Rethink respirators

Using a respirator isn't the way to avoid escaping anesthetic gas. Here's why:

1. In OSHA's safeguards, personal protective equipment comes last. OSHA expects you to implement "engineering and procedural controls" to solve safety problems before resorting to personal protective equipment. This means your hospital needs an effective scavenging system to remove waste anesthetic gas, and you need to check the anesthesia machine for leaks before each and every procedure. If you do this, employee exposure to anesthetic gas in the operating room should be almost nonexistent. The use of any personal equipment wouldn't significantly improve the employee's health or affect her pregnancy.

2. Good air circulation dilutes escaping anesthesia gases. The exposure risk occurs during the recovery portion of the surgery. Patients exhale measurable amounts of anesthetic gas as they recover. With good ventilation in the recovery room, there's little exposure because the gas is diluted to negligible levels in the air. If you're worried your circulation isn't adequate, install an exhaust fan in the recovery area to ensure the air is turned over at least four to six times per hour.

3. Respirator rules are extremely strict. When you use a respirator to control a hazard, your practice must comply with the respiratory protection standard. This OSHA regulation requires you to medically evaluate employees who wear respirators, to train employees, to implement specific cleaning procedures and schedules, and to disinfect, store, inspect, repair, properly discard, and otherwise maintain the respirators. There's a provision in the regulation that allows "voluntary use of respirators by employees when the employer has determined that respirators are not required." Even when the use of the respirator is voluntary, the business must still comply with many of the rules. One section 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 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."

Take a pregnant team member's safety concerns seriously. But remember that alleviating employees' worries is sometimes just as important as alleviating the actual hazards.