In the peak of the flu season you might see many people wearing masks. Do these protect the person wearing them? Do they protect you? Is that considered a respirator? These questions are important, but there are others you should ask about respiratory protection, especially if you work in a lab or clinic setting.

OSHA’s Respiratory Protection standard (1910.134) provides information about requirements for staff who may potentially be exposed to airborne pathogens. These requirements include specific instructions for choosing the proper respirator, for providing fit-testing, and for user training. The College of American Pathologists (CAP) also expects labs to determine the risk of airborne pathogen exposure for each employee, and they require labs to have a plan which outlines engineering and work practice controls that reduce exposure potential.

The purpose of a respirator is to protect the employee from contaminated or oxygen-deficient air. Therefore, two classes of respirators are common; air-purifying respirators which use filters to remove contaminants from the air you breathe, and atmosphere-supplying respirators which provide clean air from an uncontaminated source. These types of respirators can also be classified further as tight-fitting or loose-fitting.  Tight-fitting respirators need a tight seal between the respirator and the face and/or neck of the user in order to work properly.

There are a variety of respirators available that may be used in the laboratory. N95 masks are probably the most commonly-used respirators, often used for protection against tuberculosis and other airborne bacteria. N95 respirators are air-purifying and tight-fitting. Gas respirators (full-face or half-face) are tight-fitting and can be used in situations where harmful vapors may be encountered. Some gas respirators may be atmosphere-supplying, and others filter air through cartridges or canisters. Procedure masks, such as those handed out when people suspect they have the flu, are not technically considered respirators. The person who is sick should wear these masks in order to prevent the spread of droplets when coughing or sneezing. They protect others in the area, but they do not protect the used from harmful airborne pathogens or vapors.

Employees who may need to wear a tight-fitting respirator as part of their job are required to have fit-testing every year. This is required by OSHA, and contracted employees (such as pathologists) should be fit-tested as well. Employees who may need such respirators would be those who work in microbiology labs, cytology techs who participate in patient procedures, histology staff who work with formaldehyde, and others. Labs should perform a risk assessment for each job category to determine the type and level of potential harmful airborne exposure.

If an employee fails fit-testing, the organization will need to make a decision about how to proceed. Sometimes, the inability to be properly fitted for a respirator can alter a job or a career. In other cases, using a different fit-testing method or selecting a different respirator type can solve the issue.  Make sure staff who need tight-fitting respirators are clean-shaven (or can shave immediately when the need for a respirator arises).  Once staff is fit-tested, be sure to stock the proper respirators (and the correct sizes) in the department. Dangerous scenarios can arise when staff wears the wrong size respirator.

There is much to consider when protecting your staff from airborne contaminants or pathogens, and managing the respiratory protection program may take collaboration with other departments in the facility that help manage the process. Be sure to work together to ask the right questions and to make sure your staff is properly trained and protected to work in environments where the air is not safe to breathe.