In 1994, BLS reported 215 deaths resulting from exposure to harmful substances; 110 of these deaths were from oxygen deficiency (BLS, 2006). Safety awareness regarding respiratory protection has increased in the U.S. in the nearly 20 years since then. For example, a collaborative survey released in 2001 by NIOSH and BLS reported that in the U.S. more than 3.3 million people in 281,776 work establishments used respirators in their daily work. In 2010, 57 deaths resulting from the inhalation of harmful substances were reported (BLS, 2010).

NIOSH (2001) also found that of the work sites where respirators were used in 2001, 50% used respirators voluntarily; 41% provided no respirator training to employees; 53% did not per-form medical fitness evaluations; 64% had no written respiratory program; and 76% performed no air sampling to assess hazards in order to select the proper type of respirator. All of these factors could lead to the improper selection or use of respirators (NIOSH).

Although respiratory protection awareness has increased since 2001, respirator-related issues remain a concern. Respiratory protection was the third most cited OSHA violation in 2006 and 2007 (Doney, Greskevitch, Groce, et al., 2009). In 2011, it ranked as the fourth most cited violation (OSHA, 2011).

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