1
A Significant Undertaking

The federal agencies responsible for ensuring “safe and healthful working conditions for working men and women”1 have long needed information to measure workplace hazards, worker exposures, and their protection from exposure to those hazards. The need for information arose from the inception of programs developed in response to the enactment of the Occupational Safety and Health Act of 1970 in recognition of the unsafe and unhealthful working conditions of the workforce and the substantial burden that employee illnesses and injuries posed as a result. Since then, information gathering in various forms of data collection and surveillance has been a major aspect of these programs. The two programs developed as a result of this act were the Occupational Safety and Health Administration (OSHA), which as a part of the U.S. Department of Labor is responsible for developing and enforcing workplace safety and health regulations, and the National Institute of Occupation Safety and Health (NIOSH) which as a part of the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention is responsible for assuring safe and healthful working conditions for the workforce by providing research, information, education, and training in the field of occupational safety and health.2 OSHA maintains large databases of compliance data and has commissioned special surveys and analyses in support of its regulatory processes. Likewise, NIOSH manages a far-reaching surveillance program that has focused mainly on hazards, outcomes (fatalities and injuries), and exposures, but has also served to inform program management.

This commitment to information gathering has extended to NIOSH’s National Personal Protective Technology Laboratory (NPPTL). Established in 2001, NPPTL has as its mission the prevention and reduction of occupational disease, injury, and death for employees who rely on personal protective technologies. Respirator certification tasks were transferred from the Mine Safety and Health Administration when some functions of the Bureau of Mines were merged into NIOSH in 1995. Today, NPPTL is responsible for the certification for respirators and for the development of performance guidelines and standards for personal protective equipment (PPE). Respirators and other types of PPE, such as chemical-resistant clothing, hearing protectors, and safety goggles and glasses, are all technologies that provide protection for employees against occupational hazards or risks. The most concerted focus has been on respirators because they are the most regulated component of occupational safety and health programs in a variety of industries and because NPPTL manages an extensive program of certification for these devices.

Several attempts to gain valid information on workplace hazards and exposures have been made as part of a longstanding NIOSH program of workplace surveillance—some of which are discussed in this report. While each served a focused and valuable purpose, none of these surveys and data collections had taken a comprehensive look at the status of personal protection in the workplace. A comprehensive view of personal protection in the workplace requires obtaining information on hazards, exposures, use of protective equipment, performance of PPE, compliance with standards for programs of protection and how they interrelate, and identifying trends in these aspects of workplace protection.

To remedy this gap in knowledge, NIOSH commissioned and collaborated with the Bureau of Labor Statistics (BLS) to conduct a nationwide respirator survey in 2001. The purpose of this survey was to evaluate respirator use and practices in the workplace to help guide NIOSH respirator certification and research. Approximately 282,000 firms responded that they had required the use of respirators in the

1

Occupational Safety and Health Act of 1970.

2

See the following web site for more information: http://www.cdc.gov/niosh/about.html.



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Measuring Respirator Use in the Workplace 1 A Significant Undertaking The federal agencies responsible for ensuring “safe and healthful working conditions for working men and women”1 have long needed information to measure workplace hazards, worker exposures, and their protection from exposure to those hazards. The need for information arose from the inception of programs developed in response to the enactment of the Occupational Safety and Health Act of 1970 in recognition of the unsafe and unhealthful working conditions of the workforce and the substantial burden that employee illnesses and injuries posed as a result. Since then, information gathering in various forms of data collection and surveillance has been a major aspect of these programs. The two programs developed as a result of this act were the Occupational Safety and Health Administration (OSHA), which as a part of the U.S. Department of Labor is responsible for developing and enforcing workplace safety and health regulations, and the National Institute of Occupation Safety and Health (NIOSH) which as a part of the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention is responsible for assuring safe and healthful working conditions for the workforce by providing research, information, education, and training in the field of occupational safety and health.2 OSHA maintains large databases of compliance data and has commissioned special surveys and analyses in support of its regulatory processes. Likewise, NIOSH manages a far-reaching surveillance program that has focused mainly on hazards, outcomes (fatalities and injuries), and exposures, but has also served to inform program management. This commitment to information gathering has extended to NIOSH’s National Personal Protective Technology Laboratory (NPPTL). Established in 2001, NPPTL has as its mission the prevention and reduction of occupational disease, injury, and death for employees who rely on personal protective technologies. Respirator certification tasks were transferred from the Mine Safety and Health Administration when some functions of the Bureau of Mines were merged into NIOSH in 1995. Today, NPPTL is responsible for the certification for respirators and for the development of performance guidelines and standards for personal protective equipment (PPE). Respirators and other types of PPE, such as chemical-resistant clothing, hearing protectors, and safety goggles and glasses, are all technologies that provide protection for employees against occupational hazards or risks. The most concerted focus has been on respirators because they are the most regulated component of occupational safety and health programs in a variety of industries and because NPPTL manages an extensive program of certification for these devices. Several attempts to gain valid information on workplace hazards and exposures have been made as part of a longstanding NIOSH program of workplace surveillance—some of which are discussed in this report. While each served a focused and valuable purpose, none of these surveys and data collections had taken a comprehensive look at the status of personal protection in the workplace. A comprehensive view of personal protection in the workplace requires obtaining information on hazards, exposures, use of protective equipment, performance of PPE, compliance with standards for programs of protection and how they interrelate, and identifying trends in these aspects of workplace protection. To remedy this gap in knowledge, NIOSH commissioned and collaborated with the Bureau of Labor Statistics (BLS) to conduct a nationwide respirator survey in 2001. The purpose of this survey was to evaluate respirator use and practices in the workplace to help guide NIOSH respirator certification and research. Approximately 282,000 firms responded that they had required the use of respirators in the 1 Occupational Safety and Health Act of 1970. 2 See the following web site for more information: http://www.cdc.gov/niosh/about.html.

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Measuring Respirator Use in the Workplace past 12 months and were asked a battery of questions about respirator use practices. The survey results were published in September 2003 in a report entitled Respirator Usage in Private Sector Firms.3 This survey was a significant undertaking for these two agencies. It was preceded by several years of intensive preparation and followed by an analytical program on the part of NIOSH. Although the survey was a fairly massive data collection effort, it could be viewed as a beginning, not an end, to the collection of data on hazards, exposures, and protective equipment use. To fulfill its mandate, NIOSH must develop an ongoing strategy for better understanding of respirator use in the workplace, particularly from the employee perspective. NIOSH must do this in a time of significant change—many of the programs that underpin our workplace protection systems are being fundamentally transformed in scope and approach. To accomplish its strategic plan, NIOSH needs to identify and address additional data to be gathered in both the private and the public sectors, in a format that will maximize the usefulness of the information. To aid in this endeavor, NPPTL has requested the National Academies, through its Board on Chemical Sciences and Technology and its Committee on National Statistics, to conduct an independent review of the 2001-2002 NIOSH/BLS survey of respirator use among private firms in the United States. This review is part of a larger, more extensive look at scientific and technical issues relevant to the development, certification, deployment, selection, and use of PPE, standards, and related systems to ensure workplace safety and health. The Institute of Medicine has formed a standing Committee on Personal Protective Equipment (COPPE) in the Workplace to steer National Academies studies to support the NPPTL. This review is under the auspices of COPPE. This review addresses the following issues related to the Survey of Respirator Use and Practices (SRUP) and NPPTL’s research agenda: The adequacy and appropriateness of the survey instrument, considering both the content and the format of the instrument; The adequacy and appropriateness of the survey methodology, including the choice of sample, the sampling method, survey follow-up, and ultimate response rate; The methods of estimating the resultant survey data and the adequacy of the data to address policy concerns with respirator usage; The extent and adequacy of data analysis and publication; The appropriateness of conclusions reached from the data; The possibility of extending the utility of the data through additional statistical analysis; and The potential for obtaining additional information that is useful to NIOSH from current and future survey results. Each of these issues was considered by the committee to constitute a task to be accomplished in its review. To the extent that information was available to it, the committee assessed each of these issues and made recommendations when appropriate. ORGANIZATION OF THE REPORT The organization of this report reflects the approach to the task taken by the study committee. In Chapter 2, the data needs of the federal agencies with responsibility for workplace protection are examined, in recognition that these programs are in transition and that data needs are changing as a result of the transformation of the science and policies for employee protection. Prior attempts to build a base of understanding of hazards, exposures, and protections are discussed. The report summarizes three national surveys that, by virtue of their design, yielded qualitative, not quantitative, exposure and hazard information. They provided few firm data on protective practices. Chapter 3 documents the process of selecting the survey approach and methodology employed in the SRUP. Attention is devoted to the survey objectives since the design is influenced by those objectives and the analysis is delimited by the design. The chapter documents the major survey design steps of questionnaire development, sample selection, data collection, editing and imputation, and analysis. A critique of the survey methodology is found in Chapter 4. Based on presentations made to the committee in its fact-finding meetings and in its review of documentation provided by BLS and NIOSH, conclusions were drawn about the adequacy of the methodology utilized in addressing the major aspects of the survey design. The overall quality of the survey was assessed, in view of the purposes the survey was to have served, and consideration was given to whether the conclusions were appropriate. Finally, in Chapter 5, future data needs and potential sources of data are considered in order to provide guidance to NPPTL on data sources and approaches to obtaining measures of the information necessary to carry out the important mission of this agency. Also alternatives are suggested to the provision of information of interest that do not involve the complexity and expense of a large-scale survey of establishments, such as the SRUP, as well as a detailed protocol for a survey that could gather the type of data NIOSH and NPPTL want and need to carry out their missions. A list of acronyms used in the report is found in Appendix D. 3 Bureau of Labor Statistics and National Institute for Occupational Safety and Health; Respirator Usage in Private Sector Firms, 2001; Washington, D.C., 2003.