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Attenuation of T-lymphocyte demargination and adhesion molecule expression in response to moderate exercise in physically fit individuals.

The effects of physical fitness on leukocyte demargination and cellular adhesion molecule (CAM) responses to moderate exercise were examined. We assessed leukocyte subsets and CAM expression before, immediately after, and 10 min after a 20-min treadmill exercise at 65-70% peak oxygen consumption in fit vs. nonfit individuals. Physical fitness was determined by peak oxygen consumption during a treadmill test. Catecholamine levels were determined by radioenzymatic assay, and enumeration of cells and detection of CAM expression were assessed by flow cytometry. As expected, exercise led to significant increases in numbers of leukocyte subsets, regardless of fitness level (P < 0.01). Values returned to near resting levels 10 min after exercise. More importantly, physically fit individuals showed attenuated responses to the moderate-exercise challenge in numbers of CD3(+), CD4(+), CD8(+), memory (CD45RO(+)) CD4, and naive (CD45RA(+)62L(+)) CD4 and CD8 lymphocytes. Postexercise human leukocyte antigen-DR absent memory CD4(+) cell numbers were also lower in fit subjects. Increases in CD62L-expressing CD4(+) and CD8(+) lymphocytes and CD11a- expressing lymphocytes after exercise were also attenuated in fit individuals compared with nonfit individuals (P < 0.05). Catecholamine levels increased to a similar extent (P < 0.01) in both fitness groups. The findings suggest that physical fitness attenuates demargination of selected lymphocyte subsets in response to moderate exercise. Although the differences in plasma catecholamine responses were not significant between the groups, a possible mediating role of the sympathetic system remains to be further investigated. Being physically fit may offset exaggerated immune cell responses to stress.

Adaptation, Physiological↗

Relationship of physical fitness, hormone replacement therapy, and hemostatic risk factors in postmenopausal women.

This cross-sectional study evaluated the relationship of physical fitness, hormone replacement therapy (HRT), and hemostatic profiles at rest and after an acute bout of maximal exercise in 48 healthy postmenopausal women. Subjects were categorized by fitness and HRT user status into four groups: unfit nonusers, fit nonusers, unfit users, and fit users. Fibrinolytic variables tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1) activity, and antigen and prothrombin fragment 1 + 2, a molecular marker of in vivo thrombin generation, were measured before and after maximal exercise. Fibrinogen was also measured at rest. Higher tPA and lower PAI-1 activities (P <0.05) were seen in HRT users and fit groups. tPA and PAI-1 antigens were lower in HRT and fit groups (P <0.05) but not after correction for body mass index. Prothrombin fragment 1 + 2 was lower in the fit groups regardless of HRT status (P <0.05). Fibrinogen was similar in all groups. Favorable hemostatic profiles were observed in physically fit compared with unfit women, especially in HRT nonusers. Thus fitness is more strongly related to these hemostatic risk factors compared with HRT since HRT did not affect these hemostatic variables in fit postmenopausal women.

Cardiovascular Diseases↗

Physical fitness in persons with hemiparetic stroke.

In persons with hemiparetic stroke, assessment and promotion of fitness have so far received limited attention, partly because of the lack of appropriate measures applicable to them. Because these mobility-impaired persons are prone to inactivity, disuse and insulin resistance are likely to occur, and can aggravate the already significant health and economic consequences that stroke entails. It is therefore important to assess objectively their fitness to devize effective and efficient fitness promotion programs. Because of physical limitations, however, many persons with stroke cannot perform traditional stress testing using a treadmill or a cycle ergometer, and maximal oxygen consumption, which is regarded as a gold standard, is not a practical measure. In this article, we reviewed the current status of research on fitness in persons with hemiparetic stroke from the perspectives of evaluation, structure analysis of fitness, and longitudinal changes during a rehabilitation program. As a measure of fitness, indices obtainable with a submaximal exercise are proposed, such as anaerobic threshold and heart rate oxygen coefficient. Protocols applicable to persons with hemiparetic stroke with a variety of functional limitations have been developed (basic bedside activities, bridging activity, or single arm ergometry). The structure of their fitness is demonstrated to be described by a fitness model of healthy persons (cardiopulmonary, muscular and metabolic dimensions) if the paresis/activities of daily living dimension is added. Several studies suggest that fitness improves during a conventional stroke rehabilitation program. Studying the changes of the above four dimensions can help develop more effective fitness training programs.

Humans↗

Relating trait anxiety to perceived physical fitness.

This study was designed to determine the relation of actual cardiovascular physical fitness and perceived physical fitness to trait anxiety. 32 older adult (M age = 68.19 yr.) subjects completed a voluntary maximal graded exercise stress test on a motor driven treadmill to determine their actual cardiovascular physical fitness. Subjects also completed Abadie's Perceived Physical Fitness Scale along with Spielberger's Trait Anxiety Inventory. The partial correlation between actual cardiovascular physical fitness and trait anxiety with the influence of perceived physical fitness removed indicated a nonsignificant relation. The partial correlation between perceived physical fitness and trait anxiety with the influence of actual cardiovascular physical fitness removed indicated a significant inverse relation. Present results suggest that trait anxiety is correlated better with an individual's self-perception of his physical fitness than the actual cardiovascular physical fitness.

Aged↗

Fitness, attitude toward physical education, and self-concept of elementary school children.

Elementary school children scoring in the highest and lowest 26% or 27% of their classes on the Texas Physical Fitness test were compared for attitude toward physical education and self-concept. Data were collected on the Children's Attitude Inventory Toward Physical Education, a Game of Pairs for Preferences Among School Subjects, and the Children's Self-concept Scale. Analysis of variance indicated significant differences on all tests between boys high in fitness, girls high in fitness, boys low in fitness, and girls low in fitness. Subsequent Scheffé tests indicated that highly fit girls had significantly higher attitude and self-concept scores than boys low in fitness. Highly fit boys had higher self-concepts than boys low in fitness. No other group comparisons were significant. Pearson correlations indicated nonsignificant associations between fitness and attitude and self-concept for the four groups.

Attitude↗

Rigid contact lens fitting relationships in keratoconus. Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study Group.

PURPOSE: Although the influence of flat-fitting contact lenses on corneal scarring in keratoconus is frequently debated, the current standard of care with regard to the apical fitting relationship in keratoconus remains undocumented. METHODS: Patients were examined at baseline in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study (N = 1209). Patients wearing a rigid contact lens in one or both eyes (N = 808) had their habitual rigid contact lenses analyzed, and the fluorescein patterns and base curves were compared to the first definite apical clearance lens (FDACL). The FDACL is the flattest lens in the CLEK Study trial lens set that exhibits an apical clearance fluorescein pattern. For patients wearing a rigid contact lens in both eyes, one eye was selected randomly for analysis. RESULTS: Twelve percent of the rigid contact lens-wearing eyes were wearing lenses fitted with apical clearance based upon the clinician's fluorescein pattern interpretation. The remainder (88%) was wearing lenses fitted with apical touch. For mild (steep keratometric reading <45 D) keratoconus corneas, the mean estimate of the base curve to cornea-fitting relationship was 1.18 D flat (SD +/- 1.84 D); moderate (steep keratometric reading: 45 to 52 D) corneas were fitted on average 2.38 D flat (SD +/- 2.56 D); and severe (steep keratometric reading > 52 D) corneas were fitted an average of 4.01 D flat (SD +/- 4.11 D). CONCLUSIONS: Despite the potential risk for corneal scarring imposed by flat-fitting rigid contact lenses, most CLEK Study patients wear flat-fitting lenses. Overall, rigid lenses were fitted an average of 2.86 D (SD +/- 3.31 D) flatter than the FDACL.

Contact Lenses↗

Efficiency and accuracy of two computerized topography software systems for fitting rigid gas permeable contact lenses.

PURPOSE: The world of computerized videokeratoscopy is continually evolving. Computerized videokeratoscope contact lens programs boast the capability to accurately design final rigid gas permeable (RGP) lens parameters and simulate contact lens fluorescein patterns. We evaluated the EyeSys System 2000 Pro-Fit software (v. 4.0) and Humphrey Atlas MasterVue Contact Lens Module (v. A6) for efficiency and accuracy in fitting RGP contact lenses on normal subjects. METHODS: Balanced manifest refractions, slit lamp examinations, and computerized topographical analysis with RGP module lens fitting were performed and compared for all eyes. Lens parameters were chosen after an optimal simulated fluorescein pattern was achieved by either accepting the initially recommended default lens or a modification. Final lens parameters were based on clinical performance. RESULTS: With the Humphrey Atlas software, which uses a default topographic tear clearance fitting protocol set by the manufacturer, 24/50 (48%) eyes required modifications to the default fitting parameters based on the simulated fluorescein patterns. Nine of 50 eyes (18%) required further modifications once the RGP lens was dispensed. The EyeSys Pro-Fit software, which allows a custom tear clearance fitting protocol set by the user as default, required modifications to 20/35 eyes (57.1%) from default fittings provided by the system. Six of 35 eyes (17.1%) required subsequent modifications once the RGP lens was dispensed. Comparison of the EyeSys to Humphrey modules revealed no significant difference in efficiency (P=0.51), defined as any changes required to the default parameters; however, the user made more modifications to the EyeSys module from the default setting. There was no significant difference in final success rates between EyeSys (82.9%) and Humphrey (82%) systems (P=1.00). CONCLUSION: Although both topography guided contact lens modules offered accuracy in RGP fitting, a user programmed default (EyeSys) protocol did not improve efficiency in RGP lens parameter selection compared to a manufacturer programmed default module (Humphrey). The need for a knowledgeable contact lens fitter remains to guide the systems in achieving the optimal fit.

Contact Lenses↗

Are children of military parents more physically fit than children of civilian parents?

BACKGROUND AND OBJECTIVES: It is not known whether parental activity levels influence children's physical fitness. Members of the military are required to maintain standards of physical fitness, whereas the civilian population is not. We conducted this study to compare fitness levels of children in military and civilian families. METHODS: This was a prospective cohort study of third-grade students from two public schools in San Diego County, Calif. Attendees of one school included children of enlisted service personnel. Attendees of the other school included officers' children. Civilian students attended both schools. Students' physical fitness was tested with several standard instruments, including time on a 1-mile run. Independent variables included whether students had civilian or military parents, television viewing habits, and parental military status (enlisted personnel versus officer) as a surrogate marker for socioeconomic status. RESULTS: A total of 170 of 246 (70%) eligible students completed the study. Children of military parents had lower scores on the mile run and lower scores on other measures of fitness than did children of civilian parents. Socioeconomic status (ie, child of officer versus enlisted personnel) was the strongest predictor of poor fitness, with children of enlisted service members scoring lower on all measures of physical fitness than officers' children. More television viewing was associated with lower levels of fitness. CONCLUSIONS: Children of military parents did not have a higher fitness level than children of civilian parents. Lower socioeconomic status and more television viewing are associated with lower levels of fitness.

Analysis of Variance↗

A new curriculum for fitness education.

Regular exercise is important in a preventive approach to health care because it exerts a beneficial effect on many risk factors in the development of coronary heart disease. However, many Americans lack the skills required to devise and carry out a safe and effective exercise program appropriate for a life-time of fitness. This inability is partly due to the lack of fitness education during their school years. School programs in physical education tend to neglect training in the health-related aspects of fitness. Therefore, a new curriculum for fitness education is proposed that would provide seventh, eighth, and ninth grade students with (a) a basic knowledge of their physiological response to exercise, (b) the means to develop their own safe and effective physical fitness program, and (c) the motivation to incorporate regular exercise into their lifestyle. This special 4-week segment of primarily academic study is designed to be inserted into the physical education curriculum. Daily lessons cover health-related fitness, cardiovascular fitness, body fitness, and care of the back. A final written examination covering major areas of information is given to emphasize this academic approach to exercise. Competition in athletic ability is deemphasized, and motivational awards are given based on health-related achievements. The public's present lack of knowledge about physical fitness, coupled with the numerous anatomical and physiological benefits derived from regular, vigorous exercise, mandate an intensified curriculum of fitness education for school children.

Curriculum↗

Physical fitness and its relationship to other indices of health status in children with chronic arthritis.

OBJECTIVE: To compare aerobic and anaerobic fitness of a group of children w-th chronic arthritis with that of healthy controls, and to explore the relationship between physical fitness and other indices of health status in these children. METHODS: Thirty-one children aged 8 to 17 years with chronic arthritis of varying type and severity and 16 physically healthy controls participated in the study. Using a cycle ergometer, aerobic fitness was assessed by measuring peak oxygen uptake achieved in a 15 s period during exercise to volitional fatigue. Anaerobic fitness was assessed by measuring peak power in the legs in a 5 s period and total work completed (Wingate test). Joint pain experienced over the week before testing and during testing was measured using a 10 cm visual analog scale. Self-esteem was measured using the Self Perception Profile for Children Questionnaire. RESULTS: There were no significant differences between mean peak O2 uptake or mean peak anaerobic power for patients and controls; however, the mean values for both controls and patients were significantly lower than reported values for healthy children. Peak O2 uptake controlled for age, sex, and sum of skinfolds was negatively associated with disease severity, measured by physician global assessment (p = 0.04), but peak power was not. Neither aerobic nor anaerobic fitness were associated with disease activity measured by physician global assessment or active joint count, or with disease duration. There was a tendency for children with active arthritis to experience less pain during fitness testing than over the previous week (p = 0.06). Testing did not seem to exacerbate joint symptoms. Self-ratings of athletic competence were significantly correlated with peak O2 uptake achieved for children with arthritis (r = 0.43, p = 0.02), but not for controls. Global self-esteem was moderately correlated with self-rated athletic competence in controls (r = 0.49, p = 0.09), but was not in children with arthritis. CONCLUSION: In this sample of children, most of whom had limited joint involvement, we failed to demonstrate significant group differences in fitness between patients and controls. Disease severity may be related to fitness levels, but psychosocial factors may perhaps be more important determinants of fitness. Children with arthritis seem to have realistic perceptions of their own physical capabilities, and even those children who are less fit and perceive themselves as having less athletic competence do not appear to have lowered self-esteem.

Adolescent↗

Tracking of risk factors for coronary heart disease from adolescence to young adulthood with special emphasis on physical activity and fitness. A longitudinal study.

Physical activity (PA), fitness and selected coronary heart disease (CHD) risk factors were studied in 2 Danish adolescent cohorts; changes in PA and fitness from the age of 16-18 years were measured in a subgroup of high school children; changes in lifestyle, fitness level and coronary heart disease risk factors were measured from late adolescence to young adult hood in a random sample of subjects attending school at baseline. Risk factors and physical fitness tracked from adolescence to young adulthood. The proportion of subjects in the upper quintile of risk still being in the upper quintile 8 years later was 2-3 times the expected in most risk factors. No relationship was found between physical activity and coronary heart disease risk factors in the adolescent population, and only a weak, but highly significant, relationship was found between VO2max and blood pressure in the large cohort of 17 year olds. These weak relationships could result from a relatively high fitness level and a small variation in fitness level in the young Danish population. Because of a great statistical power in the group of subjects at the same age from population 2, it was possible to analyze the relationship between blood pressure and fitness further. Lower blood pressure was found with higher fitness level, but only VO2max, and not physical activity, related to blood pressure, and the relationship became weaker with higher fitness level. In the adult male population, the variations in both VO2max and risk factors were much larger and a great number of the men had become sedentary. Inactive lifestyle was associated with low educational level, and the decrease in fitness and increase in coronary heart disease risk factor levels were more distinct in the former trade and vocational students than in the 'gymnasium' students. In the 17-year-old cohort, lower blood pressure was found with higher VO2max until a level of 53 and 45 ml.min-1.kg-1 in boys and girls, respectively, but above these levels no relationship was found between VO2max and blood pressure.

Adolescent↗

Alternative promoter usage of the Fos-responsive gene Fit-1 generates mRNA isoforms coding for either secreted or membrane-bound proteins related to the IL-1 receptor.

Fit-1 has been identified previously as a Fos-responsive gene of rat fibroblasts. Here we show that Fit-1 is directly regulated by the estrogen-inducible transcription factor Fos-ER and that it belongs to the family of delayed early genes. Two different mRNA isoforms are expressed from the Fit-1 gene. The Fit-1M mRNA isolated from spleen codes for a membrane-bound protein which is most closely related in its extracellular, transmembrane and intracellular domains to the type I interleukin-1 (IL-1) receptor. The Fit-1S mRNA of fibroblasts directs, instead, the synthesis of a secreted protein consisting of only the extracellular domain. Analysis of the exon-intron structure of the Fit-1 gene indicated that the Fit-1S and Fit-1M mRNAs are transcribed from two different promoters and that the sequence differences at their 3' ends result from alternative 3' processing. Northern blot analysis with specific 5' and 3' probes directly demonstrated tight coupling between alternative promoter usage and 3' processing of the Fit-1 transcripts. The orthologous gene of the mouse (known as T1 or ST2) is expressed during ontogeny first in the fetal liver of the embryo and then in lung and hematopoietic tissues of the adult. The mRNA coding for the membrane-bound protein is more abundantly expressed in all of these tissues, while the transcript for the secreted form predominates in fibroblasts and mammary epithelial cells. Differential regulation of two distinct promoters is thus used to determine the ratio between secreted and membrane-bound forms of Fit-1 (T1/ST2) which may modulate signaling in response to IL-1.

Alternative Splicing↗

Replicative fitness in vivo of HIV-1 variants with multiple drug resistance-associated mutations.

The relative fitness of HIV-1 viral variants containing a broad range of drug resistance-associated mutations has been little studied in vivo. Understanding the relative fitness associated with viruses containing mutations may aid future therapeutic management. The aim of this study was to investigate the relative fitness of mutant viruses by assessing a cohort of patients who had developed resistance to many drugs and subsequently stopped all therapy. Eleven patients were assessed for drug resistance associated mutations in the protease (PR) and reverse transcriptase (RT) genes before and, at multiple time points, after stopping therapy. Relative fitness was calculated as a function of the rate of disappearance of mutant viruses when therapy was stopped. The least fit viruses were associated with the RT mutation M184I/V (11.6% less fit) and the PR mutations D30N (12.4% less fit) and M46I/L (21% less fit). Mutations at these codons were associated with significant reductions in fitness levels compared to wild-type viruses. Mutations at codons 10, 20, 36, and 63 in the PR gene remained fairly constant when therapy was stopped and may not significantly reduce viral fitness. The rapid re-population of wild-type viruses may allow the recycling of antiretroviral drugs prescribed previously.

Adult↗

The contribution of HIV fitness to the evolution pattern of reverse transcriptase inhibitor resistance.

All currently recommended anti-retroviral therapy protocols employ reverse transcriptase inhibitors (RTIs). However, mutations within the reverse transcriptase (RT) domain can lead to resistance to these agents and treatment failure. The contribution of the fitness of drug-resistant species to the evolution of RTI resistance has not been elucidated despite its potential implications for therapeutic strategies. In this study we utilized a competitive fitness assay to assess the relative fitness of 13 drug-resistant HIV-1 mutants in the presence and absence of inhibitor. Among these mutants were thymidine analog mutations (TAMs) such as 41L/210W/215Y and 67N/70R/219Q, as well as single mutants such as 103N and 181C that confer high-level resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) such as nevirapine. These studies revealed that 67N/70R and 67N/70R/219Q were fitter than the 70R progenitor species, and the acquisition of 41L by 215Y substantially increased its fitness in the absence of drug. We also observed that 215Y was more fit than 70R and 67N/70R, and that 41L/215Y and 41L/210W/215Y were the most-fit species in the presence of zidovudine. Moreover, 103N was fitter than 181C without nevirapine but less fit with nevirapine. From these studies we conclude that viral fitness contributes substantially to the evolutionary pattern of TAMs suggesting that, as for protease inhibitor resistance, mutations can act in primary (increasing resistance) and secondary (increasing fitness) capacities. We also surmise that drug resistance and fitness are competing forces underlying the emergence of nevirapine resistant mutants 103N and 181C.

Anti-HIV Agents↗

Precision of fit: the Procera AllCeram crown.

STATEMENT OF PROBLEM: Strength, color stability, and precision of fit are requirements for all-ceramic restorations. The Procera AllCeram crown system, composed of a densely sintered high-purity alumina core combined with a low fusing surface porcelain, appears to satisfy most of these requirements. However, evaluation of marginal fit has not been reported. PURPOSE: This study measured the precision of fit of the Procera AllCeram crown fabricated with Procera CAD/CAM technology for the premolar and molar teeth fit to a die. MATERIAL AND METHODS: Five ivorine maxillary first premolars and first molars were prepared for full-coverage crowns. Preparations were standardized with a convergence angle of 10 degrees, chamfer margins of 1.3 to 1.5 mm circumferentially, and occlusal reduction of 2.0 mm. AllCeram crowns were fabricated for the dies, and the fit of the crown to the die was determined by using a standardized procedure with a silicone impression material that served a dual role: (1) as a retrievable luting agent, and (2) to replicate the internal aspects of the crown. Laser videography was used to measure the gap dimension between the crowns and the dies at the marginal opening, the axial wall, the cusp tip, and the occlusal adaptation measurement locations. Mean gap dimensions and standard deviations (SDs) were calculated for marginal opening, internal adaptation, and precision of fit. RESULTS: Mean gap dimensions and standard deviations at the marginal opening for the premolar and molar crowns were 56.0 microns SD +/- 21 and 63.0 microns SD +/- 13 microns, respectively. The mean gap dimensions and SDs of the internal adaptation were 69.0 microns SD +/- 17 microns for axial wall, 48.0 microns SD +/- 12 microns for cusp tip, and 36.0 microns SD +/- 7 microns for occlusal adaptation for the premolar crowns; and 49.0 microns SD +/- 3 microns axial wall, 67.0 microns SD +/- 21 microns cusp tip, and 74.0 microns SD +/- 29 microns occlusal adaptation for molar crowns. Precision of fit and SDs for premolar and molar crowns were 52.0 microns SD +/- 19 microns and 63.0 microns SD +/- 20 microns, respectively. Mean marginal openings and precision of fit gap dimensions for the crown groups were not significantly different at the .05 level. However, gap dimensions that defined the internal adaptation at the measurement locations were different (P < or = .05). CONCLUSION: Mean gap dimensions for marginal openings, internal adaptation, and precision of fit for the crown groups were below 70 microns. These findings show that the crowns studied can be prescribed with confidence knowing that the precision of fit will consistently be less than 70 microns.

Aluminum Oxide↗

Preliminary evaluation of a Weibull function for fitting slow-component eye velocity over the time course of caloric-induced nystagmus.

We describe preliminary attempts to fit a mathematical function to the slow-component eye velocity (SCV) over the time course of caloric-induced nystagmus. Initially, we consider a Weibull equation with three parameters. These parameters are estimated by a least-squares procedure to fit digitized SCV data. We present examples of SCV data and fitted curves to show how adjustments in the parameters of the model affect the fitted curve. The best fitting parameters are presented for curves fit to 120 warm caloric responses. The fitting parameters and the efficacy of the fitted curves are compared before and after the SCV data were smoothed to reduce response variability. We also consider a more flexible four-parameter Weibull equation that, for 98% of the smoothed caloric responses, yields fits that describe the data more precisely than a line through the mean. Finally, we consider advantages and problems in fitting the Weibull function to caloric data.

Adult↗

Low affinity binding of interleukin-1 beta and intracellular signaling via NF-kappa B identify Fit-1 as a distant member of the interleukin-1 receptor family.

The fit-1 gene gives rise to two different mRNA isoforms, which code for soluble (Fit-1S) and membrane-bound (Fit-1M) proteins related to the type I interleukin (IL)-1 receptor. To investigate IL-1 binding, we have synthesized and purified histidine-tagged polypeptides corresponding to Fit-1S and the extracellular domain of the type I IL-1 receptor using a vaccinia expression system. Fit-1S is shown to interact with IL-1 beta, but not with IL-1 alpha. However, Fit-1S binds IL-1 beta only with low affinity in contrast to the IL-1 receptor, suggesting that IL-1 beta is not a physiological ligand of Fit-1S. Moreover, expression of the membrane-bound protein Fit-1M in transiently transfected Jurkat cells did not result in activation of the transcription factor NF-kappa B following IL-1 beta treatment. However, a chimeric protein consisting of the extracellular domain of the type I IL-1 receptor and of the transmembrane and intracellular regions of Fit-1M stimulated NF-kappa B-dependent transcription as efficiently as the full-length type I IL-1 receptor. These data indicate that Fit-1M is a signaling molecule belonging to the IL-1 receptor family.

Base Sequence↗

Correlation of qualitative and quantitative results from testing respirator fit.

Three qualitative respirator fit tests were evaluated for their ability to adequately measure respiratory protection. The evaluated methods were the negative pressure test, the isoamyl acetate test, and the irritant smoke test. Each test was performed concurrently with a single quantitative fit test, the dioctylphthalate (DOP) test, during 274 half-mask and 274 full facepiece wearings. The quantitative values of DOP penetration obtained after passing or failing each qualitative fit test were lognormally distributed. For each qualitative test performed on each mask type, the average log penetration values obtained after passing and failing each test were statistically different from each other. The mean of the log penetration values associated with the failed qualitative test was always larger than the mean of the log penetration values associated with passed qualitative tests for all three qualitative methods. Most (95%) of the tested study had adequately fitting respirators as determined by quantitative testing. Of these subjects, 96% to 100% passed the qualitative fit tests. Of the 5% of the study subjects with inadequately fitting half mask respirators, 93% to 100% of the inadequate fits were detected by qualitative methods. Twenty three to 46% of the poorly fitting full face masks were detected by qualitative methods. The probability of passing or failing a qualitative test with an inadequately fitting respirator can be estimated; however, the uncertainty associated with each estimate is large due to the small number of study subjects with poorly fitting respirators.

Adult↗