Respirator Fit Study FAQ – Participation / Fit Testing Questions

What will I have to do if I participate?

  1. Prior to your scheduled appointment, you will be asked to watch a 12-minute video about respirators. This video includes topics that would be covered in a respirator training session during fit testing (e.g., respirator selection, mask donning, and fit check procedures).
  2. You will be asked to come to the Gage Building (223 College St., M5T 1R4, Toronto, Ontario) or a pre-selected testing site on your scheduled appointment date. You must be clean-shaven upon arrival and refrain from smoking at least 30 minutes before testing.

At the Gage Building or pre-selected testing site, you will be asked to:

  1. Complete a daily COVID screening form (if required at time of testing) and sign a consent form. The consent form will be sent to you in advance to provide you time to read it and ask questions before participating.
  2. Complete an online 15- to 30-minute questionnaire collecting information about you (e.g., age, smoking history), your job (e.g., experience, job title), and your experience with respirators and respirator training. The information will assist us in understanding your experience with respirators and be used to identify factors that may influence respirator fit.
  3. Wear monitors to measure heart rate, blood pressure, and oxygen saturation either during or between fit tests. This will be used to measure exertion and to evaluate how fit testing/wearing a respirator affected your body.
  4. Have measurements of your weight, height, body (e.g., wrist and waist circumference) and face dimensions taken before fit testing. Face measurements will be taken using a special ruler (width, length) and a 3D scanner (bare-faced and when wearing each respirator). These measurements will be used assist in respirator selection (bare-face), to identify leaks, and to observe how well the respirator fits your face before and after use.
  5. Perform quantitative fit testing on three different respirators following two different protocols. This will take approximately 30 minutes per respirator.

The respirators are all air-filtering respirators and will include 1) a disposable N95, 2) a half-face elastomeric respirator, and 3) a full-face elastomeric respirator OR a powered air purifying respirator.

Protocol 1 = the Canadian Standards Association (CSA) Group fit testing protocol that is followed in Canadian workplaces.

Protocol 2 = a modified protocol where you will perform paramedic and firefighter tasks (e.g., compressions, lifting “patient” from floor to stretcher) that are hypothesized to put emergency workers at risk of breaking the seal of the respirator.

NOTE: If you are interested and time allows, you can complete fit testing on all four respirators.

Why do I have to watch the respirator training video before I come for fit testing?

Respirator training/review should be done before you are fit tested.  This is part of the recommended practice in fit testing in Canada.  Watching the video before you arrive will decrease the duration of time you need to be at the testing site.

What will happen if I forget to watch the respirator training video before I come for fit testing?

You will be able to watch the training video at the test site if you have not watched the training video before your appointment.

What do I have to bring with me when I come for fit testing?

Please bring long pants, a long or short sleeve shirt (i.e., not tank tops), and steel toe shoes for fit testing.  If possible, please also bring any fit testing results (i.e., card) you have received from fit testing conducted by your service. These should indicate the respirator model and size.

What type of facial hair is acceptable?

Facial hair that lies along the seal of a respirator, such as beards, sideburns, or some mustaches, will interfere with respirators that rely on a tight face-piece seal to achieve maximum protection. Please see the US CDC graphic illustrating acceptable facial hair.

What will happen if I forget to shave before my fit test appointment?

Shaving supplies will be available at the fit testing site in case your facial hair is not acceptable following the US CDC graphic.

What are anthropometric measurements and why are you taking them?

Anthropometric measurements are measurements of different body parts.

Body measurements like weight, height and wrist/waist circumference are standard measures taken to describe participants in research studies and are sometimes used as health measures.  We will also investigate if these measurements influence if someone passes/fails a fit test.

Facial measurements such as facial width and face length are taken to help select the size of respirator for a worker. A 3D scan can provide more detailed dimensions of a worker’s face and potentially identify different facial characteristics that affect respirator fit compared to the standard width and length measurements. The 3D scans with the respirator on will help identify leaks in the mask that may be difficult to observe with the human eye or detected by the wearer. The results of 3D scans will be compared with fit testing results.

What physiological measurements will be taken during fit testing?

  • Heartrate and heartrate variability will be measured using a chest strap sensor, like those used by people during exercise.
  • Oxygen saturation will be measuring by wearing a flexible silicone ring linked to a wrist strap.
  • Blood pressure will be taken using a standard automatic blood pressure monitor and arm cuff before fit testing, and after wearing each type of respirator.

These measurements will allow us to know how hard your body worked during fit testing and if wearing different respirators influenced these measures.

What will the questionnaire data be used for?

The questionnaire collects information about your background and health (e.g., ethnicity, age, gender), your work experience (e.g., your job title, experience level), experience with respirators and fit testing (e.g., use information, comfort and fit), and respirator training.

The questionnaire results will be used to investigate if these questions influence if someone passes/fails a fit test.

Why are you testing different types of respirators?

Currently there is no standard practice on the type of respiratory protection worn among paramedics and firefighters in Canada when treating potentially infectious patients.  The respirators we are testing provide a wide range of protection level.  By testing the different respirator types, we can provide better advice on the level of protection that will safely protect emergency workers during demanding tasks.

Can I bring my work respirator for fit testing?

You can bring your respirator with you, but for quality control purposes you cannot be fit tested on it.  The fit testing must be done using respirators in good working condition, using only the study respirators ensure this condition is met. It is possible we have the same respirator model in our supply that you can wear.

How will the respirators I wear be determined?

The respirator you wear during the fit test can be a decision made between you and the research team. Things that will be considered in the selection include a selection based on i) the respirator that best fits your face based on your facial measurements, ii) selection of the respirator you currently use (if available), iii) selection of a respirator you have fit test card results for so you can compare your results to your previous results, and iv) personal interest/preference.

How is a simulated work fit test different from a standard fit test?

A standard fit test follows a set of seven standard exercises that mimic movements that may be done during work tasks (e.g., nodding head slowly up/down, slowly bending at waist, talking loudly).

A simulated work fit test is a fit test that is performed a real work task (e.g., compressions on a mannequin, lifting “patient” from floor to stretcher) in a controlled environment (i.e., simulated). The movements in a simulated work fit test will be as close to the movements done during the task in the field, so are a better representation of how your body would move when wearing the respirator on the job than the standard fit test exercises.

What patient handling and life support activities are you testing?

The activities that we are currently testing include:

  • Carrying equipment bags (standard weight) to patient
  • Compressions on the floor, and on stretcher
  • Advanced airway management on the floor, and on stretcher
  • “Patient” transfer from floor to stretcher
  • Manual stretcher transfer and loading onto platform (i.e., simulating ambulance)
  • Unloading manual stretcher from platform
  • “Patient” stair transfer (pending)

Who will help me with two-man tasks?

You will be assisted by a research team member trained in performing the two-manned tasks. This may include trained paramedics or paramedic students.

Are there any risks to 3D scanning my face?

There are no dangers to 3D scanning your face.

The 3D scanner works by projecting a light source onto an object (i.e., your face) where a camera system measures the distance between the light source and object as the scanner moves.  The software then pieces these scans together to create a 3D image of the surface scanned.

What happens if I do not pass a fit test?

You will repeat the standard CSA fit testing procedure if you receive a test “fail” for the overall fit factor score.  If you fail a second time you will continue to the modified fit testing protocol. You will not repeat the simulated work fit testing if you fail.