Questions on a Respirator Fit Test Form in 6 sections

Questions on a Respirator Fit Test Form 

What are the Questions on a Respirator Fit Test Form? Here you’ll be informed on what exactly is the narration and questions asked before a respirator fit testing procedure is conducted. Through an internet search, several forms are available in which each respective company who conducts respirator fit testing uses for there official records and possibly as proof of a person's fit testing for a specific respirator and only that respirator was a successful pass for a face seal. However, at FreeBird Safety Services we conduct things just a little different.

Knowing that the requirements as outline in WorkSafe BC Regulations Policies

 and Guidelines as well as what’s set forth in the Canadian Standards Associations criteria is the minimum, we like to narrate just a little more information. Yet, for the occupations we service and their use of respirators, it may vary according to other industry requirements.

Information on a Respirator Fit Test Form

Required Information on a Respirator Fit Test Form are always filled out by the person being fit tested. This is done  as the professional fit tester verbally narrates the required information. In addition, the tester will ask questions that correspond to check boxes on the form. This is conducted to address different aspects of a fit test and different situations that may arise.

The top section of our respirator fit testing form is where the person being fit tested fills in their personal and work information. Next is where several checkboxes are located. Each area is grouped and numbered into subsections. 

Respirator Fit Testing Record Sheet (The Form) 

To the right is what we use for our Respirator Fit Testing Record Sheet. After the completion of the fit test, the person being tested will receive a copy of this record sheet as well as a laminated wallet card as proof of a successful fit test for their chosen respirator. It is also recommended that each person take a picture of both with their phones and keep that as a secondary record of a successful fit test. In addition, if a person works for a company and is not having this procedure done on their own, the company they work for is also given a paper copy or a electronic Pdf for their safety and HR records.   

Respirator Fit Testing Procedures

1. Respirator used by Worker

The 1^st section is where the respirator itself is listed. Each person writes in the provided spaces the make (manufacture), the model name or serial number, the size of the respirator, if it’s new or old, and the age. If a previous fit test was conducted and a proof of testing identification number was issued, a space for this number is at the bottom of section 1.

2. Workers Physical Condition

This is the section where we ask about a person’s physical condition and how it may affect their fit test, their breathing performance while wearing a respirator, while conducting tasks at work. If the following questions are checked off a explanation of why some difficulty in breathing might occur.

• Past history of breathing difficulty
• Lung Disease
• Smoker: Cigarettes Per Day_______
• Ever breathe in toxic fumes
• Worker sick in the past 6 months
•  Claustrophobic - is asked next. The reason being is, this condition can cause an additional hazard and put the person at a higher risk of injury. This is essentially true if a worker needs to be in a confined space while wearing a respirator and other PPE on the head like a hard hat and any type of face shield. One might start to feel closed in and unconsciously think they cannot breathe. The result could be dangerous if they start to remove the PPE in place to protect them.
• Worker is in good health - is always asked. If they are not, then why. If it is serious then maybe, they should not be there at that time.
• Hazardous Products in scope of work - is the last box in this section to be checked off. This is followed by an area where the worker will list the hazardous products or materials used or at the location of their work they need protection from. Some examples could be silica dust, asbestos, fumes and gases, viruses, and biohazards, etc.

3. Does worker have:

In this section workers check off different items they have/wear that can cause a face to mask seal breach. In the case of facial hair like whiskers or a beard, a fit test can not even be conducted under regulation 8.39 . The last question is one of experience wearing respirators.  

• Corrective Lenses
• Dentures
• Facial Hair
• Face jewelry
• Scars
• Safety glasses at work
• Ever wear a respirator in the past

Use and Care of Respirators

4. Pre- Test Instructional:  

• Condition of mask is good. – if the condition of the respirator is not in good or excellent condition, then perhaps a replacement is in order. In some cases, we ask the worker to conduct a full cleaning and disinfection procedure as instructed in section 5.
• Is the mask comfortable to wear? - The answer needs to be YES. If it is not, then a change might need to be done. If a worker has an uncomfortable fit, then they will not be fully concentrating on their task and that can create further risks and hazards. For example, playing or adjusting their respirator while in the mist of a toxic substance.
• Worker conducts a self-check. - A basic demonstration of a task each person needs to conduct to ensure the face to mask seal is achieved every day they are required to use a respirator.
• Check position of mask on worker - an instructional and demonstration of where gaps can occur on their respirator and under what conditions.
• Test will use Verifit Irritant Smoke - explaining the effects of the testing agent as well what other types of respirator fit testing agents and procedures are available.   
• HEPA Filters _________________ - Workers fill in the line with what type of HEPA filters they are using during the test. In addition, a narrative is verbalized on different types of filters, their specific uses and specialty care filters require.  
• HEPA Filter Exchange Program – an outline of how and why workers as well as their employers need to track the usage of filters. Further information can be found here on our other page titled Respirator Filter Safety Program.
• Note_______________________ -  A description of HEPA filter life expectancy. Shelf life while still packaged (5 Years) and open but not used filters (6 months) as well as a discussion on when some trades receive new filers.  

5. Workers Procedures Respirator Care:

• What to do if contaminated - A basic procedure works need to follow during and if they are contaminated with a toxic substance. In short, during any decontamination procedures, their respirator is the last item to be removed from their person when being showered down or brushing off /vacuuming off a particulate.
• Storage after task, pre cleaning - how to secure their respirator prior to a full cleaning procedure
• How the take apart a respirator - a demonstration of a complete tear down and reassembling of their respirator. More can be found on here on our page Respirator Maintenance, 8 Step Safety Process
• How to clean & products to use – this part is a in depth instructional on how the clean and disinfect each individual part of their respirator. As well as a basic daily cleaning after each use. Furthermore, what products to use and most important, what products to never use for this procedure.
• Storage Procedures/ Clean Respirator - After a full cleaning and disinfection procedure is completed, and the parts are dry and reassembled, what devises to use for storage and where to store their PPE.
• New filter purchases - a recommendation on where to purchase new HEPA filters if they are not issued new filters from a specific person inside their company.
• Fit test conducted under CSA Standard Z94.4-02 - The standard by which the Respirator Fit Testing is conducted under for the type of Respirator being used, as illustrated in the WorkSafe BC Regulations 8.40(2)

Respirator Fit Testing Procedure

 6. Fit Test Procedures

Below are the actual exercises workers are asked to do while wearing (Donning) their Respirator. These are designed to simulate basic body and head movements in the course of a worker’s workday and while they are conducting tasks.  

• Normal breathing
• Deep breathing
• Turning head side to side
• Nodding up and down
• Bend over at waist touch toes
• Talking (rainbow passage) - this part of the exercises is especially necessary. In most cases if not all, if a worker is required to use a respirator in a work environment or task situation, then they are by definition, working in a High Hazard Environment and at a higher state of Risk of Injury. With that being said, workers should never work alone. They should always work with a partner. While doing so they will need to communicate. If jaw movements or vocal tones create a gap in the respirator it needs to be addressed during this mockup exercise. In that way it will not happen in a real-world situation.     
• Normal breathing - End of Testing Procedures

Those are the Questions on a Respirator Fit Test Form that we use inhouse.

With the belief that informing the worker and conveying as much information without overwhelming them, is better then not, we hope that during our procedures the workers feel more knowledgeable  and safer then when they arrived.

To inquire about booking a

Respirator Fit Testing for your crew 

call us at

(604) 226-5933 

or email us at

[email protected]