Naturally, our survival depends on the air we breathe. How easy it is, though, to take clean air for granted, or to ignore the harmful effects of air polluted by dust and mists, gases and vapors. It can take 20-40 years for the damage to our lungs to become apparent (except, of course, in highly toxic atmospheres such as confined spaces where the consequences can be immediate). When you're young and healthy it's hard to imagine gasping for air as you walk down the street or up a flight of stairs. But years of exposure to bad air at work can take its toll, slowly diminishing lung capacity or planting the seeds of disease.

Most everyone agrees that respiratory protection is imperative to guard employees from harmful airborne contaminants, but getting employees to consistently wear respirators can be another story. In fact, the daily, "real world" use of respirators raises many questions.

We surveyed readers about some of the most common problems and issues they confront with respiratory protection, and then solicited answers from experts in the field. The information they provided should help you in your own efforts to get the most out of respiratory protection.

How do you convince employees of the dangers of not wearing a respirator when the effects are often long-term?

How you communicate, the examples you use, and how you present information can make a big difference in being able to demonstrate to employees the dangers and long-term effects of prolonged exposure to harmful chemicals.

Open communication with your employees allows you to understand their needs and concerns so that your training illustrations are relevant to them. Consultant David Sarkus suggests that you may want to enlist the help of a trusted professional who understands the perspective of the employees to tell real and recent stories pertaining to the dangers of not wearing respiratory protection.

Barry Weissman of Weissman Consultants, L.L.C., and consultant Jeff Vincoli of J.W. Vincoli & Associates show pictures of black lungs and asbestos in the lung to remind employees that these preventable diseases took 20-40 years to manifest. Know your employees, advises Peter Lemke of J.J. Keller and Associates, so your examples are applicable to their life and explained at the appropriate educational level. Get personal. Point out that lost lung capacity can keep employees from participating in sports, hobbies, their children's lives, and can even cause them to be bedridden.

How you present information about respiratory hazards determines whether employees will seriously consider the dangers of not wearing a respirator. If you simply demand that employees wear a respirator without providing adequate information, they will resist, says Lemke. Openness, sufficient explanations, and relevant examples of the harmful consequences will give employees the information they need to make the right decision.

Why is proper maintenance and storage of respirators important? And how do you get employees in the habit of caring for their equipment?

Improper storage and maintenance of a respirator will eventually render it useless-and dangerous-since it will provide users with a false sense of security. More immediately, contaminants collect inside a respirator that is not cleaned properly, which the wearer will breathe during the next use.

Here's another danger: A cartridge respirator, left in the open air, is actively working, causing its effectiveness to expire prematurely, according to Lemke. Plus, improperly stored respirators can become disfigured, destroying the face seal.

Good training and surveillance are the keys to making sure employees correctly maintain and store their respirators. Training involves describing to the employees the right cleaning procedures and explaining the dangers of breathing contaminated air. Vincoli suggests periodic, random monitoring and inspection of respirators in use to ensure compliance with maintenance and care requirements.

Why are medical exams required for respiratory use, when they are not for other hard-labor tasks?

Normal working routines become more strenuous when using a respirator because of the "dead space" in the face piece as well as the breathing resistance, discomfort, and potential for claustrophobia, says David Abrams of ARS Environmental Health, Inc. You get less air with each breath, placing a strain on your heart. Users with health issues that go undetected risk serious injury or death. A medical exam is necessary so that a doctor can determine a user's pulmonary capabilities.

Another reason medical exams are required is to monitor employee health during respirator use. Inhalation is the most direct and common route of exposure to airborne contaminants. Periodic lung examinations will determine whether lungs are being affected and any deterioration of existing conditions.

How do you ensure that employees are properly prepared for fit-tests?

An employee who is not properly prepared for a fit-test (such as shaving facial hair) will not get a good face seal, causing the respirator to potentially "leak" harmful chemicals. It's imperative that company policies address the requirements for respiratory use, including the necessity for clean-shaven faces and any religious exclusions.

Weissman recommends informing employees two weeks in advance, and then a few days before, of the location and time of their scheduled testing, as well as explaining the reason and importance of the test.

Tell employees of your respiratory testing requirements at the time of their job assignment, says Vincoli. And if they will not or cannot comply, then another employee should be selected.

Training for respiratory protection is required at the time of an initial assignment and annually thereafter, according to OSHA's respiratory protection standard. Turnover and retraining are often an inevitable part of the job, but there are ways to maintain a successful training program-and perhaps decrease turnover in the process.

For starters, you need a qualified person on site who is responsible for observing new employees as they are processed through orientation, says Abrams. "Suitable training also needs to be behavior-based. You need to explain how the program works and emphasize its importance. A company that cares and listens to employees' suggestions will create a positive work environment in which employees will probably remain, decreasing turnover," says Lemke.

David Sarkus suggests another approach: "I try to severely limit the number of respiratory users through engineering means or substitution of less harmful products." He suggests that selling management on engineering out contaminants to eliminate them completely is often the most cost-effective tactic, because training costs money in terms of time away from work.

What are some ways to enforce wearing a respirator?

Respiratory use is a safe habit that needs to be developed through repetition. But it's difficult for employees to repeat a behavior that has unpleasant consequences. Since wearing a respirator can be uncomfortable, and might interfere with communicating, you can understand why some employees are reluctant to wear one consistently. Still, there are certain strategies that you can establish to encourage employees to develop the habit.

Periodic and random monitoring by safety representatives and/or management to survey employees' respiratory use is important to assess the particular method you need to utilize in your program. The following are a variety of ways to motivate respirator use, compiled from the suggestions given by Barry Weissman, Jeff Vincoli, Peter Lemke, Molly McClintock of Safety Performance Solutions, and David Abrams.

• Minimize the natural punishing consequences by purchasing comfortable and appropriate respirators, making them easily accessible, and keeping them properly maintained. Help employees to select respirators that work for them.
• Institute effective and consistent trainingby setting clear expectations. Make sure signs are clearly posted in respirator areas. Work with employees to find ways to limit the use of respirators. Motivate employees to want to use them.
• Reward and recognize employeeswho are wearing respirators with a cup of coffee, a free dessert for lunch, or some other small positive reinforcement. More broadly, you can make safety performance an element of annual job reviews and salary raises. Still, a simple thank- you or thumbs up goes a long way.
• Ensure that supervisors and managerswho visit areas requiring protection are wearing respirators. Even though they may not need to because they are not "working" in that area, their use of respirators allows the workers to see that management considers wearing one important. You should also ensure that supervisors model the appropriate behavior when they work in a respirator-designated area.
• Disciplineshould be a last resort. While most employees will be influenced by the above strategies, a few may require some form of discipline if they fail to adopt the required behavior. The use of punishment should be consistent and the criteria for it must be adequately communicated. Examples of discipline can include verbal warnings, written warnings, suspension and, in severe situations, dismissal.

Consistent respiratory use is a safety habit that must be developed. The key is to give employees adequate and correct training that allows them to make their own informed decisions. Be flexible in your approach. As these suggestions have shown, there are a variety of ways to teach your employees about the dangers of toxic exposures; the importance of respirators; and the need to properly use, maintain, and store equipment.