Dr. Stephanie Lynch - Apr 15, 2019

Massachusetts Public Workers Joining OSHA: Respiratory Safety Protections

Public workers are responsible for teaching our children, putting out fires, and protecting our streets. They do things daily that we may take for granted including cleaning our water, picking up our trash, and maintaining our roads. Despite all the work they do to keep our communities functioning, many public workers are not provided the same safety and health protections as those of us who work in the private sector. There is nothing that suggests any of the jobs public workers perform are any less dangerous than their private sector counterparts, and there is no reason to assume this labor force is receiving the same safety and health considerations without these protections in place. Labor advocacy groups have been fighting for years across the country to expand safety and health protections to cover public workers. Thus far, only 28 states extend Occupational Safety and Health Administration (OSHA) protections to their public employees. As of February 1st, 2019, the State of Massachusetts joined these states.

This is a huge stride in the right direction. It will ensure public employees are provided appropriate training and personal protective programs and equipment that are up to the private sector’s standard. It is likely that many public employees are not even aware of some of the ways the municipalities they have worked for have overlooked their safety. It is possible the municipalities themselves are not aware of some of the ways they may be putting their employees at risk.

One area that is often overlooked for our public employees is a respiratory protection program with annual fit testing. Many public employees are required to wear a respirator as a function of their job, but they are not provided appropriate training or fit testing. OSHA requires anyone who wears a respirator as a part of their job to be fit tested. Fit testing is a process in which all people who are required to wear respirators are examined and interviewed to determine which mask best fits their facial features; it typically involves a rigorous protocol in which the tester challenges the face-to-facepiece seal with a challenge agent. This process ensures the safety of the employee wearing the respirator.

There are two different types of fit testing, qualitative fit testing (QLFT) and quantitative fit testing (QNFT). QLFT is a pass/fail, subjective test method that relies on a person’s sense of taste or smell or their reaction to an irritant to detect leakage into the respirator facepiece. The respirator passes or fails the test based on the person’s detection of the test substance. Any QLFT method provides an inherent fit factor pass level of 100. QLFT is only appropriate for disposable or half mask respirators. QNFT utilizes an instrument to measure leak. QNFT methods are objective. One OSHA approved method of QNFT is the OHD Quantifit.

The OHD Quantifit utilizes Controlled Negative Pressure (CNP) to directly measure respirator leakage, using air as the challenge agent. CNP creates a fixed vacuum on the facepiece by temporarily blocking off outside air with special adapters. The instrument measures the airflow (leak rate) needed to maintain the vacuum on the mask. The fit factor is then computed by taking an average breathing rate and dividing that number by the measured leak rate. There are obvious advantages to utilizing this method of fit testing (objectivity, ease of testing, and ability to data log), but the most important is ensuring the people who need this protection the most are receiving the highest level of protection that a respirator can provide.

By using air as the challenge agent, the Quantifit can be used anywhere that there is air. Air is also the way by which gases and vapors and other contaminants travel, so it is an excellent way to test for mask leakage and provides the most protective means of evaluating fit. The Quantifit is also the fastest way to fit test, with each test taking only three minutes. This means the Quantifit can ensure employees are fitted appropriately and reduce the time spent on fit testing. Utilizing CNP even works for positive pressure respirators by ensuring minimal leak around the face seal, extending the life of a tank, and providing the employee with more valuable time and air.

For some public workers, respiratory protection can be a matter of life and death. For firefighters it has become increasingly clear that respiratory protection should be used at every fire (even if that fire is out). Exposures are happening even in the after fire environment. Police officers respond to methamphetamine production labs, participate in wildfire evacuations, and investigate possible terrorist activities that may include toxic exposures. These types of concerns are not limited to emergency responders. Sewer workers can be overwhelmed by hydrogen sulfide if they are not properly trained and fitted with the appropriate respiratory protection. Any public employees who need respiratory protection as a part of their job should be getting trained and fit tested, and when it really matters, that fit should be objectively and quantitatively assessed.

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Written by Dr. Stephanie Lynch