Surgical mask placement over N95 filtering facepiece respirators: Physiological effects on healthcare workers

Roberge, Raymond J.; Coca, Aitor; Williams, W. Jon; Palmiero, Andrew J.; Powell, Jeffrey B.

doi:10.1111/j.1440-1843.2010.01713.x

Cited by 254 publications

(404 citation statements)

References 25 publications

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“…Interestingly, there was only one subject who mentioned the presence of moisture, a characteristic that has been reported as a major deterrent to respirator use. (22) This tends to agree with observations from the Roberge et al (23) study that found only minimal moisture (∼0.10 g) was retained on an N95 FFR after a subject's walking on a treadmill for an hour while wearing a respirator. However, given that the subjects only wore the FFR for ∼ 30 min in this study, this finding may not be surprising.…”

Section: Discussionsupporting

confidence: 78%

Impact of Three Biological Decontamination Methods on Filtering Facepiece Respirator Fit, Odor, Comfort, and Donning Ease

Viscusi

Bergman²,

Novak

et al. 2011

Journal of Occupational and Environmental Hygiene

139

255

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The objective of this study was to determine if ultraviolet germicidal irradiation (UVGI), moist heat incubation (MHI), or microwave-generated steam (MGS) decontamination affects the fitting characteristics, odor, comfort, or donning ease of six N95 filtering facepiece respirator (FFR) models. For each model, 10 experienced test subjects qualified for the study by passing a standard OSHA quantitative fit test. Once qualified, each subject performed a series of fit tests to assess respirator fit and completed surveys to evaluate odor, comfort, and donning ease with FFRs that were not decontaminated (controls) and with FFRs of the same model that had been decontaminated. Respirator fit was quantitatively measured using a multidonning protocol with the TSI PORTACOUNT Plus and the N95 Companion accessory (designed to count only particles resulting from face to face-seal leakage). Participants' subjective appraisals of the respirator's odor, comfort, and donning ease were captured using a visual analog scale survey. Wilcoxon signed rank tests compared median values for fit, odor, comfort, and donning ease for each FFR and decontamination method against their respective controls for a given model. Two of the six FFRs demonstrated a statistically significant reduction (p< 0.05) in fit after MHI decontamination. However, for these two FFR models, post-decontamination mean fit factors were still ≥ 100. One of the other FFRs demonstrated a relatively small though statistically significant increase (p < 0.05) in median odor response after MHI decontamination. These data suggest that FFR users with characteristics similar to those in this study population would be unlikely to experience a clinically meaningful reduction in fit, increase in odor, increase in discomfort, or increased difficulty in donning with the six FFRs included in this study after UVGI, MHI, or MGS decontamination. Further research is needed before decontamination of N95 FFRs for purposes of reuse can be recommended.

show abstract

Section: Discussionsupporting

confidence: 78%

Impact of Three Biological Decontamination Methods on Filtering Facepiece Respirator Fit, Odor, Comfort, and Donning Ease

Viscusi

Bergman²,

Novak

et al. 2011

Journal of Occupational and Environmental Hygiene

139

255

View full text Add to dashboard Cite

show abstract

“…Arising from the difference of breathing resistance, lower heart rate was observed among the group wearing surgical masks than those wearing N95 masks (Li et al, 2005). In addition, it was also shown that N95 FFR dead-space has higher carbon dioxide and lower oxygen levels than the ambient workplace standards, respectively (Roberge et al, 2010). In developing more comfortable respiratory masks, an exhalation valve on the N95 respirator is being adopted and is shown not to affect the respiratory protection, while contributing to reducing the breathing resistance (Lee et al, 2008).…”

mentioning

confidence: 85%

Airflow resistance and bio-filtering performance of carbon nanotube filters and current facepiece respirators

Zou

Yao

2015

Journal of Aerosol Science

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“…Data collected showed that dead-space CO 2 ranged from 2.5-3.5% CO 2 which is significantly above OSHA's ambient workplace standards. Roberge et al (2010) concluded that even though the RPD did not impose any significant physiological burden on participants, CO 2 retention was a possibility due to elevated transcutaneous CO 2 (equivalent to arterial CO 2 ) levels. On a similar note, although no symptoms of CO 2 retention were recorded in this study, the increases in CO 2 during speech were sufficient enough to impact the participant.…”

Section: Discussionmentioning

confidence: 99%

Carbon dioxide rebreathing in respiratory protective devices: influence of speech and work rate in full-face masks

2013

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Surgical mask placement over N95 filtering facepiece respirators: Physiological effects on healthcare workers

Abstract: Use of a surgical mask as an outer barrier over N95 filtering facepiece respirators does not significantly impact the physiological burden or perceptions of comfort and exertion by the wearer over that experienced without use of a surgical mask.

Cited by 254 publications

References 25 publications

Impact of Three Biological Decontamination Methods on Filtering Facepiece Respirator Fit, Odor, Comfort, and Donning Ease

Impact of Three Biological Decontamination Methods on Filtering Facepiece Respirator Fit, Odor, Comfort, and Donning Ease

Airflow resistance and bio-filtering performance of carbon nanotube filters and current facepiece respirators

Carbon dioxide rebreathing in respiratory protective devices: influence of speech and work rate in full-face masks

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