The ABCs of a Written Respiratory Program
By Robin Regan
February 26, 2020
Dangerous airborne contaminants are everywhere, whether you work in construction, manufacturing, mining, or firefighting. More than a nuisance, exposure to dust, gases and vapors can lead to serious, life-threatening diseases.
We know a “one-mask-fits-all” is not an efficient approach, but sometimes safety professionals have trouble identifying the best solution to fend off the hazard. If you’re in the process of reviewing your respiratory program or starting from scratch, here are a few guidelines to consider in respiratory PPE selection.
Setting up a respiratory program
If respirators are being used in the workplace, a written program addressing all onsite respiratory hazards is required. This program should be adaptable and fluid to accommodate any changes that may arise. Multiple locations can share a program if the locations are similar, but should be site-specific if they have their unique set of problems and solutions. The program must be reviewed any time changes are presented from a new contaminant/concentration or a new engineering control, and at least annually.
Before you consider establishing or reviewing your current respiratory program, these questions need to be addressed:
1. What are the contaminants present in the environment and what is the concentration?
2. Are the contaminants above the IDLH value or are oxygen levels below 19.5% or above 23%?
3. Is there a written respiratory program and is it up to date?
4. Have all workers had a medical evaluation completed?
5. Have all workers been fit tested with the appropriate respirator?
The written respiratory protection program should follow these steps:
1. Respiratory Selection - hazard identification and concentrations of contaminants
When starting the process of selecting a respirator, focus on the contaminant. Respirators are frequently recommended strictly by the work being done or the contaminant present when really, it’s the concentration that matters most.
For example, most workers exposed to respirable crystalline silica use an N95 disposable respirator. These types of respirators are tested and certified to protect workers up to 500 micrograms of silica per cubic meter, ten times the permissible exposure limit set by OSHA.
However, if a worker is exposed to an environment with 1,000 micrograms of silica per cubic meter, they risk developing silicosis or other life-threatening illnesses. Even if an N95 disposable respirator is the solution at hand, in this situation, it would not be enough. Instead, this worker would be best protected by a full-face respirator with a quantitative fit test or even a Powered Air-Purifying Respirator (PAPR).
2. Medical Evaluations - must be completed prior to first use and fit test and may be ongoing for specific contaminants.
Prior to selecting a respirator, workers must complete a medical evaluation to ensure they can safely use a respirator. For most applications, this is done for every new hire. Certain contaminants, such as respirable crystalline silica, may require more frequent medical evaluations. The medical evaluations can often be done quickly and without leaving the workplace by completing an online questionnaire. Contaminant specific medical evaluations are typically done in person as they may involve chest x-rays, pulmonary function tests, and more.
3. Fit Testing - required initially, annually and when face or respirator model/size changes
Once a worker is medically cleared to wear a respirator, they must be fit tested to determine that the respirator fits properly against their face.
A correctly worn respirator will be completely sealed around the nose, cheeks and chin to ensure contaminants cannot enter through gaps or breaks in the seal.
Putting a disposable respirator on requires a few easy steps:
- Hold the respirator in one hand, with the nose piece at the fingertips and let the straps hang loose.
- Place the respirator under the chin, with the nosepiece up. While holding the respirators with one hand, pull the top strap over your head and the bottom strap around the neck, below the ears.
- Using both hands, push inward with your fingertips to mold the nose piece
There are similarly easy steps to putting on a tight-fitting respirator:
- Hold the respirator in one hand, move the head straps to their full outward position.
- Place your chin inside the chin cup of the respirator. While holding the respirators with one hand, pull the straps so that they are centered on your head. Fasten the bottom straps behind your neck first and remove any slack. Then tighten the upper head straps while keeping the respirator centered on your face.
- A seal-check needs to be conducted every time a tight-fitting respirator is put on. The positive pressure seal check can be performed by placing your palm over the exhalation valve and exhaling gently. The facepiece will push away from your face slightly with no leaks. The negative pressure seal check is performed by placing the palms of each hand over the filter or cartridges so that they are completely sealed and then inhaling. The facepiece should pull inward toward your face with no leaks.
Bear in mind, facial hair can influence fit. Any facial hair can compromise the seal of a tight-fitting respirator. This does include disposable respirators, despite dangerous myths that disposable respirators do not require fit testing. OSHA has recently elaborated on the topic of facial hair by stating that the entire sealing surface must be clear of facial hair and that new growth of facial hair may not exceed one day. Loose-fitting hoods and helmets can be used with facial hair as they utilize positive pressure and do not seal against the face.
Qualitative fit testing includes methods that use a challenge agent like Irritant Smoke, Bitrex©, or Saccharin. These methods require first confirming that a worker is sensitive to these challenge agents. The test then involves exposure to the challenge agent while wearing the respirator with appropriate filters or cartridges. If a worker then smells, tastes, or reacts to one of these challenge agents while wearing their respirator, it can indicate a poor seal or leak.
Quantitative fit testing involves various methods to provide a measurable fit factor for the worker. Quantitative fit test methods provide several benefits for using these more accurate methods. Many industries use these types of testing as a standard with qualitative being the exception. In addition to the increased peace of mind of a more accurate test, faking these tests are also much more difficult compared to the qualitative versions. Finally, one of the most significant benefits would be when using a full-face respirator. Quantitative fit tests provide full-face respirators with an assigned protection factor of 50 compared to a protection factor of 10 with qualitative tests.
4. Training - why, when, and where to use, respirator limitations, inspection, filter/cartridge change-out schedule.
N95 respirators, for instance, need to be fit tested before use. People need to be medically evaluated and trained to ensure they understand how to put them on, as well as their protective limitations.
5. Proper care and use of respirators - routine and emergency use.
If the respirator gets damaged, or soiled, workers need to leave the work area and inform supervisors about the issue.
In 2018, the 4th most cited OSHA standard was the Respiratory Protection Standard, 1910.134. Ony by selecting the correct respirator, having an updated written respiratory program, and ensuring that medical evaluations and fit testing is completed for all workers can we effectively protect workers against respiratory hazards.
Honeywell offers respiratory protection for any environment, from disposables, air and powered air purifying respirators (APR and PAPR), and full range of cartridges, filters and other accessories to air supplied systems and Self Contained Breathing Apparatuses (SCBA). Learn more.
Robin Regan is the Product Sales Manager for Respiratory Protection at Honeywell Industrial Safety.