Current Issues in the Assessment of Respiratory Protective Devices for Occupational and Non-Occupational Uses Proceedings of a Workshop (2021) / Chapter Skim
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4 Respiratory Risks and User Requirements for the Public
4 Respiratory Risks and User Requirements for the Public
Pages 31-52
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From page 31... ...
When abroad, U.S. government employees and their families living in areas with high levels of air pollution often require respiratory protection outside of their workplaces -- for example, when commuting to work or school.
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From page 32... ...
If travelers decide to seek out an RPD, then the Department of State advises them on which respiratory protections 1 The Environmental Protection Agency has developed ambient air quality trends for particle pollution, also called particulate matter (PM)
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From page 33... ...
She explained that, in addition to guidance on whether the use of a facial covering is medically acceptable for individuals, the Department of State offers guidance on filtration quality, fit, and proper use. Other considerations for air pollution respiratory devices include comfort, portability, availability in sizes that fit children, the use of ear loops versus head straps, cleanability, and cost.
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From page 34... ...
Finally, Huson emphasized the need to highlight and prioritize other exposure reduction strategies. Leak Checking Air Pollution Masks Huson said that to address issues regarding the fit of employees' air pollution masks, the Department of State conducts "leak checks" by having people put on their chosen device and performing a leak challenge test.
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From page 35... ...
Regarding the first consideration, Huson suggested that RPDs will likely be necessary in light of the 2019 decision by the California Occupational Safety and Health Administration (Cal/OSHA) to establish an emergency regulation on protection from wildfire smoke to address the concerns regarding workers' exposure to smoke, ash, and poor air quality.
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From page 36... ...
User acceptance, Huson said, is determined by factors such as aesthetics, comfort, and convenience; these considerations are critical for developing persuasive messaging that convinces people to use RPDs. The devices should feature an adequate filter, Huson said, with appropriate fit and seal every time they are worn, and would benefit from an easy-to-conduct seal check procedure.
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From page 37... ...
Holm provided an overview of some of the characteristics of and evidence for cloth and medical masks. Cloth Masks Cloth masks have increasingly become a topic of interest because of their potential to decrease transmission of infectious droplets.
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From page 38... ...
No regulatory body is currently tasked with making decisions or certifications of respirators for the general public. In 2007 a NIOSH study found that without fit testing, the 95th percentile value for the class of FFR was a reduction in exposure of 70 percent or more (Duling et al., 2007)
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From page 39... ...
Many people are concerned that the use of respiratory protection by the general public, specifically by children, could create a false sense of security and promote riskier behavioral choices. Holm said this concern highlights the need for clear communication to help people understand that (1)
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From page 40... ...
. In an evaluation of the use of respirators in a general population cohort that included individuals with mild respiratory disease, some subjects reported mild discomfort, but heart rate, respiratory rate, and spirometry were found to be within normal adult ranges (Bansal et al., 2009; Harber et al., 2009)
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From page 41... ...
IMPROVING MASKS WORN BY THE GENERAL PUBLIC Mark Nicas, an emeritus adjunct professor at the University of California, Berkeley, focused on ways to improve the masks worn by the general public and offered four recommendations to do so. He explained that any face covering worn for the purpose of reducing the wearer's pollutant exposure -- including NIOSH-approved N95 FFRs, surgical masks, cloth masks, or bandanas -- is a form of respiratory protection.
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From page 42... ...
Formulating Standard Protocols for Cloth Mask Testing Nicas's second recommendation to improve masks worn by the general public was for a government agency or a professional or academic group to oversee the formulation of standard protocols for testing filter efficiency and fit, including exhalation valve leakage, of cloth masks. If a government agency tested the masks -- or funded a group to do the testing -- then the results could be posted publicly so that consumers could compare mask
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From page 43... ...
Nicas expressed concern that the current method of conducting seal checks of FFRs is not reliable and said that it would be useful to offer wearers a more reliable method. Devising Fit- and Seal-Checking Procedures for Snugly Fitting Cloth Masks Nicas's third recommendation was for a government agency or professional or academic group to devise both fit-testing and seal-checking procedures specific for snugly fitting cloth masks for use by the public, such as those equipped with head straps.
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From page 44... ...
Nicas offered rough estimates of typical amounts of CO2 gas inhaled by wearers of cloth masks. A cloth mask's dead space has a volume of roughly 100 mL, and the volume inhaled per breath during light exercise, such as walking, is roughly 1,200 mL.
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From page 45... ...
Holm said that better solutions are needed for the general public if they are to avoid resorting to ad hoc measures such as securing cloth masks with medical tape. 7 More information about challenge fit tests can be found at https://www.osha.gov/laws-regs/ regulations/standardnumber/1910/1910.134AppA (accessed October 9, 2020)
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From page 46... ...
unfiltered air coming from around the edges of cloth masks, (2) filtered air coming through the mask media itself, and (3)
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From page 47... ...
Kojola said that KN95s have been used in many health care facilities in New York state and New Jersey and that reports from representatives and staff from the health care unions indicate that these have been provided without fit testing. He stated that devices with ear loops generally do not pass fit-testing requirements and that needed fit testing is not taking place.
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From page 48... ...
He said that the only 3M study of which he is aware was published in the mid-1990s and used a pass fit factor of 10 for the quantitative fit testing to indicate a good fit, as opposed to the OSHA standard, which requires a criterion of 100. Nicas said that in that study, the seal check seemed effective because the criterion for adequacy was lowered.
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From page 49... ...
Holm was unable to address the question because of a lack of data but noted that the limited number of studies assessing different types of cloth masks suggest that the filtration characteristics of fabric vary widely. However, Holm continued, without knowing the specifics about the fabric being used, it is nearly impossible to predict how much protection such a cloth mask actually provides.
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From page 50... ...
, fit testing, and a lack of training on fit testing and use will further complicate the necessary considerations related to providing RPDs outside of respiratory protection programs. Harrison added that it appears that innovative research will be needed to improve our understanding of hazard assessment and respiratory protection to nontraditional users of RPDs.
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From page 51... ...
He added that currently no overarching health and safety agency in the United States has regulatory authority that can be extended to the public or to the multiple uses of cloth masks; even OSHA's scope is limited to certain workplaces. McDiarmid remarked that employers have some obligation to recognize respiratory hazards, even in segments of the worker population that have not traditionally been thought of as needing a formal respiratory protection program.
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From page 52... ...
To address future respiratory protection needs of the public, she added, new kinds of respirators may be needed. Such r espirators may include large sealing surfaces so that fit testing may not be required.
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