Study From AAOHN Underscores Need for Fit-Testing Guidance

Recent changes to OSHA requirements related to tuberculosis and respirator fit-testing have prompted concern from many healthcare professionals who are responsible for the health and safety, including fit-testing, of healthcare facility employees.

In an effort to better understand the challenges related to respirator fit-testing, the American Association of Occupational Health Nurses (AAOHN) surveyed more than 2,000 occupational and environmental health nurses (OHNs) and infection control professionals in hospital settings to gain information about compliance practices related to the new OSHA requirements.

According to the survey, 69 percent of respondents reported a high level of difficulty complying with the new OSHA requirement. Of these, a majority (75 percent) work in non-government not-for-profit hospitals, are responsible for fit-testing between 500 and 5,000 individuals (61 percent), and have an employee health staff of three or smaller (69 percent).

"AAOHN had heard from its members, particularly those in healthcare facilities, about their concerns related to compliance with the new general respirator requirement," said AAOHN President Susan Randolph. "We conducted this survey to better understand these issues. We now know more about the specific types of facilities and their staffing situations which allows us to better target our continuing efforts at respirator compliance assistance."

`Survey participants were asked to provide information about their compliance practices as they relate to the types of hospitals in which they work, the number of employees for whom they are responsible, the size of their employee health staff and who administers their respirator fit tests. Answers to these questions were evaluated and compared to analyze whether or not these factors contribute to a high level of difficulty with compliance.

According to AAOHN's survey, respirator fit-testing is typically handled internally. Eighty percent of respondents indicated that employee health services, or employee health services in combination with other hospital departments administer their facility's respirator program. That compares to 7 percent who use an outside vendor.

The survey also asked about the model used for TB risk assessment. Fifty-three percent indicated they use Centers for Disease Control and Prevention (CDC) guidelines when developing their respirator program, while 40 percent followed OSHA standards. The remaining 7 percent developed their own procedures or used another model.

For more information about the survey or to view an executive summary, visit

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