Environmental, Health and Safety Services

Respiratory Protection Appendices

Appendix 1
Respirator Hazard Assessment Form
Appendix 6
Respirator Cleaning Procedures
Appendix 2
Voluntary Users
Appendix 7
Assigned Protection Factors
Appendix 3
Informed Consent
Appendix 8
N, R, and P Particulate Respirator Categories
Appendix 4
Fit Test Procedures
Appendix 9
Respirator Recovery Form
Appendix 5
User Seal Check Procedures

Appendix 1

Download Respirator Hazard Request Form  ( doc | pdf )

Appendix 2

Information for Voluntary Users of Disposable Respirators

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 respirators 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 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.
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Appendix 3

Download the Informed Consent Form  ( doc | pdf)

Appendix 4

Fit-testing procedures

There are two methods of fit-test that may be used to verify the fit of the respirator: qualitative method (using irritant smoke) and the quantitative method using the Controlled Negative Pressure (CNP) equipment.

Irritant smoke (stannic chloride) test protocol

This qualitative fit test uses a person's response to the irritating chemicals released in the air to detect leakage into the respirator. Since this smoke is irritant to eyes, lungs and nasal passages, the respirator to be tested will be equiped with HEPA filters and the test will take place in a well ventilated area. The tester will take all the necessary precautions to minimize the employee's exposure to the irritant smoke. The following steps illustrate the sequence of events for a Qualitative Fit-test Procedure:

    1. Sensitivity Screening Check. The person to be tested must demonstrate his or her ability to detect a weak concentration of the irritant smoke. Employee will be advised to keep the eyes closed for the duration of the test, in order to minimize eye irritation.
    2. Testing protocol. The following sequence of exercises will be perfomed while the test operator directs the stream of irritant smoke from the smoke tube toward the faceseal area of the test subject, using the low flow pump or the squeeze bulb. The test operator shall begin at least 12 inches from the facepiece and move the smoke stream around the whole perimeter of the mask. The operator shall gradually make two more passes around the perimeter of the mask, moving to within six inches of the respirator. If the person being tested has not had an involuntary response and/or detected the irritant smoke, the tester will proceed with the test exercises.
        1. Normal breathing. In a normal standing position, without talking, the subject shall breathe normally.
        2. Deep breathing. In a normal standing position, the subject shall breathe slowly and deeply, taking caution so as not to hyperventilate.
        3. Turning head side to side. Standing in place, the subject shall slowly turn his/her head from side to side between the extreme positions on each side. The head shall be held at each extreme momentarily so the subject can inhale at each side.
        4. Moving head up and down. Standing in place, the subject shall slowly move his/her head up and down. The subject shall be instructed to inhale in the up position (i.e., when looking toward the ceiling).
        5. Talking. The subject shall talk out loud slowly and loud enough so as to be heard clearly by the test conductor. The subject can read from a prepared text such as the Rainbow Passage, count backward from 100, or recite a memorized poem or song.

          Rainbow Passage

          When the sunlight strikes raindrops in the air, they act like a prism and form a rainbow. The rainbow is a division of white light into many beautiful colors. These take the shape of a long round arch, with its path high above, and its two ends apparently beyond the horizon. There is, according to legend, a boiling pot of gold at one end. People look, but no one ever finds it. When a man looks for something beyond reach, his friends say he is looking for the pot of gold at the end of the rainbow.

        6. Grimace. The test subject shall grimace by smiling or frowning. (This applies only to QNFT testing; it is not performed for QLFT)
        7. Bending over. The test subject shall bend at the waist as if he/she were to touch his/her toes. Jogging in place shall be substituted for this exercise in those test environments such as shroud type QNFT or QLFT units that do not permit bending over at the waist.
        8. Normal breathing. Same as exercise 1.

          Each test exercise shall be performed for one minute except for the grimace exercise which shall be performed for 15 seconds. The test subject shall be questioned by the test conductor regarding the comfort of the respirator upon completion of the protocol. If it has become unacceptable, another model of respirator shall be tried. The respirator shall not be adjusted once the fit test exercises begin. Any adjustment voids the test, and the fit test must be repeated.

    3. Test outcome:

      If the person being fit tested reports detecting the irritant smoke at any time, the test is failed. The person being retested must repeat the entire sensitivity check and fit test procedure.

      Each test subject passing the irritant smoke test without evidence of a response (involuntary cough, irritation) shall be given a second sensitivity screening check, with the smoke from the same smoke tube used during the fit test, once the respirator has been removed, to determine whether he/she still reacts to the smoke. Failure to evoke a response shall void the fit test.

      If a response is produced during this second sensitivity check, then the fit test is passed.

      The test outcome is documented in writing on the Respirator Use Training Form.

Controlled Negative Pressure test protocol

The CNP fit test method measures leak rates through the facepiece as a method for determining the facepiece fit for negative pressure respirators. For the purpose of this test, the inhalation valves will be removed and special adaptors will be installed. The following sequence of exercises will be performed:

Exercises Exercise procedure Measurement procedure
Facing Forward Stand and breathe normally, without talking, for 30 seconds. Face forward, while holding breath for 10 seconds.
Bending Over Bend at the waist, as if going to touch his or her toes, for 30 seconds. Face parallel to the floor, while holding breath for 10 seconds
Head Shaking For about three seconds, shake head back and forth vigorously several times while shouting. Face forward, while holding breath for 10 seconds.
REDON 1 Remove the respirator mask, loosen all facepiece straps, and then redon the respirator mask. Face forward, while holding breath for 10 seconds.
REDON 2 Remove the respirator mask, loosen all facepiece straps, and then redon the respirator mask again. Face forward, while holding breath for 10 seconds.
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Appendix 5

Download the User Seal Check Procedures ( doc | pdf )

Appendix 6

Download Respirator Cleaning Procedures ( doc | pdf )

Appendix 7

Download Assigned Protection Factors  ( doc | pdf )

Appendix 8

Information for N, R, and P Particulate Respirator Categories

N, R, and P are NIOSH certification categories that apply to negative pressure air-purifying respirators that protect against hazardous particles. They do not apply to powered air-purifying respirators (PAPRs). The particle respirator will have an N or R or P designation along with an efficiency designation such as 95 or 99 or 100. Some examples include N95 and N100 disposable facepiece respirators and P100 cartridges.

N, R, P Designations

Use When
N No oil is present in the air.
R Oil is present, but only for a single shift or 8 hours of continuous or intermittent use.
Note:Reuse beyond a single shift or 8 hours is not recommended.
P Oil is present, but follow the manufacturer's time use limitations if you want to reuse these.

99, 95, 100 Efficiencies*

If the efficiency level is: This means
100 The filter is expected to trap 99.97 particles out of every 100. It is as efficient as a High Efficiency Particulate Air (HEPA) filter.
99 The filter is expected to trap 99 particles out of every 100.
95 The filter will trap 95 particles out of every 100.

*The table shows how efficient the respirator's filter capacity is expected to be against particles that are at least 0.3 micrometers. The higher the number, the higher the efficiency expected.

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Appendix 9

Download the Respirator Recovery Form (doc)

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