Breathing Right

Providing effective, appropriate respiratory protection for workers toiling in a contaminated environment can save lives.

What happens when employees or worse, employers are not aware that the environment in which they are working is plagued with contaminants?

Media reports of workers falling ill as a result of asbestos exposure, of ongoing respiratory ailments plaguing Ground Zero workers and of the impending threat of an avian flu pandemic all point to one important and obvious conclusion: Effective respiratory protection saves lives and prevents injuries.

"Companies should be monitoring their workplace, identifying contaminants and examining how long workers will be exposed to those contaminants," says Rick Sustello, vice president of marketing at North Safety Products. However, he adds: "Most people don't do this."

After conducting a workplace analysis to determine if respiratory hazards exist, employers are charged by OSHA to eliminate the exposure to toxins through engineering controls whenever possible.

"You aren't supposed to wear a respirator unless you can't possibly eliminate the source of contamination," Sustello points out. "Respirators are a last resort."

Sometimes it is not practical or economically feasible to eliminate the hazard. In that case, OSHA standard 1910.134 and ANSI standard Z88.1992 dictate that if a respirator is necessary to protect the health of an employee, the employer must implement a respiratory protection program.

Determining if a respiratory protection program is needed for your worksite is only half the battle. As Sustello points out, coming up with an efficient program is not that difficult, but the devil is in the details. A suitable respiratory program must include training employees in the proper use and selection of respirators, as well as teaching them about a respirator's capabilities and limitations.

Choosing the Right Respirator

The vast array of choices among respirators can be both a blessing and a curse. Which one to pick? An air-supplied respirator or an air-filtering respirator? Should I use a respirator that is resistant to oil or non-oil resistant?

Step one when developing a respiratory protection program should be knowing the types of contaminants in the workplace environment, says Heinz Ahlers, branch chief of the National Institute for Occupational Safety and Health's (NIOSH) National Personal Protective Technology Laboratory (NPPTL) in Pittsburgh. "One type of respirator, such as the air-purifying respirator, is limited in that it is specific to certain types of contaminants," he says. "If the worker is exposed to more-hazardous chemicals or other types of gases, then they need to use a different kind of respirator such as an air-supplying respirator."

Surprisingly, having too much protection can come at a cost as well. As Roland Berry Ann, acting program manager for respiratory protection at NPPTL explains, putting a person in charge of sweeping a dusty floor in a self-contained-breathing apparatus (SCBA) is not only senseless, but it also can cause that person to become ill.

"There is very little advantage in having a respirator that is a lot more protective than what you need," he explains. "More protective respirators are not only more expensive, but they also are harder to breathe through and they also weigh a lot more."

In addition, workers wearing some types of respirators need medical clearance. According to Sustello, workers suffering from asthma or reduced lung capacity might not be able to breathe through some respirators.

Many factors determine who should wear respirators, how they should wear them and when they should wear them, which is why experts say one person often the safety professional or industrial hygienist should make the recommendations for respiratory protection.

But the recommendation is useless if the person placed in charge and the employees are not properly trained, states Roy McKay, Ph.D., director of occupational pulmonary services at the University of Cincinnati.

Importance of Education

For many years, McKay has offered comprehensive education programs on respiratory protection and the requirements for meeting OSHA and ANSI standards. Although the end goal of the program is to have the person who will be in charge of administering the respiratory protection program trained to effectively conduct respirator fit tests, McKay says the courses also aim to educate students in all areas of respirator use such as storage, maintenance, use and discarding of the respirator.

"Training is very important when a respiratory protection program is started," he says. "They not only need to be familiar with the requirements, but they also must be knowledgeable of the terminology."

Becoming familiar with respirator terminology is important, as not knowing it could easily take the air out of a program that started out with the best intentions. One of the main issues McKay sees is that companies not well-versed in respirator terminology don't perform respirator fit tests, a crucial step when selecting a respirator, because they confuse it with another important procedure called a user seal check.

McKay says the confusion comes from a point in time when the user seal check procedure was referred to as a fit check. He stresses that a seal check is very different from fit testing. "The fit test detects if the respirator fits the wearer correctly and performing a user seal test makes sure the straps are correctly adjusted and the respirator is properly seated to the face," he says. "If the person is unable to properly evaluate a user seal check, then information gained from a fit test is not valuable."

Fit Testing: Qualitative or Quantitative?

Not understanding the difference between fit testing and a user seal check is one thing, but some companies still aren't complying with fit-testing requirements at all, says Andy Coats, president and owner of Occupational Health Dynamics, a manufacturer of one of the new quantitative fit testing systems called the OHD 3000. The ones that do comply often don't follow the requirements correctly, says Coats, who adds: "There definitely could be a better emphasis on fit testing."

Fit testing is important because the procedure lets the end user know if the mask fits right. Because respirators fit everyone differently, it is important to fit test each worker who is required to use one and who has been given medical clearance to wear one, says Ahlers. He points out respirators that don't fit well can have a leakage rate as high as 30 percent or more. "If a respirator doesn't fit, it doesn't [just] work a little... it tends to not work at all," he says.

The effectiveness of the two types of fit testing systems qualitative and quantitative is still up to debate as they are two very different systems.

The qualitative fit test more popular with employers as it is much less expensive and more portable than the quantitative test can be more subjective, as the person being tested may or may not have good olfactory nerves to smell the testing agents (which usually are bitrex, saccharine, isoamyl acetate [banana oil] or irritant smoke, Coats says). The quantitative test, on the other hand, generates a numerical leak rate and is not dependent on an individual's ability to taste or smell anything.

Even though the quantitative fit test is seen as a more accurate form of testing, sometimes investing in the expensive device is not always necessary, according to John Steelneck, project officer of OSHA's Respiratory Protection Program Standard revision. For example, if the respirator wearer only needs a respirator that protects them from dust and mild particles, getting a quantitative fit test will just mean the respirator will pass with a very high number.

"All it will tell you is that you passed and passed very well," he says.

The Life Expectancy of a Cartridge

So, a respiratory protection program has been developed, hazards have been identified, respirators have been chosen based on those hazards and employees have been trained and fit tested and are wearing their respirators. But for how long?

As important as fit testing is knowing when to toss out a respirator or change the cartridge. When clients go to John Hierbaum, MSA's product manager, to buy a respirator, one question always comes up: What is the life expectancy of the cartridges and filters?

"Clients are the least knowledgeable about how long a respirator cartridge should last," he says. "They should understand there is a way to calculate cartridge use."

Respirator manufacturers such as MSA, North Safety, Moldex and 3M just to name a few offer a cartridge life calculator on their Web sites that compute how long the cartridge will last by asking the user a series of questions. The questions ask about the exposures in the workplace environment and the type of respirators they are using. Ahlers notes that such calculators also on the NIOSH and OSHA Web sites (www.cdc.gov/niosh and www.osha.gov) tend to be conservative, so workers wind up throwing away the cartridge sooner than they actually need to.

According to Hierbaum, it's for their own good. "We always want to err on the side of protecting the worker," he says.

NIOSH is attempting to provide more protection for workers who need to wear respirators and make their lives easier by developing sensors manufacturers can use to notify users when the cartridge is nearing its end of service. Still in the research stages, NIOSH says it plans to distribute sensors to eight respirator manufacturer companies that volunteered to collaborate. The plan is for the manufacturers to integrate the sensors into their own cartridges and for NIOSH to test them to see how well the sensors respond.

Caring for a Respirator

Respirators are only effective when they are properly maintained. Respirator maintenance is a lot like choosing dinnerware. Paper plates serve the same function as the porcelain china, but you will just be able to use them once. Whereas with the china, you have to wash it to use it again, but then it will be as good as new.

Hazardous environments require the use of full-maintenance respirators, such as powered air-purifying respirators and self-contained breathing apparatuses, which tend to be more expensive, last longer and need frequent cleaning. For some situations, disposable respirators or no maintenance respirators such as filtering face pieces, can be worn, but usually should be disposed of after use.

Hierbaum emphasizes when choosing a respirator, it is important not to assume that the more durable one will offer better protection. "All respirators have NIOSH approvals," he says. "It's a 'pay me now or pay me later' type of thing."

When caring for a full-maintenance respirator, Ahler cautions it is important to know the proper procedures for cleaning, as not selecting the proper care method could damage the rubber or other parts of a respirator.

"Almost anything that would clean that respirator up would degrade the way it would work, so it's better to make sure that you have the proper respirator detergent," he says.

The Final Step

No respiratory protection program can be successful if no one is making sure the requirements of the program are followed. In order to make certain that a respiratory protection program is run successfully, Jeffrey Brikner, Moldex's vice president of technical services, suggests implementing a surveillance program to monitor conditions in the different work areas and determine the degree of exposure.

In addition, monitoring the amount of stress placed on employees when using respirators is important, he says, as it will make the employees buy into their workplace program and be more willing to cooperate. They are, after all, the reason why the program is there in the first place, he notes.

"Everything is important when you are talking about anything that affects a worker's respiratory system," says Birkner.

Sidebar: 11 Rules to Jumpstart a Successful Respiratory Protection Program

According to experts in the respiratory protection field, the best way to get a respiratory protection program started at any company is to go to the OSHA Web site and use their sample program as a roadmap.

"Many people forget they can just go to the OSHA site if they have any questions," says Rick Sustello, vice president of marketing at North Safety Products.

An effective respirator program as adapted from A Guide to Respiratory Protection for the Asbestos Abatement Industry, (U.S.EPA/NIOSH publication, EPA-560- OPTS86-001 September 1986) should include the following 11 components:

1. A written statement of company policy, including assignment of individual responsibility, accountability and authority for required activities of the respiratory protection program.

2. Written standard operating procedures governing the selection and use of respirators.

3. Respirator selection (from NIOSH-approved and

certified models) on the basis of hazards to which the worker is exposed.

4. Medical examinations of workers to determine whether or not they may be assigned an activity where

negative-pressure respiratory protection is required.

5. Employee training in the proper use and limitations of respirators (as well as a way to evaluate the skill and knowledge obtained by the worker through training).

6. Respirator fit testing.

7. Regular cleaning and disinfecting of respirators.

8. Routine inspection of respirators during cleaning, and at least once a month and after each use for those respirators designated for emergency use.

9. Storage of respirators in convenient, clean and sanitary locations.

10. Surveillance of work area conditions and degree of employee exposure (e.g., through air monitoring).

11. Regular inspection and evaluation of the continued effectiveness of the program.

For more information on starting a respiratory protection program at your company, visit the OSHA Web site at www.osha.gov/SLTC/respiratoryprotection/index.html or visit www.cdc.gov/od/ohs/manual/respprot.htm for a detailed view of the Centers for Disease Control/Agency for Toxic Substances and Disease Research's respiratory protection program manual.

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