Reusable Respirators Effectively Protect Healthcare Workers

Reusable respirators are effective and should be widely used to protect healthcare workers day to day and in the event of a public health emergency, according to a new evidence-based consensus report from the National Academies of Sciences, Engineering, and Medicine.

The reusable elastomeric respirators, which fit over half the face, are the standard option for many industries, but the study committee found that only two health institutions in the United States use them exclusively or primarily. Currently, most facilities use filtering facepiece respirators, which are disposable after one use.

In this image, the figure in the middle is wearing a reusable elastomeric respirator.

The committee members said in a press release, “The advantages of routine use of elastomeric respirators include increased familiarity of staff with these respirators and the continued improvement of policies and practices for cleaning, disinfection, and maintenance, leading to better preparedness during an emergency or pandemic situation. A smooth transition to urge use would be expedited and enhanced if reusable elastomeric respirators were a part of a health care facility’s day-to-day respiratory protection program.”

Among the reasons for completing the report, the authors write, is that respirators could be in short supply in the event of a global health disaster, and a large proportion of respiratory protection devices available in the United States are produced offshore.

Also, many healthcare facilities now rely on on-demand supplies, and they avoid stockpiling supplies.

“In the 2009 [influenza] pandemic, the manufacturing and supply chain limitations quickly became apparent when orders for disposable filtering facepiece respirators rapidly spiked and created a 2- to 3-year backlog,” the authors write.

Good for All Settings

The reusable respirators, made of a rubbery material, would be useful in protecting healthcare providers against airborne contaminants or infectious agents, such as the influenza virus, and in handling hazardous materials.

They would benefit workers in a wide range of settings, including home health, rural clinics, nursing homes, and hospitals, according to the report.

Addressing respiratory needs for all healthcare personnel “is an ethical imperative,” say authors of the study, which was sponsored by the Centers for Disease Control and Prevention.

There are several challenges regarding stockpiling of the respirators, the report authors acknowledge, including how to store, disinfect, and maintain them. In addition, staff would need to be trained to use them.

Standardized processes are urgently needed for using and disinfecting the equipment. Accountability for each facility’s respiratory protection program is also needed.

Design of the equipment must address particular needs, such as the potential for coming in contact with potentially lethal and highly transmissible agents, the report notes. According to the report, in the design of masks, 3D printing and facial recognition may be employed to provide a precise fit.

The authors say the masks should be lightweight and comfortable. Transparency would allow for better communication and observance of facial expressions.

Costs of using the respirators, including cleaning, disinfecting, and maintaining them, as well as educating healthcare personnel, will also need to be compared with that of other types of protection, the authors note.

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