Level of respiratory protection for healthcare workers caring for coronavirus disease 2019 (COVID-19) patients: A survey of hospital epidemiologists

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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Knowledge, perceptions and practices of healthcare workers regarding the use of respiratory protection equipment at Iran hospitals

Journal of Infection Prevention ◽

10.1177/1757177417724880 ◽

2017 ◽

Vol 19 (1) ◽

pp. 29-36 ◽

Cited By ~ 1

Author(s):

Marzieh Honarbakhsh ◽

Mehdi Jahangiri ◽

Haleh Ghaem

Keyword(s):

Healthcare Workers ◽

Cross Sectional Study ◽

Respiratory Protection ◽

Medical Sciences ◽

Cross Sectional ◽

Job Experience ◽

History Of ◽

Level Of Knowledge ◽

Spss Software ◽

Knowledge And Practice

Background: Using appropriate respiratory protection equipment (RPE) is very important to protect healthcare workers (HCWs) against respiratory hazards. The aim of this study was to identify the level of knowledge, perceptions and practices of HCWs on using RPE. Methods: This cross-sectional study was conducted with 284 employees of educational hospitals affiliated to Shiraz University of Medical Sciences. The study’s instrument was a self-made questionnaire that comprised four components: demographic inquiries and questions designed to assess the knowledge, perceptions and practice of HCWs regarding RPE. Collected data were analysed using SPSS software version 21. Results: Average scores of knowledge, perceptions and practice of HCWs on using RPE were 66.50% ± 11.93%, 80.32% ± 10.05% and 70.12% ± 20.51%, respectively. A significant association was observed between knowledge and age, job experience, history of using respirator, marital status and risk of respiratory hazards in the workplace and perceptions with age and education and practice with education. Conclusion: Studied HCWs had positive perceptions and moderate level of knowledge and practice about the use of RPE. Full implementation of respiratory protection program in the hospitals would be helpful to improve the knowledge, perceptions and practices of HCWs regarding RPE.

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Respiratory Protection for Healthcare Workers

MedEdPORTAL ◽

10.15766/mep_2374-8265.9228 ◽

2012 ◽

Vol 8 (1) ◽

Author(s):

Estella Whimbey ◽

Timothy Dellit ◽

Mary Dessel

Keyword(s):

Healthcare Workers ◽

Respiratory Protection

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Homegrown Ultraviolet Germicidal Irradiation for Hospital-Based N95 Decontamination during the COVID-19 Pandemic

10.1101/2020.04.29.20085456 ◽

2020 ◽

Cited By ~ 2

Author(s):

Eric Schnell ◽

Melanie J. Harriff ◽

Jane E. Yates ◽

Elham Karamooz ◽

Christopher D. Pfeiffer ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Healthcare Workers ◽

Global Supply Chains ◽

Protective Equipment ◽

Respiratory Protection ◽

Exposure Risk ◽

High Demand ◽

Ultraviolet Germicidal Irradiation ◽

Global Pandemic ◽

Ultraviolet C

AbstractCoronavirus disease (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, is responsible for the 2020 global pandemic and characterized by high transmissibility and morbidity. Healthcare workers (HCWs) are at risk of contracting COVID-19, and this risk is mitigated through the use of personal protective equipment such as N95 Filtering Facepiece Respirators (FFRs). The high demand for FFRs is not currently met by global supply chains, potentially placing HCWs at increased exposure risk. Effective FFR decontamination modalities exist, which could maintain respiratory protection for HCWs in the midst of the current pandemic, through the decontamination and re-use of FFRs. Here, we present a locally-implemented ultraviolet-C germicidal irradiation (UVGI)-based FFR decontamination pathway, utilizing a home-built UVGI array assembled entirely with previously existing components available at our institution. We provide recommendations on the construction of similar systems, as well as guidance and strategies towards successful institutional implementation of FFR decontamination.

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Usefulness of Pulsed-Field Gel Electrophoresis in Assessing Nosocomial Transmission of Pertussis

Infection Control and Hospital Epidemiology ◽

10.1086/501579 ◽

1999 ◽

Vol 20 (11) ◽

pp. 758-760 ◽

Cited By ~ 13

Author(s):

Michèle Nouvellon ◽

Jean-François Gehanno ◽

Martine Pestel-Caron ◽

Christian Weber ◽

Jean-François Lemeland ◽

...

Keyword(s):

Bordetella Pertussis ◽

Gel Electrophoresis ◽

Healthcare Workers ◽

Whooping Cough ◽

Close Contact ◽

Pulsed Field Gel Electrophoresis ◽

Nosocomial Transmission ◽

Respiratory Protection ◽

Pulsed Field ◽

Protection Devices

AbstractDuring a 2-week period, three infants with a cough lasting at least 8 days with whoops, were admitted to the pediatric unit; Bordetella pertussis was isolated from nasopharyngeal aspirates collected from the three infants. Approximately 1 week later, a nurse working on the same unit developed influenza-like symptoms followed by whooping cough; B pertussis was isolated. Isolates from the nurse and from one of the infants were shown to be indistinguishable by pulsed-field gel electrophoresis. These data demonstrate that B pertussis transmission to healthcare workers is possible and emphasize the need to use respiratory protection devices (Droplet Precautions) for healthcare workers having close contact with infected children.

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Respiratory protection among healthcare workers during cardiopulmonary resuscitation in COVID-19 patients

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2020.05.014 ◽

2021 ◽

Vol 39 ◽

pp. 233 ◽

Cited By ~ 2

Author(s):

Kurt Ruetzler ◽

Jacek Smereka ◽

Kobi Ludwin ◽

Anna Drozd ◽

Lukasz Szarpak

Keyword(s):

Cardiopulmonary Resuscitation ◽

Healthcare Workers ◽

Respiratory Protection

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Construction and validation of an ultraviolet germicidal irradiation system using locally available components

PLoS ONE ◽

10.1371/journal.pone.0255123 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255123

Author(s):

Eric Schnell ◽

Elham Karamooz ◽

Melanie J. Harriff ◽

Jane E. Yates ◽

Christopher D. Pfeiffer ◽

...

Keyword(s):

Healthcare Workers ◽

Respiratory Protection ◽

Exposure Risk ◽

High Demand ◽

Industrial Facilities ◽

Global Pandemic ◽

The Face ◽

Ultraviolet C ◽

Local Construction ◽

Uv C

Coronavirus disease (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, is responsible for a global pandemic characterized by high transmissibility and morbidity. Healthcare workers (HCWs) are at risk of contracting COVID-19, but this risk has been mitigated through the use of personal protective equipment such as N95 Filtering Facepiece Respirators (FFRs). At times the high demand for FFRs has exceeded supply, placing HCWs at increased exposure risk. Effective FFR decontamination of many FFR models using ultraviolet-C germicidal irradiation (UVGI) has been well-described, and could maintain respiratory protection for HCWs in the face of supply line shortages. Here, we detail the construction of an ultraviolet-C germicidal irradiation (UVGI) device using previously existing components available at our institution. We provide data on UV-C dosage delivered with our version of this device, provide information on how users can validate the UV-C dose delivered in similarly constructed systems, and describe a simple, novel methodology to test its germicidal effectiveness using in-house reagents and equipment. As similar components are readily available in many hospitals and industrial facilities, we provide recommendations on the local construction of these systems, as well as guidance and strategies towards successful institutional implementation of FFR decontamination.

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Assessment of N95 respirator decontamination and re-use for SARS-CoV-2

10.1101/2020.04.11.20062018 ◽

2020 ◽

Cited By ~ 26

Author(s):

Robert J. Fischer ◽

Dylan H. Morris ◽

Neeltje van Doremalen ◽

Shanda Sarchette ◽

M. Jeremiah Matson ◽

...

Keyword(s):

Hydrogen Peroxide ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

Nosocomial Transmission ◽

Protective Equipment ◽

Respiratory Protection ◽

Single Use ◽

N95 Respirators

The unprecedented pandemic of SARS-CoV-2 has created worldwide shortages of personal protective equipment, in particular respiratory protection such as N95 respirators. SARS-CoV-2 transmission is frequently occurring in hospital settings, with numerous reported cases of nosocomial transmission highlighting the vulnerability of healthcare workers. In general, N95 respirators are designed for single use prior to disposal. Here, we have analyzed four readily available and often used decontamination methods: UV, 70% ethanol, 70C heat and vaporized hydrogen peroxide for inactivation of SARS-CoV-2 on N95 respirators. Equally important we assessed the function of the N95 respirators after multiple wear and decontamination sessions.

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