Half measures, full fines: OSHA resp violations

Partial compliance a common problem

An employee may have had a respiratory examination, as required by the Occupational Safety and Health Administration's (OSHA) Respiratory Protection Standard, but no mask fit testing. This means your workplace is only in partial compliance with the standard, warns Michelle L. McCarthy, RN, COHN, on-site medical case manager for Genex Services in Norcross, GA. "Many times, you will see that only part of the standard is being met," she says.

In addition, says McCarthy, "there may be no records of annual training, not enough types of protection offered, or no enforcement. Even if all this was done correctly, there may be poor documentation."

Frequent violations

The most frequently violated paragraph in the Respiratory Protection Standard is the lack of a respiratory protection program, says OSHA spokesperson Richard DeAngelis, followed closely by the lack of a medical evaluation of respirator users and the lack of fit-testing. These violations make up 52% of all penalties, he adds.

"The fourth most commonly violated paragraph is the voluntary use of respirators," DeAngelis says. This includes failing to provide voluntary users with mandatory information, failing to ensure that the respirator itself does not create a hazard, and failing to have a written program when respirators other than filtering facepieces are voluntarily used, he says.

"Less frequently but still commonly cited are not evaluating the respiratory hazards in the workplace, lack of training before being assigned to wear a respirator, improper storage of respirators, and wearing respirators with facial hair," DeAngelis says.

DeAngelis adds that any facility that uses respirators needs to designate one or more individuals to maintain and evaluate their program.

Tom Ostendorf, lead respiratory protection specialist at Lab Safety Supply, a Janesville, WI-based provider of safety products, notes that non-compliance with the Respiratory Protection Standard is on OSHA's list of the most frequently cited occupational safety violations for fiscal year 2010. "It once again made the infamous list, coming in at number four for the second straight year," says Ostendorf.

This is significant, says Ostendorf, in light of OSHA estimates that approximately five million workers wear respirators at 1.2 million U.S. workplaces. To avoid violations, Ostendorf says, "If you're uncertain where to even begin, oftentimes a quick call to a comprehensive safety equipment supplier will get you pointed in the right direction."

Below are recommendations to avoiding citations:

• Create a written program.

Ostendorf says that this must address the selection process; medical evaluations; fit testing; procedures for use; procedures and schedules for cleaning, disinfecting, storing, inspecting, repairing and discarding; procedures to ensure adequate air quality; quantity and flow; training in respiratory hazards; training in use limitations; and maintenance and procedures for regularly evaluating the effectiveness of the program.

• Review the annual OSHA respiratory questionnaire for accuracy and completion.

McCarthy recommends comparing it to the prior year's questionnaire, and looking for any major changes or discrepancies.

"If there are flags — the employee is a smoker or has heart disease or high blood pressure — refer them to a qualified medical professional for further evaluation," she says.

• Perform a medical evaluation prior to fit testing or respirator use.

The physician or licensed health care professional performing the evaluation should do the following, Ostendorf says:

— Administer evaluations confidentially and conveniently during normal work hours;

— Ensure the employee understands the results of the examination;

— Note any limitations the employee may have, and if there is a need for follow-up exams;

— Provide the employee with a written copy of any recommendations.

"If medical conditions prevent an employee from using a negative-pressure respirator, a PAPR [Powered Air Purifying Respirator] will be provided," adds Ostendorf.

• Do additional medical evaluations as necessary.

These should be done if the employee reports symptoms, if observations or evaluations indicate a need, or a change in the workplace occurs that would affect the employee's physical burden, says Ostendorf. "The medical evaluation is discontinued when the employee is no longer required to use a respirator," he says. (See related story, below.)

Sources

For more information on compliance with the Respiratory Protection standard, contact:

• Michelle L. McCarthy, RN, COHN, On-Site Medical Case Manager, Genex Services, Norcross, GA. Phone: (770) 266-4922. Fax: (770) 266-4869. E-mail: michelle.mccarthy@genexservices.com

• Tom Ostendorf, Lab Safety Supply, Janesville, WI. Phone: (800) 356-2501. Fax: (800) 543-9910. E-mail: techsvc@labsafety.com.