Ethan Rhodes
There are two types of fit tests: qualitative and quantitative. Qualitative fit tests rely on the user's senses to determine if there is a gap in the seal of a respirator, while quantitative fit tests use an instrument to measure the amount of face seal leakage. Respiratory fit tests are required annually by the Occupational Safety and Health Administration (OSHA) for healthcare employees who are required to wear tight-fitting respirators. The Fecal Immunochemical Test (FIT) is another type of test that checks for hidden blood in the stool, which can be an early sign of colon cancer.
| Characteristics | Values |
|---|---|
| Purpose | To confirm a respirator forms a tight seal to your face |
| Frequency | Annually or when physical changes have occurred |
| Test Types | Qualitative, Quantitative |
| Qualitative Test | Relying on senses to determine if there is a gap in the seal of the respirator |
| Quantitative Test | Using an instrument to numerically measure the effectiveness of the respirator |
| Test Environment | Normal standing position |
| Exercises | Normal breathing, deep breathing, turning head side to side, moving head up and down, bending over, jogging in place |
| Preparation | Clean-shaven face, no assistance from the administrator in donning the respirator |
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What You'll Learn
- Respiratory fit testing: a test to ensure a respirator forms a tight seal to your face
- Fecal immunochemical test (FIT): a test used to check for hidden blood in the stool
- Qualitative fit test: a pass/fail test that relies on your senses to determine a gap in the seal of your respirator
- Quantitative fit test: uses an instrument to numerically measure the effectiveness of your respirator
- Annual fit test: OSHA requires a yearly test to confirm the fit of any respirator that forms a tight seal to your face
Respiratory fit testing: a test to ensure a respirator forms a tight seal to your face
Respiratory fit testing is a mandatory procedure for employees who wear tight-fitting respirators, such as disposable or reusable respirators, to ensure that the respirator forms a tight seal to their face. This procedure helps ensure the user has selected the correct size respirator and that it seals securely to their face, providing the expected protection. Respiratory fit testing is particularly important for healthcare employees in clinical, hospital, or research settings who may be required to wear respirators to filter harmful particles and airborne hazards.
During a respiratory fit test, the test subject is instructed to hold each chosen facepiece up to their face and eliminate those that do not give an acceptable fit. The most comfortable mask is then selected and worn for at least five minutes to assess comfort. The test subject may be directed to don the mask several times and adjust the straps to become adept at setting the proper tension. The test subject shall then conduct a user seal check, either a negative or positive pressure seal check. A positive-pressure seal check involves blocking the exhalation valve on a half or full facepiece respirator or covering the respirator surface and trying to breathe out.
Following this, the test subject will perform a series of simple exercises to ensure that the respirator seals well to their face even when they are speaking or moving. These exercises include normal breathing, deep breathing, turning the head side to side, moving the head up and down, bending at the waist, and grimacing. Each test exercise is performed for one minute, except for the grimace exercise, which is performed for 15 seconds. After completing the exercises, the test conductor will question the test subject regarding the comfort of the respirator. If the fit is unacceptable, another model of the respirator shall be tried.
It is important to note that any PPE that could interfere with the respirator's seal, such as safety glasses, hearing protection, or face shields, must be worn during the fit test. Additionally, tight-fitting respirators require a clean-shaven face where the respirator's seal comes in contact with the skin, as facial hair can interfere with the seal and reduce the effectiveness of the respirator. Respiratory fit testing should be conducted annually and whenever physical changes occur that could affect the fit, such as significant weight changes or dental work.
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Fecal immunochemical test (FIT): a test used to check for hidden blood in the stool
The Fecal Immunochemical Test (FIT) is a safe, non-invasive, and painless test that checks for hidden blood in the stool, which may indicate colorectal cancer or precancerous polyps. The test is simple and can be done at home, requiring only a few minutes and a provided test kit. It is recommended that individuals over 45 or at high risk of colorectal cancer complete the FIT annually.
To prepare for the test, there are no dietary restrictions or medication adjustments required. However, it is important to check the expiration date on the test card and ensure that it is not damaged or dirty. Additionally, if you are experiencing bleeding from hemorrhoids or menstruation, it is advised to wait until the bleeding stops for three days before proceeding with the FIT.
The test procedure involves flushing the toilet before having a bowel movement. Used toilet paper should be placed in the provided waste bag, separate from the toilet bowl. Using the provided brush, gently brush the surface of the stool and then dip the brush into the toilet water. Touch the brush to the indicated space on the test card, and then dispose of the brush in the waste bag.
After completing the test, place the test card in the specimen bag and then into the pre-paid mailing envelope. Send the envelope to the specified laboratory as soon as possible to ensure timely results. It is recommended to mail or drop off the sample within two days to avoid retesting.
While the FIT is a valuable screening tool, it is important to note that it cannot diagnose colorectal cancer. If the FIT results indicate the presence of blood in the stool, further tests, such as a colonoscopy or sigmoidoscopy, may be recommended by your healthcare provider.
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Qualitative fit test: a pass/fail test that relies on your senses to determine a gap in the seal of your respirator
Qualitative fit testing is a pass/fail test that determines whether there is a gap in the seal of a respirator. This test is important for healthcare workers who are at risk of exposure to airborne hazards. The test is conducted by a fit tester, who first performs a threshold test using a nebulizer filled with either Bitrex (a bitter-tasting solution) or saccharin (a sweet-tasting solution). The tester pumps the nebulizer into a testing hood until the person being tested signals that they can taste the agent. The number of pumps required to reach this threshold is noted.
Next, the person being tested puts on the respirator and the testing hood. They then perform a series of movements while the nebulizer is squeezed into the hood. If the person cannot taste the agent during these exercises, they pass the test and are cleared to wear the respirator. This test can be performed by sending employees to respirator fit testing clinics or by having an on-site team test employees all at once.
Qualitative fit testing is often chosen over quantitative fit testing due to its lower cost and because it prevents the waste of an N95 mask during the testing process. It is also a feasible option for nursing schools, as it is unrealistic for hospitals to provide the time and supplies required for quantitative testing for all nursing students. However, it is important to note that quantitative fit testing is superior in detecting leaks compared to qualitative fit testing.
During the COVID-19 pandemic, there was a shortage of personal protective equipment (PPE), and 3D-printed masks were designed and produced as substitutes. These masks were fit-tested at hospitals, and some hospitals implemented qualitative fit-testing programs for BSN students.
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Quantitative fit test: uses an instrument to numerically measure the effectiveness of your respirator
A Quantitative Fit Test (QNFT) is used to test the fit of any tight-fitting respirator. It involves using an instrument to measure leakage around the face seal and produces a numerical result called a "fit factor".
The test is used to ensure that the respirator is both comfortable and provides the expected protection. It is required for employees wearing tight-fitting respirators, such as disposable or reusable respirators, and must be assessed at least annually. In addition, fit tests should be performed whenever a different size, style, model, or make of respirator is used, and when any facial changes occur that could affect the fit, such as significant weight fluctuation or dental work.
There are three OSHA-accepted QNFT test protocols:
- Generated aerosol: This method uses a non-hazardous aerosol such as corn oil generated in a test chamber.
- Condensation nuclei counter (CNC): This method uses ambient aerosol and doesn't require a test chamber.
- Controlled negative pressure (CNP): This method uses a test that creates a vacuum by temporarily cutting off the air.
During the test, the subject performs a series of simple exercises that help ensure that the respirator seals well to their face, even when speaking or moving. These exercises include normal breathing, deep breathing, turning the head side to side, moving the head up and down, bending at the waist, and a grimace test where the subject smiles or frowns for 15 seconds.
The test instrument must have an effective audio or visual warning device that indicates when the test subject fails to hold their breath during the test. A record of the test shall be kept on file, assuming the fit test was successful.
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Annual fit test: OSHA requires a yearly test to confirm the fit of any respirator that forms a tight seal to your face
The Occupational Safety and Health Administration (OSHA) requires an annual fit test for respirators that form a tight seal against your face. This is to ensure that the respirator is both comfortable and provides adequate protection. The test must be performed before an employee uses a respirator in the workplace, and it must be repeated at least annually.
The test subject must be given the opportunity to select the most acceptable respirator from a range of models and sizes. They should be shown how to put on the respirator correctly, how to position it on their face, and how to adjust the straps to achieve a proper fit. A mirror should be provided to assist the subject in evaluating the fit.
The test subject should then perform a series of exercises to ensure the respirator seals well to their face, even when speaking or moving. These exercises include:
- Normal breathing: The subject breathes normally while standing in a normal position without talking.
- Deep breathing: The subject breathes slowly and deeply while standing, being careful not to hyperventilate.
- Turning the head side to side: The subject slowly turns their head from side to side, holding at each extreme to inhale.
- Moving the head up and down: The subject bends at the waist as if to touch their toes, or jogs in place if bending is not permitted.
- Grimacing: The subject smiles or frowns for 15 seconds.
After completing the exercises, the test conductor will ask about the comfort of the respirator. If the fit is unacceptable, another model or size should be tried. The respirator should not be adjusted once the fit test exercises begin, as this will void the test.
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Frequently asked questions
A fit test is a mandatory test to confirm if a respirator forms a tight seal to your face. It is required for healthcare employees who are required to wear tight-fitting respirators.
OSHA requires an annual fit test. However, if there are any physical changes, like weight loss or gain, or facial/dental alterations, a fit test should be done again.
The steps include:
- The test subject holds each chosen facepiece up to the face and eliminates those that do not fit.
- The most acceptable and comfortable mask is worn for at least five minutes.
- The test subject conducts a user seal check.
- The test subject performs a series of exercises like normal breathing, deep breathing, turning the head side to side, moving the head up and down, and bending over.
