H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health...
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Transcript of H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health...
H1N1 and OSHA/PESH RegulationsH1N1 and OSHA/PESH Regulations
New York State New York State Department of LaborDepartment of Labor
Public Employee Safety and Health Bureau PESH
James Cutrone- Garden City/White Plains District Supervisor
Barbara Stanley- Garden City Industrial Hygiene Technical Supervisor
ObjectivesObjectives Describe PESH and it’s jurisdiction in NYS Identify what PPE should be worn and when in regards to
H1N1 Outline the elements of the PPE standard that apply Explain what and when respiratory protection is required Outline the elements of the respiratory protection standard
that apply Describe and demonstrate fit testing options Provide resources for you to develop a respiratory protection
plan and a PPE Hazard Assessment. Recordkeeping
PESH JurisdictionPESH Jurisdiction
Enforcement of OSHA/PESH Regulations in Places of Public Employment, specifically State County City Towns Villages
Includes Fire Departments, Fire Districts, Fire Protection Districts, Publicly Owned EMS, Fire Department EMS and Volunteer EMS Districts
Does not cover Independent Not for Profit Corporations
PESH STAFFPESH STAFF
Enforcement Staff Industrial Hygienists Safety Inspectors
Consultation Staff Industrial Hygienists Safety Consultants
H1N1- What We KnowH1N1- What We Know Novel Virus Spread throughout the world – WHO Phase 6 “Pandemic” Range of symptoms similar to seasonal flu
Fever, cough, sore throat, fatigue, headache, body aches, lethargy, stuffy nose, chills (some with diarrhea, vomiting)
Severity similar to seasonal flu Higher risk for complications:
Lung disorders, asthma, emphysema Heart, kidney, liver, blood disorders Diabetes Weakened immune system Pregnant women Long term aspirin therapy >65 and < 5 years old
Immunity seen in people older than 60????
H1N1 Guidance Documents H1N1 Guidance Documents
CDC OSHA FDA NYSDOH NYCDOH APIC SHEA Etc………
CDC- Interim Guidance for EMS Systems and 911 CDC- Interim Guidance for EMS Systems and 911 PSAPs for Management of Patients with Confirmed or PSAPs for Management of Patients with Confirmed or Suspected Swine-Origin Influenza A (H1N1) InfectionSuspected Swine-Origin Influenza A (H1N1) Infection
Complements CDC Interim Guidance for Healthcare Settings Don PPE for suspected cases prior to entering the scene If during assessment, symptoms indicate a possible case- don PPE. PPE:
Fit tested N95 respirator Eye Protection (goggles or face shield) Disposable non-sterile gloves Gown
Encourage good vehicle airflow/ventilation Follow Basic Infection Control procedures
Decontamination, hand hygiene, cough and respiratory hygiene All patients with acute febrile respiratory illness should wear a surgical
mask, if tolerated by patient
CDC-Interim Guidance for Infection Control CDC-Interim Guidance for Infection Control for Care of Patients with Confirmed or for Care of Patients with Confirmed or
Suspected Novel Influenza A (H1N1) Virus Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare SettingInfection in a Healthcare Setting
Interim guidance for healthcare facilities and other settings where healthcare is provided
Supports what is outlined in EMS and PSAP document
OSHA/PESH RequirementsOSHA/PESH RequirementsDuring PandemicsDuring Pandemics
NIOSH certified respirator for close contact with ill people N95 is minimal level of protection
Very High Risk Workers - exposed while performing specific medical or laboratory procedures
High Exposure Risk Workers – high potential for exposure to known or suspected pandemic sources e.g. doctors, nurses, other hospital staff and emergency responders transporting sick patients
Other Workers- not normally at risk, but are performing high risk tasks such as isolating and quarantining people who are ill
Hazard AssessmentHazard Assessment
Upon entering the scene Treating suspect or confirmed cases Cleaning vehicle after patient is transported
N95 respirator required when treating a suspect or confirmed H1 N1 case
OSHA/PESH RegulationsOSHA/PESH Regulationsand Requirementsand Requirements
29CFR 1910.132
29CFR1910.134
29CFR1910.1020
PPE Standard (29CFR1910.132)PPE Standard (29CFR1910.132)General RequirementsGeneral Requirements
Protective equipment shall be provided, used and maintained in a sanitary and reliable condition whenever it is necessary by reason of hazards….
Hazard Assessment and Equipment Selection Written Certification Training
Particulate RespiratorsParticulate RespiratorsNIOSH Approved Filtering FacepieceNIOSH Approved Filtering Facepiece
Nine classes of filters Three levels of filter efficiency Each with three categories of resistance to filter efficiency
degradation Filter Efficiency:
99.97% (HEPA) 99% 95%
Resistance to filter efficiency degradation N- not resistant to oil R- is resistant to oil P- oil proof
29CFR1910. 134- Respiratory Protection29CFR1910. 134- Respiratory Protection
(a) Permissible practice
(b) Definitions
(c) Respirator program
(d) Selection of respirators
(e) Medical evaluation
(f) Fit testing
(g) Use of respirators
(h) Maintenance and care
(i) Breathing air quality and use
(j) Identification of filters, cartridges, and canisters
(k) Training and information(l) Program evaluation(m) Recordkeeping(n) Dates (o) Appendices (mandatory)
A: Fit Testing ProceduresB-1: User Seal ChecksB-2: Cleaning ProceduresC: Medical QuestionnaireD: Information for Employees Wearing Respirators When Not Required Under the Standard
Written Program ElementsWritten Program Elements Procedures for selecting respirators Medical evaluations Fit testing procedures Procedures for proper use in routine and reasonably foreseeable
emergencies Procedures and schedules for cleaning, disinfecting, storing,
inspecting, repairing, discarding, otherwise maintaining respirators
Training of employees in the hazards they are potentially exposed to
Training in the proper use and any limitations on use and maintenance
Procedures for regularly evaluating the effectiveness of the program
Fit Testing Fit Testing (cont’d)(cont’d)
The fit test must be administered using an OSHA-accepted QLFT or QNFT protocol contained in Appendix A QLFT Protocols:
Isoamyl acetate Saccharin Bitrex Irritant smoke
QNFT Protocols: Condensation Nuclei Counter (PortaCount) Generated Aerosol (corn oil, salt, DEHP) Controlled Negative Pressure (Dynatech FitTester 3000)
Recordkeeping RequirementsRecordkeeping Requirements
29 CFR 1910.1020 Records of medical evaluations must be retained and made available
29 CFR 1910.134 A record of fit tests must be established and retained until the next fit test
is administered Written copy of the current program Written materials required to be retained must be made available upon
request to affected employees and OSHA/PESH
ReferencesReferences CDC- Interim Guidance for EMS Systems and 911 PSAPs for
Management of Patients with Confirmed or Suspected Swine-Origin Influenza A (H1N1) Infection
CDC-Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare Setting
OSHA 3328-05 2007 Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers
OSHA 3327-02N 2007 Preparing Workplaces for a Pandemic EPA- Antimicrobial Products Registered for Use Against the H1N1 Flu
and Other Influenza A Viruses on Hard Surfaces OSHA’s Quick Cards www.cdc.gov www.osha.gov