Personal Protective Equipment (PPE), One Size Does Not Fit All.

In our previous blogpost, we discussed Ebola and the use of personal protective equipment.  Since then the Centers for Disease Control (CDC) has come out with revised guidance on purchasing PPE and protocols for wearing PPE while handling patients with the Ebola virus disease.  Find this information here.  

A disposable nitrile rubber glove. Nitrile gloves are available in different colours, the most common being blue and purpleCitation needed. (Photo credit: Wikipedia)

Fast Company Co.Design's article "Why Protective Gear Isn't Stopping Ebola" has an interesting discussion on the problems with PPE.  This discussion includes the usual complaints that its uncomfortable, it doesn't fit, restricts movement, visibility, etc.  It is interesting that before wearing a tight fitting respirator a worker must be either qualitatively or quantitatively fit tested with the respirator they will be wearing.  However, when it comes to PPE (like gloves or protective suits) there is no fit testing.  If you bought these items as clothing, you would try them on and purchase the best fitting one.
  

Asbestos Hands-on Demonstration

There is an unspoken assumption that the employer will purchase different sizes allowing workers to select the size that fits them the most comfortably.  This assumption is typically wrong and what actually happens is most employers buy larger sizes in the sense that one size fits all or they buy the size that fits the most people.  This results in complaints that wearing the PPE is more hazardous than not wearing it, which of course is the case if you are wearing ill-fitting or incorrect fitting PPE.

Wearing the proper PPE is not only about the right size, it is also about wearing the right type.  How many of you know that protective equipment are tested for how cut resistant they are?  The cut protection performance test (CPPT) is an American Society of Testing Materials (ASTM) F 1790 standard cut test for protective equipment.  A glove's performance rating is classified by the American National Standards Institute (ANSI)/International Safety Equipment Association (ISEA) 105-2005 from a 0-5 level, with 5 being the best cut performance, based on the outcome of the CPPT test.  Gloves are also tested for how long it takes for chemicals to breakthrough, degrade, or permeate the material the glove is made of.  ASTM F739 standard details the process for testing protective equipment for liquid and gas permeation (the video clip below shows how this is done).  Ansell Healthcare produces the "Chemical Resistance Guide" that includes permeation and degradation data for various glove material and a rating system.

When selecting PPE for your workers, unfortunately its not as simple as looking in a catalog and buying the cheapest PPE and/or buying one size that will fit most or all.  As the Occupational Safety and Health Administration (OSHA) standard (1910.133) requires for PPE, you must assess the hazard you want the PPE to protect the worker from and then find the best fitting PPE so the worker will wear it comfortably without creating a greater hazard.

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• WHO Updates Guidelines on Ebola Protective Gear
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Ebola Virus - A Proper Perspective.

There has been a lot written about the Ebola viruses and the disease that it causes.  It is important to be well informed so that you can better know what is accurate information and what is misinformation.  In the old days, the main sources of information was television news, newspapers, or libraries.   Today, there is no excuse for succumbing to fear when accurate information is only a few clicks away.  There are several websites that will provide you with accurate information regarding ebola hemorrhagic fever which is caused by several strains of viruses in the Ebolavirus genus.  As a Council-certified Indoor Environmental Consultant one of our first resource website would be the Occupational Safety and Health Administration's (OSHA) Ebola website.  Here you will find information regarding the virus its background information, hazard recognition, medical information, Standards, control & prevention, and additional resources.  The standards section details the regulations OSHA expects employers, whose employees are at risk of being exposed to ebola, to comply with.  Obviously, the bloodborne pathogen (1910.1030); the respirator (1910.134); and the personal protective equipment (PPE) standards must be complied with in addition to the "general duty clause".  When cleaning and disinfecting, the hazard communication (1910.1200) and Sanitation (1910.141) standards would also have to be complied with.

English: Ebola virus virion. Created by CDC microbiologist Cynthia Goldsmith, this colorized transmission electron micrograph (TEM) revealed some of the ultrastructural morphology displayed by an Ebola virus virion. (Photo credit: Wikipedia)

Unfortunately, it is obvious mistakes were made, in Texas & by others, in the selection and wearing the safety equipment necessary to protect the health care workers from being exposed to the Ebola Virus.  The Centers for Disease Control (CDC) is the agency that develops these protocols and provides information and assistance in helping healthcare workers, click here for their Ebola website. Their website has a PPE training program to train you on donning (putting on PPE) and doffing (taking off PPE) the proper safety equipment.  These procedures are designed to ensure you do not contaminate yourself or others,  When properly followed the procedures should reduce the risk of the worker and others being exposed to the Ebola virus.  In addition, the CDC has posted "Advice for Colleges, Universities, and Students about Ebola in West Africa" which provides guidance on study abroad and foreign exchange.

None - This image is in the public domain and thus free of any copyright restrictions. As a matter of courtesy we request that the content provider be credited and notified in any public or private usage of this image. (Photo credit: Wikipedia)

New York State's Department of Health has an Ebola website, too.  This website provides information for the public, health care providers, hospitals, & EMS providers.  Information for the public includes "School Guidance on the Ebola Outbreak", which advises the health personnel for schools to stay informed about the current situation and have access to up-to-date, reliable information as events unfold.

As you can see there are plenty of websites and sources of information regarding Ebola and that's just the US websites.  Another excellent website is the World Health Organization's (WHO) Ebola website.  Their website also includes information on PPE, travel advice, fact sheets, and discussion of trials and production of ebola vaccine.  So don't allow fear to ruin your day, get the information you need to help you move forward,  As Franklin Delano Roosevelt said "The only thing we have to fear is fear it'self - nameless, unreasoning, unjustified, terror, which paralyzes needed efforts to convert retreat into advance."  So lets move forward!

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Future Environment Designs Participates in the North Country Honor Flight’s First Annual Golf Tournament

Written by: Kimberly Granmoe, Executive Assistant

On Sunday, July 20, Future Environment Design (FED) participated in the North Country Honor Flight (NCHF) Golf Tournament held at the North Country Golf Course in Rouses Point, NY.   It was a beautiful day for the tournament, blue skies with temperatures in the low 80’s.  What a great turnout for the organization’s first fundraising tournament.  Approximately 168 golfers registered to participate in the golf tournament intended to raise money for the mission of the North Country Honor Flight.   The North Country Honor Flight, part of the Honor Flight Network, is a local non-profit organization created solely to honor America's Veterans for all their sacrifices.  Their mission is to transport America's Veterans to Washington, D.C. to visit those memorials dedicated to honor their service and sacrifices.

Future Environment Design's Golf Team

Future Environments Designs was represented by Kimberly Granmoe, Executive Assistant, and Sheryl Esposito, Marketing Assistant.  They teamed up with Troy Granmoe, Kimberly’s husband, and Justin, Kimberly's & Troy's son.  The golf tournament was a best ball-scramble and our team shot an overall score of 76, placing midway among the 35+ teams.

   

Kimberly & Sheryl at the 11th Hole

In addition, to sponsoring a team,  Future Environment Designs also sponsored the 11th hole flag.  Kimberly Granmoe, when she's not assisting Angelo Garcia, III, volunteers as an event coordinator for the NCHF.  As Event Coordinator, Kimberly coordinates flags to be flown over the Pentagon on the day the Veterans are visiting the WWII Memorial in Washington, DC.  The flag is then presented to each Veteran in a flag case together with Certification that the flag was flown in recognition of the Veterans Honor Flight visit to the WWII Memorial and in recognition of the Veterans service to our Nation.

Kimberly with Mr. Morgan Mickalsen, WWII Vet

Upon completion of the tournament, all participants enjoyed a turkey dinner, with all the trimmings, which was followed by an auction consisting of over a 100 items donated from local area businesses.  The Golf Tournament generated  over $27,000 for the NCHF.  The NCHF together with the Honor Flight Network will continue to do whatever it takes to fulfill the dreams of our Veterans and help our heroes travel absolutely free.   It is our way of paying a small tribute to those who gave so much.  Currently, top priority is given to America's most senior heroes — survivors of World War II and any veteran with a terminal illness who wishes to visit THEIR memorial.  Since America felt it was important to build a memorial to the service and the ultimate sacrifice of her veterans, the Honor Flight Network believes it's equally important that they actually get to visit and experience THEIR memorial.

If you know of any WWII Veterans interested in taking a trip of a life time or you are interested in volunteering or donating, please contact the organization at North Country Honor Flight, PO Box 2644, Plattsburgh, NY  12901 or email northcountryhonorflight@westelcom.com.

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Zadroga Act Needs An Extension

Its interesting that two things that you wouldn't normally put together have been discussed in the newspapers recently.  In the sports sections of the newspapers, extensions have been announced for Sandy Alderson, the General Manager of the New York Mets and Hal Steinbrenner, owner of the New York Yankees, has announced they are negotiating an extension for Brian Cashman, their General Manager.  At roughly the same time Newsday and other media outlets reported on 4 recent deaths of 9/11 responders dying of cancer and leukemia.  These first responders are just a few of the many thousands who are covered under James Zadroga 9/11 Health and Compensation Act which is set to expire in 2016.  Their deaths have led to calls for an extension of the Zadroga Act.  Which is necessary to help deal with the 9/11-linked illnesses being suffered by workers who worked on Ground Zero pile and were exposed to toxic dust and fumes from the smoldering rubble.

These firefighters are the latest to die since the September 11, 2001 attacks.  As reported by Newsday, the current count is 92 members of the Uniformed Fire Officers Association have died and 875 have been diagnosed with 9/11-linked illnesses.  Of those diagnosed, 80 member's illnesses are at critical stage and 177 are in remission.  Another 280 members are in the early stages of their illnesses and 25 are awaiting confirmation that their illness is World Trade Center related.

September 11, 2001 attacks in New York City: View of the World Trade Center and the Statue of Liberty. (Image: US National Park Service ) (Photo credit: Wikipedia)

The Zadroga Act has allowed the National Institute of Occupational Safety and Health (NIOSH) and others to study the effects of the toxic dust they were exposed to.  A recent blog post by NIOSH, "WTC Rescue/Recovery and Obstructive Airway Disease" discusses some of the information gathered from reviewing the medical records of the first responders such as:

• The increased incidence of respiratory disease such as obstructive airway diseases (OAD), such as asthma and chronic bronchitis have been associated with intensity of exposure as measured by arrival time at the WTC site.
• New onset OAD continues to be observed many years after exposure, contrary to conventional wisdom that irritant-induced asthma should be triggered within a relatively short time after exposure.

The above information is only touching the surface especially considering some of the other diseases we should be expecting, such as lung cancer and mesothelioma, can take 30 years or more to develop.  Some of these diseases if caught early enough can be survivable, but only with an excellent monitoring program.  In addition, it is our hope that this information will assist us in preventing first responders from being exposed to these toxic situations in any future terrorist act or environmental disaster.  The enforcement of the wearing of protective equipment including the use of proper respiratory protection would prevent the need for future Zadroga Acts.

The need to extend the Zadroga Act past 2016 is self-evident from the toxins these responders were exposed.  We hope Congress recognizes this and passes legislation and funding needed to extend the Act.

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September 5 is N95 Day - Whaaaaaat??

According to the National Institute of Occupational Safety and Health (NIOSH) today September 5 is N95 Day.  NIOSH says, "N95 Day is a time to recognize the importance of respiratory protection in the workplace and familiarize yourself with the resources available to help you make educated decisions when selecting and wearing a respirator."  To celebrate, NIOSH will be providing N95 filtering facepiece respirator information through social media channels such as a Twitter chat, a webinar, and new infographics.  For more information visit there website at:  http://www.cdc.gov/niosh/npptl/N95Day.html.

Interesting thing to us is why celebrate the N95 filtering facepiece respirators?  Filtering facepiece respirators have their place in protecting workers from respiratory hazards, however, that place is very limited.  This type of respirator cannot and should not be used for respirable dusts like asbestos or lead.  Nor should it be used for vapors or mists or gases.  As the picture above from Ground Zero - 9/11 World Trade Center rescue, recovery and cleanup shows, knowing which respirator to wear was one of the problems for the workers who worked there.  The picture shows workers wearing filtering facepiece respirators and half mask air purifying respirators.  Considering the contaminants (asbestos, mercury, PCBs, to name a few) at the site, filtering facepiece respirators should not have been a choice at all.  This is probably the main reason to have an N95 day is to make sure people understand the limitations of this type of respirator.  But why limit it to filtering facepiece respirators, we should be celebrating all respirators!  So for our part we say Happy Respirator Day!

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September 11 Deadline for World Trade Center Workers

If you were one of the workers who worked (whether you were injured, or employed, or volunteered) at Ground Zero, Fresh Kills Landfill, the barges, the piers, and the morgues you have until September 11 to register with the New York State Workers' Compensation Board to preserve your right to future benefits.

This includes workers who helped in the rescue, recovery,and cleanup of the World Trade Center.  Workers should complete form WTC-12 (http://www.wcb.ny.gov/content/main/forms/wtc-12.pdf).  For more information visit the World Trade Center Registry at:  http://www.wcb.ny.gov/WTC12/WTC12.jsp 

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OSHA Releases New Respiratory Protection Directive

The Occupational Safety and Health Administration (OSHA) issued directive number CPL 02-00-158 "Inspection Procedures for the Respiratory Protection Standard".  This new directive gives instructions to OSHA compliance safety officers and area directors on interpretations and enforcement policies for enforcing the respirator standard 1910.134.  This directive cancels and supersedes the previous directive CPL 02-00-120 dated September 25, 1998.  Directives are used by OSHA to ensure the standards are enforced uniformly across the country.  These directives are useful resources in that they inform the industry, and employers how OSHA intends on enforcing the respirator standard.

Changes to this revision include: updated definitions section to include definitions for assigned protection factors (APF) and maximum use concentrations (MUC); greater clarification on voluntary respirator use, and a better explanation of a compliant respirator program and provides additional acceptable methods to assess respiratory hazards; updates the directive with information related to the revised Hazard Communication standard (1910.1200); and provides guidance on evaluating the need for respiratory protection for chemicals used in workplaces by referring to employer's Hazard Communication program wherein chemical manufacturers communicated the need for respiratory protection.

Muster einer Atemluft-Einwegmaske (Photo credit: Wikipedia)

According to this directive if employers require employees to wear respirators for the protection against TB they must be in compliance with the respirator standard 1910.134.  Probably the most interesting portions of the directive are the modifications to voluntary use of respirators.  According to the directive, it was the intent of the standard that the employer would not be required to incur any costs associated with voluntary use of filtering  facepiece respirators (dust masks) other than providing a copy of Appendix D of the standard to each user.  OSHA is concerned that voluntary use may cause an employee's health being jeopardized by the wearing of a respirator, or the wearing of a dirty respirator that can cause dermatitis or ingestion of a hazardous chemical, and the sharing of a respirator that leads to transmittal of disease.

Voluntary use of filtering facepiece respirators is one of the most misunderstood sections of the respirator standard.  Some points from the directive: NIOSH-approved filtering facepieces are strongly recommended but are not required; voluntary use does not require the employer to have a written program; and merely posting Appendix D is not considered adequate.

The directive is a useful resource to give employers an indication of how OSHA will enforce the respirator standard and it is a useful tool to help avoid citations or to fight violations.  

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