New OSHA Directive: Tread Carefully with Respirator Shortages

Don't focus only on respirator availability

Hospitals could also be cited for not providing workers with N95 respirators or not properly fit-testing the equipment.

However, in the event of an N95 shortage, workers may extend the typical use of respirators and substitute surgical masks for N95s under some circumstances, OSHA said. Hospitals must make "a good faith effort to obtain other alternative respirators [during a shortage], such as N99, N100, or reusable elastomeric respirators," according to the compliance document.

Respirators are only part of a more comprehensive approach to H1N1 worker protection promoted by the CDC and OSHA. Ideally, hospitals should approach H1N1 precautions through these steps, in order:

1. Eliminate potential worker exposures (e.g., limits on ill visitors entering the hospital)


2. Using engineering controls (e.g., partitions in triage sites and closed-suctioning systems for intubated patients)


3. Observing administrative controls (e.g., flu vaccinations and respiratory hygiene steps)


4. Wearing personal protective equipment