Reliability of N95 respirators for respiratory protection before, during, and after nursing procedures

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HighlightsN95 respirators, although adequately fitted, may not provide consistent protection for users.Movements during nursing procedures can significantly increase the risk of face seal leakage.Improvements in respirator design to minimize face seal leakage are essential.Portable aerosol spectrometers offer a reliable method for real-time measurement of N95 mask fit.Background:The adequate fit of an N95 respirator is important for health care workers to reduce the transmission of airborne infectious diseases in the clinical setting. This study aimed to evaluate whether adequately sealed N95 respirators may provide consistent protection for the wearer while performing nursing procedures.Methods:Participants were a group of nursing students (N = 120). The best fitting respirator for these participants was identified from the 3 common models, 1860, 1860S, and 1870+ (3M), using the quantitative fit test (QNFT) method. Participants performed nursing procedures for 10-minute periods while wearing a backpack containing the portable aerosol spectrometers throughout the assessment to detect air particles inside the respirator.Results:The average fit factor of the best fitting respirator worn by the participants dropped significantly after nursing procedures (184.85 vs 134.71) as detected by the QNFT. In addition, significant differences in particle concentration of different sizes (>0.3, >0.4, >1.0, and >4.0 μm) inside the respirator were detected by the portable aerosol spectrometers before, during, and after nursing procedures.Conclusions:Body movements during nursing procedures may increase the risk of face seal leakage. Further research, including the development of prototype devices for better respirator fit, is necessary to improve respiratory protection of users.

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