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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Reusable Elastomeric
Respirators in Health Care

Considerations for Routine and Surge Use

Committee on the Use of Elastomeric Respirators in Health Care

Linda Hawes Clever, Bonnie M. E. Rogers,
Olivia C. Yost, and Catharyn T. Liverman, Editors

Board on Health Sciences Policy

Health and Medicine Division

A Consensus Study Report of

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THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by Contract #200-2011-38807 (Task Order 2) between the National Academy of Sciences and the Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-48515-9
International Standard Book Number-10: 0-309-48515-0
Digital Object Identifier: https://doi.org/10.17226/25275

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Copyright 2019 by the National Academy of Sciences. All rights reserved.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2019. Reusable elastomeric respirators in health care: Considerations for routine and surge use. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25275.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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COMMITTEE ON THE USE OF ELASTOMERIC RESPIRATORS IN HEALTH CARE

LINDA HAWES CLEVER (Co-Chair), California Pacific Medical Center

M. E. BONNIE ROGERS (Co-Chair), University of North Carolina Occupational Safety and Health Education Research Center

GLORIA ADDO-AYENSU, Fairfax County Department of Health

GIO J. BARACCO, University of Miami Miller School of Medicine and Miami Veterans Affairs Healthcare System

JIM CHANG, University of Maryland Medical Center

CHRISTOPHER FRIESE, University of Michigan School of Nursing

ROBERT HARRISON, University of California, San Francisco, School of Medicine

SUNDARESAN JAYARAMAN, Georgia Institute of Technology

JAMES S. JOHNSON, JSJ and Associates

BRUCE LIPPY, The Center for Construction Research and Training

ALLISON MCGEER, Mount Sinai Hospital and University of Toronto

ANN-CHRISTINE NYQUIST, University of Colorado School of Medicine

MIKE SCHMOLDT, Argonne National Laboratory

SKIP SKIVINGTON, Kaiser Permanente

PATRICIA STONE, Columbia University School of Nursing

TENER GOODWIN VEENEMA, Johns Hopkins University

Study Staff

CATHARYN T. LIVERMAN, Study Director

OLIVIA C. YOST, Associate Program Officer

KATIE LAWALL, Senior Program Assistant (through July 2018)

JUDY ESTEP, Program Associate (from July 2018)

DANIEL BEARSS, Senior Research Librarian

ANDREW M. POPE, Director, Board on Health Sciences Policy

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
×

Reviewers

This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, 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 thank the following individuals for their review of this report:

MARY T. BESSESEN, University of Colorado Denver

HOWARD J. COHEN, Consultant

BARBARA DEBAUN, Cynosure Health

TRISH PERL-DELISLE, UT Southwestern Medical Center

ROBERT M. ENINGER, Air Force Institute of Technology

RACHAEL JONES, University of Illinois Chicago

WILLIAM H. KOJOLA, AFL-CIO (retired)

SUZET M. MCKINNEY, Illinois Medical District Commission

JEFFREY C. NESBITT, Mayo Clinic

TERRI REBMANN, Saint Louis University

MARK SHIRLEY, Sutter Health

PRITISH K. TOSH, Mayo Clinic

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by ELAINE L. LARSON,

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Columbia University, and LINDA A. MCCAULEY, Emory University. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. Washington, DC: The National Academies Press. doi: 10.17226/25275.
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Protecting the health and safety of health care workers is vital to the health of each of us. Preparing for and responding to a future influenza pandemic or to a sustained outbreak of an airborne transmissible disease requires a high-level commitment to respiratory protection for health care workers across the wide range of settings in which they work and the jobs that they perform. Keeping health care workers healthy is an ethical commitment both in terms of addressing the occupational risks faced by health care workers and of providing for the continuity of patient care and services needed to maintain the health of individuals and communities.

During a public health emergency, challenges will arise concerning the availability of respiratory protective devices (i.e., respirators). Reusable respirators (specifically, reusable half-facepiece elastomeric respirators) are the standard respiratory protection device used in many industries, and they provide an option for use in health care that has to date not been fully explored. The durability and reusability of elastomeric respirators make them desirable for stockpiling for emergencies, where the need for large volumes of respirators can be anticipated. However, they are used infrequently in health care.

Reusable Elastomeric Respirators in Health Care explores the potential for the use of elastomeric respirators in the U.S. health care system with a focus on the economic, policy, and implementation challenges and opportunities. This report examines the practicability of elastomeric use in health care on a routine basis and during an influenza pandemic or other large aerosol-transmissible outbreak, when demand for respiratory protective devices by U.S. health care personnel may be larger than domestic supplies. The report also addresses the issues regarding emergency stockpile management of elastomeric respiratory protective devices.

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