N95 Respirator Fit-testers Training

N95 Respirator 

Fit-testers Training 

UMDNJ 

Office of Environmental Health & Safety 

Services (EOHSS) 

Updated 4 Nov 2009 

Respirator Use and Fit 

� OSHA 1910.134 – Respirators shall not be worn when 

conditions prevent a good face seal. Such conditions 

may be the growth of a beard, sideburns, a skull cap that 

projects under the facepiece, or temple pieces of 

glasses. 

� PEOSH Interpretation - Facial hair that lies along the 

sealing area of a respirator, such as beards, sideburns, 

moustaches, or even a few days growth of stubble, is not 

permitted on employees who are required to wear 

respirators that rely on a tight facepiece fit to achieve 

maximum protection 

Qualitative Fit Testing 

-To perform a qualitative test of the fit of the respirator, an 

aerosol of an agent you can taste is sprayed around the 

respirator to simulate droplet nuclei and airborne infectious 

agents. 

-If the face piece to face seal is not adequate (i.e., leaks), 

the test aerosol will by pass the filter and the user will taste 

it. 

-If the test agent is tasted, then fit is not adequate and the 

user should re-adjust the respirator or try another size. 

Why are we here today? 

•Prepare for larger H1N1 outbreak 

UMDNJ H1N1 Task Force 

http://www.umdnj.edu/h1n1 

• Personnel within 6 feet of symptomatic 

persons will need to wear an N95 

respirator, especially if there is no 

partition separating them 

•Anyone who may wear a respirator must 

first be fit-tested. 

The Fit Test Procedure 

� Qualitative vs. Quantitative Fit Testing 

� You are being taught to perform qualitative 

fit-testing (yes it fits or no it does not fit) 

Newark Forms Page 

Piscataway/NewBrunswick Forms Page

Respiratory use is one of many 

Control Measures 

•Administrative measures -promptly identify, segregate, and treat 

suspect or active patients. Symptomatic patients must wear a face 

mask 

• Vaccination (~2 weeks for immunity to develop) 

• Work Practices – Hand hygiene 

• Engineering controls such as ventilation (negative pressure 

isolation rooms), booths with high efficiency filters, and HEPA filtration 

equipment, glass partitions for frontline personnel 

• Respiratory protection and other personal protective equipment 

- Last line of defense 

Commercial unavailability of N95s 

OSHA Prioritized Use Mode 

� Since a shortage of disposable N95 respirators is possible, 

employers are advised to monitor their supply, prioritize their use of 

disposable N95 respirators and to consider the use of elastomeric 

respirators and facemasks if severe shortages occur. 

� Employer must prioritize use of respirators to ensure that sufficient 

respirators are available for providing close-contact care for patients 

with tuberculosis. 

� Healthcare workers performing high hazard aerosol-generating 

procedures (e.g., bronchoscopy, open suctioning of airways, etc.) 

on a suspected or confirmed TB or H1N1 patient must always use 

at least a fit-tested N95, even where a respirator shortage exists. 

� For low risk exposures (not conducting procedures where aerosols 

produced, no direct patient contact) to H1N1, a surgical mask is 

better than nothing – resistant to splashes, prevents wearer from 

touching nose and mouth 

N95 Particulate Respirator 

� The N designation 

means the respirator 

is designed to be 

used to filter aerosols 

free of oil. (N=not oil) 

� 95 means a filter 

efficiency level of 

95% for hardest to 

filter particles (.3 

microns). 

When should a respirator be 

worn for H1N1? 

Respirators should be worn: 

• When in close contact (within 6 feet) of 

patients with symptoms of H1N1 or seasonal 

influenza (flu) 

•Risk Assessment – may not be necessary to 

change the respirator between patients if there 

is no direct patient contact (e.g. person behind 

a partition, housekeeping) 

Examples of N95 Respirators 

These respirators are also 

known as N-95 disposable 

respirators. 

3M 1870 Healthcare Particulate 

and Surgical Mask (Latex Free) 

Sizes: “one size fits most” 

North 7130 (Latex Free) 

Sizes: One Size 

Tecnol PFR-95 (Latex free) 

Sizes: Regular and Small 

N95 Particulate Respirator 

� Intended to reduce 

wearer exposure to 

certain airborne 

particles in a size 

range of 0.1 to 

>10.0 microns 

� Fluid resistant to 

splash and splatter

N95 Respirator Limitations 

� Proper fit is critical to respirator performance. 

� Designed for filtering of particles only; Will not 

filter gases or vapors. 

� May be uncomfortable if used for extended 

periods. 

� Can not be worn by individuals with facial hair 

(beards, goatees, etc.). 

� Need to replace if wet, damaged, heavily soiled 

or contaminated. 

� Is less protective that a respiratory with a higher 

assigned protection factor 

Examples of Elastiomeric Respirators (for high risk situations where 

N95s are commercially unavailable) 

Half face Elastiomeric 

Full Face Elastiomeric 

These would need to be used with a HEPA cartridge 

Powered Air Purifying 

Respirators (PAPR) PAPRs are positive 

pressure- if there is 

any leakage, clean 

air leaks out of the 

mask 

If Worn Properly……. 

� An air purifying respirator will reduce, but 

not eliminate the inhalation of aerosol 

contaminants. 

� Does not supply oxygen. 

� Does not totally eliminate exposure to or risk 

of contracting any disease or infection. 

� PAPRs are more protective 

N95 and Elastiomeric are Negative 

Pressure Respirators 

This means they require the user to inhale 

(creating a negative pressure inside the 

respirator) in order to draw air inside the 

respirator. 

If there is any leakage, then contaminated 

air leaks into the mask. 

Why do we need to fit test N95s? 

Fit-testing is an OSHA Requirement 

We need to ensure that contaminated air does not enter 

the respirator around the facepiece. 

When you inhale, if the face piece does not fit correctly 

(i.e., there are openings or gaps), the air will enter through 

these openings instead of passing through the respirator 

filter. 

Everyone must be fit tested before being assigned a 

respirator to ensure that they have the size and respirator 

model that will provide the best fit.

Repeat fit-testing annually, and 

when: 

� changes in facial structure such as from the 

following situations: 

� weight loss or gain greater than +/- 5 pounds 

� dental/denture changes, 

� facial scarring, 

� facial surgery, 

� or other conditions which interfere with the seal 

of the face piece. 

Written Plan 

Your department may have its own Respiratory Protection Plan or it may 

use the UMDNJ Clinical Respiratory Protection Plan posted at 

http://www2.umdnj.edu/eohssweb/publications/ 

repiratory_protection_plan.pdf 

The UMDNJ Plan is designed to be customized for each unit/department by 

completion of fill-in-the-blanks. 

Medical Surveillance 

� Your school/unit/department must have 

arrangements with a licensed healthcare 

provider (usually the campus Employee 

Health/Occupational Medicine Service) 

� No specific requirement for how often 

medical clearance must be obtained 

�Request for Medical Evaluation for Respirator 

Wearer (when completed by Provider, this 

serves as documentation of Medical Clearance) 

�Respirator Wearer’s confidential Questionnaire 

Summary of OSHA Requirements: 

29 CFR 1910.134: 

Respiratory Protection Standard 

� Written Respiratory Protection Plan describing Program 

� Annual Respiratory Protection Training in the proper use, 

limitations, leak-testing, and storage of the respirator and 

in the hazard being protected against 

� Respirator Wearer Medical Surveillance to determine if 

the employee is cleared to wear a respirator 

� Annual Respirator Wearer Fit-Test to ensure that the 

respirator fits and will not allow contaminated air to leak 

into the breathing area from around the face piece. 

Annual Training 

EOHSS has an online respiratory protection training module posted at 

http://www2.umdnj.edu/eohssweb/publications/resp_training.htm 

Hands on training in donning 

and doffing the respirator and 

leak checking is part of the 

fit-testing procedure 

The EOHSS online training 

module has been updated 

to address H1N1 

Fit-testing 

� Only people with 

documented training 

can perform fittesting

Procedure for Fit Testers 

Step 1 – A week before the session inform 

people to be fit-tested of the requirements 

for being fit-tested 

� Inform them of the address of the respiratory protection module: 


and that training takes about 20-25 minutes and that they must bring 

the email documentation of training they received after completion to 

the fit-testing session. 

� If they don’t have documentation of medical clearance they need to get 

it- how to get it: download forms from 

http://www2.umdnj.edu/eohssweb/publications/fit_test.htm 

� the supervisor should fill out the Request for Medical Evaluation for Respirator Use 

form 

� The person being fit-tested should complete the N95 Medical Evaluation 

Questionnaire, put it in a sealed envelope and give it to the supervisor to be sent 

along with the request form to the campus employee health or other provider. In 

many cases people get medical clearance without the need for a medical 

appointment. 

Step 2 – Get supplies ready 

� Qualitative Fit test kit 

� Variety of N95 respirators (sizes/models) 

� Water/cups for people to drink between 

tests 

� Handouts, Fit Test Protocol Respiratory 

Protection Medical Status Update form, and 

Fit Test Record forms (download from 

http://www2.umdnj.edu/eohssweb/publications/fit_test.htm ) 

� Disinfecting wipes and paper towel (for 

cleaning and then drying the fit-test hood 

between uses 

� You may want to bring shaving supplies for 

people who arrive with facial hair 

Summary-Procedure for fit testers 

� Handouts, forms and the fit-test protocol are posted on the EOHSS website 

at: http://www2.umdnj.edu/eohssweb/publications/fit_test.htm 

� People being fit-tested must give you: 

a) documentation that they have completed respiratory 

protection training in the past year and 

b) documentation that they have received medical clearance (it does not 

have to be recent) to wear a respirator before you fit-test them. 

� People being fit-tested must complete: 

a) Respirator Medical Reevaluation form before being fit-tested, even if 

their medical clearance is recent. People who answer “yes” on the form 

should not be fit-tested. They will need to complete the respirator wearers’ 

confidential questionnaire so that occupational medicine/Employee Health 

Service can decide if they should be medically cleared or if they need an 

office visit. 

b) Should complete the appropriate section of the fit-test record form while 

waiting to be fit-tested 

� Completed forms should be given to the person coordinating the 

Respiratory Protection program for your unit/department. 

Step 1 (continued)– A week before the 

session inform people to be fit-tested of the 

requirements for being fit-tested: 

� They must not eat, drink or chew gum for 

at least 15 minutes before the session 

� Men must be clean shaven 

Step 3 – Obtain two types of documentation 

before fit-testing each person 

Documentation That Must Be Provided 

1-documentation of Medical Clearance 

2-documentation of completion of respiratory protection training 

Respiratory Training can be completed online at 


•OSHA does not specify frequency of Medical Evaluations so it does 

not need to be current 

•The training must have been completed in the past year.

Step 4 – Each person being fit-tested 

must first give the fit-tester a completed 

Medical Status Update Questionnaire 

The questionnaire is posted at: 

http://www2.umdnj.edu/eohssweb/publications/respiratory_protection_medical_status_update.pdf 

The questionnaire asks if there have been medical or 

psychological conditions since their last evaluation 

People who answer “yes” should not be fit-tested. 

They need new medical clearance before being fit 

tested. 

Step 5 – Before conducting the fit-test, 

check for facial hair - Persons who 

have Facial Hair must not be fit tested 

� Beards, stubble, or sideburns will prevent 

a good facepiece seal. 

� If practical, have shaving supplies 

available. 

� No exception to this rule 

Step 6 (cont) -Sensitivity Test 

� The test hood is placed 

over the subject’s head 

(without the respirator on) 

and the sensitivity 

solution is misted inside 

to make sure the subject 

can detect the test 

solution. 

� If the subject can not 

detect the solution after 

30 squirts a different test 

agent must be used or 

the fit-testing cannot be 

performed. 

Medical Reasons That Could 

Prohibit the Use of a Respirator 

� A history of pulmonary or lung problems 

such as: 

� Asbestosis, asthma, COPD, emphysema, 

TB, silicosis, shortness of breath, etc. 

� Do not use a respirator if you have any 

health or respiratory problem until you 

obtain clearance from a Physician or other 

Licensed Health Care Professional. 

Step 6 – Before the fit-test, perform 

the Sensitivity Test 

This test is done to assure that the person 

being tested can detect the sweet or bitter 

taste of the test solution at very low levels. 

The Sensitivity Test Solution is a very 

dilute version of the Fit Test Solution. The 

test subject should not eat, drink, or chew 

gum for 15 minutes before the test. 

Step 7 – Show the person being fit-tested 

how to inspect the respirator, don the 

respirator, and how to perform the positive 

and negative leak test 

� Select the appropriate size 

depending upon the size of the 

person’s face. 

� Inspect the respirator for 

defects. 

� Stretch the elastic straps 

slightly 

� Follow donning instructions on 

the box

Donning an N95 

� Using both hands, 

starting at the top of the 

respirator, mold the nose 

clip around your nose to 

achieve a good face-torespirator 

seal 

� Do not pinch the nose clip 

with one hand 

A properly donned N95respirator 

� The respirator must be 

correctly oriented on the face 

and held in position with both 

straps. 

� The straps must be correctly 

placed, with the upper strap 

high on the head and the lower 

strap below the ears. 

� For persons with long hair, the 

lower strap should be placed 

under (not over) the hair. 

� The nose clip must be 

tightened using both hands to 

avoid gaps between the 

respirator and the skin. 

RESPIRATOR FIT CHECKS 

Perform both a Positive Pressure Seal Check 

and a Negative Pressure Seal Check 

Positive Pressure Seal 

Check: 

With the respirator securely 

in place exhale greatly. The 

respirator will bulge slightly. 

If air leaks between the face 

and the face-seal of the 

respirator, reposition it and 

readjust the nose clip for a 

more secure seal. 

Respirator Donning (continued) 

It is important to take the time to put on the respirator 

correctly each time it is worn! 

Respirator Fit Check 

•If the solution is detected at any time during 

the test: STOP! Instruct subject to remove the 

hood and mask; take a sip of water. Re-adjust 

the N95 and try again or try a different 

size/model 

•Remind people being fit-tested that it is 

important to check the seal of the respirator by 

each time it is put on by performing the fit test. 

RESPIRATOR FIT CHECKS 

Negative Pressure Seal Check: 

With the respirator 

securely in place inhale 

greatly. The respirator 

will collapse slightly. If 

air leaks between the 

face and the face-seal 

of the respirator, 

reposition it and 

readjust the nose clip 

for a more secure seal.

Respirator Shaped Like 

a Tecnol Fluidshield 

Open respirator 

and pull out and 

separate the 

straps inside…. 

Hold respirator up to face pulling both 

straps over head, ensuring that the straps 

are not twisted. 

�the lower strap should be below the ear 

�the top strap should be as far up on the 

crown of head as possible….. 

Donning a North N95 

demonstration 

http://www2.umdnj.edu/eohssweb/publications/north.wmv 

Step 8 – Perform the qualitative 

fit test 

Follow the instructions 

on the N95 Respirator 

Fit-test Protocol 

Available at: 

http://www2.umdnj.edu/eohssweb/ 

publications/n95_qualitative_Fit_T 

est_Protocol.pdf 

Respirator Shaped Like 

a Tecnol Fluidshield (continued) 

Adjust nosepiece to 

conform around bridge 

of nose…. 

Perform both positive and 

negative seal check tests. 

Donning Kimberly Clark N95 

http://www2.umdnj.edu/eohssweb/publications/kimberlyclark.wmv 

Step 8 (cont.)– Overview of How 

to Perform the Qualitative Fit Test 

After the subject dons the respirator and 

performs a positive and negative fit, the hood is 

again placed over the head and the Fit Test 

Solution (a very concentrated saccharin or Bitrex 

solution) is misted into the hood.

Step 8 (cont)The instructor then prompts 

the wearer to perform a series of seven 1minute 

‘tests’ that are designed to 

challenge the seal of the mask 

� Normal breathing; 

� Intermittent deep breathes; 

� Turning head side-to-side; 

� Nodding head up and down; 

� Speaking out loud – The Rainbow Passage; 

� Running in place, bending (designed to raise your heart 

rate!); 

� Normal breathing 

Step 9 – Complete and sign the 

Fit-test record. 

� Give the completed and signed forms to 

the person who is coordinating the 

respiratory protection program for your 

department 

� The person coordinating the program for 

your department should ensure that 

personnel are informed of which 

respirators they were successfully fittested 

on. 

How often should N95 respirators be 

replaced? 

• as required by infection control procedures 

(generally speaking, between patients) 

•if resp is contaminated with blood or body fluids 

•if resp becomes wet or moist 

•if resp is damaged 

•if you have difficulty breathing 

•After direct contact with a person with symptoms 

of infuenza (within 6 feet, not behind a partition 

Qualitative Fit Testing 

Once a person has been successfully fit tested 

with a particular respirator, inform the person the 

brand and model number of the respirator that 

passed the fit-test. This is the only size and 

model that should used. 

Do not switch to another model or 

size for any reason without obtaining 

another fit test. 

A few more things to know 

about N95s… 

Removing an N95 

� If the respirator is grossly contaminated 

with sputum or other bodily fluids only 

handle the straps. 

� To remove 

�First pull lower strap over the head 

�Second – remove the upper strap 

� Discard the respirator if it is contaminated 

or damaged

Care of an N95 

� Must be replaced if 

wet or damaged. 

� Replace if 

contaminated (i.e. 

sputum or other bodily 

fluids) 

� Do not crease or fold 

� Do not write on the 

mask. It is ok to write 

on the strap 

contact: 

Questions? Problems? 

eohsshelp@umdnj.edu 

Your campus EOHSS office: 

Newark/Scotch Plains 2-4812 

Piscataway/New Brunswick 5-4058 

Stratford/Camden 6-6189 

Storage 

� Store unused N95s in a large resealable 

storage bag (i.e. “zip lock” bag). However, 

do not seal the bag when the respirator is 

wet.

N95 Respirator Fit-testers Training

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