1. EHSRM (v. 1/04) 1 Environmental Health, Safety and Risk Management Bob Grieshaber Sue Kerns January, 2004

2. EHSRM (v. 1/04) 2 What are the ten parts of a respirator program? 1 2 3 4 5 6 7 8 9 10 Someone in charge Medical evaluation Selection Training Fit testing Inspection & repair Cleaning Use Review Recordkeeping

3. EHSRM (v. 1/04) 3 Training Goals You should understand the extent of the requirements of a respiratory protection program. You should understand the limitations of the program and your respirator.

4. EHSRM (v. 1/04) 4Exposure Exposure is the concentration of air contaminant

5. EHSRM (v. 1/04) 5 Types of Respirators: Tight-fitting

6. EHSRM (v. 1/04) 6 Types of Respirators: Loose-fitting

7. EHSRM (v. 1/04) 7 Classes of Respirators: Positive and Negative Pressure + Positive pressure - Negative pressure

8. EHSRM (v. 1/04) 8 Positive Pressure Respirators When inhaling, the pressure inside the respirator is kept higher than outside the respirator

9. EHSRM (v. 1/04) 9 Negative Pressure Respirators When inhaling, the pressure inside the respirator is less than outside the respirator

10. EHSRM (v. 1/04) 10 Examples: negative pressure respirators Filtering facepieces or Dust masks

11. EHSRM (v. 1/04) 11 Disposable Particulate Respirator 95% efficiency rating Most common type in health care setting Lightweight Easy to wear Do not require cleaning Usually come in three sizes Can be obtained with or without an exhalation valve Video clip courtesy of NIOSH http://www.uwm.edu/Dept/EHSRM/TRAINING/N95/N95_Rating.mpg

12. EHSRM (v. 1/04) 12 N, R or P Respirators Ratings: “N,” if they are not resistant to oil “R” if somewhat resistant to oil, and “P” if strongly resistant (oil proof). Thus, there are nine types of disposable particulate respirators: N-95, N-99, and N-100 R-95, R-99, and R-100 P-95, P-99, and P-100

13. EHSRM (v. 1/04) 13 Surgical Masks and Disposable Respirators Typical surgical mask is not a respirator Because some disposable respirators resemble surgical masks, it is important to understand the difference between them Video clip courtesy of NIOSH http://www.uwm.edu/Dept/EHSRM/TRAINING/N95/SurgicalMask.mpg

14. EHSRM (v. 1/04) 14 Do surgical masks provide protection against SARS? Surgical masks are not designed for use as particulate respirators and do not provide as much protection as an N-95 respirator. Most surgical masks do not effectively filter small particles from air and do not prevent leakage around the edge of the mask when the user inhales. Surgical masks are recommended only as a last resort when no NIOSH-approved respirator equivalent to or greater than the N-95 is available

15. EHSRM (v. 1/04) 15 SARS Virus *The SARS virus has a “shell” composed of lipids, which are fats and oils. However, the amount of fat and oil in these tiny virus particles is extremely low and is not enough to affect the filter in the N-series respirator. Thus the N- series respirators such as N-95 will protect against SARS exposure. If you wear a faceshield you must ensure that it does not interfere with the respirator’s fit Video clip courtesy of NIOSH http://www.uwm.edu/Dept/EHSRM/TRAINING/N95/Faceshield.MPG

16. EHSRM (v. 1/04) 16 Voluntary and Mandatory Voluntary Use –See OSHA Form: “Required Information for Voluntary Use of Respirators” Mandatory use of dust masks kicks in the full respirator requirements

17. EHSRM (v. 1/04) 17 OSHA TB Standard Workers must be physically able to wear the respirator on the job Physician should establish the criteria for making this determination Video clip courtesy of NIOSH http://www.uwm.edu/Dept/EHSRM/TRAINING/N95/Physician.MPG

18. EHSRM (v. 1/04) 18 Fit Test -- Qualitative Relies on the wearer’s subjective response to taste, odor or irritation If subject can taste substance the fit is not acceptable If subject can not taste substance an acceptable fit has been achieved Video clip courtesy of NIOSH http://www.uwm.edu/Dept/EHSRM/TRAINING/N95/FitTesting.MPG

19. EHSRM (v. 1/04) 19 Fit Test - Quantitative The PORTACOUNT measures concentration of microscopic particles that exist in ambient air and then measures the concentration of those particles that leak into the respirator.

20. EHSRM (v. 1/04) 20 Seal Check In addition to the initial fit-test, wearers must check the seal of their respirators every time they put them on User seal checks are necessary to ensure that the respirator has been put on correctly Video clip courtesy of NIOSH http://www.uwm.edu/Dept/EHSRM/TRAINING/N95/SealCheck.MPG

21. EHSRM (v. 1/04) 21 Cleaning / Inspection A poorly maintained or malfunctioning respirator may actually be more dangerous than not wearing one at all. Video clip courtesy of NIOSH http://www.uwm.edu/Dept/EHSRM/TRAINING/N95/Maintenance.MPG

22. EHSRM (v. 1/04) 22 Cleaning / Inspection Disposables cannot be cleaned or sanitized, however routine inspection is still necessary. Determine whether the respirator straps hold the respirator tightly against the face. If not, discard the respirator. Do not attempt to tighten the respirator by knotting the straps. Inspect the respirator to determine if it is soiled or damaged. If so, discard the respirator.

23. EHSRM (v. 1/04) 23 Storage of Disposable N95 Half-Mask Respirator Store the respirator in a clean and dry location. Storing the respirator in a plastic sealed bag after use is not considered a good practice. The respirator may be damp after use and sealing prevents drying and encourages microbial growth. If plastic bags are used, respirators should be allowed to dry before storage. Respirators should be labeled for each worker.

24. EHSRM (v. 1/04) 24 How often do disposable respirators need to be replaced? Once worn in the presence of a SARS patient, the respirator should be considered potentially contaminated with infectious material, and touching the outside of the device should be avoided. Upon leaving the patient’s room, the disposable respirator should be removed and discarded, followed by hand hygiene.

25. EHSRM (v. 1/04) 25 Periodic spot checks may be made to be sure you are using your respirator correctly.Review

26. EHSRM (v. 1/04) 26 Other Options Besides the filtering facepieces, there are other designs of respirators that are more effective, e.g. PAPR, full face The PAPR provides a constant, filtered airflow to the user's facepiece thus providing the user with a higher safety factor due to positive pressure in the mask. The cooling effect of the filtered airflow into the facepiece and its comfortable fit, prevent fogging and greatly reduces the pulmonary stress associated with the extended use of negative- pressure respirators.

27. EHSRM (v. 1/04) 27