APPENDIX D - 1

Regulations (Standards - 29 CFR)

(Mandatory) Information for Employees Using Respirators When not Required
Under Standard. - 1910.134 App D

• Part Number: 1910

• Part Title: Occupational Safety and Health Standards
• Subpart: I
• Subpart Title: Personal Protective Equipment
• Standard Number: 1910.134 App D
• Title: (Mandatory) Information for Employees Using
Respirators When not Required Under Standard.

Appendix D to Sec. 1910.134 (Mandatory) Information for Employees Using

Respirators When Not Required Under the Standard
Respirators are an effective method of protection against designated hazards when properly
selected and worn. Respirator use is encouraged, even when exposures are below the
exposure limit, to provide an additional level of comfort and protection for workers. However,
if a respirator is used improperly or not kept clean, the respirator itself can become a hazard
to the worker. Sometimes, workers may wear respirators to avoid exposure to hazards, even
if the amount of hazardous substance does not exceed the limits set by OSHA standards. If
your employer provides respirators for your voluntary use, or if you provide your own
respirator, you need to take certain precautions to be sure that the respirator itself does not
present a hazard.
You should do the following:
1. Read and heed all instructions provided by the manufacturer on use, maintenance,
cleaning and care, and warnings regarding the respirators limitations.
2. Choose respirators certified for use to protect against the contaminant of concern.
NIOSH, the National Institute for Occupational Safety and Health of the U.S. Department of
Health and Human Services, certifies respirators. A label or statement of certification should
appear on the respirator or respirator packaging. It will tell you what the respirator is
designed for and how much it will protect you.
3. Do not wear your respirator into atmospheres containing contaminants for which your
respirator is not designed to protect against. For example, a respirator designed to filter dust
particles will not protect you against gases, vapors, or very small solid particles of fumes or
smoke.
1. Keep track of your respirator so that you do not mistakenly use someone else's
respirator.
 Willy Street Co-op
Voluntary Respirator Use Policy
(Loose-fitting disposable respirator only)
While Willy Street Co-op (aka WSGC) notes that respiratory protection is not required when
conducting tasks (such as sweeping, dusting or sanding) that are below the Permissible Exposure
Limit (PEL), we recognize some employees’ concerns about reducing their exposures further when
working in an unpleasant environment. A hazard assessment has been completed by Society
Insurance and WSGC for retail and operations job tasks and can be found by following the link on the
WSGC Maintenance Google site.
Accordingly, employees may voluntarily choose to wear the following loose-fitting disposable
respirator(s) when the employee wants protection from nuisance dusts, particulates, etc:

● NIOSH N95 - filters at least 95% of airborne particles but is not resistant to oil.
● NIOSH Surgical Masks - Surgical masks are not designed for use as particulate
respirators and do not provide as much respiratory protection as an N95 respirator
but they provide a barrier for protection against droplets including large respiratory
particles. They do not effectively filter small particles from the air and do not prevent
leakage around the edge of the mask when the user inhales.
● NIOSH N100 - filters at least 99.97% of airborne particles but is not resistant to oil.

Employees who voluntarily wear a loose-fitting disposable respirator when respirator protection is not
required will be provided with a copy of Appendix D from the 1910 General Industry Standards and
receive instruction on the location, replacement, storage and disposal of these masks.
Employees may not bring in their own respirators into the workplace without prior approval from
management. OSHA regulations state that the employer is responsible for ensuring all respiratory
protection used by employees provides appropriate protection for the hazard. Management shall
evaluate and authorize any requests for voluntary use of respiratory protective equipment not
provided by this company.
Any other requests by employees to wear respiratory protection during other activities not identified in
our hazard assessment will be reviewed and authorized on a case-by-case basis by the WSGC
Facilities Director and/ or HR Director.
(Note: Loose-fitting disposable respirators that do not have any NIOSH certification are not subject to
OSHA respiratory protection standards.)
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I have read the company policy and the contents of Appendix D providing information for employees
using disposable dust masks voluntarily. I agree to abide by the policy and instructions provided.

Employee name: ____________________________________

Signature: _________________________________________

Date: __________________________________________________