Physiologic and other effects and compliance with long-term respirator use among medical intensive care unit nurses

Rebmann, Terri; Carrico, Ruth; Wang, Jing

doi:10.1016/j.ajic.2013.02.017

Cited by 246 publications

(335 citation statements)

References 12 publications

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“…These findings, and recent evidence of physiological tolerance to long-term (12 hours) use of an N95 FFR by nonpregnant women, 27 suggest that N95 FFRs are likely to be safe for use by healthy, pregnant women and should serve as a stimulus for a larger study. Research reporting that the use of medical/surgical masks results in similar physiological effects as N95 FFR 37 implies that these protective facemasks are also safe for use during pregnancy.…”

Section: Discussionmentioning

confidence: 72%

“…At low work levels over 1 hour, mixed inhalation/exhalation N95 FFR deadspace CO 2 (2.8%-2.9%) 23,24 exceeds ambient levels and results in rebreathing of CO 2 ; however, CO 2 retention is generally minimal, because respirator deadspace CO 2 ≤2% is fully compensable in the short term. 26 These findings, along with the mild increase (ie, 7.6 mm Hg) in PtcCO 2 reported with 12 hours of N95 FFR use by female health care workers, 27 suggest that CO 2 retention sufficient to cause fetal distress (PtcCO 2 ≥60 mm Hg) 28,29 should not occur in healthy pregnant women wearing an N95 FFR. The finding of a significant effect of N95 FFR use on PtcCO 2 over time during exercise ( P = .04) is related to the rebreathing of higher CO 2 levels generated during exercise.…”

Section: Discussionmentioning

confidence: 99%

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N95 respirator use during advanced pregnancy

Roberge

Kim

Powell

2014

American Journal of Infection Control

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Background To determine the physiological and subjective effects of wearing an N95 filtering facepiece respirator (N95 FFR) in advanced stages of pregnancy. Methods Healthy pregnant women (n = 22) and nonpregnant women (n = 22) had physiological and subjective measurements taken with and without wearing an N95 FFR during exercise and postural sedentary activities over a 1-hour period. Results There were no differences between the pregnant and nonpregnant women with respect to heart rate, respiratory rate, oxygen saturation, transcutaneous carbon dioxide level, chest wall temperature, aural temperature, and subjective perceptions of exertion and thermal comfort. No significant effect on fetal heart rate was noted. Conclusions Healthy pregnant women wearing an N95 FFR for 1 hour during exercise and sedentary activities did not exhibit any significant differences in measured physiological and subjective responses compared with nonpregnant women.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

N95 respirator use during advanced pregnancy

Roberge

Kim

Powell

2014

American Journal of Infection Control

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“…However, prior research [7] has demonstrated no significant effect in core temperatures during up to 2 h of wearing N95 FFRs at low-moderate work rates, and investigation a included single day testing in which subjects wore N95 FFRs for a total of 4 h with only 30 min breaks between successive hours of exercise and no clinically significant changes in TMT were noted. Though recent data has indicated that elevated BMI and age may have a relationship with thermal discomfort experienced with wearing N95 FFRs [24], we did not analyze the possible impact of BMI or age on TMT because few of our subjects were overweight (9 %) or age ≥30 years (12 %). Only adult subjects were enrolled, so that we cannot comment on the impact of protective facemask wear on children.…”

Section: Discussionmentioning

confidence: 99%

Effect of wearing an N95 respirator on infrared tympanic membrane temperature measurements

Kim

Roberge

Powell

2014

J Clin Monit Comput

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To determine the impact of wearing an N95 filtering facepiece respirator (N95 FFR) on tympanic temperature measurements. TMT measurements, with and without wearing an N95 filtering facepiece respirator (N95 FFR) were obtained at the onset and termination of 1 h of treadmill exercise in 21 subjects, and at staggered time intervals (0, 20, 40, 60 min) during combined sedentary activity and exercise of another 46 subjects, to determine any effect on TMT. A total of 877 TMT measurements were obtained that demonstrated a mean TMT increase of 0.05 °C in the first study group (p = 0.04) and a 0.19 °C decrease in the second study group (p < 0.001) with the wearing of an N95 FFR, both of which were lower than controls. Wearing an N95 FFR for 1 h, at different levels of activity, results in significantly lower TMT values than not wearing an N95 FFR, but the magnitude of the changes would likely have minimal clinical significance.

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“…The main test variable in this study is the survival of bacteria that were loaded on N95 FFRs that were decontaminated by various methods under worst‐case temperature and humidity, which prevail when an FFR is placed in a zipper bag in a healthcare worker's pocket with the goal of preventing cross‐contamination, and touching of the respirator . In the experiment, B. subtilis spores were the tested microbial strain; a six‐jet Collison nebulizer (BGI, Waltham, MA) sprayed the spores into a test system, shown in Figure , where they were loaded on N95 FFRs by suction to simulate the respiratory flow of workers during intensive activity .…”

Section: Methodsmentioning

confidence: 99%

Relative survival of Bacillus subtilis spores loaded on filtering facepiece respirators after five decontamination methods

et al. 2018

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This study determines the relative survival (RS) of Bacillus subtilis spores loaded on an N95 filtering facepiece respirator (FFR) after decontamination by five methods under worst-case conditions. Relative survival was obtained by testing after decontamination and after storing the FFRs at 37°C and 95% relative humidity for 24 hours. The decontamination methods involved ethanol, bleach, ultraviolet irradiation (UVA 365 nm, UVC 254 nm), an autoclave, and a traditional electric rice cooker (TERC) that was made in Taiwan. Without decontamination, 59 ± 8% of the loaded spores survived for 24 hours. When 70% ethanol was added to the N95 FFR at a packing density of 0.23, the RS was 73 ± 5% initially and decayed to 22 ± 8% in 24 hours. Relative survival remained above 20% after 20 minutes of UVA irradiation. The other four decontamination measures achieved 99%-100% biocidal efficacy, as measured immediately after the methods were applied to the test FFRs. Relative survival is a useful parameter for measuring sterilization or degree of disinfection. Bleach, UVC, an autoclave, and a TERC provide better biocidal efficacy than ethanol and UVA. Not only a higher filter quality but also a lower value of RS produced the most decontaminated FFR.

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Physiologic and other effects and compliance with long-term respirator use among medical intensive care unit nurses

Abstract: Long-term use of respiratory protection did not result in any clinically relevant physiologic burden for health care personnel, although many subjective symptoms were reported. N95 compliance was fairly high.

Cited by 246 publications

References 12 publications

N95 respirator use during advanced pregnancy

N95 respirator use during advanced pregnancy

Effect of wearing an N95 respirator on infrared tympanic membrane temperature measurements

Relative survival of Bacillus subtilis spores loaded on filtering facepiece respirators after five decontamination methods

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