Respiratory Protection - Texas Department of Insurance

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Respiratory Protection - Texas Department of Insurance

    Sample Written Program


    Respiratory Protection

    provided as a public service by


    Occupational Safety and Health Consultation Program

Texas Department of Insurance, Division of Workers’ Compensation

    Publication No. HS02-010A(01-06) Revised 01/27/06


     Respiratory Protection

    This sample program is provided only as a guide to assist employers and employees in complying with 29 CFR 1910.134, as well as to provide other helpful information. It is not intended to supersede the requirements of the standard. An employer should review the standard for particular requirements which are applicable to their individual situation and make adjustments to this program that are specific to their company. An employer will need to add information relevant to their particular facility in order to develop an effective, comprehensive program.



    Respiratory Protection

    Table of Contents

    I. Objective

    II. Assignment of Responsibility

    A. Employer

    B. Program Administrator

    C. Supervisors

    D. Employees

    III. Applicability

    IV. Program

    A. Hazard Assessment and Respirator Selection

    B. Updating the Hazard Assessment

    C. Training

    D. NIOSH Certification

    E. Voluntary Respirator Use

    F. Medical Evaluation

    G. Fit Testing

    H. General Respirator Use Procedures

    I. Air Quality

    J. Change Schedules

    K. Cleaning

    L. Maintenance

    M. Storage

    N. Respirator Malfunctions and Defects

    O. Emergency Procedures

    P. Program Evaluation

    Q. Documentation and Recordkeeping

    V. Attachments

    A. Sample Hazard Assessment Log

    B. Sample Record of Respirator Use

    C. Sample Hazard Evaluation

    D. Sample Record of Respirator Issuance

    E. Respirator Inspection Checklist

    F. Sample Emergency Potential Log

    G. Sample IDLH Assessment


    Respiratory Protection Program


    The Company Name Respiratory Protection Program is designed to protect employees by establishing accepted practices for respirator use, providing guidelines for training and respirator selection, and explaining proper storage, use and care of respirators. This program also serves to help the company and its employees comply with Occupational Safety and Health Administration (OSHA) respiratory protection requirements as found in 29 CFR 1910.134.


    A. Employer

    Company Name is responsible for providing respirators to employees when they

    are necessary for health protection. Company Name will provide respirators that

    are applicable and suitable for the intended purpose at no charge to affected

    employees. Any expense associated with training, medical evaluations and

    respiratory protection equipment will be borne by the company.

    B. Program Administrator

    The Program Administrator for (Company Name) is

    (Responsible Person) . The Program Administrator is responsible for

    administering the respiratory protection program. Duties of the program

    administrator include:

    1. Identifying work areas, process or tasks that require workers to wear


    2. Evaluating hazards.

    3. Selecting respiratory protection options.

    4. Monitoring respirator use to ensure that respirators are used in

    accordance with their specifications.

    5. Arranging for and/or conducting training.

    6. Ensuring proper storage and maintenance of respiratory protection


    7. Conducting qualitative fit testing with Bitrex.

    8. Administering the medical surveillance program.

    9. Maintaining records required by the program.

    10. Evaluating the program.

    11. Updating written program, as needed.

    C. Supervisors


    Supervisors are responsible for ensuring that the respiratory protection program is

    implemented in their particular areas. In addition to being knowledgeable about

    the program requirements for their own protection, supervisors must also ensure

    that the program is understood and followed by the employees under their charge.

    Duties of the supervisor include:

    1. Ensuring that employees under their supervision (including new

    hires) receive appropriate training, fit testing, and annual medical


    2. Ensuring the availability of appropriate respirators and accessories.

    3. Being aware of tasks requiring the use of respiratory protection.

    4. Enforcing the proper use of respiratory protection when necessary.

    5. Ensuring that respirators are properly cleaned, maintained, and

    stored according to this program.

    6. Ensuring that respirators fit well and do not cause discomfort.

    7. Continually monitoring work areas and operations to identify

    respiratory hazards.

    8. Coordinating with the Program Administrator on how to address

    respiratory hazards or other concerns regarding this program.

    D. Employees

    Each employee is responsible for wearing his or her respirator when and where

    required and in the manner in which they are trained. Employees must also:

    1. Care for and maintain their respirators as instructed, guard them

    against damage, and store them in a clean, sanitary location.

    2. Inform their supervisor if their respirator no longer fits well, and

    request a new one that fits properly.

    3. Inform their supervisor or the Program Administrator of any

    respiratory hazards that they feel are not adequately addressed in the

    workplace and of any other concerns that they have regarding this


    4. Use the respiratory protection in accordance with the manufacturer’s

    instructions and the training received.


    This program applies to all employees who are required to wear respirators during normal work operations, as well as during some non-routine or emergency operations, such as a spill of a hazardous substance.

    In addition, any employee who voluntarily wears a respirator when one is not required (i.e., in certain maintenance and coating operations) is subject to the medical evaluation, cleaning, maintenance, and storage elements of this program, and will be provided with necessary training. Employees who voluntarily wear filtering face pieces (dust masks)


    are not subject to the medical evaluation, cleaning, storage, and maintenance provisions

    of this program.

    All employees and processes that fall under the provisions of this program are listed in

    Attachment D.


    A. Hazard Assessment and Respirator Selection

    The Program Administrator will select respirators to be used on site, based on the

    hazards to which workers are exposed and in accordance with the OSHA

    Respiratory Protection Standard. The Program Administrator will conduct a

    hazard evaluation for each operation, process, or work area where airborne

    contaminants may be present in routine operations or during an emergency. A log

    of identified hazards will be maintained by the Program Administrator (See

    Sample Hazard Evaluation, Attachment C). The hazard evaluations shall include:

    1. Identification and development of a list of hazardous substances used

    in the workplace by department or work process.

    2. Review of work processes to determine where potential exposures to

    hazardous substances may occur. This review shall be conducted by

    surveying the workplace, reviewing the process records, and talking

    with employees and supervisors.

    3. Exposure monitoring to quantify potential hazardous exposures.

    The proper type of respirator for the specific hazard involved will be selected in

    accordance with the manufacturer=s instructions. A list of employees and

    appropriate respiratory protection will be maintained by the Program

    Administrator (see Attachment D).

    B. Updating the Hazard Assessment

    The Program Administrator must revise and update the hazard assessment as

    needed (i.e., any time work process changes may potentially affect exposure). If

    an employee feels that respiratory protection is needed during a particular activity,

    he/she is to contact his/her supervisor or the Program Administrator. The

    Program Administrator will evaluate the potential hazard, and arrange for outside

    assistance as necessary. The Program Administrator will then communicate the

    results of that assessment to the employees. If it is determined that respiratory

    protection is necessary, all other elements of the respiratory protection program

    will be in effect for those tasks, and the respiratory program will be updated


    C. Training


    The Program Administrator will provide training to respirator users and their supervisors on the contents of the Company Name Respiratory Protection

    Program and their responsibilities under it, and on the OSHA Respiratory Protection Standard. All affected employees and their supervisors will be trained prior to using a respirator in the workplace. Supervisors will also be trained prior to supervising employees that must wear respirators.

The training course will cover the following topics:

    1. the Company Name Respiratory Protection Program;

    2. the OSHA Respiratory Protection Standard (29 CFR 1910.134);

    3. respiratory hazards encountered at Company Name and their health


    4. proper selection and use of respirators;

    5. limitations of respirators;

    6. respirator donning and user seal (fit) checks;

    7. fit testing;

    8. emergency use procedures;

    9. maintenance and storage; and

    10. medical signs and symptoms limiting the effective use of respirators.

    Employees will be retrained annually or as needed (e.g., if they change departments or work processes and need to use a different respirator). Employees must demonstrate their understanding of the topics covered in the training through hands-on exercises and a written test. Respirator training will be documented by the Program Administrator and the documentation will include the type, model, and size of respirator for which each employee has been trained and fit tested.

D. NIOSH Certification

    All respirators must be certified by the National Institute for Occupational Safety and Health (NIOSH) and shall be used in accordance with the terms of that certification. Also, all filters, cartridges, and canisters must be labeled with the appropriate NIOSH approval label. The label must not be removed or defaced while the respirator is in use.

E. Voluntary Respirator Use

    The Program Administrator shall authorize voluntary use of respiratory protective equipment as requested by all other workers on a case-by-case basis, depending on specific workplace conditions and the results of medical evaluations.

    The Program Administrator will provide all employees who voluntarily choose to wear the above respirators with a copy of Appendix D of the OSHA Respiratory Protection Standard. (Appendix D details the requirements for voluntary use of respirators by employees.) Employees who choose to wear a half face piece APR


    must comply with the procedures for Medical Evaluation, Respirator Use, Cleaning, Maintenance and Storage portions of this program.

F. Medical Evaluation

    Employees who are either required to wear respirators, or who choose to wear a half face piece APR voluntarily, must pass a medical exam provided by Company Name before being permitted to wear a respirator on the job. Employees are not permitted to wear respirators until a physician has determined that they are medically able to do so. Any employee refusing the medical evaluation will not be allowed to work in an area requiring respirator use.

A licensed physician at (LOCATION OF DOCTOR) , where all

    company medical services are provided, will provide the medical evaluations. Medical evaluation procedures are as follows:

    1. The medical evaluation will be conducted using the questionnaire

    provided in Appendix C of the OSHA Respiratory Protection

    Standard. The Program Administrator will provide a copy of this

    questionnaire to all employees requiring medical evaluations.

    2. To the extent feasible, the company will provide assistance to

    employees who are unable to read the questionnaire. When this is

    not possible, the employee will be sent directly to the physician for

    medical evaluation.

    3. All affected employees will be given a copy of the medical

    questionnaire to complete, along with a stamped and addressed

    envelope for mailing the questionnaire to the company physician.

    Employees will be permitted to complete the questionnaire on

    company time.

    4. Follow-up medical exams will be granted to employees as required

    by the Standard, and/or as deemed necessary by the evaluating


    5. All employees will be granted the opportunity to speak with the

    physician about their medical evaluation, if they so request.

    6. The Program Administrator shall provide the evaluating physician

    with a copy of this Program, a copy of the OSHA Respiratory

    Protection Standard, the list of hazardous substances by work area,

    and the following information about each employee requiring


    a. his or her work area or job title;

    b. proposed respirator type and weight;

    c. length of time required to wear respirator;

    d. expected physical work load (light, moderate or heavy);

    e. potential temperature and humidity extremes; and

    f. any additional protective clothing required.


    7. Positive pressure air purifying respirators will be provided to

    employees as required by medical necessity.

    8. After an employee has received clearance to wear his or her

    respirator, additional medical evaluations will be provided under the

    following circumstances:

    a. The employee reports signs and/or symptoms related to their

    ability to use the respirator, such as shortness of breath,

    dizziness, chest pains or wheezing.

    b. The evaluating physician or supervisor informs the Program

    Administrator that the employee needs to be reevaluated.

    c. Information found during the implementation of this program,

    including observations made during the fit testing and program

    evaluation, indicates a need for reevaluation.

    d. A change occurs in workplace conditions that may result in an

    increased physiological burden on the employee.

    A list of Company Name employees currently included in medical surveillance is provided in Attachment D of this program.

    All examinations and questionnaires are to remain confidential between the employee and the physician. The Program Administrator will only retain the physician=s written recommendations regarding each employee=s ability to wear

    a respirator.

G. Fit Testing

    Employees who are required to or who voluntarily wear half-face piece APRs will be fit tested:

    1. prior to being allowed to wear any respirator with a tight-fitting face


    2. annually; or

    3. when there are changes in the employee’s physical condition that

    could affect respiratory fit (e.g., obvious change in body weight,

    facial scarring, etc.).

    Employees will be fit tested with the make, model, and size of respirator that they will actually wear. Employees will be provided with several models and sizes of respirators so that they may find an optimal fit. Fit testing of powered air purifying respirators will be conducted in the negative pressure mode.

    The Program Administrator will conduct fit tests in accordance with the OSHA Respiratory Protection Standard.

H. General Respirator Use Procedures


    1. Employees will use their respirators under conditions specified in this program, and in accordance with the training they receive on the use of each particular model. In addition, the respirator shall not be used in a manner for which it is not certified by NIOSH or by its manufacturer.

    2. All employees shall conduct user seal checks each time they wear their respirators. Employees shall use either the positive or negative pressure check (depending on which test works best for them) as specified in the OSHA Respiratory Protection Standard.

    a. Positive Pressure Test: This test is performed by closing off

    the exhalation valve with your hand. Breathe air into the mask.

    The face fit is satisfactory if some pressure can be built up

    inside the mask without any air leaking out between the mask

    and the face of the wearer.

    b. Negative Pressure Test: This test is performed by closing of

    the inlet openings of the cartridge with the palm of you hand.

    Some masks may require that the filter holder be removed to

    seal off the intake valve. Inhale gently so that a vacuum occurs

    within the face piece. Hold your breath for ten (10) seconds.

    If the vacuum remains, and no inward leakage is detected, the

    respirator is fit properly.

    3. All employees shall be permitted to leave the work area to go to the locker room to maintain their respirator for the following reasons:

    a. to clean their respirator if it is impeding their ability to work; b. to change filters or cartridges;

    c. to replace parts; or

    d. to inspect respirator if it stops functioning as intended.

    Employees should notify their supervisor before leaving the area.

    4. Employees are not permitted to wear tight-fitting respirators if they have any condition, such as facial scars, facial hair, or missing dentures, that would prevent a proper seal. Employees are not permitted to wear headphones, jewelry, or other items that may interfere with the seal between the face and the face piece.

    5. Before and after each use of a respirator, an employee or immediate supervisor must make an inspection of tightness or connections and the condition of the face piece, headbands, valves, filter holders and filters. Questionable items must be addressed immediately by the supervisor and/or Program Administrator.


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