Well, not sure engineers are the ones who should be telling you about PPE, that would be occupational hygienists. That said, I’ve been trained in & used far more forms of PPE than an ID doc who has never worked in a BSL4 lab. 
We trained under STO doctrine, survival to operate. This assumed we were generating air power off an airfield either under a fallout cloud or slimed with bio or chem agents like Sarin nerve gas. We’d work 12 hours in a carbon/neoprene suit and full face respirator.
Then we’d retreat to a sealed bunker underground to decontaminate, eat and sleep until we’d do it all over again.
So all this “PPE is so uncomfortable” isn’t really compelling. You don’t believe it will save your life, is the real issue.
So all this “PPE is so uncomfortable” isn’t really compelling. You don’t believe it will save your life, is the real issue.
ID docs toss around PPE as a term without understanding what it means. PPE is a legal, legislative definition: “personal protective equipment” means a thing used or worn by a person for protection of that person from health or safety hazards that may exist at a work site;
Which legislation? It’s not medically related. That’s the Occupational Health and Safety Act. The Code goes on to define, “respiratory protective equipment” means personal protective equipment intended to protect the wearer from …inhaling airborne harmful substances…
And the Code references a CSA standard, Z94.4, Selection, Use and Care of Respirators.
Yes, a national standard that sets out how you are to select respiratory protection. In all the hand waving about masks, never seen an ID doc acknowledge this.
Yes, a national standard that sets out how you are to select respiratory protection. In all the hand waving about masks, never seen an ID doc acknowledge this.
In its latest version Z94.4 contains explicit detail on how to select the appropriate respirator for…bioaerosol exposure. But isn’t that the expert domain of ID docs? Nope. This interdisciplinary standard is made legally binding through the OH&S Code, sets out legal obligations
for all employers and all worksites. That includes hospitals and factories both. But the ID community doesn’t use this cause they know better.
If you peruse that Z94.4 you’ll find a ton of peer reviewed rigorous science about bioaerosol hazards. csagroup.org/store/product/…
If you peruse that Z94.4 you’ll find a ton of peer reviewed rigorous science about bioaerosol hazards. csagroup.org/store/product/…
Have a guess at the minimum respirator required for any bioaerosol exposure? An N95, certified respirator.
In fact, surgical or medical masks are not mentioned in the standard. How can that be?
B/c surgical masks are not within the legal definition of PPE.
In fact, surgical or medical masks are not mentioned in the standard. How can that be?
B/c surgical masks are not within the legal definition of PPE.
Section 244 of the Alberta OH&S Code sets out the mandatory requirement for respiratory PPE when there is a hazard. 246 then defines what that means. “An employer must ensure that respiratory protective equipment required at a work site is approved (a) by NIOSH, or”
The or allows a Director to approve alternatives that are not NIOSH certified.
Every time you hear or read an MD using PPE and surgical mask in the same sentence, remember they are using that term in a manner that is contrary to the OH&S law which binds their workplaces.
Every time you hear or read an MD using PPE and surgical mask in the same sentence, remember they are using that term in a manner that is contrary to the OH&S law which binds their workplaces.
This dynamic was a factor in the 2003 Sars1 outbreak. Not in Vancouver where interdisciplinary work was part of life, but in Toronto. Justice Campbell’s report is explicit that the public health and ID establishment resented the authority of Labour playing in the medical sandbox.
“Mr. Justice Campbell called the N95 respirators one of the most contentious issues in the SARS outbreak. Although the OH&S Act has required since 1993 that anyone using a N95 mask be properly trained and fitted to ensure full protection,
few Hospitals complied with the Act and some even denied its existence…Mr. Justice Campbell called it a “lightening rod” for all the underlying problems of worker safety in Hospitals."
The Commission goes on to note that the PH and ID establishment recommended that Labour be stripped of responsibility for medical facility worker safety. This seems to have a lot to do with power and control and less with worker safety.
And things haven’t changed. Ontario nurses went to court in 2021 to sue for certified respirators and a long list of ID docs signed declarations that Covid was transmitted by droplets only. That lacking any of the “high quality” evidence we hear so much about.
In fact the “high quality” evidence (speaking as a scientist and not an EBM evangelist) demonstrated exactly the opposite, as did the consensus of a huge community of aerosol scientists and engineers.
onlinelibrary.wiley.com/doi/10.1111/in…
onlinelibrary.wiley.com/doi/10.1111/in…
There’s a good reason engineers do not use EBM. It’s inappropriate when things can be empirically characterized and modelled with high fidelity. Also important to note that EBM replaced what? No-evidence medicine? Engineering evidence based from the start
ebm.bmj.com/content/27/5/2…
ebm.bmj.com/content/27/5/2…
EBM is a powerful set of tools for conducting specific types of trials. It is a highly statistical method designed to pull very low signal to noise ratio data out of things like human drug trials. It is not a universal epistemology that generates intelligent output for any trial
Yet this is what we hear repeatedly about PPE from ID docs. Who apparently don’t care that they’re speaking to a population that includes a bunch of us who rely on respiratory PPE to stop us from dying on a daily basis. Yet this is epistemic trespass as soon as it’s in a hospital
That is described by another word. Hubris. And the best overview of that comes from an outstanding voice. Mario Possamai, of the Sars1 Commission and other related publications.
Mario has written about this specifically in the context of Covid. atimeoffear.com
And “Fatal Choices” about long term care in Ontario and harm to nurses and residents. What is the core finding? A failure to heed the lessons learned from the 2002 Sars1 outbreak. We have repeated many of those errors exactly as led by PH and ID.
Experto Crede!
Experto Crede!
Some added context if you haven’t read my prior comments.
OH&S and me. 20 yrs military as general and explosives safety officer. Qual’d to be OH&S rep by GofAlberta. Entire 35 yr career involved in safety issue as work and supervisor.
15+ yrs time interpreting legislation.
OH&S and me. 20 yrs military as general and explosives safety officer. Qual’d to be OH&S rep by GofAlberta. Entire 35 yr career involved in safety issue as work and supervisor.
15+ yrs time interpreting legislation.
Military supervised ALSE, aviation life support equipment maintenance. PPE for fighter pilots. Test and development: supervised testing of STING ensemble, to increase g tolerance in fighter aircrew. Included using pressure breathing O2 under g. Lots of physiology and safety
Supervised development and certification testing of ejection seat modifications and parachute integration. In spite of the old joke, we did not RCT the parachute.
6+ yrs forensic fire investigator crawling in burned out buildings.
NBCD Officer.
6+ yrs forensic fire investigator crawling in burned out buildings.
NBCD Officer.
In military was qualified for high performance jet aircraft flight, about 75 hrs with a helmet and oxygen mask on. Every few years hyperbaric chamber ride to experience hypoxia and explosive decompression.
Sport SCUBA diver.
Sport SCUBA diver.
Grad degree and patent in microwave engineering.
7 years in the engineering and geoscience regulatory system, 5 running it.
If you ask, “if this is true why isn’t OH&S doing something?”
I don’t know, you need to ask them. It appears they’ve decided not to enforce their law.
7 years in the engineering and geoscience regulatory system, 5 running it.
If you ask, “if this is true why isn’t OH&S doing something?”
I don’t know, you need to ask them. It appears they’ve decided not to enforce their law.
All of the public health masking stuff in workplaces should have fallen under OH&S. I asked, they said it did, but then it allowed PH to dictate respiratory control in workplaces. 🤷♂️
And recall medical facilities up until recently would insist you remove an N95 for a surgical
And recall medical facilities up until recently would insist you remove an N95 for a surgical
PH has no authority to dictate respiratory control programs in workplaces, incl offices. Maybe little authority is a better term as PH has broad authority.
In Alberta those PH authorities were willingly subordinated to the Cabinet’s will. That’s not what PH law says either.
In Alberta those PH authorities were willingly subordinated to the Cabinet’s will. That’s not what PH law says either.
Interesting court case about that last bit: canlii.org/en/ab/abkb/doc…
I’m snippy about this b/c public health and infectious disease MD hubris has killed and disabled a lot of people globally. Started with the WHO refusing to say airborne and continues with thinly disguised droplet dogma today.
Science is about truth, not power and control. Fin
Science is about truth, not power and control. Fin
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