Ensuring Respiratory Protection

Graham Wilson explores how advances in wearable technology could help prevent deaths from hazardous airborne exposure in the workplace.

As professionals in the health and safety sector, we all know that respiratory health is important.

Unlike physical hazards, airborne dangers are often invisible and can have relatively minor short-term effects, but prolonged exposure can be exponentially progressive and can be truly life destroying.

Despite a greater awareness of workplace respiratory conditions, such as COPD and asbestosis, the Health and Safety Executive (HSE) still estimate that around 12,000 people die in Great Britain due to lung disease linked to past exposure at work each year.[1]

This is unacceptable.

As professionals in the field, we should be striving for “continual improvement,” doing everything we can to improve standards and minimise risk until everyone is safe in our workplaces.[2]

While an increased awareness of the risks and better standards in fit testing, training and monitoring/recording has helped save lives over the years, this is not the case everywhere.

But what can be done?

I believe developments in wearable technology hold the key to keeping our RPE wearing workforce safe in the years to come.

But before we can look at what we can do to reduce deaths and exposure rates, we must first understand what measures are currently in place to see what can be improved.

RPE

The reality is, for many jobs, it’s simply not possible to eliminate the respiratory hazard from the environment, or take away the human element of the task. For these instances, as a last resort, there is Respiratory Protective Equipment (RPE).[3]

In order to be effective, RPE needs to be both adequate and suitable.[4]

Adequate in that it is “right for the hazard faced to reduce exposure to the level required to protect the wearer’s health”, and suitable in that it is “right for the wearer, task and environment”.

Selecting adequate RPE is a matter of thorough risk assessments to identify potential respiratory hazards and subsequently finding appropriate RPE that are capable of offering protection from the type and concentration of hazard present.

Suitable RPE however, is a little more complex.

Not only does the RPE need to be suitable for the task (e.g. water-resistant, compatible with eye-protection, comfortable for extended wear etc.), the RPE must be suitable for the wearer.

Fit Testing

In order to assess whether a particular tight-fitting respirator fits a particular individual, a fit test should be undertaken by an accredited Fit2Fit tester.[5]

Once an employee has successfully passed a fit test on an adequate and suitable respirator, it’s important that they don’t deviate from this make/model/size so that the best chance of a seal can be achieved.

Since a person’s face shape changes over time, the BSiF recommend repeat fit testing at least every 2 years or sooner if an individual has facial surgery, scarring or gains/loses a significant amount of weight.[6]

The Problem

While fit testing is great at giving a reliable indication that a particular respirator fits a particular person at a particular point in time; if a wearer dons their mask incorrectly, has inadvertently damaged the casing or has forgotten to shave, their RPE may not be achieving the same seal that they achieved on the day of their fit test.

In order for RPE to work effectively and provide the level of protection offered, a seal must be formed around the wearer’s breathing zone so that contaminated air in the hazardous atmosphere is breathed in through the filters of the RPE.

If a wearer’s RPE is not sealing effectively, even by the gap of a hair, the wearer could unknowingly be exposing themselves to the respiratory contaminates present in their workplace, putting their life in danger.[7]

The Solutions

To account for this, HSE regulations in the HSG53 require users to perform pre-use checks every time they put on their respirator, including a seal check (or fit check) to assess the fit.[8]

Although the practical protocol for a fit check differs between respirator types and manufacturers, essentially the general practice involves covering/sealing the filters/inlet valve(s), breathing in and holding your breath for ten seconds.

The HSG53 explains – “If there is a good seal, the user will experience the mask sucking in toward their face. The wearer should hold their breath for ten seconds and the facepiece should not loosen. If it does, the facepiece should be readjusted and the seal checked again.”

Did I hold my breath for long enough? Was that movement in the mask? Did that jostle just effect my seal?

# Training
Training is the first, and perhaps most important, solution to this problem.

Organisations (and subsequently Health & Safety Managers and Departments) must ensure not only that their workers are fit tested, but that they also understand how to use the RPE that they have, and why it’s so important. How to don, fit check and maintain their RPE should all be part of the same process. Being trained by an experienced fit2fit accredited trainer is invaluable.

But even with the best training in the world, we are still dealing with people, and people forget.

# Monitoring & Recording
To help minimise this risk, organisations that use RPE are required to keep several types of record to ensure they are continuing to do all that they can to keep their staff safe.[9]

These records should include fit test results, RPE maintenance records and training activities; all of which are vital at ensuring continued good practice and that training is not forgotten or outdated.

However, while fit testing is recorded and monitored, fit checking – the actual assessment of seal suitability before entering the area of respiratory hazards – isn’t.

But what if it could be.

# Technology
Technology has made unfathomable advances in all sorts of areas of our lives, from smart phones to robotic surgical aids. There is no denying that in a relatively short period of time how we interact with the world has changed dramatically (and will continue to do so).

PortaCount technology has done wonders for the fit testing sector – providing measurable and recordable data on how well a respirator fits an individual. While the likes of TSI’s Real-Time FitCheck[10] offers a good proof of concept, it cannot practically replace the need for the fit check. Not only would you need a PortaCount machine directly outside every hazardous area, to perform the check you need to adapt the respirator – requiring the wearer to doff and don their RPE again.

No, instead, to solve the fit check problem, we should look to wearable technology instead.

Wearables

The HSE has acknowledged the “growing evidence that wearable devices can significantly benefit health and safety in the workplace” and is currently working on ways to validate the use of technologies in the workplace for health and safety.[11]

Thanks to the boom in the internet of things, more and more of our lives and our products are becoming connected in real-time.[12] With the likes of location tracking, heart-beat monitoring and gas detection, wearables are already being used for health and safety purposes to great advantage by many in the field.

But what if wearable technology could be applied to RPE.

Imagine if your respirator not only recorded if you’ve done a fit check, but it alerted you if you failed, and warned you if your seal becomes breached. Now that would save lives.

“Today’s imagination is tomorrow’s reality” – Albert Einstein.

Stay tuned for more information on the revolutionary FitCheck in-mask quantitative daily fit check device, coming soon.

Graham Wilson Design Director for Design Reality, a safety and medical industrial design agency based in St Asaph, Wales.

[1] https://www.hse.gov.uk/aboutus/occupational-disease/respiratory-disease.htm

[2] https://www.hse.gov.uk/opsunit/perfmeas.pdf

[3] https://www.hse.gov.uk/pubns/guidance/em6.pdf

[4] https://www.hse.gov.uk/respiratory-protective-equipment/basics.htm

[5] https://www.fit2fit.org/

[6] https://www.fit2fit.org/wp-content/uploads/2021/06/Fit2Fit-Companion-Qualitative-Method-June-2021.pdf

[7] https://www.hse.gov.uk/research/rrpdf/rr1052.pdf

[8] https://www.hse.gov.uk/pubns/priced/hsg53.pdf

[9] https://www.hse.gov.uk/pubns/priced/hsg53.pdf