Overview
Respirators and Surgical masks are widely used in healthcare facilities. Both types of personal protective equipment (PPE) can be used for infection control; however, only respirators can be used for respiratory protection against chemical hazards in the air. Because both respirators and Surgical masks are used in healthcare facilities, it is important for employers and workers to understand the differences between them.
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A study that tested the use of respirators and Surgical masks
This article introduced a study that tested the use of respirators and Surgical masks, and then recommend how to select and use respirators and Surgical masks.
1-3 Respirators are designed to protect the wearer from inhaling airborne contaminants such as dust, fumes, vapors, and infectious materials associated with inhaling droplets of small and large particles; OSHA's Respiratory Protection and Personal Protective Equipment standard provides guidance on proper selection and use. In contrast, Surgical masks provide barrier protection only for large particle droplets and are not effective in filtering inhaled small particles, fumes, or vapors.6-7 Surgical masks are primarily used to protect patients and healthcare workers from people who may have respiratory infections or to protect sterilized or disinfected medical equipment and supplies.
This study examined the use of respirators and Surgical masks by 10,383 health care workers who reported specific risky respiratory protective behaviors. Respondents were classified as respirator users if they wore an N95 respirator, powered air-purifying respirator (PAPR), or half- or full-piece respirator during at least one of the hazards; they were classified as respirator nonusers if they used only a Surgical mask or did not wear any respirator or mask. Information was also collected on barriers to the use of respirators for handling hazardous chemicals.
Study Results
In this analysis, 1,904 (18%) healthcare respondents reported wearing respiratory protection and were categorized as respirator users. The highest proportion of respirator use was for aerosol medications (ribavirin, 79%; pentoxifylline, 56%; and antibiotics, 26%), and the lowest was for chemical disinfectants (0%). The proportion of respirator users caring for patients with ILI symptoms was 21%, and the proportion of users of all other hazards was less than 11%. Of the various respirator types, the highest frequency of N95 respirator use was reported (93%). The most common reasons for not using a respirator when potentially exposed to hazardous chemicals were "not part of our protocol" and "exposure was minimal." Only 25% of respirator users reported that they had been tested for tightness.
The majority (78%) of respondents reported using Surgical masks for one or more hazards, ranging from 14% for ribavirin to 90% for Surgical fumes. Surgical masks are used in situations where respiratory protection is recommended, for example, when dispensing or administering antineoplastic drugs and when working near Surgical fumes.
How can the selection and use of respirators and Surgical masks be improved?
Employers must assess a worker's specific work environment to determine if a hazard exists or may exist that would necessitate the use of respirators or Surgical masks and other personal protective equipment.
If a hazard exists, or is likely to exist based on the hazard assessment, the employer needs to select appropriate and suitable PPE to protect workers from the hazard and communicate the selection decision to each affected worker.
All workers required to wear a tight-fitting respirator (e.g., N95 respirator, flexible respirator) must undergo a medical evaluation to determine the worker's ability to wear the respirator and, if medically certified, are required to undergo a fit test using the same type of respirator provided at the workplace.