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IH72300 Respiratory Fit Testing- QNFT Program - Brookhaven ...

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Environmental, Safety, Health Directorate<br />

Safety & Health Services Division- Industrial Hygiene<br />

IH-IHP-72300<br />

<strong>QNFT</strong> <strong>Fit</strong> Tester JPM<br />

Job Performance<br />

Measure/Qualification Documentation<br />

Candidate’s Name Life Number:<br />

Practical Skill Evaluation: Demonstration of Evaluation Methodology by Oral Exam<br />

Criteria Qualifying Performance Standard Unsat. Recov. Satisf.<br />

1. Worker<br />

Knows the worker prerequisites for fit testing- training and<br />

Qualification for fit medical approval. Demonstrates checking the BTMS and/or<br />

test<br />

the Medical Approval form.<br />

2. Worker Physical Knows to determine if the worker has the proper facial hair,<br />

Appropriateness non-smoking time, physical conditioning, and lack of facial<br />

for fit test<br />

scarring for fit testing.<br />

3. Pre-<strong>Testing</strong><br />

Inspection<br />

Verifies the Portacount is operational and functioning<br />

properly. Demonstrates start up of the computer program<br />

and turning on the Portacount.<br />

4. Donning &<br />

Demonstrates advising the test subject on the donning<br />

Familiarization procedure and having the test subject wear the mask for the<br />

period<br />

familiarization period.<br />

5. Selection of proper Demonstrates selecting the proper vendor, style and size of<br />

equipment for fit mask for fit testing from past fit test results and/or discussion<br />

testing<br />

with test subject or a call to their supervision.<br />

6. Daily Check<br />

Demonstrates performing a daily check with ambient air and<br />

filter.<br />

7. Defective Mask<br />

Trail<br />

Demonstrates how to advise the person on mask defects<br />

and provides the defective test equipment for test subject<br />

inspection.<br />

8. Portacount<br />

preparation<br />

Demonstrates how to increase ambient particle count in<br />

situations of too low of background count. Knows what level<br />

is too low.<br />

9. Setting up<br />

employee name &<br />

respirator<br />

Demonstrates how to properly select the correct employee<br />

name & respirator type in the Portacount software program.<br />

10. Measurement of fit<br />

test<br />

11. Measurement of<br />

hazard<br />

12. Hazardous Waste<br />

13. Documentation<br />

Demonstrate running the fit test regimen and evaluating if<br />

the test subject is correctly doing each exercise.<br />

Knows how to properly measure employee fit test and<br />

compare to passing criteria.<br />

Understands the need to treat un-used Isopropanol as<br />

hazardous waste if disposing.<br />

Demonstrates correctly printing the test record and filling out<br />

IH fit test forms and card.<br />

I accept the responsibility for performing this task as demonstrated within this JPM and the<br />

corresponding SOP.<br />

Candidate Signature: Date:<br />

I certify the candidate has satisfactorily performed each of the above listed steps and is capable of<br />

performing the task unsupervised.<br />

Evaluator Signature:<br />

Date:<br />

<strong>IH72300</strong> Form SHSD JPM Rev Date: 06/15/12

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