Respiratory Protection

Respirator Fit Testing

The Respirator Fit Testing Program is designed to protect the staff of NewYork-Presbyterian Hospital from airborne hazards. NewYork-Presbyterian follows the OSHA hierarchy of controls in making the hospital a safe place to work. Environmental Health and Safety performs fit testing and provides respirators when a specific or general risk has been identified involving a potential or real airborne contaminant. Circumstances may include but not be limited to harmful dusts, fogs, fumes, mists, gases, smoke, sprays, vapors or biological hazards.

Fit-testing runs concurrently with the annual health review. Workforce Health and Safety will perform a medical evaluation of the individual's fitness for wearing a respirator at the time the staff member enters the respirator fit-testing program. Workforce Health and Safety will notify Environmental Health and Safety of the medical clearance status of eligible staff.

Who is required to have respirator fit testing?

Employees who require annual Fit Testing are those who: enter the room of patients on respiratory or droplet isolation, administer aerosolized ribavirin to patients with respiratory syncytial virus, or perform procedures on patients with suspected or confirmed influenza (flu). All employees are required to be fit tested before using a respirator under actual work conditions. The user is fit tested with the same make, model, style and size of respirator which he/she will use.

What are the respirator fitting and training requirements?

Training shall be conducted annually and will cover the following topics:

• Why the respirator is necessary;
• How improper fit, usage, or maintenance can compromise the protective effects of the respirator;
• The capabilities and limitations of the respirator;
• How to use the respirator effectively;
• How to inspect, don and doff, use, and check the seals of the respirator;
• Procedures are for maintenance and storage of the respirator;
• How to recognize medical signs and symptoms which may limit or prevent the effective use of the respirator.

Respirators shall not be worn when conditions prevent a good face seal. These conditions include:

• When hair passes between the face and the sealing surface of the respirator face piece;
• When hair interferes with the respirator valve;
• Wearing eye glasses;
• Any head covering or device which interferes with the sealing surface;
• Skin, muscle and/or bone structure, missing teeth or dentures which do not accommodate a tight sealing surface.

What are the types of respirators worn at NewYork-Presbyterian?

PFR N95 Respirator: A personal protective device with an air filtering mechanism designed to protect the respiratory system from air contaminants. An N95 has 95 percent removal efficiency for particulates equal to or greater than 0.3 microns in diameter.

Power Air Purifying Respirator (PAPR): PAPRs consist of the following components: a base unit-blower/filter unit/battery pack, plastic tubing, headpiece, and a battery charging unit. Base units and tubing can be shared/used by multiple people. The headpieces must not be shared among staff, though they can be re-used by the same individual for as long as they remain intact, with two exceptions:

Self Contained Breathing Apparatus (SCBA): Self-Contained Breathing Apparatus may only be used by personnel who have successfully passed OSHA hazardous materials operations qualified course and have maintained current certification or some other equivalent or higher certification, and have been cleared by Workforce Health & Safety for such use. The use of a self contained breathing apparatus is approved only for Environmental Health and Safety staff and Emergency Medical Services.

How can I obtain Respirators?

Each department is responsible for ensuring that respirators of the appropriate brand, model, and size are available to its staff. PFR N95s can be obtained through Materials Management and PAPRs are distributed by General Stores and maintained by the department in which the individual using the apparatus works.