Respiratory Fit Testing

Respiratory Fit Testing - Made Easy!

Respirator Fit Testing - Made Easy!

By Maricia Sawnor, CIH
Senior Industrial Hygenist, New York State Department of Labor

Confused about the fit testing requirement in the Occupational Safety & Health Administration's (OSHA) Respiratory Protection Standard [29 CFR 1910.134(f)]? Anyone can perform the required fit testing procedure for their fire department once they have been trained to do so.

The standard requires that before any firefighter is required to use any respirator with a tight fitting facepiece, which covers the self contained breathing apparatus (SCBA) used by firefighters, the firefighter must be fit tested with the same make, model, style, and size respirator that he/she will be wearing. They must also be retested, at least annually, thereafter. Additionally, fit testing must be performed again if the fire department decides to use a different make, model, style, or size of respirator, if the firefighter, chief, physician, or other licensed health care professional (PLHCP) makes a visual observation of any physical changes in the firefighter that could affect the facepiece fit, or if the firefighter notifies the chief or PLHCP that the current respirator is unacceptable. It is highly recommended that each firefighter be assigned his/her own mask.

We rent quantitative fit testing units by the week. Email us for a rental quote.

If your department has an ambulance service associated with it, their N95 respirators are also required to be fit tested. N95 respirators are used by emergency medical response personnel when transporting patients, in a closed vehicle, with suspect or confirmed infectious tuberculosis.

(Note: N95 and N100 masks can be fit tested using Bitrex with a tent. Bitrex testing in a tent has been found to be more accurate than testing with a Portacount electronic quantitative fit tester. Read federal info. on Bitrex here. This note added by American Airworks)

Since all respirators leak, a fit test is a procedure to either qualitatively (pass/fail) or quantitatively (actual numerical value) evaluate the fit of the respirator on the firefighter. Each department will have to choose a fit testing method. Both qualitative and quantitative methods have advantages and disadvantages. Qualitative (pass/fail) methods are inexpensive, fast, and easy to perform. Their disadvantages include a subjective response by the firefighter, variances in individual responses to the odor threshold screening, olfactory fatigue, and interference from colds and heavy smoking with the ability to smell/taste the test agents.

Advantages to quantitative methods include an objective response from the firefighter and hard copy printouts of the test response that can be maintained as permanent record of the test.

The disadvantages include the high cost of the testing equipment and associated incidentals, and the high fit factor calculated by the software may lead the wearer to a false sense of security.

Contained in Appendix A of the standard are requirements for both quantitative (QNFT) and qualitative (QLFT) fit testing procedures. Whether your department chooses a qualitative or quantitative method, the following elements are required under the standard:

• Provide a sufficient number of respirator models and sizes

• Demonstrate donning and adjustment of the respirator

• Conduct a 5-minute comfort assessment

• Wear any additional personal protective equipment (PPE) that could potentially affect the seal of the respirator, e.g. glasses, helmet

• Perform the user seal check

After the elements listed above have been successfully performed, then either a qualitative or quantitative fit test can be administered.

What is a user seal check? It is a positive and negative pressure check performed by the firefighter to determine if the respirator is properly sealed to the face.

There are also specific test exercises required for both qualitative or quantitative fit testing procedures. In the order of performance required by the standard these are:

• Normal breathing

• Deep breathing

• Turning head side to side

• Moving head up and down

• Talking, i.e. rainbow passage

• Grimace (quantitative only)

• Bending over or jogging in place

• Normal breathing

Whether you choose the qualitative or quantitative method, the facepiece of the SCBA will need to be converted into a negative pressure respirator with a manufacturer's specific adapter and appropriate filter cartridges for the testing agent chosen.

If you select qualitative fit testing, you have a choice of test agents:

• Banana oil (isoamyl acetate), which is an odor test and requires the use of organic vapor cartridges OR

• Saccharin, which is a sweet taste test which can use any type of respirator filter OR

• Bitrex, which is an odor test that needs respirator filters designated N, R, or P 100s or a HEPA cartridge (Sometimes misspelled as Bitrix)
(Note: N95 and N100 masks can be fit tested using Bitrix with a tent. Bitrex testing in a tent has been found to be more accurate than testing with a Portacount electronic fit tester. Read federal info. on Bitrex here. This note added by American Airworks)

Banana oil, saccharin, and Bitrex all require a test chamber in which to conduct the testing and a smell or taste test to determine whether the firefighter can detect the test agent. Irritant smoke must never be used in a test chamber. If the respirator leaks excessively, the subject could be injured if he/she is not able to immediately exit the test aerosol. The test chamber need not be elaborate and can easily be constructed with some plastic sheeting and duct tape.

Quantitative fit testing is an actual measurement of how well the respirator fits the firefighter. Three testing instruments are available:

• Aerosol Test Chamber Tent

• OHD Quantifit Eletronic Fit Tester

• TSI PortaCount Electronic Fit Tester

With any of these quantitative methods a passing number of 500 or greater must be obtained.

How much does each type of test cost? Tables 1 and 2 summarize the anticipated expenses associated with each type of testing agent. A word to the wise - if the manufacturer/supplier sells a fit test kit or adapter kit, ask for an itemized list of the contents in the kit to be sure you are getting everything you need to complete the test. Some of the items, obviously, are consumable and will need to be periodically replaced.

The consultation service provided by the New York State Department of Labor (NYSDOL) Public Safety and Health (PESH) Bureau can provide hands-on training to help your fire department with the fit testing procedures, train you to perform the fit testing, and lend your department the equipment to perform the fit testing. Contact Senior Safety and Health Inspector Thomas W. Shiel at (607) 721-8211 with any questions.

Table 1: Qualitative Fit Testing Method
Testing Agent	Banana Oil	Saccharin	Bitrex	Irritant Smoke
Cartridges	$10 each oganic vapor	$8 - 10 each may type	$6 - $8 each any type	$3 each N, R, P, 100s
Facepiece Adapter (Respirator Specific)	$7	$7	$7	$7
Cost of Test Agent	$8 - $12/box of 10	$13/bottle (sensitivity & fit test solution)	$11 - $15/bottle (sensitivity & fit test solution)	$45 - $80/box of 10-12
Extras (Testing Tent)	$275/kit	$275/kit (solution & tent)	$275/kit	None

Table 2: Quantitative Fit Testing Method
Testing Equipment	OHD "Quantifit" Model Fit Tester - includes electronic unit, software and training video hard shell carry case - Approximate retail cost $8200 - $950/year Annual calibration recommended PORTACOUNT Pro+ Model 8038 - includes the unit, software, video and soft basic unit - Appromimate retail cost $11,725 - Annual Calibration Recommended/Cost Unknown
Adapter Kit (Respirator Specific)	$225 - $375 (per brand/mode l mask adapter and/or cartridge)
Testing Agent	$175/box - 24 bottles or purchase reagent grade Isopropyl alcohol (99%)

Article from: New York State Association of Fire Cheifs, Size Up magazine, with approval.
(Some pricing above has been updated as of 10/1/2009 by American Airworks)

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