Do COVID masks require fit testing, and other timely questions

WSPS staff continue to receive questions about COVID-19 precautions, especially around wearing masks and respirators. To provide the most up to date answers, we’ve turned to experts at the Ministry of Labour, Training and Skills Development.

1. Do we need to do fit testing for masks and respirators?

Here's what the ministry's Fair, Safe and Healthy Workplaces Division told us about when fit testing and respiratory protection programs are required:

“For the purposes of enforcement, R.R.O. 1990, Reg. 833: Control of Exposure to Biological or Chemical Agents and O. Reg. 490, Designated Substances do not apply to issues related to COVID-19.

“For protection against the SARS-CoV-2 virus, a NIOSH-approved N95 respirator or equivalent is required in certain situations, such as when performing aerosol generating procedures or when providing direct care to individuals confirmed or suspected to have COVID-19, as per Public Health Ontario guidance. For these situations where N95 respirators are used as personal protective equipment, workers must be fit tested for the respirators, and must be trained on the use, care and limitations of the respirator. Best practice in this situation will include a written respiratory protection program.

"In situations where respirators are not required and are used as facial coverings only, similar to a surgical or procedure mask, the N95 respirator does not need to be fit tested or meet NIOSH approval or equivalent. The minimum requirement in this situation will be to provide instruction to workers on the purpose of the respirator and its limitations, and how to wear it properly."

The ministry's Acting Provincial Hygienist, Cristina St. Pierre, responded to the following questions.

2. In terms of preventing transmission of COVID-19, what's the difference between a surgical mask and a respirator (e.g., N95s, KN95s and KF94s)?

"Both a surgical mask and a respirator will help prevent the transmission of COVID-19 by reducing the amount of droplets released into the air when a person talks, coughs or sneezes. A respirator, however, adds a layer of protection by also preventing the person wearing the respirator from breathing in potentially contaminated air. This is because a respirator generally fits more tightly on the face and is made of a material that can remove both large and smaller sized droplets from the air."

3. What would you encourage employers to consider before selecting masks and respirators?

"Employers must first assess the risk of COVID-19 transmission in the workplace to determine the appropriate level of protection required. Factors that may be considered during the assessment include the type of work being conducted, the individuals who may be affected, and other measures that are already in place to prevent the transmission of COVID-19. 

"The results of the assessment can then determine if or when masks or respirators will be required, and what specific types of masks or respirators will be suitable in the circumstances."

4. With regard to proper fit, what should mask and respirator wearers watch for? As a general rule of thumb, how can you tell when a mask or respirator fits well?

"The mask or respirator must adequately cover the nose, mouth and chin, and must not slide down or need to be adjusted when the person is talking or moving. It must fit snugly on the face, with all edges of the mask or respirator forming a tight seal against the skin. In addition to these points, a general rule of thumb is that a well-fitting mask or respirator will not have perceptible air leakage around the edges."

5. What do people need to know about facial hair and mask or respirator fit?

"Facial hair interferes with the fit of a mask or respirator by preventing a tight seal from being formed around the face. Even a short stubble is enough to break the seal of a respirator against the skin. Air flows through the path of least resistance and will find its way inside the mask or respirator through gaps formed by facial hair. To get the best protection from a mask or respirator, a tight fit is necessary with no interferences from facial hair."

6. What does "clean shaven" mean in the context of mask or respirator fit?

"Clean shaven" in the context of mask or respirator fit means facial hair that is short enough such that it does not interfere with the seal of the mask or respirator on the face. This applies more specifically when fit testing a respirator, a procedure that is required in certain situations prior to a person being issued a tight-fitting respirator (see question 1). The fit testing procedure ensures that a tight seal against the skin is achieved. Being clean shaven is necessary to pass the fit test and maintain this tight seal."

7. Can masks or respirators be re-used safely? If so, what steps or precautions would you recommend?

"Disposable masks and respirators are ideally for single use only. However, there have been times during the COVID-19 pandemic when supplies were limited and workers have had to reuse masks and respirators. This can be done safely as long as the mask is still clean and in good condition, it has maintained its structure well enough to still fit snugly on the face, and the person is still able to breathe through the mask or respirator without experiencing significant resistance. 

"It is important to always practice good hand hygiene and minimize touching the mask or respirator as much as possible. The mask or respirator must be inspected regularly to determine if it needs to be replaced. If it is to be reused, the mask or respirator must be stored in a clean, breathable container such as a paper bag."

Additional thoughts

We asked Cristina what additional guidance she could offer readers about wearing masks and respirators. Here's what she had to say:

"It is important that workers are properly trained on the use, care and limitations of the mask or respirator. The use of masks and respirators is just one layer of protection against COVID-19. There are other measures that need to be implemented in conjunction with masking to ensure the best level of protection. These measures include ventilation, physical distancing, screening, hand hygiene, cleaning and disinfection.

"It is also important to remember that the science behind COVID-19 transmission is continually evolving, and guidance on masks and respirators could still change over time."

How WSPS can help

Keep on top of provincial and local COVID-19 requirements:

• COVID-19 public health measures and advice (Ontario)
• Health Services in Your Community (local public health units)

Visit the WSPS COVID-19 Microsite, which offers critical information and resources to help employers protect their workers and patrons, including checklists, webinars, articles, eCourses, and more.

Contact WSPS Customer Care with any of your health and safety questions: 1 877 494 WSPS (9777); www.wsps.ca/customer-care.

The information in this article is accurate as of its publication date.