Congress steps into the fit-testing fight

Amendment would halt OSHA enforcement

The battle over annual fit-testing isn’t over yet. The U.S. Occupational Health and Safety Administration (OSHA) rule became effective on July 1, but two weeks later, the House appropriations committee approved an amendment that would prohibit OSHA from spending funds to enforce annual fit-testing.

As of Hospital Employee Health press time, the amendment still faced a vote in the full House. It also must gain Senate approval before an Oct. 1 adjournment of Congress. Meanwhile, hospitals began complying with the General Industry Respiratory Protection Standard for employees exposed to tuberculosis, a rule that requires annual fit-testing of N-95 filtering face-piece respirators. The rule also requires annual training, record keeping, and medical evaluation. Those aspects would not be affected by the appropriations amendment.

Employee health and infection control practitioners have argued that annual fit-testing consumes significant resources for no proven benefit. The undiagnosed TB case poses the greatest risk to health care workers, they say.

Although hospitals must continue to work toward compliance with the rule, the amendment provides some possibility of relief, says Jeanne Pfeiffer, RN, MPH, CIC, president of the Association of Professionals in Infection Control and Epidemiology in Washington, DC. "This is exciting for us. It would be another glimmer of hope," she notes.

OSHA has maintained that fit-testing is the only way to ensure a respirator provides full protection and the fit-testing requirements should be the same for all industries and all types of particulates.

Health care worker unions strongly oppose any weakening of the fit-testing requirements. But Bill Borwegen, MPH, health and safety director of the Service Employees International Union (SEIU), notes that the appropriations amendment would have only a minor impact. It does not repeal the application of the General Industry Respiratory Protection Standard to tuberculosis, and it only would be effective for one budget year.

"The only thing it does is direct OSHA not to enforce the annual fit-testing provision," he says. "It doesn’t speak to the issue of state plan states. Also [the Joint Commission on Accreditation of Healthcare Organizations] makes it pretty clear that you have to comply with all state and federal regulations. This is a regulation that’s on the books."

The amendment, proposed by Rep. Roger Wicker (R-MS) does not rescind the requirement, but only blocks the threat of OSHA enforcement, he notes.