The Use and Effectiveness of Powered Air Purifying Respirators in Health Care Workshop Summary (2015) / Chapter Skim
Currently Skimming:
2 Defining PAPRs and Current Standards
2 Defining PAPRs and Current Standards
Pages 7-18
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 7... ...
. NIOSH CERTIFICATION STANDARDS Roland Berry Ann National Personal Protective Technology Laboratory OSHA regulates workplace implementation of respiratory protection programs (29 CFR 1910.134)
|
From page 8... ...
air SOURC OSHA, 20 CE: 011. FIGUR 2-2 Examp of loose-fit RE ples tting powered a purifying re air espirators.
|
From page 9... ...
One part of NIOSH's certification testing for PAPR filters is a silica dust loading test, which is a method used to test for filter effectiveness in work conditions found in industrial settings, principally mining. Mining activities typically expose workers to dusty conditions and require workers to engage in moderate to high physical exertion rates, which means that respirators used in these settings must have high airflow rates to meet worker breathing demands.
|
From page 10... ...
Berry Ann suggested that potential next steps for PAPRs for health care could include • Assessing the potential for a new respirator class structure that would meet different performance requirements; • Developing strategies for the selection and use of PAPRs with alternate flow-rate levels that could match the respiratory needs of various types of health care workers and could address com fort and tolerability concerns; • Conducting workplace studies to determine the work exertion rates for different types of health care workers and settings as well as the "net effect of alternative PAPR flow rates on health care worker protection"; and • Assessing the International Organization for Standardization (ISO) requirements for respiratory protective devices to see if they could be used to inform improvements in NIOSH regulations.
|
From page 11... ...
The standard also requires, with some exceptions, the use of PAPRs for high-hazard proce dures (such as sputum induction, administration of aerosolized medications, bronchoscopy, and pulmonary function testing) that may involve airborne infectious diseases or aerosol transmissible pathogens.3 2 Infectious diseases identified by the Centers for Disease Control and Prevention's Healthcare Infection Control Practices Advisory Committee that require airborne infection isolation include tuberculosis, severe acute respiratory syndrome (SARS)
|
From page 12... ...
Some health care facilities have tried using surgical masks under the loose-fitting head coverings or placing the ends of the PAPR hood under the surgical gown, but neither is a tested or certified configuration. There appears to be little reliable information on infection risks from using a standard surgical ensemble, which includes a surgical cap and facemask, compared to the risks from using a PAPR, nor is there much information about how those risks can be reduced.
|
From page 13... ...
However, PAPRs are often not used in cases where the onus is on the individual health care worker to request the PAPR and there are no effective procedures to mobilize the resource. "We need NPPTL to develop criteria that satisfy infection control goals as well as employee protection in order for these respirators to be broadly accepted in health care," stated Gold.
|
From page 14... ...
ISO assigns respiratory protective devices to one of six classes based on the results of a total inward leakage (TIL) test.6 One of 6 In the TIL test, a person wears the PAPR in a chamber into which particulates (such as sodium chloride)
|
From page 15... ...
Gas and vapor Classified by capacity Classified by capacity and work rate Selection and use Varies by region or coun- Based on ISO try but generally based on classification, the protection factors protection level is linked to the TIL NOTES: ISO = International Organization for Standardization; NIOSH = The National Institute for Occupational Safety and Health; SCBA = Self-contained breathing apparatus. the areas needing further exploration is the correlation between how a device performs in the TIL test and how it performs in real work experiences.
|
From page 16... ...
acceptable protection levels and how these levels should be determined for health care workers, (2) performance criteria and the determination of the protection factors of PAPRs, (3)
|
From page 17... ...
Stating that it is important to understand the level of protection needed and the workplace performance requirements in order to assess lower flow rate products, Metzler also commented that further efforts are needed to determine if the TIL test used in Europe is "equivalent to and predictive in a manner that OSHA's assigned protection factors are." OSHA has determined APFs that apply to all respirators of a specific type or class (e.g., the APF for loose-fitting PAPRs is 25 and for full facepiece tight-fitting PAPRs is 1,000) ; ISO standards would base the protection factor on the results of the TIL tests for a specific product.
|
From page 18... ...
Gold stated that "we have to figure out how we are going to address employee protection as well as the protection of the sterile field." Discussions of respiratory protection for health care workers should encompass the education and training of those workers. Frank Califano, North Shore–Long Island Jewish Health System, noted that the use of respirators by health care workers is complicated because the workers may not use respirators as part of their daily routine and therefore respirator use is "out of the norm," suggesting that "maintaining the equipment, maintaining the training level, [and maintaining the]
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.