Personal Protective Equipment (PPE) Respiratory Protection Training

Why Proper Respiratory Protection is Critical:

• Restoration work frequently exposes workers to hazardous airborne particles like mold spores, asbestos fibers, silica dust, lead dust, and volatile organic compounds (VOCs).  

• These substances can cause immediate irritation and long-term health problems, including lung diseases, cancer, and other respiratory illnesses.

• Proper respiratory protection is the only way to effectively safeguard workers' lungs from these dangers.

Recommended Respirator Types:

• While dust masks and other forms of respiratory protection exist, the only recommended respirator types for restoration work involving hazardous materials are full-face, tight-fitting respirators or Powered Air-Purifying Respirators (PAPRs).

  • Full-face respirators provide a complete seal around the face and protect both the respiratory system and the eyes.  

    • Most economical eye protection available provides little to no protection against airborne particulate such as bioaerosols.

    • Most eye protection also becomes fogged up when used with a half face respirator. 

  • PAPRs use a battery-powered blower to force air through filters, providing a positive pressure inside the respirator, which reduces the risk of leaks and makes breathing easier.  

Donning & Doffing Respirators:

• Donning is the technical term for putting on protective equipment, in this case, placing a respirator on your head & face properly.

  • All respirators must be donned, prior to covering the wearers head with head protection (including hoods & bump hats)

    • Any obstruction between the wearers body & the respirator can effect the effectiveness of the respirator.

      • This can be caused by unexpected strap or seal movement

        • Bump hats & hard hats hoods have hard smooth surfaces which can allow the straps to move unpredictably.

        • Tyvek suit hoods have a smoother surface & can create unexpected movement.

      •  They can prevent the straps from fitting tight to the wearers face

        • hard hats & other head gear can change the angle of the straps away from the wearers head.

      • The can create gaps in the respirator seal against the wearers face. 

        • Tyvek suit hoods sometimes get trapped between the wearers face & the seal of the respirator creating a path for unfiltered air to enter.

  • N95 dust masks should have 2 straps that straddle each ear to decrease discomfort by the wearer.

    • The nose strip must be crushed to the profile of your nose & face contours.

      • Failure to press/squeeze the metal strip will fail to create a seal, allowing unfiltered debris to enter the wearers respiratory system.

  • Half Face - Tight Fitting Respirators should be adjusted properly to the wearers head. The nose cone of the respirator must seat properly to the wearers face.

    • Straps should be positioned where they do not cause discomfort to the wearers ears.

    • Straps should be pulled tight enough to create an adequate seal between the wearers face & the respirator. 

  • Full Face - Tight Fitting Respirators should be adjusted to the wearers head. The nose cone should seat properly to wearers face. 

    • Straps should be positioned where they do not cause discomfort to the wearers ears.

    • Straps should be pulled tight enough to create an adequate seal between the wearers face and the respirator.

  • Before wearers engage in dust generating activities that necessitate the wearing of a respirator, the wearer must do appropriate seal testing by moving their head around.

    • if the seal is compromised by movement, the wearer must adjust the respirator & restart the test.

  • Wearer should look up, down, and to each side to ensure that the seal doesn't break.

    • If the respirators seal breaks (wearer will feel cooler air enter along the seal) the respirator must be adjusted.

• Doffing is essentially the removal from your face & head.

  • Doffing should not be conducted within the contaminated area. Wearers should wait until they are in a "clean" zone before doffing.

  • The respirator should be pulled away from the face & lifted away from the wearers face.

  • N95 & Half Masks must not be worn on their head or around their neck as the interior of the respirator must remain clean.

    • The area's outside of the masks coverage area must be assumed to be dirty & contaminated. 

    • This can defeat the purpose of wearing a respirator.

  • Respirators must be stored in a safe manner, preferably seal down against a known to be clean surface.

Respirator Cleaning & Storage

• Respirators must be stored between uses in a manner that maintains proper sanitary conditions.

  • Most respirators come with a large drawstring plastic bag for storage.

    • Unfortunately, most of these bags are inadvertently thrown away.

  • Speciality bags & cases exist

    • Several companies make reusable nylon storage bags.

      • They run about $10- 25 per bag.

    • Some make hard walled cases. 

      • They can be as $20 - to over $130 per case.

  • Most respirators will not fit in a ziploc bag. 

  • Reasonable efforts must be taken to clean the respirator before removal from a project.

    • removal & disposal of the respirator filters & a wipe down with a mild detergent, before wiping with a disinfectant wipe.

  • Respirators that can not be cleaned before storage, may be stored temporarily in the production vehicle in situations such as leaving for lunch, but it's recommended to leave the respirator on the project until after lunch.

    • Respirators must be kept out of direct sunlight & UV light is hard on their components.

    • The nose cup will require wiping with a disinfectant wipe before wearing again.

  • Some technicians turn their storage bag inside out & put their dirty respirator in it for temporary storage.

    • This isn't generally recommended, as now the outside of the bag (now the interior) is now contaminated, leading to cross contamination situations from later handling.

    • The interior of the bag (now on the outside) can become contaminated.

    • If a storage bag is used like this, it must be decontaminated before reuse.

• Respirators must have their filters removed prior to cleaning & storage.

• Respirators must be cleaned & wiped down prior to storage.

  • Full face - tight fitting & half face respirators are both dishwasher safe (top rack), but must be disassembled prior to being placed in the dishwasher.

    • They should be washed alone, without high temperature wash & rinse, and must not be heat dried. 

    • Washing in a high temperature setting &/or drying on the heat dry setting will irreparably damage a respirator. 

    • Normal dishwashing product is sufficient, don't add any other cleaning or disinfectant products to the dishwasher.

Respirator Filter Designations:

• Respirator filters are classified using letters and numbers that indicate their level of protection:

  • N-series: Not resistant to oil. Suitable for arresting particles that are not oil-based.  

  • R-series: Resistant to oil for a limited time.  

  • P-series: Oil-proof. Suitable for particles that are oil-based or non-oil-based.  

• The number following the letter (e.g., N95, P100) indicates the percentage of airborne particles the filter removes:

  • 95: Removes at least 95% of airborne particles.  

  • 99: Removes at least 99% of airborne particles.  

  • 100: Removes at least 99.97% of airborne particles (considered HEPA filtration).

  • For restoration, P100 filters are highly recommended due to the variety of particles that can be present.

When Respiratory Protection is Necessary:

• Any work involving mold remediation, blood borne pathogens, sewage backups, or silica dust exposure requires respiratory protection.

• Work in confined spaces with contamination present also necessitates respiratory protection.

• Any time there is airborne dust, or a strong unpleasant odor, respiratory protection must be worn.

• When using or mixing chemicals that emit fumes or the SDS requires the wearing of respiratory protection.

Fit Testing and Medical Evaluation:

Fit testing is essential to ensure that the respirator forms a proper seal around the wearers face.

• • This involves using a qualitative or quantitative method to test for leaks.

    • Qualitative fit testing is a pass/fail method that relies on the wearer's senses (taste or smell) or their reaction to an irritant. It's a subjective test. 

      • How it works: The person wears the respirator and a hood is placed over their head. A harmless test agent (like a sweet-tasting saccharin solution, a bitter-tasting Bitrex solution, or an irritant smoke) is sprayed into the hood. 

    • Quantitative fit testing uses an instrument to provide a numerical measurement of the amount of leakage into the respirator. It's an objective test. 

      • How it works: A specialized machine (like a PortaCount device) is used. It measures the concentration of microscopic particles outside the respirator and compares it to the concentration inside the respirator. 

  • Fit testing must be conducted annually or whenever there is a change in facial features (such as weight gain or loss or injury).  

Respiratory medical evaluation: Before being fit tested, an employee must undergo a medical evaluation to determine if they are medically fit to wear a respirator.

• • The primary purpose of the medical evaluation is to determine if an employee is medically able to safely wear a respirator without experiencing adverse health effects. Respirators, especially tight-fitting ones, can put a physiological burden on the wearer. They can increase the effort of breathing, and potentially exacerbate existing medical conditions. 

The evaluation primarily aims to identify any underlying medical conditions that could make respirator use dangerous or difficult for the employee. This includes:

• Cardiovascular Issues: Conditions like heart disease, high blood pressure, or a history of heart attack, where the added strain of wearing a respirator (increased heart rate, blood pressure) could pose a risk.

• Respiratory Issues: Lung problems such as asthma, emphysema, chronic bronchitis, or any condition that impairs lung function, as a respirator can make breathing more challenging.

• Psychological Factors: Conditions like severe claustrophobia or anxiety, which could prevent effective respirator use or cause panic.

• Other Conditions: Any other medical condition that might interfere with the safe and effective use of a respirator, such as impaired vision or hearing that might be critical in an emergency while wearing the device.

How it works (briefly):

• Questionnaire: The process typically begins with the employee completing a standardized, confidential medical questionnaire (often OSHA's Appendix C to the Respiratory Protection Standard, 29 CFR 1910.134, or an equivalent). This questionnaire asks about their medical history, respiratory and cardiovascular symptoms, and general health.

• Review by a PLHCP: A Physician or Other Licensed Health Care Professional (PLHCP) reviews the completed questionnaire. This PLHCP must be someone whose scope of practice allows them to independently provide or be delegated the responsibility to provide such health care services.

• Follow-up (if needed): Based on the questionnaire responses, the PLHCP determines if a follow-up medical examination, including physical tests (like pulmonary function tests or a stress test), is necessary. Many individuals are cleared based on the questionnaire alone.

• Clearance/Restrictions: The PLHCP then provides a written medical opinion to the employer indicating whether the employee is medically cleared to use a respirator, whether there are any restrictions (e.g., can only wear a positive-pressure respirator), or if they are not cleared to use any respirator.

• • This testing is required by OSHA.

Facial Hair and Respirator Seals:

• Beards, mustaches, and other facial hair can interfere with the respirator seal, allowing contaminated air to leak into the respirator.  

• Therefore, employees who wear tight-fitting respirators must be clean-shaven in the area where the respirator seals to the face.  

• PAPR's are the exception to this rule. Because they use positive pressure, a beard will not affect the protection they offer.

Understanding the Different Respirator Filter Types:

Acid Gas Filters:

• What they are: These filters are specifically designed to remove acid gases, such as sulfur dioxide, hydrogen chloride, and chlorine.  

  • Sulfur Dioxide & Hydrogen Chloride are commonly encountered on fire losses as result of materials combusting.

  • Chlorine gases are commonly produced by application of Sodium Hypochlorite (household bleach) cleaning products onto incompatible cleaning products 

• How they work:

  • They contain chemical adsorbents such as baking soda that react with acid gases to neutralize them.

  • The specific adsorbent used will depend on the type of acid gas being targeted.

• Application: These are used in industries where acid gases are present, such as chemical processing, laboratories, and some industrial cleaning applications.  

Organic Vapor Filters:

• What they are: These filters are designed to remove organic vapors, such as those from solvents, paints, and fuels. But, they also work very well with odors associated with decomposition, mold, disinfectants, cleaning products, ectra.

• How they work:

  • They typically contain activated charcoal, which adsorbs organic vapor molecules.

  • The effectiveness of the filter depends on the type and concentration of organic vapors present.  

• Application: These are used in industries where organic solvents are used, such as painting, printing, and chemical manufacturing.

The acid gas & organic vapor filtration often combined in the same filter package. Meaning, most P100 filters offer nuisance level filtration of both acid gas & organic vapor.

Key Differences and Considerations:

• Particulate vs. Chemical: Pancake filters are better suited for filtration of particles, while canister filters are better suited for removal of gases and vapors.

• Specificity: Acid gas and organic vapor filters are highly specific to the types of chemicals they remove.

• Combination Filters: Many respirators use combination filters that include both particulate and chemical filtration capabilities. This provides protection against a wider range of hazards.  

• Service Life: Canister filters have a limited service life and must be replaced regularly, even if they are not used frequently. Particulate filters become harder to breathe through as they load up with particulate.

• Proper Selection: It is essential to select the correct type of filter for the specific hazards present in the work environment.

• Atmospheric monitoring: When using chemical cartridges, it is important to monitor the atmosphere to ensure that the filter is effective.

Factors Affecting Service Life:

Type of Filter:

• • Particulate filters (N, R, P series) become less effective as they become loaded with particles, making breathing more difficult.

  • Chemical cartridges (acid gas, organic vapor) have a limited capacity to adsorb gases and vapors. Once that capacity is reached, they become ineffective.  

Contaminant Concentration: Higher concentrations of contaminants will shorten the filter's lifespan.  

Breathing Rate: A higher breathing rate will cause the filter to load up or become saturated more quickly.

Humidity and Temperature: Extreme conditions can affect the filter's performance.  

Storage Conditions: Improper storage can degrade the filter material.  

General Guidelines for Replacement:

Particulate Filters:

• • Replace when breathing becomes difficult or uncomfortable.

  • Replace when the filter is visibly dirty, wet or damaged.

  • Follow the manufacturer's recommendations.

Chemical Cartridges:

• • Replace when you can smell or taste the contaminant, or experience some sort of irritation associated with breathing.

  • Replace according to the manufacturer's recommended service life, which may be based on time of use, contaminant concentration, or other factors.

  • Once a chemical cartridge has been opened, it begins to degrade, even if it is not being used.

    • The chemical compounds used start becoming neutralized as soon as exposed to air outside of their packaging.

General Practices:

• • Inspect filters before each use for damage or defects.  

  • Follow the manufacturer's instructions for storage and maintenance.

  • Establish a regular filter replacement schedule based on the specific hazards present.

  • If you are unsure, replace the filter.

The "3 D's"

A good rule of thumb is to replace a particulate filter if it is:

• • Dirty

  • Damaged  

  • Difficult to breath through (or odors are now passing through)

Important Considerations:

• OSHA Regulations: OSHA regulations may specify filter replacement requirements for certain substances.

• Manufacturer's Recommendations: Always consult the manufacturer's instructions for specific filter types.

• Safety First: When in doubt, replace the filter. It's better to error on the side of caution.

Hazard Assessment: A thorough evaluation of potential respiratory hazards in the workplace, identifying the types and concentrations of airborne contaminants.

Respirator Selection: Criteria for choosing the appropriate respirators based on the identified hazards, ensuring they meet relevant safety standards (e.g., NIOSH).

Medical Evaluation: Procedures for conducting medical evaluations to determine employees' fitness to wear respirators, including any necessary follow-up.

Fit Testing: Protocols for performing initial and annual fit testing to ensure respirators create a proper seal and provide adequate protection.

Respirator Use and Maintenance: Guidelines for the proper use, cleaning, inspection, and storage of respirators, including filter replacement schedules.

Training: A comprehensive training program covering hazard awareness, respirator selection, proper use, maintenance, and emergency procedures.

Program Evaluation: Regular reviews and updates of the plan to ensure its effectiveness and compliance with regulations.

Recordkeeping: Maintaining accurate records of medical evaluations, fit tests, training, and respirator maintenance.

Emergency procedures: Outlining what to do in case of a respirator failure, or other respiratory related emergency.

A well-executed Respiratory Protection Plan not only safeguards employees' health but also demonstrates a company's commitment to safety and compliance.