Managing an OSHA-compliant respiratory program today means understanding the risk of toxic substances and environments that are not only more prevalent for many workers, but very dangerous should they not be adequately protected. (Grainger photo)

Seven Respiratory Hazards Every Safety Manager Should Understand

Different equipment protects against different risks. Ensure your equipment matches the risk.

Breathing problems continue to rank as one of the most frequently cited1 OSHA standards. In 2017, OSHA issued 3,381 citations for respiratory-related violations, including failure to have a written respiratory protection program and failure to conduct required medical examinations for workers who use respirators. So it is clear those responsible for safety must continue to pay special attention to these issues.

The fact is today's complex industrial environments have led to changing respiratory risks. Although many of the leading risks are not new, changing conditions over time may have heightened the risks for workers. Or, in some cases, OSHA has upped the protection requirements for substances as new research emerges. Factors such as the possibility of a chemical or biological attack have heightened safety concerns.

All of these changing factors require increased focus on respiratory protection and safety equipment programs. Those responsible for safety need to understand that risks once thought to be from the past are still prevalent and quite dangerous. Now is the time to understand what respiratory risks are present in your workplace, how serious they can be, and ensure that workers have ready access to respiratory equipment that will meet such risks in a changing industrial environment.

The Seven Leading Respiratory Hazards
While many substances pose problems, here are seven respiratory risks that will require worker protection now and for some time to come.

Crystalline Silica
Respirable crystalline silica (RCS) is fine particulate (1/100th the size of an ordinary grain of sand) that can penetrate deep into the lungs of employees working with rock, concrete, brick, block, and mortar. RCS2 may cause silicosis, a chronic disease that affects workers around construction, sandblasting, and mining.

While RCS exposure is dangerous, it's also preventable. OSHA has issued two new respirable crystalline silica standards: one for construction and the other for general industry and maritime. OSHA3 began enforcing most provisions of the standard for construction on Sept. 23, 2017, and will begin enforcing most provisions of the standard for general industry and maritime on June 23, 2018.

Black Lung Disease
Coal Workers' Pneumoconiosis (CWP), commonly referred to as "black lung," is a respiratory illness caused by inhaling coal mine dust. The incidence of CWP declined after the 1969 Coal Act invoked stricter health and safety rules, but it has unfortunately seen resurgence in the last few years. In the U.S. 15 coal mining states, the federal government has increased its funding by $2.7 million to $10 million4 to treat CWP. In 2015, the incidence of black lung disease surpassed the 1975 levels.5 The resurgence is not completely understood, although some believe it could be due to mining techniques that cause a finer prevalence of silica coal dust.

Welding Fumes
Welding fumes have always been a known hazard to workers and a latent carcinogen, but their dangers were underestimated until recently. In 2017, the International Agency for Research on Cancer (IARC) updated its classification for welding fumes to Group 1 carcinogens. This designation is assigned to agents that pose sufficient risk of cancer in humans. Specifically, they determined that welding fumes increase the risk of lung cancer,6 and to some degree, kidney cancer and chronic inflammation.

Wildfire Smoke
The last few years have seen a confluence of wildfires within the United States. The number of acres burned in this country last year was the second highest since the 1950s, following only 2015. Research conducted by the University of Missouri7 predicts that climate change is influencing the probability and location of wildfires in the United States. Working in and around such fires leads to chronic illness and even fatalities. According to data compiled by the National Institute of Occupational Safety & Health (NIOSH)8, at least 350 fatalities were recorded from 2000-2016, with smoke inhalation being one of the attributable causes of the deaths. Wildfires are responsible for chronic illness and fatalities for the numerous first responders, firefighters, and supportive workers who are in and around such fires. Properly fitted, suitable, and reliable respiratory equipment is more important than ever in such environments.

Asbestos
According to recent research9 conducted by the Institution of Occupational Safety and Health (IOSH), one in four construction workers claims exposure to asbestos. Two-thirds of respondents said they did not know it can cause cancer. And most respondents also said they were uncertain what to do if they discovered asbestos at a work site. This demonstrates a continuing knowledge gap between safety managers and construction teams.

According to OSHA,10 construction and ship repair environments are still the sites of the greatest exposure to this substance. Workers are also likely to be exposed during the manufacture of asbestos products such as textiles, friction products, insulation, and other building materials, as well as during automotive brake and clutch repair work.

Hydrogen Sulfide
Animal waste is a major source of hazardous gases, including ammonia and hydrogen sulfide. Recently, the U.S. Congress passed legislation that exempts farms from reporting such pollutants to federal regulators. Now that individual states have to deal with regulating such waste releases, it ups the presence and risk of noxious wastes in and around such environments. While farms are not the only sites where hydrogen sulfide is present, they are a major contributor. With the shift of regulatory responsibility to the states, it can only mean the stakes are higher to prevent workers in and around such sites from inhaling hydrogen sulfide.

Agricultural Dusts
Agricultural environments involve numerous respiratory risks, from grain dust that gets mixed with mold, plant material, animal hair and dander, and feces to dirt stirred up by plowing. Recent reporting in Hearst's Journal-Courier said that "severe respiratory ailments are common among farmers and other agricultural workers." The article cited a pulmonary disease specialist who said that between 10 and 15 percent of those who work around grain have chronic respiratory symptoms, which can rise to 25 percent11 for workers who work in and around animal confinement systems.

Next Steps for Safety Managers
The risks highlighted above do not represent a complete inventory of respiratory risk factors. They were highlighted because they are the most common and likely to intersect with the daily exposure of many workers within the United States and elsewhere around the world.

Managing an OSHA-compliant respiratory program today means understanding the risk of toxic substances and environments that are not only more prevalent for many workers, but very dangerous should they not be adequately protected. Different equipment protects against different risks. Ensure your equipment matches the risk.

More importantly, the health risks to workers from these and other substances are the best justification for implementing a very disciplined and robust respiratory program. Understanding important and overarching respiratory risks is a proper foundation for establishing a respiratory program that is both compliant and prioritizes employee safety in a complex environment.

References
1. https://www.osha.gov/Top_Ten_Standards.html
2. https://www.osha.gov/dsg/topics/silicacrystalline/
3. https://www.osha.gov/dsg/topics/silicacrystalline/
4. https://www.npr.org/sections/thetwo-way/2018/03/28/597576628/congress-boosts-black-lung-treatment-funding-by-millions
5. https://www.nytimes.com/interactive/2018/02/22/climate/black-lung-resurgence.html
6. https://www.constructionequipment.com/welding-fumes-danger-revised-upward
7. https://munews.missouri.edu/news-releases/2018/0404-wildfires-will-become-more-frequent-due-to-rising-temperatures-but-mu-study-finds-changes-will-be-far-from-uniform/
8. https://www.cdc.gov/niosh/topics/firefighting/default.html
9. https://www.constructionnews.co.uk/best-practice/health-and-safety/asbestos-one-in-four-construction-workers-exposed/10029843.article
10. https://www.osha.gov/SLTC/asbestos/
11. https://www.myjournalcourier.com/news/article/Growing-sick-More-farmers-see-connection-between-12779786.php

This article originally appeared in the July 2018 issue of Occupational Health & Safety.

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