Respirator Fit Test Card Template

Fit testing is a qualitative or quantitative protocol used to evaluate sealing surface leakage of a specific tight fitting respirator while worn by an individual.

Respirator fit test card template. Individuals do not have to be issued the same respirator that they are fit tested with as. Download an up to date fillable form 3 2365 in pdf format down below or look it up on the us. The association of occupational health professionals in healthcares alliance with osha brainstormed the idea during a conference call that. 9 the test subject shall not be permitted to wear a half mask or quarter facepiece respirator unless a minimum fit factor of 100 is obtained or a full facepiece respirator unless a minimum fit factor of 500 is obtained.

Department of the interior forms website. This video is about the respirator fit testing requirements for any worker who is required to use a tight fitting respirator. You must be fit tested at least annually and if you change to a different respirator model. Date fit testing conducted in compliance with osha standard 1910134f.

The form was last revised in may 1 2016 and is available for digital filing. The association of occupational health professionals in healthcare aohp and the occupational safety and health administration osha alliance in conjunction with the national institute of occupational safety and healths national personal protective technology lab npptl have developed and released a generic n95 fit testing card. Respiratory fit test fit w fit and if s ml dc pr. Department of the interior.

Conduct a user seal check each time a respirator is put on. Are the fit factors for exercises 1 2 3 etc. Respirator fit test test date. Fit testing general information.

View or download pdf. Respirator fit testing. Fit test results are not tied to the employer so employees can transfer their valid fit test to another job as long as the same make and model respirator are available. The federal occupational safety and health administration also called osha and state osha agencies require employers to fit test workers who must wear these respirators on the job.

Aohposha alliance creates respirator fit testing card. A fit testing wallet card is documentation designed to be used by the employee to keep record of their fit test. Form 3 2365 or the respirator fit test record form is a form issued by the us. Generic fit test wallet cardjpg author.