Training and Fit Testing of Health Care Personnel for Reusable Elastomeric Half-Mask Respirators Compared With Disposable N95 Respirators.
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ABSTRACT:
SUBMITTER: Pompeii LA
PROVIDER: S-EPMC7097838 | biostudies-literature | 2020 May
REPOSITORIES: biostudies-literature
Publications
Training and Fit Testing of Health Care Personnel for Reusable Elastomeric Half-Mask Respirators Compared With Disposable N95 Respirators.
Pompeii Lisa A LA Kraft Colleen S CS Brownsword Erik A EA Lane Morgan A MA Benavides Elisa E Rios Janelle J Radonovich Lewis J LJ
JAMA 20200501 18
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Project description:BackgroundDuring public health emergencies, demand for N95 filtering facepiece respirators (N95 FFRs) can outpace supply. Elastomeric half-mask respirators (EHMRs) are a potential alternative that are reusable and provide the same or higher levels of protection. This study sought to examine the practical aspects of EHMR use among health care personnel (HCP).MethodsBetween September and December 2021, 183 HCPs at 2 tertiary referral centers participated in this 3-month EHMR deployment, wearing the EHMR whenever respiratory protection was required according to hospital protocols (ie, when an N95 FFR would typically be worn) and responding to surveys about their experience.ResultsParticipants wore EHMRs typically 1 to 3 hours per shift, reported disinfecting the respirator after 85% of the removals, and reported high confidence in using the EHMR following the study. EHMRs caused minimal interference with patient care tasks, though they did inhibit communication.DiscussionHCP who had not previously worn an EHMR were able to wear it as an alternative to an N95 FFR without much-reported interference with their job tasks and with high disinfection compliance.ConclusionsThis study highlights the feasibility of the deployment of EHMRs during a public health emergency when an alternative respirator option is necessary.
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Project description:Since the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in mid-2012, there has been controversy over the respiratory precaution recommendations in different guidelines from various international bodies. Our understanding of MERS-CoV is still evolving. Current recommendations on infection control practices are heavily influenced by the lessons learnt from severe acute respiratory syndrome. A debate on respiratory precautions for MERS-CoV was organised by Infection Control Association (Singapore) and the Society of Infectious Disease (Singapore). We herein discuss and present the evidence for surgical masks for the protection of healthcare workers from MERS-CoV.
| S-EPMC4294054 | biostudies-other
Project description:Face coverings are a key component of preventive health measure strategies to mitigate the spread of respiratory illnesses. In this study five groups of masks were investigated that are of particular relevance to the SARS-CoV-2 pandemic: re-usable, fabric two-layer and multi-layer masks, disposable procedure/surgical masks, KN95 and N95 filtering facepiece respirators. Experimental work focussed on the particle penetration through mask materials as a function of particle diameter, and the total inward leakage protection performance of the mask system. Geometric mean fabric protection factors varied from 1.78 to 144.5 for the fabric two-layer and KN95 materials, corresponding to overall filtration efficiencies of 43.8% and 99.3% using a flow rate of 17 L/min, equivalent to a breathing expiration rate for a person in a sedentary or standing position conversing with another individual. Geometric mean total inward leakage protection factors for the 2-layer, multi-layer and procedure masks were <2.3, while 6.2 was achieved for the KN95 masks. The highest values were measured for the N95 group at 165.7. Mask performance is dominated by face seal leakage. Despite the additional filtering layers added to cloth masks, and the higher filtration efficiency of the materials used in disposable procedure and KN95 masks, the total inward leakage protection factor was only marginally improved. N95 FFRs were the only mask group investigated that provided not only high filtration efficiency but high total inward leakage protection, and remain the best option to protect individuals from exposure to aerosol in high risk settings. The Mask Quality Factor and total inward leakage performance are very useful to determine the best options for masking. However, it is highly recommended that testing is undertaken on prospective products, or guidance is sought from impartial authorities, to confirm they meet any implied standards.
| S-EPMC8494377 | biostudies-literature
Project description:IntroductionThe COVID-19 pandemic has unveiled widespread shortages of personal protective equipment including N95 respirators. Several centers are developing reusable stop-gap respirators as alternatives to disposable N95 respirators during public health emergencies, using techniques such as 3D-printing, silicone moulding and plastic extrusion. Effective sealing of the mask, combined with respiratory filters should achieve 95% or greater filtration of particles less than 1um. Quantitative fit-testing (QNFT) data from these stop-gap devices has not been published to date. Our team developed one such device, the "SSM", and evaluated it using QNFT.MethodsDevice prototypes were iteratively evaluated for comfort, breathability and communication, by team members wearing them for 15-30min. The fit and seal were assessed by positive and negative pressure user seal checks. The final design was then formally tested by QNFT, according to CSA standard Z94.4-18 in 40 volunteer healthcare providers. An overall fit-factor >100 is the passing threshold. Volunteers were also tested by QNFT on disposable N95 masks which had passed qualitative fit testing (QLFT) by institutional Occupational Health and Safety Department.ResultsThe SSM scored 3.5/5 and 4/5 for comfort and breathability. The median overall harmonic mean fit-factors of disposable N95 and SSM were 137.9 and 6316.7 respectively. SSM scored significantly higher than disposable respirators in fit-test runs and overall fit-factors (p <0.0001). Overall passing rates in disposable and SSM respirators on QNFT were 65% and 100%. During dynamic runs, passing rates in disposable and SSM respirators were 68.1% and 99.4%; harmonic means were 73.7 and 1643.ConclusionsWe present the design and validation of a reusable N95 stop-gap filtering facepiece respirator that can match existent commercial respirators. This sets a precedence for adoption of novel stop-gap N95 respirators in emergency situations.
| S-EPMC7665821 | biostudies-literature
Project description:BackgroundDuring the coronavirus disease 2019 pandemic, wearing medical respirators and masks was essential to prevent transmission.ObjectiveTo quantify the effects of N95 mask usage by measuring facial skin biophysical characteristics and changes in the lipidome.MethodsSixty healthy volunteers wore N95 respirators for 3 or 6 h. Facial images were acquired and physiological parameters were measured in specific facial areas, before and after mask-wearing. Lipidome analysis was also performed.ResultsAfter N95 respirator usage, facial erythema was observed in both the 3 and 6 h groups. Both sebum secretion and trans-epidermal water loss increased significantly in mask-covered cheeks and chins after 6 h of mask wearing compared with before mask wearing (p < 0.05). Principal component analysis revealed significant differences in lipid composition after mask wearing compared with before. The ceramide subclass NS exhibited a positive correlation with stratum corneum hydration, whereas the AP subclass was negatively correlated with trans-epidermal water loss in the 6 h group.ConclusionProlonged wear of N95 respirators may impair facial skin function and alter lipidome composition.
| S-EPMC10941554 | biostudies-literature
Project description:There has been high demand for personal protective equipment (PPE) during the COVID-19 pandemic, especially N95 respirators. Unfortunately, at the early stage of the pandemic, the supply could not meet the demand for N95 respirators, leading to a shortage and unsafe reuse of this form of PPE. We developed the Moldable Mask to ease the demand for N95 respirators by creating a 3D-printed mask that uses a piece of N95 material as a filter. A sheet of N95 material could be used or one N95 respirator to be turned into two masks. The main feature of the mask is the ability to easily mold it in hot water to create a custom fit for each user. It can also be easily assembled at home with affordable materials. The final mask design was qualitatively fit tested on 13 subjects, with all subjects showing an improvement in fit with the hot water molding technique and 10 (77%) subjects passing the fit test. This shows that the Moldable Mask is a viable option for a safe, affordable N95 alternative when N95 mask supply is strained.
| S-EPMC8624460 | biostudies-literature
Project description:BackgroundIn response to supply shortages during the COVID-19 pandemic, N95 filtering facepiece respirators (FFRs or "masks"), which are typically single-use devices in healthcare settings, are routinely being used for prolonged periods and in some cases decontaminated under "reuse" and "extended use" policies. However, the reusability of N95 masks is often limited by degradation or breakage of elastic head bands and issues with mask fit after repeated use. The purpose of this study was to develop a frame for N95 masks, using readily available materials and 3D printing, which could replace defective or broken bands and improve fit.ResultsAn iterative design process yielded a mask frame consisting of two 3D-printed side pieces, malleable wire links that users press against their face, and cut lengths of elastic material that go around the head to hold the frame and mask in place. Volunteers (n= 41; average BMI= 25.5), of whom 31 were women, underwent qualitative fit with and without mask frames and one or more of four different brands of FFRs conforming to US N95 or Chinese KN95 standards. Masks passed qualitative fit testing in the absence of a frame at rates varying from 48 - 92% (depending on mask model and tester). For individuals for whom a mask passed testing, 75-100% (average = 86%) also passed testing with a frame holding the mask in place. Among users for whom a mask failed in initial fit testing, 41% passed using a frame. Success varied with mask model and across individuals.ConclusionsThe use of mask frames can prolong the lifespan of N95 and KN95 masks by serving as a substitute for broken or defective bands without adversely affecting fit. Frames also have the potential to improve fit for some individuals who cannot fit existing masks. Frames therefore represent a simple and inexpensive way of extending the life and utility of PPE in short supply. For clinicians and institutions interested in mask frames, designs and specifications are provided without restriction for use or modification. To ensure adequate performance in clinical settings, qualitative fit testing with user-specific masks and frames is required.
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