California Code of Regulations
Title 8 - Industrial Relations
Division 1 - Department of Industrial Relations
Chapter 4 - Division of Industrial Safety
Subchapter 7 - General Industry Safety Orders
Group 16 - Control of Hazardous Substances
Article 109 - Hazardous Substances and Processes
Appendix G - Information for Respirator Fit-Test Screening (Mandatory if Employer Does Not Provide Annual Fit-Test)

Respirators are an important means of reducing your exposure to infectious aerosols. Air purifying respirators provide a barrier to prevent health care workers from inhaling Mycobacterium tuberculosis and other pathogens. The level of protection a respirator provides is determined by the efficiency of the filter material and how well the facepiece fits or seals to your face.

Cal/OSHA regulations require that you be provided with a fit-test at the time of initial fitting, whenever a different size, make, model or style of respirator is used, and whenever you report a change in physical characteristics that may affect fit, such as major dental work, facial surgery or injury, or a change in weight.

Fit tests must also be repeated periodically, because people are not always aware of facial changes that may have affected the fit of the respirator. Generally, Cal/OSHA regulations require that fit-tests be repeated annually. The aerosol transmissible disease regulation permits employers to lengthen this interval to every two years for employees who are not exposed to high hazard procedures, such as bronchoscopies. However, if you believe that you need another fit-test to ensure that the respirator is fitting you correctly, you may request an additional fit-test, and your employer will provide it.

A respirator will not protect you if it does not fit, and if it is not worn properly. In addition to fit-testing, it is important for you to be aware of the size, make, model and style of respirator that fits you, and to understand and practice how to put the respirator on and take it off. It is particularly important to properly place the straps, and in some models, to adjust the straps and adjust the nose piece, so that it forms a snug seal on your face. During your annual training, you will be shown how to use a respirator.

Screening Questions (Answer Yes/No)

Have you had recent major dental work, facial injury or facial surgery since your last fit-test?

Have you had a significant weight gain or loss since your last fit-test?

Do you want to be provided with an additional fit-test for your current respirator?

Name _____________________________________________

Date _____________________________________________

Employee ID number ____________________

Date of fit-test (if provided) ____________________