A husband and father of two children with a history of asthma goes to work every day at a body shop. He's a painter, who's supposed to wear a positive-pressure personal fresh-air system to protect his lungs from overspray. Isocynates can kill, he's been told, but he still only wears a half-face respirator. The fresh-air mask is hot and uncomfortable, and it makes it difficult to communicate with coworkers. Now, 15 years after he started working at the shop, this painter doesn't have to worry about wearing a respirator anymore; he died several months ago of an asthmatic attack while waiting for a freshly painted car to dry.

Many workers won't worry about wearing a respirator until something bad happens, such as a death or illness of a coworker who didn't wear one. That's an eye-opening scenario, as is this real-life anecdote from a Philadelphia-area consultant.

It's easy to see after the fact why a respirator should have been worn. The long-term effects of exposure to harmful chemicals and fumes can cause lung disease and cancer. But because effects are often not immediate, they don't seem as dangerous to workers. According to OSHA, from FY1977 to 1982, 58 percent of inspected worksites with respirators present "had deficiencies."

Don Campbell, acting chief of the Respirator Certification and Quality Assurance branch of NIOSH, says these health problems can be prevented. "Silicosis is a common but serious and debilitating pulmonary disease," says Campbell. "But it is largely preventable through the benefits of an industrial hygiene program that will assess and deal with problems before they occur."

OSHA's detailed respiratory protection standard provides EHS professionals with ammunition to get their employees to wear respirators, and to understand why respiratory protection is important. OSHA requires employers to maintain "written procedures and provide for proper cleaning, disinfection, storage, inspection and maintenance," along with thorough training and some fit-testing.

To convince workers to comply, readers have tried a range of disciplinary methods, frequent training and visual aids. Most of the 35 readers ISHN surveyed experienced this same frustration, but some were more effective at getting the job done. If your safety program is in need of a few breathing lessons, see how the best of this class administer theirs.

Study groups

Bob Orzech, a safety director in Indiana, requires employees to wear respirators for potentially hazardous tasks, including nuisance vapors. In some instances, enforcing respiratory usage takes discipline. "The first time we give employees an on-the-spot correction," says Orzech. "After that, it becomes a three-day suspension and then termination. But I've never had to go beyond the first or second step in most cases."

Orzech attributes that quick adherence to the rules and to in-depth safety and respirator education. Other safety and health directors with similar successes agree.

Ed Santiago, a safety director from American Racing Custom Wheels in Rancho Dominguez, Calif., stresses training at his plant. On top of annual requirements, Santiago conducts 45-minute sessions once a month, featuring videos and pictures of coworkers who did, and did not, wear their respirators on the job during the previous month, and those who wore them properly. Hands-on education is also included.

"It's very effective," says Santiago. "We practice what it is like to wear a respirator, or to not wear one properly, and discuss the effects."

And sometimes it's just best to just pull an individual aside and conduct one-on-one coaching, like Corporate Safety Coordinator Patricia Kurz from Michigan.

But perhaps one of the best ways to encourage workers to wear respirators comes from Safety Director Stanley Shively of INC-Agrico Co., Mulberry, Fla., who is blessed with a low employee turnover rate and workers who possess a keen sense of plant pride.

"Some of our employees are safety observers who randomly check floor operations," says Shively. "They police each other through peer pressure. Sometimes people won't listen to upper management, but they will listen to their buddies." Shively publishes the number of people-not the names-of those who are complying. He claims his respirator program is working much more effectively since he put safety observers on the floor.

Some people say Shively's situation is unique. Barry Weissman, REM, CSP, CHMM, full-time regulatory manager for a chemical company, and head of Weissman Consultants, L.L.C., claims he has never seen employees so committed to safety that they've looked out for each other this way. But he does have a few other compliance tricks up his sleeve. So do some other safety experts.

Teacher's conference

Retired Air Force Bio-Environmental Engineer Lance "Skip" Edwards, CIH, spent 20 years of his professional life persuading employees to wear respirators for their own good. He, along with Weissman, understands the complaints workers have, and sympathizes with them because he realizes that when you have to hang a piece of equipment on someone, then all else has failed.

"The first-line defense is engineering controls," says Edwards. "But when you can't substitute a material for a less toxic one, then you are admitting to the employee that you can't control the toxins, that respirator is a last-ditch effort to protect them."

Weissman asks his clients and employees an important question: "Do you want to protect yourself?" Most employees say they do.

"When the safety professional is pushing hard enough, they will follow the rules," says Weissman."

He encourages workers to take breaks between large jobs to cool down, and educates employees about the dangers of not wearing a respiratory device.

Edwards claims that educating workers is the biggest tool an industrial hygienist has for getting employees to wear their personal protective equipment. Tell them the benefits of using respirators; they wouldn't be unless the conditions were hazardous.

"I try to relate a lot of the symptoms and symptomatic problems to lack of quality of life," says Edwards. "I tell them that emphysema will make climbing the stairs difficult, and may prevent them from taking their kids to the park."

Passing the course

Figuring out how to get your employees to wear respirators depends on a host of factors. Are employees committed to the job and/or company enough to want to comply? Do your executives really care about the safety program and support safety compliance ideas? Which workers comply and which don't? Is additional training necessary, and do you have the time and resources?

Relating quality of life issues to employees realistically may be the best way to encourage respirator use, regardless of the other factors you must deal with. When health effects "hit home" for an employee, the consequences of breaking OSHA and company rules become too serious to consider.