The Anthrax Matrix guides were developed to help employers assess risks to workers, identify personal protective equipment to use, and to specify safe practices for specific levels of risk. OSHA developed the matrix in cooperation with the US Post Office, CDC, NIOSH, EPA, and FBI. The matrix (shaped like a pyramid) includes three sections representing different levels of risk. The three levels are: green for low risk, yellow for medium risk, and red for high risk exposures. Each of the sections are linked to recommendations appropriate for the risk selected. The matrix is very easy to use. I found the information to be both practical and reasonable. The matrix is available on the OSHA web page at:
http://www.osha.gov/bioterrorism/anthrax/matrix/index.html
Anthrax and Respiratory Protection Facts:
CDC, NIOSH, OSHA and other agencies have released a variety of guidance documents related to Anthrax and other chemical and biological agents. Among the massive amount of information released, here are a few facts to consider. NIOSH approved particulate filter respirators will reduce exposure to biological aerosols such as Anthrax. While respirators will reduce exposure, they do not eliminate exposure. In addition, there will likely not be any obvious warning that a release has occurred (so most people should not just carry them around!). Respirators will protect your lungs, but not your skin. NIOSH does not currently certify respirators for use against Anthrax, but when properly selected and used, they work! When using tight fitting respirators (such as those recommended in the matrix described above), make sure they fit. Once you know they fit properly, continue to be clean shaven and wear them continuously in required areas.
Mold appears to be one of the newest health care concerns and for good reason; it appears to be everywhere! While there is no practical way to eliminate all mold (and it's spores), moisture control is the key to control mold growth. Currently there are more than 100,000 known species of mold. Some of these are beneficial to the environment, while others are potentially dangerous to human life. The fact is that most molds are not hazardous to healthy people. However, excessive exposure to mold may cause or aggravate a variety of respiratory conditions including asthma and other allergies. Symptoms such as runny nose, irritated eyes, coughing, chest congestion, shortness of breath, etc., are common complaints among susceptible individuals. During mold remediation, respiratory protection is highly recommended to reduce inhalation of molds, their spores, as well as other dusts. Frequently, I'm asked what type of respiratory protection should be worn? The EPA has recently released practical recommendations that can help answer this question. I've reviewed the recommendations and found them to be well organized and simple to follow. The EPA guidelines define three levels of PPE based upon the size of the remediation project. This common sense approach identifies minimum, limited, and full PPE (including respiratory protection). For details go to the EPA web site at:
NIOSH has reported results of studies that show many respirators worn by health care workers are constructed and designed so poorly that they fit few people properly (as reported in the "TB Monitor, March 2001, Vol 8). In one NIOSH study a panel of 25 subjects (experienced in donning respirators) tried on 21 different N95 respirators. Three of the models were unable to pass a fit test on any of the subjects. In addition, 17 of the 21 models fit fewer than half of the panel members. Overall, approximately 45% of these experienced users were able to pass a fit test. These data and other studies show the importance of fit testing N95 respirators. Additional NIOSH studies have shown that quantitative fit testing is also more reliable than qualitative fit testing. Because of design and fit concerns with some N95 respirators, it is very important that fit testing be conducted and done correctly. Fortunately, newer model N95 respirators are becoming available. Many of the newer model respirators have features likely to improve respirator fit. This is one reason why we continue to conduct fit testing.
Due to the recent terrorist threats and activities, NIOSH has instituted a new program to approve SCBA's for use by first responders after terrorist attacks. With the new approval, protection can be expected for first responders in situations where an act of terror releases toxic chemicals, biologicals, or radioactive materials into the air. Products meeting the new NIOSH tests will be labeled "CBRN agent-approved". NIOSH began accepting application for certification of products in January 2002. The new tests and approval, indicates the SCBA is capable of providing the user protection against chemical, biological and radioactive agents. SCBA's identified as "CBRN agent-approved" meet the traditional industrial certification requirements as well as NFPA standards. For example, the newly approved SCBA's pass special tests for resistance to chemical penetration and permeation against mustard gas and sarin.
ANSI Standard Z88.7-2001, Color Coding of Air Purifying Respirator Canisters, Cartridges, and Filters is now available (originally published as ANSI K13.1-1973). This standard provides updated guidelines for color coding and eliminates some reference to labeling requirements. To purchase a copy, contact AIHA customer service at 703-849-8888 or
http://www.aiha.org/ANSICommittees/html/z88committee.htm
The University of Cincinnati is pleased to announce the following Respiratory Protection and Fit Testing courses that may be of interest to you or your staff. They are:
Programs are held near the Cincinnati airport.
Information regarding these courses is available by contacting:
www.DrMcKay.com or 513/475-7712 and ask for Jeff.
These courses are an excellent way to obtain up to date information and clarification of respiratory protection issues. Individuals who intend to take the fit testing workshop, but have little or no experience with respiratory protection should take the one day overview class in addition to the 2-day fit testing workshop.
Dr. McKay is a member of the ANSI Z88 Respiratory Protection Committee, the Z88.10 Fit Testing committee, the AIHA Respiratory Protection committee, and others.
According to a recent survey conducted by the International Safety Equipment Association, approximately 30-40% of highway construction workers wear respiratory protection when needed.
A one day "Spirometry UPDATE - REFRESHER" training course will be given by the University of Cincinnati on May 7, 2002.
Refresher training is recommended by the American Thoracic Society (ATS), the American Association of Occupational Health Nurses (AAOHN), the American College of Occupational and Environmental Medicine (ACOEM), and others. This special one day course will be given by Roy McKay, Ph.D. Information regarding this course including on-line registration is available by contacting:
www.DrMcKay.com or by calling 513/558-1234 between 8 am and 5 pm (Eastern Standard Time). Ask for Jeff or Anita.
Dr. McKay is a member of the ATS Proficiency Standards for Clinical Pulmonary Function Laboratories (the committee responsible for developing ATS standards for lung function testing) and advisor to the American College of Occupational & Environmental Medicine's (ACOEM) Occupational & Environmental Lung Disease committee.
NIOSH has recently released interim guidelines for protective clothing and respirators for firefighters and other first responders who may be dealing with biological agents. The recommendations are based upon the anticipated level of exposure risk associated with different response situations. For details go to the NIOSH web page at:
www.cdc.gov/niosh and search for information about publication number 2002-109.
Did you know that while the relatively new NIOSH certification requirements for particulate respirators were updated in 1995, the facepiece fitting characteristics became exempt from evaluation as a condition of certification. In other words, NIOSH doesn't fit test respirators before you use them. This means that respirator program administrators must understand the importance of fit testing and other components of a comprehensive respirator program. Recently NIOSH researchers developed a mathematical model to analyze the effectiveness of a fit testing program. The results of these studies demonstrated that significant "public health and economic benefits can result when only respirators having good fitting characteristics are purchased and respirators are assigned to workers using highly accurate fit-testing methods." This is just one of many studies that demonstrate the importance of accurate fit testing. For specific details on this study go to American Industrial Hygiene Association Journal 62:36-44, 2001 for the paper entitled "Respiratory Protection as a Function of Respirator Fitting Characteristics and fit Testing Accuracy", by Campbell, Coffey, and Lenhart.
A recent program protection factor study was published by M. Wu on the effectiveness of respirators among coke oven workers. The author found rather low protection factors and concluded that "worker behavior and respirator fit may influence the level of protection provided by the respirator". While this is no shocker, it once again shows the importance of fit testing at a time when some folks are trying to eliminate fit testing as a component of a respiratory protection program. For details go to: American Industrial Hygiene Association Journal 63:72-75, 2002.
Thank you for your continuing support and hope to see you at a future training course.
Roy McKay, Ph.D.
Course Director
University of Cincinnati
www.DrMcKay.com