PPE CASE

Personal Protective Equipment Conformity Assessment Studies and Evaluations

Evaluation of a Self-Contained Breathing Apparatus Involved in a Near Miss

While Operating at a Structure Fire

Bedford County, VA, Fire and Rescue Requested the Evaluation 

of a Scott® Safety Air-Pak 4.5

This report provides a summary of NPPTL’s inspection and evaluation methods, as 

well as findings, for an SCBA that was being used by a fire fighter that had an outof-air emergency and was found with her mask on and her regulator still in place

while operating inside at a structure fire. The SCBA used was a Scott® Safety AirPak Model 4.5, 30-minute, 4500-psi unit. The Bedford County, VA, Fire and Rescue

was advised that NIOSH NPPTL would provide a written report of the investigation 

and any applicable test results.

What NIOSH Did to Protect the Worker

Upon receipt of the SCBA, NPPTL managed the custody of evidence throughout the 

inspection and evaluation process at its Morgantown, West Virginia, facility. NPPTL 

staff inspected all SCBA components and documented their findings with written 

and photographic evidence. NPPTL also tested the SCBA to determine conformance 

to NPPTL’s approval requirements as outlined in Title 42, Code of Federal 

Regulations, Part 84 (42 CFR 84). Further testing was conducted to provide an 

indication of the conformance of the SCBA to the National Fire Protection 

Association (NFPA) Air Flow Performance requirements of NFPA 1981, Standard on 

Open-Circuit Self-Contained Breathing Apparatus for the Fire Service, 2013 Edition. If the inspection or evaluation data 

suggested that the SCBA unit may have contributed to the fatality, NPPTL would have engaged in corrective action to ensure 

that no other users of the product would experience a similar incident. In this case, no such corrective action was necessary. 

NPPTL then managed the disposition of the SCBA.

NIOSH received an SCBA 

used by a fire fighter 

involved in a near miss. The 

SCBA was not found to 

contribute to the incident.

A qualified service 

technician must inspect, 

repair, test, clean, and 

replace damaged 

components of any SCBA 

involved in an incident 

before it may be returned to 

service.
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 2

Chain of Custody

The SCBA was shipped to Lab H1513 at the NIOSH facility in Morgantown, West Virginia, on January 4, 2022. The SCBA unit

remained in secured storage in Lab H1513 throughout the inspection and testing process. 

SCBA Inspection

On January 5, 2022, NPPTL employees Jay Tarley and Angela Andrews inspected the SCBA unit. The SCBA was identified as

belonging to the Moneta Volunteer Fire Company, which is associated with Bedford County Fire and Rescue. The SCBA was

visually examined, component by component, in the condition received to determine the conformance of the unit to the 

NIOSH-approved configuration. The unit was identified as the Scott® Safety Air-Pak Model 4.5, 30-minute, 4500-psi unit,

NIOSH Approval Number TC-13F-0076CBRN. 

As Received 

• The SCBA unit was shipped in a latched box inside of a cardboard container to Lab H1513.

• The unit was in good shape with some signs of dye sublimation in the strapping.

• The cylinder was received empty and closed. 

• The donning switch was off with the regulator intact. 

• The mask-mounted regulator (MMR) was attached.

• The bypass was closed.

Figure 1: Boxed SCBA as received. 
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 3

Figure 2: Unboxed SCBA as received
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 4

Components and Observations for SCBA (“right” or “left” are from the user’s perspective; “good” means 

functional and may show signs of dirt/soot; “fair” means functional, but with signs of some damage; “bad” means not 

functional, needs to be inspected by technician to possibly replace part(s)) (see Figures in Appendix)

Facepiece AV 3000 (Figures 3, 4)

• Facepiece seal P/N: 10011306; Small.

• Nosecup P/N: 10011011; Size Small: MFG date: 

2nd Q 2011.

• Retaining ring top P/N 1001124 MFG date: 

03/2012; bottom P/N: 10011025; MFG date 

03/2012.

• Facepiece assembly P/N: 11/-31; MFG date: 

12/2011.

• Facepiece retaining ring, seal, lens, and hairnet 

were all in good condition.

• Overall condition good.

• Fluid in nose cup and outside of nose cup at 

bottom of lens.

• Hairnet straps good, straps moved freely held in 

place, held securely to facepiece.

• Attachment points for straps were good.

• Regulator interface area was in good condition. 

Mask-Mounted Regulator (MMR) (Figures 5, 6)

• E-Z Flow with Vibralert and with Heads-Up Display 

(HUD).

• Regulator assembly S/N: unreadable.

• Other markings; A3Q03.

• Overall condition good.

• Donning switch was off. 

• Bypass was found closed.

• Sealing area in good condition with marking “103”.

• Regulator could be attached and removed.

• Locking assembly functioned.

• HUD fully intact. 

Low-Pressure Regulator Hose (Figures 7, 8)

• P/N: 31001446.

• Overall condition was good.

• Quick Disconnect attached and functioned.

Pressure Reducer Assembly (Figures 9, 10)

• P/N: 802220-03; S/N: RED 0403001812 AB.

• MFG date: NA.

• Overall condition was good.

• Visualert added to pressure reducer assembly to 

upgrade edition requirements. 

• All air line connections were secure with no sign of 

heat damage.

High-Pressure Hose and Cylinder Attachment (Figures 

11-13)

• Overall condition was good.

• Cylinder attachments threads good and “O” ring in 

place.

• RIC/UAC system connector markings: Eaton FD17-

1002-10-04, 30503; P/N: 802228-05,0304.

• RIC/UAC system connector cover in good 

condition.

• RIC/UIC connector was found removed.

PASS Console Assembly (Figures 14, 15)

• Label number: unreadable. 

• Overall condition good.

• Lines were in good shape—pressure/electrical.

• Gauge lens good and readable.

• No protective casing, had rubber attachment.

• SEI label present, 1998 ed.

PASS Control Module with PAK-Alert (Figures 16, 17)

• Scott label: P/N: 805796-02.

• Scott Control Module Assy SE+ 805794-01, 

P72172 March 04.

• Overall condition was good.

• Held securely to backframe.

• Wire connection connected to PASS device.

• Wire held secure to backframe and connected to 

console assembly.

Backframe Assembly (Figures 18, 19)

• P/N: 804415-11.

• SEI label readable; NFPA 2002 edition.

• NIOSH Approval Number TC-13F-76CBRN.

• Other markings: 8-22 in marker, R8102 sticker, FD 

inventory label, and service label from Atlantic 

Emergency Solutions (January 2021).

• NIOSH white/black CBRN approval sticker.

• Overall condition good.

• Shoulder straps were attached to the frame but 

with dye sublimation (only to strapping and not 

webbing).

• Cylinder strap latch good condition, functional.
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 5

Straps and Buckles (Figure 20)

• Overall strap condition good with dye sublimation.

• Both shoulder straps attached at the top of the 

backframe. 

• Hose lines and wires passed through shoulder 

straps.

• All adjustable buckles moved and held in place.

• Waist area buckle latched and released.

• Lumbar strap in good condition.

Compressed Air Cylinder and Cylinder Valve Assembly

(Figures 21-23)

• Minute Duration: 30 minute.

• DOT Number: DOT-E-10915-4500.

• TC-SU-5134-310. 

• OK80697-LUXFER.

• Scott Part number: 10009671.

• Scott logo visible; Luxfer: L45M-18; REE: 78.

• Manufacture date: 01/2004; 4500 PSIG

• Overall condition was good.

• Gauge was readable.

• Threads clean.

• As received, cylinder valve fully closed with 

no air remaining.

• Rubber bumper at base on cylinder valve 

was in good condition with a small crack.

• Rehydro label present: 2/19.

• On Stem: P/N: 804721-0.
 

TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 6

The SCBA unit was tested using the six NIOSH test methods and one NFPA test method as described in Table 1.

Table 1. Summary of results from testing SCBA.

NIOSH Tests Description of Results PASS

/FAIL

Positive Pressure Test - NIOSH Test Procedure Number 120 42 CFR Part 84 Reference: 

Subpart H, § 84.70 (a)(2)(ii)

Requirement:

The pressure inside the facepiece in relation to the immediate environment is positive 

during both inhalation and exhalation.

Procedure:

A breathing machine with a 622 kg.-m./min. cam operating at 24 RPM with a 40-liter per 

minute flow rate (115 liters per minute peak flow) is connected to an anthropometric head 

for cycling. A pressure tap in the head is connected to a transducer which in turn is 

connected to a strip chart recorder for determining the pressure in the facepiece.

The unit met the test requirement. The 

inhalation breathing resistance did not 

become negative during the test. 

*The PASS unit functioned; the digital 

remote functioned and there was a HUD. 

Inhalation Breathing Resistance: (inches 

of water column) = 0.19

PASS 

Rated Service Time Test - NIOSH Test Procedure Number 121 42 CFR Part 84 Reference: 

Subpart F, § 84.53 (a) and Subpart H, § 84.95 (a) and (b)

Requirement:

Service time will be measured while the apparatus is operated by a breathing machine as 

described in § 84.88. The open-circuit apparatus will be classified according to the length of 

time it supplies air or oxygen to the breathing machine. Classifications are listed in § 84.53.

Procedure:

A breathing machine with a 622 kg.-m./min. cam operating at 24 RPM with a 40-liter per 

minute flow rate is connected to an anthropometric head for cycling. A pressure tap in the 

head is connected to a transducer which in turn is connected to a strip chart recorder for 

determining the pressure in the facepiece. The breathing machine is run until the 

inhalation portion of the breathing curve falls below the minimum requirement.

The SCBA met the test requirement. The 

measured service time (adjusted to 

correspond with the recorded breathing 

cycles) was more than the rated service 

time of 30 minutes. The PASS unit 

functioned during the test. The SCBA did 

not go negative on inhalation; therefore, 

positive pressure was maintained in the 

facepiece. Measured Service Time:

34 Minutes 51 Seconds

PASS 
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 7

Static Pressure Test - NIOSH Test Procedure Number 122 42 CFR Part 84 Reference: 

Subpart H, § 84.91 (d)

Requirement:

The static pressure (at zero flow) in the facepiece shall not exceed 38 mm. (1.5 inches) 

water-column height.

Procedure:

The facepiece is fitted to an anthropometric head for testing. A pressure tap in the head is 

connected to a calibrated manometer. Full cylinder pressure is applied to the unit at zero 

flow and a reading from the manometer is recorded.

The SCBA met the test requirement. 

Facepiece Static Pressure: (inches of

water column) = 0.82

PASS 

Gas Flow Test - NIOSH Test Procedure Number 123 42 CFR Part 84 Reference: Subpart H, 

§ 84.93 (b) and (c)

Requirement:

The flow from the apparatus shall be greater than 200 liters per minute when the pressure 

in the facepiece of demand apparatus is lowered by 51 mm. (2 inches) water column height 

when full container pressure is applied. Where pressure-demand apparatus are tested, the 

flow will be measured at zero gage pressure in the facepiece.

Procedure:

A pressure tap in the anthropometric head is connected to a manometer for determining 

when the pressure inside the facepiece is at zero. A mass flow meter is connected in line 

between the anthropometric head and an adjustable vacuum source to measure flow. The 

SCBA cylinder is replaced by a test stand which is adjusted initially to full cylinder pressure. 

The vacuum source is adjusted during the test to maintain the desired pressure inside the 

facepiece. Once the proper facepiece pressure has stabilized, a flow reading is recorded.

The procedure is then repeated with the test stand adjusted to 500 psig.

The SCBA met the test requirement. 

Applied Pressure Air Flow (liters per min.) 

4500 psig 456.8

500 psig 634.3

PASS 

PASS
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 8

Exhalation Resistance Test - NIOSH Test Procedure Number 122 42 CFR Part 84 

Reference: Subpart H, § 84.91 (c)

Requirement:

The exhalation resistance of pressure-demand apparatus shall not exceed the static 

pressure in the facepiece by more than 51 mm. (2 inches) water-column height.

Procedure:

The facepiece is mounted on an anthropometric headform. A probe in the headform is 

connected to a slant manometer for measuring exhalation breathing resistance. The air 

flow through the apparatus is adjusted to a rate of 85 liters per minute and the exhalation 

resistance is recorded.

The SCBA met the test requirement. 

Exhalation Breathing Resistance: (inches 

of water column) = 2.09

Static Pressure: (inches of water

column) = 0.82

Difference: (inches of water column) = 

1.27

PASS 

Remaining Service Life Indicator Test - NIOSH Test Procedure Number 124 42 CFR Part 84 

Reference: Subpart H, § 84.83 (f) and Subpart G, § 84.63 (c)

Requirement:

Each remaining service life indicator or warning device shall give an alarm when the 

remaining service life of the apparatus is reduced within a range of 20 to 25 percent of its 

rated service time or pressure.

This requirement is modified under § 84.63(c) as follows: For apparatus which do not have 

a method of manually turning off remote gage in the event of a gage or gage line failure 

the remaining service life indicator is required to be set at 25% ± 2% of the rated service 

time or pressure.

Procedure:

A calibrated gauge is connected in line between the air supply and the first-stage 

regulator. The unit is then allowed to gradually bleed down. When the low-air alarm is 

activated, the pressure on the gauge is recorded. This procedure is repeated six times. The 

average of the six readings is calculated and recorded.

As these SCBA models do not have a 

remote gauge shutoff, the test 

requirement is 25% +/- 2 %.

The electrical warnings did not function 

during the test. The unit “chirped” during 

testing indicating that the batteries were 

depleted.

Electric Vibralert

Run # Alarm Point (psi) Alarm Point(psi)

1 x 1060

2 x 1065

3 x 1065

4 x 1060

5 x 1065

6 x 1060

Average x 1063

FAIL

PASS
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 9

 

National Fire Protection Association (NFPA) Test (in accordance with NFPA 1981, 2013 Edition):

NFPA Test Description of Results PASS/

FAIL 

NFPA Air Flow Performance Test - NFPA 1981 (2013 Edition) Reference: Chapter 5, 

Performance Requirements, Section 5-1.1

Requirement: 

SCBA shall be tested for air flow performance as specified in Section 6-1, Air Flow 

Performance Test, and the SCBA facepiece pressure shall not be less than 0.0 in. (0.0 

mm) water column and nor greater than 31⁄2 in. (89 mm) water column above ambient 

pressure from the time the test begins until the time the test is concluded.

Procedure: 

The required equipment specified in the NFPA standards were used to conduct the tests 

on this unit. A pressure tap in the head is connected to a transducer which in turn is 

connected to a flatbed chart recorder for determining the pressure in the facepiece.

The SCBA passed the pressure portion of 

this test. The HUD system did not 

function, which caused the unit to fail 

the test.

Maximum Facepiece Pressure: (inches 

of water column) = 2.5

Minimum Facepiece Pressure: (inches 

of water column) = 0.40 

FAIL

FAIL
 

TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 10

Disposition of SCBA

Following testing on January 12, 2022, the SCBA was returned to secure storage in Lab H1513 at the NIOSH

facility in Morgantown, West Virginia.

Synopsis of Findings

The SCBA unit inspected and evaluated by NPPTL was a Scott® Safety Air-Pak Model 4.5, 30-minute, 4500-psi

unit with NIOSH Approval Number TC-13F-0076CBRN. A corresponding facepiece and cylinder were provided 

with the unit. Overall, the SCBA was in good condition. The NFPA approval label was present and readable.

The PASS functioned, but the HUD and alarm systems did not function. The batteries were depleted in the 

unit.

The SCBA met the requirement of the NIOSH Positive Pressure Test, as the SCBA maintained a positive

pressure for the 30-minute minimum duration of the test. The unit passed all other NIOSH tests.

In light of the information obtained during this investigation, NIOSH NPPTL has proposed no further action on 

its part at this time. The SCBA was returned to the shipping container to be shipped back to Bedford County 

Fire and Rescue.

CASE Conclusion

No evidence was identified to suggest that the SCBA inspected and evaluated contributed to the incident. 

NIOSH determined that there was no need for corrective action with regards to the approval holder or users 

of the SCBAs manufactured under the approval number granted to this product.

Actions to be Taken by Fire Departments with SCBAs Involved in an 

Incident

• Any SCBA unit involved in an incident may not be placed back in service until the SCBA has been

repaired, tested, cleaned, and any damaged components replaced and inspected by a qualified

service technician, including such testing and other maintenance activities as prescribed by the 

schedule from the SCBA manufacturer

• All SCBA units, even those not involved in an incident, must undergo a flow test on at least an annual

basis
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 11

Actions PPE Users, Selectors, and Purchasers May Take to Further

Protect Themselves and Others from Hazards

• Sign up for NPPTL’s Listserv at https://www.cdc.gov/niosh/npptl/sub-NPPTL.html to receive email 

notifications relevant to PPE

To request additional information about this report, contact NPPTL at ppeconcerns@cdc.gov, and reference 

NIOSH Task Number 25514 in your request. 

For more information related to personal protective equipment, visit the NIOSH NPPTL website at 

https://www.cdc.gov/niosh/npptl/

To receive documents or other information about occupational safety and health topics, contact NIOSH:

Telephone: 1–800–CDC–INFO (1–800–232–4636) 

TTY: 1–888–232–6348

CDC INFO: www.cdc.gov/info

Or visit the NIOSH website at https://www.cdc.gov/niosh/

For a monthly update on news at NIOSH, subscribe to NIOSH eNews by visiting 

https://www.cdc.gov/niosh/eNews/
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 12

Appendix: Photographs to Support Inspection Findings for SCBA 

List of Figures

Figure 1: Boxed SCBA as received ..............................................................................................................................2

Figure 2: Unboxed SCBA as received..........................................................................................................................3

Figure 3: Front of facepiece..................................................................................................................................... 13

Figure 4: Inside of facepiece.................................................................................................................................... 13

Figure 5: Mask-mounted regulator ......................................................................................................................... 14

Figure 6: Inside seal of mask-mounted regulator and HUD.................................................................................... 14

Figure 7: Low-pressure hose ................................................................................................................................... 15

Figure 8: Low-pressure hose quick disconnect........................................................................................................ 15

Figure 9: Pressure reducer, outside view................................................................................................................ 16

Figure 10: Pressure reducer, inside view................................................................................................................. 16

Figure 11: Cylinder attachment and RIC UAC connector ........................................................................................ 17

Figure 12: RIC UAC dust cover removed ................................................................................................................. 17

Figure 13: High-pressure hose from cylinder attachment to reducer .................................................................... 18

Figure 14: PASS control console.............................................................................................................................. 18

Figure 15: SEI label on back of PASS control console, 2007 edition........................................................................ 19

Figure 16: PASS control module under cylinder attachment and CBRN sticker on backframe .............................. 19

Figure 17: PASS control module label ..................................................................................................................... 20

Figure 18: Overall of backframe, SEI label............................................................................................................... 20

Figure 19: NIOSH label on backframe...................................................................................................................... 21

Figure 20: Overall of straps and buckles ................................................................................................................. 21

Figure 21: Overall of cylinder .................................................................................................................................. 22

Figure 22: Cylinder label and rehydro label ............................................................................................................ 22

Figure 23: Cylinder valve assembly ......................................................................................................................... 23
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 13

Figure 3: Front of facepiece

Figure 4: Inside of facepiece
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 14

Figure 5: Mask-mounted regulator

Figure 6: Inside seal of mask-mounted regulator and HUD
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 15

Figure 7: Low-pressure hose

Figure 8: Low-pressure hose quick disconnect
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 16

Figure 9: Pressure reducer, outside view

Figure 10: Pressure reducer, inside view
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 17

Figure 11: Cylinder attachment and RIC UAC connector

Figure 12: RIC UAC dust cover removed 
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 18

Figure 13: High-pressure hose from cylinder attachment to reducer

Figure 14: PASS control console
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 19

Figure 15: SEI label on back of PASS control console, 1998 edition

Figure 16: PASS control module under cylinder attachment and CBRN sticker on backframe
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 20

Figure 17: PASS Control module label

Figure 18: Overall of backframe, SEI label 
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 21

Figure 19: NIOSH label on backframe

Figure 20: Overall of straps and buckles
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 22

Figure 21: Overall of cylinder

Figure 22: Cylinder label and rehydro label 
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 23

Figure 23: Cylinder valve assembly.
TN-25514 Bedford County Fire and Rescue, Virginia – Status Investigation Report 24

Disclaimer 

The purpose of this effort was to determine the conformance of a respirator to the NIOSH approval

requirements found in Title 42, Code of Federal Regulations, Part 84. A number of performance tests are

selected from the complete list of Part 84 requirements and each respirator is tested in its “as received”

condition to determine its conformance to those performance requirements. Each respirator is also

inspected to determine its conformance to the quality assurance documentation on file at NIOSH.

In order to gain additional information about its overall performance, each respirator may also be subjected

to other recognized test parameters, such as National Fire Protection Association (NFPA) consensus

standards. While the test results give an indication of the respirator’s conformance to the NFPA

approval requirements, NIOSH does not actively correlate the test results from its NFPA test equipment

with those of certification organizations which list NFPA-compliant products. Thus, the NFPA test results

are provided for information purposes only.

Selected tests are conducted only after it has been determined that each respirator is in a condition that

is safe to be pressurized, handled, and tested. Respirators whose condition has deteriorated to the point

where the health and safety of NIOSH personnel and/or property is at risk will not be tested.