salt (R) 131-74-8 EPA Acutely Toxic (P Listed) Phenol, 2,4-dinitro- 51-28-5 EPA Acutely Toxic (P Listed) Phenol, 2-cyclohexyl-4,6-dinitro- 131-89-5 EPA Acutely Toxic (P Listed) Phenol, 2-methyl-4,6-dinitro-, & salts 534-52-1 EPA Acutely Toxic (P Listed) Phenol, 3-(1-methylethyl)-, methyl carbamate. 64-00-6 EPA Acutely Toxic (P Listed) Phenol, 3-methyl-5-(1-methylethyl)-, methyl carbamate. 2631-37-0 EPA Acutely Toxic (P Listed) 86 Full Chemical Name CAS # Reference Phenol, 4-(dimethylamino)-3,5-dimethyl-, methylcarbamate (ester). 315-18-4 EPA Acutely Toxic (P Listed) phenoxybenzamine and its hydrochloride 59-96-1 IARC List of Known and Suspected Human Carcinogens phenyl-beta-naphthylamine, n- 135-88-6 IARC List of Known and Suspected Human Carcinogens Phenylmercury acetate 62-38-4 EPA Acutely Toxic (P Listed) phenylphenol, o- 90-43-7 IARC List of Known and Suspected Human Carcinogens Phenylthiourea 103-85-5 EPA Acutely Toxic (P Listed) phenytoin (and its sodium salts) 57-41-0 IARC List of Known and Suspected Human Carcinogens Phorate 298-02-2 EPA Acutely Toxic (P Listed) Phosgene 75-44-5 EPA Acutely Toxic (P Listed) Phosphine 7803-51-2 EPA Acutely Toxic (P Listed) Phosphoric acid, diethyl 4-nitrophenyl ester 311-45-5 EPA Acutely Toxic (P Listed) Phosphorodithioic acid, O,O-diethyl 298-04-4 EPA Acutely Toxic (P Listed) Phosphorodithioic acid, O,O-dimethyl S-[2-(methylamino)-2- oxoethyl] ester 60-51-5 EPA Acutely Toxic (P Listed) Phosphorofluoridic acid, bis(1-methylethyl) ester 55-91-4 EPA Acutely Toxic (P Listed) Physostigmine salicylate. 57-64-7 EPA Acutely Toxic (P Listed) Physostigmine. 57-47-6 EPA Acutely Toxic (P Listed) Pinanyl hydroperoxide 28324-52-9 49CFR173.225 Plumbane, tetraethyl- 78-00-2 EPA Acutely Toxic (P Listed) p-Menthyl hydroperoxide 26762-92-5 49CFR173.225 p-Nitroaniline 100-01-6 EPA Acutely Toxic (P Listed) polybrominated biphenyls [PBBs] 67774-32-7 IARC List of Known and Suspected Human Carcinogens polychlorinated biphenyls [PCBs] 53469-21-9 IARC List of Known and Suspected Human Carcinogens ponceau 3R 3564-09-8 IARC List of Known and Suspected Human Carcinogens ponceau MX 3761-53-3 IARC List of Known and Suspected Human Carcinogens Potassium 7440-09-7 Peroxidizable Potassium cyanide 151-50-8 EPA Acutely Toxic (P Listed) Potassium silver cyanide 506-61-6 EPA Acutely Toxic (P Listed) procarbazine 671-16-9 IARC List of Known and Suspected Human Carcinogens procarbazine hydrochloride trade name=matulan 366-70-1 IARC List of Known and Suspected Human Carcinogens Promecarb 2631-37-0 EPA Acutely Toxic (P Listed) Propanal, 2-methyl-2-(methyl-sulfonyl)-, O- [(methylamino)carbonyl] oxime. 1646-88-4 EPA Acutely Toxic (P Listed) Propanal, 2-methyl-2-(methylthio)-, 116-06-3 EPA Acutely Toxic (P Listed) propane sultone, 1,3- 1120-71-4 IARC List of Known and Suspected Human Carcinogens Propanenitrile 107-12-0 EPA Acutely Toxic (P Listed) Propanenitrile, 2-hydroxy-2-methyl- 75-86-5 EPA Acutely Toxic (P Listed) Propanenitrile, 3-chloro- 542-76-7 EPA Acutely Toxic (P Listed) Propargyl alcohol 107-19-7 EPA Acutely Toxic (P Listed) propiolactone, beta- 57-57-8 IARC List of Known and Suspected Human Carcinogens propylene dichloride [1,2-dichloropropane] 78-87-5 IARC List of Known and Suspected Human 87 Full Chemical Name CAS # Reference Carcinogens propylene oxide 75-56-9 IARC List of Known and Suspected Human Carcinogens propyleneimine [1,2-propylenimine or 2-methylaziridine] 75-55-8 IARC List of Known and Suspected Human Carcinogens propylthiouracil 51-52-5 IARC List of Known and Suspected Human Carcinogens Pyridine, 3-(1-methyl-2-pyrrolidinyl)-, (S)-, & salts 54-11-5 EPA Acutely Toxic (P Listed) quercetin 117-39-5 IARC List of Known and Suspected Human Carcinogens Radioactive Materials (Non-Excempt ) OSHA Listed Chemicals reserpine 50-55-5 IARC List of Known and Suspected Human Carcinogens S-[(ethylthio)methyl] ester EPA Acutely Toxic (P Listed) S-[2-(ethylthio)ethyl] ester EPA Acutely Toxic (P Listed) safrole 94-59-7 IARC List of Known and Suspected Human Carcinogens Selenious acid, dithallium(1+) salt 12039-52-0 EPA Acutely Toxic (P Listed) selenium sulfide 7488-56-4 IARC List of Known and Suspected Human Carcinogens Selenourea 630-10-4 EPA Acutely Toxic (P Listed) senkirkine 2318-18-5 IARC List of Known and Suspected Human Carcinogens Silver cyanide 506-64-9 EPA Acutely Toxic (P Listed) Sodium 2-diazo-1-naphthol-4-sulphonate 49CFR 173.224 Sodium 2-diazo-1-naphthol-5-sulphonate 2657-00-3 49CFR 173.224 Sodium Amide 7782-92-5 Peroxidizable Sodium azide 26628-22-8 EPA Acutely Toxic (P Listed) Sodium cyanide 143-33-9 EPA Acutely Toxic (P Listed) sodium metal 7440-23-5 Water Reactive sodium o-phenylphenate 132-27-4 IARC List of Known and Suspected Human Carcinogens spironolactone 52-01-7 IARC List of Known and Suspected Human Carcinogens sterigmatocystin 10048-13-2 IARC List of Known and Suspected Human Carcinogens streptozotocin 18883-66-4 IARC List of Known and Suspected Human Carcinogens Strychnidin-10-one, & salts 57-24-9 EPA Acutely Toxic (P Listed) Strychnidin-10-one, 2,3-dimethoxy- 35757-3 EPA Acutely Toxic (P Listed) Strychnine, & salts 57-24-9 EPA Acutely Toxic (P Listed) Styrene 100-42-5 Peroxidizable styrene oxide 96-09-3 IARC List of Known and Suspected Human Carcinogens sulfallate 95-06-7 IARC List of Known and Suspected Human Carcinogens sulfamethoxazole 723-46-6 IARC List of Known and Suspected Human Carcinogens Sulfuric acid, dithallium(1+) salt 7446-18-6 EPA Acutely Toxic (P Listed) symphytine 22571-95-5 IARC List of Known and Suspected Human Carcinogens telone II (mostly 1,3-dichloropropene) 542-75-6 IARC List of Known and Suspected Human Carcinogens tert-Amyl hydroperoxide 3425-61-4 49CFR173.225 88 Full Chemical Name CAS # Reference tert-Amyl peroxy-2-ethylhexanoate 686-31-7 49CFR173.225 tert-Amyl peroxy-2-ethylhexyl carbonate 70833-40-8 49CFR173.225 tert-Amyl peroxybenzoate 4511-39-1 49CFR173.225 tert-Amyl peroxyneodecanoate 68299-16-1 49CFR173.225 tert-Amyl peroxypivalate 29240-17-3 49CFR173.225 tert-Amylperoxy-3,5,5-trimethylhexanoate 49CFR173.225 tert-Butoxycarbonyl azide DOT Forbidden tert-Butyl cumyl peroxide 30580-75-7 49CFR173.225 tert-Butyl hydroperoxide 75-91-2 49CFR173.225 tert-Butyl monoperoxymaleate 1931-62-0 49CFR173.225 tert-Butyl monoperoxyphthalate 15042-77-0 49CFR173.225 tert-Butyl peroxy-2-ethylhexanoate 3006-82-4 49CFR173.225 tert-Butyl peroxy-2-ethylhexylcarbonate 49CFR173.225 tert-Butyl peroxy-2-methylbenzoate 22313-62-8 49CFR173.225 tert-Butyl peroxy-3,5,5-trimethylhexanoate 13122-18-4 49CFR173.225 tert-Butyl peroxyacetate 107-71-1 49CFR173.225 tert-Butyl peroxyacetate DOT Forbidden tert-Butyl peroxybenzoate 614-45-9 49CFR173.225 tert-Butyl peroxybutyl fumarate 49CFR173.225 tert-Butyl peroxycrotonate 23474-91-1 49CFR173.225 tert-Butyl peroxydiethylacetate 2550-33-6 49CFR173.225 tert-Butyl peroxyisobutyrate 109-13-7 49CFR173.225 tert-Butyl peroxyneodecanoate 26748-41-4 49CFR173.225 tert-Butyl peroxyneoheptanoate 26748-38-9 49CFR173.225 tert-Butyl peroxypivalate 927-07-2 49CFR173.225 tert-Butylperoxy isopropylcarbonate 2372-21-6 49CFR173.225 tert-Butylperoxystearylcarbonate 49CFR173.225 tert-Hexyl peroxypivalate 51938-28-4 49CFR173.225 tert-Hexylperoxyneodecanoate 49CFR173.225 testosterone and its esters 58-22-0 IARC List of Known and Suspected Human Carcinogens tetrachlorodibenzo-dioxin [TCDD] IARC List of Known and Suspected Human Carcinogens tetrachlorodibenzo-p-dioxin, 2,3,7,8- [TCDD] 1746-01-6 IARC List of Known and Suspected Human Carcinogens tetrachloroethylene [perchloroethylene] 127-18-4 IARC List of Known and Suspected Human Carcinogens tetrachlorvinphos 22248-79-9 IARC List of Known and Suspected Human Carcinogens Tetraethyl lead 78-00-2 EPA Acutely Toxic (P Listed) Tetraethyl pyrophosphate 107-49-3 EPA Acutely Toxic (P Listed) Tetraethyldithiopyrophosphate 3689-24-5 EPA Acutely Toxic (P Listed) Tetrafluoroethylene 116-14-3 Peroxidizable Tetrahydrofuran 109-99-9 Peroxidizable Tetralin 119-64-2 Peroxidizable Tetramine palladium (II) nitrate 49CFR 173.224 Tetranitromethane (R) 509-14-8 EPA Acutely Toxic (P Listed) Tetraphosphoric acid, hexaethyl ester 757-58-4 EPA Acutely Toxic (P Listed) Thallic oxide 1314-32-5 EPA Acutely Toxic (P Listed) Thallium oxide Tl2 O3 1314-32-5 EPA Acutely Toxic (P Listed) Thallium(I) selenite 12039-52-0 EPA Acutely Toxic (P Listed) Thallium(I) sulfate 7446-18-6 EPA Acutely Toxic (P Listed) thioacetamide 62-55-5 IARC List of Known and Suspected Human Carcinogens 89 Full Chemical Name CAS # Reference thiodianiline, 4,4'- 139-65-1 IARC List of Known and Suspected Human Carcinogens thiotepa 52-24-4 IARC List of Known and Suspected Human Carcinogens thiourea 62-56-6 IARC List of Known and Suspected Human Carcinogens Thorium Dioxide Select Carcinogen tolidine, o- 119-93-7 IARC List of Known and Suspected Human Carcinogens Toluene 108-88-3 Reproductive Toxin toluene diisocyanate [TDI] 584-84-9 IARC List of Known and Suspected Human Carcinogens toluidine hydrochloride, o- 540-23-8 IARC List of Known and Suspected Human Carcinogens toluidine, o- 95-53-4 IARC List of Known and Suspected Human Carcinogens toluidine, p- 106-49-0 IARC List of Known and Suspected Human Carcinogens toxaphene 8001-35-2 IARC List of Known and Suspected Human Carcinogens Treosulfan 299-75-2 Select Carcinogen triafur [2-amino-5-(nitro-2-furyl)-1,3,4-thiadiazole] IARC List of Known and Suspected Human Carcinogens trichloroethane, 1,1,2- 79-00-5 IARC List of Known and Suspected Human Carcinogens trichloroethylene 79-01-6 IARC List of Known and Suspected Human Carcinogens trichlorophenol, 2,4,6- 88-06-2 IARC List of Known and Suspected Human Carcinogens trichloropropane, 1,2,3- 96-18-4 IARC List of Known and Suspected Human Carcinogens tris(1-aziridinyl)phosphine sulfide trade name=thiotepa 52-24-4 IARC List of Known and Suspected Human Carcinogens tris(2,3-dibromopropyl)phosphate 126-72-7 IARC List of Known and Suspected Human Carcinogens tris(aziridinyl)-p-benzoquione [triaziquone] 68-76-8 IARC List of Known and Suspected Human Carcinogens trp-P-1 [3-amino,1,4-dimethyl-5H-pyrido[4,3-b]indole] 62450-06-0 IARC List of Known and Suspected Human Carcinogens trp-P-2 [3-amino-1-methyl-5H-pyrido[4,3-b]indole] IARC List of Known and Suspected Human Carcinogens trypan blue 72-57-1 IARC List of Known and Suspected Human Carcinogens uracil mustard trade name=uramustine 66-75-1 IARC List of Known and Suspected Human Carcinogens urethane [ethyl carbamate] 51-79-6 IARC List of Known and Suspected Human Carcinogens Vinyl Actetate 108-05-4 Peroxidizable vinyl bromide 593-60-2 IARC List of Known and Suspected Human Carcinogens Vinyl Chloride 75-01-4 Peroxidizable, Reproductive Toxin, Select Carcinogen vinyl fluoride 75-02-5 IARC List of Known and Suspected Human Carcinogens 90 Full Chemical Name CAS # Reference Vinylacetylene 689-97-4 Peroxidizable vinylcyclohexene, 4- 100-40-3 IARC List of Known and Suspected Human Carcinogens vinylidene chloride [1,1-dichloroethylene] 75-35-4 IARC List of Known and Suspected Human Carcinogens vinylidene fluoride monomer 75-38-7 IARC List of Known and Suspected Human Carcinogens Vinylidine Chloride 75-35-4 Peroxidizable Vinylpyridine 1337-81-1 Peroxidizable Xylene 1330-20-7 Reproductive Toxin zearalenone 17924-92-4 IARC List of Known and Suspected Human Carcinogens zinc chromate 13530-65-9 IARC List of Known and Suspected Human Carcinogens