Conserving Filtering Facepiece Respirator Provide
audience: This guide is for use during the Coronavirus Disease 2019 Public Health (COVID-19) emergency by federal, state and local health authorities who are responsible for respiratory protection program managers, leaders of occupational safety and health programs, and other managers the development and implementation of guidelines and procedures for the prevention of occupational exposure on construction sites outside the health sector.
purpose: This document provides strategies for maintaining, expanding and responding to bottlenecks in the supply of NIOSH Approved Filtered Respirators (FFRs) used on non-healthcare sites such as manufacturing and construction. NIOSH approved FFRs protect users by filtering particulates from the air the user breathes and encompass several filter classes, including N95.
The following strategies apply the principles of the hierarchy of controls and are intended to assist employers in selecting strategies to control workplace exposure during times of known supply shortages caused by the COVID-19 pandemic. Strategies 1 and 2 reinforce the demands of employers to continuously evaluate and implement traditional hazard control practices such as elimination, substitution, engineering and administrative controls. Other strategies described here include certain allowances, such as using FFRs beyond the shelf life set by the manufacturer, which may only be put into practice during periods of supply shortages during the COVID-19 public health emergency.
A secondary purpose is to reduce the demand for FFRs in general industry settings during the COVID-19 response so that (1) FFR manufacturers and distributors can maximize healthcare coverage and (2) general industrial jobs can evaluate whether possibly Excess stocks are present hold are suitable for redistribution (e.g. sale, donation) in health care. Employers should only consider reallocating excess inventory if adequate exposure controls are in place for their workers. For guidance on preventing workplace exposure to acute respiratory diseases, including COVID-19, see the CDC's preliminary guidance for businesses and employers.
background
The rising COVID-19 outbreak in the United States has resulted in an overwhelming demand for personal protective equipment (PPE), including NIOSH approved FFRs, in healthcare facilities across the country. Additionally, the supply chains of PPE from manufacturing countries have been severely disrupted due to the local spread and demand of COVID-19. Because of this surge in demand and the decline in supply, CDC has provided guidance to healthcare facilities to develop strategies to optimize the supply of N95 respirators. These guidelines describe the incremental capacity of healthcare facilities that are cared for in conventional, emergency and crisis situations. The decisions to implement measures for healthcare facilities in emergency and crisis situations are based in part on the availability of N95 respirators in particular and other types of respiratory protective devices in general.
Recognizing the demand for health care FFRs and the priority of protecting health care workers, who are the workers at greatest risk for COVID-19, the US Food and Drug Administration has issued two emergency clearancesexternal symbol to allow the wearing of FFRs not normally worn in healthcare. This can reduce the availability of these FFRs to other construction sites.
Users of NIOSH-approved FFRs in non-healthcare facilities should develop and implement strategies to maintain and expand their current inventory of respiratory protective equipment while protecting their employees during the COVID-19 pandemic. Employers should introduce alternative controls to reduce their reliance on PPE, particularly FFR, as much as possible. Traditionally, a hierarchy of controls has been used to provide workable and effective controls to protect workers. Several control strategies can be implemented simultaneously and / or one after the other. This hierarchy can be described as follows:
- Elimination
- Substitution
- Control unit
- Administrative controls
- Personal protective equipment (PPE)
Elimination and substitution
Employers should evaluate work tasks and processes to identify those activities or processes where hazard elimination or substitution can be implemented. While these are most effective at controlling hazards, they can be the most difficult to implement in existing processes, especially during times of national or local emergencies.
Control unit
Engineering controls reduce worker exposure by placing a barrier between the hazard and the worker or by removing the hazard at the source. While the initial cost of engineering controls can be higher than the cost of administrative controls or PPE, engineering controls generally offer long-term cost savings and can eliminate the need for respirators when properly designed, implemented and maintained. Examples of considerations are:
- Local exhaust ventilation
- Wet methods (when spraying water on a dusty surface or when mixing a material with water to prevent aerosolization)
- Glove boxes, cupboards or other enclosures to isolate the hazard
Administrative controls
Administrative controls are used on existing processes to limit or prevent a hazard by changing the way people work. Examples include:
- Job rotation, in which workers change jobs or areas of work to reduce their exposure and ensure the need for respiratory protection
- Establish guidelines and implement procedures to limit the amount of time an individual employee can work on a particular work item or in areas of high exposure
- Educate employees on the hazards and controls available to reduce exposure
- Posting warning signs and signs to remind employees to stay away from dangerous work tasks or areas
Personal protective equipment
While technical and administrative controls should be considered first when implementing controls, PPE can be part of a number of strategies designed to protect workers. PPE includes respirators, protective gloves, goggles and face protection, as well as a variety of other protective equipment. PPE is often used in existing processes where the hazards are not well controlled. This method of protecting workers is typically less effective than other measures as the user must put on, use and remove PPE correctly and PPE violations may occur. In addition, proper use of respiratory protection requires a comprehensive program (including medical clearance, training, and fit testing) that conforms to the OSHA respiratory protection standardexternal symbol.
During times of high demand and low supply of PPE due to the COVID-19 pandemic, non-healthcare employers should evaluate current work practices and control strategies to develop a strategic exposure prevention and control plan to continue protecting workers. As part of such a plan, strategies for employers are prioritized below. These measures are recommended in order to maintain and expand the FFR offering and to respond to the lack of manufacturer-supplied FFRs during the COVID-19 pandemic. The OSHA has also provided guidanceexternal symbol to many of these measures related to the enforcement of the Respiratory Protection Standard, 29 CFR 1910.134external symboland certain other health standards related to supply bottlenecks in available N95 FFRs.
The following actions focus on technical and administrative controls to implement exposure prevention and control plans and to reduce reliance on FFRs
- Evaluation and implementation of long-term strategies for the elimination and substitution of hazards as well as for the implementation of technical controls for processes in which FFRs are currently required.
- NIOSH technical control strategies are described online for a variety of industries and hazards
- Industry and process specific control strategies are outlined by the UK Health and Safety Officer as part of the Control of Substances Hazardous Health Health (COSHH) basicsexternal symbol and are available online
- Implement out-of-the-box technical and administrative controls to eliminate or minimize risks that employers currently require the use of FFRs for. These controls should be routinely evaluated to ensure that they continue to control exposure to acceptable levels and include:
- Moving work to ventilated enclosures such as fume cupboards and biological safety cabinets.
- Changing the processes to reduce exposure, such as: B. Drying materials into a wet slurry to reduce the potential for exposure.
- Postponing non-essential work that requires the use of FFRs.
- Limit the number of employees who need respirators to the minimum necessary to safely complete the task.
- Agree on work / production plans to reduce the number of respiratory protective devices required.
The following actions may require changes to standard daily respiratory protection practices, but may not have a significant impact and can be used temporarily during times of anticipated FFR bottlenecks
- Use qualitative methods to tailor test workers for FFRsexternal symbol. Quantitative fit test methods require the consumption of FFRs during the fit test, but qualitative ones do not. As such, qualitative fit test methods would save FFRs that can be used to control exposure in the workplace.
- Move from respiratory protection programs to the use of NIOSH-approved alternatives to FFRs when feasible. NIOSH maintains an online searchable version of the Certified Equipment List, which lists all NIOSH Approved Respirators. Alternatives to FFRs, in order of their preferred implementation in non-healthcare workplaces to get as many N95s as possible for healthcare facilities, include:
- Air-purifying respirators made of elastomer half-face: close-fitting breathing apparatus made of synthetic or rubber material with which they can be repeatedly disinfected, cleaned and reused. They are equipped with replaceable filter cartridges.
- Air-purifying respirators with elastomer full face part: Like the respirator with elastomer half face part, the respirator with elastomer full face part is also a reusable device that uses replaceable filter cartridges but has a clear plastic lens that covers the face and provides eye protection.
- Powered Air Purifying Respirators (PAPRs): Reusable breathing apparatus with hoods or helmets that are usually loose fitting. These respirators are battery operated and have a fan that draws air through connected filters or cartridges. The filter is typically a high performance filter (HE). Loose-fitting PAPRs do not require a fit test and can be worn by those with facial hair.
- When non-PPE controls are not feasible and alternative respirators to FFRs are not available, conserve current FFR supplies by extending the employer's schedule as they are disposed of and replaced.
- Organizations with policies that allow for the regular disposal and replacement of N95 and other FFRs may also consider expanding the use of these FFRs beyond normal conversion plans, if acceptable. The decision to implement guidelines that allow expanded use of FFRs should be made by the professionals who administer the facility's respiratory protection program. One of the criteria for disposing and replacing FFRs is that the filter material restricts breathing rather than regularly disposing of them, for example after a single shift. In such cases, adequate training on the storage of used respiratory protective equipment is required.
- Use FFRs beyond the manufacturer's specified shelf life for training and fit testing.
- In times of shortage, you may be able to use FFRs for training and fit testing purposes beyond the shelf life stated by the manufacturer. However, expired respirators may not meet the requirements for which they have been certified. Over time, components such as the tape and filter material can degrade, which can affect the quality of the fit and seal. Using such respirators for training and fit testing would make it possible to use unexpired N95 FFRs for normal work operations.
- Use respiratory protective equipment approved according to standards used in other countries that are similar to NIOSH approved FFRs. (See table 1.)
- Table 1 lists the country, conformity assessment standards, standards and guidance, acceptable product classification, and NIOSH classification in alphabetical order. All these respiratory protective devices have protection factors of at least 10 in the countries listed in the table, as specified in the specified standards and guidelines. NIOSH is confident that devices supplied by current NIOSH approval holders that manufacture respirators in accordance with the various standards approved in other countries will provide the stated protection, provided a proper fit is achieved. Non-NIOSH approved products developed by non-NIOSH approved manufacturers, including those approved and obtained by China, should only be used in emergency situations where no other NIOSH approved N95 respirator or respirator Listed device is approved by one of the other countries is available. To ensure this level of confidence, NIOSH developed a rating to assess the filter efficiency of respiratory protective equipment from other countries. NIOSH will be happy to carry out the tests for you and provide you with the test results. The websites for requesting respiratory protective equipment ratings are available.
The following measures may need to be considered in times of known respiratory protection deficiencies
- Use FFRs for work processes that exceed the shelf life specified by the manufacturer.
- Consideration may be given to using FFRs for operations outside of the manufacturer's specified shelf life when other controls or respiratory protective equipment are not available. Respiratory protective devices that exceed the shelf life specified by the manufacturer may not meet the requirements for which they have been certified. Over time, components such as the straps and nasal bridge material can degrade, which can affect the quality of the fit and seal. Many models found in U.S. inventory were found to continue to meet NIOSH performance standards. Users should take the following precautions before using the respirator in the workplace.
- Visually inspect the FFR to see if its integrity has been compromised.
- Make sure that components like the straps, bridge of the nose, and nasal foam material have not deteriorated. This can affect the quality of the fit and seal and thus the effectiveness of the respirator.
- If the integrity of any part of the respirator is compromised, discard the respirator and try another respirator.
- Users should perform a user seal test immediately after donning any respirator and should not use a respirator on which they cannot successfully perform the user seal test.
- Consideration may be given to using FFRs for operations outside of the manufacturer's specified shelf life when other controls or respiratory protective equipment are not available. Respiratory protective devices that exceed the shelf life specified by the manufacturer may not meet the requirements for which they have been certified. Over time, components such as the straps and nasal bridge material can degrade, which can affect the quality of the fit and seal. Many models found in U.S. inventory were found to continue to meet NIOSH performance standards. Users should take the following precautions before using the respirator in the workplace.
- If the above control steps are not feasible, FFR and higher levels of respiratory protection are not available, and alternative respiratory protection strategies are not possible, it is recommended that work activities that require such protection be suspended.
Employers who successfully implement strategies to maintain and expand their FFR supplies during the COVID-19 pandemic may find they have excess inventory. It is recommended that employers consider transferring available excess inventory to healthcare providers (e.g., sell, donate) during the COVID-19 pandemic in order to alleviate the known shortage of respirators. Workplaces that are no longer active due to work interruptions and restrictions should consider redistributing their excess PPE and adapt test kits to their state medical countermeasure contact, the Federal Emergency Management Agency (FEMA).external symbolor through other suitable channels. Non-healthcare employers who have purchased large quantities of respirators in the months leading up to the crisis should consider whether they are willing to redistribute (e.g. sell, donate) those respirators for healthcare use.
Table 1. Respirators approved according to standards used in other countries that are similar to NIOSH approved respirators with N95 filter face parts
country | Performance standard | Acceptable product classification | Can be used in place of NIOSH certified products that are classified as |
---|---|---|---|
Australia | AS / NZS 1716: 2012 | P2 | N95 |
P3 | N99 or lower | ||
Brazil | ABNT / NBR 13698: 2011 | PFF2 | N95 |
PFF3 | N99 or lower | ||
People's Republic of China | GB 2626-2006
GB 2626-2019 GB19083-2010 |
KN / KP95 | N95 |
KN / KP100 | N95 | ||
Europe | EN 149-2001 | P2 | N95 |
P3 | N99 or lower | ||
Japan | JMHLW-2000 | DS / DL2 | N95 |
DS / DL3 | N99 or lower | ||
Korea | KMOEL-2017-64 | Special 1 .. | N95 |
Mexico | NOM-116-2009 | N95 | N95 |
R95 | R95 or lower | ||
P95 | P95 or lower | ||
N99 | N99 or lower | ||
R99 | R99 or lower | ||
P99 | P99 or lower | ||
N100 | N100 or lower | ||
R100 | R100 or lower | ||
P100 | P100 or lower |
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