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      Feasibility of replacing homemade solutions by commercial products for qualitative fit testing of particulate respirators: a mixed effect logistic regression study

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          Abstract

          Qualitative fit testing is mandatory for tight-fitting respirators to ensure that the wearer fitted properly before entering a contaminated workplace. The purpose of this study was to evaluate the homemade solutions as substitution of commercial products for qualitative fit testing of particulate respirators. Two homemade solutions of Bitrex™ and saccharin were made according to the Occupational Safety and Health Administration (OSHA) regulation 29 CFR 1910.134. Threshold Screening Tests (TSTs) of commercial solutions, as well as homemade ones, were conducted on 62 participants in a random order. A placebo was also tested to assure the participants could distinguish its flavorless from other taste of solutions. There were no statistically significant differences between the commercial and homemade solutions representing that participants detected the bitter taste of the Bitrex™ and sweet taste of the saccharin solutions (96.8% vs. 91.9% and 93.5% vs. 83.9%, respectively). Homemade solutions that were stable and haven’t been contained microbial contaminations, could be substituted for commercial products in qualitative fit testing of filtering face-piece respirators (FFRs). Overall, this protocol presents a practical and cost-benefit technique to assess the fit testing of FFRs.

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          Fitting characteristics of eighteen N95 filtering-facepiece respirators.

          Michael B. Lawrence, Katrina L. Campbell, Leif P Jensen … (2004)
          Four performance measures were used to evaluate the fitting characteristics of 18 models of N95 filtering-facepiece respirators: (1) the 5th percentile simulated workplace protection factor (SWPF) value, (2) the shift average SWPF value, (3) the h-value, and (4) the assignment error. The effect of fit-testing on the level of protection provided by the respirators was also evaluated. The respirators were tested on a panel of 25 subjects with various face sizes. Simulated workplace protection factor values, determined from six total penetration (face-seal leakage plus filter penetration) tests with re-donning between each test, were used to indicate respirator performance. Five fit-tests were used: Bitrex, saccharin, generated aerosol corrected for filter penetration, PortaCount Plus corrected for filter penetration, and the PortaCount Plus with the N95-Companion accessory. Without fit-testing, the 5th percentile SWPF for all models combined was 2.9 with individual model values ranging from 1.3 to 48.0. Passing a fit-test generally resulted in an increase in protection. In addition, the h-value of each respirator was computed. The h-value has been determined to be the population fraction of individuals who will obtain an adequate level of protection (i.e., SWPF >/=10, which is the expected level of protection for half-facepiece respirators) when a respirator is selected and donned (including a user seal check) in accordance with the manufacturer's instructions without fit-testing. The h-value for all models combined was 0.74 (i.e., 74% of all donnings resulted in an adequate level of protection), with individual model h-values ranging from 0.31 to 0.99. Only three models had h-values above 0.95. Higher SWPF values were achieved by excluding SWPF values determined for test subject/respirator combinations that failed a fit-test. The improvement was greatest for respirator models with lower h-values. Using the concepts of shift average and assignment error to measure respirator performance yielded similar results. The highest level of protection was provided by passing a fit-test with a respirator having good fitting characteristics.
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            Comparison of qualitative and quantitative fit-testing results for three commonly used respirators in the healthcare sector.

            Chun-Yip Hon, Quinn Danyluk, Elizabeth Bryce … (2017)
            N95 filtering facepiece respirators are used by healthcare workers when there is a risk of exposure to airborne hazards during aerosol-generating procedures. Respirator fit-testing is required prior to use to ensure that the selected respirator provides an adequate face seal. Two common fit-test methods can be employed: qualitative fit-test (QLFT) or quantitative fit-test (QNFT). Respiratory protection standards deem both fit-tests to be acceptable. However, previous studies have indicated that fit-test results may differ between QLFT and QNFT and that the outcomes may also be influenced by the type of respirator model. The aim of this study was to determine if there is a difference in fit-test outcomes with our suite of respirators, 3M - 1860S, 1860, AND 1870, and whether the model impacts the fit-test results. Subjects were recruited from residential care facilities. Each participant was assigned a respirator and underwent sequential QLFT and QNFT fit-tests and the results (either pass or fail) were recorded. To ascertain the degree of agreement between the two fit-tests, a Kappa (Κ) statistic was conducted as per the American National Standards Institute (ANSI) respiratory protection standard. The pass-fail rates were stratified by respirator model and a Kappa statistic was calculated for each to determine effect of model on fit-test outcomes. We had 619 participants and the aggregate Κ statistic for all respirators was 0.63 which is below the suggested ANSI threshold of 0.70. There was no statistically significant difference in results when stratified by respirator model. QNFT and QLFT produced different fit-test outcomes for the three respirator models examined. The disagreement in outcomes between the two fit-test methods with our suite of N95 filtering facepiece respirators was approximately 12%. Our findings may benefit other healthcare organizations that use these three respirators.
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              The effectiveness of respiratory protection worn by communities to protect from volcanic ash inhalation. Part I: Filtration efficiency tests

              Stephanie McPherson, John W. Cherrie, Karen S Galea … (2018)
              Article 0 comments Cited 27 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Anahita Fakherpour
                Mehdi Jahangiri
                Saeed Yousefinejad
                Mozhgan Seif
                Journal
                Journal ID (nlm-ta): MethodsX
                Journal ID (iso-abbrev): MethodsX
                Title: MethodsX
                Publisher: Elsevier
                ISSN (Electronic): 2215-0161
                Publication date PMC-release: 01 June 2019
                Publication date Collection: 2019
                Publication date (Electronic): 01 June 2019
                Volume: 6
                Pages: 1313-1322
                Affiliations
                [a ]Department of Occupational Health, Shiraz University of Medical Sciences, Shiraz, 7153675541, Iran
                [b ]Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, 7153675541, Iran
                Author notes
                [* ]Corresponding author. jahangiri_m@ 123456sums.ac.ir
                Article
                Publisher ID: S2215-0161(19)30154-2
                DOI: 10.1016/j.mex.2019.05.034
                PMC ID: 6558090
                PubMed ID: 31205864
                SO-VID: 22f802ae-a018-4fa3-930e-d5fe6d74372a
                Copyright © © 2019 The Authors
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 4 March 2019
                Date accepted : 30 May 2019
                Categories
                Subject: Engineering

                Keywords: efficacy of homemade fit solutions as qualitative challenge agents for fit testing of filtering face-piece respirators (ffrs),qualitative fit test,challenge agents,commercial and homemade solutions,filtering face piece respirators
                Data availability:
                Keywords: efficacy of homemade fit solutions as qualitative challenge agents for fit testing of filtering face-piece respirators (ffrs), qualitative fit test, challenge agents, commercial and homemade solutions, filtering face piece respirators

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