User acceptance of reusable respirators in health care

Abstract

Background: Inclusion of reusable respirators, such as elastomeric half-face respirators (EHFRs) and powered air-purifying respirators (PAPRs), in hospital respiratory protection inventories may represent 1 solution to the problem of N95 respirator shortages experienced during pandemics. User acceptance of these devices is 1 potential barrier to implementing such a strategy in respiratory protection programs. Methods: To assess user attitudes toward various respirators, health care workers enrolled in respiratory protection programs in a medical system using EHFRs, N95s, and PAPRs and completed an online questionnaire that addressed attitudes, beliefs, and respirator preferences under different risk scenarios. Responses were compared between user groups. Results: Of 1,152 participants, 53% currently used N95s, 24% used EHFRs, and 23% used PAPRs. N95 users rated their respirators more favorably compared with EHFR and PAPR users (P < .001) regarding comfort and communication, however, EHFR users rated their respirators much more highly regarding sense of protection (P < .001). For all user groups, reusable respirators were significantly more likely (odds ratios 2.3-7.7) to be preferred over N95 filtering facepiece respirators in higher risk scenarios compared to "usual circumstance" scenarios. Conclusions: Despite somewhat less favorable ratings on comfort and communication, experienced EHFR and PAPR users still prefer reusable respirators over N95s in certain higher risk scenarios. This suggests that reusable respirators are an acceptable alternative to N95 respirators in health care and offer 1 viable solution to prevent pandemic-generated respirator shortages.

Self-reported impact of respirator use on health care worker ability to perform patient care

“…For example, previous research found that elastomeric respirator users, who rated the respirators less favorably with respect to comfort, but higher in perceived level of protection, still preferred to use them in certain higher risk scenarios, such as during pandemic influenza. 9 Acceptance of less convenient but more protective safeguards may be more pronounced among HCWs while providing care to COVID-19 patients.…”

“…HCWs enrolled in a medical system's respiratory protection program were queried both during a focus group interview of 11 hospital staff members and a larger medical system-wide electronic survey of 1,152 HCWs regarding their perceptions and beliefs about the impact of respirators on their ability to provide patient care. 8,9…”

Training and Fit Testing of Health Care Personnel for Reusable Elastomeric Half-Mask Respirators Compared With Disposable N95 Respirators

“…These reusable respirators are used in construction and manufacturing, but not widely used in health care 4 because of uncertainty about disinfection methods and upfront costs. 5 The goal of this demonstration study was to test the feasibility of rapidly training and fit testing health care workers to EHMRs. which health care personnel, who were randomized to EHMR (80%) or N95 (20%) groups, were rapidly fit tested and trained.…”

“…We divided our population using the National Center for Health Statistics urban-rural classification scheme into large metropolitan (≥1 million), medium and small metropolitan (50 000-999 999), and rural (<50 000) counties per the 2013 US Census classification. 5 Because data were publicly available and deidentified, ethics committee approval was not required.…”

Evaluating the Consistency of a Breathing Flow Recording Device Across Different Elastomeric Half-Mask Respirators

“…Additionally, PAPRs have been found favorable to HCWs in 6 high risk scenarios. This is because the devices are reusable and give the user a better sense of protection [14]. A study performed by Khoo…”