In the last five months, the NIH Respiratory Protection Program (RPP) has fit tested and provided training for respirators to over 700 NIH employees. The program has overcome various challenges through the COVID-19 pandemic. These challenges include limited availability of respirators, almost non-existent testing supplies, huge surges in demand for fit testing, and personnel stressed by the pandemic and its demands. The program overcame its challenges through teamwork, and the development of new processes, protocols and equipment.
John Veitch, Branch Chief of the Technical Assistance Branch (TAB) within the Division of Occupational Health and Safety (DOHS), is proud of the program and its success. He praises the team’s ability to adapt to the rapidly changing program demands. “Every day a new challenge arises and every time they rise to that challenge with new and better solutions,” says Veitch.
The NIH Respiratory Protection Program (RPP) fit tests and trains NIH federal employees on the proper use of N-95 respirators and other respiratory personal protective equipment. Due to ongoing respirator supply chain shortages, only employees required to wear respirators, due to inhalation hazard in their current work environments, are tested. The type of respirator used during testing is based on the hazard, such as biological, physical, or chemical hazards, and the risks associated with the specific tasks the personnel are conducting.
The team is led by program managers and industrial hygienists William Barnett Lavergne and Sarah Wu. The goal of the RPP team is to find the best fit so that the respirator functions at its best. “Our job is to ensure that all N-95 respirators users know how to properly wear their N-95 respirator. Once the N-95 respirator users learn to properly use the N-95, the users will have the proper seal (protection) and the mask will be more comfortable to uses than if the users do not get fit tested," William says. William added “the goal of fit testing is to confirm the fit of any respirator forms a tight seal on the employee’s face before it is used in the workplace.” William has worked within DOHS as a safety manager for two years and two weeks before the stay at home order he was transferred to TAB. Sarah, also an industrial hygienist, has worked within the division for three years. The RPP team also includes Lauren Ficek, Sheila Nyambu, Maddie Lydon and Josh Greenberg.
Sarah says the group thrives on facing new challenges and crafting solutions, vetting them, and then implementing the best solutions to provide services for the NIH. “After figuring out what works, we are making it more organized.” Sarah says the program’s successes are due to its supportive leadership. “Without leadership allowing room for flexibility, without support and enablement, the Respiratory Protection Program would not have been able to meet the challenges of COVID-19. We wouldn’t be able to come close to matching the NIH’s needs during this time, with the circumstances we were under, without leadership trusting us enough and funding these initial tests to develop new hoods or other equipment. I’m very grateful for management allowing and encouraging the evolution of our program.”
Before an employee is fit tested, they must receive medical clearance from the Occupational Medical Service (OMS). Once an employee is cleared, the team works with them to get the proper respirator or mask. During the test, the team trains an employee to safely place the respirator on his/her face. Next, he/she is trained to adjust the mask and shown how to wear it. Finally, the team ensures the employee has a proper seal. The seal must then successfully remain secure throughout test exercises, which mimic an employee's daily usage. Exercises include turning their head left and right, leaning over and seeing if their mask stays on while speaking out loud.
William says less than 10% of NIH staff ultimately fail the fit testing. If an employee fails their fit test, then the team recommends and tests with other respirators, or recommends a powered, air-purifying, respirator (PAPR) or a controlled, air-purifying, respirator (CAPR).
In existence prior to the pandemic, the program will continue well after its current COVID program. William says the program supports individuals working in other hazardous environments, such as those working around biological, physical, or chemical hazards. While NIH does have an Respiratory Protection Program to provide Personal Protective Equipment (PPE), Sarah and William note that PPE should be the last line of defense, because removing a hazard or engineering it out, engineering controls in, or placing administrative controls in place, are far more effective in the long run than PPE alone. Overall, the RPP team is grateful for the patience, courage, and heart that the NIH community has shown during this time and is inspired by everyone pulling together to keep the NIH mission going strong.
