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1
Bischoff, Werner E., JoLyn Turner, Gregory Russell, Maria Blevins, Engy Missaiel, and John Stehle. "How well do N95 respirators protect healthcare providers against aerosolized influenza virus?" Infection Control & Hospital Epidemiology 40, no. 2 (December 18, 2018): 232–34. http://dx.doi.org/10.1017/ice.2018.326.
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AbstractN95 respirator masks are recommended for protection against respiratory viruses. Despite passing fit-testing 10% of N95 respirator users encountered breakthroughs with exposure to influenza virus compared to full protection provided by a powered air purifying respirator. The current recommendation of N95 respirators should be evaluated for endemic and emerging scenarios.
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Lam, Simon Ching, Joseph Kok Long Lee, Linda Yin King Lee, Ka Fai Wong, and Cathy Nga Yan Lee. "Respiratory Protection by Respirators: The Predictive Value of User Seal Check for the Fit Determination in Healthcare Settings." Infection Control & Hospital Epidemiology 32, no. 4 (April 2011): 402–3. http://dx.doi.org/10.1086/659151.
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The N95 respirator is one type that is recommended by the World Health Organization and the Centers for Disease Control and Prevention (CDC) to prevent inhalation of droplets that may act to transmit respiratory pathogens. However, the reliability of this respirator to prevent transmission is dependent on how well it is fitted to the wearer. For ill-fitting respirators, the average penetration by ambient aerosol was found to be 33%, compared with 4% for well-fitting respirators. Such penetration or leakage may be caused by the gap between the respirator and the wearer's face. Therefore, formal fit testing should be carried out prior to the use of N95 respirators. Quantitative fit testing measures “the adequacy of respirator fit by numerically measuring the amount of leakage into the respirator” using an electronic device.
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Hines, Stella E., Clayton H. Brown, Marc Oliver, Patricia Gucer, Melissa Frisch, Regina Hogan, Tracy Roth, James Chang, and Melissa McDiarmid. "Cleaning and Disinfection Perceptions and Use Practices Among Elastomeric Respirator Users in Health care." Workplace Health & Safety 68, no. 12 (August 19, 2020): 572–82. http://dx.doi.org/10.1177/2165079920938618.
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Background: Reusable elastomeric respirator use in health care may represent one solution to address N95 respirator shortages experienced during infectious disease outbreaks, but cleaning and disinfection requirements may limit their utility. Evidence of respirator cleaning and disinfection behaviors and practices by health care workers may inform guidance on reusable respirator use. Methods: Medical system elastomeric respirator users were surveyed about respirator cleaning and disinfection practices and perceptions via an electronic survey. Respondents were subsequently classified based on reported compliance with their assigned respirator use. To explore whether respirator cleaning and disinfection issues affected compliance with assigned device use, responses were compared between user groups and adjusted for covariates. Results: A total of 432 of 2,024 (21%) eligible elastomeric respirator users completed the survey. Most (>90%) reported that their respirator was clean, but only 52% reported that they always disinfect their respirators after use according to the hospital’s expected practice. Only 40 respondents (9%) reported regularly cleaning the respirator with soap and water, in accordance with manufacturer recommendations. Reporting of suboptimal decontamination practice was not associated with assigned device compliance, however, except among providers and respiratory therapists. Conclusion/Application to Practice: Although perceptions of cleanliness and adherence to expected decontamination practices during routine use did not appear to influence compliance with assigned respirator use overall, this did predict compliance among providers and respiratory therapists, both of whom have nonfixed workstations. Practical and effective strategies to assure easy access to and availability of clean reusable respiratory protective devices are needed to facilitate their use in health care respiratory protection programs.
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Hines, Stella E., Joanna Gaitens, Nora M. Mueller, Diego Molina Ochoa, Eseosa Fernandes, and Melissa A. McDiarmid. "Respiratory Protection Perceptions among Malian Health Workers: Insights from the Health Belief Model." International Journal of Environmental Research and Public Health 19, no. 5 (March 4, 2022): 3028. http://dx.doi.org/10.3390/ijerph19053028.
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Reusable respiratory protective devices called elastomeric respirators have demonstrated their effectiveness and acceptability in well-resourced healthcare settings. Using standard qualitative research methods, we explored the feasibility of elastomeric respirator use in low- and middle-income countries (LMIC). We conducted interviews and focus groups with a convenience sample of health workers at one clinical center in Mali. Participants were users of elastomeric and/or traditional N95 respirators, their supervisors, and program leaders. Interview transcripts of participants were analyzed using a priori constructs from the Health Belief Model (HBM) and a previous study about healthcare respirator use. In addition to HBM constructs, the team identified two additional constructs impacting uptake of respirator use (system-level factors and cultural factors). Together, these framed the perceptions of Malian health workers and highlighted both facilitators of and barriers to respirator use uptake. As needs for respiratory protection from airborne infectious hazards become more commonly recognized, elastomeric respirators may be a sustainable and economic solution for health worker protection in LMIC.
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Faisal, Haruyuki Dewi, and Agus Dwi Susanto. "Peran Masker/Respirator dalam Pencegahan Dampak Kesehatan Paru Akibat Polusi Udara." Jurnal Respirasi 3, no. 1 (April 22, 2019): 18. http://dx.doi.org/10.20473/jr.v3-i.1.2017.18-25.
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Outdoor air pollution contributed harmful impact to public health. There are several respiratory disorders related to outdoor air pollution such as acute respiratory infection, lung cancer, asthma, chronic obstructive lung disease (COPD) and lung function disorder. Respirator is a personnel protective device which has role in the primary intervention step. Currently exist many types of respirators in industrial setting that have specific function to certain hazard exposure in work process. It is difficult to choose one type of respirator that can be implemented in population setting to protect against all air pollutant content. Therefore, it is relevant choosing one respirator type which has the ability to effectively filtrate one of air pollutant content that is the particulate matter. One respirator type, N95 mask has superiority in term of cost and technical use aspects for protecting particulate matter pollutant. Respirator usage effectivity in population setting is an important subject to find out more.
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McKay, Roy T. "Respirator and Respiratory Protection." Journal of Occupational & Environmental Medicine 39, no. 8 (August 1997): 791. http://dx.doi.org/10.1097/00043764-199708000-00023.
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Howard, Brittany E. "High-Risk Aerosol-Generating Procedures in COVID-19: Respiratory Protective Equipment Considerations." Otolaryngology–Head and Neck Surgery 163, no. 1 (May 12, 2020): 98–103. http://dx.doi.org/10.1177/0194599820927335.
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The correct selection and utilization of respiratory personal protective equipment is of the utmost importance in the current COVID-19 pandemic. This is especially true for health care workers exposed to high-risk aerosol-generating procedures, including otolaryngologists, ophthalmologists, neurosurgeons, maxillofacial surgeons, and laparoscopic surgeons. This communication provides a review of approved forms of respiratory protection and compares their characteristics, including surgical masks, N95 respirator, elastomeric respirators, powered air-purifying respirators, and controlled air-purifying respirators. For standard airborne precautions, N95 respirator are appropriate for respiratory protection. However, high-risk aerosol-generating procedures may create aerosolization of high viral loads that represent increased risk to health care workers. In these situations, enhanced respiratory protection with filters certified as 99, 100, or HEPA (high-efficiency particulate air) may be appropriate.
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Lee, Sanghyun, Hongjung Kim, Taeho Lim, Jaehoon Oh, Hyunggoo Kang, Chiwon Ahn, Yeongtak Song, Juncheol Lee, and Hyungoo Shin. "Simulated workplace protection factors for respirators with N95 or higher filters for health care providers in an emergency medical centre: A randomized crossover study." Hong Kong Journal of Emergency Medicine 24, no. 6 (November 2017): 282–89. http://dx.doi.org/10.1177/1024907917735088.
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Introduction: Health care providers in emergency medical centres often encounter infected sources during medical procedures; these sources can generate droplets. Wearing respirators could help to protect against infection risk. However, to the best of our knowledge, no previous study has reported the efficacy of N95 or higher respirators for health care providers in emergency medical centres. Methods: A randomized, crossover study of 26 health care providers was conducted to examine the protective performance of respirators. Quantitative fit tests with three types of respirators (cup type, fold type without valve and fold type with valve) were performed using seven exercises. Primary outcomes were the fit factors. Secondary outcomes included the percentage of fit factors above 100 and respirator preference. Results: After excluding one participant, data for 25 participants were analysed. The fit factors and the percentage of fit factors above 100 were higher when participants wore a fold-type respirator (200 fit factors [38.6–200], 100% [0–100]) relative to those for the cup-type respirator (114.0 fit factors [16.0–185.2], 60% [0–100]) and valve-type respirator (84.9 fit factors [14.2–170.8], 23.8 % [0–100]) in normal respiration. There was no clear preference regarding the type of respirator. Conclusion: The type of respirator could influence protective performance for health care providers. Health care providers in emergency medical centres should be aware of and wear the type of respirator that is well-fitted for them in advance.
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Burton, Christopher, Briana Coles, Anil Adisesh, Simon Smith, Elaine Toomey, Xin Hui S. Chan, Lawrence Ross, and Trisha Greenhalgh. "Performance and impact of disposable and reusable respirators for healthcare workers during pandemic respiratory disease: a rapid evidence review." Occupational and Environmental Medicine 78, no. 9 (January 27, 2021): 679–90. http://dx.doi.org/10.1136/oemed-2020-107058.
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ObjectivesTo synthesise evidence concerning the range of filtering respirators suitable for patient care and guide the selection and use of different respirator types.DesignComparative analysis of international standards for respirators and rapid review of their performance and impact in healthcare.Data sourcesWebsites of international standards organisations, Medline and Embase, hand-searching of references and citations.Study selectionStudies of healthcare workers (including students) using disposable or reusable respirators with a range of designs. We examined respirator performance, clinician adherence and performance, comfort and impact, and perceptions of use.ResultsWe included standards from eight authorities across Europe, North and South America, Asia and Australasia and 39 research studies. There were four main findings. First, international standards for respirators apply across workplace settings and are broadly comparable across jurisdictions. Second, effective and safe respirator use depends on proper fitting and fit testing. Third, all respirator types carry a burden to the user of discomfort and interference with communication which may limit their safe use over long periods; studies suggest that they have little impact on specific clinical skills in the short term but there is limited evidence on the impact of prolonged wearing. Finally, some clinical activities, particularly chest compressions, reduce the performance of filtering facepiece respirators.ConclusionA wide range of respirator types and models is available for use in patient care during respiratory pandemics. Careful consideration of performance and impact of respirators is needed to maximise protection of healthcare workers and minimise disruption to care.
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Bazaluk, Oleg, Alim Ennan, Serhii Cheberiachko, Oleh Deryugin, Yurii Cheberiachko, Pavlo Saik, Vasyl Lozynskyi, and Ivan Knysh. "Research on Regularities of Cyclic Air Motion through a Respirator Filter." Applied Sciences 11, no. 7 (April 1, 2021): 3157. http://dx.doi.org/10.3390/app11073157.
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In this paper, a solution to the problem of the change in the pressure drop in a respirator filter during cyclic air motion is suggested since the current theory of filtering is based on steady-flow processes. The theoretical dependence of the pressure drop in the respirator filter on air flow rate is determined, which is represented by the harmonic law, which characterizes the human respiration process during physical work. For the calculation, a filter model was used, which is represented by a system of parallel isolated cylinders with a length equal to the total length of the filter fibres surrounded by porous shells formed by a viscous air flow field, with a size determined by the equal velocities of the radial component of air flow and undisturbed flows. The flow-around process in the proposed model of air flow through the respirator filter is described by the Brinkman equation, which served to establish the total air flow resistance in the proposed system under conditions of velocity proportionality. It consists of two parts: the first characterizes the frictional resistance of the air flow against the surface of the cylinder, which imitates the filter fibre; the second—the inertial part—characterizes the frequency of pulsations of respiratory movements during physical performance. The divergence of the analytical results and experimental studies is no more than 20%, which allows the use of the established dependence to estimate the change in pressure drop in a respirator filter made of filter material “Elephlen” when the user carries out different physical activities. This allows the period of effective protective action of respirators with different cycles of respiration during physical activities to be specified, which is a very serious problem that is not currently regulated in health and safety regulations, and it also allows the prediction of the protective action of filters and respiratory protection in general.
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Crow, Sue. "The Lone Ranger Rides Again, This Time Followed by a Federal Posse." Infection Control & Hospital Epidemiology 15, no. 10 (October 1994): 673–76. http://dx.doi.org/10.1086/646831.
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AbstractThe Centers for Disease Control and Prevention proposed guidelines regarding the high-efficiency particulate air-filtered respirator have raised many questions that the healthcare worker has found difficult to answer. This product commentary addresses questions related to material that the respiratory protection program should include; provides information related to the physical exam before the use of the respirator; and explains the types of respirators. Cost issues also are discussed.
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Cheberiachko, Serhii, Olena Yavorska, Oleh Deriuhin, and Andrii Yavorskyi. "Evaluation of the probability of miners’ protection while using filtering respirators." E3S Web of Conferences 201 (2020): 01021. http://dx.doi.org/10.1051/e3sconf/202020101021.
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Objective of the research is to evaluate the probability of deterioration of the protection of miners’ respiratory organs while using filtering respirators in terms of coal mines under the coal mine conditions and to elaborate recommendations for the reduction of possible occupational disease risks. A Markovian process theory has been applied to solve the formulated problem. It has been determined that the probability of deterioration of the protection of a worker wearing a filtering respirator is up to 50%, which is stipulated by the lack of corresponding training as for the correct filtering respirator use, negligence of the physical load and its duration during the respirator selection, and possible mistakes during its operation. Reduction of the occupational disease risks is possible only in terms of the use of high-quality filtering respirator under conditions of its correct selection, maintenance and use by the trained miners with the preliminary checking of its relevance to the coal mine conditions. It has been shown that the development of a respiratory protection programme at an enterprise is the efficient tool to provide a miner with high-quality and appropriate filtering devices for the respiratory protection.
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Adhikari, Atin, Aniruddha Mitra, Abbas Rashidi, Imaobong Ekpo, Jacob Schwartz, and Jefferson Doehling. "Field Evaluation of N95 Filtering Facepiece Respirators on Construction Jobsites for Protection against Airborne Ultrafine Particles." International Journal of Environmental Research and Public Health 15, no. 9 (September 7, 2018): 1958. http://dx.doi.org/10.3390/ijerph15091958.
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Exposure to high concentrations of airborne ultrafine particles in construction jobsites may play an important role in the adverse health effects among construction workers, therefore adequate respiratory protection is required. The performance of particulate respirators has never been evaluated in field conditions against ultrafine particles on construction jobsites. In this study, respiratory protection levels against ultrafine particles of different size ranges were assessed during three common construction related jobs using a manikin-based set-up at 85 L/min air flow rate. Two NanoScan SMPS nanoparticle counters were utilized for measuring ultrafine particles in two sampling lines of the test filtering facepiece respirator—one from inside the respirator and one from outside the respirator. Particle size distributions were characterized using the NanoScan data collected from outside of the respirator. Two models of N95 respirators were tested—foldable and pleated. Collected data indicate that penetration of all categories of ultrafine particles can exceed 5% and smaller ultrafine particles of <36.5 nm size generally penetrated least. Foldable N95 filtering facepiece respirators were found to be less efficient than pleated N95 respirators in filtering nanoparticles mostly at the soil moving site and the wooden building frameworks construction site. Upon charge neutralization by isopropanol treatment, the ultrafine particles of larger sizes penetrated more compared to particles of smaller sizes. Our findings, therefore, indicate that N95 filtering facepiece respirators may not provide desirable 95% protection for most categories of ultrafine particles and generally, 95% protection is achievable for smaller particles of 11.5 to 20.5 nm sizes. We also conclude that foldable N95 respirators are less efficient than pleated N95 respirators in filtering ultrafine particles, mostly in the soil moving site and the wooden building framework construction site.
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Johnson, Barbara, Douglas R. Winters, Thomas R. Shreeve, and Christopher C. Coffey. "Respirator Filter Reuse Test Using the Laboratory Simulant Mycobacterium Tuberculosis (H37RA Strain)." Journal of the American Biological Safety Association 3, no. 3 (September 1998): 105–16. http://dx.doi.org/10.1177/109135059800300306.
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All respirators certified under Title 42, Code of Federal Regulations, Part 84, can be used by healthcare workers for protection against Mycobacterium tuberculosis (Mtb). Questions have been raised regarding the possibility of the respirator becoming contaminated with Mtb or other organisms due to reuse, handling, and storage in plastic bags. This study was conducted to: (1) determine whether, and for how long, avirulent Mtb (strain H37Ra) survives on respirator material, and (2) measure levels of contamination (assess contamination by environmental bacteria and fungi due to storage in airtight bags) potentially spread to the respirator's interior surface due to normal mechanical handling (removal and re-insertion of the respirator into airtight bag). Six models of filtering facepiece respirators were challenged with a concentration of 105 to 106 colony forming units (CFUs) H37Ra per liter of air in a steady flow system. Respirator interior and exterior surfaces were swab sampled on days -1 (prior to exposure), 0 (day of exposure), 1, 3, 7, 10, 14, 21, and 28. Between samplings, each respirator was stored at room temperature in a Zip-lock™ bag. Seven days after exposure the number of viable organisms decreased from a mean range of 27 to 131 colony forming units per square centimeter (CFU/cm2) to zero CFU/cm2 on the exterior of the different respirator models. While several respirators had interior contamination immediately following challenge, no transfer of exterior H37Ra was observed. Some colony growth was recoverable from day 14 to 28 indicating there was some incidental contamination with environmental bacteria to the interior of the respirator after repeated handling and storage.
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Chuang, Tzu-Ying, Tania Thomas, Vickie Garrison, Jonathon Schuch, Benjamin Kozower, and Joshua Eby. "1160. Infrequency of Respirator Change Following Annual Respiratory Fit Testing at an Academic Medical Center." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S349. http://dx.doi.org/10.1093/ofid/ofy210.993.
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Abstract Background The Occupational Safety and Health Administration (OSHA) of the Department of Labor requires that healthcare employers perform annual respiratory fit testing (RFT) for respiratory protection of employees with patient exposure. The annual cost of RFT in the United States is greater than $8 million and each fit test requires approximately 20 minutes. Due to the high resource expenditure for RFT, we sought to identify factors associated with changing respirators. Methods During annual RFT at the University of Virginia, employees complete a questionnaire about interval clinical changes since the last RFT. Questions are based on publications indicating that certain characteristics are associated with respirator change, including: have you had dental surgery, surgery on your face, or trauma; has your weight changed by >10%; have you been or are you currently pregnant; do you recall your mask type; do you want to change masks. Answers to these questions from May 2016 through March of 2018 were compiled and analyzed by Chi-square test using Excel and R. P-value of <0.05 was considered significant. Results A total of 4,278 employees completed questions at least once during the time period, with 29 requiring respirator change after RFT. Requesting a mask change, and 10% weight change were significantly associated with respirator change. Pregnancy and facial trauma were not significantly associated with respirator change. Of those who changed respirator, nine reported no change in weight, no facial trauma, and no pregnancy. Conclusion The infrequency of respirator change suggests that limiting RFT to those most likely to change their respirator may hold more value than screening all employees annually; however, questions included in this evaluation did not identify all employees who would require respirator change. We are continuing evaluation of predictors of respirator changes and association with tuberculin skin test conversion to improve efficiency of RFT. Disclosures All authors: No reported disclosures.
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Redmann, Rachel K., Brandon J. Beddingfield, Skye Spencer, Nicole R. Chirichella, Julian L. Henley, Wes Hager, and Chad J. Roy. "A Miniaturized Electrostatic Precipitator Respirator Effectively Removes Ambient SARS-CoV-2 Bioaerosols." Viruses 14, no. 4 (April 6, 2022): 765. http://dx.doi.org/10.3390/v14040765.
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The inhalation of ambient SARS-CoV-2-containing bioaerosols leads to infection and pandemic airborne transmission in susceptible populations. Filter-based respirators effectively reduce exposure but complicate normal respiration through breathing zone pressure differentials; therefore, they are impractical for long-term use. Objectives: We tested the comparative effectiveness of a prototyped miniaturized electrostatic precipitator (mEP) on a filter-based respirator (N95) via the removal of viral bioaerosols from a simulated, inspired air stream. Methods: Each respirator was tested within a 16 L environmental chamber housed within a Class III biological safety cabinet within biosafety level 3 containment. SARS-CoV-2-containing bioaerosols were generated in the chamber, drawn by a vacuum through each respirator, and physical particle removal and viral genomic RNA were measured distal to the breathing zone of each device. Measurements and Main Results: The mEP respirator removed particles (96.5 ± 0.4%), approximating efficiencies of the N95 (96.9 ± 0.6%). The mEP respirator similarly decreased SARS-CoV-2 viral RNA (99.792%) when compared to N95 removal (99.942%), as a function of particle removal from the airstream distal to the breathing zone of each respirator. Conclusions: The mEP respirator approximated the performance of a filter-based N95 respirator for particle removal and viral RNA as a constituent of the SARS-CoV-2 bioaerosols generated for this evaluation. In practice, the mEP respirator could provide equivalent protection from ambient infectious bioaerosols as the N95 respirator without undue pressure drop to the wearer, thereby facilitating its long-term use in an unobstructed breathing configuration.
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Chan, Jun Keat, Kah Hong Yep, Sarah Magarey, Zoe Keon-Cohen, and Matt Acheson. "Fit Testing Disposable P2/N95 Respirators during COVID-19 in Victoria, Australia: Fit Check Evaluation, Failure Rates, and a Survey of Healthcare Workers." COVID 1, no. 1 (July 6, 2021): 83–96. http://dx.doi.org/10.3390/covid1010007.
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Quantitative fit testing was utilised to evaluate the Department of Health and Human Services in Victoria (DHHS) recommended fit check and determine pass/fail rates for self-selected P2/N95 respirators. Survey experience and training related to P2/N95 respirators were also obtained. This was an observational study at a specialist tertiary referral centre, Melbourne, Australia, between 29 May 2020 and 5 June 2020. The primary outcome was quantitative fit test pass/fail results, with fit check reported against fit test as a 2 × 2 contingency table. The secondary outcomes were the number of adjustments needed to pass, as well as the pass rates for available sizes and types of self-selected respirators, survey data for attitudes, experience and training for P2/N95 respirators. The fit check predicts respirator seal poorly (PPV 34.1%, 95% CI 25.0–40.5). In total, 69% (40/58) of respirators failed quantitative fit testing after initial respirator application and is a clinically relevant finding (first-up failure rate for P2/N95 respirators). Only one person failed the fit test for all three respirator fit tests. There was significant variability between each of the seven types of self-selected P2/N95 respirators, although sample sizes were small. Few participants were trained in the use of P2/N95 respirators or the fit check prior to COVID-19, with a high number of participants confident in achieving a P2/95 respirator seal following a fit test. The fit check alone was not a validated method in confirming an adequate seal for P2/N95 respirators. Quantitative fit testing can facilitate education, improve the seal of P2/N95 respirators, and needs to be integrated into a comprehensive Respiratory Protection Program (RPP).
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Chu, Jacqueline, Omkar Ghenand, Joy Collins, James Byrne, Adam Wentworth, Peter R. Chai, Farah Dadabhoy, Chin Hur, and Giovanni Traverso. "Thinking green: modelling respirator reuse strategies to reduce cost and waste." BMJ Open 11, no. 7 (July 2021): e048687. http://dx.doi.org/10.1136/bmjopen-2021-048687.
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ObjectivesTo compare the impact of respirator extended use and reuse strategies with regard to cost and sustainability during the COVID-19 pandemic.DesignCost analysis.SettingUSA.ParticipantsAll healthcare workers within the USA.InterventionsNot applicable.Main outcome measuresA model was developed to estimate usage, costs and waste incurred by several respirator usage strategies over the first 6 months of the pandemic in the USA. This model assumed universal masking of all healthcare workers. Estimates were taken from the literature, government databases and commercially available data from approved vendors.ResultsA new N95 respirator per patient encounter would require 7.41 billion respirators, cost $6.38 billion and generate 84.0 million kg of waste in the USA over 6 months. One respirator per day per healthcare worker would require 3.29 billion respirators, cost $2.83 billion and generate 37.22 million kg of waste. Decontamination by ultraviolet germicidal irradiation would require 1.64 billion respirators, cost $1.41 billion and accumulate 18.61 million kg of waste. H2O2 vapour decontamination would require 1.15 billion respirators, cost $1.65 billion and produce 13.03 million kg of waste. One reusable respirator with daily disposable filters would require 18 million respirators, cost $1.24 billion and generate 15.73 million kg of waste. Pairing a reusable respirator with H2O2 vapour-decontaminated filters would reduce cost to $831 million and generate 1.58 million kg of waste. The use of one surgical mask per healthcare worker per day would require 3.29 billion masks, cost $460 million and generate 27.92 million kg of waste.ConclusionsDecontamination and reusable respirator-based strategies decreased the number of respirators used, costs and waste generated compared with single-use or daily extended-use of disposable respirators. Future development of low-cost,simple technologies to enable respirator and/or filter decontamination is needed to further minimise the economic and environmental costs of masks.
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Cheberiachko, Ivan, Yuriy Cheberiachko, and Andrii Yavorskyi. "On the Problem of Filter Respirator Selection." Advanced Engineering Forum 25 (November 2017): 136–42. http://dx.doi.org/10.4028/www.scientific.net/aef.25.136.
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Requirements concerning the selection of filtering respirators according to ЕN 529:2006 European standard have been analyzed; the requirements have been compared with the national recommendations given in the corresponding ДНАОП 0.00-1.04-07 normative act on labour protection. It has been determined that the protective efficiency of the respiratory protective devices is characterized by three various parameters characterizing the coefficient of protection – two of them are determined at the working place. However, adequate selection of a filtering respirator is tested in terms of nominal coefficient of protection being determined in a laboratory. Such an approach may result in certain errors due to the set of various factors being available under working conditions. It is proposed to use the value of the expected coefficient of protection determined in the USA being equal to 10 MAC while selecting a filtering respirator. Recommendations are given as for the improvement of respiratory protection of a worker under operational conditions.
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Qüdrət qızı Orucova, Elza, Lalə İslah qızı Rüstəmova, Adilə Novruz qızı Ələsgərova, Gülnarə Aydın qızı Kərimova, and Fəridə Hafiz qızı Heydərova. "To study of antiviral activity of artemicia L. etheric oil in experimental model." SCIENTIFIC WORK 75, no. 2 (February 18, 2022): 133–38. http://dx.doi.org/10.36719/2663-4619/75/133-138.
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Kəskin respirator virus infeksiyalarında terapevtik məqsədlər üçün bitki mənşəli yeni dərman vasitələrinin aparılması eksperimental təbabətin əsas istiqamətlərindən biridir. Bu tədqiqatın məqsədi eksperimental modeldə Artemicia L. efir yağının antiviral fəaliyyətini öyrənməkdir. Bu məqsədlə immunxromatoqrafiya üsulu ilə kəskin respirator infeksiya şübhəsi olan 202 xəstənin burun və burun-udlağın yaxmalarında bəzi respirator viruslar aşkar edilib. Tədqiqatların nəticələri göstərir ki, 2018-2019-cu illərdə Bakı şəhərində kəskin respirator virus infeksiyalarının törədicilərinin etioloji strukturlarında qopma tezliyindən asılı olaraq respirator sinsisial virus və respirator adenovirus üstünlük təşkil etmişdir (2,3%). Artemicia İssayevi Rzazade efir yağının antiviral aktivliyi 50-75%, Malabalia efir yağının antiviral aktivliyi təxminən 25% təşkil edir. Açar sözlər: kəskin respirator virus infeksiyaları, Artemisia L., Yovşan cinsi, Artemisia issayevi Rzazade, efir yağı,antivirus fəallıq, in vitro, immunxromatoqrafiya Elza Gudrat Orujova Lala Islah Rustamova Adila Novruz Alasgarova Gulnara Aydin Karimova Farida Hafiz Heydarova To study of antiviral activity of artemicia L. etheric oil in experimental model Summary The carrying out the new drug means of plant origin for terapeutical purpose in acute respiratory viral infections is an detual direction of experimental medicine. The aim of present investigation is to study of antiviral activity of Artemicia L. etheric oil in experimental model. For this purpose the nasal and nasopharyngeal smears of 202 patiens with suspicion for acute respiratory infection have been observed for some respiratory viruses by using the immunchromatography method. The results of investigations showes that in the etiological structures of agents of acute respiratory viral infections in Baku city during 2018-2019 years from depending of appedring frequency the respiratory sinsitsial virus and respiratory adenovirus have been dominate (2,3%). The antivirul activity of Artemicia issayevi Rzazade etheric oil was 50-75%, the antiviral activity of Malabalia etheric oil consist about 25%. Key words: the acute respiratory viral infections, Artemisia L., Artemisia issayevi Rzazade, etheric oil, antiviral activity, in vitro, immunochromatography
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Neupane, Bhanu Bhakta, and Basant Giri. "Review of materials and testing methods for virus filtering performance of face mask and respirator." PeerJ Materials Science 3 (October 7, 2021): e17. http://dx.doi.org/10.7717/peerj-matsci.17.
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Respiratory protection devices such as face masks and respirators minimize the transmission of infectious diseases by providing a physical barrier to respiratory virus particles. The level of protection from a face mask and respirator depends on the nature of filter material, the size of infectious particle, breathing and environmental conditions, facial seal, and user compliance. The ongoing COVID‒19 pandemic has resulted in the global shortage of surgical face mask and respirator. In such a situation, significant global populations have either reused the single‒use face mask and respirator or used a substandard face mask fabricated from locally available materials. At the same time, researchers are actively exploring filter materials having novel functionalities such as antimicrobial, enhanced charge holding, and heat regulating properties to design potentially better face mask. In this work, we reviewed research papers and guidelines published primarily in last decade focusing on, (a) virus filtering efficiency, (b) impact of type of filter material on filtering efficiency, (c) emerging technologies in mask design, and (d) decontamination approaches. Finally, we provide future prospective on the need of novel filter materials and improved design.
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Schumacher, Jan, James Arlidge, Declan Dudley, Jennifer Van Ross, Francesca Garnham, and Kate Prior. "First responder communication in CBRN environments: FIRCOM-CBRN study." Emergency Medicine Journal 36, no. 8 (June 19, 2019): 456–58. http://dx.doi.org/10.1136/emermed-2019-208413.
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IntroductionRecent terror attacks and assassinations involving highly toxic chemical weapons have stressed the importance of sufficient respiratory protection of medical first responders and receivers. As full-face respirators cause perceptual-motor impairment, they not only impair vision but also significantly reduce speech intelligibility. The recent introduction of electronic voice projection units (VPUs), attached to a respirator, may improve communication while wearing personal respiratory protection.ObjectiveTo determine the influence of currently used respirators and VPUs on medical communication and speech intelligibility.Methods37 trauma anaesthetists carried out an evaluation exercise of six different respirators and VPUs including one control. Participants had to listen to audio clips of a variety of sentences dealing with scenarios of emergency triage and medical history taking.ResultsIn the questionnaire, operators stated that speech intelligibility of the Avon C50 respirator scored the highest (mean 3.9, ±SD 1.0) and that the Respirex Powered Respiratory Protective Suit (PRPS) NHS-suit scored lowest (1.6, 0.9). Regarding loudness the C50 plus the Avon VPU scored highest (4.1, 0.7), followed by the Draeger FPS-7000-com-plus (3.4, 1.0) and the Respirex PRPS NHS-suit scored lowest (2.3, 0.8).ConclusionsWe found that the Avon C50 is the preferred model among the tested respirators. In our model, electronic voice projection modules improved loudness but not speech intelligibility. The Respirex PRPS NHS-suit was rated significantly less favourably in respect of medical communication and speech intelligibility.
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Reponen, Tiina A., Zheng Wang, Klaus Willeke, and Sergey A. Grinshpun. "Survival of Mycobacteria on N95 Personal Respirators." Infection Control & Hospital Epidemiology 20, no. 4 (April 1999): 237–41. http://dx.doi.org/10.1086/501618.
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AbstractObjectives:The overall aim of this study was to investigate the survival and possible growth of Mycobacterium tuberculosis simulant bacteria on respirator filters.Methods:Mycobacterium smegmatis was used as a biochemical simulant for M tuberculosis. Bacterial survival was tested on National Institute for Occupational Safety and Health-certified N95 respirators from three manufacturers. The first experiments simulated one-time respirator use and subsequent storage for 1 to 9 days under ideal conditions for the growth of mycobacteria: 37°C and 85% relative humidity. The bacteria were loaded on the respirator filters under three different nutritional conditions: in the absence of nutrients; in the presence of human saliva (simulating conditions when the respirator is worn); and in the presence of nutrient broth (for ideal growth potential). The subsequent experiments simulated respirator wear for 2 hours under medium workload conditions at a breathing rate of 56 L/min.Results:It was found that M smegmatis did not grow on the tested respirators, even when the respirators were stored at temperature, humidity, and nutrition conditions most favorable for microbial growth. However, these bacteria could survive on respirators for up to 3 days during storage. The culturability of M smegmatis was not affected by airflow that simulated the breathing rate associated with medium work-load conditions for 2 hours.Conclusions:This study shows that M tuberculosis surrogate bacteria collected on a respirator are not able to grow and are able to survive only in ideal (ie, not clinically relevant) conditions. Based on these experiments, we conclude that M tuberculosis is unlikely ever to become an infectious problem in the air again, once it is removed by a respirator.
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Schumm, Max A., Joseph E. Hadaya, Nisha Mody, Bethany A. Myers, and Melinda Maggard-Gibbons. "Filtering Facepiece Respirator (N95 Respirator) Reprocessing." JAMA 325, no. 13 (April 6, 2021): 1296. http://dx.doi.org/10.1001/jama.2021.2531.
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Chiumello, Davide, and Massimo Cressoni. "Respirator management of sepsis-related respiratory failure." Current Infectious Disease Reports 11, no. 5 (August 18, 2009): 365–71. http://dx.doi.org/10.1007/s11908-009-0052-0.
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Lee, Shu-An, Sergey A. Grinshpun, and Tiina Reponen. "Respiratory Performance Offered by N95 Respirators and Surgical Masks: Human Subject Evaluation with NaCl Aerosol Representing Bacterial and Viral Particle Size Range." Annals of Occupational Hygiene 52, no. 3 (March 7, 2008): 177–85. http://dx.doi.org/10.1093/annhyg/men005.
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Abstract Objectives: This study aimed at determining the protection factors (PFs) provided by N95 filtering facepiece respirators and surgical masks against particles representing bacterial and viral size ranges (aerodynamic size: 0.04–1.3 μm). Methods: The protection levels of N95 filtering facepiece respirators (four models) and surgical masks (three models) were investigated while they were donned by 12 subjects performing the OSHA (US Occupational Safety and Health Administration) fit-testing exercises in a test chamber. Results: About 29% of N95 respirators and ∼100% of surgical masks had PFs <10, which is the assigned PF designated for this type of respirator by the OSHA. On average, the PFs of N95 respirators were 8–12 times greater than those of surgical masks. The minimum PFs were observed in the size range of 0.04–0.2 μm. No significant difference in PF results was found between N95 respirators with and without an exhalation valve. Conclusions: The study indicates that N95 filtering facepiece respirators may not achieve the expected protection level against bacteria and viruses. An exhalation valve on the N95 respirator does not affect the respiratory protection; it appears to be an appropriate alternative to reduce the breathing resistance.
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Chen, Yumiao, Jianping Wang, and Zhongliang Yang. "The human factors/ergonomics studies for respirators: a review and future work." International Journal of Clothing Science and Technology 27, no. 5 (September 7, 2015): 652–76. http://dx.doi.org/10.1108/ijcst-06-2014-0077.
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Purpose – The purpose of this paper is to provide an overview of the human factors/ergonomics (HFE) studies for respirator. Design/methodology/approach – This review paper describes and discusses the various factors and methodologies of HFE, for the purpose of better considering human factors, used in respirator studies and further human-centered product development. Findings – Many attempts have been made to study human factors for respirators mainly including fit, human performance, comfort, and mood. Physical, psychological, and physiological indices of people are extremely valuable to HFE studies for respirator. Objective and subjective measures were methodologies widely used. Quantitative and qualitative approaches were adopted to illustrate the human performance and well-being influenced by respirators. A summary table presented with major methods used for indices of respirators in the field of HFE. According to the current researches, this review indicated three particular challenges facing HFE studies of respirators now. Practical implications – With the ever increasing role of protection from air pollution in society, respirator has become an increasingly important part of our daily lives. HFE intervene in optimizing the relationships between respirators and the human using them. Plenty of efforts have been dedicated for the development of protection capability, but HFE studies for respirators are lacking. In recent years, there has been a tremendous interest in introducing HFE research methods that can evaluate respirators from the perspective of human and translate them into constraints for designing human-centered respirators. Originality/value – This is a first paper in the field of HFE studies for respirator, which will remain helpful to the scientific community to start further human-centered research work and product development.
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Kaptsov, Valeriy Aleksandrovich. "Impact of the carbon dioxide on the health care workers during the use of respirators." Sanitarnyj vrač (Sanitary Doctor), no. 1 (January 1, 2021): 22–31. http://dx.doi.org/10.33920/med-08-2101-03.
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Relevance of the problem. The incidence of infectious diseases among health care workers is higher than the population. Better protection of workers from inhalation of bioaerosols will reduce the risk of their disease. The purpose of the study.The goal is to establish how and to what extent the use of personal respiratory protection equipment (PPE) worsens the gas exchange during breathing, and preventing their timely and proper use in the polluted atmosphere. Materials and methods. Available publications from NIOSH, Taylor & Francis, Oxford University Press and other sourceshave been used. Results. The respirator’s usage increases the «dead space», reducing the concentration of oxygen and increasing the concentration of carbon dioxide in the inhaled air. The concentration of CO2may exceed the Occupational Exposure Limits many times. The degree of exposure depends on the type of RPD and the tidal volume; in case of a light work the exposure increases. The requirements for certification of respirators cover only the case of heavy work. Therefore, meeting these requirements does not allow for an adequate assessment of the impact of the respirator on the employee when performing light work. Excessive exposure to carbon dioxide, combined with reduced oxygen concentration in the inhaled air, discomfort and skin irritation, prevents the use of the respirator and can lead to disability. Conclusion. The article gives recommendations on how to improve the protection of medical workers from inhalation of bioaerosols: reducing air pollution with the medical masks and ventilation; use the filtering Powered Air Purifying Respirators (PAPR); changing requirements to respiratory containment. There are recommendations to improve the protection of health workers from inhalation of bioaerosols — reduction of air pollution by masks and ventilation; use of PPE with air supply to the front part; changing requirements for certification of respirators.
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Lim, Taeho, Sanghyun Lee, Jaehoon Oh, Hyunggoo Kang, Chiwon Ahn, Yeongtak Song, Juncheol Lee, and Hyungoo Shin. "Endotracheal Intubation Using a Direct Laryngoscope and the Protective Performances of Respirators: A Randomized Trial." BioMed Research International 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/7565706.
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Purpose. Emergency physicians are at risk for infection during invasive procedures, and the respirators can reduce this risk. This study aimed to determine whether endotracheal intubation using direct laryngoscopes affected protection performances of respirators. Methods. A randomized crossover study of 24 emergency physicians was performed. We performed quantitative fit tests using respirators (cup type, fold type without a valve, and fold type with a valve) before and during intubation. The primary outcome was respirators’ fit factors (FF), and secondary outcomes were acceptable protection (percentage of scores above 100 FF [FF%]). Results. 24 pieces of data were analyzed. Compared to fold-type respirator without a valve, FF and FF% values were lower when participants wore a cup-type respirator (200 FF [200-200] versus 200 FF [102.75–200], 100% [78.61–100] versus 74.16% [36.1–98.9]; all P<0.05) or fold-type respirator with a valve (200 FF [200-200] versus 142.5 FF [63.50–200], 100% [76.10–100] versus 62.50% [8.13–100]; all P<0.05). There were no significant differences in intubation time and success rate according to respirator types. Conclusions. Motion during endotracheal intubation using direct laryngoscopes influenced the protective performance of some respirators. Therefore, emergency physicians should identify and wear respirators that provide the best personalized fit for intended tasks.
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Yuen, John G., Amy C. Marshilok, Peter Todd Benziger, Shan Yan, Jeronimo Cello, Chavis A. Stackhouse, Kim Kisslinger, et al. "Dry heat sterilization as a method to recycle N95 respirator masks: The importance of fit." PLOS ONE 17, no. 1 (January 5, 2022): e0257963. http://dx.doi.org/10.1371/journal.pone.0257963.
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In times of crisis, including the current COVID-19 pandemic, the supply chain of filtering facepiece respirators, such as N95 respirators, are disrupted. To combat shortages of N95 respirators, many institutions were forced to decontaminate and reuse respirators. While several reports have evaluated the impact on filtration as a measurement of preservation of respirator function after decontamination, the equally important fact of maintaining proper fit to the users’ face has been understudied. In the current study, we demonstrate the complete inactivation of SARS-CoV-2 and preservation of fit test performance of N95 respirators following treatment with dry heat. We apply scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDS), X-ray diffraction (XRD) measurements, Raman spectroscopy, and contact angle measurements to analyze filter material changes as a consequence of different decontamination treatments. We further compared the integrity of the respirator after autoclaving versus dry heat treatment via quantitative fit testing and found that autoclaving, but not dry heat, causes the fit of the respirator onto the users face to fail, thereby rendering the decontaminated respirator unusable. Our findings highlight the importance to account for both efficacy of disinfection and mask fit when reprocessing respirators to for clinical redeployment.
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Mitra, Aniruddha, Atin Adhikari, Clinton Martin, Gracia Dardano, Pascal Wagemaker, and Caleb Adeoye. "Evaluation of a Filtering Facepiece Respirator and a Pleated Particulate Respirator in Filtering Ultrafine Particles and Submicron Particles in Welding and Asphalt Plant Work Environments." International Journal of Environmental Research and Public Health 18, no. 12 (June 14, 2021): 6437. http://dx.doi.org/10.3390/ijerph18126437.
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Manufacturing sites, such as welding, casting, and asphalt production (fumes), generate vast numbers of ultrafine particles of <0.1 µm in size and submicron particles close to the ultrafine range (0.1–0.5 µm). Although cumulative masses of these particles are negligible in comparison to the larger particles, the health effects are more severe due to the higher penetration in the human lower respiratory tract, other body parts crossing the respiratory epithelial layers, and the larger surface area. This research investigates the effectiveness of two common commercially available N95 filtering facepieces and N95 pleated particulate respirator models against ultrafine and submicron particles. Two specific types of respirators, the N95 filtering facepiece and the N95 pleated particulate models, in both sealed and unsealed conditions to the manikin face, were tested at various commercial and academic manufacturing sites, a welding and foundry site, and an asphalt production plant. Two TSI Nanoscan SMPS nanoparticle counters were used simultaneously to collect data for particles of 10–420 nm in size from inside and outside of the respirators. While one of them represented the workplace exposure levels, the other one accounted for the exposure upon filtration through the respiratory surfaces. The results showed the particles generated by these manufacturing operations were mostly within the range of from 40 to 200 nm. Results also indicated that while the percentage of filtration levels varied based on the particle size, it remained mostly within the desired protection level of 95% for both of the N95 respirator models in sealed conditions and even for the N95 pleated particulate model in the unsealed condition. However, in the case of the N95 filtering facepiece model, unsealed respirators showed that the percentage of penetration was very high, decreasing the protection levels to 60% in some cases. Although the number of workplace airborne particle levels varied considerably, the filtration percentages were relatively consistent.
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Patel, B., J. C. Hardman, W. Yang, A. Robson, G. Putnam, A. George, and V. Paleri. "Reusable respirators as personal protective equipment during ENT surgery." Journal of Laryngology & Otology 134, no. 8 (July 1, 2020): 732–34. http://dx.doi.org/10.1017/s0022215120001346.
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AbstractBackgroundRobust personal protective equipment is essential in preventing the transmission of coronavirus disease 2019 to head and neck surgeons who are routinely involved in aerosol generating procedures.ObjectiveThis paper describes the collective experience, across 3 institutes, of using a reusable half-face respirator in 72 head and neck surgery cases.MethodCost analysis was performed to demonstrate the financial implications of using a reusable respirator compared to single-use filtering facepiece code 3 masks.ConclusionThe reusable respirator is a cost-effective alternative to disposable filtering facepiece code 3 respirators. Supplying reusable respirators to individual staff members may increase the likelihood of them having appropriate personal protective equipment during their clinical duties.
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Lee, M. C., S. Takaya, R. Long, and A. M. Joffe. "Respirator-Fit Testing: Does It Ensure the Protection of Healthcare Workers Against Respirable Particles Carrying Pathogens?" Infection Control & Hospital Epidemiology 29, no. 12 (December 2008): 1149–56. http://dx.doi.org/10.1086/591860.
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Objective.Respiratory protection programs, including fit testing of respirators, have been inconsistently implemented; evidence of their long-term efficacy is lacking. We undertook a study to determine the short- and long-term efficacy of training for fit testing of N95 respirators in both untrained and trained healthcare workers (HCWs).Design.Prospective observational cohort study.Methods.A group of at-risk, consenting HCWs not previously fit-tested for a respirator were provided with a standard fit-test protocol. Participants were evaluated after each of 3 phases, and 3 and 14 months afterward. A second group of previously fit-tested nurses was studied to assess the impact of regular respirator use on performance.Results.Of 43 untrained fit-tested HCWs followed for 14 months, 19 (44.2%) passed the initial fit test without having any specific instruction on respirator donning technique. After the initial test, subsequent instruction led to a pass for another 13 (30.2%) of the 43 HCWs, using their original respirators. The remainder required trying other types of respirators to acheive a proper fit. At 3 and 14 months' follow-up, failure rates of 53.5% (23 of 43 HCWs) and 34.9% (15 of 43 HCWs), respectively, were observed. Pass rates of 87.5%-100.0% were observed among regular users.Conclusions.Without any instruction, nearly 50% of the HCWs achieved an adequate facial seal with the most commonly used N95 respirator. Formal fit testing does not predict future adequacy of fit, unless frequent, routine use is made of the respirator. The utility of fit testing among infrequent users of N95 respirators is questionable.
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Farabi, Maududi, and Mila Tejamaya. "Respiratory Protection Programs (RPP) Implementation at Production Unit of A Tin Smelter at Bangka Belitung Islands Province." Jurnal Ilmu Kesehatan Masyarakat 11, no. 3 (November 30, 2020): 248–63. http://dx.doi.org/10.26553/jikm.2020.11.3.248-263.
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The fume generated from the reaction of flux and molten tin produces tin compounds in the atmosphere which potentially lead to stanosis or also known as tin pneumoconiosis after chronic inhalation and prolonged exposure in the workplaces e.g. in smelter industries. The risk can be minimized by implementing Respiratory Protection Program (RPP). This study aimed to evaluate the implementation of RPP at one smelter industries in Bangka Belitung Province. This is a evaluation study that qualitatively evaluate the implementation of RPP. eigth RPP elements from National safety Council (NSC) Australia was used as guideline. The secondary data from Occupational Health and Safety inspection and monitoring report at one of tin smelter from Department of Manpower (Disnaker), Banga Belitung Island province. It was found that several RPP elements have not been fully implemented, which were (1) compliance with respirator standards, (2) no selection of respirators procedure, (3) no protective clothing, (4) no fit testing execution, (5) improper management of cleaning and inspections, and (6) no evaluation of respirator usage. Moreover, specific work process that need Supplied Air Respirator (SAR) has not been anticipated, and improvement in the training materials, periodic training schedule and evaluation of the Respiratory Protection Program were emphasized. There were 3 informants in this study consisting of company managers, safety officers, and labor inspector. The implementation of RPP at PT X. Tin needs to be enhanced. Continuous coaching, monitoring, inspection, and evaluation related to the Respiratory Protection Program must be carried out more intensively both internally and externally from the government.
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Allison, Carrick, Mike Tennant, Peter Xiang, Jennifer Stephens, Oliver Ball, and Niall Wilton. "Navigating the shifting sands of filtering facepiece respirator provision during the COVID-19 pandemic: a system response for maximising staff safety." BMJ Open Quality 10, no. 3 (August 2021): e001163. http://dx.doi.org/10.1136/bmjoq-2020-001163.
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IntroductionPersonal protective equipment is essential to protect health workers and patients and to ensure confidence when dealing with aerosolised disease transmission. We describe the process for ensuring adequate filtering facepiece respirator (FFR) qualitative fit testing at a local level during the COVID-19 pandemic.MethodsCascaded training is described, which allowed rapid spreading of the testing process, with supervision allowing quality assurance throughout. Testing consisted of subjective ‘fit checking’, checking for leaks, followed by qualitative hood testing.ResultsThe original respirators (3M 1870) had a hood test pass rate of 87.5%. Following identification of this as a non-renewable and unsustainable option, a domestically manufactured and sustainable Help-It P2 duckbill-type respirator was adopted as the primary FFR. The hood test pass rate for this respirator was only 54%. A third respirator was made available (3M 1860), with a high pass rate of 80% but also a limited and non-renewable resource. Algorithms were constructed highlighting different proportional use of the respirators depending on the most limited resource.ConclusionThe testing format used is simple, reproducible and can be used by any hospital organisation when occupational health and safety departments are unable to provide the service during overwhelming demand. Qualitative fit testing is a scalable and effective method for ensuring appropriately sized and shaped FFRs, minimising resource consumption in the process. The use of a product with appropriate filtration capacity but a lower fit test pass rate (domestic duckbill respirator) as a replaceable resource facilitated adequate respirator availability for staff that would otherwise not have been possible. The provision of an FFR fit registry allows an organisation to make appropriate respirators available to staff from different sources as supply and demand changes.
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Zhuang, Ziqing, Dennis Groce, Heinz W. Ahlers, Wafik Iskander, Douglas Landsittel, Steve Guffey, Stacey Benson, Dennis Viscusi, and Ronald E. Shaffer. "Correlation Between Respirator Fit and Respirator Fit Test Panel Cells by Respirator Size." Journal of Occupational and Environmental Hygiene 5, no. 10 (August 4, 2008): 617–28. http://dx.doi.org/10.1080/15459620802293810.
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Cadnum, Jennifer, Basya Pearlmutter, Daniel Li, Annette Jencson, Jacob Scott, Ian Charnas, and Curtis Donskey. "Evaluation of 2 Ultraviolet-C Light Boxes for Decontamination of N95 Respirators." Pathogens and Immunity 6, no. 1 (June 5, 2021): 104–15. http://dx.doi.org/10.20411/pai.v6i1.432.
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Background: Ultraviolet-C (UV-C) light devices are effective in reducing contamination on N95 filtering facepiece respirators. However, limited information is available on whether UV-C devices meet the Food and Drug Administration’s (FDA) microbiological requirements for Emergency Use Authorization (EUA) for respirator bioburden reduction. Methods: We tested the ability of 2 UV-C light boxes to achieve the 3-log10 microorganism reductions required for EUA for reuse by single users. Whole 3M 1860 or Moldex 1513 respirators were inoculated on the exterior facepiece, interior facepiece, and internal fibers with bacteriophage MS2 and/or 4 strains of bacteria and treated with UV-C cycles of 1 or 20 minutes. Colorimetric indicators were used to assess penetration of UV-C through the respirators. Results: For 1 UV-C box, a 20-minute treatment achieved the required bioburden reduction for Moldex 1513 but not 3M 1860 respirators. For the second UV-C box, a 1-minute treatment achieved the required bioburden reduction in 4 bacterial strains for the Moldex 1513 respirator. Colorimetric indicators demonstrated penetration of UV-C through all layers of the Moldex 1513 respirator but not the 3M 1860 respirator. Conclusions: Our findings demonstrate that UV-C box technologies can achieve bioburden reductions required by the FDA for EUA for single users but highlight the potential for variable efficacy for different types of respirators.
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Yoo, Ji Yeoun, Nicolas Gaspard, Lawrence J. Hirsch, and Rafeed Alkawadri. "Respiratory Artifact on EEG Independent of the Respirator." Journal of Clinical Neurophysiology 31, no. 5 (October 2014): e16-e17. http://dx.doi.org/10.1097/wnp.0000000000000027.
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CAMPBELL, P. J., H. W. CHILTON, P. A. GARVEY, and J. M. GUPTA†. "Volumetric diffusive respirator use in neonatal respiratory failure." Journal of Paediatrics and Child Health 27, no. 1 (February 1991): 31–33. http://dx.doi.org/10.1111/j.1440-1754.1991.tb00341.x.
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Gilgoff, Irene S., Donna M. Barras, Michelle Sellers Jones, and Hazel V. Adkins. "Neck Breathing: A Form of Voluntary Respiration for the Spine-Injured Ventilator-Dependent Quadriplegic Child." Pediatrics 82, no. 5 (November 1, 1988): 741–45. http://dx.doi.org/10.1542/peds.82.5.741.
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Children with respirator-dependent quadriplegia because of C-2 spinal cord injuries are now surviving the acute stages of their injury. The major cause of mortality and morbidity in the chronic stage is due to respiratory complications. Surveillance, 24 h/d, is the best way to prevent accidental disconnection of respirator equipment from the patient and its inherent catastrophic consequences. The constant risk of disconnection adds tension to the home environment and takes away from the patient any degree of independence or privacy. Because of this, an alternative method of respiration using neck accessory muscles was developed to restore a patient-controlled, voluntary system of respiration. This method, neck breathing, is described in detail in seven children varying in age from 3 years to 16 years 3 months. All seven patients had complete paralysis of the intercostal muscles and the diaphragm. An eighth patient who was unable to learn the technique is also described. Neck breathing is also compared to glossopharyngeal breathing, an alternative method of respiration developed during the polio era.
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Lee, Eun Gyung, and Diana M. Ceballos. "Adoption of Exposure Assessment Tools to Assist in Providing Respiratory Protection Recommendations." Annals of Work Exposures and Health 64, no. 5 (March 6, 2020): 547–57. http://dx.doi.org/10.1093/annweh/wxaa023.
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Abstract Selecting a proper respirator requires determining the ratio of an employee’s maximum use concentration (MUC) divided by the occupational exposure limit of a chemical. Current industrial hygiene practice often is to obtain a percentile estimate (e.g. 95th) of the measured exposure distribution to apply as the MUC. However, practitioners who are not yet familiar with statistical or mathematical approaches may choose the highest exposure data point as the MUC, a method that is still considered appropriate by the Occupational Safety and Health Administration. Nonetheless, choosing a respirator using the highest exposure data point when only limited data are available may result in not always providing the most adequate respirator. Because some practitioners are not familiar with exposure assessment tools, our primary goal in this study was to demonstrate the best process when selecting respiratory protection by using a combination of exposure data and assessment tools. Three user-friendly tools, IHDataAnalyst, Advanced REACH Tool, and IHSTAT, were selected to demonstrate how to use different types of tool outputs when choosing a respirator. A decision logic was developed to help users navigate the combining of different data inputs. Personal full-shift exposure data collected in four different workplaces were used to describe four different outcomes generated when the maximum exposure data point and the tool’s output are compared with the exposure limit of the chemical. Outcomes varied, from determinations of ‘high confidence’ (or final decision) to ‘low confidence’ (or indicating more data are needed) in the selection of a respirator recommendation. In conclusion, systematically adopting the combination of exposure data and assessment tools could increase practitioners’ confidence in decision-making when choosing respirators from a limited exposure data set. These suggested guidelines will lead practitioners toward good industrial hygiene practices.
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Bazaluk, Oleg, Serhii Cheberiachko, Yurii Cheberiachko, Oleh Deryugin, Vasyl Lozynskyi, Ivan Knysh, Pavlo Saik, and Mykola Naumov. "Development of a Dust Respirator by Improving the Half Mask Frame Design." International Journal of Environmental Research and Public Health 18, no. 10 (May 20, 2021): 5482. http://dx.doi.org/10.3390/ijerph18105482.
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Protective efficiency of filtering dust respirators depends on the properties of filter materials from which filters are made and the structure of a half mask frame, which influences how tightly the respirator fits the face. The conducted studies on the “Lepestok 40” dust respirator revealed a large air leakage through the gaps occurring along the obturation strip. Therefore, the purpose of the study is to develop a dust respirator to provide high level of protection and usability by improving the half mask frame design. A scheme for designing a dust respirator: analysis of operating conditions for the dust respirator; facial anthropometric measurements of potential users; designing a 3D model of half mask frame; laboratory testing of the protective properties of the product. A distinctive feature of this approach is considering the facial anthropometric dimensions of employees of a particular enterprise, standard sizes formation of 3D facial models, which is the basis for designing a half mask frame for dust respirator. A new half mask frame design for dust respirator with a variable geometry of fitting to the face surface has been developed, due to special attachment points that allow changing its size according to the anthropometric dimensions of user’s face.
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Saphire, Lynn S. "Respirator Use." AAOHN Journal 44, no. 9 (September 1996): 444–46. http://dx.doi.org/10.1177/216507999604400906.
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Checchi, Vittorio, Marco Montevecchi, and Luigi Checchi. "Variation of Efficacy of Filtering Face Pieces Respirators over Time in a Dental Setting: A Pilot Study." Dentistry Journal 9, no. 4 (March 24, 2021): 36. http://dx.doi.org/10.3390/dj9040036.
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Since aerosol continuously persists in dental settings, where different procedures and patients come in succession, the use of oronasal masks is highly recommended. Among them, respirators known as Filtering Face Pieces (FFP) show a protective superiority compared to surgical masks. Even concerning respirators classified as non-reusable, it is not known how many hours of use are necessary to compromise their filtering capacity. The aim of this study is to investigate the variations of filtering capacity of an FFP2 respirator over time, in order to safely optimize the timing of its use. Five respirators were worn by the same operator during clinical activity for different usage times (8, 16, 24, 32, 40 h), and one respirator was kept unused. All respirators underwent a bacterial filtration efficacy (BFE) test. T-test for paired data with Bootstrap technique and Wilcoxon test for paired data compared BFE values of the five tested FFP2s respectively at each time, and the areas with the corresponding values of the control respirator (FFp2-F). A generalized linear mixed effect model (GLM) was applied considering type of respirator and time as fixed effects and intercept as random effect. No significant statistical differences were present in the BFE of each time. Data obtained by the present study highlight the important ability of FFP2s to maintain their BFE over time, suggesting a long lasting protective function.
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Ludwig-Begall, Louisa F., Constance Wielick, Olivier Jolois, Lorène Dams, Ravo M. Razafimahefa, Hans Nauwynck, Pierre-Francois Demeuldre, et al. "“Don, doff, discard” to “don, doff, decontaminate”—FFR and mask integrity and inactivation of a SARS-CoV-2 surrogate and a norovirus following multiple vaporised hydrogen peroxide-, ultraviolet germicidal irradiation-, and dry heat decontaminations." PLOS ONE 16, no. 5 (May 19, 2021): e0251872. http://dx.doi.org/10.1371/journal.pone.0251872.
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Background As the SARS-CoV-2 pandemic accelerates, the supply of personal protective equipment remains under strain. To combat shortages, re-use of surgical masks and filtering facepiece respirators has been recommended. Prior decontamination is paramount to the re-use of these typically single-use only items and, without compromising their integrity, must guarantee inactivation of SARS-CoV-2 and other contaminating pathogens. Aim We provide information on the effect of time-dependent passive decontamination (infectivity loss over time during room temperature storage in a breathable bag) and evaluate inactivation of a SARS-CoV-2 surrogate and a non-enveloped model virus as well as mask and respirator integrity following active multiple-cycle vaporised hydrogen peroxide (VHP), ultraviolet germicidal irradiation (UVGI), and dry heat (DH) decontamination. Methods Masks and respirators, inoculated with infectious porcine respiratory coronavirus or murine norovirus, were submitted to passive decontamination or single or multiple active decontamination cycles; viruses were recovered from sample materials and viral titres were measured via TCID50 assay. In parallel, filtration efficiency tests and breathability tests were performed according to EN standard 14683 and NIOSH regulations. Results and discussion Infectious porcine respiratory coronavirus and murine norovirus remained detectable on masks and respirators up to five and seven days of passive decontamination. Single and multiple cycles of VHP-, UVGI-, and DH were shown to not adversely affect bacterial filtration efficiency of masks. Single- and multiple UVGI did not adversely affect respirator filtration efficiency, while VHP and DH induced a decrease in filtration efficiency after one or three decontamination cycles. Multiple cycles of VHP-, UVGI-, and DH slightly decreased airflow resistance of masks but did not adversely affect respirator breathability. VHP and UVGI efficiently inactivated both viruses after five, DH after three, decontamination cycles, permitting demonstration of a loss of infectivity by more than three orders of magnitude. This multi-disciplinal approach provides important information on how often a given PPE item may be safely reused.
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Beam, Elizabeth, Kevin Kupzyk, Jocelyn Herstein, and Shawn Gibbs. "Using a Critical Safety Behavior Scoring Tool for N95 Respirator Use to Evaluate Training Interventions." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s425. http://dx.doi.org/10.1017/ice.2020.1083.
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Background: Hospitals struggle nationally to educate healthcare workers on the safe use of N95 respirators as part of their respiratory protection programs. Practical and effective interventions are needed to improve this clinical behavior, which is critical to healthcare worker safety in airborne precautions, hazardous drug administration, and pandemic response. Objective: In this analysis, we specifically investigated 2 just-in-time training interventions that would be practical to implement in a hospital setting. Methods: A simulation approach was used to evaluate 2 interventions for N95 respirator use at a Midwestern Academy Hospital system (n = 62 respirators: 32 control and 30 treatment). Healthcare workers were asked to don and doff an N95 respirator while being video-recorded in an empty hospital corridor and room. After a randomized intervention was applied, they repeated the respirator donning and doffing while being video-recorded. One intervention used an instructional video alone, and the other used the same instructional video but added a video reflection intervention. The video reflection intervention asked the participant to review and score their first performance of N95 donning and doffing using the Critical Safety Behavior Scoring Tool (CSBST). The research team used the same CSBST to score all performances of donning and doffing for comparison and evaluation. Result: The critical safety behaviors at the pretest and posttest for the 2 intervention groups reveal the impact of the 2 types of just-in-time training on demonstrated N95 respirator skills. The video alone and video reflection scores were not significantly different at pretest between the 2 groups. Scores were significantly higher on the posttest for the reflective practice intervention. Findings related to demographic information included years in healthcare, frequency of use, history of needlestick, and fatigue. Conclusions: Video reflection may improve compliance with critical safety behaviors for just-in-time training on N95 respirator use. Further research should examine the video-recorded findings for measurement elements that can be expanded in a scoring tool such as facial hair, hairstyle, and the quality of hand hygiene. Intervention studies should also examine how often the training must be repeated to maintain competency. This intervention may have implications for the training of other critical safety behaviors in infection control and other high-risk procedures.Funding: NoneDisclosures: None
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McCullough, Nicole Vars, and Lisa M. Brosseau. "Selecting Respirators for Control of Worker Exposure to Infectious Aerosols." Infection Control & Hospital Epidemiology 20, no. 02 (February 1999): 136–44. http://dx.doi.org/10.1086/501602.
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AbstractA method for selecting respirators for protection in infectious aerosol environments was developed, building on a procedure used to choose respiratory protection for environments containing nonbiological contaminants. Modifications in the traditional respirator selection method are proposed for situations where information on occupational exposure limits, toxicity, and airborne concentrations is absent. Toxicity is determined from risk rankings proposed by a variety of organizations. The nature of the activity allows assessment of source generation, which is combined with room volume and airflow to obtain a ranking of airborne concentration. Finally, concentration and toxicity ranks determine a minimum assigned protection factor, which corresponds to a respirator class. Case studies are presented to illustrate the proposed decision logic. For each situation, the procedure yielded choices that were both protective and reasonable. These results suggest that the procedure will be applicable to a variety of settings for a range of infectious organisms.
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Tony Wibowo, Gerry Silaban, and Taufik Ashar. "The Effect of the Use of Respirators for Decreasing the Subjective Symptoms Disorders in the Center Nerve System in Digital Printing Printing Workers in Medan City." Britain International of Exact Sciences (BIoEx) Journal 2, no. 1 (February 22, 2020): 417–29. http://dx.doi.org/10.33258/bioex.v2i1.178.
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Workers who are exposed to evaporated organic compound from printing in the long term will have the risk for subjective symptom of central nervous system disorder in which it is the main entrance to the body through inhalation process. Workers in the production unit will have the most dominant risk for it. The objective of the research was to analyze the influence of using respirator on subjective symptom of central nervous system disorder in worker who work at digital printing industry. The research used one group pretest-posttest design. The samples were workers, taken by using purposive sampling technique. Bivariate analysis used paired t-test at the significance level of 95% (α=0.05). The result of the research showed that p-value = 0.0001 (p<0.05) which indicated that there was significant difference in the scores of Q16 questionnaires between pre and post intervention. The result of Q16 questionnaire in Swedish version showed that 20 respondents (100%) had difficulty breathing and 20 respondents (100%) had headache at least once a week. In the post-intervention with using respirators in one month, there was no complaint anymore. Respirator is equipped with organic vapor cartridge which is able to absorb gas from contaminated air before it enters the workers’ respiratory system. Using respirator as a personal protective device influences the decrease in subjective symptom of central nervous system disorder in printing workers. Using filter, cartridge, or tube in respirator should be done accurately otherwise it will cause danger for the workers.
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Wakamatsu, H. "Nonlinear Adaptive Control of Human Respiration Using Newly Developed Respirator with Variable Respiratory Rhythm." IFAC Proceedings Volumes 23, no. 8 (August 1990): 197–202. http://dx.doi.org/10.1016/s1474-6670(17)52007-8.
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Hansen, Joyce M., Scott Weiss, Terra A. Kremer, Myrelis Aguilar, and Gerald McDonnell. "RESEARCH: Dry Heat Processing of Single-Use Respirators and Surgical Masks." Biomedical Instrumentation & Technology 54, no. 6 (November 1, 2020): 410–16. http://dx.doi.org/10.2345/0899-8205-54.6.410.
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The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged healthcare providers in maintaining the supply of critical personal protective equipment, including single-use respirators and surgical masks. Single-use respirators and surgical masks can reduce risks from the inhalation of airborne particles and microbial contamination. The recent high-volume demand for single-use respirators and surgical masks has resulted in many healthcare facilities considering processing to address critical shortages. The dry heat process of 80°C (176°F) for two hours (120 min) has been confirmed to be an appropriate method for single-use respirator and surgical mask processing.