Behind the scenes

Occupational Hygiene is a science and engineering-based discipline of anticipating, recognizing, evaluating and controlling health hazards in the working environment, with the objective of protecting worker health and wellbeing and safeguarding the community at large. We protect and promote the health of workers, including healthcare workers.

Certified Occupational Hygienists (COH)® specialise in the assessment and control of workplace hazards including biological hazards such as viruses. We conduct risk assessments in collaboration with frontline workers and utilise the Hierarchy of Control to determine a range of controls to reduce worker exposure to dangerous hazards.

Unfortunately, respiratory protective equipment (RPE) is one of the most commonly adopted control measures to protect worker health. Why do I say unfortunately? Well, it is not controlling the hazard at the source, or even in the exposure pathway, it only controls the exposure to the worker when correctly selected, fitted and worn 100% of the time.

Occupational hygienists are involved in the selection, training, and recommendations for use of respiratory protection in the workplace and therefore uniquely placed to provide valuable information to policy makers, procurement agencies and end-users such as hospitals, clinics and aged care facilities.

Whilst surgical masks have been recommended extensively in national and state guidelines to protect healthcare workers, they don’t have a ‘protection factor’ per se, as they are not respiratory protection. They are recommended to interrupt the chain of infection transmission for the general public in low risk settings where social distancing isn’t possible and designed to protect other people from droplets and aerosols expelled by the wearer. Respiratory protection, such as a P2/N95 on the other hand, is designed to be tight fitting and protect the worker from airborne particles, whether aerosols or droplets. The Australian/New Zealand Standard 1715 (Table 4.1) states that suitable protection for a Risk Group 3 Micro-organism is respiratory protection of at least a P2 level.

Where respiratory protection is selected for use as a control measure to protect worker health, a Respiratory Protection Program becomes necessary. All the elements of this are contained in the Australian Standard, but broadly they include:

• roles and responsibilities
• appointment of a program administrator
• selection of respiratory protection equipment
• education and training
• issue of RPE
• fitting of RPE (fit testing)
• wearing of RPE (including fit checking)
• maintenance, record keeping, and program evaluation.

Most states provide Guidelines for Respiratory Protection Programs. Some of these are good examples, but you should refer to Australian/New Zealand Standard 1715 to really understand its application and apply it to your organisation and facility.

What are Occupational Hygienists doing to protect healthcare workers during the pandemic?

1. Many of us would have noticed an increase in demand for P2 respiratory protection driven by both the bushfires and more immediately for CoV-SARS-2. This has resulted in non-compliant respiratory protective equipment entering the supply chain, which has been highlighted by several bodies including SafeWork NSW and WorkSafe New Zealand. “A Guide to Buying P2, or Equivalent, Respiratory Protection for use in the Australian & New Zealand Work Environment” is targeted towards those who buy disposable respiratory protection and will help them make sure that it meets suitable standards. Over 500 products have been withdrawn from the Therapeutic Goods Administration since that guide was published.
2. To support the current high demand for experienced fit-testers for healthcare workers; and promote the value of the Occupational Hygiene profession to provide solutions-based focus, the Australian Institute of Occupational Hygienists launched the RESP-FIT program early. This website provides a list of persons who are experienced at performing respirator fit testing, provides a syllabus for an approved training provider and competencies for an accredited fit tester. It also has a comprehensive set of resources and FAQ’s.
3. The AIOH and the Australian Society of Anaesthetists hosted a joint Webinar in late October with over 500 attendees.

We are continuing to work with the State Health Infection Control groups and other stakeholders on RPE and higher order controls for COVID-19. For specific questions on respiratory protection please feel free to contact respfit@aioh.org.au.

Contributed by Jane Whitelaw FAIOH, Certified Occupational Hygienist (COH)®, CIH®, The University of Wollongong.

Jane is a Certified Occupational Hygienist, Certified Industrial Hygienist and Fellow of the AIOH. She joined the University of Wollongong in 2009, where she is Academic Program Director for the Occupational Hygiene Program.

She is a Quantitative researcher whose primary area of research is in the evaluation of controls for prevention of occupational diseases with a particular focus on respiratory illnesses. She is Chair of the AIOH RESP-FIT Accreditation Committee and a member of SF10 Australian Standards Committee. A member of the DHHS Infection Prevention Working Group, she has actively developed and influenced guidelines on PPE and infection control. She is currently a PhD candidate at the University of Wollongong in the Faculty of Medicine.