This report is the result of a 12-month study conducted by an ad hoc IOM committee composed of experts in the fields of infectious disease, infection control, public health, occupational safety and health, pulmonary medicine, health promotion, microbiology, emergency preparedness and response, epidemiology, nursing, community health, industrial hygiene, and materials engineering. The IOM committee was charged with identifying new research directions, certification1 and standards-setting issues, and risk assessment issues specific to PPE for healthcare personnel to prevent transmission of pandemic influenza and other viral respiratory infections. The committee was asked to focus specifically on the following areas:

  • research needed to understand and improve the efficacy and effectiveness of personal protective equipment, particularly face masks and respirators for preventing transmission of pandemic influenza or other viral respiratory infections. Specific attention was sought on issues related to the research needed to determine the type of respiratory protection needed for the given exposure, to determine the requirements for protective ensembles to provide an appropriate level of protection based on work tasks, and to improve functionality and address human factor issues, such as wearability, compliance, and communications;

  • necessary certification, testing, and standards development issues; and

  • priorities and resources for research and certification efforts.

To accomplish its charge, the committee held three meetings and gathered information through a scientific workshop (Appendix A) that included a public comment session, discussions with numerous individuals in the infection control and occupational safety and health fields, and a review of the relevant literature. As mentioned above, this report builds on the work of the IOM committee that released the 2008 report. Throughout this report, the prior work is summarized. In large part, this committee’s task was to examine research conducted since the 2008 report in order to assess where research stands on issues that are key to improving PPE for healthcare personnel exposed to infectious respiratory diseases and to make recommendations to address current research gaps.


The committee broadly defines “certification” to encompass the entire conformity assessment process.

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