The pragmatic use of industrial elastomeric facemasks in health care practice during the COVID-19 pandemic

McMahon, Kathleèn; Jeanmonod, Donald; Check, R.; Rivard, Leah; Balakrishnan, Vamsi; Kelly, Brian; Pester, J.; Jeanmonod, Rebecca

doi:10.1016/j.ajem.2021.05.025

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…This finding is reassuring, as seal quality is the most important factor regarding employee safety in an airborne pandemic. This finding corresponds to the literature that reported data about mask seal quality in reusable elastomeric masks [ 27 , 28 ].…”

Section: Discussionsupporting

confidence: 91%

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Reusable respirators as personal protective equipment in clinical practice

Maleczek

Toemboel

Erp

et al. 2022

Wien Klin Wochenschr

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Summary Background The novel strain of severe acute respiratory syndrome coronavirus 2 is highly contagious; therefore, special emphasis must be given to personal protective equipment for healthcare workers. Reusable elastomeric respirators were previously used in intensive care units (ICU). These respirators include full or half masks and devices modified to accommodate a filter. Although the general comfort of masks used in the ICU has been studied, data comparing multiple types of masks during a pandemic are missing. Methods A prospective randomized trial was conducted in an ICU. After standardized training, participants were randomized to use one of three mask types (full, half or snorkelling mask), each fitted with a filter equivalent to a class 3 particle-filtering half mask (FFP3) during one shift. The main outcomes were characteristics of using the mask itself (donning/doffing, quality of seal, cleaning), working conditions with the mask (vision, comfort, perceived safety, communication) and a subjective comparison to single-use FFP2/3 masks. Results A total of 30 participants were included in the trial, randomized to 10 participants per group. The masks were worn 6.4 (4.5) times (mean SD) for a total duration of 132 (66) min per shift. The tested masks were rated 7 (2.6) (mean SD) in comparison to FFP2/3 on a Likert scale (0: worst, 10: best). Significant differences between the masks were found in respect to comfort (7/4/8), donning (8/7/9), overall rating (8/5/8) and comparison to single-use FFP2/3 masks (9/7/9; full-, half, snorkelling mask). Conclusion Using reusable elastomeric masks is feasible in clinical practice. Full face masks were significantly better in terms of comfort, donning, overall rating and in comparison to single-use FFP2/3 masks.

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Section: Discussionsupporting

confidence: 91%

“…In contrast to full masks, the use of three devices instead of one can change comfort ratings. This fits into the current literature reporting the use of elastomeric masks [ 11 , 16 , 27 ].…”

Section: Discussionsupporting

confidence: 87%

Reusable respirators as personal protective equipment in clinical practice

Maleczek

Toemboel

Erp

et al. 2022

Wien Klin Wochenschr

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“…A limited number of trials with small numbers of participants indicate high filtration using N95 respirators even with suboptimal fit or in the absence of fit testing and training. 65 66 67 68 69…”

Section: Discussionmentioning

confidence: 99%

Can 10x cheaper, lower-efficiency particulate air filters and box fans complement High-Efficiency Particulate Air (HEPA) purifiers to help control the COVID-19 pandemic?

Srikrishna

2021

Preprint

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BackgroundSARS-Cov-2 aerosols have potential to accumulate in airspaces of poorly ventilated, indoor spaces such as classrooms, offices, homes, restaurants, and bars. Separately, toxic aerosol pollution (e.g. wildfires, wood burning) is frequently encountered in these locations with ventilation relying on outside air. Portable high efficiency particulate air (HEPA) air purifiers are useful to remove both types of aerosols without relying on outside ventilation. To meet or exceed recommended 4 to 6 air exchanges per hour (ACH), high price-points for select HEPA air purifier models without incurring excessive noise generation make them unaffordable for many households and communities. Do-it-yourself (DIY) alternatives with box-fans and HVAC filters can be much lower cost but their clean air delivery rate (CADR) and noise generation varies greatly depending on choices of filters, number of filters, and fan speeds.ObjectiveTo compare cost-effectiveness and noise-generation of aerosol filtration by commercially available, portable HEPA air purifiers and do-it-yourself (DIY) alternatives built from box fans and HVAC filters rated at MERV 13 or 14 using single and quad filter designs.MethodsThe comparison is based on three metrics: clean air delivery rate (CADR), the noise generated (dBA), and affordability ($$) using an ISO-certified aerosol measurement device to measure input/output particle filtration of particles sizes ranging from 0.3 microns to 10 microns, airspeed meter to measure airflow, and NIOSH sound meter app to measure noise.ResultsAccounting for reduced filtration efficiency of MERV 13/14 filters compared to HEPA, estimated clean air delivery rate (CADR) of a do-it-yourself (DIY) setup using 2” and 4” filters with a box fan running at fan speed 1 for tolerable noise was 278 cfm ($38) to 371 cfm ($58), comparable or better than a commercial HEPA air purifiers running at maximum speed with low noise generation at 282 cfm ($375). However the quad filter designs, popularly known as the Corsi-Rosenthal box, achieved gains in CADR of only 60% over a single filter design but in contrast to 200-250% gains reported by UC-Davis.ConclusionsDIY alternatives using single 1”, 2” and 4” MERV 13/14 filters compare favorably to commercially available systems in terms of estimated CADR and noise but at five to ten times lower cost. Compared to use of one filter, an improvement in CADR (air flow) was observed with a popular DIY configuration involving quad filter design, popularly known as the Corsi-Rosenthal box, not as high as reported by a recent study by UC-Davis

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“…[10] Fit-testing staff adds burden to infection control teams, but NHS trusts which have made the switch have demonstrated it is possible, and there is evidence that reusable elastomeric respirators (but not disposable FFP3 masks) may be used safely with a "fit check" alone. [11] It is clear that tighter-fitting masks can be less comfortableparticularly if the fit is not suitable for the user, but surveyed staff appear in general to prefer the higher level of protection. [12] Most healthcare staff are now vaccinated, but the B1.617.2 (delta) variant appears to reduce vaccine effectiveness at a time when staff absences due to sickness and isolation can critically hamper NHS recovery as patients await delayed treatment.…”

mentioning

confidence: 99%