Matthew Judson outlines the work being done to address the thousands of deaths and cases of ill health caused by airborne hazardous substances via a new scheme to ensure respiratory protective equipment is fitted, worn and looked after properly.
Occupational respiratory disease is rife in the UK, with 6000 new cases of lung disease being diagnosed,1 and 4000 deaths from chronic obstructive pulmonary disease (COPD) due to hazardous workplace conditions occurring every year.2 Despite these worrying statistics, however, new research3 reveals that only 25 per cent of those at risk are adequately protected from harm to their respiratory system from airborne pollutants such as dust, particulates, chemical fumes, and gases.
When it comes to control options, measures that minimise the escape and spread of airborne hazardous substances — extraction, ventilation and suppression systems, for example — are the first choice, but where adequate control of exposure cannot be achieved in any of these ways, suitable personal protective equipment should be provided.
Respiratory protective equipment (RPE) can be a crucial weapon in the fight against occupational respiratory disease but the aforementioned research, carried out by the British Safety Industry Federation (BSIF) and the HSE, found that only half of the estimated 5.5 million workers who are exposed to occupationalrespiratory hazards wear such equipment in the first place, and half of them wear kit that doesn’t fit them correctly.
Many employers and workers fail to grasp that just because RPE is provided and worn, it does not mean the risk of harm from airborne pollution does not arise. A respirator is worse than useless if it leaks as a result of not fitting the user’s face Matthew Judson outlines the work being done to address the thousands of deaths and cases of ill health caused by airborne hazardous substances via a new scheme to ensure respiratory protective equipment is fitted, worn and looked after properly.
Fit for life properly, or if the user has not been taught how to check the fit to ensure it protects, and continues to protect, them.
What the law says
The use and fit-testing of RPE is covered by several pieces of legislation, including the HSWA 1974 and the Control of Substances Hazardous to Health Regulations 2002 (COSHH), which state that all tight-fitting RPE must be fit-tested to an individual by a competent person. The Control of Asbestos Regulations 2006 require fit-testing to be included as an integral part of an RPE programme for mask based devices.
In the European Union, the selection and use of respiratory protection comes under the 2005 standard EN 529. One of the main thrusts of the standard is that respirators must be fitted and must fit the wearer, and it obliges employers to provide suitable RPE and training — to be carried out at least once a year — in its correct use, fitting and maintenance.
Traditionally, however, these legal requirements have not been well enforced. Research by the BSIF, as well as anecdotal evidence from HSE inspectors, indicates that the quality of fit-testing in the past has not been adequate, and has often been carried out incompetently.
The scheme of things
Following on from the BSIF/HSE research, a new industry-regulated scheme to assess the competence of fit-testers — Fit2Fit (Fit Test Providers’ Accreditation Scheme)4 — has been developed by the two organisations, in cooperation with the Asbestos Removal Contractors Association (ARCA) and other industry stakeholders, to encourage the use of correctly fitting RPE. Under the Fit2Fit scheme, RPE should be fit-tested by an accredited provider and the wearer given subsequent training on when and how to wear it, and on the types of simple checks they can perform themselves to ensure it continues to fit adequately.
Although it is not a compulsory scheme, accredited fit-test providers will have to have passed an industry recognised examination to demonstrate their grasp of the HSE guidance on fit-testing of RPE facepieces,5 and their knowledge of the range of test methods, and of fittesting in the actual workplace (although extensive expertise in the types of RPE available is not required).
Apart from helping to ensure their employees’ health and safety, not wasting money, and making sure they can obtain adequate insurance cover, using an accredited fit-tester can, in the event of an injury or accident, help an employer demonstrate to the HSE that they have followed good practice and thus potentially mitigate their liability.
The BSIF estimates that there are currently between 3000 and 5000 individuals performing fit-testing. Because there is not, and never has been, a legal requirement for fittesters to be formally qualified, or to prove their competency, current fittesters are often non-specialist, untrained, and inexperienced staff who have simply been handed the task of performing fit-testing on coworkers by their employer. One of the aims of Fit2Fit is to get at least 500 fit-testers accredited and reduce the number of those who have been performing fit-testing ‘on the side’, so that only those with accreditation will continue to do so. Although 500 is a low figure, it is realistic at this stage, since the scheme is not compulsory by law. Companies may also appoint a single fit-tester rather than several conducting testing on an ad hoc basis, so, ultimately, there will be fewer fit-testers, but of a much higher quality.
Fit2Fit-certified testers might not necessarily hold accreditation for all four of the recognised RPE fit testing methods, so employers should check their credentials carefully to ensure they are certified for the particular testing method they use.
The qualitative, or taste-testing, method involves a bitter or sweetflavoured product being injected into a hood worn by the worker over their respirator. If they can taste the substance through the respirator, this demonstrates a poor seal to the face.
Quantitative fit-testing is recommended where a higher protection factor is required, and can be done via three methods. The most common is the ambient particlecount test, which measures the number of particles and can be used with or without a companion air sampler to measure and compare the same result inside and outside of the mask.
With the test-chamber method the wearer carries out exercises in a chamber in which a concentration of salt dust is present, and the atmospheres inside the chamber and the mask are compared.
The Controlled Negative Pressure (CNP) method involves a more rigorous, direct measurement of respirator leakage, in which air is exhausted from the respirator. This method is not widely used in the UK, except by equipment manufacturers.
Education, education, education
While fit is of paramount importance, how RPE is used is equally crucial. Training the wearers of RPE should not be limited to the physical use of the selected RPE but also enable the wearer to understand why they need to wear it, when to use it, how to fit it, and how to maintain and look after it.
To emphasise the reasons why RPE should be worn, an effective method is to illustrate the consequences of not wearing correct equipment. To this end, graphic material is available from the HSE and other organisations, showing, for example, the dire effects on the lungs of inhaling asbestos fibres.
Helping users understand when to wear it is important, as simply laying down the law and requiring them to wear it all the time, regardless of the hazard, is likely to cause resentment and non compliance. They should instead be trained to look out for situations when it might be necessary — being aware of containers that could emit gaseous vapours, for example.
Wearers also need to know what is the right type of RPE for them, in terms of the hazard(s) and their own physiognomy. People with beards or glasses, for example, will need different facepieces from cleanshaven individuals.
During fit-testing, the wearer should be instructed on the correct way of donning the RPE and checking that it is working as it should. Simple self-checks of a filtering facepiece or half-mask can be performed each time the worker puts it on by covering the face with the hands and breathing in sharply.
The mask should suck on to the wearer’s face if it is correctly fitted. Wearers should be aware that they will need to be fit-tested anew if they lose or gain weight, or suffer any injury that may cause changes to their face. It should also be emphasised that they have been fittested for one particular product, and this is the only product that will fit them — they cannot change to another one that has not been specifically fit-tested to them.
The RPE must be looked after not only while in use but also when it is stored prior to use. In particular, the performance of cartridge or canister filters for gases and vapours can be affected if they are stored in environments where gases and vapours are present. All manufacturers supply storage information, and it is important that this is followed to get the optimum performance from the RPE.
RPE works by keeping the contaminated air outside of a mask, so it will get dirty during use. Wearers should therefore be briefed on cleaning the mask to ensure the performance of the inhalation and exhalation valves is not compromised, and that the inner surfaces of the mask and storage area/vessel are not contaminated.
Finally, it must be made clear to wearers of disposable masks and filters that these should be safely disposed of after use, and they should be instructed how to do so.
Summary
Education, alongside product development, is critical for both wearers and fit-testers in order to reduce occupational disease and death from airborne respiratory hazards. Employers need a better understanding of the hazards they face, how to select RPE, why it is being worn, and why they should use a proper fit-tester, while testers must understand how to do their job effectively and safely. Workers need to have a clear understanding of how and when to wear it, and how to look after it.
Another major issue for workers is wearability, in that the RPE should be as comfortable as possible, must perform in the way it is supposed to, and must be capable of fitting a wide variety of head sizes. Work is in progress by the likes of IOSH, the HSE, the Institute of Occupational Medicine and the BSIF to look into ways of making RPE more acceptable to users and therefore more likely to be worn. The aim is to devise a programme to improve the education of wearers on the types of RPE, and when and how to wear it.
References
1 Health & Safety Laboratory figures — www.hsl.gov.uk
2 HSE figures — www.hse.gov.uk
3 BSIF research — www.bsif.co.uk
4 www.Fit2Fit.org — many RPE manufacturers will be able to offer training to fit-testers, or point them in the right direction, or testers can consult the Fit2Fit website, which, from January 2010, will offer a list of organisations providing fit-test training
5 The HSE’s specific guidance on fit-testing (HSE 282/28) can be found at www.hse.gov.uk/pubns/fittesting.pdf
Further information
Clean air? — Take care! campaign: telephone the BSIF on 01745 585600
Fit2Fit Candidates’ Handbook — www.fit2fit.org/assets
HSE Guidance HSG53 on Respiratory Protection at Work — www.hse.gov.uk/pubns/books/hsg53.htm
Matthew Judson is respiratory and technical support director for JSP Ltd.
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