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Avian Flu Plan: Appendices > Appendix D <- You Are Here

Appendix D: Instructions for Employees Who Request Voluntary Use of a Respirator During an Avian Influenza Pandemict [PDF]

Prepared by the Department of Environmental Safety (DES)
Latest Version of Protocol: June 12, 2006

NOTE of CAUTION: Since information related to pandemic influenza or avian influenza is subject to frequent and significant changes, readers of this document should check with DES to ensure they have the most recent version.

Your employer is responsible for determining if you should wear a respirator while performing your job duties during an avian influenza pandemic. If you have been told that a respirator is not necessary but you have requested to wear one, your employer will decide if "voluntary use," as defined by the Occupational Safety and Health Administration (OSHA) in 29 CFR 1910.134, is permitted.

It is important to note that the route of transmission of avian influenza to humans is not known at this time. A respirator will not eliminate the risk of exposure, infection or illness.

Before you may wear a respirator under OSHA�s voluntary use criteria, you must read and understand the following:
  1. Be sure to follow hand hygiene and respiratory etiquette procedures at all times as the best way to prevent you from getting sick. Hand hygiene means washing your hands frequently during your work shift with soap and water or using a waterless alcohol-based hand sanitizer, especially after touching potentially contaminated surfaces such as door handles, public telephones and restroom surfaces and after removing protective gloves, a respirator or a surgical mask. Respiratory etiquette means covering your cough and sneeze with a tissue and disposing of the tissue in a proper trash receptacle.
  2. You should contact your primary care physician or other qualified medical provider to determine if it is safe for you to wear a respirator. You may not be able to safely wear a respirator if you have a lung disease such as asthma or emphysema or have trouble breathing, if you have claustrophobia, or vision problems.
  3. You may not wear a respirator on a voluntary basis if it creates an unsafe condition for you while you are working. For example, a respirator that partially obstructs your vision or prevents you from wearing eyeglasses cannot be worn while driving a motor vehicle or operating heavy machinery and power tools.
  4. The respirator that is recommended by the Centers for Disease Control and Prevention (CDC) for use for Avian Influenza exposure in healthcare workers is an N95 particulate respirator. A particulate respirator may not be used for protection from gases, vapors or mists.
  5. Check with your supervisor about the availability of respirators, where and how you can get a respirator. It is possible that you may be told you will need to provide your own respirator. If you are providing your own respirator, be sure to choose the size that fits you the best. If your supervisor is providing the respirator for you, you may be asked to provide your size (regular or small).
  6. Before you wear the respirator, you must carefully read the instructions that are provided by the manufacturer on use, maintenance, cleaning or disposal, care, and warnings regarding respirator limitations. Your supervisor is required to provide you with a copy of 29 CFR 1910.134 � Appendix D, OSHA�s criteria for voluntary use of respirators which is attached to this document. Read this information carefully and let your supervisor know if there is anything you do not understand.
  7. If you wear a disposable respirator, be sure to discard it if it becomes dirty, contaminated, wet, or damaged. Respirators that are not saturated with blood or body fluids may be disposed of in regular trash receptacles. Respirators that are saturated with blood or body fluids must be disposed of in medical waste receptacles that are found in the Health Center or other healthcare facility.

Information for Employees Using Respirators When Not Required
(From 29 CFR 1910.134—Appendix D)

Respirators are an effective method of protection against designated hazards when properly selected and worn. Respirator use is encouraged, even when exposures are below the exposure limit, to provide an additional level of comfort and protection for workers. However, if a respirator is used improperly or not kept clean, the respirator itself can become a hazard to the worker. Sometimes, workers may wear respirators to avoid exposures to hazards, even if the amount of hazardous substance does not exceed the limits set by OSHA standards. If your employer provides respirators for your voluntary use, of if you provide your own respirator, you need to take certain precautions to be sure that the respirator itself does not present a hazard. You should do the following:
  1. Read and heed all instructions provided by the manufacturer on use, maintenance, cleaning and care, and warnings regarding the respirator�s limitations.
  2. Choose respirators certified for use to protect against the contaminant of concern. NIOSH, the National Institute for Occupational Safety and Health of the U.S. Department of Health and Human Services, certifies respirators. A label or statement of certification should appear on the respirator or respirator packaging. It will tell you what the respirator is designed for and how much it will protect you.
  3. Do not wear your respirator into atmospheres containing contaminants for which your respirator is not designed to protect against. For example, a respirator designed to filter dust particles will not protect you against gases, vapors, or very small solid particles of fumes or smoke.
  4. Keep track of your respirator so that you do not mistakenly use someone else's respirator.
By my signature, I acknowledge that I am not required to wear respiratory protection and that I understand the above precautions.


Signature: ______________________________________

Date: ___________________

Department/Unit: ________________________________________________________

A copy of this signed form must be given to the employee and the original kept by the employee�s department.

Informaci�n Para los Empleados Que Usan Respiradores Cuando No lo Exige el

Reglamento 29 CFR 1910.134 o el Empleador

(Tomado de: 29 CFR 1910.134 � Appendix D)

Los respiradores son un m�todo de protecci�n efectiva contra riesgos identificados, cuando se han seleccionado y utilizado adecuadamente. El uso de los respiradores se fomenta, inclusive cuando la exposici�n esta por debajo de los limites de exposici�n (m�xima cantidad o concentraci�n de un qu�mico a la que un trabajador pueda estar expuesto seg�n las normas de OSHA), para ofrecer bienestar y protecci�n del empleado. Sin embargo, el respirador puede causarle da�o si no se mantiene limpio o si no se usa correctamente. Algunas veces los empleados usan los respiradores para evitar ser expuestos a diferentes riesgos, inclusive si la cantidad de la sustancia peligrosa no excede los valores l�mites establecidos por los reglamentos de la Administraci�n de Salud y Seguridad Ocupacional (OSHA). Si su empleador provee los respiradores para uso voluntario, o s� usted provee su propio respirador, necesita tomar ciertas precauciones para que se asegure que el mismo respirador no represente un riesgo para usted. Usted debe hacer lo siguiente:
  1. Lea y haga caso a todas las instrucciones que provee el fabricante en el uso, mantenimiento, limpieza y cuidado, y las advertencias en cuanto a las limitaciones de los respiradores.
  2. Escoja respiradores certificados contra los contaminantes que le interesa. La Instituci�n Nacional para la Seguridad y Salud Ocupacional (NIOSH) del Departamento de Salud y Servicios Humanos de los Estados Unidos de Am�rica, son los que certifican los respiradores. Una etiqueta o certificado de exposici�n debe aparecer en el respirador o en el empaque del respirador. Este debe decirle para que qu�micos fue dise�ado y cuanto le va a proteger.
  3. No use su respirador en atm�sferas que contienen contaminantes para los cuales no fue dise�ado porque no le va a proteger. Por ejemplo, si un respirador es dise�ado para filtrar part�culas de polvo no le va a proteger contra gases, vapores o part�culas s�lidas de vaho (mal olor) o humo.
  4. No pierda de vista su respirador para que as� no use el respirador de otra persona por equivocaci�n.

    Firmando esta forma, reconozco que no estoy obligado a usar protecci�n respiratoria y que entiendo las precauciones anteriores.

Firma: ______________________________________

Fecha: _________________

Departamento/Unidad: ___________________________________________________

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