Course:SPPH381B/Essay 3/Ensuring Personal Protective Equipment works; the Respirator example: Samin Nagi

Personal protective equipment (PPE) is equipment or clothing worn to minimize exposure to chemical hazards in the workplace. PPE is used as a temporary (until more effective hazard control techniques can be used) or the last line of protection for workers against the occupational hazards. The PPE used depends on the work environment, the work conditions, and the processes being performed.

Types of PPE equipment

PPE includes items such as helmets, eye goggles, high-visibility clothing, safety footwear, and sometimes, respiratory masks and hearing protection equipment.

Head Protection

Hard hats are common in construction sites. They are designed to protect against flying or falling objects that would otherwise impact or penetrate the worker. Hard hats should be well-fitted; those that are too large or too small are inappropriate for use, as they are ineffective at protecting the worker.

Eye and Face Protection

Eye and face protection are equally as important as head protection. Safety goggles, spectacles, and full face shields can give workers adequate protection for their eyes and face. Examples include workers that are involved in metal work, wood-work, hot-work and air-tool operations.

Respiratory protection

Respiratory protection is vital on sites where toxic substances are present. Respiratory protections like respirators are designed to protect you from dust, fumes, paint spray, pesticides and other dangerous/poisonous substances that could cause permanent impairment. In work environments, respirators can be used when adequate ventilation is unavailable.

Hand & Skin protection

Construction jobs typically require the use of hands. Occupational skin diseases such as contact dermatitis, skin cancers, and other skin injuries and infections are the second most common type of occupational disease and can be very costly. Using gloves helps to avoid hazards usually involved when working with chemicals, glass, sheet metal, electricity, hot materials or slippery objects.

Hearing protection

Industrial noise is often discounted as an occupational hazard since it isn’t visible. Earplugs and earmuffs are common hearing protection tools. It is important to note that earmuffs are more effective in reducing high-frequency noise while earplugs are more effective for reducing low-frequency noise.

Problems with PPE equipment

Using several types of protection at the same time such as hard-hats, ear muffs and goggles, must not increase the danger or decrease the worker's ability to do the assigned job. Wearing PPE should not in itself create a greater danger. For example, gloves prevent skin damage while working with moving equipment, but can create an entanglement hazard with a drill press or metal lathe. Additionally, ear muffs protect against hearing loss or damage, however can reduce the workers hearing ability and therefore increase vulnerability and likelihood of injury. Most regulatory agencies require that PPE not be used unless the employer has taken all the necessary measures in terms of engineering controls, work practices, administrative controls, and hygiene to control the hazard.

The use of PPE does not prevent an accident from happening. It does not eliminate the hazard. It does not influence any pre-contact activities. It only minimizes the exposure or reduces the severity of injury or illness. PPE is a good point-of-contact injury control strategy. However, even at its best, PPE cannot achieve its full-protection potential without worker knowledge and cooperation.

Where personal protective equipment (PPE) is provided, and used at work, one should remember that wearing PPE may adversely affect the performance of tasks being undertaken (e.g. restricting vision or mobility). PPE may also be uncomfortable to wear and some workers may not be able to wear it (e.g. workers who are allergic to latex cannot wear rubber gloves). PPE may create new hazards (for example some items of PPE can hinder the body’s natural cooling mechanisms by preventing evaporation of perspiration).

Ebola virus

The heat stress that is associated with the use of PPE in tropical climates is an occupational hazard that, in some instances, can increase the risk of accidents and thus exposure if it is not recognized early. In Ebola, endemic countries during this epidemic, there has been a policy of “no touch” in which people do not hug, kiss, or shake hands in order to avoid potential transmission outside of Ebola treatment units. Refraining from touching one's face and frequent hand washing is encouraged to reduce the potential of self-inoculation.

Additionally, recent studies suggest that viruses including Ebola have the potential to remain infectious on PPE for longer than it is typically worn, creating an opportunity for transmission during doffing. Historically, development of PPE strategies have been driven by the paradigm that infectious agents are transmitted by one of three routes: contact, droplet, or airborne, however the consideration of self-inoculation in the removal of PPE is emerging as a major potential route of HCP infection.

Respirators

There are correct procedures for respirator fit testing, cleaning, inspection and storage, and respirator selection. However, there are also problematic areas in respirator program administration, such as, facial hair, vision, communication, respirators worn in temperature extremes, and respirators worn for protection during welding and abrasive blasting. This also includes poor fit and poor maintenance of the respirator.

Types of respirators

The two main types are air-purifying respirators (APRs) and supplied-air respirators (SARs). Air-purifying respirators can remove contaminants in the air that you breathe by filtering out particulates (e.g., dusts, metal fumes, mists, etc.). Other APRs purify air by absorbing gases or vapours on a sorbent (adsorbing material) in a cartridge or canister. They are tight-fitting and are available in several forms: mouth bit respirator (fits in the mouth and comes with a nose clip to hold nostrils closed - for escape purposes only) quarter-mask (covering the nose and mouth), half-face mask (covering the face from the nose to below the chin), or full facepiece (covering the face from above the eyes to below the chin). Respirators with a full facepiece also protect the eyes from exposure to irritating chemicals.

Supplied-air respirators (SARs) supply clean air from a compressed air tank or through an air line. This air is not from the work room area. The air supplied in tanks or from compressors must meet certain standards for purity and moisture content (e.g., CSA Standard Z180.1-00 (R2010): Compressed Breathing Air and Systems). Supplied-air respirators may have either tight-fitting or loose-fitting respiratory inlets. Respirators with tight-fitting respiratory inlets have half or full facepieces. Types with loose-fitting respiratory inlets can be hoods or helmets that cover the head and neck, or loose-fitting facepieces with rubber or fabric side shields. These are supplied with air through airlines.

Fit testing

Respiratory protective equipment will not be ordered, purchased or issued to personnel unless the respirator wearer has received respirator training and passed a fit test. Quantitative or qualitative fit tests will be performed. A fit test report, when complete and signed by an EHS representative, indicates that the wearer has successfully completed the Occupational Health respirator certification program and EHS quantitative or qualitative fit testing and training requirements. The fit test report is valid for 1 year.

Future strategies

The National Institute for Occupational Safety and Health (NIOSH) and agencies, such as the Agency for Healthcare Research and Quality, and professional organizations should better understand the role of safety culture and other behavioral and organizational factors on PPE usage in healthcare settings by conducting some more research. These efforts should include conducting human factors and ergonomics research, which should be relevant to the design and organization of healthcare work tasks to improve worker’s safety by reducing hazardous exposures and effectively using PPE (e.g., reduce unnecessary PPE donning and doffing), exploring the links between patient safety and healthcare worker safety and health that are relevant to the use of PPE, and identifying and evaluating strategies to mitigate organizational barriers that limit the use of PPE by healthcare personnel.

Conclusion

Workers need to be properly informed about the reasons for protective equipment and be fully involved in choosing it. Ongoing supervision is required to ensure that PPE is being used correctly. The PPE may make individuals feel discomfort as it can make them feel hot and restrict some movements, but they should be assured that PPE can save lives thus it must be worn. Some PPE may be uncomfortable or not easy to use; therefore, it should be considered by the administrations that approved the equipment and various inspectors who can question the issue.

Additional Resources

*Know Your Hard Hat - Work BC Head Protection