Respiratory protective devices for the healthcare workers (literature review)
https://doi.org/10.47470/0016-9900-2021-100-3-240-245
Abstract
Introduction. Healthcare practitioners are at increased risk of infection with infectious diseases, including the inhalation route. Healthcare practitioners use respirators of various designs providing different efficiency of protection.
The purpose of the study was to improve efficiency of the respiratory protection of the healthcare practitioners in Russian Federation.
There were analyzed аvailable NIOSH publications, articles in journals Taylor & Francis, Oxford University Press, published materials of Federal Service for Supervision of Consumer Rights Protection and Human Welfare (Rospotrebnadzor), and western training manuals. Differences in the requirements of the legislation were identified that increase the risk of infection in healthcare practitioners. There are no methods for assessing the risk level, and there are no specific requirements for selecting the respirator’s type that corresponds to the risk level. The employer is not obliged to provide the fit test for all employees. The respirator must be used timely, so it should not negatively affect the worker. But the average carbon dioxide concentration can exceed the STEL by more than two times. The certification requirements for respirators do not correspond to the conditions of their use in the hospitals. Respirators were not certified as means of protection against bioaerosols.
Conclusions. Identified shortcomings in the respiratory safety of health care workers show possible ways to improve their protection by harmonizing national legislation with the best of existing Western requirements.
About the Authors
Valery A. Kaptsov
All-Russian Research Institute of Transport Hygiene of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare
Russian Federation
Russian Federation
MD, Ph.D., DSci., Professor, Corresponding Member of the RAS, Head of the Department of Occupational Health of the All-Russian Research Institute of Transport Hygiene” of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow, 125438, Russian Federation.
e-mail: kapcovva39@mail.ru
Alexander V. Chirkin
LTD «Beta Pro»
Russian Federation
Russian Federation
References
1. Izmerov N.F., Kirillov V.F., eds. Occupational Hygiene [Gigiena truda]. Moscow: GEOTAR-Media; 2010. (in Russian)
2. Kalachev A.I. My Chernobyl [Moy Chernobyl’]. Moscow: ESKA; 2005. (in Russian)
3. Kaptsov V.A., Chirkin A.V. The selection of the respirators as a result of studies of their workplace protection factors (review). Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2019; 98(8): 845–50. https://doi.org/10.18821/0016-9900-2019-98-8-845-850 (in Russian)
4. Assigned Protection Factors. Available at: https://www.govinfo.gov/app/details/FR-2003-06-06/03-13749
5. OSHA Standard 29 CFR 1910.134 Respiratory protection. Available at: https://www.law.cornell.edu/cfr/text/29/1910.134
6. McCullough N.V., Brosseau L.M. Selecting respirators for control of worker exposure to infectious aerosols. Infect. Control. Hosp. Epidemiol. 1999; 20(2): 136–44. https://doi.org/10.1086/501602
7. Lenhart S.W., Seitz T., Trout D., Bollinger N. Issues affecting respirator selection for workers exposed to infectious aerosols: emphasis on healthcare settings. Appl. Biosaf. 2004; 9(1): 20–36. https://doi.org/10.1177/153567600400900104
8. Canadian Standard Association. CAN/CSA Z94.4-11. Selection, use and care of respirators. Mississauga: CSA; 2012.
9. California Code of Regulations, Title 8, Section 5199. Aerosol Transmissible Diseases. Available at: https://www.dir.ca.gov/title8/5199.html
10. Wizner K., Stradtman L., Novak D., Shaffer R. Prevalence of Respiratory protective devices in U.S. health care facilities. Workplace Health Saf. 2016; 64(8): 359–68. https://doi.org/10.1177/2165079916657108
11. The Joint Commission. Implementing Hospital Respiratory Protection Programs: Strategies from the Field. 2014. Available at: https://www.jointcommission.org/resources/patient-safety-topics/infection-prevention-and-control/respiratory-protection/hospital-respiratory-protection-resources-and-projects/
12. Foo C.C.I., Goon A.T.J., Leow Y., Goh C. Adverse skin reactions to personal protective equipment against severe acute respiratory syndrome – a descriptive study in Singapore. Contact Dermatitis. 2006; 55(5): 291–4. https://doi.org/10.1111/j.1600-0536.2006.00953.x
13. Lim E.C.H., Seet R.C.S., Lee K.H., Wilder‐Smith E.P.V., Chuah B.Y.S., Ong B.K.C. Headaches and the N95 face-mask amongst healthcare providers. Acta Neurol. Scand. 2006; 113(3): 199–202. https://doi.org/10.1111/j.1600-0404.2005.00560.x
14. Sinkule E.J., Powell J.B., Goss F.L. Evaluation of N95 respirator use with a surgical mask cover: effects on breathing resistance and inhaled carbon dioxide. Ann. Occup. Hyg. 2013; 57(3): 384–98. https://doi.org/10.1093/annhyg/mes068
15. Roberge R.J., Coca A., Williams W.J., Powell J.B., Palmiero A.J. Physiological impact of the N95 filtering facepiece respirator on healthcare workers. Respir. Care. 2010; 55(5): 569–77. https://rc.rcjournal.com/content/55/5/569
16. Vaseev I.A. Shortcomings of the negative pressure filtering half mask respirators. Gornyy zhurnal. 1954; (6): 59–61. (in Russian)
17. Sinkule E., Turner N., Hota S. Automated breathing and metabolic simulator (ABMS) CO2 test for powered and non-powered air-purifying respirators, airline respirators, and gas mask. 2003. Available at: https://www.cdc.gov/niosh/nioshtic-2/20022781.html (accessed 28 August 2020).
18. TR TS 019/2011. Technical Regulation of the Eurasian Customs Union «On the safety of personal protective equipment». Available at: https://docs.cntd.ru/document/902320567 (in Russian)
19. Better respiratory equipment using advanced technologies for healthcare employees (BREATHE). Available at: https://www.cdc.gov/niosh/npptl/hospresptoolkit/pdfs/ ProjectBREATHE-final-report-508.pdf
20. Janssen L., Ettinger H., Graham S., Shaffer R. The Use of Respirators to Reduce Inhalation of Airborne Biological Agents. J. Occup. Environ. Hyg. 2013; 10(8): D97–103. https://doi.org/10.1080/15459624.2013.799964
21. Radonovich L.J., Cheng J., Shenal B.V., Hodgson M., Benderet B.S. Respirator tolerance in health care workers. JAMA. 2009; 301(1): 36–8. https://doi.org/10.1001/jama.2008.894
22. Loeb M., Dafoe N., Mahony J., John M., Sarabia A., Glavin V., et al. Surgical mask vs N95 respirator for preventing influenza among health care workers. A randomized trial. JAMA. 2009; 302(17): 1865–71. https://doi.org/10.1001/jama.2009.1466
23. MacIntyre C.R., Wang Q., Cauchemez S., Seale H., Dwyer D.E., Yang P., et al. A cluster randomized clinical trial comparing fit-tested and non-fit-tested N95 respirators to medical masks to prevent respiratory virus infection in health care workers. Influenza Other Respir. Viruses. 2011; 5(3): 170–9. https://doi.org/10.1111/j.1750-2659.2011.00198.x
24. Offeddu V., Yung C.F., Low M.S.F., Tam C.C. Effectiveness of masks and respirators against respiratory infections in healthcare workers: a systematic review and meta-analysis. Clin. Infect. Dis. 2017; 65(11): 1934–42. https://doi.org/10.1093/cid/cix681
25. Licina A., Silvers A., Stuart R.L. Use of powered air-purifying respirator (PAPR) by healthcare workers for preventing highly infectious viral diseases – a systematic review of evidence. Syst. Rev. 2020; (9): 173. https://doi.org/10.1186/s13643-020-01431-5
Review
For citations:
Kaptsov V.A., Chirkin A.V. Respiratory protective devices for the healthcare workers (literature review). Hygiene and Sanitation. 2021;100(3):240-245. (In Russ.) https://doi.org/10.47470/0016-9900-2021-100-3-240-245
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