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! situations, such as the presence of flammable atmospheres, oxygen Aeficient environments, and toxic contaminants. once chemicals have been identified, standard information sources such as NIOSH Pocket Guide to Chemical Hazards and CHEMTREC (Chemical Transportation Emergency Center) should be consulted to identify potential hazards, recommended exposure limits (RELs), permissible exposure limits (PEW, emergency action, personal protective equipment, and first aid procedures. MSDSs should be consulted for information including; manufacturer's name, chemical synonyms, trade name, chemical family, hazardous ingredients, physical data, fire and explosion hazard data, health hazards, reactivity data, spill or leak procedures, special precautions, and special protection information. Local governments should institute a medical surveillance program for all emergency workers who are or may be exposed to hazardous substances or health hazards above the established recommended exposure limits (RELs) for 30 or more days in a 12 -month period, or who wear respirators 30 days or more a year. Medical examinations must be available for all emergency workers who may have been exposed to concentrations of hazardous substances above the recommended exposure limits. An accurate record of medical surveillance must be retained. 9.2.1 EPA Levels of Protection Based on the results of the preliminary evaluation, personal protective equipment must be selected and used. The selection process is aided by consulting the Department of Transportation's Hazardous Materials Emergency Response Guidebook and CHEMTREC. No single combination of protective equipment and clothing is capable of protecting against all hazards. Generally, the greater the level of personal protective equipment used, the greater the risk to the worker from such hazards as heat stress, physical and psychological stress, impaired vision, mobility and communication. Therefore, equipment should be selected that provides an adequate level of protection, but not over -protection. The U.S. Environmental Protection Agency (EPA) has identified four levels of protection of emergency workers. Level A (Chemical Protective Clothing and Equipment) will protect the wearer against the specific hazard for which it Indian diver County Emergency Plan for Hazardous Materials Page 111