N95 Day 2017: When to think Beyond the N95 FFR

Buckle your seat belts! Put on your high-speed safety gear! We’re about to blast off on a journey to explore the N95 respirator … and beyond. It’s N95 Day, and that means we are focusing on respiratory protection, and invite you to do the same. We’ll make it easy. NIOSH and our N95 Day partners (see the N95 Day webpage for a complete list of partners) will be orbiting the internet to spread resources for proper respiratory protection practices. As always, you can find this information by searching #N95Day on Twitter, Facebook, Instagram, and Pinterest.

During this observance, NIOSH advocates for the proper selection and use of respiratory protection. The N95 filtering facepiece respirator (FFR) is the most commonly-used type of respirator, especially in healthcare environments. This piece of personal protective equipment is a vital and essential instrument in the safety toolbox for many professionals. We cannot stress our love for N95 respirators enough. (Heck, we made an entire observance to honor them.) However, there are certain situations in which respiratory protection program managers and users should pause to consider if another type of respirator would be a better fit (pun intended). This blog identifies times when an N95 respirator should NOT be selected as the most appropriate respiratory protection device.

When the aerosols in the environment would degrade N-series filter media

Every type of air-purifying respirator can carry the N95 label if that is the type of filter used. (See our new infographic on the different types of air-purifying respirators!) One reason you might not want to reach for an N95 respirator is if the aerosol would degrade the filter media. But what does that mean … Respirator filters have three designations N (Not resistant to oil – our trusty N95 respirators are included in this category), R (Somewhat Resistant to oil), and P (strongly resistant or oil Proof). N95 respirators are designed to remove particles from the air you breathe, such as metal fumes (for example, fumes cause by welding), mineral or dust particles, or even biological particles like viruses. N95 respirators should NOT be used in the oily atmospheres including mineral, vegetable, animal, or synthetic oils and instead an R or P certified respirator should be chosen.

Similarly, an N95 respirators should NOT be selected to remove gases or vapors. If harmful gases or vapors are present in amounts greater than the exposure limits, you will need a respirator that uses a special cartridges or canisters containing specially treated charcoal to remove the harmful contaminants before you inhale it into your lungs.¹

When the exposure requires a higher level of protection than an N95 half-mask facepiece respirator provides

A half-mask air-purifying respirator (filtering facepiece or half-mask with an elastomeric facepiece) has an assigned protection factor (APF) of 10.² The APF is the minimum level of respiratory protection that would be provided by a properly fitted respirator, when all elements of an effective respirator program are implemented.³ A half-mask N95 respirator should NOT be selected if the exposure concentration exceeds the exposure limit by a factor of 10. Other respirator types can offer higher levels of protection and should be used in these instances, such as a powered air-purifying respirator (PAPR) which can offer an APF between 25 and 1000 depending on the type (half-mask, full facepiece, helmet/hood, or loose-fitting facepiece.⁴)

When you just can’t pass a fit test

Then there is that small population of people who, no matter how many models of tight-fitting facemasks they try, they just can’t pass a fit test. (See our Respiratory Protection Program Toolkit for more information) In order for a tight-fitting respirator to properly protect the user, the facepiece needs to completely seal against the person’s skin. The most common reason a respirator facepiece would not seal is if there is facial hair present where the respirator seals to the face. Other reasons a respirator might fail to fit the user is if there is facial scarring, dental changes, cosmetic surgery, or a flux in body weight.² If an N95 FFR cannot fit the user, it should NOT be used as a respiratory protective device. If a tight-fitting facemask cannot be used, it is recommended to use a loose-fitting PAPR or to reassign the worker to a job category that does not require respiratory protection.

During an emergency situation when supplies of N95 respirators are low

During the 2009 influenza pandemic we saw a shortage of available N95 FFRs.⁵ In the event of a shortage of N95 FFRs, it is crucial to save the stockpile and supplies for people working in a first responder capacity. In all industries, a hierarchy of controls should be implemented to reduce exposures to workers without relying on respiratory protection. Some strategies to consider include isolating or eliminating the hazard from workers, re-engineering the situation in order to eliminate the hazard from the worker, or making administrative changes so the worker is not exposed to the hazard.

We recently published a blog discussing the options of elastomeric respirators and PAPRS, for more information on alternatives to the N95 FFR, see Understanding respiratory protection options in Healthcare: The Overlooked Elastomeric.

But don’t stop there! Head to the N95 Day webpage for more N95 Day fun. Think you’re a respirator expert now? Take our N95 FFR and Beyond the N95 quizzes to find out. And, of course, search #N95Day to see what our partners are up to as we all recognize the importance of respiratory protection on this NIOSH-approved observance.

Margaret Sietsema, PhD is an Assistant Research Professor at the University of Illinois at Chicago and a Guest Researcher for the NIOSH National Personal Protective Technology Laboratory.

Jaclyn Krah Cichowicz, MA, is a  Health Communications Specialist in the in the NIOSH National Personal Protective Technology Laboratory.

Previous N95 Day Science Blogs

• 2012: Happy N95 Day! (aka, What is N95 Day?)
• 2013: A Guide to N95 Resources
• 2014: Respirator Preparedness – Where Technology Meets Good Practices
• 2015: The tools to build a culture of proper respiratory protection practices
• 2016: Proper Use, Filtration, and Fit – The Three-Legged Stool of Respiratory Protection

References

1. Centers for Disease Control and Prevention. Respirator Trusted-Source Information. Updated August 18, 2016. https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/respsource3selection.html
2. Occupational Safety and Health Administration. “CFR 1910.134: Occupational safety and health standards, personal protective equipment, respiratory protection.” Code of Federal Regulations (29).
3. Janssen, Larry, McKay Roy. “What’s in a Definition? New Terminology for Respiratory Protection” The Synergist. April 2016. Pp. 34-37.
4. Occupational Safety and Health Administration. Assigned protection factors for the revised respiratory protection standard. OSHA 3352-02 2009. https://www.osha.gov/Publications/3352-APF-respirators.pdf
5. Beckman, Stella, et al. “Evaluation of respiratory protection programs and practices in California hospitals during the 2009-2010 H1N1 influenza pandemic.” American journal of infection control 41.11 (2013): 1024-1031.