Respiratory protection as a function of respirator fitting characteristics and fit test accuracy

The fitting characteristics of particulate respirators are no longer assessed in the National Institute for Occupational Safety and Health respirator certification program. It is important for respirator program administrators to understand the implications of that change and the additional burden it may impose. To address that issue, a typical respirator fit-testing program is analyzed using a mathematical model that describes the effectiveness of a fit-testing program as a function of the fitting characteristics of the respirator and the accuracy of the fit-testing method. The model is used to estimate (1) the respirator assignment error, the percentage of respirator wearers mistakenly assigned an ill-fitting respirator; (2) the number of fit-test trials necessary to qualify a group of workers for respirator use; and (3) the number of workers who will fail the fit-test with any candidate respirator model and thereby fail to qualify for respirator use. Using data from previous studies, the model predicts respirator assignment errors ranging from 0 to 20%, depending on the fitting characteristics of the respirator models selected and the fit-testing method used. This analysis indicates that when respirators do not necessarily have good fitting characteristics, respirator program administrators should exercise increased care in the selection of respirator models and increased care in fit-testing. Also presented are ways to assess the fitting characteristics of candidate respirator models by monitoring the first-time fit-testing results. The model demonstrates that significant public health and economic benefits can result when only respirators having good fitting characteristics are purchased and respirators are assigned to workers using highly accurate fit-testing methods.