WRITTEN RESPIRATORY PROTECTION PROGRAM AT NORTHWEST MISSOURI STATE UNIVERSITY

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1 WRITTEN RESPIRATORY PROTECTION PROGRAM AT NORTHWEST MISSOURI STATE UNIVERSITY This program has been developed by ARAMARK (Contract Employer) in cooperation with Northwest Missouri State University (Host Employer) in accordance with the Respiratory Protection Standard 29 CFR Northwest Missouri State University designates ARAMARK to act as their representative for the purpose of respiratory protection identification and coordination of the use of respiratory protection. May/2010 Page 1

2 EXPOSURE ASSESSMENT (By Task) 1. Task Performed: 2. Chemicals Used: 3. MSDS reviewed, health effects: 4. Worksite/Location: 5. Air contaminants (dust, smoke, mists, fumes, smells) noticed: 6. Is further investigation required: Yes No Who is doing it: Outside consultant ARAMARK Safety Department contacted Facility 7. Engineering Controls used: 8. Administrative Controls used: 9. Respirator required: Yes No Type: If yes, period of time respirator will be worn during work shift: 10. Respirator characteristics, capabilities, limitations: May/2010 Page 2

3 RESPIRATOR FIT TEST AND USE EVALUATION CHECKLIST 1. Whenever possible, employee exposure to air-borne contaminants should be controlled using feasible engineering controls or work practices which eliminate the need for respirators. 2. Base the selection of respiratory protective equipment on: Work area conditions and worker exposure surveys Respirator selection is based on the hazards to which the worker is exposed. when necessary, consult other knowledgeable individuals to ensure proper selection Review medical evaluation of users for physical and psychological ability to wear selected respiratory protective equipment Allow respirator use only with medical approval Wearing of contact lenses is prohibited when using respirators Respirator use is prohibited if facial hair or other characteristics are present 3. Assess the following during respirator selection Chin properly placed Positioning of mask on nose Strap tension Fit across nose bridge Room for safety glasses Distance from nose to chin Room to talk Tendency to slip Cheeks filled out Self-observation in mirror Adequate time for assessment 4. Use only NIOSH-certified respirators Check to make sure that adequate protection is provided for the specific hazard and concentration of contaminants 5. Where practicable, issue respirators to users for their exclusive use and record issuance on USER LIST. 6. Respiratory protective equipment fitting: Users given the opportunity to try on several respirators to determine best fit Two week check: OK refit 7. Schedule next fit test. May/2010 Page 3

4 RESPIRATOR INSPECTION RECORD (From the NIOSH Guide to Industrial Respiratory Protection) TYPE NO. A. Face piece: a. Excessive dirt b. Cracks, tears, holes, or distortion from improper storage c. Inflexibility (stretch and massage to restore flexibility) d. Cracked or badly scratched lenses in full-face pieces e. Incorrectly mounted full-face piece lens or broken or missing mounting clips f. Cracked or broken air-purifying element holder(s), badly worn threads, or missing gasket(s), if required B. Inhalation valve C. Exhalation valve assembly (examine after removing cover): a. Foreign material, such as detergent residue, dust particles, or human hair under the valve seat b. Cracks, tears, or distortion in the valve material c. Improper insertion of the valve body in the face piece d. Cracks, breaks, or chips in the valve body, particularly in the sealing surfaces e. Missing or defective valve cover f. Improper installation of the valve in the valve body D. Headbands, head straps, or head harness: a. Breaks b. Loss of elasticity c. Broken or malfunctioning buckles and attachments d. Excessively worn serration on the head harness which might permit slippage (full-face pieces only) E. Air purifying elements: a. Incorrect cartridge, canister, or filter for the hazard b. Incorrect installation, loose connections, missing or worn gaskets, or cross-threading in holder c. Expired shelf-life on cartridge or canister d. Cracks or dents in outside of filter, cartridge, or canister e. Evidence of prior use of sorbent cartridge or canister, indicated by absence of sealing material, tape, foil, etc., over inlet May/2010 Page 4

5 F. Harness assembly (front- or back-mounted gas mask): a. Damage or wear to the canister holder which may prevent it being held securely in place b. Broken harness straps or fastenings G. Hose assembly (corrugated breathing tube): a. Broken or missing end connectors, gaskets, or o-rings b. Missing or loose hose clamps c. Deterioration, determined by stretching the tube and looking for cracks H. Speaking diaphragm I. Routinely-used atmosphere-supplying device with tight-fitting face piece, use the procedures above, except for air-purifying elements. J. Routinely-used atmosphere supplying device with hood, helmet, blouse, or full suit: a. Examine the hood, blouse, or full suit for rips, tears, seam integrity, etc. b. Examine the protective headgear, if required, for general condition, with emphasis on the suspension inside the headgear c. Examine the protective face shield, if any, for cracks or breaks or impaired vision due to rebounding abrasive particles d. Make sure that the protective screen is intact and secures correctly over the face shield of abrasive blasting hoods and blouses K. Examine the air supply system for: a. Integrity and good condition of air supply lines and hoses, including attachments and end fittings b. Correct operation and condition of all regulators, valves, or other airflow regulators L. Other Defects May/2010 Page 5

6 RESPIRATOR USERS MEDICAL EVALUATION Employee Name: Date: Social Security No. Employer: Respirator and Worker Exposure Information Type of respirator Additional Responsibilities: Dust mask Fire Fighting Quarter-face respirator Rescue Half-face respirator Full-face respirator Supplied-air respirator (SAR) Self-contained breathing apparatus (SCBA) Substance(s) employee is exposed to: Environmental Conditions Confined Space Temperature Extremes Other Heat Cold Required protective clothing: Repetitive Tasks Gripping/Grasping Pulling/Pushing Reaching Below Shoulder Above Shoulder May/2010 Page 6

7 RESPIRATOR USERS MEDICAL EVALUATION (cont) Employee Name: Date: Social Security No. Employer: Other Activities Walking Standing Bending/Stooping Squatting/Kneeling Climbing/Crawling Lifting 10 lbs. maximum 20 lbs. maximum 30 lbs. maximum 40 lbs. maximum 50 lbs. maximum Over 50 lbs. May/2010 Page 7

8 MEMO TO PHYSICIAN Dear Physician: I would like to thank you for conducting the medical evaluation required before we can assign anyone to tasks requiring the use of a respirator. Attached to this letter is a Medical Evaluation. Please review the information as to the respirator assigned, work to be done/tasks to be performed. The purpose of this form is to inform us as to the ability or inability of (Print Name) to wear the required respirator. Please include in your evaluation the following items: Work history Medical information including history of respiratory disease, allergies, etc. Any physical deformities or abnormalities Past and current usage of medication Past and current usage of tobacco Tolerance to increased heart rate which can be produced by heat stress Please return a copy of this memo to: APPROVED: YES NO Signed: Date: (Print Name) May/2010 Page 8

9 EMERGENCY PROCEDURES Escape Only Respirators Where escape only respirators are provided because of the potential for an emergency, employees assigned to the area must be trained in their use. Emergency Use Respirators Self-contained breathing apparatus may be required in specific areas for emergency use. This equipment must be used only by training personnel when it is necessary to enter hazardous atmospheres. Self-contained breathing apparatus (SCBA) are found in the following locations: All potential users must be fully trained in the use of this equipment and medically qualified to wear SCBAs. When the equipment is used, it must be tested in an uncontaminated atmosphere prior to entering the hazardous area. An employee wearing an SCBA may not work individually. At least one additional employee must be in contact with the SCBA wearer and must be available to render assistance if necessary. This equipment shall be inspected monthly by trained personnel. All inspections and maintenance information must be recorded in a log or on an inspection tag. Supplied Air Quality and Uses Breathing air, including compressed air, compressed oxygen, liquid air, and liquid oxygen shall be provided as specified in the standard. Identification of Filters, Cartridges and Canisters All filters, cartridges, and canisters shall be properly labeled and color coded with the NIOSH-approved label before being placed in service. Such labels shall not be removed, obscured, or defaced while the filter, cartridge, or canister is in service. Refer to pages 2-21 to 2-23 for more detailed information. TRAINING PROGRAM COMPONENTS The following components shall be addressed by respiratory protection training provided to employees: 1. Reasons for respiratory protection specific to task/job. 2. Respiratory hazard(s) employees may be exposed to: a. Nature of the hazard(s) b. Extent of the hazard(s) c. Effects of the hazard(s) May/2010 Page 9

10 3. An explanation of why engineering controls are not being applied or are not adequate to protect employees and what efforts are being taken to reduce or eliminate the need for respirators. 4. An explanation of why the specific type of respiratory protection has been selected. 5. Explanations of the operation, limitations, and capabilities of the selected respirator(s). 6. Instruction in procedures for: a. Inspecting the respirator(s) b. Donning and removing the respirator(s) c. Checking fit and seals of respirator(s) d. Wearing respirators, including giving sufficient practice to enable the employee(s) to become thoroughly familiar with, confident, and effective in performing the above tasks. 7. An explanation of maintenance procedures, including cleaning, disinfecting, and storage. 8. Instruction on how to deal with emergency situations involving the use of respirators or with respiratory malfunction. 9. Instruction on the contents of the Respiratory Protection Standard (29 CFR ) 10. Instruction on the written respiratory protection program, its location, and its availability. May/2010 Page 10

11 RESPIRATOR PROGRAM EVALUATION CHECKLIST (The following checklist is adapted from the NIOSH Guide to Industrial Respiratory Protection, and should be tailored to the specific worksite.) In general, the respirator program must be evaluated for each job and at least annually with program adjustments made, as appropriate, to reflect the evaluation results. Program function can be separated into administration and operation. A. Program Administration 1. Are feasible engineering controls or work practices used where practicable to eliminate the need for respirators? 2. Review written procedures/statements covering the various aspects of the respirator program, including: Respirator selection Purchase of NIOSH certified equipment Medical aspects of respirator equipment Issuance of equipment Fitting Training Maintenance, storage, and repair Inspection Use under special conditions; and Work area surveillance 3. Are changes required for any section of the written program? Yes No If yes, completion date: / / Responsible party to complete and implement required changes is. B. Program Operation 1. Respiratory protective equipment selection: Are work area conditions and worker exposures properly surveyed? Are respirators selected on the basis of hazards to which the worker is exposed? Are selections made by individuals knowledgeable of proper selection procedures? 2. Has a medical evaluation of the prospective user been made to determine physical and psychological ability to wear the selected respiratory protective equipment? May/2010 Page 11

12 3. Are the following assessed during respirator selection? Chin properly placed Positioning of mask on nose Strap tension Fit across nose bridge Room for safety glasses Distance from nose to chin Room to talk Tendency to slip Cheeks filled out Self-observation in mirror Adequate time for assessment 4. Are only NIOSH-certified respirators purchased and used? Do they provide adequate protection for the specific hazard and concentration of the contaminant? 5. Where practicable, have respirators been issued to the users for their exclusive use, and are there records covering issuance? 6. Respiratory protective equipment fitting: Are the users given the opportunity to try on several respirators to determine whether the respirator they will subsequently be wearing is the best fitting one? Is the fit tested at appropriate intervals? Are users prohibited from wearing contact lenses when using respirators? Is the face piece-to-face seal tested in a test atmosphere? Are workers prohibited from wearing respirators in contaminated work areas when they have facial hair or other characteristics that may cause face seal leakage? 7. Respirator use in the work area: Are respirators being worn correctly (e.g. head covering over respirator straps)? Are workers keeping respirators on all of the time while in the at-risk work area? 8. Maintenance of respiratory protective equipment: a. Cleaning and Disinfecting Are respirators cleaned and disinfected after each use when different people use the same device, or as frequently as necessary for devices issued to individual users? Are proper methods of cleaning and disinfecting used? b. Storage Are respirators stored in a manner to protect them from dust, sunlight, heat, excessive cold or moisture, or damaging chemicals? Are respirators stored properly in a storage facility in a manner to prevent them from deforming? May/2010 Page 12

13 Is storage in lockers and tool boxes permitted only if the respirator is in a carrying case? c. Inspection Are respirators inspected before and after each use and during cleaning: Are qualified individuals/users instructed in inspection techniques? Is respiratory protective equipment designated as emergency use inspected at least monthly (in addition to after each use)? Are SCBA incorporating breathing gas containers inspected weekly for breathing gas pressure? Is a record kept of the inspection of emergency use respiratory protective equipment (log or tag)? d. Repair Are replacement parts used in repairing those of the manufacturer of the respirator? Are repairs made by manufacturers or appropriately trained individuals? 9. Special Use conditions: Is a procedure developed for respiratory protective equipment usage in atmospheres immediately dangerous to life or health? Is a procedure developed for equipment usage for entry into confined spaces? 10. Training Are users trained in proper respirator use, cleaning, and inspection? Are users trained in the basis for selection of respirators? Are users evaluated, using competency-based evaluation, before and after training? May/2010 Page 13

14 RESPIRATOR USER LIST Employee Name Medical Evaluation Date Type of Respirator or Respirator Number Fit Test Date Date of Next Fit Test May/2010 Page 14

15 WRITTEN RESPIRATORY PROTECTION PROGRAM Prepared October 1997 PURPOSE The following written program is intended to help in identifying the respiratory hazards, ways to control them, selection of respirators, and the use and maintenance of respirators. Respirators are to be used when and where engineering or administrative controls are not feasible, while these controls are being installed and implemented, or in emergencies. This program supports compliance with OSHA s Respiratory Protection Standard and applies to all employees who use respirators. RESPONSIBILIIES The ARAMARK Manager, in cooperation with Northwest Missouri State University, will be responsible for: Issuing and administering the program and maintaining awareness of state and local requirements. Developing written standard operating procedures and instructions covering each of the basic elements in this program. Providing initial and periodic training on respirator use. Records of all training will be maintained by the manager and copies sent to the Safety Department at ARAMARK for recording purposes. Conducting hazard assessments to identify areas where airborne contaminants may exist. These will be maintained at the facility. Ensuring that respiratory protection equipment is approved by NIOSH. Auditing the program annually to ensure effectiveness, coordinate medical evaluations, and maintain associated records. Revise and update standard operating procedures. The ARAMARK Manager, appointed supervisors and Northwest Missouri State University will be responsible to: Know the hazards that require use of a respirator. Know the types of respirators that should be used by task/job. Enforce the wearing of respirators in areas where required. Ensure employees are knowledgeable about the equipment and the requirements for using a respirator. EXPOSURE EVALUATION An Exposure Assessment has been developed to assist in determining the need for respirators. Respirators are not to be used or assigned until such as assessment is completed. May/2010 Page 15

16 Records of exposure evaluation must be documented and maintained at the facility. MEDICAL EVALUATION An employee shall not be assigned to tasks that require the use of a respirator until it has been determined by a licensed physician that he/she is able to perform the work and wear a respirator. The employee s medical status shall be reviewed annually and at any time that the employee experiences difficulty breathing while being fitted for or using a respirator. Use forms Respirator Users Medical Evaluation (pg.6-7) to obtain the medical history and physician s opinion as to the capability of each user to wear a respirator. Complete the first page of Respirator Users Medical Evaluation (pg.6) and send a copy of the entire form along to the physician when the employee goes for medical evaluation. Direct the employee to bring back a copy of the second page (pg. 7) of Respirator Users Medical Evaluation (Memo to the Physician). This record along with the copy of the first page must be kept in a medical file for each employee. RESPIRATOR SELECTION Once the Exposure Assessment has been completed, and it has been determined that the job requires a respirator, the proper respirator must be chosen. The Material Safety Data Sheets and Types of Respirators chart will be used to decide this factor. The gas mask cartridge/filters will be selected according to Material Safety Data Sheets and the available charts. PROGRAM ELEMENTS WHICH WILL BE FOLLOWED EXPOSURE ASSESSMENT 1. All hazards will be assessed before respirators are used to decide whether a respirator is necessary. 2. Respirator selection will be based off of information gained from hazard assessment, etc. MEDICAL EVALUATION 1. All respirators users will be evaluated by a licensed physician 2. Records will be kept in a medical file for each employee. FIT TESTING 1. All users will be fitted prior to assignment. 2. Fit testing should take place annually 3. Employees with facial hair that interferes with the face piece-to-face seal must not be allowed to wear negative-pressure air-purifying respirators. 4. Fit testing records must be kept on each individual wearing a respirator. Fit testing will consist of the following steps: 1. Select the best size. 2. The user must receive instructions for fitting including demonstrations and practice in how to wear the respirator, how to adjust it, and how to determine if it fits properly. May/2010 Page 16

17 3. Test the seal of the respirator. (If employees will be wearing other personal protective equipment along with the respirator, it should be worn during the fit test. 4. Employee will be given opportunity to be checked for acceptable or unacceptable comfort of respirator. 5. Employee will be given opportunity to select a different respirator face piece and be retested as needed. PROCEDURES FOR FIT TESTING 1. Use of a Negative-Pressure, Positive Pressure, Qualitative Fit and Quantitative Fit as needed. 2. A representative from company respirator is being purchased from will be present for the fit test if at all possible. 3. A disposable size fit respirator will be used to determine the respirator to bring in. RESPIRATOR USE Specific procedures for the use of respirators in oxygen-deficient or unknown hazardous chemical locations will include the provisions outlined in the standard. 1. Respirators which rely on a tight face piece-to-face seal will not be worn by employees with conditions which prevent this. 2. Corrective glasses or goggles must not interfere with the face piece seal. 3. Respirators not in proper working condition are to be immediately repaired or discarded. 4. Disposable respirators which cannot be cleaned and sanitized must be discarded at the end of the task or work shift. Those which can be properly cleaned will be disposed of at the end of its useful life. Employees are responsible to complete fit test when donning respirator prior to going into the work area. OSHA or manufacturer recommendations shall be followed. 5. Where practicable, respirators shall be assigned to individual workers for their exclusive use and recorded on the USER LIST (pg.14). Use the Respirator Fit Test & use evaluation checklist (pg. 3) to review respirator fit. INSPECTION, MAINTENANCE AND CARE Respirators will be collected regularly and inspected for defects (including a leak check), to make sure that they are performing up to standard and are providing the proper protection to the wearer. Use Respirator Inspection Report (pg. 4-5) or representative s forms. Any employee who does not know how to properly inspect their respirator must ask for assistance from their supervisor. Every employee who has finished wearing a disposable respirator that is to be used only once will place the respirator in the appropriate trash or disposable container. It will not be taken from the premise for additional use or used a second time under any circumstances. 1. Inspection Routinely-used respirators shall be inspected by user each use and during and after cleaning after each use. Emergency respirators checked at least monthly May/2010 Page 17

18 and before and after use. Inspections shall occur according to standards. Emergency-use respirator inspections shall be certified in writing in accordance with standard. 2. Cleaning and Disinfecting Respirators shall be cleaned and disinfected using appropriate procedures. Respirators used by one user only shall be cleaned and disinfected at the end of each day s use; those issued to more than one employee and emergencyuse respirators shall be cleaned and disinfected after each use. An employee must never wear a dirty or defective respirator. RECOMMENDED PROCEDURES FOR CLEANING AND DISINFECTING RESPIRATORS WILL BE PLACED IN THE PROCEDURES MANUAL FOR CUSTODIANS. PROGRAM EVALUATION The respiratory protection program must be reviewed at least annually and frequent random inspections will be conducted to ensure compliance with the provisions of the program. The review must include all elements covered in this written program. Employees shall be consulted periodically to assess wearer acceptance and to correct any problems that are revealed. Assessment factors include: prevention of illness, proper respirator selection and fitting, whether used when necessary, and proper maintenance. RECOMMENDED FORMS TO BE USED WITH RESPIRATOR PROGRAM If a provider is not being used for the training selection program, and all other areas covered in this written program; all the following forms are being provided for the Directors, Supervisors and employees to follow. May/2010 Page 18

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