Not really. There are
three problems with this
scenario:
1) OSHA expects the practice leadership to use “engineering controls” and
“procedural controls” to solve safety problems BEFORE they resort to the use of
Personal Protective Equipment. That means there
must be an effective scavenging system in place that removes the waste
anesthetic gasses and the anesthetic machine must be checked for leaks before
each and every procedure. Following these engineering and procedural controls,
the exposure to the employee in the operating room should be virtually
non-existent. The combination of effective WAG scavenging systems and strict
procedural controls is normally very adequate to virtually eliminate the
exposure in the operating room altogether.
So when there is no real risk for exposure, the use of any
PPE would not notably improve the health of the employee or the affect the
progress of the pregnancy.
2) The real chance for exposure is
during the recovery portion of the procedure when the proper
safeguards are observed in the operating room. Patients give off
measurable amounts of anesthetic gasses in respiration during recovery.
Normally, with good general ventilation in the recovery room, there is little
exposure to the employee because the gasses are “diluted” with the room air to
the point that they negligible. However, this is still the time when most staff
members are exposed to the gas. The employee would have to wear the respirator
throughout their entire work shift if they wanted to avoid exposure to all
anesthetic gas concentrations but this is just not practical.
A better solution for poor general ventilation would be to install an exhaust
fan in the recovery area to ensure the air is “turned over” at least 4 to 6
times an hour.
3) When a respirator is used in the workplace to control a hazard, even
voluntarily, the practice must comply with the very strict rules set forth in
the Respiratory Protection Standard (1910.134), which include such provisions as
medical evaluations of employees required to use respirators, specific
procedures and schedules for cleaning, disinfecting, storing, inspecting,
repairing, discarding, and otherwise maintaining respirators, and of course,
specific employee training.
There is a provision in the regulation that allows “voluntary use of
respirators by employees when the employer has determined that respirators are
not required. Section (c)2 of the regulation states:
“An employer may provide respirators at the request of employees or
permit employees to use their own respirators, if the employer determines
that such respirator use will not in itself create a hazard. If the employer
determines that any voluntary respirator use is permissible, the employer
shall provide the respirator users with the information contained in
Appendix D to this section ("Information for Employees Using Respirators
When Not Required Under the Standard"); and
In addition, the employer must establish and implement those elements of
a written respiratory protection program necessary to ensure that any
employee using a respirator voluntarily is medically able to use that
respirator, and that the respirator is cleaned, stored, and maintained so
that its use does not present a health hazard to the user.”
So, even when the use of the respirator is voluntary, the business must still
comply with many of the rules of the RPS.
Of course, the concern by the employee must be taken seriously by the
practice leadership. Alleviating the concerns of the staff member is as
important as alleviating the actual hazards! Naturally, it’s best to avoid any
hazard when possible, but if it’s not practical, then the way to address those
safety concerns is to take the same track as one would with a medical case:
assess the physical conditions, perform laboratory tests to determine the exact
level of the problem (click
here for our Suggested Source Sheet for waste anesthetic badges) and
then prescribe a course of action (procedural controls).
Our associate is pregnant and wants to wear a respirator
in surgery. Is this a good idea?