When an employer requires respirator use by its employees, the Occupational Safety and Health Administration (OSHA) Respiratory Protection standard(opens in new window) requires all employees to follow a comprehensive and effective respiratory protection program. The program must be in writing, have a designated administrator, and specify the employer’s policies and procedures for the use of respiratory protection in the facility. OSHA requires each respiratory protection program to include several specific elements, but leaves the specifics of the policies and procedures used to meet these requirements up to individual employers.
The healthcare environment contains hazards such as bacteria, viruses, and chemicals that may be inhaled by personnel and cause injury or illness. OSHA and CDPHE chapter 2 general licensure standards(opens in new window) require health care facilities to use a “hierarchy of controls” to reduce exposure.
This means starting with the most effective controls: The elimination of hazards from the workplace, or substitution of less hazardous processes, chemicals, or products. Next in the hierarchy are engineering controls, which involve modifying equipment and/or other physical aspects of the workplace to reduce or prevent worker contact with the hazard, by isolating the hazard and/or using specialized ventilation (e.g., isolation rooms or laboratory hoods). Where these controls are not feasible or adequate, administrative controls (e.g., providing vaccinations or triaging patients) and work practices (e.g., following respiratory hygiene/cough etiquette strategies or keeping chemical containers capped) are used to reduce risk, most often by minimizing the extent or duration of the exposure, or by reducing the number of employees exposed. Respirators and other personal protective equipment (PPE) are used as a last line of defense when exposures cannot be reduced to an acceptable level using these other methods. The best occupational health practices to protect workers involves using a layered approach of techniques that fall across different tiers of the Hierarchy of Controls.
All healthcare facilities, regardless of size and/or type of care given, may find the following resources helpful in creating a Respiratory Protection Plan.