Personnel using a respirator shall be cleared by a licensed healthcare professional to use it.
Supervisors shall ensure that the user select and use a proper respirator and clean, disinfect and properly store it after the use.
Personnel shall not be assigned a task requiring respiratory protection unless they receive medical clearance from a licensed healthcare professional to use a respirator.
Each user shall be properly trained and fit‑tested by EH&S before using a respirator.
EH&S shall provide training on selection, use and maintenance of respirators and fit test each user.
EH&S shall maintain records of fit-testing.
RESPIRATORY PROTECTION PROGRAM
Respiratory protection is available to personnel subject to exposure to concentrations of dusts, gases, fumes, mists, toxic materials above OSHA established permissible exposure limits (PEL), and/or working in atmospheres deficient in oxygen. If necessary, respiratory protection will be made available to personnel handling laboratory animals or other special tasks.
Avoiding or minimizing exposure to harmful substances can protect the respiratory system; however, in some cases this may not be possible and use of an appropriate respiratory protective device may be required. Use of respirator can reduce exposure to many contaminants present in that environment; therefore, proper selection of a respirator for the condition at hand is necessary.
The Code of Federal Regulations (CFR) 29 Part 1910 requires that a standard operating procedure be written to govern the selection and use of respirators based on the hazards to which the worker is exposed. The user must be physically able to wear the respirator and properly trained in its selection, use, and maintenance. The respirator should provide adequate protection against the particular hazards for which it is selected. The Columbia University Respiratory Protection Program covers these elements:
All personnel required to wear respiratory protection shall be properly trained and fit tested. EHS will provide training and fit testing.
Medical Clearance Procedures:
Employees working at the Medical Center can get medical clearance at the Occupational Health Services, Harkness Pavilion, first floor. At the Morningside and other campuses the supervisor shall make arrangements for such clearance at no charge to the employee.
Employees who are currently in the respiratory protection program can complete the “Medical Disease Questionnaire” to get clearance from the EHS Physician Consultant. An employee who could not pass this medical review will be referred to OHS or other Physician for further review and clearance. The examining physician upon the completion of the review will complete the “Medical Clearance Form”. Copies of these forms will be on file at the Columbia University EHS offices. Employees will not be responsible for any fees and charges associated with this medical exam.
Voluntary Use of Respirator:
Voluntarily users must insure that they are not jeopardizing their health by wearing the respirator, it is clean and it is not shared. Consultation with EHS is recommended.
Respirator Use Under Special Conditions:
Facial Hair: Facial hair that lies along the sealing area of the respirator, such as beards, sideburns, mustaches, or even a few days growth of stubble, will not be permitted on employees who are required to wear respirators. Facial hair between the wearer’s skin and the sealing surfaces of the respirator will prevent a good seal. A worker should not enter an area, in which it has been determined that respiratory protection is necessary, when conditions prevent a good seal of the respirator facepiece to the face.
Eye Glasses: Ordinary eyeglasses should not be used with full-facepiece respirators. Eye glasses with temple bars or straps that pass between the sealing surface of a full - facepiece and the worker’s face will prevent a good seal. Special spectacle kits can be ordered and mounted inside a full - facepiece respirator through the employee’s supervisor.
Eyeglasses or goggles may interfere with the half facepieces. When interferences occur, a full-facepiece with special corrective lenses may be necessary.
Contact Lenses: Several factors may restrict or even prohibit the use of contact lenses while wearing any type of respiratory device. This is especially true of atmosphere-supplying respirators. With full-facepieces, incoming air directed toward the eye can cause discomfort from dirt, lint, or other debris lodging between the contact lens and the pupil.
Contact lenses should not be worn in hazardous environments without consultation with EHS. Instead the appropriate form of eye protection should be donned. This may come in the form of goggles or safety glasses.
Communication: Verbal communication while wearing respiratory protection can be very difficult and may also contribute to a poor respirator seal. Therefore, hand signals may be an easier alternative. The hand signals should be worked out with the person you are working with prior to entry into a hazardous environment.
Temperature Extremes: Low temperatures may cause respirator lenses to become fogged. Coating the inner surface of the lens with the anti-fogging compound should prevent this problem. Full-facepieces with nose cups that direct warm, exhaled air through the exhalation valve without it’s touching the lens are available. At very low temperatures, exhalation valves may freeze due to moisture.
Use of respirators in conjunction with personal protective equipment (PPE) can greatly affect the human response and endurance, especially in hot environments. Normally, in hot environments or during heavy work, the body relies a great deal on heat loss through the evaporation of sweat. With impermeable clothing, the heat loss due to water evaporation is not possible. Additionally, the weight of the respirator adds to the metabolic rate of workers, increasing the amount of heat the body produces. The net effect is one of heat stress.
When employees are wearing PPE the implementation of a work rest regimen should be implemented. This time spent working as opposed the time spent resting will be contingent upon the PPE being worn, temperature conditions, and physical demand of the work.
Administration of the Program
A. Initial Training
B. Annual Training
Maintenance and Storage
Wearing PPE of any type can cause undue stress on the individual wearing it. Therefore, engineering controls must be explored along with any other means to reduce employee exposure before utilizing PPE. If respirators must be used, supervisors through regular inspections and evaluations should determine the effectiveness of the respiratory protection program. EHS will assess the need for respiratory protection along with any changes (upgrade or downgrade) in the program.
C. CPMC OCCUPATIONAL HEALTH SERVICES at CUMC
GLOSSARY OF TERMS
Aerosol Particles, solid or liquid, suspended in air.
Air-purifying respirator A respirator in which ambient air is passed through an air purifying element, which removes the contaminant(s). Air is passed through the air purifying element by means of the breathing action or by a blower.
ANSIAmerican National Standard Institute.
Assigned protection factor The minimum expected workplace level of respiratory protection that would be provided by a properly functioning respirator or a class of respirators to properly fitted and trained users.
Atmosphere supplying respirator& A class of respirators that supply a respirable atmosphere independent of the workplace atmosphere.
Canister/cartridge A container with a filter, sorbent, or catalyst, or combination, which removes specific contaminants from the air, passed through it.
Ceiling concentration The concentration of an airborne substance that shall not be exceeded during any part of the working exposure.
Certified Evaluated and listed as permissible by the National Institute for Occupational Safety and Health (NIOSH) or the Mine Safety and Health Administration (MSHA).
CFR Code of Federal Regulations.
Confined space An enclosed space, which has limited openings for entry and exit, unfavorable natural ventilation that could contain or produce dangerous air contaminants, could contain a hazardous atmosphere and which is not intended for continuous employee occupancy.
Contaminant A harmful, irritating, or nuisance airborne material
Continuous flow respirator An atmosphere supplying respirator, which provide a continuous flow of respirable gas to the respiratory inlet covering.
Demand respirator An atmosphere supplying respirator, which admits respirable gas to the facepiece only when a negative pressure is created by inhalation.
Dust An aerosol consisting of mechanically produced solid particles derived from the breaking up of larger particles.
Escape only respirator A respirator intended only for use during emergency egress from a hazardous atmosphere.
Exposure Limit The maximum allowable concentration of a contaminant in the air to which an individual may be exposed. The may be time weighted average, short term limits or ceiling limits.
Filter A component used in respirators to remove solid or liquid aerosols from the inspired air.
Fit check A test conducted by the wearer to determine if the respirator is properly seated to the face.
Fit test The use of a challenge agent to evaluate the fit of a respirator to a particular individual.
Fume Solid aerosols formed by condensation of a gas or a vapor. Fumes generally have a smaller particle size when compared to dusts.
Gas A fluid that has neither independent shape nor volume and tends to expand infinitely.
Hazardous atmosphere An atmosphere that contains a contaminant(s) in excess of the exposure limits or is oxygen deficient.
Helmet A hood that offers head protection against impact and penetration.
High efficiency particulate airs (HEPA) filter A filter, which removes from air 99.97% or more of aerosols having a diameter of 0.3 micrometer.
Hood A respiratory inlet covering which completely covers the head, neck, and may cover portions of the shoulder.
Immediately dangerous to life or health (IDLH) Any atmosphere that poses an immediate hazard to life or poses immediate irreversible debilitating effects on health.
Loose fitting facepiece A respiratory inlet covering that is designed to form a partial seal with the face, does not cover the neck and shoulders and may or may not head protection against impact or penetration.
Mist An aerosol composed of liquid particles
Negative pressure respirator A respirator in which the air pressure inside the respiratory inlet covering is negative during inhalation with respect to the ambient air pressure.
Poor warning properties A substance is said to have poor warning properties when its odor, taste or irritation effects are not detectable and not persistent at concentrations at or below the exposure limit.
Powered air purifying respirator (PAPR) An air purifying respirator that uses a blower to force the ambient atmosphere through air purifying elements to the inlet covering.
Pressure demand respirator A positive pressure atmosphere supplying respirator, which admits respirable, gas when the positive pressure is reduced inside the facepiece by inhalation.
Qualitative fit test A pass/fail fit test that relies on the subject’s sensory response to detect the challenge agent.
Quantitative fit test A fit test that uses an instrument to measure the challenge agent inside and outside the respirator.
Radionuclide An atom which spontaneously emits particles, gamma or x‑ray radiation.
Respirator A personal device designed to protect the wearer from the inhalation of hazardous atmosphere.
Respiratory inlet covering That portion of a respirator, which connects the wearer's respiratory tract to an air purifying device or respirable gas source, or both. It may be a facepiece, helmet, hood, suit or mouth piece/nose clamp.
Sanitization The removal of contaminants and the inhibiting of the action of the agents that causes infection or disease.
Self contained breathing apparatus (SCBA) An atmosphere supplying respirator in which the respirable gas source is designed to be carried by the wearer.
Service life The period of time that a respirator provides adequate protection to the wearer.
Sorbent A material which is contained in a cartridge or canister and removes specific gases and vapors from the inhaled air.
Supervisor An individual who is immediately responsible for overseeing and directing workers who use respirator.
Tight fitting facepiece A respiratory inlet covering that is designed to form a complete seal with the face.
Time-weighted average (TWA) The average concentration of a contaminant in air during a specific time period.
Vapor The gaseous phase of matter which normally exists in a liquid or solid state at room temperature.
TYPES OF RESPIRATORS
DESCRIPTION AND LIMITATIONS
A. Tight‑fitting Respirators
A tight‑fitting respirator usually has a facepiece of molded rubber or plastic which adheres to the skin of the wearer. These units are usually available in three categories‑‑quarter mask, half mask, and full face mask.
B. Loose‑fitting Respirators
C. Negative‑Pressure Respirators
D.Air Supplied Respirators
E. Powered Air‑Purifying Respirators (PAPR)
II. TYPES OF RESPIRATORS
A. AIR‑PURIFYING RESPIRATORS
b. General Limitations
1.Gas and Vapor Removing Respirators
2. Particulate‑Removing Respirators
4. Powered Air‑Purifying Respirators (PAPR)
B. ATMOSPHERE SUPPLYING RESPIRATORS
a. General Description
G. EMERGENCY EGRESS RESPIRATORS
1. Combination Supplied‑Air/Air‑purifying Respirators
PROTECTION FACTORS FOR RESPIRATORS
Air‑purifying respirators may not be used in oxygen deficient environments.
TRAINING GUIDELINES FOR RESPIRATORY PROTECTION
B.Routes of Entry
C.Comparison and Importance
II.CONTROL OF HAZARDS
C.Use of Personal Protection Equipment
IV.TYPES OF RESPIRATORS
B.Atmosphere Supplying Respirators
V.SELECTION OF A RESPIRATOR
B. Respirator Protection Factors
VI. MEDICAL EVALUATION
C. Frequency of Fit‑Testing
VIII. MAINTENANCE AND STORAGE
B.Cleaning and Disinfecting
X. ACTUAL FIT‑TESTING
Before any kind of fit‑testing is done, each test subject must have written approval from the University Occupational Health Physician attesting that the individual is physically able to wear a respirator.
Irritant smoke can be used for both types of respirators. Air‑purifying respirators should be tested with a commercially available smoke tube normally used to check the performance of a ventilation system.
Adequate ventilation should be provided when carrying out tests to prevent contamination of the room; or they should be conducted in a room that is not used for selection and fitting. The test subject must keep his/her eyes closed during the test.
The following procedure for fit‑testing should be followed:
1. Only NIOSH approved respirators should be recommended for use.
2. test subject should be allowed to select, from a variety of respirators, the one that is most comfortable.
3. Preferably, the fitting process should be conducted in a room separate from the fit test room to prevent contamination of the room. Prior to the selection, the test subject should be shown how to put on a respirator, how it should be positioned on the face, how to set strap tension, and how to assess "comfort".
4. Assessment of comfort will include reviewing the following points with the test subject:
5. The test subject will conduct the conventional positive‑and negative‑pressure fit cheeks (e.g. see ANSI Z88.1‑1980), as described below. Before conducting these cheeks, the subject will be told to seat the mask by rapidly moving the head side‑to‑side and up and down, taking a few deep breaths.
6. At this time, the test subject is ready for fit‑testing.
7. After passing the fit‑test, the test subject will be questioned again regarding the comfort of the respirator. If it has become uncomfortable, another model should be tried.
B. Negative Pressure Test
The test subject should conduct this test after the selection of a comfortable respirator. It consists of closing off the inlet of the canister, cartridge, or filter (by covering with the palms or replacing the seals, or by squeezing the breathing tube so that air does not go through), then inhaling gently so that the facepiece collages slightly, and holding the breath for ten seconds. If the facepiece remains slightly collapsed and no leakage is detected, the respirator is considered tight enough. This test can be used only on respirators with tight‑fitting facepieces.
C. Positive Pressure Test
Very much like the negative pressure test, this test is conducted by closing off the exhalation valve and exhaling gently into the facepiece. The fit is considered satisfactory if slight positive pressure can be build up inside the facepiece without any evidence of outward leakage. The test has some limitations. depending on the type of respirator selected, which should be considered before making the test.
a. Normal breathing
b. Deep breathing
c. Turning head from side‑to‑side, taking care that the movement is complete, the respirator is not bumped on the shoulders, and inhalation is done at either side.
d. Nodding head up a down, with complete motions at a frequency of one per second and making sure that the respirator remains tight.
f. Normal breathing.
5. If the irritant smoke causes the test subject to cough, the test should be stopped, the respirator rejected, and another one selected.
6.& Each test subject who passes the smoke test without evidence of a response is given a sensitivity check of the smoke from the same tube to determine whether the subject reacts to the smoke. Failure to evoke a response voids the fit‑test.
PROCEDURES FOR CLEANING AND SANITIZING RESPIRATORS
The following procedures may be used for cleaning and sanitizing respirators. Unless the manufacturer's instructions specify different.
1. When necessary, remove the following components of respirators‑inlet covering assemblies before cleaning and sanitizing.
2.; Wash respiratory‑inlet covering assemblies in warm (490 C to 1200F maximum temperature) cleaner sanitizer solution. A stiff bristle (not wire) brush may be used to facilitate removal of dirt or other foreign material.
3. Rinse respiratory inlet covering assemblies in clean, warm (490C or 1200F.) water.
4. Drain all water and air‑dry the respiratory‑inlet covering assemblies.
5. Clean and sanitize all parts removed from respiratory‑inlet covering as recommended by the manufacturer.
6. Hand‑wipe respiratory‑inlet covering assemblies, all parts, and all gaskets and valve sealing surfaces with damp lint‑free clothe as needed to remove water residue and all foreign materials.
7. Inspect parts and replace any, which are defective.
8. Reassemble parts on respiratory‑inlet covering assemblies.
9. Attach new filters, cartridges, and canisters to respiratory‑inlet covering.
10. Visually inspect and, where possible, test parts and respirator assemblies for proper function.
11.& Place assembled respirators in appropriate containers for storage.
Machines may be used to expedite the cleaning, sanitizing, rinsing, and drying of large numbers of respirators. Extreme care must be taken to ensure against tumbling, agitation, or exposure to temperatures above those recommended by the manufacturer (normally 490C or 1200F maximum), as these condition are likely to result in damage to the respirators. Ultrasonic cleaners, clothes‑washing machines, dishwasher, and clothes dryers have been specially adapted and successfully used for cleaning and drying respirators. Cleaner sanitizers that effectively clean the respirator and contain a bactericidal agent are commercially available. The bactericidal agent frequently used is a quaternary ammonium compound.
Strong cleaning and sanitizing agents and many solvents can damage rubber or elastomeric respirators parts. These materials must be used with caution.
Alternatively, respirators may be washed in a detergent solution and then sanitized by immersion in sanitizing solution. Some solutions, which have proven effective, are:
Different concentrations of quaternary ammonium salts are required to achieve a sanitizing solution with waters of various hardness. Inflammation of the user's skin (dermatitis) may occur if the quaternary ammonium compounds are not completely rinsed from the respirator. The hypochlorite and iodine solutions are unstable and break down as time progresses; they may cause deterioration of rubber or other elastomeric parts and may be corrosive to metallic parts. Immersion times should not be extended beyond the mentioned time periods, and the sanitizers must be thoroughly rinsed from the respirator parts. Manufacturer's recommendations should be observed.
Respirators may become contaminated with toxic materials. If the contamination is light, normal cleaning procedures should provide satisfactory decontamination; otherwise separate decontamination steps may be required before cleaning.
EH&S Department Information:
Medical Center Campus