Facial Characteristics, Tester Experience Affect Respirator Fit-Testing Success, Study Shows

Researchers from Australia reporting on a large scale quantitative respirator fit-testing program conducted in acute-care hospitals and in ambulatory surgery centers, and in home nursing care, found that certain facial characteristics were associated with higher or lower pass rates. Their research was published in the journal Infection Control and Hospital Epidemiology.

Wilkinson, et al. (2010) performed quantitative facial fit-testing with TSI PortaCount instruments for healthcare workers who wore five different models of a disposable P2 (N95equivalent) respirator, as well as administered a questionnaire that included questions about healthcare workers age, sex, race, occupational category, main area of work, smoking status, facial characteristics, prior training and experience in use of respiratory masks, and number of attempts to obtain a respirator fit.

The researchers report that 6,160 healthcare workers were successfully fitted during the period from January through July 2007. Of the 4,472 healthcare workers who responded to the questionnaire and were successfully fitted, 3,707 (82.9 percent) were successfully fitted with the first tested respirator, 551 (12.3 percent) required testing with a second model, and 214 (4.8 percent) required three or more tests.

As Wilkinson, et al. (2010) explain, We noted an increased pass rate on the first attempt over time. Asians had the highest failure rate and whites had the lowest. Race was highly correlated with facial shape. Among occupational groups, doctors had the highest failure rate but they also had the highest proportion of Asians. Prior education and/or training in respirator use were not associated with a higher pass rate. Certain facial characteristics were associated with higher or lower pass rates with regard to fit-testing, and fit-testers were able to select a suitable respirator on the basis of a visual assessment in the majority of cases. For the fit-tester, training and experience were important factors; however, for the healthcare worker being fitted, prior experience in respirator use was not an important factor.

Reference: Wilkinson IJ, Pisaniello D, Ahmad J and Edwards S. Evaluation of a LargeScale Quantitative Respirator Fit Testing Program for Healthcare Workers: Survey Results. Infect Control Hosp Epidemiol. 2010;31:918-925.