Fit testing what is it

Facial Hairstyles and Filtering Facepiece Respirators pdf icon Respiratory Fit Testing external icon Skip directly to site content Skip directly to page options Skip directly to A-Z link. Section Navigation. Facebook Twitter LinkedIn Syndicate.

Fit Test FAQs. Fit Testing What is a respirator fit test? Are fit tests required? What types of respirators require fit testing? How often do I need to complete a fit test? What is a qualitative fit test? What is a quantitative fit test? Do I need any requirements or certifications to perform fit testing?

User Seal Checks What is a respirator user seal check? A successful check is when slight pressure builds up in the respirator without any leakage. Negative pressure user seal check — The person wearing the respirator quickly inhales while blocking the paths for air to enter the facepiece. A successful check is when the facepiece collapses slightly under the negative pressure.

How often do I need to perform a user seal check? Preprint Open access. Online first. Med J Aust Published online: 12 August Fit-checking is recommended prior to donning a respirator. However, fit-checking is unreliable in detecting proper fit. Fit-testing is recommended to ensure proper fit of respirators for individual health care worker and is required to comply with respirator standards. However, fit-testing is not performed in all health care settings. The small cost of performing fit-testing has to be compared to the welfare of the health care workers as well as potential cost of sick leave or legal costs.

Fit-checking and the ability to detect leak Fit-checking user seal-check, self-check , not to be confused with fit-testing, describes a subjective self-check aiming to detect good facial seal through the absence of air leaks using both positive and negative pressure tests 9.

Fit-testing and selection of optimal respirator Fit-test protocols include defined fit-test exercises to assess protection provided under simulated work conditions 9. Legislation and current practice When using respirators, fit-testing is considered the gold standard and many countries have recommendations or legislative requirements to perform this routinely but there are large variances in the actual performance of these interventions between countries and between health services within a country 5, 7, 9.

Financial and logistical considerations of implementing a fit-testing program Adopting fit-testing into a respiratory protection program poses a financial and logistic challenge 8.

Conclusions Healthcare workers exposed to aerosol-generating procedures are particularly at risk for transmission of SARS-CoV-2 and other respiratory viruses. Paediatr Anaesth. Online ahead of print: doi: Research gaps in protecting healthcare workers from SARS and other respiratory pathogens: an interdisciplinary, multi-stakeholder, evidence-based approach.

J Occup Environ Med. Published May Accessed 15th May N Engl J Med ; 16 Version 2. Published April Accessed 23rd April Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One. Published June Accessed 27th July Evaluation of a large-scale quantitative respirator-fit testing program for healthcare workers: survey results.

Infect Control Hosp Epidemiol. Accessed 25th April Performance of an N95 filtering facepiece particulate respirator and a surgical mask during human breathing: two pathways for particle penetration. J Occup Environ Hyg. Temporal changes in filtering-facepiece respirator fit. Sensitivity and specificity of the user-seal-check in determining the fit of N95 respirators. J Hosp Infect. Predictive value of the user seal check in determining half-face respirator fit. Evaluation of the user seal check on gross leakage detection of 3 different designs of N95 filtering facepiece respirators.

Am J Infect Control. Health care workers and respiratory protection: is the user seal check a surrogate for respirator fit-testing. Comparison of qualitative and quantitative fit-testing results for three commonly used respirators in the healthcare sector. Clayton M, Vaughan N. Fit for purpose? The role of fit testing in respiratory protection. Ann Occup Hyg. Accessed 13th July This ensures that users are receiving the expected level of protection by minimizing contaminant leakage into the facepiece.

If this happens, you may be exposed to harmful pathogens in the environment. In a similar vein, it is important to wear the respirator at all times during the exposure because even short periods of exposure substantially reduces your protection.

This all boils down to a simple reality: if the respirator does not form a seal with the face, it cannot provide the expected level of protection. Therefore, fit testing at all the OSHA-required times is necessary — however, during large-scale infectious disease outbreaks, there are ways to save time when fit testing as well as conserve supplies. This temporary enforcement guidance suspends the annual fit testing requirement of N95 filtering facepiece respirators.

However, initial fit tests for healthcare personnel with the same model, style, and size respirator are still required. There are two methods of fit testing — quantitative and qualitative. A quantitative fit test uses an instrument to numerically measure the effectiveness of the respirator.

Respirator sizing is not standardized across models or brands. Do not assume that because you passed a fit test wearing a size medium in one model, a medium of another model or brand will have an equivalent fit: this could result in an improperly fitted respirator and potentially harmful exposure to airborne pathogens. With the global impact of COVID, qualitative fit testing is the preferred method of fit testing to help slow the depletion of the inventory of N95 respirators, because the respirator used for a qualitative fit test can be worn again after the test.

Quantitative fit testing requires a hole to be punched in the respirator and therefore it must be disposed of after the test. In these cases, poorly fitting respirators may still pass the fit test. For healthcare systems currently using quantitative fit test methods, considerations can be made to switch to qualitative fit test methods to minimize the destruction of N95 respirators.

Any switch in methods should be assessed to ensure aptitude of the fit test operators carrying out the test. Healthcare facilities should begin training and implementing a plan for fit testing immediately. It is essential to have healthcare professionals trained and fit tested prior to receiving COVID patients. For locations where the surge has not arrived and experienced fit tester operators are lacking, begin comprehensive training now. A typical qualitative fit test should take between minutes.

However, during an outbreak, even minutes per employee can be difficult to achieve, especially for large facilities who may need to fit test a significant number of workers who are not required to wear respirators during times of normal operation because their job does not typically place them at risk for exposure to airborne infectious diseases.

Determining the number of operators depends on the number of fit tests that need to be completed and the amount of time available. A highly experienced fit testing operator can complete about three fit tests per hour. It is also helpful to have an additional person assist with logistics, recordkeeping, and management of the equipment.