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LABOR AND POLICY\\Respiratory Protection Program – Authorize & Amend Employee Handbook – 5-6-19
RESOLUTION AUTHORIZING ADOPTION AND IMPLEMENTATION
OF RESPIRATORY PROTECTION PROGRAM
RESOLUTION NO.:_______________________________________________, 2019
INTRODUCED BY: _______________________________________________
WHO MOVED ITS ADOPTION
SECONDED BY: _______________________________________________
WHEREAS, the Queensbury Town Board wishes to adopt a Respiratory Protection
Program to ensure that its employees who may be exposed to harmful levels of atmospheric
contaminants are fully protected with appropriate respiratory protection devices, and
WHEREAS, a proposed Town of Queensbury Respiratory Protection Program is
presented at this meeting,
NOW, THEREFORE, BE IT
RESOLVED, that the Queensbury Town Board hereby approves and authorizes the Town of
Queensbury Respiratory Protection Program substantially in the form presented at this meeting and
authorizes and directs its immediate implementation, and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs the Town Supervisor to
make arrangements for the distribution of a copy of such Program to any affected employee, and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs the Town Supervisor to
amend the Employee Handbook accordingly to reflect adoption of this new Program, and
BE IT FURTHER,
RESOLVED, that the Town Board further authorizes and directs the Town Supervisor to
take any other actions necessary to effectuate the terms of this Resolution.
th
Duly adopted this 6 day of May, 2019, by the following vote:
AYES :
NOES :
ABSENT :
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Town of Queensbury
Respiratory Protection Program
Town of Queensbury
Adopted May 6, 2019
Respiratory Protection Program
Table of Contents
Section Description
1.0 PURPOSE
2.0 SCOPE
3.0 RESPONSIBILITIES
4.0 DEFINITIONS
5.0 MEDICAL CLEARANCE
6.0 SELECTION
7.0 TRAINING
8.0 FIT TESTING
9.0 USAGE
10.0 MAINTANCE
11.0 STORAGE
12.0 LIMITATIONS
13.0 RECORDKEEPING
Appendices
A Current Respirator Equipment Listing
B OSHA 1910.134 Employee Information
C Respirator Fit Test Form
D Revision History
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Respiratory Protection Program
1.0 PURPOSE
This procedure establishes Town of Queensbury requirements for employee respiratory protection as per the OSHA
Respirator Standard,29 CFR 1910.134. The purpose of this Respiratory Protection Program is to ensure that workers
who may be exposed to harmful levels of atmospheric contaminants are fully protected with appropriate respiratory
protection devices. While it is the policy of the Town of Queensbury to utilize available engineering controls,such as
ventilation, mechanical equipment, or other means as a first line of defense against harmful exposures, controls are
not always feasible for some of our operations and may not completely control potential hazards. In these situations,
respirators and other protective devices must be used.
This Program contains the necessary instructions for the selection, use, care and maintenance of respiratory
protective equipment(respirators),and establishes policy regarding medical evaluations,fit testing,employee training
and information, and Program evaluation.
This Program applies to all employees who are required to wear respirators during normal or special work operations.
In situations where employees ask to be provided with a respirator even though one is not needed, the Town of
Queensbury will review each request on a case-by-case basis. If it is determined that the use of a respirator in such
cases will not jeopardize the safety or health of a worker, the Town of Queensbury will provide an appropriate
respirator for voluntary use. Employees who are allowed to voluntarily wear respirators when one is not required will
be subject to several of the same requirements of this Program as those who are required to wear respirators.
Employees participating in this Respiratory Protection Program do so at no cost to them. The expenses associated
with training, medical evaluations and respirator protection equipment will be borne by the Town of Queensbury.
2.0 SCOPE
This procedure pertains to all Town of Queensbury employees that may during the course of work be involved with
repertory protection. This procedure applies to all operations in the Town of Queensbury.
3.0 RESPONSIBILITIES
3.1 Program Administrator
• Identify work areas or tasks that may require respiratory protection, selection of respirators, and coordinate
communications between all parties involved.
• Arranging for and/or conducting employee training regarding this Program.
• Enforce all provisions of this Program.
• Provide on-site orientation to employees and the respiratory hazards associated with the particular work
assignment.
• Maintain records of all employee training.
• Evaluate overall effectiveness of the program.
• Update as necessary
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Respiratory Protection Program
The Program Administrator at the Town of Queensbury is:
The Safety Coordinator
3.2 Supervisors
• Enforce all provisions of this Program at various work locations.
• Supply employees with respirators whether required or voluntary.
3.3 Employees
• Properly use, clean, maintain and store assigned respiratory protective equipment.
• Employees are required to use respirators wherever hazards have been identified. Failure to utilize
respirators will result in disciplinary action.
• Notify the Respiratory Program Administrator,or Supervisor, if unsafe condition(s)exist.
4.0 DEFINITIONS
The following definitions are important terms used regarding respiratory protection in this Program.
Air-purifying respirator means a respirator with an air-purifying filter, cartridge,or canister that removes specific air
contaminants by passing ambient air through the air-purifying element.
Assigned protection factor(APF) means the workplace level of respiratory protection that a respirator or class of
respirators is expected to provide to employees when the employer implements a continuing, effective respiratory
protection program as specified by this section.
Canister or cartridge means a container with a filter, sorbent, or catalyst,or combination of these items, which
removes specific contaminants from the air passed through the container.
Emergency situation means any occurrence such as, but not limited to, equipment failure, rupture of containers, or
failure of control equipment that may or does result in an uncontrolled significant release of an airborne
contaminant.
Employee exposure means exposure to a concentration of an airborne contaminant that would occur if the
employee were not using respiratory protection.
End-of-service-life indicator(ESLI) means a system that warns the respirator user of the approach of the end of
adequate respiratory protection,for example, that the sorbent is approaching saturation or is no longer effective.
Filter or air purifying element means a component used in respirators to remove solid or liquid aerosols from the
inspired air.
Filtering face piece (dust mask)means a negative pressure particulate respirator with a filter as an integral part of
the face piece or with the entire face piece composed of the filtering medium.
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Respiratory Protection Program
Fit factor means a quantitative estimate of the fit of a particular respirator to a specific individual, and typically
estimates the ratio of the concentration of a substance in ambient air to its concentration inside the respirator when
worn.
Fit test means the use of a protocol to qualitatively or quantitatively evaluate the fit of a respirator on an individual.
(See also Qualitative fit test QLFT and Quantitative fit test QNFT.)
High efficiency particulate air(HEPA)filter means a filter that is at least 99.97%efficient in removing mono-disperse
particles of 0.3 micrometers in diameter.The equivalent NIOSH 42 CFR 84 particulate filters are the N100, R100,
and P100 filters.
Immediately dangerous to life or health(IDLH) means an atmosphere that poses an immediate threat to life, would
cause irreversible adverse health effects,or would impair an individual's ability to escape from a dangerous
atmosphere.
Loose-fitting face piece means a respiratory inlet covering that is designed to form a partial seal with the face.
Maximum use concentration(MUC) means the maximum atmospheric concentration of a hazardous substance
from which an employee can be expected to be protected when wearing a respirator, and is determined by the
assigned protection factor of the respirator or class of respirators and the exposure limit of the hazardous
substance.The MUC can be determined mathematically by multiplying the assigned protection factor specified for a
respirator by the required OSHA permissible exposure limit, short-term exposure limit, or ceiling limit. When no
OSHA exposure limit is available for a hazardous substance, an employer must determine an MUC on the basis of
relevant available information and informed professional judgment.
Negative pressure respirator(tight fitting) means a respirator in which the air pressure inside the face piece is
negative during inhalation with respect to the ambient air pressure outside the respirator.
Oxygen deficient atmosphere means an atmosphere with oxygen content below 19.5% by volume.
Qualitative fit test(QLFT) means a pass/fail fit test to assess the adequacy of respirator fit that relies on the
individual's response to the test agent.
Quantitative fit test(QNFT) means an assessment of the adequacy of respirator fit by numerically measuring the
amount of leakage into the respirator.
Respiratory inlet covering means that portion of a respirator that forms the protective barrier between the user's
respiratory tract and an air-purifying device or breathing air source, or both. It may be a face piece, helmet, hood,
suit, or a mouthpiece respirator with nose clamp.
Service life means the period of time that a respirator,filter or sorbent, or other respiratory equipment provides
adequate protection to the wearer.
Tight-fitting face piece means a respiratory inlet covering that forms a complete seal with the face.
User seal check means an action conducted by the respirator user to determine if the respirator is properly seated
to the face.
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Respiratory Protection Program
5.0 MEDICAL CLEARANCE
A. Prior to issuing a required respirator, a determination must be made by the Town of Queensbury Occupational
Medical Consultant Standard Medical Services, 68 Quaker Road, Queensbury NY 12804 of each individual's
physical condition and ability to tolerate such equipment. Only those employees who have received medical
clearance may be issued required respiratory protective equipment.
B. Medical re-evaluation will be provided if after an employee has received clearance and has begun to wear the
respirator, he reports signs and/or symptoms which may be related to wearing the respirator, such as shortness
of breath, dizziness, chest pains or wheezing. Medical re-evaluation may also be required if a change takes
place in workplace conditions that could result in an increased physiological burden on the respirator wearer or
as may be determined during a program evaluation.
6.0 SELECTION
A. Employees must use only respirators selected, supplied, and/or approved by the Town of Queensbury. The
Program Administrator will ensure that the proper respirator is selected and purchased. This selection is based
on the hazards that workers may be exposed to and/or as required by applicable OSHA standards.
B. Air purifying respirators must be approved half-face or full-face piece, dual cartridge respirators, or approved
filtering face piece respirators. Air-purifying respirator cartridge selection must be based on the specific inhalation
hazards anticipated. The following points will be considered when selecting air purifying cartridges or canisters:
• The potential for a contaminant(s)to be present in concentrations which present an immediate danger to life
and health (IDLH)and/or an oxygen deficient atmosphere.
• The nature of the air contaminant(e.g. gas, vapor,or particulate).
• The anticipated contaminant concentration;
• The odor characteristics, including odor threshold.
• Irritant properties.
• The Occupational Safety and Health Administration,Permissible Exposure Limit(OSHA,PEL),The American
Conference of Governmental Industrial Hygienist, Threshold Limit Value (ACGIH, TLV), and/or the National
Institute of Occupational Safety and Health, Recommended Exposure Limit(NIOSH, REL).
• Anticipated duration of respirator usage.
C. All respirators must have NIOSH/MSHA approval.
D. A listing of the current respiratory protection equipment, by job task, is attached in Appendix A.
E. Nothing contained herein shall prevent an employee from wearing,on a voluntary basis,the N95 two strap filtering
face piece respirator as referenced in 29 CFR 1910.134.
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Respiratory Protection Program
7.0 TRAINING
A. All employees that use respirators must be trained in the proper use, care, storage, and limitations of respiratory
protective equipment prior to use.
B. Each required respirator wearer shall be given annual training (and retraining when necessary), which includes,
but is not limited to,explanations and discussions of:
• The respiratory hazard and the effect on the wearer if the respirator is not used properly.
• The engineering and administrative controls being used and the need for respirators to provide protection.
• The reason for selecting a particular type of respirator.
• The function, capabilities, and limitations of the selected respirator.
• The method of donning the respirator and checking its fit and operation.
• Proper wearing of the respirator.
• Respirator maintenance, inspection, and storage.
• Recognizing and handling emergency situations.
• Applicable governmental regulations for specific substances.
C. All employees voluntarily wearing respirators will be provided with respirator information contained in 29 CFR
1910.134 Appendix"D"attached in Appendix B of this program.
8.0 FIT TESTING (Required Respirators)
A. Initial and periodic qualitative fit testing must be performed for employees required to wear respirators. These
tests must be performed at least annually.An example fit-test form is attached in Appendix C.
B. Respirators must be properly fitted and not worn when facial conditions prevent a good respirator-to-face seal.
This includes the presence of facial hair, beards, head coverings, and eyeglass temple bars.
C. Only those respirators, which have been properly fitted, may be worn by the individual. Alternative respirator
makes and models may require additional fit testing.
9.0 USAGE
A. Employees must wear and properly use all respirators in accordance with instruction and training.
B. Respirators must be assigned to each individual for their exclusive use.
C. No attempt will be made to make adjustments or repairs beyond the respirator manufacturers'recommendation.
D. All respirator users must vacate the contaminated area immediately upon notice of physical symptoms, such as
nausea,dizziness, odor breakthrough or any other condition, which indicates respirator failure.
E. Respirator cartridges must be discarded and replaced whenever damaged,defective,dirty,or if odor is detected.
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Respiratory Protection Program
10.0 MAINTENANCE
A. All respirators must be inspected by the user both before and after each use, for defects in the face piece,
headbands, and cartridge retaining mechanism.
B. All respirators must be cleaned and disinfected by the user after each use. Following cleaning and disinfecting,
the respirator must be re-inspected and placed in a plastic bag or sanitary container for storage.
11.0 STORAGE
A. All respirators must be stored in the employees' locker in a re-sealable, 1-gallon plastic bag so as to protect it
against dust, sunlight, extreme heat and cold, excessive moisture, and damaging chemicals.
B. Respirators must be packed and stored so that the face piece and exhalation valve will retain a normal position
and function.
C. Unused filters and cartridges must be stored in a contaminant-free environment determined by the Program
administrator.
12.0 LIMITATIONS
A. The following restrictions apply to the use of all respirators:
• Employees must not enter an atmosphere that is known or suspected to be dangerous without wearing the
appropriate respiratory protection.
• Employees must use only those respirators for which he/she has been properly fit tested.
• Air-purifying, negative pressure respirators must not be used when one or more of the following conditions is
known or suspected to exit:
o Airborne concentrations of contaminants exceed the calculated Maximum Use Concentration(MUC)
for the respirator in use (e.g., MUC equals the Assigned Protection Factor (APF) multiplied by the
applicable PEL, TLV or REL).
o In atmospheres which are IDLH or oxygen deficient(e.g., less than 19.5%oxygen).
o For protection against contaminants having inadequate warning properties, (e.g., poor odor or
irritation threshold) unless specifically permitted by an OSHA substance specific standard.
o For protection against chemicals which the cartridge is inappropriate, and/or where a cartridge is not
available for the contaminant of concern.
• Employees must not enter a confined space (e.g.,tank,sewer,closed vessel, etc.)without consulting either
their Supervisor and/or the Program Administrator.
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Respiratory Protection Program
13.0 RECORDKEEPING
A. Records of medical certification and recertification for employees wearing required respirators will be retained by
the Program Administrator as per 29 CFR 1910.1020(the duration of employment plus 30 years).
B. All current fit test forms for employees wearing required respirators will be retained by the Program Administrator.
C. A copy of this program, and a copy of the OSHA Respirator Standard, will be made available to any Town of
Queensbury employee from the Program Administrator.
D. All current training documentation will be retained by the Program Administrator.
14.0 PROGRAM EVALUATION
A. The Program Administrator will conduct periodic evaluations to ensure that all provisions of the Program are
being implemented. Evaluations will be conducted by having regular consultations with employees who use
respirators and their supervisors to identify problems, by conducting periodic air monitoring, by making frequent
observations of the work processes where respirators are being used, and through routine medical surveillance.
Problems or program deficiencies will be properly documented and corrected in a timely manner.
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Respiratory Protection Program
Appendix A CURRENT RESPIRATOR EQUIPMENT LISTING BY JOB TASK
Town of Queensbury
RESPIRATOR USAGE CHART
Type of Job/Specific Duties Type of Respirator
Crematory Moldex 8000 Series
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Respiratory Protection Program
Appendix B OSHA 1910.134 APPENDIX D EMPLOYEE INFORMATION
Appendix D to Sec. 1910.134(Mandatory)Information for Employees Using Respirators When Not Required Under
the Standard
I,the undersigned,have been trained on the Town of Queensbury Respiratory Protection Program Policy and requirements. In
addition,I understand Appendix D to the Respiratory Protection Standard 1910.134(Mandatory)Information of Employees Using
Respirators When Not Required Under the Standard.
Respirators are an effective method of protection against designated hazards when properly selected and worn. Respirator
use is encouraged,even when exposures are below the exposure limit,to provide an additional level of comfort and protection
for workers. However,if a respirator is used improperly or not kept clean,the respirator itself can become a hazard to the
worker.Sometimes,workers may wear respirators to avoid exposures to hazards,even if the amount of hazardous substance
does not exceed the limits set by OSHA standards. If your employer provides respirators for your voluntary use,or if you
provide your own respirator,you need to take certain precautions to be sure that the respirator itself does not present a
hazard.
You should do the following:
1. Read and heed all instructions provided by the manufacturer on use, maintenance,cleaning and care,and warnings
regarding the respirators limitations.
2.Choose respirators certified for use to protect against the contaminant of concern. NIOSH,the National Institute for
Occupational Safety and Health of the U.S. Department of Health and Human Services,certifies respirators.A label or
statement of certification should appear on the respirator or respirator packaging. It will tell you what the respirator is designed
for and how much it will protect you.
3. Do not wear your respirator into atmospheres containing contaminants for which your respirator is not designed to protect
against.For example,a respirator designed to filter dust particles will not protect you against gases,vapors,or very small solid
particles of fumes or smoke.
4. Keep track of your respirator so that you do not mistakenly use someone else's respirator.
[63 FR 1152,Jan.8,1998;63 FR 20098,April 23, 1998]
In addition I have been trained on the signs and symptoms that prevent the affective use of the respirator such as detecting vapor or gas
breakthrough,changes in breathing resistance,or leakage of the face piece.
Print Name Signature Date
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Respiratory Protection Program
Appendix C RESPIRATOR FIT TEST FORM
Town of Queensbury
RESPIRATOR FIT TEST RECORD
Name: Company:
Date:
Clean Shaven?_Yes No Spectacle Kit? -Yes No
Manufacturer/Model Size: S M L
Protocol:
Fit Factor: Pass Fail
Manufacturer/Model Size: S M L
Protocol:
Fit Factor: Pass Fail
Manufacturer/Model Size: S M L
Protocol:
Fit Factor: Pass Fail
Next Test Due:
NOTES:
Operator(Print and Sign):Person Preforming Fit Test
Operator:
Date:
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APPENDIX D
REVISION HISTORY
REVISION NO ACTIONS DATE BY
000 Initial issue as a controlled document 5/6/2019
001
002
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