Respiratory Protection Program

• The Centers for Disease Control (CDC) recommends that health care workers protect themselves from any disease spread through airborne transmission (i.e. TB, varicella, SARS) by wearing a respirator, such as a "N95".
• OSHA and the CDC recommends wearing a "N95" when:
  • a. Entering an isolation room
    • i. Visitors also should be given respirators and instructed in their use before entering isolation rooms.
  • b. Performing cough-inducing or aerosol-generating procedures
  • c. Transporting an individual with suspected or confirmed infectious TB in an enclosed vehicle or anytime you may be expected to attend or come into contact with an unmasked, active TB patient.

• Surgical masks are not designed for use as particulate respirators and do not provide as much protection as an "N95". Surgical masks do however provide barrier protection against droplets including large respiratory particles, but most surgical masks do not effectively filter small particles from the air and do not prevent leakage around the edge of the mask when the user inhales.
• Some of the N95’s we purchase here at TTUHSC are both N95 and a "surgical mask" for example the "Kimberly Clark Fluidshield* PFR95* N95 Particulate Filter Respirator and Surgical Mask." Always check the product manufacturer for further information about the respirator your department has purchased.

A "Surgical N95 Respirator" is a NIOSH-approved N95 respirator that has also been cleared by the Food and Drug Administration (FDA) as a surgical mask. These products are designated with a product or model number with the letters (FDA) proceeding.

• Individuals with chronic respiratory, cardiac or other conditions that make it more difficult to breath may have difficulty in wearing a respirator. Consult your healthcare provider before use.
• Respirators are also not designed for children, since their faces may be too small for a proper fit.

• If a "N95" is used voluntarily in a situation where respiratory protection is not mandated, then fit testing is not required. Although not mandated, fit testing is highly recommended to provide the user with the best protection against possible airborne contaminants in their work area.
• When respiratory protection is required and respirators are issued to employees, OSHA requires fit testing as part of the employers Respiratory Protection Program.

• If a "N95" is used, fit testing should be conducted prior to initial use and annually thereafter.
• When respiratory protection is required and respirators are issued to employees, OSHA requires fit testing annually as part of the employers Respiratory Protection Program.
• Fit testing should also be conducted whenever a different respirator facepiece is used, or if the wearer has a change in facial structure, such as facial surgery or significant weight loss.

• Qualitative fit testing uses a protocol that has a challenge agent such as saccharin or Bitrex®. It is a pass/fail test based on the test subjects responses.
• Quantitative fit testing measures the number of particles leaking around a particular mask, providing a numerical measurement of the facial fit expressed as a "fit factor". Some of the other regional campuses use the Quantitative Fit Test Protocol which utilizes the TSI PortaCount®.

• No, OSHA does not allow the use of respirators with tight-fitting facepieces to be worn by individuals with facial hair. Facial hair between the skin and sealing surface of the mask will interfere with the seal of the mask and may compromise filtering efficiency.
• Individuals with mustaches and short goatees that do not interfere with the seal of the mask can be fit tested.

• Before handling the respirator, wash hands thoroughly with soap and water.
• To put the N95 on correctly, follow these instructions:

1. Prestretch the straps before placing respirator on your face.
2. Separate the edges of the respirator to fully open it.
3. Slightly bend the nose wire to form a gentle curve.
4. Hold the respirator upside down to expose the two headbands.
5. Using your index fingers and thumbs, separate the two headbands.
6. While holding the headbands with your index fingers and thumbs, cup the respirator under your chin.
7. Pull the headbands up over your head.
8. Release the lower headband from your thumbs and position it at the base of your neck.
9. Position the remaining headband on the crown of your head.
10. Conform the nosepiece across the bridge of your nose by firmly pressing down with your fingers.
11. Continue to adjust the respirator and secure the edges until you feel you have achieved a good facial fit.
12. Perform a user Seal Check or Fit Check!

• To assure the wearer is provided with the intended level of protection, a User Seal Check or Fit Check should be conducted every time a respirator or "N95" is worn.
• To perform this Fit Check, the wearer should forcefully inhale and exhale several times. The respirator should collapse slightly upon inhaling and expand upon exhaling. The wearer should not feel any air leaking between his/her face and the mask.
• If the mask does not collapse or expand OR if air is leaking out between the wearer’s face and the mask, then this is NOT a good facial fit. The wearer should readjust the mask until the leakage is corrected or get another sized mask.

• When a "N95" is used voluntarily in a situation where respiratory protection is not mandated, then a medical exam is not required.
• When respiratory protection is required, OSHA requires a medical evaluation by a physician or other licensed health care professional to determine whether any health conditions exist that could affect the employee’s ability to wear that respirator. Contact Safety Services for additional information.