OSHA is urging employers to consider alternate types of respiratory protection due to the shortage of N95 masks caused by COVID-19.
As just about everyone knows by now, the coronavirus pandemic has created a vital need for substantial numbers of N95 respirators and personal protective equipment for doctors, nurses, EMTs, and other essential front-line workers. On April 3, to help reduce the current supply shortage, OSHA issued a memo detailing interim enforcement guidance.
This new guidance is primarily intended for OSHA CSHOs (Compliance Safety and Health Officers) inspecting workplaces in which workers are using N95 respirators.
- Outlines enforcement discretion for CSHOs to permit the extended use and reuse of N95 respirators, as well as the use of expired N95 respirators (meaning those N95 respirators beyond their manufacturer’s recommended shelf life);
- applies to workplaces in all industries with respiratory hazards covered by one or more OSHA substance-specific health standards;
- applies to healthcare personnel who are “exposed to patients with suspected or confirmed coronavirus disease 2019 (COVID-19) and other sources of SARS-CoV-2 (the virus that causes COVID-19);”
- is effective as of April 3, 2020; and,
- is time-limited and will remain in effect until further notice.
N95 & Other Acceptable Types of Respirators
According to the memo, alternative classes of respirators could provide protection equal to, or greater than, the N95 FFR. This includes the NIOSH-approved, non-disposable elastomeric respirators and powered, air-purifying respirators.
And, according to OSHA, specific N95 masks that are beyond their shelf life still provide greater protection than surgical or homemade cloth masks. Testing suggests that specific N95 models continue to protect against hazards, and can filter out 95% of particles.
The Centers for Disease Control and Prevention (CDC) and NIOSH recommend that expired N95 FFRs only be used as outlined in their strategies for optimizing the supply of N95 respirators.
Acting Director of the OSHA Directorate of Enforcement Programs Patrick Kapust explained that, “other filtering facepiece respirators, such as N99, N100, R95, R99, R100, P95, P99, and P100, are also permissible alternatives for those who are unable to obtain N95 FFRs. However, per 29 CFR § 1910.134(d)(1)(ii), when considering N95 alternatives, check to ensure that they are NIOSH-approved, at www.cdc.gov/niosh/npptl/topics/respirators/disp_part/default.html.
When these alternatives are not available, or where their use creates additional safety or health hazards, employers may consider the extended use or reuse of N95 FFRs, or use of N95 FFRs, that were NIOSH-approved but have since passed the manufacturer’s recommended shelf life.”
COVID-19 Respirator Enforcement Guidance
Employers who require, or permit voluntary use of, respirators must continue to manage respiratory programs in accordance with the OSHA respirator standard.
Specifically, when a respiratory protection citation is being considered, the new guidance gives OSHA inspectors enforcement discretion, but only under certain circumstances.
While this new guidance is in effect, all employers:
- Should pay close attention to shortages of N95s during the COVID-19 pandemic;
- must continue to manage their respiratory protection program following OSHA’s respiratory protection standard (29 CFR § 1910.134);
- should consider if and how they might be able to decrease the need for N95 respirators – reevaluate engineering controls, work practices, and administrative controls. OSHA provides examples such as, “consider whether it is possible to increase the use of wet methods or portable local exhaust systems or to move operations outdoors. In some instances, an employer may also consider taking steps to temporarily suspend certain non-essential operations;”
- may consider the use of alternative classes of respirators that provide equal or greater protection compared to an N95 respirator (if respiratory protection must be used). Alternative classes of permissible alternative respirators might include NIOSH-approved, non-disposable, elastomeric respirators or powered, air-purifying respirators, and N99, N100, R95, R99, R100, P95, P99, and P100;
- should check to ensure any alternate respirators are NIOSH-approved;
- may consider the extended use or reuse of N95 respirators or use N95 respirators that were NIOSH-approved, but have since passed the manufacturer’s recommended shelf life (when alternatives are not available, or where their use creates additional safety or health hazards).
If employers find it necessary to extend the use or to reuse N95 respirators, they must:
- include in their written respiratory protection programs “the circumstances under which a disposable respirator will be considered contaminated and not available for extended use or reuse;”
- train workers to understand how to assess the structural and functional integrity of the N95 respirator and when to discard;
- train workers to perform a successful user seal check and to discard if a successful seal check cannot be achieved;
- train workers on “an appropriate sequence for donning/doffing procedures to be used to prevent contamination.”
If employers find it necessary to use expired N95 respirators, they:
- must use only previously NIOSH-certified expired N95 respirators;
- must notify workers they are using expired N95s;
- should not co-mingle expired products with items that are within their shelf life;
- should visually inspect, or ensure that workers visually inspect, the N95 respirators “to determine if the structural and functional integrity of the respirator has been compromised. Over time, components such as the straps, nose bridge, and nose foam material may degrade, which can affect the quality of the fit and seal;”
- should, if using expired N95s from their own inventory (i.e., not from the U.S. Strategic National Stockpile), “seek assistance from the respirator manufacturer or independent lab regarding testing of stored respirators prior to use.”
Healthcare employers only: There are certain circumstances when expired masks may not be used by health care personnel (HCP):
- Expired N95s may not be used with HCP perform surgical procedures with patients infected with COVID-19 or during procedures that generate aerosols or where respiratory secretions are likely to be ill-controlled (e.g., cardiopulmonary resuscitation, intubation, extubation, bronchoscopy, nebulizer therapy, sputum induction);
- HCP should aim to optimize the supply of respirators by activity type. For high-exposure procedures, such as those listed above, N95s within their shelf life should be prioritized before expired masks.
The new policy also includes the following citation guidance for CSHOs to consider when inspecting workplaces where respiratory protection with N95 respirators are being used.
Enforcement discretion consideration should be given when an employer:
- Monitored their supply of N95s and prioritized their use according to CDC guidance;
- made a good faith effort to obtain other alternative classes of respirators that provide equal or greater protection compared to an N95 respirator;
- provided surgical masks and eye protection (e.g., face shields, goggles) as an interim measure to protect employees;
- implemented feasible measures to protect employees. These measures could include engineering controls, work practices, or administrative controls that reduce the need for respiratory protection.
It’s important to remember that, if you are supplying N-95 respirators, or any other type of respirators to your employees, OSHA’s respirator standard requires the following:
- Program administration;
- worksite-specific procedures;
- respirator selection;
- employee training;
- fit testing;
- medical evaluation; and,
- respirator use, cleaning, maintenance, and repair.
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