CORPORATE POLICY, STANDARDS and PROCEDURE NUMBER TBA POLICY TITLE RESPIRATORY PROTECTION

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1 Page 1 of 8 INTENT / PURPOSE Fraser Health will provide a safe workplace by eliminating or reducing the risk of exposure to airborne contaminants through the use of the hierarchy of controls (elimination, substitution, isolation, engineering, administrative and personal protective equipment). Respiratory protection, an example of personal protective equipment, will be utilized only when other control options are either not possible or practicable or when additional protective measures are required because engineering or administrative controls are insufficient to reduce exposure below the applicable exposure limits or the exposure results from a temporary or emergency condition. When required, Fraser Health will ensure that all staff requiring the use of respiratory protection are provided with the appropriate type and are adequately educated, trained and fit-tested prior to performing duties requiring the use of a respirator and that they will be fit-tested at least annually thereafter. POLICY The application of this policy pertains to any department or situation where a staff member would reasonably be expected to perform a job duty that could potentially result in exposure to an airborne contaminant and is required to wear respiratory protection as prescribed by WorkSafeBC (WSBC) Occupational Health and Safety regulation. Respirator use is based on risk assessments performed by Workplace Health and, where applicable, in collaboration with Infection Control. STANDARDS A. Executive Team and Directors Ensures the provision of resources for the implementation and maintenance of the Respiratory Protection Program including the provision of respirators, fit-testing supplies and equipment, resources for the education and training of staff and policies and procedures for minimizing the risk of exposure to airborne contaminants. Ensures that Directors, Managers and Supervisors are aware of the annual respirator fit-testing requirement as detailed in the Respiratory Protection Program and in the WSBC Occupational Health and Safety Regulation.

2 Page 2 of 8 B. Managers and Supervisors Ensures risk identification and assessments are completed for their work area identifying potential airborne contaminant exposures. Contacts Workplace Health whenever there is a new procedure or change in procedure that introduces a new chemical, significantly modifies the manner in which a chemical is utilized or introduces another airborne contaminant (i.e. dust) into the work environment. Ensures the provision for resources, education and training of staff. Informs staff of any airborne exposure risks and respirator use requirements. Ensures that the policy regarding Respiratory Protection and annual fit-testing is communicated to staff. Ensures that staff under their supervision when required to utilize a respirator as part of their job requirements, are educated on the use of respirators and fit-tested prior to the staff being assigned such job requirements and at least annually thereafter. Co-ordinates and organizes, with appropriate lead times, annual education, training and fit-testing for staff under their supervision. Provides trained fit testers in the department, as appropriate. Ensures that staff utilize the appropriate respiratory protection, as determined by Workplace Health and/or Infection Control, whenever the potential for airborne contaminant exposure exists. Ensures that an appropriate and adequate supply of respiratory protective equipment is available to workers, properly worn when required and properly cleaned, inspected, maintained and stored. Ensures that problems and issues are documented and remedied without undo delay. Where employees can not be fit to an available respirator, alternative measures are implemented C. Employees Attends a respirator fit-testing session at least annually, if applicable.

3 Page 3 of 8 Reports to Workplace Health as soon as possible, any factors which may affect the fit of a respirator including ~ substantial changes in weight (gain or loss of more than 10% of body weight from when initially fit-tested) or the use of dentures. Must be clean shaven where the respirator comes in contact with the face whenever fit-testing is to be completed and/or a respirator is utilized. If due to religious reasons being clean shaven is not possible, other options may be utilized through discussion with the Manager and, if required, Workplace Health and Infection Control. Uses equipment in accordance with the instructions and the manufacturer s guidelines. Inspects and conducts a user seal check on the equipment before each use. Refrains from wearing protective equipment outside the work area of where it is required. Ensures that respirators are kept clean and stored appropriately, when applicable. Reports any equipment malfunction to the Supervisor or employer immediately. D. Workplace Health Ensures that all chemical respiratory hazards are identified, assessed and evaluated. For biological hazards, works with Infection Control as needed. Wherever practicable, control options, as per the hierarchy of controls, will be established and utilized. Determines which situations require respiratory protection including the specific type of respirator(s) and communicates to the departments affected. Evaluates the adequacy of respiratory protection devices. Educates and trains staff to become Trained Fit-Testers. Refers staff, when required, for medical assessment by a health care professional. Ensures that appropriate education and training is available for all staff. Provides education and training to staff regarding the use, care and maintenance of respirators. Provides regularly scheduled monthly drop-in fit-test sessions at each Fraser Health acute care site.

4 Page 4 of 8 Provides, where deemed necessary by Workplace Health and in consultation with the Manager/designate of the department, additional fit-test sessions for departments where staff shifts do not permit attendance to any of the monthly drop-in sessions throughout the year. Maintains documentation of education, training and fit-testing. Maintains a database of staff education, training and fit-test results. Provides advice and guidelines to department Managers and staff to assist with compliance with policy and program requirements. Maintains respirator fit-test kits. Evaluates the Respiratory Protection Program at least annually. E. HSSBC Coordinates contracts and/or purchases of respiratory protection as per respirator model specifications obtained from Workplace Health. Ensures that the appropriate levels of respirators are stocked in the Shared Service Facility warehouse and are readily available for departments upon request. Consults with Workplace Health if any changes in stock items pertaining to respiratory protection are being considered and/or or stock items become unavailable. F. Infection Control Ensures that situations requiring the use of respirators for protection against airborne infectious microorganisms or bioaerosols are identified and procedures involving the use of the respirator are developed, in consultation with Workplace Health, as part of the appropriate level of precaution. In consultation with Workplace Health specifies when respiratory protection is required for protection against airborne infectious microorganisms and communicates this to the department(s) affected. G. Trained Fit-Testers Attends a Train-the-Fit-Tester session (and refreshers as required) provided by Workplace Health.

5 Page 5 of 8 Becomes familiar with the material discussed in the session. If questions or concerns arise will contact Workplace Health. Follows all steps and addresses all points outlined in the fit-test procedures and education/training documents. Keeps up-to-date with any information provided by Workplace Health regarding respirator education/training and/or fit-testing. Signs-out, picks-up and returns on time and in good order, the required qualitative fittest kits. Provides fit-testing to new hires within their department that are required to wear a respirator to safely perform their job duties or to staff, as required, to meet surge demands or if urgent fit-testing is required within their department. Consults with department management, staff and Workplace Health regarding any fittesting or respirator use issues or concerns that arise. Provides all required fit-test records and associated documentation to Workplace Health. Provides fit-test records and other applicable documentation management. to department Ensures that all staff within their specified department are fit-tested within the timeframe discussed with Workplace Health and department management. H. Physicians Attends annual fit-test sessions to ensure that the appropriate respirator is utilized. Must be clean shaven where the respirator comes in contact with the face whenever fit-testing is to be completed and/or a respirator utilized. If due to religious reasons being clean shaven is not possible, other options may be utilized through discussion with the department Manager and, if required, Workplace Health and Infection Control. Ensures that respiratory protection is used at all times where potential or confirmed exposure to airborne contaminants exist.

6 Page 6 of 8 I. Contractors Complies with the WSBC Occupational Health and Safety Regulation pertaining to respiratory protection. Wears and properly utilizes a respirator for those situations identified by their Supervisor as requiring its use. Complies with Fraser Health Infection Control and Workplace Health policies and procedures regarding respirator use as applicable. Receives fit-testing, through their employer, on a NIOSH-approved respirator which meets the requirements of the WSBC Occupational Health and Safety Regulation. J. Students Complies with the WSBC Occupational Health and Safety Regulation pertaining to respiratory protection. Wears and properly utilizes a respirator for those situations identified by their Fraser Health Supervisor as requiring its use. Complies with Fraser Health Infection Control and Workplace Health policies and procedures regarding respirator use. Receives fit-testing, through their academic institution, on a model of respirator currently utilized by Fraser Health prior to their placement at a Fraser Health facility. Carries proof of fit-testing, at all times during the placement experience, which details the fit-test date, respirator brand, model and size. Informs their Fraser Health Supervisor if they are required to wear a respirator and have not received fit-testing. K. Joint Occupational Health and Safety Committees Assists, upon request, in reviewing the respiratory protection program as it applies within their site and/or program. Promotes proper use of respiratory protection.

7 Page 7 of 8 DEFINITIONS AIRBORNE CONTAMINANTS Chemical or biological (i.e. airborne precautions as defined by Infection Control) substances which may either enter the respiratory tract or upon exposure to the airborne vector may result in an adverse health effect. CONTRACTOR A company, agent(s) or representative(s) of that company that provides a service or performs work at sites and facilities owned by Fraser Health. This also includes companies of contractors sub-contractors, consultants, vendors and suppliers. FIT-TEST The use of a qualitative or a quantitative method to evaluate the fit of a specific make, model and size of a respirator on an individual as outlined in the Canadian Standards Association (CSA) Standard Z Selection, Use and Care of Respirators. HIERARCHY OF CONTROLS A term that refers to using the most effective means possible to control hazards. The order of effectiveness to control hazards is: elimination of the hazard, substitution with a different product or process, engineering solutions to control the hazard (such as isolation), administrative controls to change the way the work is organized and lastly using personal protective equipment. RESPIRATOR A type of personal protective equipment designed to cover the entrances to the respiratory tract (the mouth and the nose). Types of respirators include half-face piece, full-face piece, filtering face piece (i.e. N95) and powered air purifying respirator (PAPR) styles. USER SEAL CHECK A quick, basic procedure done to help ensure that a respirator has been donned correctly. For elastomeric respirators, the seal with the face is checked by covering the cartridge or filter inhalation openings and inhaling then by covering the respirator exhalation cover(s) and

8 Page 8 of 8 exhaling. For filtering face piece respirator masks (i.e. N95), the seal is checked by covering the face piece with the hands and inhaling and exhaling to check for positive and negative pressure. A User Seal Check is required every time a respirator is donned ~ may also be known as a fit check. REFERENCES Fraser Health Authority Workplace Health and Safety Policy Fraser Health Authority Respiratory Protection Program, British Columbia, Canada, Revised 2011 Workers Compensation Board of British Columbia (1999), Occupational Health and Safety Regulation, Sections Canadian Standards Association (CSA) Standard Z Selection, Use and Care of Respirators