Commentary: the use of respirators to reduce inhalation of airborne biological agents.
Janssen-L; Ettinger-H; Graham-S; Shaffer-R; Zhuang-Z
J Occup Environ Hyg 2013 Aug; 10(8):D97-D103
The use of respiratory devices to protect against potentially hazardous biological aerosols that are transmittable via inhalation has increased in recent years. When in an environment containing this potential hazard, both surgical masks (SM) and N95 filtering facepiece respirators (FFR) have been used by the general public as well as health care workers. While the superior filtration and fit characteristics of N95 FFR over surgical masks have been demonstrated in laboratory and workplace studies with inert (non-biological) particles, their superiority in reducing disease transmission in clinical/field settings is still questioned by some members of the health care/infection control industry. Attempts to study the relative efficacy of the two devices in the field using clinical outcomes have yielded inconclusive results because of limitations in experimental design and implementation. This commentary examines the differences between the two devices and identifies considerations necessary to study their performance properly. No study to date has been conducted in a manner that would allow the performance of the two types of devices to be differentiated. In particular, study subjects failing to wear the assigned device during all times of potential exposure, along with a lack of continuous observation of subjects' use, compromise the superior protection the N95 FFR can provide. Additionally, the lack of formalized, complete respiratory protection programs negates the superior filtration and fit characteristics of the N95 FFR. As has been shown in industrial workplaces, one may reasonably expect that N95 FFR will effectively reduce health care workers' inhalation exposures to airborne biological agents when complete, effective respiratory programs are in place. Because voluntary users and the general public will not likely use respirators under the guidance of a formal program, the benefit of respirator use alone is likely to be minimal.
Respirators; Respiratory-equipment; Respiratory-protective-equipment; Air-purifying-respirators; Inhalants; Biological-agents; Personal-protective-equipment; Air-contamination; Aerosols; Aerosol-particles; Hazardous-materials; Face-masks; Performance-capability; Equipment-reliability; Filtration; Disease-control; Disease-transmission
Larry Janssen, Larry Janssen Consulting, LLC, 12097 87th St. North, Stillwater, MN 55082
Healthcare and Social Assistance
Journal of Occupational and Environmental Hygiene