[MCOH-EH] Fit test-

[Lawrence Budnick]

At Rutgers New Jersey Medical School, we had a similar approach to Wendy’s. Safety asked a more general question - Has your health changed since your most recent previous fit test? - for referral to Occ Med for review. 

We did not ask about facial hair, which is generally not a medical issue, unless someone requested a medical exemption to have facial hair and then would be referred to Occ Med. Often, people would shave to get the fit test and then would regrow. The NIOSH beard chart was useful, often defused the situation and generated many humorous comments: https://www.cdc.gov/niosh/npptl/pdfs/facialhairwmask11282017-508.pdf <https://www.cdc.gov/niosh/npptl/pdfs/facialhairwmask11282017-508.pdf> 

Annual training in respirator use is required for users of both PAPRs and N95 respirators, although only users of N95s have mandatory fit testing

Larry

Lawrence D. Budnick, MD
New Jersey Medical School
Robert Wood Johnson Medical School
Rutgers University  

> On Oct 24, 2024, at 1:46 PM, Thanassi, Wendy via MCOH-EH <mcoh-eh at mylist.net> wrote:
> 
> Thank you Melanie.
>  
> For Rebecca – also – though they need annual fit testing they do not need annual medical clearance by OHS. There are a few questions  -  such as did they gain lose weight, have facial surgery, grow a beard since the last fit test – that should occur. We have the Safety Service doing the fit testing and asking those 4 questions, and then only if there is a positive answer or a failed fit test are they sent to OHS for review. It lightened our workload by the thousands!
>  
> Just FYI.
>  
> Wendy
>  
> W. Thanassi MD, MA, MRO
> VAPAHCS and Qiagen
>  
> From: MCOH-EH <mcoh-eh-bounces+wendy.thanassi=va.gov at mylist.net <mailto:mcoh-eh-bounces+wendy.thanassi=va.gov at mylist.net>> On Behalf Of Swift, Melanie D., M.D., M.P.H. via MCOH-EH
> Sent: Monday, October 21, 2024 7:36 AM
> To: MCOH-EH <mcoh-eh at mylist.net <mailto:mcoh-eh at mylist.net>>
> Cc: Swift, Melanie D., M.D., M.P.H. <Swift.Melanie at mayo.edu <mailto:Swift.Melanie at mayo.edu>>
> Subject: [EXTERNAL] Re: [MCOH-EH] Fit test-
>  
> Hello Rebecca,
> The short answer is that everyone who is enrolled in a Respiratory Protection Program (RPP) due to their risk of contact with pathogens that can be transmitted through the “airborne” route needs annual fitting, unless they only use a PAPR. While droplet to airborne is admittedly a continuum, there are pathogens and clinical situations that warrant a respirator. If that respirator is tight-fitting (e.g. N95) then annual fit testing is a requirement of the OSHA standard.
>  
> But I wonder if the question you may be asking is whether all lab personnel at your facility need to be enrolled in the RPP. Certainly any research lab personnel working in a BSL3 lab need to be enrolled. Microbiology lab staff who work routinely with cultures of M. tb and other pathogens that are easily transmitted through the air should be enrolled. As for the other staff, there should be a conversation involving your medical director of Occupational Health, your IPAC medical director, your safety officer and someone from laboratory management, to do a risk assessment and determine which lab personnel need to be enrolled in the RPP.
>  
> If your medical director is not an occupational physician or needs support in their occ med role, please let them know about the MCOH Section of ACOEM where they can always “phone a friend”! They can also take our annual Medical Center Occupational Health Basics course offered in conjunction with AOHC.
>  
> Hope this helps!
>  
> Melanie
>  
> From: MCOH-EH <mcoh-eh-bounces+swift.melanie=mayo.edu at mylist.net <mailto:mcoh-eh-bounces+swift.melanie=mayo.edu at mylist.net>> On Behalf Of Rebecca Ryan via MCOH-EH
> Sent: Wednesday, October 16, 2024 8:48 PM
> To: mcoh-eh at mylist.net <mailto:mcoh-eh at mylist.net>
> Cc: Rebecca Ryan <rebecca.ryan at curryhealth.org <mailto:rebecca.ryan at curryhealth.org>>
> Subject: [EXTERNAL] [MCOH-EH] Fit test-
>  
> Hello
> I am newer to Employee health role  and working on updating Respiratory Protection Policy . The question that I have: Do all Lab personnel need to be fit test to meet the OHSA annual requirements.
> Thank you 
>  
> Rebecca Ryan BSN RN CIC
> Infection Preventionist & EH RN
> Curry Health Network
> 94220 4th Street
> Gold Beach, OR 97444
> 541-247-3021
> Rebecca.ryan at curryhealth.org <mailto:Rebecca.ryan at curryhealth.org>
> Teamwork. Service.  Integrity. Curiosity.
>  
> “In the realm of healthcare, the well-being of the patient should eclipse all other concerns, for their care is the true measure of our success."
> <image001.jpg>
>  
>  
>  
> 
> 
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