COMPARISON BETWEEN QUALITATIVE AND QUANTITATIVE FIT TESTING - AS COMPLETED BY STAFF AT CITY HOSPITAL BIRMINGHAM

Sep 27, 2026

Uploaded by Angel

Examines respirator fit testing in a UK NHS Trust context, contrasting Qualitative Fit Testing (QLFT) and Quantitative Fit Testing (QNFT). QLFT is described as low-cost and subjective, relying on wearer detection of chemical stimulants and vulnerable to protocol shortcuts. QNFT is presented as objective, instrument-measured, using aerosol challenge concentrations and a fit factor with defined minimums. The Trust’s transition to the PortaCount system is detailed to reduce guesswork, improve confidence, automate guidance, streamline documentation, and raise pass rates.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Introduction

Situation

Types of fit testing

Solution

Conclusion

COMPARISON BETWEEN QUALITATIVE AND QUANTITATIVE FIT TESTING – AS COMPLETED BY STAFF AT CITY HOSPITAL BIRMINGHAM Introduction Sandwell and West Birmingham Hospitals NHS Trust is an integrated care organisation dedicated to improving the lives of local people, maintaining an outstanding reputation for teaching and education, and facilitating innovation and research. The Trust employs over 7,000 people and spends around £430m of public money, largely drawn from their local Clinical Commissioning Group. That Group and the Sandwell and West Birmingham Hospitals NHS Trust are responsible for the care of 530,000 local people across North-West Birmingham and Sandwell. Situation Respirator t testing is a key component to any respiratory protection programme, protecting sta􀀞 from airborne hazards. Anyone wears a tight tting respirator is required by HSE INDG 479 to perform respirator t testing. The Infection Prevention and Control Team at the Trust are responsible for providing over 4,000 frontline sta􀀞 members with a respirator t test to ensure the FFP3 masks they use are protecting them. There are two basic types of t tests: Quantitative Fit Testing (QNFT) and Qualitative Fit Testing (QLFT) . QLFT is a low cost, subjective pass/fail test that exposes the respirator wearer to a chemical stimulant (while donning a test hood) such as Isoamyl Acetate, Sodium Saccharin, Bitrex or Irritant Smoke that can only be detected if the respirator leaks. The respirator wearer must breathe through their mouth, with tongue extended during the t test to enable detection (tasting) of leakage into the respirator. QLFT methods are often compromised by wellmeaning test operators who skip important steps, unknowingly invalidating the t test. To properly follow the protocol, a t test operator must squeeze the nebulizer bulb between 75 and 225 times for each t test performed. The temptation to get through the test faster is strong, especially when the same test operator t tests dozens of people per day. UNDERSTANDING, ACCELERATED “Very few sta had been 􀀞t tested due to lack of available training for 􀀞t testers, sta were losing con􀀞dence in how to perform the 􀀞t test and a high percentage of those tested were unclear as to whether they could taste the Bitrex® solution once a mask was 􀀞tted.” COMPARISON BETWEEN QUALITATIVE AND QUANTITATIVE FIT TESTING – AS COMPLETED BY STAFF AT CITY HOSPITAL BIRMINGHAM QNFT is an objective test that involves the use of an instrument to measure how well the respirator ts. The measurement is not dependent on the person’s voluntary response. The instrument measures the t while the person performs a series of special exercises and automatically records the results. An aerosol challenge agent concentration (Cout) is measured outside the respirator and then again inside the respirator (Cin). The ratio of the two measurements (Cout/Cin) is called a t factor. The minimum t factor required by HSE, which should be achieved in each of the test exercises when carrying out a quantitative t test, is 2,000 fora full-face mask, 100 for a half-mask and 100 for FFP3, FFP2 and FFP1 ltering facepieces. Prior to 2018 at the Sandwell and West Birmingham Hospitals, NHS Trust t testing was carried out using the Qualitative Hood method.“Very few sta􀀞 had been t tested due to lack of available training for t testers, sta􀀞 were losing con dence in how to perform the t test and a high percentage of those tested were unclear as to whether they could taste the Bitrex® solution once a mask was tted”, says Kasmiro Aheer, Infection, Prevention & Control Nurse Advisor. Consequently, some sta􀀞 lost con dence in the accuracy of the system. Solution To resolve this issue, the Trust made the decision to invest in a Quantitative Fit Testing solution to eliminate the guesswork associated with QLFT methods such as Saccharin and Bitrex® and better measure respirator t. They chose to invest in the PortaCount® Respirator Fit Test

FAQs

What is the key difference between qualitative and quantitative respirator fit testing?

Qualitative fit testing relies on the wearer’s subjective ability to detect chemical stimulants when the mask leaks. Quantitative fit testing measures respirator fit objectively with an instrument and records results automatically.

Why can qualitative fit testing fail even when the protocol exists?

Qualitative testing can be compromised when operators skip important steps or do not follow the required procedure, which can invalidate the test outcomes. The document also notes operator temptation to rush due to testing many people daily.

What changes did the Trust make to improve fit testing and confidence?

The Trust invested in a Quantitative Fit Testing solution using the PortaCount Respirator Fit Tester. It added guided animations and FitCheck™ Mode for real-time pass/poor fit feedback, centralized documentation, and easier reporting, leading to higher confidence and pass rates.

Sep 27, 2026

Uploaded by Angel