STATE OF WASHINGTON · Web viewDuring contracting sessions, HCS/AAA/DDA contracting staff must remind IPs of the requirement to wear a face mask when they are in a client’s home

STATE OF WASHINGTONDEPARTMENT OF SOCIAL AND HEALTH SERVICESAging and Long-Term Support AdministrationHome and Community Services Division

PO Box 45600, Olympia, WA 98504-5600

HCS MANAGEMENT BULLETIN

H20-109 Policy & Procedure

December 28, 2020

TO:

Home and Community Services (HCS) Division Regional Administrators

Developmental Disabilities Administration (DDA) Regional Administrators

Area Agency on Aging (AAA) Directors

FROM:

Bea Rector, Director, Home and Community Services Division

Shannon Manion, Director, Division of Field Services, Developmental Disabilities Administration

SUBJECT:

Health and Safety obligations for Individual Providers (IPs) including:

· Requirements to wear a face mask while in a client’s home; and

· N95 mask and Fit-Testing for Individual Providers (IPs)

PURPOSE:

To inform HCS/AAA/DDA staff about previous and upcoming information provided to Individual Providers regarding safe care practices during the COVID-19 outbreak, specifically related to wearing face masks and about N95 mask distribution, fit-testing, and one-time payments for IPs for fit testing when working with clients with aerosol generating procedures.

BACKGROUND:

Individual Providers (IPs) have an obligation to perform their duties in a manner that does not compromise the health and safety of any DSHS client. This includes a requirement to wear a face covering when out of their home and in their worksite, including when in the home of a DSHS client. They must also comply with COVID-19 work site-specific safety practices as outlined in the Governor’s “Safe Start” Proclamation 20-25.4, the guidelines set forth by the Washington State Department of Health and safety guidance provided by DSHS. (See attached).

Workers caring for clients with the following Aerosol Generating Procedures (AGP) have additional requirements for wearing fit-tested N-95 masks.

· CPAP or BiPAP

•Nebulizer

•High flow oxygen therapy

•Respiratory therapy

•Suctioning

•Tracheostomy care

•Ventilator/Respirator

N95 masks were distributed to IPs who are caring for clients with AGPs. Each shipment contained the following communications: (See attached)

· Fit-Testing Locations

· CDC Fit-Testing FAQ

· Don and Doff N95

· Fit-Testing Warning

WHAT’S NEW, CHANGED, OR CLARIFIED:

Individual Providers will receive additional written safety information and reminders regarding the requirement to wear face coverings/personal protective equipment when they are at their worksite.

Individual Providers caring for clients identified with Aerosol Generating Procedures (AGP) have already received N-95 masks and instructions for fit testing. They will receive a one-time payment for fit-testing in January of 2021.

ALTSA and DDA will be developing a FAQ document to respond to additional questions that have been received. In addition we will continue to post communications when guidance from Department of Health (DOH) and Center for Disease Control (CDC) are revised.

Individual Provider postcard and DOH home care guidance (see attachments below) will be placed in the IPs contracting packets.

ACTION:

Effective Immediately:

IP Contracting Staff:

During contracting sessions, HCS/AAA/DDA contracting staff must remind IPs of the requirement to wear a face mask when they are in a client’s home.

Contracting staff should remind IPs that if they are caring for a client with AGP there is a requirement to wear an N-95 mask and remind them of provider resources related to fit-testing and a one-time payment for fit testing. (See attached).

Include the IP postcard and DOH home care guidance documents in IP contracting packets.

Case Managers

If case managers receive calls or questions from clients or IPs about face masks, including N-95 masks, provide information and reminders that IPs are required to wear a face mask when they are in a client’s home, and that fit tested N-95 masks must be worn by providers caring for clients with AGP. If there are issues with fit-testing, additional information will be provided in the FAQ that is being developed. If alternative brand N95s are needed, the IP may contact the Incident Management Team at one of the contacts listed below.

Refer the client and IP to publications about these requirements as appropriate and inform them of a one-time January payment for fit testing.

Identification of IPs who are providing services to clients with AGP will be done on a routine basis to identify new IPs that have not been issued a shipment of N95s or a one-time fit testing payment. This process will be managed at headquarters at this time.

RELATED REFERENCES:

Washington State Department of Social and Health Services Individual Providers (IPs) Guidance for Providing Safe Care During the COVID-19 Outbreak

https://www.governor.wa.gov/sites/default/files/COVID19%20Homecare%20Worker%20Guidelines.pdf

https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/HomeHealthAide_Guidance.pdf

ATTACHMENT(S):

CONTACT(S):

Dawn Williams, Incident Management Team (IMT)

[email protected]

Hannah Thompson, Incident Management Team (IMT)

[email protected]

Rachelle Ames, Care Management Unit Manager, HCS

(360)725-2353

[email protected]

Stacy Graff, Individual Provider and Administrative Hearing Program Manager, HCS

(360) 725-2533

[email protected]

Jaime Bond, State Plan Services Unit Manager

Phone: 360-407-1567

[email protected]

Melissa Randles, Individual Provider Program Manager

Phone: 360-407-1515

[email protected]

Cloth_Face_Coverin

g_Insert_Flyer.pdf

YOUR ACTIONS MATTER

The fight against COVID-19 isn’t over yet. You are required to wear surgical masks at work. Keep wearing your mask and practicing social distancing in your personal life. We know that combating the Coronavirus isn’t always convenient, but together we can Stop the Spread.

Thank You for Being a Caregiver

WEAR BECAUSE YOU CARE

Masks are Required PPE is FREE Home is Safest

You’re required to wear at least a surgical

mask anytime you’re working with a client or in a client’s home.

You can request free PPE at anytime by visiting www.research.net/r/

RequestPPE

Home is still the safest place to be.

Limit possible exposure by staying home

when not at work.

Wear a mask | Keep your distance | Wash your hands

Cloth_Face_Coverin

g_Sticker_4x3.33.pdf

IMPORTANT

Help Stop the Spread.Wear these cloth face coverings when

you’re not at work to help protect yourself and others from COVID-19.

Surgical Masks are Required at WorkSurgical masks must be worn when

working with a client.

Postcard_IP_12.03.2

020_DRAFT.pdf

Masks Are Required: Protect Yourself and Others

Wear the Right Mask for the Task

Personal lifeWear in public and

anytime you’re around people you

don’t live with.

Wear to workWear for activities like

shopping, cooking meals, housekeeping

and laundry for your client.

Wear to workWear for hands-on client personal care when your client is

not sick.

Wear to workWear when your client is sick and for aerosolizing

procedures.

Cloth Face Covering

*Optional Additional Protection

Wear a face shield or goggles with your mask

Surgical Mask*Cloth Face CoveringN95 Respirator

+ Face Shield

MASKS ARE REQUIRED AT WORK

Masks and Face Shields Delivery - Coming Soon

PPE is FREE

Masks are required anytime you’re working with a client or in a client’s home.Visit https://bit.ly/390gR0G to read the complete guidance.

We’re sending a shipment of cloth face coverings, surgical masks and face shields to you soon! Check your mail for the delivery.

Order free PPE anytime by visiting the website at www.research.net/r/RequestPPE

Blake Office Park4500 10th Ave SELacey, WA 98503

20201105 Fit Testing

Locations IP.docx

This guide was developed for informational purposes during the COVID-19 pandemic. DSHS offers no recommendation or endorsement for any listed location. Employers should independently research fit testing services. Employers must independently verify that any fit testing satisfies WAC 296-842-22010.

ADAMSASOTINBENTON

Confluence Health

(509) 764-6400

840 E Hill Ave

Moses Lake, WA

Columbia Safety

(509) 820-3883

418 N Kellogg St, STE D

Kennewick, WA 99336

Lourdes Occ. Health

(509) 546-2222

9915 Sandifur Pkwy

Pasco, WA 99301

Columbia Safety

(509) 820-3883


Kennewick, WA 99336

Lourdes Occ. Health

(509) 546-2222

9915 Sandifur Pkwy

Pasco, WA 99301

CHELANCLALLAMCLARK

Confluence Health

(509) 436-4009

317 N. Mission St

Wenatchee, WA 98801

The Doctors Clinic

(360) 782-3300

9621 Ridgetop Blvd NW,

Silverdale, WA 98363

Performance Occ. Health

(360) 334-7001

11109 NE 14th St, STE A

Vancouver, WA 98684

COLUMBIACOWLITZDOUGLAS

Columbia Safety

(509) 820-3883


Kennewick, WA 99336

Lourdes Occ. Health

(509) 546-2222

9915 Sandifur Pkwy

Pasco, WA 99301


(360) 524-3929

1118 14th Avenue,

Longview WA 98632

Confluence Health

(509) 436-4009

317 N. Mission St

Wenatchee, WA 98801

FERRYFRANKLINGARFIELD

North Valley Hospital

509-486-3110

22 W. First St

Tonasket, WA 98855

Confluence Health

(509) 826-1800

916 Koala Dr

Omak, WA 98841

Columbia Safety

(509) 820-3883


Kennewick, WA 99336

Lourdes Occ. Health

(509) 546-2222

9915 Sandifur Pkwy

Pasco, WA 99301

Columbia Safety

(509) 820-3883


Kennewick, WA 99336

Lourdes Occ. Health

(509) 546-2222

9915 Sandifur Pkwy

Pasco, WA 99301

FERRYFRANKLINGARFIELD


509-486-3110

22 W. First St

Tonasket, WA 98855

Confluence Health

(509) 826-1800

916 Koala Dr

Omak, WA 98841

Columbia Safety

(509) 820-3883


Kennewick, WA 99336

Lourdes Occ. Health

(509) 546-2222

9915 Sandifur Pkwy

Pasco, WA 99301

Columbia Safety

(509) 820-3883


Kennewick, WA 99336

Lourdes Occ. Health

(509) 546-2222

9915 Sandifur Pkwy

Pasco, WA 99301

GRANTGRAYS HARBORISLAND

Confluence Health

(509) 764-6400

840 E Hill Ave

Moses Lake, WA 98837

Concentra Urgent Care

(360) 455-1350

3928 Pacific Avenue SE

Lacey, WA 98503

Central Welding Supply

(360) 651-2307

13300 38th Avenue NE

Marysville, WA 98271


(425) 259-0300

3726 Broadway, STE 101

Everett, WA 98201

JEFFERSONKINGKITSAP

The Doctors Clinic

(360) 782-3300




(425) 228-2218

15700 Nelson Road South

Tukwila WA 98188


(206) 624-3651

3223 1st Ave S. STE C

Seattle WA 98134

The Doctors Clinic

(360) 782-3300



KITTITASKLICKITATLEWIS

Confluence Health

(509) 436-4009

317 N. Mission St

Wenatchee, WA 98801

KVH Workplace Health

(509) 933-8830

702 E Mountain View Ave

Ellensburg, WA 98926

Yakima Worker Care

(509) 575-2949

409 12th Avenue

Yakima, WA 98902


(360) 455-1350


Lacey, WA 98503

LINCOLNMASONOKANOGAN


(509) 747-0770

2005 E. 29th Ave

Spokane, WA 99203


(360) 455-1350


Lacey, WA 98503


509-486-3110

22 W. First St

Tonasket, WA 98855

Confluence Health, Omak Clinic

(509) 826-1800

916 Koala Dr

Omak, WA 98841

PACIFICPEND OREILLEPIERCE


(360) 524-3929

1118 14th Avenue,

Longview WA 98632


(509) 747-0770

2005 E. 29th Ave

Spokane, WA 999203

Occupational Medicine Clinic

(253) 922-9570

4703 Pacific Hwy E STE A

Tacoma, WA 98424


(253) 475-5908

2624 South 38th St. STE C

Tacoma, WA 98409

SAN JUANSKAGITSKAMANIA


(360) 651-2307

13300 38th Avenue Northeast


Care Medical Group

(360) 734-4300

4043 Northwest Ave

Bellingham WA 98226


(360) 651-2307

13300 38th Avenue NE



(425) 259-0300

3726 Broadway, STE 101

Everett, WA 98201


(360) 334-7001

11109 NE 14th St, STE A

Vancouver, WA 98684

SNOHOMISHSPOKANESTEVENS


(360) 651-2307

13300 38th Avenue Northeast



(425) 259-0300

3726 Broadway STE 101

Everett, WA 98201


(509) 747-0770

2005 E. 29th Ave

Spokane, WA 999203

Providence Occupational Med

(509) 944-8907

16528 E Desmet Ct STE 1600

Spokane WA 99216


(509) 747-0770

2005 E. 29th Ave

Spokane, WA 999203

THURSTONWAHKIAKUMWALLA WALLA


(360) 455-1350


Lacey, WA 98503


(360) 524-3929

1118 14th Avenue,

Longview WA 98632

Columbia Safety

(509) 820-3883


Kennewick, WA 99336

Lourdes Occupational Health

(509) 724-4300

9915 Sandifur Pkwy

Pasco, WA 99301

WHATCOMWHITMANYAKIMA

Care Medical Group

(360) 724-4300

4043 Northwest Ave

Bellingham WA 98226


(509) 747-0770

2005 E. 29th Ave

Spokane, WA 999203

Yakima Worker Care

(509) 575-2949

409 12th Avenue

Yakima, WA 98902

We invite additional suggestions to [email protected]

IP PPE Letter_5

(n95).doc

STATE OF WASHINGTON

DEPARTMENT OF SOCIAL AND HEALTH SERVICESAging and Long-Term Support Administration

Home and Community Services Division

PO Box 45600, Olympia, WA 98504-5600

November 12, 2020

Payment for Fit Testing and Free PPE from DSHS

Dear Individual Provider,

The purpose of this mailing is to:

1) Remind you that you may request free personal protective equipment (PPE) from DSHS. It is important to wear PPE when providing personal care services to your client(s). Instructions for ordering PPE are found below.

2) You will soon receive an advance payment for N95 respirator fit testing. You should wear N95 masks when assisting your client with aerosolizing procedures, such as: nebulizers, high flow oxygen or ventilators. N95 masks must be fit tested to work properly.

$103 Payment for Fit Testing

You will soon receive a $103 payment from DSHS. This payment will cover the cost of fit-testing the N95 respirators included in this mailing.

Fit testing is extremely important. N95 masks do not work if they do not fit. Please seek fit testing now so that you are safe when you wear N95.

Please reserve this money for fit testing and follow these instructions.

How to find a fit-tester:

a) Refer to the included list of fit-testing providers. OR

b) Search Google for “respirator fit testing” in your area

After your fit-testing appointment:

a) If the respirators do not fit, immediately notify [email protected].

Billing instructions

Before the payment arrives, you will be mailed an authorization letter from IPOne. The letter will include the newly-authorized service code SA603 “IP Reimbursement” – this is the authorization notice for your fit test payment.

The letter will state that the person you serve owes you $0.00 in Client Responsibility for service code SA603, but they still may owe Client Responsibility for regular personal care services.

If you or the person you serve have questions about Client Responsibility, please contact their case manager.

Free PPE from DSHS

PPE protects you and the person you serve. Follow these steps to receive free PPE.

You may order once per month – please wait 28 days between orders.

If your client develops symptoms of COVID-19 or tests positive, order immediately and the monthly limit will be waived.

COVID-19 is spreading rapidly. It is essential to follow infection control guidance to protect yourself and others. Wearing PPE is important and masks are required.

TO REQUEST PPE:

· If you have access to the internet:

· Go to https://www.research.net/r/RequestPPE and carefully complete the form with accurate information. If you have a question, contact [email protected].

· If you don’t have access to the internet:

· If you are serving a client through Aging and Long Term Support Administration or an Area Agency on Aging, use the table on the next page to find the PPE contact in your local area. Call or email and your contact will help you order PPE. If you are serving a Developmental Disability client, contact Barb Uehara at [email protected] or (360) 407-1593.

Please direct questions to your local PPE contact. The SEIU Member Resource Center is also available to assist with questions at [email protected] or (866) 371-3200.

Counties

Email

Phone

Name

Clallam, Grays Harbor, Jefferson, Pacific County

[email protected]

360-379-4421

Heaven Gregg

Island, San Juan, Skagit, Whatcom

[email protected]

360-746-7415

Snohomish

[email protected]

425-388-7368

Shari Sinnett-Kelly

King

[email protected]

206-573-4617

Tara Shively

King

[email protected]

206-399-8635

Abin Mohamed

King

[email protected]

206-390-9466

Caroline Bacon

Pierce

[email protected]

253-798-4363

Tiffany Conaway

Pierce

[email protected]

253-798-4390

Jennifer Long

Lewis, Mason, Thurston

[email protected]

888-545-0910

Manfay Chan

Clark, Cowlitz, Klickitat, Skamania, Wahkiakum

[email protected]

888-637-6060

Lisa Sadoski

Adams, Chelan, Douglas, Grant, Lincoln, Okanogan

[email protected]

800-572-4459 x 404

Darla Bedard

Adams, Chelan, Douglas, Grant, Lincoln, Okanogan

[email protected]

509-886-0700 x 209

Christine Johnson

Kittitas, Yakima, Benton, Franklin

[email protected]

1-855-567-0252

Columbia, Walla Walla, Garfield, Asotin

[email protected]

1-855-567-0252

Yakama Reservation

[email protected]

509-865-7164

Anita Nez

Yakama Reservation

[email protected]

Launa Ambrose

Ferry, Pend Oreille, Spokane, Stevens, Whitman

[email protected]

509-458-2509

Jenn Lourdeau

Ferry, Pend Oreille, Spokane, Stevens, Whitman

[email protected]

Kristi Eppinger

Colville Reservation

[email protected]

888-881-7684

Larry Robinette

Colville Reservation

[email protected]

Laura Pakootas

Kitsap

[email protected]

800-562-6418

Lisa Williams

Kitsap

[email protected]

Matthew Harnack

Kitsap

[email protected]

Gena Pereira

CDC Fit-Testing

FAQ.pdf

Filtering out Confusion: Frequently Asked Questions about Respiratory Protection

Fit Testing Over 3 million United States employees, in approximately 1.3 mil-lion workplaces, are required to wear respiratory protection. The Occupational Safety and Health Administration (OSHA) (29 CFR 1910.134) requires an annual respirator fit test to confirm the fit of any respirator that forms a tight seal on the wearer’s face before it is used in the workplace. This ensures that users are receiving the expected level of protection by minimizing any contaminant leakage into the facepiece. The following are some frequently asked questions about respiratory protection and fit testing.

What is a Respirator Fit Test?A fit test is conducted to verify that a respirator is both comfortable and correctly fits the user. Fit test methods are classified as either qualitative or quantitative. A qualitative fit test is a pass/fail test that relies on the individual’s sensory detection of a test agent, such as taste, smell, or involuntary cough (a reaction to irritant smoke*). A quantitative fit test uses an instrument to numerically measure the effectiveness of the respirator.

The benefits of a fit test include better protection for the employee and verification that the employee is wearing a correctly-fitting model and size of respirator.1 Higher than expected levels of exposure to a con-taminant may occur if the respirator has a poor face seal against the user’s skin, which can result in leakage.

How Often Must Fit Testing Be Conducted?In addition to fit testing upon initially selecting a model of respirator, OSHA requires that fit testing be con-ducted annually, and repeated “whenever an employee reports, or the employer or the physician or other li-censed health care professional makes visual observations of changes in the employee’s physical condition that could affect respirator fit (e.g., facial scarring, dental changes, cosmetic surgery, or an obvious change in body weight).” 2

The appropriate length of time between respirator fit tests has been a point of debate and discussion for many years due to its use of workplace time and resources, especially in reference to the commonly-used filtering facepiece respirator (FFR).3 In response to these concerns, NIOSH completed a study that confirmed the ne-cessity of the current OSHA respirator fit testing requirement, both annually and when physical changes have occurred.2

http://blogs.cdc.gov/niosh-science-blog/2016/01/05/fit-testing/

Once I am Fit Tested, Can I use any Brand/Make/Model Respirator as Long as it is the Same Size?A successful fit test only qualifies an employee to use the specific brand/make/model and size of respirator that he or she wore during that test. Respirator sizing is not standardized across models or brands. For example, a medium in one model may not offer the same fit as a different manufacturer’s medium model.

Can I Have Facial Hair and still be Fit Tested to Wear a Tight-Fitting Respirator?The OSHA respirator standard prohibits tight-fitting respirators to be worn by workers who have facial hair that comes between the sealing surface of the facepiece and the face of the wearer. Facial hair that lies along the seal-ing area of a respirator, such as beards, sideburns, or some mustaches, will interfere with respirators that rely on a

tight facepiece seal to achieve maximum protection.

Research tells us that the presence of facial hair under the sealing surface causes 20 to 1000 times more leakage compared to clean-shaven individuals.4 Gases, vapors, and particles in the air will take the path of least resistance and bypass the part of the respirator that captures or filters hazards out. A common misconcep-tion is that human hair can act as a crude filter to capture any particles that are in the airstream between the sealing surface and the user’s skin. However, while hu-man hair appears to be very thin to the naked eye, hair is much larger in size than the particles inhaled. Facial hair is not dense enough and the individual hairs are too large to capture particles like an air filter does; nor will a beard trap gases and vapors like the carbon bed in a respirator cartridge. Therefore, the vast majority of particles, gases, and vapors follow the air stream right through the facial hair and into respiratory tract of the wearer. In fact, some studies have shown that even a day or two of stubble can begin to reduce protection.

This document is in the public domainand may be freely copied or reprinted.DOI: https://doi.org/10.26616/NIOSHPUB2018129DHHS (NIOSH) Publication No. 2018-129

To receive NIOSH documents or more information about occupational safety and health topics, please contact NIOSH:Telephone: 1–800–CDC–INFO (1–800–232–4636) TTY: 1–888–232–6348 CDC INFO: www.cdc.gov/info or visit the NIOSH Web site at www.cdc.gov/NIOSH. For a monthly update on news at NIOSH, subscribe to NIOSH eNews by visiting www.cdc.gov/niosh/eNews.

References1. Duling MG, Lawrence RB, Slaven JE, Coffey CC [2007]. Simulated workpalce protection factors for half-facepiece respiratory protective devices. J Occup Environ Hyg. 4(6):420-431.2. OSHA [1998]. Respiratory Protection. 29 CFR 1910.134. Final rule. Fed Regist 63:1152-1300. 3. Zhuang Z, Bergman MS, Brochu E, Palmiero AJ, Niezgoda G, He X, Roberge RJ, Shaffer RE [2016]. Temporal changes in filtering-facepiece respirator fit. J Occup Environ Hyg. 13(4), pp.265-274.4. Stobbe TJ, daRoza RA, Watkins MA [1988]. Facial hair and respirator fit: a review of the literature. Am. Ind Hyg Assoc J. 49(4):199-204.Photos courtesy of NIOSH and Shutterstock

Incorrect respirator use due to beard and strap placement

Do Powered Air-Purifying Respirators (PAPRs) Require Fit Testing? The answer to this question depends on the type of facepiece that the respirator has. Any facepieces that form a tight seal to the wearer’s face, e.g., half-masks and full facepieces, must be fit tested. Loose-fitting PAPRs, in which the hood or helmet is designed to form only a partial seal with the wearer’s face or hoods which seal loosely around the wearer’s neck or shoulders, do not require fit testing.

Where can I Find More Information? This information and more is available on the NIOSH Respirator Trusted-Source webpage.

*NIOSH does not endorse or recommend the use of the irritant smoke fit test. NIOSH, in its formal comments to OSHA on the proposed revision of 29 CFR 1910, 1915, and 1926, strongly recommended against the use of this fit test method because of the health risk associated with exposure to the irritant smoke. That recommendation was primarily based on studies conducted as part of a NIOSH HHE (HETA 93-040-2315) and described in Appendix A of the NIOSH comments to OSHA dated May 15, 1995 (docket H-049)

https://doi.org/10.26616/NIOSHPUB2018129

https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/respsource.html

don-doff-n95.pdf

How to Properly Put on and Take off a Disposable Respirator

WASH YOUR HANDS THOROUGHLY BEFORE PUTTING ON AND TAKING OFF THE RESPIRATOR.

If you have used a respirator before that fit you, use the same make, model and size.

Inspect the respirator for damage. If your respirator appears damaged, DO NOT USE IT. Replace it with a new one.

Do not allow facial hair, hair, jewelry, glasses, clothing, or anything else to prevent proper placement or come between your face and the respirator.

Follow the instructions that come with your respirator.1

Employers must comply with the OSHA Respiratory Protection Standard, 29 CFR 1910.134 if respirators are used by employees performing work-related duties.

1 Manufacturer instructions for many NIOSH approved disposable respirators can be found at www.cdc.gov/niosh/npptl/topics/respirators/disp_part/

2 According to the manufacturer’s recommendations

For more information call 1-800-CDC-INFO or go to http://www.cdc.gov/niosh/npptl/topics/respirators/

Position the respirator in your hands with the nose piece at your fingertips.

Place both hands over the respirator, take a quick breath in to check whether the respirator seals tightly to the face.

DO NOT TOUCH the front of the respirator! It may be contaminated!

Cup the respirator in your hand allowing the headbands to hang below your hand. Hold the respirator under your chin with the nosepiece up.

Place both hands completely over the respirator and exhale. If you feel leakage, there is not a proper seal.

Remove by pulling the bottom strap over back of head, followed by the top strap, without touching the respirator.

The top strap (on single or double strap respirators) goes over and rests at the top back of your head. The bottom strap is positioned around the neck and below the ears. Do not crisscross straps.

If air leaks around the nose, readjust the nosepiece as described. If air leaks at the mask edges, re-adjust the straps along the sides of your head until a proper seal is achieved.

Discard in waste container. WASH YOUR HANDS!

Place your fingertips from both hands at the top of the metal nose clip (if present). Slide fingertips down both sides of the metal strip to mold the nose area to the shape of your nose.

If you cannot achieve a proper seal due to air leakage, ask for help or try a different size or model.

Putting On The Respirator

Checking Your Seal2

Removing Your Respirator

CS 207843DHHS (NIOSH) Publication No. 2010-133