Occupational health scientists lobby Congress on fit-testing

Letter may have swayed decision

In what may have had a critical influence on a recent decision to restore enforcement of annual fit-testing in health care settings, more than 50 occupational and environmental health researchers and professors signed a July 17 letter to David Obey, chairman of the Committee on Appropriations in the U.S. House of Representatives. The letter is summarized as follows:

Dear Mr. Chairman: The signers of this letter, scientists and experts in the field of occupational safety and health, are writing to express our strong opposition to the Wicker amendment that would prohibit OSHA from enforcing the annual fit-testing requirement of its respirator standard as it applies to exposure to tuberculosis (TB). This amendment would place health care workers and first responders at increased risk of developing TB. Respirators can only offer adequate protection to the wearer if they fit well on the wearer's face. To determine if a respirator fits properly and does not leak, it is essential that an initial fit-test be performed. The scientific evidence establishing the need and requirement for fit-testing is substantial. The evidence clearly shows that fit-testing is essential in order to identify respirators that fit well on the worker's face and that passing a fit-test increases the likelihood of receiving the expected level of protection that is assigned to the respirator. Research has also shown that in the absence of fit testing, many respirators fail to provide adequate protection.

In order to maintain continuing adequate protection of the respirator, it is essential that follow-up fit-testing be conducted. The scientific evidence also supports the OSHA regulatory requirement to conduct fit-testing on an annual basis. Performing annual fit-tests will assure that workers maintain the level of protection the respirator is designed to provide.

Our government's scientific expert agency on respiratory protection, the National Institute for Occupational Safety and Health (NIOSH), strongly supports the necessity of conducting initial and annual fit-testing for workers who must wear respirators on the job. That would include health care workers and first responders exposed to TB. We believe that Congress should rely and act on the expertise and advice by NIOSH and support annual fit-testing for workers exposed to TB and oppose the Wicker amendment.