Face masks in the post-COVID-19 workplace: Who needs protection?

By Julie Barbaro, Senior Risk Engineering Consultant

By now, it’s understood the coronavirus can spread through transmission of respiratory droplets. Social distancing, thorough hand-washing, respiratory etiquette and other measures have all been communicated to the general public as ways to help prevent the disease from spreading.

However, as more businesses resume operations, new questions emerge in tackling this challenge within the workplace. Are the aforementioned measures enough, or do employees need to take the extra precaution of wearing face coverings, face masks or other types of personal protective equipment (PPE) at work? Zurich’s Risk Engineering team has created a new report, “Face Coverings, Face Masks, and Respiratory Protection for COVID-19,” that explores this topic.

Although facial protection is worth consideration, the first priority should be implementing appropriate engineering and administrative controls to help minimize the spread of COVID-19, notes the Occupational Health and Safety Administration (OSHA).¹ Even with the implementation of those controls, the use of face coverings, face masks and/or respiratory protection may be necessary. Requirements and guidance can vary by location, so employers should always refer to the latest federal, state and local requirements when developing controls.

Determine the level of risk

Many factors will influence an employer’s decision to require the use of face coverings, face masks or respiratory protection. OSHA’s guidance is for employers to consider the level of exposure of each workplace based on factors such as community spread, cases of COVID-19 in the workplace and the exposure level employees face.¹

OSHA classifies employees’ exposure risk level in four categories – very high, high, medium and low – to help employers decide the additional controls that may be needed. Below are guidelines from OSHA, along with the related guidance (“very high” and “high” merit the same directive). Note, too, that according to this guidance, most non-healthcare work environments will be medium- or low-exposure risk level.¹

• Very high and high: This includes workers with high potential for exposure to known or suspected sources of COVID-19 during specific healthcare, medical postmortem or lab procedures. This would include healthcare personnel, healthcare delivery and transport staff, emergency responders, certain laboratory personnel, as well as “death care” workers, such as those employed by morgues and funeral homes.
  

  OSHA guidance for both categories: Will likely need additional PPE, including either a face mask or respirator, depending on job tasks and exposure risks.
  
  

• Medium: Jobs that require frequent and/or close contact (within 6 feet) with people who may be infected with COVID-19, but who are not known or suspected COVID-19 patients and are in areas with ongoing community transmission. (Remember, symptoms of COVID-19 may not appear for two to 14 days after infection.) This includes workers who may come in contact with the general public, such as in schools and high-volume retail settings and those working in areas with high-density populations.

  OSHA guidance: Depending on other controls in place, additional PPE may be needed, and the items required will vary by work task. As with the very high- and high-risk groups, gloves and plastic gowns may also be considered.
  
  

• Lower risk: Jobs that do not require contact with people known to be, or suspected of being, infected with COVID-19 and do not require frequent contact (within 6 feet) of the general public. There also is limited contact with coworkers.

  OSHA guidance: Additional PPE is not recommended. Employees should continue practicing preventive measures they would ordinarily follow. However, keep in mind that the Centers for Disease Control and Prevention (CDC) has recently updated its guidance and encourages employees to wear cloth face coverings in the workplace, when appropriate.²

Four things to remember when determining PPE requirements

Whether you are considering the use of face coverings, face masks and/or respiratory protection like an N95 respirator, remember per OSHA requirements that employees must be trained to correctly use the PPE, and the equipment must be:

• Selected based on exposures to the worker
• Properly fitted, and refitted, as applicable (i.e., respirators)
• Consistently and correctly worn when required
• Properly maintained, replaced and/or disposed¹

Types of face coverings, face masks and respiratory protection: Understanding the differences

When considering the use of face coverings, face masks or respirators, it’s important to understand the differences, as well as the requirements related to their use.

Cloth face coverings protect others from the wearer’s respiratory emissions. It can help prevent those who may have the virus (and don’t know it) from spreading it to others. Cloth coverings aren’t proven to protect the wearer and are not considered respiratory protection.

The CDC recommends cloth face coverings in public settings where social-distancing measures are difficult to maintain. OSHA doesn’t offer specific guidance, and the use of this item is not regulated.^1,3,4,5

Surgical masks (face masks) protect wearers against large droplets, splashes or sprays of bodily or other hazardous fluids. They also help protect others from the wearer’s respiratory emissions. Because these loose-fitting masks don’t provide the wearer with a reliable level of protection from inhaling smaller airborne particles, they are not considered respiratory protection.

The CDC notes that these masks are intended for use by healthcare and death-care workers, should only be used once and should not be shared. OSHA does not offer specific guidance on these masks, and does not regulate them. Fit testing is not required.^1,4,5

N95 respirators (filtering facepieces) protect wearers by reducing exposure to particles, small-particle aerosols and large droplets, and filter out 95% of airborne particles. They are not intended for use by the general public.

The CDC recommends these respirators be used by healthcare and death-care workers. They should only be used once and should not be shared. OSHA guidance notes that N95 respirators should be worn by workers in high-risk and very high-risk work environments for COVID-19, as listed above.

Users wearing N95 respirators must follow OSHA guidelines (29 CFR 1910.134, and workers must be advised of the contents of Appendix D). Companies using this equipment must have a written respiratory protection program. If N95 is required PPE, fit testing is required, and the wearer must be clean-shaven. This requirement does not apply to voluntary use.^1,4,5

Half-mask respirators are, when worn correctly, more protective than filtering facepiece respirators for procedures that are likely to generate aerosols. They are not intended for use by the general public. The CDC offers no specific guidance on half-mask respirators, but OSHA notes they could be needed for workers in very high and high-risk exposure work environments, and used when N95 respirators are not available.

Users wearing half-mask respirators must follow OSHA guidelines (29 CFR 1910.134, and workers must be advised of the contents of Appendix D). Companies using this equipment must have a written respiratory protection program. If a half-mask is required PPE, fit testing is required, and the wearer must be clean-shaven. Like the N95, this requirement does not apply to voluntary use.^1,4,5

Additional considerations

Remember that guidance related to personal protective equipment may change. As most of us already have learned throughout the coronavirus outbreak, levels of risk and exposures are constantly evolving, and so are the governmental recommendations.

“Businesses are strongly encouraged to coordinate with state and local health officials so timely and accurate information can guide appropriate responses,” notes the CDC. “Local conditions will influence the decisions that public health officials make regarding community-level strategies.”²

Subsequently, the protective measures needed may depend on the impact of COVID-19 in your geographical area, updates to risk assessments, and information on the effectiveness of various types of PPE. For these reasons, it is also important to regularly visit governmental websites, including the resources listed below.

Julie Barbaro is a Senior Risk Engineering Consultant with Zurich North America. She has 10 years of safety experience, including seven years with Fiat Chrysler Automobiles (FCA).

For more information, download our RiskTopics, “Face Coverings, Face Masks, and Respiratory Protection for COVID-19.”

For more articles on COVID-19 and its impact on businesses, visit our Coronavirus (COVID-19) Resource Hub.

Download the infographic

References

1. “Guidance on Preparing Workplaces for COVID-19.” OSHA 3990-03. Occupational Health and Safety Administration. March 2020.
2. “Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19), May 2020.” Centers for Disease Control and Prevention. 5 May 2020.
3. “Use of Cloth Face Coverings to Help Slow the Spread of COVID-19.” Centers for Disease Control and Prevention. 14 April 2020.
4. “Understanding the Difference.” Centers for Disease Control and Prevention. 2020.
5. “N95 Respirators and Surgical Masks (Face Masks).” U.S. Food and Drug Administration. 5 April 2020.