N95 Respirators: Use and Fit Testing Train the Trainer Presented by Connecticut OSHA in cooperation with DESPP/DEMHS and CT DPH Outline • N95 Respirators- Use and Limitations • OSHA’s Respirator Standard • Developing a Written Respirator Program • Qualitative Fit Testing N95 Respirators • Air purifying • Tight fitting • N: not resistant to oil • 95: 95% effective at reducing exposure to 0.3 micron particles Can be used to protect workers from airborne infectious agents N95s are: Air Purifying vs. Atmosphere Supplying N95s are: Tight Fitting vs. …. and can be discarded after use (vs decontaminated) Loose Fitting N95s purify the air with: filters vs. cartridges N95: not resistant to oil and 95% effective at reducing exposure to 0.3 micron particles CBRN (chemical, biological, radiological and nuclear agents) Multiple Configurations and Manufacturers Surgical masks are not respirators appropriate for cough etiquette & protection from droplets (not aerosols) N95 respirators provide inhalation protection from infectious airborne agents (aerosols) The Route of Exposure Leads to Selection of PPE Refer to the CDCs: Interim Guidance for EMS Systems and 9-1-1 Public Safety Answering Points for Management of Patients with Known or Suspected Ebola Virus Disease in the US. Guidance on PPE To Be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing) OSHA’s Respirator Standard 29 CFR 1910.134 a) Permissible Practice b) Definitions c) Written Respiratory Protection Program d) Selection e) Medical Evaluation f) Fit Testing g) Use h) Maintenance k) Training l) Evaluation m) Recordkeeping (a) Permissible Practice When effective engineering controls are not feasible, or while they are being instituted, appropriate respirators shall be used pursuant to this section…… (c) Written Respirator Program Purpose and Scope The purpose of this respirator program is to ensure that all employees are protected from person-to-person transmission of airborne (inhalational) infectious agents. Your Department: • Who is your Program Administrator? • What tasks may expose staff to infectious airborne agents? • Who in your department may be required to wear an N95 Respirator? (d) Selection Which Respirators have been selected: N95s Powered Air Purifying Respirators (PAPRs) Your Department: • Which N95 respirators will you select? Availability Expiration Dates Cost Portability Exhalation valves Latex free Nose Clips Experience with successful fit (e) Medical Evaluations (before respirator use or fit testing) • Employees complete a mandatory medical evaluation questionnaire (Appendix C) • The questionnaire is reviewed by a PLHCP to determine the employee’s ability to wear the N95 respirator • The PLHCP completes a clearance review form and sends a copy to the employer and employee • Annual medical clearance not required unless employee reports signs or symptoms related to ability to wear respirator Your Department: • Which Physician or Licensed Health Care Professional (PLHCP) will review the medical evaluation questionnaire? (f) Fit Testing (annual) and (g) Use • Qualitative or Quantitative Methods (Appendix A) • Features which compromise fit Facial hair that interferes w/ seal Improper donning Humidity, Sweat Work Practices Facial disfigurement Eye glasses Excessive weight gain or loss Failure to complete a fit check Your Department: • Who will do the fit testing? • What qualitative fit testing supplies will you use? – Cost – Type of fit test (saccharin or bitrex® for N95) – User comfort – Expiration dates on fit test solutions Stop Eating, Chewing Gum, Smoking and Drinking (except for water) (15 minutes prior to fit test) (h) Maintenance Discard after use, followed by hand hygiene. Your Department: • Where will new respirators be stored? • How will individuals store and label their personal respirators ? (i) Training • The respiratory hazards to which staff are potentially exposed during routine and emergency situations • The proper use of respirators, including putting on and removing them, any limitations on use, and their maintenance. Your Department: • Who will do the respirator hazards and respirator use training? (l) Program Evaluation and (m) Record Keeping • Medical evaluations • Fit testing • Written respirator program Fit Test Demonstration Questions??? CONN-OSHA 38 Wolcott Hill Road Wethersfield, CT 06107 860-263-6900 Some of the photos used in this presentation were selected from a presentation prepared by OSHA’s Office of Training and Education. In their presentation OSHA acknowledged 3M Occupational Health and Safety Division, MSA, North Safety Products and TSI for contributing some of the graphics used in their program. Appearance of their products does not imply endorsement by the U.S. Department of Labor.