Study Objectives
The COVID-19 pandemic has changed the way that we interact with our patients, specifically in regards to the importance of using personal protective equipment (PPE) during all patient interactions. The abrupt onset of the pandemic has created shortcomings, though, in stocks of disposable equipment prompting the use of alternative, often self-provided, PPE. Some practitioners have started to use reusable elastomeric respirator facemasks in lieu of the disposable N95 variety provided in our emergency department (ED). We sought to evaluate how well these masks functioned in terms of repeated fit testing in an emergency department.
Methods
We performed a prospective cohort study of ED physicians required to use respirators at an academic, level one trauma center. All investigators performing fit testing reviewed OSHA qualitative fit testing guidelines and training and were familiar with the testing protocol. All subjects had purchased commercial elastomeric respirator masks with disposable filters (N95, P95, or P100) for personal use as PPE due to concerns regarding shortages of disposable surgical and N95 medical masks. All masks have a manufacturer-stated filter life of approximately 40-hours of continuous use specifically in industrial application. All subjects chose their mask size independently with no input from employee health regarding appropriate fit. Per study protocol, subjects were fit tested periodically during clinical shifts over the course of the 8-week study period. Data points collected included the age of the mask, subjective assessment of mask seal quality, and fit test results. The data was analyzed using descriptive statistics. The study was approved by the Institutional Review Board.
Results
88 fit tests were performed on physicians wearing elastomeric masks during their clinical ED shifts. Only eight tests were performed on masks with filters within the 40-hour lifespan per manufacturer specifications. Eighty fit tests were performed on masks with filters that had been in use for greater than 40 hours. There were no fit test failures in any subjects.
Conclusion
Reusable elastomeric respirators have an extremely low failure rate and may be a worthwhile investment as PPE. Further, the filters likely can be safely used well outside of the manufacturer-stated 40 hours of use in health care practice.