Healthcare professionals are always on the front lines when an outbreak of a contagious disease occurs, placing themselves in very vulnerable situations and exposing themselves to the virus to save others.

At-risk workers that face hazardous exposure are usually protected by their work environment's engineering and administrative controls. However, facilities should also ensure that these employees know how to properly use respiratory protection and other personal protective equipment.

N95 respirator masks offer excellent protection, blocking out air-borne germs and contaminants. These masks are essential to fields that include healthcare personnel, frontline workers, and anyone else needing top-notch protection to do their job.

Occupational safety and health using N95 respirator masks is all about risk mitigation. It can be vital to do respirator fit testing. This guide will instruct you on how to do respirator fit tests to ensure your team members are fitted with the right size and model of masks.

Proper Use, Filtration, and Fit

This means you should choose a respirator that captures 95% or above of the particles that enter through the filter (like the N95 mask), and the respirator should be worn properly and fit your face to reduce the risk of particles passing through the filter at gaps between the respirator seal and your skin. If any of these factors are not in place, you may be at risk.

Proper Use

If you don't use the respirator appropriately during exposure, it won't prevent you from getting into contact with harmful particles.

The N95 respirator should be worn in such a manner that it is fitted and worn correctly, so that leakage is minimal around the N95's edges when you're inhaling. This ensures that the air you breathe is directed to the filter material. Workers who are required to use respiratory protection should undertake respirator fit testing, training, and medical clearance.

You should don and take off the respirator properly before and during exposure. Filtration

NIOSH-approved N95 respirators are tested by simulating “worst case” scenarios to guarantee their effectiveness. These tests guarantee that the respirators' filters will effectively filter hazardous aerosols found in workplaces, at a minimum of 95% efficacy.

Fit tests involve making sure your face and the respirator's facepiece have a tight seal. The qualitative fit test takes about fifteen to twenty minutes and should be carried out once a year. If you pass a fit test with a particular respirator, you should use the same model, size, and style with this respirator from now on to guarantee a proper fit.

If the respirator is not properly seated on your face, there is a risk of contaminated air leaking into your respirator facepiece, putting you at risk of inhaling harmful substances.

Initial fit testing is vital for any workplace safety program requiring workers to wear respirators. The Occupational Safety and Health Administration (OSHA) has mandated that initial respirator fit tests be conducted to determine the right type, size, and style of respirator for each employee, which would confirm that the mask properly fits and provides the expected level of protection. Moreover, tight-fitting masks like N95s need a user seal check every time you wear them to ensure a perfect fit. In the United States, NIOSH-approved respirators provide the instructions for a seal check.

Employers may experience setbacks when conducting respirator fit tests during extreme shortages when supplies like respirators or fit test kits are low, but there are steps employers can take to prioritize the safety of their workers. You can refer to this guide to identify the suitable respirator that best fits each employee:

• Before and during hiring, workers should be given their first round of protective respirators to ensure it still fits a year later and to create a proper seal once a year.
• Anytime the facial shape of a worker changes, for instance, after a weight change, scarring, cosmetic surgery, dental work, or even with facial hair changes, it affects the fit of the facepiece and should be checked for protection.
• When an employer or worker chooses to change to another type of respirator, fit tests are necessary again.

Respirator fit testing methods come in two types: qualitative fit testing and quantitative fit testing. OSHA recommends qualitative tests for healthcare environments, which are pass/fail tests that use the sense of smell or taste to identify leakage in the respirator.

Qualitative Fit Testing (QLFT)

• Generally used for half-mask respirators
• More common
• Rely on the user's senses

Quantitative Fit Testing (QNFT)

• It uses a device to identify leakage into the facepiece numerically.

There are four types of qualitative-approved tests:

• Bitrex (bitter)
• Saccharine (sweet)
• Irritant smoke (produces coughing)
• Isoamyl acetate (bananas)

A respirator fit test shouldn't be confused with a user seal check, which is a quick check performed by the wearer every time the respirator is worn, to determine if the respirator is correctly seated on the face or needs adjusting.

Situational Approaches to Get the Best Respirator Fit in Times of Crisis

In dire situations such as a major outbreak, when respirator supplies are minimal, you may not have the chance to get fit-tested before using it.

Even if fit tests are unavailable, however, you need to work with your employer to select the suitable respirator that fits you best. Even with no fit testing, it's better to use a respirator than a face mask because it will guarantee better safety and protection.

If you have had a fitting test before, it's best to start with the size of the mask used in that test. However, sizes can vary with the manufacturer and the model, so you may need to wear a different size for a perfect fit, but it can at least be used as a reference point.

The respirator must fit securely over your nose and underneath your chin. If it does not fit correctly, try another size or model for improved results.

If you need to start using respirators as soon as possible without a respirator fit test, talk to your employer about getting additional product training material from the manufacturer. This should include videos and literature that can help with appropriate donning and doffing.

Familiarize yourself with the respirator, and ensure a good fit by conducting user seal checks routinely. It's helpful to check the fit in front of a mirror or get someone else to confirm that it's correctly positioned and sealing your face properly.

Although fit testing is perfect for confirming whether a respirator fits or not, healthcare professionals must be trained to do a seal check themselves before using the respirator.

On top of a seal check, donning the respirator properly in the first place will aid in achieving a perfect fit. Below are several other things to consider when putting on your respirator:

• Place your respirator on top of your nose and underneath your chin. If it has two straps, put them over your ears.
• To ensure an effective seal, use the fingertips from both hands to firmly shape the nose clip (the thin metal bar at the top of your respirator) against your face and your nose. Be sure not to pinch with one hand.
• Before entering any patient room, do a user seal check each time you wear your respirator. The respirator may come with instructions on how to do such checks properly.
• For respirators to function correctly, you must be clean-shaven, because facial hair can make the respirator leak. However, some kinds of facial hair can be tolerated, provided that the facial hair does not come in contact with the respirator's seal.
• If you experience any symptoms such as dizziness, lightheadedness, or nausea, it's essential to immediately leave the patient room, take off your respirator, and seek medical assistance.

Throw away the respirator when you experience any of the following:

• It gets harder to breathe through the respirator.
• The respirator gets dirty.
• The respirator becomes damaged.

Never touch the front of your respirator without washing your hands. Always keep the respirator clean and dry. Finally, ensure you read and follow the manufacturer's advice on use and storage.

Ensuring that facial respirators fit is an essential part of the Occupational Safety and Health Administration's guidance on safeguarding workers' health. Hence, proper tests are carried out on employees to confirm that their respirators provide enough protection.

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