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H1N1 and OSHA/PESH Regulations

H1N1 and OSHA/PESH Regulations. New York State Department of Labor. Public Employee Safety and Health Bureau PESH James Cutrone- Garden City/White Plains District Supervisor Barbara Stanley- Garden City Industrial Hygiene Technical Supervisor. Objectives.

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H1N1 and OSHA/PESH Regulations

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  1. H1N1 and OSHA/PESH Regulations

  2. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone- Garden City/White Plains District Supervisor Barbara Stanley- Garden City Industrial Hygiene Technical Supervisor

  3. Objectives • Describe PESH and it’s jurisdiction in NYS • Identify what PPE should be worn and when in regards to H1N1 • Outline the elements of the PPE standard that apply • Explain what and when respiratory protection is required • Outline the elements of the respiratory protection standard that apply • Describe and demonstrate fit testing options • Provide resources for you to develop a respiratory protection plan and a PPE Hazard Assessment. • Recordkeeping

  4. PESH Jurisdiction • Enforcement of OSHA/PESH Regulations in Places of Public Employment, specifically • State • County • City • Towns • Villages • Includes Fire Departments, Fire Districts, Fire Protection Districts, Publicly Owned EMS, Fire Department EMS and Volunteer EMS Districts • Does not cover Independent Not for Profit Corporations

  5. PESH STAFF • Enforcement Staff • Industrial Hygienists • Safety Inspectors • Consultation Staff • Industrial Hygienists • Safety Consultants

  6. H1N1- What We Know • Novel Virus • Spread throughout the world – WHO Phase 6 “Pandemic” • Range of symptoms similar to seasonal flu • Fever, cough, sore throat, fatigue, headache, body aches, lethargy, stuffy nose, chills (some with diarrhea, vomiting) • Severity similar to seasonal flu • Higher risk for complications: • Lung disorders, asthma, emphysema • Heart, kidney, liver, blood disorders • Diabetes • Weakened immune system • Pregnant women • Long term aspirin therapy • >65 and < 5 years old • Immunity seen in people older than 60????

  7. H1N1 Guidance Documents • CDC • OSHA • FDA • NYSDOH • NYCDOH • APIC • SHEA • Etc………

  8. CDC- Interim Guidance for EMS Systems and 911 PSAPs for Management of Patients with Confirmed or Suspected Swine-Origin Influenza A (H1N1) Infection • Complements CDC Interim Guidance for Healthcare Settings • Don PPE for suspected cases prior to entering the scene • If during assessment, symptoms indicate a possible case- don PPE. • PPE: • Fit tested N95 respirator • Eye Protection (goggles or face shield) • Disposable non-sterile gloves • Gown • Encourage good vehicle airflow/ventilation • Follow Basic Infection Control procedures • Decontamination, hand hygiene, cough and respiratory hygiene • All patients with acute febrile respiratory illness should wear a surgical mask, if tolerated by patient

  9. CDC-Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare Setting • Interim guidance for healthcare facilities and other settings where healthcare is provided • Supports what is outlined in EMS and PSAP document

  10. OSHA/PESH RequirementsDuring Pandemics • NIOSH certified respirator for close contact with ill people • N95 is minimal level of protection • Very High Risk Workers - exposed while performing specific medical or laboratory procedures • High Exposure Risk Workers – high potential for exposure to known or suspected pandemic sources e.g. doctors, nurses, other hospital staff and emergency responders transporting sick patients • Other Workers- not normally at risk, but are performing high risk tasks such as isolating and quarantining people who are ill

  11. Hazard Assessment • Upon entering the scene • Treating suspect or confirmed cases • Cleaning vehicle after patient is transported • N95 respirator required when treating a suspect or confirmed H1 N1 case

  12. OSHA/PESH Regulationsand Requirements • 29CFR 1910.132 • 29CFR1910.134 • 29CFR1910.1020

  13. PPE Standard (29CFR1910.132)General Requirements • Protective equipment shall be provided, used and maintained in a sanitary and reliable condition whenever it is necessary by reason of hazards…. • Hazard Assessment and Equipment Selection • Written Certification • Training

  14. Particulate RespiratorsNIOSH Approved Filtering Facepiece • Nine classes of filters • Three levels of filter efficiency • Each with three categories of resistance to filter efficiency degradation • Filter Efficiency: • 99.97% (HEPA) • 99% • 95% • Resistance to filter efficiency degradation • N- not resistant to oil • R- is resistant to oil • P- oil proof

  15. (a) Permissible practice (b) Definitions (c) Respirator program (d) Selection of respirators (e) Medical evaluation (f) Fit testing (g) Use of respirators (h) Maintenance and care (i) Breathing air quality and use (j) Identification of filters, cartridges, and canisters (k) Training and information (l) Program evaluation (m) Recordkeeping (n) Dates (o) Appendices (mandatory) A: Fit Testing Procedures B-1: User Seal Checks B-2: Cleaning Procedures C: Medical Questionnaire D: Information for Employees Wearing Respirators When Not Required Under the Standard 29CFR1910. 134- Respiratory Protection

  16. Written Program Elements • Procedures for selecting respirators • Medical evaluations • Fit testing procedures • Procedures for proper use in routine and reasonably foreseeable emergencies • Procedures and schedules for cleaning, disinfecting, storing, inspecting, repairing, discarding, otherwise maintaining respirators • Training of employees in the hazards they are potentially exposed to • Training in the proper use and any limitations on use and maintenance • Procedures for regularly evaluating the effectiveness of the program

  17. Fit Testing (cont’d) • The fit test must be administered using an OSHA-accepted QLFT or QNFT protocol contained in Appendix A • QLFT Protocols: • Isoamyl acetate • Saccharin • Bitrex • Irritant smoke • QNFT Protocols: • Condensation Nuclei Counter (PortaCount) • Generated Aerosol (corn oil, salt, DEHP) • Controlled Negative Pressure (Dynatech FitTester 3000)

  18. Recordkeeping Requirements • 29 CFR 1910.1020 • Records of medical evaluations must be retained and made available • 29 CFR 1910.134 • A record of fit tests must be established and retained until the next fit test is administered • Written copy of the current program • Written materials required to be retained must be made available upon request to affected employees and OSHA/PESH

  19. References • CDC- Interim Guidance for EMS Systems and 911 PSAPs for Management of Patients with Confirmed or Suspected Swine-Origin Influenza A (H1N1) Infection • CDC-Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare Setting • OSHA 3328-05 2007 Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers • OSHA 3327-02N 2007 Preparing Workplaces for a Pandemic • EPA- Antimicrobial Products Registered for Use Against the H1N1 Flu and Other Influenza A Viruses on Hard Surfaces • OSHA’s Quick Cards • www.cdc.gov • www.osha.gov

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