According to NIOSH, over 3 million workers in the United States are required to wear respirators to protect themselves from workplace hazards. Under OSHA’s respiratory protection standard, only employees who pass medical evaluations for respirator use may be fit-tested. The fit test must use the same respirator make, model, style, and size the employee will use on the job.
OSHA requires a respirator fit test:
- Before the first use of the respirator on the job
- Whenever a different respirator face piece is used
- At least annually after the first test
- When the employee, the employee’s supervisor, a healthcare professional, or another observer notes physical changes that could affect respirator fit, such as facial scarring, dental changes, cosmetic surgery, or an obvious change in body weight
Employer Concerns Prompt Study
Since fit testing is time-consuming and a burden on resources, the appropriate length of time between respirator fit tests has been a point of debate for many years. In response to employer concerns—especially those in the healthcare industry, NIOSH initiated a pilot study to address three basic questions:
- Does respirator fit change over time?
- Does weight change cause respirator fit change?
- Is annual fit testing necessary?
The pilot study indicated a need for a larger study. This recently released study focused on N95 filtering face piece respirators (FFRs) because they are the most commonly worn respirator used in the healthcare industry and, according to NIOSH, the necessity of annual fit testing for these types of respirators is often debated.
20 Is the Magic Number
The study found that respirator fit did change over time. In fact, the greater the weight loss, the higher the chance that respirator fit will change. Twenty-four percent of subjects in the study who lost more than 20 pounds had an unacceptable fit. In its findings, NIOSH not only supported the current OSHA requirement for annual fit testing, but it also recommended that respirator users who lose over 20 pounds since his or her last fit test should be retested to be sure that the current size and model of respirator in use still properly fits.