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For Respirator Users

Workers with respiratory protection

Key Resources

Respirator Trusted-Source Information
Provides methods to identify NIOSH-approved filtering facepiece respirators and answers to frequently-asked questions.

Approved Particulate Filtering Facepiece Respirators (FFRs) with Donning Instructions
Tables listing NIOSH-approved FFRs in the 7 classes.

Certified Equipment List (CEL)
A searchable list of commercially-available, respiratory personal protective devices certified by NIOSH to meet the requirements of Title 42, Code of Federal Regulations, Part 84.

Respiratory Protection Videos

Respiratory Protection for Healthcare Workers Training Video (January 2011)
A presentation about the use of respirators in healthcare settings.

The Difference Between Respirators and Surgical Masks Video (December 2009)
A presentation about the difference between respirators and surgical masks.

Donning (Putting on) and Doffing (Taking off) and User Seal Checks Video (December 2009)
A presentation about donning (putting on) and doffing (taking off) and user seal checks.

Respirator Safety (Training Video section)

OSHA Respiratory Protection Videos (January 2012)

 

General Respirator Information

Respirator Topic page
A respirator is a personal protective device that is worn on the face, covers at least the nose and mouth, and is used to reduce the wearer’s risk of inhaling hazardous airborne particles, gases, or vapors. Respirators should be used as a "last line of defense." Respirators protect the user in two basic ways. The first type, air-purifying respirators, removes contaminants from the air. This includes particulate respirators, which filter out airborne particles, and “gas masks,” which filter out chemicals and gasses. Air-supplying respirators protect by providing clean air from another source and includes airline respirators and self-contained breathing apparatus.

Seasonal Influenza-related Respirator Research
NIOSH research projects that focus on various issues which affect the use of filtering facepiece respirators.

Respirator User Notices
A warning issued by NIOSH or the manufacturer when a condition or risk may exist with a NIOSH-certified respirator.

MultiVapor™ Version 2.2.3 Application
A computer tool for estimating breakthrough times and service life of air-purifying respirator cartridges.

PPE Concerns? [PDF - 164 KB]
Do you encounter obstacles in the selection and use of PPE? Call our hotline.

Letters to Interested Parties
Official letters announcing public meetings, new requirements, NIOSH policies and other information for our stakeholders.

OSHA Respiratory Protection Videos


Publications

Fact Sheet: What’s special about Chemical, Biological, Radiological, and Nuclear (CBRN) air-purifying respirators (APR)?
DHHS (NIOSH) Publication No. 2013-157 (September 2013)
The guidance recommended in this fact sheet will help respiratory protection program administrators, managers, and air-purifying respirator (APR) wearers understand the special features of a NIOSH-approved Chemical, Biological, Radiological, and Nuclear (CBRN) APR.

Fact Sheet: What’s special about Chemical, Biological, Radiological, and Nuclear (CBRN) powered air-purifying respirators (PAPR)?
DHHS (NIOSH) Publication No. 2013-156 (September 2013)
This guidance will help respiratory protection program administrators, managers, and powered air-purifying respirator (PAPR) wearers understand the special features of a NIOSH-approved chemical, biological, radiological, and nuclear (CBRN) PAPR.

Fact Sheet: Getting optimal performance from a powered air‐purifying respirator (PAPR) depends on the condition of its battery!
DHHS (NIOSH) Publication No. 2013-146 (September 2013) Español
The guidance in this fact sheet will help respiratory protection program administrators, managers, and powered air-purifying respirator (PAPR) wearers understand the importance of a PAPR’s battery in assuring effective respiratory protection.

Respirator Awareness: Your Health May Depend On It
DHHS (NIOSH) Publication No. 2013-138 (June 2013) Español
One of the occupational hazards in the healthcare setting is the airborne transmission of certain infectious diseases. The potential of exposure is not limited to physicians, nurses, and support personnel in direct patient care. It extends to those delivering food, cleaning patient rooms, and performing maintenance. Anyone working in areas with patients infected with airborne-transmissible diseases is potentially at risk.

Fact Sheet: Understanding the Breathing Gas Capacities (ratings) of Escape Respirators for Mineworker Use
DHHS (NIOSH) Publication No. 2013-148 (May 2013)
This information will help workers understand the meaning of breathing gas capacity of a jointly approved National Institute for Occupational Safety and Health (NIOSH) and Mine Safety and Health Administration (MSHA) closed-circuit escape respirator (CCER). Understanding the uses and limitations of the CCER is important in planning for an escape during a mine emergency.

Fact Sheet: What's Special about CBRN Self-contained Breathing Apparatus (SCBA)?
DHHS (NIOSH) Publication No. 2011-183 (June 2011)
CBRN SCBA Respirators are different than other NIOSH-approved SCBAs because the equipment must comply with additional requirements and special tests. These include chemical agent permeation and penetration resistance against distilled sulfur mustard and sarin, and laboratory respirator protection level tests. The units must also meet the NFPA 1981 Standard for open-circuit self-contained breathing apparatus for emergency services.

Fact Sheet - NIOSH Approval Labels — Key Information to Protect Yourself
DHHS (NIOSH) Publication No. 2011-179 (May 2011)
Used in conjunction with the manufacturer’s user instructions, the NIOSH approval label provides essential information to determine if the configured assembly is NIOSH-approved.

NIOSH Respirator Selection Logic
DHHS (NIOSH) Publication No. 2005-100 (October 2004)
Respirator Selection Logic provides guidance to respirator program administrators on respirator selection that incorporates the changes necessitated by the revisions to the respirator use and certification regulations and changes in the NIOSH policy.

Fact Sheet: What You Should Know in Deciding Whether to Buy Escape Hoods, Gas Masks, or Other Respirators for Preparedness at Home and Work (2001)
Guidance information on what respirators are, how they work, and what is needed for a respirator to provide protection.

Respirator Usage in Private Sector Firms, 2001
NIOSH and the Bureau of Labor Statistics conducted a voluntary survey of U.S. employers regarding the use of respirators. The findings are intended to provide information to develop interventions and to increase the frequency and effectiveness of respirator use in the workplace.

NIOSH Guide to Industrial Respiratory Protection
DHHS (NIOSH) Publication No. 87-116
A single source for respirator information, including selection, use, and maintenance.

NOTE: The decision logic appendix of this document was updated in the Respirator Selection Logic (2005-100).


Information for Workers

Emergency Responders

Functional Safety for Programmable Electronics Used in PPE: Best Practice Recommendations
The objective of this contract was to establish and document recommendations for using a System Safety Approach to ensure the safe design and use of high-tech personal protective equipment throughout its complete life cycle. This project was completed in 2008. However, the information contained in this report remains valid.

Fire Fighters Service SCBA Cylinder Part Numbers
A quick reference showing those cylinders which are authorized components of NIOSH-approved self-contained breathing apparatus (SCBA). Based on information provided by the manufacturer, listed are SCBA models commonly used in the fire service and the corresponding approved cylinder and valve assemblies.

Personal Alert Safety Systems (PASS) Information
To report any PASS malfunctions and other problems with PASS functioning to NIOSH-NPPTL, send an email to: npptl@cdc.gov. Please review the PASS Information Document [PDF - 20 KB] and provide the contact information listed before submitting your request.

A User Notice has been provided by the National Fire Protection Association (NFPA): Pass Alarm signals can fail at high temperatures, Dec. 6, 2005.

A User Notice is a written notice provided to inform users of a condition or risk that may exist with a NIOSH-certified product. NIOSH has reviewed and concurs with the facts in the user notice as of the date indicated on the NIOSH website.

Disclaimer: Links to non-Federal organizations do not constitute an endorsement of these organizations, their products, or programs by NIOSH and none should be inferred. NIOSH is not responsible for the content of the individual organization web pages found at these links. They are provided solely as a service to our users. A NIOSH certificate of approval is not an endorsement of the respirator by NIOSH. Such endorsements are not to be stated or implied by manufacturers in advertisements or other publicity. NIOSH certification represents that the equipment has met the requirements of Title 42, Code of Federal Regulations (CFR) Part 84.

Safety and Health in Law Enforcement
DHHS (NIOSH) Publication No. 2011-134 (January 2011)
Law enforcement agencies, professional associations, labor unions, research organizations, and government agencies are encouraged to build partnerships to help reduce the risk of occupationa injury and illness among law enforcement personnel.

Guidance Documents for Protecting Emergency Responders

Interim Guidance on Using CBRN Canisters for Activities Other than Response to Terrorist Events
This interim guidance provides recommended guidelines for CBRN APR use in applications other than terrorist events (e.g. industrial and hazmat response, natural disaster response, etc.). This guidance remains interim at this time (5/31/2012).


Healthcare Workers

Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings
This document recommends practices for extended use and limited reuse of NIOSH-certified N95 filtering facepiece respirators (commonly called “N95 respirators”). The recommendations are intended for use by professionals who manage respiratory protection programs in healthcare institutions to protect health care workers from job-related risks of exposure to infectious respiratory illnesses.

Respirator Evaluation in Acute Care Hospitals Study (REACH)

REACH I
This project assessed the usage of respiratory protection for influenza exposure among healthcare workers (HCWs) in 16 California hospitals during the H1N1 influenza. 204 HCWs participated in this study representing a variety of clinical specialties (i.e. ER, ICU, Peds) and roles including unit managers, respiratory protection administrators, and direct care providers. Observational methods were also employed to better understand donning and doffing practices.
Relevance to worker safety and health - Findings from REACH I serve as a 'snap shot' of: 1) the extent to which hospitals in California have implemented required elements of a respiratory protection program for influenza; and 2) the usage of personal respiratory protection for influenza exposure among California healthcare workers.
Key Findings

  • 50% of the hospital managers reported that their facility had experienced a shortage of respirators between April 2009 and the survey period (January 20 - February 23, 2010).
  • The observational data indicates improper use of respiratory protective equipment as evidenced by donning and doffing practices.
    • Not performing a seal check
    • Improper strap placement
    • Touching the face piece upon doffing
  • In response to the question what healthcare workers believe, 65% felt that they were at a high risk of becoming ill with influenza due to their work, 96% felt that wearing an N95 or better respirator could help protect them from on-the-job exposures to influenza and 94% indicated that N95 respirators are more effective at protecting them from influenza than surgical masks.
  • Inresponse to a question related to how respondents knew that they needed to wear a respirator, the top two responses indicated that they waited to be "cued" by signage on the door or to be told during shift report.

Reference -A paper summarizing this work has been published in the American Journal of Infection Control:

Beckman S, Materna B, Goldmacher S, Zipprich J, D’Alessandro M, Novak D, Harrison R [2013]. Evaluation of respiratory protection programs and practices in California hospitals during the 2009-2010 H1N1 influenza pandemic. Am J Infect Control 41(11):1024-1031.

Status - Completed
Point of Contact - Debra Novak, PhD, RN, ian5@cdc.gov


REACH Intervention and Evaluation

The objective of this project is to extend and build upon the work previously completed under REACH I by examining the effectiveness of various interventions for improving respiratory protection programs in California acute care facilities.
Relevance to worker safety and health - Findings from REACH I suggest that N95 respirators are being widely used, although gaps in training, appropriate donning and evaluation have been identified. This project identified and evaluated effective interventions and best practices to strengthen California hospitals' respiratory protection programs and reinforce healthcare workers' proper use of respiratory protection.
Key Findings - A toolkit of effective strategies was developed and tested in 14 California hospitals. The California Respirator Program Administrators toolkit can be accessed at: http://www.cdph.ca.gov/programs/ohb/Pages/RespToolkit.aspx
Status - Completed
Point of Contact - Debra Novak, PhD, RN, ian5@cdc.gov


REACH II

Expanded upon REACH I to evaluate hospitals' written respiratory protection programs and assess healthcare workers' usage of respiratory protection for influenza (droplet) and aerosol-transmissible exposures in five regions of the United States (Northeast, Southeast, Midwest, Southwest, and  West).
Relevance to worker safety and health - Findings from REACH II serve as a 'snap shot' of: 1) the extent to which hospitals across the United States have implemented required elements of a respiratory protection program for influenza and 2) the usage of personal respiratory protection for seasonal influenza exposure among healthcare workers.
Key Findings

  • Data collection completed in five regions and six sates of the U.S. The final data set included 98 hospitals, over 1500 participants (i.e. HCWs, Hospital and Unit Managers) as well as over 300 demonstrations of respirator donning and doffing.
  • Over 80% of participating hospitals reported adherence to many of the OSHA required respiratory protection program elements, such as:
    • Medical evaluations and fit testing prior to initial respirator use
    • Employee training on how and when to use respiratory protection
    • Respiratory protection guidelines regarding close contact with a patient with suspected or confirmed infectious disease or seasonal influenza
  • The lowest levels of adherence concerned factors, such as:
    • Frequency of medical evaluations
    • Informing staff about the model and size of respirator they have been fit tested for
    • Formal evaluations of respiratory protection programs
  • Similarly to REACH I findings, HCWs demonstrated improper donning and doffing procedures:
    • 46% used incorrect strap placement
    • 85% did not perform a seal check
    • 57% did not use straps during doffing
    • 45% used improper respirator disposal methods
  • Hospital and Unit Managers reported overall higher adherence rates to respiratory protection guidelines than HCWs. In other words, those closest to the “bedside” (i.e. more contact with patients) were less likely to provide correct survey responses with regards to respiratory protection recommendations or requirements for selected diseases.

Reference - A paper summarizing findings from New York State has been published in the American Journal of Infection Control

Hines L, Rees E, Pavelchak N [in press]. Respiratory protection policies and practices among the health care workforce exposed to influenza in New York State: Evaluating emergency preparedness for the next pandemic. Am J Infect Control.

Status - Completed
Point of Contact - Debra Novak, PhD, RN, ian5@cdc.gov


Other Resources for Healthcare Workers

Respirator Awareness: Your Health May Depend On It
DHHS (NIOSH) Publication No. 2013-138 Español
One of the occupational hazards in the healthcare setting is the airborne transmission of certain infectious diseases. The potential of exposure is not limited to physicians, nurses, and support personnel in direct patient care. It extends to those delivering food, cleaning patient rooms, and performing maintenance. Anyone working in areas with patients infected with airborne-transmissible diseases is potentially at risk.

Seasonal Influenza-related Respirator Research
NIOSH research projects that focus on various issues which affect the use of filtering facepiece respirators.

California Toolkit: Respirator Use in Health Care Workplaces
Evaluations of respirator use in California hospitals conducted during the 2009 H1N1 pandemic and the 2010-11 influenza season showed that some hospitals could use help to improve the effectiveness of their respirator programs. The Toolkit was developed to provide useful tools and resources for California hospitals to reinforce and strengthen the respiratory protection programs. The guide covers key requirements of the Cal/OSHA Respiratory Protection and Aerosol Transmissible Diseases standards, guidance on developing and evaluating a respiratory protection program, and information on the selection and use of respirators. The tools and resources are now available through links within the electronic version of the guide itself. While directed toward California, the tools provide a useful resource for the nation as NIOSH NPPTL continues to work toward developing more generalized tools.

Barriers to Selection and Use of PPE in Healthcare [PDF - 134 KB]
NPPTL is interested in learning more about the potential barriers to the proper selection and use of personal protective equipment by healthcare workers.

Fact Sheet: Understanding Respiratory Protection Against SARS (2003)
Q & A about respirators and SARS, including what types of respiratory protection should be used by health care workers and others to protect against SARS.

Respirators: Your TB Defense / TB Respiratory Protection: Administrator's Review
DHHS (NIOSH) Publication No. 2002-114d. DVD.
Includes the programs 'Respirators: Your TB Defense', 'TB Respiratory Protection: Administrator's Review', and written materials in electronic format. The information in this DVD remains current and viable in 2012.

TB Respiratory Protection Program in Health Care Facilities
DHHS (NIOSH) Publication No. 99-143
This manual is designed to serve as a practical guide for those individuals responsible for initiating and running a TB respiratory protection program in health care facilities. The information in this manual remains current and viable in 2012.

NIOSH Science Blog: N95 Respirators and Surgical Masks
October 14, 2009
Recommend the use of a NIOSH-certified N95 or better respirator for the protection of healthcare workers who come in direct contact with patients with H1N1.


National Academies of Science

Institute of Medicine (IOM) Reports

In response to a request from NPPTL the Institute of Medicine formed a Standing Committee on Personal Protective Equipment (COPPE) for Workplace Safety and Health. This committee supplies a forum for discussion of scientific and technical issues relevant to the development, certification, deployment, and use of personal protective equipment, standards, and related systems to ensure workplace safety and health. 

The committee provides liaison and oversight to ad hoc study committees requested by NIOSH and approved by the Institute of Medicine and the National Academies. Standing committee discussions have led to the formation of a number of ad hoc committees, which have investigated topics related to personal protective equipment and authored the reports.

View the IOM Reports.


Mine Workers


Long Term Field Evaluations (LTFE)
The Long-Term Field Evaluation (LTFE) program for self-contained self-rescuers (SCSRs) for miners was initiated more than 20 years ago by the U.S. Bureau of Mines. The objective for the LTFE program is to obtain data to determine the expected performance characteristics of SCSRs used in the mining industry. LTFE program results based on scientific principles can provide useful information to monitor expected SCSR performance and assess possible degradation due to the physical stresses of in-mine use. Of utmost concern is the successful performance of any SCSR that passes its inspection criteria specified by the manufacturer. It is such apparatus that must be relied upon in an emergency.

Self-Contained Self-Rescuer (SCSR) Long Term Evaluation Tenth Phase Results - RI9675
DHHS (NIOSH) Publication No. 2008-138 (June 2008)
This report presents findings regarding laboratory-tested SCSRs in the tenth phase of testing, from July 2004 to March 2006.

Self-Contained Self-Rescuer (SCSR) Long Term Field Evaluation: Combined Eighth and Ninth Phase Results
DHHS (NIOSH) Publication No. 2007-103 (October 2006)
Over 400 units were evaluated by NPPTL and MSHA from December 2000 until April 2004.  This report presents the findings of the laboratory testing.


Self-Contained Self-Rescuers (SCSR)
Dockable, Hybrid Self-Contained-Self-Rescuer for use in Mines under development [PDF - 14 KB]

Development of Both a Dockable and Hybrid Person-Wearable Self-Contained Self-Rescuer [PDF 5.16 MB]


SCSR Interactive Training
Self-Contained Self-Rescuers (SCSR), Inspection, Maintenance, and Use - Interactive Training Course (MSHA Web site)
Inspection, Maintenance, and Use - Interactive Training Course


Closed-Circuit Escape Respirator (CCER)

Understanding the Breathing Gas Capacities (ratings) of Escape Respirators for Mineworker Use
Understanding the uses and limitations of the CCER is important in planning for an escape during a mine emergency.


Workers Handling Engineered Nanoparticles

Respiratory Protection for Workers Handling Engineered Nanoparticles Science Blog
Provides an update on the science and rationale behind NIOSH’s recommendations for the use and selection of respirators against engineered nanoparticles.

 

 
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