Respirator Program

SEIU is teaming up with hospitals to train hospital workers about emerging health threats, including assistance in developing respirator fit testing programs to ensure that respirators provide adequate protection.

The following article from Hospital Employee Health, March 2005 was reprinted with permission granted by Thomson American Health Consultants © 1991-2005 by Thomson American Health Consultants. 


Breathe easy with fit-test programs that work

Link program with emergency preparedness

(Editor's note: For many hospitals, annual respirator fit-testing represents a costly and time-consuming burden. But this hospital found a way to manage fit-testing by expanding it into hospital-wide emergency preparedness, and shared their approach with Hospital Employee Health.)

Ever since Sept. 11, when the first victims of the World Trade Center tragedy came across the river to Long Island College Hospital in Brooklyn, NY, Lewis Kohl, DO, chairman of emergency medicine and emergency preparedness, has been even more acutely aware of the hazards posed to health care workers.

It could be severe acute respiratory syndrome (SARS), avian influenza, or smallpox. It could be an act of terrorism. It could be some newly emerging infectious disease. Employees need to know how to respond -- and how to protect themselves. And respirator fit-testing is a part of that, he says. "Our perspective here was we really need to fit-test everybody if it's at all possible," Kohl adds, noting that his hospital has 2,500 on-site employees. "You stop and say, 'That's impossible.' Everyone's going to say you just don't have the resources."

He says he found the resources by combining fit-testing with a comprehensive emergency preparedness program. The hospital teamed up with the Service Employees International Union (SEIU), which had funds and trainers to provide an eight-hour course -- including money to provide backup for employees who were pulled off their shifts for the training.

The SEIU received a hazardous materials training grant from the National Institute of Environmental Science, which is part of the National Institutes of Health.

For some hospitals, training funds may be available from the National Bioterrorism Hospital Preparedness Program, which is part of the Health Resources and Services Administration. (Those funds may be distributed by state health departments. More information is available at

The eight-hour, one-day course covers a variety of topics, including hazardous materials, MSDS sheets, when to use a respirator and how to put it on and take it off safely, and the hospital's emergency response plan. During the day, employees are pulled out for their respirator fit-testing.

There are 15 to 25 employees in each class. So far, the hospital has trained more than 1,300 employees in various departments and job titles.

"It has worked as a seamless flow," says Steve Schrag, eastern region hazmat program coordinator for the SEIU, which assists with the training. "People learn about what they're exposed to, and they learn how to protect themselves. They get an opportunity to wear a respirator and learn how to put it on properly."

The training has raised awareness in a number of areas, Kohl adds. For example, trainers discuss the hazards of blood and body fluids and of the respiratory secretions of coughing patients. That improves employee compliance with using personal protective equipment and following respiratory hygiene, such as asking patients with a cough and a fever to wear a mask.

As part of the program, the hospital now has 50 employees trained to conduct fit-testing. The fit-testing showed that more choices were needed to accommodate different facial structures, and the hospital now provides three different styles as well as different sizes of N95 filtering facepiece respirators. The hospital also was able to set up as many as six fit-testing stations at a time -- as long as it used a spacious room that would not become saturated with the saccharin smell, he notes.

The SEIU may provide a four-hour refresher course. But Kohl says he's confident follow-up fit-testing and training updates will be feasible. Meanwhile, with the training, employees know where to go and what to do if disaster strikes. The class uses group activities to help employees walk through scenarios, from a hazardous materials spill to an unknown infectious disease. "My obligation is to make sure everyone in the hospital knows what the disaster plan is," he explains.

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