“RESPIRATOR TRAINING: How to Conduct a Respirator Fit-test?”

1. Safety Systems Hawaii, Inc. presents “RESPIRATOR TRAINING: How to Conduct a Respirator Fit-test?” By Rocky Alvin T. Guillermo Cell: (808) 330-2320 Email: rockyguillermo@hawaii.rr.com

2. Reasons WHY We Are Having this Training… • To know some significant OSHA standards. • To be aware of what a contaminated air or hazardous particles can bring to us. • To know some basic points about respirators. • To learn the proper protocol on how to conduct respirator fit-testing.

3. Some OSHA Standards… 1910.134 (a) (2) “A respirator shall be provided to each employee when such equipment is necessary to protect the health of such employees. The employer shall provide the respirators which are applicable and suitable for the purpose intended.” 1910.134 (d) (1) (ii) “The employer shall select a NIOSH-certified respirator. The respirator shall be used in compliance with the condition of its certification.” 1910.134 (d) (1) (iii) “…Where the employer cannot identify or reasonably estimate the employee exposure, the employer shall consider the atmosphere to be IDLH.”

4. Today’s Major topics… • Respirators • Fit-testing Procedure using Bitrex/Saccharin

5. Click one… Where? When? Disposable Respirators Why? What? How? Who?

6. WHAT? 1. WHAT is a respirator? 2. WHAT are the kinds of respirator? a. APR (Air Purifying Respirators) - Disposable Respirators - Reusable Half Masks/Halfpiece Respirators - Reusable Full Mask/Fullface Respirators b. SAR (Supplied Airline Respirators) c. SCBA (Self-Contained Breathing Apparatus)

7. WHERE? 1. WHERE NOT to use Air-Purifying Respirators? • environment less or greater than 20.9% Oxygen • egress or means of escape is limited • where ventilation is a problem • in IDLH Environments(Immediately Dangerous to Life and Health)/Confined Spaces like manholes, vaults, silos, sewers and etc. • working places not designed for continuous occupancy • working areas where unknown atmospheric hazards are present like ( CO, H2S, and Methane) DANGER: Do not use an APR in a confined space.

8. WHEN? 1. WHEN to change or toss a respirator? • Worn • Torn • Cuts • Chemical Burns • Loose Straps • Really Dirty • Frayed • Missing Parts/Components * If a respirator is of disposable kind then it should be tossed away or condemned right after use.

9. WHY? 1. WHY should you use a respirator? • For protection of yourself from airborne Pathogens like viruses, flu, and SARS, and also from toxic dusts and particulates, and noxious gases and vapors; • For protection of the patient especially when doing surgery operations; (Ex. Surgical masks) • For compliance to avoid citations; “Respiratory protection is the number 1 most frequently cited OSHA standards in year 2008 here in Hawaii. Statistics shows that there were a total of 42 citations.”

10. WHO? 1. WHO uses a respirator? • Militaries • Doctors and nurses • Construction Workers • Maintenance Workers • Firefighters • Painters 2. WHO can use a respirator? • Anyone who has money; • Most importantly, anyone who is expose to atmosphere hazards 3. WHO is responsible to provide a respirator? - EMPLOYER. 4. WHO is responsible to take care of a respirator? - EMPLOYEE/WEARER.

11. HOW? • HOW to inspect a disposable respirator ? DON’Ts of Disposable Respirators - Clean the respirator with alcohol/non-alcohol wipes/towelletes. - Clean it with warm water and mild soap/detergents. - Air dry or put it in the dryer machine. - Soak respirator in water. Always inspect your respirator every time you use it.

12. PARTICLES

13. Filter Ratings

14. Before wearing a respirator… • You must be fit-tested; • You must be trained how to use, inspect and maintain it; • You must be aware about its scope and limitations;

15. Before undergoing a respirator fit-testing… • You must have a medical clearance from a physician or other licensed health care professional (PLHCP); • You must be clean shaven; (mustache, side burns, stubble beard growth and any thing that may interfere with the seal of the respirator is not allowed.) - A Licensed Health Care Professional (PLHCP) is an individual who has successfully completed a prescribed program of study in a variety of health fields and who has obtained a license of certificate indicating his or her competence to practice in that field. - A Licensed Health Care Professional (PLHCP) is one who administers, prescribes, or dispenses medications or procedures to relieve another person’s pain or discomfort, even if the medication or procedure may hasten or increase the risk of death.

16. Fit-testing Means the use of protocol to qualitatively or quantitatively evaluate the fit of a respirator on an individual. 1. Qualitative Fit Test (QLFT) Means a pass/fail fit test to assess the adequacy of respirator fit that relies on the individual’s response to the test agent. 1. Using a Bitrex (Denatonium Benzoate)/Saccharin – test of taste 2. Using an Irritant Smoke (Stannic Chloride) – test of smell 2. Quantitative Fit Test (QTFT) Means an assessment of the adequacy of respirator fit by numerically measuring the amount of leakage into the respirator. Ex. Through the use of computer/sensor

17. Things needed in conducting a respirator fit-test: • Fit-testing kit (Bitrex/Saccharin/Irritant Smoke) • Paperwork (Records/Certificates) • Selection of Respirators (Brand, Sizes, and Kinds) • Gloves/Safety Glass • Shaver and Shaving Cream • Pens • Mirror

18. Criteria in Choosing the Best Respirator Fit… • Comfortability • Seals well on the nose bridge • Room for eye protection/vision • Room to talk • Covers the nose bridge to the chin • Adequate strap tension

19. Fit-testing using a Bitrex or Saccharin • Ask for medical clearance. • Ask to shave if there are any beards, sideburns, mustache or anything that may interfere with the seal of the respirator. • Did you eat, drink (except plain water), smoke and chew gum in the last 15 minutes? • Protect yourself using gloves. • Inform what kind of testing agent and ask fit-test subject to open mouth and slightly extend tongue. • Check sensitivity of the employee with the sensitivity solution using an approved hood with an interval of 10 squeezes. Trial and error, up to 30 squeezes. (Note how many squeezes was solicited which is either 10, 20 or 30 squeezes) • Ask test subject to gargle with water. • Conduct a simple training. • Must ask to wear the respirator for at least 5 minutes. • Each step shall be performed in a minute. • Do positive and negative user seal check. • Pump the number of squeezes solicited initially then pump half of the number of squeezes solicited every after 30 seconds. • Steps:(Remember: Tell test subject to breathe through the mouth with tongue extended and not to adjust mask during the process or this voids the test.) • Breathe normally; (ASK) • Breathe deeply; (ASK) • Turn head all the way from one side to another; (ASK) • Nod head up-and-down; (ASK) • Talking; (ASK) (Ex. Rainbow Passage, Count backward from 100, or recite a memorized poem or song) • Bending over/Jogging in place; (ASK) • 7. Breathe normally; (ASK)

20. Questions: • How about if a disposable respirator does not give good fit to the wearer or he failed during the fit-testing? • ANSWER: Recommend another brand. • 2. How often shall a qualitative fit-testing be conducted? • ANSWER: At least 6 months. • 3. When is fit-testing required? • ANSWER: • a. Every year; • b. Weight change of 20 pounds or more; • c. Significant facial scarring in the area of the facepiece seal; • d. Reconstructive or cosmetic surgery; • e. Significant dental changes; multiple extractions without prosthesis.

21. Influenza A Virus Subtype H1N1 • * Popularly known as the swine flu and this is caused by any strain of influenza virus endemic in pigs (swine). Swine flu is rare in human. The 2009 swine flu outbreak originated in Venacruz State, Mexico and the first victim was a 5-year old child. • * Right now, there are 3766 confirmed deaths because of Swine Flu in America and 5335 total all over the world. • * Symptoms: chills, fever, sore throat, muscle pains, severe headache, coughing, weaknesses, and general discomfort. • * Prevention of spread in humans: • Frequent washing of hands with soap and water; • Social Distancing; • Using protective barriers like respirators and safety glasses; • Covering mouth when sneezing and coughing;

22. Questions???

23. Cheat Sheet Hands-on Test