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OSHA Issues Respiratory Fit Guidance During COVID-19 Outbreak

March 18, 2020
Measures address massive shortage in N95 respirators.

New temporary guidance has been issued to ensure healthcare workers have adequate access to N95 respiratory protection.

The mass purchasing of respirators caused a shortage across the country. A memorandum set forth by President Donald Trump on March 11, 2020 in response to the global COVID-19 outbreak aimed at making general use face masks available to U.S. healthcare workers.

"Unfortunately, at present, public health experts anticipate shortages in the supply of personal respiratory devices (respirators) available for use by healthcare workers in mitigating further transmission of COVID-19," the memorandum states. "To help prevent the spread of COVID-19, the Secretary of Health and Human Services shall take all appropriate and necessary steps with respect to general use respirators to facilitate their emergency use by healthcare personnel in healthcare facilities and elsewhere, including under the authorities granted by section 319F-3 of the Public Health Service Act (42 U.S.C. 247d-6d) and section 564 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-3). Additionally, the Secretary of Labor shall consider all appropriate and necessary steps to increase the availability of respirators."

OSHA reiterates that proper respiratory protection is required for healthcare workers providing direct care to infected patients, recommending that "employers follow existing CDC guidelines, including taking measures to conserve supplies of these respirators while safeguarding HCP. One such measure is that healthcare employers may provide HCP with another respirator of equal or higher protection, such as N99 or N100 filtering facepieces, reusable elastomeric respirators with appropriate filters or cartridges, or powered air purifying respirators (PAPR)."

“The safety and health of Americans are top priorities for the President. That’s why the Administration is taking this action to protect America’s healthcare workers,” U.S. Secretary of Labor Eugene Scalia said to the media. “Today’s guidance ensures that healthcare workers have the resources they need to stay safe during the COVID-19 outbreak.”

The temporary guidance also states that healthcare employers switch from a quantitative fit testing method to a qualitative testing method to preserve integrity of N95 respirators.

Agency field offices are at their own discretion as to whether or not they want to cite an employer for the annual fit testing requirement so long as employers:

  • Make a good faith effort to comply with the respiratory protection standard;
  • Use only NIOSH-certified respirators;
  • Implement strategies recommended by OSHA and Centers for Disease Control and Prevention for optimizing and prioritizing N95 respirators;
  • Perform initial fit tests for each healthcare employee with the same model, style, and size respirator that the employee will be required to wear for protection from coronavirus;
  • Tell employees that the employer is temporarily suspending the annual fit testing of N95 respirators to preserve the supply for use in situations where they are required to be worn;
  • Explain to employees the importance of conducting a fit check after putting on the respirator to make sure they are getting an adequate seal;
  • Conduct a fit test if they observe visual changes in an employee’s physical condition that could affect respirator fit; and
  • Remind workers to notify management if the integrity or fit of their N95 respirator is compromised.

Principal Deputy Assistant Secretary for Occupational Safety and Health Loren Sweatt said:"America’s healthcare workers need appropriate respiratory protection as they help combat the COVID-19 outbreak." 

She added that the guidance, which went into effect beginning March 14, 2020, outlines "common-sense measures that will keep personal respiratory devices available for our country’s healthcare workers.”

The temporary guidance will remain active until further notice. Additional information about COVID-19 is available from the Centers for Disease Control and Prevention.

About the Author

Stefanie Valentic

Stefanie Valentic was formerly managing editor of EHS Today, and is currently editorial director of Waste360.

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