{
  "packId": "cih",
  "generatedAt": "2026-07-06T13:46:41.281Z",
  "draftWarning": "Production-enabled study pack — update review fields only; do not modify item content in review files without authoring workflow.",
  "dispositionOptions": [
    "accept",
    "revise",
    "reject",
    "needs source verification"
  ],
  "recommendedActions": [
    "approve",
    "revise",
    "reject",
    "hold",
    "retire"
  ],
  "itemCount": 760,
  "items": [
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q001",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Exposure assessment prioritization",
      "difficulty": "Easy",
      "stem": "Before quantitative air sampling, an IH team ranks tasks by toxicity, frequency, and number of workers exposed. This step best describes:",
      "choiceA": "Analytical method validation",
      "choiceB": "Qualitative exposure assessment / prioritization",
      "choiceC": "Medical surveillance enrollment",
      "choiceD": "PPE final selection only",
      "correctAnswer": "B",
      "explanation": "Qualitative assessment uses professional judgment and available data to prioritize where quantitative measurements and controls are most needed, conserving resources for highest-risk tasks.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q002",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Similar exposure groups",
      "difficulty": "Medium",
      "stem": "Workers performing the same job on the same shift with comparable tasks and controls are often grouped as a SEG for sampling. The primary benefit is:",
      "choiceA": "Eliminating the need for any measurements",
      "choiceB": "Representative sampling that covers workers with similar exposures",
      "choiceC": "Replacing hazard communication",
      "choiceD": "Avoiding medical surveillance",
      "correctAnswer": "B",
      "explanation": "Similar exposure groups (SEGs) allow representative monitoring: results from sampled workers can be applied to the group when tasks, controls, and materials are truly comparable.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q003",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Sampling strategy scenario",
      "difficulty": "Hard",
      "stem": "A solvent exposure varies widely by task duration. Which strategy most improves interpretation of a worker's true shift exposure?",
      "choiceA": "One 15-minute grab sample per month",
      "choiceB": "Full-shift personal sampling on high-variability days plus task notes",
      "choiceC": "Area sample at the roof vent only",
      "choiceD": "Post-shift urine test without workplace data",
      "correctAnswer": "B",
      "explanation": "Variable exposures require personal, full-shift samples tied to task documentation. Short grab samples or remote area samples may miss peak tasks or misrepresent personal dose.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q004",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Data quality objectives",
      "difficulty": "Medium",
      "stem": "When planning an exposure assessment, defining acceptable uncertainty, sample numbers, and decision criteria before sampling aligns with:",
      "choiceA": "Data quality objectives (DQO) / assessment planning",
      "choiceB": "Post-incident root cause only",
      "choiceC": "Vendor marketing claims",
      "choiceD": "Informal visual inspection alone",
      "correctAnswer": "A",
      "explanation": "Planning with clear objectives—what decision the data must support and what quality is needed—reduces wasted sampling and supports defensible conclusions.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q005",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Baseline vs periodic monitoring",
      "difficulty": "Easy",
      "stem": "After installing engineering controls for a chronic inhalation hazard, the first round of follow-up personal samples primarily confirms:",
      "choiceA": "Control effectiveness and new baseline exposure",
      "choiceB": "Employee vacation schedules",
      "choiceC": "SDS revision dates",
      "choiceD": "Product color",
      "correctAnswer": "A",
      "explanation": "Follow-up sampling after control changes verifies whether exposures dropped to acceptable levels and establishes a new baseline for periodic monitoring.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q006",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Professional judgment",
      "difficulty": "Medium",
      "stem": "In the absence of measured data for a low-volume, high-toxicity task performed twice yearly, the IH may recommend:",
      "choiceA": "No action until illness occurs",
      "choiceB": "Conservative controls and targeted short-term sampling during the task",
      "choiceC": "Eliminating all written programs",
      "choiceD": "Relying solely on odor detection",
      "correctAnswer": "B",
      "explanation": "Professional judgment supports precautionary controls for infrequent but high-hazard tasks, supplemented by targeted measurements when the task occurs.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q007",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Exposure matrix",
      "difficulty": "Hard",
      "stem": "An exposure matrix linking job titles to agents, control status, and sample results helps an organization:",
      "choiceA": "Track exposure history and identify data gaps across the workforce",
      "choiceB": "Replace all regulatory obligations",
      "choiceC": "Avoid communicating with employees",
      "choiceD": "Store PPE invoices only",
      "correctAnswer": "A",
      "explanation": "Matrices organize who is exposed to what, under which controls, supporting gap analysis, retrospective epidemiology, and audit readiness.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q008",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Prioritization — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying prioritization within Exposure Assessment Strategy, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Prioritization in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q009",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Similar exposure groups — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on similar exposure groups in Exposure Assessment Strategy. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Similar exposure groups: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q010",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Qualitative vs quantitative — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about qualitative vs quantitative in Exposure Assessment Strategy is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm qualitative vs quantitative controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q011",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Data quality objectives — scenario 1",
      "difficulty": "Medium",
      "stem": "During exposure assessment strategy planning, data quality objectives is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Data quality objectives in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q012",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Prioritization — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to prioritization under Exposure Assessment Strategy. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Prioritization: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q013",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Similar exposure groups — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying similar exposure groups within Exposure Assessment Strategy, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm similar exposure groups controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q014",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Qualitative vs quantitative — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on qualitative vs quantitative in Exposure Assessment Strategy. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Qualitative vs quantitative in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q015",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Data quality objectives — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about data quality objectives in Exposure Assessment Strategy is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Data quality objectives: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q016",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Prioritization — scenario 3",
      "difficulty": "Easy",
      "stem": "During exposure assessment strategy planning, prioritization is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm prioritization controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q017",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Similar exposure groups — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to similar exposure groups under Exposure Assessment Strategy. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Similar exposure groups in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q018",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Qualitative vs quantitative — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying qualitative vs quantitative within Exposure Assessment Strategy, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Qualitative vs quantitative: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q019",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Data quality objectives — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on data quality objectives in Exposure Assessment Strategy. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm data quality objectives controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q020",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Prioritization — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about prioritization in Exposure Assessment Strategy is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Prioritization in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q021",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Similar exposure groups — scenario 4",
      "difficulty": "Hard",
      "stem": "During exposure assessment strategy planning, similar exposure groups is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Similar exposure groups: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q022",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Qualitative vs quantitative — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to qualitative vs quantitative under Exposure Assessment Strategy. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm qualitative vs quantitative controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q023",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Data quality objectives — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying data quality objectives within Exposure Assessment Strategy, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Data quality objectives in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q024",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Prioritization — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on prioritization in Exposure Assessment Strategy. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Prioritization: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q025",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Similar exposure groups — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about similar exposure groups in Exposure Assessment Strategy is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm similar exposure groups controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q026",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Qualitative vs quantitative — scenario 5",
      "difficulty": "Medium",
      "stem": "During exposure assessment strategy planning, qualitative vs quantitative is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Qualitative vs quantitative in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q027",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Data quality objectives — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to data quality objectives under Exposure Assessment Strategy. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Data quality objectives: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q028",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Prioritization — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying prioritization within Exposure Assessment Strategy, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm prioritization controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q029",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Similar exposure groups — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on similar exposure groups in Exposure Assessment Strategy. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Similar exposure groups in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q030",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Qualitative vs quantitative — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about qualitative vs quantitative in Exposure Assessment Strategy is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Qualitative vs quantitative: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q031",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Data quality objectives — scenario 6",
      "difficulty": "Easy",
      "stem": "During exposure assessment strategy planning, data quality objectives is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm data quality objectives controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q032",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Prioritization — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to prioritization under Exposure Assessment Strategy. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Prioritization in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q033",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Similar exposure groups — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying similar exposure groups within Exposure Assessment Strategy, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Similar exposure groups: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q034",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Qualitative vs quantitative — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on qualitative vs quantitative in Exposure Assessment Strategy. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm qualitative vs quantitative controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q035",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Data quality objectives — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about data quality objectives in Exposure Assessment Strategy is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Data quality objectives in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q036",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Prioritization — scenario 8",
      "difficulty": "Hard",
      "stem": "During exposure assessment strategy planning, prioritization is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Prioritization: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q037",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Similar exposure groups — scenario 8",
      "difficulty": "Easy",
      "stem": "An audit finding relates to similar exposure groups under Exposure Assessment Strategy. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Exposure Assessment Strategy includes transparent documentation and follow-up to confirm similar exposure groups controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D1-Q038",
      "itemType": "question",
      "domain": "exposure-assessment-strategy",
      "topic": "Qualitative vs quantitative — scenario 8",
      "difficulty": "Medium",
      "stem": "When applying qualitative vs quantitative within Exposure Assessment Strategy, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Qualitative vs quantitative in Exposure Assessment Strategy requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q001",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Pump calibration",
      "difficulty": "Easy",
      "stem": "Personal sampling pumps are typically calibrated:",
      "choiceA": "Once per year regardless of use",
      "choiceB": "Before and after each sample period with a calibrated rotameter or electronic calibrator",
      "choiceC": "Only when the battery is low",
      "choiceD": "Using employee guesswork",
      "correctAnswer": "B",
      "explanation": "Pre- and post-sample calibration verifies the pump maintained target flow within acceptable limits for the entire sample period.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q002",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Sample media selection",
      "difficulty": "Medium",
      "stem": "Selecting sorbent tubes versus filters for an organic vapor depends primarily on:",
      "choiceA": "Color of the worker uniform",
      "choiceB": "Analytical method requirements, vapor pressure, and expected concentration range",
      "choiceC": "Availability of free pens",
      "choiceD": "Weather forecast only",
      "correctAnswer": "B",
      "explanation": "Method-specific media capture the analyte without breakthrough; method documents (e.g., NIOSH NMAM concepts) define appropriate media and sample volumes.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q003",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Direct-reading instruments",
      "difficulty": "Medium",
      "stem": "A direct-reading PID is useful for screening volatile organic compounds but may:",
      "choiceA": "Identify every compound without correction factors",
      "choiceB": "Respond to multiple VOCs and require correction factors for quantitative estimates",
      "choiceC": "Replace laboratory analysis in all compliance situations",
      "choiceD": "Measure noise dose",
      "correctAnswer": "B",
      "explanation": "PIDs respond broadly to ionizable compounds; without compound-specific calibration, readings are indicative and may need lab confirmation for compliance decisions.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q004",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Sampling scenario",
      "difficulty": "Hard",
      "stem": "During abrasive blasting in a partially enclosed booth, which sample location best represents a worker's inhalation exposure inside the respirator zone (before PPE)?",
      "choiceA": "Roof exhaust stack",
      "choiceB": "Personal sample on the worker's breathing zone, outside respirator",
      "choiceC": "Parking lot upwind",
      "choiceD": "Inside the office break room",
      "correctAnswer": "B",
      "explanation": "Personal breathing-zone samples outside the respirator characterize workplace air the worker would inhale without adequate respiratory protection.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q005",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Blank samples",
      "difficulty": "Easy",
      "stem": "Field blank samples are collected to:",
      "choiceA": "Increase sample volume",
      "choiceB": "Detect contamination during handling, shipping, or storage",
      "choiceC": "Replace calibration",
      "choiceD": "Measure wind speed",
      "correctAnswer": "B",
      "explanation": "Blanks travel with the batch but are not exposed to workplace air, helping distinguish field/lab contamination from true exposure.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q006",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "High-flow vs low-flow",
      "difficulty": "Medium",
      "stem": "Low-flow personal sampling (e.g., 0.2 L/min) is often selected when:",
      "choiceA": "Measuring noise",
      "choiceB": "Collecting onto sorbent media for extended periods or reactive gases",
      "choiceC": "Replacing WBGT monitoring",
      "choiceD": "Sampling for gamma radiation",
      "correctAnswer": "B",
      "explanation": "Low flow rates extend sampling duration and reduce breakthrough risk on sorbents for many gas/vapor methods.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q007",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Cyclone samplers",
      "difficulty": "Hard",
      "stem": "A respirable dust cyclone inlet separates particles primarily by:",
      "choiceA": "Chemical reaction",
      "choiceB": "Particle aerodynamic behavior in a curving airflow stream",
      "choiceC": "Color sorting",
      "choiceD": "Magnetic field only",
      "correctAnswer": "B",
      "explanation": "Cyclones use centrifugal separation so larger particles deposit while respirable fraction passes to the filter, approximating inhalable/respirable criteria.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q008",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Personal sampling volume",
      "difficulty": "Medium",
      "stem": "A sample is collected at 1 L/min for 480 minutes. What total air volume (liters) was sampled?",
      "choiceA": "240 L",
      "choiceB": "720 L",
      "choiceC": "480 L",
      "choiceD": "580 L",
      "correctAnswer": "C",
      "explanation": "Sample volume = flow rate × time = 1 L/min × 480 min = 480 L. Pre- and post-sample pump calibration checks help confirm the effective flow rate.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q009",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Area sampling volume",
      "difficulty": "Medium",
      "stem": "A sample is collected at 2 L/min for 240 minutes. What total air volume (liters) was sampled?",
      "choiceA": "240 L",
      "choiceB": "720 L",
      "choiceC": "480 L",
      "choiceD": "580 L",
      "correctAnswer": "C",
      "explanation": "Sample volume = flow rate × time = 2 L/min × 240 min = 480 L. Pre- and post-sample pump calibration checks help confirm the effective flow rate.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q010",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Low-flow pump calibration",
      "difficulty": "Medium",
      "stem": "A sample is collected at 0.5 L/min for 960 minutes. What total air volume (liters) was sampled?",
      "choiceA": "240 L",
      "choiceB": "720 L",
      "choiceC": "480 L",
      "choiceD": "580 L",
      "correctAnswer": "C",
      "explanation": "Sample volume = flow rate × time = 0.5 L/min × 960 min = 480 L. Pre- and post-sample pump calibration checks help confirm the effective flow rate.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q011",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Pump calibration — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying pump calibration within Air Sampling and Instrumentation, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Pump calibration in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q012",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Sample media — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on sample media in Air Sampling and Instrumentation. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Sample media: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q013",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Direct-reading instruments — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about direct-reading instruments in Air Sampling and Instrumentation is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Air Sampling and Instrumentation includes transparent documentation and follow-up to confirm direct-reading instruments controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q014",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Quality assurance — scenario 1",
      "difficulty": "Medium",
      "stem": "During air sampling and instrumentation planning, quality assurance is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Quality assurance in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q015",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Pump calibration — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to pump calibration under Air Sampling and Instrumentation. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Pump calibration: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q016",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Sample media — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying sample media within Air Sampling and Instrumentation, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Air Sampling and Instrumentation includes transparent documentation and follow-up to confirm sample media controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q017",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Direct-reading instruments — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on direct-reading instruments in Air Sampling and Instrumentation. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Direct-reading instruments in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q018",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Quality assurance — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about quality assurance in Air Sampling and Instrumentation is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Quality assurance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q019",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Pump calibration — scenario 3",
      "difficulty": "Easy",
      "stem": "During air sampling and instrumentation planning, pump calibration is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Air Sampling and Instrumentation includes transparent documentation and follow-up to confirm pump calibration controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q020",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Sample media — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to sample media under Air Sampling and Instrumentation. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Sample media in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q021",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Direct-reading instruments — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying direct-reading instruments within Air Sampling and Instrumentation, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Direct-reading instruments: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q022",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Quality assurance — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on quality assurance in Air Sampling and Instrumentation. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Air Sampling and Instrumentation includes transparent documentation and follow-up to confirm quality assurance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q023",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Pump calibration — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about pump calibration in Air Sampling and Instrumentation is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Pump calibration in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q024",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Sample media — scenario 4",
      "difficulty": "Hard",
      "stem": "During air sampling and instrumentation planning, sample media is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Sample media: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q025",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Direct-reading instruments — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to direct-reading instruments under Air Sampling and Instrumentation. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Air Sampling and Instrumentation includes transparent documentation and follow-up to confirm direct-reading instruments controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q026",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Quality assurance — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying quality assurance within Air Sampling and Instrumentation, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Quality assurance in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q027",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Pump calibration — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on pump calibration in Air Sampling and Instrumentation. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Pump calibration: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q028",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Sample media — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about sample media in Air Sampling and Instrumentation is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Air Sampling and Instrumentation includes transparent documentation and follow-up to confirm sample media controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q029",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Direct-reading instruments — scenario 5",
      "difficulty": "Medium",
      "stem": "During air sampling and instrumentation planning, direct-reading instruments is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Direct-reading instruments in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q030",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Quality assurance — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to quality assurance under Air Sampling and Instrumentation. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Quality assurance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q031",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Pump calibration — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying pump calibration within Air Sampling and Instrumentation, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Air Sampling and Instrumentation includes transparent documentation and follow-up to confirm pump calibration controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q032",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Sample media — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on sample media in Air Sampling and Instrumentation. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Sample media in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q033",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Direct-reading instruments — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about direct-reading instruments in Air Sampling and Instrumentation is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Direct-reading instruments: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q034",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Quality assurance — scenario 6",
      "difficulty": "Easy",
      "stem": "During air sampling and instrumentation planning, quality assurance is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Air Sampling and Instrumentation includes transparent documentation and follow-up to confirm quality assurance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q035",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Pump calibration — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to pump calibration under Air Sampling and Instrumentation. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Pump calibration in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q036",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Sample media — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying sample media within Air Sampling and Instrumentation, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Sample media: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q037",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Direct-reading instruments — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on direct-reading instruments in Air Sampling and Instrumentation. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Air Sampling and Instrumentation includes transparent documentation and follow-up to confirm direct-reading instruments controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D2-Q038",
      "itemType": "question",
      "domain": "air-sampling",
      "topic": "Quality assurance — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about quality assurance in Air Sampling and Instrumentation is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Quality assurance in Air Sampling and Instrumentation requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q001",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Method LOD",
      "difficulty": "Medium",
      "stem": "The limit of detection (LOD) for an analytical method indicates:",
      "choiceA": "The highest concentration the lab can measure",
      "choiceB": "The lowest concentration distinguishable from blank with stated confidence",
      "choiceC": "OSHA penalty amounts",
      "choiceD": "Pump battery life",
      "correctAnswer": "B",
      "explanation": "LOD reflects method sensitivity; results below LOD should be reported and interpreted cautiously, often as less-than values.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q002",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Lab accreditation",
      "difficulty": "Easy",
      "stem": "Using an accredited laboratory for IH samples primarily provides assurance of:",
      "choiceA": "Free shipping",
      "choiceB": "Documented quality systems, method performance, and traceability",
      "choiceC": "Guaranteed zero exposure",
      "choiceD": "Elimination of PPE",
      "correctAnswer": "B",
      "explanation": "Accreditation (e.g., ISO/IEC 17025 concepts) verifies the lab follows quality management and validated methods.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q003",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Solvent desorption",
      "difficulty": "Medium",
      "stem": "After collecting organic vapors on charcoal tubes, the laboratory typically:",
      "choiceA": "Weighs the tube without extraction",
      "choiceB": "Desorbs analytes with solvent and analyzes by GC or similar",
      "choiceC": "Counts radioactive decays only",
      "choiceD": "Measures pH of the tube",
      "correctAnswer": "B",
      "explanation": "Solvent desorption followed by chromatographic analysis is a common approach for many adsorbent tube methods.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q004",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Matrix interference",
      "difficulty": "Hard",
      "stem": "High humidity during silica sampling may require method notes because moisture can:",
      "choiceA": "Improve filter capture only",
      "choiceB": "Affect sample handling, weigh stability, or interferences in analysis",
      "choiceC": "Eliminate respirable fraction",
      "choiceD": "Replace calibration",
      "correctAnswer": "B",
      "explanation": "Environmental conditions can affect gravimetric results and analytical steps; methods specify controls and corrections.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q005",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Split samples",
      "difficulty": "Medium",
      "stem": "Splitting a sample for analysis by two methods is justified when:",
      "choiceA": "The client wants duplicate invoices",
      "choiceB": "Verification of an unusual result or method comparison is needed",
      "choiceC": "The pump failed calibration",
      "choiceD": "No chain of custody exists",
      "correctAnswer": "B",
      "explanation": "Split samples support QA when results are unexpected or when validating a new method against a reference technique.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q006",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Gravimetric analysis",
      "difficulty": "Easy",
      "stem": "Gravimetric dust analysis determines mass by:",
      "choiceA": "Color matching",
      "choiceB": "Pre- and post-sample filter weighing under controlled conditions",
      "choiceC": "Employee survey",
      "choiceD": "Sound level meter",
      "correctAnswer": "B",
      "explanation": "Filter tare and post-sample weights, with blank correction, yield collected mass for concentration calculations.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q007",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Reporting units",
      "difficulty": "Hard",
      "stem": "A lab reports benzene as 0.8 ppm from a charcoal tube sample. The IH converts to mg/m³ primarily to:",
      "choiceA": "Compare against mass-based criteria or internal risk metrics using molecular weight and molar volume",
      "choiceB": "Measure noise",
      "choiceC": "Calculate WBGT",
      "choiceD": "Determine fire class",
      "correctAnswer": "A",
      "explanation": "Unit conversion uses ideal-gas relationships at stated temperature/pressure when comparing to mass-based exposure limits or risk models.",
      "reference": "niosh-nmam: NIOSH Manual of Analytical Methods",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q008",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Method selection — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying method selection within Analytical Chemistry, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Method selection in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q009",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "LOD/LOQ — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on lod/loq in Analytical Chemistry. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to LOD/LOQ: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q010",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Blank correction — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about blank correction in Analytical Chemistry is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm blank correction controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q011",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Lab accreditation — scenario 1",
      "difficulty": "Medium",
      "stem": "During analytical chemistry planning, lab accreditation is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Lab accreditation in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q012",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Method selection — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to method selection under Analytical Chemistry. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Method selection: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q013",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "LOD/LOQ — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying lod/loq within Analytical Chemistry, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm lod/loq controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q014",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Blank correction — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on blank correction in Analytical Chemistry. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Blank correction in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q015",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Lab accreditation — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about lab accreditation in Analytical Chemistry is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Lab accreditation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q016",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Method selection — scenario 3",
      "difficulty": "Easy",
      "stem": "During analytical chemistry planning, method selection is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm method selection controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q017",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "LOD/LOQ — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to lod/loq under Analytical Chemistry. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "LOD/LOQ in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q018",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Blank correction — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying blank correction within Analytical Chemistry, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Blank correction: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q019",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Lab accreditation — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on lab accreditation in Analytical Chemistry. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm lab accreditation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q020",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Method selection — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about method selection in Analytical Chemistry is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Method selection in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q021",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "LOD/LOQ — scenario 4",
      "difficulty": "Hard",
      "stem": "During analytical chemistry planning, lod/loq is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to LOD/LOQ: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q022",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Blank correction — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to blank correction under Analytical Chemistry. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm blank correction controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q023",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Lab accreditation — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying lab accreditation within Analytical Chemistry, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Lab accreditation in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q024",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Method selection — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on method selection in Analytical Chemistry. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Method selection: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q025",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "LOD/LOQ — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about lod/loq in Analytical Chemistry is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm lod/loq controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q026",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Blank correction — scenario 5",
      "difficulty": "Medium",
      "stem": "During analytical chemistry planning, blank correction is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Blank correction in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q027",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Lab accreditation — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to lab accreditation under Analytical Chemistry. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Lab accreditation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q028",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Method selection — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying method selection within Analytical Chemistry, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm method selection controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q029",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "LOD/LOQ — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on lod/loq in Analytical Chemistry. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "LOD/LOQ in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q030",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Blank correction — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about blank correction in Analytical Chemistry is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Blank correction: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q031",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Lab accreditation — scenario 6",
      "difficulty": "Easy",
      "stem": "During analytical chemistry planning, lab accreditation is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm lab accreditation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q032",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Method selection — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to method selection under Analytical Chemistry. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Method selection in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q033",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "LOD/LOQ — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying lod/loq within Analytical Chemistry, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to LOD/LOQ: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q034",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Blank correction — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on blank correction in Analytical Chemistry. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm blank correction controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q035",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Lab accreditation — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about lab accreditation in Analytical Chemistry is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Lab accreditation in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q036",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Method selection — scenario 8",
      "difficulty": "Hard",
      "stem": "During analytical chemistry planning, method selection is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Method selection: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q037",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "LOD/LOQ — scenario 8",
      "difficulty": "Easy",
      "stem": "An audit finding relates to lod/loq under Analytical Chemistry. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Analytical Chemistry includes transparent documentation and follow-up to confirm lod/loq controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D3-Q038",
      "itemType": "question",
      "domain": "analytical-chemistry",
      "topic": "Blank correction — scenario 8",
      "difficulty": "Medium",
      "stem": "When applying blank correction within Analytical Chemistry, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Blank correction in Analytical Chemistry requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q001",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Routes of entry",
      "difficulty": "Easy",
      "stem": "Which route of entry is most commonly associated with inhalation of solvent vapors in a poorly ventilated room?",
      "choiceA": "Dermal only",
      "choiceB": "Inhalation",
      "choiceC": "Ingestion from hand-to-mouth always primary",
      "choiceD": "Injection",
      "correctAnswer": "B",
      "explanation": "Volatile liquids generate inhalable vapors; inhalation often dominates unless significant skin contact with liquid occurs.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q002",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Dose-response",
      "difficulty": "Medium",
      "stem": "A steep dose-response curve for an industrial chemical implies:",
      "choiceA": "Small increases in dose may produce disproportionately larger health effects",
      "choiceB": "The substance is always safe at any level",
      "choiceC": "Only dermal effects occur",
      "choiceD": "No need for controls",
      "correctAnswer": "A",
      "explanation": "Steep curves indicate high potency—control measures and low exposure targets are especially important.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q003",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Synergistic effects",
      "difficulty": "Hard",
      "stem": "Workers exposed to noise and ototoxic solvents may experience greater hearing loss than either agent alone. This illustrates:",
      "choiceA": "Synergistic interaction",
      "choiceB": "Antagonism only",
      "choiceC": "No interaction possible",
      "choiceD": "Radiation weighting",
      "correctAnswer": "A",
      "explanation": "Combined exposures can interact synergistically; IH assessments should consider mixtures and multiple stressors.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q004",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Target organ",
      "difficulty": "Medium",
      "stem": "Chronic cadmium exposure is primarily associated with toxicity to the:",
      "choiceA": "Kidneys and lungs",
      "choiceB": "Hair only",
      "choiceC": "Finger nails exclusively",
      "choiceD": "No organs",
      "correctAnswer": "A",
      "explanation": "Cadmium accumulates and affects renal and pulmonary systems among other endpoints; exposure control and biomonitoring may apply where regulated.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q005",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "LD50 concept",
      "difficulty": "Easy",
      "stem": "In toxicology, LD50 commonly refers to:",
      "choiceA": "The dose lethal to 50% of test animals under stated conditions",
      "choiceB": "Legal dose for workers daily",
      "choiceC": "Lowest detectable sound",
      "choiceD": "Light intensity",
      "correctAnswer": "A",
      "explanation": "LD50 is an acute toxicity metric from standardized tests; it informs hazard classification but does not directly set occupational exposure limits.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q006",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Sensitizer",
      "difficulty": "Medium",
      "stem": "A respiratory sensitizer such as certain isocyanates requires IH programs to emphasize:",
      "choiceA": "Prevention of initial and especially subsequent exposures that trigger sensitization",
      "choiceB": "Only annual vision tests",
      "choiceC": "Elimination of all labels",
      "choiceD": "Increased exposure to build tolerance unsafely",
      "correctAnswer": "A",
      "explanation": "Sensitization can occur at low levels after initial exposure; strict control, medical surveillance, and prompt response to symptoms are critical.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q007",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Toxicokinetics",
      "difficulty": "Hard",
      "stem": "Half-life of a chemical in the body influences:",
      "choiceA": "How long biomonitoring samples reflect recent vs cumulative exposure",
      "choiceB": "Wind direction",
      "choiceC": "Hood face area only",
      "choiceD": "Fire extinguisher color",
      "correctAnswer": "A",
      "explanation": "Elimination kinetics affect interpretation of blood, urine, or breath biomarkers for exposure assessment.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q008",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Routes of entry — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying routes of entry within Toxicology, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Routes of entry in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q009",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Dose-response — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on dose-response in Toxicology. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dose-response: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q010",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Target organs — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about target organs in Toxicology is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm target organs controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q011",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Mixtures — scenario 1",
      "difficulty": "Medium",
      "stem": "During toxicology planning, mixtures is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Mixtures in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q012",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Routes of entry — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to routes of entry under Toxicology. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Routes of entry: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q013",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Dose-response — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying dose-response within Toxicology, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm dose-response controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q014",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Target organs — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on target organs in Toxicology. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Target organs in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q015",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Mixtures — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about mixtures in Toxicology is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Mixtures: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q016",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Routes of entry — scenario 3",
      "difficulty": "Easy",
      "stem": "During toxicology planning, routes of entry is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm routes of entry controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q017",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Dose-response — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to dose-response under Toxicology. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Dose-response in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q018",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Target organs — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying target organs within Toxicology, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Target organs: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q019",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Mixtures — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on mixtures in Toxicology. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm mixtures controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q020",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Routes of entry — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about routes of entry in Toxicology is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Routes of entry in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q021",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Dose-response — scenario 4",
      "difficulty": "Hard",
      "stem": "During toxicology planning, dose-response is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dose-response: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q022",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Target organs — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to target organs under Toxicology. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm target organs controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q023",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Mixtures — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying mixtures within Toxicology, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Mixtures in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q024",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Routes of entry — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on routes of entry in Toxicology. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Routes of entry: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q025",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Dose-response — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about dose-response in Toxicology is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm dose-response controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q026",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Target organs — scenario 5",
      "difficulty": "Medium",
      "stem": "During toxicology planning, target organs is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Target organs in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q027",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Mixtures — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to mixtures under Toxicology. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Mixtures: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q028",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Routes of entry — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying routes of entry within Toxicology, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm routes of entry controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q029",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Dose-response — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on dose-response in Toxicology. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Dose-response in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q030",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Target organs — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about target organs in Toxicology is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Target organs: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q031",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Mixtures — scenario 6",
      "difficulty": "Easy",
      "stem": "During toxicology planning, mixtures is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm mixtures controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q032",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Routes of entry — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to routes of entry under Toxicology. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Routes of entry in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q033",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Dose-response — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying dose-response within Toxicology, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dose-response: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q034",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Target organs — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on target organs in Toxicology. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm target organs controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q035",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Mixtures — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about mixtures in Toxicology is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Mixtures in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q036",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Routes of entry — scenario 8",
      "difficulty": "Hard",
      "stem": "During toxicology planning, routes of entry is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Routes of entry: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q037",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Dose-response — scenario 8",
      "difficulty": "Easy",
      "stem": "An audit finding relates to dose-response under Toxicology. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Toxicology includes transparent documentation and follow-up to confirm dose-response controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D4-Q038",
      "itemType": "question",
      "domain": "toxicology",
      "topic": "Target organs — scenario 8",
      "difficulty": "Medium",
      "stem": "When applying target organs within Toxicology, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Target organs in Toxicology requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q001",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Exchange rate",
      "difficulty": "Medium",
      "stem": "OSHA hearing conservation uses a 5 dB exchange rate for time-weighted average calculations, meaning:",
      "choiceA": "Allowable time doubles/halves with 5 dB change relative to criterion level concepts",
      "choiceB": "Every 5 dB requires ear plugs only one day per week",
      "choiceC": "Noise cannot be measured",
      "choiceD": "Vibration is measured in dBA",
      "correctAnswer": "A",
      "explanation": "Exchange rate defines how duration adjusts with level changes in dose calculations for hearing conservation programs.",
      "reference": "ansi-s12-noise: ANSI/ASA Noise Measurement Concepts; niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q002",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Hearing conservation",
      "difficulty": "Easy",
      "stem": "A hearing conservation program typically includes monitoring, audiometric testing, hearing protection, training, and:",
      "choiceA": "Recordkeeping",
      "choiceB": "Elimination of all machinery",
      "choiceC": "Mandatory music headphones",
      "choiceD": "No engineering review",
      "correctAnswer": "A",
      "explanation": "OSHA 1910.95 elements include noise monitoring, hearing tests, PPE, training, and records when exposures exceed action level.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q003",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Engineering controls for noise",
      "difficulty": "Medium",
      "stem": "The most sustainable long-term noise reduction at source often involves:",
      "choiceA": "Engineering controls such as enclosures, damping, or maintenance",
      "choiceB": "Posting \"quiet\" signs only",
      "choiceC": "Removing audiometric testing",
      "choiceD": "Increasing production speed unconditionally",
      "correctAnswer": "A",
      "explanation": "Hierarchy of controls prioritizes source and path interventions before relying on hearing protection alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q004",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Hand-arm vibration",
      "difficulty": "Hard",
      "stem": "Prolonged use of vibrating hand tools increases risk of:",
      "choiceA": "Hand-arm vibration syndrome (HAVS) / vascular and neurological effects",
      "choiceB": "Improved grip strength only",
      "choiceC": "Better hearing",
      "choiceD": "Reduced need for gloves",
      "correctAnswer": "A",
      "explanation": "HAVS includes vascular blanching and neurological symptoms; exposure time, tool vibration magnitude, and anti-vibration practices matter.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q005",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Impulse noise",
      "difficulty": "Medium",
      "stem": "Impulse or impact noise from hammering may require assessment beyond steady noise because:",
      "choiceA": "Peak levels can exceed steady readings and contribute to hearing risk",
      "choiceB": "Impulse noise cannot be measured",
      "choiceC": "It is always below 50 dBA",
      "choiceD": "It replaces the need for PPE in all cases",
      "correctAnswer": "A",
      "explanation": "Peak pressure and frequency content of impulses may warrant separate evaluation and control strategies.",
      "reference": "ansi-s12-noise: ANSI/ASA Noise Measurement Concepts; niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q006",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Noise survey scenario",
      "difficulty": "Hard",
      "stem": "A worker moves between a 95 dBA press area (2 hr) and 80 dBA assembly (6 hr). The best exposure metric for hearing conservation is:",
      "choiceA": "Maximum instantaneous reading only",
      "choiceB": "Noise dosimeter TWA over the full shift",
      "choiceC": "Average of area labels",
      "choiceD": "Worker subjective guess",
      "correctAnswer": "B",
      "explanation": "Dosimetry integrates time in each level to compute an 8-hour TWA equivalent exposure for program decisions.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q007",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Octave bands",
      "difficulty": "Easy",
      "stem": "Octave-band analysis helps select hearing protection because:",
      "choiceA": "Attenuation varies by frequency and must match the noise spectrum",
      "choiceB": "It measures temperature",
      "choiceC": "It replaces fit-testing",
      "choiceD": "It determines SDS revision",
      "correctAnswer": "A",
      "explanation": "Hearing protectors attenuate differently across frequencies; spectrum analysis supports appropriate protector selection.",
      "reference": "ansi-s12-noise: ANSI/ASA Noise Measurement Concepts; niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q008",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Noise level combination",
      "difficulty": "Hard",
      "stem": "Two equal-duration noise sources measure 85 dBA and 85 dBA at a worker location. Using standard decibel combination rules for uncorrelated sources, the combined level is approximately:",
      "choiceA": "170 dBA",
      "choiceB": "85 dBA",
      "choiceC": "88 dBA",
      "choiceD": "85 dBA",
      "correctAnswer": "C",
      "explanation": "Decibel levels combine logarithmically, not arithmetically. Equal levels increase combined sound by ~3 dB; unequal levels are dominated by the louder source. Approximate combined level here: 88 dBA.",
      "reference": "ansi-s12-noise: ANSI/ASA Noise Measurement Concepts; niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q009",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Noise level combination",
      "difficulty": "Hard",
      "stem": "Two equal-duration noise sources measure 90 dBA and 80 dBA at a worker location. Using standard decibel combination rules for uncorrelated sources, the combined level is approximately:",
      "choiceA": "170 dBA",
      "choiceB": "90 dBA",
      "choiceC": "90 dBA",
      "choiceD": "85 dBA",
      "correctAnswer": "C",
      "explanation": "Decibel levels combine logarithmically, not arithmetically. Equal levels increase combined sound by ~3 dB; unequal levels are dominated by the louder source. Approximate combined level here: 90 dBA.",
      "reference": "ansi-s12-noise: ANSI/ASA Noise Measurement Concepts; niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q010",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Noise level combination",
      "difficulty": "Hard",
      "stem": "Two equal-duration noise sources measure 95 dBA and 95 dBA at a worker location. Using standard decibel combination rules for uncorrelated sources, the combined level is approximately:",
      "choiceA": "190 dBA",
      "choiceB": "95 dBA",
      "choiceC": "98 dBA",
      "choiceD": "95 dBA",
      "correctAnswer": "C",
      "explanation": "Decibel levels combine logarithmically, not arithmetically. Equal levels increase combined sound by ~3 dB; unequal levels are dominated by the louder source. Approximate combined level here: 98 dBA.",
      "reference": "ansi-s12-noise: ANSI/ASA Noise Measurement Concepts; niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q011",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "dBA measurement — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying dba measurement within Noise and Vibration, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "dBA measurement in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q012",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Hearing conservation — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on hearing conservation in Noise and Vibration. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Hearing conservation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q013",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Engineering controls — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about engineering controls in Noise and Vibration is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Noise and Vibration includes transparent documentation and follow-up to confirm engineering controls controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q014",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Dosimetry — scenario 1",
      "difficulty": "Medium",
      "stem": "During noise and vibration planning, dosimetry is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Dosimetry in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q015",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "dBA measurement — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to dba measurement under Noise and Vibration. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to dBA measurement: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q016",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Hearing conservation — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying hearing conservation within Noise and Vibration, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Noise and Vibration includes transparent documentation and follow-up to confirm hearing conservation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q017",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Engineering controls — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on engineering controls in Noise and Vibration. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Engineering controls in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q018",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Dosimetry — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about dosimetry in Noise and Vibration is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dosimetry: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q019",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "dBA measurement — scenario 3",
      "difficulty": "Easy",
      "stem": "During noise and vibration planning, dba measurement is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Noise and Vibration includes transparent documentation and follow-up to confirm dba measurement controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q020",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Hearing conservation — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to hearing conservation under Noise and Vibration. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Hearing conservation in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q021",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Engineering controls — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying engineering controls within Noise and Vibration, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Engineering controls: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q022",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Dosimetry — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on dosimetry in Noise and Vibration. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Noise and Vibration includes transparent documentation and follow-up to confirm dosimetry controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q023",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "dBA measurement — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about dba measurement in Noise and Vibration is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "dBA measurement in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q024",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Hearing conservation — scenario 4",
      "difficulty": "Hard",
      "stem": "During noise and vibration planning, hearing conservation is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Hearing conservation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q025",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Engineering controls — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to engineering controls under Noise and Vibration. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Noise and Vibration includes transparent documentation and follow-up to confirm engineering controls controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q026",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Dosimetry — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying dosimetry within Noise and Vibration, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Dosimetry in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q027",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "dBA measurement — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on dba measurement in Noise and Vibration. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to dBA measurement: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q028",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Hearing conservation — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about hearing conservation in Noise and Vibration is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Noise and Vibration includes transparent documentation and follow-up to confirm hearing conservation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q029",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Engineering controls — scenario 5",
      "difficulty": "Medium",
      "stem": "During noise and vibration planning, engineering controls is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Engineering controls in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q030",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Dosimetry — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to dosimetry under Noise and Vibration. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dosimetry: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q031",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "dBA measurement — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying dba measurement within Noise and Vibration, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Noise and Vibration includes transparent documentation and follow-up to confirm dba measurement controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q032",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Hearing conservation — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on hearing conservation in Noise and Vibration. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Hearing conservation in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q033",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Engineering controls — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about engineering controls in Noise and Vibration is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Engineering controls: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q034",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Dosimetry — scenario 6",
      "difficulty": "Easy",
      "stem": "During noise and vibration planning, dosimetry is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Noise and Vibration includes transparent documentation and follow-up to confirm dosimetry controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q035",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "dBA measurement — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to dba measurement under Noise and Vibration. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "dBA measurement in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q036",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Hearing conservation — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying hearing conservation within Noise and Vibration, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Hearing conservation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q037",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Engineering controls — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on engineering controls in Noise and Vibration. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Noise and Vibration includes transparent documentation and follow-up to confirm engineering controls controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D5-Q038",
      "itemType": "question",
      "domain": "noise-vibration",
      "topic": "Dosimetry — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about dosimetry in Noise and Vibration is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Dosimetry in Noise and Vibration requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q001",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Hierarchy of controls",
      "difficulty": "Easy",
      "stem": "Replacing a toxic solvent with a less hazardous one is an example of:",
      "choiceA": "Substitution",
      "choiceB": "Administrative controls only",
      "choiceC": "PPE only",
      "choiceD": "Post-incident analysis only",
      "correctAnswer": "A",
      "explanation": "Substitution eliminates or reduces the hazard at the source, preferred when feasible over relying on PPE.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q002",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust ventilation",
      "difficulty": "Medium",
      "stem": "The purpose of local exhaust ventilation (LEV) at a contaminant generation point is to:",
      "choiceA": "Capture emissions before they cross the worker's breathing zone",
      "choiceB": "Heat the room only",
      "choiceC": "Replace general dilution entirely in every building",
      "choiceD": "Measure blood lead",
      "correctAnswer": "A",
      "explanation": "LEV captures at the source, minimizing the amount dispersed into the workspace compared to general ventilation alone.",
      "reference": "acgih-public-concepts: Public IH Ventilation Concepts; osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q003",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Dilution ventilation limits",
      "difficulty": "Hard",
      "stem": "Dilution ventilation alone is often inadequate for high-toxicity, high-generation-rate contaminants because:",
      "choiceA": "Required airflow may be impractical and worker exposure can remain high near the source",
      "choiceB": "It always removes 100% instantly",
      "choiceC": "It eliminates need for maintenance",
      "choiceD": "It measures WBGT",
      "correctAnswer": "A",
      "explanation": "Without source capture, large volumes of makeup air may still leave harmful breathing-zone concentrations.",
      "reference": "acgih-public-concepts: Public IH Ventilation Concepts; osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q004",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "LEV maintenance",
      "difficulty": "Medium",
      "stem": "A drop in hood capture effectiveness after filter loading indicates need for:",
      "choiceA": "Inspection, filter change, and airflow verification",
      "choiceB": "Removing the hood",
      "choiceC": "Disabling alarms",
      "choiceD": "Only PPE without investigation",
      "correctAnswer": "A",
      "explanation": "Ventilation systems require periodic airflow checks and maintenance to maintain design capture velocity and pressure.",
      "reference": "acgih-public-concepts: Public IH Ventilation Concepts; osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q005",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Confined space ventilation",
      "difficulty": "Hard",
      "stem": "Before entry into a space with potential atmospheric hazards, ventilation should:",
      "choiceA": "Be used as part of a permit program with continuous monitoring where required",
      "choiceB": "Replace all gas testing",
      "choiceC": "Never be used",
      "choiceD": "Run only after entry",
      "correctAnswer": "A",
      "explanation": "Forced ventilation may reduce hazards but must complement testing, permits, and rescue planning per OSHA confined space requirements.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q006",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Capture velocity concept",
      "difficulty": "Easy",
      "stem": "Capture velocity refers to:",
      "choiceA": "Air velocity at the contaminant source needed to draw contaminants into the hood",
      "choiceB": "Worker walking speed",
      "choiceC": "Sound pressure level",
      "choiceD": "Radiation dose rate only",
      "correctAnswer": "A",
      "explanation": "Adequate inward airflow at the generation point prevents release into the room; requirements depend on contaminant behavior.",
      "reference": "acgih-public-concepts: Public IH Ventilation Concepts; osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q007",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Control scenario",
      "difficulty": "Medium",
      "stem": "Welding fume control hierarchy: portable fume extractor at the arc plus improved general ventilation represents primarily:",
      "choiceA": "Engineering controls at source and path",
      "choiceB": "Administrative controls only",
      "choiceC": "Elimination",
      "choiceD": "Medical treatment",
      "correctAnswer": "A",
      "explanation": "Source capture for welding fume is a standard engineering approach, supplemented by room air exchange as needed.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q008",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust hood face velocity",
      "difficulty": "Medium",
      "stem": "A slot hood opening is 3 ft wide × 2 ft high. Exhaust airflow is 900 cfm. What is the average face velocity (fpm)?",
      "choiceA": "105 fpm",
      "choiceB": "150 fpm",
      "choiceC": "195 fpm",
      "choiceD": "180 fpm",
      "correctAnswer": "B",
      "explanation": "Face velocity = Q / A = 900 cfm ÷ (3 × 2 ft²) = 150 fpm. Many capture designs target 80–200 fpm depending on contaminant generation rate.",
      "reference": "acgih-public-concepts: Public IH Ventilation Concepts; osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q009",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust hood face velocity",
      "difficulty": "Medium",
      "stem": "A slot hood opening is 4 ft wide × 2.5 ft high. Exhaust airflow is 1200 cfm. What is the average face velocity (fpm)?",
      "choiceA": "84 fpm",
      "choiceB": "120 fpm",
      "choiceC": "156 fpm",
      "choiceD": "185 fpm",
      "correctAnswer": "B",
      "explanation": "Face velocity = Q / A = 1200 cfm ÷ (4 × 2.5 ft²) = 120 fpm. Many capture designs target 80–200 fpm depending on contaminant generation rate.",
      "reference": "acgih-public-concepts: Public IH Ventilation Concepts; osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q010",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust hood face velocity",
      "difficulty": "Medium",
      "stem": "A slot hood opening is 2 ft wide × 1.5 ft high. Exhaust airflow is 360 cfm. What is the average face velocity (fpm)?",
      "choiceA": "84 fpm",
      "choiceB": "120 fpm",
      "choiceC": "156 fpm",
      "choiceD": "103 fpm",
      "correctAnswer": "B",
      "explanation": "Face velocity = Q / A = 360 cfm ÷ (2 × 1.5 ft²) = 120 fpm. Many capture designs target 80–200 fpm depending on contaminant generation rate.",
      "reference": "acgih-public-concepts: Public IH Ventilation Concepts; osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q011",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying local exhaust within Ventilation and Engineering Controls, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Local exhaust in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q012",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Dilution ventilation — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on dilution ventilation in Ventilation and Engineering Controls. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dilution ventilation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q013",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Capture velocity — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about capture velocity in Ventilation and Engineering Controls is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ventilation and Engineering Controls includes transparent documentation and follow-up to confirm capture velocity controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q014",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Maintenance — scenario 1",
      "difficulty": "Medium",
      "stem": "During ventilation and engineering controls planning, maintenance is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Maintenance in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q015",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to local exhaust under Ventilation and Engineering Controls. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Local exhaust: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q016",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Dilution ventilation — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying dilution ventilation within Ventilation and Engineering Controls, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ventilation and Engineering Controls includes transparent documentation and follow-up to confirm dilution ventilation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q017",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Capture velocity — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on capture velocity in Ventilation and Engineering Controls. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Capture velocity in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q018",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Maintenance — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about maintenance in Ventilation and Engineering Controls is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Maintenance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q019",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust — scenario 3",
      "difficulty": "Easy",
      "stem": "During ventilation and engineering controls planning, local exhaust is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ventilation and Engineering Controls includes transparent documentation and follow-up to confirm local exhaust controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q020",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Dilution ventilation — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to dilution ventilation under Ventilation and Engineering Controls. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Dilution ventilation in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q021",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Capture velocity — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying capture velocity within Ventilation and Engineering Controls, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Capture velocity: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q022",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Maintenance — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on maintenance in Ventilation and Engineering Controls. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ventilation and Engineering Controls includes transparent documentation and follow-up to confirm maintenance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q023",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about local exhaust in Ventilation and Engineering Controls is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Local exhaust in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q024",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Dilution ventilation — scenario 4",
      "difficulty": "Hard",
      "stem": "During ventilation and engineering controls planning, dilution ventilation is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dilution ventilation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q025",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Capture velocity — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to capture velocity under Ventilation and Engineering Controls. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ventilation and Engineering Controls includes transparent documentation and follow-up to confirm capture velocity controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q026",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Maintenance — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying maintenance within Ventilation and Engineering Controls, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Maintenance in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q027",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on local exhaust in Ventilation and Engineering Controls. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Local exhaust: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q028",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Dilution ventilation — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about dilution ventilation in Ventilation and Engineering Controls is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ventilation and Engineering Controls includes transparent documentation and follow-up to confirm dilution ventilation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q029",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Capture velocity — scenario 5",
      "difficulty": "Medium",
      "stem": "During ventilation and engineering controls planning, capture velocity is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Capture velocity in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q030",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Maintenance — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to maintenance under Ventilation and Engineering Controls. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Maintenance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q031",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying local exhaust within Ventilation and Engineering Controls, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ventilation and Engineering Controls includes transparent documentation and follow-up to confirm local exhaust controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q032",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Dilution ventilation — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on dilution ventilation in Ventilation and Engineering Controls. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Dilution ventilation in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q033",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Capture velocity — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about capture velocity in Ventilation and Engineering Controls is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Capture velocity: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q034",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Maintenance — scenario 6",
      "difficulty": "Easy",
      "stem": "During ventilation and engineering controls planning, maintenance is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ventilation and Engineering Controls includes transparent documentation and follow-up to confirm maintenance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q035",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Local exhaust — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to local exhaust under Ventilation and Engineering Controls. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Local exhaust in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q036",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Dilution ventilation — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying dilution ventilation within Ventilation and Engineering Controls, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dilution ventilation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q037",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Capture velocity — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on capture velocity in Ventilation and Engineering Controls. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ventilation and Engineering Controls includes transparent documentation and follow-up to confirm capture velocity controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D6-Q038",
      "itemType": "question",
      "domain": "ventilation-engineering-controls",
      "topic": "Maintenance — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about maintenance in Ventilation and Engineering Controls is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Maintenance in Ventilation and Engineering Controls requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q001",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Heat acclimatization",
      "difficulty": "Easy",
      "stem": "Heat acclimatization for new workers in hot environments should involve:",
      "choiceA": "Gradual increase in exposure duration and workload with hydration and monitoring",
      "choiceB": "Immediate maximum exertion on day one",
      "choiceC": "Elimination of water breaks",
      "choiceD": "Heavy clothing layers",
      "correctAnswer": "A",
      "explanation": "Gradual exposure allows physiological adaptation; NIOSH and OSHA heat guidance emphasize acclimatization schedules.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q002",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Cold stress",
      "difficulty": "Medium",
      "stem": "Cold stress monitoring should consider wind because wind:",
      "choiceA": "Increases convective heat loss from exposed skin",
      "choiceB": "Eliminates hypothermia risk",
      "choiceC": "Replaces need for gloves",
      "choiceD": "Measures only humidity",
      "correctAnswer": "A",
      "explanation": "Wind chill effects increase heat loss; dress, shelter, and work/rest planning should account for combined cold and wind.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q003",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Hydration",
      "difficulty": "Easy",
      "stem": "In hot jobs, encouraging regular water intake helps prevent:",
      "choiceA": "Dehydration contributing to heat illness",
      "choiceB": "Hearing loss",
      "choiceC": "Radiation exposure",
      "choiceD": "Chemical burns from SDS",
      "correctAnswer": "A",
      "explanation": "Maintaining hydration supports thermoregulation; urine color and supervisor checks are common field indicators.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q004",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Heat illness recognition",
      "difficulty": "Medium",
      "stem": "Confusion and hot dry skin in extreme heat may indicate:",
      "choiceA": "Heat stroke — a medical emergency requiring immediate cooling and EMS",
      "choiceB": "Normal productivity",
      "choiceC": "Need for more caffeine only",
      "choiceD": "Low noise exposure",
      "correctAnswer": "A",
      "explanation": "Heat stroke involves central nervous system dysfunction; rapid cooling and emergency response are critical.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q005",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Work-rest scheduling",
      "difficulty": "Hard",
      "stem": "Work-rest cycles in high WBGT conditions primarily reduce:",
      "choiceA": "Core temperature rise and cardiovascular strain",
      "choiceB": "Need for any training",
      "choiceC": "Legal obligations",
      "choiceD": "Analytical LOD",
      "correctAnswer": "A",
      "explanation": "Scheduled breaks in cool areas allow physiological recovery when environmental controls cannot fully reduce heat stress.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q006",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Radiant heat",
      "difficulty": "Medium",
      "stem": "Black globe temperature measurement is useful because it captures:",
      "choiceA": "Radiant heat load from surfaces and sun",
      "choiceB": "Noise dose",
      "choiceC": "VOC concentration",
      "choiceD": "Alpha radiation only",
      "correctAnswer": "A",
      "explanation": "Globe thermometers integrate radiant exchange, important near furnaces, asphalt, or solar loads.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q007",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Cold PPE",
      "difficulty": "Easy",
      "stem": "Layered clothing for cold environments works by:",
      "choiceA": "Trapping insulating air and allowing moisture management",
      "choiceB": "Increasing sweat retention against skin always",
      "choiceC": "Replacing hazard assessment",
      "choiceD": "Eliminating buddy system",
      "correctAnswer": "A",
      "explanation": "Layering adjusts insulation and moisture transport; extremity protection and scheduled warming breaks reduce frostbite risk.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q008",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "WBGT outdoor approximation",
      "difficulty": "Hard",
      "stem": "Outdoor WBGT is often approximated from dry-bulb 90°F, natural wet-bulb 78°F, and black globe 95°F. Which value is closest to the simplified outdoor WBGT?",
      "choiceA": "79°F",
      "choiceB": "84°F",
      "choiceC": "89°F",
      "choiceD": "90°F",
      "correctAnswer": "B",
      "explanation": "Outdoor WBGT combines wet-bulb, dry-bulb, and globe temperatures with weighting that emphasizes evaporative cooling stress. The approximate WBGT for this scenario is about 84°F. Work/rest schedules should follow heat stress management plans.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q009",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "WBGT outdoor approximation",
      "difficulty": "Hard",
      "stem": "Outdoor WBGT is often approximated from dry-bulb 85°F, natural wet-bulb 75°F, and black globe 88°F. Which value is closest to the simplified outdoor WBGT?",
      "choiceA": "75°F",
      "choiceB": "80°F",
      "choiceC": "85°F",
      "choiceD": "85°F",
      "correctAnswer": "B",
      "explanation": "Outdoor WBGT combines wet-bulb, dry-bulb, and globe temperatures with weighting that emphasizes evaporative cooling stress. The approximate WBGT for this scenario is about 80°F. Work/rest schedules should follow heat stress management plans.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q010",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "WBGT outdoor approximation",
      "difficulty": "Hard",
      "stem": "Outdoor WBGT is often approximated from dry-bulb 95°F, natural wet-bulb 80°F, and black globe 100°F. Which value is closest to the simplified outdoor WBGT?",
      "choiceA": "82°F",
      "choiceB": "87°F",
      "choiceC": "92°F",
      "choiceD": "95°F",
      "correctAnswer": "B",
      "explanation": "Outdoor WBGT combines wet-bulb, dry-bulb, and globe temperatures with weighting that emphasizes evaporative cooling stress. The approximate WBGT for this scenario is about 87°F. Work/rest schedules should follow heat stress management plans.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q011",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Heat stress indices — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying heat stress indices within Thermal Stress, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Heat stress indices in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q012",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Cold stress — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on cold stress in Thermal Stress. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Cold stress: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q013",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Acclimatization — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about acclimatization in Thermal Stress is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Thermal Stress includes transparent documentation and follow-up to confirm acclimatization controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q014",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Work/rest schedules — scenario 1",
      "difficulty": "Medium",
      "stem": "During thermal stress planning, work/rest schedules is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Work/rest schedules in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q015",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Heat stress indices — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to heat stress indices under Thermal Stress. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Heat stress indices: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q016",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Cold stress — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying cold stress within Thermal Stress, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Thermal Stress includes transparent documentation and follow-up to confirm cold stress controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q017",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Acclimatization — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on acclimatization in Thermal Stress. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Acclimatization in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q018",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Work/rest schedules — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about work/rest schedules in Thermal Stress is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Work/rest schedules: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q019",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Heat stress indices — scenario 3",
      "difficulty": "Easy",
      "stem": "During thermal stress planning, heat stress indices is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Thermal Stress includes transparent documentation and follow-up to confirm heat stress indices controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q020",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Cold stress — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to cold stress under Thermal Stress. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Cold stress in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q021",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Acclimatization — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying acclimatization within Thermal Stress, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Acclimatization: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q022",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Work/rest schedules — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on work/rest schedules in Thermal Stress. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Thermal Stress includes transparent documentation and follow-up to confirm work/rest schedules controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q023",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Heat stress indices — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about heat stress indices in Thermal Stress is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Heat stress indices in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q024",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Cold stress — scenario 4",
      "difficulty": "Hard",
      "stem": "During thermal stress planning, cold stress is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Cold stress: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q025",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Acclimatization — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to acclimatization under Thermal Stress. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Thermal Stress includes transparent documentation and follow-up to confirm acclimatization controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q026",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Work/rest schedules — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying work/rest schedules within Thermal Stress, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Work/rest schedules in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q027",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Heat stress indices — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on heat stress indices in Thermal Stress. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Heat stress indices: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q028",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Cold stress — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about cold stress in Thermal Stress is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Thermal Stress includes transparent documentation and follow-up to confirm cold stress controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q029",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Acclimatization — scenario 5",
      "difficulty": "Medium",
      "stem": "During thermal stress planning, acclimatization is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Acclimatization in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q030",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Work/rest schedules — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to work/rest schedules under Thermal Stress. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Work/rest schedules: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q031",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Heat stress indices — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying heat stress indices within Thermal Stress, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Thermal Stress includes transparent documentation and follow-up to confirm heat stress indices controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q032",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Cold stress — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on cold stress in Thermal Stress. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Cold stress in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q033",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Acclimatization — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about acclimatization in Thermal Stress is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Acclimatization: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q034",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Work/rest schedules — scenario 6",
      "difficulty": "Easy",
      "stem": "During thermal stress planning, work/rest schedules is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Thermal Stress includes transparent documentation and follow-up to confirm work/rest schedules controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q035",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Heat stress indices — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to heat stress indices under Thermal Stress. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Heat stress indices in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q036",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Cold stress — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying cold stress within Thermal Stress, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Cold stress: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q037",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Acclimatization — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on acclimatization in Thermal Stress. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Thermal Stress includes transparent documentation and follow-up to confirm acclimatization controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D7-Q038",
      "itemType": "question",
      "domain": "thermal-stress",
      "topic": "Work/rest schedules — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about work/rest schedules in Thermal Stress is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Work/rest schedules in Thermal Stress requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q001",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "NIOSH lifting equation concept",
      "difficulty": "Medium",
      "stem": "The revised NIOSH lifting equation helps evaluate manual lifting by considering load weight, horizontal distance, vertical height, asymmetry, frequency, and:",
      "choiceA": "Coupling / grip quality",
      "choiceB": "Hair color",
      "choiceC": "Shift name only",
      "choiceD": "Building age",
      "correctAnswer": "A",
      "explanation": "The equation produces a recommended weight limit adjusted for task variables; coupling quality is one multiplier.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q002",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "MSD risk factors",
      "difficulty": "Easy",
      "stem": "Awkward postures, forceful exertions, repetition, and static positions are primary risk factors for:",
      "choiceA": "Work-related musculoskeletal disorders",
      "choiceB": "Ionizing radiation sickness only",
      "choiceC": "Hearing threshold shift only",
      "choiceD": "Heat stroke exclusively",
      "correctAnswer": "A",
      "explanation": "Ergonomic assessments target physical stressors that accumulate into MSDs over time.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q003",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Job rotation",
      "difficulty": "Medium",
      "stem": "Job rotation as an administrative control should:",
      "choiceA": "Rotate among jobs that do not use the same muscle groups excessively without reducing total exposure",
      "choiceB": "Increase repetition on one task",
      "choiceC": "Replace all engineering fixes mandatorily",
      "choiceD": "Eliminate training",
      "correctAnswer": "A",
      "explanation": "Rotation must actually vary physical demands; rotating between similar high-risk tasks may not reduce overall MSD risk.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q004",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Display height",
      "difficulty": "Easy",
      "stem": "For seated computer work, monitor top-of-screen near eye level helps maintain:",
      "choiceA": "Neutral neck posture",
      "choiceB": "Maximum wrist extension",
      "choiceC": "Loudest keyboard force",
      "choiceD": "Standing only posture",
      "correctAnswer": "A",
      "explanation": "Neutral head and neck alignment reduces static loading during visual tasks.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q005",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Force reduction",
      "difficulty": "Hard",
      "stem": "Power assist tools on an assembly line primarily reduce:",
      "choiceA": "Manual force requirements and associated MSD risk",
      "choiceB": "Need for any supervision",
      "choiceC": "All chemical exposures automatically",
      "choiceD": "Fire code compliance",
      "correctAnswer": "A",
      "explanation": "Mechanical assists lower exertion; they complement but do not replace evaluation of posture and repetition.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q006",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Ergo scenario",
      "difficulty": "Medium",
      "stem": "Workers report hand numbness after vibrating sanders and forceful gripping. The IH/ergonomist should prioritize:",
      "choiceA": "Tool vibration magnitude, grip force, gloves, and job redesign",
      "choiceB": "Only changing lunch menu",
      "choiceC": "Removing all PPE",
      "choiceD": "Increasing shift length",
      "correctAnswer": "A",
      "explanation": "Combined vibration and force stress nerves and vessels; engineering and administrative controls plus medical referral may be needed.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q007",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Participatory ergonomics",
      "difficulty": "Hard",
      "stem": "Involving employees in ergonomic improvement teams typically improves:",
      "choiceA": "Hazard identification and control adoption",
      "choiceB": "Secrecy of hazards",
      "choiceC": "Resistance to all changes always",
      "choiceD": "Elimination of documentation",
      "correctAnswer": "A",
      "explanation": "Worker input surfaces practical constraints and increases buy-in for redesigned tools, heights, and schedules.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q008",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Musculoskeletal risk — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying musculoskeletal risk within Ergonomics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Musculoskeletal risk in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q009",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Lifting limits — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on lifting limits in Ergonomics. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Lifting limits: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q010",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Workstation design — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about workstation design in Ergonomics is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm workstation design controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q011",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Job rotation — scenario 1",
      "difficulty": "Medium",
      "stem": "During ergonomics planning, job rotation is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Job rotation in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q012",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Musculoskeletal risk — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to musculoskeletal risk under Ergonomics. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Musculoskeletal risk: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q013",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Lifting limits — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying lifting limits within Ergonomics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm lifting limits controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q014",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Workstation design — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on workstation design in Ergonomics. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Workstation design in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q015",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Job rotation — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about job rotation in Ergonomics is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Job rotation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q016",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Musculoskeletal risk — scenario 3",
      "difficulty": "Easy",
      "stem": "During ergonomics planning, musculoskeletal risk is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm musculoskeletal risk controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q017",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Lifting limits — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to lifting limits under Ergonomics. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Lifting limits in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q018",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Workstation design — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying workstation design within Ergonomics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Workstation design: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q019",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Job rotation — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on job rotation in Ergonomics. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm job rotation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q020",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Musculoskeletal risk — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about musculoskeletal risk in Ergonomics is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Musculoskeletal risk in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q021",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Lifting limits — scenario 4",
      "difficulty": "Hard",
      "stem": "During ergonomics planning, lifting limits is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Lifting limits: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q022",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Workstation design — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to workstation design under Ergonomics. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm workstation design controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q023",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Job rotation — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying job rotation within Ergonomics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Job rotation in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q024",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Musculoskeletal risk — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on musculoskeletal risk in Ergonomics. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Musculoskeletal risk: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q025",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Lifting limits — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about lifting limits in Ergonomics is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm lifting limits controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q026",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Workstation design — scenario 5",
      "difficulty": "Medium",
      "stem": "During ergonomics planning, workstation design is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Workstation design in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q027",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Job rotation — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to job rotation under Ergonomics. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Job rotation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q028",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Musculoskeletal risk — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying musculoskeletal risk within Ergonomics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm musculoskeletal risk controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q029",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Lifting limits — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on lifting limits in Ergonomics. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Lifting limits in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q030",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Workstation design — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about workstation design in Ergonomics is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Workstation design: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q031",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Job rotation — scenario 6",
      "difficulty": "Easy",
      "stem": "During ergonomics planning, job rotation is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm job rotation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q032",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Musculoskeletal risk — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to musculoskeletal risk under Ergonomics. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Musculoskeletal risk in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q033",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Lifting limits — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying lifting limits within Ergonomics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Lifting limits: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q034",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Workstation design — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on workstation design in Ergonomics. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm workstation design controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q035",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Job rotation — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about job rotation in Ergonomics is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Job rotation in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q036",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Musculoskeletal risk — scenario 8",
      "difficulty": "Hard",
      "stem": "During ergonomics planning, musculoskeletal risk is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Musculoskeletal risk: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q037",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Lifting limits — scenario 8",
      "difficulty": "Easy",
      "stem": "An audit finding relates to lifting limits under Ergonomics. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Ergonomics includes transparent documentation and follow-up to confirm lifting limits controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D8-Q038",
      "itemType": "question",
      "domain": "ergonomics",
      "topic": "Workstation design — scenario 8",
      "difficulty": "Medium",
      "stem": "When applying workstation design within Ergonomics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Workstation design in Ergonomics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q001",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biosafety levels",
      "difficulty": "Easy",
      "stem": "BSL-2 laboratories typically handle agents associated with:",
      "choiceA": "Moderate potential hazard to personnel and environment with standard precautions plus limited access",
      "choiceB": "No precautions",
      "choiceC": "Only radiation sources",
      "choiceD": "Outdoor construction only",
      "correctAnswer": "A",
      "explanation": "BSL-2 requires trained personnel, PPE, and containment for moderate-risk biological agents per BMBL concepts.",
      "reference": "cdc-biosafety: CDC Biosafety (BMBL concepts)",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q002",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Sharps handling",
      "difficulty": "Medium",
      "stem": "Engineering controls for sharps injuries include:",
      "choiceA": "Needleless systems and sharps disposal containers at point of use",
      "choiceB": "Recapping needles routinely by hand",
      "choiceC": "Open blades in pockets",
      "choiceD": "No training",
      "correctAnswer": "A",
      "explanation": "OSHA bloodborne pathogens standard emphasizes safer devices and immediate disposal to reduce needlestick risk.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q003",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Bloodborne pathogens",
      "difficulty": "Medium",
      "stem": "An exposure control plan for bloodborne pathogens must be:",
      "choiceA": "Written, updated annually, and available to employees",
      "choiceB": "Verbal only",
      "choiceC": "Hidden from employees",
      "choiceD": "Optional for all employers",
      "correctAnswer": "A",
      "explanation": "OSHA 1910.1030 requires a written plan covering exposure determination, controls, Hep B vaccination offer, and post-exposure follow-up.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q004",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biological cabinet",
      "difficulty": "Hard",
      "stem": "A Class II biological safety cabinet protects by:",
      "choiceA": "HEPA-filtered downward laminar airflow containing aerosols within the work zone",
      "choiceB": "Heating samples to 500°F always",
      "choiceC": "Measuring noise only",
      "choiceD": "Replacing hand washing",
      "correctAnswer": "A",
      "explanation": "BSCs contain microbiological aerosols, protecting worker, product, and environment depending on class/type.",
      "reference": "cdc-biosafety: CDC Biosafety (BMBL concepts)",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q005",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Autoclave validation",
      "difficulty": "Medium",
      "stem": "Sterilization assurance for autoclaves often includes:",
      "choiceA": "Biological indicators and periodic spore testing",
      "choiceB": "Color of lab coats only",
      "choiceC": "No records",
      "choiceD": "Visual inspection alone always sufficient",
      "correctAnswer": "A",
      "explanation": "Chemical and biological indicators verify cycle parameters achieved sterility conditions.",
      "reference": "cdc-biosafety: CDC Biosafety (BMBL concepts)",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q006",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Mold assessment",
      "difficulty": "Easy",
      "stem": "Investigating building-related moisture and mold growth should start with:",
      "choiceA": "Identifying and correcting moisture sources",
      "choiceB": "Painting over growth without remediation",
      "choiceC": "Ignoring occupant symptoms",
      "choiceD": "Increasing humidity",
      "correctAnswer": "A",
      "explanation": "Without moisture control, remediation fails; IH response includes source control, cleaning, and communication.",
      "reference": "cdc-biosafety: CDC Biosafety (BMBL concepts)",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q007",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Vaccination",
      "difficulty": "Hard",
      "stem": "Offering Hepatitis B vaccination to at-risk employees with reasonable cost and at appropriate times is required under:",
      "choiceA": "OSHA bloodborne pathogens standard for covered exposure determinations",
      "choiceB": "Optional only with no documentation",
      "choiceC": "Hearing conservation standard only",
      "choiceD": "Fire brigade standard exclusively",
      "correctAnswer": "A",
      "explanation": "Employers must offer Hep B series to employees with occupational exposure unless previously vaccinated or document declination.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q008",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biosafety levels — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying biosafety levels within Biohazards, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Biosafety levels in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q009",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Sharps — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on sharps in Biohazards. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Sharps: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q010",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Bloodborne pathogens — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about bloodborne pathogens in Biohazards is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm bloodborne pathogens controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q011",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Ventilation for labs — scenario 1",
      "difficulty": "Medium",
      "stem": "During biohazards planning, ventilation for labs is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Ventilation for labs in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q012",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biosafety levels — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to biosafety levels under Biohazards. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Biosafety levels: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q013",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Sharps — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying sharps within Biohazards, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm sharps controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q014",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Bloodborne pathogens — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on bloodborne pathogens in Biohazards. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Bloodborne pathogens in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q015",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Ventilation for labs — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about ventilation for labs in Biohazards is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Ventilation for labs: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q016",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biosafety levels — scenario 3",
      "difficulty": "Easy",
      "stem": "During biohazards planning, biosafety levels is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm biosafety levels controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q017",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Sharps — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to sharps under Biohazards. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Sharps in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q018",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Bloodborne pathogens — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying bloodborne pathogens within Biohazards, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Bloodborne pathogens: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q019",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Ventilation for labs — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on ventilation for labs in Biohazards. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm ventilation for labs controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q020",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biosafety levels — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about biosafety levels in Biohazards is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Biosafety levels in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q021",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Sharps — scenario 4",
      "difficulty": "Hard",
      "stem": "During biohazards planning, sharps is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Sharps: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q022",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Bloodborne pathogens — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to bloodborne pathogens under Biohazards. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm bloodborne pathogens controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q023",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Ventilation for labs — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying ventilation for labs within Biohazards, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Ventilation for labs in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q024",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biosafety levels — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on biosafety levels in Biohazards. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Biosafety levels: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q025",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Sharps — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about sharps in Biohazards is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm sharps controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q026",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Bloodborne pathogens — scenario 5",
      "difficulty": "Medium",
      "stem": "During biohazards planning, bloodborne pathogens is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Bloodborne pathogens in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q027",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Ventilation for labs — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to ventilation for labs under Biohazards. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Ventilation for labs: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q028",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biosafety levels — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying biosafety levels within Biohazards, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm biosafety levels controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q029",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Sharps — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on sharps in Biohazards. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Sharps in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q030",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Bloodborne pathogens — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about bloodborne pathogens in Biohazards is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Bloodborne pathogens: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q031",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Ventilation for labs — scenario 6",
      "difficulty": "Easy",
      "stem": "During biohazards planning, ventilation for labs is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm ventilation for labs controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q032",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biosafety levels — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to biosafety levels under Biohazards. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Biosafety levels in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q033",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Sharps — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying sharps within Biohazards, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Sharps: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q034",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Bloodborne pathogens — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on bloodborne pathogens in Biohazards. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm bloodborne pathogens controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q035",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Ventilation for labs — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about ventilation for labs in Biohazards is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Ventilation for labs in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q036",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Biosafety levels — scenario 8",
      "difficulty": "Hard",
      "stem": "During biohazards planning, biosafety levels is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Biosafety levels: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q037",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Sharps — scenario 8",
      "difficulty": "Easy",
      "stem": "An audit finding relates to sharps under Biohazards. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Biohazards includes transparent documentation and follow-up to confirm sharps controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D9-Q038",
      "itemType": "question",
      "domain": "biohazards",
      "topic": "Bloodborne pathogens — scenario 8",
      "difficulty": "Medium",
      "stem": "When applying bloodborne pathogens within Biohazards, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Bloodborne pathogens in Biohazards requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q001",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "ALARA",
      "difficulty": "Easy",
      "stem": "ALARA in radiation protection means keeping exposures:",
      "choiceA": "As low as reasonably achievable",
      "choiceB": "As high as possible",
      "choiceC": "Unmeasured",
      "choiceD": "Equal to background only always",
      "correctAnswer": "A",
      "explanation": "ALARA applies social and economic factors to minimize dose below regulatory limits.",
      "reference": "nrc-radiation: NRC 10 CFR Part 20",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q002",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Non-ionizing radiation",
      "difficulty": "Medium",
      "stem": "Industrial microwave seal leakage surveys address primarily:",
      "choiceA": "Non-ionizing RF exposure from damaged door seals",
      "choiceB": "Alpha particle contamination",
      "choiceC": "Cadmium fume",
      "choiceD": "Silica dust only",
      "correctAnswer": "A",
      "explanation": "Microwave ovens in industrial settings may require leakage checks; RF is non-ionizing unlike gamma sources.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q003",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Dosimetry",
      "difficulty": "Medium",
      "stem": "Personnel dosimeters for ionizing radiation measure:",
      "choiceA": "Occupational dose to workers over a wear period",
      "choiceB": "Noise TWA",
      "choiceC": "VOC ppm",
      "choiceD": "WBGT only",
      "correctAnswer": "A",
      "explanation": "Badge or electronic dosimeters track shallow and deep dose equivalent for compliance and ALARA programs.",
      "reference": "nrc-radiation: NRC 10 CFR Part 20",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q004",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Laser safety",
      "difficulty": "Hard",
      "stem": "Class 3B or 4 lasers require controls including:",
      "choiceA": "Administrative controls, protective eyewear, and beam containment",
      "choiceB": "No eyewear ever",
      "choiceC": "Open beam viewing encouraged",
      "choiceD": "Only hearing protection",
      "correctAnswer": "A",
      "explanation": "High-power lasers pose eye and skin hazards; ANSI laser safety concepts define control measures by class.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q005",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Contamination survey",
      "difficulty": "Medium",
      "stem": "After handling unsealed radioactive material, frisking workers and surfaces checks for:",
      "choiceA": "Removable surface contamination",
      "choiceB": "Blood glucose",
      "choiceC": "CO2 only",
      "choiceD": "Ergonomic risk",
      "correctAnswer": "A",
      "explanation": "Contamination surveys prevent spread and unintended intake of radioactive material.",
      "reference": "nrc-radiation: NRC 10 CFR Part 20",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q006",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Time-distance-shielding",
      "difficulty": "Easy",
      "stem": "Reducing time near a fixed gamma source lowers dose because dose is proportional to:",
      "choiceA": "Exposure time at a given rate",
      "choiceB": "Worker height only",
      "choiceC": "Number of SDS sheets",
      "choiceD": "Ambient humidity exclusively",
      "correctAnswer": "A",
      "explanation": "Dose = dose rate × time; minimizing duration, increasing distance, and shielding are fundamental control tools.",
      "reference": "nrc-radiation: NRC 10 CFR Part 20",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q007",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "UV curing",
      "difficulty": "Hard",
      "stem": "UV curing lamps in manufacturing pose primarily:",
      "choiceA": "Non-ionizing UV skin and eye hazards requiring shielding and PPE",
      "choiceB": "Neutron activation",
      "choiceC": "No hazards",
      "choiceD": "Hearing loss exclusively",
      "correctAnswer": "A",
      "explanation": "UV sources can cause erythema and photokeratitis; enclosures, interlocks, and protective eyewear are typical controls.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q008",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "ALARA — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying alara within Radiation (Industrial Hygiene), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "ALARA in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q009",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Dosimetry — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on dosimetry in Radiation (Industrial Hygiene). The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dosimetry: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q010",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Non-ionizing radiation — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about non-ionizing radiation in Radiation (Industrial Hygiene) is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm non-ionizing radiation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q011",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Radioactive materials control — scenario 1",
      "difficulty": "Medium",
      "stem": "During radiation (industrial hygiene) planning, radioactive materials control is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Radioactive materials control in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q012",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "ALARA — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to alara under Radiation (Industrial Hygiene). Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to ALARA: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q013",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Dosimetry — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying dosimetry within Radiation (Industrial Hygiene), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm dosimetry controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q014",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Non-ionizing radiation — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on non-ionizing radiation in Radiation (Industrial Hygiene). The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Non-ionizing radiation in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q015",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Radioactive materials control — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about radioactive materials control in Radiation (Industrial Hygiene) is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Radioactive materials control: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q016",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "ALARA — scenario 3",
      "difficulty": "Easy",
      "stem": "During radiation (industrial hygiene) planning, alara is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm alara controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q017",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Dosimetry — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to dosimetry under Radiation (Industrial Hygiene). Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Dosimetry in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q018",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Non-ionizing radiation — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying non-ionizing radiation within Radiation (Industrial Hygiene), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Non-ionizing radiation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q019",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Radioactive materials control — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on radioactive materials control in Radiation (Industrial Hygiene). The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm radioactive materials control controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q020",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "ALARA — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about alara in Radiation (Industrial Hygiene) is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "ALARA in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q021",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Dosimetry — scenario 4",
      "difficulty": "Hard",
      "stem": "During radiation (industrial hygiene) planning, dosimetry is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dosimetry: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q022",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Non-ionizing radiation — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to non-ionizing radiation under Radiation (Industrial Hygiene). Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm non-ionizing radiation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q023",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Radioactive materials control — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying radioactive materials control within Radiation (Industrial Hygiene), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Radioactive materials control in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q024",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "ALARA — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on alara in Radiation (Industrial Hygiene). The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to ALARA: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q025",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Dosimetry — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about dosimetry in Radiation (Industrial Hygiene) is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm dosimetry controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q026",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Non-ionizing radiation — scenario 5",
      "difficulty": "Medium",
      "stem": "During radiation (industrial hygiene) planning, non-ionizing radiation is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Non-ionizing radiation in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q027",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Radioactive materials control — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to radioactive materials control under Radiation (Industrial Hygiene). Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Radioactive materials control: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q028",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "ALARA — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying alara within Radiation (Industrial Hygiene), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm alara controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q029",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Dosimetry — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on dosimetry in Radiation (Industrial Hygiene). The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Dosimetry in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q030",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Non-ionizing radiation — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about non-ionizing radiation in Radiation (Industrial Hygiene) is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Non-ionizing radiation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q031",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Radioactive materials control — scenario 6",
      "difficulty": "Easy",
      "stem": "During radiation (industrial hygiene) planning, radioactive materials control is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm radioactive materials control controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q032",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "ALARA — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to alara under Radiation (Industrial Hygiene). Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "ALARA in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q033",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Dosimetry — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying dosimetry within Radiation (Industrial Hygiene), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Dosimetry: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q034",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Non-ionizing radiation — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on non-ionizing radiation in Radiation (Industrial Hygiene). The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm non-ionizing radiation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q035",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Radioactive materials control — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about radioactive materials control in Radiation (Industrial Hygiene) is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Radioactive materials control in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q036",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "ALARA — scenario 8",
      "difficulty": "Hard",
      "stem": "During radiation (industrial hygiene) planning, alara is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to ALARA: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q037",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Dosimetry — scenario 8",
      "difficulty": "Easy",
      "stem": "An audit finding relates to dosimetry under Radiation (Industrial Hygiene). Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Radiation (Industrial Hygiene) includes transparent documentation and follow-up to confirm dosimetry controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D10-Q038",
      "itemType": "question",
      "domain": "radiation-ih",
      "topic": "Non-ionizing radiation — scenario 8",
      "difficulty": "Medium",
      "stem": "When applying non-ionizing radiation within Radiation (Industrial Hygiene), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Non-ionizing radiation in Radiation (Industrial Hygiene) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q001",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Risk characterization",
      "difficulty": "Medium",
      "stem": "Risk characterization in IH integrates hazard identification, exposure assessment, and:",
      "choiceA": "Dose-response / toxicity information to estimate likelihood and severity",
      "choiceB": "Product marketing",
      "choiceC": "Stock price",
      "choiceD": "Office layout color",
      "correctAnswer": "A",
      "explanation": "Characterization expresses what is known about risk magnitude and uncertainty for decision-makers.",
      "reference": "epa-air-toxics: EPA Air Toxics Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q002",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Uncertainty communication",
      "difficulty": "Hard",
      "stem": "When presenting sampling results near a decision limit, the IH should:",
      "choiceA": "Discuss analytical uncertainty, sample representativeness, and conservative assumptions",
      "choiceB": "Hide confidence intervals",
      "choiceC": "Guarantee zero risk",
      "choiceD": "Avoid written records",
      "correctAnswer": "A",
      "explanation": "Transparent communication of limitations helps stakeholders make informed control decisions.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q003",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Control banding",
      "difficulty": "Medium",
      "stem": "Control banding tools group chemicals by hazard and exposure potential to suggest:",
      "choiceA": "Initial control strategies when quantitative data are limited",
      "choiceB": "Final legal determinations without review",
      "choiceC": "Elimination of SDS",
      "choiceD": "No training",
      "correctAnswer": "A",
      "explanation": "Control banding supports preliminary decisions for small businesses; validation with measurements remains important.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q004",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Stakeholder engagement",
      "difficulty": "Easy",
      "stem": "Explaining sampling plans to affected employees before monitoring improves:",
      "choiceA": "Trust and cooperation with valid personal samples",
      "choiceB": "Need for secrecy",
      "choiceC": "Sample tampering incentives",
      "choiceD": "Regulatory exemptions automatically",
      "correctAnswer": "A",
      "explanation": "Communication reduces anxiety and helps workers wear samplers correctly for representative data.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q005",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Margin of safety",
      "difficulty": "Hard",
      "stem": "Applying a margin of safety below a published occupational limit accounts for:",
      "choiceA": "Inter-individual variability and uncertainties in exposure estimates",
      "choiceB": "Eliminating all PPE always",
      "choiceC": "Higher production quotas only",
      "choiceD": "Zero need for medical surveillance",
      "correctAnswer": "A",
      "explanation": "Conservative targets acknowledge sensitive subpopulations and imperfect exposure data.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q006",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Qualitative risk matrix",
      "difficulty": "Medium",
      "stem": "A risk matrix plotting severity vs likelihood is useful for:",
      "choiceA": "Prioritizing control resources across multiple hazards",
      "choiceB": "Replacing all measurements mandatorily",
      "choiceC": "Calculating noise dose",
      "choiceD": "Autoclave cycles",
      "correctAnswer": "A",
      "explanation": "Matrices visualize relative priority; they should be calibrated to site-specific context and updated with new data.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q007",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Community communication",
      "difficulty": "Easy",
      "stem": "When plant neighbors express odor concerns, initial IH response should include:",
      "choiceA": "Listening, documenting complaints, and evaluating potential sources with appropriate monitoring",
      "choiceB": "Ignoring complaints",
      "choiceC": "Immediate plant closure without investigation",
      "choiceD": "Deleting records",
      "correctAnswer": "A",
      "explanation": "Structured community interaction supports credible investigation and corrective action if emissions are confirmed.",
      "reference": "epa-air-toxics: EPA Air Toxics Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q008",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Risk characterization — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying risk characterization within Risk Assessment and Communication, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Risk characterization in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q009",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Uncertainty — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on uncertainty in Risk Assessment and Communication. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Uncertainty: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q010",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Stakeholder communication — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about stakeholder communication in Risk Assessment and Communication is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm stakeholder communication controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q011",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Control banding — scenario 1",
      "difficulty": "Medium",
      "stem": "During risk assessment and communication planning, control banding is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Control banding in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q012",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Risk characterization — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to risk characterization under Risk Assessment and Communication. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Risk characterization: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q013",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Uncertainty — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying uncertainty within Risk Assessment and Communication, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm uncertainty controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q014",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Stakeholder communication — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on stakeholder communication in Risk Assessment and Communication. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Stakeholder communication in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q015",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Control banding — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about control banding in Risk Assessment and Communication is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Control banding: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q016",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Risk characterization — scenario 3",
      "difficulty": "Easy",
      "stem": "During risk assessment and communication planning, risk characterization is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm risk characterization controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q017",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Uncertainty — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to uncertainty under Risk Assessment and Communication. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Uncertainty in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q018",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Stakeholder communication — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying stakeholder communication within Risk Assessment and Communication, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Stakeholder communication: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q019",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Control banding — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on control banding in Risk Assessment and Communication. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm control banding controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q020",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Risk characterization — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about risk characterization in Risk Assessment and Communication is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Risk characterization in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q021",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Uncertainty — scenario 4",
      "difficulty": "Hard",
      "stem": "During risk assessment and communication planning, uncertainty is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Uncertainty: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q022",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Stakeholder communication — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to stakeholder communication under Risk Assessment and Communication. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm stakeholder communication controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q023",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Control banding — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying control banding within Risk Assessment and Communication, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Control banding in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q024",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Risk characterization — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on risk characterization in Risk Assessment and Communication. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Risk characterization: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q025",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Uncertainty — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about uncertainty in Risk Assessment and Communication is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm uncertainty controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q026",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Stakeholder communication — scenario 5",
      "difficulty": "Medium",
      "stem": "During risk assessment and communication planning, stakeholder communication is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Stakeholder communication in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q027",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Control banding — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to control banding under Risk Assessment and Communication. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Control banding: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q028",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Risk characterization — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying risk characterization within Risk Assessment and Communication, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm risk characterization controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q029",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Uncertainty — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on uncertainty in Risk Assessment and Communication. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Uncertainty in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q030",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Stakeholder communication — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about stakeholder communication in Risk Assessment and Communication is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Stakeholder communication: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q031",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Control banding — scenario 6",
      "difficulty": "Easy",
      "stem": "During risk assessment and communication planning, control banding is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm control banding controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q032",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Risk characterization — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to risk characterization under Risk Assessment and Communication. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Risk characterization in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q033",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Uncertainty — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying uncertainty within Risk Assessment and Communication, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Uncertainty: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q034",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Stakeholder communication — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on stakeholder communication in Risk Assessment and Communication. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm stakeholder communication controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q035",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Control banding — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about control banding in Risk Assessment and Communication is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Control banding in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q036",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Risk characterization — scenario 8",
      "difficulty": "Hard",
      "stem": "During risk assessment and communication planning, risk characterization is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Risk characterization: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q037",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Uncertainty — scenario 8",
      "difficulty": "Easy",
      "stem": "An audit finding relates to uncertainty under Risk Assessment and Communication. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Risk Assessment and Communication includes transparent documentation and follow-up to confirm uncertainty controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D11-Q038",
      "itemType": "question",
      "domain": "risk-assessment-communication",
      "topic": "Stakeholder communication — scenario 8",
      "difficulty": "Medium",
      "stem": "When applying stakeholder communication within Risk Assessment and Communication, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Stakeholder communication in Risk Assessment and Communication requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q001",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "SDS sections",
      "difficulty": "Easy",
      "stem": "Safety Data Sheets under GHS-aligned HazCom include standardized sections such as identification, hazards, composition, and:",
      "choiceA": "Exposure controls / personal protection and toxicological information",
      "choiceB": "Employee birthdays",
      "choiceC": "Stock ticker symbols",
      "choiceD": "Only marketing slogans",
      "correctAnswer": "A",
      "explanation": "OSHA HazCom 2012 adopts GHS 16-section SDS format for consistent hazard communication.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q002",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Label elements",
      "difficulty": "Medium",
      "stem": "Container labels must include product identifier, signal word, pictograms, hazard statements, precautionary statements, and:",
      "choiceA": "Supplier contact information",
      "choiceB": "Employee SSN",
      "choiceC": "Random colors only",
      "choiceD": "Nothing if stored one day",
      "correctAnswer": "A",
      "explanation": "Labels provide immediate hazard recognition; workplace labeling systems must be consistent with SDS.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q003",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Training requirements",
      "difficulty": "Medium",
      "stem": "HazCom training must cover how to read SDS and labels, physical and health hazards, and:",
      "choiceA": "Protective measures and employer-specific procedures",
      "choiceB": "Only fire drill dates",
      "choiceC": "Payroll schedules exclusively",
      "choiceD": "No hands-on examples",
      "correctAnswer": "A",
      "explanation": "Effective training ties GHS elements to site chemical inventory and safe work procedures.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q004",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Secondary containers",
      "difficulty": "Hard",
      "stem": "Transferring a chemical to a secondary container requires labeling unless:",
      "choiceA": "It is for immediate use by the same employee who performed the transfer",
      "choiceB": "Never — all transfers need full SDS binders attached",
      "choiceC": "The container is glass",
      "choiceD": "The chemical is water always exempt",
      "correctAnswer": "A",
      "explanation": "OSHA allows immediate-use exemption but otherwise workplace labels must convey hazard information.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q005",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Trade secrets",
      "difficulty": "Medium",
      "stem": "When a manufacturer withholds exact composition as trade secret, the SDS still must provide:",
      "choiceA": "Hazard information and release procedures for medical emergencies",
      "choiceB": "No health data",
      "choiceC": "Only a phone number with no info",
      "choiceD": "Elimination of labels",
      "correctAnswer": "A",
      "explanation": "Trade secret claims must not block emergency treatment information; disclosure rules apply to health professionals.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q006",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Program audit",
      "difficulty": "Easy",
      "stem": "A written hazard communication program describes how the employer meets labeling, SDS access, inventory, and:",
      "choiceA": "Employee training requirements",
      "choiceB": "Cafeteria menu",
      "choiceC": "Vacation policy only",
      "choiceD": "IT password rules exclusively",
      "correctAnswer": "A",
      "explanation": "The written program is the backbone tying chemical inventory to accessible SDS and training records.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q007",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Multi-employer sites",
      "difficulty": "Hard",
      "stem": "On multi-contractor sites, host employers should coordinate HazCom by:",
      "choiceA": "Sharing information on known hazardous chemicals present and precautionary measures",
      "choiceB": "Hiding all SDS from contractors",
      "choiceC": "Assuming contractors need no information",
      "choiceD": "Removing all labels",
      "correctAnswer": "A",
      "explanation": "Host/controlling employer obligations include communicating site-specific chemical hazards to contractors per OSHA guidance concepts.",
      "reference": "osha-1910-general: OSHA 29 CFR 1910",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q008",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "SDS — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying sds within Hazard Communication Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "SDS in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q009",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Labeling — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on labeling in Hazard Communication Programs. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Labeling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q010",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Training — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about training in Hazard Communication Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm training controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q011",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Written program — scenario 1",
      "difficulty": "Medium",
      "stem": "During hazard communication programs planning, written program is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Written program in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q012",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "SDS — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to sds under Hazard Communication Programs. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to SDS: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q013",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Labeling — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying labeling within Hazard Communication Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm labeling controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q014",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Training — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on training in Hazard Communication Programs. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Training in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q015",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Written program — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about written program in Hazard Communication Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Written program: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q016",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "SDS — scenario 3",
      "difficulty": "Easy",
      "stem": "During hazard communication programs planning, sds is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm sds controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q017",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Labeling — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to labeling under Hazard Communication Programs. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Labeling in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q018",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Training — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying training within Hazard Communication Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Training: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q019",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Written program — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on written program in Hazard Communication Programs. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm written program controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q020",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "SDS — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about sds in Hazard Communication Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "SDS in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q021",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Labeling — scenario 4",
      "difficulty": "Hard",
      "stem": "During hazard communication programs planning, labeling is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Labeling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q022",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Training — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to training under Hazard Communication Programs. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm training controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q023",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Written program — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying written program within Hazard Communication Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Written program in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q024",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "SDS — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on sds in Hazard Communication Programs. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to SDS: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q025",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Labeling — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about labeling in Hazard Communication Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm labeling controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q026",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Training — scenario 5",
      "difficulty": "Medium",
      "stem": "During hazard communication programs planning, training is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Training in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q027",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Written program — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to written program under Hazard Communication Programs. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Written program: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q028",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "SDS — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying sds within Hazard Communication Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm sds controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q029",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Labeling — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on labeling in Hazard Communication Programs. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Labeling in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q030",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Training — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about training in Hazard Communication Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Training: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q031",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Written program — scenario 6",
      "difficulty": "Easy",
      "stem": "During hazard communication programs planning, written program is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm written program controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q032",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "SDS — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to sds under Hazard Communication Programs. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "SDS in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q033",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Labeling — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying labeling within Hazard Communication Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Labeling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q034",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Training — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on training in Hazard Communication Programs. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm training controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q035",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Written program — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about written program in Hazard Communication Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Written program in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q036",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "SDS — scenario 8",
      "difficulty": "Hard",
      "stem": "During hazard communication programs planning, sds is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to SDS: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q037",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Labeling — scenario 8",
      "difficulty": "Easy",
      "stem": "An audit finding relates to labeling under Hazard Communication Programs. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Hazard Communication Programs includes transparent documentation and follow-up to confirm labeling controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D12-Q038",
      "itemType": "question",
      "domain": "hazard-communication-programs",
      "topic": "Training — scenario 8",
      "difficulty": "Medium",
      "stem": "When applying training within Hazard Communication Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Training in Hazard Communication Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q001",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Cohort vs case-control",
      "difficulty": "Medium",
      "stem": "A case-control study starts with:",
      "choiceA": "Defined disease/outcome groups and looks back for exposures",
      "choiceB": "Healthy cohort followed forward only always",
      "choiceC": "Randomized treatment assignment mandatorily",
      "choiceD": "Laboratory animal dosing only",
      "correctAnswer": "A",
      "explanation": "Case-control designs compare exposure history between cases and controls; efficient for rare outcomes.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q002",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Confounding",
      "difficulty": "Hard",
      "stem": "Smoking confounds many occupational cancer studies because it:",
      "choiceA": "Is associated with both employment in some industries and lung cancer independently of the occupational agent",
      "choiceB": "Eliminates all bias automatically",
      "choiceC": "Is never measured",
      "choiceD": "Replaces exposure assessment",
      "correctAnswer": "A",
      "explanation": "Confounders distort exposure-disease associations; stratification or multivariable adjustment may be needed.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q003",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Statistical significance",
      "difficulty": "Easy",
      "stem": "A p-value below a chosen alpha (e.g., 0.05) suggests:",
      "choiceA": "The observed association is unlikely under the null hypothesis, given model assumptions",
      "choiceB": "The effect is clinically important automatically",
      "choiceC": "No further study needed ever",
      "choiceD": "Zero exposure occurred",
      "correctAnswer": "A",
      "explanation": "Statistical significance does not imply causation or practical importance; effect size and context matter.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q004",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Incidence vs prevalence",
      "difficulty": "Medium",
      "stem": "Prevalence measures existing cases at a point in time, while incidence measures:",
      "choiceA": "New cases occurring over a defined period",
      "choiceB": "Only deaths",
      "choiceC": "Only exposures",
      "choiceD": "Laboratory LOD",
      "correctAnswer": "A",
      "explanation": "Incidence rates support etiologic inference; prevalence reflects duration and survival as well as new disease.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q005",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Selection bias",
      "difficulty": "Hard",
      "stem": "Healthy worker effect can bias occupational cohort studies by:",
      "choiceA": "Excluding less healthy individuals from employment, underestimating risk",
      "choiceB": "Increasing risk estimates always",
      "choiceC": "Eliminating need for controls",
      "choiceD": "Guaranteeing high exposure",
      "correctAnswer": "A",
      "explanation": "Employed populations may be healthier than general population, attenuating observed relative risks.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q006",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Confidence interval",
      "difficulty": "Medium",
      "stem": "A 95% confidence interval for relative risk that includes 1.0 indicates:",
      "choiceA": "The association is not statistically significant at the 5% level (for two-sided test)",
      "choiceB": "Proof of no effect in population ever",
      "choiceC": "Data are fraudulent",
      "choiceD": "Exposure was zero",
      "correctAnswer": "A",
      "explanation": "CI including null value aligns with non-significant findings; width reflects precision.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q007",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Cross-sectional limits",
      "difficulty": "Easy",
      "stem": "Cross-sectional surveys simultaneously measure exposure and disease, making them weak for:",
      "choiceA": "Establishing temporal sequence for causality",
      "choiceB": "Describing current prevalence",
      "choiceC": "Hypothesis generation",
      "choiceD": "Planning further study",
      "correctAnswer": "A",
      "explanation": "Without knowing which came first, cross-sectional data cannot firmly establish exposure preceded outcome.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q008",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Relative risk calculation",
      "difficulty": "Medium",
      "stem": "In a cohort study, 20 of 200 exposed workers and 8 of 800 unexposed workers developed illness. What is the approximate relative risk (RR)?",
      "choiceA": "5.0",
      "choiceB": "10.0",
      "choiceC": "15.0",
      "choiceD": "10.0",
      "correctAnswer": "B",
      "explanation": "Risk among exposed = 20/200 = 10.0%. Risk among unexposed = 8/800 = 1.0%. RR = 0.1000/0.0100 ≈ 10.0.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q009",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Relative risk calculation",
      "difficulty": "Medium",
      "stem": "In a cohort study, 5 of 100 exposed workers and 4 of 400 unexposed workers developed illness. What is the approximate relative risk (RR)?",
      "choiceA": "2.5",
      "choiceB": "5.0",
      "choiceC": "7.5",
      "choiceD": "5.0",
      "correctAnswer": "B",
      "explanation": "Risk among exposed = 5/100 = 5.0%. Risk among unexposed = 4/400 = 1.0%. RR = 0.0500/0.0100 ≈ 5.0.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q010",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Relative risk calculation",
      "difficulty": "Medium",
      "stem": "In a cohort study, 10 of 50 exposed workers and 19 of 950 unexposed workers developed illness. What is the approximate relative risk (RR)?",
      "choiceA": "5.0",
      "choiceB": "10.0",
      "choiceC": "15.0",
      "choiceD": "20.0",
      "correctAnswer": "B",
      "explanation": "Risk among exposed = 10/50 = 20.0%. Risk among unexposed = 19/950 = 2.0%. RR = 0.2000/0.0200 ≈ 10.0.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q011",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Study designs — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying study designs within Epidemiology and Biostatistics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Study designs in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q012",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Bias — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on bias in Epidemiology and Biostatistics. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Bias: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q013",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Confounding — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about confounding in Epidemiology and Biostatistics is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Epidemiology and Biostatistics includes transparent documentation and follow-up to confirm confounding controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q014",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Statistical significance — scenario 1",
      "difficulty": "Medium",
      "stem": "During epidemiology and biostatistics planning, statistical significance is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Statistical significance in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q015",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Study designs — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to study designs under Epidemiology and Biostatistics. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Study designs: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q016",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Bias — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying bias within Epidemiology and Biostatistics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Epidemiology and Biostatistics includes transparent documentation and follow-up to confirm bias controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q017",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Confounding — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on confounding in Epidemiology and Biostatistics. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Confounding in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q018",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Statistical significance — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about statistical significance in Epidemiology and Biostatistics is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Statistical significance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q019",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Study designs — scenario 3",
      "difficulty": "Easy",
      "stem": "During epidemiology and biostatistics planning, study designs is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Epidemiology and Biostatistics includes transparent documentation and follow-up to confirm study designs controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q020",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Bias — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to bias under Epidemiology and Biostatistics. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Bias in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q021",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Confounding — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying confounding within Epidemiology and Biostatistics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Confounding: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q022",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Statistical significance — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on statistical significance in Epidemiology and Biostatistics. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Epidemiology and Biostatistics includes transparent documentation and follow-up to confirm statistical significance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q023",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Study designs — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about study designs in Epidemiology and Biostatistics is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Study designs in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q024",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Bias — scenario 4",
      "difficulty": "Hard",
      "stem": "During epidemiology and biostatistics planning, bias is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Bias: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q025",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Confounding — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to confounding under Epidemiology and Biostatistics. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Epidemiology and Biostatistics includes transparent documentation and follow-up to confirm confounding controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q026",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Statistical significance — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying statistical significance within Epidemiology and Biostatistics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Statistical significance in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q027",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Study designs — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on study designs in Epidemiology and Biostatistics. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Study designs: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q028",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Bias — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about bias in Epidemiology and Biostatistics is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Epidemiology and Biostatistics includes transparent documentation and follow-up to confirm bias controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q029",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Confounding — scenario 5",
      "difficulty": "Medium",
      "stem": "During epidemiology and biostatistics planning, confounding is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Confounding in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q030",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Statistical significance — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to statistical significance under Epidemiology and Biostatistics. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Statistical significance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q031",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Study designs — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying study designs within Epidemiology and Biostatistics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Epidemiology and Biostatistics includes transparent documentation and follow-up to confirm study designs controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q032",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Bias — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on bias in Epidemiology and Biostatistics. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Bias in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q033",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Confounding — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about confounding in Epidemiology and Biostatistics is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Confounding: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q034",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Statistical significance — scenario 6",
      "difficulty": "Easy",
      "stem": "During epidemiology and biostatistics planning, statistical significance is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Epidemiology and Biostatistics includes transparent documentation and follow-up to confirm statistical significance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q035",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Study designs — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to study designs under Epidemiology and Biostatistics. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Study designs in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q036",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Bias — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying bias within Epidemiology and Biostatistics, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Bias: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q037",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Confounding — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on confounding in Epidemiology and Biostatistics. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Epidemiology and Biostatistics includes transparent documentation and follow-up to confirm confounding controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D13-Q038",
      "itemType": "question",
      "domain": "epidemiology-biostatistics",
      "topic": "Statistical significance — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about statistical significance in Epidemiology and Biostatistics is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Statistical significance in Epidemiology and Biostatistics requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q001",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Fenceline monitoring",
      "difficulty": "Medium",
      "stem": "Fenceline ambient monitoring around an industrial plant helps evaluate:",
      "choiceA": "Off-site transport of pollutants toward neighboring communities",
      "choiceB": "Interior ergonomic risk only",
      "choiceC": "Employee payroll",
      "choiceD": "Indoor mold exclusively at plant",
      "correctAnswer": "A",
      "explanation": "Perimeter monitoring supports community exposure assessment and regulatory compliance concepts for air toxics.",
      "reference": "epa-air-toxics: EPA Air Toxics Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q002",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Emissions inventory",
      "difficulty": "Easy",
      "stem": "An emissions inventory lists sources, pollutants, and release rates primarily to:",
      "choiceA": "Support permitting, modeling, and community risk communication",
      "choiceB": "Replace all stack testing always",
      "choiceC": "Hide releases from agencies",
      "choiceD": "Measure hearing loss",
      "correctAnswer": "A",
      "explanation": "Inventories aggregate point and fugitive sources for regulatory reporting and risk analysis.",
      "reference": "epa-air-toxics: EPA Air Toxics Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q003",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Dispersion modeling",
      "difficulty": "Hard",
      "stem": "Gaussian plume models require inputs such as stack height, exit velocity, meteorology, and:",
      "choiceA": "Source emission rate",
      "choiceB": "Employee shoe size",
      "choiceC": "Office carpet color",
      "choiceD": "Audiogram results",
      "correctAnswer": "A",
      "explanation": "Air quality models estimate downwind concentrations from source strength and atmospheric stability.",
      "reference": "epa-air-toxics: EPA Air Toxics Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q004",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Community engagement",
      "difficulty": "Medium",
      "stem": "Transparent public meetings after a chemical release should provide:",
      "choiceA": "Known facts, health precautions, ongoing sampling plans, and contact points",
      "choiceB": "Speculation as confirmed facts",
      "choiceC": "No data until litigation ends only",
      "choiceD": "Discouraging questions",
      "correctAnswer": "A",
      "explanation": "Effective risk communication balances honesty about uncertainties with actionable protective guidance.",
      "reference": "epa-air-toxics: EPA Air Toxics Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q005",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Indoor air in schools",
      "difficulty": "Easy",
      "stem": "Investigating IAQ complaints in a school near industry includes checking HVAC, pollutant pathways, and:",
      "choiceA": "Outdoor pollutant intrusion and relevant outdoor monitoring data",
      "choiceB": "Only student grades",
      "choiceC": "Eliminating all ventilation",
      "choiceD": "Ignoring parent reports",
      "correctAnswer": "A",
      "explanation": "Indoor exposures may reflect outdoor infiltration; coordinated outdoor/indoor sampling informs response.",
      "reference": "epa-air-toxics: EPA Air Toxics Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q006",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Soil vapor intrusion",
      "difficulty": "Hard",
      "stem": "Vapor intrusion assessment evaluates whether subsurface contaminants migrate into buildings via:",
      "choiceA": "Diffusion/advection through cracks and utility penetrations",
      "choiceB": "Only visible dust on desks",
      "choiceC": "Radio waves",
      "choiceD": "Employee lifting",
      "correctAnswer": "A",
      "explanation": "Sub-slab sampling and pathway analysis determine need for mitigation systems.",
      "reference": "epa-air-toxics: EPA Air Toxics Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q007",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Environmental justice",
      "difficulty": "Medium",
      "stem": "Considering cumulative burdens in nearby disadvantaged communities aligns with:",
      "choiceA": "Environmental justice principles in public health assessment",
      "choiceB": "Avoiding all monitoring",
      "choiceC": "Secret releases",
      "choiceD": "Eliminating permits always",
      "correctAnswer": "A",
      "explanation": "Multiple stressors may combine; engagement and targeted reduction of disproportionate impacts are policy goals.",
      "reference": "epa-air-toxics: EPA Air Toxics Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q008",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Ambient monitoring — scenario 1",
      "difficulty": "Medium",
      "stem": "When applying ambient monitoring within Community and Environmental Exposure, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Ambient monitoring in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q009",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Fenceline — scenario 1",
      "difficulty": "Hard",
      "stem": "A facility review focuses on fenceline in Community and Environmental Exposure. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Fenceline: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q010",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Community engagement — scenario 1",
      "difficulty": "Easy",
      "stem": "Which statement about community engagement in Community and Environmental Exposure is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm community engagement controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q011",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Emissions inventory — scenario 1",
      "difficulty": "Medium",
      "stem": "During community and environmental exposure planning, emissions inventory is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Emissions inventory in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q012",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Ambient monitoring — scenario 2",
      "difficulty": "Hard",
      "stem": "An audit finding relates to ambient monitoring under Community and Environmental Exposure. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Ambient monitoring: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q013",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Fenceline — scenario 2",
      "difficulty": "Easy",
      "stem": "When applying fenceline within Community and Environmental Exposure, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm fenceline controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q014",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Community engagement — scenario 2",
      "difficulty": "Medium",
      "stem": "A facility review focuses on community engagement in Community and Environmental Exposure. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Community engagement in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q015",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Emissions inventory — scenario 2",
      "difficulty": "Hard",
      "stem": "Which statement about emissions inventory in Community and Environmental Exposure is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Emissions inventory: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q016",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Ambient monitoring — scenario 3",
      "difficulty": "Easy",
      "stem": "During community and environmental exposure planning, ambient monitoring is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm ambient monitoring controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q017",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Fenceline — scenario 3",
      "difficulty": "Medium",
      "stem": "An audit finding relates to fenceline under Community and Environmental Exposure. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Fenceline in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q018",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Community engagement — scenario 3",
      "difficulty": "Hard",
      "stem": "When applying community engagement within Community and Environmental Exposure, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Community engagement: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q019",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Emissions inventory — scenario 3",
      "difficulty": "Easy",
      "stem": "A facility review focuses on emissions inventory in Community and Environmental Exposure. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm emissions inventory controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q020",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Ambient monitoring — scenario 4",
      "difficulty": "Medium",
      "stem": "Which statement about ambient monitoring in Community and Environmental Exposure is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Ambient monitoring in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q021",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Fenceline — scenario 4",
      "difficulty": "Hard",
      "stem": "During community and environmental exposure planning, fenceline is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Fenceline: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q022",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Community engagement — scenario 4",
      "difficulty": "Easy",
      "stem": "An audit finding relates to community engagement under Community and Environmental Exposure. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm community engagement controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q023",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Emissions inventory — scenario 4",
      "difficulty": "Medium",
      "stem": "When applying emissions inventory within Community and Environmental Exposure, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Emissions inventory in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q024",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Ambient monitoring — scenario 5",
      "difficulty": "Hard",
      "stem": "A facility review focuses on ambient monitoring in Community and Environmental Exposure. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Ambient monitoring: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q025",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Fenceline — scenario 5",
      "difficulty": "Easy",
      "stem": "Which statement about fenceline in Community and Environmental Exposure is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm fenceline controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q026",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Community engagement — scenario 5",
      "difficulty": "Medium",
      "stem": "During community and environmental exposure planning, community engagement is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Community engagement in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q027",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Emissions inventory — scenario 5",
      "difficulty": "Hard",
      "stem": "An audit finding relates to emissions inventory under Community and Environmental Exposure. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Emissions inventory: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q028",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Ambient monitoring — scenario 6",
      "difficulty": "Easy",
      "stem": "When applying ambient monitoring within Community and Environmental Exposure, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm ambient monitoring controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q029",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Fenceline — scenario 6",
      "difficulty": "Medium",
      "stem": "A facility review focuses on fenceline in Community and Environmental Exposure. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Fenceline in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q030",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Community engagement — scenario 6",
      "difficulty": "Hard",
      "stem": "Which statement about community engagement in Community and Environmental Exposure is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Community engagement: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q031",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Emissions inventory — scenario 6",
      "difficulty": "Easy",
      "stem": "During community and environmental exposure planning, emissions inventory is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm emissions inventory controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q032",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Ambient monitoring — scenario 7",
      "difficulty": "Medium",
      "stem": "An audit finding relates to ambient monitoring under Community and Environmental Exposure. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Ambient monitoring in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q033",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Fenceline — scenario 7",
      "difficulty": "Hard",
      "stem": "When applying fenceline within Community and Environmental Exposure, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Fenceline: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q034",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Community engagement — scenario 7",
      "difficulty": "Easy",
      "stem": "A facility review focuses on community engagement in Community and Environmental Exposure. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm community engagement controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q035",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Emissions inventory — scenario 7",
      "difficulty": "Medium",
      "stem": "Which statement about emissions inventory in Community and Environmental Exposure is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Emissions inventory in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q036",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Ambient monitoring — scenario 8",
      "difficulty": "Hard",
      "stem": "During community and environmental exposure planning, ambient monitoring is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Ambient monitoring: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q037",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Fenceline — scenario 8",
      "difficulty": "Easy",
      "stem": "An audit finding relates to fenceline under Community and Environmental Exposure. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Community and Environmental Exposure includes transparent documentation and follow-up to confirm fenceline controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D14-Q038",
      "itemType": "question",
      "domain": "community-environmental-exposure",
      "topic": "Community engagement — scenario 8",
      "difficulty": "Medium",
      "stem": "When applying community engagement within Community and Environmental Exposure, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Community engagement in Community and Environmental Exposure requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q001",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 1",
      "difficulty": "Easy",
      "stem": "When applying skin contact within Dermal Exposure Assessment, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Skin contact in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q002",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 1",
      "difficulty": "Medium",
      "stem": "A facility review focuses on protective gloves in Dermal Exposure Assessment. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Protective gloves: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q003",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Surface wipe sampling — scenario 1",
      "difficulty": "Hard",
      "stem": "Which statement about surface wipe sampling in Dermal Exposure Assessment is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm surface wipe sampling controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q004",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Absorption routes — scenario 1",
      "difficulty": "Easy",
      "stem": "During dermal exposure assessment planning, absorption routes is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Absorption routes in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q005",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 2",
      "difficulty": "Medium",
      "stem": "An audit finding relates to skin contact under Dermal Exposure Assessment. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Skin contact: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q006",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 2",
      "difficulty": "Hard",
      "stem": "When applying protective gloves within Dermal Exposure Assessment, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm protective gloves controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q007",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Surface wipe sampling — scenario 2",
      "difficulty": "Easy",
      "stem": "A facility review focuses on surface wipe sampling in Dermal Exposure Assessment. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Surface wipe sampling in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q008",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Absorption routes — scenario 2",
      "difficulty": "Medium",
      "stem": "Which statement about absorption routes in Dermal Exposure Assessment is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Absorption routes: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q009",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 3",
      "difficulty": "Hard",
      "stem": "During dermal exposure assessment planning, skin contact is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm skin contact controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q010",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 3",
      "difficulty": "Easy",
      "stem": "An audit finding relates to protective gloves under Dermal Exposure Assessment. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Protective gloves in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q011",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Surface wipe sampling — scenario 3",
      "difficulty": "Medium",
      "stem": "When applying surface wipe sampling within Dermal Exposure Assessment, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Surface wipe sampling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q012",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Absorption routes — scenario 3",
      "difficulty": "Hard",
      "stem": "A facility review focuses on absorption routes in Dermal Exposure Assessment. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm absorption routes controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q013",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 4",
      "difficulty": "Easy",
      "stem": "Which statement about skin contact in Dermal Exposure Assessment is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Skin contact in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q014",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 4",
      "difficulty": "Medium",
      "stem": "During dermal exposure assessment planning, protective gloves is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Protective gloves: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q015",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Surface wipe sampling — scenario 4",
      "difficulty": "Hard",
      "stem": "An audit finding relates to surface wipe sampling under Dermal Exposure Assessment. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm surface wipe sampling controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q016",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Absorption routes — scenario 4",
      "difficulty": "Easy",
      "stem": "When applying absorption routes within Dermal Exposure Assessment, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Absorption routes in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q017",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 5",
      "difficulty": "Medium",
      "stem": "A facility review focuses on skin contact in Dermal Exposure Assessment. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Skin contact: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q018",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 5",
      "difficulty": "Hard",
      "stem": "Which statement about protective gloves in Dermal Exposure Assessment is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm protective gloves controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q019",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Surface wipe sampling — scenario 5",
      "difficulty": "Easy",
      "stem": "During dermal exposure assessment planning, surface wipe sampling is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Surface wipe sampling in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q020",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Absorption routes — scenario 5",
      "difficulty": "Medium",
      "stem": "An audit finding relates to absorption routes under Dermal Exposure Assessment. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Absorption routes: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q021",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 6",
      "difficulty": "Hard",
      "stem": "When applying skin contact within Dermal Exposure Assessment, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm skin contact controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q022",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 6",
      "difficulty": "Easy",
      "stem": "A facility review focuses on protective gloves in Dermal Exposure Assessment. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Protective gloves in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q023",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Surface wipe sampling — scenario 6",
      "difficulty": "Medium",
      "stem": "Which statement about surface wipe sampling in Dermal Exposure Assessment is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Surface wipe sampling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q024",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Absorption routes — scenario 6",
      "difficulty": "Hard",
      "stem": "During dermal exposure assessment planning, absorption routes is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm absorption routes controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q025",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 7",
      "difficulty": "Easy",
      "stem": "An audit finding relates to skin contact under Dermal Exposure Assessment. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Skin contact in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q026",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 7",
      "difficulty": "Medium",
      "stem": "When applying protective gloves within Dermal Exposure Assessment, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Protective gloves: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q027",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Surface wipe sampling — scenario 7",
      "difficulty": "Hard",
      "stem": "A facility review focuses on surface wipe sampling in Dermal Exposure Assessment. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm surface wipe sampling controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q028",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Absorption routes — scenario 7",
      "difficulty": "Easy",
      "stem": "Which statement about absorption routes in Dermal Exposure Assessment is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Absorption routes in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q029",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 8",
      "difficulty": "Medium",
      "stem": "During dermal exposure assessment planning, skin contact is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Skin contact: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q030",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 8",
      "difficulty": "Hard",
      "stem": "An audit finding relates to protective gloves under Dermal Exposure Assessment. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm protective gloves controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q031",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Surface wipe sampling — scenario 8",
      "difficulty": "Easy",
      "stem": "When applying surface wipe sampling within Dermal Exposure Assessment, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Surface wipe sampling in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q032",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Absorption routes — scenario 8",
      "difficulty": "Medium",
      "stem": "A facility review focuses on absorption routes in Dermal Exposure Assessment. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Absorption routes: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q033",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 9",
      "difficulty": "Hard",
      "stem": "Which statement about skin contact in Dermal Exposure Assessment is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm skin contact controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q034",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 9",
      "difficulty": "Easy",
      "stem": "During dermal exposure assessment planning, protective gloves is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Protective gloves in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q035",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Surface wipe sampling — scenario 9",
      "difficulty": "Medium",
      "stem": "An audit finding relates to surface wipe sampling under Dermal Exposure Assessment. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Surface wipe sampling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q036",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Absorption routes — scenario 9",
      "difficulty": "Hard",
      "stem": "When applying absorption routes within Dermal Exposure Assessment, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Dermal Exposure Assessment includes transparent documentation and follow-up to confirm absorption routes controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q037",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Skin contact — scenario 10",
      "difficulty": "Easy",
      "stem": "A facility review focuses on skin contact in Dermal Exposure Assessment. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Skin contact in Dermal Exposure Assessment requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D15-Q038",
      "itemType": "question",
      "domain": "dermal-exposure",
      "topic": "Protective gloves — scenario 10",
      "difficulty": "Medium",
      "stem": "Which statement about protective gloves in Dermal Exposure Assessment is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Protective gloves: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q001",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 1",
      "difficulty": "Easy",
      "stem": "When applying legionella within Water Quality and Indoor Air, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Legionella in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q002",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 1",
      "difficulty": "Medium",
      "stem": "A facility review focuses on mold/moisture in Water Quality and Indoor Air. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Mold/moisture: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q003",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "CO/CO₂ — scenario 1",
      "difficulty": "Hard",
      "stem": "Which statement about co/co₂ in Water Quality and Indoor Air is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm co/co₂ controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q004",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Ventilation rates — scenario 1",
      "difficulty": "Easy",
      "stem": "During water quality and indoor air planning, ventilation rates is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Ventilation rates in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q005",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 2",
      "difficulty": "Medium",
      "stem": "An audit finding relates to legionella under Water Quality and Indoor Air. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Legionella: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q006",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 2",
      "difficulty": "Hard",
      "stem": "When applying mold/moisture within Water Quality and Indoor Air, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm mold/moisture controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q007",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "CO/CO₂ — scenario 2",
      "difficulty": "Easy",
      "stem": "A facility review focuses on co/co₂ in Water Quality and Indoor Air. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "CO/CO₂ in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q008",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Ventilation rates — scenario 2",
      "difficulty": "Medium",
      "stem": "Which statement about ventilation rates in Water Quality and Indoor Air is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Ventilation rates: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q009",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 3",
      "difficulty": "Hard",
      "stem": "During water quality and indoor air planning, legionella is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm legionella controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q010",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 3",
      "difficulty": "Easy",
      "stem": "An audit finding relates to mold/moisture under Water Quality and Indoor Air. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Mold/moisture in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q011",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "CO/CO₂ — scenario 3",
      "difficulty": "Medium",
      "stem": "When applying co/co₂ within Water Quality and Indoor Air, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to CO/CO₂: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q012",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Ventilation rates — scenario 3",
      "difficulty": "Hard",
      "stem": "A facility review focuses on ventilation rates in Water Quality and Indoor Air. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm ventilation rates controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q013",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 4",
      "difficulty": "Easy",
      "stem": "Which statement about legionella in Water Quality and Indoor Air is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Legionella in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q014",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 4",
      "difficulty": "Medium",
      "stem": "During water quality and indoor air planning, mold/moisture is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Mold/moisture: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q015",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "CO/CO₂ — scenario 4",
      "difficulty": "Hard",
      "stem": "An audit finding relates to co/co₂ under Water Quality and Indoor Air. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm co/co₂ controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q016",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Ventilation rates — scenario 4",
      "difficulty": "Easy",
      "stem": "When applying ventilation rates within Water Quality and Indoor Air, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Ventilation rates in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q017",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 5",
      "difficulty": "Medium",
      "stem": "A facility review focuses on legionella in Water Quality and Indoor Air. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Legionella: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q018",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 5",
      "difficulty": "Hard",
      "stem": "Which statement about mold/moisture in Water Quality and Indoor Air is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm mold/moisture controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q019",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "CO/CO₂ — scenario 5",
      "difficulty": "Easy",
      "stem": "During water quality and indoor air planning, co/co₂ is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "CO/CO₂ in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q020",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Ventilation rates — scenario 5",
      "difficulty": "Medium",
      "stem": "An audit finding relates to ventilation rates under Water Quality and Indoor Air. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Ventilation rates: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q021",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 6",
      "difficulty": "Hard",
      "stem": "When applying legionella within Water Quality and Indoor Air, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm legionella controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q022",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 6",
      "difficulty": "Easy",
      "stem": "A facility review focuses on mold/moisture in Water Quality and Indoor Air. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Mold/moisture in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q023",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "CO/CO₂ — scenario 6",
      "difficulty": "Medium",
      "stem": "Which statement about co/co₂ in Water Quality and Indoor Air is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to CO/CO₂: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q024",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Ventilation rates — scenario 6",
      "difficulty": "Hard",
      "stem": "During water quality and indoor air planning, ventilation rates is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm ventilation rates controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q025",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 7",
      "difficulty": "Easy",
      "stem": "An audit finding relates to legionella under Water Quality and Indoor Air. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Legionella in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q026",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 7",
      "difficulty": "Medium",
      "stem": "When applying mold/moisture within Water Quality and Indoor Air, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Mold/moisture: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q027",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "CO/CO₂ — scenario 7",
      "difficulty": "Hard",
      "stem": "A facility review focuses on co/co₂ in Water Quality and Indoor Air. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm co/co₂ controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q028",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Ventilation rates — scenario 7",
      "difficulty": "Easy",
      "stem": "Which statement about ventilation rates in Water Quality and Indoor Air is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Ventilation rates in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q029",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 8",
      "difficulty": "Medium",
      "stem": "During water quality and indoor air planning, legionella is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Legionella: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q030",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 8",
      "difficulty": "Hard",
      "stem": "An audit finding relates to mold/moisture under Water Quality and Indoor Air. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm mold/moisture controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q031",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "CO/CO₂ — scenario 8",
      "difficulty": "Easy",
      "stem": "When applying co/co₂ within Water Quality and Indoor Air, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "CO/CO₂ in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q032",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Ventilation rates — scenario 8",
      "difficulty": "Medium",
      "stem": "A facility review focuses on ventilation rates in Water Quality and Indoor Air. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Ventilation rates: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q033",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 9",
      "difficulty": "Hard",
      "stem": "Which statement about legionella in Water Quality and Indoor Air is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm legionella controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q034",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 9",
      "difficulty": "Easy",
      "stem": "During water quality and indoor air planning, mold/moisture is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Mold/moisture in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q035",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "CO/CO₂ — scenario 9",
      "difficulty": "Medium",
      "stem": "An audit finding relates to co/co₂ under Water Quality and Indoor Air. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to CO/CO₂: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q036",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Ventilation rates — scenario 9",
      "difficulty": "Hard",
      "stem": "When applying ventilation rates within Water Quality and Indoor Air, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Water Quality and Indoor Air includes transparent documentation and follow-up to confirm ventilation rates controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q037",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Legionella — scenario 10",
      "difficulty": "Easy",
      "stem": "A facility review focuses on legionella in Water Quality and Indoor Air. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Legionella in Water Quality and Indoor Air requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D16-Q038",
      "itemType": "question",
      "domain": "water-quality-indoor-air",
      "topic": "Mold/moisture — scenario 10",
      "difficulty": "Medium",
      "stem": "Which statement about mold/moisture in Water Quality and Indoor Air is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Mold/moisture: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q001",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 1",
      "difficulty": "Easy",
      "stem": "When applying chemical reactivity within Industrial Process Safety Interface, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Chemical reactivity in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q002",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 1",
      "difficulty": "Medium",
      "stem": "A facility review focuses on process ventilation in Industrial Process Safety Interface. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Process ventilation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q003",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Emergency isolation — scenario 1",
      "difficulty": "Hard",
      "stem": "Which statement about emergency isolation in Industrial Process Safety Interface is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm emergency isolation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q004",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "IH-PSM coordination — scenario 1",
      "difficulty": "Easy",
      "stem": "During industrial process safety interface planning, ih-psm coordination is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "IH-PSM coordination in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q005",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 2",
      "difficulty": "Medium",
      "stem": "An audit finding relates to chemical reactivity under Industrial Process Safety Interface. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Chemical reactivity: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q006",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 2",
      "difficulty": "Hard",
      "stem": "When applying process ventilation within Industrial Process Safety Interface, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm process ventilation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q007",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Emergency isolation — scenario 2",
      "difficulty": "Easy",
      "stem": "A facility review focuses on emergency isolation in Industrial Process Safety Interface. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Emergency isolation in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q008",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "IH-PSM coordination — scenario 2",
      "difficulty": "Medium",
      "stem": "Which statement about ih-psm coordination in Industrial Process Safety Interface is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to IH-PSM coordination: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q009",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 3",
      "difficulty": "Hard",
      "stem": "During industrial process safety interface planning, chemical reactivity is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm chemical reactivity controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q010",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 3",
      "difficulty": "Easy",
      "stem": "An audit finding relates to process ventilation under Industrial Process Safety Interface. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Process ventilation in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q011",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Emergency isolation — scenario 3",
      "difficulty": "Medium",
      "stem": "When applying emergency isolation within Industrial Process Safety Interface, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Emergency isolation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q012",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "IH-PSM coordination — scenario 3",
      "difficulty": "Hard",
      "stem": "A facility review focuses on ih-psm coordination in Industrial Process Safety Interface. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm ih-psm coordination controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q013",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 4",
      "difficulty": "Easy",
      "stem": "Which statement about chemical reactivity in Industrial Process Safety Interface is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Chemical reactivity in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q014",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 4",
      "difficulty": "Medium",
      "stem": "During industrial process safety interface planning, process ventilation is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Process ventilation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q015",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Emergency isolation — scenario 4",
      "difficulty": "Hard",
      "stem": "An audit finding relates to emergency isolation under Industrial Process Safety Interface. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm emergency isolation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q016",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "IH-PSM coordination — scenario 4",
      "difficulty": "Easy",
      "stem": "When applying ih-psm coordination within Industrial Process Safety Interface, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "IH-PSM coordination in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q017",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 5",
      "difficulty": "Medium",
      "stem": "A facility review focuses on chemical reactivity in Industrial Process Safety Interface. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Chemical reactivity: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q018",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 5",
      "difficulty": "Hard",
      "stem": "Which statement about process ventilation in Industrial Process Safety Interface is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm process ventilation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q019",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Emergency isolation — scenario 5",
      "difficulty": "Easy",
      "stem": "During industrial process safety interface planning, emergency isolation is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Emergency isolation in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q020",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "IH-PSM coordination — scenario 5",
      "difficulty": "Medium",
      "stem": "An audit finding relates to ih-psm coordination under Industrial Process Safety Interface. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to IH-PSM coordination: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q021",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 6",
      "difficulty": "Hard",
      "stem": "When applying chemical reactivity within Industrial Process Safety Interface, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm chemical reactivity controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q022",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 6",
      "difficulty": "Easy",
      "stem": "A facility review focuses on process ventilation in Industrial Process Safety Interface. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Process ventilation in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q023",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Emergency isolation — scenario 6",
      "difficulty": "Medium",
      "stem": "Which statement about emergency isolation in Industrial Process Safety Interface is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Emergency isolation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q024",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "IH-PSM coordination — scenario 6",
      "difficulty": "Hard",
      "stem": "During industrial process safety interface planning, ih-psm coordination is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm ih-psm coordination controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q025",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 7",
      "difficulty": "Easy",
      "stem": "An audit finding relates to chemical reactivity under Industrial Process Safety Interface. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Chemical reactivity in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q026",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 7",
      "difficulty": "Medium",
      "stem": "When applying process ventilation within Industrial Process Safety Interface, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Process ventilation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q027",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Emergency isolation — scenario 7",
      "difficulty": "Hard",
      "stem": "A facility review focuses on emergency isolation in Industrial Process Safety Interface. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm emergency isolation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q028",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "IH-PSM coordination — scenario 7",
      "difficulty": "Easy",
      "stem": "Which statement about ih-psm coordination in Industrial Process Safety Interface is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "IH-PSM coordination in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q029",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 8",
      "difficulty": "Medium",
      "stem": "During industrial process safety interface planning, chemical reactivity is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Chemical reactivity: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q030",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 8",
      "difficulty": "Hard",
      "stem": "An audit finding relates to process ventilation under Industrial Process Safety Interface. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm process ventilation controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q031",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Emergency isolation — scenario 8",
      "difficulty": "Easy",
      "stem": "When applying emergency isolation within Industrial Process Safety Interface, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Emergency isolation in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q032",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "IH-PSM coordination — scenario 8",
      "difficulty": "Medium",
      "stem": "A facility review focuses on ih-psm coordination in Industrial Process Safety Interface. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to IH-PSM coordination: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q033",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 9",
      "difficulty": "Hard",
      "stem": "Which statement about chemical reactivity in Industrial Process Safety Interface is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm chemical reactivity controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q034",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 9",
      "difficulty": "Easy",
      "stem": "During industrial process safety interface planning, process ventilation is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Process ventilation in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q035",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Emergency isolation — scenario 9",
      "difficulty": "Medium",
      "stem": "An audit finding relates to emergency isolation under Industrial Process Safety Interface. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Emergency isolation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q036",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "IH-PSM coordination — scenario 9",
      "difficulty": "Hard",
      "stem": "When applying ih-psm coordination within Industrial Process Safety Interface, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Industrial Process Safety Interface includes transparent documentation and follow-up to confirm ih-psm coordination controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q037",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Chemical reactivity — scenario 10",
      "difficulty": "Easy",
      "stem": "A facility review focuses on chemical reactivity in Industrial Process Safety Interface. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Chemical reactivity in Industrial Process Safety Interface requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D17-Q038",
      "itemType": "question",
      "domain": "industrial-process-safety",
      "topic": "Process ventilation — scenario 10",
      "difficulty": "Medium",
      "stem": "Which statement about process ventilation in Industrial Process Safety Interface is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Process ventilation: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q001",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 1",
      "difficulty": "Easy",
      "stem": "When applying medical surveillance within Occupational Health Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Medical surveillance in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q002",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 1",
      "difficulty": "Medium",
      "stem": "A facility review focuses on fit testing in Occupational Health Programs. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Fit testing: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q003",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Wellness integration — scenario 1",
      "difficulty": "Hard",
      "stem": "Which statement about wellness integration in Occupational Health Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm wellness integration controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q004",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Return-to-work — scenario 1",
      "difficulty": "Easy",
      "stem": "During occupational health programs planning, return-to-work is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Return-to-work in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q005",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 2",
      "difficulty": "Medium",
      "stem": "An audit finding relates to medical surveillance under Occupational Health Programs. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Medical surveillance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q006",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 2",
      "difficulty": "Hard",
      "stem": "When applying fit testing within Occupational Health Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm fit testing controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q007",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Wellness integration — scenario 2",
      "difficulty": "Easy",
      "stem": "A facility review focuses on wellness integration in Occupational Health Programs. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Wellness integration in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q008",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Return-to-work — scenario 2",
      "difficulty": "Medium",
      "stem": "Which statement about return-to-work in Occupational Health Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Return-to-work: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q009",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 3",
      "difficulty": "Hard",
      "stem": "During occupational health programs planning, medical surveillance is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm medical surveillance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q010",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 3",
      "difficulty": "Easy",
      "stem": "An audit finding relates to fit testing under Occupational Health Programs. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Fit testing in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q011",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Wellness integration — scenario 3",
      "difficulty": "Medium",
      "stem": "When applying wellness integration within Occupational Health Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Wellness integration: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q012",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Return-to-work — scenario 3",
      "difficulty": "Hard",
      "stem": "A facility review focuses on return-to-work in Occupational Health Programs. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm return-to-work controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q013",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 4",
      "difficulty": "Easy",
      "stem": "Which statement about medical surveillance in Occupational Health Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Medical surveillance in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q014",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 4",
      "difficulty": "Medium",
      "stem": "During occupational health programs planning, fit testing is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Fit testing: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q015",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Wellness integration — scenario 4",
      "difficulty": "Hard",
      "stem": "An audit finding relates to wellness integration under Occupational Health Programs. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm wellness integration controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q016",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Return-to-work — scenario 4",
      "difficulty": "Easy",
      "stem": "When applying return-to-work within Occupational Health Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Return-to-work in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q017",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 5",
      "difficulty": "Medium",
      "stem": "A facility review focuses on medical surveillance in Occupational Health Programs. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Medical surveillance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q018",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 5",
      "difficulty": "Hard",
      "stem": "Which statement about fit testing in Occupational Health Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm fit testing controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q019",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Wellness integration — scenario 5",
      "difficulty": "Easy",
      "stem": "During occupational health programs planning, wellness integration is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Wellness integration in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q020",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Return-to-work — scenario 5",
      "difficulty": "Medium",
      "stem": "An audit finding relates to return-to-work under Occupational Health Programs. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Return-to-work: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q021",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 6",
      "difficulty": "Hard",
      "stem": "When applying medical surveillance within Occupational Health Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm medical surveillance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q022",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 6",
      "difficulty": "Easy",
      "stem": "A facility review focuses on fit testing in Occupational Health Programs. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Fit testing in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q023",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Wellness integration — scenario 6",
      "difficulty": "Medium",
      "stem": "Which statement about wellness integration in Occupational Health Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Wellness integration: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q024",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Return-to-work — scenario 6",
      "difficulty": "Hard",
      "stem": "During occupational health programs planning, return-to-work is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm return-to-work controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q025",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 7",
      "difficulty": "Easy",
      "stem": "An audit finding relates to medical surveillance under Occupational Health Programs. Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Medical surveillance in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q026",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 7",
      "difficulty": "Medium",
      "stem": "When applying fit testing within Occupational Health Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Fit testing: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q027",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Wellness integration — scenario 7",
      "difficulty": "Hard",
      "stem": "A facility review focuses on wellness integration in Occupational Health Programs. The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm wellness integration controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q028",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Return-to-work — scenario 7",
      "difficulty": "Easy",
      "stem": "Which statement about return-to-work in Occupational Health Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Return-to-work in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q029",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 8",
      "difficulty": "Medium",
      "stem": "During occupational health programs planning, medical surveillance is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Medical surveillance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q030",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 8",
      "difficulty": "Hard",
      "stem": "An audit finding relates to fit testing under Occupational Health Programs. Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm fit testing controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q031",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Wellness integration — scenario 8",
      "difficulty": "Easy",
      "stem": "When applying wellness integration within Occupational Health Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Wellness integration in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q032",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Return-to-work — scenario 8",
      "difficulty": "Medium",
      "stem": "A facility review focuses on return-to-work in Occupational Health Programs. The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Return-to-work: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q033",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 9",
      "difficulty": "Hard",
      "stem": "Which statement about medical surveillance in Occupational Health Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm medical surveillance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q034",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 9",
      "difficulty": "Easy",
      "stem": "During occupational health programs planning, fit testing is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Fit testing in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q035",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Wellness integration — scenario 9",
      "difficulty": "Medium",
      "stem": "An audit finding relates to wellness integration under Occupational Health Programs. Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Wellness integration: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q036",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Return-to-work — scenario 9",
      "difficulty": "Hard",
      "stem": "When applying return-to-work within Occupational Health Programs, which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Occupational Health Programs includes transparent documentation and follow-up to confirm return-to-work controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q037",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Medical surveillance — scenario 10",
      "difficulty": "Easy",
      "stem": "A facility review focuses on medical surveillance in Occupational Health Programs. The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Medical surveillance in Occupational Health Programs requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D18-Q038",
      "itemType": "question",
      "domain": "occupational-health-programs",
      "topic": "Fit testing — scenario 10",
      "difficulty": "Medium",
      "stem": "Which statement about fit testing in Occupational Health Programs is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Fit testing: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q001",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 1",
      "difficulty": "Easy",
      "stem": "When applying spill assessment within Emergency Response (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Spill assessment in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q002",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 1",
      "difficulty": "Medium",
      "stem": "A facility review focuses on responder ppe in Emergency Response (IH). The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Responder PPE: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q003",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Air monitoring during incidents — scenario 1",
      "difficulty": "Hard",
      "stem": "Which statement about air monitoring during incidents in Emergency Response (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm air monitoring during incidents controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q004",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Decontamination — scenario 1",
      "difficulty": "Easy",
      "stem": "During emergency response (ih) planning, decontamination is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Decontamination in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q005",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 2",
      "difficulty": "Medium",
      "stem": "An audit finding relates to spill assessment under Emergency Response (IH). Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Spill assessment: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q006",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 2",
      "difficulty": "Hard",
      "stem": "When applying responder ppe within Emergency Response (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm responder ppe controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q007",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Air monitoring during incidents — scenario 2",
      "difficulty": "Easy",
      "stem": "A facility review focuses on air monitoring during incidents in Emergency Response (IH). The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Air monitoring during incidents in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q008",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Decontamination — scenario 2",
      "difficulty": "Medium",
      "stem": "Which statement about decontamination in Emergency Response (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Decontamination: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q009",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 3",
      "difficulty": "Hard",
      "stem": "During emergency response (ih) planning, spill assessment is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm spill assessment controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q010",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 3",
      "difficulty": "Easy",
      "stem": "An audit finding relates to responder ppe under Emergency Response (IH). Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Responder PPE in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q011",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Air monitoring during incidents — scenario 3",
      "difficulty": "Medium",
      "stem": "When applying air monitoring during incidents within Emergency Response (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Air monitoring during incidents: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q012",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Decontamination — scenario 3",
      "difficulty": "Hard",
      "stem": "A facility review focuses on decontamination in Emergency Response (IH). The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm decontamination controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q013",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 4",
      "difficulty": "Easy",
      "stem": "Which statement about spill assessment in Emergency Response (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Spill assessment in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q014",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 4",
      "difficulty": "Medium",
      "stem": "During emergency response (ih) planning, responder ppe is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Responder PPE: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q015",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Air monitoring during incidents — scenario 4",
      "difficulty": "Hard",
      "stem": "An audit finding relates to air monitoring during incidents under Emergency Response (IH). Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm air monitoring during incidents controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q016",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Decontamination — scenario 4",
      "difficulty": "Easy",
      "stem": "When applying decontamination within Emergency Response (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Decontamination in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q017",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 5",
      "difficulty": "Medium",
      "stem": "A facility review focuses on spill assessment in Emergency Response (IH). The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Spill assessment: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q018",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 5",
      "difficulty": "Hard",
      "stem": "Which statement about responder ppe in Emergency Response (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm responder ppe controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q019",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Air monitoring during incidents — scenario 5",
      "difficulty": "Easy",
      "stem": "During emergency response (ih) planning, air monitoring during incidents is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Air monitoring during incidents in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q020",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Decontamination — scenario 5",
      "difficulty": "Medium",
      "stem": "An audit finding relates to decontamination under Emergency Response (IH). Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Decontamination: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q021",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 6",
      "difficulty": "Hard",
      "stem": "When applying spill assessment within Emergency Response (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm spill assessment controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q022",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 6",
      "difficulty": "Easy",
      "stem": "A facility review focuses on responder ppe in Emergency Response (IH). The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Responder PPE in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q023",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Air monitoring during incidents — scenario 6",
      "difficulty": "Medium",
      "stem": "Which statement about air monitoring during incidents in Emergency Response (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Air monitoring during incidents: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q024",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Decontamination — scenario 6",
      "difficulty": "Hard",
      "stem": "During emergency response (ih) planning, decontamination is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm decontamination controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q025",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 7",
      "difficulty": "Easy",
      "stem": "An audit finding relates to spill assessment under Emergency Response (IH). Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Spill assessment in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q026",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 7",
      "difficulty": "Medium",
      "stem": "When applying responder ppe within Emergency Response (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Responder PPE: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q027",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Air monitoring during incidents — scenario 7",
      "difficulty": "Hard",
      "stem": "A facility review focuses on air monitoring during incidents in Emergency Response (IH). The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm air monitoring during incidents controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q028",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Decontamination — scenario 7",
      "difficulty": "Easy",
      "stem": "Which statement about decontamination in Emergency Response (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Decontamination in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q029",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 8",
      "difficulty": "Medium",
      "stem": "During emergency response (ih) planning, spill assessment is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Spill assessment: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q030",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 8",
      "difficulty": "Hard",
      "stem": "An audit finding relates to responder ppe under Emergency Response (IH). Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm responder ppe controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q031",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Air monitoring during incidents — scenario 8",
      "difficulty": "Easy",
      "stem": "When applying air monitoring during incidents within Emergency Response (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Air monitoring during incidents in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q032",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Decontamination — scenario 8",
      "difficulty": "Medium",
      "stem": "A facility review focuses on decontamination in Emergency Response (IH). The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Decontamination: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q033",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 9",
      "difficulty": "Hard",
      "stem": "Which statement about spill assessment in Emergency Response (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm spill assessment controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q034",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 9",
      "difficulty": "Easy",
      "stem": "During emergency response (ih) planning, responder ppe is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Responder PPE in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q035",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Air monitoring during incidents — scenario 9",
      "difficulty": "Medium",
      "stem": "An audit finding relates to air monitoring during incidents under Emergency Response (IH). Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Air monitoring during incidents: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q036",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Decontamination — scenario 9",
      "difficulty": "Hard",
      "stem": "When applying decontamination within Emergency Response (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in Emergency Response (IH) includes transparent documentation and follow-up to confirm decontamination controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q037",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Spill assessment — scenario 10",
      "difficulty": "Easy",
      "stem": "A facility review focuses on spill assessment in Emergency Response (IH). The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Spill assessment in Emergency Response (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D19-Q038",
      "itemType": "question",
      "domain": "emergency-response-ih",
      "topic": "Responder PPE — scenario 10",
      "difficulty": "Medium",
      "stem": "Which statement about responder ppe in Emergency Response (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Responder PPE: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q001",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 1",
      "difficulty": "Easy",
      "stem": "When applying global oel concepts within International Standards (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Global OEL concepts in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q002",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 1",
      "difficulty": "Medium",
      "stem": "A facility review focuses on harmonized labeling in International Standards (IH). The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Harmonized labeling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q003",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Cross-border compliance — scenario 1",
      "difficulty": "Hard",
      "stem": "Which statement about cross-border compliance in International Standards (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm cross-border compliance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q004",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "WHO/ILO guidance — scenario 1",
      "difficulty": "Easy",
      "stem": "During international standards (ih) planning, who/ilo guidance is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "WHO/ILO guidance in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q005",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 2",
      "difficulty": "Medium",
      "stem": "An audit finding relates to global oel concepts under International Standards (IH). Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Global OEL concepts: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q006",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 2",
      "difficulty": "Hard",
      "stem": "When applying harmonized labeling within International Standards (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm harmonized labeling controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q007",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Cross-border compliance — scenario 2",
      "difficulty": "Easy",
      "stem": "A facility review focuses on cross-border compliance in International Standards (IH). The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Cross-border compliance in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q008",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "WHO/ILO guidance — scenario 2",
      "difficulty": "Medium",
      "stem": "Which statement about who/ilo guidance in International Standards (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to WHO/ILO guidance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q009",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 3",
      "difficulty": "Hard",
      "stem": "During international standards (ih) planning, global oel concepts is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm global oel concepts controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q010",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 3",
      "difficulty": "Easy",
      "stem": "An audit finding relates to harmonized labeling under International Standards (IH). Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Harmonized labeling in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q011",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Cross-border compliance — scenario 3",
      "difficulty": "Medium",
      "stem": "When applying cross-border compliance within International Standards (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Cross-border compliance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q012",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "WHO/ILO guidance — scenario 3",
      "difficulty": "Hard",
      "stem": "A facility review focuses on who/ilo guidance in International Standards (IH). The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm who/ilo guidance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q013",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 4",
      "difficulty": "Easy",
      "stem": "Which statement about global oel concepts in International Standards (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Global OEL concepts in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q014",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 4",
      "difficulty": "Medium",
      "stem": "During international standards (ih) planning, harmonized labeling is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Harmonized labeling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q015",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Cross-border compliance — scenario 4",
      "difficulty": "Hard",
      "stem": "An audit finding relates to cross-border compliance under International Standards (IH). Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm cross-border compliance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q016",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "WHO/ILO guidance — scenario 4",
      "difficulty": "Easy",
      "stem": "When applying who/ilo guidance within International Standards (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "WHO/ILO guidance in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q017",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 5",
      "difficulty": "Medium",
      "stem": "A facility review focuses on global oel concepts in International Standards (IH). The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Global OEL concepts: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q018",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 5",
      "difficulty": "Hard",
      "stem": "Which statement about harmonized labeling in International Standards (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm harmonized labeling controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q019",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Cross-border compliance — scenario 5",
      "difficulty": "Easy",
      "stem": "During international standards (ih) planning, cross-border compliance is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Cross-border compliance in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q020",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "WHO/ILO guidance — scenario 5",
      "difficulty": "Medium",
      "stem": "An audit finding relates to who/ilo guidance under International Standards (IH). Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to WHO/ILO guidance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q021",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 6",
      "difficulty": "Hard",
      "stem": "When applying global oel concepts within International Standards (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm global oel concepts controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q022",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 6",
      "difficulty": "Easy",
      "stem": "A facility review focuses on harmonized labeling in International Standards (IH). The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Harmonized labeling in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q023",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Cross-border compliance — scenario 6",
      "difficulty": "Medium",
      "stem": "Which statement about cross-border compliance in International Standards (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Cross-border compliance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q024",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "WHO/ILO guidance — scenario 6",
      "difficulty": "Hard",
      "stem": "During international standards (ih) planning, who/ilo guidance is evaluated. The priority action is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm who/ilo guidance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q025",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 7",
      "difficulty": "Easy",
      "stem": "An audit finding relates to global oel concepts under International Standards (IH). Corrective action should:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Global OEL concepts in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q026",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 7",
      "difficulty": "Medium",
      "stem": "When applying harmonized labeling within International Standards (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Harmonized labeling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q027",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Cross-border compliance — scenario 7",
      "difficulty": "Hard",
      "stem": "A facility review focuses on cross-border compliance in International Standards (IH). The most defensible next step is:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm cross-border compliance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q028",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "WHO/ILO guidance — scenario 7",
      "difficulty": "Easy",
      "stem": "Which statement about who/ilo guidance in International Standards (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "WHO/ILO guidance in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q029",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 8",
      "difficulty": "Medium",
      "stem": "During international standards (ih) planning, global oel concepts is evaluated. The priority action is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Global OEL concepts: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q030",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 8",
      "difficulty": "Hard",
      "stem": "An audit finding relates to harmonized labeling under International Standards (IH). Corrective action should:",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm harmonized labeling controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q031",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Cross-border compliance — scenario 8",
      "difficulty": "Easy",
      "stem": "When applying cross-border compliance within International Standards (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Cross-border compliance in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q032",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "WHO/ILO guidance — scenario 8",
      "difficulty": "Medium",
      "stem": "A facility review focuses on who/ilo guidance in International Standards (IH). The most defensible next step is:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to WHO/ILO guidance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q033",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 9",
      "difficulty": "Hard",
      "stem": "Which statement about global oel concepts in International Standards (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm global oel concepts controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q034",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 9",
      "difficulty": "Easy",
      "stem": "During international standards (ih) planning, harmonized labeling is evaluated. The priority action is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Harmonized labeling in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q035",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Cross-border compliance — scenario 9",
      "difficulty": "Medium",
      "stem": "An audit finding relates to cross-border compliance under International Standards (IH). Corrective action should:",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Cross-border compliance: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q036",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "WHO/ILO guidance — scenario 9",
      "difficulty": "Hard",
      "stem": "When applying who/ilo guidance within International Standards (IH), which approach best aligns with professional practice and public guidance?",
      "choiceA": "Document assumptions, communicate findings, and schedule follow-up verification",
      "choiceB": "Close the issue without root-cause analysis",
      "choiceC": "Withhold results from affected workers",
      "choiceD": "Use proprietary prep content without citation",
      "correctAnswer": "A",
      "explanation": "Professional practice in International Standards (IH) includes transparent documentation and follow-up to confirm who/ilo guidance controls remain effective.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q037",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Global OEL concepts — scenario 10",
      "difficulty": "Easy",
      "stem": "A facility review focuses on global oel concepts in International Standards (IH). The most defensible next step is:",
      "choiceA": "Use documented, reference-backed methods and verify control effectiveness",
      "choiceB": "Rely on undocumented assumptions without follow-up",
      "choiceC": "Skip worker communication and training",
      "choiceD": "Discard sampling or inspection records",
      "correctAnswer": "A",
      "explanation": "Global OEL concepts in International Standards (IH) requires traceable data, appropriate public methods, and verification that controls perform as intended.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    },
    {
      "packId": "cih",
      "itemId": "CIH-D20-Q038",
      "itemType": "question",
      "domain": "international-standards-ih",
      "topic": "Harmonized labeling — scenario 10",
      "difficulty": "Medium",
      "stem": "Which statement about harmonized labeling in International Standards (IH) is supported by standard occupational health and safety practice?",
      "choiceA": "Prioritize elimination or engineering controls before administrative measures and PPE",
      "choiceB": "Use PPE alone without assessing source controls",
      "choiceC": "Defer all action until an injury occurs",
      "choiceD": "Ignore applicable regulatory minimums",
      "correctAnswer": "A",
      "explanation": "The hierarchy of controls applies to Harmonized labeling: reduce exposure at the source before relying on administrative measures or PPE alone.",
      "reference": "niosh-pub: NIOSH Occupational Health Guidance",
      "reviewStatus": "accepted",
      "reviewerName": "",
      "reviewerRole": "",
      "reviewComments": "",
      "recommendedAction": "",
      "sourceAdequacy": "",
      "technicalAccuracy": "",
      "clarity": "",
      "disposition": ""
    }
  ]
}
