1. Respirators: Use in the Hospital Terry Walley 360-902-5478 wate235@lni.wa.gov January 29, 2010

2. Objectives: Become familiar with the DOSH regulations. Emphasis on Filtering Facepiece Respirators

3. Respirators: The Standard Chapter WAC 296- 842 Printed Copy Online at www.lni.wa.gov Workplace Safety & Health Rules CD

4. Respirators: Scope 296-842-100 Evaluate the respiratory hazards at the worksite. Compare results to the PEL table in WAC 296- 841, Airborne Contaminates. Other airborne hazard such as biological hazards.

5. Respirators: Program Administrator Does not require a certification or formal training Overall responsibility for the program Will oversee the program development Coordinate implementation Conduct required evaluations of program effectiveness

6. Respirators: Voluntary Use 296-842-110 Voluntary use of filtering facepiece- Train on Table 2 contents Voluntary use of all other respirators –Train on Table 2 –Provide for medical evaluation –Written program for specific requirements –Program administrator

7. Filtering Facepiece Cartridge Respirator

8. Respirators: Written Program 296-842-12005 Written program is to be worksite specific Detailed so future administrators can implement Cover all applicable elements in Table 3 Updated when changes take place Available to employees and others

9. Respirators: Written Program 296-842-12005 Specific Items from Table 3: A list specifying the appropriate respirator for each respiratory hazard in your workplace Filtering Facepiece Throughout Hospital- Comfort Voluntary Half-Face with Formaldehyde/Organ ic Vapor Cartridge Specimen Handling- Formaldehyde Required PAPR with HEPA Cartridge Isolation Rooms- TB, H1N1 Required

10. Respirators: Written Program 296-842-12005 Specific Items from Table 3: APRs used for gas or vapor contaminates must have: –End-of-service-life-indicator (ESLI) –Or cartridge change out schedule including information relied upon to calculate it Q: When do you change a dust filter? A: When there is resistance to breathing.

11. Respirators: Selection 296-842-13005 So what kind of respirator do I need?

13. What do the Letters and Numbers Mean? Numbers designate expected filter efficiency to remove particles: 95 = 95% efficiency 99 = 99% efficiency 100 = 100% efficiency 100% efficiency = HEPA rating HEPA = High Efficiency Particulate Air filter

14. Use Restrictions for N, R, and P Respirator Categories UseWhen NNo oil is present in the air ROil is present, but only for a single shift or 8 hours of continuous or intermittent use. Note: Reuse beyond a single shift or 8 hours is not recommended. POil is present, but follow the manufacturers time use limitations if you want to reuse these.

15. N, R, P, 95, 99, 100 Designation

16. Are These Considered Respirators? No.

17. Does not Seal to the Face Does Seal to the Face

18. Respirators: Selection 296-842-13005 Respirators selected are to be certified by the National Institute for Occupational Safety and Health (NIOSH). NIOSH certification is voided when: Users dont follow the approval labels use specifications, including listed cautions and limitations. Respirator parts used arent listed under the respirator assemblys TC number.

20. Other Respirator Options

21. Respirators: Medical Evals 296-842-14005 Clears employees to wear a respirator Required prior to fit-testing or respirator use Identify a LHCP to perform medical evaluations –By questionnaire –By physical exam Follow up dependant upon LHCP, changes in respirator use, or employee difficulties Medical Evaluations are not required annually

22. Respirators: Fit Testing 296-842-15005 Fit-test the same make, model and size to be used All fit-tests require the employee to perform fit test exercises as listed in Table 19. Exercises stress facepiece seal Fit testing is required at least annually.

23. Purpose of Fit Testing

24. Respirators: Fit Testing 296-842-15005 There are two types of fit testing: - Qualitative -Quantitative

25. Fit-Tests Types Qualitative Fit-Test Procedures: Isoamyl Acetate vapor (banana oil- not for filtering facepiece) Saccharine aerosol Bitrex aerosol Irritant Smoke (HEPA Only)

26. Fit-Tests Types Quantitative Fit-Test Procedures: Ambient aerosol condensation nuclei counter (Portacount) Controlled negative pressure (CNP) Generated aerosol

27. Respirators: Training 296-842-16005 Initially, before use begins Periodically, within 12 months of previous training (annually) Additionally –When employees havent retained knowledge –Changes in worksite –Changes in respirator type make previous training out of date.

28. Respirators: Maintenance 296-842-17005 Clean and Disinfect: As often as needed to keep it clean and functional and to prevent health hazards. Before it is worn by another employee. After each use for emergency respirators.

29. Respirators: Maintenance 296-842-17005

30. Respirators: Use & Removal 296-842-18005 Prevent Sealing Problems with Tight-Fit Resp. Seal Check (+,- pressure check) each time put one on No facial hair between face and sealing surface or that interferes with valve function No other PPE or glasses that breaks respirator seal Leave contaminated area prior to removing respirator for any reason.

31. Respirators: Use & Removal 296-842-18005

32. Respirators: Reqd Procedures 296-842-22005 Medical questionnaire location Fit-Test procedures for each approved test including test exercises Procedures for cleaning and disinfecting Procedures for seal checking

33. Respirators: Reqd Procedures 296-842-22005 Q: Can an employee who has facial hair be fit tested? A: No!!! Prohibited under 842-22010 (6)

34. Contact your local L&I office and ask for the consultation supervisor for help with this and other DOSH requirements. www.lni.wa.gov OSHA : Resp. Safety and Diff. Between Resp. tp://www.youtube.com/usdepartmentoflabor#p/u/ 4/Tzpz5fko-fg