OSHA Voluntary Respirator Use: Challenges incurred with use of N95 filtering facepiece respirators during the COVID-19 pandemic

Abstract

This article discusses several lessons learned in dealing with the interpretation of the Occupational Health and Safety Administration (OSHA) Voluntary Use provision of the Respiratory Health Standard at health-care facilities during the COVID-19 pandemic in the United States. This includes (but is not limited to) (a) confusion about OSHA policy and procedures when health-care workers brought outside personal protective equipment (PPE; N95 filtering facepiece respirators) into the workplace; (b) challenges in adhering to guidelines stated in Appendix D of the Respiratory Protection Standard; (c) difficulty in achieving respirator fit testing for workers; and (d) vague or inconsistent determination of “non-hazardous” environments (concerning COVID-laden droplets and aerosols). The purpose was to identify gaps in knowledge to help policy makers, enforcement personnel, safety managers, and health-care workers in the United States prepare for similar future events involving PPE shortages.

Performance evaluation of occupational health and safety in relation to the COVID-19 fighting practices established by WHO: Survey in multinational industries

“…The first practice to combat COVID-19 considered by this work addressed the supply of water and soap (COV1), as well as adequate access to handwashing facilities at work ( Dennerlein et al, 2020 , Jahangiri et al, 2020 , Michaels and Wagner, 2020 ) with neutral detergent, as well as the use of hospital disinfectants active against the virus ( Dufour et al, 2020 ; O’Neill, 2020 ), 0.1% sodium hypochlorite solution or solution 70% ethanol ( Spinazzè et al, 2020 ). In addition, COV1 assesses the provision of personal protective equipment ( Gharibi et al, 2020 ; Gibbs and Nonnenmann, 2020 ) - and the definition of mandatory use in relation to its extensive use ( Otañez and Grewal, 2021 ) - and the use of thermo-flash thermometers for body measurement allows early detection of fever from a safe distance ( Ndiaye and Diatta, 2020 , Garzillo et al, 2020 ).…”

“…In addition, the provision of personal protective equipment, such as masks and face shields and proper training on how to use them ( Gharibi et al, 2020 ) must be provided for both employees and customers, depending on the type of business establishment ( Dennerlein et al, 2020 ). An example of this is the availability of type N95 masks for professionals who need to have contact with people infected with the new coronavirus ( Gibbs and Nonnenmann, 2020 ).…”

“… Code Practices to combat COVID-19 according to WHO Authors COV1 Make available to its employee's resources against COVID-19 such as hand hygiene using water and soap or 70% alcohol; self-reported symptoms form; body temperature measurement; personal protective equipment in terms of surgical face masks. Dennerlein et al, 2020 , Dufour et al, 2020 , Garzillo et al, 2020 ; Gharibi et al (2020) ; Gibbs and Nonnenmann, 2020 , Jahangiri et al, 2020 , Michaels and Wagner, 2020 , Ndiaye and Diatta, 2020 ; O’Neill (2020) ; Spinazzè et al, 2020 , Otañez and Grewal, 2021 COV2 Organize the workplace to maintain a safe distance (1.5 m) between workers, considering the guidelines of the Ministry of Health and the characteristics of the work environment. Demartini et al, 2020 , Dennerlein et al, 2020 , Gallardo et al, 2020 , Garzillo et al, 2020 ; Gharibi et al (2020) ; Giorgi et al, 2020 , Jahangiri et al, 2020 , Laroche et al, 2020 , Michaels and Wagner, 2020 ; O’Neill (2020) ; Parker, 2020 , Sönmez et al, 2020 , Otañez and Grewal, 2021 , Sorensen et al, 2021 COV3 Prioritize measures to distribute the workforce throughout the day, avoiding concentrating it in just one shift.…”

“… Dennerlein et al, 2020 , Dufour et al, 2020 , Gallardo et al, 2020 , Garzillo et al, 2020 , Jahangiri et al, 2020 , Michaels and Wagner, 2020 , Ndiaye and Diatta, 2020 ; O’Neill (2020) ; Parker, 2020 , Sönmez et al, 2020 COV5 Provide emergency care to suspected or confirmed cases of COVID-19, considering the use of PFF2 or N95 respirators or masks. Dennerlein et al, 2020 , Garzillo et al, 2020 , Gibbs and Nonnenmann, 2020 , Ndiaye and Diatta, 2020 ; O’Neill (2020) …”

“…It is worth mentioning the actions that improve the performance of companies and have a direct relationship with the safety of employees were also investigated. Thus, on-the-job training (S1) on the importance of personal protective equipment ( Gibbs and Nonnenmann, 2020 ; O’Neill, 2020 ) and OH&S ( De Cieri and Lazarova, 2020 ), with a focus on practice operational, is fundamental for combating COVID-19 ( Gharibi et al, 2020 ; Dufour et al, 2020 , Ravi et al, 2020 ). In addition, protocols for safe training, including those aimed at worker resilience ( Giorgi et al, 2020 ), should be promoted.…”