A process evaluation of the National Institute for Occupational Safety and Health's (NIOSH) respirator approval process

According to the United States (U.S.) Bureau of Labor Statistics, in 2016, the civilian workforce included over 253 million individuals. In that same year, 2.9 million non-fatal occupational injuries and illnesses were reported in the private sector. However, the true burden of occupational illnesses may never be accurately quantified as conditions such as asthma and cancer often go unrecognized as being occupationally induced. However, occupational illnesses affect an individual’s quality of life, require long-term, expensive treatment, and cost employers a significant amount from lost work productivity. For these reasons, it is critical that interventions be developed to prevent or reduce these exposures are effective. One strategy to reduce occupational hazards is the use of respiratory protective devices (RPD). RPDs are used by workers who could potentially be exposed to inhalation hazards in the workplace as a last resort to mitigate exposure. In 1995, Title 42 of the Code of Federal Regulations, Part 84, Approval of Respiratory Protective Devices (42 CFR 84) charged the National Institute of Occupational Health (NIOSH) to serve as the governmental third party responsible for helping to assure respiratory protective devices are safe for their intended use when selected, used and maintained in the condition under which they were approved. Given the public health significance of NIOSH’s role in assuring the safety of RPDs an internal process evaluation of the Respirator Approval Program was undertaken to examine approval process time and identify opportunities for efficiency improvements. The evaluation included three phases: 1) a formative phase, 2) a qualitative phase, and 3) an approval process documentation phase. Evaluation findings were then used by the evaluator to develop five recommendations to improve the efficiency of the approval process. The importance of process evaluations cannot be understated. As it relates to the RAP, upon completing a multi-modal evaluation, results indicate that opportunities for process improvement do indeed exists. Findings demonstrate great variations in application processing time, likely associated with the lack of formally documented quality assurance materials as well as inconsistences in enforcing standard application procedures