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Measuring Respirator Use in the Workplace
ment practices. These rather ambitious plans were not implemented, and only a more narrowly focused effort to collect information on respirator use bore fruit.
Respirator Surveillance Team. The overall NIOSH surveillance program turned its immediate attention to the work of an internal NIOSH team—the Respirator Surveillance Team. This team conducted a study of options for surveillance of respirator use and integration of respirator surveillance into the ongoing NIOSH program of field investigations. The team had multiple objectives for the study: to inform a fiscal year 1999 respirator surveillance project, to provide information to other program teams and the certification program, and to inform other parties interested in the use of respirators to control occupational exposures.4
In consultation with staff of the respirator certification program, the Respirator Surveillance Team developed a list of questions that a respirator program might answer:
Of the total U.S. workforce, how many employees use respirators?
Of those employees using respirators, what respirator types are used?
For each respirator type, what hazards are they used to protect against?
Of those employees using respirators, how many are employed by firms with a complete written respirator program, with a designated program administrator, and with a program that includes hazard assessment, fit-testing, training, and maintenance?
Of those employees with access to a complete program, what fit-test methods are used?
Of those employees who are fit-tested, is fit-testing conducted by in-house personnel or by a private vendor of fit-testing service?
NIOSH personnel recognized that these questions were not suitable for direct administration in a field collection instrument. These are topical questions formulated to focus on the type of information to be developed.
It was further recognized by members of the Respirator Surveillance Team that the questions identified did not address a fundamental aspect of respirator protection—the acceptance of them by employees. The team had considered including provisions for exploring respirator acceptance by including an item such as: “Provide feedback to NIOSH about any aspects of respirator design or use that could be improved to promote respirator use when engineering controls are inadequate.” However, the team elected to focus only on aspects of respirator use that could be assessed objectively with help from the employer alone.5 NIOSH personnel decided to forgo direct collection from employees (i.e., respirator users) themselves, setting the stage for a significant weakness in the eventual survey.
The Respirator Surveillance Team reviewed a number of options for collecting the necessary information. These options included repeating data collections along the lines of the National Occupation Exposure Survey and National Occupational Health Survey of Mining projects; a NIOSH interdivisional survey of occupational safety and health programs; surveys in collaboration with BLS; field studies; and focus groups. Considering these options, the team recommended several future actions that would lead to a survey of respirator programs.
Development of the NIOSH-BLS Working Agreement. In the end, NIOSH selected the option of commissioning a BLS survey and elected to enter into an Interagency Agreement with BLS. It did so for several reasons, not the least of which was NIOSH recognition that BLS is an unbiased, reliable, and objective source of expertise. Importantly, BLS had laid some of the groundwork for a respirator use survey by having established respondent contacts as part of its recent (1999) collection of SOII data. Finally, BLS had the methodological infrastructure to conduct such a survey. Nonetheless, this special-purpose survey constituted a new line of business for the Office of Safety, Health, and Working Conditions of BLS.
Although it is a large, multipurpose statistical agency, BLS had some limitations in conducting surveys of this type. Although well acclimated to the conduct of the large annual SOII and other regular collections, BLS had little experience in conducting special-purpose, reimbursable surveys in this field. Importantly, the agency had methodological expertise but did not have the field infrastructure to support a data collection effort of this scope and complexity. The agency would have to contract out data collection to the National Opinion Research Center at the University of Chicago.
The interagency agreement negotiated between NIOSH and BLS translated the overall objectives into a very specific statement of requirements. Data collected from the SRUP would be used by NIOSH “to identify by industrial sector and establishment size: (1) the distribution of respirator use, (2) the types of respirators used, (3) the hazards that respirators are used against, (4) the training of respirator users, (5) the extent medical examinations are used to qualify employees for respirator use for all respirator users, (6) the extent fit testing is used to qualify employees for respirator use, (7) the conductor of fit testing by users, (8) the distribution of fit test methods, (9) the training level of respirator program administrators, (10) the characteristics of respirator programs, and (11) the usefulness of NIOSH
Campbell, Don, Al Dieffenbach, Dennis Groce, Ruth Ann Jajosky, and Greg Spransy, Respirator Surveillance Team report to DRDS lead team, NIOSH Internal Document, September 15, 1998.