Many employers are unaware of their responsibilities when it comes to issuing RPE (Respiratory Protective Equipment) to their workforce, and in particular what their responsibilities are surrounding Fit Testing. Fit Testing is a method for checking that a tight fitting facepiece matches the wearer’s facial features and seals adequately. The performance of tight-fitting facepieces depends on filtering technologies and achieving a good seal between the wearer’s skin and the mask, therefore wearing an inadequately fitting mask that is the wrong size will significantly reduce the protection provided and could put the wearer’s health, or even life, in danger.
The HSE has produced a detailed guide on Fit Testing called: OC282/28. Initially produced for their inspectors this document is publicly available on the HSE website and answers many of the most commonly asked questions. It states that Fit Testing can only be carried out by a “competent person” and it gives definite guidelines as to what knowledge this competent person should have. It is not possible to nominate “Mr Smith” because he knows more about masks than anyone else. A competent person must have a thorough understanding of RPE, from the initial selection process, to identifying poorly maintained or fitting RPE, through to a good knowledge of Fit Testing and the various methods available.
One of the most common questions we get asked is, “Do I need to Fit Test my workforce?” The answer is “Yes”, it is a legal requirement that workers using tight fitting RPE as a control measure under Health and Safety Legislation must be fit tested. This requirement is detailed in the CoSHH regulations and the associated ACOPs. An example of a mask that does not require Fit Testing would be a loose fitting hood. If a mask is being used for comfort purposes and not as a control measure then a Fit Test is not required but this should be clearly demonstrated in the employers risk assessment.
Is a Pre-use Fit Check the same as a Fit Test? No, a Pre-use Fit Check is a method of checking that a face mask has been fitted correctly and should be carried out each time the mask is worn and prior to entering a hazardous environment. An example of a Fit Check on a half mask would be to cover-up or close off the particulate filters and take a deep breath in. If the mask is a good fit then you will see and feel the mask contract to the face. A Fit Check should also be conducted as part of the Fit Test process after the mask is applied and should form part of the educational process so the wearer understands the benefits of its application. In a recent statement released by the HSE they confirm that the only recognised methods of Fit Testing are the qualitative and quantitative Fit Test methods described in OC 282/28. By not Fit Testing or by using an un-validated method you could receive enforcement action from the HSE.
Whichever method of validated Fit Test is chosen it is important to have a good knowledge and understanding of how to fit a respirator correctly. It is also extremely important that the Fit Testing procedures are conducted with care and precision, and that a good technique is used. The operation of the nebulisers during qualitative fit testing is a good example of when an excellent technique is required. Firstly, it is very important to check that your nebulisers are working correctly. To do this, hold the nebuliser up to the light (or a dark background) and dispense the solution, you should see a fine mist. Fit Testing solutions can crystallise inside the nebuliser if they are not cleaned out properly causing the nebuliser to become blocked. These blockages can be easily removed by using the pin supplied within the Fit Testing Kit. In addition to checking the nebulisers are working correctly it is extremely important to ensure that the right amount of solution is being dispersed with each application. When pumping the solution use a slow, controlled action so the nebuliser bulb is fully deflated and inflated with each motion. The nebuliser should remain upright throughout the process, as holding it at an angle can affect its ability to draw the solution up. The application of the nebuliser is a two handed job; hold the top section of the nebuliser with one hand whilst applying the pumps with the other. This keeps the nebuliser stable and ensures it remains in an upright position. It is also important to label up the nebulisers so you can clearly identify the solutions, getting these mixed up during the process would interfere with the test results. One of the most common mistakes made when conducting this type of Fit Testing is the amount of sensitivity and test solution administered during the testing process. Firstly the sensitivity test is conducted to determine how sensitive the test subject is to the solution being used. The outcome will tell you if the test subject has low, medium or high sensitivity and this in turn tells you how much of the test solution should be used during the test. The Fit Test is made up of seven exercises, each lasting one minute. At the start of the first exercise either 10, 20 or 30 pumps of test solution are administered (10 = low, 20 = medium and 30 = high sensitivity). After this first step only half the initial number of squeezes (5,10 or 15) should be administered every 30 seconds (half way through the first exercise, at the beginning of the 2nd exercise, half way through the second exercise, at the beginning of the 3rd exercise…and so on).
Another common reason for failing a Fit Test is the presence of facial hair and stubble on the test subject. The HSE have published a report into the effect that facial hair and stubble has on the efficiency of RPE, it showed that even stubble which was present 24 hours after shaving can impact on the efficiency of RPE. Educating RPE wearers on the importance of being clean shaven should form part of the Fit Test process and many companies are now introducing clean shaven policies as a result.
In a bid to increase the proficiency of Fit Testing within the UK the BSIF have developed an accreditation scheme to help validate competency; the Fit2Fit RPE Fit Test Providers Accreditation Scheme. The scheme is supported by the HSE, following this scheme is not compulsory and employers are free to take other action to comply with the law. But if you follow this scheme, you will be doing enough to demonstrate good practice. As you can see there is a lot more to Fit Testing than you’d initially expect. Knowledge, experience and technique are all extremely important in the application of a good Fit Test and it is essential not to forget that a poorly executed Fit Test could result in a person wearing a mask that is not suitable for them and does not offer them the level of protection assumed.