N95 Love – Staying True to the NIOSH Approval

Over the years, we’ve made use of the Valentine’s Day observance to offer a lot of respirator relationship advice. We’ve talked about the importance of high standards, compatibility, when to break up, and when to put more effort into maintaining your relationship. Dear Abby has nothing on us when it comes to knowing how to get the most out of your relationship with your Personal Protective Equipment (PPE).  And though we continue to offer our pearls of wisdom, your respirator relationship is still bound to face some challenges. With more people wearing NIOSH-approved N95 filtering facepiece respirators (FFRs) than ever, more information is bound to be circulating, some accurate and some not. Using your respirator in the way that was intended by the manufacturer (which is also how it was approved to be used by NIOSH) will ensure that you are getting the most of out of your relationship.

The Only One for You

Is there anything more frustrating than when a perfectly good relationship ends over false rumors and assumptions? How many romantic comedies hit their peak of emotional turmoil due to this contrived conflict? It’s a plotline that hits close to home for us because when it comes to respirators, rumors of how to bolster the protection that they provide can actually have the opposite outcome – reducing their effectiveness and even voiding the NIOSH approval.

We’ve heard it all at this point. Recommendations for respirators combined with cloth masks on top, disposable masks underneath, and “Hi my name is…” written across the front.

It’s time to clear the air…

When it comes to N95 FFRs, you don’t need to add a thing. We like them just as they are. In fact, NIOSH-approved respirators are held to such a high standard (42 CFR part 84, to be exact), that adding anything to them, such as a cloth or disposable mask layered on top or below, can impact your respirator’s fit, taking away from its potential effectiveness. Things (like particles) are bound to slip through the cracks.

When a respirator does not fit properly, a portion of the air you breathe can bypass the respirator’s filter and inhaled through breaks in the seal of the respirator along your face. Fit testing ensures that users receive the expected level of protection by minimizing leakage around the edges of the respirator. If you are using your N95 as part of a workplace respiratory protection program, then you should have been “matched” (fit tested) with the N95 that is a perfect fit for you.

But wait. What about wearing two N95s at the same time? Double masking is a thing … why not double respiratoring (besides it being a ridiculous word)? Again, due to considerations of fit, as well as consideration of breathing resistance, wearing more than one respirator at a time is not consistent with the NIOSH approval. This is just not how they were designed, and approved, to be worn. You’d be setting yourself up for an uncomfortable (physically) and potentially ineffective, situation.

Of course, there are exceptions to every rule. During a period of high respirator demand and low supply, you may have worn a surgical mask over top of your N95 to prolong its lifespan. We get it – you’ve been through the best of times and maybe a lot of the worst of times with your N95. Things may have gotten complicated there for a while. But in terms of your respiratory protection program, it’s time to get back to normal with conventional, ideal use of these devices to get the expected level of protection. This means exclusively sticking with the make, model, and size respirator(s) that you wore when you passed your annual fit test (your perfect match!) and disposing of it after a single use if you are using it in the workplace.

Similarly, you may be tempted to personalize your perfect match with some bedazzling or decorative fabric, so everyone knows it’s the only one for you. Unfortunately, respirators, like partners, are not customizable and these modifications would change the original design, potentially decreasing effectiveness and definitely voiding the NIOSH approval.

Is Our Relationship Over?

In life, there’s no relationship guide to tell you when it’s over, even though that could save a lot of time and heartbreak. Some relationships last a day, while others last a lifetime. Lucky for respirator users, all NIOSH-approved respirators come with manufacturer’s instructions for use. These instructions will tell you how to properly care for your respirator including when to throw it in the trash (callous, but necessary). Generally, N95 FFRs are designed for single use but some situations allow the relationship to last a little longer. When using respirators in the workplace, follow the guidelines of your respiratory protection program. However, if you are using an N95 outside of an occupational setting, and the manufacturer does not specify a duration of use (e.g., single use), its service life is limited by considerations of hygiene, damage, and breathing resistance. If it becomes dirty, damaged, or difficult to breathe through, it is time for the relationship to end. While some users may try to salvage the relationship and replace the respirator’s broken components, this would modify its design and void the NIOSH approval.

It may be difficult to part with your respirator after you’ve been through so much together in recent times. But extreme shortages may have led to strategies that are not accepted during normal operations. You may have sent your respirator off to be disinfected and reused it upon its return, but these methods can result in changes to your respirator that impact its level of performance. Disinfection processes such as heat-treating or sanitizing your respirator with chemicals may impact its performance, fit, or even worse…both. These changes are not consistent with the NIOSH approval during conventional operations, as the level of protection may be impacted and the relationship would no longer be safe.

Commitment Till the End

We’ve made it official! NIOSH has recorded the stylized NIOSH logo with and without text, as well as the certification marks N95, N99, N100, P95, P100, and the term “NIOSH-approved”, with the U.S. Patent and Trademark Office (USPTO). NIOSH, as the certifying federal entity for the N95 Respirator Approval Program, now owns these certification marks. This means that only NIOSH approval holders will be legally allowed to use these marks. This is our way of showing our commitment.

When using a NIOSH-approved respirator, you must be fully committed just like we are. It needs to be worn correctly and fit properly to provide the expected level of protection. While you may have found your match during fit testing, it is important that you continue to wear your respirator correctly. Each respirator comes with donning instructions, and CDC provides a page of general instructions for putting on an N95 FFR. These resources will help you stay protected (and prevent you from wearing your respirator upside down).

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

Meghan Kiederer is a Health Communications Fellow at the NIOSH National Personal Protective Technology Laboratory.