Fit-testing of respiratory protective equipment in the UK during the initial response to the COVID-19 pandemic

Green, S.; Gani, Akil; Bailey, Morgan; Brown, Oliver S.; Hing, Caroline

doi:10.1016/j.jhin.2021.04.024

Cited by 12 publications

(16 citation statements)

References 6 publications

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“…While the aforementioned studies found females were less readily fitted to an FFR, other research has found no significant difference in pass rates between males and females. 13 , 14 , 19 , 21 , 27 Foreland et al reported no significant difference in fit test pass rate between sexes, but their sample of 127 Norwegian workers included only 15 females. 13 Both Spies et al and Winter et al supported this finding, however smaller sample sizes of less than 50 HCWs were utilised.…”

Section: Discussionmentioning

confidence: 95%

“…This large-scale multicenter study only considered the rate of total failure across all FFRs tested, including reusable respirator models, rendering comparison with the present study difficult. 27 Oestenstad and Bartolucci assert that while sex may have influence FFR fit, individual facial anthropometric dimensions are of greater importance. 28 …”

Section: Discussionmentioning

confidence: 99%

“…More recent QNFT studies have not reported on age as a variable in fit testing. 17 , 18 , 27 , 29 Theoretically, age can influence respirator fit; Zhuang et al found statistically significant differences in facial anthropometric dimensions across almost 4000 U.S. survey respondents who were over 45 years old, when compared to workers aged between 18 and 29. 30 In the present study, 67% of fit tested HCWs were female.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

P2/N95 filtering facepiece respirators: Results of a large-scale quantitative mask fit testing program in Australian health care workers

Milosevic

Biswas

Innes

et al. 2022

American Journal of Infection Control

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

P2/N95 filtering facepiece respirators: Results of a large-scale quantitative mask fit testing program in Australian health care workers

Milosevic

Biswas

Innes

et al. 2022

American Journal of Infection Control

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“…More skin reactions among females may be explained by genetic factors, hormonal differences, physical activity, hygiene practices and the use of skin care products ( 15 ). Moreover, PPE is typically designed for white male size and shape and incorrect fitting for the anthropometric facial features of Black, Asian, and Minority (BAME) ethnicities has been reported elsewhere ( 17 , 30 ). Hence, in this study, ill-fitted PPE, due to gender differences in facial features, may account for the increased skin reactions seen among females when worn for extended periods.…”

Section: Discussionmentioning

confidence: 99%

Personal protective equipment (PPE) related adverse skin reactions among healthcare workers at the main COVID-19 isolation center in Barbados

Bharatha

Krishnamurthy

Rahman³

et al. 2022

Front. Public Health

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BackgroundThe use of personal protective equipment (PPE) reduces the risk of transmission of infectious agents significantly among healthcare workers (HCWs). The study aimed to investigate the prevalence and characteristics of PPE-related adverse skin reactions among HCWs working at the main COVID-19 isolation center in Barbados.MethodsA cross-sectional web-based online survey was conducted during April to June 2021 which recorded demographic information, details of PPE use and adverse skin reactions including severity and duration of onset of symptoms.ResultsMost of the respondents used PPE for consecutive days (77.9%), 1–6 h/day (59.2%), and more than a year (62.5%). Fewer than half of the participants (45.6%) experienced adverse skin reactions from the use of PPE. The reactions were mostly observed in the cheeks (40.4%) and nose bridges (35.6%). Females had more reactions than their male counterparts (p = 0.003). The use of N95 masks and a combination of surgical and N95 masks produced adverse effects predominantly in the ears (60%) and cheeks (56.4%). Binary logistic regression showed that female HCWs (OR = 5.720 95% CI: 1.631, 20.063), doctors (OR = 5.215 95% CI: 0.877, 31.002), and longer duration of PPE use (>1 year) (OR = 2.902 95% CI: 0.958, 8.787) caused a significantly higher prevalence of adverse skin reactions.ConclusionThe PPE-related skin reactions were common among HCWs which mainly occurred due to prolonged use. Preventive measures inclusive of appropriate training of HCWs on the use of PPE are recommended to minimize these adverse events.

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“…24 , 25 It is known that the respirator fit pass rate vary with ethnicity. 26 , 27 Similarly, we only tested for three respirators. Therefore, the results may be different among other N95 respirators.…”

Section: Discussionmentioning

confidence: 99%

Prediction of N95 Respirator Fit from Fogging of Eyeglasses: A Pilot Study

Kyaw¹,

Johns²,

Lim³

et al. 2021

Indian Journal of Critical Care Medicine

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A bstract Aim and objective Fogging of eyeglasses while wearing N95 respirators is common. It is commonly held that the N95 respirator has a poor fit if there is fogging of eyeglasses. We conducted this prospective, pilot study to determine if fogging of eyeglasses predicts poor fit of N95 respirator. Materials and methods Seventy volunteer healthcare workers from a tertiary intensive care unit in Sydney, Australia participated. The participants donned one of the following N95 respirators: three-panel flat-fold respirator (3M 1870), cup-shaped respirator (3M 1860), or a duckbill respirator. After a satisfactory “user seal check” as recommended by the manufacturer, the participants donned eyeglasses and checked for fogging. A quantitative fit test (QnFT) of the respirator was then performed (using PortaCount Respirator Fit Tester 8048, TSI Inc., Minnesota, USA). A fit factor of <100 on quantitative fit testing indicates poor fit. The sensitivity and specificity for fogging of eyeglasses (index test) to predict the poor fit of N95 respirator was determined, compared to QnFT (gold standard test). Results Fogging of eyeglasses as a predictor of poor respirator fit (i.e., fit factor <100 on QnFT) had sensitivity of 71% (95% CI, 54–85%) and specificity 46% (95% CI, 29–63%). The odds ratio of fogging as a predictor for poor fit was 2.10 (95% CI, 0.78–5.67), with a two-tailed p -value of 0.22 (not significant). The receiver operating characteristic curve for fogging of eyeglasses as a diagnostic test had the area under the curve of 0.59. Conclusion Fogging of eyeglasses is neither a sensitive nor a specific predictor for poor fit of N95 respirators. How to cite this article Kyaw S, Johns M, Lim R, Stewart WC, Rojas N, Thambiraj SR, et al. Prediction of N95 Respirator Fit from Fogging of Eyeglasses: A Pilot Study. Indian J Crit Care Med 2021;25(9):976–980.

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Fit-testing of respiratory protective equipment in the UK during the initial response to the COVID-19 pandemic

Cited by 12 publications

References 6 publications

P2/N95 filtering facepiece respirators: Results of a large-scale quantitative mask fit testing program in Australian health care workers

P2/N95 filtering facepiece respirators: Results of a large-scale quantitative mask fit testing program in Australian health care workers

Personal protective equipment (PPE) related adverse skin reactions among healthcare workers at the main COVID-19 isolation center in Barbados

Prediction of N95 Respirator Fit from Fogging of Eyeglasses: A Pilot Study

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