The Occupational Safety and Health Administration (OSHA) has issued respiratory protection guidance for longterm care facilities. that focuses on the use of respirators, according to an article on the EHS Daily Advisor website.

The guidance also emphasizes a primary reliance upon engineering and administrative controls  consistent with good industrial hygiene practice and OSHA’s “hierarchy of controls.”

The industrial hygiene “hierarchy of controls” is a series of workplace safety and health interventions that begins with elimination of hazards, followed by substitution, then engineering controls, administrative controls (including work practices), and personal protective equipment (PPE).

OSHA says workers must wear respirators when when in close contact with a resident of a longterm care facility with suspected or confirmed coronavirus infection. Employees then must wear an N95 filtering facepiece respirator or equivalent or a higher-level respirator approved by the National Institute for Occupational Safety and Health .

Earlier this year, OSHA issued enforcement guidance allowing the decontamination and reuse of N95 respirators during the pandemic on a case-by-case basis. The interim guidance to the agency’s Compliance Safety and Health Officers (CSHO) allows the reuse, in certain circumstances, of filtering facepiece respirators (FFR) decontaminated using methods that have shown promise in limited research.

According to OSHA, employers should:

• Make a good-faith effort to provide and ensure workers use the most appropriate respiratory protection available for expected workplace hazards;
• Ensure decontamination is performed according to CDC guidance;
• Ensure employees perform a user seal-check each time they don a respirator and not permit use of a respirator on which the user cannot perform a successful user seal-check;
• Train employees to follow appropriate precautionary measures detailed in the CDC’s guidance before using a decontaminated FFR;
• Train employees using decontaminated respirators to understand that if the structural and functional integrity of any part of the respirator is compromised, it should not be used for respiratory protection—an inability to achieve a successful user seal-check could be an indicator that the integrity of the respirator is compromised;
• Visually inspect, or ensure that workers visually inspect, FFRs to determine if the structural and functional integrity of the respirators has been compromised—components such as the straps, nose bridge, and nose foam material may degrade over time or as a result of decontamination and affect the quality of the respirators’ fit and seal; and
• Train employees on the procedures for properly donning and doffing respirators to prevent self-contamination.

Read the full EHS Daily Advisor article.