Component analysis of respirator user training.

Respirators must be properly used to be effective. In an experimental protocol, 145 subjects were trained and then observed donning and doffing respirators. Filtering facepiece and dual cartridge half face mask types were studied. Subjects were then tested for knowledge and for proper performance using video recording analysis. Knowledge tests showed adequate learning, but performance was often poor. Inspection, strap tension (half mask), seal checking, and avoiding mask contact during doffing were particularly problematic. Mask positioning was generally well done. Correlation between knowledge and performance for specific items was generally poor, although there was a weak correlation between overall knowledge and overall performance (rho = 0.32) for the half mask users. Actual unprompted performance as well as knowledge and fit-testing should be assessed for user certification. Respirator design approval should consider users' ability to learn proper technique.