Performing Qualitative Mask Fit Testing Without a Commercial Kit: Fit Testing Which Can Be Performed at Home and at Work

O’Kelly, Eugenia; Arora, Amit; Pearson, Charlotte; Ward, James; Clarkson, P. John

doi:10.1017/dmp.2020.352

Cited by 7 publications

(8 citation statements)

References 7 publications

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“…30 Another study by O’Kelly et al assessed the other options for fit test hoods and nebulizers; therefore, it concluded that aroma diffusers and smaller hoods could be used as alternatives while performing the QLFT procedure. 26 It seems necessary to further clarify other alternatives for fit test nebulizers.…”

Section: Discussionmentioning

confidence: 99%

A Medical Nebulizer as a Substitute for the OSHA-Approved Nebulizer for Qualitative Fit Testing of Respirators During the Respiratory Infectious Pandemics: An Experimental Feasibility Study

Fakherpour

Jahangiri

Seif

2022

Disaster med. public health prep.

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Objective: The qualitative fit testing procedure would be challenging due to severe shortages, high cost, and unavailability of commercial fit test kits in the marketplaces during pandemics of respiratory infectious diseases. Assessment of alternatives for commercial fit test kits to be prepared for emergencies is critically required. This study aimed to investigate the feasibility of an alternative of the Accumed NF60 nebulizer for the OSHA-approved Allegro one. Methods: Thirty-two participants were randomly allocated to six filtering facepiece respirators (FFRs). They were qualitatively fit tested by both manual Allegro and automated Accumed NF60 nebulizers. Results: There was no statistically significant difference between the Allegro and Accumed NF60 nebulizers by passing rates. The odds for passing fit testing using the Accumed NF60 nebulizer was similar to that of the Allegro one [OR=1.0, 95% CI (0.58-1.74)]. Conclusions: The Accumed NF60 nebulizer could be used as a cost-benefit substitute for the standard fit test nebulizers in the pandemic situation where there is a shortage and difficulty of access. It is more convenient, decreases the time investment, and reduces the contact stress in the operators’ hands as it does not require squeezing the nebulizer bulb frequently. The test solutions' preparation and fit testing procedures on many personnel are more straightforward, efficient, and hygienic than the Allegro one.

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Section: Discussionmentioning

confidence: 99%

A Medical Nebulizer as a Substitute for the OSHA-Approved Nebulizer for Qualitative Fit Testing of Respirators During the Respiratory Infectious Pandemics: An Experimental Feasibility Study

Fakherpour

Jahangiri

Seif

2022

Disaster med. public health prep.

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“…There are two established methods used to assess the fit of face masks: quantitative fit testing and qualitative fit testing [ 7 , 8 ]. Quantitative fit testing is the most robust and accurate method, providing a nuanced measurement of the degree of fit.…”

Section: Methodsmentioning

confidence: 99%

Face mask fit hacks: Improving the fit of KN95 masks and surgical masks with fit alteration techniques

et al. 2022

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Introduction During the course of the COVID-19 pandemic, there have been suggestions that various techniques could be employed to improve the fit and, therefore, the effectiveness of face masks. It is well recognized that improving fit tends to improve mask effectiveness, but whether these fit modifiers are reliable remains unexplored. In this study, we assess a range of common “fit hacks” to determine their ability to improve mask performance. Methods Between July and September 2020, qualitative fit testing was performed in an indoor living space. We used quantitative fit testing to assess the fit of both surgical masks and KN95 masks, with and without ‘fit hacks’, on four participants. Seven fit hacks were evaluated to assess impact on fit. Additionally, one participant applied each fit hack multiple times to assess how reliable hacks were when reapplied. A convenience of four participants took part in the study, three females and one male with a head circumference range of 54 to 60 centimetres. Results and discussion The use of pantyhose, tape, and rubber bands were effective for most participants. A pantyhose overlayer was observed to be the most effective hack. High degrees of variation were noted between participants. However, little variation was noted within participants, with hacks generally showing similar benefit each time they were applied on a single participant. An inspection of the fit hacks once applied showed that individual facial features may have a significant impact on fit, especially the nose bridge. Conclusions Fit hacks can be used to effectively improve the fit of surgical and KN95 masks, enhancing the protection provided to the wearer. However, many of the most effective hacks are very uncomfortable and unlikely to be tolerated for extended periods of time. The development of effective fit-improvement solutions remains a critical issue in need of further development.

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“…It has been shown that it is possible to improve the protection against a certain class of infectious agents (e.g., chemical treatments) or generally (for example, improving the fitting of the masks against the face of the wearer). 3D printing is beginning to be used to compensate for the shortage of personal protective equipment including masks (78), and could be used with existing knowledge about mask fitting [e.g., (79,80)] to fit masks to individual anatomy. Furthermore, in situations when there is solid evidence for the Viruses have unique biophysical properties including elasticity/deformability, brittleness/hardness, material fatigue, and resistance to osmotic stress (81) that might be targets for antiviral interventions, perhaps also to produce better masks.…”

Section: Possible Avenues For Improved Masks and Maskingmentioning

confidence: 99%

Challenges and Controversies in COVID-19: Masking the General Population may Attenuate This Pandemic's Outbreak

Johansson

2021

Front. Public Health

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SARS-CoV-2, the virus that causes COVID-19, spreads i. a., by respiratory droplets. The use of masks in preventing spread is controversial; masks are considered useless by many, while being mandated in some locations. Here, the effect of masking the general population on a COVID-19-like epidemic is estimated by computer simulation using three separate types of software. The main questions are whether mask use by the general population can limit the spread of SARS-CoV-2 in a country and how to identify opportunities when mask use is cost-effective and safe. To address these questions, the protective effects of different types of masks, the side-effects of masks, and avenues for improvements of masks and masking are addressed. Main results: (i) Any type of mask, even simple home-made ones, may be of value, even if the protective effect of each mask (here dubbed “one mask-protection”) is low. Strict adherence to mask use does not appear to be critical but increasing one mask-protection to >50% was found to be advantageous. (ii) Masks do seem to reduce the number of new cases even if introduced at a late stage in an epidemic, but early implementation helps reduce the cumulative and total number of cases. (iii) The simulations suggest that it might be possible to eliminate a COVID-19 outbreak by widespread mask use during a limited period. There is a brief discussion of why the reported effect size of masking varies widely, and is expected to do so, because of different filtration abilities of different masks, differences in compliance and fitting, other routes of transmission, pre-existing immunity, and because a system of interconnected, disease-prone individuals has non-linear properties. A software solution to visualize infection spread is presented. The results from these simulations are encouraging, but do not necessarily represent the real-life situation, so it is suggested that clinical trials of masks are now carried out while continuously monitoring effects and side-effects. As mask use is not without risks and costs, it is suggested that governments and scientists have an important role in advising the public about the sensible use of masks.

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Performing Qualitative Mask Fit Testing Without a Commercial Kit: Fit Testing Which Can Be Performed at Home and at Work

Cited by 7 publications

References 7 publications

A Medical Nebulizer as a Substitute for the OSHA-Approved Nebulizer for Qualitative Fit Testing of Respirators During the Respiratory Infectious Pandemics: An Experimental Feasibility Study

A Medical Nebulizer as a Substitute for the OSHA-Approved Nebulizer for Qualitative Fit Testing of Respirators During the Respiratory Infectious Pandemics: An Experimental Feasibility Study

Face mask fit hacks: Improving the fit of KN95 masks and surgical masks with fit alteration techniques

Challenges and Controversies in COVID-19: Masking the General Population may Attenuate This Pandemic's Outbreak

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