Hospital Respiratory Protection Program Toolkit

Hospital Respiratory Protection Program Toolkit

Resources for Respirator Program Administrators

MAY 2015

TM

U.S. Department of Labor

U.S. Department of Labor

This document is in the public domain and may be freely copied or reprinted.

This document was adapted from a California-specific guide, Implementing Respiratory Protection Programs in Hospitals: A Guide for Respirator Program Administrators, May 2012, which was developed by the California Department of Public Health, Occupational Health Branch, and the Public Health Institute under contract no. 254-2010-345-11 from the National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory (NIOSH-NPPTL). The guide was adapted under contract no. 254-2011-M-40839 from NIOSH-NPPTL to produce this toolkit.

Special thanks to the following organizations for assistance in the development and/or review of these materials:

3M, Inc.

America Federation of Labor-Congress of Industrial Organizations (AFL-CIO)

Hospital Corporation of America

Service Employees International Union (SEIU)

Illinois State University,

University of Minnesota, School

Department of Health Sciences of Public Health

American Federation of State, County, and Municipal Employees (AFSCME)

Arizona Division of Occupational Safety and Health

Children's Healthcare of Atlanta, Inc.

Coalition of Kaiser Permanente Unions

Intermountain Healthcare

Kaiser Permanente

Mayo Clinic

Michigan Public Institute, Center for Healthy Communities

New York State Department of Health

University of North Carolina, Chapel Hill

Veterans Health Administration, Iowa City VA Health Care System

Veterans Health Administration, Office of Public Health

Y. Day Designs

This guidance document is not a standard or regulation, and it creates no new legal obligations. It contains recommendations as well as descriptions of mandatory safety and health standards. The recommendations are advisory in nature, informational in content, and are intended to assist employers in providing a safe and healthful workplace. The Occupational Safety and Health Act requires employers to comply with safety and health standards and regulations promulgated by OSHA or by a state with an OSHA-approved state plan. In addition, the Act's General Duty Clause, Section 5(a)(1), requires employers to provide their employees with a workplace free from recognized hazards likely to cause death or serious physical harm.

Cover photo courtesy of 3M. ?2015

Hospital Respiratory Protection Program Toolkit

Resources for Respirator Program Administrators

May 2015

TM

U.S. Department of Labor

U.S. Department of Labor

Intentionally left blank

Table of Contents

Abbreviations Used in the Toolkit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii Introduction to This Toolkit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Why Hospitals Need a Respiratory Protection Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Respiratory Hazards in the Healthcare Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Respiratory Protection Reduces Inhalation of Aerosols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Multiple Approaches are Needed for Infection Prevention and Control . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 The 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 More Considerations About Respirator Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 The OSHA Respiratory Protection Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Types of Respiratory Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Air-Purifying Respirators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Air-Supplying Respirators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Developing a Respiratory Protection Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Assigning Responsibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Performing a Hazard Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Developing Policies and Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 References, Resources, and Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Regulatory Standards and Interpretations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Healthcare Resources and Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 General Respiratory Protection Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Medical and Industrial Hygiene Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Administrative Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Training and Educational Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

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