N95 respirator fit tests

10/6/2020

 

Following is a question by Professor the Hon Joseph Lee and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (June 10):

Question:

     According to the guidelines of the Hospital Authority (HA), healthcare personnel should undergo a facial contour fit test (fit test) before using an N95 respirator (respirator), in order to ensure that they are given appropriate respirators. Healthcare personnel with a significant change in facial contour should take the fit test afresh. Earlier on, some nurses working in public hospitals have relayed to me that after the outbreak of the coronavirus disease 2019 (COVID-19) epidemic, HA had, without conducting the fit tests for them, given them respirators of the models concerned on the basis of the results of the fit tests they underwent in as early as 2003. HA had not conducted the fit tests for them until the time when HA had to check whether respirators of another model were suitable for use by them because the respirators of the models concerned had become out of stock. As the fit test results have revealed that they had all along been using respirators that did not fit their facial contour, they consider that such a situation had unnecessarily increased their risks of infection at work. Regarding the conduct of fit tests by HA for its healthcare personnel, will the Government inform this Council if it knows:

(1) the criteria adopted by HA for determining the healthcare personnel for whom the fit tests are to be arranged, and the arrangements for the fit tests;

(2) the number of healthcare personnel for whom HA conducted the fit tests in the past three years;

(3) whether, after the outbreak of the COVID-19 epidemic, healthcare personnel have all been arranged to take the fit tests prior to being deployed to work in high-risk areas or perform high-risk medical procedures; if not, of the reasons for that;

(4) the current number of healthcare personnel who need to wear respirators at work, with a breakdown by the cluster, hospital, department and grade to which they belong; whether all such personnel took the fit tests within the past six months; if not, of the reasons for that; and

(5) the current number of staff members responsible for conducting the fit tests for healthcare personnel, with a breakdown by the cluster, hospital, department and grade to which they belong; the justifications for arranging such staff members to take charge of such work; whether HA has provided them with training on conducting the fit tests; if so, of the details; if not, the reasons for that?

Reply:

President,

     In consultation with the Hospital Authority (HA), I provide the following reply to the various parts of the question raised by Professor the Hon Joseph Lee.

(1) to (4) Public hospitals would arrange facial contour fit tests (fit tests) for all clinical healthcare staff (including new recruits) who need to wear N95 respirators. Test results of healthcare staff are kept by division heads in accordance with the hospital's code of practice and individually by each healthcare staff. Healthcare staff should use suitable model and size of N95 respirator in accordance with the fit test results and perform a seal check whenever they put on N95 respirator to ensure that it fits snugly over the face.

     According to HA's relevant guidelines, healthcare staff should repeat the fit test if the following situations occur where the healthcare staff has:

(i) significant weight gain or loss (of about 10 per cent of the total body weight);

(ii) a change in facial contour due to dental treatment, facial surgeries or accidents;

(iii) any other conditions that may affect the seal of the respirator; or

(iv) to use respirators of a different brand, model or size.

     The HA does not keep relevant statistics on healthcare staff using N95 respirators and taking fit tests.

(5) In public hospitals, N95 respirator fit tests are mainly conducted by the hospital infection control team or the occupational health and safety team. Relevant staff have received training on performing fit tests, which covers the fit test methods, standards and requirements of the fit test for relevant respirators, practical skills for operating the fit testers, etc. The HA does not maintain the number of staff responsible for conducting fit tests.