1. N95 Respirators:
Use and Fit Testing
Train the Trainer
Presented by Connecticut OSHA in
cooperation with
DESPP/DEMHS and CT DPH
2. Outline
• N95 Respirators- Use and Limitations
• OSHA’s Respirator Standard
• Developing a Written Respirator
Program
• Qualitative Fit Testing
3. N95 Respirators
• Air purifying
• Tight fitting
• N: not resistant to oil
• 95: 95% effective at reducing exposure to 0.3
micron particles
Can be used to protect workers from airborne
infectious agents
5. N95s are:
Tight Fitting vs. Loose Fitting
…. and can be discarded after use
(vs decontaminated)
6. N95s purify the air with:
filters vs. cartridges
CBRN (chemical, biological,
radiological and nuclear agents)
N95: not resistant to oil and 95%
effective at reducing exposure to 0.3
micron particles
10. The Route of Exposure Leads
to Selection of PPE
Refer to the CDCs:
Interim Guidance for EMS Systems and 9-1-1 Public Safety
Answering Points for Management of Patients with Known
or Suspected Ebola Virus Disease in the US.
Guidance on PPE To Be Used by Healthcare Workers
During Management of Patients with Ebola Virus Disease
in U.S. Hospitals, Including Procedures for Putting On
(Donning) and Removing (Doffing)
11. OSHA’s Respirator Standard
29 CFR 1910.134
a) Permissible Practice
b) Definitions
c) Written Respiratory Protection Program
d) Selection
e) Medical Evaluation
f) Fit Testing
g) Use
h) Maintenance
k) Training
l) Evaluation
m) Recordkeeping
12. (a) Permissible Practice
When effective engineering controls are not
feasible, or while they are being instituted,
appropriate respirators shall be used
pursuant to this section……
13. (c) Written Respirator Program
Purpose and Scope
The purpose of this respirator program is
to ensure that all employees are protected
from person-to-person transmission of
airborne (inhalational) infectious agents.
14. Your Department:
• Who is your Program Administrator?
• What tasks may expose staff to infectious
airborne agents?
• Who in your department may be required to
wear an N95 Respirator?
16. Your Department:
• Which N95 respirators will you select?
Availability
Expiration Dates
Cost
Portability
Exhalation valves
Latex free
Nose Clips
Experience with successful fit
17. (e) Medical Evaluations
(before respirator use or fit testing)
• Employees complete a mandatory medical
evaluation questionnaire (Appendix C)
• The questionnaire is reviewed by a PLHCP to
determine the employee’s ability to wear the N95
respirator
• The PLHCP completes a clearance review form
and sends a copy to the employer and employee
• Annual medical clearance not required unless
employee reports signs or symptoms related to
ability to wear respirator
18. Your Department:
• Which Physician or Licensed Health Care
Professional (PLHCP) will review the
medical evaluation questionnaire?
19. (f) Fit Testing (annual) and (g) Use
• Qualitative or Quantitative
Methods (Appendix A)
• Features which
compromise fit
Facial hair that interferes w/ seal
Improper donning
Humidity, Sweat
Work Practices
Facial disfigurement
Eye glasses
Excessive weight gain or loss
Failure to complete a fit check
20. Your Department:
• Who will do the fit testing?
• What qualitative fit testing supplies will you
use?
– Cost
– Type of fit test (saccharin or bitrex® for N95)
– User comfort
– Expiration dates on fit test solutions
21. Stop Eating, Chewing Gum, Smoking and
Drinking (except for water)
(15 minutes prior to fit test)
23. Your Department:
• Where will new respirators be stored?
• How will individuals store and label their
personal respirators ?
24. (i) Training
• The respiratory hazards to which staff are
potentially exposed during routine and
emergency situations
• The proper use of respirators, including
putting on and removing them, any
limitations on use, and their maintenance.
29. Some of the photos used in this
presentation were selected from a
presentation prepared by OSHA’s Office of
Training and Education. In their
presentation OSHA acknowledged 3M
Occupational Health and Safety Division,
MSA, North Safety Products and TSI for
contributing some of the graphics used in
their program. Appearance of their products
does not imply endorsement by the U.S.
Department of Labor.
Editor's Notes
Tight fitting respirators have to be fit tested and can not be worn by individuals with facial hair that compromises the seal.
Any respirator with an “N95” has been approved by a NIOSH using a specific respirator testing protocol.
When respirator use is required, you need to comply with OSHA’s respirator standard, 1910.134
Appendix A: fit testing procedures
Appendix B-1: user seal check.
Appendix B-2: Cleaning procedures
Appendix C: Medical Evaluation Questionnaire
Appendix D: Information for Voluntary Use
Use alternative means to minimize exposures
Isolate or remove the source
Minimize opportunities for transmission
Make the unexposed population less vulnerable
Observe good hygiene
Wear ppe
Employers are not required to include in a written respiratory protection program those employees whose only use of respirators involves the voluntary use of filtering face pieces (dust masks). These employees should be given a copy of a Voluntary PPE information sheet (Appendix D).
PLHCP: An individual whose legally permitted scope of practice (i.e., license, registration, or certification) allows him/her to independently provide, or be delegated the responsibility to provide, some or all of the health care services required by paragraph (e), Medical evaluation.
All workers who are required to wear tight fitting respirators, including first responders who are issued N95 respirators, need to be fit tested to insure that the respirators work. First responders need to be trained to recognize the features that may compromise the fit.
Demonstrate a fit test briefly
When worn in the presence of an individual who has a disease that could be transmitted person to person by an airborne route of exposure, the respirator should be considered potentially contaminated with infectious material, and touching the outside of the device should be avoided.