Respiratory rule includes several fit-testing basics

Worker must be able to do variety of tests

The Occupational Safety and Health Administration’s (OSHA) 1998 respiratory protection standard, which now applies to tuberculosis exposures in health care settings, includes the following general requirements for respirator fit-testing:1

Assessment of comfort shall include a review of the following points with the test subject and allowing the test subject adequate time to determine the comfort of the respirator:

1. position of the mask on the nose;

2. room for eye protection;

3. room to talk;

4. position of mask on face and cheeks.

The following criteria shall be used to help determine the adequacy of the respirator fit:

1. chin properly placed;

2. adequate strap tension, not overly tightened;

3. fit across nose bridge;

4. respirator of proper size to span distance from nose to chin;

5. tendency of respirator to slip;

6. self-observation in mirror to evaluate fit and respirator position.

The test shall not be conducted if there is any hair growth between the skin and the face piece sealing surface, such as stubble beard growth, beard, mustache or sideburns which cross the respirator sealing surface. Any type of apparel, which interferes with a satisfactory fit, shall be altered or removed.

If a test subject exhibits difficulty in breathing during the tests, he or she shall be referred to a physician or other licensed health care professional, as appropriate, to determine whether the test subject can wear a respirator while performing his or her duties.

If the employee finds the fit of the respirator unacceptable, the test subject shall be given the opportunity to select a different respirator and be retested.

Exercise regimen. Prior to the commencement of the fit test, the test subject shall be given a description of the fit test and the test subject’s responsibilities during the test procedure. The description of the process shall include a description of the test exercises that the subject will be performing. The respirator to be tested shall be worn for at least five minutes before the start of the fit test.

The fit test shall be performed while the test subject is wearing any applicable safety equipment that may be worn during actual respirator use, which could interfere with respirator fit.

The test subject shall perform exercises, in the test environment, in the following manner:

1. Normal breathing. In a normal standing position, without talking, the subject shall breathe normally.

2. Deep breathing. In a normal standing position, the subject shall breathe slowly and deeply, taking caution so as not to hyperventilate.

3. Turning head side to side. Standing in place, the subject shall slowly turn his or her head from side to side between the extreme positions on each side. The head shall be held at each extreme momentarily, so the subject can inhale at each side.

4. Moving head up and down. Standing in place, the subject shall slowly move his or her head up and down. The subject shall be instructed to inhale in the up position (i.e., when looking toward the ceiling).

5. Talking. The subject shall talk out loud slowly and loud enough so as to be heard clearly by the test conductor. The subject can read from a prepared text, count backward from 100, or recite a memorized poem or song.

6. Grimace. The test subject shall grimace by smiling or frowning.

7. Bending over. The test subject shall bend at the waist as if he or she were to touch his or her toes. Jogging in place shall be substituted for this exercise in those test that do not permit bending over at the waist.

Each test exercise shall be performed for one minute except for the grimace exercise, which shall be performed for 15 seconds. The test subject shall be questioned by the test conductor regarding the comfort of the respirator upon completion of the protocol. If it has become unacceptable, another model of respirator shall be tried. The respirator shall not be adjusted once the fit test exercises begin. Any adjustment voids the test, and the fit test must be repeated.

Reference

1. Department of Labor. Occupational Safety and Health Administration. Respiratory protection; final rule. 63 Fed Reg 1,152-1,200 (Jan. 8, 1998).