ONLINE self-study

1. ONLINE self-study UNC Respiratory Protection Program for Public Safety Department

2. Page Title • Class Objectives

3. Class Objectives • Introduction to the Respiratory Protection Program • Understand why Respiratory Protective Equipment has been issued to UNC-CH Police Officers. • Be able to discuss the types of chemical inhalation hazards including riot control agents, CBRN agents, and miscellaneous chemicals used at UNC-CH. Review biological agents. • Explain the different types of Respiratory Protective Equipment Used. • Review Respirator Use Procedures. • Review Medical Evaluation Procedures. • Understand the purpose of respirator fit-testing • Review Respirator Inspection, Maintenance, and Storage Procedures.

4. Introduction

5. Introduction The University of North Carolina at Chapel Hill (UNC-CH) Respiratory Protection Program describes written policy and procedures for the use of respirators to protect the health of employees in accordance with the Occupational Safety and Health Administration’s (OSHA) Respiratory Protection Standard, 29 CFR 1910.134 (General Industry Respirator Standard). The purpose of the Respiratory Protection Program is to prevent occupational illnesses and disease as result of employee exposure to unsafe levels of airborne hazards in the occupational setting.

6. Introduction The primary means to control occupational exposures caused by breathing contaminated air is through the use of feasible engineering controls, such as enclosures, confinement of operations, ventilation, or substitution of less toxic materials. When effective engineering controls and other types of workplace controls (administrative, product substitution, etc.) are not feasible, or while they are being instituted, appropriate respirators shall be used. The use of respirators is the last line of defense. An effective respirator program is critical for the safe use of the issued respiratory protective equipment.

7. Purpose of Respiratory Protection for Public Safety

8. Purpose of Respiratory Protection for Public Safety Why does Public Safety need a respirator? Some examples include: • Maintaining the perimeter at “crowd-control” incidents where tear gas is used • Terrorism/Chemical/Biological threat incidents (warm & cold zone requirements); • To prevent exposure to airborne respiratory infectious agents (i.e. influenza virus) The following slides explains these examples further.

9. Purpose of Respiratory Protection for Public Safety 1) Maintaining the perimeter at “crowd-control” incidents where tear gas is used: Crowd Control includes riots, disorders, and violence arising from dissident gatherings and marches, rock concerts, political conventions, and personal violence among two or more persons. Respirators could be used by officers during the release of “warning smoke”, “tear-gas,” or other types of riot control agents when there is a potential for exposure to airborne forms of these agents such as when encountered when maintaining crowd control.

10. Purpose of Respiratory Protection for Public Safety An example of an incident which law enforcement personnel used respiratory protective equipment for protection against riot control agents was in Seattle, 1999, during the World Trade Organization protests and demonstrations. Police officers used tear gas and other devices to control crowds of protestors. The following slides were taken on Wednesday, December 1, 1999 in downtown Seattle, WA. The following two pages illustrate the demonstrations that occurred and use of tear gas by Seattle Police Officers to control the crowds of protestors. The third slide illustrates riot police in full dress (including gas masks at their sides) where they arrested hundreds of protestors in Westlake Park, downtown Seattle.

11. Purpose of Respiratory Protection for Public Safety • Left Picture: The line is drawn at 4th and Pike Street. • Right Picture: Tear gas is launched at 4th and Pike Street.

12. Purpose of Respiratory Protection for Public Safety • Left Picture: After dark, 4th and Pike Street • Middle Picture: Police Use Teargas Again • Right: Police occupy 4th and Pike Again

13. Purpose of Respiratory Protection for Public Safety • Left Picture: Riot Control Police at 4th and Pike St, Seattle, Dec 1, 1999. • Right Picture: Police contain and arrest hundreds of protestors in Westlake Park

14. Purpose of Respiratory Protection for Public Safety 2) Terrorism/Chemical/Biological threat incidents: It is a threat that we hope never happens, but we must be prepared if an incident does occur. Public Safety may be in the area of a threat or incident or may be required to help enforce exclusion/barrier/ security zones once exposure conditions are understood. Public Safety may also help victims and the public around the incident area. The respiratory equipment (gas mask with P100 filter & chemical cartridge) issued provides protection against gasses, vapors, and all biological aerosol agents that could potentially be encountered.

15. Purpose of Respiratory Protection for Public Safety 2) Terrorism/Chemical/Biological threat incidents (Continued): The issued gas mask also provides protection against low level chemical warfare agents such as nerve and blister agents, but it is not designed to be used in oxygen deficient atmospheres or in areas where levels of agents exceed the limitations of the respirator chemical cartridge and are considered Immediately Dangerous to Life and Health.

16. Purpose of Respiratory Protection for Public Safety 3) To prevent exposure to airborne respiratory infectious agents (i.e. influenza virus): In the event of a pandemic influenza outbreak, research indicates that a N95 filtering face piece respirator is an adequate form of protection against the inhalation exposure hazard to the influenza virus due to the respirator’s ability to filter out very small size particles including the size of viruses. In addition to your issued disposable N95 respirator, you use a combination filter/chemical protective cartridge (P/N 817588) with your MSA gas mask. The prefilter, is a P100 filter, which has the highest filtering efficiency (99.97% against very small particles) of all NIOSH approved respirator filters. It is also protective against respiratory infectious agents.

17. Review of Airborne Hazards and Chemical Inhalation Hazards

18. Review of Airborne Hazards and Chemical Inhalation Hazards Airborne hazards which public safety could be potentially exposed during an incident generally fall into the following basic categories: • Gases. Gases are formless fluids that occupy the space or enclosure and which can be changed to the liquid or solid state only by the combined effect of increased pressure and decreased temperature. • Vapors. Vapors are the gaseous form of substances that are normally in the solid or liquid state at room temperature and pressure. • Smoke. Smoke consists of carbon or soot particles resulting from the incomplete combustion of carbonaceous materials such as coal or oil. Smoke generally contains droplets as well as dry particles.

19. Review of Airborne Hazards and Chemical Inhalation Hazards • Dusts. Particles that are formed or generated from solid organic or inorganic materials by reducing their size through mechanical processes such as crushing, grinding, drilling, abrading, or blasting. • Fumes. Particles formed when a volatilized solid, such as a metal, condenses in cool air. The media usually confuses the definition of vapor with fume. • Oxygen deficiency. The respirators issued to Public Safety are not protective against oxygen deficient atmospheres. Only approved air supplying respirators (e.g. SCBA’s such as used by Fire Fighters) can be used in this type of environment.

20. Review of Airborne Hazards and Chemical Inhalation Hazards • Acute health effects are the negative effects from a substance that occur after one or multiple exposures in a short period of time. (e.g. the immediate effects of riot control agents explained on the next slides) • Chronic health effects are the negative adverse health effects from a substance that occur over a longer period of time, usually from repeated exposure of low doses. Sometimes delayed for years. (Ex. Asbestos exposure)

21. Review of Chemical Inhalation Hazards- Riot Control Agents

22. Review of Chemical Inhalation Hazards-Riot Control Agents Riot Control Agents: Are compounds that cause temporary incapacitation by irritation of the eyes and irritation of the upper respiratory tract. They are often called irritants, irritating agents, and harassing agents. The general public usually calls them tear gas.

23. Review of Chemical Inhalation Hazards-Riot Control Agents When using riot-control agents you could be exposed to different airborne hazards through breathing fine droplets or particles in the air, or a combination of forms of agents. Some of the different riot control chemical types include: • -CS (Coroson/Stoughton), malenonitrile • Pepper spray (Capsaicin) • Oleoresin capsicum, the “active” ingredient of OC tear gas. • CN (commercial); Mace;chloracetophenone • -DM (vomiting agent) Your issued MSA phalanx gas mask is protective against CN-Mace, CS irritant, and OC tear gas agents.

24. Review of Chemical Inhalation Hazards-Riot Control Agents Riot Control Agents Acute Health Effects of Exposure: • Eyes- burning, lacrimation, injection, blepharospasm • Nose- Burning, rhinorrhea, sneezing • Mouth- burning of mucosa membranes including palate and tongue. • Airways- burning, tightness in the chest, coughing • Skin- Burning, stinging, erythema

25. Review of Chemical Inhalation Hazards-Riot Control Agents Long-lasting exposure or exposure to a large dose of riot control agent; especially in enclosed, unventilated areas can cause severe effects such as the following: • Eyes- Blindness, Glaucoma (a serious eye condition that could lead to blindness). • Nose- Severe burning • Mouth- Severe chemical burns to the throat • Airways- Severe chemical burns to the lungs • Skin- Severe burns

26. Review of Chemical Inhalation Hazards-Riot Control Agents Characteristics of Riot Control Agents: • Usual forms of dispersal and delivery consists of solid primarily (CS, CN,) and aqueous solution (e.g. CN-Mace). • Dispersal devices consist of: pressurized canisters (spray devices) & explosive cartridges (pen guns, shotgun canisters) • Dispersal forms consist of: -solid suspended in the air (aerosol, smoke). -solution suspended in the air (true aerosol).

27. Review of Chemical Inhalation Hazards-Riot Control Agents Degrees of Hotness: • -Measured in Scoville Heat Units (SHU) • *Green bell pepper – zero • *Jalapeno pepper – 5,000 • *Pepper Spray – 5000,000 to 2 Million • *Pure capsaicin – 15 Million The ScovilleOrganoleptic Scale was developed by Wilbur Scoville in 1919 as a way to quantify a chile pepper’s heat. Originally, tasters were asked to judge how many parts of sugar water added to one part of chile essence were needed to completely erase the chile’s heat. Now a chemical process called High Performance Liquid Chromatography (HPLC) measures capsaicin concentrations in chiles, but the Scoville scale is still very accurate, approx. 16 times the HPLC calculation.

28. Review of Chemical Inhalation Hazards-Riot Control Agents How can you protect yourself from exposure to riot control agents?: • If released outdoors, move away from the area where released. Avoid dense, low-lying clouds of riot control agent vapor. • Go to the highest ground possible, because riot control agents will form a dense cloud that can travel close to the ground. • If the release of agents was indoors, get out of the building. • Additional guidance can be found on the Center for Disease Control website at http://emergency.cdc.gov

29. Review of Chemical Inhalation Hazards- “CBRN” & Toxic Industrial Chemicals

30. Review of Chemical Inhalation Hazards-“CBRN” & Toxic Industrial Chemicals Classes of Threat Chemicals CBRN is an acronym for “Chemical, Biological, Radiological, and Nuclear” usually followed by a word like “agents”, “weapons”, or “warfare”. CBRN includes a full spectrum of potential and non-traditional threats from terrorism including chemical warfare agents and toxic industrial chemicals.

31. Review of Chemical Inhalation Hazards-“CBRN” & Toxic Industrial Chemicals What is a Chemical Warfare Agent? Synthesized substance used to incapacitate, seriously injure, or kill man as a result of its physiological effects. • Can be disseminated by a variety of Means: artillery, aircraft, or by non conventional methods • Examples include Nerve Agents, Blistering Agents/Vesicants, Blood Agents. • Can be disseminated by a variety of Means: artillery, aircraft, or by non conventional methods • Can be in form of Gas, Vapor, or Aerosol (droplets) • Additional guidance on specific types of chemical warfare agents can be found on the Center for Disease Control website at http://emergency.cdc.gov

32. Review of Chemical Inhalation Hazards-“CBRN” & Toxic Industrial Chemicals What is an example of a situation in the past where CBRN agents were used in terrorism? • Sarin (Nerve Agent)- On a Monday morning in March 1995, AumShinrikyo cultists released a cloud of impure Sarin gas in a crowded Tokyo subway. Even in dilute form, the chemical killed 12 and sickened thousands. Though they posed no threat in the U.S., the cult had an office in New York City, just a few blocks from the Times Square subway station. • Cyanide- A London plot to release cyanide gas on the Underground tube network was foiled with the arrest of three reported to have links to Al Quaeda.

33. Review of Chemical Inhalation Hazards-“CBRN” & Toxic Industrial Chemicals Toxic Industrial Chemicals Toxic Industrial Chemicals (TICs) is a term that refers to chemical agents that are used in industrial operations which could be used by terrorists. The intentional use of TICs could cause not only health effects, but flammable and explosive hazards. Some examples of chemicals that are considered TICs Include Anhydrous Ammonia, Acrylontirile, Propane, Ethylene Oxide, and Chlorine.

34. Review of Chemical Inhalation Hazards-“CBRN” & Toxic Industrial Chemicals Toxic Industrial Chemicals The University uses a variety of chemicals for research procedures and in industrial work areas for work processes. There are federal and state regulations (e.g. HAZCOM and environmental regulations) to ensure that these materials are properly controlled, inventories of materials are maintained, and to ensure that employees that work with them understand the potential hazards and safe use requirements for these materials.

35. Review of Chemical Inhalation Hazards-“CBRN” & Toxic Industrial Chemicals Examples of chemicals at UNC • Ammonium Nitrate • Fertilizer • Propane • Tanks, forklifts • Acetylene • Welding • Bromine • Water treatment • Chlorine • Pools

36. Review of Chemical Inhalation Hazards-“CBRN” & Toxic Industrial Chemicals Toxic Industrial Chemicals For more information regarding specific types of TICs, the Center for Disease Control and Prevention Website is an excellent resource. The following link takes you directly to their Chemical Emergencies Section where you can obtain more information regarding TICs: http://emergency.cdc.gov/chemical/

37. Review of Biological Agents

38. Review of Biological Agents What are Biological Agents? Viruses, Bacteria, Fungi, and biological toxins. Examples of Biological agents that could be used for terrorism: -Anthrax, -Botulism toxin, -Smallpox, -Plague, -Staphylococcal bacteria, etc. Some agents are contagious, some are not. They require time after inhaled/ingested to multiply enough to overcome the body’s defenses. Routes of exposure: inhalation, dermal route, orally, percutaneously (injected through skin).

39. Review of Biological Agents • Bioterrorism: the intentional use of microorganisms, or toxins, derived form living organisms, to produce death or disease in humans, animals, or plants. • Bioterrorism- Did you know that the first bioterrorism incident against a U.S. community occurred in 1984? Oregon’s local heath authoritites closed down restraunts with salad bars after nearly 400 people became infected with Salmonella Typhimurium. A total of 751 people were victims of a bizarre scheme to hold down voter turnout. A religious cult called the Rajneeshees grew their own bacteria and intentionally contaminated salad bars. • Anthrax- In October 2001, the testing Lab at For Detrick Maryland, found that anthrax spores sent to Senator Tom Daschle were extremely potent. It took months to clear all traces of the weapons –grade anthrax from the Hart Senate Office Building. • 2 postal workers in a mail facility that handled the anthrax-tainted letters also died.

40. Types of Respiratory Protective Equipment

41. Types of Respiratory Protective Equipment There are two primary types of respirators. They are called air- purifying and atmosphere supplying. • Air-Purifying Respirator (APR): Both Negative & Positive Pressure Types. Removes contaminants by mechanical removal of particulates using filters and chemical cartridges used for the removal of gasses & vapors by adsorption (surface binding). They can’t be worn in oxygen-deficient or IDLH atmospheres. The air concentration must be within the maximum use concentration of the respirator. • Atmosphere Supplying: Provides fresh breathing air (“Grade D” quality) from an external source. Examples of types of supplied air are Airline respirators, Self-Contained Breathing Apparatus (SCBA), and Escape only respirators.

42. Types of Respiratory Protective Equipment What type of Respirator does Public Safety use? Air-Purifying Respirator: A respirator with an air-purifying filter, cartridge, or canister that removes specific air contaminants (such as gas, vapor, particulate, or combinations) by passing ambient air through the air-purifying element.

43. Types of Respiratory Protective Equipment A Filtering Facepiece Respirator is a particulate respirator with the entire facepiece composed of the filtering medium. It is protective against aerosols of very small size which could enter your respiratory system (less than one micrometer size) such as particles, dusts, generated from dusty operations and infectious diseases. The 3M 9211 N95 respirator issued to public safety is also protective against biological & infectious agent aerosols and viruses such as influenza viruses and could be used for inhalation protection in the event of an Influenza pandemic outbreak..

44. Types of Respiratory Protective Equipment MSA Phalanx Gas Mask:

45. Types of Respiratory Protective Equipment MSA Phalanx Respirator/Gas Mask: The MSA Phalanx respirator/gas mask that has been issued to you when used with canister P/N 817589 is also effective against the following chemical warfare agents: Nerve GA, GB (Sarin), GD, VX, Blister: mustard and lewisite and ALL Biological Warfare agents. It is also effective against OC (Oleoresin Capsicum) Riot Control Agent and HCN (Hydrogen Cyanide), but is not approved nor has it been tested by the National Institute of Occupational Safety and Health (NIOSH).

46. Types of Respiratory Protective Equipment MSA Phalanx Respirator/Gas Mask Manufacture Information: (Please click on link below to pull up Phalanx Gas Mask Specifications)

47. Types of Respiratory Protective Equipment MSA Phalanx Respirator/Gas Mask: The respirator canister (cartridge) is composed of a combination particulate filter (P100 filter) and treated activated carbon bed. In combination, this cartridge is protective against aerosols, gasses, and vapors. The issued gas mask is equipped with a combination filter/and chemical cartridge. The P100 filter has greater filtering efficiency (99.97%) against aerosols of 0.3 um median diameter size). It has a higher filter efficiency than the 3M 9211 N95 filtering facepiece.

48. Types of Respiratory Protective Equipment Gas Mask Chemical Cartridge/Canister: It is important to implement a chemical cartridge change out schedule. For Public Safety the change schedule is to dispose the cartridge and obtain a new one after eachresponse action. The change schedule will ensure that canisters or cartridges are changed before their end of service life. This will help prevent “break-through” of the chemical cartridge and will prevent the wearer from being exposed to air contaminants as a result of overuse of a saturated chemical cartridge. When using a respirator for protection for gasses and vapors, if you detect a chemical taste, smell, or irritation, you should exit to a clean area and replace the cartridges and inspect the respirator immediately.

49. Types of Respiratory Protective Equipment Atmosphere-Supplying Respirator is a respirator that supplies the user with breathing air from a source independent of the ambient atmosphere. Types include supplied-air respirators (SARs) and self-contained breathing apparatus (SCBA) units. The types of respirators used by Public Safety are not air-supplying!! They are air purifying respirators.

50. Types of Respiratory Protective Equipment Self-Contained Breathing Apparatus (SCBA) is an atmosphere supplying respirator for which the breathing air source is designed to be carried by the user. This type of respirator is considered to provide the highest level of respiratory protection. Pressure-demand types of SCBAs are used for fire fighting, rescue, emergency response, and other situations. This respirator is acceptable for oxygen-deficient conditions, and against a wide variety of contaminants, and for entry into IDLH atmospheres. Disadvantage is that the work time is limited to amount of air in the external tank and the extra weight of the tank.