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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×

PREVENTING TRANSMISSION OF PANDEMIC INFLUENZA AND OTHER VIRAL RESPIRATORY DISEASES

Personal Protective Equipment for Healthcare Personnel

UPDATE 2010

Committee on Personal Protective Equipment for Healthcare Personnel to Prevent Transmission of Pandemic Influenza and Other Viral Respiratory Infections: Current Research Issues

Board on Health Sciences Policy

Elaine L. Larson and Catharyn T. Liverman, Editors

INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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THE NATIONAL ACADEMIES PRESS
500 Fifth Street, N.W.
Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This study was requested by the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention and was supported by Contract No. 200-2005-10881 (Task Order #8) between the National Academy of Sciences and the Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-16254-8

International Standard Book Number-10: 0-309-16254-8

Additional copies of this report are available from the

National Academies Press,

500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2011 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested citation: IOM (Institute of Medicine). 2011. Preventing transmission of pandemic influenza and other viral respiratory diseases: Personal protective equipment for healthcare personnel. Update 2010. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×

“Knowing is not enough; we must apply.

Willing is not enough; we must do.”

—Goethe

INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES


Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine


The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.


The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.


The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.


The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.


www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×

COMMITTEE ON PERSONAL PROTECTIVE EQUIPMENT FOR HEALTHCARE PERSONNEL TO PREVENT TRANSMISSION OF PANDEMIC INFLUENZA AND OTHER VIRAL RESPIRATORY INFECTIONS: CURRENT RESEARCH ISSUES

ELAINE L. LARSON (Chair), Professor of Pharmaceutical and Therapeutic Research,

Columbia University

GLORIA ADDO-AYENSU, Director,

Fairfax County Department of Health

ALLISON E. AIELLO, John G. Searle Assistant Professor of Public Health,

University of Michigan School of Public Health

HOWARD J. COHEN, Consultant, Professor Emeritus,

University of New Haven

ROBERT COHEN, Director,

Pulmonary and Critical Care Medicine, Cook County Health and Hospitals System, and

Chair,

Division of Pulmonary Medicine/Critical Care and Occupational Medicine, Stroger Hospital of Cook County

KAREN COYNE, Research General Engineer,

U.S. Army Edgewood Chemical Biologic Center

DAVID M. DEJOY, Professor,

University of Georgia

KEN GALL, Professor,

Georgia Institute of Technology

WILLIAM H. KOJOLA, Industrial Hygienist,

Department of Occupational Safety and Health, AFL–CIO

ALLISON MCGEER, Director,

Infection Control, Mount Sinai Hospital, University of Toronto

PETER PALESE, Professor and Chair,

Mount Sinai School of Medicine

DAVID PREZANT, Chief Medical Officer and Special Advisor to the Fire Commissioner for Health Policy,

Fire Department of the City of New York, and

Professor of Medicine,

Pulmonary Division, Albert Einstein College of Medicine

M. E. BONNIE ROGERS, Director,

North Carolina Occupational Safety and Health Education and Research Center and Occupational Health Nursing Program, School of Public Health, University of North Carolina–Chapel Hill

RICHARD P. WENZEL, Professor and Former Chair,

Department of Internal Medicine, Virginia Commonwealth University

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×

Study Staff

CATHARYN T. LIVERMAN, Project Director

ANDREW M. POPE, Director

SARAH CODREA, Associate Program Officer (until July 2010)

LARA ANDERSEN, Research Associate

JUDY ESTEP, Program Associate

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×

Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Lisa Brosseau, University of Minnesota

Benjamin Cowling, University of Hong Kong

Lewis R. Goldfrank, Bellevue Hospital Center and New York University Medical Center

Kathleen Harriman, California Department of Public Health

Sundaresan Jayaraman, Georgia Institute of Technology

Mark Nicas, University of California

Daniel R. Perez, University of Maryland

Trish M. Perl, Johns Hopkins University School of Medicine

Peg Seminario, AFL–CIO

Michael Tapper, Lenox Hill Hospital, New York City

David Weber, University of North Carolina–Chapel Hill

Annalee Yassi, University of British Columbia

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the con-

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×

clusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Caroline Breese Hall, University of Rochester School of Medicine, and Johanna T. Dwyer, Tufts University School of Medicine. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×
Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×

Acronyms and Abbreviations

AAMI Association for the Advancement of Medical Instrumentation

B.R.E.A.T.H.E. Better Respiratory Equipment Using Advanced Technologies for Healthcare Employees

CBRN chemical, biological, radiological, and nuclear

CDC Centers for Disease Control and Prevention

CFR Code of Federal Regulations

CI confidence interval

CO2 carbon dioxide

DOL Department of Labor

FDA Food and Drug Administration

FFP2 or FFP3 filtering facepiece respirator class P2 or P3

HHS Department of Health and Human Services

ICU intensive care unit

IOM Institute of Medicine

IV intravenous

MPPS most penetrating particle size

NaCl sodium chloride

NIOSH National Institute for Occupational Safety and Health

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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NPPTL National Personal Protective Technology Laboratory

NVHA Northern Virginia Hospital Alliance

NYC New York City

OSHA Occupational Safety and Health Administration

PAPR powered air-purifying respirator

PPE personal protective equipment

PPT personal protective technologies

RNA ribonucleic acid

RSV respiratory syncytial virus

RT-PCR real-time polymerase chain reaction

SARS severe acute respiratory syndrome

SNS Strategic National Stockpile

TICD50 tissue culture infective dose50

TIL total inward leakage

UV ultraviolet

WHO World Health Organization

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
×
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010. Washington, DC: The National Academies Press. doi: 10.17226/13027.
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In 2009, the H1N1 influenza pandemic brought to the forefront the many unknowns about the virulence, spread, and nature of the virus, as well as questions regarding personal protective equipment (PPE) for healthcare personnel. In this book, the Institute of Medicine assesses the progress of PPE research and identifies future directions for PPE for healthcare personnel.

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