RESPIRATORY CODE OF PRACTICE

Transcription

1 RESPIRATORY CODE OF PRACTICE GOVERNING THE SELECTION, MAINTENANCE AND USE OF RESPIRATORY PROTECTION EQUIPMENT FOR COVENANT HEALTH PERSONNEL PREPARED BY: Occupational Health and Safety DATE PREPARED: August 2009 UPDATED: January 2017, September 2018 Version 3 Page 1

2 TABLE OF CONTENTS 1.0 GENERAL Purpose Scope Policies and Procedures ROLES AND RESPONSIBILITIES Covenant Health Management Front Line Managers / Supervisors Employees (Personnel) Occupational Health, Safety & Wellness (OHS) Trained Respiratory Fit Testers Corporate Supply Chain Operations DETERMINING THE NEED FOR RESPIRATORY PROTECTION SELECTION OF RESPIRATORY PROTECTIVE EQUIPMENT Individuals Selecting Respiratory Protection Equipment Determining the Degree of Respiratory Hazard Respirator Approvals Specific Hazard Respiratory Requirements RESPIRATOR CLASSIFICATION, CHARACTERISTICS AND LIMITATIONS 5.1 Respirator Classification Respirator Characteristics and Limitations Respirator Comfort and Duration of Use TRAINING User Training 11 Page 2

3 7.0 EFFECTIVE FACIAL SEAL AND FIT TESTING REQUIREMENTS Covenant Health Requirements Regarding Facial Hair Respiratory Fit Testing RESPIRATORY EQUIPMENT STORAGE MAINTENANCE / SERVICE AND INSPECTION Maintenance / Service Inspection HEALTH SURVEILLANCE PROGRAM EVALUATION RECORD KEEPING 15 REFERENCES 16 APPENDICES A. Applicable Definitions 17 B. Alberta OH&S Code (2009) Part 18 Personal Protective Equipment (Respiratory Protective Equipment Sections ) 20 C. Respiratory Protective Equipment Identification and Assessment Form 25 D. Respiratory Protective Equipment Record Form 29 E. Respiratory Protective Equipment Assigned Protection Factors 33 F. Respirator Classification, Characteristics, and Limitations 35 G. Procedures for Cleaning and Sanitizing Respirators 44 H. Donning and Doffing Instructions N I. Required Respirator Position Based 48 Page 3

4 1.1 GENERAL 1.2 Purpose The purpose of the Respiratory Code of Practice (RCOP) is to establish guidelines governing the selection, maintenance and use of respiratory protection equipment (RPE) used within the work site. It is written to comply with Part 18 of the Alberta Occupational Health & Safety Code (OHS Code) and CSA Standard Z Selection, Use and Care of Respirators (CSA Standard). 1.3 Scope The contents of this RCOP are intentionally general in order to cover a broad scope of applications. This RCOP is designed to reflect the basics of respiratory protective practices while satisfying legislative requirements. It is expected that the users of this RCOP will need to make additions and/or minor changes to the text in order for it to best suit the needs within the work site. 1.4 Policies / Procedures The need for a RCOP and respiratory equipment is incorporated into: Covenant Health General Manual Policy II-165 Occupational Health & Safety Influenza Immunization and Outbreak Management 2.1 ROLES AND RESPONSIBILITIES 2.2 Covenant Health Senior Management Covenant Health Senior Management will implement a Respiratory Code of Practice, which is designed and organized to ensure respirators are properly selected, used and maintained by Covenant Health personnel, and to meet the provincial legislation. 2.3 Front Line Managers / Supervisors Managers / Supervisors of employees required to wear respiratory protection are responsible for: Ensuring that health screening, fit testing, and training are completed prior to assigning a user any task that requires the use of a respirator; Ensuring that respirators are cleaned, sanitized, inspected, maintained, repaired, and stored in accordance with written instructions and manufacturer s recommendations; Ensuring respirators are used in accordance with the instructions, the training received, and the safe operating procedures established for the workplace; In the case of a tight-fitting face piece, ensuring respirator users maintain their required clean-shaven condition, and do not have any object or material that would interfere with the seal or operation of the respirator; Ensuring that changes to processes, equipment, or operating procedures that may have an impact on environmental conditions, and respiratory protection requirements are appropriately assessed; Page 4

5 Providing adequate storage facilities and encourage proper equipment maintenance; Ensuring that employees who may be exposed to airborne bio hazardous material have training on an annual basis (section 245(2) of the Alberta Occupational Health and Safety Code (2009)). Developing and maintaining a record of respiratory protection equipment for the area as per the Respiratory Protection Equipment Record Form (See Appendix D); Consulting with OHS when determining the need and selection of respiratory protective equipment. 2.4 Employees Each employee required to wear a respirator is responsible for: In the case of a tight-fitting face piece, maintaining their clean-shaven condition, and refrain from having any object or material that would interfere with the seal or operation of the respirator; Checking the respirator and ensuring it is clean and in good operating condition prior to each use; Performing a negative and/or positive pressure user seal-check when donning a tight-fitting respirator; Removing from service a respirator that is determined to be defective and report to their immediate supervisor; Reporting to their supervisor any condition or change that may impact on their ability to use a respirator safely; Using the respirator in accordance with the written instructions and training received; and Ensuring that their respirators are protected against physical damage, kept clean and stored in a safe location or disposed of as required. 2.5 Occupational Health and Safety Occupational Health and Safety is responsible for: Reviewing the health status of all personnel who may be required to wear respiratory protective equipment in the completion of their assigned tasks; Assisting (when requested or necessary) with the selection of appropriate respiratory protection; Providing respiratory education/training; Providing fit testing and/or fit test training for the organization; Ensuring personnel performing fit-tests and interpreting fit-test results are qualified; Establishing medical evaluation and surveillance procedures; and Retain medical records related to health surveillance and assessment for use of respiratory protective equipment. Page 5

6 2.6 Trained Respiratory Fit Testers Individuals trained and certified through 3M or OHS are responsible for: Conducting N95 filtering face-piece respirator fit testing in accordance with the training provided and Covenant Health protocol; Submitting all fit test records to OHS; Providing user training in accordance with the CSA Standard and Covenant Health protocol; and Ensuring that fit testing hoods are sanitized between fit tests. 2.7 Corporate Supply Chain Operations Covenant Health (Corporate Supply Chain Operations) will assist in the purchasing of and stocking of selected respiratory protection equipment 3.1 DETERMINATION OF THE NEED FOR RESPIRATORY PROTECTION Respirators are designed for specific purposes to meet the certain needs within a well defined set of limitations. The degree of airborne hazard within each work site and whether RPE is required must be determined if: A worker is or may be exposed to an airborne contaminant or mixture of airborne contaminants in a concentration exceeding their occupational exposure limits (OEL) set fourth in the OHS Code Schedule 1 Table 2, Occupational Exposure Limits for Chemical Substances, or The atmosphere has or may have an oxygen concentration of less than 19.5 percent by volume; or A worker is or may be exposed to an airborne biological or radiological contaminant that may be harmful to his/her health. Respiratory protection shall be used to protect a user from inhaling a hazardous atmosphere where: Engineering or administrative control measures are not practicable or not adequate; While such controls are being instituted; or During shutdown for maintenance, repair, or emergency. As recommended by Infection Prevention & Control for the control of communicable diseases. Some specific examples include: Emergencies where: o IDLH (immediately dangerous to life and health) atmospheres are routinely encountered; o Respiratory protective devices are required for escape or rescue; or o Respiratory protective devices are required for specially trained crews in the clean up of spills and/or the handling of specific hazardous waste. As temporary measures where: o Exhaust systems designed for the control of airborne contaminants are down or under repair. Page 6

7 4.1 SELECTION OF RESPIRATORY PROTECTIVE EQUIPMENT 4.2 Individuals Selecting Respiratory Protective Equipment Individuals selecting respiratory protective equipment shall have a thorough understanding of application and the different types of equipment available. These individuals must be familiar with the equipment s capabilities, including the degree of protection it can provide, and its limitations. Consultation with OHS may be required during the selection of appropriate respiratory protection through performing an Occupational Hygiene assessment. When requesting assistance through OHS, complete the Respiratory Protection Equipment Identification and Assessment form (See Appendix C). The selection of respiratory protection equipment shall be performed in accordance with the CSA Standard Z This Standard is not intended to address the selection of respirators used against Chemical, Biological, Radiological, and Nuclear (CBRN) hazards by emergency responders and military personnel as there is a separate CSA standard (Z ) for respiratory protection in those specific contexts. However, the standard does apply to all other aspects of the respiratory protection program for the abovementioned agents. 4.3 Determining the Degree of Respiratory Hazard The degree of danger must be determined for the conditions that are or may be present at the work site in which workers are present. Several important factors need to be considered in determining the hazard present, when respirators are required and what types of respiratory protective devices are needed. These factors include: The type and nature of any contaminants. o The type and nature of contaminant(s) will need to be identified as the respirator selected needs to be approved for protecting against the specific contaminant. The concentration or likely concentration of any airborne contaminants and occupational exposure limits. o Concentrations and occupational exposure limits of airborne contaminants need to be identified in order to determine a hazard ratio which is referenced against the assigned protection factor of the respirator. o In any event, where concentrations of toxic airborne contaminants are in doubt, a thorough Occupational Hygiene assessment is required. Where it is determined that the exposure concentrations may exceed the Occupational Exposure Limits prescribed in the Alberta OHS Code respiratory protection will be mandatory (subject to the conditions outlined in section 2.0). The duration or likely duration of the worker s exposure. o Duration of worker exposure can assist in determining the overall exposure and may identify the need for a specific type of respirator as well as the length of time that it should be worn and any appropriate filter change schedules. The toxicity of the contaminants. o Certain toxic properties of the contaminant will influence the choice of a respirator. For example, contaminants that irritate the eyes may require a full-face piece respirator, or Page 7

8 goggles in addition to a half-mask respirator in order to effectively protect the worker. Page 8

9 The concentration of oxygen. o Oxygen concentrations for certain areas / activities may need to be assessed (i.e. confined spaces) because an oxygen deficient atmosphere can create an environment immediately dangerous to life and health. The warning properties of the contaminants. o Warning properties (odour, taste or irritancy) of airborne contaminants need to be identified as this information can be used to educate workers on how to detect the contaminant. The detection of the contaminant can indicate a poorly fit respirator, a leak, or that a respirator has exhausted its cartridge or canister. However, it is important to note that the 2011 CSA standard stipulates that it is unacceptable to wait for the presence of warning properties before changing filtration cartridges or canisters. In other words, workers must either be given a pre-calculated filter change schedule or the equipment must come with visible end-of-service-life indicators to prevent any exposure when filters become saturated. o Calculation of change out schedule needs to be completed by a qualified person. o The gradually increasing difficulty in drawing in air (breathing resistance) experienced with N95 and P100 respirators is an acceptable change-out indicator, as it does not compromise the safety of the worker. The need for emergency escape. o In the event of an emergency, in certain situations, an emergency escape type of air-purifying respirator can be used to provide protection against the contaminant present, providing the atmosphere is not oxygen deficient. Where applicable, the determination of the hazard should take into consideration the possible additive or synergistic effects of environmental factors. For example, in a spray painting operation, if a mixture of hydrocarbon solvents is used as thinner, the assessment must take into consideration the total concentration and adverse effects of all the solvents combined. Based on the information above, the selection of the appropriate type of respiratory protection equipment and specific model can be determined. 4.4 Respirator Approvals Under the Alberta OHS Code Part 18, Section 246, all respiratory protective equipment required at a work site must be approved by: NIOSH (National Institute of Occupational Safety and Health), or By another standards setting and equipment testing organization, or combination of organizations, approved by a Director of Occupational Hygiene at Alberta Workplace Health and Safety (otherwise known as WorkSafe Alberta). 4.5 Specific Hazard Respiratory Requirements Airborne Communicable Diseases o An individual may need to wear a respirator while providing patient care in situations where a known and/or suspected airborne communicable disease is present (e.g. Varicella, Measles, and Tuberculosis). Protection in these types of situations will typically require N95 filtering face piece respirators. o A newly introduced feature in CSA Z is the control banding approach to selecting respiratory protection for infectious bioaerosols (liquid/solid particles suspended in air) in Page 9

10 healthcare environments for which there is no known exposure limit or if airborne concentration. The approach uses a risk matrix (Figure 2.0) found in Appendix I to determine the correct tier of respiratory protective equipment that is recommended for any particular situation based the following three factors referred to as risk group (virulence of the agent), generation rate (extent of contamination), and control level (ventilation conditions). The matrix can be used by first select the quadrant by identifying the appropriate risk group using the legend on the left side of the page. Then find the correct risk colour within that quadrant by via the intersection of the generation rate and control level that match the situation for which respiratory protection is desired. Next, to identify the appropriate piece of respiratory equipment, consult the hierarchy of respiratory protection (Figure 2.1) for the tier of respiratory protection that matches the risk (acceptable level) colour identified via the matrix. Atmospheric Oxygen Levels If it is likely that at any time the work environment will contain less than 19 kilopascals partial pressure of oxygen (approx. 19.5% by volume), then an air supplying respirator is required (Alberta OHS Code, Section 252). Atmospheric Contaminant Concentrations IDLH If the toxicity and/or concentration of atmospheric contaminants are such that the atmosphere is immediately dangerous to life and health (IDLH), only positive pressure, atmosphere supplying respiratory protective devices are acceptable. Atmospheric Contaminant Concentrations in Excess of OELs but not IDLH For concentrations of contaminants which are not immediately dangerous to life and health but are or likely to be in excess of the Occupational Exposure Limit, an air purifying type of respirator may be effective. 5.1 RESPIRATOR CLASSIFICATION, CHARACTERISTICS, AND LIMITATIONS The physical characteristics, the functional capabilities, and the performance limitations of the various types of respirators shall be assessed in respirator selection. 5.2 Respirator Classification Respirators may be classified according to mode of operation as follows: Atmosphere-supplying respirators: A respirator that supplies the respirator user with breathing air/gas from a source independent of the ambient atmosphere. These may be: o self-contained (open- and closed-circuit, demand and pressure-demand); o supplied-air (demand, pressure-demand, and continuous-flow); o combination self-contained and supplied-air Air used in a self-contained breathing apparatus or an air line respirator shall comply with the OHS Code, Section 249 Quality of Breathing Air and with Table 1 of CSA Standard Z (R2005), Compressed Breathing Air and Systems, and shall not contain a substance in a concentration that exceeds 10 percent of its occupational exposure limit. Air-purifying respirators: A respirator with an air-purifying filter, cartridge, or canister removes specific air contaminants by passing ambient air through the air-purifying element. These may be: o gas and vapour removing; Page

11 o particulate removing; or o combination particulate, vapour, and gas removing. Air purifying respirators may be worn if the: o oxygen content of the air will remain at 19.5 percent or greater by volume, o equipment is designed to protect the worker against the specific airborne contaminant, or combination of contaminants, present, and o concentration does not exceed the maximum concentration specified by the manufacturer, taking into consideration the duration of its use. Change-out procedures, schedules and service time for the replacement of air-purifying elements of respirators shall be established by an individual that has a thorough understanding of the application and manufacturer s specifications before their useful service life is ended. Factors that can affect the service life and change out procedures of a gas/vapour cartridge or canister or a particulate filter can include: o The contaminant s chemical properties, physical state, and the concentration; o The environment, temperature, humidity, and atmospheric pressure; o The physical/chemical characteristics of the air-purifying element; surface area, volume and the mechanism used to remove the contaminant; and filtration, electrostatic charge, and absorption or adsorption; o The effectiveness of the air purifying element against the contaminant(s); Page

12 o The breathing rate and volume of the respirator user; and o Pattern of use, whether continuous or intermittent. o The availability of end-of-service-life indicators. Gas/vapour removing cartridges or canisters equipped with an end-of-service-life indicator shall be replaced when the indicator dictates. Special-use respirators: o supplied-air suits; and o escape-only respirators. 5.3 Respirator Characteristics and Limitations Specific information regarding the general characteristics and limitations of the above respiratory protection are located in Appendices E and F. The manufacturer s specifications for the specific respiratory protection also need to be referenced to fully understand the selected respirators characteristics and limitations. 5.4 Respirator Comfort and Duration of Use Although comfort and duration are rather subjective areas of concern in respirator selection, they are important because ultimately they affect the user's willingness to accept the devices and use them properly. Face piece size and the potential temperature extremes within the environment are the two most important factors affecting comfort and the duration of use. 6.1 TRAINING 6.2 User Training User acceptance of respiratory protective devices and their willingness to use it properly depends on their full understanding of when and why respiratory protection is necessary and why other controls are not feasible. All personnel required to use respiratory protective equipment must be thoroughly trained in its use and limitations. Training shall be in accordance with the CSA Standard and include: Information about the airborne contaminants, including their potential health effects and ways to detect the contaminants present Why the particular respirator was chosen, and information about its capabilities and limitations How to properly put on and take off the respirator How to test for a satisfactory fit How to use, care and maintain the respirator Familiarization with the Code of Practice. The CSA Standard requires that refresher training be provided at least every 2 years. As per section 245(2) of the Alberta Health and Safety Code In the case of a Health Care worker who may be exposed to airborne bio hazardous material, an employer must ensure that the code of practice required under subsection (1) includes training on at least an annual basis. Covenant Health OHS provides the necessary respiratory training during fit testing. Page 10

13 7.1 EFFECTIVE FACIAL SEAL AND RESPIRATORY FIT TESTING Respiratory protective equipment that depends on an effective facial seal for its safe use must be fitted and tested in accordance with: the CSA Standard Z , Selection, Use and Care of Respirators, or; a method approved by a Director of Occupation Hygiene within Alberta Workplace Health and Safety. In accordance with the OHS Code, if a worker is or may be required to wear respiratory protective equipment and the effectiveness of the equipment depends on an effective facial seal, the worker must be clean-shaven where the face piece of the equipment seals to the skin or the face. The facial seal of a respirator may also be affected when there are changes in the user's physical condition (i.e., facial scarring, dental changes, cosmetic surgery, or an obvious change in body weight). Other personal protective equipment such as protective eyewear will need to be carefully selected to prevent any break in the seal. 7.2 Covenant Health Requirements Regarding Facial Hair Covenant Health employees who wear respiratory protection that requires a facial seal shall be clean shaven where the face piece of the respirator seals with the face. Generally a cleanly trimmed moustache to the corners of the mouth, with no more than a one day growth of beard, is the only acceptable facial hair. Employees within Covenant Health that for religious reasons are unable to comply the facial hair requirements, or who for medically supported reasons are unable to wear a close fitting respirator, will be provided with suitable alternatives. Contact Occupational Health and Safety for further direction. 7.3 Respiratory Fit Testing Achieving correct fit is critical. Wearing a respirator face piece which does not seal properly around the face defeats the purpose of the respirator and gives the wearer a false sense of security and protection. There are two test methods which may be used to verify that an adequate fit is achieved; the qualitative (QLFT) and quantitative (QNFT) fit tests. Fit testing must be performed by a competently trained individual and in accordance with the CSA Standard. Fit testing is primarily performed through Covenant Health OHS. In certain locations within Covenant Health, trained individuals may also be responsible for performing qualitative fit testing for their facility. Page 11

14 Qualitative Testing Qualitative fit testing is used to determine the effective facial seal of N95 filtering face-piece respirators. The test is a taste test and is conducted in accordance with the CSA Standard in which a challenge agent is used and the individual is required to perform different exercises. Quantitative Tests Quantitative fit tests are more sophisticated and involve the monitoring of actual contaminant concentrations inside the respirator face piece compared to the outside concentration. The quantitative fit test is used to for all other respirators that require an effective facial seal (i.e. half-face, full-face, SCBA, etc) or when an individual is unable to be qualitatively fit tested. Frequency of Fit Testing Respiratory fit testing is required under the CSA Standard to be conducted every two (2) years. Other parameters that may indicate a need for a fit test may include: Situations of weight gain or weight loss; Change in facial features; Unable to obtain an effective seal on a previously fitted respirator Health Care Worker exposed to bio hazardous material training must be on an annual basis. 8.1 RESPIRATORY EQUIPMENT STORAGE Required respiratory protection equipment must be kept ready to protect a worker as per the following: Stored in a readily accessible location; Stored in a manner that prevents its contamination; Maintained in good working condition. 9.0 MAINTENANCE / SERVICE AND INSPECTION 9.1 MAINTENANCE / SERVICE This is a very important part of a respiratory protection program. implemented maintenance schedule is necessary. A developed and The more complex a device is, the more sophisticated routine maintenance becomes. For example, to disassemble and evaluate a self contained breathing apparatus, qualified technicians and the proper tools are required. Maintenance procedures will vary with the type of device and it is best to observe the manufacturer's recommendations. Most air purifying types of respirators however, are quite simple to clean and maintain. Respiratory protection must be serviced in accordance with the manufacturer s specifications. Respirator maintenance personnel shall be qualified through training and experience to inspect, maintain, and repair respirators in accordance with the manufacturer s written instructions. Page 12

15 9.2 Inspection Respirators must be inspected before and after each use to ensure it is in a satisfactory working condition and in accordance with manufacturer s specifications. Respiratory protection that is not used routinely but is kept for emergency use must be inspected at least once every calendar month by a competent worker to ensure it is in working condition HEALTH SURVEILLANCE Health surveillance is important to ensure that a person is able to use a respirator without serious difficulty. Health surveillance is performed for the purpose of confirming that the individual is free from any physiological or psychological condition that may preclude him or her from being assigned the use of the selected respirator. Prior to a respirator being assigned a medical questionnaire and/or health assessment is required to be completed. OHS facilitates these questionnaires and performs any necessary follow-up through consultation with the consulting occupational physician. In certain circumstances individuals may be required to participate in a continuous health surveillance program because of the type of hazard, type RPE being worn or identified medical restrictions. All medical records related to respiratory protective equipment will be maintained by OHS in the employee s personal health record file PROGRAM EVALUATION The respiratory protection program and the RCOP shall be reviewed at least annually, when changes to the program occur by the site/area, or by OHS when changes to the legislation occur RECORD KEEPING All respiratory fit test and medical questionnaires/assessments records are maintained by Covenant Health OHS. Each site/area is responsible for maintaining records pertaining to the education on the Respiratory Code of Practice and its review, as well as any inspection records required for the equipment used. For site/areas that use supplied air respirators, a Material Safety Data Sheet for the breathing air must also be maintained. All hazard assessments pertaining to respiratory equipment will be maintained either by the site/area or OHS. Page 13

16 REFERENCES 1. Occupational Health and Safety Code, Alberta: Queens Printer, Government of Alberta, Alberta Employment, Immigration and Industry Workplace Health and Safety Bulletin Respiratory Protective Equipment: An Employer s Guide 3. Alberta Employment, Immigration and Industry Workplace Health and Safety Bulletin, Guideline for the Development of a Code of Practice for Respiratory Protective Equipment 4. Alberta Employment, Immigration and Industry Workplace Health and Safety Bulletin, Operation of Scott II and IIA Self-Contained Breathing Apparatus in Negative Pressure Mode 5. CSA Standard Z , Selection, Use and Care of Respirators 6. CSA Standard Z , Compressed Breathing Air & Systems 7. Covenant Health Occupational Health and Safety, Respirator Wearer s Health Screening Questionnaire For Health Care Workers Page 14

17 APPENDIX A APPLICABLE DEFINITIONS Page 15

18 Assigned Protection Factor (APF) the anticipated level of respiratory protection that would be provided by a properly functioning respirator or class of respirators to properly fitted and trained users. Fit factor A quantitative measure of the fit of a particular respirator to a particular individual. Fume solid particles generated by condensation from the gaseous state, generally after volatilization from melted substances (e.g. Welding) and often accompanied by a chemical reaction, such as oxidation. Gas a substance that is in the gaseous state at ambient temperature and pressure. Hazardous Atmosphere any atmosphere that is oxygen-deficient, exceeds occupational exposure limits, presents a fire/explosion hazard, and/or contains an airborne toxic or disease-producing contaminant in concentrations deemed to be hazardous. Immediately Dangerous to Life or Health Atmosphere (IDLH) - an atmosphere that poses an immediate threat to life, would cause irreversible adverse health effects, or would impair an individual s ability to escape. Mist liquid particles in a gaseous medium. Occupational Exposure Limit (OEL) a maximum concentration of airborne contaminants deemed to be acceptable, as defined by Alberta Workplace Health and Safety. Particulate airborne contaminants other than gas and vapour, but including dusts, fumes, mists, fibres, fog, pollen, smoke, and spores. Qualified Person an individual who possess the knowledge, experience, and training to fulfill the competencies of the role(s) defined in the standard. Qualitative Fit Test (QLFT) a pass/fail test method that relies on the subject s sensory response to detect a challenge agent in order to assess the adequacy of respirator fit. Quantitative Fit Test (QNFT) a test method that uses an instrument to assess the amount of leakage into the respirator in order to assess the adequacy of respirator fit. Service Life the period of time during which a respirator provides adequate protection to the user. Type N Particulate Filter NIOSH classification for particulate filter effective against particulate aerosols free of oil, time-use restrictions may apply. Type P Particulate Filter - NIOSH classification for particulate filter effective against all particulate aerosols. Type R Particulate Filter - NIOSH classification for particulate filter effective against all particulate aerosols; time-use restrictions may apply. User seal check an action conducted by the respirator user to determine if the respirator is properly sealed to the face. Vapour the gaseous state of a substance that is solid or liquid at ambient temperature and pressure. Page 16

19 APPENDIX B ALBERTA OHS CODE (2018) Part 18 Personal Protective Equipment Respiratory Protective Equipment Sections Page 17

20 Respiratory Protective Equipment Respiratory dangers 244(1) An employer must determine the degree of danger to a worker at a work site and whether the worker needs to wear respiratory protective equipment if: (a) a worker is or may be exposed to an airborne contaminant or a mixture of airborne contaminants in a concentration exceeding their occupational exposure limits, or (b) the atmosphere has or may have an oxygen concentration of less than 19.5 percent by volume. (c) a worker is or may be exposed to an airborne bio hazardous material. (2) In making a determination under subsection (1), the employer must consider: (a) the nature and exposure circumstances of any contaminants or bio hazardous material, (b) the concentration or likely concentration of any airborne contaminants, (c) the duration or likely duration of the worker s exposure, (d) the toxicity of the contaminants, (e) the concentration of oxygen, (f) the warning properties of the contaminants, and (g) the need for emergency escape. (3) Based on a determination under subsection (1), the employer must (a) subject to subsection 3(b) provide and ensure the availability of the appropriate respiratory protective equipment to the worker at the work site and, (b) despite section 247, when the effects of airborne bio hazardous materials are unknown, provide and ensure the availability of respiratory protective equipment appropriate to the worker s known exposure circumstances. 244(3.1) Subsection (3) does not apply when an employer has developed and implemented procedures that effectively limit exposure to airborne bio hazardous material 244(4) A worker must use the appropriate respiratory equipment provided by the employer under subsection (3). Code of practice 245(1) If respiratory protective equipment is used at a work site, an employer must prepare a code of practice governing the selection, maintenance and use of respiratory protective equipment. (2) In the case of a health care worker who may be exposed to airborne bio hazardous material, an employer must ensure that the code of practice required under subsection (1) includes training on at least an annual basis. Approval of equipment 246 An employer must ensure that respiratory protective equipment required at a work site is approved: (a) by NIOSH, or (b) by another standards setting and equipment testing organization, or combination of organizations, approved by a Director of Occupational Hygiene. Selection of equipment 247 An employer must ensure that respiratory protective equipment used at a work site is selected in accordance with CSA Standard Z , Selection, Use and Care of Respirators. Page 18

21 Storage and use 248(1) An employer must ensure that respiratory protective equipment kept ready to protect a worker is: (a) stored in a readily accessible location, (b) stored in a manner that prevents its contamination, (c) maintained in a clean and sanitary condition, (d) inspected before and after each use to ensure it is in satisfactory working condition, and (e) serviced and used in accordance with the manufacturer s specifications. (2) An employer must ensure that respiratory protective equipment that is not used routinely but is kept for emergency use is inspected at least once every calendar month by a competent worker to ensure it is in satisfactory working condition. Quality of breathing air 249(1) An employer must ensure that air used in a self-contained breathing apparatus or an air line respirator: (a) is of a quality that meets the requirements of Table 1 of CSA Standard Z (R2005), Compressed Breathing Air and Systems, and (b) does not contain a substance in a concentration that exceeds 10 percent of its occupational exposure limit. 249(2) does not contain a substance in a concentration that exceeds 10 percent of its occupational exposure limit. Effective facial seal 250(1) An employer must ensure that respiratory protective equipment that depends on an effective facial seal for its safe use is correctly fit tested and tested in accordance with: (a) CSA Standard Z , Selection, Use and Care of Respirators, or (2) An employer must ensure that, if a worker is or may be required to wear respiratory protective equipment and the effectiveness of the equipment depends on an effective facial seal, the worker is clean shaven where the face piece of the equipment seals to the skin of the face. Equipment for immediate danger 251 If an employer determines under section 244 that breathing conditions at a work site are or may become immediately dangerous to life or health, the employer must ensure that a worker wears self-contained breathing apparatus or an air line respirator that: (a) is of a type that will maintain positive pressure in the face piece, (b) has a capacity of at least 30 minutes unless the employer s hazard assessment indicates the need for a greater capacity, (c) provides full face protection in situations where contaminants may irritate or damage the eyes, (d) in the case of an air line respirator, is fitted with an auxiliary supply of breathing air of sufficient quantity to enable the worker to escape from the area in an emergency, and (e) in the case of a self-contained breathing apparatus, has an alarm warning of low pressure. Page 19

22 Equipment - no immediate danger 252 An employer must ensure that a worker wears self-contained breathing apparatus or an air line respirator having a capacity of at least 30 minutes if: (a) the employer determines under section 244 that conditions at the work site are not or cannot become immediately dangerous to life or health but (i) the oxygen content of the atmosphere is or may be less than 19.5 percent by volume, or (ii) the concentration of airborne contaminants exceeds or may exceed that specified by the manufacturer for air purifying respiratory equipment, and (b) the complete equipment required by section 251 is not provided. Air purifying equipment 253 An employer may permit workers to wear air purifying respiratory protective equipment if: (a) the oxygen content of the air is, and will continue to be, 19.5 percent or greater by volume, (b) the air purifying equipment used is designed to provide protection against the specific airborne contaminant, or combination of airborne contaminants, present, and (c) the concentration of airborne contaminants does not exceed the maximum concentration specified by the manufacturer for the specific type of air purifying equipment, taking into consideration the duration of its use. Emergency escape equipment 254(1) Despite sections 251 and 252, if normal operating conditions do not require the wearing of respiratory protective equipment but emergency conditions may occur requiring a worker to escape from the work area, the employer may permit the escaping worker to wear: (a) a mouth bit and nose-clamp respirator if (i) the respirator is designed to protect the worker from the specific airborne contaminants present, and (ii) the oxygen content of the atmosphere during the escape is 19.5 percent or greater by volume, or (b) alternative respiratory protective equipment that can be proven to give the worker the same or greater protection as the equipment referred to in clause (a). (2) Before permitting a worker to use the equipment referred to in subsection (1), the employer must consider the length of time it will take the worker to escape from the work area. Abrasive blasting operations 255 If a worker is performing abrasive blasting, the employer must ensure that the worker wears a hood specifically designed for abrasive blasting supplied with air that is at a positive pressure of not more than 140 kilopascals. Page 20

23 APPENDIX C RESPIRATORY PROTECTIVE EQUIPMENT IDENTIFICATION AND ASSESSMENT FORM Page 21

24 Respiratory Protective Equipment Identification & Assessment Form DEPARTMENT SITE Name of Manager /Supervisor completing form Phone # Please fax this form to: OHS at (MCH) (EGH) (GNCH) Positions Exposed to HAZARD Specific HAZARD CHEMICAL/AIRBORNE DISEASE/SUBSTANCE Requiring Use of Respiratory Protective Equipment Respirator Type Cartridge Type Cartridge Number Page 22

25 APPENDIX D RESPIRATORY PROTECTIVE EQUIPMENT RECORD FORM Page 23

26 Respiratory Protective Equipment Record Sheet This record sheet provides specific information for the site and/or department/unit noted below, and must be used in conjunction with the Covenant Health Respiratory Code of Practice. One record sheet must be completed for each unique respiratory hazard. Site: Manager: Department / Unit: Phone: 1) Person Responsible for Respiratory Protective Equipment: Name: Position: Location: Phone: 2) Hazard(s) Requiring Use of Respiratory Protective Equipment: Airborne Communicable Disease Chemical (specify) Asbestos Mould Silica Wood Dust Welding Fume Oxygen Deficient Atmosphere (< 19.5% O2) Other (specify) Frequency of Exposure: Daily Weekly Monthly Yearly Duration of Exposure: Description of Exposure: Current Controls: Page 24

27 3) Selection of Respiratory Protective Equipment Model: Manufacturer: Half Face Full Face PAPR (Loose Hood) PAPR (Fitted) SCBA Supplied Air Other Cartridges / Filters: Organic Vapour Acid Gas Ammonia/Methylamine Formaldehyde/Organic Vapour Multi Gas Mercury Cartridge Other P100 Filter N95 Filter P95 Filter Filter- Other 4) Use of Respiratory Protective Equipment Number of Staff requiring Respiratory Protective Equipment: Use: Routine Ventilation Installation/Repair Spill Response Confined Space Entry IDLH Atmosphere Access to Contaminated Space Other Fit Testing: Qualitative Quantitative Frequency: Training: Date Completed: Performed by: Page 25

28 5) Cleaning and Maintenance of Respiratory Protective Equipment Person Assigned: Cleaning Schedule: Preventative Maintenance Schedule: Cleaning Procedure: Inspection Schedule: Storage Location: 6) Other Information Page 26

29 APPENDIX E RESPIRATORY PROTECTIVE EQUIPMENT ASSIGNED PROTECTION FACTORS (APF) Page 27

30 Respirator Class Air Purifying 10 Powered Air Purifying (PAPR) Supplied-air (demand) Supplied-air (pressure demand) Supplied-air (continuous flow) RESPIRATOR STYLE Half Face piece Full Face piece Helmet/Hood 50 (10 if QLFT* used) n/a Loose Fitting Face piece/visor SCBA (Demand) 10 SCBA (Positive Pressure Demand) * QLFT Qualitative Fit Testing 100 (10 if QLFT* used) n/a n/a ** (10 if QLFT* used) n/a 10000* 10000* n/a * * Assigned protection factors listed are from CSA Standard Z for a respirator that has been fitted using quantitative fit-test methods according to the standard. If qualitative fir testing is done, the assigned protection factor for demand-mode airline respirators and SCBA is 10. n/a n/a n/a n/a n/a Page 28

31 APPENDIX F RESPIRATOR CLASSIFICATION, CHARACTERISTICS AND LIMITATIONS Page 29

32 Under CSA Standard Z Selection, Use and Care of Respirators, respirators may be classified according to mode of operation as follows: 1. atmosphere-supplying respirators: (a) self-contained (open- and closed-circuit, demand and pressure demand); (b) supplied-air (demand, pressure-demand, and continuous-flow); or (c) combination self-contained and supplied-air; 2. air-purifying respirators: (a) gas- and vapour-removing; (b) particulate-removing; or (c) combination gas-, vapor-, and particulate-removing; or 3. combination atmosphere-supplying and air-purifying respirators. 1. ATMOSPHERE SUPPLYING RESPIRATORS General Characteristics: Atmosphere-supplying respirators provide a breathing atmosphere that is independent of atmospheric conditions. Limitations: Aside from the parts of the body enclosed within the supplied-air apparatus, no protection is provided against skin irritation by material such as ammonia and hydrogen chloride, or against the absorption of materials such as hydrogen cyanide, tritium oxide, or organic phosphate pesticides through the skin. Fit testing is required for every user of tight-fitting face pieces. (a) Self-Contained Breathing Apparatus (SCBA) General Characteristics: The supply of air, oxygen, or oxygen-generating materials is carried by the user, typically in the form of a pack on the user s back. Limitations: The period over which the device will provide protection is limited by the amount of air or oxygen in the apparatus, the ambient atmosphere pressure (service life is cut in half by a doubling of the atmospheric pressure), and the degree of physical activity. The actual service time is usually less than the NIOSH rated service time. Some SCBA devices have a short service life (less than 15 min) and are suitable only for escape from an IDLH atmosphere. SCBA devices are typically heavy and bulky. Their use requires more physical exertion, more training, and more maintenance than most other respirators. Page 30

33 Closed-Circuit SCBA (Oxygen Only) Characteristics: Demand or pressure-demand closed-circuit SCBA are typically available in the following configurations and types: (a) compressed gaseous oxygen; or (b) chemical oxygen generation. All types are equipped with either a face piece or a mouthpiece and nose-clamp. Compressed oxygen systems use high-pressure gaseous oxygen from a gas cylinder that passes through a pressure-reducing valve to a reservoir. Compressed oxygen systems utilize pressure-relief valves, bypass systems, saliva traps, etc. In both systems, the user inhales, and the gaseous oxygen is delivered from the reservoir to the face piece or mouthpiece utilizing appropriate tubing, check valves, regulators, etc. Exhaled breathing gas is directed into a carbon dioxide removal medium and then the breathing gas recirculates through the system. Makeup oxygen may enter the reservoir on a continuous basis or when the volume of breathing gas in the reservoir is reduced sufficiently to activate an oxygen admission valve. Some types of oxygen closed-circuit SCBA may utilize both a continuous flow as well as a demand system to supply gaseous oxygen to the reservoir. Chemical oxygen systems generate gaseous oxygen by a chemical reaction. Water vapor and carbon dioxide in the exhaled breath react with the chemical in the canister, causing gaseous oxygen to be generated. The gaseous oxygen passes into a breathing bag reservoir from which the user of the SCBA inhales. The exhaled breathing gas is returned to the canister where carbon dioxide and moisture contained in the exhaled breath react with the chemical to generate gaseous oxygen. The process is continuous until the oxygen generating chemical is consumed. The volume of oxygen generated by this system is directly proportional to the volume of moisture and carbon dioxide in the exhalation breath of the user of the SCBA. The closed-circuit operation conserves oxygen and permits longer service life at reduced weight. Units are available with up to 4 hours rated service time. Limitations: Closed-circuit devices provide high-temperature breathing air due to the chemical reactions inherent to their operation. Page 31

34 Open-Circuit SCBA Characteristics: Open-circuit SCBA are available in the following configurations: (a) demand; and (b) pressure-demand. Demand types are equipped with a face piece, or mouthpiece and nose clamp combination. The demand valve permits oxygen or air flow only during inhalation. Exhaled air passes through a valve(s) in the face piece to the ambient atmosphere. Demand-type respirators are equipped with a demand valve that is activated on initiation of inhalation and permits the flow of breathing atmosphere to the face piece. On exhalation, pressure in the face piece becomes positive and the demand valve is deactivated. The pressure-demand type maintains a constant positive pressure in the face piece or hood by utilizing special regulators and exhalation valves. The apparatus may have provision for the user to select the demand or positive-pressure mode of operation, in which case the demand mode should be used only when donning or removing the apparatus. Except on escape-type units, a manually operated bypass system shall be required if the mode of failure of regulator or demand valve cuts off the air supply. This bypass permits the user to breathe and to conserve the breathing gas supply. Limitations: Demand SCBA are considered negative-pressure respirators and are not suitable for use where an SCBA is required. (b) Supplied Air Respirator General Characteristics: The respirable air supply is not limited to the quantity a person can carry. The devices are lightweight and simple. Limitations: Supplied-air respirators are limited to use in atmospheres from which the user can escape unharmed without the aid of the respirator (non-idlh), should the air supply fail. Maximum use concentrations based on contaminant toxicity apply. The user is restricted in movement by the air-supply hose and must return to a respirable atmosphere by retracing the route of entry. Page 32

35 Air Line Respirators Characteristics: Breathing air is supplied through a small diameter hose from a compressor or compressed-air cylinder(s). The hose is attached to the user by a belt and can be detached rapidly in an emergency. A flow-control valve or orifice is provided to govern the rate of airflow to the user. Exhaled air passes to the ambient atmosphere through a valve(s) or opening(s) in the enclosure (face piece, helmet, hood, or suit). Up to 90 m of hose length is permissible. (a) demand (b) pressure-demand; and (c) continuous-flow. Demand types are equipped with a face piece and a demand valve that is activated on initiation of inhalation and permits the flow of breathing atmosphere to the face piece. On exhalation, pressure in the face piece becomes positive and the demand valve is deactivated. Pressure-demand types are equipped with a face piece, an exhalation valve, and a regulator, all of which are configured to contribute to maintaining positive pressure in the face piece when a proper face-to-face piece seal is maintained by the user. Continuous-flow and pressure-demand types are equipped with a face piece, hood, helmet, or suit. It requires at least 115 L/min (4ft3/min) of air to tight-fitting face pieces and 170 L/min (6 CFM) of air to loose-fitting helmets, hoods, and suits. Air is supplied to a suit through a system of internal tubes and valves to the head, trunk, and extremities. Continuous-flow and pressure-demand types are designed to maintain a positive pressure in the face piece and are less apt to permit inward leakage of contaminants. Supplied-air suits may protect against atmospheres that irritate the skin or that may be absorbed through the skin. Limitations: Air line respirators provide no protection if the air supply fails. The demand-type respirator develops a negative pressure in the face piece on inhalation and therefore can only be used in an atmosphere where a non-powered air-purifying respirator is suitable. Continuous-flow types require a higher volume of breathing air than demand or pressure-demand, because the air is flowing at a constant rate independent of breathing rate. An instantaneous negative pressure may be created in pressure-demand and continuous-flow supplied-air respirators if the respirator is over breathed. The material of the air line itself may be permeable to substances such as aromatic hydrocarbons. For this reason, only air supply hoses made expressly for air line respirators should be used. The NIOSH approved respirator includes the air supply hoses, therefore substitution of other hoses or other respirator manufacturer s air supply hose voids the approval and the respirator is no longer considered accepted. Page 33

36 (c) Combination Air -Line Respirator with Auxiliary Self-Contained Air Supply Characteristics: The auxiliary self-contained air supply on this type of device allows the user to work in an IDLH atmosphere. To escape from an IDLH atmosphere in the event that the primary air supply fails to operate, the user switches to the auxiliary self-contained air supply. Limitations: The escape route shall be planned such that the time needed to escape does not exceed the rated service time of the auxiliary air supply. The auxiliary air supply should only be used to enter the hazardous atmosphere before connecting to an air supply line if the rated service time is at least 15 min, and the time of entry does not exceed 25% of the rated service time of the auxiliary air supply. 2. AIR PURIFYING RESPIRATORS General Characteristics: Ambient air, prior to being inhaled, is passed through a filter, cartridge, or canister that removes particles, vapors, gases, or a combination of these contaminants. Air-purifying respirators are available in two modes of operation: (a) non-powered (b) powered The breathing action of the user operates the non-powered types. The powered types contain a blower carried by the user that passes ambient air through an air-purifying component, and then supplies purified air to the face piece. Non-powered types are equipped with a facepiece or mouthpiece and nose-clamp. Powered types are equipped with a face piece, helmet, hood, or suit. Certain types of air-purifying devices may be used for escape purposes only. Selection and application of respirators for escape purposes should be conducted in close consultation with the manufacturer of the device and the regulatory authority. Limitations: Air-purifying respirators should not be used where oxygen content of the air is less than the equivalent of 19.5% at sea level. Air-purifying respirators should not be used in IDLH atmospheres. Respirator effectiveness is based on contaminant toxicity, respirator face piece style, and mode of operation. The proper type of canister, cartridge, or filter should be selected for the particular atmosphere and conditions. The time period over which protection is provided is dependent on the canister, cartridge, or filter type, the concentration of a contaminant, humidity levels in the ambient atmosphere, and the user s respiratory rate. Non-powered, air-purifying respirators may cause discomfort due to a noticeable resistance to inhalation. This problem is minimized in powered respirators. Powered respirators are limited by battery life. Quantitative fit testing is required for all users of all tight-fitting face piece respirators. Page 34

37 Some respirator face pieces may present special problems to individuals required to wear corrective lenses, as the face piece will not seal around eyeglasses. In these cases, manufacturers offer spectacle kits that may be fitted with the user s prescription and inserted into the respirator face piece. Escape-only air-purifying respirators shall not be used for entry into contaminated atmospheres. APFs are not applicable for escape-type respirators. (a) Vapor- and Gas-Removing Respirator Characteristics: Vapor- and gas-removing respirators are equipped with cartridge(s) or canister(s) to remove a single vapor or gas, a single class of vapors or gases (for example, organic vapor), or a combination of two or more classes of vapors and gases from the air. Vapor- and gas-removing respirators are available in the following inlet configurations: (a) a full-face piece respirator that provides protection against eye irritation in addition to providing respiratory protection (b) quarter- and half-face piece respirators (c) a mouthpiece respirator that is used only for escape applications. Mouth breathing prevents detection of contaminant by odor. The nose clamp must be secured in place to prevent breathing through the nose. Limitations: The use of vapor- and gas-removing respirators require an end-of-service-life indicator for the contaminant, or a change-out schedule has been established that would ensure that the cartridge is changed before the service life has ended. Little protection is provided against particulate contaminants unless paired with a particular filter. A rise in the canister or cartridge temperature indicates that a gas or vapor is being removed from the inhaled air. An uncomfortably high temperature indicates a high concentration of gas or vapor and requires an immediate return to fresh air. (b) Particulate-Removing Respirator Characteristics: Particulate-removing respirators are equipped with filter(s) to remove particulate matter from the air. The filter may be a replacement part or a permanent part of the respirator. The filter may be of the single-use or reusable type. The N95 respirator is the respirator suggested by the OHS Medical Consultant to be used during exposure to laser plume smoke (See Appendix F). Particulate filters for non-powered respirators are available in 3 minimum efficiencies and 3 classes. The 3 efficiencies are 95%, 99%, and 99.97% (referred to as 100%). The 3 classes are Class N, Class R, and Class P. Page 35

38 Class N filters are suitable for any particulate not containing oil. Class R and P filters are suitable for any particulate. Particulate filters for powered air-purifying respirators are available in one efficiency only (99.97%), and these filters are designed as High Efficiency (HE). Particulate-removing respirators are available in the following inlet configurations: (a) a full-face piece respirator that provides protection against eye irritation in addition to providing respiratory protection. (b) quarter- and half-face pieces respirators, including a filtering face piece type. Limitations: Protection is provided against nonvolatile particles only. No protection is provided against gases and vapours. The following limitations apply: (a) Class N filters are not suitable for particulates where oil is present. (b) Class R filters are restricted to a maximum of 8-h use or total respirator particulate load of 200mg. (c) Class N and P filters may also have restrictions on their useful life; the manufacturer should be consulted (d) High Efficiency (HE) filters should be replaced before the airflow falls below the required volume. (c) Combination Particulate-, Vapor-, and Gas-Removing Respirators Characteristics: Combination particulate- and vapor/ gas-removing respirators are equipped with cartridge(s) or canister(s) to remove particulate matter, vapors, and gases from the air. The filter may be a permanent or a replaceable part of a cartridge or canister. Limitations: The limitations of both vapor / gas-and particulate-removing air-purifying respirators apply. 3. COMBINATION ATMOSPHERE SUPPLYING AND AIR PURIFYING RESPIRATORS Characteristics: An atmosphere-supplying respirator with an auxiliary air-purifying element may be used only when the concentration of airborne contaminants in the workplace d oes not exceed the maximum use concentration of the respirator when used in the air-purifying mode. Page 36

39 APPENDIX G PROCEDURES FOR CLEANING AND SANITIZING RESPIRATORS Page 37

40 Procedures for Cleaning and Sanitizing Respirators Canadian Standards Association (CSA) published CSA Z Standard, Selection, Use and Care of Respirators. The procedures below are taken from Appendix F of this CSA Standard. A. Remove filters, cartridges, or canisters. Disassemble face pieces by removing speaking diaphragms, demand and pressure- demand valve assemblies, hoses, or any components recommended by the manufacturer. Discard or repair any defective parts. B. Wash components in warm (43 deg. C [110 deg. F] maximum) water with a mild detergent or with a cleaner recommended by the manufacturer. A stiff bristle (not wire) brush may be used to facilitate the removal of dirt. C. Rinse components thoroughly in clean, warm (43 deg. C [110 deg. F] maximum), preferably running water. Drain. D. When the cleaner used does not contain a disinfecting agent, respirator components should be immersed for two minutes in one of the following: 1. Hypochlorite solution (50 ppm of chlorine) made by adding approximately one milliliter of laundry bleach to one liter of water at 43 deg. C (110 deg. F); or, 2. Aqueous solution of iodine (50 ppm iodine) made by adding approximately 0.8 milliliters of tincture of iodine (6-8 grams ammonium and/or potassium iodide/100 cc of 45% alcohol) to one liter of water at 43 deg. C (110 deg. F); or 3. Other commercially available cleansers of equivalent disinfectant quality when used as directed, if their use is recommended or approved by the respirator manufacturer. See Notes below. NOTE 1: 3M recommends that these respirators be sanitized by soaking in a quaternary ammonia disinfectant, sodium hypochlorite and other disinfecting agents (3M Technical Data Bulletin #150, 176). NOTE 2: Triad III Quaternary Disinfectant Cleaner (1:64 use solution) can be used as disinfecting solution as per Note 1. E. Rinse components thoroughly in clean, warm (43 deg. C [110 deg. F] maximum), preferably running water. Drain. The importance of thorough rinsing cannot be overemphasized. Detergents or disinfectants that dry on face pieces may result in dermatitis. In addition, some disinfectants may cause deterioration of rubber or corrosion of metal parts if not completely removed. F. Components should be hand-dried with a clean lint-free cloth or air-dried. G. Reassemble face piece, replacing filters, cartridges, and canisters where necessary. H. Test the respirator to ensure that all components work properly. Page 38

41 APPENDIX H INSTRUCTIONS: DONNING AND DOFFING N95 RESPIRATOR Page 39

42 DONNING 1. Pre-stretch the top and bottom straps before placing the respirator on your face. (For 3M model 8210 ONLY) Other respirators do not need pre-stretching. 2. Cup the respirator in your hand, with the nosepiece (the metal piece) at your fingertips, allowing the straps to hang freely below your hand. 3. Position the respirator under your chin with the nosepiece up. Pull the bottom strap over your head and position it around the neck below your ears. 4. Then pull the top strap over your head resting it high at the top back of your head. 5. Use two fingertips on both sides; mold the nosepiece to the shape of your nose by pushing inward while moving your fingertips down both sides of the nosepiece. ** Pinching the nosepiece using one hand may result in improper fit and less effective respirator performance. 6. Seal Checks must be done prior to entering the contaminated area. POSITIVE: Perform a positive seal check by covering the respirator completely with your hand and exhale. If air leaks around the nose, re-adjust the nosepiece. If air leaks at the respirator edges, work the straps back along the sides. NEGATIVE: Perform a negative seal check by covering the respirator completely with your hand and inhale. This should pull the respirator in towards your face. ** IF YOU CANNOT ACHIEVE A PROPER FIT, DO NOT ENTER THE CONTAMINATED AREA. Page 40

43 DOFFING 1. DO NOT handle the respirator; use ONLY the straps during removal of the respirator. 2. Pull bottom strap over your head and hold on to the strap. 3. Pull the top strap over your head. 4. Carefully, touching only the straps, remove the respirator from your face. 5. Discard the respirator. 6. Annual training will be conducted in the case of Healthcare workers who may be exposed to biohazardous material. Page 41

44 Position Facilities Maintenance Staff Facilities Maintenance Staff Facilities Maintenance Staff Facilities Maintenance Staff Facilities Maintenance Staff Facilities Maintenance Staff Facilities Maintenance Staff Facilities Maintenance Staff Facilities Maintenance Staff Facilities Maintenance Staff Facilities Maintenance Staff Surgical Processor RN, LPN, Service Attendant, SLP, RT PT, Audiologist, PTA, OTA Sonographer, Unit Clerk, Medical Secretary, Psychologist, Mental Health Therapist, Occupational Therapistr RESPIRATORY HAZARDS Steamate NA5640 Corrshield MD4102 Spectrus NX1106 Spectrus OX1203 Hantavirus Chlorine Sulphuric Acid Freon R11 Freon R12 Freon 134A Asbestos Guteraldehyde Chickenpox(Varicella) Disseminated Zoster Potential Health Affects of Hazard/Rational for Choice of Respirator Corrosive to skin/irritation to upper respiratory tract/cns depression/msds based Severe eye irritant/upper respiratory tract irritation/msds based Corrosive to skin/irritation to upper respiratory tract/msds based Corrosive to skin/irritation to upper respiratory tract/eye irritation/msds based Irritation to the skin/eyes/irritation to upper respiratory tract/msds based Irritation to the skin/eyes/irritation to upper respiratory tract/msds based Appendix H Capabilities and limitations of Respirator Air Purifying Only Air Purifying Only Air Purifying Only Air Purifying Only Air Purifying Only Air Purifying Only Air Purifying Only How to test for fit, Don and Doff Quantitative, Appendix H Quantitative, Appendix H Quantitative, Appendix H Quantitative, Appendix H Quantitative, Appendix H Quantitative, Appendix H Quantitative, Appendix H Results in Oxygen displacement/air Supplying RespiratorRequired/MSDS based Air Supplying Qualitative Results in Oxygen displacement/air Supplying RespiratorRequired/MSDS based Air Supplying Qualitative Results in Oxygen displacement/air Supplying RespiratorRequired/MSDS based Air Supplying Qualitative Confirmed Human Carcinogen/MSDS based Eye/Skin Irritant/Skin and Respiratory Sensitizer/MSDS based Air Purifying Only Air Purifying Only Convenant Health Infection Prevention and Control Airborne Precautions CDC Guideline for the Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007 pg 55 IIE Air Purifying Only Quantitative, Appendix H Quantitative, Appendix H RESPIRATOR TYPE CARTRIDGE TYPE NORTH CARTRIDGE # Half Piece Face Mask Multi-Purpose 75SC Half Piece Face Mask Multi-Purpose 75SC Half Piece Face Mask Multi-Purpose 75SC Half Piece Face Mask Multi-Purpose 75SC Half Piece Face Mask P-100 Particulate 7580P100 Half Piece Face Mask Multi-Purpose 75SC Multi- Half Piece Face Purpose/acid gas Mask cartridge 75SC Supplied Air Full Face N/A N/A Supplied Air Full Face N/A N/A Supplied Air Full Face N/A N/A Half Piece Face Mask P-100 Particulate 7580P100 ** Half Piece Face Mask Organic Vapor Cartridge OVM Quantitative, Appendix H N95 N/A N/A RN,LPN Pharmacy Technician RN, LPN, Service Attendant, SLP, RT PT, Audiologist, PTA, OTA Community Peace Officer, Sonographer, Attendant I, Attendant II, Porters, Dietician Pharmacist, Unit Clerk, Psychologist, Mental Health Therapist,NA,Ward Aide RN, LPN, Service Attendant, SLP, RT PT, Audiologist, PTA, OTA Community Peace Officer, Sonographer, Attendant I, Attendant II, Porters, Dietician, Unit Clerk, Psychologist, Mental Health Therapist,NA,Ward Aide cytotoxic/hazardous drugs H1N1 Measles(Rubella) Respirator chosen because of NIOSH recommendation Cytotoxic/Hazardous drugs are considered drugs that exhibit one of more of the following effects in studies involving humans or animals: Carcinogenicity. Teratogenicity, Genotoxicity, Organ toxicity/msds based Air Purifying Only Air Purifying Only Convenant Health Infection Prevention and Control Airborne Precautions CDC Guideline for the Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007 pg 55 IIE Air Purifying Only Quantitative, Appendix H N95 N/A N/A Quantitative, Appendix H N95 N/A N/A Quantitative, Appendix H N95 N/A N/A

45 Position RN, LPN, Service Attendant, SLP, RT PT,NA, Audiologist, PTA, OTA Community Peace Officer, Sonographer, Attendant I, Attendant II, Porters, Dietician,Ward Aide RN, LPN, Service Attendant, SLP, RT PT, NA, Audiologist, PTA, OTA Community Peace Officer, Sonographer, Attendant I, Attendant II, Porters, Dietician, Unit Clerk, Psychologist, Mental Health Therapist,Ward Aide RESPIRATORY HAZARDS SARS Pulmonary TB Potential Health Affects of Hazard/Rational for Choice of Respirator Capabilities and limitations of Respirator Air Purifying Only Air Purifying Only How to test for fit, Don and Doff RESPIRATOR TYPE CARTRIDGE TYPE NORTH CARTRIDGE # Quantitative, Appendix H N95 N/A N/A Quantitative, Appendix H N95 N/A N/A Facilities Maintenance Staff Alkyds/Aerosols/Lacquers CNS Depression/MSDS Air Purifying Only Quantitative, Appendix Half Face Organic Vapor Cartridge 8G151

46 APPENDIX I Figure 2.0 Control Banding Approaching for Bioaerosols in Health Care Facilities Adapted from CSA Z

47 Figure 2.1 Hierarchy of Respiratory Protection