- OSHA Healthcare Advisor - http://blogs.hcpro.com/osha -

Ask the expert: A lot of fit-testing questions

Q: Where does someone get training for fit testing?  Are there different ways to do fit testing?  Can we just get something with a strong odor and see if if the person can smell it?  If someone passes the fit test, there is no guarantee that the next time they put the mask on that they would have passed.  Maybe they squeezed the nose bridge better for fit testing.  What happens if the employee does not pass the fit testing?

A: That’s a lot of questions. I’ll take then in the order in which you asked.

Q: Where does someone get training for fit testing?

A: The trainer qualifications for performing OSHA-compliant fit testing are minimal, according to Appendix A of the Respiratory Protection standard: [1]

“The employer shall ensure that persons administering QLFT [qualitativefit test] are able to prepare test solutions, calibrate equipment and perform tests properly, recognize invalid tests, and ensure that test equipment is in proper working order.”

Q: Are there different ways to do fit testing? Can we just get something with a strong odor and see if the person can smell it?

A: OSHA recognizes qualitative (QLFT), using a sweet or bitter substance, and quantitative fit test (QNFT). “The fit test shall be administered using an OSHA-accepted QLFT or QNFT protocol. The OSHA-accepted QLFT and QNFT protocols and procedures are contained in Appendix A.” [1]

Most companies that manufacture fit-test kits provide online training. I know 3M does, [2] for example. Hospitals do a lot of fit testing, so you could establish a train-the-trainer agreement or even acquire training at from a community college that offers an occupational health and safety course.

Q: If someone passes the fit test, What guarantee is there that the next time they put the mask on that they would have passed?

A: There may be no guarantee, but OSHA would say that the employer is responsible for training the employee to properly don the respirator to ensure safe use.

Q: What happens if the employee does not pass the fit testing?

A: Test again using a different respirator model or size, or switch to a different fit test; consider moving to a non-tight-fitting face piece respirator such as a PAPR; establish administrative controls (reassignment) or engineering controls to remove the worker from the respiratory hazard.

But make no mistake about it. Having an employee wear a respirator without a confirmed fit test is an OSHA violation. Last year in healthcare facilities the average initial fine for not fit-testing employees required to wear a respirator, 1910.134(f)(1), was $625. The average initial fine for not conducting annual fit testing, 1910.134(f)(2), was $487.

[3] Get into compliance with HCPro’s Basic OSHA Compliance Manual Kits for medical [3] or dental [4] practices. Receive bimonthly electronic manual updates through your newsletter subscription [5] that keep your regulatory manual up to date and in compliance!