Frequently Asked Questions on N95 Respirator
Frequently Asked Questions
Regarding N95 Respirators
This document is intended to address questions and concerns from
all staff regarding the use of N95 respirators.
GENERAL INFORMATION ON N95s
What does N95 mean?
Do N95s provide protection against aerosols and droplets?
Will an N95 provide protection against splashes?
Why are there different N95s?
Which of the N95s is the best?
Do any of the N95s contain latex?
FIT-TESTING
What is a fit-test?
Do I really need to be fit-tested?
Is it safe to be exposed to Bitrex?
I have asthma – is it safe for me to be exposed to Bitrex?
I am pregnant – is it safe for me to be exposed to Bitrex?
What if I cannot detect Bitrex during the sensitivity test?
What if I taste the Bitrex during the fit-test when I am wearing a N95?
Why have I been told not to eat, smoke, drink (with the exception of water), or chew
gum or candy for at least 15 minutes before my fit-test?
Do I need to be clean shaven in order to wear a N95?
Are the hoods used for the sensitivty test and fit-test cleaned between staff?
What is an Assigned Protection Factor (APF)? What does an APF of 10 mean?
I have had a fit-test on a particular model of N95. Can I wear other similar models?
I have been fit-tested with a N95. How do I store it until I need to use it?
USING AN N95
How long can I wear a N95 for? How many times can I wear a N95?
Can a N95 be decontaminated if it becomes soiled?
How do I dispose of the N95 once I have used it?
How is donning and doffing done with an N95?
What is a User Seal Check?
How do I perform a User Seal Check?
When do I perform a User Seal Check?
Will I be able to get enough oxygen if I use a N95?
Why do I feel uncomfortable when wearing a N95?
Is it normal for my face to feel warm under the N95? Is it normal for my face to be red
when I remove the N95?
My glasses fog up when I wear the N95. Does this mean that it is not working properly?
Will air come in through the sides of the N95 if I move my head around a lot?
When do I remove my N95?
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GENERAL INFORMATION ON N95s
What does N95 mean?
Personal equipment designed to provide a wearer with respiratory protection from
contaminants are called respirators. Respirators used to provide protection against
particulate and aerosols must be tested according to criteria laid out by the National
Institute of Occupational Health and Safety (NIOSH). If a respirator passes using the
NIOSH protocols, it will be classified as a “NIOSH approved” respirator.
Particulate respirators are used in industry as well as healthcare. These respirators are
comprised of tiny fibres which are electrostatically charged. While it is not an issue in
the healthcare setting, in certain industries, oil mists are present in the air. Oil mist will
“coat” the electrostatically charged fibres and make the respirator less efficient. As a
result, certain respirators are designed to be used in oil mist environments.
The first letter for the respirator rating is an “N”, “R”, or “P”. The “N” means that the
respirator is “Not oil resistant”; the “R” means that the respirator is “Oil resistant”, and
the “P” means that the respirator is “Oil proof”. In health care, oil mist is not a concern,
and respirators with the “N” rating are used.
Next on the respirator rating is the filter efficiency when tested against particles of 0.3
micron size. The respirator is rated at either 95%, 99%, or 100% efficient. The 0.3
micron particle size is chosen because this is the particle size that the material is
actually least efficient. Particles are filtered using two main methods. Particles larger
than 0.3 microns are filtered through impaction and interception of the particles by the
fibres. As particle size gets smaller, these mechanisms become less and less efficient.
Very small particles are filtered using the electrostatic charge on the fibres and through
a process called Brownian motion (small particles behave more like gases than they do
like solids). As particle size increases, Brownian motion is a less efficient way of
capturing particles. Therefore, particles greater or less than 0.3 microns are actually
captured with much greater efficiency than they are for 0.3 micron particles.
Thus the rating of the
respirator masks used
in healthcare are
“N95”. Respirators
with 99% or 100%
efficiency are typically
only more efficient for
0.3 micron particles.
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Do N95s provide protection against aerosols and droplets?
Yes. N95 respirators are designed to provide at least 95% filtration efficiency against
solid and liquid aerosols [of the 0.3 micron size] and droplets which may contain
bacteria, viruses and dust.
Will an N95 provide protection against splashes?
Proper face protection must be worn whenever there is the potential for any blood or
body fluid splashes. If the mask or respirator comes in contact with blood or body fluids
the respirator must be changed as soon as possible. Respirators should only be
removed when the wearer is in an area that is considered free of airborne hazards.
Why are there different N95s?
There are two main models of N95s in use in the Health Authority sites:
x 3M 1860 (also available in small size 3M 1860S)
x 3M 1870
The main reason for having more than one model is that staff have a variety of different
face shapes and some models of N95 fit some face shapes better than others. To
ensure that that there are N95s available for the range of faces, a number of different
respirator models and sizes are available.
Which of the N95s is the best?
No particular make or model of N95 is any better than another in terms of protection
provided. In order to receive the NIOSH N95 rating, respiratory protection must undergo
and successfully complete a series of stringent tests.
Certain N95s will fit certain shapes of faces better than others. This is why it is important
to undergo a fit-test and use only the model of N95 with which you passed.
Do any of the N95s contain latex?
All standard N95s (3M 1860/1860S, 3M 1870, and the special order AO Safety Pleats
Plus) are latex-free.
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FIT-TESTING
What is a fit-test?
A fit test is a series of procedures used to determine if the N95 provides an adequate
seal around the face. Without conducting a fit-test, there is no way to be certain that the
N95 will be providing the full protection it is designed for.
The fit-test procedures take approximately 15 minutes. During this time an introduction
of respiratory protection is provided, proper donning/doffing methods are reviewed, the
selection and fit-test of the N95 is completed and other information required in order to
use an N95 are detailed.
The fit-test procedure uses a product called Bitrex, one of the most bitter substances
known, to illicit a taste response. Bitrex is comprised of water, table salt, and
denatonium benzoate. It is the denatonium benzoate (a salt) that is important for the
test as exposure results in a bitter taste. Bitrex can be detected at extremely low levels.
The use of Bitrex is standardized as a validated method recognized by numerous
agencies and jurisdictions, including WorkSafe BC, Canadian Standards Association,
and Occupational Health and Safety Administration (OSHA - USA).
The first part of the fit-test procedure is the sensitivity test. A large hood, used to contain
and concentrate the solution, is placed over the head of the staff. A dilute solution is
injected into the hood until the taste is experienced by the staff. This step is required
because different concentrations are required for different people and a small number of
staff cannot detect Bitrex at all.
During the fit-test, the N95 is donned, the hood placed over the staff’s head again, and
a more concentrated Bitrex solution is added (100 times more concentrated). A series of
six exercises are performed, each with a duration of at least 30 seconds. The exercises
are designed to simulate movements that may occur while wearing the N95 in an actual
working environment.
If no taste is experienced, the N95 properly fits the face. Only the model of N95 passed
during the fit-test may be utilized, as only this type of model has demonstrated a good
seal.
Is it safe to be exposed to Bitrex?
The Bitrex solution used during the fit-tests is not an exposure hazard and not
anticipated to result in adverse health effects. The amount of Bitrex actually used in the
test is extremely low. People can detect Bitrex at 50 parts per billion (ppb) in water. A
MSDS is available upon request.
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I have asthma – is it safe for me to be exposed to Bitrex?
Bitrex has not demonstrated any problem for individuals with asthma. Additionally, the
amount of Bitrex actually used in the test is extremely low. People can detect Bitrex at
50 parts per billion (ppb) in water.
If an individual is required to wear a respirator and there is doubt about the individual’s
ability to use a respirator for medical reasons, prior to fit-testing the individual is to be
examined by a physician to assess whether a respirator can be worn.
A MSDS is available upon request.
I am pregnant – is it safe for me to be exposed to Bitrex?
Bitrex is safe for pregnant individuals. Additionally, the amount of Bitrex actually used in
the test is extremely low. People can detect Bitrex at 50 parts per billion (ppb) in water.
A MSDS is available upon request.
What if I cannot detect Bitrex during the sensitivity test?
If you cannot detect Bitrex during the sensitivity test (and have eaten, smoked, drank
(with the exception of water), or chewed gum or candy in the past 15 minutes), you may
not be able to detect Bitrex at the concentrations required for a fit-test. If so, another
alternative testing method may also be utilized – either a quantitative method (that does
not rely on individuals’ ability to taste a test agent) or a different test agent, substance
called Saccharine, will be used.
What if I taste the Bitrex during the fit-test when I am wearing a N95?
This means that a proper seal of the N95 to your face was not obtained. You will be
asked to remove the N95 and re-don it. If you can still detect the Bitrex, a different
model of N95 will be selected and fit-tested.
Why have I been told not to eat, smoke, drink (with the exception of water), or
chew gum or candy for at least 15 minutes before my fit-test?
Because the fit-test requires a taste response, certain foods and activities may interfere
with your ability to taste. In order to efficiently utilize time, you will be asked not to
participate in these activities for the 15 minute-period prior to the fit-test.
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Do I need to be clean shaven in order to wear a N95?
Yes, you must be clean shaven wherever the respirator comes into contact with the
face. Facial hair (even very short stubble) interferes with the seal of the N95 to the face,
thereby reducing its efficiency to provide respiratory protection.
Are the hoods used for the sensitivty test and fit-test cleaned between staff?
Between uses, hoods are wiped down with an isopropyl alcohol solution.
What is an Assigned Protection Factor (APF)? What does an APF of 10 mean?
An Assigned Protection Factor (APF) is a value assigned to a respirator by WorkSafe
BC. It is the level of protection that the respirator can be expected to provide at least
95% of the time. Although not directly applicable to biological agents, the APF is used
when selecting respirators for particular chemical substances. For example, an
appropriate respirator with an APF of 10 would allow an individual to enter an
atmosphere containing up to 10 times the exposure limit for the chemical.
The accepted practice for passing a fit-test is to require the respirator to demonstrate
the ability to provide protection ten times the APF. For example, a respirator assigned
an APF of 10 by the WCB, requires the respirator actually demonstrate a protection
factor of 100 during the fit-test. This allows for an additional “safety factor” to be used
when using the respirator in the “real world”.
N95s are fit-tested to demonstrate a protection factor of 100 during the fit-test (APF of
10 in the work environment). It is important to remember that APF are designed for
substances with exposure limits (e.g. certain chemicals) and are not necessarily directly
applicable for biological agents. However, Health Canada requires N95s provide a “tight
facial seal (less than 10% leak)”.
Do I really need to be fit-tested?
Yes. Fit-testing is required to ensure that the N95 is providing you the respiratory
protection required of it. Without fit-testing a N95, you cannot be certain that it is offering
you the degree of protection it is designed to provide. Fit-testing requirements are a
WorkSafe BC, Canadian Standards Association, manufacturer, and Health Authority
requirement.
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I have had a fit-test on a particular model of N95. Can I wear other models if they
look similar?
No. Different makes and models may utilize different materials (e.g. different straps)
and although they may appear to look similar, they may fit your face quite differently.
Only use the model of N95 for which you have passed a fit-test, as only this type of
model has been tested and shown to provide you with a good seal.
Now that I have been fit-tested on a N95 do I ever have to be fit-tested again?
Fit-testing is required annually by WorkSafeBC. This is because individuals may
experience physical changes over time (e.g. weight gain or loss) which can affect the fit
of the N95. An annual fit-test also allows for a refresher on the issues surrounding the
N95.
USING N95s
How long can I wear a N95 for? How many times can I wear a N95?
The length of time an N95 can be worn varies. If at any point the N95 becomes wet,
soiled, damaged, or interferes with breathing, exit the area and following proper
infection control protocols, remove the N95 and replace with a new one.
An N95 may only be used once. When an N95 is removed it must be discarded, even if
it does not appear to be visibly contaminated. If it is necessary to enter the area again,
a new N95 must be donned.
Use proper infection control protocols when removing the N95 and replacing with a new
one.
Can a N95 be decontaminated if it becomes soiled?
No, N95 respirators are not designed to be decontaminated if soiled. If the N95
becomes contaminated remove it in an area free of inhalation risks and dispose of it.
How do I dispose of the N95 once I have used it?
Unless the N95 is visibly contaminated, it may be disposed of in regular waste. If it is
visibly contaminated with Blood or Body Fluids or Cytotoxics, dispose of it along with
other contaminated material in Biohazardous Waste or Cytotoxic waste as applicable.
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How is donning and doffing done with an N95?
The N95 should be the last piece of protective equipment removed.
Wash your hands with soap and water or alcohol hand cleanser before removing the
N95. Doff the N95 in the reverse order of the donning procedure (make sure you do not
“drag” it over your head!) Dispose of the N95 and wash your hands.
What is a User Seal Check?
A user seal check is a quick, basic procedure you must do to help ensure that you have
donned the N95 correctly. It is not the same, nor is able to replace, a fit-test.
How do I perform a User Seal Check?
Conduct the user seal check as instructed during your fit-test session. Instructions are
provided by the manufacturer and instruction pages are available from your manager,
on the intranet, or from Workplace Health.
A basic user seal check will involve placing both hands over the N95 and inhaling and
exhaling sharply. If air leaks around the nose, adjust the nosepieces. If air leaks around
the edges, adjust the straps. If a proper seal cannot be attained, DO NOT enter the
area. Consult your supervisor/manager.
When do I perform a User Seal Check?
A user seal check must be performed every time you put on a N95 prior to entering the
precaution area.
Will I be able to get enough oxygen if I use a N95?
Yes. Gas molecules can pass freely through the N95. Individuals wearing a N95 easily
obtain enough oxygen. Likewise, carbon dioxide levels inside the N95 are also at safe
levels.
Individuals with compromised respiratory systems should not wear an N95 without
obtaining medical clearance from their physician. By wearing a N95, the dead space of
your lungs is basically increased. This means that breathing is slightly more labour
intensive. While this does not affect a healthy individual, wearing a N95 should be
avoided by someone with a compromised respiratory system. Remember N95 are
meant for staff and should not be placed on patients.
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Why do I feel uncomfortable when wearing a N95?
This may be as a result of the fact that you are not used to wearing a respirator. First-
time users of N95s may breathe more quickly than usual due to anxiety and/or are not
used to wearing a N95. If at any point, breathing becomes difficult, you feel faint or
dizzy, exit the area immediately and remove the N95 using proper infection control
protocols.
Is it normal for my face to feel warm under the N95? Is it normal for my face to be
red when I remove the N95?
Yes. As you breathe out, your breath is warm and humid. This air will heat up the inside
of the N95 which will make your face feel warm. This warm air will increase the surface
temperature of the skin on your face, which can result in reddening of the skin. If at any
point, breathing becomes difficult, you feel faint or dizzy, exit the area immediately and
remove the N95 using proper infection control protocols.
My glasses fog up when I wear the N95. Does this mean that it is not working
properly?
Not necessarily, provided that you have been fit-tested and passed on that model, and
that you have performed a user seal check immediately after donning the N95. When
we breathe out, the inside of the N95 becomes positively pressurized. This means that
the pressure inside the N95 will be greater than the surrounding air, and the air from
inside will rush out. A large majority will pass directly through the material, but some
may go around the outside of the N95.
When you breathe in however, the inside of the N95 becomes negatively pressurized.
As a result, the N95 will collapse closer to your face and incoming air is forced to enter
through the material.
The air we breathe out is warm and moist, and a small amount can fog up glasses. If
you find your glasses tend to fog up, try adjusting them prior to entering an isolation
area. You may also find it helpful to put antifog solution on the lenses to prevent them
from fogging up.
If you wore your glasses during your fit-test, you probably noticed them fog up at that
time as well. If you passed your fit-test, this will have demonstrated that even though
they fogged up, the N95 provided sufficient respiratory protection.
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Will air come in through the sides of the N95 if I move my head around a lot?
During the fit-test process, a number of exercises are required to be performed,
including turning your head side-to-side, nodding up and down, and talking. These
exercises are used to simulate some of the extreme movements that can be performed
in a care or work setting. A passed fit-test demonstrates that even while performing
these types of exercises, the N95 provides sufficient respiratory protection.
When do I remove my N95?
The N95 should only be removed in a clean area, such as in an anti-room. All other
personal protective equipment (i.e. gown, gloves, eye protection, etc) must be removed
prior to removing the N95.
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