N95 fit testing is generally safe during pregnancy, but modifications are often needed for the comfort and well-being of the expectant worker. Testing confirms the N95 mask forms a proper seal, preventing airborne contaminants from entering. While pregnancy causes physiological changes, weight gain typically does not alter the facial measurements determining respirator fit. Concerns revolve around the physical demands of the test exercises and the use of certain chemical agents.
What Standard N95 Fit Testing Involves
Standard N95 fit testing is required for all workers who wear tight-fitting respirators. The protocol involves the worker performing a sequence of one-minute actions while wearing the respirator. These exercises simulate physical activity to test the seal and include normal breathing, head movements, and talking. Bending over or jogging in place is often required as a final exercise.
There are two main types of tests: qualitative and quantitative. Qualitative fit testing (QLFT) uses test agents like saccharin or Bitrex, relying on the wearer’s sense of taste or smell to detect leakage. Quantitative fit testing (QNFT) uses an instrument to measure particle concentration inside and outside the respirator, providing a numerical result called a “fit factor.”
Safety Guidelines and Adjustments for Pregnant Workers
Before using a respirator, employees must undergo a medical evaluation to determine their ability to safely wear the device. Pregnancy requires review by a physician or other licensed healthcare professional (PLHCP) before the fit test. This clearance ensures that physiological changes, such as increased oxygen consumption and altered lung function, are not overly stressed by the respirator’s breathing resistance.
Procedural adjustments are frequently made for comfort, even though pregnancy does not significantly change facial dimensions critical for fit. Physical exercises, particularly bending over or jogging in place, may be modified or eliminated entirely to accommodate the worker’s stage of pregnancy. The test administrator must stop the test immediately if the worker reports symptoms like shortness of breath, dizziness, or nausea.
The test agents used in qualitative fit testing, such as saccharin and Bitrex, are generally considered safe. These agents are administered as a fine mist and are not systemic toxins. The employer must ensure the PLHCP confirms clearance for the fit test, including the challenge agent exposure.
Alternatives to Standard N95 Fit Testing
If a pregnant worker cannot achieve a proper fit, or if the PLHCP advises against the standard procedure, employers must explore alternative respiratory protection. The most common alternative is a Powered Air-Purifying Respirator (PAPR), which eliminates the need for a fit test. PAPRs use a battery-powered blower to supply filtered air into a loose-fitting hood or helmet, requiring no tight seal.
PAPRs are effective for workers who cannot be fit-tested due to medical conditions or inability to achieve an adequate seal. If no suitable alternative protection can be provided, employers may consider temporary reassignment to a role that does not require a tight-fitting respirator.
The employer must provide the required protection. If the necessary fit factor cannot be achieved, the employee cannot work in areas requiring that specific respiratory protection. An additional fit test may be warranted if weight gain affects the face seal, but this is determined case-by-case following the medical evaluation.