Additional OSHA Guidance Issued Regarding Covid-19 and Respirator Use: Putting on and Taking off a Mask

OSHA has a new video up at https://www.youtube.com/watch?v=oU4stQgCtV8 demonstrating the proper method for putting on and taking off a respirator so that the wearer does not cross contaminate the inside (breathing zone) of the mask with bacteria, virus particles or other contaminants. It takes some intentionality to minimize the chance that virus particles (if present) are introduced to the inside of the mask while taking it on or off. As you might expect, the video also stresses that the wearer should wash their hands before handling the mask. Finally, the video includes some helpful tips to ensure an adequate seal on the mask to the face.  The video gives specific guidance about how to adjust the nose piece, if so equipped. It does not address the issue of facial hair and how it can render a respirator less effective, but the same guidance regarding facial hair and other air contaminants would apply.

Covid-19 and Respirator Use Precautions

One of the key precautions being advised for people during the Covid-19 Pandemic is the use of a face covering to help prevent the spread of the virus. Preliminary indications are that face coverings are likely useful in preventing an infected person from spreading the virus. It is also likely that some covering over one’s mouth and nose is preferable to no covering. To date, there have not been clear indications to date of how fine the filtration of the face covering needs to be in order to be “effective.” 

Of course, there will always be some small (non-zero) chance of transmission, but guidance from OSHA with respect to respirator use for other air contaminants is worth noting. In order to get an adequate seal, OSHA requires that employees who will be required to use respirators be clean-shaven. Employees must also complete a questionnaire to screen for breathing problems, and if answers so indicate, be approved to a health care provider to use the respirator.

If a person has pre-existing respiratory issues, wearing a respirator can create other problems. There is the recent example of a man wearing an N95 respirator involved in a lone occupant single vehicle car accident. While police could not definitively establish that the driver had breathing problems while driving, he was noted to have been wearing an N95 mask, and no other factors such as drugs or alcohol were noted.

OSHA’s screening questionnaire for “medical clearance” for employees who must wear a respirator is contained in Appendix C and is reproduced in part below:

1. Do you currently smoke tobacco, or have you smoked tobacco in the last month: Yes / No

2. Have you ever had any of the following conditions?
      a. Seizures: Yes / No
      b. Diabetes (sigar disease): Yes / No
      c. Allergic reactions that interfere with your breathing: Yes / No
      d. Claustrophobia (fear of closed places): Yes / No
      e. Trouble smelling odors: Yes/ No

3 Have you ever had any of the following pulmonary or lung problems?
      a. Seizures: Yes / No
      b. Diabetes (sigar disease): Yes / No
      c. Allergic reactions that interfere with your breathing: Yes / No
      d. Claustrophobia (fear of closed places): Yes / No
      e. Trouble smelling odors: Yes/ No

4. Do you currently have any of the following symptoms of pulmonary or lung illness?
      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 (collaspe 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 problems that you've been told about: Yes / No

5. Have you ever had any of the following cardiovascular or heart problems?
      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

6. Have you ever had any of the following cardiovascular or heart symptoms?
      a. Heart attack: Yes / No
      b. Sroke: 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

7. Do you currently take medication for any of the following problems?
      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

8. If you've used a respirator, have you ever had any of the following
problems? (If you've never used a respirator, check the following
space and go to questions 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

Dr. Jerry P Purswell, PhD. http://www.purswell.com/index.html