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H1N1 and OSHA/PESH H1N1 and OSHA/PESH Regulations Regulations

H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

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Page 1: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

H1N1 and OSHA/PESH RegulationsH1N1 and OSHA/PESH Regulations

Page 2: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains
Page 3: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

New York State New York State Department of LaborDepartment of Labor

Public Employee Safety and Health Bureau PESH

James Cutrone- Garden City/White Plains District Supervisor

Barbara Stanley- Garden City Industrial Hygiene Technical Supervisor

Page 4: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

ObjectivesObjectives Describe PESH and it’s jurisdiction in NYS Identify what PPE should be worn and when in regards to

H1N1 Outline the elements of the PPE standard that apply Explain what and when respiratory protection is required Outline the elements of the respiratory protection standard

that apply Describe and demonstrate fit testing options Provide resources for you to develop a respiratory protection

plan and a PPE Hazard Assessment. Recordkeeping

Page 5: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

PESH JurisdictionPESH Jurisdiction

Enforcement of OSHA/PESH Regulations in Places of Public Employment, specifically State County City Towns Villages

Includes Fire Departments, Fire Districts, Fire Protection Districts, Publicly Owned EMS, Fire Department EMS and Volunteer EMS Districts

Does not cover Independent Not for Profit Corporations

Page 6: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

PESH STAFFPESH STAFF

Enforcement Staff Industrial Hygienists Safety Inspectors

Consultation Staff Industrial Hygienists Safety Consultants

Page 7: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

H1N1- What We KnowH1N1- What We Know Novel Virus Spread throughout the world – WHO Phase 6 “Pandemic” Range of symptoms similar to seasonal flu

Fever, cough, sore throat, fatigue, headache, body aches, lethargy, stuffy nose, chills (some with diarrhea, vomiting)

Severity similar to seasonal flu Higher risk for complications:

Lung disorders, asthma, emphysema Heart, kidney, liver, blood disorders Diabetes Weakened immune system Pregnant women Long term aspirin therapy >65 and < 5 years old

Immunity seen in people older than 60????

Page 8: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

H1N1 Guidance Documents H1N1 Guidance Documents

CDC OSHA FDA NYSDOH NYCDOH APIC SHEA Etc………

Page 9: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

CDC- Interim Guidance for EMS Systems and 911 CDC- Interim Guidance for EMS Systems and 911 PSAPs for Management of Patients with Confirmed or PSAPs for Management of Patients with Confirmed or Suspected Swine-Origin Influenza A (H1N1) InfectionSuspected Swine-Origin Influenza A (H1N1) Infection

Complements CDC Interim Guidance for Healthcare Settings Don PPE for suspected cases prior to entering the scene If during assessment, symptoms indicate a possible case- don PPE. PPE:

Fit tested N95 respirator Eye Protection (goggles or face shield) Disposable non-sterile gloves Gown

Encourage good vehicle airflow/ventilation Follow Basic Infection Control procedures

Decontamination, hand hygiene, cough and respiratory hygiene All patients with acute febrile respiratory illness should wear a surgical

mask, if tolerated by patient

Page 10: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

CDC-Interim Guidance for Infection Control CDC-Interim Guidance for Infection Control for Care of Patients with Confirmed or for Care of Patients with Confirmed or

Suspected Novel Influenza A (H1N1) Virus Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare SettingInfection in a Healthcare Setting

Interim guidance for healthcare facilities and other settings where healthcare is provided

Supports what is outlined in EMS and PSAP document

Page 11: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

OSHA/PESH RequirementsOSHA/PESH RequirementsDuring PandemicsDuring Pandemics

NIOSH certified respirator for close contact with ill people N95 is minimal level of protection

Very High Risk Workers - exposed while performing specific medical or laboratory procedures

High Exposure Risk Workers – high potential for exposure to known or suspected pandemic sources e.g. doctors, nurses, other hospital staff and emergency responders transporting sick patients

Other Workers- not normally at risk, but are performing high risk tasks such as isolating and quarantining people who are ill

Page 12: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

Hazard AssessmentHazard Assessment

Upon entering the scene Treating suspect or confirmed cases Cleaning vehicle after patient is transported

N95 respirator required when treating a suspect or confirmed H1 N1 case

Page 13: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

OSHA/PESH RegulationsOSHA/PESH Regulationsand Requirementsand Requirements

29CFR 1910.132

29CFR1910.134

29CFR1910.1020

Page 14: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

PPE Standard (29CFR1910.132)PPE Standard (29CFR1910.132)General RequirementsGeneral Requirements

Protective equipment shall be provided, used and maintained in a sanitary and reliable condition whenever it is necessary by reason of hazards….

Hazard Assessment and Equipment Selection Written Certification Training

Page 15: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

Particulate RespiratorsParticulate RespiratorsNIOSH Approved Filtering FacepieceNIOSH Approved Filtering Facepiece

Nine classes of filters Three levels of filter efficiency Each with three categories of resistance to filter efficiency

degradation Filter Efficiency:

99.97% (HEPA) 99% 95%

Resistance to filter efficiency degradation N- not resistant to oil R- is resistant to oil P- oil proof

Page 16: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

29CFR1910. 134- Respiratory Protection29CFR1910. 134- Respiratory Protection

(a) Permissible practice

(b) Definitions

(c) Respirator program

(d) Selection of respirators

(e) Medical evaluation

(f) Fit testing

(g) Use of respirators

(h) Maintenance and care

(i) Breathing air quality and use

(j) Identification of filters, cartridges, and canisters

(k) Training and information(l) Program evaluation(m) Recordkeeping(n) Dates (o) Appendices (mandatory)

A: Fit Testing ProceduresB-1: User Seal ChecksB-2: Cleaning ProceduresC: Medical QuestionnaireD: Information for Employees Wearing Respirators When Not Required Under the Standard

Page 17: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

Written Program ElementsWritten Program Elements Procedures for selecting respirators Medical evaluations Fit testing procedures Procedures for proper use in routine and reasonably foreseeable

emergencies Procedures and schedules for cleaning, disinfecting, storing,

inspecting, repairing, discarding, otherwise maintaining respirators

Training of employees in the hazards they are potentially exposed to

Training in the proper use and any limitations on use and maintenance

Procedures for regularly evaluating the effectiveness of the program

Page 18: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

Fit Testing Fit Testing (cont’d)(cont’d)

The fit test must be administered using an OSHA-accepted QLFT or QNFT protocol contained in Appendix A QLFT Protocols:

Isoamyl acetate Saccharin Bitrex Irritant smoke

QNFT Protocols: Condensation Nuclei Counter (PortaCount) Generated Aerosol (corn oil, salt, DEHP) Controlled Negative Pressure (Dynatech FitTester 3000)

Page 19: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

Recordkeeping RequirementsRecordkeeping Requirements

29 CFR 1910.1020 Records of medical evaluations must be retained and made available

29 CFR 1910.134 A record of fit tests must be established and retained until the next fit test

is administered Written copy of the current program Written materials required to be retained must be made available upon

request to affected employees and OSHA/PESH

Page 20: H1N1 and OSHA/PESH Regulations. New York State Department of Labor Public Employee Safety and Health Bureau PESH James Cutrone-Garden City/White Plains

ReferencesReferences CDC- Interim Guidance for EMS Systems and 911 PSAPs for

Management of Patients with Confirmed or Suspected Swine-Origin Influenza A (H1N1) Infection

CDC-Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare Setting

OSHA 3328-05 2007 Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers

OSHA 3327-02N 2007 Preparing Workplaces for a Pandemic EPA- Antimicrobial Products Registered for Use Against the H1N1 Flu

and Other Influenza A Viruses on Hard Surfaces OSHA’s Quick Cards www.cdc.gov www.osha.gov