ABSTRACT
BACKGROUND: Reusable elastomeric half-mask respirators (EHMR) are an alternative to address shortages of disposable respirators. While respirator discomfort has been noted as a barrier to adherence to wearing an N95 filtering facepiece respirator (FFR) among health care personnel (HCP), few have examined EHMR comfort while providing patient care, which was the purpose of this study. METHOD: Among a cohort of 183 HCP, we prospectively examined how HCP rated EHMR tolerability using the Respirator Comfort, Wearing Experience, and Function Instrument (R-COMFI) questionnaire at Study Week 2 and Week 10. At the completion of the study (Week-12), HCP compared EHMR comfort with their prior N95 FFR use. Overall R-COMFI scores and three subscales (comfort, wear experience, and function) were examined as well as individual item scores. FINDINGS: The HCP reported an improved overall R-COMFI score (lower score more favorable, 30.0 vs. 28.7/47, respectively) from Week 2 to Week 10. Many individual item scores improved or remained low over this period, except difficulty communicating with patients and coworkers. The overall R-COMFI scores for the EHMR were more favorable than for the N95 FFR (33.7 vs. 37.4, respectively), with a large proportion of workers indicating their perception that EHMR fit better, provided better protection, and they preferred to wear it in pandemic conditions compared with the N95 FFR. CONCLUSION/APPLICATION TO PRACTICE: Findings suggest that the EHMR is a feasible respiratory protection device with respect to tolerance. EHMRs can be considered as a possible alternative to the N95 FFR in the health care setting. Future work is needed in the EHMR design to improve communication.
ABSTRACT
Federal regulations require refuge alternatives (RAs) in underground coal mines to provide a life-sustaining environment for miners trapped underground when escape is impossible. A breathable air supply is among those requirements. For built-in-place (BIP) RAs, a borehole air supply (BAS) is commonly used to supply fresh air from the surface. Federal regulations require that such a BAS must supply fresh air at 12.5 cfm or more per person to maintain the oxygen concentration between 18.5% and 23% and carbon dioxide level below the 1% limit specified. However, it is unclear whether 12.5 cfm is indeed needed to maintain this carbon dioxide level. The minimal fresh air flow (FAF) rate needed to maintain the 1% CO2 level will depend on multiple factors, including the number of people and the volume of the BIP RA. In the past, to predict the interior CO2 concentration in an occupied RA, 96-h tests were performed using a physical human breathing simulator. However, given the infinite possibility of the combinations (number of people, size of the BIP RA), it would be impractical to fully investigate the range of parameters that can affect the CO2 concentration using physical tests. In this paper, researchers at the National Institute for Occupational Safety and Health (NIOSH) developed a model that can predict how the %CO2 in an occupied confined space changes with time given the number of occupants and the FAF rate. The model was then compared to and validated with test data. The benchmarked model can be used to predict the %CO2 for any number of people and FAF rate without conducting a 96-h test. The methodology used in this model can also be used to estimate other gas levels within a confined space.
