6 Easy Steps to Establishing a Respiratory Program – Step 4

4. The Medical Evaluation

A more recent development in the area of respiratory protection is the advent of the medical evaluation. Any and all workers who are doing to wear respirators need to get a medical evaluation done. This medical evaluation needs to be done before the worker can be fit tested (which is step 5).

The reasoning behind this step is that there are certain people for whom wearing a respirator might be potentially problematic. People with asthma for example might have increased difficulty breathing as a result of wearing a respirator. I can’t tell you the number of times people have come in to get fit tested and had to go away without having it done because they’ve skipped this step. We cannot and will not fit test anyone who hasn’t first been cleared medically; the liability should anything happen to the person we are fit testing is just too great.

In most cases, the medical evaluation is simple. Workers answer a number of questions. The form is then submitted to a “licensed healthcare professional” who then determines, based on those answers, whether or not the worker needs to have a full blown medical checkup before he or she can wear a respirator. Unless there is something obvious, most workers are simply cleared to wear a respirator without having to have a pulmonary test. If the questionnaire uncovers any areas of concern, the licensed healthcare professional will then order a more complete exam.

The medical evaluation is confidential. Employers are not allowed to look at the answers given by the employee. The employee simply fills in the questionnaire and seals it in an envelope to his place of employment who will send it in or he is instructed about where to submit it directly to the medical facility.

3M has the medical evaluation available to view or download on their website here.

Most doctors or medical facilities can sign off on the medical evaluation. 3M even has an online medical evaluation where employees can sit down at a computer and complete the form. 3M has a licensed healthcare professional who will look over the evaluation and sign off right then and there, making it easy and quick (as well as making it less expensive). There is a link to the 3M online medical evaluation available on our website (www.nationalsafetyinc.com) in the respiratory section. If you’ve got several employees to get into respirators, this is a convenient way to get the medical evaluation done.

Tomorrow: Step 5 – The fit test

6 Easy Steps to Establishing a Respiratory Program – Step 3

3. The Selection of the Respirator

Once the contaminants have been identified and the exposure levels found, it’s time to select the respirator that is appropriate and that is going to effectively protect the workers. The type of respirator will largely be determined by the nature and levels of the contaminants.

All respirators have a protection factor assigned to them. You’re going to have to do a little math at this point. Here’s the equation:

Contaminant Concentrations

_________________________ = Hazard Ratio

Occupational Exposure Limit

Once you’ve determined the hazard ratio, using the above equation you just need to make sure that the protection factor for the respirator that you select is equal to or greater than that hazard ratio.

The Occupational Exposure Limit can be usually be found using the MSDS sheet or by downloading a respirator selection guide. 3M has one that you can download for free which contains a list of almost 700 different chemicals.

The Protection Factors for respirators are as follows:

Air Purifying Respirators

  • Half Mask Respirators = 10
  • Full Facepiece Respirators = 50

Powered Air Purifying Respirators (PAPRs)

  • Loose-fitting = 25
  • Half Mask PAPR Respirators = 50
  • Full Facepiece PAPR Respirators = 1000

Supplied Air Respirators (AKA Airline Respirators)

  • Continuous Flow Loose-fitting = 25
  • Continuous Flow Half Mask = 50
  • Continuous Flow Full Facepiece Respirator = 1000
  • Pressure Demand Full facepiece Respirator = 1000

Pressure Demand combined with an Escape Self-Contained Breathing Apparatus (SCBA)
= 10,000

If the hazard ratio is unknown or if the area has been classified as IDLH (immediately Dangerous to Life and Health), an SCBA is required

If you are using an air purifying respirator you will also need to determine what the cartridge life schedule is going to be. In other words, the old adage that said “when you smell or taste it, it’s time to change out the cartridges” is no longer valid. If you are tasting or smelling something you are also ingesting it and a respirator program is specifically designed to make sure that you don’t ingest any contaminants. A cartridge life program simply calculates, based on the concentration present, how long your respirator cartridges are going to last before they start letting contaminants through.

If you need help with selecting the right respirator, cartridges or help coming up with a cartridge life schedule, and opt for 3M respirators, 3M has a great tool available online that’ll walk you through this whole process. The 3M Respirator Tools and Software is available on the 3M website.

Tomorrow: Step 4 – The Medical Evaluation

Which Respirator Cartridge should I use?

One of the questions that we get almost every day, sometimes several times a day, is “Which cartridge should I use for _________ (fill in the blank with the process or chemical in question)?”

It is also one of the questions that we will not answer for you.

Why? First and foremost because of liability and secondly because we don’t know the full story and cannot be telling you what you should use.

So, how do you find out what to use?

The answer really isn’t all that complicated but the procedure might be…

  1. What are you being exposed to?
  2. What are the concentrations?
  3. How long are you going to be exposed to it?

The answers to the three questions above are going to determine which respirator cartridge, and, in some cases, which respirator you need to be wearing. The problem is that, most often, the person on the phone can’t give us an answer to one or more of these questions. If you can’t answer all three than you need to find the answers before you start wearing a respirator.

One of the first places to start, is to look at the MSDS sheet or the back of the can or bottle of whatever it is that you are trying to protect against. The manufacturer should have done the research for you. They should be able to tell you which cartridge you need to use to protect yourself. If you can’t find the information you need, you should call the manufacturer and insist that they get you the information you need. Call them, not us (not that we don’t want to help, it’s just that we can’t provide you with the information that they have).

Secondly is the issue of concentrations. Knowing how much of the “methel-ethel-bad-stuff” you are being exposed to is important in determining two things:

  1. Is a cartridge going to be good enough or do you need to step up to a supplied air system, SCBA, etc…
  2. How long the cartridge is going to last. Every cartridge has a service life (the manufacturer of the cartridge should be able to give you this information). Match the concentration of the substance you are protecting against to this chart and it will tell you when you need to swap the cartridge out.

Finally, the issue of how long you will be working around the stuff will further tell you the level of protection you need. Exposure to 10 ppm for one hour is obviously not the same as exposure to 5 ppm over a period of 10 hours. In the first case you are only exposed to 10 ppm for the whole day, while in the second case you are exposed to 50 ppm.

For a fuller study and explanation concerning respiratory protection, download “The Basics of Respiratory Protection

When was the last time you cleaned your respirator?

Respirators are designed to keep “bad stuff” out of your lungs. The respirator is fit tested to make sure that you have a proper seal and that the only air that gets in has to come through the filter medium. What filter medium will, of course, depend on what it is that you are exposed to.

While most respirator wearers understand the need to change out these cartridges on a regular basis to make sure that the air that they are breathing in is properly filtered, it never ceases to amaze me, when walking through a facility where workers wear respirators, to see how these same worker treat their respirators.

Respirators must be properly maintained and cleaned regularly in order to be effective. I have seen workers remove their respirators while going to lunch or on a break and they leave their respirator cup up while on break. Whatever it is that they are trying to protect against is slowly accumulating in the cup. The worker comes back from break, puts the respirator on and inhales a lungful of all the stuff that they’ve been trying to protect against all day.

Respirators must also be properly maintained (inhalation and exhalation valves checked and replaced regularly, for example) and cleaned using an effective respirator cleaner.

When not in use, store the respirator properly in a respirator bag, coffee can (some like the smell of coffee inside their respirator when they put it on in the morning) or large ziplock bag.

Don’t allow the very thing that is designed to protect you because the source of the problem.

Video highlights the difference between a respirator and a surgical mask

“A surgical mask is not a respirator and that’s an important distinction for you and your employer to understand.”

This is how the US Department of Labor describes their new youtube video entitled “The Difference between Respirators and Surgical Masks”

The 5 minute and 36 second video, available for viewing here, covers the basic differences between a respirator and a surgical mask. This is an important video to watch and share if you don’t understand the difference as a surgical mask is not considered

Additionally, you can watch this short 47 second youtube video to make sure that you are wearing the surgical mask properly or, for more information on respirator safety, this 9 minutes and 16 second video goes into more detail about fit testing, seal checks, etc… on a respirator.

The truth is that most of us won’t read instructions so showing a couple of quick videos might be the best and smartest way to make sure employees get the proper information.