Frequently Asked Questions about Respiratory Protection

On this page:
Why is respiratory protection necessary?
When should we use personal respiratory protection?
Who establishes and maintains a respiratory protection program?
When does the employer provide respirators?
How do health care and public safety settings differ from industrial settings?
What are possible airborne infectious disease exposures in health care and public safety settings?
What are the technologies that can mitigate exposure to a hazard?
Are temporary employees exempt from these requirements? 
Does a positive response to any question on the medical screening questionnaire mandate a physician encounter?
Who pays for the medical clearance?
More frequently asked questions

Why is respiratory protection necessary?

• Engineering or administrative controls are not always possible:
  • Confinement of infectious agent may be difficult or impossible
  • Improved ventilation may not be practical or feasible 
• Employees may be exposed to a wide variety of air contaminants
  • infectious agents
  • chemical agents
• Environmental controls may not be feasible

When should we use personal respiratory protection?

• Employees must wear respirators in the following circumstances:
  • Employees entering areas where patients with suspected or confirmed airborne infectious disease are being isolated.
  • Employees who are present when cough-inducing or aerosol-generating procedures are performed on such patients.
  • When employees perform high hazard procedures on persons who have suspected or confirmed airborne infectious disease.
  • When emergency response employees or others must transport in a closed vehicle, a patient with suspected or confirmed airborne infectious disease.
  • Employees in other settings where administrative and environmental controls are not likely to protect them from inhaling infectious airborne droplet nuclei; these other settings should be identified on the basis of risk assessment.

Who establishes and maintains a respiratory protection program?

• The establishment and maintenance of the respiratory protection program is the responsibility of the employer.

When does the employer provide respirators?

• Respirators are to be provided by the employer when:
  • such equipment is necessary to protect the health of the employee
  • such equipment is applicable and suitable for the purpose intended

How do health care and public safety settings differ from industrial settings?

• In the health care setting there is a:
  • diversity of job titles and duties
  • unique "business" of caring for the ill
  • societal behaviors related to caregiving role
  • exotic and unique exposures
  • suspension of usual self protection behaviors
  • emphasis on confidentiality

What are possible airborne infectious disease exposures in health care and public safety settings?

Airborne infectious disease hazards in health care, public health, and public safety settings that may be mitigated by respiratory protection:

• Tuberculosis
• SARS
• Smallpox
• Measles
• Varicella (chickenpox)

What are the technologies that can mitigate exposure to a hazard?

• The order in which these elements are selected to control exposure is important
  • Environmental controls
    • Physically separate the employee from the hazard
    • Do not require direct employee compliance for efficacy
    • Example: airborne infection isolation rooms for patients with known or suspect airborne infectious disease.
      • Airborne infection isolation rooms
        • Monitored negative air pressure in relation to the surrounding areas
        • 6 to 12 air changes per hour
        • Appropriate discharge of air outdoors or monitored high-efficiency filtration of room air before the air is circulated to other areas in the hospital
        • Door that closes (and is kept closed)
  • Administrative and work practice controls
    • Policies, procedures, and programs that minimize the intensity or duration of exposure
    • Standard procedures/behaviors in caring for patients, i.e., hand hygiene
    • Example: placing a sign on the door of an airborne infection isolation room
       
  • Personal Protective Equipment (apparel)
    • Lowest rung of hierarchy – requires employee compliance for efficacy
    • Means higher elements of hierarchy fail to adequately protect employee
    • May involve use of gowns, gloves, eye/splash protection or respirators
      • Personal Protective Equipment (PPE)
        Information and instructions for using PPE

Are temporary employees exempt from these requirements?

• No.

Does a positive response to any question on the medical screening questionnaire mandate a physician encounter?

• No. The scope of the medical evaluation is left to the discretion of the physician. In some cases, an interview may provide the needed clarification.

Who pays for the medical clearance?

• The employer pays for the medical clearance.

More frequently asked questions

• OSHA: Respiratory Protection Frequently Asked Questions
  More frequently asked questions about respiratory protection from OSHA.