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Respiratory Protection Checklist
II. SELECTION OF RESPIRATORY PROTECTION

A. Do respirators issued to HCWs meet the following performance for protection against
Mycobacterium tuberculosis:

1. Are all respirators used approved by NIOSH? Y / N

2. Does the respirator have the ability to filter particles 1 micrometer in size in Y / N
the unloaded state with a filter efficiency greater than or equal to 95% (i.e.,
filter leakage of less than or equal to 5%), given flow rates of up to 50 liters
(L) per minute?

(If “yes” attach any documentation attesting to this)

3. Does the respirator have the ability to be qualitatively or quantitatively fit Y / N
tested in a reliable way to obtain face-seal leakage of less than or equal to
10%?

(If “yes” attach any documentation attesting to this)

4. Does the respirator have the ability to fit different facial sizes and Y / N
characteristics of HCWs (i.e., is it available in at least three sizes)?

(If “yes” attach any documentation attesting to this)

5. Does the respirator have the ability to be checked for facepiece fit, Y / N
in accordance with OSHA standards and good industrial hygiene
practice, by HCWs each time they put on their respirator?

(If “yes” attach any documentation attesting to this)

6. Are different levels of respiratory protection (such as powered air purifying Y / N
or positive pressure airline respirators), which exceed the above performance
criteria, available for selected high-risk procedures on patients known or
suspected to have TB (e.g., bronchoscopy, autopsy).

(If “yes” clarify what respirators are used for high-risk procedures)

7. Are the respirators selected appropriate for procedures requiring a sterile field? Y / N
(if respirators have exhalation valves or are positive pressure they do not
protect the sterile field)

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