# Presentation: 378978

## Module 5Personal Protective Equipment

## CSEPP Approach to PPE

**Current CSEPP policy does not provide for deployment of civilian emergency workers into areas which are known or suspected to be contaminated with chemical weapon agent until monitoring and sampling confirms that concentrations are within range for which PPE provides protection.**
**To provide protection in event of entry into contaminated areas, individuals identified in state and local plans as initial off-site emergency workers will be issued PPE appropriate for prescribed job functions.**

**Notes:**
Current CSEPP policy does not provide for deployment of civilian emergency workers into areas which are known or suspected to be contaminated with chemical warfare agents until monitoring and sampling confirms that concentrations are within range for which PPE provides protection. 
To provide protection in the event of entry into contaminated areas, individuals identified in state and local plans as initial off-site emergency workers will be issued PPE appropriate for prescribed job functions. These off-site workers may perform a variety of functions including:
• setting up and manning traffic control points,
• providing emergency medical services, and
• performing emergency decontamination of victims.

## Federal PPE Requirements

**U.S. Government requires that employer provide workers with PPE if it is required on your job**
**Code of Federal Regulations (CFR) 29 CFR 1910.120 and 1910.134 and 40 CFR 311 prescribe guidelines for training, protective clothing and equipment**
**Other State and local regulations may specify types of PPE for specific positions or tasks in dealing with range of hazardous materials**
**Workers should be familiar with local and job-specific requirements as well as federal regulations**

**Notes:**
Federal regulations on worker safety requires that an employer provide workers with PPE if it is required to perform the job.
29 CFR 1910.120 and 134 prescribe the guidelines for training, protective clothing and equipment. 
40 CFR 311 on worker protection also applies.
Other state and local regulations may specify types of PPE for specific positions or tasks in dealing with a range of hazardous materials All workers - including volunteers - should be very familiar with local and job-specific requirements as well as the federal regulations.

## Who Needs PPE and Training

**All persons (including volunteers) designated as part of the emergency response (e.g., police, medics, paramedics, firefighters, medical personnel) to a chemical agent release **
**All persons who anticipate being active in potentially hazardous environments as part of a CSEPP emergency response plan **
**Before training, a medical evaluation must be performed**
**Regular drills and training sessions designed to maintain familiarity with equipment should be incorporated into emergency response protocols**

**Notes:**
Workers who will require PPE include everyone - including volunteers - designated as part of the emergency response to a chemical warfare release.  These include police and firefighters, EMTs, medical personnel and others such as those operating decontamination stations or who anticipate being active in a potentially hazardous environment.
If you are an emergency worker who has been issued PPE, you must be certified as physically able to wear the appropriate level of PPE by a medical doctor. You must also be trained in the restrictions and limitations of the PPE, know inspection and maintenance techniques and be able to  don and doff PPE properly.
Regular drills and training sessions for wearing the equipment should be incorporated into the emergency response protocols to ensure workers remain familiar with the equipment and the work rules regarding its use. This is particularly important in addressing the stay and rest times for workers wearing PPE because most people will want to do all they can for victims of a chemical warfare release and may put themselves - and others - at significant risk if work rules are not followed. 

## What is PPE?

**Personal Protective Equipment (PPE) is defined as articles worn or equipment used in order to protect wearer from harmful contaminants in environment**
**Main function of PPE is to provide****a shield between worker and agent contaminating environment**
**To be effective it must prevent worker from being contaminated by airborne****or surface agents**

**Notes:**
PPE is defined as all articles worn or equipment used in order to protect the wearer from harmful contaminants in the environment. 
The main function of PPE is to provide a shield between the person and the agent which may be contaminating the environment. In order for this shield to be effective it must prevent the person from being contaminated by airborne and surface agents. 
 Many workers are accustomed to attending to an injured victim immediately, sometimes disregarding the possibility of danger to themselves. Consequently, a worker entering a contaminated area also risks exposure and has the potential to become a victim.  Even though the rescue of an injured or chemically exposed person is important, it should only be attempted after it is certain that the worker will not become injured or exposed. When dealing with nerve and blister agents, PPE protection  may be required. 

## 4 Levels of PPE

**Level A**
**Level B**
**Level C **
**	****- used in CSEPP **
**	****- includes PAPR**
**Level D**
**work uniform**

- A

- B

**Notes:**
EPA has designated four levels of protection to assist in determining which combinations of respiratory protection and protective clothing should be employed:
Level A protection should be worn when the highest level of respiratory, skin, eye, and mucous membrane protection is needed. It consists of a fully-encapsulated, vapor-tight, chemical-resistant suit, chemical-resistant boots with steel toe and shank, chemical-resistant inner/outer gloves, coveralls, hard hat, and self-contained breathing apparatus (SCBA).
Level B protection should be selected when the highest level of respiratory protection is needed but a lesser degree of skin and eye protection is required. It differs from Level A only in that it provides splash protection through use of chemical-resistant clothing (overalls and long-sleeved jacket, two-piece chemical splash suit, disposable chemical-resistant coveralls, or fully-encapsulated, nonvapor-tight suit and SCBA).

## Levels of PPE

**Level A**
**Level B**
**Level C **
**	****- used in CSEPP **
**	****- includes PAPR**
**Level D**
**work uniform**

- C

- D

**Notes:**
Level C protection should be selected when the type of airborne substances is known, concentration is measured, criteria for using air-purifying respirators are met, and skin and eye exposures are unlikely. This involves a full facepiece, air-purifying, canister-equipped respirator and chemical-resistant clothing. It provides the same level of skin protection as Level B, but a lower level of respiratory protection.This is the protection that is recommended for CSEPP emergency civilian workers and includes a PAPR.
Level D is primarily a work uniform. It provides no respiratory protection and minimal skin protection, and it should not be worn on any site where respiratory or skin hazards exist.

## Proper Use Critical

**If PPE is used it must be used correctly**
**It is not possible to be partially protected from nerve or blister agents**
**You are either protected or not protected**

**Notes:**
It is important to know one critical fact about the use of PPE; it must be used, and it must be used correctly. It is not possible to be partially protected from nerve or blister agents; a person is either protected or not protected. 

## Recommended PPE(for CSEPP)

**Potential nerve and blister agent contamination requires respiratory protection and protective covering for all parts of the body.  PPE includes:**
**powered air-purifying respirator (PAPR)**
**hood**
**protective suit**
**overshoes**
**gloves**
**This type of protection guards against skin, respiratory tract, and eye exposures**

**Notes:**
The recommended PPE for dealing with nerve and blister agent contamination consists of respiratory protection and protective covering for all parts of the body. 
The PPE includes the following chemical protective items: 
• powered air-purifying respirator (PAPR),  
 hood, 
 protective suit,  
 gloves,  and
 overshoes. 
The selected respirators provide both respiratory and eye and face protection. The protective suit, gloves, and overshoes completely cover the body. 

## CSEPP Protective Clothing

**CSEPP, in conjunction with the Centers for Disease Control and Prevention/National Center for Environmental Health, have conducted several studies and tests on PPE to select the appropriate PPE for CSEPP**

**Notes:**
Gloves, overshoes, coveralls, and other items made of protective materials must be worn to eliminate prolonged or repeated contact with chemical agents. The Army, in conjunction with the Centers for Disease Control and Prevention/National Center for Environmental Health (CDC/NCEH) has conducted several studies and tests on PPE to select the appropriate PPE for CSEPP workers potentially exposed to a chemical warfare agent. 

## Protective Suit

**4 suits approved for CSEPP use**
**Only 2 suits initially used by CSEPP communities**
**DuPont® Responder**
**DuPont® CPF3**

**Notes:**
4 suits initially approved for CSEPP use but only 2 suits selected by States and communities in the program. These were:
• the Dupont® Responder and the 
• Dupont Tychem® CPF3

Note: CPF is used by Dupont® to mean Chemical Protection Fabric. Dupont® offers several levels of fabric protection ranging from 1-4. Level 3 indicates that the product was certified by the Safety Equipment Institute (SEI) for NFPA 1994, Class 3 ensembles. NFPA 1994 is a standard that sets performance requirements for protective clothing used by first responders at a chemical and biological terrorism incidents.  NFPA 1994 ensembles are a combination of garment, gloves and footwear that are tested against the specific requirements of the standard.
4 suits were: DOD Battledress Overgarment (BDO) - DuPont/Kappler Responder Coverall - DuPont/Kappler CPF3 Coverall - ADI Technologies Mark IV Overgarment 

## DuPont® Responder and CPF 3 Suits

**One-piece coverall suits for wear over street clothes or long underwear**
**Multiple layer, composite material provides protection**
**Responder weighs less; CPF 3 is tougher**
**Do not protect from heat and cold**

**Notes:**
The DuPont (formerly Kappler) Responder and CPF3 suits being used by CSEPP communities are one-piece suits that have demonstrated the ability to protect wearers against chemical agent challenges. Both suits have a hood with elastic around the face as well as elastic at the cuffs of the sleeves and pant legs. Some models have attached booties. 
The Responder suit is made from a multiple layer composite material laminated with a non-woven substrate. The CPF3 suit uses a similar composite material laminated to a strong polypropylene fabric. While both suits meet the protective requirements of CSEPP, the Responder suit is lighter in weight. The CPF3 suit provides greater physical strength for workers involved in more rigorous activities. The Responder suit is blue, the CPF3 is tan.  Both suits are made as coveralls with front zippers. The zipper is covered with a double overlapping storm flap with a velcro or taped closure. The seams of both suits are stitched and covered with heat-sealed tape. The suits are expected to provide chemical protection within a temperature range of -85oF (-65oC) to 200oF (93oC). They do not protect the wearer from the effects of heat or cold. 

## Storage and Shelf Life

**Store on hangers or in shipping bag**
**Shelf life of 5 years**
**Not repairable; discard if damaged, punctured  or worn out**
**Discard after exposure to chemical agent**

**Notes:**
The protective suits can be stored on a hanger or in an opened shipping bag inside the Ready Bag. 
DuPont recommends that the suits be replaced or used only for training purposes after 5 years or when visual inspection reveals any damage or weakness in the suit material or seams. 
The suits are not repairable - forget the duct tape - and should be discarded if damaged, punctured or worn out.  Some communities use them for training purposes. 
Suits should be decontaminated before being removed after a chemical agent response and must be properly disposed of after an actual incident according to State and local regulations.  

Note: Suggest the video training on Re-ACT FAST II

## Gloves

**Outer glove for protection and inner glove for perspiration absorption**
**Outer gloves impermeable, black, butyl rubber**
**Inner gloves thin, white cotton**
**Protect against liquid chemical****agents and vapor hazards**
**If become contaminated,****replace within 24 hours **
**Replace if exposed to any****petroleum-based products**

**Notes:**
The gloves protect against liquid chemical agents and vapor hazards. Each glove consists of an outer glove for protection and an inner glove for perspiration absorption.   
The outer gloves are made of an impermeable, black, butyl rubber. The inner gloves are made of thin, white cotton. 
 If the glove set becomes contaminated, replace within  24 hours after exposure. 
The glove set should be  replaced if exposed to any petroleum-based products.  
The shelf life for gloves is 15 years. 

## Boots

**Military-issue vinyl overshoes with elastic fasteners**
**Protect feet from contamination by all known agents for up to 24 hours following contamination; for up to 14 days if not contaminated**
**Alternative is commercial HAZMAT boot**

**Notes:**
Street shoes are worn inside the overshoes or inside the integrated bootie of the coverall. The overshoes can be decontaminated but are not intended for use in civilian hazardous materials response efforts.  The shelf life for the overshoes is 15 years.
These overshoes protect the feet for 24 hours from contamination by all known chemical warfare agents following contamination.  If not contaminated they protect for up to 14 days. 
In some communities responder boots are also used.

## Ready Bag

**Canvas bag designed to carry all the protective equipment - protective suit, hood, gloves, overshoes, and PAPR**

**Notes:**
The ready-bag is a canvas bag designed to carry all PPE - protective suit, hood, gloves, overshoes, PAPR.

## Respiratory Equipment

**Prevents airborne contaminants from being inhaled**
**Protects facial skin from exposure**
**Must be only used in context of complete respirator program as described in OSHA regulations and NIOSH publications**

**Notes:**
The respiratory equipment approved for CSEPP prevents airborne chemical warfare agents from being inhaled and facial skin from exposure. 
No one should wear a respirator who has not been trained and fit-tested as described in OSHA regulations 29 CFR 1910.120 and134 and the NIOSH publications. 

OSHA: The Occupational Safety and Health Administration
NIOSH: The National Institute for Occupational Safety and Health.

## Powered Air-Purifying Respirator (PAPR)

**Protects against**
**particulates**
**gases and vapors**
**Typically uses organic Vapor/HE particulate filter**

**Notes:**
The Powered Air-Purifying Respirator - called the PAPR  - protects the wearer from particulates as well as gases and vapors.

## PAPR Components

**2 types of PAPR are approved for CSEPP**
**Tight-fitting PAPR**
**Loose-fitting PAPR**
**Tight-fitting PAPR provides better respiratory protection**
**Loose-fitting PAPR is easier to use; accommodates facial hair and eyeglasses**
**Tight-fitting provides protection if batteries fail, while loose-fitting must be removed**

**Notes:**
Two types of PAPRs were approved for CSEPP emergency workers: the tight-fitting PAPR and the loose-fitting PAPR. 
The hood for the tight-fitting PAPR has been designed to attach to the face-piece of the PAPR. The tight-fitting PAPR provides greater respiratory protection but is more complex to use. Personnel wearing the tight-fitting PAPR must be clean-shaven since facial hair interferes with the ability to obtain a tight seal around the face-piece. 
In the loose-fitting PAPR, the face-piece and hood are integrated into one unit. The loose-fitting PAPR will accommodate facial hair and eyeglasses. 
Tight-fitting provides protection if batteries fail, while loose-fitting must be removed.
The hoods are made of butyl rubber-covered cloth that prevents airborne agents from contaminating the head and neck. The hoods are not intended for civilian hazardous materials response. 

## PAPR Components

**Both types of PAPRs consist of **
**full face piece**
**butyl rubber-covered hood**
**breathing tube**
**motor-blower unit with filter cartridges**
**battery**

**Notes:**
The PAPRs consist  of the following parts: 
• a full face-piece,  
 a butyl rubber-covered hood,  
 a breathing tube assembly,  
 a belt mounted motor-blower with appropriate filter cartridges and
 a battery pack.

## Powered Air-Purifying Respirator (PAPR)

**Draws outside air through filters which remove contaminants and delivers the cleaned air through corrugated breathing tube into facepiece assembly on face of wearer**
**Battery-operated blower delivers decontaminated air at slight positive pressure into face piece **
**if leak occurs, air will flow from inside facepiece to outside air**
**Air flow also provides wearer comfort**

**Notes:**
The PAPR uses a battery-operated blower that is designed to deliver decontaminated air at a slight positive pressure into a full face-piece (air pressure in the face-piece is higher than the surrounding air). This means that if a leak occurs, air will flow from inside the face-piece to the outside air. The powered blower draws ambient air through air-purifying elements (filters or chemical cartridges) which remove specific contaminants and delivers the clean air through a corrugated breathing tube into a face-piece assembly on the face of the respirator wearer. 
Airflow also provides wearer comfort. 

## Why the PAPR Was Selected

**Civilian air-purifying respirators approved by CDC/NCEH **
**NIOSH confirmed cartridge tests were conducted in valid scientific manner **
**Data support conclusion that commercial cartridges tested will remove up to 0.5 milligram per cubic meter of nerve agent GB for up to 16 hours**
**Concentration chosen because it is the maximum predicted concentration to which emergency worker would be exposed **
**U.S. Army data on military gas masks indicate that nerve agent GB wears out filters more quickly than other agents**** **** **

**Notes:**
The PAPR selected for CSEPP civilian workers is approved by CDC and the National Center for Environmental Health.
The National Institute for Occupational Safety and Health - NIOSH - has confirmed that tests on the cartridges were conducted in a scientific manner and will protect workers if used correctly. 
The data from the tests support the conclusion that the commercial cartridges tested removes up to 0.5 milligrams per cubic meter of nerve agent GB for up to 8 hours.
This concentration of 0.5 milligrams per cubic meter was selected because it is the maximum predicted concentration to which emergency workers would be exposed over an 8 hour period.
Army data on military gas masks indicate that nerve agent GB wears out filters more quickly than other warfare agents. 

## Spectacle Kit

**Proper seal with tight-fitting PAPR cannot be established if the temple bars of eyeglasses extend through sealing edge of full facepiece **
**3M has developed spectacle kits that mount corrective lenses inside full facepieces**
**Personnel who wear eyeglasses should use a spectacle kit or wear a loose-fitting PAPR**

**Notes:**
Proper sealing of the tight-fitting PAPR face-piece cannot be established if a person is wearing eye glasses and the temple bars extend through the sealing edge,
3M has developed spectacle kits that mount corrective lenses inside the full face-piece. 
Individuals who wear glasses should use the spectacle kit or wear the loose-fitting PAPR.

## Limitations of PAPRS

**Do NOT use in atmospheres immediately dangerous to life or health (IDLH)**
**Do NOT use in atmospheres containing less than 19.5% oxygen (confined spaces)**
**Do NOT use the respirators in a flammable or explosive atmosphere**
**Do NOT use air-purifying elements beyond useful life**
**Use only fully charged battery packs when respirator is donned**
**Protect batteries/battery packs from fire and heat at all times**

**Notes:**
To protect the wearerユs health and avoid possible injury or death, it is essential that the following PAPR limitations be understoo:
• Do not use in atmospheres immediately dangerous to life or health (IDHL)
• Do not use in atmospheres containing less that 19.5% oxygen (confined spaces)
• Do not use respirators in a flammable or explosive atmospheres
• Do not use air-purifying elements beyond useful life
• Use only fully charged battery packs when donning respirator
* Protect battery packs from fire and heat at all times
The wearer should immediately return to a non-contaminated area if: 
 ・ The taste or smell of contaminants is detected,  
・ The eyes, nose, or throat become irritated, 
・ Breathing becomes difficult, 
・ The air becomes uncomfortably warm, 
・ Nausea or dizziness sets in, or 
・ The flow of air through the respirator slows or stops. 

## Air-Purifying Cartridges

**Most common filtration method for airborne particulates and vapors**
**Often referred to as filter or canister**
**Always read cartridge labels**
**All cartridges in blower unit must be identical and must be replaced at same time**
**Follow good industrial hygiene practices when replacing and disposing of cartridges**

**Notes:**
Air-purifying cartridges are most common method for filtering airborne particulates. Always read the labels on air-purifying elements (referred to as filter cartridge or canister) to be sure they will be effective against the contaminants being encountered. 
All air-purifying elements in a blower unit must be identical and must be replaced at the same time. 
Air-purifying elements must not be used beyond their useful life (when they become plugged with particulates or saturated with gases or vapors or whenever they contribute to increased airflow resistance).  Air-purifying elements that have been used may contain measurable quantities of the contaminant or contaminants they have been removing from the air passing through them. They must be handled accordingly. Follow applicable regulations and good hygiene practices when replacing elements and disposing of used elements. 

## Cartridges

**Identify cartridge by properly worded labels and  color code**
**Correct color code for organic vapor is **_**black **_
**Each ready bag should have 3 sets of 3 cartridges**
**1 set for chemical accident/incident **
**1 set for backup**
**1 set for training marked ****“For Training Purposes Only****”**

**Notes:**
The PAPR removes contaminants by drawing air through filter media (also called filter cartridges or canisters). As required by 29 CFR 1910.134 (j), air-purifying cartridges display a color-coded NIOSH approval label. This label must not be removed from the cartridge and must remain legible. Cartridges approved for CSEPP use are color-coded black, which indicates that they are certified to remove organic vapors. Each cartridge is stamped with an expiration date. No cartridge should be used after the indicated date.  
Three sets of cartridges will be stored in each Ready Bag: one set to be used in a chemical agent response; one set for back-up use; and one set for training. The training cartridges will be marked “For Training Purposes Only.” Each set contains 3 cartridges.

## Respirator Fit Testing

**Shall be done while wearing all protective equipment that could interfere with fit and/or wearer acceptance**
**Must be based upon 29 CFR 1910.134 Appendix A**
**Must be repeated at least annually based on 29 CFR 1910.134(f) **
**Medical evaluation required for wearer**
**Wearer should be familiar with all State and local requirements as well as federal regulations**

**Notes:**
Tight-fitting PAPRs are effective only if a good seal is maintained between the respirator and face. Because of this, Federal regulations require fit testing to ensure that each wearer is assigned the proper style and size of respirator. 
Fit testing is performed while wearing protective equipment, such as spectacles and hood, that could interfere with the fit and/or wearer acceptance. The 29 CFR 1910.134 Appendix A outlines the mandatory testing procedures to be followed for qualitative and quantitative fit testing. 
Fit testing should be repeated periodically (at least, annually). In addition, regulations call for new fit testing whenever the worker has obvious change in body weight, significant facial scarring in the area of the face-piece seal,  significant dental change such as multiple extractions without prosthesis, or acquiring dentures, reconstructive or cosmetic surgery, or any other condition that may interfere with face-piece sealing. 
A physician or other licensed health care professional will evaluate the results of the questionnaire and provide a written determination of the personユs ability to use a respirator, including any restrictions on such use. In some cases, a medical examination may be necessary.
The wearer should also be familiar with State and local requirements.

## Respirator Storage

**Before storing facepiece should be inspected, repaired if needed, cleaned, and dried**
**While in storage, facepiece should be protected from distortion from weight or pressure of surrounding objects or being placed in too small a place**
**Never store PPE equipment in car or truck because of potential for heat damage but keep in a location easily accessible**
**Fully charged battery pack should be stored in closed plastic bag in dry, cool, uncontaminated place **
**Remember - when sold, batteries not charged**

**Notes:**
Before storing the face-piece, it should be inspected, repaired, if necessary, cleaned, dried, and given a final inspection.
While it is in storage, the face-piece should be protected from distortion from the weight or pressure of surrounding objects or being placed in too small a place.  
Never store the PPE in a car or truck because of the potential for heat damage. Rather, store the PPE in a readily accessible location.  
The fully charged battery pack should be stored in a closed plastic bag in a dry, cool place where the atmosphere is uncontaminated. You should remember that when sold, the batteries/battery pack is not charged. 

## Respirator Storage (cont.)

**Use battery charger and AC/DC adapter to charge and recharge battery pack**
**All parts in plastic bag should be connected together in manner of assembled respirator**
**Facepiece and its subparts should be stored separately from remainder of PAPR**
**Only fully operable facepieces should be stored**

**Notes:**
Use the battery charger and AC/DC rectifier (adapter) to charge and recharge the battery pack. When the battery is fully charged, a light located on the adapter turns on. 
All the parts in the plastic bag should be connected together in the manner of an assembled respirator. 
The face-piece and its subparts should be stored separately from the blower unit. 
Only fully operable face-pieces should be stored. 

## Storage of Protective Clothing

**DuPont® Responder and CPF3 protective suits come sealed in a shipping bag    **
**The protective suit may be stored in the open shipping bag inside the Ready Bag along with, gloves, hood, overshoes **
**Alternatively, the suits can be stored on hangers **
**Store:**
**away from sunlight and direct heat**
**in a clean, dry, cool place that is free from contaminating vapors, gases and particulates**
**storage temperatures must not exceed 120°F (49°C) **

**Notes:**
The DuPont Responder and CPF3 protective suits come sealed in a shipping bag. 
The suit may be stored in the open shipping bag inside the Ready Bag along with the gloves, hood, and overshoes. Alternatively, the suit may be stored on a hanger. 
The protective suits should be stored:  
away from sunlight and direct heat, 
 in a clean, dry, cool place that is free from contaminating vapors, gases,and particulates, 
 where storage temperatures do not exceed 120°F (49°C).

## Basis and Timing for Working in PPE

**Emergency workers who enter an area where PPE is required must limit their activities so that protection from contamination and excessive exposure is assured**

**Notes:**
Emergency workers who enter an area where PPE is required, must limit their activities to ensure they are protected from contamination and excessive exposure. 

## Basis and Timing for Working in PPE

**Emergency worker requirements**
_**Not**_** be sent into environments which are known or suspected to be immediately dangerous to life or health (IDLH)**
_**Not**_** remain in potentially contaminated area long enough to receive agent dosage sufficient to affect health or ability to execute assigned tasks**
_**Not**_** remain in potentially contaminated area long enough to exceed agent absorption capacity of canisters used in PAPR**
_**Not**_** be exposed to agent deposition density levels exceeding maximum capability of protective suit**

**Notes:**
This requires that emergency workers:  
not be sent into environments which are known or suspected to be IDLH,
not remain in a potentially contaminated area long enough to receive an agent dosage sufficient to affect their health or their ability to execute assigned tasks. 
not remain in a potentially contaminated area long enough to exceed the agent absorption capacity of the cartridges used in the PAPR, and
not be exposed to agent deposition levels that exceed the capability of the protective suit. 

## Airborne Agent ConcentrationsImmediately Dangerous to Life or Health (IDLH)

**IDLH**

**GA/GB****	****	****	****0.1**
**VX****	****	****	****0.003**
**HD****	****	****	****0.7***

**Agent****	****Concentration (mg/m****3****)**

- *  Dept. of Health and Human Services (DHHS) Centers for Disease Control and Prevention (CDC).
- “Interim recommendations for airborne exposure limits for chemical warfare agents
- H and HD (Sulfur Mustard).” *Federal Register *69 (85), 24164-24168 (3 May 2004).

**Notes:**
The Office of the U.S. Army Surgeon General has recommended the establishment of IDLH airborne concentration levels for various chemical weapons agents in the U.S. stockpile. The recommended IDLH concentration levels corresponding to an exposure time of 30 minutes are listed in this table. 
This exposure time should allow an individual working in an area where the agent concentration is at or below the IDLH level sufficient time to exit the area if a respirator failure were to occur. 
Immediately following an accidental chemical agent release, it would most likely be the IDLH concentration level would restrict emergency workers from entering a contaminated area. At later times, as the agent is transported downwind and disperses, the protection capacity of the respirators would limit the time emergency workers could remain in an contaminated area. 

## Exposure Limits

**Simplest, most effective work rule to assure that respirator cartridges are used within capacity is to avoid sending emergency workers into areas where a plume containing airborne chemical agent may be present**
**Activity of off-site emergency workers in areas where airborne chemical agent may be present must be limited**
**To ensure that workers are not exposed to average airborne agent concentrations greater than those established for agent workers, even when using respiratory protection**
**To ensure that agent absorption capacity of respirator cartridges is not exceeded**

**Notes:**
The simplest and most effective work rule to assure that respirators are used within their capacity is to avoid sending emergency workers into areas where a plume containing airborne chemical agent may be present. 
Activity of off-site emergency workers in areas where airborne chemical agent may be present must be limited to ensure that:  
the emergency workers are not exposed to average airborne agent concentrations greater than those established for occupational exposure, even when using respiratory protection, and 
the agent absorption capacity of their respirator cartridges is not exceeded. 

## Respirator Cartridge Limits

**Have been determined to provide at least 16 hours of protection when exposed to an agent vapor concentration of 0.5 mg/m****3**
**Possible that under certain release and atmospheric conditions this dosage may be exceeded outside boundaries of several storage installations**

**Notes:**
The respirator cartridges have been determined to provide at least 16 hours of protection when exposed to an agent vapor concentration of 0.5 mg/m3. This corresponds to protection against a total dosage of 480 mg-min/m3 (0.5 mg/m3 × 16 hr × 60 min/hr). 
It is possible that under certain release and atmospheric conditions this dosage (480 mg-min/m3) may be exceeded outside the controlled boundaries of several storage installations.

## Respirator Cartridge Limits

**Work rules must avoid possibility that emergency workers can be exposed to conditions in excess of cartridge’s absorption capacity**
**Once airborne agent concentration level has declined below IDLH level, combination of limited stay times and use of chemical detector kits can assist emergency workers in using PPE within its capabilities**

**Notes:**
Work rules must avoid the possibility that emergency workers can be exposed to conditions in excess of the cartridge’s absorption capacity. 
Once the airborne agent concentration level has declined below the IDLH level, limitations on stay times can assist the emergency worker in using the PPE within its capabilities.

## PAPR-Limited Stay Times

**Depend on:**
**Concentration of chemical agent in the air**
**Exposure limit for the chemical agent**
**The protection factor for the respirator**
**The dosage capacity of the filter cartridges**

**Notes:**
The length of time a responder wearing a PAPR remains in a potentially hazardous area depends on:
• concentration of the chemical agent in the air,
• exposure limit for the chemical agent,
• the protection factor for the respirator, and
• the dosage capacity of the filter cartridges.

## Work Intensity

**Along with ambient temperature, work intensity is major contributing factor to heat stress **
**Work/rest cycles should be instituted to control heat stress. Cycles need to be flexible because of **
**variability in work intensity**
**differences in an individual’s susceptibility to heat stress**
**unique demands of each emergency situation**

**Notes:**
Along with ambient temperature, work intensity is a major factor contributing to heat stress when wearing full PPE.
Work and rest cycles should be instituted to ensure workers are not put at risk of heat stress. 
Heat stress can occur in cool environments.
Cycles need to be flexible for tasks to be accomplished because:
• work intensity will vary. For example workers staffing traffic control points will be performing less strenuous tasks than others at decontamination stations,
• workers will vary in their individual susceptibility to heat stress, and
• each emergency situation will place unique demands on workers that may not be anticipated.  

## Clothing-Limited Stay Times

**COOL TEMPERATURES**
**50 – 70°F (10 – 21°C) [Wet Bulb/Globe Temperature (WBGT)]**
**Work 30 – 45 minutes**
**Followed by 10 –15 minutes rest**** **
**WARM TEMPERATURES**
**70 – 85°F (21 – 29°C) [Wet Bulb/Globe Temperature (WBGT)]**
**Work 20 – 30 minutes**
**Followed by 40 – 60 minutes rest**** **
**HOT TEMPERATURES**
**85 – 100°F (29 – 38°C) [Wet Bulb/Globe Temperature (WBGT)]**
**Work 15 – 20 minutes**
**Followed by indefinite rest**

**Notes:**
The length of stay and rest times are based on ambient temperature. Remember that frequent short breaks are effective at sustaining task performance.
These times are only recommendations and should be adjusted for the situation encountered.
At temperatures between 50 and 70 degrees F, personnel may work 30 to 45 minutes at a time time followed by a 10 to 15 minute rest period.
At temperatures between 70 and 85 degrees, personnel may work for 20 to 30 minutes at a time, followed by a 40 to 50 minute rest period.
At temperatures between 85 to 100 degrees, personnel may  work for 15 to 20 minutes followed by a rest period of indefinite length. It is important to provide relief as soon as possible when working in extreme temperatures, 

## Heat Stress Factors

**PPE restricts heat loss mechanisms because of low permeability to water vapor**
**Amount of heat accumulation depends upon**
**amount of physical activity**
**level of hydration**
**clothing worn**
**load carried**
**state of heat acclimatization**
**physical fitness and fatigue**
**terrain and climatic conditions**

**Notes:**
Guidelines for reducing heat stress should be followed whenever PPE is used.  Body temperature must be maintained within narrow limits for optimum physical and mental performance. Normally, the body cools itself by evaporation of sweat and radiation of heat at the skinユs surface. PPE restricts these heat loss mechanisms because of its low permeability to water vapor. 
The amount of heat accumulation depends upon:  
• the amount of physical activity, 
• the level of hydration, 
• the clothing worn, 
• the load carried, 
• the state of heat acclimatization, physical fitness and fatigue, and 
• terrain and weather conditions. 

## Dehydration

**Because of higher body temperatures, individuals in PPE sweat considerably more than usual, often more than 1.5 quarts of water every hour during work**
**Water must be consumed to replace lost fluids or dehydration will follow**
**Inability to drink in full PPE increases likelihood of dehydration**
**Dehydration and need for regular and timely fluid replacement in workers is limiting factor on stay time in full PPE**

**Notes:**
Eating and drinking are not possible while wearing the full-face respirator, and it is important to replenish the water lost through sweating and to prevent dehydration from occurring while wearing PPE.
Because of the higher body temperature in individuals wearing full PPE, individuals in PPE sweat considerably more than usual,often more than 1.5 quarts of water every our during work.
Dehydration and need for regular and timely fluid replacement in workers is limiting factor on stay time in full PPE.

## Psychological Factors

**Wearing full PPE reduces ability to see and hear clearly**
**Makes it more difficult to recognize and communicate with others**
**Creates or increases feelings of isolation and confusion**
**Causes frustration in many, and claustrophobia in others**
**Experience in wearing and exercising in PPE can reduce these factors**

**Notes:**
Wearing full PPE can have distinct psychological effects on the wearer. This is because  wearing full PPE can :
• reduce the ability to see and hear clearly,
• makes it more difficult to recognize and communicate with others,
• create or increase feelings of isolation and confusion, and 
• cause  frustration or claustrophobia. 
One way to diminish these factors is to have potential wearers regularly wear and train in full PPE during exercises. 

## Effects of Heat Stress on Performance in PPE

**Workers wearing PPE will take about 1.5 times longer to perform most tasks**
**Performance is affected by stress in a variety of ways:**
**reaction and decision times are longer**
**routine tasks are completed more slowly**
**errors of omission are more common**
**Use the buddy system whenever possible; a buddy can check for signs of stress and fatigue**
**Critical jobs should be shared and work should be double-checked**

**Notes:**
An emergency responder wearing a PAPR, hood, suit, gloves, and overshoes will not be able to perform tasks as quickly, easily, and efficiently as when wearing street clothes. Workers wearing PPE will take about 1.5 times longer than normal to perform most tasks. Decision making and precision control tasks (such as typing a message or using an auto-injector) may take 2.5 times as long as normal. Even more time may be required if workers have been in PPE for an extended period or are overheated.
Performance is affected by stress in a number of ways:
• reaction and decision times are lengthened
• routine tasks completed more slowly, and
• errors of omission are more common.
Use of a buddy system means that individuals are monitored by others  for signs of stress and fatigue before they affect performance. The last point is that critical jobs should be shared and work double-checked when workers are wearing PPE. 

## Cold Stress Factors

**Can directly affect an individual’s health and performance while wearing PPE**
**Can lower body temperature, resulting in cold injuries and impaired performance**
**Often accompanied by wind, rain, snow and ice, which can worsen the effects of cold**
**Cold weather clothing and PPE may be difficult to integrate**

**Notes:**
Though far less likely to be a complicating factor than is heat stress, cold stress can directly affect an individual’s health and performance while wearing PPE. Cold can lower body temperature, resulting in injuries and impaired performance. Cold weather is often accompanied by wind, rain, snow and ice, which can worsen the effects of cold, as well as contribute to injury and performance impairments in and of themselves. Cold weather clothing and PPE are difficult to integrate.

## Buddy System Recommended

**Good industrial hygiene practice recommends buddy system be used if resources permit**
**Can assist other workers in dressing out in PPE**
**Can ensure that all workers are regularly checked for signs of stress and agent exposure**
**Pair an experienced worker with inexperienced “buddy” whenever possible**

**Notes:**
Good industrial hygiene practice recommends a buddy system be used whenever resources permit for workers  wearing PPE. OSHA’s 29 CFR 1910.120 defines a buddy system as a system of organizing workers into work groups in such a manner that each individual of the work group is designated to be observed by at least one other person in workgroup.
The purpose of the buddy system is to provide rapid assistance in an emergency but buddies can help in a number of ways, such as:
• donning or removing PPE, and 
• ensuring that other workers are periodically checked for signs and symptoms of stress or fatigue and agent exposure.
For practical purposes it is recommended that an experienced buddy be paired with an inexperienced buddy whenever possible.

## Work Rules Summary:Plan Ahead

**Follow guidance for working in PPE**
**Ensure serviceability of equipment through regular inspections of PPE equipment**
**Plan work/rest cycles appropriate to environment and situation**
**Use standard operating procedures to reduce command, control, and communication tasks**
**Keep plans and operations simple**

**Notes:**
To summarize:
Plan Ahead  
• Follow guidance for working in PPE. 
• Ensure serviceability of equipment through regular inspections of PPE equipment. 
• Plan work/rest cycles appropriate to the environment and the situation. 
• Use standard operating procedures to reduce command, control, and communication tasks. 
• Keep plans simple.

## Work Rules Summary: Think Teamwork

**Use methods of individual identification **
**Encourage small talk while wearing PPE**
**If resources permit, use the buddy system to ensure that all workers are regularly checked for signs of stress, dehydration, and agent exposure**
**Pair experienced worker with inexperienced “buddy” whenever possible**

**Notes:**
Think Teamwork  
•  Use methods of individual identification (name tags, names written on duct tape on backs of protective suits). 
•  If resources permit, use the buddy system to ensure that all emergency workers are regularly checked for signs of stress and agent exposure. And 
• Pair an experienced emergency worker with an inexperienced buddy whenever possible.

## Work Rules Summary;Good Practices

**Provide relief from PPE outside hazard area as soon as situation allows**
**Use work/rest ratios, slow work rate, and minimize work intensity**
**Work in the shade whenever possible**
**Rotate jobs and people during long periods of relative inactivity**
**Provide relief from extreme temperatures (hot or cold) as soon as possible**
**Remember that even short breaks from total encapsulation are effective in sustaining performance**
**Enforce drinking of water to reduce dehydration and heat casualties**

**Notes:**
And work Smart when wearing PPE: 
• Provide relief from PPE as soon as situation allows. 
• Use work/rest ratios, slow work rate, and minimize work intensity. 
• Work in the shade whenever possible. 
• Rotate jobs and people during long periods of relative inactivity. 
• Provide relief from extreme temperatures (hot or cold) as soon as possible. 
• Remember that even short breaks from total encapsulation are effective in sustaining performance. And
• Enforce drinking water to reduce dehydration and heat casualties.