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Home My WebLink Aboutltcf-respiratory-resources-2023-08-03Alameda County Health Care Services Agency Colleen Chawla, Director Public Health Department Kimi Watkins-Tartt, Director www.acphd.org Nicholas Moss, MD, Health Officer Public Health Department: Main Line (510) 267-8000 COVID-19 Information: (510) 268-2101 *Please note: provision of vendor names does not imply endorsement. RESPIRATORY PROTECTION RESOURCES 1 ver: 08.03.23 Respiratory Protection The COVID-19 pandemic has highlighted the importance of proper infection control practices in long-term care facilities (LTCFs). The Alameda County Public Health Department is committed to helping LTCFs protect employees from workplace hazards, including airborne pathogens such as SARS-CoV-2. Per OSHA, “healthcare providers who are in close contact with an LTCF resident with suspected or confirmed SARS-CoV- 2 infection must use a NIOSH-approved N95 respirator…” Wearing a N95 respirator is different than wearing a typical face mask. Fit testing must be completed for all staff who wear N95 respirators during COVID-19 outbreaks or suspected outbreaks. Please be aware of some additional requirements for respiratory protection in your workplace, including: • A written Respiratory Protection Program • Performing medical evaluations of workers prior to required respirator use. • Fit testing and training on respirator use (yearly and when there is a change in type of mask used) Steps for Respiratory Protection 1. Create a written Respiratory Protection Program. • OSHA How to Set-up Respiratory Protection Plan • Sample RPP Template (automatic download) 2. Staff must have respiratory medical clearance before being fit tested. • Available through various resources. For example: o Use a Medical Director. o Use Concentra Urgent Care.  Appointments vary based on location, walk-ins may be available, cost: $59/person. o Use an Online Respirator Medical Evaluation:  Examinetics Medical Evaluation: Examinetics*  3M Medical Evaluation: 3M* 3. Conduct on-site fit testing and document accordingly or utilize a company to conduct on or off-site fit testing. • Options for completing Fit Testing: o Use a listed company from the Resources for Respirator Fit Testing for Alameda County.* o Use a trained staff member:  For fit testing training documents see “Fit Testing Resource Links” below.  Fit Testing Kit Needed:  N95 Fit Testing Kits may be available through Alameda County EMS; contact LTCFoutbreak@acgov.org  Fit Testing Kit search to purchase: Qualitative Fit Testing Kits Alameda County Health Care Services Agency Colleen Chawla, Director Public Health Department Kimi Watkins-Tartt, Director www.acphd.org Nicholas Moss, MD, Health Officer Public Health Department: Main Line (510) 267-8000 COVID-19 Information: (510) 268-2101 *Please note: provision of vendor names does not imply endorsement. RESPIRATORY PROTECTION RESOURCES 2 ver: 08.03.23 FAQ’S What is a Respiratory Protection Program? • A written respiratory protection program requires worksite-specific procedures and elements for required respirator use. The program must be administered by a suitably trained program administrator. • OSHA How to Set-up Respiratory Protection Plan • Sample Respiratory Protection Program Template (automatic download) What is fit testing? • Per OSHA, Fit testing means the use of a protocol to qualitatively or quantitatively evaluate the fit of a respirator on an individual. • Long Term Care OSHA Requirements: “Even when control strategies are in place, PPE, including respirators, will be needed for workers when close contact with someone who is known or suspected of having COVID- 19 cannot be avoided. Whenever respirators are required, employers must implement a written, worksite- specific respiratory protection program (RPP), including medical evaluation, fit testing,2 training, and other elements, as specified in OSHA’s Respiratory Protection standard (29 CFR 1910.134).” • Annual requirement per OSHA Respiratory Protection standard (1910.134), “The employer shall ensure that an employee using a tight-fitting facepiece respirator is fit tested prior to initial use of the respirator, whenever a different respirator facepiece (size, style, model or make) is used, and at least annually thereafter.” What is a respiratory medical evaluation and clearance? • Per OSHA Respiratory Protection standard (1910.134; 1910.134(e)), “the purpose of a medical evaluation program is to ensure that any employee required to use a respirator can tolerate the physiological burden associated with such use, including the burden imposed by the respirator itself; musculoskeletal stress; limitations on auditory, visual, and odor sensations; and isolation from the workplace environment.” Are respiratory medical evaluations and clearance a must? • Yes, a medical evaluation is an element of the written respiratory protection program that is required by the Occupational Safety and Health Administration (OSHA) (29 CFR 1910.134). The standard requires that if you are required to wear a respirator due to a potential hazard in your work environment, you must be fit tested, trained, and medically evaluated prior to having a respirator issued. Fit Testing Resource Links: • OSHA Fit Testing Procedures: 5144- Appendix A Alameda County Health Care Services Agency Colleen Chawla, Director Public Health Department Kimi Watkins-Tartt, Director www.acphd.org Nicholas Moss, MD, Health Officer Public Health Department: Main Line (510) 267-8000 COVID-19 Information: (510) 268-2101 *Please note: provision of vendor names does not imply endorsement. RESPIRATORY PROTECTION RESOURCES 3 ver: 08.03.23 • Fit testing procedure links* o 3M Quick Reference Guide: Qualitative Fit Testing and Video Demonstration Link o 3M Overview of Respiratory Protection • Staff Seal Checks prior to each use: CDC Fact Sheet “Respirator On/ Respirator Off” Respiratory Protection Regulations: The California Department of Industrial Relations, Division of Occupational Safety and Health (also known as Cal/OSHA), enforces a standard on the use of respiratory protection found in California Code of Regulations (CCR), Title 8, Section 5144. https://www.dir.ca.gov/title8/5144.html