How to implement and manage an effective respirator fit testing

How to implement and manage

an effective respirator fit

testing programme

Introduction

Do you know if your workers are wearing

tight-fitting respirators that actually fit them?

Tight-fitting respirators must seal to the

wearer’s face in order to provide the

expected protection. If there is a leak in the

face seal, they may be exposed to harmful

airborne contaminants. Fit testing is required

by law in many different countries around the

world and is being increasingly adopted by

companies as best practice even where there

is not a mandatory requirement to fit test.

What is fit testing?

A respirator fit test can be defined

(1)

as:

“…a method for checking that a tight-fitting

facepiece matches the person’s facial

features and seals adequately to the wearer’s

face. It will also help to identify unsuitable

facepieces which should not be used.”

Why fit testing?

A good fit means the tight-fitting respiratory

protective device (RPD) will seal to your

skin. A respirator can only provide adequate

respiratory protection to the wearer when

air passes through the filter and does not

enter the wearer’s breathing zone via any

other route. Air will take the path of least

resistance, so if there isn’t a good face seal,

some of the contaminated air will go through

this path rather than through the respirator

filter, and therefore reduce the protection.

Every wearer’s face is different in shape,

size and features. Tight-fitting respirators

are also available in a wide range of shapes,

styles, materials and sizes. Unfortunately,

there is no single tight-fitting respirator that

can be expected to fit every possible wearer.

Therefore, the fit of a respirator is personal,

individual and unique to each wearer. The

only way to know if a respirator can provide

an adequate seal to a wearer is to fit test each

respirator-wearer combination.

Fit testing as part of your

respiratory protection

programme

Implementing an effective respiratory

protection programme should be a

methodical and documented process.

All programmes should start with an exposure

and risk assessment to determine the level

of adequate respiratory protection required.

After this, the focus is the selection and fit

testing of an RPD that is suitable for the

workplace, the task and the wearer. A suitable

tight-fitting RPD also needs to be compatible

with other items of Personal Protective

Equipment (PPE) such that the protection

provided by the PPE is not compromised,

be comfortable to wear and importantly fit

the wearer. In some countries, a mandatory

medical evaluation may be required prior

to fit testing. Finally, the entire programme

should be documented, particularly wearer

training in the limitations, fitting, use and

maintenance of the respirator.

Fit testing is a key part of a workplace

respiratory protection programme. A fit

test gives an assessment of how well the

respirator fits the wearer. A fit test also

helps with the assessment of the respirator’s

comfort, compatibility with other PPE and

overall suitability for the wearer, along with

being an ideal training opportunity for the

wearer on the correct fitting and use of

the product.

What type of RPD should

be fit tested?

Any tight-fitting facepiece should be fit

tested. These include filtering facepiece

respirators (disposable respirators, commonly

referred to as ‘dust masks’), half-masks with

filters and full-face masks with filters. Any

tight-fitting facepiece that is connected to

a powered or supplied air system should

also be fit tested; this includes tight-fitting

face masks used with turbos, breathable

compressed air or self-contained breathing

apparatus.

Filtering facepieces (disposable respirators)

Full-facepiece respirators

Half-mask respirators

Tight-fitting powered

or supplied air respirators (including SCBA)

How to implement and manage an effective respirator fit testing programme

Intro

Only respirators that rely upon positive air

flow through a loose-fitting headtop do not

require face fit testing. Such products may

be selected for a variety of reasons, which

may include the need for higher protection

levels available from some classes and

types, wearer facial hair that may affect the

seal of a tight-fitting respirator, long wear

durations, wearer comfort and the need for

a single item of PPE that offers combined

protection from other hazards.

Fit test methods and

regulations

Most respirator fit test methods rely upon

the wearer wearing the respirator in an

atmosphere containing a harmless aerosol,

with the amount of the aerosol entering

inside of the respirator due to face seal

leakage being assessed either qualitatively

or quantitatively.

Around the world there are several

interpretations of how fit testing

should be implemented.

All the fit test methods have significant

commonality, and in most cases, are

derived from the methods and regulations

first implemented in the USA.

Fit test methods

Fit test methods can be defined

asbeingeither qualitative (QLFT)

orquantitative (QNFT):

Qualitative (QLFT)

Qualitative fit testing is subjective, requiring

the wearer to provide input to the fit test.

The predominant methods use either a

Saccharine or Bitrex

test solution, sprayed

into an over hood, which the respirator

wearer decides if they can taste whilst

conducting a number of fit test exercises.

If the test solution is not tasted during the fit

test, then the test is deemed a pass (with an

assumed fit factor of 100 for the respirator).

Other methods are available and used in

some countries, for example isoamyl acetate

(banana oil) or stannic acid (irritant fumes).

Qualitative methods can be used to fit

test filtering facepieces and half-masks

(with particulate or combination filters)

only. Qualitative methods may be suitable

for full face masks according to some

fit test regulations and only in certain

circumstances.

Quantitative (QNFT)

A quantitative fit test is an objective method

that can be used to fit-test most tight-fitting

respirators. It involves using an instrument

to measure leakage around the face seal

and produces a numerical result called

a“FitFactor.”

Note: the fit factor should not be confused

with respirator protection factors such as

nominal protection factor (NPF) or assigned

protection factor (APF) that may be used

topredict reduction of inhalation exposure.

Figure 1 - 3M

™

Qualitative Fit Test Apparatus Kit and Bitrex

Fit Test kit being used to conduct a

Qualitative Fit Test (QLFT) upon a subject wearing a filtering facepiece respirator

Most respirator fit test

methods rely upon

the wearer wearing

the respirator in an

atmosphere containing

aharmless aerosol

How to implement and manage an effective respirator fit testing programme

PPE improving workplace productivity – case studies

There are two main QNFT methods in use:

Ambient aerosol condensation nuclei-

counter (CNC) quantitative fit test procedure

The most commonly used method is

condensation nuclei counter (CNC) using

a TSI

PortaCount

Respirator Fit Tester.

This machine uses the principle of ‘ambient

particle counting’ – it measures the

concentration of both the ambient aerosol

and the particles inside of the respirator being

tested, the ratio of which is the Fit Factor. For

more information on the use and operations

of the TSI

PortaCount

Respirator Fit Tester,

please see the manufacturer’s website

(2)

and

national protocols such as OSHA 1910.134

(3)

or HSE INDG 479

(1)

Ambient Particle Counting:

Controlled negative pressure (CNP)

quantitative fit test procedure

An alternative method is controlled negative

pressure (CNP) method using a OHD

Quantifit

machine. This machine and method

uses the principle of ‘controlled negative

pressure’ – it creates a slight negative

pressure inside of the respirator being tested

(while the wearer holds their breath and

remains still), and monitors the pressure

in order to measure any face seal leakage.

A variant of the CNP fit testing protocol

developed by OHD for the Quantifit is the

REDON protocol. With the REDON protocol,

the fit factor is measured after three different

exercises, with the additional doffing and

re-donning undertaken twice, with fit factor

measurement after each re-donning. The

REDON protocol is permitted in OSHA

1910.134

(3)

only. For more information on the

use and operations of the OHD Quantifit,

please see the manufacturer’s website

(4)

and

national protocols such as OSHA 1910.134

(3)

orHSE INDG 479

(1)

Controlled Negative Pressure:

Fit test regulations

There are many countries that currently

have fit testing guidance or regulations

for tight-fitting respirators (for simplicity,

wewill call these all ‘regulations’ in this

document). Across Europe, there is growing

interest in fit testing and the implementation

of fit testing regulations with some countries

now having published their own specific

regulations. Please refer to Table 1 for the

current position of fit testing regulations

across Europe and North America.

In 2017, ISO 16975-3

(5)

was published as

part of a larger body of work to standardise

international performance and test standards

for respiratory protective devices. A summary

of current fit testing regulations and the key

differences between them is given below:

OSHA 1910.134

OSHA 29 CFR 1910.134

(3)

specifies all of the

elements for implementing a respiratory

protection programme, including both the fit

test regulations and methods (protocols).

Key elements include:

• Mandatory annual refit testing

• Wide range of permissible qualitative fit

testing methods, including Saccharine and

Bitrex taste methods

• Quantitative fit testing:

• 8 different fit test exercises, includes

a 15 second ‘grimace’

• The ‘overall fit factor’ from a fit test

must exceed the required minimum

fit factor for the test to be deemed

to be a pass

• Wearer medical examination

is a prerequisite to fit testing

• Qualitative methods can be used for

full face mask if they are used in

positive pressure mode, OR if they are

used in negative pressure mode but

an APF of 10 is adequate. Note, that

if a full face mask with an APF of 50

is needed, then a quantitative fit test

must be used.

The most commonly used

method [of quantitative fit

testing] is condensation

nuclei counter (CNC)

using a TSI

PortaCount

Respirator Fit Tester

Table 1 - Fit testing regulations

Country Regulation

UK HSE INDG 479

France ED 6273

Netherlands HSE 282/28

Italy UNI 11719:2018

USA

OSHA 29 CFR

1910.134

Canada CSA Z94.4-2011

Figure 2 - Ambient Particle Counting - TSI

PortaCount

Respirator Fit Tester Model 8038

being used to conduct a Quantitative Fit Test (QNFT) upon a subject wearing a filtering

facepiece respirator

Figure 3 - Controlled Negative Pressure - OHD

Qantifit

CNP using the REDON method being used to conduct

a Quantitative Fit Test (QNFT) upon a subject wearing a

filtering facepiece respirator. Image: courtesy of OHD

How to implement and manage an effective respirator fit testing programme

PPE improving workplace productivity – case studies

HSE INDG 479

HSE INDG 479 (in its original version

HSE 282/28)

(1)

was implemented by

the UK Health and Safety Executive

over a decade ago, making fit testing

of tight-fitting respirators mandatory.

This document provides best practice

fit test methods for demonstrating

compliance. There are a number of

key differences between HSE INDG 479

and OSHA 1910.134:

• No mandatory refit test requirement

(unless required by other applicable

regulations)

• Permissible qualitative fit testing methods

are Saccharine and Bitrex taste methods

• Quantitative fit testing:

• 7 different fit test exercises, excludes

a 15 second ‘grimace’

• Longer in mask sampling times for

the TSI

PortaCount

Respirator Fit

Tester method

• The fit factor calculated from each fit

test exercise and the ‘overall fit factor’

must exceed the required minimum fit

factor for the test to be deemed to be

a pass

• Fit test exercises, with the exception

of bending over, are conducted at

elevated work rates (walking, stepping,

static cycling)

• No mandatory requirement to complete

a wearer medical examination prior to

fit testing

ED 6273

INRS published ED 6273 “Protection

respiratoire – Réaliser des essais

d’adjustment”

(6)

in December 2016, making fit

testing of tight-fitting respirators mandatory

for wearers in the French asbestos industry.

ED 6273 is based upon HSE INDG 479, but

contains a few differences:

• Wide range of permissible qualitative fit

testing methods, including Saccharine,

Bitrex and Isoamyl Actate methods

• Quantitative fit testing

(ambient particle counting)

• The first 7 fit test exercises as

HSE INDG 479, conducted whilst

standing still

• An additional 8th exercise, deep

breathing, is conducted whilst stepping

ISO 16975-3

(5)

was published in 2017.

This ISO standard may be used voluntarily by

employers or countries in lieu of any other

national requirements. ISO 16975-3 has

many similarities with the other protocols

mentioned, particularly OSHA 1910.134 and

HSE INDG 479. It is very likely that if adopted

as national standards, then the implementing

nation may add a national foreword or

annex that provides additional performance

requirements, detail or instruction that shall

be complied with.

There are a number of key differences

between HSE INDG 479 and/or OSHA

1910.134 and ISO 16975-3:

No mandatory refit test requirement is

specified (unless required by other applicable

regulations)

• Permissible qualitative fit testing methods

are Saccharine, Bitrex

and Isoamyl

Acetate methods

• Quantitative fit testing:

• 7 different fit test exercises, excludes

a 15 second ‘grimace’

• The fit factor is as an ‘overall fit factor’

• Fit test exercises are not conducted at

elevated work rates (walking, stepping,

static cycling)

• No mandatory requirement to complete

a wearer medical examination prior to fit

testing

• Minimum fit factors are not by product

type (as OSHA 1910.134 or HSE INDG 479

do), but by Protection Class as defined

in ISO 16973:2016

(7)

In countries where there is no mandatory

fit testing regulation, 3M recommend that

employers follow recognised regulations,

methods and guidance from other countries,

such as the UK’s HSE INDG 479

(1)

, the USA’s

OSHA 1910.134

(3)

or ISO 16975-3:20167

(6)

See Table 2 for a comparison of fit test

method suitability by product type

and minimum fit factor requirements.

* FFP1 filtering facepiece can only be, and FFP2 filtering facepiece respirator should ideally be fit tested using the TSI

PortaCount

Respirator Fit Tester Model 8038 or 4038 Pro+ .

** Qualitative fit testing may be used for full facepieces used in positive or negative pressure mode. However, for negative

pressure full facepiece respirators, the assigned protection factor must be reduced to 10 instead of 50.

Qualitative

(Saccharine /

Bitrex taste)

Quantitative – Ambient

Particle Counting

(TSI

PortaCount

Respirator

Fit Tester)

Quantitative – Controlled

Negative Pressure

(OHD

Quantifit

)

Suitability Suitability Minimum Fit

Factor

Suitability Minimum Fit

Factor

Filtering

facepiece

HSE: Yes

OSHA: Yes

INRS: Yes

Yes

HSE: 100*

OSHA: 100

INRS: 100

n/a

Half mask HSE: Yes

OSHA: Yes

INRS: Yes

Yes

HSE: 100*

OSHA: 100

INRS: 100

Yes

HSE: 100

OSHA: 100

INRS: 100

Full face

mask

HSE: No

OSHA: Yes*

INRS: No

Yes

HSE: 2000

OSHA: 500

INRS: 2000

Yes

HSE: 2000

OSHA: 500

INRS: 500

Table 2 - Suitability of fit test method by product type and minimum fit factor requirements

How to implement and manage an effective respirator fit testing programme

PPE improving workplace productivity – case studies

Respirator stability

and fit test exercises

A key part of a fit test is to determine the

respirator’s ability to retain its seal when the

wearer is in motion. That’s why wearers are

instructed to perform several standardised

exercises that are meant to put the seal of the

tight-fitting respirator under stress, as part

oftesting. The most common exercises used

inprotocols are as follows:

a. Normal breathing

b. Deep breathing

c. Turning head from side to side

(inhaling at the extremes)

d. Moving head up and down

(inhaling when looking up)

e. Reading/talking aloud

f. Grimace

g. Bending over at the waist

h. Normal breathing

Grimace features in OSHA 1910.134, quantitative fit testing

methods only (excluded from HSE INDG 479) – duration is

15 seconds, sampling within the mask is discarded for final

fit factor calculation

May be substituted for jogging on the spot in OSHA 1910.134

if the fit test method setup does not permit bending over

atthe waist

When to conduct a fit test?

A fit test must be conducted whenever there

is a new wearer and tight-fitting facepiece

combination, for example a new wearer

orachange to a new type, brand or model

oftight-fitting respirator. A fit test must also

be conducted should some characteristic of

the wearer or the product change that may

affect the seal upon the face, for example

when any facial changes occur that could

affect fit, such as significant weight change,

skin scarring or dental work.

Some national fit testing regulations, industry

specific national regulations or employer’s

health and safety policies require that fit

testing be repeated on a regular basis, for

example:

• At least annually in the USA according

toOHSA 1910.134

(2)

• At least annually in the UK asbestos

industry according to the Control of

Asbestos Regulations (CAR) 2012

(7)

If there is no national guidance, or maximum

period of time between fit tests, then it is good

practice for companies to determine their own

policies on repeating fit testing. If neither the

wearer nor respirator have changed in any

way that would affect the fit of the respirator,

then a set period of time should be determined,

for example every 2 years.

Importance of fit

Incorrectly fitted respirators may not achieve

a reliable seal to the wearer’s face and may be

uncomfortable, possibly leading to wearers

not wearing the respirator during all periods

of exposure.

There are many factors that affect the fit

oftight-fitting respirators:

• Donning procedure: everything from

putting the respirator on the right way up

through to the correct position and tension

adjustment of the headbands or proper

formation of the noseclip (if fitted).

• Facial hair: look out for hair under the

faceseal, beard growth/stubble, forward

hairlines (full face masks) and big sideburns.

Beards, moustaches, or even stubble

interfere with the seal of a tight-fitting

respirator. Wearers must be clean-shaven

in any area of the face and neck where the

respirator comes into contact with the face.

This rule applies not only for the day of fit

testing, but for any day when a tight-fitting

respirator is worn in the workplace.

• Other contaminants: anything that can

interfere with the seal to the face, includes

hair, cosmetics, sweat, facial jewellery,

foreign bodies within the mask and

facialhair.

• Face shape and size: extremes of face size

(length and width of face) and well as very

angular or very round faces can cause issue

with fit.

• Facial features: prominent facial features

can also cause some issues such as

cleft chins, scars on the facesealing

area, depressions around the temple/

cheekbones, unusual chin profiles

(chiselled features), unusual nose shapes

(very large or very flat).

User (wearer) seal check:

an essential everyday test

Employees wearing tight-fitting respiratory

protection should perform a wearer seal

check each time they put on their respirator

(including before a fit test). A fit test ensures

that the respirator is able to fit and provide a

secure seal, but a wearer seal check ensures

that it’s being worn right each time – a quick

way of identifying errors in fitting and certain

faults with the respirator. Wearers can either

perform a positive-pressure or negative-

pressure seal check, as detailed in the

manufacturer’s user instructions:

• A positive-pressure check means blocking

the exhalation valve on a half or full

facepiece respirator or covering the

respirator surface on a filtering facepiece,

usually by using your hands, and trying to

breathe out. If slight pressure builds up,

that means the seal is adequate. Note that

exhalation valves on filtering facepieces are

not designed to be blocked, so this method

is not viable for valved filtering facepieces.

• A negative-pressure check involves

blocking the intake valves or filters on a half

or full facepiece respirator or covering the

respirator surface on a filtering facepiece,

typically using your hands and trying to

breathe in. If no air enters, the seal is

adequate. See the product user instructions

for more details.

Incorrectly fitted

respirators may

not achieve a reliable

seal to the wearer’s

face and may

beuncomfortable,

possibly leading

to wearers not

wearing the

respirator during

all periods

of exposure.

How to implement and manage an effective respirator fit testing programme

Reducing the PPE burden

Compatibility with other PPE

Prescription and safety spectacles, goggles,

face shields, hearing protection, hard

hats and coveralls can all compete with a

respirator for space upon a wearer’s face,

head or body. For instance, if a half mask

respirator doesn’t fit well (especially if it’s

too large), it can overlap with spectacles.

The more that happens, the more fogging

can potentially occur on the spectacles.

Adjusting the position of a respirator upon

the face to better accommodate spectacles

and goggles, or a hard hat or coverall hood

affecting the correct positioning of respirator

headbands can all interfere with the

respirator’s seal.

To catch these problems before they happen

on the job, any item of PPE that could

potentially interfere with the respirator’s seal

should also be worn during the fit test.

Interpreting fit test passes and

fit factor values

A respirator fit test pass means that on that

day, in those circumstances, the respirator

was shown to be able to provide an adequate

seal to the wearer’s face. A fit test pass is not

a guarantee of adequate respirator fit when

the next respirator is worn. Therefore, a

tight-fitting respirator should be fitted

correctly and in accordance with the

manufacturer’s instructions, and the wearer

must always perform a wearer seal check

(fit check) each time the respirator is fitted.

With quantitative fit tests, there may be

a temptation to interpret the fit factor values

from a fit test, particularly if comparing two

or more different models of respirator.

With all fit tests, there are a number of

product, wearer, fit testing device,

environmental and fit tester variables

that can affect the fit test and the

resulting fit factor measured. Therefore,

unless the effect of these variables is

reduced or eliminated, and the results

have been shown to be both scientifically

reproducible and repeatable, then caution

is advised when comparing fit factor values.

Furthermore, little to no correlation has been

shown between quantitative fit factors and

workplace performance.

It is important to note that provided that the

overall (and individual fit test exercise

if you are using the HSE INDG 479 regulation)

fit factor(s) exceed the minimum fit factor

requirement, then the fit test has been

passed. Then a record of the fit test must

be made and stored, and the respirator can

be worn by the wearer in the workplace.

According to HSE INDG 479, a fit test record

should contain the following:

1. the name of person fit tested;

2. the make, model, material and size

of the face-piece;

3. whether the subject’s own facepiece,

company shared facepiece or a test

facepiece was used;

4. the test exercises performed during

the fit test;

5. the fit test method employed, i.e. test

chamber, ambient particle counting

device, controlled negative pressure

or qualitative taste test agents;

6. the measured fit factor for each individual

test exercise and the overall fit factor;

7. the pass level used in the test;

8. the result of the fit test in terms of a pass

or fail;

9. the date of the test;

10. the details of who performed the test,

name of firm, address, etc; and also

where possible;

11. the condition of the wearer’s own

facepiece;

12. whether the wearer required assistance

donning and fit checking the facepiece

before the fit test;

13. how many repeat tests were needed to

obtain a pass and the reasons why; and

14. the serial number or other means

ofidentifying the equipment employed

in the fit test.

A respirator fit test

pass means that on

that day, in those

circumstances,

the respirator

was shown to be

able toprovide

anadequate seal

tothe wearer’s face.

How to implement and manage an effective respirator fit testing programme

Reducing the PPE burden

Facial hair and clean-shaven policies

Wearer facial hair is perhaps the most commonly cited issue

regarding both respirator selection, use and fit testing. It can be a

highly contentious issue, touching on wearer’s rights, employment

law, religious beliefs and employer responsibilities. The rights of the

wearer need to be balanced against the needs to protect the health

and safety of the wearer – a balance that can be tricky to achieve in

many circumstances.

Ultimately though, tight-fitting respirators rely upon a good seal to the

face to protect the wearer. Anything that can interfere with this seal

and create gaps, including the full range of facial hair from stubble

tobeards, can and will compromise protection.

Numerous different researchers have evaluated the effects of facial

hair upon the performance of tight-fitting respirators. None of the

studies showed that facial hair improves the seal of the respirator

tothe face, with the conclusion being that the effects of facial hair

are variable by length and person but generally facial hair reduces the

protection to the wearer.

HSE RR1052

The effect of wearer stubble on the protection given by

Filtering Facepieces Class 3 (FFP3) and Half Masks, 2015

(9)

This study evaluated the effect of facial hair growth on the inward

leakage (fit) of seven different makes and models of filtering

facepiece (disposable) FFP3 respirators and two different makes

and model of half masks. Fifteen male subjects were tested with the

respirators over the course of one week, starting with clean-shaven

through to 7 days of facial hair growth. Each subject, respirator

combination was tested for leakage (fit) daily throughout the study.

The effects of facial hair varied by subject and respirator worn:

• By day 7, all subjects with all respirators had unacceptable

degradation in protection due to facial hair growth

• For some subject respirator combinations, protection degraded

significantly by the end of day 4

• For other respirators and some subjects, protection degraded with

facial hair growth, yet for a minority little/no degradation occurred.

The effect of stubble upon protection is unpredictable as each person

has different facial and facial hair characteristics (coarseness, hair

density, growth rate, etc.) and each respirator can respond differently

to facial hair. However, the research clearly supported guidance

that workers should be clean-shaven – within 8 hours of the start

of the shift – in the area of the faceseal when wearing tight fitting

respirators.

SideburnsBeardsStubbleMoustache

Soul Patch

Thin Moustache

Facial hair

Any facial hair that interferes with the seal of the respirator onto the face can compromise protection.

Even long hair can interfere with the seal of the respirator to the face, particularly on full-face masks. However, some facial hair

can be worn provided that it does not interfere with the respirator seal to the face – two examples of facial hair that may be acceptable are

provided below. As facial hair varies, evaluate facial hair on a case by case basis and if a fit test pass is achieved, record the condition and

length of any acceptable facial hair; this will then have to be managed in the workplace.

Personal Protective

Equipment influencing

productivity whitepaper

Clean-shaven policies

Implementing a mandatory clean-shaven policy for wearers who

wear tight-fitting respirators is the obvious solution and yet can

be challenging to implement effectively. Wearers can be reluctant

or refuse to be clean-shaven, with common reasons being linked

to behavior, religious or medical grounds:

• Lack of understanding of the need to protect themselves

or be clean-shaven

• Misunderstanding about how respirators work, for example

tight-fitting respirators require a good seal to the face,

whilst loose-fitting do not

• Bravado around respiratory hazards: “it won’t happen to me”

– a natural optimism

• Defiance of the rules - the need to be clean-shaven:

“why should I” or “I don’t want to and don’t care”

• Laziness/absentmindedness – apathy to the need to shave

• Personal religious and customs are protected by law and

employers must make reasonable allowances, for example

non-enforcement of clean-shaven policies, for example

devout followers of Sikhism, Islam, and some sects of Judaism;

selection of loose-fitting RPD

• A wide variety of medical conditions can also exempt wearers

from needing to shave, for example dermatological conditions

aggravated by shaving.

Addressing behavioural issues can be difficult. The best approach

is to engage with the employees and seek to change their behaviour

by making them fully aware of the hazards and risks to their health,

explanation of the need to be clean-shaven, training on the correct

use and fitting of respirators in order to address the issues head on.

Policies around fit testing and being clean-shaven must be transparent,

well documented, and available and applied to all. Policies need to

be continuously monitored and enforced, not just a passing fad or

a one-off activity. The ideal would be to incorporate clean-shaven

policy into the terms of employment.

However, including this in employment contracts for new hires or

retrospectively for existing employees may be problematic or even

illegal in some countries.

For employees who have legitimate reasons for having facial hair

or when enforcement of a clean-shaven policy is impractical or has

failed, other options such as alternative respiratory protective devices

or alternative work tasks that do not require respiratory protection

should be considered.

NIOSH – acceptable facial hair styles for use with filtering facepiece or half-mask respirator

(10)

Not only are our faces unique (shape, size, skin textures/firmness, etc.), but men’s facial hair is also unique.

Variables that may affect the interaction with a tight-fitting respirator include

(11)(12)

• Density (hairs/cm

)

• Distribution on face (density variations on different

parts of the face)

• Curliness of the hair

• Hair stiffness (how stiff is the hair itself)

• Hair cross-sectional size/diameter and shape

• Number of days of growth and facial hair length

(note: men have different facial hair growth rates)

In the US, the National Institute for Occupational Safety and Health (NIOSH) has created guidance for wearers around facial hair that may

ormay not be acceptable under a tight-fitting half-mask or filtering facepiece

*(10)

. The intended purpose was to give guidance and support

tomen’s health awareness charity events in the month of November (for example ‘Movember’).

*May be suitable – case by case assessment of potential to interfere with face seal needs to be required

How to implement and manage an effective respirator fit testing programme

Reducing the PPE burden

Managing a fit testing programme

Tips and good practises

Managing wearer time/minimise

man hours lost

Fit testing takes time. The actual fit test

itself may take 7-8 minutes, but additional time

is required for the following:

• Sensitivity test (if applicable)

• Preparation of facepiece for the test

• Instruction of the wearer in the fit test

exercises

• Donning and performing the wearer

seal check of the facepiece fit

• Comfort assessment period

• The actual fit test

• Removal of facepiece

• Explanation of the results of the fit test

• Training on selection, use, donning,

maintenance of the respirator or any

other questions from the subject.

A successful fit test will take 20-30 minutes

per subject – respirator combination

As a rule of thumb, allow 20-30 minutes

per wearer – respirator fit test; ‘experienced’

wearers who are familiar with the process

may require closer to 20 minutes, whilst

new wearers and/or respirators may

require closer to 30 minutes. Additional

fit tests – repeats due to initial failure

or for more than one respirator – will

need to be accommodated or rescheduled.

Preparing for fit testing

As discussed above, fit testing takes

time – time when the wearer is not

being productive. It is therefore

advisable to seek the cooperation

of the production colleagues when

fit testing is being conducted, so that

cover is in place for wearers being fit

tested. Scheduling fit testing appointments

will also help minimise time lost due to

waiting around, yet a level of flexibility

is required as you will have some failures

and a need to conduct additional repeat

fit tests.

Fit testing should not be conducted

in a hazardous environment, but should

be conducted in a safe and private room,

for example in an office. Some wearers

can be self-conscious, so the use of a

private office or meeting room is advisable.

Qualitative fit test methods are best

conducted in larger rooms with good

ventilation. Conversely, quantitative

ambient particle counting methods

(TSI

PortaCount

Respirator Fit Tester) are

best conducted in smaller rooms, where

air conditioning can be turned off and the

ambient particle concentration can be more

easily controlled and maintained.

Hood Headtop/helmet

Powered or supplied air respirators require a relatively significant initial investment compared to many tight-fitting respirators. This upfront cost

is a potential barrier to implementation, however these systems can actually prove to be more cost-effective, in the long term, than some

tight-fitting respirators, in addition to having numerous other practical, comfort and wearer protection benefits.

Alternative RPD

If wearers will not or are unable to comply with a clean-shaven policy, there are alternative products that may be considered. Loose-fitting

facepieces or headtops have a close fit to the head and/or face, but do not rely on a tight seal to the wearer’s face. These types of product are

connected to a continuous flow of filtered or uncontaminated air. Examples of loose-fitting facepieces and headtops include:

What is clean-shaven?

Not only are men’s facial hair characteristics different, but people shave differently and at varying frequencies.

Unfortunately, there is little guidance or technical definition on what actually ‘clean-shaven’ actually is or how to measure growth.

Therefore, it is a personal interpretation for the respirator wearer, employer and if conducting a respirator fit test, the fit tester.

A general rule of thumb is that if stubble is seen to clearly protrude above the skin, then the subject is not clean-shaven. But this is not scientific

and is open to interpretation. Clean-shaven (or a close shave) can mean different things to different people. A sharp razor blade will shave closer

and more consistently than a blunt blade. Shaving with the grain can produce a ‘close shave’, but shaving against the grain of the hair can result

ina ‘very close shave’, but at the risk of razor bumps and skin irritation.

Different models and makes of electric razor, sharpness of the cutting elements, pressure and shaving duration will equally produce different results.

EN 529:2005

(13)

provides us with at least a time-based definition: “unshaven means hair which has not been shaved within the previous

8h period prior to the work shift”

How to implement and manage an effective respirator fit testing programme

Lean principles for PPE

Wearer responsibilities

• Turn up for the fit test when scheduled

• Be clean-shaven

• Should not eat, drink (except water),

chew gum or smoke or vape in the 30

minutes (or 60 minutes in the case of

ambient particle counting method)

prior to conducting a fit test.

The results of fit testing are affected

by anything that changes the sense

of smell/taste (qualitative methods) or

results in wearer generated particles

(quantitative particle counting methods)

• Bring their respirator (as required)

and any other item of PPE that they wear

that may affect the fit of the respirator

• Don the respirator as trained and as per

the manufacturer’s user instructions

• Be able to conduct the required fit

test exercises.

Employer responsibilities

• Select suitable and adequate RPD,

and make this readily available to

those wearers who require it

• Ensure all employees wearing tight fitting

RPD have been successfully fit tested

and ARE wearing the correct facepiece

• Ensure that the RPD is used in accordance

with the manufacturer’s instructions

• Ensure that the RPD is maintained properly

and is in good condition

• Comply with all relevant fit testing

and health and safety regulations

and legislation, etc.

Importance of training

The short time each RPD wearer is taken

away from the production environment

for a fit test is not just an opportunity

to conduct the actual fit test, it is also

a unique opportunity for training

and assessing behavioural safety:

• Fit the product correctly

• Check on maintenance, storage,

end of service life

• Feedback on all aspects of the respirator

and the RPD programme

• Raise awareness of the hazards

and risks in the workplace

• Reinforce the message of the

importance of correct fitting.

Respirator selection, realistic expectations

and managing fit test failures

Although modern tight-fitting respirators

can have excellent fitting characteristics,

no single tight-fitting respirator will likely fit

all workers in a large population.

Management of both wearer and employer

expectations is important in implementing

and managing a fit testing programme.

A failed fit test should not affect the

employment status of the wearer.

So, be prepared for some level of fit

test failure – whether that be a repeat

fit test to correct poor fit or an alternative

respirator size, model or even type.

If you do have a fit test failure,

then the following is recommended:

1. At the end of a failed fit test, and without

the wearer removing the respirator

– inspect for any obvious signs or poor

fit. It may be useful to ask the wearer

to repeat the exercise when the fit test

failed as this may help show any

poor fitting.

• If poor fitting has been identified

– attempt to correct the fit,

conduct a wearer seal check

and if this passes, then repeat

the fit test

• If poor fitting cannot be identified

– ask the wearer to remove

the respirator, and then refit.

Inspect for signs of poor fitting

– correct as required. If using

a quantitative fit test method,

check the function of the test

equipment and the probing of

the respirator. Conduct a wearer

seal check and if this passes,

then repeat the fit test.

2. If a second fit test failure has occurred

after attempting to correct poor fitting,

then an alternative respirator size, model

or type should be selected. Repeat the

fit testing procedure (as required) with

the new respirator.

Note: if conducting qualitative fit testing,

the wearer must repeat the sensitivity test

for each fit test having allowed sufficient

time for the taste from the previous test

to have dissipated.

“The short time

each RPD wearer

is taken away from

the production

environment for

afit test is not just

an opportunity to

conduct the actual

fit test, it is also a

unique opportunity

for training

and assessing

behavioural safety”

Although modern

tight-fitting respirators

can have excellent

fitting characteristics,

no single tight-fitting

respirator will likely

fit all workers in a

large population.

How to implement and manage an effective respirator fit testing programme

PPE improving workplace productivity – case studies

Whenever you conduct fit testing, there must be prior agreement between the employer and the fit tester on what the first-choice respirator

is and a range of alternatives. These respirators must be available for fit testing and for use in the workplace. This may mean that more products

will need to be purchased and managed as a result of fit testing.

In the example above, if a failure is experienced on the first-choice disposable respirator, then the next choice might be a different shape

of disposable respirator. If failures occur on this respirator, then it might be appropriate to use a half-mask and filters – particularly as these

are typically available in range of sizes.

It is important to note that a fit test is respirator-wearer specific. A change in the respirator, e.g. from one model of disposable to another

model of disposable, even though they may be of the same class, e.g. FFP3, does require another fit test.

Method selection

Table 2 (page 4) details what types of respirator can be fit tested by what method. For products where either method can be used,

the selection process often comes down to perceptions of the method, personal experience and the ability/desire to conduct

the fit testing in-house or use an external specialist (see below). A summary of the key points of each of the main methods are below:

In-house vs out-sourced fit testing

The choice as to whether to use an in-house fit tester (commonly a member of the company health and safety team or company nurse)

or employ an external fit testing company is complex. Factors to consider include:

• Available resources and competencies: do you have personnel who are competent and have spare time to deliver in-house fit testing?

• Number of wearers to be fit tested

• Types of respirator to be fit tested

• Are you initiating a programme (for example fit testing 500 wearers for the first time) or is there a continuous need

(several new hires/contractors each week)?

• Is there funding available to invest in a QLFT kit, TSI

PortaCount

Respirator Fit Tester or OHD

Quantifit

, or pay for an external company

tofit test your wearers?

• Is there a particular deadline that you must achieve?

Qualitative Bitrex

/ Saccharine taste Quantitative TSI

PortaCount

Respirator Fit Tester

Initial cost Low High

Fit tester Typically in-house (H&S officer or company nurse) Typically external specialist

Method Subjective Objective

Ease of use Relatively easy Relatively difficult

Products Filtering facepieces and half-masks All types

Perception Basic/old-fashioned Modern/scientific

Wearer seal check

assistance

No Yes (real-time mode)

Validity Valid method Valid method

1st choice:

FFP3 flat-fold disposable respirator

2nd choice:

FFP3 cup-shaped disposable respirator

3rd choice:

Half-mask (available in 3 sizes) with P3 filters

How to implement and manage an effective respirator fit testing programme

PPE improving workplace productivity – case studies

Who can conduct a fit test?

In theory, anybody can conduct a fit test - provided they are competent to do so.

Unfortunately, fit testing is often conducted by people with little or no training or practical experience. The result of a fit test can be greatly

influenced by competency of the fit tester and if a fit test is not conducted correctly, the health of the respirator wearer may be put at risk.

The UK HSE INDG 479

(1)

describes in detail the requirements for a fit tester to be deemed competent. Concerns about the competency of some

fit testers lead to the creation of the first fit tester competency assessment scheme. Created by the British Safety Industry Federation (BSiF),

the Health and Safety Executive (HSE) and other UK industry stakeholders, the Fit2Fit scheme

(13)

involves both a multiple-choice exam

and a practical demonstration as part of the competency assessment in line with the requirements of HSE INDG 479. Being a Fit2Fit accredited

fit tester is not mandatory in the UK. But by being Fit2Fit accredited, fit testers are deemed to be sufficiently competent by demonstrating good

practice and compliance with the requirements of HSE INDG 479.

Fit test competency is gained from a mixture of training and practical experience. Fit testing under supervision and mentoring are invaluable

in gaining competence.

HSE INDG 479

(1)

: To be competent the fit tester should have adequate knowledge, and have received adequate instruction and training

in the following areas:

1. selection of adequate and suitable RPD;

2. examination of RPD and the ability to identify poorly maintained facepieces;

3. ability to correctly fit a facepiece and perform pre-use fit checks;

4. ability to recognise a poor fitting facepiece;

5. the purpose and applicability of fit testing; the differences between, and the appropriate use of,

quantitative and qualitative fit testing methods;

6. the purpose of the fit test exercises;

7. preparation of facepieces for fit testing;

8. how to carry out diagnostic checks on the facepiece and the fit test equipment;

9. capabilities and limitations of the fit test equipment;

10. how to perform a correct fit test with the chosen method;

11. be aware of and know how to prevent and correct problems during fit testing;

12. interpretation of fit test results;

13. an understanding of the differences between fit factor, workplace protection factor,

assigned protection factor and nominal protection factors;

14. HSE Regulations

Some national

regulations specify

a time limit between

repeat fit tests, and

yet others do not

specify a time limit.

ISO 16975-3 could be said to be built upon HSE INDG 479 in terms of listing the requirements

of a competent fit tester. ISO 16975-3 states that fit testers should be properly trained

and demonstrate a proficiency in the fit-test method(s) being used. The standard goes

on to list in some detail the qualifications and required competencies of the fit tester

around general RPD knowledge used for the fit test, knowledge of the fit test method,

ability to set up and monitor the function of the equipment used, ability to conduct the

fit test and the ability of the fit tester to identify the likely cause of a fit test failure.

When to repeat fit test

As discussed previously, some national regulations specify a time limit between repeat fit

tests, and yet others do not specify a time limit. Of course, should the respirator or some

characteristics of the wearer change in some way that might affect fit, then a fit test should

be conducted.

People age, and typical consequences are changes in elasticity of the skin and fat content.

For these reasons, periodic repeat fit testing is best practice, even if it is not mandated.

Programme management

Fit testing is more than just a one-off fit test of your wearers with their current respirators.

Employees leave and are hired, respirator types, makes and models may change over time,

wearers themselves age and their faces change. Furthermore, implementing a fit testing

programme will likely affect the type, model and number of respirator purchased, impacting

both purchasing and stores within your organisation. The benefits of enhanced wearer

protection may likely need to be explained to other stakeholders in the organisation.

Fit testing should be an established part and a continuous consideration of your respiratory

protection and general health and safety policies. An effective programme should contain

elements similar to those detailed in OHSAS 18001

(15)

• Plan – determine your policy, plan for implementation, communicate roles

and responsibilities for all involved

• Do – implement the fit testing plan

• Check – measure the performance of the programme and impact

on purchasing and production

• Act – review performance of the programme (implementation and products used)

and act upon improvement actions

How to implement and manage an effective respirator fit testing programme

Reducing the PPE burden

It is important to stress that following a successful fit test, the wearer

should be instructed that they must wear the exact respirator model

as they wore during the fit test and that they fit it as instructed on

every occasion. Passing a fit test does not mean that the wearer

will obtain a good fit every time unless they follow the donning

and wearer seal checking procedures.

Benefits of fit testing

There are many benefits of implementing a fit testing programme.

In many countries, the obvious benefit is compliance with

the local laws. In countries where fit testing is not mandatory,

many employers are implementing fit testing programmes

as their own company policy.

Fit testing also provides a unique opportunity for one-to-one

training for wearers covering topics as diverse as respirator

use and limitations, workplace hazards, donning techniques

and compatibility with other items of PPE (which should be

part of the fit test).

Whether fit testing is implemented voluntarily or mandatorily,

it is recognised as best practice. Studies have demonstrated that

when fit testing is performed – poor fitting respirators are eliminated

– the work place protection provided to the respirator wearer is

increased. However, studies struggled to prove a direct correlation

between Fit Factors (FF) (resulting from a fit test) and Workplace

Protection Factors (WPFs).

• The best correlations between WPFs and FFs have been found

where respirators are poor fitting. However, as it is unethical

to expose wearers that knowingly have failed a respiratory fit

test to concentrations exceeding Occupational Exposure Limits

(OELs), it is difficult to perform expansive studies

• There are many differences between WPF studies and fit tests

which introduce variability that adversely affect correlation

• Aerosol size distribution in the workplace is different

than in fit test protocols and this can introduce variability

• WPF studies use gravimetric measurements, whilst the most

commonly used fit testing method used in such studies

(TSI

PortaCount

Respirator Fit Tester) employs ambient

particlecounting

• Fit tests are short duration tests using representative exercises that

do not significantly increase subject metabolic/breathing rates.

In contrast, WPF studies are conducted in the workplace, whilst

subjects conduct real work activities for extended

durations – the stresses and strains upon the respirator seal

to the face and the metabolic/breathing rates in the workplace

will be significantly more varied

Colton, CE., Filtering facepieces: Study supports need for

fit-testing, 3M Job Health Highlights, Vol 17, No 2, 1999

(16)

The chart below shows a probability plot of aggregated Workplace

Protection Factors for 16 different studies conducted between 1984

and 1996. The results are separated as to whether

or not the subjects undertook a fit test prior to the WPF study.

• 12 studies conducted fit testing upon the subjects: subjects

who failed the fit test were excluded from the WPF study

• The remaining 4 studies did not conduct a fit test on the subjects

prior to the WPF study: therefore all subjects were included

Comparison of half-mask respirator performance values

with and without fit-testing

The 5th percentile is a commonly used statistical analysis term used

to model a sample population of results in order to predict a value that

95% of the total population would realistically be expected to achieve.

• The 5th percentile WPF without prior fit-testing

is approximately 2

• The 5th percentile WPF with prior fit-testing

is in the range of 20-30

How to implement and manage an effective respirator fit testing programme

Reducing the PPE burden

3M Personal Safety Division

3M United Kingdom PLC

3M Centre, Cain Road

Bracknell, Berkshire RG12 8HT

Tel: 0870 60 800 60

www.3M.co.uk

and

PortaCount

Respirator Fit Tester are registered trademarks of TSI incorporated. OHD and

Quantifit are registered trademarks of Occupational Health Dynamics LLLP. Bitrex is a registered

3M Ireland Limited

The Iveagh Building

The Park, Carrickmines

Dublin 18

Tel: 1 800 320 500

References

1. HSE INDG479 Guidance on respiratory protective equipment (RPE) fit testing. 2019 [Online] http://www.hse.gov.uk/pubns/indg479.pdf

2. Respirator Fit Testers. [Online] http://www.tsi.com/Respirator-Fit-Testers.

3. 29 CFR 1910.134 - OSHA Respiratory Protection Standard.

4. Quantifit

| The Gold Standard in Respirator Fit Testing. [Online] http://www.ohdusa.com/products/quantifit.

5. ISO 16975-3:2017 - Respiratory protective devices - Selection, use and maintenance - Part 3: Fit-testing procedures.

6. ED 6273 “Protection respiratoire – Réaliser des essais d’adjustment”.

7. ISO 16973:2016 Respiratory protective devices - classification for respiratory protective device (RPD), excluding RPD for underwater application.

8. Managing and working with asbestos. Control of Asbestos Regulations 2012. 2012.

9. HSE RR1052 - The effect of wearer stubble on the protection given by Filtering facepiece Class 3 (FFP2) and Half Masks. 2015.

10. To Beard or not to Beard? That’s a good Question! [Online] https://blogs.cdc.gov/niosh-science-blog/2017/11/02/noshave/.

11. Gillette – Face Shaving tips: against the grain. [Online] https://gillette.co.uk/en-gb/shaving-tips/how-to-shave/against-the-grain.

12. Braun – How to get a close shave. [Online] https://uk.braun.com/en-gb/male-grooming/the-world-of-shaving/get-close-shave.

13. EN 529:2005 Respiratory protective devices — Recommendations for selection, use, care and maintenance — Guidance document.

14. Fit2Fit. [Online] www.fit2fit.org.

15. OHSAS 18001 - Occupational Health and Safety Management (OHS).

16. Filtering facepieces: Study supports need for fit-testing. Colton, CE. 2, 1999, 3M Job Health Highlights, Vol. 17.