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Respiratory Protection Plan - Wappingers Central School District

1. Exhalation Valve Seat Fie o LC 19 Suspension Part Listing PART NO ITEM NO DESCRIPTION F46S Yoke Small Yoke Medium Large Suspension Assembly Listing Associated Replacement Parts PART NO ITEM NO DESCRIPTION RP21 Filter Base RP22R Filter Retainer Fit Check Cover 20 CARTRIDGE AND FILTER TABLE R96 Nos N99 TO 708 TOS Tod TO7 708 709 21 Q WARRANTY AND LIMITATION OF LIABILITY LIMITED WARRANTY SPERIAN warrants this product to be free from defects in ma terials and workmanship for 5 years for the skirt and 1 year for all other components from the date of purchase During this period SPERIAN will repair or replace defective parts at SPERIAN s option Freight charges to and from the SPERIAN factory shall be paid by the purchaser EXCLUSIONS NOTWITHSTANDING ANY CONTRARY TERM IN THE PURCHAS ER S PURCHASE ORDER OR OTHERWISE THE ONLY WARRANTY EXTENDED BY SPERIAN IS THE EXPRESSED LIMITED WARRANTY DEFINED ABOVE THIS WARRANTY IS EXCLUSIVE AND IN LIEU OF ANY IMPLIED WARRANTY OF MER CHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE CONDITIONS To maintain this warranty this product must be used maintained and inspected as prescribed in the owner s instruction manual including prompt replace ment or repair of defective parts and such other necessary maintenance and repair as may be required Normal wear and tear parts damaged by abuse misuse negli gence or ac
2. a Shortness of breath b Shortness of breath when walking fast on level ground or walking up a slight hill or incline c Shortness of breath when walking with other people at an ordinary pace on level ground d Have to stop for breath when walking at your own pace on level ground e Shortness of breath when washing or dressing yourself f Shortness of breath that interferes with your job g Coughing that produces phlegm thick sputum h Coughing that wakes you early in the morning i Coughing that occurs mostly when you are lying down j Coughing up blood in the last month k Wheezing I Wheezing that interferes with your job m Chest pain when you breathe deeply n Any other symptoms that you think may be related to lung problems 5 Have you ever had any of the following cardiovascular or heart problems a Heart attack b Stroke c Angina d Heart failure e Swelling in your legs or feet not caused by walking f Heart arrhythmia heart beating irregularly g High blood pressure h Any other heart problem that you ve been told about Reviewed by Initials 2 S FORMS FIRE OSHARESP DOC Rev 06 10 CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes Yes CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No E CI No CI No CI No CI No CI No No 6 Have you ever had any of the following cardiovascular or heart sym
3. 12 District and shall cover a Donning wearing and removing the respirator b Adjusting the respirator so that its respiratory inlet covering is properly fitted on the wearer and so that the respirator causes a minimum of discomfort to the wearer c Allowing the respirator wearer to wear the respirator in a safe atmosphere for an adequate period of time to ensure that the wearer is familiar with the operational characteristics of the respirator d Providing the respirator wearer an opportunity to wear the respirator in a test atmosphere to demonstrate its effectiveness A test atmosphere is any atmosphere in which the wearer can carry out activities stimulating work movements and respirator leakage or the wearer can detect respirator malfunction Each respirator wearer shall be retrained as necessary to ensure effective respirator use Refresher training shall be given at least annually and shall include the provisions of 3g through k and 4c Wappingers Central School APPENDIX B The Note to the employer According to OSHA after an_ initial medical evaluation is performed prior to first respirator use WorkPlace additional medical evaluations are not required unless a health In LL problem is noted OSHA assigns the responsibility of discovering Saint Francis Hospital and Health Centers employees significant medical changes to the employer This form 845 431 8740 is designed to be used annually to discover and fol
4. No LJ No QI No 10 Have you ever lost vision in either eye temporarily or permanently 11 Do you currently have any of the following vision problems a Wear contact lenses b Wear glasses c Color blind d Any other eye or vision problem 12 Have you ever had an injury to your ears including a broken ear drum 13 Do you currently have any of the following hearing problems a Difficulty hearing b Wear a hearing aid c Any other hearing or ear problem 14 Have you ever had a back injury Healthcare Reviewer s comments for yes answers 6 14 Reviewed by Initials 3 S FORMS FIRE OSHARESP DOC Rev 06 10 CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes 15 Do you currently have any of the following musculoskeletal problems CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No a Weakness in any of your arms hands legs or feet b Back pain c Difficulty fully moving your arms and legs d Pain or stiffness when you lean forward or backward at the waist e Difficulty fully moving your head up or down f Difficulty fully moving your head side to side g Difficulty bending at your knees h Difficulty squatting to the ground i Climbing a flight of stairs or a ladder carrying more than 25 lbs j Any other muscle or skeletal problem that interferes with using a respirator Healthcare Provider comments for yes answers 15 Part B O Yes
5. U Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes LI No LI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No 1 In your present job are you working at high altitudes over 5 000 feet or in a place that has lower than normal amounts of oxygen If yes do you have feelings of dizziness shortness of breath pounding in your chest or other symptoms when you re working under these conditions 2 At work or at home have you ever been exposed to hazardous solvents hazardous airborne chemicals e g gases fumes or dust or have you come into skin contact with hazardous chemicals If yes name the chemicals if you know them 3 Have you ever worked with any of the materials or under any of the conditions listed below a Asbestos b Silica e g in sandblasting c Tungsten cobalt e g grinding or welding this material d Beryllium e Aluminum f Coal for example mining g Iron h Tin i Dusty environments j Any other hazardous exposures If yes describe these exposures 4 List any second jobs or side businesses you have 5 List your previous occupations 4 S FORMS FIRE OSHARESP DOC Rev 07 05 6 List your current and previous hobbies UU Yes U No 7 Have you been in the military services If yes were you exposed to biological or chemical agents either in training or combat QI Yes U No 8 Have you ever worked on a
6. allows the use of respirators for protection against contami nants with poor warning properties such as isocyanates To maximize protection against chemicals with poor warning properties it is im portant to replace the cartridges when the end of service life indicator if so equipped has changed color or in accordance with an OSHA compliant cartridge change out schedule that is based on objective information or data that ensures the cartridges are changed before the end of their service life A WARNING You must immediately leave the contaminated area if you taste or smell contaminants or if your eyes or throat become irritated Replace the cartridges before reentering the contaminated area You must replace the combination cartridges when breathing becomes uncomfortable or difficult As particulates collect on the filter surface the breathing resistance of the respirator increases If you wait too long to replace the cartridges particulates may leak past the face seal instead of being collected on the filter therefore SPERIAN recom mends that the cartridge be changed at least daily Establishing the cartridge service life for mixtures of contaminants is a complex task and one that requires considerable professional judg ment to create a reasonable change out schedule OSHA provides a rule of thumb method for determining the cartridge service life for mixtures The method addresses two situations The first is where the
7. and in this manual or as authorized by SPERIAN or modification of this respirator in any manner will void the NIOSH certification and invalidates all SPERIAN s warranties for the respirator e Always read and follow the instructions listed in the Material Safety Data Sheet for the chemicals that are present in the work area e Do not use if you have a preexisting skin condition for example folliculi tus or vitiligo until you obtain clearance from a medical doctor e This respirator must be worn and used as specified in SPERIAN s in structions No respirator can provide complete protection from all con ditions Use extreme care for emergency conditions e Some individuals are sensitive to chemicals e g isocyanates latex oil mists etc or may have some type of respiratory disorder e g asth ma chronic obstructive airway disease etc If you are sensitive to any chemical or have a respiratory disorder you may have a severe reac tion at contaminant levels well below accepted health levels such as the OSHA Permissible Exposure Limit PEL ACGIH Threshold Limit Value TLV or the NIOSH Recommended Exposure Limits REL Many chemicals e g isocyanates mercury etc have no physical warning properties and you cannot taste or smell the contaminants even though they may be present in the respirator facepiece This respirator will re duce but will not eliminate the possibility of contaminants entering the facepiece and caus
8. exposed to when you are using your respirator s Name of any toxic substance s Estimated maximum exposure s level s per shift Duration of exposure s per shift The name of any other toxic substances that you will be exposed to while using your respirator 19 Describe any special responsibilities you will have while using your respirator s that may affect the safety and well being of others for example rescue security ATTESTATION OF ACCURACY I attest that all of the information I ve provided on this form is true and accurate to the best of my knowledge I understand that falsification of information could endanger my health during respirator use or lead to my not being approved for respirator use Signed Date MEDICAL RELEASE OF INFORMATION By my signature below I hereby authorize The WorkPlace to use the information I ve provided on this form and or data from my physical examination to make a decision as to my medical clearance for respirator use I understand that under Federal OSHA PESH regulations my employer is required to receive a written recommendation regarding my ability to use a respirator but will not receive any details of my private health information Signed Date 6 S FORMS FIRE OSHARESP DOC Rev 07 05 THIS PAGE INTENTIONALLY BLANK Suvivair Premiere Plus NIOSH Respiratory Protection APPENDIX C Product Family Survivair Premier Plus Y NIOSH The Survivair Premier Plus silico
9. further details on training All employees shall receive training prior to being issued and or wearing a respirator B Each division shall maintain training records These records must be readily available to representatives of the Health amp Safety office Wappingers Central School District REVISED on Mav 14 2012 IL MEDICAL EVALUATIONS Prior to initially being issued a respirator all employees shall be medically evaluated Persons with physical disabilities such as but not limited to respiratory impairments or claustrophobia when wearing a respirator shall not be assigned to tasks requiring the use of respirators unless it has been determined by a qualified physician that they are physically able to perform work and use the equipment All respirator users medical status will be reviewed annually Employees are required to notify their Supervisors immediately of any health problems that would necessitate a re evaluation of their ability to wear respiratory protection This information is required to be brought to the Program Administrator s attention immediately All employees will fill out the Respirator Wearer Health Survey see Appendix B annually provided by The WorkPlace to determine the need for a medical evaluation If medical evaluation is needed it will be scheduled at The WorkPlace in Poughkeepsie NY If no medical evaluation is deemed necessary the employee will be scheduled for an annual fit test Per OSHA CR
10. g lubricants cutting fluids glycerine etc An R series filter used in an oil containing atmosphere must be replaced after each 8 hour work shift A P series filter can be used for more than one 8 hour work shift Refer to NIOSH Guide to the Selection and Use of Particulate Respirators Certified Under 42CFR84 for additional guidelines on use limitations for filters A WARNING Filters improperly used or improperly assembled to the facepiece could cause leakage which could result in personal injury illness or death 2 Mercury Vapor Cartridges Special or Critical User s Instructions The mercury vapor cartridges incorporate passive end of service life indicators ESLIs Each ESLI yellow in color when new turns to gray when exposed to mercury vapor Do not use these cartridges unless you can distinguish between the safe and discard colors of the ESLI The indicators must be visible when wearing the respirator without having to manipulate either the face piece or the indicator If the indicator cannot be seen do not wear the respirator The cartridges must be replaced when the ESLIs change color from yellow to gray when the ESLIs become dirty or damaged after 30 days of use or if removed from their original packaging and not used within 30 days Never enter or remain in a hazardous atmosphere if one or more of the ESLIs is gray 3 Cartridge Filter Installation a Ensure that you have the correct cartridge and or filter ty
11. hazards to which the employee is exposed e Proper respirator use under the workplace conditions the employee encounters and e Proper respirator maintenance B RECORD KEEPING The WCSD Health amp Safety Department will retain written information regarding medical evaluations fit testing and the respiratory program This information will facilitate employee involvement in the respiratory program assist the employer in auditing the adequacy of the program and provide a record for compliance determinations by OSHA Wappingers Central School District REVISED on Mav 14 2012 GLOSSARY This glossary provides common definitions to assist Supervisors in the selection of the proper respirator Definitions AEROSOL A system consisting of particles solid or liquid CONTAMINANT A harmful irritating or nuisance material that is foreign to the normal atmosphere DUST Solid particles suspended in air generated by handling drilling crushing grinding rapid impact detonation or decrepitation of organic or inorganic materials such as rock ore metal coal wood grain etc FOG A mist of sufficient concentration to perceptibly obscure vision FUME Solid particles suspended in air generated by condensation from gaseous state generally after volatilization from molten metals etc and often accompanied by a chemical reaction such as oxidation GAS A normally formless fluid which can be changed to the liquid or solid state by the effect
12. high blood pressure e chest tightness e any heart or chest pain J e heartbeat irregularity Have you begun taking any medication for problems with breathing heart blood pressure or seizures e Have you begun smoking tobacco since your last respirator evaluation e When you ve used a respirator have you experienced any eye irritation skin allergies or rashes anxiety general weakness fatigue or any other problem YES I have experience one or more of the above listed signs or symptoms or would like to speak to or be evaluated by a healthcare provider before again wearing a respirator 4 NO SYMPTOMS have carefully read the above and attest that have not experienced any of the listed signs or symptoms or any other symptom that may interfere with respirator use Print Name Signature Date Please return this completed form to Employer Representative P OSHA RESPIRATOR Annual Questions doc THIS PAGE INTENTIONALLY BLANK APPENDIX B2 The WorkPlace Occupational Health Program of Saint Francis Hospital and Health Centers T 845 431 8740 1910 134 Appendix C OSHA Respirator N 95 Medical Evaluation Questionnaire Mandator To the employee Can you read Yes LJ No Employer Organization Your employer must allow you to answer this questionnaire during normal working hours or at a time and place that is convenient to you To maintain your confidentiality your employer or supervisor
13. individual compounds of the mixture have similar breakthrough times i e within one order of magnitude In this case OSHA recommends adding the concentrations of all the components of the mixture to de termine a total concentration then determine the mixture service life by applying the total concentration to the component with the short est service life The second is where the individual compounds have breakthrough times that vary by 2 orders of magnitude or greater In this case OSHA recommends the mixture service life be based on the contaminant with the shortest breakthrough time The OSHA rule of thumb methods may not be applicable for all mixtures In some cases the actual mixture service life may be much lower than the one calcu lated For this reason SPERIAN recommends that the cartridge ser vice life for mixtures be determined using experimental methods If you are unsure how to determine the cartridge service life for mixtures please contact SPERIAN Failure to comply with this warning may result in personal injury ill ness or death The gas vapor service life depends on the user s breathing rate the characteristics of the contaminant and environmental conditions such as temperature and humidity Saturated cartridges will leak trace amounts of contaminants to the wearer which may be detected by odor taste and or irritation Replace the cartridges when the end of service life indicator if so equipped has
14. must not look at or review your answers and your employer must tell you how to deliver or send this questionnaire to the health care professional who will review it Part A Section 1 Mandatory The following information must be provided by every employee who has been selected to use any type of respirator please print 1 Today s date 2 Your Name Last First M I 3 Your Address Street City Town State Zip 4 Date of Birth mm dd yyyy 5 Your age to nearest year 6 Sex circle one Male Female 7 Your height ft in 8 Your weight Ts 9 Your job title at the above named organization 10 A phone number where you can be reached by the health care professional who reviews this questionnaire include the Area Code 11 The best time to phone you at this number QI Yes QI No 12 Has your employer told you how to contact the health care professional who will review this questionnaire 13 Check the type of respirator you will use you can check more than one category LJ a 111 N R or P disposable respirator N 95 particulate filter mask non cartridge type only LJ b 111 Other type for example half or full facepiece type powered air purifying supplied air self contained breathing apparatus QI Yes QI No 14 Have you worn a respirator circle one If yes what type s 1 S FORMS FIRE OSHARESP DOC Rev 06 10 PART A Section 2 please use the space on the right of the questions to
15. of increased pressure or decreased temperature or both HAZARDOUS Any atmosphere either immediately or not immediately dangerous to life or health which is oxygen ATMOSPHERE deficient or contains a toxic or disease producing contaminant MIST Liquid droplets suspended in air generated by condensation from the gaseous to liquid state or by breaking up a liquid into a dispersed state such as by splashing foaming or atomizing ORGANIC VAPOR Any chemical containing as an element of its composition a carbon atom Examples are hydrocarbons such as oils epoxies many cleaning solvents fuels paints lacquers and enamels 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 referred to as an aerosol VAPOR The gaseous form of a substance which is normally in the solid or liquid state 10 Wappingers Central School District THIS PAGE MEANT TO BE BLANK EL Wappingers Central School District APPENDIX A REQUIRED TRAINING GUIDE FOR RESPIRATOR USERS The Supervisor the person issuing respirators and respirator wearers shall be given adequate training by a qualified person s to ensure the proper use of respirators Written records shall be kept in each department of the names of the persons trained and the dates when training occurred I 2 3 Supervisors shall be given adequate training to ensure the proper use
16. of regulators and valves consult manufacturer s recommendations Correct operation of air purifying elements and carbon monoxide or high temperature alarms Self contained Breathing Apparatus SCBA Consult manufacturer s literature D RESPIRATOR STORAGE 1 Proper storage is very important Respirators must be protected from dust sunlight heat extreme cold excessive moisture and damaging or contamination chemicals When not in use place the respirator in a clean dry convenient sanitary location 2 Inspect respirators stored for emergency use for damage and function monthly minimum Wappingers Central School District REVISED on Mav 14 2012 E FIT EVALUATION PRIOR TO USE 1 Employees are expected to perform seal checks prior to using a respirator These seal checks are referred to as the positive and negative pressure checks During seal checks the respirator straps must be properly located in accordance with the manufacturer s direction and must be as comfortable as possible Over tightening the straps will sometimes reduce facepiece leakage but the wearer may be unable to tolerate the respirator for any length of time The facepiece should not press into the face and shut off blood circulation or cause major discomfort 2 Inspect the respirator visually for damage malfunction and cleanliness prior to performing the negative pressure check and positive pressure check The procedures for these checks are described Ap
17. of respirators A person assigned the task of issuing respirators shall be given adequate training to ensure that the correct respirator is issued for each application To ensure the proper and safe use of a respirator the minimum training of each respirator wearer shall include the following elements a The reasons for the need of respiratory protection b The nature extent and effects of respiratory hazards to which the person may be exposed c An explanation of why engineering controls are not being applied or are inadequate and of what effort is being made to reduce or eliminate the need for respirators d An explanation of why a particular type of respirator has been selected for a specific respiratory hazard e An explanation of the operation capabilities and limitations of the respirator selected f Instruction in inspecting donning checking the fit of and wearing the respirator g An opportunity for each respirator wearer to handle the respirator learn how to don and wear it properly check its seals wear it in a safe atmosphere and wear it in a test atmosphere h An explanation of how to maintain and store respirators i Instruction in how to recognize and cope with emergency situations j Instruction as needed for special respirator use k Regulations concerning respirator use 4 Wearing instructions and training including practice demonstrations shall be given to each respirator wearer 5
18. personal injury illness or death if not carefully followed CAUTION Maintenance or operating procedures and techniques that may result in dam age to equipment and or minor to moderate personal injury if not carefully followed NOTE Maintenance or operating procedures and techniques or information considered important enough to emphasize A WARNINGS AND LIMITATIONS e The employer is responsible for establishing that this respirator is suitable for the user s application e SPERIAN cannot predict what will happen to this respirator in every potential environment Materials can be chemically attacked if ex posed to the wrong environment and may exhibit excessive corro sion or other forms of damage Permeation or penetration of gases liquids or particles through the materials could be excessive Ex tremes of temperature might cause thermal degradation Each of these things or a combination of them could create conditions in which this SPERIAN respirator would be dangerous to use Before entering a hazardous environment while wearing this respira tor you must conduct safe scientific tests to determine if the envi ronment could render the equipment unsafe Results of this testing should be well documented Seek the help of a certified safety profes sional or industrial hygienist DO NOT USE this equipment if the user would be endangered in any way through environmentally induced degradation of the materials in the appara
19. smell contaminants or if your eyes nose or throat become irritated b Breathing becomes difficult c The air you are breathing becomes uncomfortably warm d You feel nauseous or dizzy e The facepiece moves slips or leaks e This respirator does not protect exposed areas of the body Some contaminants can be absorbed directly through the skin while others may irritate exposed areas e This respirator does not supply oxygen and must not be used in at mospheres containing less than 19 5 oxygen by volume e This respirator must be used in conjunction with a written respirator program meeting the requirements of the OSHA Standard for Respi ratory Protection 29 CFR 1910 134 available from the U S Depart ment of Labor Occupational Safety and Health Administration The program must include procedures for evaluating air contaminants and selecting appropriate respirators procedures for proper use of respirators procedures for testing the facepiece to face fit of respira tors procedures for cleaning disinfecting inspecting maintaining and storing respirators procedures for determining if workers are physically and medically capable of wearing respirators and proce dures for training employees in the use and care of respirators and in recognizing the hazards associated with contaminants in the work place e Do not wear this respirator if a satisfactory facepiece to face fit as de termined by a qualitative or quantitative fi
20. 0 deg F maximum water with a mild detergent or with a cleaner recommended by the manufacturer A stiff bristle not wire brush may be used to facilitate the removal of dirt C Rinse components thoroughly in clean warm 43 deg C 110 deg F maximum preferably running water Drain D When the cleaner used does not contain a disinfecting agent respirator components should be immersed for two minutes in one of the following 1 Hypochlorite solution 50 ppm of chlorine made by adding approximately one milliliter of laundry bleach to one liter of water at 43 deg C 110 deg F or 2 Aqueous solution of iodine 50 ppm iodine made by adding approximately 0 8 milliliters of tincture of iodine 6 8 grams ammonium and or potassium iodide 100 cc of 45 alcohol to one liter of water at 43 deg C 110 deg F or 3 Other commercially available cleansers of equivalent disinfectant quality when used as directed if their use is recommended or approved by the respirator manufacturer E Rinse components thoroughly in clean warm 43 deg C 110 deg F maximum preferably running water Drain The importance of thorough rinsing cannot be overemphasized Detergents or disinfectants that dry on facepieces may result in dermatitis In addition some disinfectants may cause deterioration of rubber or corrosion of metal parts if not completely removed F Components should be hand dried with a clean lint free cloth or air dried G Reassemble f
21. 1910 134 e 7 Additional medical evaluations At a minimum the employer shall provide additional medical evaluations that comply with the requirements of this section if An employee reports medical signs or symptoms that are related to ability to use a respirator A PLHCP supervisor or the respirator program administrator informs the employer that an employee needs to be reevaluated Information from the respiratory protection program including observations made during fit testing and program evaluation indicates a need for employee reevaluation or A change occurs in workplace conditions e g physical work effort protective clothing temperature that may result in a substantial increase in the physiological burden placed on an employee IV FITTING OF RESPIRATORS A Proper fitting of respirators is essential and required in order to provide protection for the employee Prior to being issued and or wearing a negative pressure respirator the employee shall be individually fitted for size comfort and special conditions eyeglasses facial scars welding applications etc at The WorkPlace in Poughkeepsie NY If employee has previously been fitted and issued a respirator by a district representatives said employee must bring the issued respirator to annual fit test appointment B Fit testing can be arranged through the Health and Safety office E There are two ways of fit testing qualitative pass fail and quantitative mea
22. 44 Respiratory Protection Employees who wear respirators are required to read and understand this Respiratory Protection Program The program outlines the responsibilities of both the District and those employees required to wear respiratory protection to perform their work safely To ensure the availability of this written Respiratory Program copies shall be distributed as follows ii All Supervisors who have personnel required to use respiratory protection in the course of their employment Employees using respiratory protection during training and as requested Representatives of the Health amp Safety committee In main office of each school and the transportations offices Upon request X XX X POLICY amp PROCEDURES I ADMINISTRATION The Director of the Health amp Safety department shall administer the Respiratory Protection Program Questions regarding elements of this program and employee protection shall be directed to the Health amp Safety office located in the Facilities amp Operations office at the RCK Annex 99 Meyers Corners Rd Wappingers Falls NY 12590 II EMPLOYEE TRAINING PROGRAM A Per OSHA CR 1910 134 K 1 Each employee designated by the District to wear a respirator must receive initial training and annual refresher training Training sessions will be provided by a competent person to ensure that employees understand the limitations use and maintenance of respiratory equipment See Appendix A for
23. HAZMAT team QI Yes U No 9 Other than medications for breathing and lung problems heart trouble blood pressure and seizures mentioned earlier in this questionnaire are you taking any other medications for any reason including over the counter medications If yes name the medications if you know them 10 Will you be using any of the following items with your respirator s QI Yes LINo a HEPA Filters QI Yes U No b Canisters for example gas masks QI Yes LINo c Cartridges 11 How often are you expected to use the respirator s check yes or no for all answers that apply to you QI Yes U No a Escape only no rescue U Yes U No b Emergency rescue only QI Yes U No c Less than 5 hours per week QI Yes U No d Less than 2 hours per day QI Yes U No e 2 to 4 hours per day QI Yes U No f Over 4 hours per day 12 During the period you are using the respirator s is your work effort QI Yes LINo a Light less than 200 kcal per hour If yes how long does this period last during the average shift hrs mins Examples of a light work effort are sitting while writing typing drafting or performing light assembly work or standing while operating a drill press 1B3 Ibs or controlling machines CI Yes LI No b Moderate 200 to 350 kcal per hour If yes how long does this period last during the average shift hrs mins Examples of moderate work effort are sitting while nailing or filing driving a tru
24. SY ets Central Schoo N IS gr Wappingers Central School District REVISED an Mav 14 2012 RESPIRATORY PROTECTION PLAN TABLE OF CONTENTS Purpose of the Program Policy amp Procedures I Administration II Employee Training Program MI Medical Evaluations IV Fitting of Respirators V Selection and Use of Respiratory Protection Equipment VI Availability VII Employee Responsibilties A General B Cleaning and Disinfecting Respirators C Routine Inspection of Respirators D Respirator Storage E Fit Evaluation prior to use VIII Respirator Program Evaluation and Record Keeping GLOSSARY Appendix A Required Training Guide for Respirator Users Appendix B Annual Respirator Wearer Health Survey Appendix B2 OSHA Respirator N 95 Medical Evaluation Questionaire Appendix C Sperian Premier Plus Manufacturer Brochure Appendix D Sperian Premier Plus Donning amp Care Instructions Appendix E OSHA Respirator Cleaning Procedure Appendix F OSHA User Seal Check Procedures Appendix H Employee Acknowledge of Respiratory Protection Program Wappingers Central School District REVISED on Mav 14 2012 Wappingers Central School District RESPIRATORY PROTECTION PROGRAM PURPOSE OF THE PROGRAM The purpose of this written respiratory program is to define the Wappingers Central School District s policy and procedures regarding the use of respirators and to comply with the General Industry Safety Orders Title 8 Section 51
25. acepiece replacing filters cartridges and canisters where necessary H Test the respirator to ensure that all components work properly 63 FR 1152 Jan 8 1998 e Next Standard 1910 134 App C e Regulations Standards 29 CFR Table of Contents Freedom of Information Act Privacy amp Security Statement Disclaimers Customer Surve Important Web Site Notices International Contact Us http www osha gov pls oshaweb owadisp show document p 1d 9782 amp p table STANDARDS 5 16 2012 10 57 09 AM THIS PAGE INTENTIONALLY BLANK User Seal Check Procedures Mandatory 1910 134 App B 1 APPENDIX F N UNITED STATES EE DEPARTMENT OF LABOR nat A to Z Index En Espanol Contact Us FAQs About OSHA OSHA Me El ES newsletter RSS Feeds Print This Page PY EJ text size Occupational Safety amp Health Administration We Can Help What s New Offices Home Workers Regulations Enforcement Data amp Statistics Training Publications Newsroom Small Business OSHA e Regulations Standards 29 CFR Table of Contents e Part Number 1910 e Part Title Occupational Safety and Health Standards e Subpart e Subpart Title Personal Protective Equipment e Standard Number 1910 134 App B 1 e Title User Seal Check Procedures Mandatory Appendix B 1 to 8 1910 134 User Seal Check Procedures Mandatory The individual who uses a tight fitting respirator is to perform a user seal check to ensure th
26. adstraps shall be checked for Breaks or tears Loss of elasticity Broken or malfunctioning buckles or attachments Excessively worn serrations of the head harness which might allow the facepiece to Slip Inhalation Valve and Exhalation Valve shall be checked for Detergent residue dust particles or dirt on valve seat Cracks tears or distortion in the valve material or valve seat Missing or defective valve cover Filter elements shall be checked for Proper filter for hazard Approval designation TC ID Missing or worn gaskets Worn threads Cracks or dents in filter housing Power Air Purifying Respirators Check facepiece headstraps valve and breathing tube as for regular air purifying respirators Hood or helmet if applicable check for Wappingers Central School District REVISED on Mav 14 2012 3 4 Headgear suspension adjust properly for wearing Cracks or breaks in faceshield replace faceshield Supplied Air Respirators Facepiece Headstrap and Valves shall be checked as specified above In addition the following checks shall be performed Breathing tube shall be checked for Cracks Missing or loose hose clamps Broken or missing connectors Hood helmet or suit shall be checked for Headgear suspension Cracks or breaks in faceshield Rips or torn seams Air supply system shall be checked for Breaks or kinks in air supply hoses and end fitting attachments Tightness of connections Proper setting
27. at an adequate seal is achieved each time the respirator is put on Either the positive and negative pressure checks listed in this appendix or the respirator manufacturer s recommended user seal check method shall be used User seal checks are not substitutes for qualitative or quantitative fit tests I Facepiece Positive and or Negative Pressure Checks A Positive pressure check Close off the exhalation valve and exhale gently into the facepiece The face fit is considered satisfactory if a slight positive pressure can be built up inside the facepiece without any evidence of outward leakage of air at the seal For most respirators this method of leak testing requires the wearer to first remove the exhalation valve cover before closing off the exhalation valve and then carefully replacing it after the test B Negative pressure check Close off the inlet opening of the canister or cartridge s by covering with the palm of the hand s or by replacing the filter seal s inhale gently so that the facepiece collapses slightly and hold the breath for ten seconds The design of the inlet opening of some cartridges cannot be effectively covered with the palm of the hand The test can be performed by covering the inlet opening of the cartridge with a thin latex or nitrile glove If the facepiece remains in its slightly collapsed condition and no inward leakage of air Is detected the tightness of the respirator is considered satisfactory II Manufacture
28. ate adjustments at the straps as they exit the top slots on the yoke Gently pull the free ends to make final adjustments Do not overtighten the respirator to your face D DONNING INSTRUCTIONS FOR THE SPERIAN PREMIER HALF MASK a Make sure the lower headbands are adjusted at the yoke See inset 1 Remove protective eyewear and place the respirator under the chin and over the nose The narrow part of the face piece should be located over the nose Pull the crown strap over the head and adjust its placement until it is comfortable See inset 2 The crown strap is adjust able in length for ease of fit 3 Using both hands hook the lower headband straps together behind the neck Adjust the headbands by pulling sideways away from the hook and loop See inset 3 DO NOT adjust at the facepiece yoke 4 Adjust the upper headbands by pulling then downwards from 5 the crownstraps DO NOT adjust the headbands or tension at the yoke Continue adjusting the headbands until a comfort able fit has been obtained DO NOT overtighten the respira tor to the face See inset 4 5 Excess lengths of upper straps may be secured out of the way by using the clips molded into the crownstraps Use of these tabs also helps to reduce the possibility of headband slippage See Inset 5 WARNING If the respirator does not fit you correctly you may not receive adequate pro tection Each time you use a respirator you must check for proper fi
29. ccurs readjust the face b piece and headstraps then retest If filter retainers are used do not remove them after the fit check is completed Remov ing the filter retainers may shift the facepiece and break the facepiece to face seal G HOW TO USE THE RESPIRATOR To receive the maximum protection available from your respirator you must read understand and follow all the Warnings limitations and instructions contained in this manual and follow your employer s instructions on the use and maintenance of the respirator Read and understand the following warnings prior to using the respirator A WARNING Never remove the respirator for any reason while you are in the work area You must leave the work area immediately if the facepiece to face seal is disturbed for any reason such as Slipping due to excessive sweating or excessive head movement The facepiece becomes dislodged as a result of being knocked You sneeze or cough while wearing the facepiece You need to blow your nose scratch covered areas of your face or need to adjust your spectacles kit e For any other reason that would cause the facepiece seal to be disturbed You must restore the facepiece to face seal and perform a fit check in a non hazardous environment before reentering the work area The failure to comply with this warning may result in personal injury illness or death H CARTRIDGE SERVICE LIFE AND REPLACEMENT A WARNING e OSHA
30. changed color or in accordance with an OSHA compliant cartridge change out schedule that is based on objective informa tion or data that ensures that cartridges are changed before the end of their service life Replace the cartridges earlier if you detect the contaminant by smell taste or irritation or if either cartridge shows any signs of damage SPERIAN recommends cartridges be replaced daily even if the end of service life indicator has not changed color or the change out schedule is determined to be greater than 1 day Always replace cartridges in pairs Replace cartridges as follows 1 Return to fresh air 12 2 Remove cartridges by turning counterclockwise Dispose of used cartridges in accordance with Federal state and local guidelines 3 Install new cartridges taken only from sealed packages as described in section A 4 Perform a facepiece fit check as described in section F I PARTICULATE FILTER SERVICE LIFE AND REPLACEMENT The filter service life depends on the filter series type used the user s breathing rate the characteristics of the contaminant and environmental conditions such as humid ity All N and R series filters should be replaced whenever they are damaged soiled contaminated with water or causing increased breathing resistance such that the res pirator becomes uncomfortable to wear In addition when an R series filter is used in an oil containing atmosphere the filter must be replaced after each 8 h
31. cidents and inhalation and exhalation valves and twin seals are specifi cally excluded from this warranty LIMITATION OF LIABILITY No other oral warranties representations or guarantees of any kind have been made by SPERIAN its distributors or the agents of either of them that in any way alter the terms of this warranty EXCEPT AS HEREIN PRO VIDED SPERIAN SHALL HAVE NO LIABILITY FOR ANY LOSS OR DAMAGE WHETHER DIRECT INDIRECT INCIDENTAL OR CONSEQUENTIAL TO ANY PURCHASER OR USER OF THIS PRODUCT ARISING FROM THE SALE USE OR OPERATION OF THIS PRODUCT A WARNING The failure to use and maintain this equipment in strict conformance with the applicable instruction manual may result in personal injury ill ness or death The equipment s use in any manner that is not expressly authorized pursuant to the applicable instruction manual may result in severe adverse impacts to human health 22 Figure 1 SURVIVIAR Valuair Plus Facepiece T Series Figure 2 SURVIVIAR Premier Facepiece T Series Figure 3 SURVIVIAR Premier Plus Facepiece T Series 25 www sperianprotection com O S PE RI A N THIS PAGE INTENTIONALLY BLANK Respirator Cleaning Procedures Mandatory 1910 134 App B 2 APPENDIX E y UNITED STATES si SEARCH DEPARTMENT OF LABOR A to Z Index En Espanol Contact Us FAQs About OSHA OSHA BR Sea ETE newsletter EJ rss Feeds Ej Print This Page ES Text Size Occupational Safet
32. ck or bus in urban traffic standing while drilling nailing performing assembly work or transferring a moderate load about 35 Ibs at trunk level walking on a level surface about 2 mph or down a 5 degree grade about 3 mph or pushing a wheelbarrow with a heavy load about 100 Ibs on a level surface QI Yes U No c Heavy above 350 kcal per hour If yes how long does this period last during the average shift hrs ins Examples of heavy work are lifting a heavy load about 50 Ibs from the floor to your waist or shoulder working on a loading dock shoveling standing while bricklaying or chipping castings walking up an 8 degree grade about 2 mph climbing stairs with a heavy load about 50 Ibs QI Yes U No 13 Will you be wearing protective clothing and or equipment other than the respirator when you are using your respirator If yes describe this protective clothing and or equipment 5 S FORMS FIRE OSHARESP DOC Rev 07 05 QI Yes LINo 14 Will you be working under hot conditions temperature exceeding 77 F UU Yes U No 15 Will you be working under humid conditions 16 Describe the work you will be doing while you are using your respirator s 17 Describe any special or hazardous conditions you might encounter when you are using your respirator s For example confined spaces any hazardous gases pesticides etc 18 Provide the following information if you know it for each toxic substance that you ll be
33. e Small Facepiece Medium Facepiece Large Inhalation Valve Cartridge Filter Connector 17 Facepiece Assembly Listing PART NO ITEM NO DESCRIPTION Exhalation Valve Assembly Consists of Exhalation Valve Seat 6 Exhalation Valve Suspension Assembly Listing 8 Suspension Assembly Consists of Do fe SCS Associated Replacement Parts PART NO ITEM NO DESCRIPTION RP21 Filter Base RP22R Filter Retainer Fit Check Cover Premier Mask T Series Parts Assembly Listing See Figure 2 on page 24 Facepiece Part Listing PART NO ITEM NO DESCRIPTION RP1S Facepiece Small RP2ZS Facepiece Medium RP3S Facepiece Large RP17 Inhalation Valve RP16 Cartridge Filter Connector Facepiece Assembly Listing PART NO ITEM NO DESCRIPTION RP10 Exhalation Valve Assembly Consists of RP12 Exhalation Valve Seat RP11 Exhalation Valve RP13 18 Suspension Assembly Listing PART NO ITEM NO DESCRIPTION Es Suspension Assembly Consists of 10 E Re 13 Loop for Neck Strap Associated Replacement Parts PART NO ITEMNO DESCRIPTION RP21 FilterBase RP22R FilterRetainer FitCheck Cover Premier Plus Mask T Series Parts Assembly Listing See Figure 3 on page 25 Ress 9 we ____ Facepiece Part Listing 4 fracpiece Smal SSCS TT Facepiece Mecum Facepiece Assembly Listing PART NO ITEM NO DESCRIPTION FS 6 Exhalation Valve Assembly Consists of
34. epiece fit check as described in section F J INSPECTION Inspect this respirator as described below for defects before and after each use and at least monthly if not used Repair as necessary clean and disinfect after each use and store properly to assure that the respirator is maintained in satisfactory working condition Keep a record of inspection and repair dates and results 13 A WARNING e Do not use the respirator with damaged or improperly operating valves e The failure to comply with this warning may result in personal injury illness or death 1 Inspect the facepiece skirt for cuts gouges punctures tears nicks and deterio ration from age heat or contamination and the face seal area for distortion 2 Inspect the headbands for abrasions cuts nicks loss of elasticity or deteriora tion from age heat or contamination 3 Inspect the inhalation and exhalation valves for nicks cracks tears or creases and the exhalation valve seat for nicks cracks or dents 4 Check the exhalation valve for proper operation by exhaling through the respira tor and pausing before inhaling The exhalation valve must close by itself before inhaling Replace valves which fail to close K MAINTENANCE Respirators should be cleaned after each day s use by washing with mild soap and warm water Then disinfect the respirators with a suitable sanitizing solution OSHA 1910 134 latest edition and ANSI Z88 2 latest editi
35. he cartridge connector NOTE 1 8 of a turn will seat and unseat the cartridge 3 Place the appropriate pad filter into the filter retainer P N RP22R with the printed side facing the facepiece Run your finger around the inside edge of the retainer to ensure the filter is seated correctly on the sealing ledge of the retainer 4 Prior to assembling of the RP22R filter retainer depress the filter base s re tainer extractor tab toward the bayonet connector Place the retainer with the filter installed over the filter base and push it all the way down until it snaps firmly into place all along its perimeter Make sure the retainer is pushed all the way down over the base The translucent retainer will allow you to deter mine that the filter base is completely covered by the filter when the assembly is examined from the top and sides of the retainer 5 To replace filters grip the retainer extractor tab and press upward against the wall of the RP22R filter retainer until fully assembled Remove the used filter and dispose of it properly Install a new filter as explained in step c 3 d Chemical Cartridge and Pad Filter Replacement 1 Install the chemical cartridges as described in step b 2 Install the filter into the filter retainer as described in step c 3 3 Snap the retainer with the filter installed over the chemical cartridge Push down until the retainer snaps firmly into place Make sure the retainer is pushed a
36. ing a severe reaction Do not use this respirator un til you obtain clearance from a medical doctor e Do not alter or modify any respiratory product e If this respirator will be used during welding it is the user s responsibility to obtain the proper equipment for protection against sparks optical radiation and impact This respirator will not protect you against these hazards A WARNING Continued e The respirator facepiece assembly contains natural rubber latex which may cause allergic reactions in some individuals Discontinue use if you experience an allergic reaction e Discontinue use if you experience skin irritation or discoloration e This product may provide less than adequate protection if improperly used which may result in personal injury illness or death e For use by trained qualified personnel only e Routinely used respirators must be inspected before and after each use Stored emergency respirators must be inspected after each use and at least once every 30 days A written record must be kept of inspections of emergency respirators e FAILURE TO OBSERVE ALL WARNINGS MAY RESULT IN PERSONAL INJURY ILLNESS OR DEATH e Users must clean and maintain this respirator only in accordance with SPERIAN s instructions WARNING Following is a partial list of materials for which these respirators MUST NOT be used This list is far from complete Contact SPERIAN for infor mation on other material Failure to compl
37. it and protection factor provided This determination will be made by The WorkPlace based on the employees answers on the OSHA 1910 134 App C Respirator N 95 Medical Evaluation Questionaire see Appendix B2 medical evaluation and fit test Individually owned respirators are prohibited Questions regarding the type of respirator to use for a specific operation shall be directed to the Health amp Safety office Respirator users shall not be allowed to wear contact lenses if the risk of eye damage is increased by their use If a spectacle goggle face shield or welding helmet must be worn with a facepiece it shall be worn so as not to adversely affect the seal of the facepiece to the face AVAILABILITY Each employee who needs or is required to wear a respirator will be issued one Consideration will be given to standardizing the brand of respirators utilized Utilizing different parts cartridges filters valves etc of other makes of respirators voids the certification by the manufacturer A supply of parts will be available to respirator wearers for replacement and repair Wappingers Central School District REVISED on Mav 14 2012 Vil EMPLOYEE RESPONSIBILITIES A GENERAL Employees are expected to properly use respiratory protection when and as required clean and disinfect the units change filters as required inspect units for damage or malfunction check the fit via positive and negative pressure tests prior to use and p
38. ll the way onto the cartridge B HOW TO DON THE RESPIRATOR A WARNING Always read cartridge labels prior to use to be certain that you have car tridges and or filters that will provide the required protection Filters la beled for protection against particulates only shall not be used for gases vapors and cartridges labeled for protection against gases vapors WARNING Continued only shall not be used for particulates Both cartridges filters must be of the same type Failure to comply with this warning may result in per sonal injury illness or death NOTE Inspect the respirator before donning as described in section J 1 2a C DONNING INSTRUCTIONS FOR THE VALUAIR PLUS HALF MASK 1 Loosen the elastic band without completely pulling the band out of the slots in the crown suspension See inset 1 2 Pull gently on the lower neck strap creating a large loop and pull it over the head See insets 2a and 2b 3 Place the respirator to the face covering the mouth and nose The narrow part of the facepiece should be over the nose Pull the crown suspension over the head and adjust its placement until it is comfortable See inset 3 4 Using both hands grasp the free ends of the elastic band and gently pull the elastic straps away from your face until the respirator is snug and seated comfortably Be sure the neckstrap is flat and smooth against the back of the neck To tighten the neckstrap make intermedi
39. low up on any symptoms that could make respirator use dangerous for the user ANNUAL RESPIRATOR WEARER HEALTH SURVEILLANCE Wearing a respirator can place a burden on your heart lungs and other body systems Please carefully read the questions and lists below and check the yes answer on the bottom of this form if youve experienced any of the symptoms listed Return form to your supervisor Please do not give specific answers on this form If you have experienced any of the listed symptoms and check the yes box below you should be evaluated by a healthcare provider before continuing respirator use In the past year or since your last respirator evaluation questionnaire review have you experienced any medical signs or symptoms that are related to ability to use a respirator such as e seizures fits gt e any vision problems e diabetes sugar disease e ear injuries or difficulty hearing e claustrophobia fear of closed in places e musculoskeletal problems such as e trouble smelling odors weakness in arms hands legs e lung or breathing problems or serious illness e back pain or stiffness e shortness of breath or wheezing e difficulty moving joints neck head e chest lung injuries or surgeries e difficulty climbing stairs e chronic coughing or coughing blood e swelling in your legs or feet e heart attack heart failure e chronic heartburn or indigestion e stroke e broken ribs e
40. n section F L STORAGE After inspection and cleaning store your respirator to protect it against dust sunlight extreme heat and cold excessive moisture or damaging chemicals A WARNING e This SPERIAN respirator does not have a defined storage life Care fully inspect it before each use e The failure to comply with this warning may result in personal injury illness or death 16 CAUTION The maximum storage temperature for this device is 140 F 60 C Long term exposure to elevated storage temperatures could cause premature deterioration M SHIPMENT All products returned to SPERIAN s factory distributors or repair centers must be decontaminated prior to shipment N OVERHAUL FREQUENCY This SPERIAN respirator does not have an overhaul requirement other than that required in section K Maintenance O ADDITIONAL INFORMATION If you need assistance or additional information on any SPERIAN product consult your local distributor or contact SPERIAN 3001 S Susan Street Santa Ana CA 92704 U S A 714 545 0410 or Toll Free 888 APR SCBA FAX 714 850 0299 ALL RETURNED PRODUCTS MUST BE DECONTAMINATED PRIOR TO SHIP MENT PRODUCTS CONTAMINATED WITH DANGEROUS SUBSTANCES WILL BE REFUSED AND RETURNED FREIGHT COLLECT P REPLACEMENT PARTS SPERIAN ValuairPlus Mask T Series Parts Assembly Listing See Figure 1 on page 23 Facepiece Part Listing PART NO ITEM NO DESCRIPTION Facepiec
41. ne half mask respirator is designed with a triple flange design for superior fit comfort and protection Product Numbers Key Features recio Uai ot iiho e Three flanges provides backup sealing security e Silicone facepiece construction is flexible lightweight and durable Overview e Wide wraparound and pleated silicone facepiece fits a large variety of facial types e Strategic lateral placement of inhalation valves and cartridge ports enhances field of vision e Exhalation valve provides quick exhaust of warm exhaled air e Cradle suspension with D ring roller mechanism for easy and secure adjustment e Packaged in a resealable bag to protect the respirator from contamination when not in use e OV N95 S Series and OV R95 T Series cartridges filters available with respirator for quick Literature amp Documents ordering Recommended Industries Use Specifications Training amp Proper Use e Chemical e Construction Additional Information e Fire Protection Technical Support e Government e Law Enforcement e Manufacturing e Medical e Military e Oil and Gas e Pharmaceutical e Utilities Hazards e Airborne Particulates e Biohazard e Chemical e Contamination e Extreme Environment e Gas Vapors Smoke Regulations e NIOSH 42 CFR 84 Historical Brand Survivair Warranty Information Sperian warrants this product to be free of defects in materials and workmanship for 5 years 1 year for plastic parts f
42. ng approximately 0 8 milliliters of tincture of iodine 6 8 grams ammonium and or potassium iodide 100 cc of 45 alcohol to one liter of water at 43 deg C 110 deg F or 3 Other commercially available cleansers of equivalent disinfectant quality when used as directed if their use is recommended or approved by the respirator manufacturer E Rinse components thoroughly in clean warm 43 deg C 110 deg F maximum preferably running water Drain The importance of thorough rinsing cannot be overemphasized Detergents or disinfectants that dry on facepieces may result in dermatitis In addition some disinfectants may cause deterioration of rubber or corrosion of metal parts if not completely removed F Components should be hand dried with a clean lint free cloth or air dried G Reassemble facepiece replacing filters cartridges and canisters where necessary H Test the respirator to ensure that all components work properly Wappingers Central School District REVISED on Mav 14 2012 C ROUTINE INSPECTION OF RESPIRATORS 2 Inspection of the respirator is an important routine task It must be done before and after each use The following items shall be checked at a minimum 1 Air Purifying Respirators half mask and full facepiece Rubber facepieces shall be checked for Excessive dirt Cracks tears or holes Distortion and improper storage Cracked scratched or loose fitting lens Broken or missing mounting clips He
43. on also provide information and guidelines on the cleaning and sanitizing of respirators 1 Cleaning WARNING e Specialized processes are required to disinfect and decontaminate a respirator You must follow the instructions of the manufacturer of the equipment and chemicals e It is the user s responsibility to ensure that the processes chosen pro vide adequate cleaning disinfection and decontamination and do not damage the respirator in any way e In the absence of a commercial sanitizing product the hypochlorite solution described below will eliminate many but not all biohazards e The failure to comply with this warning may result in personal injury illness or death 14 CAUTION Do not use solvent type cleaners to clean any part of the respirator NOTE Silicone and rubber parts of the facepiece may be cleaned between washings with SPERIAN Mask Wipes P N 140096 or 140082 Make a cleaning solution of warm water and a mild detergent Remove the cartridges filters from the facepiece Immerse the facepiece in the cleaning solution Agitate the facepiece and gently clean with a soft brush D Qa 0 Oo Thoroughly rinse the facepiece in fresh water paying particular attention to re moval of all soap residue from the exhalation valve If possible direct running water onto the exhalation valve f Disinfect the facepiece in a warm 120 F or 48 C maximum suitable sanitizing solution such a
44. our work shift All P series filters must be replaced whenever they are damaged soiled contaminated with water or as soon as they are too difficult to breathe through SPERIAN recommends due to considerations of hygiene that all filters be replaced at least daily and more often if necessary Whether used in oil containing or non oil containing atmospheres SPERIAN recommends the filters be replaced daily because the user may be unable to detect small defects in the filter resulting in a loss of filter efficiency and the determination of when breathing resistance becomes too uncom fortable is subjective Filters should also be replaced in accordance with schedules established by regulatory agencies A WARNING Failure to properly assemble filter pads to cartridges or filter holders can cause leakage which could result in personal injury illness or death Replace filters as follows 1 Return to fresh air 2 If using P100 filters remove by turning them counterclockwise Dispose of used filters in accordance with Federal state and local guidelines 3 If using filter pads remove the filter retainers from the cartridges or filter holders Remove the used filter pads and dispose of them in accordance with Federal state and local guidelines Clean the filter retainer and cartridge or holder if necessary 4 Install new P100 filters or filter pads taken only from sealed packages as de scribed in section A 5 Perform a fac
45. pe for the contami nants in your work area If you are not sure consult your supervisor or safety professional See paragraph A 2 for special user s instructions if you are using Mercury Vapor Cartridges b Chemical Cartridge P100 Filter Replacement Align the cartridge down onto the cartridge connec tor see inset and begin to turn the cartridge in a clockwise direction until an increasing amount of resistance is felt Visually inspect the area between the cartridge and the facepiece to ensure that the cartridge is seated correctly Continue turning the cartridge until a click is heard The click indicates a positive installation has been made Do not con tinue to turn the cartridge after the click 6 NOTE 1 8 of a turn will seat and unseat the cartridge c Pad Filters Only Replacement 1 Attach the two 2 filter bases P N RP21 to the facepiece cartridge connec tor To attach align the filter base down onto the connector and turn the base clockwise Visually inspect the sealing area of the base to ensure full engage ment of both components prior to clockwise mounting rotation of the base to the connector Turn the filter base clockwise about 1 8 onto the connector until a click is heard The click indicates a positive installation has been made Do not continue to turn the filter base after the click 2 To remove the RP21 filter base turn it counterclockwise and lift it off t
46. pendix E OSHA 29 134 App B1 User Seal Check Procedures Mandatory If the respirator fails to pass either of these tests it may only be necessary to adjust the straps on the respirator and repeat the checks If subsequent negative or positive pressure checks fail the respirator shall not be used The respirator user shall notify their Supervisor to determine if another size or respirator brand should be issued Vill RESPIRATORY PROTECTION PROGRAM EVALUATION AND RECORD KEEPING A RESPIRATORY PROTECTION PROGRAM EVALUATION The WCSD s Safety Committee shall conduct annual evaluation and review of the written respiratory protection plan The plan administrator and Supervisors will ensure the plan is being properly implemented will consult employees to ensure that they are using the respirators properly and shall conduct evaluations of the workplace as necessary to ensure that the provisions of the current written program are being effectively implemented and that it continues to be effective The Supervisors shall regularly consult employees required to use respirators to assess the employees views on program effectiveness and to identify any problems Any problems that are identified during this assessment shall be corrected Factors to be assessed include but are not limited to e Respirator fit including ability to use the respirator without interfering with effective workplace performance e Appropriate respirator selection for the
47. protection against particulates only shall not be used for gases vapors and cartridges labeled for protection against gases vapors only shall not be used for particulates Both cartridges filters must be of the same type The failure to comply with this warning may lead to personal injury illness or death Never remove the respirator for any reason while you are in the work area e You must leave the work area immediately if the facepiece to face seal is disturbed for any reason such as a Slipping due to excessive sweating or excessive head movement b The facepiece becomes dislodged as a result of being knocked c You sneeze or cough while wearing the facepiece d You need to blow your nose scratch covered areas of your face or need to adjust your spectacles kit e For any other reason that would cause the facepiece seal to be disturbed You must restore the facepiece to face seal and perform a fit check in a non hazardous environment before reentering the work area The failure to comply with this warning may lead to serious personal injury serious illness or death tighten the straps The straps have adjustable clips to secure the free ends down onto the middle of the straps after tightening To release the straps first pull off the free ends held by the clips then push up on the tabs on the buckles with your thumbs and pull the facepiece away from your face Unhook the lower st
48. provide a brief explanation for yes answers for 1 9 QI Yes U No J Do you currently smoke tobacco or have you smoked tobacco in the last month CI Yes CI Yes CI Yes CI Yes U Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes CI Yes LJ Yes CI Yes CI Yes CI Yes CI Yes Healthcare Reviewer comments for yes answers 1 5 CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No CI No 2 Have you ever had any of the following conditions a Seizures fits b Diabetes sugar disease c Allergic reactions that interfere with your breathing d Claustrophobia fear of closed in places e Trouble smelling odors 3 Have you ever had any of the following pulmonary or lung problems a Asbestosis b Asthma c Chronic bronchitis d Emphysema e Pneumonia f Tuberculosis g Silicosis h Pneumothorax collapsed lung i Lung cancer j Broken ribs k Any chest injuries or surgeries I Any other lung problem that you ve been told about 4 Do you currently have any of the following symptoms of pulmonary or lung illness
49. ptoms a Frequent pain or tightness in your chest b Pain or tightness in your chest during physical activity c Pain or tightness in your chest that interferes with your job d In the past two years have you noticed your heart skipping or missing a beat e Heartburn or indigestion that is not related to eating f Any other symptoms that you think may be related to heart or circulation problems 7 Do you currently take medication for any of the following problems a Breathing or lung problems b Heart trouble c Blood pressure d Seizures fits 9 If you ve used a respirator have you ever had any of the following problems If you ve never used a respirator check the box to the left and go to question 9 a Eye irritation b Skin allergies or rashes c Anxiety d General weakness or fatigue e Any other problem that interferes with your use of a respirator 9 Would you like to talk to the health care professional who will review this questionnaire about your answers to this questionnaire Questions 10 to 15 below must be answered by every employee who has been selected to use either a full facepiece 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 U Yes CI Yes CI Yes CI Yes CI Yes U Yes U Yes U Yes U Yes U Yes LI No CI No CI No CI No CI No LI No LJ No LJ
50. r s Recommended User Seal Check Procedures The respirator manufacturer s recommended procedures for performing a user seal check may be used instead of the positive and or negative pressure check procedures provided that the employer demonstrates that the manufacturer s procedures are equally effective 63 FR 1152 Jan 8 1998 Next Standard 1910 134 App B 2 e Regulations Standards 29 CFR Table of Contents Freedom of Information Act Privacy amp Security Statement Disclaimers Customer Survey Important Web Site Notices International Contact Us http www osha gov pls oshaweb owadisp show document p table STANDARDS amp p id 9781 5 16 2012 11 13 33 AM APPENDIX H Wappingers Central School District Employee Acknowledge re RESPIRATORY PROTECTION PROGRAM l am in receipt of WCSD Respiratory Protection Plan and have read said plan am also in receipt of one Sperian Premium Plus Half Mask Air Purifying Respirator and 1 refill P100 Particulate filter cartridge as recommend by The WorkPlace through medical evaluation and or fit testing Additionally have received the Respiratory Protection and Safety training and copies of OSHA regulations titled Respirator Cleaning Procedures 29 CFR 1910 134 App B 1 and User Seal Procedures 29 CFR 1910 134 App B 2 understand that it is my sole responsibility to properly clean and maintain my PPE personal protective equipment Signature Date
51. raps and remove the respirator Perform a fit check before using the respirator For more information or assistance on Sperian Respiratory products contact your local Sperian distributor or Sperian Respiratory Protection www sperianprotection com Sperian Respiratory Protection USA LLC 3001 South Susan Street Santa Ana CA 92704 1 800 821 7236 www survivair com INSTRUCTION MANUAL SPERIAN AIR PURIFYING RESPIRATOR SURVIVAIR VALUAIR PLUS SURVIVAIR PREMIER AND SURVIVAIR PREMIER PLUS HALF MASK FACEPIECES With T Series Connectors A WARNING DO NOT USE this respirator until you completely read and un derstand this instruction manual You are required to inspect the respirator prior to putting it into field service Please refer to the inspection procedures in this manual Failure to com ply with this warning may result in personal injury illness or death NIOSH Approved See Separate Approval Label AN ISO 9001 SPERIAN REGISTERED SPERIAN Respiratory Protection USA LLC COMPANY 3001 South Susan St Santa Ana CA 92704 Copyright July 2008 All Rights Reserved Toll Free 888 APR SCBA or 714 545 0410 SPERIAN Respiratory Protection USA LLC Fax 714 850 0299 P N 54140934 Rev E 03 09 www sperianprotection com SAFETY PRECAUTIONS The Warnings Cautions and Notes contained in this manual have the following significance A WARNING Maintenance or operating procedures and techniques that may result in
52. rom the date of purchase See user manual for all and complete details http www honeywellsafety com Products Sperian Respiratory Protection Survivair Premier Plus NIOSH aspx site americas 5 16 2012 1 01 27 PM THIS PAGE INTENTIONALLY BLANK APPENDIX D 27 PAGES SPERIAN Protection you can trust Survivair Premier Plus How to Don and Fit Check Your Sperian Half Mask Respirator How to Don the Respirator With cartridges or filters attached fit facepiece on the bridge of the nose and swing the bottom of the facepiece Bring the upper straps with Pull the free ends of the lower Adjust the straps just tight the cradle over the crown of straps until the lower strap is enough to prevent any air the head above the ears and secure leaks around the facepiece pull the free ends of the straps It is not necessary to over Bring the lower straps of the headband around the nape of the neck and attach the hook and ring together into contact with the chin Fit Check Instructions behind the head equally on each side until a comfortable and secure fit is obtained You must perform the following fit check each time the respirator is worn or before entering the contaminated area A POSITIVE FIT CHECK Hold the palm of your hand gently over the exhalation valve outlet See photo A below DO NOT distort the natural shape of the facepiece Exhale gently and hold your breath to create and main
53. rovide sanitary storage Employees shall be completely familiar with the manufacturer s written instructions see Appendix D B CLEANING AND DISINFECTING RESPIRATORS Whenever possible a respirator will be reserved for the exclusive use of a single individual Following each use the respirator must be cleaned and disinfected according to the manufacturer s written directions Appendix D or the directions listed below per OSHA standard 29 CFR 1910 134 App B 2 see Appendix E Procedures for Cleaning Respirators A Remove filters cartridges or canisters Disassemble facepieces by removing speaking diaphragms demand and pressure demand valve assemblies hoses or any components recommended by the manufacturer Discard or repair any defective parts B Wash components in warm 43 deg C 110 deg F maximum water with a mild detergent or with a cleaner recommended by the manufacturer A stiff bristle not wire brush may be used to facilitate the removal of dirt C Rinse components thoroughly in clean warm 43 deg C 110 deg F maximum preferably running water Drain D When the cleaner used does not contain a disinfecting agent respirator components should be immersed for two minutes in one of the following 1 Hypochlorite solution 50 ppm of chlorine made by adding approximately one milliliter of laundry bleach to one liter of water at 43 deg C 110 deg F or 2 Aqueous solution of iodine 50 ppm iodine made by addi
54. s a hypochlorite solution for 2 to 3 minutes A 50 ppm hypochlo rite solution can be made by mixing 0 13 ounce of laundry bleach per each gallon of water Rinse thoroughly with fresh warm 120 F or 48 C maximum water g Allow the facepiece to drip dry or dry with a lint free cloth Warm air may be used to speed up drying h Hold the facepiece firmly against your face and exhale several times to ensure that the exhalation valve functions smoothly i Carefully inspect the respirator as described in section J Reinstall the cartridges and or filters before use 2 Repair See the Table at the End of this Manual for Replacement Parts Repair by the user is limited to replacement of components listed in this manual and as listed on the NIOSH approval label Disassembly should be performed only to the extent necessary to replace the components To protect your warranty and the NIOSH certification of the equipment all other repairs must be done only by authorized SPE RIAN technicians and repair centers Consult your SPERIAN distributor for the one nearest you You must perform a fit check as described in section F after any repair and before respirator use a Bayonet Connector Replacement for SPERIAN Valuair Plus and SPERIAN Premier Half Masks 1 Remove cartridges P100 filters or filter holders from the facepiece 2 Remove the damaged bayonet connector RP16 from the facepiece by pressing it inward 3 Insert a new connec
55. suring the levels within the mask Fit tests may be either quantitative or qualitative performed in accordance with State Law The WorkPlace uses the Quantitative procedure for fit testing D All records pertaining to fit test are on file at the Health amp Safety office Wappingers Central School District REVISED on Mav 16 2012 Employees who wear negative pressure respirators shall perform both a positive and negative pressure fit test each time the respirator is worn The procedures for these tests are included with this written program Employees who wear respirators shall contact their Supervisors to arrange for a refitting evaluation when the following occur significant weight loss or gain beards or mustaches are grown eye glasses are required dental changes affect mouth piece seal scars or broken bones which change facial conformation or any other occurrences which may affect the respirator to face seal Employees have been issued a NIOSH approved Sperian Premier Plus Half Mask T Series with P100 Particulate Filters See Appendix C for details on respirator SELECTION AND USE OF RESPIRATORY PROTECTION EQUIPMENT Respirators shall be approved by the Mine Safety and Health Administration MSHA or the National Institute for Occupational Safety and Health NIOSH Selection is dependent upon the type and level of airborne contaminant present the hazardous operation performed and on the basis of comfort proper individual f
56. t before entering a contaminated area Failure to comply with this warning may result in personal injury illness or death E DONNING INSTRUCTIONS FOR THE SPERIAN PREMIER PLUS HALF MASK 1 With cartridges or filters attached fit facepiece on the bridge of the nose and swing the bottom of the facepiece into contact with the chin 2 Bring the lower straps of the headband around the nape of the neck and attach the hook and ring together behind the head 3 Bring the upper straps with the cradle over the crown of the head above the ears and pull the free ends of the straps equally on each side until a comfortable and secure fit is obtained 4 Pull the free ends of the lower straps until the lower strap is secure 5 Adjust the straps just tight enough to prevent any air leaks around the facepiece It is not ON Adjustable Cp necessary to overtighten the nt ae straps The straps have adjust able clips to secure the free ends down onto the middle of the straps after tightening See inset To release the straps first pull off the free ends held by the clips then push up on the tabs on the buckles with your thumbs and pull the facepiece away from your face Unhook the lower straps and remove the respirator F HOW TO FIT CHECK THE RESPIRATOR You must perform the following fit check each time the respirator is worn or before entering the contaminated area A WARNING If a leak tight seal is not obtained during the following fi
57. t check do not wear the respirator Ask your supervisor or safety professional for assistance The failure to comply with this warning may result in personal injury ill ness or death A Positive Pressure Fit Check Hold the palm of your hand gently over the exhalation valve outlet See inset a Do not distort the natural shape of the facepiece Exhale gently and hold your breath to create and maintain a slight positive pressure inside the facepiece If air leakage occurs readjust the facepiece and headstraps then retest B Negative Pressure Fit Check Cover the inlet of the car tridges and or filters with the palms of your hands or another suitable item such as a thin sheet of plastic or rubber See inset b When the respirator is equipped with cartridges filter retainers may be used as an aid Alternatively the cartridges may be removed to per form the fit check If removed SPERIAN recommends someone other than yourself reinstall them after a leak tight fit is achieved It is difficult for the wearer to reinstall 10 the cartridges without disturbing the facepiece to face seal and to determine whether the cartridges are correctly seated against the facepiece It is your responsibility to ensure that the facepiece to face seal is not disturbed when reinstalling the cartridges and that each cartridge is sealed against the facepiece Inhale gently and hold your breath to slightly col lapse the facepiece If air leakage o
58. t test cannot be obtained See ANSI Z88 2 latest issue and OSHA 29 CFR 1910 134 latest edition Beards stubble or sideburns will prevent a good facepiece seal and facial hair may interfere with valve function Do not use this respirator A WARNING Continued unless you are clean shaven Absence of one or both dentures can seri ously affect the fit of the respirator e This respirator will reduce but will not eliminate the inhalation of con taminants Some sensitive individuals may experience health problems when exposed to even minute amounts of contaminants This respirator will not prevent health problems for those individuals Where suspected cancer causing contaminants are present positive pressure supplied air respirators will provide higher protection levels e Persons sensitized can have a severe reaction to chemicals at levels well below accepted health levels such as the OSHA Permissible Expo sure Limit PEL ACGIH Threshold Limit Value TLV or NIOSH Rec ommended Exposure Limits REL lsocyanates are potent sensitizers Use positive pressure supplied air respirators to provide better protec tion from these chemicals Do not use this respirator if you have been sensitized from previous exposure or believe that you may be sensitive or allergic to any chemical e g isocyanates latex etc until you ob tain clearance from a medical doctor e Use of components other than those listed on the NIOSH approval la bel
59. tain a slight positive pressure inside the facepiece If air leakage occurs readjust the facepiece and headstraps then retest B NEGATIVE FIT CHECK Cover the inlet of the cartridges and or filters with the palms of your hands or another suitable item such as a thin sheet of plastic or rubber See photo B below When the respirator is equipped with cartridges filter retainers may be used as an aid Alternatively the cartridges may be removed to perform the fit check If removed Sperian recommends someone other than yourself reinstall them after a leak tight fit is achieved It is difficult for the wearer to reinstall the cartridges without disturbing the facepiece to face seal and to determine whether the cartridges are correctly seated against the facepiece It is your responsibility to ensure that the facepiece to face seal is not disturbed when reinstalling the cartridges and that each cartridge is sealed against the facepiece Inhale gently and hold your breath to slightly collapse the facepiece If air leakage occurs readjust the facepiece and headstraps then retest If filter retainers are used DO NOT remove them after the fit check is completed Removing the filter retainers may shift the facepiece and break the facepiece to face seal Warning Always read cartridge labels prior to use to be certain that you have cartridges and or filters that will provide the required protection Filters labeled for
60. tor bayonet end first from inside the facepiece Push the 15 connector completely until the connector flange is securely seated b Bayonet Connector Replacement for SPERIAN Premier Plus Half Masks 1 Remove cartridges P100 or HEPA filters or filter holders from the facepiece 2 Remove the RP186 cartridge connector gasket 3 Turn the RP156 adapter counterclockwise so that it unscrews from the F38 threaded connector 4 Remove the F38 connector from the facepiece by pressing it inward 5 Insert a new F38 connector threaded end first from inside the facepiece Push the connector completely until the connector flange is securely seated Install a new RP156 adapter from outside the facepiece by threading it onto the F38 connector 6 Reinstall RP186 gasket before installing cartridges filters c Exhalation Valve Seat and Cover Replacement 1 Remove the exhalation valve cover using the small tab on the cover 2 Remove the exhalation valve 3 Remove the valve seat by pushing outward to disengage the seat from the facepiece 4 Insert a new valve seat from outside the facepiece Securely seat the smaller diameter flange by flexing the facepiece material while pressing the seat working the facepiece into the seat groove 5 Install a new valve by pulling the stem through the seat until it snaps into place 6 Reinstall the exhalation valve cover 7 Test the new valve by performing a negative pressure fit check as described i
61. tus e Do not use this respirator in environments where the concentrations of contaminants are unknown or are immediately dangerous fo life or health IDLH IDLH atmospheres are defined as a Those which the wearer could not breathe for short periods b Those from which the wearer could not escape without the aid of the respirator c Those which have an immediate or delayed adverse effect on health A WARNING Continued e This respirator must be worn and used as specified in SPERIAN s instructions e Do not use this respirator if you have health or respiratory problems as identified by 29 CFR 1910 134 appendix C medical evaluation questionaire or by a medical professional e Do not use this respirator without the appropriate SPERIAN cartridg es and or filters securely attached onto the facepiece Always read cartridge labels prior to use and be certain that you have cartridges and or filters that will provide the required protection This respira tor must be used for protection against only those air contaminants listed on the air purifying cartridge filter and or the NIOSH approval label Respirators labeled for protection against particulates only shall not be used for gases vapors Respirators labeled for protec tion against gases vapors only shall not be used for particulates e Do not use this respirator at ambient temperatures above 130 F 55 C e Immediately return to a non contaminated area if a You taste or
62. y amp Health Administration We Can Help What s New Offices Home Workers Regulations Enforcement Data amp Statistics Training Publications Newsroom Small Business OSHA e Regulations Standards 29 CFR Table of Contents e Part Number 1910 e Part Title Occupational Safety and Health Standards e Subpart e Subpart Title Personal Protective Equipment e Standard Number 1910 134 App B 2 e Title Respirator Cleaning Procedures Mandatory Appendix B 2 to 1910 134 Respirator Cleaning Procedures Mandatory These procedures are provided for employer use when cleaning respirators They are general in nature and the employer as an alternative may use the cleaning recommendations provided by the manufacturer of the respirators used by their employees provided such procedures are as effective as those listed here in Appendix B 2 Equivalent effectiveness simply means that the procedures used must accomplish the objectives set forth in Appendix B 2 i e must ensure that the respirator is properly cleaned and disinfected in a manner that prevents damage to the respirator and does not cause harm to the user I Procedures for Cleaning Respirators A Remove filters cartridges or canisters Disassemble facepieces by removing speaking diaphragms demand and pressure demand valve assemblies hoses or any components recommended by the manufacturer Discard or repair any defective parts B Wash components in warm 43 deg C 11
63. y with this warning may result to personal injury illness or death Hydrogen Acrolein Carbonyls S lanide Ozone Aniline Cyanogen Phosgene i Methanol Arsine Dimethylaniline Phosphine Methylene Chloride Methyl Phosphorous Dimethyl Sulfate Bromide Methyl Trichloride Chloride Eh Gyande Niro Compom s Carbon Dioxide Fluorine Nitrogiyecrm Sulfur Chloride Carbon Nitrobenzene i Hydrogen Cyanide Nitromethane Vinyl Chloride A HOW TO INSTALL CHEMICAL CARTRIDGES AND PARTICULATE FILTERS Boron Hydrides 1 Particulate Filters Before using a particulate filter you must confirm the atmosphere is non IDLH and not oxygen deficient the contaminant is a particulate hazard and you must determine the hazard ratio hazard concentration exposure limit If the hazard ratio is less than 10 you may use a half mask respirator with a filter efficiency of 95 or higher If the 5 hazard ratio is less than 20 you may use a full facepiece respirator with a filter hazard ratio is less than 20 you may use a full facepiece respirator with a filter efficiency of 95 or higher If the hazard ratio is less than 100 you may use a full facepiece respi rator with a filter efficiency of 99 or higher If the hazard ratio is greater than 100 you must use another type of respirator N series filters must only be used for non oil containing aerosols or particulates R or P series filters can be used if the atmosphere contains oil e

Respiratory Protection Plan - Wappingers Central School District

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