Occupational Respiratory Disease Surveillance

Featured Discussion: RESPIRATOR USE AND PRACTICES

Background Information

In August 2001, the National Institute for Occupational Safety and Health (NIOSH) and the Bureau of Labor Statistics (BLS) conducted a survey of respirator use and practices among private sector employers in the U.S. The results, methodology, and survey questionaire were published in Respirator Usage in Private Sector Firms, 2001¹ (PDF only 1,118 KB (278 pages)) The purpose of the survey was to gather information on respirator use and practices that could aid in guiding NIOSH respirator certification and research.

The 40,002 surveyed establishments were selected from a sample of 174,305 private sector establishments used in the 1999 BLS Survey of Occupational Injuries and Illnesses (SOII).² Most of the survey questions addressed respirator use that is “required” by regulation.³ Survey questions were designed to gather information on types of respirators used, conditions under which respirators are used, the amount of usage by industries, and characteristics of respirator programs. The survey responses were used to estimate the numbers of establishments and numbers of employees who use respirators.

Findings

Findings of the survey raise concerns that respirators are often not being used in the manner recommended by federal agencies. Proper respirator use could lead to decreased morbidity and mortality among workers.

Findings of the survey provide detailed, useful information on respirator use by private sector employers in the U.S. They show clear patterns of respirator use in the workplace and help identify research needed to improve respirator effectiveness and respirator training. Data collected from the survey could be used as a baseline for future respirator use surveys.

Selected findings from the survey are summarized in the figures and table presented below.
Figure 1. Types of required respirators used
Figure 2. Employees and establishments with required respirator use by major industry division
Figure 3. The ten hazardous agents for which air-purifying respirators are most commonly used by establishments
Figure 4. The ten hazardous agents for which air-supplied respirators are most commonly used by establishments
Figure 5. Percent of establishments using respirators by method of determining respirator use
Figure 6. Indications of an inadequate respiratory protection program
Table 1. Characteristics of respirator programs

What types of required respirators are used? (See Figure 1.)
Of the establishments requiring the use of respirators,
94.9% used air-purifying respirators, and
16.8% used air-supplied respirators.

How many jobs have requirements for respirator usage? (See Figure 1.)
During the 12-month period prior to the survey,
4.5% of all establishments required respirator use; and
3.1% of all employees were required to use respirators, by regulation or by the employer.

Which industries have the highest rate of required respirator use for their establishments/employees? (See Figure 2.)
The required use of respirators were found to be highest within the following industries:
Manufacturing (12.8% of establishments, 4.8% of employees)
Mining (11.7% of establishments, 9.9% of employees)
Construction (9.6% of establishments, 8.9% of employees)
Agriculture, forestry, and fishing (9.4% of establishments, 5.8% of employees)

From which substances are workers protected by using respirators? (See Figure 3 and Figure 4.)
Establishments using air-purifying respirators most frequently used those respirators to protect workers from the following:
Dust (49.8% of establishments)
Paint vapors (41.8% of establishments)
Solvents (32.3% of establishments)

Establishments using air-supplied respirators most frequently used those respirators to protect workers from the following:
Paint vapors (45.7% of establishments)
Solvents (28.3% of establishments)
Dust (24.8% of establishments)

Who makes decisions concerning respirator use? (See Figure 5.)
Among the establishments using respirators, decisions involving respirator use were determined by the following:
A written program adopted by management (34%)
The supervisor (23%)
The employee (22%)
The respirator manufacturer instructions (20%)

Do employees use appropriate respirators for their work conditions? (See Table 1.)
Many employees appear to use respirators in conditions not permitted by regulations or that may not be adequately protective. In particular, dust masks are used at 71% of establishments that use respirators. Dust masks vary considerably in performance between models and have high error rates in fit testing.⁴ Furthermore, an estimated 35,700 establishments use dust masks for protection against chemical vapors. Such filtering facepieces do not adequately protect workers from exposure to vapors or gases. Supplied-air respirators, or respirators with appropriate chemical vapor/gas cartrigides should be used.

Are there indications that respiratory protection programs may be inadequate? (See Figure 6.)
Nearly all (90%) of establishments using respirators had at least one indicator of an inadequate respiratory protection program, and more than 45% had at least five. This is consistent with OSHA Fiscal Year 2004 compliance surveys in which more than 4,400 citations were issued for respiratory protection. This same source indicates that respiratory protection citations were the fifth highest in a list of 383 different types of citations.⁵

Figures and Table

Figure 1. Types of required respirators used

*Further breakdown is provided in Respirator Usage in Private Sector Firms, 2001¹ (PDF only 1,118 KB (278 pages))
Note: The percentages of establishments that use respirators do not add up to 100% because there can be more than one type of respirator used. The percentages for different types of respirator use are calculated using the total respirator use as the denominator. (establishments n = 281,776; employees n = 3,303,414). Return to Discussion.

Figure 2. Employees and establishments with required respirator use by major industry division

*”Services” has the highest number of employees using respirators (n = 1,160,300) and highest number of respirator-using establishments (n = 89,600). Return to Discussion.

Figure 3. The ten hazardous agents for which air-purifying respirators are most commonly used by establishments

Note. Denominator is the total number of establishments that used air-purifying respirators (n = 267,467). The category “dust” includes “other dust” and “other” text responses that were determined to be in the form of dusts. The category “other vapors” includes “other vapors” and “other” text responses that were determined to be in the form of vapors. Return to Discussion.

Figure 4. The ten hazardous agents for which air-supplied respirators are most commonly used by establishments

Note. Denominator is the total number of establishments that used air-supplied respirators (n = 47,290). The category “dust” includes “other dust” and “other” text responses that were determined to be in the form of dusts. The category “other vapors” includes “other vapors” and “other” text responses that were determined to be in the form of vapors. Return to Discussion.

Figure 5. Percent of establishments using respirators by method of determining respirator use Note. The percentages do not total to 100% due to rounding. Return to Discussion.

Figure 6. Indications of an inadequate respiratory protection program Return to Discussion.

Table 1. Characteristics of respirator programs

Respirator Selection 70% of all respirator-using establishments did not use air sampling as a basis to select respirators for protection from the respiratory hazard(s) to which their workers were exposed. Program Administrator 42% of program administrators at respirator-using establishments had no specific respirator training. With a trained administrator, 70% of establishments had a written procedure for cleaning respirators. 55% evaluated the effectiveness of respirator use. Without a trained administrator, 23% of establishments had a required written procedure for cleaning respirators. 11% evaluated the effectiveness of respirator use. Employee Respirator Training 40% of respirator-using establishments did not provide required respirator training to their employees. Assessment of Medical Fitness to Wear a Respirator Half of respirator-using establishments did not provide required assessment of employees for medical fitness to wear a respirator. Fit Testing 40% of establishments requiring use of tight-fitting respirators did not provide required fit testing. Airline Respirator Hose Coupling Compatibility 18% of all airline respirator-using establishments failed to use respirator hose couplings that were incompatible with other air or gas supply lines. (Fatalities have resulted when an airline has been connected to a coupling with inert gases such as nitrogen or argon.6,7) Return to Discussion.

References

¹ NIOSH/BLS [2003]. Respirator usage in private sector firms, 2001 (PDF only 1,118 KB (278 pages)). Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institutue for Occupational Safety and Health.

² BLS [1999]. U.S. Bureau of Labor Statistics: Survey of occupational injuries and illnesses, 1999 (Summary 01-01). Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics.

³ 29 Code of Federal Regulations, 1910.134, Respiratory Protection.

⁴ Coffey CC, Zhuang Z, Campbell DL, Myer WR [1998]. Quantitative fit-testing of N95 respirators: Part II – results, effect of filter penetration, fit-test, and pass/fail criteria on respirator performance. J Int Soc Respir Prot 16(1-4):25–36.

⁵ OSHA [2005]. Frequently cited OSHA standard database: SIC all [http://www.osha.gov/oshstats/
std2.html]. Date accessed: February 18, 2005.

⁶ Hudnall JB, Suruda A, Campbell DL [1993]. Deaths involving airline respirators connected to inert gas sources. Am Ind Hyg Assoc J 54(1):32-35.

⁷ Suruda A, Milliken W, Stephenson D, Sesek R [2003]. Fatal injuries in the United States involving respirators, 1984-1995. Appl Occup Environ Hyg 18(4):289-292.