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HomeMy WebLinkAbout99-052RESOLUTION APPROVING 'hHE BUTTE COUNTY RESPIRII"TORY PROTECTION PROGR/1M WHEREAS, the California Labor Code Sectio~~ (~4t)1.7 directs the California Occupational Safety and Health Standards (Cal-OSHA) Board to adopt 1~ew regulatory reduirements regarding an occupational injury and illness prevention program, and, WHEREAS, the C=alifornia Code of Regulations, Title S, Section 5144 of the General Industry Safety Orders and Section 1531 of the Construction Safety Orders included a number of significant changes regarding respirator use in the workplace, and; WHEREAS, it is the desire of the Butte County board of Supervisors, to maintain compliance v~~ith the provisions of the California Code of Regulations, and the California Labor Code, and; WHEREAS, it is the desire of the Butte County Board of Supervisors to hratect emplovees from the harmful effects of respiratory a>ntaminants, and; WHEREAS, it is the policy of the Butte County Beard of Supervisors to establish guidelines and procedures for ensuring the protection of emplovees p~irsuant to the provisions of the Respiratory Protection Program. "hhis is accomplished by medical evaluations, respirator selection, respirator issuance, respirator fit-tests, respirator i~~spections, respirator training, respirator maintenance and storage, and air sampling to validate exposure levels. NOW, THEREFORE, BE IT RESOLVED by the Butte County Board of Supervisors as follows: I. 1~he Butte County Respirator Protection Program attached hereto is hereby adopted to become effective immediately. -~- 2. The Chief Administrative Officer is responsible for the Injury and Illness Prevention Program for Butte County employees. "I'he responsibility of the Respirator Protection Progran~i is hereby delegated to each department head, court officer andror appointing authority, and the Butte County Safety Officer. 3. It is the responsibility of these persons to ensure the overall implementation of the Respirator Protection Program bti~ directing the tasks identified in the program. PASSED AND AT30I'TED by the Butte County Board of Supervisors this 13th day of April, 1999 by the following vote: AYES: Supervisors Beeler, Houx, Josiassen, Davis and Chair Dolan NOES: None ABSENT: None NO'T' VOTING: None Jane Dolan, Chair, Butte County Board of Supervisors AZYI'ES'I': JOHN S. BLACKI~OCK, Chief Administrative Officer and Cleric of the Bo~~xd of Supervisors '~ ~~)(t _ '~ J .. ~' .l - ,~~~r T ! _. ,,x. `? ~~ . R e s p ira t o ry Pi n t e c ti o n ' / Table of Contents General ........................................................................................ ........................................ 1 Policy ........................................................................................ ........................................1 Responsibilities ..................................................................... ............. .......................... 1 .............. Department Heads/Management ................................................. ........................................ 1 Supervisors .................................................................................. ........................................1 Employees ................................................................................... . ..................... 1 .................. Definitions ........................................................................................ ....................................2, 3 Program Administration .................................................................... ........................................ 3 Respiratory Protection Program Administrator ............................ ........................................ 3 Medical Evaluation ............................................................................. ........................................ 4 Work Area Exposure Evaluation ...................................................... ........................................ 5 Work Area Evaluation .................................................................. ........................................ 5 Respirator Selection ..................................................................... ........................................ 5 Use of Respirators ....................................................................... ........................................ 6 A. Facepiece Seal Protection ................................................ ........................................ 6 B. Continuing Respirator Effectivaness ................................. ........................................ 6 Respirator Training and Fitting ......................................................... ........................................ 7 Training ....................................................................................... ....... ...7 .............................. Fit Testing .................................................................................... ........................................ 7 Respirator Inspection, Maintenance and Starage .......................... ........................................ 8 Inspection ..................................................................................... ........................................ 8 Repair ........................................................................................ .. ............8 .......................... Cleaning ....................................................................................... ........................................ 8 Storage ........................................................................................ ........................................ 8 Compressed Air Systems ............................................................ ........................................ 9 Emergency Use Respirators ............................................................. ........................................ 9 Locations ...................................................................................... ........................................ 9 Special Requirements .................................................................. ........................................9 Program Evaluation ........................................................................... ...................................... 10 Voluntary Use of Respirators by Employees .................................. ......................................10 Appendices A. Medical Questionnaire for Respirator Users .................................................11, 12, 13, 14, 15 B. Respirator Selection Worksite-Specific Procedure .............................................16, 17, 18, 19 C. Qualitative Fit Test Protocol ................................................................................20, 21, 22, 23 D. Qualitative Fit Test Record Form ......................................................................................... 24 E. Respirator Cleaning Pracedures .......................................................................................... 25 F. "Information for Employees Using Respirators When Nat Required Under the Standard" ..26 E. Examples of Respiratory Protective Equipment Used by County Employees ...........................27 Butte County Respiratory Protection Program 1 GENERAL The OSHA standard for respiratory protection Section 5144, Title 8 of the California Code of Regulations requires that a respiratory protection program be established to effectively control employee exposures to respiratory hazards. The fallowing procedures are based on the requirements established by the Occupational Safety and Health Administration and the American National Standard for Respiratory Protection, ANSI 288.2. POLICY It is the policy of Butte County to provide its employees with a safe and healthful work environment. The guidelines in this program are designed to help reduce employee exposure against occupational dusts, fogs, fumes, mists, gases, smokes, sprays or vapors. The primary objective shall be to prevent atmospheric contamination and to prevent employee exposure to airborne contaminants. This is accomplished as far as feasible by accepted engineering and work practice control measures. When effective engineering controls are not feasible, or while they are being implemented or evaluated, respiratory protection may be required to achieve this goal. In these situations, respiratory protection, training and medical evaluations are provided at no cost to the employees. RESPONSIBILITIES 1. Department Heads/Management It is management's responsibility to determine what specific applications require the use of respiratory protective equipment. Management must also provide proper respiratory protective equipment to meet the needs of each specific application. Employees must be provided with adequate training and instructions on all equipment. 2. Supervisors Supervisors of each area are responsible for insuring that all personnel under their control are completely knowledgeable of the respiratory protection requirements for the areas in which they work. They are also responsible for insuring that their subordinates comply with all facets of this respiratory protection program, including respirator inspection and maintenance. They are responsible for implementing disciplinary procedures for employees who do not comply with respiratory protection requirements. 3. Employees It is the responsibility of the employees to have an awareness of the respiratory protection requirements far their work areas (as explained by management). Employees are also responsible for wearing the appropriate respiratory protective equipment according to proper instructions and for maintaining the equipment in a clean and operable condition. Butte County Respiratory Protection Program 2 DEFINITIONS The following definitions are important terms used in the respiratory protection program. - Air-purifying respirator means a respirator with an air-purifying filter, cartridge, or canister that removes specific air contaminants by passing ambient air through the air-purifying element. - Atmosphere-supplying respirator means a respirator that supplies the respirator user with breathing air from a source independent of the ambient atmosphere, and includes supplied-air respirators (SARs} and self-contained breathing apparatus (SCBA} units. - Canister or cartridge means a container with a filter, sorbent, or catalyst, or combination of these items, which removes specific contaminants from the air passed through the container. - End-of-service-life indicator (ESLI) means a system that warns the respirator user of the approach of the end of adequate respiratory protection, far example, that the sorbent is approaching saturation or is no longer effective. - Filtering facepiece (dust mask) means a negative pressure particulate respirator with a filter as an integral part of the facepiece or with the entire facepiece composed of the filtering medium. - Fit test means the use of a protocol to qualitatively or quantitatively evaluate the fit of a respirator on an individual. (See also Qualitative fit test QLFT and Quantitative fit test QNFT.} - Immediately dangerous to life ar health (IDLH) means an atmosphere that gases an immediate threat to life, would cause irreversible adverse health effects, or would impair an individual's ability to escape from a dangerous atmosphere. - Interior structural firefighting means the physical activity of fire suppression, rescue or both, inside of buildings or enclosed structures which are involved in a fire situation beyond the incipient stage. - Loose-fitting facepiece means a respiratory inlet covering that is designed to form a partial seal with the face. - Negative pressure respirator (tight fitting) means a respirator in which the air pressure inside the facepiece is negative during inhalation with respect to the ambient air pressure outside the respirator. - Oxygen deficient atmosphere means an atmosphere with an oxygen content below 19.5°lo by volume. - Physician or other licensed health care professional (PLHCP) means an individual whose legally permitted scope of practice (i.e., license, registration, or certification) allows him or her to independently provide, or be delegated the responsibility to provide, some or all of the health care services required by Section 5144 (e), Title 8 CCR. - Positive pressure respirator means a respirator in which the pressure inside the respiratory inlet covering exceeds the ambient air pressure outside the respirator. - Powered air-purifying respirator (PAPR) means an air-purifying respirator that uses a blower to force the ambient air through air-purifying elements to the inlet covering. Butte County Respiratory Protection Program 3 - Qualitative fit test (QI.FT) means apass/fail fit test to assess the adequacy of respirator fit that relies on the individual's response to the test agent. - Quantitative fit test (QNFT} means an assessment of the adequacy of respirator fit by numerically measuring the amount of leakage into the respirator. - Self-contained breathing apparatus (SCBA} means an atmosphere-supplying respirator for which the breathing air source is designed to be carried by the user. - Supplied-air respirator (SAR} or airline respirator means an atmosphere-supplying respirator for which the source of breathing air is not designed to be carried by the user. - Tiaht-fitting facepiece means a respiratory inlet covering that forms a complete seal with the face. PROGRAM ADMINISTRATION 1. The Butte County Safety Officer is responsible for the administration of the respiratory protection program: Name: Jeff Deel Title: Butte County Safety Officer Department: Risk ManagementlSafety This individual has the authority to act on any and all matters relating to the operation and administration of the respiratory protection program. All employees, operating departments, and service departments will cooperate to the fullest extent. The Safety Officer is referred to as the Respiratory Protection Program Administrator in this program. The Respiratory Protection Program Administrator's responsibilities include but are not limited to: • monitoring or conducting an exposure assessment of the respiratory hazard, developing worksite-specific procedures for this program, maintaining records, and conducting program evaluations. contaminant identification and measurement, including technical support, air sampling, and laboratory analysis. directing and coordinating engineering projects which are directly related to respiratory protection. • assisting departments in the selection, issuance, training, and fit testing of respirators used by Butte County employees, including record keeping. This Respiratory Protection Program replaces the old Respiratory Protection Program approved and implemented by the Butte County Board of Supervisors on March 5, 1991. The Butte County Board of Supervisors adapted this Respiratory Protection Program on April 13, 1999. Butte County Respiratory Protection Program 4 MEDICAL EVALUATION Every employee who is being considered for inclusion in the Respiratory Protection Program will participate in a medical evaluation. A determination will be made initially upon employment, or change into a job classification requiring respiratory pratection and every 24 months thereafter, with the following exceptions: • Butte County Fire Department Volunteers The Butte County Fire Department is administering the respiratory pratection requirements for the Butte County Volunteer Fire Fighters. The respiratory protection requirements for the Volunteers differ only in the fact that SCBA's are used in interior structural fire fighting which requires a medical evaluation every 12 months. Butte County employees will fill out the "Medical Questionnaire for Respirator Users" which will be reviewed by a PLHCP (physician or other licensed health care professional) or undergo an initial medical examination that obtains the same information as the medical questionnaire. A copy of the Medical Questionnaire for Respirator Users is included in Appendix A. A PLHCP shall review the answers to the medical questionnaires and provide a written recommendation regarding the employee's ability to use a respirator. The written recommendation shall provide only the following information pursuant to Section 5144 (6)(A}: 1) Any limitations on respirator use related to the medical condition of the employee, or relating to the workplace conditions in which the respirator will be used, including whether or not the employee is medically able to use the respirator; 2) The need, if any, for follow-up medical evaluations; and 3) A statement that the PLHCP has provided the employee with a copy of the PLHCP's written recommendation. All written recommendations will be returned to the appropriate Butte County Department that each employee works. The written recommendations will be addressed to the Department Head. The Department Head can review the recommendations or delegate someone in the department to carry out the necessary actions by the department to achieve full compliance with any limitations for respirator use rendered by the PLHCP. A follow-up medical examination may be necessary for the PLHCP to make a medical determination about the employee's ability to wear a respirator. A follow-up medical examination will be provided for an employee who gives a positive response to any questions 1 through 8 in Section 2, Part A of the "Medical Questionnaire for Respirator Users" or whose initial medical examination demonstrates the need for a follow-up medical examination. The medical examinations will include any medical tests, consultations or diagnostic procedures that the PLHCP deems necessary to make a final determination. The medical questionnaire and examinations will be administered confidentially during the employee's normal working hours or at a time and place convenient to the employee. The questionnaire will be returned to the PLHGP after it has been completed. The employee may discuss the questionnaire and examination results with the PLHCP. Butte County Respiratory Protection Program 5 The purpose of the questionnaire and the initial and fallow-up examination is to assure that the employees are physically and psychologically able to pertorm their work while wearing respiratory protective equipment. If the PLHCP denies approval, the employee will not be able to participate in the Respiratory Protection Program. Medical Records: Copies of the completed medical evaluation and questionnaire will be kept by the medical provider in accordance with Section 3204, Title 8 of the California Code of Regulations. The following medical providers are ready to assist departments in implementing the medical evaluation requirements listed above: • Butte County Public Health Department, 18-B County Center Drive, Oroville • Premier Hea/fh Care, 1940 Feather River Blvd, Suite N & O, Oroville • Golden Valley Occupational Health, 274 Cohasset Rd, Suite 110, Chico WORK AREA EXPOSURE EVALUATION 1. WORK AREA EVALUATION Exposure evaluation will be performed on a periodic basis to provide far a continuing healthful environment for employees and to aid in proper respirator selection. In order to determine the exposure level, air samples of the work place representative of the work period; exposure assessment based on analogous processes; or professional judgment will be used. Personal sampling equipment may be used in accordance with accepted industrial hygiene practice or standards to sample each work area. Results of these samples will pinpoint areas where respiratory protection is required. The exposure assessment will be performed prior to commencing any routine or non-routine task requiring respiratory protection. Periodically thereafter as required by OSHA substance specific standards or every 12 months, a review of the exposure assessment will be made to determine if respiratory protection continues to be required. If respiratory protection is still necessary, the previously chosen respirators will be reviewed to assure that they still provide adequate protection. Records of all exposure assessments will be kept by the Respiratory Protection Program Administrator. 2. RESPIRATOR SELECTION Respirators will be selected and approved for use by management. The selection will be based upon the physical and chemical properties of the air contaminants and the concentration level likely to be encountered by the employee. Departments will consult with the respirator program administrator prior to making respirators available to each employee who is placed as a new hire ar a transferee to a job that requires respiratory protection. Replacement respirators/cartridges and filters will be made available as required. Butte County Respiratory Protection Program 6 The selection of the proper respirator type will be made following the most current respirator selection information. Appendix B contains the respirator selection guide to be used by Butte County employees. All respirators will be NIOSH approved. Respirators will be purchased from various vendors who sell approved respiratory protection equipment. 3. USE OF RESPIRATORS A. Facepiece seal protection Facial hair or any other condition that prevents direct contact between the face and the edge of the respirator will not be permitted with tight fitting half or full facepieces (negative or positive pressure) or loose fitting facepieces where a contaminant concentration exists at or above the Permissible Exposure Level (PEL) or in an atmosphere that is immediately dangerous to life and health (IDLH). Eyeglasses, goggles, and other personal protective equipment will be worn in a manner that does not interfere with the respirator sealing surface. Facial hair or any other condition that interferes with the function of exhalation or inhalation valves will not be permitted. All users of tight fitting facepieces will perform a user seal check each time they put on the respirator. Methods for performing the user seal checks will be covered in employee training. B. Continuing respirator effectiveness Supervisors will maintain ongoing surveillance of employee exposure or stress. If conditions change such that respirator effectiveness may be affected, the respiratory protection program administrator will re-evaluate the respirator selection. Employees will be allowed to leave the contaminated area: 1. To wash face and facepiece as necessary to prevent skin or eye irritation 2. Detection of vapor or gas breakthrough, changes in breathing resistance, or facepiece leakage 3. To replace the respirator or filter, cartridge, or canister 4. Upon malfunction of the respirator 5. If severe discomfort in wearing the respirator is detected 6. Illness of the respirator wearer, including: sensation of dizziness, nausea, weakness, breathing difficulty, coughing, sneezing, vomiting, fever and chills If an employee leaves the work area for any of the above reasons, they will not re-enter until the specific problem has been identified and corrected. This may require repair or replacement of the respirator. Butte County Respiratory Protection Program ? RESPIRATOR TRAINING AND FITTING 1. TRAINING Employees, upon assignment to an area requiring respirators, will be instructed by their Supervisors relative to their responsibilities in the respiratory protection program. They will also be instructed in the need, use, limitations, and care of their respirator. The person responsible for respiratory protection training will provide the specific training content pursuant to this document and the Respiratory Protection Standard. Retraining will be given at least every 12 months after initial training and when changes in the workplace or the type of respirator make the previous training obsolete, inadequacies in the employee's knowledge or use of the respirator indicate that the employee has not retained the requisite understanding or skill, or any other situation arises in which retraining appears necessary to ensure safe respirator use. Records of the training given each individual will be maintained by the Departmental Safety Representative. 2. FIT TESTING Employees who use tight fitting half mask air-purifying respirators will be properly fitted and tested for a face seal prior to use of the respirator in a contaminated area. Qualitative fit testing will be performed every 12 months. This will be done by following the mandatory fit test procedures listed in Appendix C. Quantitative fit testing will be performed for fit testing of full facepiece respirators used in the negative pressure mode for protection greater than 10 times the exposure limit but not to exceed 50 times the exposure limit. If quantitative fit testing is necessary, the testing will comply with the mandatary quantitative fit test protocols in Section 5144, Appendix A-(C), Title 8 of the California Code of Regulations. Quantitative fit testing will also be performed every 12 months. Fit testing will be done initially upon employee assignment to an area where respirators are required. All tight fitting respirators (negative and positive pressure) will be fit tested. Positive pressure tight fitting respirators will be fit tested in the negative pressure mode. Additional fit tests will be conducted whenever the employee reports, or the PLHCP, supervisor, or program administrator makes visual observations of changes in the employee's physical condition that could affect respirator fit. Such conditions include, but are not limited to, facial scarring, dental changes, cosmetic surgery, or an obvious change in body weight. If after passing a fit test, the employee subsequently notifies management (e.g., supervisor, program administrator, or PLHGP) that the fit of the respirator is unacceptable, the employee will be given a reasonable opportunity to select a different respirator facepiece and to be retes#ed. Individual fit testing records will be kept on each individual by completing the Qualitative Fit Test Record and may be found on file at the Departmental Safety Representative's Office or by contacting the respiratory protection program administrator. A copy of the Fit Test Record form is included in Appendix D. Butte County Respiratory Protection Program $ NOTE: If it is determined that an individual cannot obtain an adequate fit or face seal with any negative pressure respirator, a loose fitting powered air purifying or supplied air respirator will be used instead. Fit testing of employees with any hair growth such as stubble beard growth, beard or long sideburns that extends under the face seal or interferes with valve function is prohibited. RESPIRATOR INSPECTION, MAINTENANCE AND STORAGE Respirators will be properly maintained to retain their original effectiveness by periodic inspection, repair, cleaning and proper storage. 1. INSPECTION The wearer of a respirator will inspect it daily whenever it is in use, prior to use and during cleaning. Supervisors will periodically spot check respirators for fit, usage, and condition. The use of defective respirators will not be permitted. If a defective respirator is found during inspection, it will be returned to the following individual: The Departmental Safety Representative. 2. REPAIR During cleaning and maintenance, respirators that do not pass inspection will be replaced or repaired immediately. Repair of the respirator will be done with parts designed for the respirator in accordance with the manufacturer"s instructions. No attempt will be made to replace components or make adjustments, modifications or repairs beyond the manufacturer's recommendation. 3. CLEANING Respirators not discarded after one shift use will be cleaned on a daily basis (or after each use if not used daily) according to the manufacturer's instructions by the assigned employee or other person designated by the respiratory protection program administrator. Respirators issued to more than one employee will be cleaned and disinfected before being worn by different individuals. This may require cleaning more frequently than on a daily basis. Respirators used in fit testing and training will be cleaned and disinfected after each use. Facilities and supplies far cleaning these respirators will be made available. Detailed cleaning procedures will be found in Appendix E. 4. STORAGE Respirators not discarded after one shift use, will be stored in a suitable container away from areas of contamination. The respirators will be stored in a location where they are protected from sunlight, dust, heat, cold, moisture, and damaging chemicals and they will be stored or packed to prevent deformation of the facepiece and exhalation valve. Whenever feasible, respirators not Butte County Respiratory Protection Program 9 discarded after one shift use, will be marked and stored in such a manner to assure that they are worn only by the assigned employee. Respirators will be stored in a clean and dry container or bag. The employees are instructed to keep respirators stored in locations that are not in direct sunlight or in harsh weather. 5. COMPRESSED AIR SYSTEMS Special precautions will be taken to assure breathing quality air when an air line respirator or SCBA is to be used. This air will meet the specifications for Grade D Air as stated in the OSHA respiratory protection standard. Cylinders of purchased breathing air will have a certificate of analysis from the supplier that the breathing air meets the requirements far Grade D breathing air. Compressors used to supply breathing air to respirators will be constructed and situated so as to prevent entry of contaminated air into the air-supply system, will have suitable in-line air-purifying sorbent beds and filters to further ensure breathing air quality. sorbent beds and filters will be maintained and replaced or refurbished periodically following the manufacturer's instructions. The compressor(s) will have a tag containing the most recent change date and the signature of the person authorized by the program administrator to perform the sorbent bed and/or filter change. The tag will be maintained at the compressor. For non-oil lubricated compressors, the carbon monoxide levels in the breathing air will not be allowed to exceed 10 ppm. Oil lubricated compressors will use ahigh-temperature or carbon monoxide alarm or bath to monitor carbon monoxide levels. If only high-temperature alarms are used, the air supply will be monitored at intervals sufficient to prevent carbon monoxide from exceeding 10 ppm in the breathing air. EMERGENCY USE RESPIRATORS Self contained breathing apparatus will be required in specific areas for emergency use. This equipment will be used only by trained personnel when it is necessary to enter hazardous atmospheres. 1. Locations Self contained breathing apparatus(SCBA) will be found in the following location(s): • Butte County Jail 2. Special Requirements All potential users will be fully trained in the use of this equipment. They will also be medically qualified to wear the device. When the equipment is used, it will be tested in an uncontaminated atmosphere prior to entering the hazardous area. Butte County Respiratory Protection Program 10 Respirators maintained for emergency use shall be cleaned and disinfected after each use. Emergency respirators wil! be kept accessible to the work area, stored in compartments or covers that are clearly marked as containing emergency respirators and stored in accordance with any applicable manufacturer instructions. Air and oxygen cylinders of SCBAs will be maintained in a fully charged state and will be recharged when the pressure falls to 90°1° of the manufacturer's recommended pressure level. Emergency use respirators will be certified by documenting the date the inspection was performed, the name (or signature) of the person who made the inspection, the findings required, remedial action, and a serial number or other means of identifying the respirator. This equipment will be inspected monthly and in accordance with the manufacturer's recommendations by trained department or group personnel. Inspection and maintenance information will be recorded in a log book or inspection reports stored in paper or electronic files or an inspection tag or label that is attached to the respirator storage compartment. The inspectionlmaintenance certification information will be maintained until replaced fallowing a subsequent certification. PROGRAM EVALUATION This program will be periodically reviewed and evaluated every 12 months. The evaluations of the workplace will be carried out to ensure that the current written program is effectively implemented. They will include regular consultations with employees using respirators to assess their view on program effectiveness and to identify any problems. Factors to be assessed include: respirator fit (including the ability to use the respirator without interfering with effective workplace performance), appropriate respirator selection far the hazards to which the employee is exposed, proper respirator use under workplace conditions the employee encounters, and proper respirator maintenance. A written report will be made of each evaluation, summarizing the findings. For each deficiency identified, corrective action taken will be noted. Copies of the summary reports can be obtained from the respiratory protection program administrator. VOLUNTARY USE OF RESPIRATORS BY EMPLOYEES Employees are not required to be medically evaluated who voluntarily use filtering facepieces {dust masks) in atmospheres that are proven through air sampling to be below OSHA permissible exposure levels (PEL) or were engineering or administrative controls are effective in reducing contaminant levels below OSHA standards. This does not apply to biological contaminants such as Mycobacterium tuberculosis (M. tuberculosis) considering that: 1) there probably is no safe concentration level of M. tuberculosis in air; and 2) OSHA has not established a PEL for M. tuberculosis. Departments must determine that voluntary use of respirators will not in itself create a hazard. The respirator user shall be provided with the information contained in Appendix F ("Information for Employees Using Respirators When Not Required Under the Standard"). APPENDIX A 11 Butte County Respiratory Protection Program Medical Questionnaire for Respirator Users Employee's Name Home address: Home Phone #: Date of Birth: SSN: To the Employee: Can you read? (check one): Yes,41 No Your Supervisor must allow you to answer this questionnaire during normal working hours, or at a time and place that is convenient to you. To maintain your confidentiality, your employer or supervisor must not look at or review your answers, and your supervisor must tell you haw to deliver or send this questionnaire to the health care professional who will review it. Part A. Section 1. (Mandatory) The following information must be provided by every employee who has been selected to use any type of respirator (please print). 1. Sex (circle one): Male / Female 2. Your height: ft. in. 3. Your weight: lbs. 4. Is it okay for the health care professional who reviews this questionnaire to contact you a at one of the telephone numbers listed above? Yes ~ No If No is checked, please list the telephone number where you can be reached. 5. What is the best time to reach you at this number: 6. Has your supervisor told you how to contact the health care professional who will review this questionnaire? Yes No 7. Check the type of respirator you will use (you can check more than one category): a. N, R, or P disposable respirator (filter-mask, non-cartridge type only). b. Half- orfull-facepiece air-purifying type c. Powered-air purifying, supplied-air d. Self-contained breathing apparatus (SCBA) 8. Have you worn a respirator? Yes ~ No If "yes," what type(s): a. N, R, or P disposable respirator (filter-mask, non-cartridge type only). b. Half- orfull-facepiece air-purifying type c. Powered-air purifying, supplied-air d. Self-contained breathing apparatus (SCBA) Confidential Health Questionnaire Page 1 Age: Number of Years Worked for the Department. Date: Department:- Address: Work Phone #: Job Title: APPENDIX A ~2 Butte County Respiratory Protection Pr©gram Medical Questionnaire for Respirator Users Part A. Section 2. (Matldat(3ry) Questions 1 through 9 below must be answered by every employee who has been selected to use any type of respirator. (please circle " Yes" or "No") 1. Do you currently smoke tabacco, or have you smoked tobacco in the last month: Yes No a. If yes, what quantity {how many cigarettes per day)? b. If you did smoke tabacco and quit, how long has it been since you last smoked? _ 2. Have you ever had any of the following conditions? a. Seizures (fits): Yes No b. Diabetes (sugar disease): Yes No c. Allergic reactions that interfere with your breathing: Yes No d. Claustrophobia {fear of closed-in places}: Yes No e. Trouble smelling odors: Yes No 3. Have you ever had any of the following pulmonary or lung problems? a. Asbestosis: Yes No b. Asthma: Yes No c. Chronic bronchitis: Yes No d. Emphysema: Yes No e. Pneumonia: Yes No f. Tuberculosis: Yes No g. Silicosis: Yes No h. Pneumothorax (collapsed lung): Yes No i. Lung cancer: Yes No j. Broken ribs: Yes No k. Any chest injuries or surgeries: Yes No I. Any other lung problem that you've been told about: Yes No 4. Do y ou currently have any of the following symptoms of pulmonary or lung illness? a. Shortness of breath: Yes No b. Shortness of breath when walking fast on level ground or walking up a slight hill or incline: Yes No c. Shortness of breath when walking with other people at an ordinary pace an level ground: Yes No d. Have to stop for breath when walking at your own pace on level ground: Yes No e. Shortness of breath when washing or dressing yourself: Yes No f. Shortness of breath that interferes with your job: Yes No g. Coughing that produces phlegm (thick sputum}: Yes No h. Coughing that wakes you early in the morning: Yes No i. Coughing that occurs mostly when you are lying down: Yes No j. Coughing up blood in the last month: Yes Na k. Wheezing: Yes No I. Wheezing that interferes with your job: Yes No m . Chest pain when you breathe deeply: Yes No n. Any other symptoms that you think may be related to lung problems: Yes No 5. Have you ever had any of the following cardiovascular or heart problems? a. Heart attack: Yes No b. Stroke: Yes No c. Angina: Yes No d. Heart failure: Yes No e. Swelling in your legs or feet (not caused by walking): Yes No f. Heart arrhythmia (heart beating irregularly}: Yes No g. High blood pressure: Yes No h. Any other heart problem that you've been told about: Yes No Confidential Health Questionnaire Page 2 APPENDIX A 13 Butte County Respiratory Protection Program Medical Questionnaire for Respirator Users 6. Have you ever had any of the following cardiovascular or heart symptoms? a. Frequent pain or tightness in your chest: Yes No b. Pain or tightness in your chest during physical activity: Yes No c. Pain or tightness in your chest that interferes with your job: Yes No d. In the past two years, have you noticed your heart skipping or missing a beat: Yes No e. Heartburn or indigestion that is not related to eating: Yes No f. Any other symptoms that you think may be related to heart or circulation problems: Yes No 7. Do you currently take medication for any of the following problems? a. Breathing or lung problems: Yes Na b. Heart trouble: Yes No c. Blood pressure: Yes No d. Seizures (fits): Yes No $. If you've used a respirator, have you ever had any of the following problems? (If you've never used a respirator, go to question 9:) a. Eye irritation: Yes No b. Skin allergies or rashes: Yes No c. Anxiety: Yes No d. General weakness or fatigue: Yes No e. Any other problem that interferes with your use of a respirator: Yes No 9. Would you like to talk to the health care professional who will review this questionnaire about your answers to this questionnaire? Yes No Part B. 1. At work or at home, have you ever been exposed to hazardous solvents, hazardous airborne chemicals, or have you come into skin contact with hazardous chemicals? Yes No If "yes," circle or name them: a. Asbestos: Yes No b. Silica (e.g., in sandblasting): Yes No c. Lead: Yes No d. Pesticides: Yes No e. Glues and Adhesives: Yes No f. Clandestine Drug Labs: Yes No g. Dusty Environments: Yes No h. Other: 2. List any second jobs or side businesses you have: 3. List your previous occupations: 4. Have you ever worked on a HAZMAT team? Yes No 5. Other than medications mentioned earlier in this questionnaire, are you taking any other medications for any reason (including over-the-counter medications): Yes No If "yes," name the medications if you know them: Confidential Health Questionnaire Page 3 APPENDIX A 14 Butte County Respiratory Protection Program Medical Questionnaire for Respirator Users (Part B Continued) 6. How often are you expected to use the respirator(s) (circle "Yes" or "No" for all answers that ap ply to you)?: a. Escape only (no rescue): Yes No b. Emergency rescue only: Yes No c. less than 5 hours per week: Yes No d. less than 2 hours per day: Yes No e. 2 to 4 hours per day: Yes No f. Over 4 hours per day: Yes No 7. During the period you are using the respirators}, is your work effort: a. Light.' Yes No If "yes," how long does this period last during the average shift: hrs. mins. Examples of a tight work effort are sitting while writing, typing, drafting, or performing light assembly work; or standing while operating a drill press (1-3 lbs.) or controlling machines. b. Moderate: Yes No If "yes," how long does this period last during the average shift: hrs. mins. Examples of moderate work effort are sitting while nailing or filing; driving a truck or bus in urban traffic; standing while drilling, nailing, performing assembly work, or transferring a moderate load (about 35 lbs.} at trunk level; walking on a level surface abaut 2 mph or down a 5-degree grade about 3 mph; or pushing a wheelbarrow with a heavy load (about 100 lbs.} on a level surface. c. Heavy Yes No If "yes," how long does this period last during the average shift: hrs. mins. Examples of heavy work are lifting a heavy load (about 50 lbs.) from the floor to your waist or shoulder; working on a loading dock; shoveling; standing while bricklaying or chipping castings; walking up an 8- degree grade about 2 mph; climbing stairs with a heavy load (about 50 Ibs.). 8. Will you be working under hot conditions (temperature exceeding 77 deg. F): Yes No 9. Will you be working under humid conditions: Yes No 10. Describe the work you'll be doing while you're using your respirator(s): 11. Describe any special or hazardous conditions you might encounter when yau're using your respirator{s) {for example, confined spaces, life-threatening gases): Confidential Health Questionnaire Page 4 APPENDIX A Part C. (Full-Facepiece Respirators and SCBAs) 15 Questions 1 to 6 below must be answered by every employee who has been selected to use either afull-facepiece respirator or aself-contained breathing apparatus (SCBA}. For employees who have been selected to use other types of respirators, answering these questions is voluntary. 1. Have you ever lost vision in either eye (temporarily or permanently}: Yes No 2. Do you currently have any of the following vision problems? a. Wear contact lenses: Yes Yes No No b. Wear glasses: Yes No c. Color blind: d. Any other eye or vision problem: Yes No 3. Have you ever had an injury to your ears, including a broken ear drum: Yes No 4. Do you currently have any of the following hearing problems? a. Difficulty hearing: Yes No b. Wear a hearing aid: Yes No c. Any other hearing or ear problem: Yes No 5. Have you ever had a back injury: Yes No 6. Do you currently have any of the fallowing musculoskeletal problems? a. Weakness in any of your arms, hands, legs, or feet: Yes No b. Back pain: Yes No c. Difficulty fully moving your arms and legs: Yes No d Pain or stiffness when you lean forward or backward at the waist: Yes No e. Difficulty fully moving your head up or down: Yes No f. Difficulty fully moving your head side to side: Yes No g. Difficulty bending at your knees: Yes No h. Difficulty squatting to the ground: Yes No i. Climbing a flight of stairs or a ladder carrying more than 25 Ibs: Yes No j. Any other muscle or skeletal problem that interferes with using a respirator: Yes No CERTIFICATION: I certify that I have provided true and complete information concerning my health. Employee Signature Date Confidential Health Questionnaire Page 5 PI ans\Respratr\Question APPENDIX B RESPIRATOR SELECTION WORKSITE-SPECIFIC PROCEDURE 16 Respirators will be selected according to the following procedure. 1. SELECTION Respirator selection involves reviewing each operation to (a) determine what hazards may be present (hazard determination} and (b) select which type or class of respirators can offer adequate protection. 2. HAZARD DETERMINATION STEPS The nature of the hazard shall be determined as follows: a) If the potential for an oxygen-deficient environment exists, measure the oxygen content; b) Determine what contaminant(s) may be present in the workplace; c) Determine whether there is a published Threshold Limit Value, Permissible Exposure Limit, or any other available exposure limit or estimate of toxicity for the contaminant(s). Determine if the IDLH concentration for the contaminant is available; d) Determine if there is a comprehensive health standard (e.g. lead, asbestos) for the contaminant(s). If so, there may be specific respirators required that would influence the selection process; e} Determine the physical state of the contaminant. Determine if vapor pressure of the aerosol is significant at the maximum expected temperature of the work environment; f) Measure or estimate the concentration of the contaminant(s); g) Determine whether the contaminant(s) present can be absorbed through the skin, produce skin sensitization, or be irritating or corrosive to the eyes or skin; h) Determine for a gas or vapor contaminant{s) if a known odor, taste, or irritation concentration exists. i) Determine for a gas or vapor contaminant(s) 1) if a chemical cartridge with an end-of-service- life indicator (ESLI) exists or 2) if service life data exists for chemical cartridges that might be used. 3. SELECTION STEPS The proper respirator shall be selected as follows: a) If there is an oxygen-deficient atmosphere, the type of respirator selected depends on the partial pressure (altitude) and concentration of oxygen and the concentration of the other contaminant(s) that may be present; go to (f) and 3.1.1 through 3.1.2; APPENDIX B 17 RESPIRATOR SELECTION WORKSITE-SPECIFIC PROCEDURE b) If unable to determine what potentially hazardous contaminant may be present, the atmosphere shall be considered IDLH; go to 3.1; c) If no exposure limit or guideline is available, and estimates of the toxicity cannot be made, the atmosphere shall be considered IDLH; go to 3.1; d) If the exposure level cannot be identified or reasonably estimated, the atmosphere shall be considered IDLH; go to 3.1; e) If a specific standard exists for the contaminant, consider thaw guidelineslrequirements; f) If the measured or estimated concentration of the contaminant(s) is considered IDLH; go to 3.1; g) Divide the measured or estimated concentration of each contaminant by the exposure limit or guideline to obtain a hazard ratio. When two or more substances are present, consider if there is a synergistic or combined effect of exposure rather than considering each substance individually. Select a respirator from among those with an assigned protection factor greater than the value of the hazard ratio, as listed in Table 1. If an air-purifying respirator is under consideration, continue with (h); h) If the contaminant(s) is a gas or vapor only, go to (m). i) If the contaminant is an aerosol; and a specific regulation or regulatory policy does not require a Class 100 fitter, select a Class 95 filter. Go to step (j); j) If the contaminant is an oil or oil mist is present in the air, or if the presence of oil is unknown, go to (k). If no oil is present, ga to (I); k) If the filter will be used for more than 8 hours or for more than 200 mg of loading, select a respirator with a P filter. If not, a respirator with either an R or P filter is acceptable I) If no oil mist is present, select a respirator with either N, R, or P filters; Note: A powered air-purifying respirator with an appropriate APF and a high efficiency filter may be selected in lieu of particulate respirators selected using steps (i) through (I). mj If the contaminant is a gas or vapor, select an airline respirator unless: 1) an air-purifying respirator with an end-of-service-life indicator for the contaminant is available or, 2) a change schedule based on service life information or other objective data is implemented to ensure that canisters and cartridges are changed before the end of their service life. APPENDIX B 18 RESPIRATOR SELECTION WQRKSITE-SPECIFIC PROCEDURE 3.1 SELECTION OF RESPIRATORS FOR ATMOSPHERES IMMEDIATELY DANGEROUS TO LIFE OR HEALTH, FOR USE IN CONFINED SPACES, OR REDUCED-PRESSURE ATMOSPHERES 3.1.1 RESPIRATORS FOR USE UNDER IDLH CONDITIONS AT NORMAL ATMOSPHERIC CONDITIONS The required respiratory protection for IDLH conditions caused by the presence of toxic materials or a reduced percentage of oxygen as described in conditions (a), (b), or (c) in 3.1.2 is a: • positive-pressure SCBA (with a service of 30 min or more) or • a combination of a supplied-air respirator with auxiliary SCBA. If the SCBA is 5, 10 or 15 min in service life, the airline mode must be used for entry into the atmosphere. 3.1.2 ATMOSPHERES IMMEDIATELY DANGEROUS TO LIFE OR HEALTH A location is considered IDLH when: a} it is an atmosphere known or suspected to have concentrations above the IDLH level, or b) it is a confined space that contains less than the normal 20.9°l° oxygen, unless the source of the oxygen reduction is understood and controlled, or c) oxygen content is below 19.5°l0. Exception: If the employer demonstrates that under all foreseeable conditions, the oxygen concentration can be maintained within the ranges specified in the following table (i.e., for the altitudes set out in the table), then any atmosphere supplying respirator (airline or SCBA) may be used. Oxygen deficient atmospheres for which the employer may rely on any atmosphere-supplying respirators Altitude (ft.) (°1oOz} < 3,001 16.0 - 19.5 3,001 - 4,000 16.4 - 19.5 4,001 - 5,000 17.1 - 19.5 5,001 - 6,000 17.8 - 19.5 6,001 - 7,000 18.5 - 19.5 7,001 - 8,000* 19.3 - 19.5 * Above 8,000 feet the exception does not apply. Oxygen enriched breathing air must be supplied above 14,000 feet. APPENDIX B 19 RESPIRATOR SELECTION WORKSITE-SPECIFIC PROCEDURE TABLE 1 -ASSIGNED PROTECTION FACTORS FOR RESPIRATOR SELECTION RESPIRATORY INLET COVERING TYPE OF RESPIRATOR Half Mask(1) Fuli Facepiece Air purifying 10 50 Atmosphere supplying SCBA{demand)(2) 10 50 Airline (demand) 10 50 RESPIRATORY INLET COVERING TYPE OF RESPIRATOR Half Full Helmet/ Loose-fitting Mask Face Hood Facepiece Powered air purifying 50 1000(3} 1000(3) 25 Atmosphere supplying • Airline- - pressure demand 50 1000 - - -continuous flaw 50 1000 1000 25 Self-contained - breathing apparatus - pressure demand - (4} - - open/closed circuit (1) Includes quarter-masks, disposable half-masks, and half-masks with elastomeric facepieces. (2) Demand SCBA shall not be used for emergency situations such as fire fighting. (3) Protection factors listed are for high-efficiency filters and sorbents (cartridges and canisters). With dust filters, an assigned protection factor of 100 is to be used due to the limitations of the filter. (4) Although positive-pressure respirators are currently regarded as providing the highest level of respiratory protection, a limited number of recent simulated workplace studies concluded that all users may not achieve protection factors of 10,000. Based on this limited data, a definitive assigned protection factor could not be listed for positive-pressure SCBAs. For emergency planning purposes, where hazardous concentrations can be estimated, an assigned protection factor of no higher than 10,000 should be used. NOTE: Assigned protection factors are not applicable for escape respirators. For combination respirators, e.g. airline respirators equipped with an air-purifying filter, the mode of operation in use will dictate the assigned protection factor to be applied. *See ANSI 288.2 Standard for specific selection details. APPENDIX C QUALITATIVE FIT TEST PROTOCOL 20 1. RESPIRATOR SELECTION A. The test subject shall be allowed to select the most comfortable respirator from an array of various sizes and models. The number of respirator sizes and models must be sufficient so that the respirator is acceptable to and correctly fits the user. B. Prior to the selection, the test subject shall be shown how to put in a respirator, how it should be positioned on the face, how to set strap tension and how to assess a "comfortable" respirator. A mirror shall be available to assist the subject in evaluating the fit and positioning of the respirator. C. The test subject must understand that he/she is being asked to select the respirator, which provides the most comfortable fit. Each respirator represents a different size and shape and, if fit properly, will provide adequate protection. D. The test subject holds each facepiece up to the face and eliminates those, which are obviously not giving a comfortable fit. Normally, selection will begin with a half mask and if a fit cannot be found here, the subject will be asked to go to the full facepiece respirators. (A small percentage of users will not be able to wear any half-mask}. E. The more comfortable facepieces are recorded; the most comfortable mask is donned and worn at least five minutes to assess comfort. Assistance in assessing comfort can be given by discussing the points in F below. If the test subject is not familiar with using a particular respirator, he/she shall be directed to don the mask several times and to adjust the straps each time, so that he/she becomes adept at setting proper tension on the straps. F. Assessment of comfort shall include reviewing the fallowing points with the test subject: *Chin properly placed. *Positioning of mask on nose. *Strap tension. *Fit across nose bridge. *Room for safety glasses. *Distance from nose to chin. *Tendency to slip. *Cheeks filled out. *Self-observation in mirror. *Adequate time for assessment. G. The test subject shall conduct the user seal checks according to the respirator manufacturer's instructions (see respirator packaging}. Before conducting the user seal checks, the subject shall be told to "seat" the masks by moving the head side-to-side and up and down slowly while taking a few slow deep breaths. H. The test subject is now ready for fit testing. If a test subject exhibits difficulty in breathing during the tests, he/she shall be referred to a PLHCP, as appropriate, to determine whether the subject can wear a respirator while performing his/her duties. APPENDIX C QUALITATIVE FIT TEST PROTOCOL 21 J. After passing the fit test, the test subject shall be questioned again regarding the comfort of the respirator. If it has become uncomfortable, the test subject shall be given the opportunity to select a different respirator and to be retested. 2. GENERAL PRECAUTIONS AND PROCEDURES A. Prior to beginning the fit test, the test subject shall be given a description of the fit test and the test subject's responsibilities during the test procedure. B. The fit test shall be performed while the test subject is wearing any applicable safety equipment that may be worn during actual respirator use, which could interfere with respirator fit. C. The respirator shall not be adjusted once the fit test exercises begin. Any adjustment voids the test and the fit test must be repeated. 3. FIT TEST PROTOCOL USING 3M'S QUALITATIVE FIT TEST KIT This protocol can be used with either the FT-10 Qualitative Fit Test Apparatus (sweet solution) or the FT-30 Qualitative Fit Test Apparatus (bitter solution). A. EQUIPMENT 1. FT-10 Qualitative Fit Test Apparatus (sweet solution) or FT-30 Qualitative Fit Test Apparatus (bitter solution) a. Hood b. Collar c. Nebulizer #1 (Sensitivity Solution) d. Nebulizer #2 {Fit Test Solution) e. FT-11 Sensitivity Solution (sweet) OR FT-31 Fit Test Solution (bitter) f. FT-12 Fit Test Solution (sweet) OR FT-32 Fit Test Solution (bitter) NOTE: If FT-11 Sensitivity Solution is used, FT-12 Fit Test Solution must be used. If FT-31 Sensitivity Solution is used FT-32 Fit Test solution must be used.. 2. Respirators equipped with particulate filters B. PREPARATION 1. Attach haad to collar by placing draw string between flanges on collar. Tighten draw string and tie with square knot or bow. 2. Pour a small amount (approximately one teaspoonful) of the Sensitivity Solution into the nebulizer labeled "#1 Sensitivity Solution." {Continued Next Page} APPENDIX G QUALITATIVE FIT TEST PROTOCOL 22 3. Pour the same amount of Fit Test Solution into the second nebulizer labeled "#2 Fit Test Solution." C. SENSITIVITY TEST This test is done to assure that the person being fit tested can detect the taste of the test solution at very low levels. The Sensitivity Solution is a very dilute version of the Fit Test Solution. The test subject should not eat, drink, or chew gum for 15 minutes before the test. 1. Have the test subject put on the hood and collar assembly without a respirator. 2. Position the hood assembly forward so that there is about six inches between the subject's face and the hood window. 3. Instruct the test subject to breathe through the mouth. 4. Tell the test subject the taste response to expect (sweet or bitter). 5. Using Nebulizer #1 with the Sensitivity Solution, inject the aerosol into the hood through the hole in the hood window. Rapidly inject ten squeezes of the bulb, fully collapsing and allowing the bulb to expand fully on each squeeze. Both plugs on the nebulizer must be removed from the openings during use. The nebulizer must be held in an upright position to ensure aerosol generation. 6. Ask the test subject if he/she can detect the taste of the solution. If tasted, note the number of squeezes and proceed to the fit test. 7. If not tasted, inject an additional ten squeezes of the aerasol into the hood. Repeat with ten more squeezes if necessary. Note the number of squeezes required to produce a taste response. If the number of squeezes required was 1-10, note 10; if the number of squeezes required was 11-20, note 20; if the number of squeezes required was 21 -30, note 30. This number , 10, 20 or 30, will be used in the next part of the test. 8. If 30 squeezes are inadequate, in that the subject does not taste the Sensitivity Solution, terminate the test. Another type of fit test must be used. 9. Remove the test hood and give the subject a few minutes to clear the taste from the mouth. It may be helpful to have the subject rinse the mouth with water. D. FIT TEST NOTE: if FT-11 Sensitivity Solution was used in the sensitivity test, FT-12 Fit Test Solution must be used in the fit test. If FT-31 Sensitivity Solution was used in the sensitivity test, FT-32 Fit Test Solution must be used in fit test. 1. Have the test subject put on the respirator and perform the user seal check per the instructions provided with the respirator. 2. Have the subject put on and position the test hood as before, and breathe through the mouth. (Continued Next Page) APPENDIX C QUALITATIVE FIT TEST PROTOCOL 23 3. Using Nebulizer #2 with the Fit Test Solution, inject the fit test aerosol using the same number of squeezes noted in the Sensitivity Test (10, 20, or 30). A minimum of 10 squeezes is required, fully collapsing and allowing the bulb to expand fully on each squeeze. Both plugs on the nebulizer must be removed from the openings during use. The nebulizer must be held in an upright position to ensure aerosol generation. 4. To maintain an adequate concentration of aerosol during this test, one half the number of squeezes used in step 3 (5, 10, or 15) is injected every 30 seconds for the duration of the fit test procedure. 5. After the initial aerosol is injected, ask the test subject to perform the following test exercises for 60 seconds each. a. Normal breathing. In normal standing position, without talking, the subject shall breathe normally. b. Deep breathing. In a normal standing position, the subject shall breathe slowly and deeply, taking caution so as not to hyperventilate. Breaths should be deep and regular. c. Turning head side-to-side. Standing in place, the subject shall slowly turn hislher head from side to side between the extreme positions an each side. The head shall be held at each extreme momentarily so the subject can inhale at each side. Movement should be complete, with one turn about every second. d. Moving head up-and-down. Standing in place, the subject shall slowly move hislher head up and down. The subject shall be instructed to inhale in the up position (i.e., when looking toward the ceiling). Movement should be complete and made about one per second. e. Talking. The subject shall talk out loud slowly and loud enough so as to be heard clearly by the test conductor. The subject can read from a prepared text such as the "Rainbow Passage" (see below}, count backward from 100, or recite a memorized poem or song. is suggested. f. Bending over. The test subject shall bend over at the waist as if he/she were to touch hislher toes. Jogging in place shall be substituted for this exercise in those test environments such as shroud type QLFT units that do not permit bending over at the waist. g. Normal breathing. Same as exercise #1. 6. Terminate the test if the subject detects the taste of the test solution at any time. This indicates an inadequate fit. Wait 15 minutes and perform the sensitivity test again. 7. Repeat the fit test after redonning and readjusting the respirator. A second failure may indicate that a different size or model respirator is needed. $. If the entire test is completed without the subject detecting the taste of the test solution, the test is successful and acceptable respirator fit has been demonstrated. 9. immediately after completion of the fit test, rinse the nebulizers with warm water to prevent clogging. Wipe out the inside of the hood with a damp cloth or paper towel to remove any deposited Fit Test Solution. RAINBOW PASSAGE When the sunlight strikes raindrops in the air, they act like a prism and form a rainbow. The rainbow is a division of white light into many beautiful colors. These take the shape of a long round arch, with its path high above, and its two ends apparently beyond the horizon. There is, according to legend, a boiling pot of gold at one end. People look, but no one ever finds it. When a man looks for something beyond his reach, his friends say he is looking for the pot of gold at the end of the rainbow. APPENDIX D ~urrE coun~~r RESPIRATOR ASSIGNMENT AND FIT TEST RECORD 24 EMPLOYEE NAME: DEPT: DATE: JOB DESCRIPTION: CONTAMINANTS: RESPIRATOR TYPE: FIT TEST RESULTS: ^ SATISFACTORY ^ UNSATISFACTORY REMARKS: Sensitivity Test = NAME OF PERSON CONDUCTING TEST EMPLOYEE'S NAME Forms/Fit-test.doc APPENDIX E RESPIRATOR CLEANING PROCEDURES 25 These procedures are provided for employer use when cleaning respirators. They are general in nature, and the employer as an alternative may use the cleaning recommendations provided by the manufacturer of the respirators used by their employees, provided such procedures are as effective as those listed here in Appendix E. Equivalent effectiveness simply means that the procedures used must accomplish the objectives set forth in Appendix E, i.e., must ensure that the respirator is properly cleaned and disinfected in a manner that prevents damage to the respirator and does not cause harm to the user. Procedures for Cleaning Respirators. A. Remove filters, cartridges, or canisters. Disassemble facepieces 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 110 ° 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 110 ° 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 fallowing: 1. Hypochlorite solution (50 ppm of chlorine) made by adding approximately one milliliter of laundry bleach to one liter of water at 110 ° 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 iodidel100 cc of 45% alcohol) to one liter of water at 110 ° 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. E. Rinse components thoroughly in clean, warm 110 ° F maximum, preferably running water. Drain. The importance of thorough rinsing cannot be overemphasized. Detergents or disinfectants that dry on facepieces 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 facepiece, replacing filters, cartridges, and canisters where necessary. H. Test the respirator to ensure that all components work properly. APPENDIX F 26 Information far Employees Using Respirators When Not Required Under the Standard Respirators are an effective method of protection against designated hazards when properly selected and warn. Respirator use is encouraged, even when exposures are below the exposure limit, to provide an additional level of comfort and protection for workers. However, if a respirator is used improperly or not kept clean, the respirator itself can become a hazard to the worker. Sometimes, workers may wear respirators to avoid exposures to hazards, even if the amount of hazardous substance does not exceed the limits set by OSHA standards. If your employer provides respirators for your voluntary use, or if you provide your own respirator, you need to take certain precautions to be sure that the respirator itself does not present a hazard. You should do the following: 1. Read and heed all instructions provided by the manufacturer on use, maintenance, cleaning and care, and warnings regarding the respirators limitations. 2. Choose respirators certified for use to protect against the contaminant of concern. NIOSH, the National Institute for Occupational Safety and Health of the U.S. Department of Health and Human Services, certifies respirators. A label or statement of certification should appear on the respirator or respirator packaging. It will tell you what the respirator is designed for and how much it will protect you. 3. Do not wear your respirator into atmospheres containing contaminants for which your respirator is not designed to protect against. For example, a respirator designed to filter dust particles will not protect you against gases, vapors, or very small solid particles of fumes or smoke. 4. Keep track of your respirator so that you do not mistakenly use someone else's respirator. APPENDIX G Examples of Respiratory Protective Equipment Used by County Employees 2~ Particulate, Mist. Spray Pre-filter a....-~ vepo~ Cartridge