The Use and Effectiveness of Powered Air Purifying Respirators in Health Care: Workshop Summary (2015)

Jim Johnson, Chair, IOM Workshop Planning Committee

Linda Hawes Clever, Chair, IOM Standing Committee on Personal Protective Equipment for Workplace Safety and Health (COPPE)

• NPPTL Certification Standards Roland Berry Ann, NPPTL
• ISO Standards
  Craig Colton, 3M Personal Safety, 3M
• Regulatory Perspective
  Deborah Gold, Cal/OSHA (via WebEx)

• What are the strengths and weaknesses of various approaches to modifying the PAPR certification requirements, including
  • Use of current NIOSH standards and certification processes
  • Changes to the PAPR certification standard that could be incorporated in 42 CFR 84 to provide improved health care worker protection
  • Use of the ISO standards for the certification of health care PAPRs
• If the ISO standards are incorporated by reference:

• What scientific studies are available to support the incorporation of the standards as currently drafted?
• What scientific studies are needed to validate the draft standards to address these requirements?
• What safeguards would be necessary to ensure the intended work rates are not exceeded?

Panel 2: Employee and Worker Experience in Using PAPRs in Health Care Settings
Facilitator: Bill Kojola, COPPE Committee Member

• Debbie Novak, NPPTL (via WebEx)
• Jo Garrison, OSF Saint Francis Medical Center
• Karen Anderson, CA Pacific Medical
• Mark Catlin, Service Employees International Union

Issues for Presentations and Discussion:

• Why, where, and how are PAPRs being used in health care settings?
• What actions need to be taken to ensure PAPRs are properly used in the health care setting?
• What has the experience been in using PAPRs—benefits, challenges, barriers?
• What changes in PAPR design and function are needed?
• How can certification standards be used to encourage these changes?

• Jim Chang, University of Maryland
• Lewis Radonovich, Department of Veterans Affairs
• Trish Perl, Johns Hopkins University (via WebEx)
• Jeffrey C. Nesbitt, Mayo Clinic

• Why are PAPRs selected over other respirators and what factors affect selection of specific PAPRs for purchase? What criteria are used for purchases of PAPRs?
• What efforts are needed to improve maintenance or life of PAPRs and how does this affect supplies?
• What steps are necessary to ensure that workers comply with instructions on use, including training and efforts to increase compliance?
• What changes in PAPR design and function are needed?

• David Ladd, Massachusetts Hazardous Materials Team
• Robert Huebner, The Biomedical Advanced Research and Development Authority, Office of the Assistant Secretary for Preparedness and Response
• Francis Califano, North Shore–LIJ Health System
• Annemarie Flood, Association for Professionals in Infection Control and Epidemiology
• Christopher Shields, Chicago Department of Public Health

• How do PAPRs currently fit in to pandemic preparedness planning? What are the possibilities for future preparedness plans? What are the economic and logistical considerations?
  What are other issues that are considered in decisions about PAPRs?
• What actions need to be taken to ensure PAPRs are properly used in the health care setting, especially as part of the national pandemic preparedness?
• What changes in PAPR design and function are needed? How can certification standards be used to facilitate these changes?

• Understanding the Respiratory Demands of the Health Care Workforce Philip Harber, University of Arizona
• The Importance of Appropriate Battery Life in PAPR Usage, Maintenance, and Lifespan
  Rich Metzler, NPPTL
• Research and Design and the Impact of Certification Standards
  Larry Green, Syntech International
• Evaluating the Physiological Performance of PAPRs
  Edward J. Sinkule, NPPTL

• What research has been done on determining optimal flow rates for health care workers? On the need for shorter life batteries? Where are the research gaps and needs for future research?
• What work is being done to improve the interactions with patients by health care workers wearing PAPRs (e.g., noise,

• visibility, communications issues, and others)?
• What work is being done to improve the design of PAPRs to improve ease and comfort of use by health care workers?

• Bonnie Rogers, University of North Carolina at Chapel Hill
• Craig Colton, 3M Personal Safety
• Lewis Radonovich, Department of Veterans Affairs
• Karen Anderson, CA Pacific Medical
• Linda Clever, University of California, San Francisco

• What major issues have been identified?
• What are the priorities for improving the use of PAPRs in health care settings?
• What are the strengths and weaknesses of various approaches to modifying the PAPR certification requirements and standards?