Decision model for optimizing respirator protection

Respirators are widely used for protection against inhaled toxins. The emph asis of research and implementation effort has evolved through several stag es: the respirator device itself, use situation respirator program factors under employer control, individual worker factors not under employer contro l, and occupational health systems. For this study, a computer-simulation d ecision assistance model was developed to assess the impact of various fact ors on the number of workers receiving adequate protection. Factors include the respirator protection factor identification of sites needing respirato r protection, selection of proper device, availability when needed, frequen cy of ever use, regularity of use among users, and variability in personal susceptibility or other factors. This analysis demonstrates that for both m oderate-risk and high-risk (ie, IDLH, immediately dangerous to life and hea lth) exposures under current circumstances, the actual protection afforded depends upon the optimization of program factors and detection of atypical outlier persons and worksites. Therefore, programs and research must focus an these areas. Occupational medicine specialists should help optimize thes e areas and in addition, use each case of respiratory protection failure as an index case to improve the overall programs.