Respiratory Protection has Never Been More Important: Selection and Considerations for Proper Use

When the respiratory system encounters threats for which little to no effective natural defense exists, it is imperative to have controls in place to prevent exposure.  

• By Dr. Alex Birrell
• Feb 01, 2022

Respiratory protection is essential to the health and productivity of workers at risk of exposure to airborne hazards. Common airborne contaminants in large industrial or healthcare sectors are at best irritants—and at worst, acutely lethal. In the industrial sector, there are known carcinogens, such as crystalline silica, present in workspaces. In healthcare, employees must be protected against life-threatening airborne viruses.

Through modern industrial processes or global pandemics, exposure to airborne contaminants such as silica, wildfire smoke, coal, welding fumes and Covid-19 could pose acute and long-term health issues such as asthma, COPD, cancer or viral infections. In some cases, the hazards are dose dependant and in others even limited exposure cause serious life-threatening disease. When the respiratory system encounters threats for which little to no effective natural defence exists, it is imperative to have controls in place to prevent exposure.

RPE—The Personal Line of Defense

There remain many workplaces and specific tasks where exposure cannot be controlled by engineering controls alone. For example, where tasks are undertaken in new or unfamiliar sites (contract work and mobile teams), remote locations (mine operations) or where workers are required to be located close to the source of the airborne contaminant (patient care, hard rock cutting). Some hazards may remain even after the use of engineering controls and the use of respiratory protective equipment (RPE) becomes necessary to protect workers.

Considerations in Selection

When selected and used appropriately, PPE can significantly reduce exposure to occupational hazards. In the selection of RPE, there are environmental considerations such as type of airborne contaminant, tasks, other personal equipment and location (clinical setting, intrinsically safe areas, tight spaces, working from height). Due to the importance of RPE selection, there are guidelines, standards and regulations advising the type, fit and level of protection offered. The standards will also state that the choice of respirator must correspond to the type of hazard.

Other considerations for RPE use are: compatibility with any other personal protective equipment (PPE) and user factors such as hot workplace environments, health conditions, confined workspaces or other relevant conditions to a particular workplace setting. There exist a sizable range of respirators, filters and cartridges specifically designed to handle contaminants in a variety of forms—particles, gases or vapours. Below, we will discuss the two most popular: N95s and PAPRs.

N95 Particulate Respirators. N95 disposable respirators are specifically manufactured to be able to filter particles that are above 0.3 microns in size with 95 percent filtration efficiency. They achieve this level of filtration by using a filter layer in the mask that is created from non-woven fiber or material, such a polypropylene. N95s are negative pressure masks which means air is drawn in through the mask.

Used widely, disposable respirators are intended “only for low hazard levels” and are strictly protective against particles and cannot protect against chemicals, gases, or vapours. In order to be effective, N95 respirators are designed to be worn with a tight seal against the wearer’s face. This ensures that when the wearer inhales, the air being drawn in is coming through the mask’s filtration layers, and not from leakage around the edges of the mask where it meets the face. Part of the procedures for proper use of an N95 mask requires that the mask be correctly fitted to assure that it is properly donned. There are workers, due to face shape, who cannot achieve a seal in disposable masks.

There are some additional limitations of this class of respirators; wearers with certain medical conditions may have difficulty or may not be able to use this type of respirator due to the breathing resistance experienced by negative pressure masks. This class of product is single use and associated with a significant waste and environmental contamination.

Powered Air Purifying Respirators (PAPRs). One of the highest levels of workplace protection provided is with powered air purifying respirator (PAPR) devices. PAPRs consist of a battery-powered air handler or blower that draws ambient air through a filter cartridge, directing the purified air to headgear such as a mask, hood or helmet. The power unit generates positive pressure inside the mask, which serves to keep unfiltered ambient air from entering the headgear and being potentially inhaled by the user.

This positive pressure feature means that the fit of the headgear used with PAPRs need not form a tight seal, unlike the N95 mask where the tight fit to the face is a key requirement. This capability means that users with facial hair are able to wear the respirators because if there is a break in the seal, the air is pushing outwards, preventing any air from entering.

PAPRs are capable of filtering anywhere from 96 percent of contaminants at the low end to upwards of 99.9 percent at the higher end of the filtration metric. With a positive pressure respirator, there is significantly less risk of airborne contaminants breaching the mask and the wearer inhaling contaminants even during inadvertent mask movement, such as when the wearer adjusts the mask or speaks.

Adoption of RPE

Many operations inherently require staff to be active—moving in and out of the contaminated area. These operations can also involve staff in physically demanding tasks in hot temperatures over long shifts or in remote or constantly new locations. In today’s world, teams can be working around the clock to deliver care, productivity or efficiency targets. Despite offering a higher level of protection, many employers are unable to practically deploy traditional belt mounted hood PAPRs—which are complex and slow to don. They cannot be stored, carried or worn in mobile or remote work and are difficult to clean and disinfect in clinical settings.

For employers who invest in large hooded PAPR systems, the complex parts (increasing time for assembly and donning), see these PAPRs being underused, as staff tend to opt for fast and simple masks or nothing at all. RPE is not protective if systems cannot be adopted or used correctly.

A Breath of Fresh Air

In the last 20 years, technology has driven unprecedented advances in equipment transforming the health and safety of workers around the world. With advances in respirator technology, workers can feasibly have the option of comfortable and easy-to-use PAPRs. Where once these were belt mounted and cumbersome, companies have developed lightweight, compact products which enable staff to rapidly put on their masks and freely undertake activities like bending, sitting and getting in and out of vehicles.

Now employers can access a high protection, sustainable mask that staff can readily use in many modes of work and applications. Industries such as mining, metal works and stonemasonry, where workers are exposed to harmful contaminants such as coal dust, silica and welding fumes, have welcomed an alternative.

The Importance of Internationally Recognized PPE

Respiratory protection has never been more important. Employers should be able to purchase reliable equipment and workers should be able to wear their RPE with confidence.

The importance of internationally recognized certifications and approvals has yet again been highlighted following increased reporting of counterfeit and poor-quality filtering facepiece respirators and PPE. U.S. regulators recently banned the products of one of the world’s largest N95 manufacturers due to unsatisfactory quality management systems. This ruling serves as a reminder that highly protective, approved mask solutions are available and can be deployed immediately. Better PPE gives everyone peace of mind.

When reviewing respiratory protection, employers should look for international certifications from the National Institute for Occupational Safety and Health (NIOSH), Europe’s CE mark or Australia’s Therapeutic Goods Administration (TGA).

This article originally appeared in the February 1, 2022 issue of Occupational Health & Safety.