Public Health Department Policy & Procedure Manual Example



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Administration

      • Determine what Public Health situations require the use of respiratory protection equipment


      • Evaluate tasks and workplaces where respiratory protection is required

      • Provide fit testing and training as necessary

      • Maintain the Buffalo County Health Department’s written Respiratory Protection Plan (coexists with PPE procedure annually)

      • Periodically review and update written respiratory protection policies and procedures (annually)
    1. Employee


      • Understand the respiratory protection requirements for their work duties

      • Correctly wear the appropriate respiratory protective equipment according to proper instructions as provided

      • Follow site-specific procedures

      • Attend training classes as necessary

      • Complete the required medical evaluation questionnaire and undergo fit testing as necessary

      • Inspect respiratory protective equipment prior to each use

      • Perform a negative and positive pressure fit check before each use

      • Report damaged or malfunctioning equipment immediately



  1. PROGRAM ADMINISTRATION



Administrator: Jennifer Rombalski, Health Officer

The Administrator has complete responsibility of the Respiratory Protection Program. This individual has the authority to act on any and all matters relating to the operation and administration of the Buffalo County Health Department Respiratory Protection Program. The individual is responsible for developing standard operating procedures, maintaining records, and conducting program evaluations.

Manager(s): Angela Gray, Registered Nurse

Paula Stansbury, DHHS Director

The Managers are responsible for hazard identification, hazard measurement if possible, technical support, evaluation of employee’s health via the medical questionnaire, directing and coordinating engineering projects if necessary, selection, issuance, training, fit-testing and record keeping of the Buffalo County Health Department.


This program will be effective starting March 26, 2008.


  1. MEDICAL EVALUATION

See Appendix A: Medical Evaluation Form
OSHA requires that every employee who is being considered for inclusion in the Buffalo County Health Department Respiratory Protection Program must participate in a medical evaluation. A determination of the employee’s ability to wear a respirator while working is made initially before fit testing. Medical evaluations shall be completed every two years.
Additional medical evaluations shall be scheduled when:

  • The employee reports signs or symptoms that are related to respirator use or the employee’s ability to use a respirator

  • The employee’s supervisor requests a re-evaluation

  • Observation of the employee indicates a need for re-evaluation

  • There are changes in the workplace or task that may significantly increase the employee’s exertion while wearing a respirator (i.e., physical work changes, temperature changes, added protective clothing, etc.)

A mandatory medical evaluation questionnaire in 1910.124 must be used and reviewed by a physician or other licensed healthcare professional (PLHCP). If the PLHCP deems it necessary, the employee will receive an examination. The purpose of the medical evaluation is to assure that the employee is physically and psychologically able to perform the assigned work while wearing respiratory protective equipment. If the PLHCP denies approval, the employee will be unable to participate in the Respiratory Protection Program.


  1. HAZARD ASSESSMENT

See Appendix B: Coulee Region Public Health Consortium Hazard Assessment



When using respiratory protection, the type of respirator is selected on the basis of the hazard and its airborne concentration. The hazard assessment will be performed prior to the task requiring respiratory protection. Periodically, as required by OSHA standards or at least every 12 months, a review of the hazard assessment will be made to determine respiratory protection equipment effectiveness.

Emerging Infectious Diseases & Bioterrorism
For a biological agent, the air concentration of infectious particles will depend upon the method used to release the agent. The Center for Disease Control and Prevention interim statement for Recommendations for the Selection and Use of Protective Clothing and Respirators Against Biological Agents states:

  1. Biological agents may expose people to bacteria, viruses, or toxins as fine airborne particles. Biological agents are infectious through one or more of the following mechanisms of exposure, depending upon the particular type of agent:

    1. Inhalation, with infection through respiratory mucous or lung tissues;

    2. Ingestion or contact with the mucous membranes of the eyes, or nasal tissues; or

    3. Penetration of the skin through open cuts (even very small cuts and abrasions of which employees might be unaware).
  2. Organic airborne particles share the same physical characteristics in air or on surfaces as inorganic particles from hazardous dusts. This has been demonstrated in military research on biological weapons and in civilian research to control the spread of infection in hospitals.


  3. Because biological weapons are particles, they will not penetrate the materials of properly assembled and fitted respirators or protective clothing.

  4. Existing recommendations for protecting workers from biological hazards require the use of half-mask or full face piece air-purifying respirators with particulate filter efficiencies ranging from N95 (for hazards such as pulmonary tuberculosis) to P100 (for hazards such as hantavirus) as a minimum level of protection.

  5. Public Health employees will be a critical component of emergency response in a biological, infectious disease outbreak and/or other public health threats and emergencies. Biological and infectious diseases that require the use of air purifying respirator by the Buffalo County Health Department employees can be found in Section 11.0 Appendix B – Coulee Region Public Health Consortium Hazard Assessment of this document.



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