1160. Infrequency of Respirator Change Following Annual Respiratory Fit Testing at an Academic Medical Center

Abstract

BackgroundThe Occupational Safety and Health Administration (OSHA) of the Department of Labor requires that healthcare employers perform annual respiratory fit testing (RFT) for respiratory protection of employees with patient exposure. The annual cost of RFT in the United States is greater than $8 million and each fit test requires approximately 20 minutes. Due to the high resource expenditure for RFT, we sought to identify factors associated with changing respirators.MethodsDuring annual RFT at the University of Virginia, employees complete a questionnaire about interval clinical changes since the last RFT. Questions are based on publications indicating that certain characteristics are associated with respirator change, including: have you had dental surgery, surgery on your face, or trauma; has your weight changed by >10%; have you been or are you currently pregnant; do you recall your mask type; do you want to change masks. Answers to these questions from May 2016 through March of 2018 were compiled and analyzed by Chi-square test using Excel and R. P-value of <0.05 was considered significant.ResultsA total of 4,278 employees completed questions at least once during the time period, with 29 requiring respirator change after RFT. Requesting a mask change, and 10% weight change were significantly associated with respirator change. Pregnancy and facial trauma were not significantly associated with respirator change. Of those who changed respirator, nine reported no change in weight, no facial trauma, and no pregnancy.ConclusionThe infrequency of respirator change suggests that limiting RFT to those most likely to change their respirator may hold more value than screening all employees annually; however, questions included in this evaluation did not identify all employees who would require respirator change. We are continuing evaluation of predictors of respirator changes and association with tuberculin skin test conversion to improve efficiency of RFT.Disclosures All authors: No reported disclosures.