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NASA
Procedural
Requirements

NPR 1800.1E
Effective Date: March 16, 2023
Expiration Date: March 16, 2028

COMPLIANCE IS MANDATORY FOR NASA EMPLOYEES

Subject: NASA Occupational Health Program Procedures

Responsible Office: Office of the Chief Health & Medical Officer

Chapter 3. Primary Prevention and Health Promotion

3.1 General

3.1.1 General

3.1.1.1 Primary prevention is the foundation of OH. NASA’s preventive and health promotion policies align with the DHHS (e.g., Total Worker Health and Healthy People) recommendations, guidelines, and goals. To promote a healthful work environment with commitment to the physical and mental health and productivity of the NASA workforce, Centers shall implement a prevention and health promotion program designed to increase employee awareness.

3.1.1.2 Prevention and health promotion programs may:

a. Encompass both health promotion and preventive health elements toward employees’ optimal health, health-risk reduction, and preventing illnesses and injuries.

b. Include collaborative partnerships among Center disciplines (e.g., medical, safety, environmental health, physical fitness, and employee assistance) to promote a holistic approach.

c. Focus on:

(1) Educating and encouraging employees to increase control over and improve their health, beyond individual behavior, and a wide range of social and environmental considerations.

(2) Educating employees about illnesses and conditions by conveying one or more interventions of proven efficacy.

3.1.2 Responsibilities

3.1.2.1 The OCHMO shall:

a. Designate an Agency Fitness/Wellness/Health Promotion Manager (hereinafter, Agency Fitness Manager). Duties of this position include frequent coordination and communications with Center points of contact regarding health promotion, fitness, wellness, safety, preventive health and similar activities and initiatives.

b. Coordinate, facilitate, and maintain an Agency-wide HPWF team (hereinafter, Mission: HEALTH Team), with representatives from all Centers.

c. Assist Centers with outreach and marketing Agency-wide to facilitate attendance and increase awareness of events, classes, campaigns, and similar activities, when requested.

d. Conduct at least one annual campaign, initiative, event, or similar Agency-wide activity to highlight physical fitness and encourage employees to begin or maintain a program to improve their overall health and wellness.

e. Serve as the conduit to coordinate and gather information and statistics from Centers related to health/wellness/fitness requests by other Federal agencies (e.g., OPM, DHHS, and DOL) and similar entities.

f. Maintain a section or sections on the Agency Health4Life website as an employee informational portal for health resources.

g. Conduct OCHMO-led and/or shared Center presentations on preventive health, health promotion, physical fitness, mental health, and similar topics for the benefit of the NASA workforce, at least three times per year.

h. Evaluate each Center’s approach to preventive health and health promotion as part of OCHMO’s triennial OH reviews and Center annual OH reviews.

3.1.2.2 To support Mission: HEALTH, Centers shall:

a. Designate at least two representatives to serve on the Agency’s Mission: HEALTH Team and attend the OCHMO quarterly team meetings.

b. Encourage all employees to participate and contribute ideas for Center-based health promotion initiatives.

c. Encourage Mission: HEALTH Team members and other Center OH representatives to promote and support OCHMO’s Agency-level communications, programs, initiatives, and campaigns to employees at their locations.

d. Provide the status of their Center-based inter-disciplinary health promotion program during Agency triennial OH reviews and Center annual OH reviews.

3.1.2.3 To support preventive health services, Centers shall:

a. Utilize various methods (e.g., educational presentations, health fairs, screenings, and individual counseling services) to ensure, annually, at least four topic-specific activities are conducted.

b. Ensure all activities (e.g., health screenings, classes, demonstrations, and presentations) are provided by qualified (e.g., licensed or certified) employees. Topics may include cardiovascular health, immunizations, injury prevention and safety, ergonomics, fitness, exercise and pre-participation screening, weight control/management, stress management and mental health, tobacco/vaping/smokeless- tobacco cessation, nutrition and diet, skin cancer prevention, and sleep hygiene.

3.2 Physical Fitness

3.2.1 General

Fitness facilities and their associated programs are offered to employees as resources to establish and maintain their physical and mental fitness and help prevent illness and disease.

3.2.2 Responsibilities

3.2.2.1 Centers shall:

a. Offer employee health services to promote and maintain physical and mental fitness and to help prevent illness and disease (e.g., exercise and weight control intervention programs) meeting the requirements of 41 CFR § 102-79.35, Assignment and Utilization of Space - Fitness Centers. OCHMO fitness facility policies are intended to meet OPM recommendations. OPM uses the most recent American College of Sports Medicine (ACSM) industry standards (e.g., facility design, equipment selection and maintenance, and safety) as the basis for their recommendations.

b. Encourage and advocate employee participation in activities such as organized walking events, aerobic exercise classes, weightlifting, yoga, spinning, and other activities to enhance cardiovascular and muscular endurance, strength, and flexibility.

c. Operate fitness facilities with hours of operation meeting most users' needs and work schedules. Center fitness facilities operate in NASA-funded space, which may also include swimming pools, indoor basketball courts, locker rooms, and restrooms.

Note: Center unstaffed fitness facilities (e.g., Armstrong Flight Research Center, Wallops Flight Facility, Michoud Assembly Facility, and JPL) are covered by requirements in this document.

d. Adhere to policies and procedures (e.g., orientation procedures, pre-participation screening, and safety) applicable to regular members and operations of such facilities.

e. Ensure applicable American National Standard Institute (ANSI), American Society for Testing and Materials, Americans with Disabilities Act (e.g., access points and signs that can be read by visually impaired) and OSHA (e.g., hazardous chemicals) signage is posted prominently in the fitness facility.

f. Provide the names (and update as necessary) of their fitness facility's primary and secondary points of contact to interface and communicate with the Agency Fitness Manager or designee.

g. Encourage and support employee utilization of the fitness facility and employee participation in health and wellness activities.

h. If operating a staffed fitness facility, ensure there is an individual responsible (e.g., fitness manager/director, wellness manager/director, or exchange manager) for the operation, maintenance, and oversight of the facility during regular operating hours.

i. If operating an unstaffed fitness facility, designate at least one primary and one secondary point of contact (e.g., exchange manager, volunteer safety/OHP representative, or medical clinic representative) to ensure applicable safety-related responsibilities listed for a fitness/wellness manager are accomplished.

j. If operating an unstaffed fitness facility, implement a method for members to alert an appropriate point of contact regarding unsafe equipment or other safety or maintenance concerns.

3.2.2.2 The Agency Fitness Manager or designee shall:

a. Interface and coordinate with Center fitness professional staff. Activities conducted by the Agency Fitness Manager and the Centers may include quarterly or ad hoc Mission: HEALTH meetings, promotion and marketing of OCHMO-based physical fitness campaigns and initiatives, and facilitating the sharing of Center-specific fitness/wellness presentations, events, and campaigns among the entire NASA workforce.

b. Conduct triennial OH reviews, pursuant to chapter 7.

c. Ensure at least one OCHMO-based annual health promotion, wellness, or fitness campaign is conducted to encourage improving and enhancing the workforce health and physical fitness.

d. Assist Centers in reviewing and providing recommendations for their fitness facility plans and similar documents, when requested.

3.2.2.3 For staffed fitness facilities, fitness/wellness managers, equivalent, or designees shall:

a. Communicate regularly with the Agency Fitness Manager or designee.

b. Track and update fitness professional staff certifications and licenses, ensure a safe environment for members, implement emergency procedures and participate in drills, supervise fitness professional staff, and ensure a process is in place for members to receive the appropriate level of pre-participation screening.

c. Ensure there is a process in place for a general weekly visual inspection of the fitness facility, including verification that entrances and exits are not blocked, trip hazards are addressed, water leaks are identified, and equipment is checked to identify unsafe items or items in disrepair.

d. Ensure Cardiopulmonary Resuscitation (CPR)/Basic Life Support (BLS) training is conducted within 30 days of hiring for all fitness professional staff (if not already certified), with training renewal completed based on Federal, state, and local requirements (usually every two years).

3.2.2.4 Fitness professional staff initiating health promotion and wellness activities, programs, or campaigns (e.g., cardiovascular screening) for which they do not possess adequate medical expertise/credentials shall ensure Clinic professional employees are actively involved.

3.2.3 Staffing, Certifications, and Qualifications

3.2.3.1 Fitness professional staff will possess the necessary competencies, certifications, licenses, and credentials for fulfilling their roles and responsibilities to ensure the safety of fitness facility members as described below.

3.2.3.2 In general, categories of fitness professional staff with the primary importance placed on responsibilities, expertise, and certification are (1) fitness/wellness manager, (2) fitness director, (3) personal trainer, (4) group exercise trainer/leader/instructor, and (5) administrative support. In some instances where the fitness facility falls under an Exchange, the Exchange Manager may opt to conduct facility operations, oversight, and communications in lieu of a fitness/wellness manager or fitness director.

3.2.3.3 All fitness professional staff responsible for daily operation of the fitness facility will maintain CPR/BLS certification and have received basic bloodborne pathogen training.

3.2.3.4 Fitness/wellness managers will possess a degree in a health and fitness related field or possess equivalent relevant experience, with at least one year of supervisory experience in the fitness industry and be professionally certified at an advanced level by a nationally recognized health or fitness organization.

3.2.3.5 Fitness professional staff and/or others employed who conduct group exercise classes will possess current certification in group exercise from the Aerobics and Fitness Association of America, ACSM, American Council on Exercise, National Strength and Conditioning Association, National Federation of Professional Trainers, or a comparable professional organization. They will also be CPR/BLS certified and have at least six months' experience in conducting group exercise classes.

3.2.3.6 Fitness professional staff providing services in allied health fields, such as nutrition or physical therapy/rehabilitation, will be certified, licensed, or registered within their state, as required by state law.

3.2.4 Membership and pre-screening/pre-participation

3.2.4.1 Fitness facility membership requires pre-participation screening.

3.2.4.2 Centers shall:

a. Use the most recent version of the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) or equivalent for all members of staffed and unstaffed fitness facilities. Determination of an equivalent questionnaire will be made in coordination with the appropriate OM staff. The questionnaire will provide the means for fitness facility members to identify whether a level of risk exists such that they should seek consultation from a qualified healthcare professional before engaging in physical activity (e.g., group exercises and/or cardio and strength training).

Note: The most recent version of the PAR-Q+ questionnaire is maintained on the Agency Health4Life website.

b. Not create excessive barriers (e.g., excessive application requirements and other administrative burdens) for employee utilization of the fitness facility nor participating in group exercise classes.

c. Implement a convenient method that enables employees from other Centers on official business travel to easily utilize their fitness facility, provided members have already been pre-screened for participation at their home Center’s fitness facility. Reciprocity for clearance at an employee’s home Center fitness facility will be recognized to avoid barriers and unnecessary complexities. The method used should be prominently described on the Center’s fitness website, including the process for transmitting information to other Centers so travelers are easily aware of the procedures.

3.2.4.3 Members shall complete initial pre-participation health screening (e.g., PAR-Q+),. Thereafter, annual health screening is required. If there is a change in a member’s health status at any point during membership, a more detailed screening may be required.

3.2.4.4 For both staffed and unstaffed fitness facilities, a qualified health/fitness/healthcare professional shall review all initial, annual, and additional health screening questionnaires and maintain documentation for at least one year, until the next health screening questionnaire is completed.

3.2.5 Member orientation

3.2.5.1 Centers shall:

a. Ensure a detailed written fitness facility orientation is offered to each new member, including a discussion of emergency procedures, fitness facility rules, the importance of spotters for applicable weight-training activities, and instructions on how to safely use all types of equipment in the facility. An OCHMO-developed orientation template is available for Centers’ use (under the Professional Resources tab) on the OHP website.

b. Conduct fitness facility orientations. Where staffed, this will be conducted by the fitness professional staff.

Note: Fitness facility orientations may be conducted face-to-face, one-on-one or by group and/or electronically through a Center’s website, by online sessions, by using in-house computer kiosks, or other means that will relay the information.

c. Obtain the signature of each member who has received an orientation indicating they understand the information provided.

d. Frequently remind members to clean hands before and after workouts with soap and water or hand sanitizer and to keep skin lesions covered with a clean, dry dressing/bandage. Prominent signage throughout the fitness facility may be used to amplify these reminders.

e. For both staffed and unstaffed fitness facilities, provide appropriate means for members (including members who are vision- or hearing-impaired or with special needs) to obtain additional information about the proper use of equipment, assistance with their personal fitness program, or a refresher orientation upon request

Note: This may be accomplished by posting instructions on the fitness facility website, conducting face-to-face demonstrations, and/or posting signs and information throughout the facility.

3.2.6 Fitness facility requirements

3.2.6.1 Centers shall include the following in fitness facilities:

a. Separate male and female shower facilities and locker rooms.

b. At least one exercise room/area large enough to safely accommodate pre-exercise stretching and/or group classes.

c. Flooring in specific areas conducive to, and appropriate for, activities performed in those areas (e.g., non-slip floors in all shower and locker room areas).

d. Space permitting, a variety of commercial-grade indoor exercise equipment (e.g., treadmills, stair climbers, strength-training machines, and free weights).

e. For interior physical activity areas, a large wall-mounted clock, a prominent chart/poster of target heart rates, and a prominent chart/poster depicting ratings of perceived exertion to enable members to monitor their activity.

f. An easily accessible first-aid kit containing bandages and gloves . For staffed facilities, this kit should be monitored by fitness personnel to ensure supplies are refreshed as necessary.

g. A notification system (e.g., buttons, pull cords, phones) in the fitness facility that includes prominent signage directing individuals where and how to call medical, first aid, and security. Inoperable or partially functioning emergency systems will be repaired immediately, with sign(s) posted to notify members of the system’s status and alternative methods for emergency assistance.

h. At least one prominently labeled AED available within a 1.5-minute walk to any location in the facility where it may be needed.

Note: As of 2022, states with AED legislation for health/fitness facilities include California, Louisiana, and Maryland.

i. Prominent (larger than 8.5 X 11) wall-mounted diagrams/schematics showing the facility exit routes in cases of emergency.

3.2.6.2 Centers shall ensure the following activities are conducted:

a. Solicitation and evaluation (e.g., survey tool located on fitness facility or other Center website) of Center employee (not just fitness facility members) comments and feedback, conducted at least annually to identify concerns and improvements regarding the quality of the fitness facility and associated programs.

b. Development and implementation of a method to identify (badge, keyed lock) members who have been screened and eligible to use the facility.

c. Utilization of a non-paper-based system for members to sign in each time they use the fitness facility. The software system/package can be on a non-networked, standalone computer and will, at a minimum, be able to generate reports showing daily or weekly utilization.

d. Implementation of a process for fitness facilities with saunas, where appropriately knowledgeable staff are available to instruct members on personal safety in these environments, especially regarding time limits for use, precautions if pregnant, medication use dangers, and/or cardiac/blood pressure precautions.

e. Establishment (for safety and in accordance with industry recommendations), of a method (e.g., real-time streaming wide-angle video cameras with continual monitoring by fire department/security) for unstaffed fitness facilities to monitor members whenever the facility is open so that if a health-related event occurs, victims can be afforded timely assistance.

f. Completion of a quarterly (at a minimum) safety walk-through in and around the fitness facility, in addition to the Center’s comprehensive annual safety program inspection.

3.2.7 Fitness facility equipment and special features

3.2.7.1 At all staffed and unstaffed fitness facilities, Centers shall:

a. Utilize commercial grade manual and electronic fitness equipment and accessories to reduce the number of repairs and extend the life of all items.

b. Employ a method to monitor recalls and alerts associated with fitness equipment and accessories to ensure safety of members and not rely solely on manufacturer notifications and alerts.

c. Conduct, at least weekly, a visual inspection using a prepared checklist to identify any broken or unsafe items at least weekly. For convenience, an OCHMO-developed checklist is available (under the Professional Resources tab) on the OHP website.

d. Remove or prominently tag all broken and/or unsafe equipment to disable and prevent its use.

e. At least twice per year, conduct a preventive maintenance program for fitness equipment, including formal documentation describing the work performed, the date the work was performed, and the name of the qualified individual or entity that performed the work.

f. If saunas are featured, ensure monitoring/warning systems are present so safe conditions are automatically maintained in these environments, along with posting prominent signage describing member health risks and time limits for use.

g. If saunas are featured, ensure they are professionally inspected at least annually, maintained, calibrated, and cleaned according to the manufacturer and industry recommendations.

h. If a swimming pool is featured, ensure water-chemistry safety requirements mandated by Federal, state, and local codes and regulations are met, including chemical storage/disposal and the availability of appropriate safety equipment (e.g., shepherd's crook, safety rope). This may require specific training of fitness facility personnel unless the Center arranges for an external professional company to conduct weekly maintenance.

3.2.8 Communication, promotion, and awareness

3.2.8.1 Centers shall:

a. Designate at least one effective method (e.g., electronic billboards outside the fitness facility, Center-wide e-mail communications, fitness facility website, bulletin boards located throughout the Center, or daily electronic newsletters) to communicate information to current members and the general workforce.

b. Include fitness facility benefits and information in health promotion and awareness communications, new employee orientations, campaigns, health fairs, and other similar events to encourage utilization toward the goal of improving employee physical fitness.

3.2.8.2 Fitness facility employees shall ensure communications related to available classes, campaigns, membership drives, health fairs, and health/wellness initiatives, etc., are promoted Center-wide vs. only to fitness members.

3.2.9 Fitness facility plan

3.2.9.1 Centers shall ensure all staffed and unstaffed fitness facilities have a written and dated plan that describes pertinent information about operations, requirements, points of contact, equipment maintenance, and sanitation. The plan may be also described as a program, manual, instructions, procedures, or guide and will be used as a reference for the individual(s) overseeing or managing the fitness facility. Ideally, the plan should be electronic for ease of use and updating. An OCHMO-developed template is available (under the Professional Resources tab) on the OHP website.

3.2.9.2 Centers shall include the following in their plans:

a. Date generated and latest date of revisions.

b. Program or point of contact responsible for developing and reviewing the plan.

c. Confirmation that the location/address of the facility and a map showing emergency exits and location(s) of AEDs are posted in prominent areas of the fitness facility.

d. Facility days and hours of operation and whether those days and hours are staffed.

e. Number and type of staff (e.g., exchange manager, fitness manager, group exercise instructors, fitness technicians) associated with the facility, as well as their qualifications, certifications, and responsibilities (this can be an appendix or other adaptable document that can be easily revised as conditions warrant).

f. Brief description of other resources, entities, agencies that participate in the program or contribute to its operations (e.g., Center tenants and contractors).

g. Description of the methods used to integrate the fitness program with other Center or Agency functions or related programs (e.g., medical, safety, employee assistance, protective services, and fire department).

h. Member pre-activity screening and orientation procedures used by the professional fitness staff or other designated employees. Centers may consider placing membership packets on their fitness websites for employees to download.

i. Brief description of instructions to members to wipe down free weights, fitness assessories and equipment (e.g., balls, bands, and straps), mats, and similar items after each use to address sweat, dirt, and build up.

j. Brief description of procedures utilized for handling broken equipment or equipment that is going to be permanently removed from service.

k. Brief description of how fitness facility staff safely handle bodily fluids (e.g., sweat, blood droplets, unknown fluids) and materials contaminated by bodily fluids (e.g., discarded clothing, used towels, razors, bar soap), including appropriate disposal as required by OSHA.

l. Brief description of how fitness facility staff or others handle and dispose of potentially hazardous materials (e.g., chemicals, cleaning agents, swimming pool chemicals, lubricants) and whether a hazardous communication plan is required or in place.

m. Emergency response procedures and a description of how required annual drills are conducted in the fitness facility and logged/documented to ensure adequate response to basic first-aid situations, external events (e.g., power outages, severe weather, and natural disasters) and more critical onsite incidents (e.g., heat illness, sudden cardiac arrest, heart attack, and stroke).

n. For unstaffed fitness facilities, emergency response procedures will include instructions regarding notification procedures for an emergency, the anticipated response time, and how an AED would be deployed to an impacted individual.

3.2.9.3 The plan will be stored in a location accessible by all fitness personnel and Center designated points of contract for unstaffed fitness facilities such that more than one person knows the location and its content. The plan will be reviewed at least annually to incorporate any new policies, procedures, or changes required due to new contracts or personnel changes.

3.2.10 Sanitation and janitorial

3.2.10.1 Centers shall:

a. Ensure clean disposable towels/wipes, anti-bacterial cleaning solution or similar supplies are prominently located and convenient to members to wipe off equipment.

b. Ensure all towels/wipes purchased by the Center for this purpose are compatible with sensitive electronic equipment, rubber materials, vinyl, and other surfaces found on exercise equipment and accessories.

c. Ensure prominently posted signage to remind members of wipe-off requirements.

d. For unstaffed fitness facilities, identify the methods and employees assigned to ensure items are cleaned at least weekly. Since janitorial staff contracts may not include wipe-downs of equipment and accessories and janitorial staff may not know safe cleansing procedures or solutions to be used on certain areas (e.g., electronics, metal, silicone, rubber, vinyl), points of contact need to be assigned to ensure sanitation.

e. Ensure sinks, toilets, and urinals are regularly cleaned and disinfected by appropriate janitorial employees on a schedule consistent with conditions in facilities used by a large volume of individuals on a frequent and daily basis.

f. Ensure floors in showers and locker rooms are cleaned by janitorial employees frequently enough to address the presence of mold, mildew, soap scum, and unhealthy conditions resulting from high utilization.

g. Ensure shower curtains are inspected regularly and cleaned or replaced whenever there is evidence of tears, rips, mold, mildew, soap scum, or other unsanitary conditions.

h. Ensure ventilation grills, vents, and mounted/portable fans in all areas of the fitness facility are visually inspected and cleaned by the appropriate employees to address dust, debris, and dirt build up on the grills and fan blades

i. Ensure all ice machines, portable water dispensers, drinking water bottle filling stations, drinking fountains and other similar amenities are maintained and sanitized according to manufacturer recommendations and other relevant requirements.

3.2.10.2 Janitorial support and frequency will be thorough. The cleaning frequency and protocols will be determined based on facility use, locker room and shower use, floor composition (e.g., carpeting, rubber mats, hardwood), member feedback, and inspection results. Centers shall:

a. Not utilize professional fitness facility employees to serve as janitorial support in activities such as mopping floors, cleaning toilets, cleaning sinks, vacuuming, cleaning mirrors/windows, and similar activities.

b. Ensure fitness professionals are aware of the process for obtaining emergency support for an unexpected incident (e.g. sewage back-up, large spill, and burst pipe).

3.2.11 Recordkeeping and Retention

Centers shall maintain membership documents, pre-participation screening documents, doctor reports, doctor notes, and any other documents with Personally Identifiable Information according to NASA recordkeeping standards and confidentiality policies. This may require that member documentation is maintained in the Clinic. Centers may opt to upload member medical-related documents to the Agency EHRS, which may also facilitate transmission and reciprocity of membership clearance if an employee travels to another Center and wants to use their fitness facility.

3.2.12 Injuries and Accidents

3.2.12.1 Members shall immediately report all accidents and injuries to the Center’s safety point of contact and the injured employee’s supervisor.

3.2.12.2 Centers shall ensure all accidents or injuries requiring the use of an AED or emergency transport to an external medical facility be immediately reported to the OCHMO and/or the Agency Fitness Manager, even if the incident has already been reported to the Center’s safety point of contact.

3.2.12.3 Civil service employees using a fitness facility have the right to file a FWC claim if they are injured or become ill using the facility, in accordance with the Federal Employees' Compensation Act, 5 U.S.C. § 8101, et seq., which provides for the payment of workers' compensation benefits to Federal employees sustaining injuries while in the performance of their duties. The DOL is the entity that determines whether an injury or illness is compensable.