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  • This is a presentation about the use of respirators in

  • healthcare settings.

  • In certain situations, healthcare workers may need to

  • be protected from airborne hazards, such as infectious

  • agents or hazardous chemicals in their workplace.

  • Respirators are a type of personal protective equipment,

  • or PPE, that can protect you from breathing in such hazards.

  • After viewing this video, you should

  • have a basic understanding of why respirators are used

  • in the healthcare industry, and how to properly use them.

  • You should also understand that a standard

  • issued by OSHA - the Occupational Safety and Health

  • Administration - or by an OSHA-approved State plan,

  • requires your employer to have a comprehensive

  • respiratory protection program whenever respirators

  • must be used.

  • In addition, this video will discuss some

  • common myths about respirators that you may hear in

  • your workplace.

  • It is required that you understand how to use a

  • respirator, and understand the major components of a

  • respiratory protection program.

  • This video may be a part of your respiratory protection training,

  • but it’s not a substitute for the more in-depth, worksite-specific

  • training that your employer is required to provide.

  • While this video discusses your employer’s

  • responsibilities under OSHA’s respiratory protection

  • standard, remember that the purpose of a respirator is

  • to protect your health and safety.

  • So let’s begin:

  • Airborne hazards may be solid particles - like dusts -

  • droplets - like mists -

  • or gases.

  • When such hazards are present in your workplace, your

  • employer must control them in several ways, including

  • engineering controls, work practice controls, and

  • administrative controls.

  • When workers cannot be adequately protected from

  • respiratory hazards through engineering, work practice,

  • and administrative controls, employers must provide,

  • and workers must use, personal protective equipment,

  • also known as PPE.

  • Respirators are a type of PPE used to protect workers

  • against breathing airborne hazards and they are often

  • used with other types of PPE such as gloves, goggles,

  • and procedure gowns.

  • In this presentation, one of our goals is to set the record

  • straight about the proper use of respirators in

  • healthcare settings.

  • So during this video we will take a look at some of the

  • misconceptions, or myths that you may encounter in

  • your workplace.

  • Myth: Respirators are only necessary for tuberculosis

  • or TB - exposures.

  • Actually there are a number of situations in healthcare

  • settings where workers may need to wear a respirator

  • to protect against airborne hazardsTB is only one of them.

  • There are two primary types of respiratory hazards in

  • healthcare settingsairborne infectious agents and

  • gaseous chemical exposures.

  • Let’s take a look at these two types of hazards, the ways

  • workers might be exposed to them and how they can be

  • protected from them.

  • First let’s look at airborne infectious agents.

  • Probably the most common use of respirators in

  • healthcare settings is to protect workers against

  • airborne infectious agents that cause diseases such as

  • tuberculosis, SARS, pandemic influenza, chicken pox, and measles.

  • Healthcare workers are exposed to these

  • hazards during the care of patients suspected or

  • confirmed to have airborne transmissible diseases.

  • Workers might also be exposed when they enter a

  • negative pressure airborne infection isolation roomor AIIR;

  • when they are present during aerosol-generating medical

  • or laboratory procedures or during

  • autopsies on suspected or confirmed infectious individuals;

  • when they transport infectious patients in an enclosed vehicle;

  • and when they function as first receivers of

  • victims from a biological agent attack.

  • Patient care isn’t the only situation where respiratory

  • protection may be needed to protect workers against

  • airborne transmission.

  • For example, laboratory personnel working with

  • highly infectious agents may need respiratory protection.

  • Also, engineering and maintenance staff may be

  • exposed during tasks such as replacing filters in an

  • isolation room or a laboratory hood ventilation system.

  • Now let’s talk about gaseous chemical exposures.

  • Workers in healthcare settings may also need to use

  • respirators to protect against airborne chemical

  • exposures from substances such as pharmaceuticals

  • during dose preparation, sterilants, like glutaraldehyde,

  • and fixatives like formaldehyde.

  • It’s very important to understand that the respirators

  • used to protect against infectious agents may be

  • inappropriate to protect against chemical hazards.

  • We will discuss respirator selection in more detail later

  • in the program.

  • When a respirator is required by your employer, your

  • employer must develop and implement a

  • comprehensive respiratory protection program.

  • This program must meet the requirements of either Federal

  • or State OSHA’s Respiratory Protection Standard.

  • Employers must comply with the standard, and you

  • need to have a basic understanding of their responsibilities.

  • Your employer must:

  • identify and evaluate hazards;

  • develop a written program;

  • properly select respirators;

  • evaluate respirator use;

  • correct any problems with respirator use;

  • conduct medical evaluations and fit testing;

  • provide for the maintenance, storage and cleaning of respirators;

  • provide training;

  • and provide you with access to specific

  • records and documents, such as a written copy of your

  • employer’s respiratory protection program.

  • Because each workplace is different, your employer’s

  • respiratory protection program must be tailored to your

  • specific workplace.

  • For example, workplaces will differ

  • in types of respiratory hazards, designated personnel,

  • policies, procedures, and methods of compliance.

  • These differences must be reflected in the employer’s program.

  • Your employer’s respiratory protection program must

  • be managed by a properly trained program administrator.

  • Their job is to monitor the implementation of the

  • program and to make sure that workers are properly protected.

  • Myth: Surgical masks provide the same protection as respirators.

  • Respirators and surgical masks are two types of

  • personal protective equipment - or PPE - that are

  • used to protect workers in healthcare settings.

  • A surgical mask is not a respirator, and that’s an

  • important distinction for you and your employer to

  • understand, so let’s review the significant differences

  • between a respirator and a surgical mask.

  • What is a respirator? A respirator is a type of personal

  • protective equipment designed to reduce your

  • exposure to airborne contaminants.

  • Respirators are available in different types and sizes,

  • and the respirator you use must be individually selected

  • to fit your face and to provide a tight seal.

  • A proper seal between your face and the respirator

  • forces inhaled air to be pulled

  • through the respirator’s filter material, and not through

  • gaps between your face and the respirator.

  • If your supervisor requires you to use a respirator, it

  • must be NIOSH-certified and must be used in the

  • context of a comprehensive respiratory protection

  • program, according to OSHA’s Respiratory Protection

  • standard, twenty nine CFR nineteen ten point one thirty

  • four, which includes but is not limited to medical

  • evaluation, fit testing, and training elements.

  • Respirators are used routinely to protect healthcare

  • workers against airborne infectious diseases, such as

  • tuberculosis, anthrax, SARs, and Hantavirus because

  • they protect against both large and small particles.

  • What is a Facemask? A facemask is a loose-fitting,

  • disposable mask that covers your nose and mouth.

  • Surgical masks, dental masks, medical procedure masks,

  • isolation masks and laser masks are all types of facemasks.

  • Facemasks help stop large droplets from being spread

  • by the person wearing them, whether that person is a

  • patient or a healthcare worker.

  • Facemasks also keep splashes or sprays from reaching the

  • mouth and nose of the person wearing them.

  • However, facemasks are not designed or certified

  • to seal tightly against your face or

  • to prevent the inhalation of small airborne contaminants.

  • During inhalation, small airborne contaminants pass

  • through gaps between the face and the facemask and

  • the material of the mask.

  • Remember, facemasks are not considered respirators

  • and they do not provide respiratory protection.

  • Only facemasks that are cleared by the U.S.

  • Food and Drug Administration, the FDA for short, may be legally

  • marketed in the United States.

  • The FDA approval signifies that they have been tested for their ability to

  • resist splashes of blood and other body fluids.

  • To offer protection, both facemasks and respirators

  • need to be worn correctly and consistently throughout

  • the time that they are being used.

  • When used properly, facemasks and respirators both play

  • an important role in preventing exposures to different types of hazards.

  • If you need the protection of both a facemask and a

  • respirator, you can use a surgical N95 respirator.

  • Surgical N95 respirators offer protection from both

  • airborne and body fluid contaminants and are approved

  • by both NIOSH and the FDA.

  • Your employer is responsible for selecting appropriate

  • respirators when they are needed to protect you from

  • airborne hazards.

  • That selection is based in part on the

  • level of protection a given type of respirator can provide.

  • And this brings us to another myth:

  • All respirators offer the same level of protection.

  • The truth is that different types of respirators protect

  • against different hazards and offer different levels of protection.

  • So when your employer selects respirators

  • they must first identify the hazard and then consider

  • these two factors: the respirator’s level of protection

  • and the expected workplace exposure level.

  • Your employer must also consider whether the hazard

  • has any additional characteristics that may affect the

  • type of respirator selected.

  • For example, does the hazard irritate the eyes?

  • Do you need splash and spray protection, as well as eye protection?

  • If so, a full facepiece respirator or some type of

  • eye protection will be needed.

  • There are advantages and disadvantages to each type of

  • respirator, so it’s important that your employer select the type

  • that’s best suited for your work setting and the hazards you face.

  • These are filtering facepiece respirators, sometimes

  • referred to as N95s or TB respirators.

  • They come in a variety of configurations, such as cup shaped,

  • flat fold, and duckbill.

  • Because this is a tight-fitting respirator, it needs to be fit

  • tested to assure a good face seal.

  • This type is commonly used by healthcare providers

  • during patient care.

  • Filtering facepiece respirators do not protect

  • against gaseous chemical hazards, such as

  • formaldehyde and glutaraldehyde, and must not be

  • used for such purposes.

  • Filtering facepiece respirators are available with or

  • without exhalation valves.

  • Respirators with exhalation valves should not be

  • used where a sterile field must be maintained,

  • such as in an operating room.

  • The Surgical N95 respirator, shown here, is used in

  • situations that require the protection of both a surgical

  • mask and a respirator.

  • This is an elastomeric half-facepiece respirator.

  • This type needs to be fit tested and can be used instead of a

  • filtering facepiece respirator.

  • Some healthcare providers are beginning to use this

  • type of respirator for protection against infectious agents.

  • An elastomeric half-facepiece respirator can be cleaned,

  • decontaminated, and reused.

  • Remember, this is not the case for a filtering facepiece

  • respirator, which is normally discarded after use.

  • This is an elastomeric full-facepiece respirator.

  • This type of respirator provides a higher level of protection

  • than filtering facepiece and elastomeric half-facepiece respirators.

  • Why? Because it provides a better seal to the wearer’s face.

  • Another advantage of this respirator is that it covers the

  • wearer’s eyes, protecting them from liquid splashes and chemical vapors.

  • It might be used by workers exposed to formaldehyde

  • or by laboratory, pharmacy, or maintenance personnel.

  • In addition, it could be used by healthcare workers who

  • are first receivers of victims of hazardous substance

  • releases, or by a healthcare facility’s internal hazmat team.