Title: CBRN and Non-CBRN Respirators2
1Respiratory Protection Program (RPP) Discussions
in the Deep South Terrence K. Cloonan,
Physical Scientist
The Deep South Center for Occupational Health
Safety NIOSH Education and Research Center
Respiratory Protection Program Respirator Fit
Testing Workshops Gulfport, Mississippi April 5
- 7, 2010
2Overview
- Training objectives
- Assessment discussions
- Federal precedence
- Deep South RPP Analysis
- Permissible practice
- OSHA RPP Scope
- RPP definitions responsibilities
- Tips on How to Write a RPP
- Sample RPP
- Assistance sources
- Recognizing compliant respirators
-
3Training Objectives/Take-Away
- Discuss/assess example workplace respiratory
hazards - Review Federal RPP precedence sources
- Facilitate a NIOSH ERC Deep South RPP analysis
- Interpret Southern state and local information
- Provide a NPPTL perspective on who, when, and
what as it relates to implementing OSHA
Respiratory Protection Program scope,
definitions, paragraphs, appendices - Provide tips on how to write a RPP
- Assist users in determining compliancy of
respirators - Gain feedback on field use of NIOSH-approved
respirators
4Hazard Assessment Discussion
- Production of polymers bulk toxic industrial
chemicals - Production of small engines toxic waste
byproducts - Production of paint concrete products dust
particulate - Production of bone void fillers/biologics
bio-particulates - Processing of healthcare patients universal
precautions - Conduct of OSHA Respirator Med Exam H1N1
potential - Academic chemistry labs worker and student PPE
use - NASA rocket launches bulk toxic fuel
containment - US Naval aviation operations disaster
preparedness
5Training Assessment Discussion
- Are there injury trends?
- Are there worker concerns?
- Near misses or fatalities? OSHA Log entries?
- Workmens comp claims?
- How is respirator use evaluated?
- Is there a partial or full RPP?
- When are respirators really worn?
- How are respirators really worn?
- When are user seal checks done?
- Are NIOSH cautions and limitations for each
respirator common user knowledge?
6Federal Training Precedence
- OSHA 29 CFR 1910.120 - HAZWOPER
- OSHA 29 CFR 1910.134 - Respiratory Protection
- OSHA 29 CFR 1910.146 - Permit Confined Space
- OSHA 29 CFR 1910.156 - Fire Brigade
- OSHA 29 CFR 1910.1025 - Lead ( other substance
specific stds.) - EPA 40 CFR 311 Worker Protection
- CDC NIOSH 42 CFR 84 Respiratory Protective
Devices - U.S. Army, AR 11-34 The Army RPP
- U.S. Navy Marine Corps PH Center Generic RPP
SOP - U.S. NRC 10 CFR 20.1703 - Use of Individual
Respiratory Protection Equipment
7Federal OSHA or OSHA State Plan?
- Alabama, Mississippi, Georgia, and Louisiana
workplaces are diverse farming and industry - Federal OSHA requirements
- Private workers
- Public workers
- NIOSH ERC Deep South University of Alabama at
Birmingham - University OHS Programs
- State Public Health Programs
- School District Safety Program
8Deep South RPP Analysis
- AL, GA, LA, MS non-plan States per OSHA
- APPLICABLE Federal OSHA for private business
workplaces - EXCLUSIONS Currently state and local government
employees are excluded from federal OSHA coverage
under the OSH Act of 1970. See the link
http//www.osha.gov/dcsp/osp/public_sector.html - EMPLOYEE TYPE If you have to write a RPP,
knowing the type of employee is vital. Two Types
of Employees Public and Private. Federal, state,
county, city, borough, township, village Public
sector worker (state or local government
employee career, temporary, volunteer
(paid/nonpaid)) Private sector worker any
employed private citizen (full time, half time,
part time) Private or state academic institution
worker private or public sector worker? - OSHA State Plans 27 total 22 state level
governments operate OSHA-approved state plans
covering both public and private sector
employees. 5 operate public sector employee-only
plans (state and local government).
http//www.osha.gov/dcsp/osp/index.html - EPA 40 CFR 311 Non-plan state? Hazardous waste
disposal work should default to worker coverage
under EPA 40 CFR 311. - Public Workers/Responder Use RPP authority is at
the state or lowest local municipal government
level. Respirator use is voluntary. Appendix D of
29 CFR Part 1910.134 should be provided.
9Search Results for Sample RPP
- INVISTA polymers, resins, fibers 37 products
and brands http//www.invista.com/page_product_ind
ex_en.shtml - Briggs Stratton engines, generators, air
compressors http//www.briggsandstratton.com/corp/
safety_use/air_compressor.aspx - Methodist Healthcare respirator medical
clearance exam http//www.methodisthealth.org/meth
odist/HealthcareServices/MedicalServices/WorkIn
juryCare/WorkInjuryPhysicalExaminations - University of South Alabama Dept of Safety and
Env. Compliance http//www.southalabama.edu/enviro
nmental/department.html - Community Health Network OSHA State Plan,
Indiana DOL OSHA 3079 http//www.in.gov/dol/2603.h
tm - Wright Medical Technology Code of Business
Conduct EHS http//www.wmt.com/Corporate/Code_o
f_Business_Conduct_072009.pdfsearch"Occupational
Safety - Benjamin Moore Co paint concrete repair kit
MSDS http//www.benjaminmoore.com/bmpsweb/Download
Binary?fileNameMSDS_M72C_en_US.pdfnodeIdBEA
Repository/16403propertyIdBEA
Repository/16403/data_sheet_file_en_US - Jacobs Technology NASA Contract GSA schedule
899 information http//jacobstechnology.com/gsa/en
v_sch899.html - Yuma Proving Ground Kofa region EA. PETN,
DNT,TNT, RDX MSDS http//www.yuma.army.mil/docs
/IAExpansion_EA_Draft_FONSI_25Mar10.pdf - Naval Hospital-Pensacola/NASP OPN Prepare - H1N1
Prevention https//www.cnic.navy.mil/CNIC_HQ_Site/
OperationPrepare/FluInformation/H1N1FluPreventionI
ncludingVaccination/index.htm
10State, Regional, and Local Interpretations
- Alabama Department of Labor, Safe Employment Law,
Title 25, Industrial Relations and Labor
http//www.alalabor.state.al.us/FAQ.htm - Georgia Code, Title 34 Labor and Industrial
Relations, Department of Labor, Safe Employment
and Title 25 Fire Protection and Safety
http//www.lexis-nexis.com/hottopics/gacode/de
fault.asp - Mississippi Department of Public Safety, Homeland
Security, CBRN SCBA on DHS AEL http//www.homeland
security.ms.gov/docs/FY07AuthorizedEquipmentList.p
df - Louisiana Workforce Commission, Classes and
Components of Safety Plan http//www.laworks.net/
Downloads/OWC/safetyrequirements.pdf - Respiratory protection program training is in
academic universities and private loss-control
companies http//www.hascats.com/hascatsinc2_012.
htm -
11OSHA Permissible Practice
Workplace Hierarchy of Controls
12Program Scope
- Federal respiratory protection program actions
- Identify hazards worksite specific procedures
- Specify required use address voluntary use
- Address exclusion considerations
- Write publish ten provisions/appendices,
w/effective date - Develop implement a full written program
- Administer it by a suitably trained administrator
- Update as necessary to reflect changes
- Non-OSHA Plan State? Exclusions in effect.
Identify type of employee, inspect
respirator, provide a written copy of OSHA 29
CFR 1910.134 Appendix D
13RPP Definitions and Responsibilities
- OSHA 1910.134 Defines 35 technical terms used in
writing a RPP - Deep South RPP University programs. Others?
- OSHA 1910.134 identifies responsibilities for
eight types of RPP users - the employer, the RPP administrator, the
physician/licensed health care professional
(P/LHCP), the fit test subject, the individual
using a tight-fitting respirator during a user
seal check, every employee that has been selected
to use any type of respirator, and employees who
voluntarily use an employers respirator, or
provide and use their own respirator. - Sample state RPP can identify responsibilities
for for eight types of State level RPP
users - the departmental safety coordinator,
manager/supervisor, bureau director, P/LHCP,
general services employee, private or contingent
employee, contractors.
14WHO is Required to have a RPP?
- Any private business that requires respirators to
be used by its employees - Private business
- Hospitals, private ambulance companies
- General industry, construction industry
- River shipyards, ocean terminals, etc.
- Federally regulated workplaces
- Nuclear reactor facilities and industry
http//www.hss.energy.gov/CSA/CSP/hepa/lessons.cfm
- http//www.nrc.gov/reading-rm/doc-collections/reg-
guides/occupational-health/active/8-15/ - http//www.eia.doe.gov/cneaf/nuclear/page/at_a_gla
nce/states/statesal.html - Private contractors e.g. Exelon Nuclear at TMI,
Browns Ferry of TVA, J.M. Farley of Alabama
Power - ?Voluntary use of a Filtering Facepiece
Respirator (FFR) does not require the use of a
written RPP
15WHO Should have a RPP ?
- Fire service
- Law enforcement
- EMS, ambulance crews
- Public works
- Public health
- HAZMAT response and decon strike teams
- Transportation agencies railroad, aviation,
water
16WHEN is a Respiratory Protection Program Needed?
- Before the incident or training occurs
- Before a new employee is hired
- Before new respirators are purchased
- Evaluate while in use
- Update the RPP routinely
17WHAT Respirator Use Needs to be Covered?
- 29 CFR 1910. Subpart I. section.134 Section is
applicable to five private workplace sectors - General Industry (Part 1910), Shipyards (Part
1915), Marine Terminals (Part 1917), Longshoring
(Part 1918), and Construction (Part 1926). - OSHA-approved State Plans may update
applicability to address public and private
sectors or just state public sector employees - Any use of filtering facepiece respirators (N95
FFR) - Any use of ½ masks, APR, PAPR, HOODS, SCBA,
CC-SCBA, SAR, CBRN Respirators and fit testing
instruments - Any use of breathing air cylinders, couplings,
and compressors - Mandatory, not required, self-provided, and
voluntary situations
18Where has a Partial or Full RPP been Used?
- What type of business in Deep South?
- National response framework, ESF 8 activated
Hurricane Katrina response - Human Resources safety policies
- Nuclear reactor facility RPP
- State public safety academy standards
- State fire academy- flashover simulator
- Local VFD/PD Asbestos structural fires, meth
raids, hazardous material spill - Use of respirators/masks by EMS
19Examples of Existing Partial Programs
- Can you have a written policy that addresses only
an aspect of an OSHA compliant RPP? - Published letterhead policies, by safety topic
- Hairline and facial hair policy for safe use of
SCBA respirators - PPE Checklists for turn-out gear address SCBA
requirements - Does a published standard operating procedure
(SOP) or guideline (SOG) exist for respirator use
in - Active fire incidents and live fire training
evolutions - Active medical incidents
- Active traffic incidents
- Universal precautions
20 How do I write a RPP?
- ANALYZE Know workplace regulatory requirements
and standards - PLAN Recognize the respiratory and dermal
hazards - Quantify the concentrations of the hazard(s)
- Assume worst case if quantification is unknown
- IMPLEMENT Assess protection qualities of
equipment - Available personal protective equipment (PPE)
that includes respirators, ensembles/suits,
gloves, boots, tools, and other technologies - a
PPE systems approach using current technical
standards defining PPE use expectations. - Locate the conformity assessment labels on
respirators and PPE - Recognize and determine the authenticity of the
compliance labels - Read and re-read the PPE user instructions and
train - NIOSH issues systems approvals not subcomponent
approvals - EVALUATE PROGRESS Write and vet a draft RPP
tailored to the type of PPE
available, proficiency, and workplace needs - Evaluate the effectiveness of the draft RPP
- RE-EVALUATE Publish a RPP. Use the RPP at the
worksite and update it
21WHO is Your Responsible Individual?
- Plant Manager
- Industrial Hygienist
- Business Owner
- City Mayor
- City Director of Public Safety
- County Department of Health Director
- Director of Emergency Management Agency
- What are the workplace hierarchy of safety
control measures? - Responsible individual or Line officer enforces
the use of them?
22OSHA RPP Foundation Standard 19 Topics
- 29 CFR 1910.134 Respiratory Protection Standard,
with 2009 Update - Permissible practice
- Definitions
- Respiratory Protection Program scope and
provisions - EVALUATION of Hazards, Initial Training,
Selection, Assigned Protection Factors (APF)
Maximum Use Concentration (MUC), and Oxygen
Deficient Atmospheres - MEDICAL evaluation, clearance, periodicity,
disqualifiers, and claims of users - FIT TESTING and evaluation of tight fitting
respirators - ESTABLISHMENT of worksite control procedures for
proper use by wearers - MAINTENANCE and care of respirators used by
employees - BREATHING AIR quality, its use in SCBA and SAR
and SCBA for escape - FILTRATION - Identification of filters,
cartridges, and canisters for air-purifying
respirators - USE - Training on mandatory/voluntary use,
evaluation of use, and where use is not required - ARCHIVE OF RECORDS Recordkeeping, activation of
RPP, and termination of RPP - AUDITS - Systematic program evaluation of users
and administrators - Appendices A, B-1, B-2, C, and D (all five are
mandatory) - Effective date of the program
23Elimination of Hazard/Evaluation of Hazards
- OSHA respiratory permissible practice applied in
a states homeland security spectrum of
operations - Crisis situation
- Responders rarely have engineering controls to
eliminate the hazard they must evaluate and use
certified PPE - DHS grants for PPE Responder protection
purchase and use of NIOSH-approved CBRN
respirators and NFPA certified C/B ensembles
Image source Pennsylvania Emergency Management
Agency, February 1, 2010.
24Initial Training and Selection
- Deep South AL, GA, MS, LA, FL, Texas
Multiple counties with
multiple municipalities and multiple school
districts need for common RPP - Can a state or EMA statewide RPP be
implemented for each county? - Is initial training of workers
conducted using NIOSH-approved respirators
as part of a state safe employment law? - RPP use enforces the proper selection
of a model of respirator.
Multiple facepiece sizes need to be
available for users, since no
one single model can seal
to 100 of all types of faces
25Selection of Respirators
- Keep it as simple as possible, since it is a
difficult task - Use a national rule or standard as a reference
- Evaluate the Hazards OSHA 29 CFR 1910.134
(d)(1)(iii) The employer shall identify and
evaluate the respiratory hazard(s) in the
workplace - Reasonable estimate of the employee exposures and
an identification of the contaminants chemical
state and physical form. - Where the employer cannot identify or reasonably
estimate the exposure, the employer shall
consider the atmosphere to be IDLH. - Use a NIOSH-certified Respirator OSHA 29 CFR
1910.134 (d)(1)(ii) The employer shall select a
NIOSH-certified respirator. The respirator shall
be used in compliance with the conditions of its
certification. - Offer Multiple Sizes and Makes OSHA 29CFR
1910.134 (d)(1) (iv) The employer shall select
(offer) respirators from a sufficient number of
respirator models and sizes so that the
respirator (selected) is acceptable to
correctly fits the user. - Use the 2004 NIOSH Respirator Selection Logic
http//www.cdc.gov/niosh/docs/2005-100/
26Common Types of Respirator Facepieces
- ¼ Mask
- ½ Mask FFR
- ½ Mask Elastomeric
- Full Facepiece Elastomeric
- Hoods
Drawing Source OSHA 3352-02, 2009, pg 5,
Attiliis Associates
27RPP Provisions Remaining Key Topics
- Medical Physical fitness, claustrophobia, color
blindness - Fit Testing Fit factors, conversion of SCBA
facepiece, drink tubes as sampling port, fit test
adapters, and sizes - Use Oxygen deficient, IDLH, fires, CBRN, DECON
- Maintenance User instructions, levels,
warranties - Breathing Air Escape SCBA, NIOSH, DOT, NFPA
- Filtration Identification OSHA, NIOSH, FDA, ANSI
- Training Demonstration of use knowledge, NIOSH
CL - Evaluation Fit, seal, selection, use,
maintenance, medical - Records Funding, oversight, audits, retention,
periodicity
28Mandatory Non-Mandatory Appendices
- Appendix A Fit Testing Procedures applies and
defines all OSHA-accepted fit test methods, both
QLFT and QNFT - Appendix B-1 User Seal Checks Procedures
applies to individuals who use a tight-fitting
respirator and perform user-specific functions
checks each time the respirator is put on. Not a
substitute for a QLFT or QNFT. - Appendix B-2 Respirator Cleaning Procedures
applies to the employer to ensure the respirator
in use is cleaned and disinfected in a manner
that prevents damage and does not cause harm to
the user. - Appendix C Respirator Medical Evaluation
Questionnaire - Appendix D Use of Respirators when not Required
29Standards to Help Write a RPP
- OSHA 29 CFR 1910.134 http//www.osha.gov/SLTC/resp
iratoryprotection/index.html - Washington State Department of Labor and
Industries, Respiratory Protection Standards
http//www.lni.wa.gov/Safety/Topics/AtoZ/RespProte
ction/RespA.asp - Michigan State Department of Labor and Economic
Growth, Part 451, Respiratory Protection
http//www.michigan.gov/documents/CIS_WSH_part451_
54075_7.pdf - ANSI Z88.2-1992, American National Standards
Institute - ANSI Z88.2-200x, Standard for Respiratory
Protection http//www.cdc.gov/niosh/npptl/resource
s/pressrel/announcements/113004wkshp/pdfs/Presenta
tion2018_James20Johnson.pdf - National Fire Protection Association (NFPA)
http//www.nfpa.org/catalog/product.asp?pid140406
order5FsrcB484 - International Safety Equipment Association (ISEA)
http//www.safetyequipment.org/c/resp.cfm - ISO TC 94/SC15 Respiratory Protection
http//ustagrespirators.com/docs/USTAGAPPLICATIONT
C94SC15.doc - ASTM E54.4-PPE
http//www.astm.org/COMMIT/SUBCOMMIT/E54
04.htm
30How do Users Determine OSHA/NIOSH Compliancy?
- NOT REQUIRED Lowest level of trained user does
not assess compliancy. It is not a requirement to
perform work. User is told to train, don, use,
survive, maintain. - REACTIVE Question current compliancy only after
a loss time injury or line-of-duty death (LODD) - FREE MARKET Rely on specifications
of a competitive bid - marketing
process - GRANTS Compliancy is pre-determined by local
jurisdiction or grant funded purchase criteria
(CBRN) - RPP State written respiratory protection program
- LOCAL Best practices, SOP, SOG, Insurance policy
31NIOSH Non-CBRN and CBRN Respirators
- Both are NIOSH-approved
- Non-CBRN respirators traditional industrial
standards current protection levels (FFR, ½
masks etc.) - CBRN SCBA traditional industrial standards, NFPA
specific standards, special chemical
warfare agent gas, vapor, and LRPL tests - CBRN APR, PAPR, APER traditional industrial
standards, new human factor standards, special
chemical warfare agent gas, vapor, and LRPL tests - Distinction knowledge of UI labels
32Recognizing a NIOSH CBRN Respirator
- Locate Labels
- Verify labels
- Know UI, CL
- GB HD STP
- LRPL STP
- In-Use Life
- Upgrades
- Interoperability
- Does the use of NIOSH-approved
CBRN respirators in an
industrial
workplace preclude
the need to rewrite the RPP?
33Pathways to NIOSH Compliance
- Certified Equipment List (CEL) Confirms approval
http//www2a.cdc.gov/drds/cel/cel_form_code.asp - Is it a 2007 edition CBRN SCBA?
http//www2a.cdc.gov/drds/cel/cel_cbrn_results.asp
?startrecord1maxrecords50SearchQScbrncbrn_s
cba - Is it a replica SCBA cylinder/valve assembly?
http//www.cdc.gov/niosh/npptl/topics/respirators/
firescbacylinder.html - What Gas Masks are CBRN Approved?
http//www2a.cdc.gov/drds/cel/cel_cbrn_results.asp
?startrecord1maxrecords50SearchQScbrncbrn_a
pr - Need a Respirator User Notice?
http//www.cdc.gov/niosh/npptl/usernotices/default
.html - Want NIOSH Guidance Documents?
http//www.cdc.gov/niosh/npptl/guidancedocs/ - Need OSHA HAZWOPER Training?
http//www.oshahazwopertraining.com/
34Working Examples of RPP in Use
- Health Care Worker State of Vermont
http//www.healthvermont.gov/hc/ems/documents/Mode
lN95respprotectprogram090619.doc - Private sector Washington State (WISHA)
http//www.lni.wa.gov/safety/basics/Programs/Accid
ent/Samples/RespProtectguide2.doc - Insurance Fund State of California
http//www.scif.com/safety/losscontrol/Article.asp
?ArticleID541 - Private sector EPA http//www.epa.gov/d
fe/pubs/auto/respirator/rpp.pdf - Law Enforcement - State of Illinois
http//www.ileas.org/respirators/labor_issues/matr
ix.pdf - Fire Service State of Michigan
http//www.michigan.gov/documents/cis_wsh_cet5731_
90303_7.doc
35Deep South Sources for Assistance
- OSHA Region 4
http//iforms.osha-slc.gov/oshdir/r04.html - OSHA Area Offices
- OSHA Consultation Projects http//www.osha.gov/os
hdir/ga.html - OSHA RPP Inspection Procedures
http//www.osha.gov/pls/oshaweb/owadisp.show_docum
ent?p_tableDIRECTIVESp_id2275 - NIOSH ERC Deep South http//www.soph.uab.edu/dsc/
academicprogram - NIOSH http//www.cdc.gov/niosh/contact/
- NPPTL Pittsburgh http//www.cdc.gov/niosh/npptl/d
efault.html - NIOSH Respirator Trusted Source page
http//www.cdc.gov/niosh/npptl/topics/respirators/
disp_part/RespSource.html
36Indicators of NIOSH Compliancy SCBA
- Example 1
NIOSH-CBRN SCBA to NFPA 1981 1997 ed. - Example 2
NIOSH-CBRN SCBA to NFPA 1981 2002 ed. - Example 3
NIOSH-CBRN SCBA/APR/PAPR
SCBA only is compliant to
NFPA 1981/1982 2007
edition (ed.) - Example 4
NIOSH-CBRN SCBA to NFPA 1981 2002 ed
37Example 1 1997 EDITION CBRN SCBA
- 2 sets of SCBA Hardware Same make and NFPA
edition - One functional. One non-functional. Both
non-compliant. - Both models are NIOSH-approved, NFPA certified,
but not NFPA or DOT compliant - Recognition in the field is decal label
dependent
38Example 2 2002 Edition CBRN SCBA
- Functional SCBA has all subcomponents
- All NFPA-NIOSH quality assurance adhesive labels
are present. - CDC/NIOSH logoed CBRN Agent Approved label
visible - HHS/NIOSH logoed13F backframe/harness label is
visible. - Cylinder missing DOT requalification stamp
39Example 3 2007 EDITION MODE-of-USE CBRN SCBA
with NIOSH CBRN PAPR or APR
- Three sets of respirators and 3 UI
- One make of facepiece with integrated but
distinct pressure-demand negative air-pressure
boundaries - Carries independent NIOSH-approvals for each
class of CBRN respirator technology
40Example 4 2002 EDITION CBRN SCBA w/ AIRHATCH
REGULATOR
- Significant amount of 2002 edition CBRN SCBA in
the field - Common edition for applying CBRN SCBA upgrade kit
- NIOSH-approved with CBRN Protections
(SC/PD/CBRN), NFPA certified and compliant and
DOT compliant
41Indicators of NIOSH Compliancy APR
- Canister is correctly labeled, colored and stored
in required packaging - Canister connects correctly into the facepiece.
Use is per the UI - User instructions (UI) contain the NIOSH approval
label and CL - Facepiece has all authorized components and is
marked with a size and part number - CBRN canister is marked with NIOSH TC-approval
number - Canister abbreviated label is present
42Respirators Brought to Workshop Assessment Logic
- NIOSH Approval Label present?
- Manufacturer User Instructions (UI) present?
- Manufacturer adhesive labels applied?
- All subcomponents present?
- All subcomponents present approved to be
connected per NIOSH approval label? - All third party quality assurance labels and
certifications present? - Other observations
43- DISCLAIMER The findings and conclusions in this
presentation have not been formally disseminated
by the National Institute for Occupational Safety
and Health (NIOSH) and should not be construed to
represent any agency determination or policy.
Mention of any respirator or personal protective
equipment company, product, policy or the
inclusion of any stakeholder reference does not
constitute endorsement by NIOSH. The presentation
is provided only as a guide to assist workers in
complying with OSHA 29 CFR 1910.134. It is not
intended to supersede the requirements detailed
in the regulation. Users should review the
current OSHA standard and other federal, state or
local requirements which are applicable.
National Personal Protective Technology
Laboratory (NPPTL) of NIOSH P.O Box 18070,
Pittsburgh, PA 15236 (412) 386-6736 www.cdc/gov/ni
osh/npptl
Authhor Terrence K. Cloonan tcloonan_at_cdc.gov (412
) 386-6701