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Filtration Efficiency of Hospital Face Mask Alternatives Available for Use During the COVID-19 Pandemic
- Source :
- JAMA Internal Medicine
- Publication Year :
- 2020
- Publisher :
- American Medical Association (AMA), 2020.
-
Abstract
- Importance Procuring respiratory protection for clinicians and other health care workers has become a major challenge of the coronavirus disease 2019 (COVID-19) pandemic and has resulted in nonstandard practices such as the use of expired respirators and various decontamination processes to prolong the useful life of respirators in health care settings. In addition, imported, non–National Institute for Occupational Safety and Health (NIOSH)-approved respirators have been donated or acquired by hospitals as a potential replacement for limited NIOSH-approved N95 respirators. Objective To assess fitted filtration efficiencies (FFEs) for face mask alternatives used during the COVID-19 pandemic. Design, Setting, and Participants For this quality-improvement study conducted between April and June 2020, we used the Occupational Safety and Health Administration’s Quantitative Fit Testing Protocol for Filtering Facepiece Respirators in a laboratory atmosphere supplemented with sodium chloride particles to assess the FFEs of a variety of respirators worn by a male volunteer and female volunteer. Main Outcomes and Measures The FFEs of respirators commonly worn by clinicians and other health care workers and available respirator alternatives during the COVID-19 pandemic. Results Of the 29 different fitted face mask alternatives tested on 1 man and 1 woman, expired N95 respirators with intact elastic straps and respirators subjected to ethylene oxide and hydrogen peroxide sterilization had unchanged FFE (>95%). The performance of N95 respirators in the wrong size had slightly decreased performance (90%-95% FFE). All of the respirators not listed as approved in this evaluation (n = 6) failed to achieve 95% FFE. Neither of the 2 imported respirators authorized for use by the Centers for Disease Control and Prevention that were not NIOSH-approved tested in this study achieved 95% FFE, and the more effective of the 2 functioned at approximately 80% FFE. Surgical and procedural face masks had filtering performance that was lower relative to that of N95 respirators (98.5% overall FFE), with procedural face masks secured with elastic ear loops showing the lowest efficiency (38.1% overall FFE). Conclusions and Relevance This quality-improvement study evaluating 29 face mask alternatives for use by clinicians interacting with patients during the COVID-19 pandemic found that expired N95 respirators and sterilized, used N95 respirators can be used when new N95 respirators are not available. Other alternatives may provide less effective filtration.
- Subjects :
- Ethylene Oxide
Infectious Disease Transmission, Patient-to-Professional
business.product_category
Coronavirus disease 2019 (COVID-19)
N95 Respirators
Health Personnel
Fit testing
01 natural sciences
Occupational safety and health
03 medical and health sciences
0302 clinical medicine
Materials Testing
Health care
Pandemic
Equipment Reuse
Internal Medicine
Humans
Medicine
030212 general & internal medicine
0101 mathematics
Respirator
Infection Control
SARS-CoV-2
business.industry
010102 general mathematics
Masks
COVID-19
Sterilization
Hydrogen Peroxide
medicine.disease
Quality Improvement
Disease control
Equipment Failure Analysis
Face masks
Equipment Contamination
Medical emergency
business
Filtration
Disinfectants
Subjects
Details
- ISSN :
- 21686106
- Volume :
- 180
- Database :
- OpenAIRE
- Journal :
- JAMA Internal Medicine
- Accession number :
- edsair.doi.dedup.....8b9b93d92ebd2cb3d14f3135b4b6333b