223. Development of an Abbreviated Qualitative Fit Test Using Bitter Aerosol

Nelson, Thomas J.; Janssen, Larry; Mullins, Haskelle; Luinenburg, Michael D.

doi:10.3320/1.2757901

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…In contrast, the study by Hardis et al and Nelson et al 26 , 32 ) , showed that most of the American subjects passed the IAA fit tests. Meanwhile, Skretvedt et al stated that 98% of the clean-shaven subjects passed the IAA fit tests; however, the bearded subjects were considerably more at risk than the clean-shaven ones 33 ) .…”

Section: Discussionmentioning

confidence: 85%

“…It draws the conclusion that the IAA fit test could be considered as an acceptable procedure for assessing the leakage into the respirators. According to the previous study, the IAA fit testing protocol was considered as a safe and valid procedure for qualitative assessment of the leakage into the respirator 25 , 26 ) . Han et al evaluated the IAA fit test compared to the condensation nuclei counter (CNC) QNFT procedure and showed that the IAA fit test passing rate was 72.70%.…”

Section: Discussionmentioning

confidence: 99%

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Qualitative fitting characteristics of elastomeric half face-piece respirators using Isoamyl acetate agent

2021

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To examine the fit testing of elastomeric half face-piece respirators (EHRs), a total of 41 candidates were randomly assigned into seven EHRs equipped with organic vapor (OV) cartridges which were commonly used in the Iranian industrial workplaces. The qualitative fitting into the facial dimensions was assessed using the Allegro Isoamyl Acetate fit test kit. While the studied EHRs showed very low passing fit testing rates, the 3M, AoSafety (Medium), and AoSafety (Large) had the highest passing rates with 22.0%, 14.60%, and 9.76%, respectively. The AoSafety (All sizes) delivered a higher passing fit test rate than the 3M brand (29.30 vs. 22.0%). The one size fits all respirators including the DUO and Climax showed lower proportions of passing fit tests compared with AoSafety three-size system brands (2.40% and 4.90% vs. 29.30%). Low fit test passing rates were determined among different respirators. The respirators with various sizes and styles had more opportunities for different wearers to pass the fit test than single size models. The initial and annual fit testing requirements shall be developed by local government. Also, the manufacturers are required to pay attention to respirator features and subject characteristics during the production to obtain satisfactory protection for the end-users.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Qualitative fitting characteristics of elastomeric half face-piece respirators using Isoamyl acetate agent

2021

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“…Respirator fit testing was performed using the 3M Fit Test Kit FT-31 (3M Canada Company, Ontario, Canada) (denatonium benzoate solution). [4] In the procedure for the respirator fit testing program, [5] the 1st part of the test is to screen the ability of the examinee to detect (taste) aerosolized droplets of a dilute solution of denatonium benzoate; then the examinee wears the respirator for the 2nd part of the test, and a more concentrated solution of the denatonium benzoate is sprayed into the hood while the individual performs a set of actions. The test criterion of the respirator fit test is the failure to taste the denatonium benzoate by the examinee.…”

Section: Case Reportmentioning

confidence: 99%

Asthma associated with denatonium benzoate in a healthcare worker in Taiwan

Chen

Chung

Chung³

et al. 2019

Medicine

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Rationale: Denatonium benzoate is a useful indicator to ensure that the respirator being used by an individual forms a tight enough seal to adequately protect against unwanted airborne exposure. Although the relative risk for adverse effects of fit testing using denatonium benzoate is low, the absolute number of workers with adverse reactions may nevertheless be sizeable. Patient concerns: A 34-year-old female nurse rapidly developed shortness of breath, cough, and agitation after denatonium benzoate fit testing. She had a history of allergy to shrimp, crab, mite, and disinfecting products (containing quaternary ammonium). Diagnoses: Due to typical symptoms of asthma after exposure to denatonium benzoate aerosol without any other apparent cause, serial pulmonary function tests indicating obstructive lung function and a higher concentration of immunoglobulin antibody E, she was diagnosed with allergic asthma. Interventions: This patient was treated with omalizumab (Xolair), corticosteroid, β 2 agonist, montelukast, and Symbicort turbuhaler. Outcomes: The patient showed quick responses after treatment with diphenhydramine (intramuscularly), fenoterol HBr (inhalation), and prednisolone (oral). Approximately 2 weeks later, she suffered from difficulty breathing and asthmatic symptoms again when she was exposed to polished wax and disinfectant. She was treated with omalizumab (Xolair), corticosteroid, β 2 agonist, montelukast, and Symbicort turbuhaler. The patient was in stable condition with improvement in symptoms during follow-up. Lessons: There may be potentially important health risks when healthcare workers are exposed to denatonium benzoate. Individuals who have a history of allergy to disinfecting products (containing quaternary ammonium) should avoid exposure of denatonium benzoate. More advanced research is needed in the future.

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“…(2) The generated aerosol QNFT has been used as the reference method for validation of the other common fit-tests, including the ambient particle and controlled negative pressure QNFT and the Bitrex QLFT. (3)(4)(5)(6)(7)(8)(9) However, these common fit-tests have not been extensively compared with one another. In addition, the generally accepted ''passing'' quantitative fit factors for half-and full-facepiece respirators are based on multiplying the APF for negative pressure configurations of those respirators by an arbitrary safety factor of 10.…”

mentioning

confidence: 99%

Comparison of Three Commercially Available Fit-Test Methods

Janssen¹,

Luinenburg²,

Mullins³

et al. 2002

AIHA Journal

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American National Standards Institute (ANSI) standard Z88.10, Respirator Fit Testing Methods, includes criteria to evaluate new fit-tests. The standard allows generated aerosol, particle counting, or controlled negative pressure quantitative fit-tests to be used as the reference method to determine acceptability of a new test. This study examined (1) comparability of three Occupational Safety and Health Administration-accepted fit-test methods, all of which were validated using generated aerosol as the reference method; and (2) the effect of the reference method on the apparent performance of a fit-test method under evaluation. Sequential fit-tests were performed using the controlled negative pressure and particle counting quantitative fit-tests and the bitter aerosol qualitative fit-test. Of 75 fit-tests conducted with each method, the controlled negative pressure method identified 24 failures; bitter aerosol identified 22 failures; and the particle counting method identified 15 failures. The sensitivity of each method, that is, agreement with the reference method in identifying unacceptable fits, was calculated using each of the other two methods as the reference. None of the test methods met the ANSI sensitivity criterion of 0.95 or greater when compared with either of the other two methods. These results demonstrate that (1) the apparent performance of any fit-test depends on the reference method used, and (2) the fit-tests evaluated use different criteria to identify inadequately fitting respirators. Although "acceptable fit" cannot be defined in absolute terms at this time, the ability of existing fit-test methods to reject poor fits can be inferred from workplace protection factor studies.

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223. Development of an Abbreviated Qualitative Fit Test Using Bitter Aerosol

Cited by 7 publications

References 5 publications

Qualitative fitting characteristics of elastomeric half face-piece respirators using Isoamyl acetate agent

Qualitative fitting characteristics of elastomeric half face-piece respirators using Isoamyl acetate agent

Asthma associated with denatonium benzoate in a healthcare worker in Taiwan

Comparison of Three Commercially Available Fit-Test Methods

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