Why qualitative testings no longer fit

Quantitative is taking over for good reason

July 17, 2023
By Blue Print Editorial Team

As a safety professional, I have completed hundreds of qualitative fit testings during my years in the industry. I have visited many customers and worked with many of their employees within a respiratory program. It goes without saying, the importance of ensuring a mask fits well and provides the necessary protection is essential to the basic drive we all share and that is, simply stated, to keep our employees safe each day.

The bonus to this test method was the reaction of the employee as we began the tests. It was always a little fun to see the faces of those that tasted the Bitrex as it hit their tongue during the pre-test test. I also, learned that you don’t want to be chewing bubble gum while testing an employee. ICK!

I have always enjoyed working closely with my customers and their teams. The qualitative fit testing method had always been preferred due to its speed, and I would brag about the number of people I could test at a single time.

But as we know now, these tests are very subjective and can be influenced by things like an employee smoking minutes before the test or if they had coffee just before walking into the room. Certainly, there are limitations to qualitative fit testing. If you get a moment, read through the Safety+Health article, “The limitations of qualitative respirator fit testing,” dated Jan. 1, 2001, authored by Jeff Weed. Within the article he notes the following.

• “Properly designed qualitative protocols include a threshold sensitivity test that each person must pass prior to being fit tested to ensure that he or she can detect the very low in-mask concentration that results when the fit factor is just below 100. If a person cannot pass the threshold test, that qualitative fit test method cannot be used.
• Most people have the ability to sense 1/100 concentrations, but the percentage of people who can reliably sense lower concentrations such as 1/500 or less drops off quickly. Because of this, it is unlikely that a qualitative fit test method will ever be developed for a pass level of 500 or higher.”

This isn’t new news. We have always been aware of the limitations, but I would suggest that in a post-COVID world our sensitivities of taste and smell makes the threshold test more difficult to pass. COVID is here to stay in one variant or another.

This fall, we will prepare our employees for flu and COVID season. We know a healthy workforce is a happy and productive workforce. It’s clear that COVID has affected workers. At www.healthline.com there is an article that notes “90% of people who lose sense of smell or taste from COVID-19 regain it within 2 years.”

The story reminds us that “nearly 27 million people worldwide have experienced COVID-related smell or taste loss.” This is a huge chunk of the population, and it begs me to ask the question: Am I testing a person who has regained their senses, and if so, to what percent? How were they (if at all) affected by COVID?

Yahoo News had an article written by the Miami Herald titled, “COVID left millions without the full sense of taste, smell, study says. Can anything help?” From that piece:

• “Millions of people who strangely lost their ability to taste or smell after a COVID-19 infection have had their senses fully return, according to another study. However, the same can’t be said for millions of others in the U.S., a study published June 2 in the Laryngoscope, a peer-reviewed medical journal, suggests.
• Of 35.8 million U.S. patients diagnosed with COVID-19 in 2021, 60.5% reported a loss of smell, while 58.2% experienced a loss of taste, according to the work involving researchers at Massachusetts Eye and Ear, a Harvard University teaching hospital based in Boston.
• “While most studied completely regained their lost senses, smell didn’t fully return for 24.1% of patients and 3.7% didn’t recover that sense at all, the study found. Meanwhile, 20.6% didn’t fully recover their sense of taste and 2.6% haven’t regained that sense.
• This was estimated to be about 6 million and 4.8 million patients with their senses of smell or taste, respectively, still lacking, study author Dr. Neil Bhattacharyya, a professor of otolaryngology at Mass Eye and Ear, confirmed in a statement to McClatchy News.”

All this brings me back to my initial thesis: Qualitative fit testing methods no longer fit in with in a best-in-class respiratory program. At Fastenal, our Safety Services Division offers to its customers quantitative fit testing, using PortaCount devices. With these units, we can, accurately quantify the fit factor required by a customer’s respiratory program without having to rely on the subjectivity of an employee.

Upon completion of a testing session, we provide a high level, premium test method to ensure the employee is returning to the production floor FIT for duty, and I have accomplished this premium test in the same amount of time it takes to conduct the qualitative testing method.

As technology and time move forward, we need to follow them. Trusting the metrics of quantitative testing is one way we can do that. Reach out to us to find out how: safetyservices@fastenal.com.

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