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Fit Testing Face Masks to Avoid Transmitting Infection During the Coronavirus (COVID-19) Outbreak

HSE updates its guidance regarding RPE and face fit testing.

A fit test should be carried out before people wear RPE for the first time.

An inadequate fit can reduce the protection provided and lead to immediate or long-term ill-health or can even put the RPE wearer’s life in danger. A fit test should then be repeated whenever there is a change to the RPE type, size, model or material or whenever there is a change to the circumstances of the wearer that could alter the fit of the RPE, for example:

  • weight loss or gain
  • substantial dental work
  • any facial changes (scars, moles, effects of ageing etc) around the face seal area
  • facial piercings
  • introduction or change in other head-worn personal protective equipment (PPE)

There is no stipulated frequency for re-testing, and you don’t need one if there are no changes in these circumstances.  However, currently times are different, infection is a real risk and the following advice needs to be heeded.

Respiratory protective equipment (disposable)

Tight-fitting respirators (such as disposable FFP3 masks and reusable half masks) rely on having a good seal with the wearer’s face to work. A face fit test should be carried out to ensure the respiratory protective equipment (RPE) can protect the wearer.  IMPORTANT – during these times reusable half masks MUST NOT BE SHARED.

One way to ensure you have put on tight-fitting RPE correctly is to use a mirror, another is to ask a colleague. If you do this however the “fit tester” should follow the government advice on social distancing and make their observations from a safe distance (2 metres) away and deliver any instructions verbally.   The user should then carry out a pre-use seal check or fit check. The following gives guidance on how to put on disposable respirators and how to do a pre-use seal check or fit check.

  • You should be clean-shaven around the face seal to achieve an effective fit when using disposable respirators. Beards and stubble will stop the disposable respirator sealing to your face and protecting you properly.
  • Make sure it is the right disposable respirator for your work and for you – have you passed a face fit test in this disposable respirator? Also make sure the disposable respirator is clean and undamaged before use.
  • Follow the manufacturer’s instructions for checking the disposable respirator and putting it on, i.e.
  1. Cup the disposable respirator in one hand, with the straps hanging out of the way and then hold the disposable respirator in place on your face.
  2. Pull the bottom strap over your head, to the back of your neck.
  3. Pull the top strap over your head to sit above your ears.
  4. Check the straps are not twisted. If you need to tighten the straps, pull both ends at the same time, bottom first, then top.
  5. If there is a nose clip, press this firmly to the shape of your nose.
  6. Before entering the workplace, a user seal check should be carried out. This is done by placing your hands over the filter material and breathing in. The mask should suck down onto your face when you breathe in sharply. You should hold your breath for ten seconds and the disposable respirator should not loosen. If it does, you should readjust and repeat.
  • Check the fit every time you put on the disposable respirator to ensure there are no leaks.

Minimise the risk of transmission when using non disposable RPE

 People who have symptoms of COVID-19 or who are self-isolating in accordance with the current government requirements SHOULD NOT attend a face fit test.  However not everyone will get ill and the virus can be carried and passed on by a perfectly well person.  Therefore, to minimise the risk of transmission of COVID-19 during face-fit testing the following additional measures should be taken:

  • Fit testers should follow the government advice on social distancing (2 metres, 6 feet or three paces according to your measuring system), as they can make observations from this distance and deliver any instructions verbally.
  • Those being fitted should keep their respirators on if closer observation is required to minimise risk to testers.
  • Both the fit tester and those being fit tested should wash their hands before and after the test in accordance with NHS guidelines:
  1. Wash your hands with soap and water for at least 20 seconds
  2. Do not touch your eyes, nose or mouth if your hands are not clean
  • Those being fit tested with non-disposable masks should clean the mask themselves before and immediately after the test using a suitable disinfectant cleaning wipe (check with manufacturer to avoid damaging the mask).
  • Test facepieces that cannot be adequately disinfected (e.g. disposable half masks) should not be used by more than one individual.
  • Fit testers should wear disposable gloves when undertaking cleaning of the tubes, hoods etc and ensure they remove gloves correctly by using the following procedure

https://www.hse.gov.uk/skin/posters/glovesingleuse.pdf

  • Immediately dispose of used gloves, disposable masks, cleaning wipes etc in a waste bin.

Fit testers should familiarise themselves with the following potential contact points and actions to minimise transmission:

Inside and outside of the respirator – The wearer should clean the inside and outside of the mask using a suitable disinfectant cleaning wipe under the fit tester’s instruction and supervision.

Inside and outside (where held) of hood used for qualitative fit tests – The fit tester should clean the inside and outside (where held) of the hood between each test using a suitable disinfectant wipe that won’t damage the visor and wearing disposable gloves.

Moisture from the wearer’s breath collected inside the ambient particle counting device tubing (i.e. for quantitative testing) – Only touch used tubing when wearing gloves. Clean the mask end of the tube with a suitable disinfectant wipe after use. Have a stock of spare tubes (to allow used tubes to dry); or ensure the end of used tubing is placed in a wad of tissue if removing the condensate between tests by blowing out with compressed / canned air.

Moisture from the wearer’s breath collected inside the ambient particle counting device tubing (i.e. for quantitative testing) – Only touch used tubing when wearing gloves. Clean the mask end of the tube with a suitable disinfectant wipe after use. Have a stock of spare tubes (to allow used tubes to dry); or ensure the end of used tubing is placed in a wad of tissue if removing the condensate between tests by blowing out with compressed / canned air.

Fit testing adaptors and sampling probe – Clean at the same time as cleaning the mask following the fit test using a suitable disinfectant cleaning wipe, under the instruction and supervision of the fit tester.

Specific inner mask supplied by fit tester when fit testing powered RPE and the existing inner mask is replaced – This should be cleaned by the wearer at the same time as they clean the inside of the mask using a suitable disinfectant cleaning wipe following their fit test, under the instruction and supervision of the fit tester.

Filters – Although, the wearers exhaled air does not pass through the filters used when testing half and full facemasks, they may be re-used and handled between tests and so should be wiped using a suitable disinfectant cleaning wipe.