The COVID-19 pandemic has brought to the forefront the need to protect patients and workers through the use of personal protective equipment (PPE). In the recent past , healthcare workers were provided PPE such as masks, gloves, gowns and safety eyewear or face shields. OSHA requires employers to protect their workers first through the use of engineering and administrative controls, but in most healthcare situations the use of PPE is necessary. This PPE has been there for the protection of workers, but employers have had to struggle to enforce the use of these protective measures. Now that there is a shortage and there’s a virus that can infect through coughing and sneezing, the PPE is well-respected and considered a necessity.
Now the term “N95” has become a household word. Not many people even knew of the existence of this respirator mask unless their employer was already requiring its use for reasons other than protection from pathogens. Due to the shortage of this respirator, alternatives have been designated. On March 14, 2020, Patrick J. Kapust, Acting Director for OSHA’s Directorate of Enforcement programs issued a Memorandum for OSHA Regional Administrators and State Designees. This Memorandum is a temporary enforcement guidance for healthcare respiratory protection annual fit-testing for N95 filtering facepieces during the COVID-19 outbreak. It provides guidance to OSHA’s Compliance Safety and Health Officers to:
- Enforce the Respiratory Protection Standard, 29 CFR 1910.134, but allows healthcare employers to “provide HCP (health care personnel) with another respirator of equal or higher protection, such as N99 or N100 filtering facepieces, reusable elastomeric respirators with appropriate filters or cartridges, or powered air purifying respirators (PAPR)”.
- Change the method of fit testing from a destructive method (i.e., quantitative) to a non-destructive method (i.e., qualitative).
- Use either of these methods to ensure that the fitted respirator can be safely used for work tasks that require respiratory protection.
It goes on to state that the OSHA field offices shall exercise enforcement discretion concerning the annual fit-testing requirement as long as employers:
- Make a good-faith effort to comply with 29 CFR 1910.134;
- Use only NIOSH-certified respirators;
- Implement CDC and OSHA strategies for optimizing the supply of N95 filtering facepiece respirators and prioritizing their use;
- Perform initial fit tests for each HCP with same model, style, and size respirator that the worker will be required to wear;
- Inform workers that the employer is temporarily suspending the annual fit testing of N95 respirators;
- Explain to workers the importance of performing a user seal check at each donning;
- Conduct a fit test if any visual changes in the employee’s physical condition are observed that impede a good facial seal;
- Remind workers to inform their supervisor or respirator program administrator if integrity and/or fit of their N95 is compromised.
The memorandum states that if the employer fails to comply with any requirements such as initial fit testing, maintenance, care, and training in the Respiratory Protection standard, the employer is to be cited under the applicable section of 29 CFR §1910.134.
It also states that this is an enforcement discretion policy beginning on March 14, 2020 and applicable where respirators are needed to protect HCP during the COVID-19 outbreak. It will no longer apply upon notification.
PPE is critical in many working conditions. After all this has passed, employers still need to assess the hazards in their workplace and determine when PPE is to be required. That can also include implementation of a written Respiratory Protection Program, medical evaluations, and fit testing. From SafeLink’s experience, it seems that educating workers on the need for this protection and then enforcing the use of required PPE remains a challenge in many workplaces. Need help in writing your employee safety policy? Contact an OSHA compliance consultant. CDC FAQ About PPE Equipment
If your business requires employees to use an N95 respirator, then your health and safety Program must include a Respiratory Protection Program. When respiratory protection is mandatory, you’ll need to perform fit testing and have medical questionnaires completed for employees who are required to wear them. That medical questionnaire must be submitted to a healthcare professional for review to determine if it is ok for the employee to wear a respirator. Contact us for further guidance on these requirements. Learn more about SafeLink's Cloud-based health and safety manual.
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