The need for training
Being Face Fit Tested on a tight-fitting respirator is a legal requirement for your employer, if you are required to wear one for work.
This is to ensure the respiratory protective equipment (RPE) that you’re wearing is suitable for your face size/shape.
However, even if you’ve passed a Fit Test it’s important not to underestimate the importance of being trained to perform regular fit checks.
A study entitled ‘The effect of respirator training’ assessed the likelihood that healthcare workers could pass a Qualitative Fit Test on a given respirator – depending on whether or not they had received donning/doffing training.
Initial tests showed that 94% of those who were trained in putting on their respirator passed first time, compared to just 79% of those not given any training.
A later study looking specifically at fit check training, P. Or et al showed similar results. Comparing how 84 hospital staff performed on a real-time Quantitative Fit Test check, the study split the group in two – half of which were taught how to perform a fit check and half of which were not.
A significant difference was recorded, showing that those who had been trained to perform a fit check received much higher fit factors.
They noted: “Passing a fit test does not guarantee that every time a wearer dons a face piece an adequate fit will be achieved. The respirator has the potential to provide an adequate fit only when the wearer fits the respirator correctly. Each time workers don respirators they should check the fit by performing the user fit checks.”
Indeed, the HSE’s own OC282/28 – which dictates the legal regulations for RPE usage in the UK – states that: “A fit test does not remove the need for correct and careful day-to-day fitting of the facepiece, which should always include a pre-use fit check.”
It continues: “A pre-use fit check is required each time the facepiece is worn and before entering the hazardous environment. It is needed to determine if the facepiece has been correctly fitted before a contaminated work area is entered.”
But if training and fit checking are so important? Do we need to even bother with Face Fit Testing?
Performing fit checks never replaces the need for an initial Fit Test.
A team of researchers, led by S. Lam, posed the very same question and went about seeing whether or not fit checks were a possible substitute for Face Fit Testing.
Assessing 204 undergraduate nursing students on two different respirator models, the subjects undertook user-seal-checks followed by Quantitative Fit Tests. The researchers then compared the students’ self-assessment for fit based on their fit-check and the pass rate given by the Quantitative Fit Test.
While the results did indicate some accuracy for predicting whether or not a respirator would fit – confirming the value of the user-seal-check – it was not found to be a reliable substitute for a Quantitative Fit Test.
They conclude: “We recommend that QNFT is used to determine the fit of N95 [FFP3] respirators.”
So how can we improve the effectiveness of our Fit Testing?
Education, education, education.
Proved by multiple studies and research papers, there is no substitute for proper education and training.
In fact, one American study found that as few as 24% of people were able to correctly don a tight-fitting respirator without training.
Yes you may have a respirator that fits, and yes you may pass a Fit Test. But without the training and knowledge of how to don/doff your equipment properly; it’s very unlikely that you’ll get a perfect fit every time.
Full Support offer a wide-range of training courses for the use of RPE and Qualitative and Quantitative Fit Testing.
If you’d like to find out more, please get in touch with our RPE Experts on:
01933 672180 | firstname.lastname@example.org
 Or, P., et al. (2012). ‘Does Training in Performing a Fit Check Enhance N95 Respirator Efficacy?’ Workplace Health & Safety, vol. 60, no. 12, pp. 511-515 https://doi.org/10.1177/216507991206001202 [19 March 2018]
 Or, P., et al. (2012).
 HSE OC 282/28 pp. 9 – http://www.hse.gov.uk/foi/internalops/ocs/200-299/282_28.pdf [19 March 2018]
 HSE OC 282/28 pp. 36
 Lam S.C, (2011) ‘Sensitivity and specificity of the user-seal-check in determing the fit of N95 respirators, Journal of Hospital Infection, vol. 77, no. 3, pp. 252-256 https://www.sciencedirect.com/science/article/pii/S0195670110004640 [19 March 2018]
 Kristin J Cummings et al. Respirator Donning in Post-Hurricane New Orleans. Emerg Infect Dis. 2007 May; 13(5): 700–707. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738466