Tolerability, user acceptance and preference for a novel reusable respirator among health care workers.

BACKGROUND: The CleanSpace Technology Halo respirator combines a clear face mask and a powered air supply, without belts or hoses. Although providing higher protection than other respirators used in health care, user acceptance of this device has not been assessed with validated tools. METHODS: We surveyed healthcare workers (HCWs) within a US medical system using Halo respirators in 2021. Subjects completed 3 surveys over 8 weeks, which included the Respirator Comfort, Wearing Experience, and Function Instrument (R-COMFI), a validated tool to assess respirator tolerability. The survey included additional questions about user acceptability and respirator preference. Responses were evaluated for change over time and for significant predictors. RESULTS: Of 113 HCWs who completed the initial survey (29% response rate), mean ± SD R-COMFI score was 9.1± 5.1, (scale 0-47, lower = more tolerable) and did not change over time (P = .42). Fewer years in healthcare significantly predicted better R-COMFI score (P = .01). Many users preferred Halo in both usual care (45%-52%) and care of patients with COVID-19 (60%-64%). DISCUSSION: Halo respirators received favorable tolerability scores by HCWs, who often preferred them, especially during care of patients with COVID-19. CONCLUSIONS: Given demand for respirator use in health care, the innovative design provides higher protection than other respirators with a favorable user experience.

Characteristics Associated With Health Care Worker Knowledge and Confidence in Elastomeric Half-Mask Respirator Use.

OBJECTIVE: This study evaluated health care workers' (HCWs') knowledge and confidence in using elastomeric half-mask respirator (EHMR) attributes known to influence usage. METHODS: Health care workers were surveyed regarding their EHMR donning and doffing experience. Respondents were categorized into competency categories based on their scores. Category differences were analyzed using χ 2 and multiple logistic regression. RESULTS: Seventy-two percent showed high levels of EHMR donning and doffing knowledge and confidence (mastery); however, 21% had greater confidence than knowledge (misinformed). Respiratory therapists had greater odds of mastery than other HCWs ( P < 0.05), whereas those working in medical/surgical and pediatric units had greater odds of doubt than other HCWs ( P < 0.01). CONCLUSIONS: Although most HCWs show high knowledge and confidence with EHMR use, strategies to confirm respirator use competency may ensure greater HCWs protection.

Physiological Impacts of Surgical Mask Coverage of Elastomeric Half-mask Respirator Exhalation Valves in Healthcare Workers.

OBJECTIVES: Elastomeric half-mask respirator (EHMR) use in healthcare increased significantly during the COVID-19 pandemic. Concern for potential release of infectious aerosols from EHMR exhalation valves prompted recommendations to cover them with surgical masks (SMs), thereby improving source control. The physiological and subjective effects of wearing a SM over the exhalation valve of an EHMR, however, are unknown. METHODS: Twelve healthy healthcare worker volunteers completed a 30-min series of simulated healthcare-related tasks, including resting, talking, walking, and bending, proning and supinating a weighted manikin, and performing cardiopulmonary resuscitation. This series recurred three times with different mask configurations-SM only, EHMR only, or EHMR with SM covering the exhalation valve. A transcutaneous sensor continuously measured carbon dioxide (tcPCO2), oxygen saturation (SpO2), and heart rate (HR) from each subject. Subjects scored their rates of perceived exertion (RPE) and levels of discomfort after each round. Physiological parameters and subjective scores were analyzed using mixed linear models with a fixed effect for mask type, activity, age, body mass index (BMI), and gender. Analysis also tested for interaction between mask type and activity. RESULTS: Physiological parameters remained within normal ranges for all mask configurations but varied by task. Statistically significant but small decreases in mean tcPCO2 (37.17 versus 37.88 mmHg, P < 0.001) and SpO2 (97.74 versus 97.94%, P < 0.001) were associated with wearing EHMR with SM over the exhalation valve compared with EHMR alone. Mean HR did not differ between these mask configurations. Wearing SM only was associated with lower RPE and level of discomfort compared with EHMR, but these subjective scores did not differ when comparing EHMR with SM to EHMR only. Age, BMI, and gender had no significant effect on any outcomes. CONCLUSIONS: Wearing a SM over an EHMR did not produce clinically significant changes in tcPCO2, SpO2, or HR compared with uncovered EHMR during healthcare-related tasks. Covered EHMR use also did not affect perceived exertion or discomfort compared with uncovered EHMR use. Covering the exhalation valve of an EHMR with a SM for source control purposes can be done safely.