Emergency Preparedness and Response: Getting Started

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Introduction to PPE for Emergency Response Workers

Worker exposures to many types of hazards can be prevented or minimized by using engineering controls, administrative controls, and safe work practices. When controls are not feasible, or when such controls are insufficient to reduce worker exposures to certain hazards to or below safe levels (e.g., an OSHA permissible exposure limit [PEL] or other recognized limit), employers must ensure that their workers are provided at no cost and correctly use appropriate PPE. PPE is only one component of a comprehensive worker protection program, and, by itself, does not eliminate a hazard. For PPE to be effective, workers must properly put on, use, and take off appropriate equipment.

Employers of emergency response and recovery workers are responsible for ensuring that their workers have and properly use PPE when necessary. PPE can include respiratory protection, protective clothing, and protective barriers used to protect workers from exposure to chemical (including oil), biological, radiological and nuclear (CBRN) materials and other hazards. The selection of PPE is based on anticipated hazards and PPE selection may need to be modified as a result of monitoring and assessing actual working conditions. In planning for worker PPE needs, employers should consider the full range of a particular hazard a worker may experience (e.g., respirator cartridges suitable for both chemical and particulate exposures even if workers may only need protection from particulates most of the time).

Different types and levels of PPE may be used depending on the specific hazard or hazards present. PPE also may be needed to protect workers from other hazards, such as electric shock hazards or hazards associated with exposures to hazardous substances that may be encountered during emergency response and recovery operations.

The following are some of the important steps employers with emergency response and recovery workers need to take with respect to PPE:

• Conduct a hazard assessment to determine what safety and health hazards workers may encounter;
• Follow the hierarchy of controls—including elimination/substitution and engineering, work practice, and administrative controls—before relying on PPE to protect workers;
• Determine what PPE workers need;
• Provide the proper PPE to workers;
• Train workers in the proper use of PPE, including how to put it on and take it off correctly, and how to clean, maintain and dispose of it after or between uses;
• Ensure that PPE is used properly and whenever necessary;
• Provide medical exams and/or fit testing, as required by OSHA standards, prior to using certain types of PPE (e.g., respirators); and
• Regularly review and update the PPE program as hazards change.

It is crucial that employers plan in advance of an emergency for the PPE needs of their workers. During and immediately after an emergency, there may be limited supplies of PPE available for purchase, so it is important to have the necessary PPE on hand in advance. In an emergency situation, employers may have little or no time to train or fit workers (e.g., perform fit testing for respirators) for certain types of equipment, so it can be critical to have those tasks completed before an emergency occurs.

Selecting PPE for Emergency Response Workers

In selecting PPE for workers, employers should match the PPE to a worker's specific job tasks and working conditions. Select PPE based on a thorough hazard assessment at the worksite.  Consider the durability of PPE materials, such as tear resistance and seam strength, in relation to the worker's tasks. Evaluate other aspects of PPE use, including its impact on heat stress, length of time a worker is able to wear a specific combination of equipment, the physical condition of the worker, demands of the specific work activity, and any effects on worker mobility or dexterity. In some cases, layers of PPE may be necessary to provide sufficient protection.

Combinations or ensembles of PPE are classified generally into four levels, ranging from the most protective (Level A) to the least protective (Level D). Each level of PPE, described in the table below and detailed in Appendix B of the Hazardous Waste Operations and Emergency Response (HAZWOPER) standard (29 CFR 1910.120), consists of a combination of protective equipment and clothing that help reduce respiratory, eye, skin, and other types of exposures. The table includes a description of the respiratory protection devices associated with each PPE level. However, respiratory protection also is discussed in greater detail in the "Respiratory Protection" [anchor link to section below] section of this page.

LevelDescription and DetailsEquipment to be used as appropriate 

A

Consists of a Self-Contained Breathing Apparatus (SCBA) and a totally encapsulating chemical-protective (TECP) suit. Is to be selected when the greatest level of skin, respiratory, and eye protection is required. Practical limitations include limited air supply (20 – 50 minutes) and heat stress. If the HAZWOPER standard applies wearers must complete 40-hour HAZWOPER training at a minimum.

• Positive pressure, full-facepiece SCBA, or positive pressure Supplied Air Respirator (SAR) with escape SCBA, approved by the National Institute for Occupational Safety and Health (NIOSH).
• Totally encapsulating chemical-protective suit.
• Inner and outer chemical-resistant gloves.
• Boots, chemical-resistant, toe and metatarsal impact protection (e.g., steel or composite).
• Disposable protective suit, gloves and boots (depending on suit construction, may be worn over totally encapsulating suit).
• Coveralls, long underwear, and/or hard hat (under suit), optionally, as applicable.

B

Consists of a positive-pressure respirator (SCBA or SAR) and non-encapsulated chemical-resistant garments, gloves, and boots, which guard against chemical splash exposures. Provides the highest level of respiratory protection with a lower level of dermal protection.

• Positive pressure, full-facepiece SCBA, or positive pressure air purifying respirator (APR) with escape SCBA (NIOSH approved).
• Hooded chemical-resistant clothing (overalls and long-sleeved jacket; coveralls; one or two-piece chemical-splash suit; disposable chemical-resistant overalls).
• Inner and outer chemical-resistant gloves.
• Boots, outer, chemical-resistant with impact resistance.
• Boot-covers, outer, chemical-resistant (disposable).
• Coveralls, chemical-resistant boot covers, face shield and/or hard hat (under suit), optionally, as applicable.

C

Consists of an air-purifying respirator (APR) and non-encapsulated chemical-resistant clothing, gloves, and boots. Provides the same level of skin protection as Level B, with a lower level of respiratory protection.  Used when the type of airborne exposure is known to be guarded against adequately by an APR. Because of limitations of an APR, allowable only when oxygen levels are adequate (i.e., >19.5%), air contaminants are known, and a cartridge can be selected to provide protection from contaminants.

• Full-face or half-mask, air purifying respirators (NIOSH approved).
• Hooded chemical-resistant clothing (overalls; two-piece chemical-splash suit; disposable chemical-resistant overalls).
• Inner and outer chemical-resistant gloves.
• Eye protection is usually added if a half-face respirator is worn. Goggles or glasses, depending on the hazard encountered.
• Coveralls, chemical-resistant outer boots, chemical-resistant disposable boot covers, escape mask, face shield and/or hard hat (under suit), optionally, as applicable.

D

Consists of standard work clothes without a respirator. For example, in hospitals, consists of surgical gown, mask, and latex gloves (universal precautions). Provides no respiratory protection and only minimal skin protection.

• Coveralls.
• Boots/shoes.
• Eye protection is often added.
• Gloves, chemical-resistant outer boots, safety glasses or chemical splash goggles, escape mask, face shield and/or hard hat, optionally, as applicable.
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In addition to items listed in the table above, other types of PPE may be added, including but not limited to eye protection, hearing protection, fall and falling object protection, high visibility clothing, or U.S. Coast Guard-approved personal flotation devices, depending on anticipated hazards and specific worker tasks. OSHA's Safety and Health Topic page on Personal Protective Equipment provides information on PPE for various hazards across a range of industries, and links to relevant OSHA standards and more specific Safety and Health Topics web pages. These pages may help employers and workers identify the types of PPE necessary to prevent and reduce exposure to specific chemical, biological, radiological, electrical, and physical hazards.

Employers should also be familiar with the consensus standards of the National Fire Protection Association (NFPA) and other standards-setting organizations, as these may provide additional recommendations about PPE selection and use.

During an emergency involving a release of a hazardous substance, emergency response workers conducting operations outside of the contaminated areas, but who are anticipated to have contact with contaminated victims, may require Level C or D PPE. PPE selection may depend on a worker's anticipated proximity to the contamination zone perimeter, as well as anticipated contact with other potential sources of contamination (e.g., victims, other workers, or materials and equipment coming from contaminated areas). These workers may include healthcare professionals in hospitals or clinics receiving and treating patients from the site of an emergency or the surrounding contaminated areas. The OSHA Best Practices for Hospital-Based First Receivers of Victims document provides guidance in this area. Appendix B of the HAZWOPER standard (29 CFR 1910.120) also provides information about PPE levels and compliance with PPE requirements during emergency response operations.

Whenever an emergency event involves environmental contamination, the incident commander or unified command staff should communicate to workers and employers the boundaries between contaminated and uncontaminated areas. Employers should be aware that movement of workers, equipment, and members of the public between contaminated and uncontaminated areas may result in low levels of contamination outside of established boundaries.

Additional resources for assistance with PPE selection include:

• Emergency Response Resources: Personal Protective Equipment. Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS).
• OSHA/NIOSH Interim Guidance: Chemical, Biological, Radiological, and Nuclear (CBRN) Personal Protective Equipment Selection Matrix for Emergency Responders. Occupational Safety and Health Administration (OSHA), U.S. Department of Labor; and National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS).
• Guidance documents for protecting responders. National Personal Protective Technology Laboratory (NPPTL), Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS).
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If workers provide their own protective equipment, employers must ensure that the equipment is adequate to protect the worker from hazards at the worksite and properly used at all times. Employers also must ensure that the equipment is properly maintained and decontaminated after/between use(s). Paragraph (h) of the Respiratory Protection standard (29 CFR 1910.134) and paragraphs (a) and (b) of the PPE standard (29 CFR 1910.132) outline this requirement.

Operations that expose workers to harmful levels of particulates, chemical vapors, biological agents, and other airborne contaminants require implementation of a comprehensive respiratory protection program that meets the requirements of the Respiratory Protection standard (29 CFR 1910.134). Respiratory protection may also be necessary if workers must pass through or may encounter toxic atmospheres (such as dust, mists, gases, or vapors) or oxygen-deficient areas, including while conducting rescue operations and during evacuations. Respiratory protection programs require fit testing and training for workers, medical evaluation and monitoring and selection of appropriate respirators (and cartridges, if required).

Several categories of respiratory protection devices (i.e., respirators) are available to protect workers from inhalation hazards. The table below describes some of these categories.

Respiratory Protection

• Self-Contained Breathing Apparatus (SCBA)
• Highest level of respiratory protection, with an assigned protection factor of 10,000 when used in a pressure-demand or other positive-pressure mode and as part of a continuing, effective respirator program as required by the OSHA Respiratory Protection standard.
• Full-facepiece connected by a hose to a portable tank of compressed breathing air.
• Open-circuit, positive-pressure SCBA is most common type.
• Provides clean air under pressure from breathing-air cylinder.
• Negative-pressure SCBAs are prohibited by OSHA regulations for HAZMAT incidents. Response workers using level A or B PPE with an SCBA should be provided with a positive-pressure SCBA.
• Supplied-Air Respirator (SAR)
• Facepiece connected to an air source away from the contaminated area via an airline.
• Have greater breathing air capacities than SCBAs, so they can be used for longer periods.
• Although negative-pressure SARs are available, full-facepiece, positive pressure SARs are recommended for HAZMAT incidents.  These have an assigned protection factor of 1,000.
• Drawbacks of SARs include the necessity of checklists to ensure the purity of supplied air and the use hoses that deliver the breathing air.  Hoses must be protected from contamination, constriction and physical damage, and are limited to a distance of 300 feet.
• Air-Purifying Respirator (APR)
• Facepiece worn over the face (full facepiece), or mouth and nose (half facepiece), with a cartridge or filter that removes specified contaminants from ambient air before inhalation.
• Do NOT protect against all air contaminants.
• Must NOT be used where oxygen levels are inadequate.
• Full-facepiece APRs offer more protection (factor of 50) than half face-piece APRs (factor of 10).
• A powered air-purifying respirator (PAPR) is a type of air-purifying respirator that uses a blower to force the ambient air through air-purifying elements to the inlet covering. PAPRs have a higher assigned protection factor than half face-piece APRs: loose-fitting PAPR, APF 25; and hooded PAPR, APF 50.

Use respiratory protection specifically approved by NIOSH for CBRN exposures during such events, if possible. If NIOSH-approved CBRN-specific respirators are not available, the incident commander may allow alternative NIOSH-approved respirators. The table of assigned protection factors (Table 1) of the Respiratory Protection standard (29 CFR 1910.134) may help employers select appropriate respirators for particular operations.

Specifically for CBRN events, there is additional guidance on respiratory requirements in OSHA's Safety and Health Information Bulletin on CBRN Escape Respirators (SHIB 03-08-29 (A)).  Also, the National Institute for Occupational Safety and Health (NIOSH) has a fact sheet to help respiratory protection program administrators, safety officers, managers, and APR wearers understand the special features of a NIOSH-approved CBRN APR: What's special about Chemical, Biological, Radiological, and Nuclear (CBRN) air-purifying respirators (APR)?

OSHA's Respiratory Protection eTool and Respiratory Protection Safety and Health Topics web page provide additional information about selection and use of various types of air-purifying respirators and other respiratory protection equipment. Several OSHA training videos cover fit testing, maintenance and care, and other important aspects of respiratory protection program management.

Note that surgical masks are not designed or approved for protection against particulates or chemical vapors. In some situations, such as during outbreaks of communicable diseases, surgical masks may help to reduce transmission to other people when worn by infected individuals.

Emergency responses to hazardous substance releases are covered under OSHA's Hazardous Waste Operations and Emergency Response (HAZWOPER) standard (29 CFR 1910.120). Recommended PPE in the OSHA/NIOSH PPE Selection Matrix for Emergency Responders is selected to meet the requirements of this standard and Subpart I (Personal Protective Equipment). In order to use the guidance effectively, an employer must assess the risk of a hazardous substance release to the emergency response workers and base PPE selection on that risk.

There are twenty-eight OSHA-approved State Plans, operating state-wide occupational safety and health programs. State Plans are required to have standard and enforcement programs that are at least as effective as OSHA's and may have different or more stringent requirements.

Section 5(a)(1) of the Occupational Safety and Health (OSH) Act of 1970, often referred to as the General Duty Clause, requires employers to "furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees." This section may be used to address hazards for which there are no specific standards (e.g., exposure to certain biological or chemical agents).

Paragraph 11(c) of the OSH Act prohibits employers from retaliating against workers for raising concerns about safety and health conditions. OSHA encourages workers who suffer such discrimination to submit a complaint to OSHA. Such complaints must be filed within 30 days.

Depending on the specific work task, setting, and exposure to various hazards, additional OSHA standards may also apply. The list below includes general industry standards that commonly apply to emergency response and recovery operations. However, employers in the construction (29 CFR 1926); shipyard, maritime, and longshoring (29 CFR 1915, 1917, and 1918); and agriculture (29 CFR 1928) industries should be familiar with the OSHA standards that cover their workers, including those for HAZWOPER, PPE, and respiratory protection. In particular, standards for the construction industry are likely to apply during demolition, rebuilding, and other aspects of recovery following a disaster or other emergency event.

General Industry (29 CFR 1910)

• 1910 Subpart I, Personal protective equipment (PPE)
  • 1910.132, General requirements [related topics page]
  • 1910.133, Eye and face protection [related topics page]
  • 1910.134, Respiratory protection [related topics page]
    • Appendix A, Fit testing procedures (Mandatory)
    • Appendix B-1, User seal check procedures (Mandatory)
    • Appendix B-2, Respiratory cleaning procedures (Mandatory)
    • Appendix C, OSHA respirator medical evaluation questionnaire (Mandatory)
    • Appendix D, Information for employees using respirators when not required under standard (Mandatory)
  • 1910.135, Occupational head protection
  • 1910.136, Occupational foot protection
  • 1910.137, Electrical protective devices
  • 1910.138, Hand protection
• 1910 Subpart J, General environmental controls
  • 1910.141, Sanitation
• 1910 Subpart Z, Toxic and hazardous substances [related topics page]
  • 1910.1000, Air contaminants (also see related substance-specific standards in 1910 Subpart Z)
  • 1910.1020, Access to employee exposure and medical records
    • Also see 29 CFR 1904, Recording and Reporting Occupational Injuries and Illness
  • 1910.1030, Bloodborne pathogens [related topics page]

Certain emergency operations may require balancing worker protection with the need to conduct critical missions, such as those necessary for life-saving or critical infrastructure protection. In these instances, an employer should work with the incident commander, unified command staff, and other health and safety personnel to limit worker exposures to all hazards through a combination of engineering and administrative controls and safe work practices, supplemented by PPE.

Emergency response organizations should coordinate with employers in their jurisdictions to ensure they are prepared to respond to and safely perform rescue operations as needed at worksites that may pose unique or particularly hazardous conditions for emergency responders. This may include preparing, training, and exercising capabilities for response and rescue operations at steep angles or heights, such as in pits, tanks, manholes, boilers, furnaces, silos, hoppers, vaults, pipes, ducts, and bins or on slopes, communication towers, or other tall structures, including those under construction; in confined spaces, trenches, or underground; and over, near, or in water of various depths. Such operations may require special engineering and administrative controls, work practices, and PPE to protect emergency response and recovery workers. Employers may need to select and provide workers with, for example, special safety harnesses, ropes or cables, and respirators and cartridges appropriate for the hazards they may encounter. As always, PPE should be used as the final level of protection in the hierarchy of engineering (e.g., ventilating equipment, barriers, shields) and administrative controls and safer work practices.

Reference:  https://www.osha.gov/SLTC/emergencypreparedness/gettingstarted_ppe.html 

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