N95 Day 2017: When to think Beyond the N95 FFR

Posted on by Margaret Sietsema, PhD, and Jaclyn Krah Cichowicz, MA

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

Link to infographic

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.

Link to chart

 

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

 

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.

 

 

Posted on by Margaret Sietsema, PhD, and Jaclyn Krah Cichowicz, MA

9 comments on “N95 Day 2017: When to think Beyond the N95 FFR”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    Hi, I watched the webinar today. How can I get a copy of Lew Radonovich presentation ? And the link to the recording? Thanks!

    I was looking to see if anyone can provide the rationale for yearly N95 fit testing for individuals working in health related fields. I know most bio-environmental agencies abide by OSHA’s guidelines which state the N95 must be fit-tested on a yearly basis, but if there are no changes to weight, dental or cosmetic procedures, or injuries, how can the cost be justified to fit-test each year? For gas mask fit testing, we only do an initial fit test for protection in a chemical, biological, radiological, and nuclear environment. Any comments on justification on the yearly N95 fit testing are welcomed!

    Thanks for your excellent question. We wondered that ourselves, and so we conducted research on that issue. NIOSH researchers followed a cohort of 229 subjects measuring N95 filtering facepiece respirator (FFR) fit and physical characteristics (e.g., face size, weight) every six months. Of the 195 subjects who participated in 2 or more visits, the estimated percent of workers whose respirator did not fit them increased with increasing length of time between fit tests; from 10% at Year 1 to 20% at Year 2, and to 26% at Year 3. There is much more detail about this study in the science blog we posted on January 5, 2016: New NIOSH Study Supports the OSHA Annual Fit Testing Requirements for Filtering Facepiece Respirators, and in the journal papers referenced at the end of that blog. In addition to earlier identification of a worker having an ill-fitting respirator, annual training is important and should be done in addition to the fit testing.

    Hello Dr. Siestsema and Ms. Cichowicz,

    Thank you for these great training resources! We’ve used your handouts for health fairs and fit test clinics to spread the word on respirators –

    Most Grateful!

    What is NIOSH’s position on the filtering facepieces like Moldex 2400 N95 and 3M 8514 N95, which are promoted to protect the wearer from “nuisance level” organic vapor exposure? Since these N95’s are advertised to work if levels do not exceed any organic vapor related PEL, does that mean that if you don’t need them then they will work but if you do need them they won’t protect the user from the exposure? If that is the case, the masks are almost equivalent to wearing nothing and may give the wearer a false sense of security. Any information on this matter would be extremely helpful. Thank you.

    Air-Purifying Filtering Facepiece Respirators (FFR) can include a carbon layer that will remove nuisance level odors which are typically below the PEL or REL and are labeled with a special caution and limitation that states ‘This respirator offers nuisance level relief from (type of odor (such as organic vapors)) that are below the permissible exposure limit (PEL). Nuisance level refers to concentrations not exceeding the OSHA PEL or other government occupational exposure limits, whichever is lower.’

    During respirator selection, the employer should establish by sampling or other means that the concentrations of organic vapors do not exceed their exposure limits. Under those circumstances, respirators incorporating a carbon layer for odor reduction and relief will not create a “false sense of security” and therefore will not be a hazard to the wearer. If the concentration of organic vapors exceed their exposure limit, a respirator equipped with a cartridge certified for organic vapors would be required.

    Hallo I’m a M.D. in North Italy: in my Dept. we use FFR 2 to protect ourselves from COVID19; is this device actually protective against it? if it is, what’s the time of employment before the FFR 2 loss efficacy? Please answer me ASAP. Sincerely, Dr. Marco Meloni

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Page last reviewed: September 5, 2017
Page last updated: September 5, 2017