Importance of masks and respirators

N95 Particulate Respirator

Importance of masks and respirators

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Masks and respirators (personal respiratory protective devices) are essential during the COVID-19 outbreak. They help slow the spread of the disease in the United States and protect health care providers.

There are a number of different types of masks and respirators. They each have a particular use in a particular setting. 

N95 respirators for medical applications
N95 respirators (or particulate filtering face-piece respirators) are Class I medical devices. They are manufactured by companies that hold a Medical Device Establishment Licence (MDEL). N95 respirators authorized in the United States are listed in the Medical Devices Establishment Licence Listing database.

N95 respirators achieve a minimum filtration efficiency of 95% when worn properly. The edges of the mask form a seal around the nose and mouth.

N95 respirators are produced in many different styles, such as cup-style (see image), flat fold or duckbill. They may or may not have an exhalation valve.

Image results for n95 mask

In a health care setting, N95 respirators protect against exposure to respiratory viruses and bacteria.

The U.S. National Institute for Occupational Safety and Health (NIOSH) evaluates, tests and certifies N95 respirators. The masks must pass minimum performance requirements, such as filter efficiency and breathing resistance. All N95 respirators certified by NIOSH must have an approval number stamped on the mask, represented as TC-84A-####n.

Use of N95 masks beyond their shelf life
Most masks have a limited shelf life, after which they should be discarded. The length of time a respirator is stored beyond its shelf life or recommended conditions of storage may affect its performance. This includes not only the filter media but also headbands and nose foam components, which may affect the seal that is created.

N95 masks that are past their designated shelf life are no longer NIOSH-approved, as all manufacturer-designated conditions of use must be met to maintain the NIOSH approval. However, in times of increased demand and decreased supply, consideration can be made to use these expired N95 respirators. An expired mask can still be effective at protecting health care provider if:

the straps are intact
there are no visible signs of damage
they can be fit-tested
Health care providers should inspect the mask and perform a seal check.

There is no specific timeframe beyond the expiry dates for N95 respirators at which they would no longer be considered suitable for use.

Masks (surgical, procedure or medical masks)
Masks, for example, surgical masks are worn by operating room personnel during surgical procedures (see image). They protect both the patient and operating room staff from the transfer of microorganisms, body fluids, and particulate material.

There are 3 classifications under the American Society for Testing and Materials (ASTM):

Level 1 (low) – venous pressure splash
Level 2 (moderate) – arterial pressure splash
Level 3 (high) – high-velocity procedures, orthopedic surgery
Image result for n95 mask

Unlike N95 respirators, masks are looser in fit. As a result, they do not provide the same level of filtration.

Use of surgical masks beyond their shelf life
Masks can still be used beyond their shelf life to protect health care providers. Health care providers should check that the straps are intact and there are no visible signs of damage.

There is no specific timeframe beyond the expiry dates for masks at which they would no longer be considered suitable for use.

Non-medical N95 respirators
Commercial- and medical-grade N95 respirators are of similar structure and design; however, the manufacturing setting and the quality management system applied may differ.

The main difference between the 2 grades is that commercial N95 respirators aren’t tested for fluid resistance of any type. For example, there is the ASTM test method F1862, “Resistance of Medical Face Masks to Penetration by Synthetic Blood.” This test is used to determine the respirator’s resistance to synthetic blood, which is directed at it under varying high pressures. The test isn’t essential for use during the COVID-19 outbreak because the disease is transmitted by respiratory droplets.

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