Sunday, November 08, 2009

The Respirator Controversy Continues

 

 

# 3973

 

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N-95 Respirator               Surgical Facemask

 

 

The N95 respirator versus surgical masks as protective gear for HCW (Health Care Workers) has been an ongoing controversy for months. 

 


Very briefly, for many years, surgical masks have been considered inferior (practically non-existent) protection for the wearer from respiratory viruses. 

 

N95 respirators have been considered the minimum `protective’ mask. 

 

Now . . .in the face of a pandemic and shortages of N95 respirators, there is a move to certify surgical masks as adequate protective gear. 


The CDC, OSHA, and the IOM have all come down in favor of N95 respirators – when that option is available – as being the preferred level of protection.  

 

But several recent studies have suggested that surgical masks may be equally protective  (see JAMA: Surgical Masks vs N95 Respirators).

 

There are practical concerns here, in that we simply don’t have enough N95 masks to go around.  But many HCWs believe that any watering down of the standards is wrong, and places their health in jeopardy.

 

ANA Calls Shortage Of N95 Respirators Unacceptable
CNA/NNOC Plan Protest Over Inadequate H1N1 Protection
Report: Nurses File Complaint Over Lack Of PPE

 

Three major Infectious Disease Organizations are now calling for a change in the standards, to make surgical masks an acceptable substitute for N95 respirators when dealing with influenza patients.  

 

While an official chance in policy on surgical masks would clear the way for hospitals to use them, it remains to be seen how well HCWs would accept that ruling. 

 

This from Medical News Today.

 

White House Urged To Modify 2009 H1N1 Guidance For Healthcare Workers And Issue Moratorium On OSHA Enforcement


Article Date: 08 Nov 2009 - 3:00 PST

 

Three leading scientific organizations specializing in infectious diseases prevention issued a letter to President Obama expressing their significant concern with current federal guidance concerning the use of personal protective equipment (PPE) by healthcare workers in treating suspected or confirmed cases of 2009 H1N1 influenza. The Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA) and the Association for Professionals in Infection Control and Epidemiology (APIC) urged the administration to modify the guidance and issue an immediate moratorium on Occupational Safety and Health Administration's (OSHA) enforcement of the current requirements.

 
Federal PPE guidance and requirements issued recently by the Centers for Disease Control and Prevention (CDC) and OSHA include the use of fit-tested N95 respirators by healthcare workers rather than the use of standard surgical masks. According to these organizations--representing scientists, infectious disease specialists and healthcare professionals dedicated to healthcare quality, safety and infection control--this guidance does not reflect the best available scientific evidence. Their letter to the White House cited two recent studies demonstrating that the use of N95 respirators does not offer additional protection over that provided by the use of surgical masks.

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