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Healthcare Respiratory Protection Resources

Program Administrator

Program Administrator

NIOSH Documents

Filtering Facepiece Respirators with an Exhalation Valve: Measurements of Filtration Efficiency to Evaluate Their Potential for Source Control
This technical report summarizes research undertaken by the National Personal Protective Technology Laboratory (NPPTL) to provide improved science-based recommendations on the use of filtering facepiece respirators (FFRs) with an exhalation valve. FFR models with an exhalation valve are thought to increase the wearer’s comfort at high work rates and be suitable for longer periods of use. However, respiratory secretions expelled by wearers may exit along with air through the exhalation valve. A concern with FFRs with an exhalation valve is that individuals may spread disease if unfiltered, virus-laden aerosols pass through the valve. Therefore, the question has emerged about the effectiveness of using an FFR with an exhalation valve for source control—i.e., to filter respiratory secretions to prevent disease transmission to others—and whether the valve should be covered with a surgical mask, procedure mask, or a cloth face covering that does not interfere with the respirator fit.

The findings in this report are based on tests of 13 FFR models from 10 different manufacturers. These findings show that FFRs with an exhalation valve provide respiratory protection to the wearer and can also reduce particle emissions to levels similar to or better than those provided by surgical masks, procedure masks, or cloth face coverings. This study also shows that modifications to these respirators can further reduce particle emissions. Specifically, the use of an electrocardiogram pad or surgical tape secured over the valve from the inside of the FFR can provide source control similar to that of an FFR with no exhalation valve. These findings have important implications for guidance on source control and mitigation.

Hospital Respiratory Protection Program Toolkit
This toolkit was developed to assist hospitals in developing and implementing effective respiratory protection programs, with an emphasis on preventing the transmission of aerosol transmissible diseases (ATDs) to healthcare personnel.

Healthcare personnel are paid and unpaid persons who provide patient care in a healthcare setting or support the delivery of healthcare by providing clerical, dietary, housekeeping, engineering, security, or maintenance services. Healthcare personnel may potentially be exposed to ATD pathogens. Aerosols are particles or droplets suspended in air. ATDs are diseases transmitted when infectious agents, which are suspended or present in particles or droplets, contact the mucous membranes or are inhaled.

Implementing Hospital Respiratory Protection Programs: Strategies from the Field
Protecting workers from exposure to all types of respiratory hazards is an important issue for hospitals and other healthcare organizations. In order to address this often overlooked danger, The Joint Commission and Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL) have collaborated to develop a new educational monograph designed to assist hospitals in implementing their respiratory protection programs (RPPs).


Year of the Nurse
The World Health Organization has designated 2020 the Year of the Nurse and the Midwife. Nurses play a critical role in our healthcare system and in the lives of the patients they care for.

Journal Articles

Differences in hospital managers’, unit managers’, and health care workers’ perceptions of the safety climate for respiratory protection
Peterson-K; Rogers-BME; Brosseau-LM; Payne-J; Cooney-J; Joe-L Novak-D, Workplace Health Saf 2014 Apr.

Respiratory Protection: Compliance, Research are Key Issues for the Future