February 10, 2022

National Academies Proposes Expansion of Respiratory Protection to the Public

A report released today by the National Academies of Sciences, Engineering, and Medicine (NAS) calls for extending respiratory protection to the public and to workers not currently covered by relevant OSHA requirements. During a virtual presentation accompanying the report’s release, Dr. Jonathan Samet, chair of the NAS committee that developed the report, said that its recommendations “will require action at the highest levels of government” to provide respiratory protection to the entire United States population.

The NAS committee recommends that two “coordinating entities,” one for workers and one for the public, be given responsibility for assessing inhalation hazards, determining necessary respiratory protective devices, ensuring the devices’ availability, and incorporating new information as it arises. Formed in 2020 in response to the COVID-19 pandemic, the committee also addressed questions related to other inhalation hazards such as wildfire smoke and airborne infectious agents in addition to SARS-CoV-2.

According to the report, OSHA should be the coordinating entity for workers, and Congress should revise the Occupational Safety and Health Act to extend the agency’s authority to workplaces not currently covered by the Act. Other recommendations include improving the NIOSH respirator conformity assessment processes, developing guidance for a broader range of workers, and expanding research and surveillance of inhalation hazards in workplaces.

The coordinating entity for the public should be established within the Department of Health and Human Services, the report states. This entity would have the capability to oversee the development of standards for respiratory protection for the public and the approval of respiratory protective devices. The report acknowledges that a laboratory will be needed to serve the same role for the development of devices suitable for the public that the NIOSH National Personal Protective Technology Laboratory plays for respiratory protection in the workplace. Other priorities for the public entity would be to create a process for identifying the correct device for the inhalation hazard of concern and ensure the availability of devices as well as guidance and training that meets the needs of the whole population.

A key feature of the committee’s proposal is the need for the coordinating entities to actively monitor and evaluate activities related to respiratory protection. “This is not a static system,” Dr. Samet said. “We’ll learn as it’s implemented.”

The report broadly defines respiratory protective devices as those that protect against inhalation hazards. Both devices that protect the user and those that protect others through source control, including masks and face coverings, are addressed in the report.

The report was commissioned by NIOSH, EPA, the Department of State, and the CDC Foundation. A free PDF version of the report is available for download by registered users of the National Academies Press website. More information can be found in a new post to the NIOSH Science Blog.