RESPIRATOR PROTECTION Z PROGRAM (RPP) - colby.edu · 4.5 The RPP Administrator or WPH will conduct...

CEHS-PR-H03 (rev: E)

Respirator Protection Program Colby College 5500 Mayflower Hill Waterville, ME 04901 1 of 14

Z

RESPIRATOR PROTECTION PROGRAM (RPP)

CEHS-PR-H03

Colby Environmental, Health, and Safety Procedures, Programs, and Policies

CEHS-PR-H05 Respirator Protection Program

CEHSPPP



REVISION HISTORY

This program is reviewed annually per Colby College policy and amended as necessary to reflect

workplace changes that affect respirator use, including but not limited to the following:

Equipment or process changes

Introduction of new respiratory hazards

Changes in respirators

Issues noted by respirator users

REVISION DESCRIPTION OF CHANGE REVISION EFFECTIVE DATE

REVISION COMPLETED BY: NAME / COMPANY

MANAGER APPROVAL / DATE

A Initial program 2/2015 Wade Behnke / Colby College

Mark Crosby

B Updated Appendix G,

Authorized Respirator Users

2/2016 Wade Behnke / Colby College

Mark Crosby

C Updated Appendix G,



Mark Crosby

D

Updated Appendix G, Authorized Respirator Users

Medical questionnaires will be completed per conditions listed in Section 4.3.4 (not annually)


Mark Crosby

E

Updated Appendix G, Authorized Respirator Users

Revised to Meet CEHSPPP format


Mark Crosby

This plan is maintained by the Environmental, Health, and Safety Director. Please direct and

concerns or comments to the Director.



TABLE OF CONTENTS: 1.0 PURPOSE

2.0 SCOPE

3.0 RESPONSIBILITIES

4.0 PROCEDURE

5.0 RECORDS

6.0 TRAINING

7.0 DEFINITIONS

APPENDICES: Appendix A: Voluntary Use Respirator Form

Appendix B: Respirator Selection Table

Appendix C: Cartridge Change Out Schedule

Appendix D: Medical Evaluation Questionnaire

Appendix E: Respirator Manufacturer Technical Information

Appendix F: Respirator Inspection Form

Appendix G: Authorized Respirator Users



1.0 PURPOSE

1.1 This program is intended to protect Colby College employees from respiratory

hazards that they may encounter in the workplace and to ensure compliance with

United States Occupational Safety and Health Administration (OSHA) Respiratory

Protection Standard (29 Code of Federal Regulations [CFR] 1910.134).

1.2 Good industrial hygiene practice emphasizes exposure prevention and

minimization. Colby will minimize the use of respirators/PPE by following the

hierarchy of safety controls in the order listed below:

Materials elimination or substitution,

Engineering controls,

Administrative controls and work practices, and

Personal protective equipment (PPE).

2.0 SCOPE

2.1 This written RPP applies to all Colby employees who are required to use

respirators.

2.2 Voluntary use of respirators at Colby is limited to the use of dust masks only.

Employees who are authorized to use respirators even though their use is not

required by OSHA will be provided OSHA 29 CFR 1910.134 Appendix D

(reprinted and included herein as Appendix A, Voluntary Respirator Use

Documentation Form). Employees will be required to sign a copy of Appendix D,

which Colby’s RPP Administrator will maintain in a file for documentation

purposes. The RPP Administrator will answer any questions employees may

have regarding their voluntary use of respirators.

3.0 RESPONSIBILITIES

3.1 Responsibilities for oversight and implementation of Colby College’s RPP are

assigned below. Identified personnel may designate tasks assigned to them to a

qualified employee or consultant, as appropriate.

3.2 Environmental, Health, and Safety (EHS) Director

Act as Colby College’s RPP Administrator;

Provide training to required respirator wearers in compliance with this

Program and the OSHA standard;

Maintain and annually review the written Program;

Implement and oversee this Program;



Ensure that each employee included in the RPP is provided the medical evaluation, fit test, equipment and information necessary to fulfill the requirements and purposes specified within the scope of this RPP; and

Identifying processes or areas where respiratory protection may be

required and determine applicability.

3.3 Respirator Wearing Employees

Follow all Colby College and respirator use procedures to ensure the

effectiveness of this program;

Attend and actively participate in training provided by Colby to ensure their

health and safety;

Properly clean, store, and wear their respirator in accordance with this

Program;

Answer medical questionnaires truthfully and completely in order for the

medical evaluation to effectively protect their health (note that these

questionnaires are confidential medical records and will not be reviewed by

Colby College); and

Notify the RPP Administrator or, in his absence, their supervisor, of any

questions or concerns regarding respiratory hazards that may be

encountered in the workplace.

4.0 PROCEDURE

4.1 Respirator Selection

4.1.1 Respirator selection requires correctly matching the respirator with the

hazard, the user, and the work environment. The respirator selected

must be adequate to effectively reduce the exposure of the user under all

conditions of use, including reasonably foreseeable emergency situations.

Proper respirator selection involves choosing a device that fully protects

the employee from the respiratory hazard and permits the employee to

perform the job with minimal physical burden.

4.1.2 Applicable industrial hygiene air monitoring results have been included

in Appendix B, Respirator Selection Table, which lists the results for a

required task alongside applicable PELs and/or TLVs as well as the

appropriate respirator for the task as determined by the air monitoring

or Colby College policy.

4.1.3 Appendix B, Respirator Selection Table, identifies all job tasks and

process areas at Colby where a respirator use is required. The RPP

Administrator is responsible for identifying new tasks and/or areas

where respiratory protection may be required. In addition, all Colby

employees are expected to inform the RPP Administrator, or, in his

absence, their direct supervisor, of any respiratory hazard concerns. All



potentially applicable respiratory hazard areas or activities should be

entered into Appendix B.

4.1.4 When exposure levels have the potential to exceed the PELs but have not

been tested, the area or task will be considered respirator required until

air monitoring can be conducted.

4.1.5 Ensure that affected employees are medically cleared to use the

respirator type(s) that will be required for their specific job tasks. Ensure

that all other RPP elements are satisfied (i.e. affected employees must be

fit tested and trained with the new respirators).

4.2 Additional Respirator Selection Criteria

4.2.1 When the atmosphere is immediately dangerous to life and health (IDLH),

OSHA requires the use of full-face Pressure Demand Respirators with

minimum 30-minute air supply. Supplied air respirators are required

when a gas or vapor has an odor threshold below the PEL or TLV.

Note: Colby College employees are not allowed to enter into an IDLH

atmosphere or an atmosphere where a supplied air respirator or

SCBA is required.

4.2.2 Corrective lens inserts, or contacts, are encouraged for persons requiring

vision correction in order to avoid interference with the respirator

facepiece seal. If an employee wears corrective eyeglasses, they must be

worn during the fit testing procedure and must not interfere with the seal

of the facepiece to the face.

4.2.3 Respirators assigned to higher protection factor classes may be used for

lower class exposures (i.e., an employee authorized to wear a cartridge

respirator for working in the spray booth, for example, is permitted to

use the respirator for a less hazardous activity).

4.2.4 All respirators and respirator parts, including filters and

cartridges/canisters, must be NIOSH-certified.

4.2.5 For protection against gases and vapors, an air-purifying respirator

(APR) equipped with appropriate organic vapor (OV) cartridges or

canisters may be used, provided that it is suitable to the work being

performed and that there is an end of service life indicator (ESLI) or an

adequate cartridge or canister change-out schedule. See Appendix C,

Cartridge Change Out Schedule and Appendix B, Respirator Selection

Table for more information.

4.2.6 Respirators and cartridges/canisters that are selected will be specifically

rated for all anticipated substances to which personnel may be exposed.

In cases where protection from multiple contaminants is necessary, Colby

will ensure that the respirator is appropriate for each contaminant and

can handle the maximum anticipated concentration of each substance.



4.3 Medical Evaluations

4.3.1 Due to the physical burden associated with respirator use, before use an

initial medical evaluation is required to ensure that it will not create a

health hazard for the employee. The degree of burden varies with the

type of respirator, task, workplace conditions, and physical health of the

employee. The medical evaluation will include completion of the

confidential Respirator Medical Evaluation Questionnaire (Appendix D)

and may include a medical exam if deemed appropriate by medical

provider. Medical exams are typically required for a positive response on

the questionnaire or use of a cartridge respirator.

4.3.2 The medical provider (physician or other PLHCP) clinic for Colby College

is Workplace Health (WPH), Waterville, Maine.

4.3.3 Colby will provide WPH with a copy of this RP Program, and the following

additional information as needed:

The type of the respirator(s) the employee will use,

The duration and frequency of respirator use,

The expected physical work effort and conditions, and/or

Additional protective clothing and equipment the employee will

use.

4.3.4 WPH will provide follow-up medical evaluations/physicals if deemed

necessary by the physician reviewing the evaluation or in the following

instances:

The employee reports medical signs or symptoms related to their

ability to wear a respirator;

The employee’s supervisor, RPP Administrator, fit tester, or

physician requests a new evaluation;

A change in workplace conditions (e.g. physical/work effort, PPE,

temperature, etc.) or a RPP evaluation warrants re-examination;

and /or

4.3.5 Colby will obtain a written recommendation (determination) from WPH

regarding the employee's ability to use a respirator. The determination

shall provide the following information:

Whether the employee is medically able to use the respirator,

including any limitations placed on respirator use related to the

employee's medical condition or relating to workplace conditions

where the respirator will be used;

The need, if any, for follow-up medical evaluations; and

A statement that the physician or PLHCP has provided the

employee with a copy of the physician or PLHCP's written

recommendation.



4.4 A respirator fit test must be completed following a successful medical evaluation

and before an employee is required/allowed to use any respirator. The fit test

must be completed with the same make, model, style, and size of respirator that

will be used. Fit testing will be performed at the following frequency:

Prior to the employee's initial use of the respirator;

At least annually;

Whenever a different respirator facepiece is used (size, style, model or

make); and

Whenever the employee, RPP Administrator, physician or PLHCP,

supervisor, or others report or observe that a change in the employee's

physical condition could affect the fit of the respirator (e.g., scarring,

dental changes, or large weight gain/loss).

4.5 The RPP Administrator or WPH will conduct qualitative fit tests. Fit tests will be

conducted in accordance with OSHA/manufactured recommended fit test

protocols and procedures. If after passing a fit-test the employee notices that the

respirator fit is unacceptable, they must inform their supervisor or the RPP

Administrator. In such an instance, the employee will be provided an

opportunity to select a different respirator and be retested. Fit test records will

include the following minimum information:

Name and identification of the employee tested;

Type of fit test performed;

Specific make, model, style, and size of the respirator tested;

Date of the test; and

Result of the test.

4.6 Employee Fit Check Procedure

4.6.1 Each employee is required to perform a facepiece seal check (also known

as “fit check”, “seal check” or “leak test”) every time they put on a

respirator. The user has the option of using either positive or negative

seal checks or the respirator manufacturer’s recommended method

(technical data sheets for respirators used at Coby, including

manufacturer’s recommended fit check procedures, are provided in

Appendix E, Respirator Manufacturer Technical Information). Basic

pressure checks are summarized below.

Positive Pressure Check -- Close off the exhalation valve and

exhale gently into the facepiece. The fit is considered satisfactory

if a slight positive pressure can be built up inside the facepiece

without any evidence of outward leakage of air at the seal. For

most respirators, this method of leak testing requires the wearer

to first remove the exhalation valve cover before closing off the

exhalation valve and then carefully replacing it after the test.



Negative Pressure Check -- Close off the inlet opening of the

canister or cartridge(s) by covering it with the palm of the hands

or by replacing the filter seals. Inhale gently so that the facepiece

collapses slightly, and hold your breath for 10 seconds. If the

cartridge inlet opening cannot be fully covered with your palm,

the test can be performed by covering the inlet opening with a

latex glove. If the facepiece remains slightly collapsed and no air

leakage is detected then the respirator seal is satisfactory.

4.7 General Respirator Use Requirements

4.7.1 Only authorized and trained employees may use respirators; and they

may use only the respirator that they were trained on and properly fitted

to use. Appendix G list all current authorized Colby College respirator

users.

4.7.2 Employees must use the proper respirator for the job as is called for by

this Program or determined by the RPP Administrator or consulting

industrial hygienists.

4.7.3 Employees who are required to wear a respirator shall notify their

supervisor and/or the RPP Administrator of any physical stress resulting

from using a respirator.

4.7.4 Respirator wearers shall maintain and store respirators in accordance

with this RPP and associated training.

4.7.5 Colby employees must leave the respirator use area:

To clean the face-piece, etc;

If they detect or suspect respiratory failure; or

To replace respirator filters, cartridges, or canisters.

4.8 Respirator Use Prohibitions

4.8.1 Any condition which interferes with the face-to-facepiece seal, such as

facial hair.

4.8.2 Using a defective or damaged respirator.

4.8.3 Using defective or damaged canisters or cartridges or those with illegible

or removed labels.

4.8.4 Removing respirators in hazardous environments.

4.8.5 Improper storage of a respirator.

4.8.6 Sharing of a respirator resulting in the use of a respirator by an employee

who is not authorized and trained to do so.

4.8.7 Any other activity or condition which could adversely impact the

effectiveness of the respirator or is otherwise in contrast to this RPP.

4.10 Procedures for Emergency Use or Unknown Atmospheres

4.10.1 Colby employees are not permitted to use respirators for emergency use.



4.10.2 Colby employees must leave the respirator use area if there is any

indication of respirator failure, including but not limited to if the

employee:

Detects contaminant odor or taste;

Experiences dizziness, headache, or other adverse medical

symptoms;

Experiences changes in breathing resistance, shortness of breath,

coughing, chest pain or wheezing; and/or

Identifies facepiece leakage or other respirator deficiency.

4.10.3 Colby employees are prohibited from entering IDLH atmospheres.

Unknown potentially hazardous atmospheres must be treated as if they

are immediately dangerous to life and health. If these situations arise,

contact the RPP Administrator.

4.11 Respirator Cleaning

4.11.1 Respirators are to be maintained in good sanitary and operational

condition by the wearer. Respirators must be cleaned, disinfected, and

dried using the procedures recommended by the manufacturer (refer to

Appendix E for respirator manufacturer technical information). In

general respirators (including those used in fit testing/training) must be

cleaned after each use and between users (note that Colby does not

currently allow sharing of respirators) using the following procedures:

Disassemble the respirator and check for defects and damage;

Wash all components in warm running water with a mild

detergent or respirator manufacturer-recommended cleaner (use

a soft [not wire] brush to facilitate removal of dirt);

Rinse all components in clean, warm running water;

Drain to remove excess water;

Rinse all components in warm running water; and

Air dry or hand dry components with a clean and lint free cloth.

4.11.2 Colby provides all necessary respirator cleaning products such as

respirator wipes and mild detergents.

4.12 Storage

4.12.1 All respirators and filters or cartridges must be stored to protect them

from the following:

Damage

Contamination

Dust

Sunlight

Extreme temperatures

Excessive moisture

Damaging chemicals



4.12.2 The respirator must be fully dry before storing. Respirators must be kept

in a storage container (e.g. plastic bag or container) which can be sealed,

and put away in the employee’s locker or other secure place. The storage

container and space must be of adequate size so as to not distort the

respirator face piece or exhalation valve. Temporary storage (mid-shift)

must also protect the respirator and filters or cartridge from the

conditions listed above.

4.13 Routine Inspections

4.13.1 All non-disposable (N95s) respirators used in routine situations shall be

inspected before each use and during cleaning. Respirator inspections

should be formally documented routinely, typically at least once per

month, depending on use. Appendix F, Respirator Inspection Form,

provides the inspection elements and a means of documentation.

4.13.2 The documented inspection must specifically address all elements

required by OSHA, including:

4.13.2.1 A check of respirator function;

4.13.2.2 A check of tightness of connections;

4.13.2.3 A check of the condition of various parts, including but not

limited to:

Facepiece;

Head straps;

Valves;

Connecting/breathing tube (if applicable);

Cartridges, canisters or filters; and

A check of elastomeric parts for pliability and signs of

deterioration.

5.0 RECORDS 5.1 Colby’s recordkeeping under the RPP is as follows:

5.1.1 Medical records such as medical questionnaires reviews and physician or

PLHCP respirator determinations will be retained for the duration of

employment plus thirty (30) years;

5.1.2 Fit test records will be retained until the next fit test is administered (at

least annually);

5.1.3 Training records will be retained until the next training is received by the

employee; and

5.1.4 Monthly respirator inspection forms will be retained until the next

inspection is completed or longer.

5.2 Recordkeeping is intended to provide employees and their designated

representatives a right of access to relevant exposure and medical records, and to



provide representatives of OSHA a right of access to these records in order to

fulfill responsibilities under the Occupational Safety and Health Act.

6.0 EMPLOYEE TRAINING 6.1 Training will be presented in a comprehensive and understandable way.

Employees may be trained using videotapes or online training courses; these

training materials will be supplemented with Colby specific information. Such

information may be distributed in a classroom setting, during a routine safety

meeting, or other appropriate means.

6.2 Required Training Frequency

Before the employee initially uses a respirator in the workplace; and

No less than annually thereafter;

Whenever changes in the workplace or respirator type render previous

training obsolete or insufficient;

Whenever an employee's respirator use or knowledge demonstrates a

lack of understanding or skill; and

Whenever any other situation arises in which retraining appears

necessary to ensure safe respirator use and compliance with the RPP.

6.3 Required Training Elements

Why the respirator is necessary and how improper fit, usage, or

maintenance can compromise the protective effect of the respirator;

An overview of Colby’s specific respiratory hazards, the extent of

employee exposures to those hazards, and the potential health effects of

such exposure;

Limitations and capabilities of respirators used at Colby College;

An explanation of how to use respirators effectively in emergency

situations, including when the respirator malfunctions;

Instructions and demonstrations on how to inspect, put on and remove,

use and check the seal of the respirator;

The procedures for respirator maintenance and storage; and

An explanation of how to recognize medical signs and symptoms that

may limit or prevent the effective use of respirator.

7.0 DEFINITIONS 7.1 Air-purifying respirator (APR): A respirator with an air-purifying filter,

cartridge, or canister that removes specific air contaminants by passing ambient

air through the air-purifying element.

7.2 Assigned protection factor (APF): The workplace level of respiratory protection

that a respirator or class of respirators is expected to provide to employees when



the employer implements a continuing, effective respiratory protection program

as specified by 29 CFR 1910.134.

7.3 Canister or cartridge: A container with a filter, sorbent, or catalyst, or

combination of these items, which is attached to a respirator facepiece and

removes specific contaminants from the air passed through the container.

7.4 Ceiling (C): limit is the amount or concentration of a regulated air contaminant

which may not be exceeded at any time; and is enforceable by OSHA. This is

applied to materials that have immediate effects.

7.5 Emergency situation: Any occurrence such as, but not limited to, equipment

failure, rupture of containers, or failure of control equipment that may or does

result in an uncontrolled significant release of an airborne contaminant.

7.6 Employee exposure: Exposure to a concentration of an airborne contaminant that

would occur if the employee were not using respiratory protection.

7.7 End-of-service-life indicator (ESLI): A system that warns the respirator user of

the approach of the end of adequate respiratory protection, for example, that the

sorbent is approaching saturation or is no longer effective.

7.8 Filter or air purifying element: A component used in respirators to remove solid

or liquid aerosols from the inspired air.

7.9 Filtering facepiece (dust mask): A negative pressure particulate respirator with a

filter as an integral part of the facepiece or with the entire facepiece composed of

the filtering medium.

7.10 Fit factor: A quantitative estimate of the fit of a particular respirator to a specific

individual, and typically estimates the ratio of the concentration of a substance in

ambient air to its concentration inside the respirator when worn.

7.11 Fit test: A protocol to qualitatively or quantitatively evaluate the fit of a

respirator on an individual.

7.12 Immediately dangerous to life or health (IDLH): An atmosphere that poses an

immediate threat to life, would cause irreversible adverse health effects, or

would impair an individual's ability to escape from a dangerous atmosphere.

7.13 Permissible Exposure Limit (PEL): The maximum amount or concentration of a

regulated air contaminant that a worker may be exposed to over a specified

period of time; and it is enforceable by OSHA. It is expressed as an 8-hour time

weighted average (TWA) or as a 15- or 30-minute Short Term Exposure Limit

(STEL), usually in milligrams per cubic meter of air (mg/m3) or parts per million

(ppm).

7.14 Physician or other privately licensed health care professional (PLHCP): An

individual whose legally permitted scope of practice (i.e., license, registration, or

certification) allows him or her to independently provide, or be delegated the

responsibility to provide, some or all of the health care services required by 29

CFR 1910.134(e).



7.15 Qualitative fit test (QLFT): A pass/fail fit test to assess the adequacy of respirator

fit that relies on the individual's response to the test agent.

7.16 Quantitative fit test (QNFT): An assessment of the adequacy of respirator fit by

numerically measuring the amount of leakage into the respirator.

7.17 Threshold Limit Value (TLV): The maximum amount of a regulated air

contaminant which a worker may be exposed to as recommended (non-

enforceable) by the American Conference of Governmental Industrial Hygienists

(ACGIH).

7.18 Time-weighted average (TWA): The average exposure over a specified period of

time, usually 8-hours

7.19 User seal check: An action conducted by the respirator user to determine if the

respirator is properly seated to the face.

Colby College 5500 Mayflower Hill Waterville ME 04901

Appendix A: Voluntary Use Respirator Form


Mandatory Information for Employees Using Respirators

When Not Required Under the OSHA Respiratory Protection Standard

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 or 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 for what purpose the respirator is

designed 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 particles of fumes or smoke.

4. Keep track of your respirator so that you do not mistakenly use someone else's respirator.

NOTE: Voluntary use of respirators at Colby College is limited to the use of filtering

facepieces (dust masks); and voluntary use of other respirator types is prohibited

without authorization.

Employee Signature: ______________________________________ Date: _____________________________

RP Program Administrator Notes/Conditions of Use (if applicable):

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________


Appendix B: Respirator Selection Table


RESPIRATOR SELECTION TABLE

Department Task Air Contaminant(s)

Highest Result (in mg/m3

unless otherwise noted)

OSHA PEL (8-hour TWA in mg/m3 unless otherwise noted)

ACGIH TLV (8-hour TWA in mg/m3 unless otherwise noted)

Respirator & Cartridge Required3

Health Center Contagious Disease Response

Various biological agents

NA NA NA Cardinal N95

Central Heating Plant (PPD)

Cleaning hydraulic alley

Respirable Particulates

.0792 5 NA

Moldex N95 Total Particulates

.144 15 NA

Paint Department

Solvent based wood treatment spray application

Various organic solvents

Not tested Various based on product

Various based on product

North 7700/N75001 cartridge

Notes:

OSHA = United States Occupational Safety and Health Administration.

ACGIH = American Conference of Governmental Industrial Hygienists.

PEL = Permissible Exposure Limit, enforceable limit set by OSHA.

TLV = Threshold Limit value, recommended (non-enforceable) limit set by ACGIH.


Appendix C: Cartridge Change Out Schedule


RESPIRATOR CARTRIDGE CHANGE-OUT SCHEDULE/LOG

Use the following log form to determine when respirator cartridges have reached their end of service and should be replaced with a new cartridge

Cartridge Change-Out Information

Date

Amount of time Respirator is Worn (Min)

Total (Cumulative) Time respirator has been worn

Where worn Product / Chemical Used

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

Each time you use the respirator/set of cartridges, record the time it was used under “Amount of Time Respirator is Worn”, add that amount to the time in the “Total/Cumulative Time” column. Replace the cartridge after a maximum of 30 hours of use.


Appendix D: Medical Evaluation Questionnaire

RESPIRATOR MEDICAL EVALUATION QUESTIONNAIRE

To the employer: Answers to questions in Section 1, and to question 9 in Section 2 of Part A, do not require a medical examination. However, certain responses, or patterns of response, may lead the reviewer to request further information, or a medical examination, in order to reach a conclusion regarding the employee’s ability to safely use a respirator. To the employee, Patient ID: Your employer must allow you to answer this questionnaire during normal working hours, or at a time and place that is convenient to you. To maintain your confidentiality, your employer or supervisor must not look at or review your answers, and your employer must tell you how to deliver or send this questionnaire to the healthcare professional who will review it.

CAN YOU READ? YES NO

Part A. Section 1. (Mandatory) Every employee who has been selected to use any type of respirator must provide the following information.

1. 1. Today’s Date: 2. Your Name:

3. Your age (to nearest year): Date of Birth_________ 4. Sex: Male Female

5. Your height: ft. in. 6. Your weight: lbs.

7. Your job title:

8. A phone number where you can be reached by the healthcare professional who reviews this questionnaire (include the Area Code):

9. The best time to phone you at this number:

10. Has your employer told you how to contact the health care professional who will review this questionnaire? NoYes

11. Check the type of respirator you will use (you can check more than one category):

a. N, R, or P disposable respirator (filter-mask, non-cartridge type only).

Other type (for example, half- or full-face piece type, powered-air purifying, supplied-air,b.self-contained breathing apparatus).

12. Have you worn a respirator? Yes No

If “yes” what type(s):

Page 1 of 4

Part A

15 Enterprise Rd, Suite 200

Augusta, ME 04330

Phone 207-621-7550

149 North St. Waterville, ME 04901

Phone: 207-872-4260

3. Have you ever had any of the following pulmonary or lung problems?

a. Asbestosis: b. Asthma: c. Chronic bronchitis: d. Emphysema: e. Pneumonia: f. Tuberculosis: g. Silicosis: h. Pneumothorax (collapsed lung): i. Lung cancer: j. Broken ribs: k. Any chest injuries or surgeries: l. Any other lung problem that you’ve been told about:

4. Do you currently have any of the following symptoms of pulmonary or lung illness?

a. Shortness of breath: b. Shortness of breath when walking fast on level ground or walking

up a slight hill or incline:c. Shortness of breath when walking with other people at an ordinary

pace or level ground: d. Have to stop for breath when walking at your own pace on level ground:

e. Shortness of breath when washing or dressing yourself: f. Shortness of breath that interferes with your job: g. Coughing that produces phlegm (thick sputum): h. Coughing that wakes you early in the morning: i. Coughing that occurs mostly when you are lying down: j. Coughing up blood in the last month: k. Wheezing: l. Wheezing that interferes with your job: m. Chest pain when you breathe deeply: n. Any other symptoms that you think may be related to lung problems:

Page 2 of 4

Part A. Section 2. (Mandatory) Every employee who has been selected to use any type of respirator must answer questions 1 through 9 below.

1 Do you currently smoke tobacco, or have you smoked tobacco in the last month?

2.

Have you ever had any of the following conditions?

a. Seizures (fits): b Diabetes (sugar disease): c. Allergic reactions that interfere with your breathing: d Claustrophobia (fear of closed-in places): e. Trouble smelling odors:

.

.

.

6. Have you ever had any of the following cardiovascular or heart problems?

a. Frequent pain or tightness in your chest: b. Pain or tightness in your chest during physical activity: c. Pain or tightness in your chest that interferes with your job: d. In the past two years, have you noticed your heart skipping or missing a

beat:e. Heartburn or indigestion that is not related to eating: f. Any other symptoms that you think may be related to heart or circulation

problems:

7. Do you currently take medication for any of the following problems?

a. Breathing or lung problems: b. Heart trouble: c. Blood pressure: d. Seizures (fits):

8. If you’ve used a respirator, have you ever had any of the following problems?

a. Eye irritation: b. Skin allergies or rashes: c. Anxiety: d. General weakness or fatigue: e. Any other problem that interferes with your use of a respirator:

9. Would you like to talk to the healthcare professional who will review this questionnaire about your answers to this questionnaire?

Page 3 of 4

5. Have you ever had any of the following cardiovascular or heart problems?

a. Heart attack: b. Stroke: c. Angina: d. Heart failure: e. Swelling in your legs or feet (not caused by walking): f. Heart arrhythmia (heart beating irregularly): g. High blood pressure: h. Any other heart problem that you’ve been told about:

Part A. Section 2. (Mandatory) (Continued)

12. Have you ever had an injury to your ears, including a broken ear drum?

13. Do you currently have any of the following hearing problems?

a. Difficulty hearing: b. Wear a hearing aid: c. Any other hearing or ear problem:

14. Have you ever had a back injury?

15. Do you currently have any of the following musculoskeletal problems?

a. Weakness in any of your arms, hands, legs, or feet: b. Back pain: c. Difficulty fully moving your arms and legs: d. Pain or stiffness when you lean forward or backward at the waist: e. Difficulty fully moving your head up or down: f. Difficulty fully moving your head side to side: g. Difficulty bending at your knees: h. Difficulty squatting to the ground: i. Climbing a flight of stairs or a ladder carrying more than 25 lbs: j. Any other muscle or skeletal problem that interferes with using a

respirator: Employee Signature Date Medical Provider Signature Date Employee Name Medical Provider Name

Page 4 of 4

Questions 10 to 15 below must be answered by every employee who has been selected to use either a full-face piece respirator or a self-contained breathing apparatus (SCBA). For employees who have been selected to use other types of respirators, answering these questions is voluntary.

10 Have you ever lost vision in either eye (temporarily or permanently)?

11 Do you currently have any of the following vision problems?

a. Wear contact lenses: b. Wear glasses: c. Color blind: d. Any other eye or vision problem:

keward

Text Box

__________

keward

Text Box

__________

keward

Text Box

___________________________


Appendix E: Respirator Manufacturer Technical

Information

5500 & 7700 Series Half Mask Air

P u r i f y i n g

R e s p i r a t o rOperating andMaintenance Instruction Manual

ENGLISH

FRANÇAIS

ESPAÑOL

©2001 North Safety Products Printed in U.S.A. Part No. 46000375 Rev. C

CONTENTS PAGE

1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31.1 IMPORTANT INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31.1.1 TERMINOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31.1.2 GENERAL WARNINGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41.1.3 USER REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61.1.4 TRAINING PROGRAM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71.1.5 FIT TESTING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71.1.6 PERIODIC SEAL CHECKS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81.2 RESPIRATOR DESCRIPTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82 PRE-USE INSTRUCTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92.1 FACEPIECE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92.2 FILTERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92.3 ASSEMBLING THE RESPIRATOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 TO PUT ON THE RESPIRATOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104 USE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154.1 SERVICE LIFE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164.1.1 CARTRIDGES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164.1.2 PARTICULATE FILTERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165 TO TAKE OFF THE RESPIRATOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166 TURNAROUND MAINTENANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176.1 AIR-PURIFYING ELEMENTREPLACEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176.1.1 FILTERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176.1.2 CARTRIDGES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .186.2 INSPECTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187 STORAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188 PERIODIC MAINTENANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188.1 CLEANING AND SANITIZING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .198.2 PREPARE FOR USE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .209 REPLACEMENT PARTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2010 ACCESSORIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2211 KEY TO CAUTIONS AND LIMITATIONS CONTAINED IN NIOSH APPROVAL LABELS . . . .2311.1 SPECIALUSER’S INSTRUCTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24

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North Safety Products2000 Plainfield PikeCranston, RI 02921U.S.A.Telephone 800 430-4110Facsimile 800 572-6346www.northsafety.com

North Safety Products North Safety Products10550 Parkway Blvd. NoordmonsterweglAnjou, Quebec 4332 Sc MiddlebergCanada H1J2K4 The NetherlandsTelephone 888-212-7233 Telephone +31 (0) 118 656400Fascimile 514-355-7233 Telephone +31 (0) 118 627535

1 INTRODUCTION

North Air-Purifying respirators are intended to be used for respiratory protection against haz-ardous vapors, gases and/or particulate matter, depending on the air-purifying elements usedand the contaminant concentration and/or toxicity; but only if there is sufficient oxygen presentin the contaminated atmosphere to support life. These respirators are approved by the NationalInstitute of Occupational Safety and Health (NIOSH) and are suitable for use in workplacesregulated by the Occupational Safety and Health Administration (OSHA). If you have convertedthis respirator to a supplied air respirator, use the Instructions for Use that accompanied theAirline Accessory.

1.1 IMPORTANT INFORMATION

This Operating and Maintenance Instruction Manual contains important information and mustbe completely read and understood by all persons who may use or maintain this respirator.

This Respirator should be used or maintained only by persons who understand the instructionscontained within this manual.

1.1.1 TERMINOLOGY

Warnings, cautions and notes used in this manual have the following significance:

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Procedures and techniques which, if notcarefully followed, will result in damageto the equipment.

NOTE CAUTION

Procedures and techniques that are con-sidered important enough to emphasize.

Procedures and techniques which, if not carefully followed, will exposethe user to the risk of serious injury, illness or death.

WARNING

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4

1.1.2 GENERAL WARNINGS

1. Do not use this Operating and Maintenance Instruction Manual if you have converted this respi-rator to a supplied air respirator, use the Instructions for use that accompanied the AirlineAccessory.

2. Failure to properly select the appropriate respirator for all the contaminants and their concentra-tions against which protection is required, or a failure to follow North’s instructions and warnings,may result in exposure to the hazardous materials, exposing the user to the risk of seriousinjury, illness or death.

3. Do not use this respirator for protection against air contaminants other than those listed on theair-purifying elements and on the NIOSH Approval Label which is supplied with each respiratorand/or replacement air purifying element .

4. Do not use this respirator under any of the following conditions:

• While performing or observing abrasive blasting (sandblasting) operations.

• For fire fighting.

• In oxygen-deficient atmospheres (any atmosphere having less than 19.5 % oxygen by volumeat sea level).

• In atmospheres where the concentrations of toxic contaminants are unknown, or areImmediately Dangerous to Life or Health (IDLH). An IDLH atmosphere is any atmospherewhich has a concentration of any toxic, corrosive or asphyxiant substance that poses animmediate threat to life, which would cause irreversible debilitating effects on health, or whichwould interfere with the ability to escape from a dangerous atmosphere.

• In atmospheres where the concentration of the contaminant exceeds the respirator’sMaximum Use Concentration. That is, where the concentration of the contaminant exceeds:

i. 10 times the contaminant’s permissible exposure limit (the maximum permissible 8-hourtime weighted average (TWA) concentration) established by applicable OSHAor othergovernment regulations, or by NIOSH or ACGIH publications; or

ii. any lower Maximum Use Concentration for that contaminant (when using a half mask airpurifying respirator) established by such OSHAor other government regulations (as in thecase of asbestos) or NIOSH or ACGIH publications, or shown in the contaminant’sMaterial Safety Data Sheet (MSDS), in a pesticide label, or in the current edition of theNorth Respirator Selection Guide.

WARNINGS

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5

• In poorly ventilated areas, or confined spaces such as tanks, small rooms, tunnels or vessels,unless the confined space is well ventilated and the concentration of toxic contaminants isknown to be, and will continue to be, below the Maximum Use Concentration recommendedfor the respirator.

• In atmospheres containing oil unless a NIOSH "R" or "P’ class filter is used.

• For protection against gas or vapor contaminants unless the air-purifying elements are equipped with End-of-Service-Life-Indicators for that contaminant; or a cartridge change schedule is implemented based on objective service data.

• For protection against gases or vapors which generate high heats of reaction with the sorbentmaterial in the cartridge.

• For protection against gases or vapors which are not adsorbed by the sorbent material in the cartridge (e.g. Methanol).

5. Do not use any air purifying respirator when conditions prevent a good facepiece-to-face seal.Examples of such conditions are:

i. the growth of beards, mustaches or sideburns which will pass between the facepiece seal-ing area and the face;

ii. the use of spectacles, goggles or other devices which interfere with the respirator;

iii. the use of head or face coverings which contain materials which will pass between thefacepiece sealing area and the face; and

iv. missing teeth or dentures, facial deformities or deep scars.

6. Immediately leave the contaminated area if:

i. breathing becomes difficult;

ii. dizziness or other distress occurs;

iiii. you smell, taste or sense irritation from the contaminants;

iv. the air purifying element is equipped with an End-of-Service-Life Indicator which haschanged color to indicate expiration, or

v. the respirator becomes damaged.

WARNINGS (CONTINUED)

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1.1.3 USER REQUIREMENTS

To use this respirator you must know;

1) The contaminants and their concentrations. (Ask your Safety Director or IndustrialHygienist, or follow the hazard determination steps as outlined in paragraph 7.2.2.1 ofAmerican National Standards Institute (ANSI) Standard Z88.2-1992, American National

Standard for Respiratory Protection.)

2) That this is the respirator approved for use against those contaminants and at those con-centrations. (Carefully read the NIOSH Approval Summary booklet included with this face-piece. Make sure the part numbers on the respirator components match the componentnumbers on the NIOSH Approval Label or on the configuration chart. If you have anydoubts, prior to using the respirator consult an Industrial Hygienist, or North SafetyProducts Customer Service in the United States at 1-800-430-4110 or 1-401-943-4400.)

3) That the contaminated atmosphere is not Immediately Dangerous to Life or Health (IDLH).For the definition of IDLH see Warning #4 of the preceding list of General Warnings.

4) That this respirator fits you properly. (See Warning #5 of the preceding list of GeneralWarnings.)

7. Any air purifying respirator, when properly selected and fitted, will significantly reduce, but willnot completely eliminate, the breathing of contaminant(s) by the respirator wearer. When work-ing in atmospheres containing substances which are reported to cause cancer in amounts belowtheir permissible exposure limit, you will obtain better protection from a continuous flow or posi-tive pressure air supplied respirator or self-contained breathing apparatus (an SCBA).

8. This respirator does not provide protection to exposed areas of the body. If the contaminatedatmosphere contains vapors, gases or airborne particulate matter which may either irritate orburn the eyes or the skin, or can be absorbed by the body through penetration of the skin, theuse of specialized eye, hand and/or body coverings may be required for protection.

WARNINGS (CONTINUED)

5) That you do not have any physical limitations or illness which would preclude you fromusing this respirator or be aggravated by an increase in breathing resistance. (Ask yourSafety Director or physician.)

You should not enter any potentially contaminated atmosphere unless you have confirmed all of these factors.

1.1.4 TRAINING PROGRAM

These brief written instructions cannot substitute for a formal Respirator Training Program.Such training should include an opportunity for you to handle the respirator, learn how toinspect it, have it properly fitted, test its facepiece-to-face seal, wear it in normal air for a longfamiliarity period, and finally, to wear it in a test atmosphere. The Training Program should bebased on ANSI Z88.2-1992, and should familiarize you with OSHARegulation 29CFR Section1910.134 and other regulations promulgated by various Regulatory Authorities.1.1.5 FIT TESTING

A respirator should not be assigned to a person unless the person is given a qualitative orquantitative respirator fit test and the results of the test indicate that the facepiece of the respi-rator fits properly.

This respirator is available in three sizes; large, medium and small. Most faces can be fit withthe medium, however person with small faces may get a better fit with the small size, and per-son with large faces may get a better fit with the large size.

Fit tests should be conducted at least annually and more frequently if there are factors such asweight change or dental surgery which may affect the fit of the respirator.

A fit test adapter is available for conducting quantitative fit tests. (See Accessories.)

Instructions for carrying out qualitative and quantitative respirator fit tests are given in publica-tions such as ANSI Z88.2-1992, and respirator manuals published by government agenciessuch as NIOSH, ERDA, and NRC.

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1.1.6 PERIODIC SEAL CHECKS

Each time that the respirator is put on, before entering an area containing hazardous atmos-pheres, and periodically while wearing the respirator in the contaminated area, the respiratorwearer should check the effectiveness of the seal of the facepiece to the wearer’s face by carrying out a negative or positive pressure seal check. Instructions for carrying out user sealchecks on this respirator are given in Section 3 of this manual.

1.2 RESPIRATOR DESCRIPTION

This device is an air-purifying respirator consisting of a half mask facepiece assembly and a pair of replaceable air-purifying elements which provide respiratory protection against hazardous vapors, gases and/or particulate matter, depending upon the type of air-purifyingelement used.

When the respirator wearer inhales, the contaminated air is drawn through the air-purifying elements, which, depending upon their type, remove the hazardous vapors, gases and/or par-ticulate matter from the air before it enters the lungs. During inhalation, the inhalation valves inthe facepiece open and the exhalation valve closes to prevent contaminated air from enteringthe facepiece. During exhalation, the exhalation valve opens, and the inhalation valves close to prevent exhaled air from passing back through the air-purifying elements.

This respirator is approved by NIOSH to protect against, and reduce exposure to the type of aircontaminants specified on the air-purifying elements and in the approval label supplied with therespirator or the air-purifying elements. Use of the Back Pack accessory allows the wearer toplace the air-purifying elements on his back.

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2 PRE-USE INSTRUCTIONS

WARNING

2.1 FACEPIECE

Remove the facepiece assembly from its container and visually check the facepiece to makesure that the sealing flange is not distorted, and that all components including the exhalationvalve flap are in place, in good condition and secure.

2.2 FILTERS

If replaceable pad style filters are required, they should be assembled to the cartridges or filterholders before the cartridges or filter holders are attached to the facepiece. Follow the direc-tions on the filter for proper orientation. Place the filters in the appropriate filter covers so thatthe entire outer edges of the filters are seated evenly and securely against the inner wall of thefilter covers. (See Figure 1.) Snap the filter covers, with the filters seated evenly and securely,to the cartridge or filter holders. (See Figure 2.)

FIGURE 1: Assembling the Filter FIGURE 2: Attaching the Cover

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The respirator facepiece and air-purifying elements may be sold separately. Do not usethis respirator unless the proper air-purifying elements are attached. See the NIOSHApproval label included in the air-purifying element packaging for a list of the approvedcomponents, or check with your Safety Director or Industrial Hygienist or North SafetyProducts Customer Service in the United States at 1-800-430-4110 or 1-401-943-4400.

2.3 ASSEMBLING THE RESPIRATOR

If using the Back Pack Accessory, assemble the respirator facepiece by screwing the breathingtubes to the inhalation connectors mounted on the facepiece. Assemble the respirator byscrewing the two appropriate air-purifying elements onto the inhalation connectors mounted onthe facepiece, or onto the metal connectors which are located on the Back Pack mountingplate. Check to be sure that each air-purifying element is effectively sealed against the face-piece or against the rubber gasket attached to each metal Back Pack connector. (See Figure 3)

FIGURE 3

Attaching Air-Purifying Elements

After assembling the respirator facepiece and air-purifying elements, inspect the respirator tomake certain that the respirator has not been damaged.

3 TO PUT ON THE RESPIRATOR

The following should be performed in an area with uncontaminated air.

1) 1) Remove your eyewear (if worn), then grasp the front of the respirator with one handand the upper headband with your other hand. Then place the Back Pack breathing tubes(if so equipped) over your head and the portion of the facepiece containing the exhalation

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A respirator must be inspected by the wearer before and after each use to insure that it isin good working condition.

CAUTION

valve under your chin (See Figure 4 and 4A)

FIGURE 4 FIGURE 4A

Putting on the Respirator

2) Position the narrow portion of the respirator on your nose bridge and place the cradle sus-pension system on your head so that the top headband rests across the top of your headand the bottom headband rests above your ears, on the back of your head. Then hook thebottom headband behind your neck, below your ears, and adjust the position of the face-piece on your face for best fit and comfort. (See Figure 5.)

3) The length of the headbands are adjustable; tighten or loosen by holding the respiratorbody or headband yoke with one hand and pulling on the elastic material in the appropri-ate direction with your other hand. (See Figure 6.)

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FIGURE 5

Hooking the Bottom Headband

FIGURE 6

Adjusting the Facepiece

4) Position the facepiece so that the nose section rests as low on the bridge of your nose asis comfortable, and tighten the upper headband on both sides just tight enough so that therespirator doesn’t slide down on your nose. Do not over tighten. If the respirator pinchesyour nose, loosen the upper headband slightly. (See Figure 7.)

FIGURE 7

Adjusting the Upper Headband

5) Then, tighten the lower headband on both sides just tight enough to secure the respiratorunder your chin. (See Figure 8.)

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For a comfortable fit, the headbands must be adjusted equally on both sides of the respirator.

NOTE

FIGURE 8

Adjusting the Lower Headband

6) If you previously removed your eyewear, put it back on at this time.

7) Conduct a positive or negative seal check as follows:

To conduct a negative pressure seal check,without the Back Pack accessory place thepalms of your hands over the openings in the cartridges or filter covers (if so equipped) or,unscrew the air-purifying elements from the respirator and place the palms of your handsover the inhalation connectors, inhale and hold your breath for about 5 seconds. To con-duct a negative pressure seal check with the Back Pack accessory, grasp each breathingtube and squeeze a tight fold in each, inhale and hold your breath for about 5 seconds. Ifthe facepiece collapses slightly and no air leaks between the facepiece and your face aredetected, an effective seal has been obtained. If air leaks are detected, reposition thefacepiece on your face and/or readjust the tension of the headbands and repeat the nega-tive pressure check until an effective seal is obtained. If the air-purifying elements wereremoved, once an effective facepiece-to-face seal is obtained, a co-worker or a represen-tative of the Safety or Industrial Hygiene Department must assist you by screwing the air-

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For proper positioning and comfort, the upper headband must be adjusted first, then the lowerheadband must be adjusted.

NOTE

purifying elements onto the inhalation connectors mounted on the facepiece. (This mustbe done without removing the facepiece from your face.) Check to be sure that each air-purifying element is effectively sealed against the facepiece. (See Figure 9 and 9A.)

FIGURE 9 FIGURE 9A

Negative Pressure Seal Check

To conduct a positive pressure seal check, block the openings in the exhalation valve guard usingthe palm of your hand and simultaneously exhale. If the facepiece bulges slightly and no air leaksbetween the facepiece and your face are detected, an effective seal has been obtained. If air isdetected to be leaking out between the facepiece and your face, reposition the facepiece on yourface and/or readjust the tension of the headbands to eliminate the leakage. This check must berepeated until an effective seal of the facepiece to your face is obtained. (See Figure 10.)

FIGURE 10: Positive Pressure Seal Check

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4 USE

You are now ready to enter the use environment for which the respirator is intended.

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If the air-purifying elements have End-of Service-Life Indicators, you must be able to see the End-of-Service-Life Indicators without manipulation of the cartridges or facepiece while wearing the respirator.

Refer to specific user instructions supplied with cartridges for additional ESLI information

Do not use the Back Pack accessory with air-purifying elements that have End-of Service- Life Indicators because you will not be able to see the End-of-Service-Life Indicators while wearing the respirator.

If you cannot see the indicators, do not use the respirator because you will not know when the cartridge has expired. Should this occur, and you remain in the contaminated work area, you risk exposure to hazardous quantities of the air contaminant which can result in serious injury or illness.

WARNING

Immediately leave the work area and replace the respirator if;i. breathing becomes difficult;ii. dizziness or other distress occurs,iii. you smell, taste or sense irritation from the contaminants in the work area,iv. the air purifying element is equipped with an End-of-Service-Life Indicator which

has changed color to indicate expiration, orv. the respirator becomes damaged.

Should any of these occur, and you remain in the contaminated work area, you risk exposure to hazardous quantities of the air contaminant which can result in serious injury or illness.

WARNING

4.1 SERVICE LIFE

The service life of this respirator will vary depending on the work environment.

4.1.1 CARTRIDGES

When you are using a gas or vapor cartridge respirator which does not have End-Of-Service-Life Indicators, you must establish a change out schedule that will result in cartridges beingchanged before the end of their useful service life. North provides EZ GUIDETM software forassisting the user in establishing a change out schedule.

If the respirator has End-Of-Service-Life Indicators, the cartridges must be changed when thecolor of either one of the indicators match the color standard indicated on the cartridge.

4.1.2 PARTICULATE FILTERS

When you are using a particulate filter respirator, or a gas or vapor respirator with filtersattached, the filters should be replaced when breathing becomes difficult.

Any “R” class filter if used in an oil environment must be replaced after a total of 8 hours use,or sooner, regardless of breathing resistance.

5 TO TAKE OFF THE RESPIRATOR

1) Go to an area with uncontaminated breathable air.

2) Loosen headbands and remove the facepiece.

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6 TURNAROUND MAINTENANCE

After each use, the respirator should be examined by trained personnel:

6.1 AIR-PURIFYING ELEMENT REPLACEMENT

6.1.1 FILTERS

To replace pad style filters, detach the filter cover from the cartridge or filter holder, discard oldfilters and replace them with new ones. Follow the directions printed on the filter for proper ori-entation. Check to ensure that the entire outer edge of the filters are seated evenly andsecurely against the inner wall of the filter covers. Snap the filter covers with the filters to thecartridges or filter holders. (See Figures 1 and 2.)

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It is good hygiene practice to replace the air-purifying elements after a single day of useeven if the service life of the air-purifying elements have not expired.

NOTE

The replacement of air-purifying elements must be done in a safe area containing uncontam-inated breathable air.

NOTE

Always replace air-purifying elements after water spray decontamination. Excessive mois-ture can damage the air-purifying elements and expose the user to the risk of seriousinjury, illness.

WARNING

6.1.2 CARTRIDGES

To replace gas, particulate or combination cartridges, unscrew them from the inhalation con-nectors, which are mounted on the facepiece, and discard them. Screw on new cartridgestightly to insure an effective seal between each cartridge and the facepiece. (See Figure 3.)

6.2 INSPECTION

Visually inspect all components for damage or wear, especially rubber parts. Replace partswhere needed.

If needed, clean and sanitize the facepiece assembly (see Section 8: Periodic Maintenance).

7 STORAGE

Store in a clean dry area in the respirator storage bag provided with the facepiece.

8 PERIODIC MAINTENANCE

As needed, remove, inspect and clean the facepiece assembly.

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Rubber and elastomeric parts must be stored in a manner which will prevent them fromtaking an abnormal set. Do not expose this device, during storage, to excessive heat(above 140°F/60°C), moisture, contaminating gaseous substances or airborne particu-lates. Excessive heat may distort the facepiece resulting in the inability to achieve a properfit. Moisture and contaminated air can damage the air purifying elements. Either of theseconditions will expose the wearer to the risk of serious injury or illness.

CAUTION

8.1 CLEANING AND SANITIZING

1) Remove filters and/or cartridges from connectors and discard them.

2) Inspect headbands for wear. Check all elastomer and rubber parts for pliability and signsof deterioration.

3) Remove the facepiece breathing tubes, inhalation connectors, inhalation valves, headbandassembly, exhalation valve guard, valve and seat from the facepiece.

4) Remove the inhalation valves from inhalation connectors.

5) Prepare a solution of cleaner/sanitizer (North Catalog Number 80992) according to thecleaner/sanitizer instructions.

6) Wash the facepiece and components in the cleaning solution.

7) Rinse components completely in clean warm water, then air dry in a clean area.

8) Visually inspect the exhalation valve for damage. If damage or wear is evident, replace.

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The NIOSH Approval and all North warranties for this respirator are nullified if other thanNorth replacement parts are used.

WARNING

Never allow air-purifying elements to come in contact with water or cleaning and sanitiz-ing solutions. Excessive moisture can damage the air-purifying elements and expose theuser to the risk of serious injury or illness.

WARNING

9) Reassemble the facepiece. Follow steps 2 through 4 above, in reverse order.

8.2 PREPARE FOR USE

1) Install a new pair of air-purifying elements.

2) Perform a seal check to make sure that components are functioning properly.

9. REPLACEMENT PARTS

COMPLETE ASSEMBLIES

CATALOG NUMBER DESCRIPTION

5500 SERIES 7700 SERIES

5500-30S 7700-30S Facepiece Assembly Complete, Small5500-30M 7700-30M Facepiece Assembly Complete, Medium5500-30L 7700-30L Facepiece Assembly Complete, Large

COMPONENTS (See Figure 11.)

ITEM CATALOG NUMBER DESCRIPTION

5500 SERIES 7700 SERIES

1 7700-16 7700-16 Inhalation Connector2 7700-17 7700-17 Inhalation Valve3 7700-18 7700-18 Exhalation Valve4 7700-19 7700-19 Exhalation Valve Seat5 7700-20 7700-20 Exhalation Valve Guard6 5500-92 7700-92 Cradle Suspension System7 5500-11S 7700-11S Basic Facepiece, Small7 5500-11M 7700-11M Basic Facepiece, Medium7 5500-11L 7700-11L Basic Facepiece, Large

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FIGURE 11

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6

4

5

3

2

1

7

10 ACCESSORIES

CATALOG NUMBER DESCRIPTION

7002 Seal Check Ampule7700-21 Fit Test AdapterN7500-27 Filter Cover80992 Cleaner/Sanitizer PowderESLIFE esLife C/D ROMBP1002 Back Pack Accessory

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11 KEY TO CAUTIONS AND LIMITATIONS CONTAINED IN NIOSH APPROVAL LABELS

A – Not for use in atmospheres containing less than 19.5 percent Oxygen.B – Not for use in atmospheres immediately dangerous to life or health.C – Do not exceed maximum use concentrations established by regulatory standards.H – Follow established cartridge and canister change schedules or observe ESLI to ensure

that cartridges and canisters are replaced before breakthrough occurs.J – Failure to properly use and maintain this product could result in injury or death.K – The Occupational Safety and Health Administration regulations require gas-proof goggles

to be worn with this respirator when used against formaldehyde.L – Follow the manufacturer’s Instructions for changing cartridges, canisters, and/or filters.M – All approved respirators shall be selected, fitted, used and maintained in accordance with

MSHA, OSHA, and other applicable regulations.N – Never substitute, modify, add, or omit parts. Use only exact replacement parts in the

configuration as specified by the manufacturer.O – Refer to User’s Instructions, and/or maintenance manuals for information on use and

maintenance of these respirators.P – NIOSH does not evaluate respirators as surgical masks.S – Special or critical User ’s Instructions and/or specific use limitations apply. Refer to User’s

Instruction before donning.

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11.1 S - SPECIAL USER’S INSTRUCTIONS

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If the air-purifying elements have End-of Service-Life Indicators, you must be able to seethe End-of-Service-Life Indicators without manipulation of the cartridges or facepiecewhile wearing the respirator.

Refer to speciffic user instructions supplied with cartridges for additional ESLI information

Do not use the Back Pack accessory with air-purifying elements that have End-of-Service-Life Indicators because you will not be able to see the End-of-Service-LifeIndicators while wearing the respirator.

If you cannot see the indicators, do not use the respirator because you will not knowwhen the cartridge has expired. Should this occur, and you remain in the contaminatedwork area, you risk exposure to hazardous quantities of the air contaminant which canresult in serious injury or illness.

WARNING

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Thread the cartridges or filter assemblies onto the cartridge connectors in the facepiece.

Snap filter cover with filter onto the cartridge or N750015 filter holder if a cartridge is not being used.

For prefilters only: Insert the filter into the filter cover following the directions on the filter so it is facing the correct direction.

ASSEMBLY OF FILTERS AND CARTRIDGES:If replaceable particulate filters are not used go to step 6.

Gently pull the respirator away from your face and maneuver it to assure it is centered, com-fortable and snug. Plastic loops on the top straps slide back to hold down any loose strap material.

Tighten the lower head straps by pulling evenly on the end straps in the back of the respirator until the entire respirator is snug, comfortable and centered on your face.

Fasten the bottom elastic straps behind your neck and under your hair. Remove any slack in the bottom straps by pulling the end tabs in the back towards the front. DO NOT TIGHTEN AT THIS TIME.

Tighten the upper head straps in small, equal increments to ensure the top half of the respirator is tightened evenly and centered on your face.

With your other hand, position the plastic straps so they are centered on your head. Remove any slack in the upper straps by pulling the two end tabs back and toward your ears. DO NOT TIGHTEN AT THIS TIME.

With one hand holding the respirator, place your chin inside the chin cup and the top of the respi-rator over your nose.

Adjust the respirator head straps and clips to their full outward position

PUTTINGON YOURRESPIRATOR:If you are wearing eyewear or a hardhat, remove these items before putting on your respirator. Put this safety gear back on after you have put on your North respi-rator.

Your North Half Mask RespiratorYour North respirator is designed to minimize the breathing of airborne contaminants. But it must be worn correctly to protect you. Before you use your North respirator, you should become familiar with it in uncontaminated air, learn how to inspect and put it on, and what to do during an emergency. This information is covered as part of a complete Respirator Training Program. If you have any questions on this North respirator or how to use it, see your supervisor.

Your North respirator must be:

• Properly fitted to your face during a routine (usually annual) fit test• Kept clean and in good working condition• Worn correctly every time

This poster demonstrates how to inspect and put on your North half mask respirator.

Negative Pressure Seal Check: Place the palm of each hand over the two cartridges or filters so they are completely sealed and inhale. Hold your breath for 5 seconds. If you have a good seal the facepiece will collapse.

Positive Pressure Seal Check: Place the palm of your hand over the exhalation valve so it is completely sealed and exhale gently. If you have a good seal the facepiece will bulge out slightly.

USER SEAL CHECK:A positive and/or negative pres-sure User Seal Check assures you the respirator is seated correctly and in good working order. Before performing Seal Checks exhale vigorously.

If any air leaks are detected during either check, reposition the facepiece and/orreadjust the head straps. Repeat the seal check(s) until a seal is obtained.

77005500

INSPECTION:Inspect the respirator before each use. If any parts are missing or damaged replace those parts or the entire mask.

Check the facepiece to make sure it is in good condition, without any holes or tears. Check the cartridge connectors to make sure they are not cracked and are fully inserted into the mask.

Check all the valves to be sure they are present and in good condition. They should be lying flat, without any distortion, tears or holes.

Check the headstraps to be sure they have not lost their elasticity. Make sure the straps are not twisted.

Job #: 8901F RPPS07HMEN0000 SP07

USA1-800-430-41101-401-943-4400

EUROPE & MIDDLE EAST+31 (0) 118 656400Middleburg/Holland

CANADA1-888-212-72331-514-351-7233

CHINA86-10-67892289/90/91

ASIA PACIFIC61-3-9337-9111

LATIN AMERICA1-954-322-1691

®

EMLab P&K Products Division1501 W. Knudsen Dr. Phoenix, AZ 85027www.emlabpk.com

1

2

3

4

5 5

Cup both hands over the mask, checking for tightness, Inhale sharply, negative pressureshould be felt in the mask, Re-adjust as necessary.

The respirator should be fit checked for each wearing. Place both handscompletely over the respirator and exhale. If air leaks around nose of the edges, adjust the nosepiece and/or headbands until a good fit is achieved.


Appendix F: Respirator Inspection Form


RESPIRATOR INSPECTION FORM Inspector’s signature: __________________________________________________________ Date:__________________ Respirator Type: _______________________________________ USER MUST COMPLETE A VISUAL INSPECTION EACH TIME BEFORE USE. COMPLETE THIS DOCUMENTED INSPECTION AT LEAST MONTHLY. Submit to RP Program Administrator for filing if no defects noted OR immediately correct any failed safety items, note the correction, and submit to the RP Program Administrator.

REQUIREMENT (place check mark in pass/fail column) PASS FAIL

Rubber Face-piece

Excessive dirt

Cracks, tears, or holes

Distorted

Cracked, stretched, or loose lenses

Head Straps

Breaks or tears

Loss of elasticity

Broken or malfunctioning buckles or attachments

Excessively worn head harness

Inhalation/Exhalation Valves

Coated with detergent residue, dust, or dirt

Cracks, tears, or distortion

Missing or defective valve cover

Filter Elements

Properly named and color coded

NIOSH approved correct for hazard

Missing or worn gaskets

Worn threads

Cracks or dents in filter housing


Appendix G: Authorized Respirator Users



Colby employees who are required to use respirators are listed below. Employees who are not listed are not currently authorized to use

respirators or engage in tasks where respiratory protection is needed.

TABLE 1: LIST OF EMPLOYEES WHO ARE REQUIRED TO USE RESPIRATORS

Employee Name

Department Respirator

Type Size

Tasks Requiring Respirator

Medical Exam

Date Fit Test Date

Paul Berkner Health

Center (HC) Secure Gard

N95 M

Contagious disease response

11/27/18 4/1/19

Laura Patterson HC Cardinal N95 S Contagious disease

response 11/20/18 3/5/19

Suzanne Brown HC Cardinal N95 Contagious disease

response 1/9/19 2/25/19

Judy Whyte HC Cardinal N95 M Contagious disease

response 11/20/18 2/11/19

Lydia Bolduc-Marden

HC Cardinal N95 S Contagious disease

response 11/20/18 2/11/19

Helen Balgooyen

HC Cardinal N95 M Contagious disease

response 11/20/18 4/6/19

Robin Shafer HC Cardinal N95 S Contagious disease

response 11/20/18 4/8/19

Alison Gagliardi HC Cardinal N95 M Contagious disease

response 11/20/18 3/5/19

Jeff Jason Facilities North

7700/N75001 cartridge

L Spray Booth 6/13/17 2/15/19

Stephen Chestnut

Facilities North


M Spray Booth 1/27/17 3/19/19


Employee Name

Department Respirator

Type Size

Tasks Requiring Respirator

Medical Exam

Date Fit Test Date

Gary Rollins Facilities North


L Spray Booth 1/27/17 2/15/19

Paul Anderson Facilities Moldex

N95 M/L Biomass Cleaning 1/27/17 2/15/19

Greg Nadeau Facilities Moldex


Russell Rollins Facilities Moldex


Ray Rayeski Facilities Moldex


Dave Waltz Facilities Moldex


James Knowlton Facilities Moldex


Richard Lawrence

Facilities Moldex N95

M/L Biomass Cleaning 3/14/19 2/15/19

Notes:

1. Cardinal N95 is a National Institute for Occupational Safety and Health (NIOSH)-approved dust mask. This mask is not effective against gases or vapors

and is not to be sued in environments with suspended oil particles in air.

2. Moldex 2300N95 N95 is a National Institute for Occupational Safety and Health (NIOSH)-approved dust mask. This mask is not effective against gases or

vapors and is not to be sued in environments with suspended oil particles in air.

3. North® 7700 is a National Institute for Occupational Safety and Health (NIOSH)-approved half-face air purifying respirator (APR).

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