Elastomeric Respirators for COVID-19 and the Next Respiratory Virus Pandemic: Essential Design Elements

Abstract

Respiratory viruses are transmitted via respiratory particles that are emitted when people breath, speak, cough, or sneeze. These particles span the size spectrum from visible droplets to airborne particles of hundreds of nanometers. Barrier face coverings (“cloth masks”) and surgical masks are loose-fitting and provide limited protection from airborne particles since air passes around the edges of the mask as well as through the filtering material. Respirators, which fit tightly to the face, provide more effective respiratory protection. Although healthcare workers have relied primarily on disposable filtering facepiece respirators (such as N95) during the COVID-19 pandemic, reusable elastomeric respirators have significant potential advantages for the COVID-19 and future respiratory virus pandemics. However, currently available elastomeric respirators were not designed primarily for healthcare or pandemic use and require further development to improve their suitability for this application. The authors believe that the development, implementation, and stockpiling of improved elastomeric respirators should be an international public health priority.

The time has come to protect healthcare workers and patients from aerosol transmissible disease

“…Greater routine use of respirators might well stimulate improvements in design that improve comfort and ease of donning and doffing; and a steady demand for respirators might make the supply chain more robust. Reusable elastomeric respirators offer advantages in comparison to disposable respirators ( 44 ) because they can be cleaned and their filters are very long lasting. Especially in pandemic or surge situations, elastomeric respirators have considerable strategic value.…”

Tolerability, user acceptance and preference for a novel reusable respirator among health care workers

“…Our study contributes to the field in several ways. First, an expanding body of literature documents the benefits of using reusable respirators over disposable N95 FFRs, such as averting supply shortages, economic, and environmental benefits (18)(19)(20)(21) . EHMRs cost significantly less than PAPRs, but have lower APFs and, as shown in this study, were less preferred than Halo.…”

Respirators and complications of airway management

“…We have been continuously wearing N95 filtering facepiece (FFP) or elastomeric respirators while providing patient care since the early phases of the COVID‐19 pandemic in April 2020. We have also advocated for anaesthetists to wear respirators while providing patient care on a universal basis, whether or not patients are known or suspected of being infected with SARS‐CoV‐2 [ 2 , 3 ]. Based on our personal experience and the literature describing the use of respirators in healthcare, we are sceptical of the results of the study by Potter et al., and we are unaware of any plausible explanation for an increase in complications of airway management depending on whether anaesthetists are wearing respirators or fluid‐resistant surgical masks.…”