Attachment 01_ANSI Z88.6-2006 10 Special Testing 10.1.pdf

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L L i i c c e e n n s s e e e e E E n n g g i i n n e e e e r r i i n n g g D D e e v v e e l l o o p p m m e e n n t t D D e e p p t t . .

C C D D S S

Respiratory Respiratory Protection —Protection — Respirator UseRespirator Use

PhysicalPhysical QualificationsQualifications for Personnelfor Personnel

ANSI/AIHA Z88.6– ANSI/AIHA Z88.6–20062006

A Publication by A Publication by American Industrial Hygiene American Industrial Hygiene AssociationAssociation

American American

NationalNational

StandardStandard for for

ANSI/AIHA Z88.6—2006ANSI/AIHA Z88.6—2006

American National StandardAmerican National Standard for Respiratory Protection —for Respiratory Protection —

Respirator Use —Respirator Use — Physical Qualifications for PersonnelPhysical Qualifications for Personnel

Approved: August 25, 2006Approved: August 25, 2006

American Industrial Hygiene AssociationAmerican Industrial Hygiene Association

AmericanAmerican NationalNational StandardStandard

Approval of an American National Standard requires verification by ANSI thatApproval of an American National Standard requires verification by ANSI that the requirement for due process, consensus, and the requirement for due process, consensus, and other criteria for approvalother criteria for approval have been met by the standard’s developer.have been met by the standard’s developer.

Consensus is established when, in the judgment of the ANSI Board ofConsensus is established when, in the judgment of the ANSI Board of Standards ReviewStandards Review, substantial agreement has , substantial agreement has been reached by directly been reached by directly andand materially affected interests. Substantial agreement means much more than amaterially affected interests. Substantial agreement means much more than a simple majority, but not necessarily simple majority, but not necessarily unanimityunanimity. Consensus requires that al. Consensus requires that al ll views and objection be considered, and that a concerted effort be madeviews and objection be considered, and that a concerted effort be made toward their resolution.toward their resolution.

The use of American National Standards is completely voluntary; their exis-The use of American National Standards is completely voluntary; their exis-tence does not in any respect preclude anyone, whether he or she hastence does not in any respect preclude anyone, whether he or she has approved the Standards, or not, from manufacturing, marketing, purchasing, orapproved the Standards, or not, from manufacturing, marketing, purchasing, or using products, processors, or procedures not conforming to the Standards.using products, processors, or procedures not conforming to the Standards.

The American National Standards Institute does not develop standards andThe American National Standards Institute does not develop standards and will in no circumstances give an interpretation of any American Nationalwill in no circumstances give an interpretation of any American National Standard. MoreovStandard. Moreover, no person shall have the rer, no person shall have the r ight or authority ight or authority to issue anto issue an interpretation of an American National Standard in the name of the Americaninterpretation of an American National Standard in the name of the American National Standards Institute. Requests for interpretations should be National Standards Institute. Requests for interpretations should be addressedaddressed to the secretariat or sponsor whose name appears on the title page of thisto the secretariat or sponsor whose name appears on the title page of this standard.standard.

CAUTION NOTICE:CAUTION NOTICE: This American National Standard may be revised or with-This American National Standard may be revised or with-drawn at any time. drawn at any time. The procedures of The procedures of the American National the American National StandardsStandards Institute require that action Institute require that action be taken to reaffirm, be taken to reaffirm, revise, or withdraw thisrevise, or withdraw this Standard no later Standard no later than five years from the date than five years from the date of approval. Purchasers ofof approval. Purchasers of American National Standards may receive current information on all standardsAmerican National Standards may receive current information on all standards by calling or writing the American National Standards Institute.by calling or writing the American National Standards Institute.

Published byPublished by

American Industrial Hygiene AssociationAmerican Industrial Hygiene Association 2700 Prosperity Ave., Suite 2502700 Prosperity Ave., Suite 250 Fairfax, VA 22031Fairfax, VA 22031 www.aiha.orgwww.aiha.org

Copyright © 2006 by the American Industrial Hygiene AssociationCopyright © 2006 by the American Industrial Hygiene Association All rights reserved.All rights reserved.

No part of this publication may be reproduced in any form,No part of this publication may be reproduced in any form, in an electronic retrieval system or otherwise, without thein an electronic retrieval system or otherwise, without the prior written permission of the publisher.prior written permission of the publisher.

Printed in the United States of America.Printed in the United States of America.

Stock No: SRPA06-716Stock No: SRPA06-716

ISBN: 1-931504-71-7ISBN: 1-931504-71-7

ContentsContents PagePage

ForewForewordord .................................................................................................................................................................................................................................................................iii.........iii

Subcommittee Subcommittee Members..................Members.........................................................................................................................................................................................................v.v

11 Scope Scope and and PurposePurpose.......................................................................................................................................................................................................................................1...1

1.11.1 Scope....................Scope.......................................................................................................................................................................................................................................1

1.21.2 PurposePurpose ...............................................................................................................................................................................................................................................1

1.31.3 “Shall” “Shall” and and “Should”“Should” .................................................................................................................................................................................................................1

1.41.4 ExceptionsExceptions ...........................................................................................................................................................................................................................................1

22 Normative Normative References.................References............................................................................................................................................................................................................1

33 DefinitionsDefinitions.................................................................................................................................................................................................................................................................1

44 Respirator Respirator CharacteristicsCharacteristics .................................................................................................................................................................................................................3

55 Medical Medical Evaluation Evaluation RationaleRationale .................................................................................................................................................................................................4

66 QualifQualificatioication of Pn of Personersons Whs Who Conduo Conduct Medct Medical Evical Evaluatialuations to Dons to Determietermine Suitane Suitability bility toto Use Use Respiratory Respiratory Protective Protective Devices....................Devices................................................................................................................................................................4

77 Evaluation Evaluation RequirementsRequirements ...................................................................................................................................................................................................................4

88 Medical Medical HistoryHistory ..............................................................................................................................................................................................................................................5

99 Medical Medical EvaluationEvaluation .......................................................................................................................................................................................................................................6

9.19.1 FrequencyFrequency...........................................................................................................................................................................................................................................6

9.29.2 General General ConsiderationsConsiderations

1010 Special Special TTesting..............esting....................................................................................................................................................................................................................................8

10.110.1 SpirometrySpirometry ............................................................................................................................................................................................................................................8

AnnexesAnnexes

AnneAnnex x AA ExeExercise rcise StresStress s TTesting......esting................................................................................................................................................................................9..9

AnneAnnex B1x B1 RespiRespiratorator Medical Examinr Medical Examination Formation Form/T/Temporemporary Disqualifary Disqualificatioication Criteria....n Criteria...............1...111

AnneAnnex B2x B2 RequeRequest fst for Medor Medical Cleical Clearanarance foce for Respr Respiratoirator Use Qr Use Questiouestionnairennaire PLHCP PLHCP Determination Determination of of Class Class FormForm

AnneAnnex B3x B3 ExampExample of the Medicle of the Medical Questial Questionnaironnaire for Rese for Respiratpirator Users Ior Users Initial Fnitial Form......orm

AnneAnnex B4x B4 ExampExample of the Mele of the Medical Qudical Questionestionnaire fnaire for Respor Respiratoirator Users Pr Users Periodic Feriodic Formorm .................15.15

AnneAnnex B5x B5 ExampExample of Emplole of Employee Copyee Copy of PLHCP’y of PLHCP’s Writs Written Commten Communicatunication Formion Form ...........................16...16

AnneAnnex Cx C SpiromSpirometry (Guetry (Guidance fidance for Peor Perfrformance aormance and Interpnd Interpretatretation)...ion)

AnneAnnex x DD FuturFuture e ReseaResearch rch Areas.....Areas..............................................................................................................................................................................19.19 iiiiii

ANSI/AIHA Z88.6–2006ANSI/AIHA Z88.6–2006

FOREWORDFOREWORD

A series of related American National Standards were identified after the development of ANSIA series of related American National Standards were identified after the development of ANSI Z88.2–1980 “Respiratory Protection Programs” to address specialized technical Z88.2–1980 “Respiratory Protection Programs” to address specialized technical elements of respi-elements of respi-ratory protection programs. ratory protection programs. ANSI Z88.6–1984 “RespirANSI Z88.6–1984 “Respirator Use —ator Use — Physical Qualifications forPhysical Qualifications for Personnel” wPersonnel” was the as the first of these first of these standards to be standards to be developed. developed. ANSI/AIHA Z88.10–2001 “RespiratorANSI/AIHA Z88.10–2001 “Respirator Fit TFit Testing Methods” has also been esting Methods” has also been developed and is available to provide detailed developed and is available to provide detailed respiratory pro-respiratory pro-tection program guidance in tection program guidance in the area of the area of respirator fit testing.respirator fit testing.

American National Standard Z88.6-1984 contained general, rather than specific requirementsAmerican National Standard Z88.6-1984 contained general, rather than specific requirements because it was the first standard to deal with this subject. It was intended that “more specificbecause it was the first standard to deal with this subject. It was intended that “more specific requirements” would be provided in future editions that would provide more detailed guidance torequirements” would be provided in future editions that would provide more detailed guidance to assist medical professionals in determining which individuals should and should not be medicallyassist medical professionals in determining which individuals should and should not be medically qualified to wear respirators. Annex C of the 1984 qualified to wear respirators. Annex C of the 1984 standard concluded with suggested “Areas standard concluded with suggested “Areas ofof Future Investigation.Future Investigation.” This standard addresses these and other ” This standard addresses these and other areas and presents a areas and presents a process thatprocess that meets, and in many areas exceeds, the minimum requirements of the Occupational Safety andmeets, and in many areas exceeds, the minimum requirements of the Occupational Safety and Health Administration’s (“OSHA”) Respiratory Protection Standard (the “federal standard”) 29 CFRHealth Administration’s (“OSHA”) Respiratory Protection Standard (the “federal standard”) 29 CFR 1910.134, and:1910.134, and:

•• Includes all the questions Includes all the questions required by trequired by the OSHA respirathe OSHA respirator questionnaire as or questionnaire as well as additionalwell as additional questions to assess the risk of cardiac disease,questions to assess the risk of cardiac disease, •• Recommends phRecommends physician review ysician review of all cases that of all cases that fall outside fall outside certain parameters, andcertain parameters, and •• Considers the physiologic demConsiders the physiologic demand of the type of wand of the type of work to be performed, and ork to be performed, and type of respirator ftype of respirator foror which approval is granted.which approval is granted.

The Committee has made the following determinations regarding the revised Standard:The Committee has made the following determinations regarding the revised Standard:

•• Any medical profAny medical professional authorized to essional authorized to evaluate evaluate respirator use respirator use should be required to should be required to know theknow the physiologic demands associated with various types of respirators.physiologic demands associated with various types of respirators.

•• The impact of The impact of safe and safe and reliable work perfreliable work performance on felloormance on fellow workers w workers and the public and the public should beshould be considered.considered.

•• The impact of The impact of medical factors medical factors on job perfon job performance exclusive ormance exclusive of respirator use of respirator use should be considered.should be considered.

•• ConditConditional approional approval maval may be granted in approy be granted in appropriate caspriate cases.es.

•• A periodic medical A periodic medical questionnaire prior tquestionnaire prior to annual ro annual respirator fit espirator fit testing should be testing should be administered.administered.

•• Clinical Exercise Stress Clinical Exercise Stress TTesting (EST) is a useful test esting (EST) is a useful test for efor evaluating the functional capacity (wvaluating the functional capacity (workork capacity) of users of industrial respirators as respiratory reserve is normally greater than circulatorycapacity) of users of industrial respirators as respiratory reserve is normally greater than circulatory system reserve and cardiac disease is more common as a disqualifier than pulmonary disease.system reserve and cardiac disease is more common as a disqualifier than pulmonary disease.

•• The routine use of spirometThe routine use of spirometry to determine the suitability of individry to determine the suitability of individuals to use respiratuals to use respiratory protectivory protectivee devices is not required, although pulmonary function data (especially aggregate data) may be andevices is not required, although pulmonary function data (especially aggregate data) may be an important measure of response to worker exposure.important measure of response to worker exposure.

•• Workers arWorkers are less likely te less likely to have o have clinically significant Coronary Artery Disease clinically significant Coronary Artery Disease “CAD” “CAD” and to beand to be heat intolerant if they achieve a negative EST to 10 METs.heat intolerant if they achieve a negative EST to 10 METs.

•• Specific blood pressureSpecific blood pressure, body w, body weight, and pulmonary function eight, and pulmonary function values will requvalues will require physician con-ire physician con-sideration, and/or evaluation, and/or medical testing.sideration, and/or evaluation, and/or medical testing.

•• The conservative definition of The conservative definition of “heavy” “heavy” work as suggested by work as suggested by “OSHA” “OSHA” should be adopted.should be adopted.

•• A concise staA concise statemetement regarnt regarding fading facial hair shocial hair should be includeuld be included.d.

•• WorkWorkers using conters using contact lensesact lenses, and worker, and workers with perfs with perforatorated tympaned tympanic membric membranes should notanes should not bebe routinely excluded.routinely excluded.

•• A chest X-raA chest X-ray should not be y should not be used routinely to used routinely to determine suitability to use determine suitability to use respirators.respirators.

•• Spirometry should be Spirometry should be interpreted in accordance interpreted in accordance with the with the recommendations of recommendations of the Americanthe American

Thoracic Society (ATS) and that AThoracic Society (ATS) and that ATS recommendations for performing spirometry tests TS recommendations for performing spirometry tests should beshould be considered as useful considered as useful guidance by evaluators.guidance by evaluators.

iviv

There are four annexes in this There are four annexes in this standard. standard. These annexes are informative and are not These annexes are informative and are not consideredconsidered part of part of the standard. Suggestions for the improvement of this standard will the standard. Suggestions for the improvement of this standard will be welcome. be welcome. TheyThey should be sent to the ANSI Z88 Secretariat, American Industrial Hygiene Association, 2700should be sent to the ANSI Z88 Secretariat, American Industrial Hygiene Association, 2700 Prosperity Avenue, Suite 250, Fairfax VA. 22031.Prosperity Avenue, Suite 250, Fairfax VA. 22031.

Future revisions are anticipated to provide even more detailed guidance, especially as it applies toFuture revisions are anticipated to provide even more detailed guidance, especially as it applies to workers with known serious medical issues.workers with known serious medical issues.

vv

This standard was processed and approved for submittal to ANSI by the Z88 Accredited StandardsThis standard was processed and approved for submittal to ANSI by the Z88 Accredited Standards Committee on Respiratory Protection. Committee approval of the Standard does Committee on Respiratory Protection. Committee approval of the Standard does not necessarilynot necessarily imply that all imply that all committee members voted for its approval. At the time it approved this committee members voted for its approval. At the time it approved this Standard theStandard the Z88 Committee had the Z88 Committee had the following members:following members:

James S. Johnson, PhD, CIH, QEP, ChairJames S. Johnson, PhD, CIH, QEP, Chair Stephen C. Graham, CIH, CSP, Vice ChairStephen C. Graham, CIH, CSP, Vice Chair Mili Mavely, Secretariat RepresentativeMili Mavely, Secretariat Representative

Organization Organization Represented Represented Name Name of of Representative Representative AAmmeerriiccaan n IInndduussttrriiaal l HHyyggiieenne e AAssssoocciiaattiioonn CC. C. Coollttoonn AAmmeerriiccaan n IIrroon n aannd d SStteeeel l IInnssttiittuuttee PP.. HHeerrnnaannddeezz AAmmeerriiccaan n SSoocciieetty y oof f SSaaffeetty y EEnnggiinneeeerrss RR.. HHaarrlleeyy AAmmeerriiccaan n WWeellddiinng g SSoocciieettyy SS.. HHeeddrriicckk BBWWXXTT, , YY--1122 MM. . HHaasskkeeww CCoon n EEddiissoon n oof f NNeew w YYoorrkk GG.. SSlliinnttaakk EEGG&&G G GGrroouupp RR.. MMeettzzlleerr FFoorrd d MMoottoor r CCoommppaannyy SS.. MMiinnggeellaa HHeeaalltth h PPhhyyssiiccs s SSoocciieettyy HH.. CCeemmbbeerr IInntteerrnnaattiioonnaal l AAssssoocciiaattiioon n oof f FFiirreeffiigghhtteerrss RR. D. Duuffffyy IInntteerrnnaattiioonnaal l BBrrootthheerrhhooood d oof f BBooiilleerrmmaakkeerrss DD. H. Haaggggeerrttyy IInntteerrnnaattiioonnaal l SSaaffeetty y EEqquuiippmmeennt t AAssssoocciiaattiioonn JJ. C. Coommeer r BBrraaddlleeyy LLaawwrreenncce e LLiivveerrmmoorre e NNaattiioonnaal l LLaabboorraattoorryy JJ. J. Joohhnnssoonn LLoos s AAllaammoos s NNaattiioonnaal l LLaabboorraattoorryy BB.. RReeiinneerrtt NNaattiioonnaal l FFiirre e PPrrootteeccttiioon n AAssssoocciiaattiioonn BB.. TTeeeellee NNaattiioonnaal l IInnssttiittuutte e oof f OOccccuuppaattiioonnaal l SSaaffeetty y aannd d HHeeaalltthh RR.. BBeerrrry y AAnnnn NNaattiioonnaal l PPaarrk k SSeerrvviiccee JJ.. SSaahhmmeell NNaavvy y EEnnvviirroonnmmeennttaal l HHeeaalltth h CCeenntteerr DD.. SSppeellccee PPeeaacch h BBoottttoom m AAttoommiic c PPoowweer r SSttaattiioonn EE.. GGeeee UUnniivveerrssiitty y oof f CCiinncciinnnnaatti i MMeeddiiccaal l CCeenntteerr RR. M. MccKKaayy UUnniivveerrssiitty y oof f PPiittttssbbuurrgghh JJ.. SScchhwweerrhhaa UU..SS. . DDeeppaarrttmmeennt t oof f EEnneerrggyy DD.. MMaarrssiicckk UU..SS. . DDeeppaarrttmmeennt t oof f LLaabboorr JJ.. SStteeeellnnaacckk UU..SS. . DDeeppaarrttmmeennt t oof f tthhe e AArrmmyy SS.. GGrraahhaamm

Individual Members Individual Members CC.. BiBienen DD.. BeBevisvis TT.. NelsoNelsonn

At the time it approved this standard, the Z88 Committee had the following alternate members:At the time it approved this standard, the Z88 Committee had the following alternate members:

OOrrggaanniizzaattiioon n RReepprreesseenntteedd NNaamme e oof f AAlltteerrnnaatte e RReepprreesseennttaattiivve e IInntteerrnnaattiioonnaal l SSaaffeetty y EEqquuiippmmeennt t AAssssoocciiaattiioonn JJ. B. Biirrkknneerr NNIIOOSSHH MM.. DD’’AAlleessssaannddrroo UU..SS. . DDeeppaarrttmmeennt t oof f EEnneerrggyy DD.. WWeeiittzzmmaann UU..SS. . DDeeppaarrttmmeennt t oof f tthhe e AArrmmyy II.. RRiicchhaarrddssoonn vivi

The Z88.6 Subcommittee on The Z88.6 Subcommittee on Respirator Use – Physical Qualification Respirator Use – Physical Qualification for Personnel, which devel-for Personnel, which devel-oped this Standard, had the following members:oped this Standard, had the following members:

Ronald J. Mack M.D., MPH, ChairRonald J. Mack M.D., MPH, Chair RRoosss s LL. . CCllaayy, , MMDD, , MMPPHH RRoobbeerrt t KK. . MMccLLeellllaann. . MMDD, , MMPPHH WWiilllliiaam m DDyyssoonn, , PPhhDD, , CCIIHH RRooy y TT. . MMc c KKaayy, , PPhhDD RRiicchhaarrd d EEnnkkeebboollll RRiicchhaarrd d RR. . RReeiillllyy, , PPhhDD CCoonnnniie e RR. . FFrreeiibbeerrgg, , CCSSPP JJaammees s PP. . SSeewwaarrdd, , PPhhDD AAnnddrreew w JJaacckkssoonn MMaarry y CC. . TToowwnnsseenndd, , DDrrPPHH CChhaarrllees s PP. . LLiissaa, , MMDD PPaattrriicck k WWeesstteerrkkaammpp Michael G. MaroldoMichael G. Maroldo

11 SSccooppe e aannd d PPuurrppoossee

11..11 SSccooppee.. This standard provides This standard provides informationinformation that is useful for the medical evaluation ofthat is useful for the medical evaluation of respirator users. This standard does notrespirator users. This standard does not deal with medical surveillance or biologi-deal with medical surveillance or biologi-cal exposure monitoring. It is understoodcal exposure monitoring. It is understood that local circumstances vary, that no setthat local circumstances vary, that no set of guidelines can cover all situations, andof guidelines can cover all situations, and that specific programs and proceduresthat specific programs and procedures should be modified for each should be modified for each individualindividual workplace. Medical evaluation is only oneworkplace. Medical evaluation is only one element of a complete respiratory protec-element of a complete respiratory protec-tion program. A complete respiratory pro-tion program. A complete respiratory pro-tection program is defined in ANSItection program is defined in ANSI Z88.2–1992.Z88.2–1992.

11..22 PPuurrppoossee.. This standard provides informa-This standard provides informa-tion and guidance to physicians or othertion and guidance to physicians or other licensed health care professionalslicensed health care professionals (PLHCPs) to assist them in determining(PLHCPs) to assist them in determining the medical suitability of personnel for res-the medical suitability of personnel for res-pirator use. It identifies the responsibilitypirator use. It identifies the responsibility of management to provide the PLHCPof management to provide the PLHCP with supplemental information before thewith supplemental information before the PLHCP makes a recommendation con-PLHCP makes a recommendation con-cerning an employee’s ability to use a res-cerning an employee’s ability to use a res-pirator (see Section 7.1 of this Standard).pirator (see Section 7.1 of this Standard).

Evaluators shall use their clinical judgmentEvaluators shall use their clinical judgment in the application of these guidelines andin the application of these guidelines and require additional information or evalua-require additional information or evalua-tion as necessary to permit certification ortion as necessary to permit certification or classification for respirator use.classification for respirator use.

1.1.33 “S“Shahallll” ” anand d “S“Shohoululd.d.” The provisions of” The provisions of this standard are mandatory in naturethis standard are mandatory in nature where the word “shall” is used and advi-where the word “shall” is used and advi-sory in nature where the word “should” issory in nature where the word “should” is used.used.

11..44 EExxcceeppttiioonnss.. Users of this standardUsers of this standard should be aware that regulatory agenciesshould be aware that regulatory agencies may have requirements that are may have requirements that are differentdifferent from this standard.from this standard.

22 NNoorrmmaattiivve Re Reeffeerreenncceess.. The followingThe following standards contain provisions which,standards contain provisions which, through reference in this text, constitutethrough reference in this text, constitute provisions of this American Nationalprovisions of this American National Standard. At the time of publication, theStandard. At the time of publication, the editions indicated were editions indicated were valid. All stan-valid. All stan-dards are subject to revision, and partiesdards are subject to revision, and parties to agreements based on this Americanto agreements based on this American National Standard are encouraged toNational Standard are encouraged to investigate the possibility of applying theinvestigate the possibility of applying the most recent editions of the standardsmost recent editions of the standards indicated indicated belowbelow..

ANSI Z88.2–1992, American NationalANSI Z88.2–1992, American National Standard for Respiratory Standard for Respiratory ProtectionProtection

ANSI Z88.6–1984, RespiratoryANSI Z88.6–1984, Respiratory Protection–RespirProtection–Respirator ator Use Use —— PhysicalPhysical Qualifications for PersonnelQualifications for Personnel

ANSI/AIHA Z88.10–2001- ANSI/AIHA Z88.10–2001- Respirator Fit TestRespirator Fit Test MethodsMethods

33 DDeeffiinniittiioonnss

3.3.11 BoBody dy mamass ss inindedex (x (BMBMI)I):: A measure-A measure-ment used to assess weight, relative toment used to assess weight, relative to height. BMI is calculated by dividing bodyheight. BMI is calculated by dividing body weight in kilograms by height in metersweight in kilograms by height in meters squared (kg/msquared (kg/m22).).

3.3.22 CaCaninistster er or or cacartrtriridgdge:e: A container withA container with a filter, sorbent, or catalyst, or a filter, sorbent, or catalyst, or combina-combina-tion of these items, which removes spe-tion of these items, which removes spe-cific contaminants from the air passedcific contaminants from the air passed through the container.through the container.

3.3.33 EmEmerergegencncy y sisitutuatatioion:n: Any occurrenceAny occurrence such as, but not limited to, equipmentsuch as, but not limited to, equipment failure, rupture of containers, or failure offailure, rupture of containers, or failure of control equipment that control equipment that maymay, or , or does,does, result in an uncontrolled significantresult in an uncontrolled significant release of an airborne contaminant.release of an airborne contaminant.

3.3.44 EmEmplployoyee ee eexpxpososurure:e: An exposure to aAn exposure to a concentration of an airborne contaminantconcentration of an airborne contaminant

American National Standard for Respiratory Protection —American National Standard for Respiratory Protection — Respirator Use —Respirator Use — Physical Qualifications for PersonnelPhysical Qualifications for Personnel

AAMMEERRIICCAAN N NNAATTIIOONNAAL L SSTTAANNDDAARRDD AANNSSI I ZZ8888..66——22000066 that would occur if that would occur if the employee werethe employee were not using respiratory protection.not using respiratory protection.

3.3.55 EnEnd-d-ofof-s-serervivicece-l-lifife inde indicicatatoror:: A systemA system that warns the user of the approach thatthat warns the user of the approach that the end of adequate respiratory protec-the end of adequate respiratory protec-tion is imminent.tion is imminent.

3.3.66 EsEscacapepe-o-onlnly rey respspiriratatoror:: A respiratorA respirator intended only for use during emergencyintended only for use during emergency egress from a hazardous egress from a hazardous atmosphere.atmosphere.

3.3.77 ExExerercicise se ststreress ss tetest st (E(ESTST):): A standardA standard graded exercise test used to assess angraded exercise test used to assess an individual’s ability to tolerate increasingindividual’s ability to tolerate increasing intensities of exercise while electrocar-intensities of exercise while electrocar-diographic (EKG), hemodynamic, anddiographic (EKG), hemodynamic, and symptomatic responses are monitoredsymptomatic responses are monitored for manifestations of ischemia, electricalfor manifestations of ischemia, electrical instabilityinstability, or , or other exertion-relatedother exertion-related abnormalities.abnormalities.

33..88 FFiilltteerr:: A component used in respiratorsA component used in respirators to remove solid or liquid aerosols fromto remove solid or liquid aerosols from the inspired air.the inspired air.

3.3.99 FiFiltltererining g fafacecepipiecece:e: A negative-pressureA negative-pressure respirator with an air-purifying elementrespirator with an air-purifying element as an integral part of the facepiece oras an integral part of the facepiece or with the entire facepiece composed ofwith the entire facepiece composed of the air-purifying medium.the air-purifying medium.

3.3.1010 FiFit ft facactotor:r: A numeric estimate of howA numeric estimate of how well a tight-fitting respirator facepiece fitswell a tight-fitting respirator facepiece fits an individual during a quantitative fit test.an individual during a quantitative fit test.

It is the ratio of the concentration outsideIt is the ratio of the concentration outside the facepiece (C out) to the concentrationthe facepiece (C out) to the concentration inside the facepiece (C in). (Fit factor =inside the facepiece (C in). (Fit factor = C out/C in ).C out/C in ).

3.3.1111 FiFit tt tesest:t: The use of a challenge agent toThe use of a challenge agent to evaluate an individual’s ability to obtain anevaluate an individual’s ability to obtain an adequate seal with a specific respirator.adequate seal with a specific respirator.

3.3.1212 HeHelmlmetet:: A hood that offers head protec-A hood that offers head protec-tion against impact and penetration.tion against impact and penetration.

33..1133 HHoooodd:: A respiratory inlet covering thatA respiratory inlet covering that completely covers the head and neckcompletely covers the head and neck and may cover portions of the shoulders.and may cover portions of the shoulders.

3.13.144 ImmImmediediateately danly dangergerous to lious to life andfe and health (IDLH):health (IDLH): Any atmosphere thatAny atmosphere that poses an immediate hazard to life orposes an immediate hazard to life or poses immediate irreversible debilitatingposes immediate irreversible debilitating effects on health.effects on health.

3.153.15 InterInterior ior strucstructural tural firefirefightfighting:ing: TheThe physical activity of fire suppression, res-physical activity of fire suppression, res-cue or both, inside of buildings orcue or both, inside of buildings or enclosed structures which are involved inenclosed structures which are involved in a fire situation beyond the incipient statea fire situation beyond the incipient state (See 29 CFR 1910.155).(See 29 CFR 1910.155).

3.13.166 LooLoose-se-fitfittinting facg facepiepieceece:: A respiratoryA respiratory inlet covering that is designed to form ainlet covering that is designed to form a partial seal with the face, does not coverpartial seal with the face, does not cover the neck and shoulders, and may or maythe neck and shoulders, and may or may not offer head protection against impactnot offer head protection against impact and penetration.and penetration.

3.13.177 MetMetaboabolic equlic equivivalealents (MEnts (METs)Ts):: A unit ofA unit of energy expended: one MET is 3.5 mLenergy expended: one MET is 3.5 mL 0022 /kg/min and represents the energy /kg/min and represents the energy expended at expended at rest. Standardized exerciserest. Standardized exercise protocols express energy expended inprotocols express energy expended in terms of multiples of resting metabolicterms of multiples of resting metabolic energy or METs.energy or METs.

3.13.188 NegNegatiative presve pressursure respe respirairatortor:: A respi-A respi-rator in which the air pressure inside therator in which the air pressure inside the respiratory inlet covering is negative dur-respiratory inlet covering is negative dur-ing inhalation with respect to the ambienting inhalation with respect to the ambient air pressure.air pressure.

3.13.199 OxyOxygen defgen deficiicient atent atmosmosphephere:re: An oxy-An oxy-gen partial pressure of 96 to 122 mmHggen partial pressure of 96 to 122 mmHg shall be considered an oxygen-deficientshall be considered an oxygen-deficient atmosphere that is not immediately dan-atmosphere that is not immediately dan-gerous to life (IDLH). An oxygen partialgerous to life (IDLH). An oxygen partial pressure of 95 mmHg or less shall bepressure of 95 mmHg or less shall be considered IDLH. The oxygen deficiencyconsidered IDLH. The oxygen deficiency may be caused by a reduction in the nor-may be caused by a reduction in the nor-mal 20.9% oxygen content, by reducedmal 20.9% oxygen content, by reduced total atmospheric pressure, or by anytotal atmospheric pressure, or by any combination of reduced percentage ofcombination of reduced percentage of oxygen and reduced pressure.oxygen and reduced pressure.

3.23.200 PhPhysiysiciacian or othen or other licer licensensed heald healthth care professional (PLHCP):care professional (PLHCP): An individ-An individ-ual whose legally permitted scope ofual whose legally permitted scope of practice (i.e., license, registration, or cer-practice (i.e., license, registration, or cer-tification under state law) allows him ortification under state law) allows him or her to independently provide, or be dele-her to independently provide, or be dele-gated the responsibility to provide, somegated the responsibility to provide, some or all of the health care services requiredor all of the health care services required by paragraph (e) of 29 CFR 1910.134.by paragraph (e) of 29 CFR 1910.134.

3.23.211 PPosiositivtive presse pressure resure respirpiratoator:r: A respira-A respira-tor in which the pressure inside the respi-tor in which the pressure inside the respi-ratory inlet covering is normally positiveratory inlet covering is normally positive with respect to ambient air pressure.with respect to ambient air pressure.

3.23.222 QuaQualitlitatiative five fit test (t test (QLFQLFT):T): A pass/failA pass/fail test that relies on the subject’s sensorytest that relies on the subject’s sensory response to detect the challenge agent.response to detect the challenge agent.

3.23.233 QuaQuantintitattative fiive fit test (Qt test (QNFTNFT):): A fit testA fit test that uses an instrument to measure thethat uses an instrument to measure the challenge agent inside and outside thechallenge agent inside and outside the respirator.respirator.

3.23.244 ResRespirpiratoatory inlry inlet coet coververinging:: The portionThe portion of a respirator that of a respirator that connects the wearer’sconnects the wearer’s respiratory tract to an air-purifying devicerespiratory tract to an air-purifying device or respirable gas source, or or respirable gas source, or both. It mayboth. It may be a facepiece, helmet, hood, suit, orbe a facepiece, helmet, hood, suit, or mouthpiece/nose clamp.mouthpiece/nose clamp.

3.253.25 SelfSelf-cont-contained ained breatbreathing hing apparaapparatustus (SCBA):(SCBA): An atmosphere supplying respi-An atmosphere supplying respi-rator in which the respirable gas sourcerator in which the respirable gas source is designed to be carried by the user.is designed to be carried by the user.

3.3.2626 SeServrvicice e lilifefe:: The period of time that aThe period of time that a respirator provides adequate protectionrespirator provides adequate protection to the wearer.to the wearer.

3.23.277 TigTight-ht-fitfittinting facg facepiepieceece:: A respiratoryA respiratory inlet covering that is designed to form ainlet covering that is designed to form a complete seal with complete seal with the face. A half-fthe face. A half-face-ace-piece (includes quarter masks, filteringpiece (includes quarter masks, filtering facepieces, and masks with elastomericfacepieces, and masks with elastomeric facepieces) covers the nose and mouth;facepieces) covers the nose and mouth;

a full facepiece covers the nose, a full facepiece covers the nose, mouth,mouth, and eyes.and eyes.

3.3.2828 UsUser er seseal al chchececk:k: A procedure conduct-A procedure conduct-ed by the wearer to determine if the res-ed by the wearer to determine if the res-pirator is properly sealed to the face.pirator is properly sealed to the face.

44 RReessppiirraattoor r CChhaarraacctteerriissttiiccss

4.4.11 AiAir-r-PuPuririfyfyining g ReRespspiriratatororss

4.4.1.1.11 GeGeneneraral.l. Air-Purifying Respirators (APR)Air-Purifying Respirators (APR) remove specific air contaminants byremove specific air contaminants by passing ambient air through an air-purify-passing ambient air through an air-purify-ing filter, cartridge, or ing filter, cartridge, or canister. canister. APR areAPR are either non-powered or either non-powered or powered. APR arepowered. APR are not approved for fire-fighting efforts.not approved for fire-fighting efforts.

4.1.24.1.2 AirAir-puri-purifying (nonpofying (nonpowerewered) respira-d) respira-tors:tors: Inhalation through the filteringInhalation through the filtering media and exhalation through media and exhalation through the valvethe valve depend only on the breathing action ofdepend only on the breathing action of the lungs. the lungs. Inhalation resistances Inhalation resistances are lessare less than 35mm Hthan 35mm H220 and exhalation resist-0 and exhalation resist-ances are less than 25 mm Hances are less than 25 mm H220.0.

4.1.34.1.3 PoPowered airwered air-purif-purifying respiying respiratorratorss (PAPR):(PAPR): Powered units contain a blowerPowered units contain a blower to move the air through the filtering media.to move the air through the filtering media.

Inhalation and exhalation resistance isInhalation and exhalation resistance is negligible, similar to a continuous-flow air-negligible, similar to a continuous-flow air-line device. The weight of the line device. The weight of the blowerblower varies from approximately 5 to 15 lb.varies from approximately 5 to 15 lb.

4.4.22 AtAtmomospspheherere-S-Supupplplyiying ng ReRespspiriratatororss

4.4.2.2.11 GeGeneneraral.l. Atmosphere-supplying respira-Atmosphere-supplying respira-tors are either self-contained or airlinetors are either self-contained or airline units. units. The self-contained breathing The self-contained breathing appa-appa-ratus (SCBA) is completely ratus (SCBA) is completely portable. portable. TheThe airline apparatus requires the trailing ofairline apparatus requires the trailing of an air hose from the wearer to thean air hose from the wearer to the source of breathing source of breathing air.air.

Atmosphere-supplying respirators oper-Atmosphere-supplying respirators oper-ate in continuous- ate in continuous- flowflow, demand, or pres-, demand, or pres-sure-demand modes. Continuous-flowsure-demand modes. Continuous-flow respirators blow air continuously into therespirators blow air continuously into the mask. Demand-type apparatus requiremask. Demand-type apparatus require the wearer to inhale and reduce thethe wearer to inhale and reduce the mask pressure below atmospheric pres-mask pressure below atmospheric pres-sure, before the regulator will sure, before the regulator will supply air.supply air.

(This is similar to inhaling through an air-(This is similar to inhaling through an air-purifying device). In a pressure-demandpurifying device). In a pressure-demand (positive-pressure) device, a slight posi-(positive-pressure) device, a slight posi-tive pressure is maintained in the face-tive pressure is maintained in the face-piece at all piece at all times by the regulator. Moretimes by the regulator. More air is admitted to the mask as the posi-air is admitted to the mask as the posi-tive pressure decreases during inhala-tive pressure decreases during inhala-tion. Exhalation resistances are greatertion. Exhalation resistances are greater than for demand devices.than for demand devices.

4.24.2.2.2 OpeOpen-cn-cirircuicuit t SCSCBABA.. Open-circuit SCBAOpen-circuit SCBA is available in demand or pressure-is available in demand or pressure-demand devices. In open-circuit devices,demand devices. In open-circuit devices, breathing air is supplied from a cylinder tobreathing air is supplied from a cylinder to the mask, and then dumped into thethe mask, and then dumped into the atmosphere on exhalation. The nitrogen inatmosphere on exhalation. The nitrogen in the breathing air is excess weight thatthe breathing air is excess weight that does not contribute to the wearer’s metab-does not contribute to the wearer’s metab-olism. The maximum allowed weight is 35olism. The maximum allowed weight is 35 lb, although modern half-hour units maylb, although modern half-hour units may weigh 10 lb less. Significant reduction (upweigh 10 lb less. Significant reduction (up to 20%) in work capacity of the wearerto 20%) in work capacity of the wearer can occur since the 35 lb load must becan occur since the 35 lb load must be carried. Heavy work rates may becarried. Heavy work rates may be required during fire-fighting and rescue sit-required during fire-fighting and rescue sit-uations while wearing SCBA.uations while wearing SCBA.

Regulators on current SCBA may notRegulators on current SCBA may not meet the high instantaneous demands ofmeet the high instantaneous demands of wearers at heavy work rates, and so wearers at heavy work rates, and so maymay impair work impair work out-put further. Theout-put further. The increased exhalation resistance of pres-increased exhalation resistance of pres-sure-demand units may also degradesure-demand units may also degrade ability to perform heavy work.ability to perform heavy work.

4.2.34.2.3 CloseClosed-cird-circuit cuit SCBSCBA.A. Closed-circuitClosed-circuit SCBA is available in demand or pres-SCBA is available in demand or pres-sure-demand devices. In closed-circuitsure-demand devices. In closed-circuit units (also known as units (also known as rebreathers), oxy-rebreathers), oxy-gen is supplied from a compressed gas,gen is supplied from a compressed gas, liquid, or chemical source. Exhaled air isliquid, or chemical source. Exhaled air is scrubbed of carbon dioxide and returnedscrubbed of carbon dioxide and returned to the to the facepiece. Cfacepiece. Closed-circuit deviceslosed-circuit devices have a longer duration for their have a longer duration for their weightweight than does open-circuit equipment.than does open-circuit equipment.

Breathing is into and out of a bag ratherBreathing is into and out of a bag rather than from a than from a regulator. regulator. Oxygen concentra-Oxygen concentra-tions may range from 21 to 90 percent.tions may range from 21 to 90 percent.

4.2.44.2.4 SupplSupplied-aied-air respirir respiratorators (SAR).s (SAR).

Supplied-air or airline respirators areSupplied-air or airline respirators are available as continuous-flowavailable as continuous-flow, demand, , demand, oror pressure-demand devices. All suppliedpressure-demand devices. All supplied air respirators require a trailing air hoseair respirators require a trailing air hose that limits movement about the work-that limits movement about the work-place. Duration of use is limited only byplace. Duration of use is limited only by the air source and the metabolic workthe air source and the metabolic work rate. Exhalation resistance is equal to orrate. Exhalation resistance is equal to or lower than that of demand equipment,lower than that of demand equipment, since the exhalation valve is held opensince the exhalation valve is held open by the continuous outward flow of by the continuous outward flow of air.air.

Demand and pressure-demand versionsDemand and pressure-demand versions of airline of airline units have physiological effectsunits have physiological effects similar to the SCBA, except for the addi-similar to the SCBA, except for the addi-tional weight burden of tional weight burden of the SCBA.the SCBA.

55 MMeeddiiccaal El Evvaalluuaattiioon Rn Raattiioonnaallee The effects of physical work effort, pro-The effects of physical work effort, pro-tective clothing, tective clothing, temperature, humiditytemperature, humidity,, and the physiologic burden placed on aand the physiologic burden placed on a worker using a respirator must be con-worker using a respirator must be con-sidered during the medical evaluation forsidered during the medical evaluation for respirator use. PLHCPs shall providerespirator use. PLHCPs shall provide reasonable assurance that a worker canreasonable assurance that a worker can endure these stressors without adverseendure these stressors without adverse medical consequences, and recommendmedical consequences, and recommend any limitations on respirator use relatedany limitations on respirator use related to the medical condition of the employeeto the medical condition of the employee or the work place conditions in which theor the work place conditions in which the respirator will be used.respirator will be used.

66 QQuuaalliiffiiccaattiioonns os of Pf Peerrssoonns s WWhhoo Conduct Medical Evaluations toConduct Medical Evaluations to Determine Suitability to UseDetermine Suitability to Use Respiratory Protective DevicesRespiratory Protective Devices

6.16.1 Medical evaluation shall be performed byMedical evaluation shall be performed by a physician or other licensed health carea physician or other licensed health care professional (LHCP) (e.g., nurse practi-professional (LHCP) (e.g., nurse practi-tioner, physician assistant, occupationaltioner, physician assistant, occupational health nurse), provided that their licensehealth nurse), provided that their license permits them to perform such evalua-permits them to perform such evalua-tions. LHCPs are expected to consulttions.