Improvement in Fitted Filtration Efficiency of N95 Respirators With Escalating Instruction of the Wearer

Chen, Hao; Pennington, Edward Ross; Case, Martin; Tong, Haiyan; Rappold, Ana G.; Samet, James M.; Prince, Steven E.

doi:10.1016/j.focus.2022.100014

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…The necessity of implementing fit testing and performance evaluation of HCWs when making procurement decisions was emphasized by Ng et al In the interim, wearer compliance, respirator fitting, and purchasing decisions are influenced by the fit test passing rate, usability, and comfort evaluations [ 80 ]. Training on proper selection, donning and doffing, and the importance of fit testing protocols could improve the subjects’ knowledge, perception, attitude, skill, and experience toward respirator fit testing compared to the pre-fit test steps [ 59 , 76 , 83 , 161 ].…”

Section: Discussionmentioning

confidence: 99%

A systematic review of passing fit testing of the masks and respirators used during the COVID-19 pandemic: Part 1-quantitative fit test procedures

Fakherpour,

Jahangiri,

Jansz

2023

PLoS ONE

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Background During respiratory infection pandemics, masks and respirators are highly sought after, especially for frontline healthcare workers and patients carrying respiratory viruses. The objective of this study was to systematically review fit test pass rates and identify factors influencing the fitting characteristics. Methods Potentially relevant studies were identified using PubMed, Scopus, Web of Science, and Science Direct during the COVID-19 pandemic from February 5, 2020, to March 21, 2023. The search strategy using the following keywords was conducted: Quantitative Fit Test, Condensation Nuclei Counter, Controlled Negative Pressure, PortaCount, Sibata, Accufit, Fit, Seal, Mask, Respirator, Respiratory Protective Device, Respiratory Protective Equipment, Protective Device, Personal Protective Equipment, COVID-19, Coronavirus, and SARS-CoV-2. The quality of the included studies was also assessed using the Newcastle-Ottawa scale. Results A total of 137 articles met the eligibility criteria. Fifty articles had a quality score of less than 7 (good quality). A total of 21 studies had a fit test pass rate of less than 50%. 26 studies on disposable respirators and 11 studies on reusable respirators had an FF of less than 50 and less than 200, respectively. The most influential factors include respirator brand/model, style, gender, ethnicity, facial dimensions, facial hair, age, reuse, extensive movement, seal check, comfort and usability assessment, and training. Conclusion 37.36% of the disposable respirator studies and 43% of the reusable respirator studies did not report fit test results. 67.86% of the disposable respirator studies had a fit test pass rate greater than 50%, and 35.84% of these studies had an FF greater than 100. Also, 85.71% of the reusable respirator studies had a fit test pass rate greater than 50%, and 52.77% of these studies had an FF greater than 1000. Overall, the fit test pass rate was relatively acceptable. Newly developed or modified respirators must undergo reliable testing to ensure the protection of HCWs. Subject and respirator characteristics should be considered when implementing fit testing protocols. An optimal fit test panel should be developed prior to respirator design, certification, procurement decisions, and selection procedures.

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Section: Discussionmentioning

confidence: 99%

A systematic review of passing fit testing of the masks and respirators used during the COVID-19 pandemic: Part 1-quantitative fit test procedures

Fakherpour,

Jahangiri,

Jansz

2023

PLoS ONE

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A Narrative Review on the Impact of Air Pollution on Heart Failure Risk and Exacerbation

Ward‐Caviness

Cascio

2023

Canadian Journal of Cardiology

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Variation in the fitted filtration efficiency of disposable face masks by sex

Pennington,

Griffin,

McInroe

et al. 2024

J Expo Sci Environ Epidemiol

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Background & objective Disposable face masks are a primary protective measure against the adverse health effects of exposure to infectious and toxic aerosols such as airborne viruses and particulate air pollutants. While the fit of high efficiency respirators is regulated in occupational settings, relatively little is known about the fitted filtration efficiencies of ear loop style face masks worn by the public. Methods We measured the variation in fitted filtration efficiency (FFE) of four commonly worn disposable face masks, in a cohort of healthy adult participants (N = 100, 50% female, 50% male, average age = 32.3 ± 9.2 years, average BMI = 25.5 ± 3.4) using the U.S. Occupational Safety and Health Administration Quantitative Fit Test, for an N95 (respirator), KN95, surgical, and KF94 masks. The latter three ear loop style masks were additionally tested in a clip-modified condition, tightened using a plastic clip to centrally fasten loops in the back of the head. Results The findings show that sex is a major determinant of the FFE of KN95, surgical, and KF94 masks. On average, males had an 11% higher FFE relative to females, at baseline testing. We show that a simple modification using an ear loop clip, results in improvements in the average FFE for females but provides comparatively minor changes for males. On average, females had a 20% increased FFE when a clip was worn behind the head, relative to a 6% increase for males. Impact The efficacy of a disposable face mask as protection against air contaminants depends on the efficiency of the mask materials and how well it fits the wearer. We report that the sex of the wearer is a major determinant of the baseline fitted filtration efficiency (FFE) of commonly available ear loop style face masks. In addition, we show that a simple fit modifier, an ear loop clip fastened behind the head, substantially improves baseline FFE for females but produces only minor changes for males. These findings have significant public health implications for the use of face masks as a protective intervention against inhalational exposure to airborne contaminants.

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Improvement in Fitted Filtration Efficiency of N95 Respirators With Escalating Instruction of the Wearer

Cited by 5 publications

References 13 publications

A systematic review of passing fit testing of the masks and respirators used during the COVID-19 pandemic: Part 1-quantitative fit test procedures

A systematic review of passing fit testing of the masks and respirators used during the COVID-19 pandemic: Part 1-quantitative fit test procedures

A Narrative Review on the Impact of Air Pollution on Heart Failure Risk and Exacerbation

Variation in the fitted filtration efficiency of disposable face masks by sex

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