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Episode 23 - Respiratory Fit Testing 1
3M Transcript for the following interview: Ep-23-Respiratory Fit Testing
Mark Reggers (R) Terry Gorman (G)
Introduction: The 3M Science of Safety podcast is a free publication. The
information presented in this podcast is general only, and you should always seek
the advice of a licensed or certified professional in relation to your specific work or
task.
Welcome to the 3M Science of Safety podcast presented by 3M Australia and
New Zealand Personal Safety Division. This is a podcast that is curious about the
signs and systems of all things work, health and safety, that keep workers safe and
protect their health. I am Mark Reggers, an occupational hygienist, who likes to
ask the questions Why, How, and Please Explain. Whether you are a safety
professional, occupational hygienist, or someone with any level of WHS
responsibility in the workplace, maybe you are a user of safety products or maybe
you are a bit of a safety nerd who finds this stuff really interesting, then this is a
podcast for you.
Ep 23: Respiratory fit Testing
(R) Today we are talking respiratory fit testing with Terry Gorman. Welcome,
Terry.
(G) Good morning Mark, how are you.
(R) Doing very, very well. Thanks for joining us again. For those that haven’t heard
any of our other podcasts we’ve done with you, can you introduce yourself, who
are you, what do you do, and where are you from?
(G) Yes, Mark, I am an occupational hygienist working for 3M for the last 19 years I
think it is. I’ve been in the safety game for nearly 30 years now. My initial training
Episode 23 - Respiratory Fit Testing 2
was as a chemist. I started in safety at the Lucas Heights reactor site and learned
my trade there, a great place to learn hygiene, there is one of everything on that
site. I have been working for 3M in the field of PPE for many years and have
supported the products in the field and the technical side of the business in that
time.
(R) Fantastic. So, like most of our podcasts, I’d like to start off, where does PPE sit
in the hierarchy of control.
(G) Yes, Mark, we know it is at the bottom, so there are many better approaches,
let’s say, many more advanced approaches that we can use. PPE is at the bottom
because it relies on people, people are people and do things a bit differently, so
there are inherent issues. You need to pay close attention to PPE and make sure it
is doing the right job because people are involved.
(R) Good summary there. So, we are talking about respiratory fit testing, but as a
whole, fit testing, what is it?
(G) So, certain types of respiratory protective equipment we call tight fitting, so
masks, people will probably be familiar with the look of a mask, it covers your
mouth and your nose in the half-face mask configuration or a full-face mask which
covers your entire face. These products rely on an effective fit or face seal of that
mask onto the individual’s face to give the level of protection required.
(R) That protection, you’ve got to think about the filters, masks that have filters, but
in that fit when we’re thinking about protection we look at the whole combination
of everything. So, is fit testing legally required? Why should a workplace do fit
testing?
Episode 23 - Respiratory Fit Testing 3
(G) Well, the Australian standard mandates fit testing for anyone wearing a tight-
fitting mask. Australian standards are not specified in legislation, but every
employer has a duty to provide a safe workplace. One way to demonstrate that in
terms of respiratory protection is to follow the Australian Standard 1715 and use
products that meet the Australian Standard 1716. Fit testing is required as part of
that for all individuals wearing tight-fitting masks.
(R) So how is fit testing actually conducted? How does a workplace check that a
mask fits a worker’s face?
(G) There’s a couple of ways to do it. They divide into two different approaches,
one called qualitative fit testing and one called quantitative fit testing. Qualitative
fit testing is a go/no go type of test. We challenge the fit of the product on the
individual, and if they do not detect the taste challenge agent, they pass, if they do
detect the challenge agent, then the seal is not effective, and it does not fit them.
Either the product is not the right size or perhaps not put on correctly.
(R) So that challenge agent, is it a nice challenge agent or a not so nice challenge
agent?
(G) There’s two options, one is saccharin, saccharin is essentially a very sweet
solution, you spray that into the breathing zone of the wearer, if they taste that
sweet taste obviously there is a leak and the mask is not fitting effectively. If they
go through the whole process which involves a number of head exercises and
movements, if they do not taste that sweet challenge agent, then they’ve got a pass
and that mask is giving them an effective seal. The alternate is a material called
Bitrex, rather than being sweet like the saccharin, this is a bitter, harsh-tasting
product. Again, it is a taste test, so you will taste a horrible bitter taste if you are
not getting an effective seal during the fit test.
Episode 23 - Respiratory Fit Testing 4
(R) What are the advantages of qualitative fit testing? Is it hard to do? Easy to do?
Can people do it themselves? Should people do it themselves?
(T) The Australian Standard allows for it, as a valid method. It's a prescribed set of
exercises and process. If the tester follows that protocol and does all the steps in
the appropriate manner, then they can get a valid result. It takes a bit of practice
and a bit of knowledge. It's not rocket science but it still needs to be done properly
so that you've got confidence that you are getting the correct answer at the end of
the day. The Australian Standards are a bit vague in terms of the specifics so it's
easier to follow the OSHA Standard from the US. The OSHA Protocol is very clear
or the UK Protocol from the HSE. Those are all valid methods that can be used and
very, very similar, so there's not much variation there.
(R) What are the down sides, are there any disadvantages to that particular method
compared to the other one we are going to talk about in a second?
(G) The moist obvious down side is that some people cannot taste saccharin and/or
Bitrex, so some people don’t have that ability, some people have destroyed their
taste buds, heavy smokers is a group that comes to mind, where their taste buds
are no longer operable, and they can’t taste the challenge agents. Clearly if you
can’t taste the challenge agent you will not know if the mask is leaking or not, so
the method is then not usable for that group of people. The test requires the
subject to provide a response, so you are relying on the individual being tested to
give you a truthful and honest answer in terms of whether the mask is leaking, or
they get the taste, or they do not. Some people have agendas so that can be a
complication at times. There is no calibration required, this is a relatively
straightforward situation, you get all your elements out of a kit or a box, you can do
the testing and put it away and get it out next time you need it. So fairly
straightforward, fairly simple, inexpensive, and available to anybody who needs it.
Episode 23 - Respiratory Fit Testing 5
(R) Can you test all types of masks using that particular method?
(G) The qualitative fit testing is only used for half-face mask testing, so if you need
the higher protection that you need from a full-face mask, you cannot use
qualitative fit test, you have to go to the other one we are going to talk about,
Quantitative fit testing.
(R) Is there any other qualitative types, or that is the only type?
(G) There is some other more exotic ones that are not so widely used. There is an
irritant smoke test that is no longer in favour because it is by definition an irritant
and has been known to give some people a bit of problem in terms of their
response, so it is a pretty rare beast these days.
(R) So quantitative, we’ve spoken qualitative, relying on the worker to tell us the
response, so what is the difference to quantitative?
(G) Quantitative, we are now using a method that allows us to come up with a
number, a figure on how well that product fits. The qualitative system was a yes or
a no, this actually, the quantitative system gives you a number to give you a relative
indication of how well the mask fits the individual. There is a couple of types, there
is a full-on laboratory test chamber situation where the test lab can put you in a
small, enclosed room, put a challenge agent in there, typically it will be salt
particles, and see how many of those salt particles can bypass the face seal and be
measured inside the mask. These are pretty rare beasts, and certainly not
something that is available out in the average workplace. To get a test that is
portable and can be used anywhere where there is power essentially you need to
buy a, there’s some portable counting devices, the most popular one is called the
PortaCount. This uses the natural particles that are floating around in the
Episode 23 - Respiratory Fit Testing 6
atmosphere everywhere. It uses those as the challenge agent and measures the
concentration of those particles floating outside the mask, compare it with a
concentration inside the mask, to give you a fit factor, a number that indicates how
well that mask is fitting on your face. If the number is high enough you get a pass,
if the number is not high enough, that mask is not fitting your face correctly and
you need to go and refit it or perhaps try a different mask.
(R) So, one of the benefits or advantages of the quantitative is you are not relying
on the worker to tell you anything, the machine gives you a number, it’s
acceptable, not acceptable. Any other benefits of that particular method?
(G) The subjective result that we were talking about earlier disappears, so this is an
objective measurement, it does not rely on a response from the wearer, the wearer
is simply a fitting or a holder for the mask, if you like, the machine does the
measurement and tells you whether you’ve got a significant leak or a poor fit and
you can respond accordingly. So, the individual subject does not have to be
involved in the process other than to wear the mask.
(R) So, everything’s got pros and cons, advantages and disadvantages. What is the
disadvantages with this methodology?
(G) This equipment is quite expensive. We are talking up towards $20,000 in that
sort of range, so it is certainly not a unit that can be bought by the local smash
repair shop or a small company, it is just too expensive. They would have to look at
other ways of getting access. There are consultants who will come and fit test for a
fee, and that is clearly another alternative, or you go back to the qualitative if that
works in your situation.
Episode 23 - Respiratory Fit Testing 7
(R) So, you mentioned earlier when we were talking about qualitative exercises that
they do, so do they just sit there while they’re wearing the mask, or what
movements do they have to do?
(G) There’s a number of head movements involved, so normal breathing, heavy
breathing, head moving side-to-side like you’re watching the tennis, head moving
up and down like you are nodding, we do a section where the test subject does
some talking, in other words they are moving their jaw and putting some stress on
the face seal, they do a bending over exercise where you are bending at the waist,
again to mimic the sort of movements that might happen in the workplace, and
then some more breathing. So, all of those exercises are trying to give us a rough
indication of the sort of movements that would occur and then see if the face seal
remains effective during those movements to give us overall hopefully a pass and
that mask is suitable.
(R) The big question that comes up all the time, being clean-shaven. What effect
does beard stubble have on these masks and the ability to show that it can fit a
worker?
(G) The standard and all of the associated literature and testing that has been done
shows that facial hair degrades the face seal. The facial hair acts like a steeple, if
you like, to hold the mask off your face, creating openings and creating a leak path,
and clearly that lets in the challenge agent or the particles, and you will get a lower
number or a failure of your test. The hair needs to be removed. The simple truth is
that you need to be clean-shaven at the start of every shift. Any facial hair is going
to degrade, and you need to make sure there is no facial hair between the mask
and the face of the wearer.
(R) A few comments I get when I’m doing fit testing, but my beard, my beard will
help filter out the dust that’s in the environment, and I’ve got a couple of really
Episode 23 - Respiratory Fit Testing 8
good pictures that I am happy to share with our listeners to show, the workers are
thinking about the big stuff they can see, what about the stuff that is smaller than
your beard stubble or your beard hair.
(G) Exactly. The beard might capture a big chunk of sawdust or something clearly
visible. What we are really concerned about is the microscopic particles that we
can’t see, and they’re the ones that get deep down into the lungs and cause the
damage, so those particles are not evident to the worker with his beard or his
moustache or whatever, and that facial hair has to go so that the mask can perform.
If there is obviously a disagreement about removal of the beard or the moustache
or whatever, there are other options that do not require a tight-fitting mask, there
are respirators that use loose hoods or helmets, those sort of options that can give
people an alternative where they can keep their beloved moustache or beard and
still get respiratory protection. But, if you’re wearing a tight-fitting mask, you need
to be clean-shaven.
(R) The point I always bring up when I’m doing training is your day 3 growth is
different to my day 3 growth versus day 5 versus day 7, so it is not reliable, it is not
predictable between worker to worker, we want to take that ambiguity out of it,
and we know what their face shape is when it is clean-shaven.
(G) Exactly right. We all know people whose facial hair grows almost while you’re
looking at it, and others who are just the opposite, it grows very slow, all people
have different rates of growth depending on the season, depending on their health
condition, there are whole lot of factors that come into that rate. The simplest
most basic way to make sure everyone’s at an equal level in terms of performance
is to make sure everyone is clean-shaven at the start of the shift, that way you’re
going to get the same level of protection you got when you passed the fit test and
therefore getting the level of protection you need in your workplace.
Episode 23 - Respiratory Fit Testing 9
(R) Is, there any other quantitative fit testing methods?
(G) There is another alternative, a rare beast in Australia, but there is what’s called a
controlled negative pressure device. This is a unit that relies on let’s say taking a
deep breath inside the mask and the unit measures the loss of pressure or the
pressure change that occurs over time. If you’ve got a badly-fitting mask the
negative pressure will disappear very quickly to indicate the mask is not fitting well.
If you’ve got the pressure stays negative for a long time, that indicates that seal is
effective, and you get a pass. These units are available overseas. They are pretty
rare over this side, and the PortaCount by far is the most commonly used option in
this type of area.
(R) Is there one fit testing methodology, quantitative, qualitative, that you
recommend, is one better than the other when workplaces should be considering
all these different types?
(G) They’re all acceptable under the Australian standard, so the regulators and the
courts and everyone else will accept a fit test of any kind given that it was done
appropriate to the protocols. You follow the steps appropriately, the records are
kept that the person was tested on such and such a date, and on what product, so
if all those things are in place appropriately then any fit test is appropriate. There
are issues in terms of those things we talked about with the qualitative testing,
people that cannot taste the challenge agent or people who require high protection
factors, you cannot use that type of approach, you have to go to the Quantitative
testing method. So, it’s a case of pick the one that works best in your local world
and do it properly and that will be acceptable.
(R) So, Terry, people doing the fit testing, because like any process that you
alluded to earlier, the methodology must be followed to have that reliability of the
Episode 23 - Respiratory Fit Testing 10
fit being tested. What level of knowledge or competence or skills should fit testers
have, because that's a pretty important part of making sure this is accurate?
(G) Yeah, absolutely. There are certainly people we have seen that are not doing
the process correctly and you end up with questionable results. ISO, the
International Standards Organisation is currently doing a whole new set of
respiratory protection standards and they've done a whole subsection on fit
testing, which goes into all of the requirements, the reasons, the whys and the
wherefores and also describes the competencies of the fit tester; what sort of
knowledge the fit tester should have, what issues they should be able to cover and
that way they will … by having those competencies they will much more likely
follow the method, get the right answers and get the end result that you want, in
other words, a mask that is proven to fit the individual and will give the protection
that they need.
(R) Like any methodology, if you don't follow the process, you may still get a result,
but is it accurate and can that be relied on because at the end of the day, this is
about making sure the workers can get a fit when it really matters on the job?
(G) Yeah, so the standard methods that are allowed for fit testing certainly can be
relied on, given, as you say, you follow the recipe, you follow the steps, you do all
the right things. Like any process, you can do it the wrong way. You'll get a result,
but it won't be necessarily be the one that you want. In other words, proof that the
product fits the individual, so those competencies and those skills are part of that
picture and inform the fit tester, so they are getting the right answer at the end of
the day.
(R) And that ISO Standard, that is out now, as we're recording, for people to access
if they want to go and look at that particular standard?
Episode 23 - Respiratory Fit Testing 11
(G) Yes, it is released. It hasn’t been adopted by the Australian Standards itself but
…
(R) At the time of this recording, yep.
(G) … at the time of this recording but we certainly are looking at that and it may, in
the future, be adopted as a guidance document to inform those using the Australian
Standard system.
(R) If listeners want more detailed information, because this really is just a skim
overview around respiratory fit testing, where can they go to find more
information?
(G) Of course, the Australian Standard contains information about fit testing, it
goes into the issues we talked about a little bit more deeply and provides a bit more
information. The same type of information can be found from other international
organisations like NIOSH in the US or HSE in the UK. These are countries that pay
close attention to fit testing and have information and documents that cover the
issues that we’ve spoken about as well and can provide some background
information as well about the whole subject.
(R) Really appreciate your time today, Terry.
(G) You’re welcome, Mark.
(R) Just in summarising fit testing, is not just about passing the test at that time of
the test, it is about giving confidence to workers and workplaces that that mask is
going to be providing that level of protection that is required for where they are
working. So, keep that in mind, it is about the worker and what they are being
exposed to and making sure they are not breathing that in.
Episode 23 - Respiratory Fit Testing 12
Well thanks for listening, everyone. If you have any questions, comments,
suggestions for future topics or other guests that you think we should talk to, you
can shoot us an email to [email protected]. You can also contact us
via that email if you want any help within your place around respiratory protection
and respiratory fit testing as well, 3M are here to help.
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