N95 Respirators:
Use and Fit Testing
Train the Trainer
Presented by Connecticut OSHA in
cooperation with
DESPP/DEMHS and CT DPH
Outline
• N95 Respirators- Use and Limitations
• OSHA’s Respirator Standard
• Developing a Written Respirator
Program
• Qualitative Fit Testing
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
N95s are:
Air Purifying
vs.
Atmosphere Supplying
N95s are:
Tight Fitting
vs.
…. and can be discarded after use
(vs decontaminated)
Loose Fitting
N95s purify the air with:
filters
vs.
cartridges
N95: not resistant to oil and 95%
effective at reducing exposure to 0.3
micron particles
CBRN (chemical, biological,
radiological and nuclear agents)
Multiple Configurations and Manufacturers
Surgical masks are not respirators
appropriate for cough etiquette & protection
from droplets (not aerosols)
N95 respirators provide inhalation protection
from infectious airborne agents (aerosols)
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)
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
(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……
(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.
 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?
(d) Selection
Which Respirators have been selected:
N95s
Powered Air Purifying Respirators (PAPRs)
 Your Department:
• Which N95 respirators will you select?
Availability
Expiration Dates
Cost
Portability
Exhalation valves
Latex free
Nose Clips
Experience with successful fit
(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
 Your Department:
• Which Physician or Licensed Health Care
Professional (PLHCP) will review the
medical evaluation questionnaire?
(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
 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
Stop Eating, Chewing Gum, Smoking and
Drinking (except for water)
(15 minutes prior to fit test)
(h) Maintenance
Discard after use, followed by hand hygiene.
 Your Department:
• Where will new respirators be stored?
• How will individuals store and label their
personal respirators ?
(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.
Your Department:
• Who will do the respirator hazards and
respirator use training?
(l) Program Evaluation and
(m) Record Keeping
• Medical evaluations
• Fit testing
• Written respirator program
Fit Test Demonstration
Questions???
CONN-OSHA
38 Wolcott Hill Road
Wethersfield, CT 06107
860-263-6900
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.