Health Care Workers and Respiratory Protection: Is the User Seal Check a Surrogate for Respirator Fit-Testing?

Many agencies recommend that health care workers wear N95 filtering facepiece respirators (N95-FFR) to minimize occupational exposure to bioaerosols, such as tuberculosis and pandemic influenza. Published standards outline procedures for the proper selection of an N95-FFR model, including user seal...

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Publicado en:Journal of Occupational & Environmental Hygiene Vol. 8; no. 5; pp. 267 - 271
Autores principales: Danyluk, Quinn, Hon, Chun-Yip, Neudorf, Mike, Yassi, Annalee, Bryce, Elizabeth, Janssen, Bob, Astrakianakis, George
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd May2011
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2011
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      pub: Taylor & Francis Ltd
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        atl: Health Care Workers and Respiratory Protection: Is the User Seal Check a Surrogate for Respirator Fit-Testing?
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        au:
          Danyluk, Quinn
          Hon, Chun-Yip
          Neudorf, Mike
          Yassi, Annalee
          Bryce, Elizabeth
          Janssen, Bob
          Astrakianakis, George
        affil: Workplace Health, Fraser Health, Burnaby, BC, Canada
      sug:
        subj:
          Respiratory Protective Devices Evaluation
          Occupational Exposure Prevention and Control
          Sample Size
          Evaluation Research
          Descriptive Statistics
          Health Personnel
          American National Standards Institute
      ab: Many agencies recommend that health care workers wear N95 filtering facepiece respirators (N95-FFR) to minimize occupational exposure to bioaerosols, such as tuberculosis and pandemic influenza. Published standards outline procedures for the proper selection of an N95-FFR model, including user seal checks and respirator fit-testing. Some health officials have argued that the respirator fit-test step should be eliminated altogether, given its additional time and cost factors, and that only a user seal check be utilized to ensure that an adequate face seal has been achieved. One of the aims of the current study is to examine whether a user seal check is an appropriate surrogate for respirator fit-testing. Subjects were assigned an N95-FFR and asked to perform a user seal check (as per manufacturer's instructions) after which they immediately underwent a respirator fit-test. Successfully passing a respirator fit-test was based on not detecting a leakage through the face seal (either qualitatively with a test agent or quantitatively with a particulate counter). The sample population consisted of 647 subjects who had never been previously fit-tested (naive), while the remaining 137 participants were experienced respirator users. Only four of the 647 naive subjects (0.62%) identified an inadequate seal during their user seal check. Of the 643 remaining naive subjects who indicated that they had an adequate face seal prior to fit-testing, 158 (25%) failed the subsequent quantitative fit-test and 92 (14%) failed the qualitative fit-test. All 137 experienced users indicated that they had an adequate seal after performing the user seal check; however, 41 (30%) failed the subsequent quantitative fit-test, and 30 (22%) failed the qualitative fit-test. These findings contradict the argument to eliminate fit-testing and rely strictly on a user seal check to evaluate face seal.
      pubtype: Academic Journal
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      ougenre: Article
    language: English
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