Respiratory Protection Policy (TFD)

Overview

• This document establishes TFD's policy on respiratory protection
• Procedures include inspection, alarm testing, cleaning, underwater emergencies, equipment failure and EEBSS transfill

Scope

• This policy applies to all TFD personnel responsible for using and maintaining respiratory protection gear
• It supersedes all previous documents, including General Order 3, Section 4 and the TFD Respiratory Protection Program dated February 2000

Associated Forms

• FIR 2530-0019: SCBA Daily Inspection Log
• FIR 2530-0020: SCBA Weekly Inspection Log
• OSHA form A-5-1.2: Respiratory Program Evaluation
• Medical Evaluation Questionnaire - Mandatory: WAC 296-842-22005

Related TFD Policies

• TFD Policy 2018: MAYDAY
• TFD Policy 2022: Rapid Intervention Crew(s)
• TFD Policy 3503: Exposure Control Plan for Blood-borne Pathogens
• TFD Policy 4002: Confined Space Rescue
• TFD Policy 4004: Hazardous Materials Emergency Response
• TFD Policy 5004: Safety Officer and Incident Safety Officers
• TFD Policy 5024: Overhaul Safety and Post-fire Operations
• TFD Policy 5029: Water Rescue

Responsibilities of the Deputy Chief of Training and Technology

• The Deputy Chief oversees training, practice, testing and record keeping, ensuring they follow the document's guidelines

Responsibilities of the Assistant Chief of Emergency Medical Services

• The Assistant Chief makes sure that all respirator user's medical status is reviewed annually

Responsibilities of the Administrative Battalion Chief for Safety

• Administering the TFD Respiratory Protection Program while adhering to the set guidelines
• Maintaining and updating the respiratory protection policy

Responsibilities of the TFD Incident Commanders

• Ensuring proper respiratory protection is used at each incident
• Ensuring respiratory protection policies and procedures are followed

Responsibilities of the TFD Incident Safety Officers

• Ensuring on-scene personnel wear appropriate respiratory protection equipment

Responsibilities of the TFD Company Officers

• Ensuring crew members use appropriate respiratory equipment for encountered hazards
• Performing and documenting daily inspections, as well as donning of respiratory equipment
• Maintaining proficiency in SCBA use

Responsibilities of the Station 17 Captain

• Ensuring all fit testing adheres to guidelines
• Repairing, replacing and maintaining all respiratory protection equipment
• Keeping records of fit testing, equipment repairs, replacements and maintenance

Responsibilities of the TFD Training Division

• Providing initial and ongoing training for personnel who use respiratory protection equipment
• Keeping training records according to the outlined guidelines

Responsibilities of the TFD Fire Garage

• Testing, maintaining and repairing air compressor equipment according to the guidelines

Responsibilities of all TFD Personnel using Respiratory Protection

• Complying with all requirements outlined within the document
• Sustaining respiratory equipment
• Reviewing the policy annually

Definitions: Asbestos

• A human carcinogen mineral causing lung cancer and mesothelioma

Definitions: Cascade System

• A compressed gas storage system which uses a series of large cylinders to fill smaller cylinders

Definitions: Company Officer

• TFD personnel holding the rank of Lieutenant or Captain

Definitions: EEBSS

• Emergency Escape Breathing Support System

Definitions: Facepiece

• A full-face respirator with lens that uses an attached filter or connected to an air supply for protection

Definitions: Fit Check

• A test conducted by a SCBA wearer to determine if the respirator is properly sealed

Definitions: Grade D Breathing Air

• Air for SCBA cylinders that meets minimum requirements:
• Water vapor level of 24 ppm or less
• 19.5-23.5% oxygen
• Condensed hydrocarbon of no more than 5 mg per cubic meter of air
• CO content of no more than 10 ppm
• CO2 level of no more than 1,000 ppm

Definitions: Health Care Provider

• Doctors of medicine or osteopathy authorized to practice medicine or surgery
• State licensed professionals: Podiatrists, Dentists, Clinical psychologists, Clinical social workers, Optometrists, Chiropractors (limited), Nurse practitioners, Nurse-midwives
• Christian Science practitioners
• Any health care provider recognized by the employer

Definitions: IDLH

• Immediately dangerous to life or health is the concentration of airborne contaminants posing a threat of death, immediate or delayed permanent adverse health effects or effects preventing escape

Definitions: MRSA

• Methicillin-Resistant Staphylococcus Aureus

Definitions: NIOSH

• National Institute for Occupational Safety and Health

Definitions: Oxygen Deficient

• Atmosphere contains less than 19.5% oxygen by volume, or has a partial pressure of 148 millimeters of mercury or less

Definitions: PASS

• Personal Alert Safety System

Definitions: Qualitative Fit Test

• A pass/fail test to assess the adequacy of respirator fit

Definitions: PHI

• Protected Health Information is health-related, individually identifiable or demographic, regarding past or present physical/mental health, provision/payment for care, or created/received by a health entity

Definitions: Quantitative Fit Test

• Assesses respirator fit adequacy by measuring leakage quantity

Definitions: Respirator

• A breathing device that protects the wearer from harmful substance inhalation

Definitions: Single Use/Disposable Respirator

• A NIOSH-approved respirator featuring a soft, fibrous, negative pressure facepiece for tuberculosis protection; also known as an N95 mask

Definitions: SCBA

• Self-contained breathing apparatus with a positive pressure respirator supplied by a compressed air cylinder and used for oxygen deficient and IDLH conditions

Definitions: SAR

• Supplied airline respirator is a positive pressure respirator supplied by a NIOSH approved high pressure hose connected to a remote air source

Definitions: Transfill

• Transferring the contents of one air bottle to another with the EEBS system

References

• HIPAA Privacy Rule, 45 CFR, parts 160 and 164
• ANSI/CGA G7.1: Commodity Specification for Air
• "Key Elements of a Sound Respiratory Protection Program," July 2008; Mine Safety Appliance website, http://www.msanet.com
• NFPA 1981: Standard on Open-Circuit Self-Contained Breath Apparatus (SCBA) for Emergency Services
• OSHA 29CFR 1910.134 (1): Respiratory Protection
• WAC 296-62-07715: Respiratory Protection
• WAC 296-62 Part I-1: Asbestos, Tremolite, Anthrophyllite and Actinolite
• WAC 296-305: Firefighter Safety Standards
• WAC 296-842: Respiratory Protection Standard

Rules & Guidelines

• Tacoma Fire Department (TFD) must have a written respiratory protection policy that complies with WAC 296-305 and WAC 296-842 regulations
• TFD personnel using respirators must undergo medical evaluation per WAC 296-842-14005, irrespective of usage duration/frequency
• Qualitative/quantitative fit testing must comply with WAC 296-842, sections 15005/22010
• Respiratory equipment training should follow guidelines in WAC 296-305-04001, WAC 296-842, and WAC 296-62-07715
• Functioning in hazardous atmospheres requires: using SCBA with fitted facepiece, ensuring proper working condition of the components/respirator
• Personnel cannot be assigned to duties requiring respiratory protection without training, medical approval and fit testing
• SCBA must be worn in contaminated, rapidly hazardous/contaminated and oxygen deficient atmospheres and during structure fire overhauls and in the presence of asbestos fibers
• An N95 mask must be worn when transporting unmasked patients with suspected or confirmed infectious tuberculosis in an enclosed vehicle
• Do not used department provided respiratory protection equipment underwater
• Respiratory protection in confined spaces must follow TFD Policy 4002
• Using equipment near water requires compliance with TFD Policy 5029
• Policy should get reviewed and updated annually per OSHA 29CFR 1910.134(1) via OSHA form A-5-1.2

Officer Guidelines

• The Assistant Chief of Emergency Medical Services ensures timely reviews of TFD personnel's medical status related to respirator use, following set guidelines

The TFD Safety Officer Regulations

• Administer the department's Respiratory Protection Program per state and federal guidelines
• Perform annual program effectiveness appraisal
• Create correction and improvement recommendations
• Submit annual appraisal findings and improvement recommendations to the Fire Chief

TFD Company Officers Regulations

• Verify personnel under their supervision conduct daily SCBA inspections
• Verify documentation of SCBA inspections on FIR 2530-0019
• Ensure proficiency in SCBA use

TFD Station 17 Captain Regulations

• Fit testing should be performed in compliance with WAC 296-842
• Ensure timely and compliant repairs, maintenance and replacement to existing resiratory equipment
• Maintain records for employee fit testing and respiratory repairs
• Schedule and verify compressed air cylinders testing

Operations Personnel Guidelines

• TFD personnel should maintain issued equipment in sanitary and operational condition
• Respiratory protection equipment should be used, maintained, protected from damage, and inspected regularly

Medical Evaluation, Personnel Regulations

• Personnel should complete a mandatory questionnaire, reviewed by a Health Care Provider (HCP)
• TFD will provide a medical evaluation to determine respirator fitness

Medical Evaluation: Department Guidelines

• TFD personnel can use private HCP for medical evaluations at their own expense
• Medical evaluations are conducted during work hours, following all PHI rules
• TFD must use licensed HCPs for evaluations
• The HCP evaluation uses a department questionnaire
• The TFD Safety Officer provides HCP information on the respirator to the employee along with any workplace conditions
• TFD must provide HCP with policy documents, WACs, questionnaires, and work descriptions including respirator weight, type, work effort, clothing, and temperature

Medical Evaluations Conduct

• Initial assessment occurs pre-fit testing
• There will be follow-up evaluations every 3 years, when reporting symptoms and when recommended by a HCP
• Evaluations would occur when requested by supervisor/officer and when indicated by fit testing/program evaluation
• Evaluations would also occur due to changes in workplace conditions/equipment/policy
• HCP provides written recommendation: indicates respirator use capability, any limitations, and the need for follow-up evaluations
• Assistant Chief of Admin and Support Services provides employee with copy of the HCP's recommendation

Fit Testing Instructions

• New TFD personnel must pass fit tests before SCBA training and be proficient in SCBA usage before going into hazardous zones
• Personnel must use only the make, model, and size respirator they were trained and fit tested on in the past 12 months
• Wearing contacts with a respirator facepiece is acceptable if a HCP determines it won't increase eye damage risk
• Those that must wear glasses, goggles or a face shield with a respirator facepiece must wear the equipment without affecting the seal on their face
• The straps or tample bars should not affect seal between face and respirator
• No facial hair that compromises facepiece seal or valve function
• Fit test cannot be conducted on personnel with facial hair that compromises with seal
• Personnel that use respirators must perform a fit check each time when using the procedure outlined in the document
• Appropriate equipment must be used and conduct testing with the procedures from the manufacturer, following the manufacturer's fit test form

Fit Testing Repetition Guidelines

• At least every 12 months
• When employee changes respirator or facepiece type
• Significant physical changes, including weight, scarring, dental or cosmetic changes
• Fit test records include pass/fail criteria, brand/model of test, type, equipment used, tested person's name, ID# of operator, date, results

Respiratory Protection Equipment Selection

• TFD must select and provide NIOSH certified respiratory protection equipment, following NFPA 1981, WAC 296-305-04001, and WAC 296-842-13005 compliance standards
• Use positive pressure SCBA or airline respirators (SAR) with escape bottles in IDLH atmospheres only
• SCBA service capacity should exceed 15 minutes; air supply use shouldn't exceed 20% of entry
• SAR air line must connect before entering IDLH
• SAR must have 5 minute minimum bottle capacity and maximum 300 ft of non-kinking hose
• Single-use/disposable respirators are for airborne pathogens only
• Personnel cannot use SAR for structural firefighting

SCBA equipment

• SCBA must have integrated PASS device and redundant alarm/pressure gauge, compliant with NFPA 1981 standards
• SCBA use means wearing facepiece and breathing supplied air
• SCBA is used when; the environment is contaminated (or suspected), potentially contaminated suddenly, or is oxygen deficient (or suspected)
• SCBA should be used when; Operating an active fire area, directly above them, a potential explosion area (including gas leaks), or during extinguishing vehicle/dumpster fires
• SCBA should be used where products of combustion are present (including carbon monoxide), where toxic products are present/suspected and/or released without warning, or in untested/monitored confined spaces
• SCBA should be used where overhaul operations are taking place

Asbestos fiber operations

• SCBA is required in asbestos areas
• Avoid dust with insulation, tiles shingles or adhesives
• Keep materials wet to minimize dust when cutting with a saw
• Decontaminate per TFD Policy 4004

Cold Weather Operations

• In cold weather, store the mask mounted regulator (MMR) in standby mount
• Use the neckstrap to keep the facepiece upside down to prevent any water from entering MMR
• Prevent moisture entering system during cylinder changes

PASS Device Regulations

• Personnel have to make sure PASS device is functional when using SCBA
• PASS device should be cleaned with a damp cloth after each use
• PASS device contaminated by harmful materials should follow decontamination or disposal procedures according to TFD Policy 4004 with all regulation standards
• Device shouldn't be painted or etched

Emergency Escape Breathing Support System (EEBSS) Regulations

• Thorough training/proficiency in EEBSS use is mandatory per WAC 296-305-04001
• TFD Company Officers shall carry an EEBSS hose on SCBA at all times
• EEBSS use is restricted to life-threatening emergencies or training exercises; not for routine work
• For transfill, firefighter with higher SCBA pressure is donor
• Minimum firefighter pressure to function as a donor:1000 psi (2216 cylinder rated) or 2000 psi (4500 cylinder rated)
• Transfilling is safe from high-pressure bottle to low with identical quick-fill fittings and pressure relief valves (prevents over-pressurization)
• Donor cannot attempt transfill with a low air alarm
• If the donor's low air alarm begins, donor must disconnect immediately
• Donor must notify Incident Commander (IC) of urgent EEBSS situation + location
• Notified IC deploys Rapid Intervention Crew (RIC) and air supply/rescue
• In the event of completion, the donor + receiver immediately exit area while notifying the IC

Breathing Air Quality Directives

• Breathing air in cylinders needs to meet requirements of ANSI/CGA G7.1 for grade D air and WAC 296-842-20005 for dew point standards
• When using mobile air compressors (Unit 42) on emergency scenes, one MUST ensure that the compressor is level during operation, that the composer avoids areas of high moisture level in air or water, and lastly the compressor position is upwind of sources of contamination
• TFD personnel should only use breathing air compressor systems after proper training
• The TFD Fire garage personnel must perform air quality tests quarterly
• TFD personnel perform air quality tests when compressed air changes or repairs are made

Respiratory Equipment Removal Procedures

• Wear equipment until the Incident Commander (IC) approves removal if the atmosphere is doubtful
• Take reasonable precautions to avoid contaminating the atmosphere
• One is to be decontaminated if possible when hazardous materials are present
• Facepiece should not be compromised in hazardous conditions even if air quality is unknown

Respiratory Equipment Inspections

• Inspect SCBA daily and after use including proper orientation of unit
• Inspect PASS for funtion prior to use, at shift change, after replacements, after each use, and when moving positions during a shift
• Results get documented on FIR 2530-0019
• Faulty equipment must be reported to the company officer

Procedures for Company Officers

• Officers shall ensure extra gear gets inspected and cleaned
• Make arrangements with Station 17 when repairs are needed
• Get spare equipment when needed
• All repair equipment needs to get inspected upon return

Procedure for Individuals SCBA

• Inspects every week and after use & documents results on FIR 2530-0020
• Contacts Station 17 regarding repairs
• SCBA that fails inspection cannot be used

Repair and Maintenance

• Made according to the manufacturer's recommendation
• Personnel and training from station 17 is used
• Items are to be removed if repair is needed

Personnel & Tagging

• Tag the items with pertinent defect informaiton
• Spare equipment is obtained
• Deliver to station 17
• A daily inspect is carried out after repair

What to do if there are excess concerns

• Disposable respirator is discarded
• Batteries have to be replaced
• Cylinders that are showing heat exposure should removed from use and tested

Regulatory: Facepiece Cleaning

• SCBA one that has been used
• One for personnel that can be cleaned with dish soap and water
• A spare one that is to be cleaned and disinfected

Regulatory: Personnel Action

• Keep clean equipment that will always be in good working condition
• Equipment is to be organized to not cause equipment compromise with the elements
• Personnel needs training for cleaning and sanitizing

Training

• Personnel from TFD training is to provide the equipment with all the following
• Scenarios that would require the use of respiratory equipment
• How to manage air supply
• Procedures used to don and doff respirators
• Check to see if the respirator is functioning properly
• Recognize hazards during operation
• Recognize limitations or components

Practice Frequency

• Training divisions personnel require each employee to practice each type of respirator
• Complete training and annual testing on all aspects
• Place training files together

Steps on Inspection Component

• Check components daily and after each use
• High pressure hose: Cuts, abrasions, tight fitting
• Facepiece: Rubber deterioration,dirt /cracks/tears/holes/ tackiness, check for head strap loss, cleanliness of lens, tight seal, and clean vlave
• Carrier and harness: cuts or chemical damage, secure screws, strap adjustment for twisted
• Cylinder checks and guages: cylinder cracking, guage needles are readable and at 90% capacity, heat damage

Audible Alarm

• Testing and security is required and alignment should function

Air pack steps

• Steps on cylinder usage
• Shoulder straps are straight and tucked
• Regulators are in the close position

Regulator System Steps

• Open cylidner valve and listen for alarms
• Guage should be consistent with settings on pack
• Follow steps on harness
• Should be at a value of no less then the required value

Facepiece Donning

• Facepiece is held
• Pull harness
• Check inlet
• Connection needs to be done for 10 seconds
• Block inlet again

Regulator System

• Open flow with button
• Quick connect the piece
• Sharp inhale for flow
• Check for values

Operation Tests

• Listen for the sound of air to test
• Follow green lights to show connection
• Reset and prepare for completion

PASS System test

• The system enters a mode
• Check the illumination
• Air should bleed on crack bypass

Personnel Cleaning

• Remove the part
• Clean throughly
• Dry the pieces
• Ensure testing

SCBA Usage

• Stay under 4 components
• Don't trust the mask inwater
• Keep the face piece on
• Regulate the valve
• Wide open with air supplies are low

Respirator Failures Actions

• Maintain calm
• Notify partner
• Preform all duties while doing below

Bypass Breathing

• Open and close during mouth breathing
• Small air is needed only

Alternate action

• Breathe with controlled levels

EEBSS Transfill Procedures

• Remove components
• Connect the components
• Preform audible test
• The test runs for 60 seconds
• Cylinders should be balanced