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Health hazard evaluation report: HETA-2009-0184-3126, evaluation of respiratory protection practices for employees at federal immigration and customs agency workplaces - Nationwide.

de Perio-MA; Niemeier-RT; King-BS; Mueller-CA
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HETA 2009-0184-3126, 2011 Apr; :1-43
In July 2009, NIOSH received an HHE request from the American Federation of Government Employees. The union was concerned about respiratory protection for federal immigration and customs agency employees during the pH1N1 pandemic. NIOSH investigators reviewed the agency's written respiratory protection procedures, observed a respirator fit-testing session for employees at agency headquarters, and surveyed employees nationwide about respiratory protection practices. We found that the agency's respiratory protection policy, the respirator medical evaluation questionnaire, the qualitative fit-testing protocol, and the slide presentation serving as training for fit testers were comprehensive. The quality of the observed respirator fit-testing procedures was good. However, we identified several areas that needed improvement. Though the response rate for our survey was suboptimal with 2,218 responding employees, we found that that most respondents, particularly those from DRO and OI, have face-to-face contact with immigrants in their current job. This contact places them at risk for exposure to airborne infectious agents, including Mycobacterium tuberculosis, influenza virus, rubeola virus, and varicella zoster virus. Most respondents completed all of the steps required for respirator use (medical clearance, respirator training, respirator fit testing). However, some gaps between medical clearance and respirator training existed. We also found low employee compliance with respirator usage and annual tuberculosis screening. The written respiratory protection programs were not readily available in some workplaces. The agency should maintain a written respiratory protection program for all workplaces to protect against airborne infectious agents and other respiratory hazards. The agency should require and arrange fit testing for employees at least annually and verify medical clearance prior to the fit test. Clear written procedures for the use of respirators should be developed and maintained, and specific indications for respirator usage should be included in training. Annual evaluations of the workplaces to ensure that the written respiratory protection program is being properly implemented should be conducted. Training provided to employees and fit testers should be improved to include more information on the technical capabilities of respirators and more specific instructions for performing face seal checks and for donning and doffing respirators. Employees who should undergo routine tuberculosis screening should be identified and informed. Finally, annual influenza vaccination should be recommended to all employees.
Health-hazards; Infectious-diseases; Respiratory-system-disorders; Respiratory-protective-equipment; Employee-exposure; Employee-health; Worker-health; Respirators; Work-practices; Health-surveys; Questionnaires; Training; Bacterial-infections; Viral-infections; Medical-screening; Risk-analysis; Exposure-assessment; Airborne-particles; Respiratory-infections; Vaccines; Infection-control; Author Keywords: tuberculosis; TB; immigration facility; influenza; H1N1; measles; rubeola; chicken pox; varicella; infections; respirators; respiratory protection
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Field Studies; Hazard Evaluation and Technical Assistance
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National Institute for Occupational Safety and Health