Abstract
Background
Fit testing is used to determine whether a N95 mask will provide respiratory protection for the wearer by preventing inhalation of airborne transmitted microorganisms. National guidelines recommend that healthcare workers (HCW) who use N95 masks require fit testing. Quantitative fit testing requires the purchasing and use of fit testing solutions and associated equipment. In high volume, these solutions are expensive and may not be readily available, as was seen in the 2009 H1N1 influenza pandemic. The aim of this study was to determine how a homemade solution compared against a commercially available product and a placebo.
Methods
Afit test was performed on the same person, on three separate occasions, using three different solutions – commercial (45% sodium saccharin), homemade (to be disclosed) and placebo (water). The solution was double blinded and solutions were chosen and administered in a random order.
Results
Atotal of 48 people participated in this study.At the threshold testing stage, 8.3% did not taste any solution, 16.7% of people could taste the placebo, 89.6% could taste the commercial solution and 91.7% could taste the homemade solution. All persons who could taste the commercial solution could taste homemade solution.
Conclusion
The findings of our study suggest that fit testing solutions could be made locally with a similar effect to that of commercial products, that quantitative fit testing is unreliable and that serious consideration should be given to the role of quantitative fit testing in future guidelines and standards. We recommend that this study be conducted on a larger scale to support our findings.
References
- 1.Seto W.H., Tsang D., Yung R.W., Ching T.Y., Ng T.K., Ho M. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS) Lancet. 2003;361(9368):1519–1520. doi: 10.1016/S0140-6736(03)13168-6. doi:10.1016/S0140-6736 (03)13168-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Webster R., Peiris M., Chen H., Guan Y. H5N1 Outbreaks and Enzootic Influenza. Emerg Infect Dis. 2006;12(1):3–8. doi: 10.3201/eid1201.051024. doi:10.3201/eid1201. 051024. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Bearden A., Friedrich T.C., Goldberg T.L., Byrne B., Spiegel C., Schult P. An outbreak of the 2009 influenza a (H1N1) virus in a children's hospital. Influenza Other Respir Viruses. 2012;6(5):374–379. doi: 10.1111/j.1750-2659.2011.00322.x. doi:10.1111/j.1750-2659.2011.00322.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.National Health and Medical Research Council. Australian Guidelines for the Prevention and Control of Infection in Healthcare. Canberra: National Health and Medical Research Council; 2010. Available from: http://www.nhmrc.gov.au/node/30290 [verified September 2012].
- 5.Lam S.C., Lee J.K.L., Yau S.Y., Charm C.Y.C. Sensitivity and specificity of the user-seal-check in determining the fit of N95 respirators. J Hosp Infect. 2011;77(3):252–256. doi: 10.1016/j.jhin.2010.09.034. doi:10.1016/j.jhin.2010.09.034. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Department of Health & Human Services Tasmania . Department of Health & Human Services Tasmania; Hobart, Tas: 2009. Infection Control Advice Fit Testing of P2 (N95) masks. [Google Scholar]
- 7.Occupational Safety and Health Administration . Fit testing. Occupational Safety and Health Administration; Washington, DC: 2010. , Personal Protective, Equipment. [Google Scholar]
- 8.Kimberly-Clark Professional. Qualitative Fit Testing Instructions. For KIMBERLY-CLARK* TECNOL* PFR95* N95 Particulate Filter Respirators and Surgical Masks. Kimberly-Clark Professional; 2006. Available from: http://www.kcprofessional.com/us/download/product%20literature/KCPI_0356_fit_test%202.pdf [verified June 2012].
- 9.Hannum D., Cycan K., Jones L., Stewart M., Morris S., Markowitz S.M. The effect of respirator training on the ability of healthcare workers to pass a qualitative fit test. Infect Control Hosp Epidemiol. 1996;17(10):636–640. doi: 10.1086/647195. doi:10.1086/647195. [DOI] [PubMed] [Google Scholar]
- 10.Lee M.C.M.D., Takaya S.M., Long R.M., Joffe A.M.M.D. Respirator-fit testing: does it ensure the protection of healthcare workers against respirable particles carrying pathogens? Infect Control Hosp Epidemiol. 2008;29(12):1149–1156. doi: 10.1086/591860. doi:10.1086/591860. [DOI] [PubMed] [Google Scholar]
- 11.Au S.S.W., Gomersall C.D., Leung P., Li P.T.Y. A randomised controlled pilot study to compare filtration factor of a novel non-fit-tested highefficiency particulate air (HEPA) filtering facemask with a fit-tested N95 mask. J Hosp Infect. 2010;76(1):23–25. doi: 10.1016/j.jhin.2010.01.017. doi:10.1016/j.jhin.2010. 01.017. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Kelly L., Clark K. The effectiveness of training and taste testing when using respirator masks. J Hosp Infect. 2004;58(3):240–241. doi: 10.1016/j.jhin.2004.07.009. doi:10.1016/j.jhin.2004.07.009. [DOI] [PMC free article] [PubMed] [Google Scholar]