***Lawrence Berkeley National Laboratory***

***Environment, Health & Safety Division***

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

***Respiratory Protection***

***for***

***Lawrence Berkeley National Laboratory***

***Revision 1.3***

***November, 2003***

######## Prepared for the U.S. Department of Energy under Contract No. DE-AC03-76SF00098

***Respiratory Protection***

***for***

***Lawrence Berkeley National Laboratory***

*Revision 1.3*

*November, 2003*

*Revised By:*

*Betsy MacGowan*

*Respiratory Protection Program Administrator*

*Environment, Health and Safety Division*

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_*Date:*\_\_\_\_\_\_\_\_\_

######### Carole Fried

*Respiratory Protection Program Manager*

*Environment, Health and Safety Division*

***TABLE OF CONTENTS***

***PAGE***

*I. Introduction*

*A. Laboratory Policy 1*

*B. Program Elements 1*

*II. General Responsibilities*

*A. EH&S Industrial Hygiene Group 1*

*B. Health Services Group 2*

*C. Supervisors / Principal Investigators 2*

*D. Employees 3*

*E. Waste Management Group 4*

*III. Respirator Use Prerequisites*

*A. Use Authorization 4*

*B. Hazard Evaluation 4*

*C. Medical Qualification 5*

*D. Quantitative Fit-Testing -- Tight-Fitting Facepieces 5*

*E. Training 6*

*IV. Respirator Selection*

*A. General Discussion 7*

B.  *Filtering Facepiece Respirators (Dust Masks) 7*

C.  *IDLH Environments 7*

*V. Respirator Use*

*A. General Discussion 7*

B.  *Assigned Protection Factors 8*

C.  *Cartridge Service Life 8*

D.  *Field Use 9*

*C. Respirator and Cartridge (Filter) Storage 9*

*D. Respirator Return 10*

*E. Inspection, Cleaning, and Sanitizing 10*

*F. Facial Hair Policy 11*

*G. Contact Lens or Spectacle Use 11*

*VI. Auditing*

*A. Program Audits 12*

*APPENDICES*

*Appendix A: Definitions 14*

*Appendix B: Respirator Certification Protocol 17*

*Appendix C: Medical Questionnaire for Respirator Users 18*

*Appendix D: Respirator Fitting and Issue Record 20*

*Appendix E: Quantitative Fit Test Procedure 21*

*Appendix F: Selection of Respirators 23*

*Appendix G: Hazard Evaluation Form 27*

*Appendix H: Training Review Guidelines 28*

*Appendix I: Photo Documentation 29*

***I. Introduction***

***A. Laboratory Policy***

> It is the policy of Lawrence Berkeley National Laboratory (LBNL) to
> maintain work environments that will not adversely affect the health,
> safety, and well-being of LBNL employees, contract employees
> supervised by LBNL, and guests. Because of the potential hazards
> involved from exposure to hazardous substances and atmospheres, the
> Laboratory provides necessary respiratory protective equipment and
> develops safe use procedures for those persons required to utilize
> this equipment. The use of respirators is the least desirable method
> of protecting employees; they are used only after all feasible
> engineering controls (e.g., ventilation and isolation) and
> administrative controls have been applied. All activities involving
> the use of respiratory protective equipment shall be conducted in
> compliance with 29 CFR 1910.134 and ANSI Z88.2. This manual
> establishes the procedures and requirements necessary to meet
> Department of Energy prescribed regulations for use of respiratory
> protective equipment and to provide necessary health and safety
> protection to LBNL employees, guests, and contract employees
> supervised by LBNL.

***B. Program Elements***

> The Respiratory Protection Program includes:

1\. identification of groups at LBNL involved with implementation of the
program and their responsibilities;

> 2\. requirements for respirator use, including medical qualifications,
> fit-testing and training;
>
> 3\. guidelines for the selection of proper respiratory protective
> equipment;
>
> 4\. instructions detailing the use, inspection, cleaning, and storage
> of respirators; and

5.  provisions for the auditing of program compliance.

***II. General Responsibilities***

***A. EH&S Industrial Hygiene Group***

> The Industrial Hygiene Group, of the Environment, Health and Safety
> (EH&S) Division, administers the Respiratory Protection Program. The
> EH&S Industrial Hygiene Group shall:
>
> 1\. purchase respiratory protective equipment and supplies**,**
> including filtering facepieces (disposable dust masks), air-purifying
> respirators (APR), supplied-air systems and self-contained breathing
> apparatus (SCBA);
>
> 2\. provide training for respiratory protection users and their
> supervisors in accordance with 29 CFR 1910.134 and ANSI Z88.2,
> including but not limited to: selection of respirators, explanation of
> TLVs, PELs, and protection factors, donning and doffing procedures,
> and limitations of issued respirators;
>
> 3\. quantitatively fit test with the TSI Porta Count Plus, those
> employees who are required to wear respirators with tight-fitting
> facepieces;
>
> 4\. provide for the inventory, stocking, maintenance, cleaning, and
> sanitizing of air-purifying respiratory protective equipment;
>
> 5\. perform documented hazard evaluations (See Appendix G) for each
> respirator user, (Evaluations will be conducted with health physicists
> if respirators are used for protection against radionuclides);
>
> 6\. review compliance with the requirements of this document at least
> annually;
>
> 7\. provide information and assistance to LBNL employees on matters
> relating to respiratory protection;
>
> 8\. retain records as required by ANSI Z88.2 and DOE (Records shall be
> retained for at least 75 years after the wearer\'s termination date
> from the Laboratory);

9.  perform and document quarterly testing of grade D air quality for
    stationary breathing-air compressors in accordance with 29 CFR
    1910.134 and CGA G-7.1-1997; and

10. perform monitoring for carbon monoxide, on air from portable air
    compressors used to supply breathing air to supplied-air
    respirators. This monitoring shall be done periodically, and
    whenever the compressor is moved to a new location.

***B. Health Services Group***

> The Laboratory Occupational Health Physician, with Health Services
> staff, provides the health care services necessary for respirator
> medical evaluations. Health Services shall:
>
> 1\. establish health standards which shall be met by all prospective
> respirator users, referencing 29 CFR 1910.134, ANSI Z88.6, 29 CFR
> 1926.1101, 29 CFR 1910.1001, and other applicable standards;
>
> 2\. require that respirators users complete a Medical Questionnaire
> Form (See Appendix C) and perform initial and follow-up medical
> examinations, as needed, on all persons who:
>
> a\. will wear respirators with tight-fitting facepieces for protection
> from potential hazards;
>
> b\. have been previously approved for use of respiratory protective
> equipment, but who report medical signs or symptoms that are related
> to their ability to wear a respirator;

c.  are referred by the EH&S Industrial Hygiene Group, a supervisor, or
    Health Care Professional, and

d.  provide a signed approval for those individuals found to be capable
    of wearing a respirator.

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3.  Health Services will maintain records of all pulmonary function
    tests and medical history questionnaires.

***C. Supervisors / Principal Investigators***

> Laboratory supervisors and principal investigators shall:

1.  complete EHS 0318, Respirator Supervisor Training;

> 2\. ensure that employees assigned to wear respirators for a given
> task or job are clean-shaven before respirators may be worn;
>
> 3\. identify, with the assistance of the EH&S Industrial Hygiene
> Group, those employees who may need respiratory protective equipment;
>
> 4\. schedule employees required to wear respiratory protective
> equipment for initial and subsequent medical evaluation, fit testing,
> and training, as required by this document;
>
> 5\. obtain approval from the Laboratory Occupational Health Physician
> before assigning known or suspected medically restricted employees to
> jobs requiring the use of respirators;
>
> 6\. ensure that employees have clean respirators and that these
> respirators are being returned at the conclusion of projects,
> especially contract labor work;
>
> 7\. periodically inspect employees\' respirator storage locations to
> ensure proper storage guidelines as outlined on page 9 (Respirator and
> Cartridge Storage).

8.  ensure that employees receive medical reevaluations if the employee
    reports medical signs or symptoms that are related to ability to use
    a respirator,

9.  ensure that employees receive medical reevaluations if the
    supervisor or principal investigator feels that the employee needs
    to be reevaluated,

10. ensure that employees receive medical reevaluations if a change in
    workplace conditions such as physical work effort, protective
    clothing, or temperature, may result in a substantial increase in
    the physiological burden placed on the employee.

***D. Employees***

> Any Laboratory employee who wears a respirator shall:
>
> 1\. maintain a close shave as necessary to ensure the proper fit of
> the respirator for health and safety purposes;
>
> 2\. use the issued respirator in accordance with this document and the
> training provided by the Industrial Hygiene Group;
>
> 3\. inspect the issued respirator for cleanliness and operation before
> each use;
>
> 4\. perform positive and negative pressure seal checks before each use
> (See Appendix E, Negative and positive-pressure check);
>
> 5\. store the respirator and cartridges (when dry) in separate, sealed
> plastic bags;
>
> 6\. inform his/her supervisor, Industrial Hygiene, or Health Services,
> of any medical signs or symptoms that are related to respiratory use;
>
> 7\. guard respiratory protective equipment against damage or
> modification and ensure that respirators are not disassembled or
> altered in any way other than by changing cartridges or filters;
>
> 8\. keep respirators clean to ensure they are free of contamination
> that could affect the fit and compromise personal protection;
>
> 9\. report any malfunction of respiratory protective equipment to the
> Respirator Program Administrator;
>
> 10\. use only issued respirators for which he/she is trained and
> fitted;
>
> 11 use the correct type of respirator and filter cartridge for the
> hazard involved;
>
> 12\. stop work immediately and change filters/cartridges if breathing
> resistance increases due to filter loading or if chemical breakthrough
> is detected;
>
> 13\. inform his/her supervisor and/or the EH&S Division Liaison when
> new situations arise where respiratory protective equipment may be
> necessary;

14\. return respirator to the IH Lab in B75 in person or through the
LBNL mail (See Respirator Return, page 9); and

15. follow the Training Review Guidelines (Appendix H).

***E. Waste Management Group***

> The Waste Management Group shall:
>
> 1\. perform and keep auditable records of monthly inspections of SCBA
> units in accordance with 29 CFR 1910.134 and ANSI Z88.2;
>
> 2\. properly maintain, clean, and store SCBA units located at Building
> 85, in accordance with 29 CFR 1910.134, and ANSI Z88.2 standards.

***III. Respirator Use Prerequisites***

***A. Use Authorization***

> Only those persons authorized by their supervisors and the EH&S
> Industrial Hygiene Group to wear respiratory protective equipment, and
> who have been medically qualified, fitted and trained, shall use
> respiratory protective equipment.

***B. Hazard Evaluation***

> Before respiratory protective equipment is issued, a Hazard Evaluation
> is performed by an Industrial Hygienist and/or a Health Physicist if
> radiation hazards are present. Hazard Evaluations may be completed for
> ongoing programs where the hazards for specific operations may be
> reasonably predicted for the tasks performed. Hazard Evaluations may
> also be completed for particular projects. Hazard Evaluations may be
> completed for a group of workers with similar exposures, or for
> individual workers.
>
> These evaluations are recorded on the LBNL Hazard Evaluation Form
> (Appendix G). Hazard Evaluations shall:

1.  include identification of the respiratory hazards that may be
    present in the workplace;

2.  include sampling or objective data to estimate the potential
    employee exposures in the workplace. The objective data will
    represent the highest contaminant exposures likely to occur under
    reasonable foreseeable conditions of processing, use or handling.
    Since workplace operations may vary greatly at LBNL these objective
    data may be most important for unique operations. Where possible,
    and for on-going routine operations, sampling will be the preferred
    method of hazard evaluation;

3.  include information on the chemical state and physical form of the
    contaminant(s) in the workplace, including regulatory limits for the
    contaminants(s);

4.  be included in the employee's respirator file and reviewed at least
    annually at the time of annual fit testing and training. Hazard
    evaluations may reference LBNL's Comprehensive Tracking System (CTS)
    of exposure tracking.

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C.  ***Medical Qualification***

> Prior to being fitted and trained for respirator use, personnel must
> be medically capable of wearing a respirator. The medical screening
> proceeds as follows:
>
> 1\. Employees are required to complete the Medical Questionnaire for
> Respirator Users (Appendix C) at the time of the initial respirator
> medical evaluation. The Health Services receptionist has these forms
> and employees can fill them out in person. When the questionnaire is
> completed, it will be reviewed by an occupational health nurse. Health
> Services will perform a pulmonary function test, blood pressure check,
> and other medical tests deemed necessary. A copy of the signed medical
> approval will be issued to the employee to bring to their scheduled
> fit test.

2.  Annual medical evaluations are not required for most respirator
    wearers, except as noted below for SCBA wearers. However, should the
    wearer experience difficulty in respirator use, he or she would be
    referred to Health Services for reevaluation before being allowed to
    continue respirator use. Conditions which would indicate a need for
    reevaluation, as noted elsewhere in this plan, include:

    a.  The employee exhibits difficulty breathing, shortness of breath,
        dizziness, or a severe psychological reaction during any phase
        of annual fit testing.

    b.  The employee reports signs or symptoms that are related to
        respirator use.

    c.  The Respiratory Protection Program Administrator or Health
        Services representative finds any indication that the employee
        may need reevaluation.

    d.  The employee, or his/her Supervisor or Principal Investigator,
        finds any indication that the employee may need reevaluation.
        This would include any change in employee exposure or stress,
        physical difficulty in respirator use, or change in work
        conditions such as physical work effort, protective clothing, or
        temperature.

    e.  The employee reports, or the Supervisor or Principal
        Investigator, Health Services, or Respiratory Protection Program
        Administrator makes visual observations of changes in the
        employee's physical condition that could affect respirator fit.
        Facial scarring, dental changes, cosmetic surgery, or a change
        in body weight could affect respirator fit.

3.  Medical evaluations for SCBA users shall be repeated every 5 years
    for employees 45 years of age and older. Employees who have existing
    medical conditions may need to be evaluated on an annual basis.

***D. Quantitative Fit Testing -- Tight-Fitting Facepieces***

> 1\. The safe and effective use of respirators with tight-fitting
> facepieces requires that the respirator be properly fitted to the
> employee. Poorly fitted respirators may leak and fail to provide the
> required degree of protection. Several models and sizes may have to be
> donned and tested before the best fitting respirator can be issued.
>
> 2\. Prior to issuing a tight-fitting respirator to any employee, the
> employee must successfully pass a quantitative fit test on that
> respirator (See Appendix I, Illus. 9).
>
> 3\. The following restrictions apply prior to the fit testing of any
> respirator:

a.  An employee cannot be fit tested with any tight-fitting respirator
    facepiece if there is any facial hair present which would interfere
    with the face-to-facepiece sealing surface. Moderate stubble at the
    sealing surface is considered excessive facial hair.

b.  If an employee exhibits any difficulty breathing or a severe
    psychological reaction during any phase of the fit testing, they
    shall be referred to Health Services for medical reevaluation.

> 4\. Fit testing requirements are listed below:
>
> a\. Quantitative fit testing shall be repeated at least annually. Fit
> testing shall also be performed based on physical changes such as:
>
> i\. weight changes of 20 pounds or more;
>
> ii\. significant facial scarring in the area of the face seal;
>
> iii\. significant dental changes occur (e.g., multiple extractions
> without prosthesis, or dentures);
>
> iv\. reconstructive or cosmetic surgery occurs; or
>
> v\. any other condition that may affect the facepiece seal.

5\. Surrogate Mask Testing

a\. Where positive pressure masks are used, a surrogate mask may be used
for the quantitative fit test.

b\. Surrogate masks may be probed masks or negative pressure masks,
which have the same facepiece size and style as the mask to be used.

***E. Training***

> 1\. Employees required to wear respiratory protective equipment must
> be trained in the selection, care, use and limitations of that
> equipment. Training will be completed for tight-fitting and
> loose-fitting facepiece respirators. Training may vary depending on
> the type of respirator to be issued and the nature of the airborne
> hazard. At a minimum, the training shall include:
>
> a\. the purpose of respiratory protective equipment;
>
> b\. the prerequisites for respirator use, including medical
> qualification, training, and fit testing;
>
> c\. the different types of respirators, their specific application,
> selection, and limitations;
>
> d\. the issuance procedure for respirators;
>
> e\. the use of respirators, including field seal checking procedures;
>
> f\. cleaning and sanitizing procedures;
>
> g\. the proper storage of respirators;
>
> h\. inspection and maintenance procedures;
>
> i\. a review of the LBNL Respiratory Protection Training Review
> Guidelines (Appendix H); and
>
> j\. the viewing of a respiratory protection training video.

1.  Specialized training will be required for personnel assigned to use
    SCBA or airline systems.

***IV. Respirator Selection***

***A. General Discussion***

> There are several types of respirators available. All respirators used
> by LBNL personnel must be NIOSH approved.
>
> Air-purifying respirators clean the air as the wearer breathes or are
> powered by a fan worn by the user. Air-supplied respirators provide
> clean air to the employee from tanks or from an air compressor. Each
> type has specific capabilities and limitations. Therefore, it is
> necessary that the employee be provided with the appropriate
> respirator for a given job. Refer to appendix F for the types of
> respirators available at Berkeley Lab, their advantages, limitations,
> applications, and protection factors. The Industrial Hygienist will
> conduct a Hazard Evaluation for each task which may require
> respiratory protection. If the hazard cannot be sufficiently reduced
> or eliminated through engineering controls, and it is found that
> respiratory protection is recommended for employee protection, a
> respirator may be issued. The Respirator Program Administrator will
> issue respirators and appropriate filters or cartridges based upon
> guidelines in this Program and the Hazard Evaluation.

***B***. ***Filtering Facepiece Respirators (Dust Masks)***

> Filtering facepiece respirators may be issued for voluntary use, for
> personal comfort, when it has been determined that respiratory
> protection is not required to protect employees from workplace
> hazards. Filtering facepiece respirators may also be issued where
> contamination of equipment is an issue.
>
> Groups at LBNL who may use filtering facepiece respirators for
> personal comfort include the Facilities Labor Shop, Carpenters,
> Custodians, and the Health Services Group of EH&S.
>
> Clean rooms and laboratories may use NIOSH-approved filtering
> facepiece respirators to minimize contamination of equipment.
>
> These employees using filtering facepiece respirators on a voluntary
> basis will be provided training and instructions in the use of those
> respirators and will be issued a copy of Appendix D to the respirator
> standard, 29 CFR 1910.134. These employees will not be required to be
> medically evaluated or enrolled in the Respirator Program. However
> their training will be documented and records of this training will be
> kept with the LBNL Respirator Program.

B.  ***IDLH Environments***

> In emergency situations, or where a reasonable estimate of contaminant
> concentrations cannot be made, the atmosphere shall be considered to
> be immediately dangerous to life or health (IDLH). All
> oxygen-deficient atmospheres shall be considered IDLH.
>
> In IDLH environments, workers shall wear full facepiece SCBA
> respirators, certified by NIOSH for a minimum service life of 30
> minutes, or combination full facepiece pressure-demand supplied-air
> respirators with auxiliary self-contained air supply.

***V. Respirator Use***

> ***A. General Discussion***
>
> Once the proper respirator has been selected, care must be exercised
> in its use, cleaning, storage, and maintenance. This section describes
> the controls which assure that each respirator will function up to its
> design specifications.

B.  ***Assigned Protection Factors***

> The APF is the workplace level of respiratory protection that a
> respirator or class of respirators is expected to provide. For worker
> protection, LBNL will use the assigned protection factors (APFs)
> proposed or adopted by OSHA. These APFs will be applied where
> applicable to respirators used at LBNL, except where those respirators
> are used for personal comfort only, as with filtering facepiece
> respirators. LBNL may elect to choose a more restrictive APF for
> specific respirators, as noted the descriptions of respirators used at
> LBNL, in Appendix F, Selection of Respirators.
>
> ***C. Cartridge Service Life***

1.  ***Particulate filters*** Particulate filter change in the absence
    of oil aerosols will be required when the user detects increased
    breathing resistance, or the filter becomes soiled or damaged. Where
    the use of a particulate filter in an environment with oil aerosols
    is required, the manufacturer's recommended service life for their
    P-series filters will be used. Should R-series filters be used in an
    oil aerosol environment, the filter will be discarded after 8 hours
    of use. Particulate filters used at LBNL are typically P100-rated,
    when used to protect against workplace hazards.

> This option will be considered only when oil aerosols are not present
> in the work environment. R-series or N-series filters will not be used
> in oil aerosol environments, or to protect from particulate hazards,
> at LBNL.
>
> ***2. End-of-Service Life Indicators (ESLI)*** When appropriate
> cartridges with ESLI are available to protect against a workplace
> contaminant, the ESLI may be used as an indicator of when the
> cartridge in no longer adequate for employee protection.
>
> ***3. Cartridge Change Schedules*** Industrial Hygiene will assess
> workplace contaminant concentrations as part of the Hazard Evaluation.
> When the contaminants include gases and vapors, the Industrial
> Hygienist will provide a cartridge change schedule to the respirator
> user or group of users, for each task requiring respiratory
> protection. The cartridge change schedule will be created based on
> calculated cartridge service life, taking into consideration the
> nature of the contaminant or mixture of contaminants, the accuracy of
> the workplace concentration measurements, the presence of other
> organic vapors, the possibility of high relative humidity, potential
> for cartridge bed migration, warning properties of the contaminant,
> and any other factors found to be important in the hazard assessment.
> Where possible, cartridge change schedules will be developed using the
> manufacturer's service life calculators. Service life will be
> calculated using the following guidelines.

a.  Exposure Level OSHA PEL or more restrictive limits will be used for
    calculation of the cartridge service life.

b.  Breakthrough Level In using the manufacturers' service life
    calculators the allowable breakthrough concentration shall be 50% of
    the exposure limit, unless the contaminant concentration is less
    than ten times the exposure limit, in which case the allowable
    breakthrough concentration shall be 10% of the concentration.

c.  Safety Factor A safety factor of 50%, or as determined by the
    Industrial Hygienist, shall be employed for calculations.

d.  Work Environment Additional parameters such as work rate,
    temperature, and relative humidity, shall be entered according to
    the work and the work environment.

e.  Low Boiling Point Organic Vapors Cartridge bed migration may result
    in contaminant desorption and migration, even when there is no
    additional exposure to the contaminant. Where the contaminant's
    boiling point is less that 65 degrees Celsius, cartridges should be
    changed after every work shift where exposure occurs, or more
    frequently if the service life calculation indicates this is
    necessary. Workers should be educated about the chemical properties
    of contaminants they work with. For contaminants with boiling points
    slightly greater than 65 degrees Celsius, cartridge change frequency
    may be determined in consultation with the Industrial Hygienist,
    based on the nature of the contaminant and the work environment.

f.  Warning Properties Contaminant warning properties are not a reliable
    measure of cartridge functioning and should not be used to determine
    the cartridge service life. However, workers should be educated
    about the contaminant warning properties for the contaminants to
    which they may be exposed. Warning properties include odor, taste,
    irritation, burning and any other indication the contaminant may be
    present in the air. Workers should be instructed to replace
    cartridges and contact the industrial hygienist when contaminant
    odor or any other indicator is detected inside the mask. Where the
    contaminant has poor warning properties, the cartridge change
    schedule may be modified to provide a greater safety factor.

> ***D. Field Use***
>
> 1\. Immediately before using the respirator, the employee shall:
>
> a\. inspect it to determine if it is the correct type of respirator
> for the job;
>
> b\. inspect it to determine if it is intact and complete; and
>
> c\. don the mask and perform both the positive and negative pressure
> seal checks (See Appendix E, Negative and Positive Pressure Checks) to
> make sure that the valves and face seal are working properly (Notify
> the EH&S Industrial Hygiene Group of any problems encountered).
>
> 2\. Field Inspection / Maintenance Prior to each use, the employee
> shall inspect the respirator as described during training. Respirators
> that are damaged or fail to fit properly shall be returned to the EH&S
> Industrial Hygiene Group.
>
> 3\. Cartridge Replacement When installing new chemical cartridges the
> user will mark the date on the side of the new cartridge. Users will
> follow instructions as detailed above, for cartridge replacement.
>
> ***E. Respirator and Cartridge (Filter) Storage***

1.  When not in use, respirators shall be stored to protect against
    dust, sunlight, extremes of temperature, excessive moisture, or
    damaging chemicals. Respirators should be decontaminated if
    necessary, and allowed to dry before being stored in zip lock
    plastic bags or other sealed containers.

2.  2\. The cartridges or filters shall be stored in separate zip-lock
    storage bags to extend the shelf life of the organic-vapor
    cartridges and to prevent cross contamination of the respirator.

3.  Respirators shall be stored in a manner that the facepiece shape is
    not deformed.

4.  Respirator cleaning and decontamination may be accomplished by the
    employee if facilities are available, or at any time by bringing the
    respirator to the Respirator Program Manager for decontamination in
    the respirator washer.

***F. Respirator Return***

1\. Employees who use their respirators on a temporary basis (i.e.,
contract employees or workers on temporary projects) shall return their
respirators to the Industrial Hygiene Lab through the LBNL mail system
when the job is finished.

2.  To return a respirator through the mail system, employees are
    instructed to put the respirator into a sealed zip-lock bag and then
    into a large manila envelope and write, \"IH Lab, MS 75-123\" on the
    outside of the envelope, or employees may drop them off in person.

> 3\. If a respirator is needed after an employee leaves the lab or is
> off the Respirator Program, and later returns, the employee calls the
> EH&S Industrial Hygiene Group to request another respirator. Before
> another respirator is issued, the EH&S Industrial Hygiene Group will
> verify fit test records and hazard evaluation, and request that a new
> respirator medical evaluation be completed. The employee may be
> required to repeat Respirator Fit Testing and Training before being
> issued a respirator.
>
> 4\. A respirator must also be returned to the industrial hygiene lab
> if the respiratory protective equipment:
>
> a\. malfunctions or is damaged
>
> b\. becomes grossly contaminated; or
>
> c\. becomes too dirty or difficult to wipe down or self-clean.
>
> 5\. Respirators shall be returned in plastic bags and labeled
> accordingly if contaminated with toxic material.
>
> 6\. Respirators used for radioisotope protection shall not be returned
> through the mail system and must be decontaminated prior to return. If
> decontamination is not possible, the mask should be disposed of in
> accordance with Waste Management Procedure.

7.  Respirators used by LBNL employees shall be returned to the
    Industrial Hygiene Lab on an annual basis during fit testing.
    Respirators will be reissued after cleaning and the employee
    successfully completes the fit test and training.

> ***G. Inspection, Cleaning, and Sanitizing***
>
> 1\. In addition to the employee\'s inspection prior to each use, every
> respirator shall be routinely inspected by the EH&S Industrial Hygiene
> Group when it is returned to the Industrial Hygiene Lab. This involves
> examining the straps, hoses, valves, gaskets, mask body, and
> filters/cartridges, as required. Defective or worn parts will be
> replaced with new parts by an industrial hygienist. Parts will not be
> interchanged between different brands of respirators, as this would
> void their NIOSH approval.
>
> 2\. Field cleaning of respirators shall be performed by the user by
> washing the entire respirator (after removing cartridges and filters)
> with soap and warm water in a clean area on a regular basis. When the
> respirator requires a thorough cleaning and sanitizing, it shall be
> returned to the EH&S Industrial Hygiene Group and exchanged for a
> sanitized mask. Sanitary wipes can be used for additional cleaning
> before each use.
>
> 3\. The cleaning and sanitizing by the EH&S Industrial Hygiene Group
> shall be performed with the use of a respirator washer / dryer system
> manufactured by Steel Case (See Appendix I, Illus. 10). This system is
> specifically designed for washing, drying and sanitizing a high volume
> of respirators. The washing agent is called Masklenze MK-1 (Alkaline
> Detergent); its major ingredient is potassium metasilicate. The
> sanitizing agent is regular household bleach (5.25% concentration).
> 7-8 ml of bleach and 15-17 ml of the Masklenze detergent are
> automatically added to the 2 gallons of water in the washing machine.
> The washing/sanitizing cycle runs for 10 minutes.

3.  Probed respirators that are used for quantitative fit testing are
    sanitized after each use with the automatic respirator washer /
    dryer system. Respirators that are tried for size but not issued to
    employees are also sanitized prior to returning them to storage.

> ***H. Facial Hair Policy***
>
> It is LBNL\'s Policy that employees who have facial hair that intrudes
> into the area where the negative or positive pressure respirator seals
> against the face, or interferes with valve function, shall not be
> fitted with a respirator. Additionally, any employee who is not
> clean-shaven shall not be allowed to wear a negative or
> positive-pressure respirator.
>
> LBNL does not accommodate employees for a non-health and safety issue.
> Hence, employees with facial hair who require a negative- or
> positive-pressure tight-fitting respirator will need to shave so that
> a respirator can be worn.
>
> LBNL recognizes that no one size or model of respirator will fit all
> face types. For this reason, LBNL will offer a selection of
> respirators including Powered Air Purifying Respirators (PAPRs) with
> hoods to accommodate the employee, if fitting problems result from
> uncontrollable physiological facial features such as excessively
> protruding cheekbones, deep creases in facial skin, scars, hollow
> temples, and the absence of teeth or dentures. The type of respirator
> that is the most appropriate, and which will provide adequate
> protection, must be determined on a case-by-case basis.
>
> ***I. Contact Lens or Spectacle Use***
>
> An employee may wear their own prescription contact lenses while
> wearing a half mask or full facepiece respirator if they choose this
> option. This option should be evaluated to assure that the respirator
> does not interfere with the eyewear, make it uncomfortable, or force
> the employee to remove the eyewear. The employee may also be fitted
> with prescription lenses that fit inside a full face mask.

***VI. Auditing***

> ***A. Program Audits***
>
> Informal reviews of the LBNL Respiratory Protection Program will be
> performed on a periodic basis. Reviews will include a review of
> workplace conditions and regulatory changes.
>
> Included in the Program Reviews will be field inspections of at least
> 30% of respirator users, on an annual basis. These inspections will
> include observation of the workplace and the condition of the
> respirator, as well as questioning users on their respirator use.
> Documentation of these inspections will be in the form of a written
> questionnaire, to be kept in the employee's file. Based on these field
> inspections, problems will be corrected and the dates of correction
> noted.
>
> In addition, the supervisors of employees who wear respirators shall
> periodically audit respirator storage locations and proper use.

***APPENDICES***

**APPENDIX A**

**DEFINITIONS**

**ANSI:** American National Standards Institute.

**Approved:** Certified for use by the National Institute for
Occupational Safety and Health (NIOSH) of the U.S. Department of Health
and Human Services (DHHS). A label or statement of certification should
appear on the respirator or respirator packaging. Color-coded cartridges
should have the DHHS and NIOSH emblems on the package insert, and
"NIOSH" printed on each cartridge. Respirators and cartridges issued
prior to 1999 may be jointly certified by NIOSH and the Mine Safety and
Health Administration.

**Air-purifying respirator (APR):** A respirator with an air-purifying
filter or cartridge that removes specific air contaminants by passing
ambient air through the air-purifying element.

**Assigned protection factor (APF):** The workplace level of respirator
protection that a respirator or class of respirators is expected to
provide to employees when those employees are properly fitted and
trained and enrolled in the respiratory protection program. The
protection factor is a measure of the degree of protection provided by a
respirator to the wearer. APFs have been proposed by OSHA, but until
they are adopted the Lab will follow NIOSH and ANSI guidance for classes
of respiratory protection. Where respiratory protection requirements are
contained in OSHA substance-specific standards, these requirements will
take precedence when the respiratory protection is used for protection
from that substance.

**CFR:** Code of Federal Regulations

**Cartridge (air-purifying):** A container with a filter, sorbent, or
catalyst, or any combination thereof, which removes specific
contaminants from the air drawn through it.

**Contaminant:** A harmful, irritating, or nuisance material that is
foreign to the normal atmosphere.

**Exhalation valve:** A device that allows exhaled air to leave a
respirator and prevents outside air from entering through the valve.

**Facepiece:** That portion of a respirator that covers the wearer\'s
nose and mouth.

**Filter or air-purifying element:** A media component used to remove
solid or liquid aerosols from the inspired air.

**Filtering facepiece:** (disposable dust mask) a negative pressure
particulate respirator with a filter as an integral part of the facpiece
or with the entire facepiece composed of the filtering medium.

**Gas:** A substance which is in the gaseous state at standard
temperature and pressure.

**Hazardous atmosphere:** Any atmosphere, either immediately or not
immediately dangerous to life or health, which is oxygen deficient or
which contains a toxic or disease-producing contaminant exceeding the
legally established permissible exposure limits (PEL) or, where
applicable, the Threshold Limit Value (TLV) established by the American
Conference of Governmental Industrial Hygienists (ACGIH).

**High Efficiency Particulate Air Filter (HEPA):** A filter which
removes from the air 99.97% or more of monodisperse particles of 0.3
micrometers in diameter. 30 CFR Part 11 provided for certification and
testing of these filters. This regulation has been superseded by 42 CFR
Part 84, with nine classes of filters, including the P100 which closely
resembles the HEPA. The new 42 CFR Part 84 filters will be used with
non-powered, air-purifying, particulate filter respirators. HEPA filters
would still be used with powered, air purifying respirators.

**Hood:** A respiratory inlet covering that completely covers the head
and neck and may also cover portions of the shoulders and torso.

**Immediately Dangerous to Life or Health (IDLH):** Any atmosphere that
poses an immediate threat to life, would cause irreversible adverse
health effects, or would impair an individual's ability to escape from a
dangerous atmosphere.

**Inhalation valve:** A device that allows respirable air to enter a
respirator and prevents exhaled air from leaving the respirator through
the valve.

**Maximum use concentration (MUC):** The maximum atmospheric
concentration of a hazardous substance from which an employee can be
expected to be protected when wearing a respirator. This is determined
by the APF of that respirator and the exposure limit of the hazardous
substance. The MUC can be determined by multiplying the APF specified
for a respirator by the permissible exposure limit, threshold limit
value, short-term exposure limit, ceiling limit, or other exposure limit
for the hazardous substance.

**Negative pressure respirator (tight fitting):** A respirator in which
the air pressure inside the facepiece is negative during inhalation with
respect to the ambient air pressure outside the respirator.

**NIOSH:** National Institute for Occupational Safety and Health.

**Oxygen deficient atmosphere:** An atmosphere containing less than
19.5% oxygen by volume.

**Pl00 Filter:** Filter cartridge that replaces the old **HEPA** filter
for half-mask and full-face mask non-powered respirators. 42 CFR Part 84
provides for nine classes of filters (three levels of filter efficiency,
with three categories of resistance to filter degradation). The levels
of filter efficiency indicate minimum filtration of particulate which is
0.3 microns in size. P100 is the 99.97% efficient oil-proof filter.

  ---------------- -------------------- ------------------ ----------------
  **Particulate                                            
  Filter                                                   
  Designations**                                           

  **Nine                                                   
  Designations                                             
  based on 3                                               
  Filter                                                   
  Efficiencies and                                         
  3 categories of                                          
  Resistance to                                            
  Degradation by                                           
  Oil Mist**                                               

                   99.97% Efficient     99% Efficient      95% Efficient

  Oil **P**roof    **P100**             **P99**            **P95**

  Oil              **R100**             **R99**            **R95**
  **R**esistant                                            

  **N**ot Oil      **N100**             **N99**            **N95**
  Proof                                                    
  ---------------- -------------------- ------------------ ----------------

**Particulate matter:** A suspension of fine solid or liquid particles
in air, such as dust, fog, fume, mist, smoke, or spray. Particulate
matter suspended in air is commonly known as an aerosol.

**Permissible Exposure Limit (PEL):** The OSHA 8 hour time-weighted
average (TWA) concentration of a contaminant that shall not be exceeded.

**Positive-pressure respirator:** A respirator in which the air pressure
inside the respiratory-inlet covering is positive relative to the air
pressure of the outside atmosphere during exhalation and inhalation.

**Powered air-purifying respirator (PAPR):** An air-purifying respirator
that uses a blower to force the ambient air through air-purifying
elements to the inlet covering.

**Pressure-demand respirator:** A positive pressure atmosphere-supplying
respirator that admits breathing air to the facepiece when the positive
pressure is reduced inside the facepiece by inhalation.

**Resistance:** Opposition to the flow of air, as through a canister,
cartridge, particulate filter, orifice, valve, or hose.

**Respirable:** Able to be breathed. Also refers to particle size
diameter less than or equal to 10 micrometers.

**Respirator:** A device designed to protect the wearer from the
inhalation of harmful atmospheres.

**Respiratory inlet covering:** That portion of a respirator that forms
the protective barrier between the user's respiratory tract and an
air-purifying device or breathing air source, or both.

**Seal Check:** An action conducted by the respirator user every time
the respirator is put on, to determine if the respirator is properly
seated to the face.

**Service Life:** The period of time that a respirator, filter or
sorbent, or other respiratory equipment, provides adequate protection to
the wearer.

**SCBA:** Self-Contained Breathing Apparatus.

**Time-Weighted Average (TWA):** The average concentration of a
contaminant in air during a specific time period.

**Threshold Limit Value (TLV):** Airborne concentration recommended by
the American Conference of Governmental Industrial Hygienists. The
time-weighted average concentration for a normal 8-hour workday and a
40-hour work week, to which nearly all workers may be repeatedly
exposed, day after day, without adverse effect.

## APPENDIX B

**Respiratory Protection Certification Protocol**

1.  **HAZARD EVALUATION FORM** -- If your supervisor requests that you
    get a respirator, your workplace exposure must be evaluated by an
    EH&S Industrial Hygienist. The evaluation may recommend the use of
    an Air-purifying, Airline, or SCBA respirator.

2.  **RESPIRATOR MEDICAL APPROVAL:** After receiving a **HAZARD
    EVALUATION** from Industrial Hygiene, employees should contact
    Health Services (Bldg. 26, x6266) and request a Respirator Medical
    Evaluation. Health Services requires the employee to complete the
    **MEDICAL QUESTIONNAIRE** **FOR RESPIRATOR USERS** (Appendix C of
    this Respirator Program.) Health Services will review your
    questionnaire. They will perform a pulmonary function test (lung
    function test) and blood pressure check, and additional evaluations
    as indicated. Upon satisfactory completion of the Respirator Medical
    Evaluation, Health Services will provide a signed copy of the
    approval section of the **MEDICAL QUESTIONNAIRE** for you to bring
    to your scheduled fit test appointment with the EH&S Industrial
    Hygiene Group. Medical approval should take approximately 30
    minutes.

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2.  **INITIAL FIT TESTING AND TRAINING - AFTER MEDICAL APPROVAL:** Upon
    satisfactory completion of the **RESPIRATOR MEDICAL EVALUATION,**
    respirator fit testing and training will be done in B75 Room 112A.
    (Please call in advance to make an appointment. Check the EH&S
    website: Who to Call/Subject Matter for contact information). The
    fit testing and training takes approximately 30 minutes to one hour.

3.  **ANNUAL FIT TESTING AND TRAINING** -- Call the EH&S Respirator
    contact person to schedule your annual fit testing. Additional
    Medical Evaluation may be required before this annual Fit Testing
    and Training. Medical Reevaluation is required if the employee
    respirator training has lapsed.

4.  **EMPLOYEE PRE-TESTING CONCERNS:** An employee cannot be fitted with
    a tight-fitting respirator if there is any **facial** **hair**
    present that would interfere with the mask-sealing surface. Moderate
    stubble at the sealing surface is considered excessive facial hair.
    Please be clean-shaven for your scheduled fit test.

5.  **RESPIRATOR TRAINING:** Respirator Training includes basic
    information on why the respirator is necessary and how improper fit,
    usage, or maintenance can compromise its effectiveness; respirator
    limitations and capabilities; emergency situations; inspection,
    maintenance and storage, how to recognize medical signs and symptoms
    that may limit or prevent the use of respirators.

6.  **FIT TEST PROTOCOL:** OSHA-accepted fit test protocols, as
    described in Appendix A to the Federal Respirator Standard, 29 CFR
    1910.134, are used in fit testing employee respirator fit. A TSI
    PortaCount fit testing machine is used to conduct quantitative fit
    tests.

## APPENDIX C

## MEDICAL QUESTIONNAIRE

**FOR RESPIRATOR USERS**

Name (Last, First, Middle
initial):\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Employee#\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Work #\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\
Division\_\_\_\_\_\_\_\_\_\_\_\_\_ Mail Stop:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Job
Title\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date of Birth
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

RESPIRATOR TYPE: AIR PURIFYING SUPPLIED AIR

  -------------------------- ---------------- ----------------------------
   Filtering face piece      Full-Face Mask  Airline (Continuous Flow)
  (dusk mask)                                 

   Half-Mask                 PAPR            Airline (Pressure Demand)

  Have you worn a                              SCBA
  respirator? Yes / No                        
  -------------------------- ---------------- ----------------------------

In order to satisfy Federal OSHA requirements, each individual must be
medically approved prior to performing a task while wearing respiratory
protective equipment. This questionnaire must be completed even if you
have had a recent physical examination in the Health Services
Department.

Contaminant(s):\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

The employee listed above is medically able to wear respiratory
protection. A copy of this approval has been provided to the employee.

**Medical approval:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Medical restrictions:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Employee's signature:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*Questions 1 through 12 below must be answered by every employee who has
been selected to use any type of respiratory (please circle "yes" or
"no").*

1\. Do you ***[currently]{.underline}*** smoke tobacco, or have you
smoked tobacco in the last month: Yes / No

2\. Have you ***[ever had]{.underline}*** any of the following
conditions?

a\. Seizures (fits): Yes / No

b\. Diabetes (sugar disease): Yes / No

c\. Allergic reactions that interfere with your breathing: Yes / No

d\. Claustrophobia (fear of closed-in places): Yes / No

e\. Trouble smelling odors: Yes / No

3\. Have you ***[ever had]{.underline}*** any of the following pulmonary
or lung problems?

a\. Asbestosis: Yes / No

b\. Asthma: Yes / No

c\. Chronic bronchitis: Yes / No

d\. Emphysema: Yes / No

e\. Pneumonia: Yes / No

f\. Tuberculosis: Yes / No

g\. Silicosis: Yes / No

h\. Pneumothorax (collapsed lung): Yes / No

i\. Lung cancer: Yes / No

j\. Broken ribs: Yes / No

k\. Any chest injuries or surgeries: Yes / No

l\. Any other lung problem that you've been told about: Yes / No

4\. Do you ***[currently]{.underline}*** have any of the following
symptoms of pulmonary or lung illness?

a\. Shortness of breath: Yes / No

b\. Shortness of breath when walking fast on level ground or walking up
a slight hill or incline: Yes / No

c\. Shortness of breath when walking with other people at an ordinary
pace on level ground: Yes / No

d\. Have to stop for breath when walking at your own pace on level
ground: Yes / No

e\. Shortness of breath when washing or dressing yourself: Yes / No

f\. Shortness of breath that interferes with your job: Yes / No

g\. Coughing that produces phlegm (thick sputum): Yes / No

h\. Coughing that wakes you early in the morning: Yes / No

i\. Coughing that occurs mostly when you are lying down: Yes / No

j\. Coughing up blood in the last month: Yes / No

k\. Wheezing: Yes / No

l\. Wheezing that interferes with your job: Yes / No

m\. Chest pain when you breathe deeply: Yes / No

n\. Any other symptoms that you think may be related to lung problems:
Yes / No

5\. Have you ***[ever had]{.underline}*** any of the following
cardiovascular or heart problems?

a\. Heart attack: Yes / No

b\. Stroke: Yes / No

c\. Angina: Yes / No

d\. Heart failure: Yes / No

e\. Swelling in your legs or feet (not caused by walking): Yes / No

f\. Heart arrhythmia (heart beating irregularly): Yes / No

g\. High blood pressure: Yes / No

h\. Any other heart problem that you've been told about: Yes / No

6\. Have you ***[ever had]{.underline}*** any of the following
cardiovascular or heart symptoms?

a\. Frequent pain or tightness in your chest: Yes / No

b\. Pain or tightness in your chest during physical activity: Yes / No

c\. Pain or tightness in your chest that interferes with your job: Yes /
No

d\. In the past two years, have you noticed your heart skipping or
missing a beat: Yes / No

e\. Heartburn or indigestion that is not related to eating: Yes / No

f\. Any other symptoms that you think may be related to heart or
circulation problems: Yes / No

7\. Do you ***[currently]{.underline}*** take medication for any of the
following problems?

a\. Breathing or lung problems: Yes / No

b\. Heart trouble: Yes / No

c\. Blood pressure: Yes / No

d\. Seizures (fits): Yes / No

8\. If you've used a respirator, have you ***[ever had]{.underline}***
any of the following problems? (*If you've never used a respirator,
check the following space \_\_\_\_\_\_\_\_\_ and go to question 9*)

a\. Eye irritation: Yes / No

b\. Skin allergies or rashes: Yes / No

c\. Anxiety: Yes / No

d\. General weakness or fatigue: Yes / No

e\. Any other problem that interferes with your use of a respirator: Yes
/ No

9\. Would you like to talk to the health care professional who will
review this questionnaire about your answers to this questionnaire: Yes
/ No

10\. Have you ever worked with any of the materials, or under any of the
conditions, listed below:

a\. Asbestos: Yes / No

b\. Silica (e.g., in sandblasting): Yes/No

c\. Tungsten/cobalt (e.g., grinding or welding this material): Yes / No

d\. Beryllium: Yes / No

e\. Aluminum: Yes / No

f\. Coal (for example, mining): Yes / No

g\. Iron: Yes / No

h\. Tin: Yes / No

i\. Dusty environments: Yes / No

j\. Any other hazardous exposures: Yes / No

if "yes," describe these exposures:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

11\. List any second jobs or side businesses you have related to
chemical use:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

12\. List your current and previous hobbies related to chemical use:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Questions 13 through 18** must be answered by every employee who has
been selected to use either a full-face respirator or a self-contained
breathing apparatus (**SCBA**). For employees who have been selected to
use other types of respirators, answering these questions is voluntary.

13\. Have you ***[ever lost]{.underline}*** vision in either eye
(temporarily or permanently) Yes / No

14\. Do you ***[currently]{.underline}*** have any of the following
vision problems?

a\. Wear contact lenses: Yes / No

b\. Wear glasses: Yes / No

c\. Color blind: Yes / No

d\. Any other eye or vision problem: Yes / No

15\. Have you ***[ever had]{.underline}*** an injury to your ears,
including a broken ear drum: Yes / No

16\. Do you ***[currently]{.underline}*** have any of the following
hearing problems?

> a\. Difficulty hearing: Yes / No
>
> b\. Wear a hearing aid: Yes / No
>
> c\. Any other hearing or ear problem: Yes / No

17\. Have you ***[ever had]{.underline}*** a back injury: Yes / No

18\. Do you ***[currently]{.underline}*** have any of the following
musculoskeletal problems?

> a\. Weakness in any of your arms, hands, legs, or feet: Yes / No
>
> b\. Back pain: Yes / No
>
> c\. Difficulty fully moving your arms and legs: Yes / No
>
> d\. Pain or stiffness when you lean forward or backward at the waist:
> Yes / No
>
> e\. Difficulty fully moving your head up or down: Yes / No
>
> f\. Difficulty fully moving your head side to side: Yes / No
>
> g\. Difficulty bending at your knees: Yes / No
>
> h\. Difficulty squatting to the ground: Yes / No
>
> i\. Climbing a flight of stairs or a ladder carrying more than 25 lbs:
> Yes / No
>
> j\. Any other muscle or skeletal problem that interferes with using a
> respiratory: Yes / No

## APPENDIX D

**LAWRENCE BERKELEY NATIONAL LABORATORY**

**RESPIRATOR FITTING & ISSUE RECORD**

### I. EMPLOYEE INFORMATION

> Name: Phone: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> (Last) (First) (MI)
>
> Division: Job Title: \_\_\_\_\_\_\_\_\_\_\_\_\_Medical review
> date:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Mail stop:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ DOB: Employee
> No.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Supervisor: Phone: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> (Last) (First)

### 

### II. BRIEF HAZARD DESCRIPTION

##### Comments : \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**III. QUANTITATIVE FIT TESTING RESULTS**

> (Pass=1000 or greater for 1/2 masks & 2500 or greater for full
> facepiece respirators)

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> (Brand) (Model #) (Half or Full face) (Size) (Overall fit factor)
> (Pass/Fail)
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> (Brand) (Model #) (Half or Full face) (Size) (Overall fit factor)
> (Pass/Fail)
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> (Brand) (Model #) (Half or Full face) (Size) (Overall fit factor)
> (Pass/Fail)
>
> Fit Test Operator: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> Filters/Cartridges Issued:
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**IV. RESPIRATOR USE STATUS**

> High use \[ \] Moderate use \[ \] Infrequent use \[ \] Off program \[
> \] Date off program:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Does the employee report medical signs or symptoms related to
> respirator use (shortness of breath, dizziness, chest pains,
> wheezing)? (Yes/No)
>
> Has Health Services or a Supervisor informed Industrial Hygiene that
> the employee needs to be reevaluated? (Yes/No)
>
> Is there any information from the Respiratory Protection Program,
> including any indication during fit testing and Program evaluation,
> that the employee needs to be reevaluated? (Yes/No)
>
> Has there been a change in workplace conditions (e.g., physical work
> effort, protective clothing, temperature) that might result in a
> substantial increase in the physiological burden placed on the
> employee? (Yes/No)
> Comments:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> If **Yes** is circled on any of the questions above, **Date referred**
> to Health Services for Medical Reevaluation\_\_\_\_\_\_\_\_\_\_

### V. TRAINING

> The employee named has been trained in the selection, use, storage,
> limitations, cleaning, and other requirements for the respirator
> specified in Section III as per 29 CFR 1910.134 and Z88.2. If
> additional medical review is indicated, the employee has been
> reevaluated and approved by Health Services.
>
> Employee Signature: Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

EH&S Signature: Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> **APPENDIX E**

**QUANTITATIVE FIT TESTING PROCEDURE**

**USING THE PORTA COUNT PLUS**

###### Porta Count Start-up

1\. Turn on the computer and monitor. Open the TSI FitPlus software.

2\. Turn-on the Porta Count to allow for the 60 seconds warm-up cycle.

3\. Do the Daily Checks to verify PortaCount functioning.

4\. From the People Database that appears on the screen, select the name
of the individual to be fit-tested, or enter a new employee in the
database. Fields in the TSI Fit Plus database are populated as follows:
COMPANY is Berkeley Lab Division; LOCATION is the employee Mailstop;
CUSTOM 1 is the employee's Supervisor Last Name; CUSTOM 2 is Supervisor
First Name; CUSTOM 3 is Program Status, where CU indicates a current
user and OP indicates the individual is off program.

5\. Required forms may be found in the front of the file of employee fit
testing records. These include: the Respiratory Fitting and Issue Record
form (Appendix D), the Hazard Evaluation Form if this has not been
provided by an IH, the Training Review Guidelines, and the Course
Completion Form The employee must provide a signed copy of the Medical
Approval from Health Services.

6\. The TSI PortaCount machine is set to run the OSHA 29 CFR 1910.134
fit test protocol

7.  Finish entering fit test data.

8\. Once a suitable respirator has been selected, press COUNT on the
PortaCount to view real-time particle concentration inside the mask.
When a suitable particle concentration is achieved with the mask being
tested, press FIT TEST and begin the test.

###### Explanation of test to wearer

Explain to the respirator wearer that seven fit test exercises will be
performed. These exercises include: normal breathing, deep breathing,
moving head side to side, moving head up and down, speaking (reading the
rainbow passage), grimace (15 seconds only) bending over, and normal
breathing. Each exercise will run for 80 seconds. If the deep breathing
and head movement exercises cause dizziness, either slow down the
movements or stop the exercise all together.

###### Donning the respirator

> Attach the P100 filters and the probed adapter to the chosen
> respirator to be fit tested, then have the wearer don the respirator.

####### Attaching the sample tubing

> Attach the clear tygon tubing from the Porta Count to the probed
> filter adapter.

**APPENDIX E (Continued)**

###### Negative and positive pressure seal check

> Have the person perform the negative and positive pressure seal checks
> (See Appendix I, Illus. 6 and 7) by gently placing the palms of their
> hands over the cartridges, without pushing the respirator against
> their face, to obtain a good seal. Ask the wearer to inhale to create
> a negative pressure inside the respirator. The respirator should
> collapse slightly on the wearer\'s face. No leakage around the face
> seal should be noted while maintaining a negative pressure inside the
> respirator for several seconds. This test is not feasible with all
> brands of respirators. The positive pressure test should also be
> performed by gently covering the exhalation valve with the palm of the
> wearer's hand and exhaling gently to create a positive pressure
> build-up inside the respirator. No leakage outward around the seal
> should be noted. This test is not feasible with all brands or
> respirators.
>
> If the wearer fails to obtain a good facial fit on both the negative
> or positive pressure seal checks, the head straps and mask placement
> on the face should be adjusted, and the testing procedure repeated. A
> variety of masks is available for testing and issuance.

***Begin fit testing***

1\. Press the \[Return\] key to begin the fit testing. The computer will
lead you through the rest of the testing.

2\. Explain to the wearer how the Porta Count works and the meaning
behind the information shown on the screen.

3\. Ask the wearer to doff the respirator after the computer calculates
the overall protection factor.

***Saving and printing data***

> The computer automatically saves and prints the fit test data. Fit
> test information is also copied into LBNL's FitTest Access Database.

***Exiting from the computer***

1\. After the printing is completed, press CANCEL to close the People
Database screen.

> **APPENDIX F**
>
> **SELECTION OF RESPIRATORS**

###### A. General Discussion

LBNL offers the respirators discussed in this appendix. Protection
factors are noted for each type of respirator. Where OSHA
Substance-specific Standards include Maximum Use Concentrations for
specific respiratory protection, those values shall take precedence over
the Protection Factors given here, for protection against the
contaminant addressed by that Substance-Specific Standard. OSHA
Respirator Standard APFs will be incorporated into the LBNL Respirator
Program at such time as they are adopted by OSHA.

###### B. Filtering Facepiece (Disposable Dust Mask) Respirators 

1.  **Description:** The Laboratory offers N-95 filtering facepiece
    respirators for protection against nuisance particulates only. The
    use of these masks, commonly known as dust masks, is restricted to
    work where the mask is not needed to protect against workplace
    hazards but is for employee comfort. These masks may also be worn
    where protection is desired to protect equipment or work areas.

> Unlike other respirators, filtering facepiece respirators may be worn
> on a voluntary basis without completion of a Respirator Medical
> Evaluation or enrollment of the employee in the LBNL Respirator
> Program. A hazard assessment must show that respiratory protection is
> not required for the work operation. However, voluntary users of
> filtering facepiece respirators must be trained in their use and
> provided with a copy of Appendix D to the Respirator Standard.
> Filtering facepiece training is available to individuals or groups who
> use these masks, through the Respirator Program Administrator.

2.  **Advantages:** These respirators are lightweight, disposable,
    comfortable, and inexpensive. They provide protection from nuisance
    dust. A filtering facepiece may be re-used if desired, until the
    filter media becomes degraded or until there is a noticeable
    increase in difficulty breathing. The "N" designation indicates the
    filter media is "Not oil-proof," and the "95" efficiency indicates
    the filter media removes 95% of particles at the 0.3 micron size.

3.  **Limitations:** Disposable dust masks offer minimal protection,
    compared to other types of respirators, due to their face-sealing
    characteristics and filtration efficiency. Their effectiveness is
    compromised when worn by an employee who has facial hair that
    interferes with the skin-to-mask seal. They offer no protection
    against oxygen deficient atmospheres or organic vapors.

4.  **Applications:** Low concentrations of nuisance dusts, pollen, dry
    wall, and animal dust. These masks may also be worn voluntarily when
    it is desirable to protect processes (clean rooms), rather than the
    individual wearing the mask.

5.  **Protection Factor: 1** LBNL does not issue filtering facepiece
    respirators for environments where a hazard is found to be present.
    Since these masks are not issued to protect from a hazard, and are
    not quantitatively fit-tested, they are not assigned a protection
    factor higher than one.

> **APPENDIX F (Continued)**

###### C. Air-Purifying Half-Mask Respirators

> **1. Description:** The half-mask facepiece has a silicone face seal
> which fits over the nose and under the wearer\'s chin. It is fitted
> with filters or cartridges that purify the air as the wearer breathes.
> Different types of cartridges are available for a variety of air
> contaminants. These air-purifying respirators are negative pressure
> respirators.
>
> **2. Advantages:** These respirators offer a better seal than the
> filtering facepiece respirators and greater protection. They are
> relatively comfortable and are the most commonly selected type of
> air-purifying respirator due to their convenience and comfort.
>
> **3. Limitations:** Air-purifying respirators cannot be used for all
> types of air contaminants, including contaminants whose concentration
> cannot be reliably estimated, or when a suitable cartridge is not
> available for a given contaminant. They cannot be used where facial
> hair interrupts the facial sealing surface or in the atmospheres
> deficient in oxygen. They do not protect the eyes from irritating
> contaminants.
>
> **4. Applications:** Applications of these respirators depend upon the
> contaminant present, and the filter or cartridge used. There are
> several different types of cartridges; each type is designed to
> protect against a specific type of hazard. Cartridges are color coded
> to identify their applicability. The most common types of cartridges
> are:

a.  P100 Filter (Magenta): For filtration of particulates, including
    asbestos, lead, and silica. The "P" indicates the filter media is
    "oil-Proof", and the "100" indicates the filter efficiency is 99.97%
    of particles at the 0.3 micron size.

b.  Organic Vapor Cartridge (Black): For certain organic vapors. These
    cartridges are not useful against natural gas, propane, or vapors
    with poor warning properties. IH will determine service life based
    on the specific contaminants.

c.  Acid Gas Cartridges (White): Useful in atmospheres with acid gas,
    such as chlorine, hydrogen chloride, sulfur dioxide, hydrogen
    fluoride.

d.  Combination Cartridge (Combined Colors): Useful for environments
    with more than one contaminant present (e.g., vapor and particulate
    exposure.)

e.  Mercury Vapor and Chlorine Gas Cartridge (Orange): Useful for
    protection against mercury vapor or chlorine gas.

f.  Organic Vapor/Acid Gas (Yellow): For certain organic vapors, and
    acid gases.

g.  Multi (Olive): For certain organic vapors, acid gases, and
    formaldehyde, ammonia, and methylamine.

> **5. Protection Factor: 10**

###### D. Air-Purifying Full Facepiece Respirators

1.  **Description:** Air-purifying full face-piece respirators are
    similar to the half-mask respirators described above in that ambient
    air is filtered as the wearer breathes. Again, specific cartridges
    are available to protect against specific hazards. However, the full
    facepiece extends around the entire face, covering the eyes in
    addition to the nose, chin, and mouth. These air-purifying
    respirators are negative pressure respirators.

**APPENDIX F (Continued)**

> **2. Advantages:** Full facepiece respirators may provide more
> protection than half-mask air-purifying respirators. They also protect
> the eyes from irritating vapors, mists, and chemical splashes. Full
> facepieces do not currently provide ANSI-rated protection from impact,
> so a faceshield must be used in addition to the full facepiece mask
> when impact protection is required. A full facepiece respirator may
> provide a better fit for some individuals.
>
> **3. Limitations:** These respirators are heavier than half masks.
> Air-purifying respirators cannot be used for all types of air
> contaminants, including contaminants whose concentration cannot be
> reliably estimated, or when a suitable cartridge is not available for
> a given contaminant. They cannot be used where facial hair interrupts
> the facial sealing surface or in the atmospheres deficient in oxygen.
> The wearer\'s field of vision is compromised. When prescription lenses
> are required by a wearer, a spectacle kit may be provided for wearer
> to take to the Lab's optician to have the proper prescription lenses
> installed. Use of spectacles may require additional time to don and
> doff the respirator.
>
> **4. Applications:** Full facepiece air-purifying respirators are used
> in the same manner as half-mask air-purifying respirators. A full
> facepiece respirator is recommended where a greater degree of
> respiratory protection is needed or where eye protection from
> irritants is desirable. The same cartridges used on the half-mask
> respirator may be used on the full face mask.
>
> **5. Protection Factor: 50**

***E. Powered Air-Purifying Respirators (PAPRs)***

> **1. Description:** This class of respirators features a
> battery-powered motor-blower that draws air through a particulate or
> chemical filter and blows it to the facepiece. The fan/filter unit may
> be mounted on the wearer\'s back or belt, or may be integral to the
> facepiece. Full facepieces and hoods are available. PAPRs may be used
> with tight-fitting full facepieces, with loose-fitting facepieces, or
> with hoods or helmets.
>
> **2. Advantages:** The major advantage of this type of respirator is
> the positive pressure
>
> provided to the facepiece or hood. This type of respirator may be used
> during exposure assessment, when contaminant concentration is unknown
> but reasonably expected to be below IDLH concentrations.
>
> **3. Limitations:** These units are relatively expensive to purchase
> and maintain. The battery adds additional weight, and must be carried
> on the wearer\'s belt. The battery must be charged up prior to use.
> This class of respirator cannot be used in IDLH atmospheres or
> atmospheres deficient in oxygen. Heavy exertion may create negative
> pressure reducing the respirator\'s effectiveness.
>
> **4. Applications:** These types of units are useful for work that is
> more physically demanding; the air blown into the helmet, hood or
> tight fitting facepiece helps eliminate the strain put on the
> respiratory system.
>
> **5. Protection Factor: 25** (Loose-fitting facepiece); **50**
> (Half-facepiece); **1000** (Tight-fitting full facepiece, Hood, or
> Helmet)

**APPENDIX F (Continued)**

***F. Airline Respirators (Continuous Flow)***

> **1. Description:** This type of respirator provides fresh air to the
> wearer from a compressor or compressed-air cylinders. They may be
> equipped with a full facepiece or a hood. Breathing air must meet the
> requirements of Compressed Gas Association Commodity Specification for
> Air, G-7.1-1989, Grade D.
>
> **2. Advantages:** This class of respirator provides a high degree of
> protection against all varieties of air contaminants. Hood models can
> be worn by personnel with facial hair if required and necessary as
> outlined in LBNL\'s Respiratory Protection Facial Hair Policy.
>
> **3. Limitations:** Air is delivered to the mask or hood through a
> breathing air hose. This hose can be awkward, heavy, and tends to
> tangle and crimp. The cost involved in equipping an air compressor can
> be prohibitive. Air supplied by a compressor must be tested.
>
> **4. Applications:** Airline respirators operated in the continuous
> flow mode can be used in atmospheres that require a greater degree of
> comfort to the wearer or that require supplied-air when air-purifying
> respirators are not recommended.
>
> **5. Protection Factor:** **1000** (full facepiece, hood or helmet;
> **continuous flow or pressure-demand,** unless otherwise specified by
> OSHA substance-specific standard)

Note: **25** (**continuous flow** with loose-fitting facepiece)

Note: **50** (**continuous flow** with half mask)

Note: Hood or helmet must ensure the maintenance of a positive pressure
inside the facepiece during use.

Note: **Pressure demand or other positive pressure SAR**, with auxiliary
SCBA (escape bottle) may be used for IDLH environments.

***G. Self-Contained Breathing Apparatus (SCBA)***

> **1. Description:** This type of respirator provides the user with
> clean air from a high pressure cylinder carried on the wearer\'s back.
> A full face mask is worn. These units are operated in the
> pressure-demand mode.
>
> **2. Advantages:** The SCBA offers the greatest degree of protection
> against all airborne contaminants, including atmospheres deficient in
> oxygen and IDLH atmospheres.
>
> **3. Limitations:** SCBA units are expensive to purchase and maintain,
> require the wearer to carry 20 to 30 pounds of equipment, and provide
> a limited supply of air, usually 30 minutes. Personnel with facial
> hair which comes between the respirator sealing surface and the
> wearer\'s face cannot use SCBA equipment.
>
> **4. Applications:** For use by the Waste Operations Group for
> responding to chemical spills, fires, radiation leaks, etc.
>
> **5. Protection Factor: 10,000** Maximum (Pressure-demand or other
> positive pressure mode)

**APPENDIX G**

**LBNL INDUSTRIAL HYGIENE**

## HAZARD EVALUATION FORM

Name:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Emp. #:\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

#### Division:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ MS:\_\_\_\_\_\_\_\_\_\_\_ Bldg #:\_\_\_\_\_ Rm:\_\_\_\_\_\_\_ Ext:\_\_\_\_\_\_\_\_

#### Supervisor\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ MS:\_\_\_\_\_\_\_\_\_\_\_ Bldg #:\_\_\_\_\_ Rm:\_\_\_\_\_\_\_ Ext:\_\_\_\_\_\_\_\_

Hazardous
Material(s):\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Operation /
Description:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Hazard Controls:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

#### Exposure Frequency:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Monitoring
Needed:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Recommendations**:**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Industrial
Hygienist:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ CC:**

**APPENDIX H**

**TRAINING REVIEW GUIDELINES**

This respirator has been issued to you for a specific airborne
contaminant. **IT WILL NOT PROTECT YOU FROM OTHER CONTAMINANTS.** The
following are reminders of the instruction you have received:

• **MAINTENANCE** check before each use:

a\) Sealing surface clean and free of cracks and holes.

b\) Inhalation and exhalation valves are clean and seated properly.

c\) Straps are sufficiently elastic and free of worn areas.

• **CHECK OF PROPER FIT** prior to each use:

a\) Positive pressure check (Close off exhalation valve and exhale).

b\) Negative pressure check (Close off cartridges and inhale).

> • **CLEAN MASK** [ON A REGULAR BASIS]{.smallcaps} with a mild soap and
> warm water solution and allow it to air dry overnight. (Make sure the
> cartridges / filters are removed from the respirator before cleaning).
>
> • **STORE** respirators and filter cartridges in separate zip-lock
> storage bags away from excessive heat sources. Filters and cartridges
> should be removed from the respirator and stored in separate ziplock
> bags to prevent cross contamination.
>
> • **DO NOT STORE** items on top of respirator which could deform the
> facepiece shape.
>
> • **CHANGE CARTRIDGES/FILTERS** as required. (**IMPORTANT -** change
> cartridges/filters if you experience an increased resistance in
> breathing or when you detect contaminant odors or taste while wearing
> your respirator).
>
> • **MASK TO FACE SEAL** must be unobstructed by facial hair. [You must
> be clean-shaven to obtain an effective seal.]{.underline}
>
> • This respirator has been assigned to you only - **DO NOT LOAN** it
> to anyone else.
>
> • **RETURN MASK** to the Industrial Hygiene Lab at your next fit test
> or when the job is finished.
>
> • Be familiar with **CHEMICAL PROPERTIES** of the substance you are
> using the respirator to protect yourself from. Some chemicals require
> the cartridges to be changed every 4-8 hours, regardless of exposure
> level. Consult the **MSDS** or EH&S for this information.
>
> • **QUANTITATIVE FIT TESTING** must be repeated
> [immediately]{.underline} when any of the following has taken place:
>
> a\) Weight change of 20 lbs. or more
>
> b\) Facial scarring in the area of the face-piece seal
>
> c\) Significant dental changes (Multiple extractions without
> prosthesis, or acquiring dentures)
>
> d\) Reconstructive or cosmetic surgery

e.  Any other condition that may interfere with the facepiece seal

Employee Signature:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

EH&S Signature:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**APPENDIX I**

**PHOTO DOCUMENTATION**

![](media/image1.jpeg){width="2.625in" height="2.0993055555555555in"}

**Filtering Facepiece Respirators Half Mask**

**(Dust masks) Air-purifying respirators**

![](media/image3.jpeg){width="2.375in" height="1.8993055555555556in"}

####  Full Facepiece Air Powered Air Purifying Respirators

####  Purifying Respirators (full facepiece and hood)

**APPENDIX I (Continued)**

![](media/image5.emf){width="3.0in" height="4.125in"}

**Airline Respirator using the Bullard Breathing-Air Compressor**

**(Continuous Flow)**

![](media/image6.jpeg){width="2.375in" height="1.8993055555555556in"}

**Positive Pressure Seal Check Negative Pressure Seal Check**

**APPENDIX I (Continued)**

![](media/image8.jpeg){width="2.125in" height="1.6993055555555556in"}
![](media/image9.emf){width="2.3465277777777778in"
height="1.7069444444444444in"}

**SCBA Unit Quantitative Fit Test with the TSI**

**PortaCount Plus**

![](media/image10.emf){width="3.015277777777778in"
height="2.192361111111111in"}

**Respirator Washer/Dryer System**