Reusable respirators are an effective and viable option for protecting health care personnel

December 06, 2018

WASHINGTON - Half-facepiece reusable elastomeric respirators are an effective and viable option for protecting health care workers from exposure to airborne transmissible contaminants or infectious agents -- for example, influenza virus -- during day-to-day work or with a sudden or rapid influx of patients, such as during a public health emergency, says a new report from the National Academies of Sciences, Engineering, and Medicine. Implementation challenges including storage, disinfection, and maintenance; training and education; user comfort and tolerability; and supply logistics and emergency stockpiling need to be addressed.

Respirators are one component of a range of administrative, engineering, and environmental hazard controls and prevention strategies used in health care to protect workers from exposure to airborne hazards during patient care and laboratory analysis, and while handling hazardous medication or waste. Reusable respirators (made from elastomeric or flexible rubber-like materials) are the standard respiratory protection device used in many industries, especially for industrial purposes, and their durability and reusability make them desirable for stockpiling in case of emergencies. They are not used widely in health care, however. Only two U.S. health institutions were identified by the study committee as using reusable elastomeric respirators either exclusively or primarily. Most health facilities use filtering facepiece respirators, often called N95s, which are disposable after one use or in between seeing patients.

The advantages of routine use of elastomeric respirators include increased familiarity of staff with these respirators and the continued improvement of policies and practices for cleaning, disinfection, and maintenance, leading to better preparedness during an emergency or pandemic situation. A smooth transition to surge use would be expedited and enhanced if reusable elastomeric respirators were a part of a health care facility's day-to-day respiratory protection program.

Addressing the respiratory needs of health care workers across their wide range of settings and jobs -- including, for example, home health caregivers, rural clinic personnel, nursing home staff, and hospital staff -- is an ethical imperative, the report says. It will require the design of innovative reusable respirators and the implementation of robust respiratory protection programs. These should take into account the distinctive characteristics of the health care workplace, including responsibilities of caring for multiple patients with varying health conditions; sudden and non-routine need for respiratory protection; and the possibility of needing to address unknown, potentially lethal, and highly transmissible infectious agents.

In addition, urgent action is needed to resolve gaps in knowledge and leadership on transmissibility of airborne contaminants or infectious agents. This includes the lack of standardized processes for the cleaning and disinfection of reusable respirators, the need for consistent guidance and standards by regulatory and policymaking authorities, and the need to establish accountability policies for each facility's respiratory protection program. The committee developed a set of recommendations for the National Institute for Occupational Safety and Health, National Center for Immunization and Respiratory Diseases, professional associations, and accrediting organizations, among others, to spur research; enable effective respiratory protection programs, training, and education; and ensure rapid and seamless implementation.
-end-
The study was sponsored by the Centers for Disease Control and Prevention. The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln. For more information, visit nationalacademies.org. A committee roster follows.

Social Media:

Follow us on Twitter: @theNASEM and @NASEM_health
Follow us on Instagram: @theNASEM
Follow us on Facebook: @NationalAcademies

Resources:

Report Highlights
Recommendations
Download the report at http://www.nationalacademies.org/ElastomericRespirators

Contacts:

Dana Korsen, Media Relations Officer
Andrew Robinson, Media Relations Assistant
Office of News and Public Information
202-334-2138; e-mail news@nas.edu
Newsroom

Copies of Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use are available from the National Academies Press on the Internet at http://www.nap.edu or by calling 202-334-3313 or 1-800-624-6242. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).

THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE

Health and Medicine Division
Board on Health Sciences Policy

Committee on the Use of Elastomeric Respirators in Health Care

Linda Hawes Clever* (co-chair)
Founding Chair
Department of Occupational Health
California Pacific Medical Center, and
Clinical Professor of Medicine
University of California
San Francisco

M. E. Bonnie Rogers (co-chair)
Director
North Carolina Occupational Safety and Health Education Research Center, and
Director
Occupational Health Nursing Program, and
Professor
Public Health Leadership Program
University of North Carolina
Chapel Hill

Gloria Addo-Ayensu
Director
Department of Health
Fairfax County
Fairfax, Va.

Gio J. Baracco
Professor of Clinical Medicine
Division of Infectious Diseases
Miller School of Medicine
University of Miami
Miami

Jim Chang
Director of Safety and Environmental Health
University of Maryland Medical Center
Baltimore

Christopher Friese
Elizabeth Tone Hosmer Professor of Nursing, and
Director
Center for Improving Patient and Population Health
University of Michigan
Ann Arbor

Robert Harrison
Clinical Professor of Medicine
Division of Occupational and Environmental Medicine
University of California
San Francisco

Sundaresan Jayaraman
Kolon Professor
School of Materials Science and Engineering, and
Founding Director
Kolon Center for Lifestyle Innovation
Georgia Institute of Technology
Atlanta

James S. Johnson
Consultant
JSJ and Associates
Pleasanton, Calif.

Bruce Lippy
Director of Safety Research
CPWR, The Center for Construction Research and Training
Silver Spring, Md.

Allison McGeer
Professor
Department of Laboratory Medicine and Pathobiology
Dalla Lana School of Public Health
University of Toronto
Toronto

Chris Nyquist
Professor of Pediatrics-Infectious Diseases, and
Medical Director for Infection Prevention and Control, and
Medical Director for Occupational Health
Children's Hospital Colorado, and
School of Medicine
University of Colorado
Aurora

Mike Schmoldt
Program Industrial Hygienist
Argonne National Laboratory
Richland, Wash.

Skip I. Skivington
Vice President of Health Care Continuity Management and Support Services
Kaiser Permanente
Oakland, Calif.

Patricia Stone
Centennial Professor of Health Policy, and
Director
Center for Health Policy
School of Nursing
Columbia University
New York City

Tener Goodwin Veenema
Professor
School of Nursing, and
Professor,
Bloomberg School of Public Health
Johns Hopkins University
Baltimore

STAFF

Cathy T. Liverman
Staff Officer

*Member, National Academy of Medicine

National Academies of Sciences, Engineering, and Medicine

Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.