Evaluation of Minnesota and Illinois hospital respiratory protection programs and healthcare worker respirator use.
Brosseau-LM; Conroy-LM; Sietsema-M; Cline-K; Durski-K
J Occup Environ Hyg 2015 Jan; 12(1):1-15
The objective of this study was to assess respiratory protection programs for aerosol-transmissible diseases in acute care hospitals for conformance with regulatory requirements and public health guidelines. Twenty-eight representative hospitals were selected by size, location and ownership in Minnesota and Illinois. Interviews were conducted with 363 healthcare workers and 171 managers from high-risk departments. Written programs from each hospital were reviewed for required elements. Seventy-seven healthcare workers were observed donning and donning a FFR. The most serious deficiency in many written programs was failure to identify a program administrator. Most written programs lacked adequate details about medical evaluation, fit testing and training and did not include a comprehensive risk assessment for aerosol transmissible diseases; tuberculosis was often the only pathogen addressed. Employees with the highest probability of tuberculosis exposure were most likely to pick a respirator for close contact, but higher levels of respiratory protection were rarely selected for aerosolgenerating procedures. Surgical masks were most commonly selected for close contact with droplet disease- or influenza-infected patients; better protection (e.g. respirator) was rarely selected for higher risk exposures. Most of the observed healthcare workers had access to a NIOSH-certified N95 FFR, properly positioned the facepiece and formed the nose clip. The most frequent deficiencies were failure to correctly place straps, perform a user seal check and remove the respirator using straps.
Respiration; Respiratory-equipment; Respiratory-protection; Respiratory-protective-equipment; Aerosols; Aerosol-particles; Diseases; Medical-facilities; Public-health; Humans; Men; Women; Health-care-personnel; Workers; Risk-factors; Training; Infectious-diseases; Viral-infections; Viral-diseases;
Author Keywords: Respiratory protection; Healthcare; Aerosol transmissible disease;
Lisa M. Brosseau, ScD, University of Minnesota, School of Public Health, 420 Delaware St SE, Minneapolis MN 55455
Journal of Occupational and Environmental Hygiene