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Full text of "PPT Program Past, Present, Future"

PPT Program 



Past 





Present 



Roland Berry Ann 
Deputy Director, NPPTL 




Future 




Courtesy of: Viramask 



Maryann D'Alessandro 
Assoc. Dir. for Science, NPPTL 
PPT Program Coordinator 






tffr^ifuff ftirtrtmirip* 



Respiratory Protection - Not New 



Pliny the Elder (23-79) described 
a filtering device for use against 

vermillion dust 




16th century-16 th Century - 
Leonardo da Vinci envisioned a 
cloth mask used to protect a 
person from toxic powder 



The history of protective masks dates back to 
the 16th century. 

Leonardo da Vinci (1452-1519) described a 
fine cloth dipped in water to cover the nose 
and mouth. 

The description indicates that the mask could 
protect sailors from a toxic powder weapon 
he had designed. 



Sources: 

http://www.womensmemorial.org/H&C/Collections/photoexample.html 

http://www.kausal.com/leonardo/ 






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Respiratory Protection - Not New to Healthcare 



17 th Century Physician 
Visiting a Plague House 



21 st Century Surgeons in a Modern 
Operating Room 











tftriurtifT ftirtrtmirip* 



First U.S. patent for an air-purifying 
respirator granted in 1849 



Haslett's Lung Protector used a moistened 
wool filter or similar porous material and two 
one-way clapper valves to filter dust. 

One valve allowed inhalation of air through the 
filter 

One valve released exhaled air into the 
atmosphere. 



tftriurtifT ftirtrtmirip* 



Congress established the U.S. Bureau of 

Mines in 1910 



Prior to USBOM, coal mine 
fatalities exceeded 2000 
annually 

Charged to adopt 
improved safety 
procedures to help reduce 
accidents in the coal 
mining industry 



/ MB 


1 © 


I- ■ 








tftriurtifT fWfnrn/W/w 



During the 1918 Pandemic face 
coverings were used by the general 
public for protection 







tftriurtifT ftirtrtmJrip* 



1918 - Facemasks used to protect against 

influenza 







tftriurtifT ftirtrtmirip* 




During the 1940s, 
overseas, military 
personnel, nurses and 
civilians were legally 
required to carry gas 
masks at all times. 




P1I0TECT fatflt GAS MASK. . . 



...IT WILL PROTECT YOU 



Dche kifliLL* yam gu nunk EDUGHIV. 
Ful yam £■« m*ik in tares*: COBHICTLV. 

Dry Jact- piece il wv t. 

Keep waicr Irani Hitaiiny canirivc. 

DojVI hi* your gu ttiimJ< jih r ml dt 
pillow. 

Dvnl uw cannAcr li a h*nrarr 

Oori'l eptn eiiUtMt idi any I4U4A, 

P»n> evtrUI*f<b k+*d hiinm. 

Hon I Til* jnn: - 3 *i MWh i-h#n a <i-.ii! 

ivpi r*J?i will d*. 
Ripen gM mftffc d*(#Gti to NCQ pramplly 
Den'i fairy uuBulhariiDd idemi in youi gat mart caixUr. 

Keep "y QU| AM ■■»**■: in a cwJ, dry placv ouJ o( diic-cl i-un- 

tighd Kheri not lii uk-. 

At ALL TtMCS! 





Harriette (Burandt) York Collection, Gift of Marylouise 
Ethington, Women's Memoria I Foundation Collection. 



Source: http://www.womensmemorial.org/H&C/Collections/photoexample.html 






tftriurtifT FrirtnmJrifH 



Advancements in Protection 



. i 







1917 MSA 




:1 ..# 5&V?( 




1917 MSA 





1924 BOM 
Kilman's 
cap-style 
dust respirator 






tftriurtifT ftirtrtmJrip* 



Early PPT Activities, Including the 
Creation of NIOSH (Pre-1977) 



• The first concerted effort to 
address the safety and 
protection of coal miners was 
the creation of the USBM in 
1910. 

• When NIOSH was established 
in 1971, a crucial need to 
determine the correct role of 
respiratory protection in 
workplaces was recognized. 



1910 



Bureau of Mines created 



1969 


Mine Act mandates joint 




DOI/HEW approval of 




respirators 


1970 


OSH Act creates NIOSH 


1972 


NIOSH and BOM 




consolidate Approval 




Schedules into 




regulations 






TtOSH 



\J DD f T r ¥ Research to Pricikt 1 



PPT Program (1977-1996) 



In 1977, the NIOSH Division of Safety 1977 

Research (DSR) was created in 

Morgantown, West Virginia, becoming the 

first division-level focus on PPT research 

within NIOSH. DSR work included the 

testing and certification of respirators and 

other PPE. 

Prior to 1995, all respirator certifications were 
issued jointly by MSHA and NIOSH. Under the 1995 
new respirator certification regulations (42 
CFR Part 84), NIOSH became the sole 
approving authority for most respirators. 



PPT research 
established in 
NIOSH's DSR 



NIOSH publishes 
42 CFR Part 84 
approval 
requirements 






TtOSH 



\J f> D f T r ¥ RtfMvrch to Pricikt 1 1 



Resurgence of Mycobacterium 
tuberculosis (Mtb) (1990 - 1994) 



Modes of 



Debates 



• Respiratory Protection Level Debates 

- Surgical Mask - High Efficiency PAPR 

- Comfortable protection 

- Cost effective 

- Fit testing issues 

• Healthcare Support for New N95 Respirator 






tftriurtifT ftirtrtmirip* 



1995-Federal Regulation 42 CFR Part 84 



Certification requirements for 
respiratory protective devices 
upgrades testing requirements 
for particulate filters. 

New public health regulations 
replace MSHA regulations 







TtOSH 



\J DD f T r ¥ RtfMvrch to Pricikt 1 3 



Proposal for Federal Certification of PPE and 
Clothing for Firefighters and Emergency 

Response Personnel 

Report prepared by NIOSH and contractor in response 
to 1997 Senate Appropriations Report Number 104-368, 
DOL, DHHS, Education and Related Agencies 
Appropriations Bill, HR 3755 

The Committee is aware of concern over the lack of standards and 
certification of personal protective clothing and equipment used by 
firefighters and emergency response personnel. 

Submitted to NIOSH Director in 1997 in preparation for 
1998 budget hearings. 

No action taken 






PPT Program (1997-2000) 



Two significant events occurred during 1996-1997 that had major impacts upon 
the PPT Program: 



• First, the USBM was abolished, 
resulting in the transfer of the 
Pittsburgh Research Laboratory 
(PRL) into NIOSH, together with 
its hearing protection activities. 



Second, NIOSH's respirator 
certification functions were 
transferred from DSR to the 
Division of Respiratory Disease 
Studies (DRDS). 



1910 
USBM 



1971 
NIOSH 



1977 
DSR 



1995 
42 CFR Part 84 



1996 

PRL 1997 
DRDS 




1/1/1900 



12/31/2050 






tftriurtifT ftirtrtmirip* 



Evolution of NIOSH Respirator Regulations 



1910 
1919 
1969 

1970 
1972 

1973 
1977 

1995 
2001 



Bureau of Mines created 

BOM publishes Schedules 13 and 14 

Mine Act creates MESA from BOM, mandates joint DOI/HEW 
approval of respirators 

OSH Act creates NIOSH 

NIOSH and BOM consolidate Approval Schedules into 
regulations 

BOM approval responsibility transferred to MESA 

Mine Act transfers MESA to DOL as MSHA, mandates joint 
DOL/HEW approval of respirators 

NIOSH publishes 42 CFR Part 84 approval requirements 

NPPTL created with respirator program as cornerstone 






TtOSH 



\J DD f T r ¥ Research to Pricikt 1 6 



NPPTL Congressional Direction 



Congressional FY 
2001 Appropriations 
Bill: 

- Identified the need for 
protective equipment 

- Encouraged research 
for personal protective 
technologies 

Congress allocated 
funds to establish 
NPPTL 







TtOSH 






Foundation of NPPTL 



Morgantown 



r 



Respirator 
Approval 
Program 



Protective 
Clothing 



Pittsburgh 



Long-Term 

Field 
Evaluation 



New 



NPPTL 

Research 

Focus Areas 



Respirator 
Research 



Policy & 

Standards 

Development 







TtOSH 






The terrorist attacks of 9-11 intensify 
the need for CBRN respirator 
standards 



Large numbers of 
respirators anticipated 
in time of large-scale 
response 

Decontamination 
procedures needed for 
safe removal and 
disposal of respirators 







TtOSH 



\J /> Z> T*/ Att**nrh to Pricikt 1 9 



Severe Acute Respiratory Syndrome (SARS) 

2003 



SARS global outbreak of 2003 spread to more 
than two dozen countries in North America, 

South America, Europe, and Asia in a few 

months before it was contained. 

Respirator supply issues 

- Extended use 

- Combination of protections 







TtOSH 



\J f> D f T r ¥ Research to Pr*cik* 20 




NIOSH PPT 

Relevance a 

Mine Escape Issues 

• Mine Emergency Respirator 
Investigations 

• New Technology Research 

• Escape Respirator Research 

• Escape Respirator 
Standards 

• MSHA Collaboration 



Program 
nd Impact 

CBRN Issues 

• Respirator Standards 
Development 

• CBRN PPT Research 

• Respirator Certification 

• NFPA/IAFF Collaboration 

• TSWG IAA 

• OSHA Collaboration 





Nanotechnology Issues 

• Filtration Research 

• Protective Clothing Research 

• Respirator Research 

• Respirator Certification 

• Workplace Guidance 



Pandemic Issues 

• N95 Respirator Research 

• Standards (Total Inward 

Leakage) 

• Respirator Certification 

• FDA Collaboration 

• National Academies 
Activities 

• Pandemic Planning and 
Response 







tftriurtifT ftirtrtmirip* 



NIOSH Program Portfolio Structure 
Established in 2006 



NORA /NIOSH 
Industry Sectors (N=8) 



NIOSH Cross Sector Programs (N=24) 



Agriculture, forestry, and 
fishing 

Construction 

Healthcare and social 
assistance 

Mining 

- Oil & Gas Extraction 

Manufacturing 

Services 

- Public Safety 

Transportation, 
warehousing, and utilities 

Wholesale and retail trade 



Authoritative 

recommendations 

development 

Cancer, reproductive, 
cardiovascular, 
neurological & renal 
diseases 

Communications and 
information dissemination 

Emergency 
preparedness/response 

Global collaborations 

Health hazard evaluation 
(HHE) 

Hearing loss prevention 

Immune, dermal and 
infectious diseases 

Musculoskeletal disorders 

Personal Protective 
Technology (PPT) 



Radiation dose 
deconstruction 

Respiratory diseases 

Training grants 

Traumatic injury 

Work organization and 
stress-related disorders 

Economics 

Exposure assessment 

Engineering controls 

Work life initiative 

Occupational health 
disparities 

Small business assistance 
and outreach 

Surveillance 

Nanotechnology 

Prevention through design 






tftrinfiifT ftirtrtmirip* 



Where are we going? 




Photo Courtesy: Flickr.com 






tftriurtifT fWfnrn/W/w 



PPT Program Planning Inputs Drive the Future 



External 
Factors 



2nna 



SARS 



2004 



2005 



Hurricanes 



o 



200fi I 2007 2008 200Q 2010 



O 



Mine Disasters 
Sago, Darby, Alma 
I 



Avian Influenza Threat 
Pandemic Influenza Threat 



TB protection controversy 
Congressional Mandates, public policy 



.2018 



Surveillance 



BLS/NIOSH 
SPUR 



Strategic Planning 



* 



* 



•*► 



Reports ♦ 
& Evaluations 



Peer Reviews 



w^m^m 



w^m^m 



w^m^m 



♦ 

CSS 
IOM Reuse 



Draft HCW 

♦ 

IOM 
A Anthro ^ 

NRC IOM 
SPUR Pandemic 



♦ 

CSS 



▲ NA 
Review 



i^a^ai 



i^a^ai 



i^M 



COPPE D 
Public Meeting A 
Manufacturer — 

Meeting 
Workshop # 
Other Meetings 



AAA AAA 



A 



□ □ □ 
A 



zm 



■ ■ 
A 



COPPE 
Pandemic 



_ 



• • 



HCW 

Action 

Plan 



Open docket 
Revise Plan 



Implement Plan 



tofeV Unci H#crilh- 



jfrFijjivA FiirtrtmJrip* 



The PPT Program Target is 103 employees 



120i 






-— - - 


r 


100- 

c/) 




103 






£ 80- 


^ _,-— 


Q. 

§j 60- 
o 


^ 




73 


74 


-i 


50 


57 


60 


60 


61 


62 


66 


<D 40- 
.q 

E 

Z 20 

n. 


30 



DFY01 DFY02 D FY03 □ FY04 D FY05 ■ FY06 □ FY07 D FY08 □ FY09 □ FY10 D FTE-MASO 






tftriurtifT ftirtrtmirip* 



PPT Program has received modest funding increases 



c 
o 



C 8 

6 



01 



-si 

CO 



»= 



00 




k> 



00 
CD 




■ 



J* 
00 






O) 












FY05 



FY06 



FY07 



FY08 



FY09 



FY10 













BIT 

Mm 




£* Wh*V OncJ HiHI'l 



Total Funding 



PS&B (Federal & Contractor) 



Other Discretionary 



tftriurtifT fWrnrn/W/w 



National Academies 1 PPT Program Evaluation 
Discussed Emerging Issues 



• Continue research in priority areas 

• New materials technology, including "no-fit" respirators 

• PPT ensembles and seamless integration of multiple PPT 
components 

• Usability, comfort, ergonomics, and human factors which 
determine whether or not the PPE is worn by the worker 

• Enhancing the culture of workplace safety through worker 
education, training, and understanding of hazardous exposure risk 
to health 

• Other emerging issues 






tftriurtifT ftirtrtmirip* 



Some Trends and Challenges 



• PPE interfaces and integration 

• Certification of non-respiratory PPE 

• Comfort and fit of PPE 

• Intelligent PPE 

• Methods to extend the useful life of PPE 






tftriurtifT ftirtrtmirip* 



How can nature and science fiction be 
leveraged for future PPE designs? 




N. M 

Photo Courtesy: Flickr.com 





Veronica 'Georgia Blue 6 Photo Courtesy: 

The Personal Garden Coach (Christina Salwitz) 





1 



Photo Courtesy: Photobucket.com 




Photo Courtesy: UXmatters.com 






tftriurtifT ftirtrtmirip* 



PPE ensemble integration is a challenge 



Need to demonstrate that PPE works together 

Need to understand the impact on the NIOSH 
approval when respirators are used as part of an 
ensemble 

Need to know what interface parameters affect 
performance 






TtOSH 



\J f> D f T r ¥ Rvsturch tff Pr*cikt 30 



Certification of non-respiratory PPE is 

being explored 

• NA Recommendation: "Oversee all PPT certification in order to 
ensure a minimum uniform standard of protection and 
wearability" 

• PPT Program incorporated non-respiratory certification in Action 
Plan 

• PPT Program funded the IOM to explore: 

- How can NIOSH oversee certification of all PPT as stated by the NA 
Evaluation of the PPT Program to "oversee all PPT certification in order to 
ensure a minimum uniform standard of protection and wearability"? 

from The PPT Program at NIOSH: Review of Research Programs of NIOSH, IOM 
and NRC (2008), page 12 

• ASTM created new subcommittee on Certification and PPE 
Interoperability (F23.50) 






Seamless interfaces between PPE 
components will be developed 



Respirators and other PPE 

Improved communications 

Ability to interoperate with 
or function when using 
other required devices 
(e.g. stethoscope) 






■-I 


^nB 




L 







tftriurtifT ftirtrtmirip* 



Human centered design approaches are 

needed 



Design with personality 
and behaviors in mind 

Reduce weight 

Reduce heat stress 



Improve usability and 
safety 









tffr^ifuff ftirtrtmirip* 



Issues with comfort and fit 



Users in multiple industry sectors 
indicate that PPE is not worn because it 
is uncomfortable 

There is a resistance to respirator fit 
testing across multiple industry sectors 

Sizing for population diversity is 
problematic 



tffr^ifuff ftirtrtmirip* 



New materials technologies will enhance 
comfort and fit 



Shape memory polymers 

-Potential means to achieve 
improved comfort and fit 

-More breathable garment 
material 



New no-fit test designs 
being explored 





Courtesy of: 
Viramask 






tftriurtifT fWfnrn/W/w 



kos have microscopic hair-like surfac 

on their feet 




Photo Courtesy: iStockphoto /Stephan Hoerold 






TtOSH 



\J f> D f T r ¥ Research to Pr*cik* 36 



Sensing technology for PPE is in its infancy 



Current projects focused on 
end-of-service-life technology 

Numerous sensing technologies 
developed 

- Tracking sensors 

- Monitoring sensors 

- Warning sensors 










tffr^ifuff ftirtrtmirip* 



Intelligent PPE will be developed to inform 
users when PPE is no longer efficacious 



• End-of-service life 

• Remaining service life 



• Face-seal leak 
detection will warn 
users when seal is 
compromised 







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tffr^ifuff ftirtrtmirip* 



Yesterday's science fiction... 




Photo Courtesy: UXmatters.com 






tffr^ifuff ftirtrtmirip* 



Is tomorrow's science. 



Noninvasively measures 
oxygen consumption, 
blood and tissue 
chemistry 

Let's astronauts know 
when they are low on 
oxygen 




Photo Courtesy: National Space Biomedical 
Research Institute (NSBRI), Luigi Piarulli 






TtOSH 



\J f> D f T r ¥ Research to Pricikt 40 



In 1972, Michael 
Crichton imagined 
a brain implantable 
device to terminate 
seizures 




Photo Courtesy: Photobucket.com 






TtOSH 



\J f> D T* / Research to Pricikt 4 1 



Today, clinical trials are underway to 
terminate seizures with a brain implantable 
device 




r- 






^^^w^ 






l' 











Photos Courtesy: Rosana Esteller 



CAUTION-lnvestigational device. Limited by United States law to investigational use. 
Used with permission from Neuropace Inc. 






tftriurtifT fWfF?fn£f/w 



Methods to extend the useful life of 
PPE are needed 



90 million FFRs needed to support 42 
day pandemic outbreak 

1.7 million healthcare-associated 
infections annually 

Cause about 99,000 deaths 

Cost from $35.7 to $45 billion in 
additional healthcare costs annually 

$15,000 per incidence 

PPE may survive on FFRs long enough 
to present a fomite hazard 



REUSABILITY OF FACEMASKS 

DURING AN INFLUENZA PANDEMIC 



Y^ 








tffr^ifuff ftirtrtmirip* 



Methods to extend the useful life of 
PPE have been explored 



Some decontamination 
methods have been 
successful on FFRs 

Decontamination procedure 
is device dependent 

Manufacturers should 
identify most appropriate 
procedure for their 
technology 



Microwave Generated Steam 





■ 1 J 

1 

I 1 





Ultraviolet-C Irradiation 







TtOSH 



\fPPTf Research to Pr+cikv 44 



Unique surface pattern of Galapagos shark skin 
controls microorganism adhesion and growth 







tftriurtifT ftirtrtmirip* 



Superhydrophobicity causes water to bead 
and pick up surface contaminants 




Photo Courtesy: Sto Corp., Atlanta, GA 




Photo Courtesy: 

GE Global Research Center 



J* 



Photo Courtesy: William Thielicke / w.th@gmx.de 






TtOSH 



\J /> Z> TT / Rvsfurrh to Pricikt 46 



Superhydro phobic legs enable mosquitoes 
and water stride rs to stand on water 
surfaces 





Photo Courtesy: U.S. Army Corps of Engineers (USACE) 



Photo Courtesy: CWES / Andrew Thornton 






TtOSH 



\J f> D f T r ¥ Rvsfurrh to Pricikt 47 



Geckos rely on their tails to maneuver 
themselves in midair when they fall 





J> 



Photo Courtesy: 

T. Libby & Robert Full / UC Berkeley 






TtOSH 



\J f> D T*/ Research to Pricikt 48 






' I ' <£>*»* ',..., ..I €!«■« www;. 













Can all PPE be made as comfortable, 
efficient, and effective to wear and as 
desirable as eyeglasses? 






TtOSH 






SCBA 'flat pack' prototype expected in 

September 




Photo Courtesy: 
International Association of Fire Fighters (IAFF) 






TtOSH 



\J f> D T*/ Research to Pr*cik* 50 



The future is now... 




Photo Courtesy: Talia Frenkel and the American Red Cross 






TtOSH 



\J f> D T* / Research to Pr*cikv 5 1 



NIOSH PPT Program 







Visit Us at: http://www.cdc.gov/niosh/programs/ppt/ 
http://www.cdc.gov/niosh/npptl/default.html 

Thank you 






tftriufKfr Fnrtrtmirip*