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Friday, June 09, 2006

Guidelines For Use of PPE

This is part of a report published by the CDC through Morbidity and Mortality Weekly Review on 6/9/06.
The entire article can be found at:http://www.cdc.gov/mmwr/PDF/rr/rr5508.pdf

PPE Guidelines for Workers in Mold-Contaminated Areas

Outdoor

Exposure to some level of airborne mold is inevitable because molds are found indoors and outdoors (6,17). However, demolishing or cleaning heavily mold-contaminated materials outdoors can lead to excessive exposure to mold. The level of exposure to mold outdoors is primarily based on the amount of mold-contaminated material, the amount of mold in the material, and the type of work being performed. The need for PPE (including respiratory, skin, and eye protection) for outdoor workers requires ongoing professional assessment that considers the potential for exposure to mold and the potential for exposure to other hazardous substances that might be in the outdoor work area.

Indoors

Guidelines summarized below are based on guidelines from OSHA (37,42,43), EPA (13), and the New York City Department of Health and Mental Hygiene (18). These guidelines recommend particular respirators on the basis of the size of the area of mold contamination. However, the size criteria are based on general professional judgment and practicality because data are limited related to the extent of contamination to the frequency or severity of health effects.

When determining the potential for airborne exposure to mold and the need for PPE, the size of the area is not the only criterion to be considered. The activities being performed in relation to the mold-contaminated materials are at least as important. Therefore, ongoing professional judgment always must play a part in decisions concerning PPE. For example, any remediation or other work that disturbs mold and causes mold spores to become airborne increases the degree of respiratory exposure.
Actions that tend to disperse mold include
breaking apart moldy porous materials such as wallboard;
destructive invasive procedures to examine or remediate mold growth in a wall cavity;
removal of contaminated wallpaper by stripping or peeling;
and using fans to dry items or ventilate areas.

In addition, health status and other characteristics of the persons potentially exposed to mold also might need to be considered.

Category I Protection

Respiratory protection (e.g., N-95 disposable respirator). Respirators must be used in accordance with the OSHA respiratory protection standard (9,37).

Gloves and eye protection.

For use while cleaning the following:
Small isolated areas (<10 square feet) of heating, ventilation, and HVAC systems (includes pipes, ducts, and vents).
Isolated areas (<100 square feet) of building materials (e.g., ceiling tiles, small areas on walls, and individual or multiple wallboard panels).

Category II Protection

Respiratory protection with full face-piece respirators, with N100, R100, P100 (or for powered air purifying respirators, HEPA) particulate filters. Respirators must be used in accordance with the OSHA respiratory protection standard (13).
Disposable protective clothing covering entire body including both head and shoes.
Gloves.

For use while cleaning the following:
Large contaminated areas (>10 square feet) of HVAC systems.
Extensively contaminated (>100 contiguous square feet) building materials.
Any size area where substantial dust is generated during cleaning or debris removal (e.g., when abrasives must be used to clean contaminated surfaces or plaster walls are being demolished).
Areas where the visible concentration of mold is heavy (blanket coverage rather than patchy).

These guidelines should be followed according to professional judgment. For example, more protective respirators might be required if toxic contaminants such as asbestos or lead are encountered during cleanup. All workers dealing with large areas of contamination should be properly trained to handle hazardous materials.

PPE Guidelines for the Public (Nonworkers) in Residences and Nonoccupational Settings

Clean-up, Debris Removal, or Similar Activities

The activities (and possible exposure to mold) of persons re-entering their homes or working outside might be similar to those of workers. Preventing the creation of dust and limiting exposure to dust are the best ways to minimize exposure to mold (
1,9,18). For example, using wet mops or vacuums with HEPA filters instead of dry sweeping dust and debris will decrease the amount of dust in the air (1,9,18).

If building occupants, residents, or anyone must be around mold-contaminated dust, respirators will offer some protection. Particulate respirators (such as NIOSH-certified N-95 respirators) can be purchased in safety supply stores and in most home improvement stores. Several factors are required for respirators to provide protection from inhalation hazards (15,38,41,43):
The respirator must fit well and be worn correctly. The manufacturer's instructions on the package should be followed. Because respirators are meant to be used by healthy workers who have had training, medical evaluations, and a proper fitting, the amount of protection provided by a respirator to the general public might be much less.


No U.S. agency tests and certifies respirators for public use. However, NIOSH tests and certifies respirators for use by workers to protect against workplace hazards. Respirators certified by NIOSH will be labeled "NIOSH Approved" and will have an approval label that identifies the hazard it will protect against. The N-95 respirator is approved only for particulates including dust in the air from sweeping, sawing, mold removal, and other activities that cause dust. The N-95 respirator is not designed to protect against exposure to vapors or gases (e.g., carbon monoxide) and will not provide protection from them.

A properly worn disposable respirator requires that:
Metal nose piece
, if present, is on the top to adjust the fit to the wearer's nose.
NIOSH label is on the bottom outside of the respirator.
Both respirator retaining straps are in place, and they are securing the respirator to the face (some respirators have only one strap).


For the Public Not Involved in Clean-up, Debris Removal, or Similar Activities

Persons not involved in activities that disturb mold-contaminated materials have a lower risk for inhalation exposure relative to persons performing those types of activities. Persons collecting belongings, visually inspecting homes or buildings, or doing basic clean-up for short periods in a previously flooded home or building will not usually need to use a respirator.

For the Public Unable to Use PPE or at High Health Risk from Exposure to Mold

The effect of exposure to mold varies widely. Persons who might be affected to a greater extent than the majority of healthy adults include (5,6,9):
persons with respiratory conditions (e.g., asthma) or allergies, and
persons with weakened immune systems (e.g., patients receiving chemotherapy, organ or bone marrow transplant recipients, or persons with human immunodeficiency virus infection or autoimmune diseases).


Persons with special health concerns should consult their health-care provider if they are concerned about mold exposure. Symptoms that might seem related to mold exposure might have other causes, such as bacterial or viral infections or other allergies. The level of risk associated with exposure activities and the potential benefit of recommended PPE are unknown for pregnant women, persons aged >65 years, and children aged <12 years; exposure-reducing behavior and respiratory protection might be difficult for children aged <12 years.

Using respirators or other PPE might increase health risks for persons with underlying health conditions. Persons who have trouble breathing while using a respirator should stop working and contact a doctor or other medical provider (
1).

For persons at potentially increased health risks from exposure to mold, persons of unknown or uncertain risk, or persons unable to use respirators, caution is recommended when entering heavily mold contaminated environments, particularly when mold clean-up is occurring. Persons in these categories should avoid such situations if possible.

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