Letter from nursing community to Senators Harkin and Specter urging them to oppose efforts to diminish respiratory protections for health care workers in the FY 2008 Labor, Health and Human Services, and Education Appropriations Act

September 11, 2007

Senator Tom Harkin
Chairman, Subcommittee on Labor,
  Health and Human Services, and Education
Committee on Appropriations
United States Senate
Washington, DC  20510

Senator Arlen Specter
Ranking Member, Subcommittee on Labor,
  Health and Human Services, and Education
Committee on Appropriations
United States Senate
Washington, DC  20510

Dear Chairman Harkin and Ranking Member Specter:

The undersigned organizations, representing the breadth and scope of the registered nursing profession, urge you to oppose efforts to diminish respiratory protections for health care workers in the FY 2008 Labor, Health and Human Services, and Education Appropriations Act. A legislative rider added to the last three appropriations bills by Representative Roger Wicker seriously undermines the effectiveness of respirators and needlessly places nurses at increased risk for contracting and transmitting infectious diseases such as M. tuberculosis (TB), smallpox, and avian flu.

N95 respirators are used to protect nurses and other first responders from airborne biohazards. When used effectively, they remove at least 95% of the hazard from inhaled air, but they are seriously compromised when a proper face seal is not obtained. In normal circumstances, OSHA requires that these respirators be fit-tested annually. The fit-test ensures that the respirator has a proper face seal, as factors such as weight changes, facial hair, and dental work are known to cause the respirators to fail. The Centers for Disease Control and Prevention has found that non tested respirators expose the wearer to eight times more contaminant than those that are tested.

The Canadian SARS outbreak proved that inadequate fit can lead to disastrous public health problems, as nurses spread - rather than help contain - the virus. Many Canadian nurses contracted the virus, even though they wore ill-fitting N95 respirators. The very fit-testing opposed by Representative Roger Wicker could have avoided these infections.

The annual fit-testing requirement is not overly burdensome. OSHA estimates that the cost of the enforcement of the annual fit-test and training provision is $16.80 per person per year. Certainly, the costs associated with the increased nosocomial transmission of TB, smallpox, and avian flu is much greater. We look forward to working with you to ensure that the health and safety of nurses and their patients are protected through the appropriations process.

Sincerely,

American Association of Critical-Care Nurses
American Association of Occupational Health Nurses, Inc.
American Nephrology Nurses' Association
American Nurses Association
American Psychiatric Nurses Association
Association of Women's Health, Obstetric and Neonatal Nurses
National Association of Clinical Nurse Specialists
Oncology Nursing Society