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Zhang M(M, Hackett L, Smith J, Pritchard Z, Casey M, Low C, Buntine P. Striving to be the fittest: quantitative P2/N95 respirator fit test results among hospital staff during the COVID-19 pandemic. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e233. [PMID: 38156215 PMCID: PMC10753470 DOI: 10.1017/ash.2023.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 12/30/2023]
Abstract
Objective To provide fit rates for specific P2/N95 respirators and compare these results by age, sex, clean-shaven status, and fit tester experience. Design Exploratory audit involving secondary analysis of existing quantitative fit testing data. Setting In response to the COVID-19 pandemic, healthcare services across Australia implemented respiratory protection protocols. This study details healthcare workers' (HCWs) fit testing results from a large Victorian public health service. Participants Fit-tested employees of a large tertiary public health network. Methods Fit rates for ten individual P2/N95 respirators were calculated, and the effect of age, sex, clean-shaven status, and fit tester experience was examined via logistic regression. Results 4593 employees were included, with 97.98% successfully fitting at least one respirator. Males were found to have significantly increased odds of achieving fit success compared to females (OR 11.61 95%CI 1.60-84.10). Fit rates dropped by 4% with each 1-year age increase (OR 0.96 95%CI 0.94-0.98). Clean-shaven individuals were also more likely to achieve a fit compared to non-clean-shaved individuals (OR 79.23 95%CI 10.21-614.62). More experienced fit testers also yielded significantly higher fit rates (OR 3.95, 95%CI 2.34-6.67). Conclusions 98% of staff achieved a successful fitting of at least one respirator, with three-panel flat fold models (Industree Trident, 3M Aura 9320A+, and 3M Aura 1870+) performing the most consistently. An individual's ability to achieve a successful fit was associated with; male sex, younger age, clean-shaven status, and fit tester experience.
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Affiliation(s)
- Melanie (Meilun) Zhang
- Eastern Health Clinical School, Monash University, Melbourne, Australia
- Department of General Surgery, Eastern Health, Melbourne, Australia
| | - Liam Hackett
- Eastern Health Clinical School, Monash University, Melbourne, Australia
- Eastern Health Emergency Medicine Program, Melbourne, Australia
| | - Jesse Smith
- Eastern Health Emergency Medicine Program, Melbourne, Australia
| | - Zoe Pritchard
- Eastern Health Emergency Medicine Program, Melbourne, Australia
- Genitourinary Medicine, Chalmers Centre, NHS Lothian, Scotland
| | - Matthew Casey
- OHS, Emergency Management and Wellbeing, Eastern Health, Melbourne, Australia
| | - Caitlin Low
- Eastern Health Clinical School, Monash University, Melbourne, Australia
- Department of Anaesthesia, Pain and Perioperative Medicine, Eastern Health, Melbourne, Australia
- Department of Anaesthesia, Austin Health, Melbourne, Australia
| | - Paul Buntine
- Eastern Health Clinical School, Monash University, Melbourne, Australia
- Eastern Health Emergency Medicine Program, Melbourne, Australia
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Khairul Hasni NA, Ismail R, Muhamad Robat R, Mohamad N, Suib FA, Pahrol MA, Mahmud H, Osman B, Lim YC, Seman Z, Shaharudin R. The effect of N95 designs on respirator fit and its associations with gender and facial dimensions. PLoS One 2023; 18:e0288105. [PMID: 38019763 PMCID: PMC10686483 DOI: 10.1371/journal.pone.0288105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/28/2023] [Indexed: 12/01/2023] Open
Abstract
This study examined the association of various brands of NIOSH-certified N95 filtering face-piece respirators (FFR) fit with facial dimensions and gender. One hundred and thirty-five participants (77 females and 58 males) were recruited from the previous facial anthropometry study among Malaysians in 2020. Quantitative respirator fit testing of six FFR were performed using the TSI Portacount Pro+ 8038 which comprised of four exercises (bending over, talking, up-down head movement, and side to side head movement). An overall fit factor (FF) of ≥ 100 was considered a pass for each FFR. Analysis was done using T-test, Pearson's correlations, and generalised linear regression. The passing rates for the six FFR were 36.3% (Cup B), 50.4% (Trifold A), 54.1% (Duckbill A), 57.0% (Cup A), 74.1% (Trifold B), and 83.7% (Duckbill B). Both Duckbill B and Trifold B had the highest passing rates for both genders. However, certain FFR models (Cup B, Trifold A, Trifold B, and Duckbill A) fit better for participants with large facial size who were mostly males, while others (Cup A and Duckbill B) specifically fit better for those with small facial size, who were mostly females. This study showed significant positive effect of nose protrusion, nasal root and subnasale-sellion and the negative effect of menton-sellion, bigonial breadth and nose breadth on fit factors of various FFR. The results of this study emphasized the importance of choosing and designing FFR based on local anthropometry data, with careful consideration on the dimensions that affect the respirator fit. Since N95 are commonly used in the healthcare settings to prevent airborne transmission, the practice of respirator fit testing and selecting N95 with high passing rates for healthcare workers need to be emphasized.
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Affiliation(s)
- Nurul Amalina Khairul Hasni
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Rosnawati Muhamad Robat
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Nadia Mohamad
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Fatin Amirah Suib
- Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Muhammad Alfatih Pahrol
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Haalah Mahmud
- National Institute of Occupational Safety and Health, Ministry of Human Resources, Malaysia
| | - Baderin Osman
- National Institute of Occupational Safety and Health, Ministry of Human Resources, Malaysia
| | - Yin Cheng Lim
- Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics & Data Repository, National Institutes of Health, Ministry of Health, Malaysia
| | - Rafiza Shaharudin
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
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Fakherpour A, Jahangiri M, Jansz J. A systematic review of passing fit testing of the masks and respirators used during the COVID-19 pandemic: Part 1-quantitative fit test procedures. PLoS One 2023; 18:e0293129. [PMID: 37883443 PMCID: PMC10602271 DOI: 10.1371/journal.pone.0293129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND During respiratory infection pandemics, masks and respirators are highly sought after, especially for frontline healthcare workers and patients carrying respiratory viruses. The objective of this study was to systematically review fit test pass rates and identify factors influencing the fitting characteristics. METHODS Potentially relevant studies were identified using PubMed, Scopus, Web of Science, and Science Direct during the COVID-19 pandemic from February 5, 2020, to March 21, 2023. The search strategy using the following keywords was conducted: Quantitative Fit Test, Condensation Nuclei Counter, Controlled Negative Pressure, PortaCount, Sibata, Accufit, Fit, Seal, Mask, Respirator, Respiratory Protective Device, Respiratory Protective Equipment, Protective Device, Personal Protective Equipment, COVID-19, Coronavirus, and SARS-CoV-2. The quality of the included studies was also assessed using the Newcastle-Ottawa scale. RESULTS A total of 137 articles met the eligibility criteria. Fifty articles had a quality score of less than 7 (good quality). A total of 21 studies had a fit test pass rate of less than 50%. 26 studies on disposable respirators and 11 studies on reusable respirators had an FF of less than 50 and less than 200, respectively. The most influential factors include respirator brand/model, style, gender, ethnicity, facial dimensions, facial hair, age, reuse, extensive movement, seal check, comfort and usability assessment, and training. CONCLUSION 37.36% of the disposable respirator studies and 43% of the reusable respirator studies did not report fit test results. 67.86% of the disposable respirator studies had a fit test pass rate greater than 50%, and 35.84% of these studies had an FF greater than 100. Also, 85.71% of the reusable respirator studies had a fit test pass rate greater than 50%, and 52.77% of these studies had an FF greater than 1000. Overall, the fit test pass rate was relatively acceptable. Newly developed or modified respirators must undergo reliable testing to ensure the protection of HCWs. Subject and respirator characteristics should be considered when implementing fit testing protocols. An optimal fit test panel should be developed prior to respirator design, certification, procurement decisions, and selection procedures.
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Affiliation(s)
- Anahita Fakherpour
- Student Research Committee, Department of Occupational Health and Safety Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Jahangiri
- Department of Occupational Health and Safety Engineering, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Janis Jansz
- School of Mines: Minerals, Energy and Chemical Engineering, Faculty of Science and Engineering, Curtin University, Perth, Australia
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D'Ercole S, Parisi P, D'Arcangelo S, Lorusso F, Cellini L, Dotta TC, Di Carmine M, Petrini M, Scarano A, Tripodi D. Correlation between use of different type protective facemasks and the oral ecosystem. BMC Public Health 2023; 23:1992. [PMID: 37828542 PMCID: PMC10571399 DOI: 10.1186/s12889-023-16936-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Spread worldwide through droplets, the Virus Sars-Cov-19 has caused a global health emergency alarm. In order to limit its spread, the use of masks has become part of the daily life of the entire population, however, little is known about its constant use and the changes generated in the oral cavity. This work aims to investigate correlations between the continuous use of masks covering the nose and mouth for 3 h and changes in the ecological factors of the oral cavity. METHODS 34 volunteers were divided into 2 groups: wear only the filtering facepiece code 2 (FFP2) mask (Group A) and wear the FFP2 mask covered by a surgical mask (Group B). Measurement of Volatile Organic Compounds (VOCs), saliva rehydration and consistency test, collection of basal saliva and saliva stimulated with paraffin gum and mucosal swab were collected and analyzed at two times: before using the mask(s) (T0) and 3 h after continuous use of the mask(s) (T1). RESULTS The results indicated a significant difference between the groups, in which the basal saliva volume and pH and the peaks of VOCs increased for group B between T0 and T1. The rehydration time decreased and the volume and pH of the stimulated saliva increased, but with no significant difference between the groups. Furthermore, group B showed a significant decrease in Candida albicans Colony Forming Units (CFUs) and Total Bacterial Count (TBC) between T0 and T1. CONCLUSION It is concluded that the prolonged use of the FFP2 mask covered by a surgical mask can generate oral alterations in the user.
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Affiliation(s)
- Simonetta D'Ercole
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy.
| | - Paolo Parisi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Sara D'Arcangelo
- Department of Pharmacy, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University "Gd'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Luigina Cellini
- Department of Pharmacy, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Tatiane Cristina Dotta
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, 14040-904, Brazil
| | - Maristella Di Carmine
- Department of Innovative Technologies in Medicine and Dentistry, University "Gd'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University "Gd'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Domenico Tripodi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
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Cass HG, Hanlon GC, McKenzie DP, Harley NS, Kelly DN, Barrett JA. The adequacy of user seal checking for N95 respirators compared to formal fit testing: A multicentred observational study. Aust Crit Care 2023; 36:787-792. [PMID: 36244917 DOI: 10.1016/j.aucc.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 08/14/2022] [Accepted: 08/22/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the adequacy of the user seal check (USC) in predicting N95 respirator fit. DESIGN This was a prospective, observational study conducted from May to September 2020. SETTING The study setting included three private intensive care units (ICUs) in Victoria, Australia. PARTICIPANTS ICU staff members in three private ICUs in Melbourne and regional Victoria participated in this study. MAIN OUTCOME MEASURES The main outcome measure is the proportion of participants who passed a USC and subsequently failed fit testing of an N95 respirator. INTERVENTION Three different respirators were available: two N95 respirator brands and CleanSpace HALO® powered air-purifying respirator. Participants were sequentially tested on N95 respirators followed by powered air-purifying respirators until either successful fit testing or failure of all three respirators. The first N95 tested was based on the availability on the day of testing. The primary outcome was failure rate of fit testing on the first N95 respirator type passing a USC. RESULTS Of 189 participants, 22 failed USC on both respirators, leaving 167 available for the primary outcome. Fifty-one of 167 (30.5%, 95% confidence interval = 23.7-38.1) failed fit testing on the first respirator type used that had passed a USC. CONCLUSION USC alone was inadequate in assessing N95 respirator fit and failed to detect inadequate fit in 30% of participants. Mandatory fit testing is essential to ensure adequate respiratory protection against COVID-19 and other airborne pathogens. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12620001193965.
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Affiliation(s)
- Helen G Cass
- Intensive Care Department, Epworth HealthCare, Epworth Richmond, Victoria, 3121, Australia
| | - Gabrielle C Hanlon
- Intensive Care Department, Epworth HealthCare, Epworth Richmond, Victoria, 3121, Australia
| | - Dean P McKenzie
- Research Development and Governance, Epworth HealthCare, Richmond, Victoria, 3121, Australia; Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, 3122, Australia
| | - Nerina S Harley
- Intensive Care Department, Epworth HealthCare, Epworth Freemasons, East Melbourne, Victoria, 3002, Australia; Intensive Care Department, Epworth HealthCare, Epworth Geelong, Geelong, Victoria, 3216, Australia
| | - Diane N Kelly
- Intensive Care Department, Epworth HealthCare, Epworth Richmond, Victoria, 3121, Australia
| | - Jonathan A Barrett
- Intensive Care Department, Epworth HealthCare, Epworth Richmond, Victoria, 3121, Australia.
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Caggiari S, Bader D, Packman Z, Robinson J, Tranka S, Böhning D, Worsley P. Retrospective evaluation of factors affecting successful fit testing of respiratory protective equipment during the early phase of COVID-19. BMJ Open 2023; 13:e065068. [PMID: 37230519 DOI: 10.1136/bmjopen-2022-065068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES Respiratory protective equipment is critical to protect healthcare workers from COVID-19 infection, which includes filtering facepiece respirators (FFP3). There are reports of fitting issues within healthcare workers, although the factors affecting fitting outcomes are largely unknown. This study aimed to evaluate factors affecting respirator fitting outcomes. DESIGN This is a retrospective evaluation study. We conducted a secondary analysis of a national database of fit testing outcomes in England between July and August 2020. SETTINGS The study involves National Health Service (NHS) hospitals in England. PARTICIPANTS A total of 9592 observations regarding fit test outcomes from 5604 healthcare workers were included in the analysis. INTERVENTION Fit testing of FFP3 on a cohort of healthcare workers in England, working in the NHS. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measure was the fit testing result, that is, pass or fail with a specific respirator. Key demographics, including age, gender, ethnicity and face measurements of 5604 healthcare workers, were used to compare fitting outcomes. RESULTS A total of 9592 observations from 5604 healthcare workers were included in the analysis. A mixed-effects logistic regression model was used to determine the factors which affected fit testing outcome. Results showed that males experienced a significantly (p<0.05) higher fit test success than females (OR 1.51; 95% CI 1.27 to 1.81). Those with non-white ethnicities demonstrated significantly lower odds of successful respirator fitting; black (OR 0.65; 95% CI 0.51 to 0.83), Asian (OR 0.62; 95% CI 0.52 to 0.74) and mixed (OR 0.60; 95% CI 0.45 to 0.79. CONCLUSION During the early phase of COVID-19, females and non-white ethnicities were less likely to have a successful respirator fitting. Further research is needed to design new respirators which provide equal opportunity for comfortable, effective fitting of these devices.
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Affiliation(s)
- Silvia Caggiari
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Dan Bader
- School of Health Sciences, University of Southampton, Southampton, UK
| | | | | | | | - Dankmar Böhning
- Southampton Statistical Sciences Research Institute, University of Southampton, Southampton, UK
| | - Peter Worsley
- School of Health Sciences, University of Southampton, Southampton, UK
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Bharatha A, Krishnamurthy K, Cohall D, Rahman S, Forde CA, Corbin-Harte R, Ojeh N, Kabir R, Parsa AD, Rabbi AMF, Majumder MAA. Personal protective equipment (PPE) related adverse skin reactions among healthcare workers at the main COVID-19 isolation center in Barbados. Front Public Health 2022; 10:978590. [PMID: 36304246 PMCID: PMC9592812 DOI: 10.3389/fpubh.2022.978590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background The 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. Methods A 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. Results Most 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. Conclusion The 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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Affiliation(s)
- Ambadasu Bharatha
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Kandamaran Krishnamurthy
- PICU Consultant, Queen Elizabeth Hospital, Bridgetown, Barbados,*Correspondence: Kandamaran Krishnamurthy
| | - Damian Cohall
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Sayeeda Rahman
- American University of Integrative Sciences, School of Medicine, Bridgetown, Barbados
| | - Corey A. Forde
- Infection Prevention and Control/Infectious Diseases Programs, The Queen Elizabeth Hospital, Bridgetown, Barbados
| | - Rhea Corbin-Harte
- Isolation Facilities Client Relations and Activities, Bridgetown, Barbados
| | - Nkemcho Ojeh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Russell Kabir
- Faculty of Health Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Ali Davod Parsa
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
| | | | - Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
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Shah K, Serban S, Douglas GVA. Improving the fit of filtering facepiece respirators. Br Dent J 2022:10.1038/s41415-022-4512-3. [PMID: 35931750 PMCID: PMC9362026 DOI: 10.1038/s41415-022-4512-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/18/2022] [Indexed: 11/08/2022]
Abstract
Aims To assess the effectiveness and acceptability of smartphone customised frame technology to improve the fit of disposable filtering facepiece class 3 (FFP3) respirators for dental staff who previously failed fit testing.Method In total, 20 volunteers who previously failed FFP3 fit testing were recruited to use smartphone technology (Bellus3D FaceApp) to have a 3D-printed bespoke face frame produced for them. They underwent qualitative fit testing with and without the frame with two freely available disposable FFP3 respirator designs (mask A: GVS F31000 Segre folded model; mask B: Valmy Spireor). The order of testing was random. Ease of use of the smartphone technology and the comfort of the frame were determined by questionnaire.Results Fit test passes increased from 5% without the frame to 70% and 95%, respectively, for masks A and B with the frame (p <0.01). Very few participants reported using the technology as difficult (n = 1/20) or the frame uncomfortable (n = 3/20) or difficult to wear (n = 0/20).Conclusion Customised frames produced using smartphone technology improved qualitative fit test pass rates for two commonly available FFP3 respirators. Using smartphone technology for frame design, wearing a frame and frame comfort levels were all acceptable to the majority of participants.
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Affiliation(s)
- Kamini Shah
- NHS England and NHS Improvement North East and Yorkshire, The Old Exchange Barnard Street, Darlington, DL3 7DR, UK.
| | - Stefan Serban
- School of Dentistry, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK
| | - Gail V A Douglas
- School of Dentistry, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK
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9
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Milosevic M, Kishore Biswas R, Innes L, Ng M, Mehmet Darendeliler A, Wong A, Denney-Wilson E. P2/N95 filtering facepiece respirators: Results of a large-scale quantitative mask fit testing program in Australian health care workers. Am J Infect Control 2022; 50:509-515. [PMID: 34971710 PMCID: PMC8767955 DOI: 10.1016/j.ajic.2021.12.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022]
Abstract
Background In response to the COVID-19 pandemic, 6,287 Australian health care workers (HCWs) were fit tested to N95 filtering facepiece respirators (FFRs). This study determined how readily HCWs were fitted to 8 FFRs and how age and sex influenced testing. Methods HCWs were fit tested following the quantitative OSHA protocol. After bivariate analysis, a logistic regression model assessed the effect of FFR model, HCW age and sex on fit test results. Results Of 4,198 female and 2,089 male HCWs tested, 93.3% were successfully fitted. Fifty-five percent passed the first FFR, 21% required 2 and 23% required testing on 3 or more models. Males were 15% less likely to pass compared to females (P < .001). Individuals aged 18-29 were significantly more likely to pass compared to colleagues aged 30-59. Cup-style 3M 1860S was the most suitable model (95% CI: 1.94, 2.54) while the duckbill BSN TN01-11 was most likely to fail (95% CI: 0.11, 0.15). Conclusions Current N95 FFRs exhibit suboptimal fit such that a large proportion (45%) of HCWs require testing on multiple models. Older age and male sex were associated with significantly higher fit failure rates. QNFT programs should consider HCW characteristics like sex, age, racial and facial anthropometric measurements to improve the protection of the health workforce.
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Kyaw S, Johns M, Lim R, Stewart WC, Rojas N, Thambiraj SR, Shehabi Y, Arora S. Prediction of N95 Respirator Fit from Fogging of Eyeglasses: A Pilot Study. Indian J Crit Care Med 2021; 25:976-980. [PMID: 34963713 PMCID: PMC8664036 DOI: 10.5005/jp-journals-10071-23947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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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Affiliation(s)
- Sandy Kyaw
- Department of Intensive Care Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Moira Johns
- Department of Intensive Care Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Rimen Lim
- Department of Intensive Care Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Warren C Stewart
- Department of Intensive Care Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Natalia Rojas
- Department of Intensive Care Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Solomon R Thambiraj
- Department of Intensive Care Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Yahya Shehabi
- Clinical School of Medicine, University of New South Wales
| | - Sumesh Arora
- Department of Intensive Care Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia
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