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Fit testing 101: The basics from NIOSH and OSHA
Selection, fit important before testing
Now that annual fit-testing in back on the compliance books, a little refresher may be in order. The following information on respirator fit-testing in health care settings is summarized from guidance by the National Institute for Occupational Safety and Health (NIOSH) and U.S. Occupational Safety and Health Administration (OSHA):
Conduct a risk assessment and determine who must wear a respirator and be included in the program. A fit-test must be conducted to determine which brand, model, and size of respirator fits the user adequately and to ensure that the user knows when the respirator fits properly. Such knowledge is important because TB aerosol can leak around the facepiece into the respirator and be inhaled if the respirator does not fit the user's face.
Determining facepiece fit involves qualitative fit-testing (QLFT) or quantitative fit-testing (QNFT). A QLFT test relies on the wearer's subjective response to taste, odor, or irritation. A QNFT uses another means of detecting facepiece leakage and does not require the wearer's subjective response. Respirator models and brands have inherently different fitting characteristics. Therefore, more than one brand or model, and various sizes of a given type of respirator should be purchased to take advantage of the different fitting characteristics of each and to increase the chances of properly fitting all workers.
Procedures for fit testing:
OSHA requires employers to conduct fit testing using the following procedures:
Each test exercise should be performed for one minute, except for the grimace, which is performed for 15 seconds. The employee should be asked about the acceptability of the respirator upon completion of the protocol. If unacceptable, the process should be repeated with another respirator before proceeding to the specific qualitative or quantitative test protocols.