1. DR JOHN WALLAART PhD, MBA, Dip. Chem., Dip. Mgt, Dip. OH&S Mgt
Protective Equipment
Respiratory Protective Equipment
(RPE)
Presentation ANZSOM Conference 2015

2. Overview-RPE Respiratory Protective Equipment NOTE:ISRP
History of RPE
Why the increasing emphasis on RPE
Why is RPE “the last line of defence?”
Surgical masks?
The different types of RPE
Some myths that persist…
Limitations of RPE in such situations as “Avian Flu” or “SARS”
Practical requirements of implementing a RPE programme
Changing scene-ISO and AUS/NZ standards 2015 onwards
Questions!
Presentation ANZSOM Conference 2015

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Last line of defence…….
The respirator
But it has some real issues…………………
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Surgical masks
These are not respirators, not certified, and do not meet respiratory protection standards Medical masks are not designed to protect the wearer from exposure to airborne hazards
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8. Evidence for prevention or reduction of occ asthma
Numerous studies
Type and use of equipment (RPE) is very important but “glossed over”
Presentation ANZSOM Conference 2015

9. Typical current recommendations (Ebola)
CDC (2014)
PAPR or N95 certified respirator
Training in the use of
Facial fit testing
Donning and removal
OSHA, CDC, NIOSH (2015)
Hospital Respiratory Protection Program Toolkit
Most helpful document to date
Presentation ANZSOM Conference 2015

10. Other useful reference
Shaffer, R. E et al. (2014). Recommended requirements, test methods, and pass/fail criteria for a “B95” respirator for health care workers. Journal International Society for Respiratory Protection. Vol No. 1.
Presentation ANZSOM Conference 2015

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Some precautions
Anything that lifts the respirator off the face will negate the protection offered. For example, beards and moustaches……… “Face Seal” is very important.
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“Protection factor”
Essentially the ratio of contaminant concentration outside the respirator versus that inside For negative pressure respirators a protection factor of 10 is considered minimal.
Presentation ANZSOM Conference 2015

13. What are some issues (1)? TIL allowed under AUS/NZS 1716:2009
Non-powered half-face piece, with P1 filter allowed 22% leakage
(About one in 5 breaths unfiltered)
As above, with a Class 2 filter-8% leakage.
Presentation ANZSOM Conference 2015

14. AEROBIOLOGY OF INFECTIOUS AGENTS (2007) Eugene C. Cole, DrPH
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Sneezing…….
Size of infectious bioaerosols probably about 0.1 to 10 micron. Diameter of droplets-95% are in the order of micron. They dry very rapidly-0.3 to 1.3 seconds. Particles smaller than 10 micron remain in air for a few hours. (The 1 metre rule has no foundation)
Presentation ANZSOM Conference 2015

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Biological
Most spread by virus-laden droplets expelled during coughing or sneezing
A sneeze can generate 40,000 particles when dried are of 0.5 to 12 micron size (drying occurs between 0.3 to 1.3 seconds)
Virus -range from particle size 0.08 micron to 0.12 micron.
WES not applicable as for chemical exposure.
Infectious bioaerosols consists of a mixture of mono-dispersed and aggregate cells, spores and viruses carried by other materials. Generally,
micron bacterial cells
micron viruses.
The dried residuals are generally 0.5 to 12 micron.
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Human hair about micron diameter
Dusts that cannot be seen are more critical…………(SARS and “white powder”?)
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19. SARS protective recommendations (Many cases may have been prevented)
US CDC (as far back as 2003! Repeated in 2007)
At least as protective as an N95 respirator should be used
WHO
“at least P100/FFP3 or P99/FFP2” should be provided
Note terminology “Surgical N95 respirators” (OSHA)
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2007
Useful document 1
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22. Intervention-Respiratory Disease-overview (AS/NZS 1715:2009)
Generally the most expensive/intensive effort option, e.g.,
Monitoring (personal and static)
Health monitoring
Individual assigned to the programme
Medical screening (physical or psychological)
Employee training (hazards, respirator, facial fit,etc)
Cleaning and disinfecting the respirator
Provision for storage and maintenance
Inspection and maintenance
Presentation ANZSOM Conference 2015

23. Fit testing equipment (Quantitative)
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24. The count needs to be 200 times lower inside the mask than outside the mask to pass
Fit factor=Outside concentration/ inside concentration

25. Saccharin
Isoamyl acetate (banana oil)
Bitrex

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An example A practical situation-Choice of respirator Chemical substances and biological agents-Studies and Research Projects 2007
Personnel working in the room of a patient infected with the SARS virus Expert recommendation: Personnel wear a N95 filtering, half-face respirator, alone or under another respirator offering greater protection, such as an PAPR. This related to high risk activities (e.g., intubation, induced sputum).
Presentation ANZSOM Conference 2015

27. Respiratory protective devices-selection, use and maintenance-Part 2:
New ISO Standards (2015)
Respiratory protective devices-selection, use and maintenance-Part 2:
Condensed guide to establishing and implementing a respiratory protective device programme
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Questions?
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