Train the Trainer Content Outline

Overview

Upon successful completion of this workshop, employees will understand the importance of using respiratory protective equipment.  Due to the changes in face physiology it is highly recommended that fit testing be conducted at least annually.

Program design

This course is flexible and versatile in adapting to the needs of participants.  Scenarios are utilized to be consistent with the work environments of the participants.  The delivery is lively and fun, in a non-threatening environment and participants are evaluated and assisted throughout to minimize the anxiety associated with written assessment of knowledge.  Humour is used generously to maintain a relaxed atmosphere, and participants are encouraged to share their experiences.  The application of adult learning principles results in a highly interactive atmosphere.  All of the essentials are covered from recognizing, assessing and controlling hazards.

Qualitative fit testing involves placing a plastic hood over the employee's head. The tester then introduces either a sweet (Saccharin), or bitter (Bitrex) chemical into the hood and
the employee informs the tester if he/she can taste it both with and without the respirator
on. These fit test methods are subjective and rely on the response of the employee.
Note: Qualitative fit test results are dependent upon subjective employee response to the
taste and may be more time consuming to conduct the test.



Course Description

Course Goal: This course will prepare individuals in public health to deliver educational programs to the public health workforce by developing presentation skills.

Course Objectives: Upon completion of this course, learners will be able to:        -
-          Articulate adult learning principles
-          Utilize effective presentation skills
-          Prepare and deliver the Respirator Fit Testing - Qualitative

Course modules:  The following modules are presented in this course:
-          Adult Learning Principles
-          Presentation Skills, Part I
-          Presentation Skills. Part 2
-          Respirator Fit Testing - Qualitative content

Format: Using adult learning principles and effective presentation skills, successful trainers recognize the unique needs of working adults in terms of:
-          time available away from the worksite,
-          direct job function relationship of training content, and
-          easily referenced materials
















Please send a request above for a quotation.  We offer both Train the Trainer Workshops and Onsite Fit testing for your valued Personnel.

Please read about Testing Methods Below!



QUALITATIVE AND QUANITATIVE Respirator FIT TESTING



Respiratory protection is a important subject matter. Please consider the following; with regards to the methods of both qualitative and quantitative fit testing methods of N95 respirators, and review the benefits and drawbacks of the individual testing methods.

N95 air-purifying respirators ("N" means "Not resistant to oil", "95" refers to a 95% filter efficiency of airborne particles 0.3 microns and larger) are utilized in general industry for protection from dusts, fibers, and mold. N95 respirators are also commonly utilized in the health care industry for protection from bio-aerosols such as TB, influenza, bacteria, and SARS. There is a general misconception that "it's just another dust mask" or "its just a surgical mask". Based upon these misconceptions, I often hear statements from doctors, nurses, and welders alike "What do you mean you want to check how it fits? I just grabbed one out of the box and it fits fine!" Sometimes I hear employers say "Yes, we have a great respiratory protection program, we use this Brand X, one-size-fits all!"

There are several good reasons to perform fit testing on employees utilizing N95 respirators. First off, it helps to ensure the respirator is actually providing the level of protection it was designed to meet. N95 respirators are made in well over 150 models, shapes, and sizes. In a 2004 Tokyo hospital study examining 134 health care worker fit tests: "Upon the first test, 34.6% of health care workers had a large amount of leakage of more than 10%, and by instruction or changing a mask type, most of them could achieve 10% leakage or below."

Fit testing (and the hands-on training performed before and during fit testing) also helps to ensure the employee puts on the N95 properly. NIOSH recently published a study looking at 538 participants in the post hurricane Katrina clean-up activities. The results indicated that only 24% of these individuals could demonstrate proper donning of a N95 respirator, and 22% put it on upside down!

All methods require adequate training of the individual conducting the fit-testing.

In general, qualitative fit testing involves placing a plastic hood over the employee's head. The tester then introduces either a sweet (Saccharin), or bitter (Bitrex) chemical into the hood and the employee informs the tester if he/she can taste it both with and without the respirator on. These fit test methods are subjective and rely on the response of the employee. "Can you taste it now? How about now? What about now? Tell me when!"

Quantitative fit testing involves utilizing a machine to obtain numerical measurements to calculate a "fit factor". The "fit factor" is a numerical estimate of how effective the respirator fits the employee. The most commonly used quantitative fit testing devices are the TSI Portacount machine, and the more recently developed OHD FitTester. The Portacount performs a comparison measurement of airborne particles both in the room (ambient level) and inside the respirator (breathing zone) to calculate the fit factor. The OHD FitTester performs a direct volumetric measurement of leakage to calculate the fit factor.

So which method is "better" for fit testing the N95 respirator?
Repeat: All methods require adequate training of the individual conducting the testing.


A COMPARISON

Qualitative:
Pros: Cheapest testing device
Highly portable
Very low tech (no computer or electricity required)
Cons: Results dependent upon subjective employee response to the taste
"I think I might be tasting something." Is that a "Yes, or No?"
More time consuming to conduct the test (15-30 min. from personal experience)
Time spent of the employee and tester can be a high cost/efficiency issue
Some employees cannot tolerate a plastic hood over their head (claustrophobia)
A 2006 study in the Journal of Chemical Health and Safety reported "carbon dioxide levels rose to 4.2% and mean oxygen levels dropped to 15.5%" when the test hood is used. This study concluded "Some groups may be especially sensitive to this test such as the elderly, pregnant women, persons with pulmonary and/or cardiac disease, or persons with psychological disorders such as anxiety, panic disorders, or claustrophobia." (Based upon personal experience, I do not recall any past significant medical events while conducting this test, but this experience is based upon testing oil-field workers, 99% male, avg. age of 18-45.)

Quantitative:
Pros: Non-subjective test results/not dependent upon employee response
Provides instant real-time numerical feedback to both the employee and tester allowing for effective training in proper donning and adjustment of the respirator
(Based upon personal experience, employees pay more attention, generate more awareness, and like to actually see how well the respirator is performing vs. relying on their perception of taste. I also utilize the time during test maneuvers to provide further respirator education.)
Printable test results show data results of each test maneuver
Faster test time (8-10 min. based upon personal experience)
High-tech (In my opinion, more "professional")
Cons: Expensive initial equipment investment. Daily/weekly rental options are available
Less portable (does pack up in a carry-on sized case, without the computer)
High-tech (requires electricity and a computer, not ideal for very remote locations)

Fit testing is an essential component to an effective workplace respiratory protection program. Scientific research supports the value of fit testing to help ensure the proper selection (model and size) and utilization of the N95 respirator by an individual employee. The options for fit-testing do allow for some discretion in both affordability and convenience, but in my opinion, quantitative testing has far more advantages.
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