N-95/P2 respirator compliance with fit testing recommendations and respirator satisfaction amongst hospital staff.

BACKGROUND: Filtering Facepiece Respirators (FFRs) are an important and readily scalable infection control measure; however their effectiveness is ultimately determined by compliance. We aimed to examine staff compliance and satisfaction with wearing the N95/P2 FFRs assigned to them via the standardised fit testing protocol implemented in a single large healthcare network in Victoria, Australia. METHODS: In this cross-sectional survey, employees from five hospital campuses who participated in the health networks N95/P2 FFR fit testing process were invited in person to participate in the study. Data were analysed descriptively, after which chi-squared analysis was performed to determine differences between respirator types, gender, and age groups. RESULTS: Amongst the 258 staff members surveyed, 28% had either never or only sometimes worn an FFR to which they had been successfully fit tested, and 11% had experienced facial changes that potentially rendered their most recent fit test invalid. More than half (53%) of those surveyed had experienced side effects, the most common being skin irritation and pressure sores. A majority (87%) of staff felt that wearing an FFR had some impact on their ability to perform their duties. Pooled mean self-reported satisfaction ratings were highest for three-panel flat-fold and duckbill models. CONCLUSION: 28% of HCWs surveyed described not wearing N-95/P2 FFRs for which they had successfully been fit tested. Reasons for non-compliance remain unclear, but rates of side effects and interference with duties were high. Further research is required to determine and address potential causative factors and ascertain ongoing optimal organisation-level fit test strategies.

The effect of clinical face shields on aerosolized particle exposure.

Background: Face shields protect healthcare workers (HCWs) from fluid and large droplet contamination. Their effect on smaller aerosolized particles is unknown. Materials & methods: An ultrasonic atomizer was used to simulate particle sizes equivalent to human breathing and forceful cough. Particles were measured at positions correlating to anesthetic personnel in relation to a patient inside an operating theatre environment. The effect of the application of face shields on HCW exposure was measured. Results & Conclusion: Significant reductions in particle concentrations were measured after the application of vented and enclosed face shields. Face shields appear to reduce the concentration of aerosolized particles that HCWs are exposed to, thereby potentially conferring further protection against exposure to aerosolized particles in an operating theatre environment.

Face shields protect health workers from splash contamination. We do not know if they protect against smaller invisible aerosol drops that can carry diseases like coronavirus 2019/COVID-19. The authors tested whether face shields can stop floating droplets using different types of face shields. This included one that was designed and made by a 3D printer, and traditional face shields. The shields were tested in a hospital operating room. A machine was designed that made invisible saltwater droplets. A monitor was used to measure the droplets present at a doctor's or nurse's mouth and then if this changed when a face shield was used. The face shield might be helpful in stopping health workers from catching diseases by stopping the flow of aerosol drops.

Striving to be the fittest: quantitative P2/N95 respirator fit test results among hospital staff during the COVID-19 pandemic.

Objective: To provide fit rates for specific P2/N95 respirators and compare these results by age, sex, clean-shaven status, and fit tester experience. Design: Exploratory audit involving secondary analysis of existing quantitative fit testing data. Setting: In response to the COVID-19 pandemic, healthcare services across Australia implemented respiratory protection protocols. This study details healthcare workers' (HCWs) fit testing results from a large Victorian public health service. Participants: Fit-tested employees of a large tertiary public health network. Methods: Fit rates for ten individual P2/N95 respirators were calculated, and the effect of age, sex, clean-shaven status, and fit tester experience was examined via logistic regression. Results: 4593 employees were included, with 97.98% successfully fitting at least one respirator. Males were found to have significantly increased odds of achieving fit success compared to females (OR 11.61 95%CI 1.60-84.10). Fit rates dropped by 4% with each 1-year age increase (OR 0.96 95%CI 0.94-0.98). Clean-shaven individuals were also more likely to achieve a fit compared to non-clean-shaved individuals (OR 79.23 95%CI 10.21-614.62). More experienced fit testers also yielded significantly higher fit rates (OR 3.95, 95%CI 2.34-6.67). Conclusions: 98% of staff achieved a successful fitting of at least one respirator, with three-panel flat fold models (Industree Trident, 3M Aura 9320A+, and 3M Aura 1870+) performing the most consistently. An individual's ability to achieve a successful fit was associated with; male sex, younger age, clean-shaven status, and fit tester experience.

Pass rates of four P2/N95 respirators or filtering facepiece respirators in Australian healthcare providers: A prospective observational study.

P2/N95 respirators or filtering facepiece respirators may not have the same pass rate on quantitative fit testing. The aim of this study was to investigate the pass rate of four commonly used filtering facepiece respirators in Australian healthcare providers. The secondary objectives included assessing the ease of donning, doffing and comfort of wearing these four filtering facepiece respirators for more than 30 minutes. A multivariable analysis was also conducted to assess if certain variables (e.g. age, sex, body mass index, ethnicity, facial width and length) were associated with passing or failing fit testing. We conducted a prospective observational study of 150 hospital staff who presented for fit testing in a metropolitan hospital in Victoria, Australia. The order of the four filtering facepiece respirators being tested was randomised. A Cochran's Q test was used to test the global null hypothesis that all four filtering facepiece respirators being tested have the same pass rate. A difference in pass rate was found between the four filtering facepiece respirators that were tested (P < 0.001). The 3M™ Aura 1870+ (3M Australia Pty Ltd, North Ryde, NSW) had the highest pass rate (83%) followed by the 3M™ 1860 (3M Australia Pty Ltd, North Ryde, NSW) (61%), BSN ProShield™ N95 (BSN Medical, Mulgrave, Victoria) (55%) and the BYD DE2322 N95 (BYD Care, Los Angeles, CA, USA) (44%). There was also a difference in the ease of donning, doffing and comfort. Therefore, healthcare facilities that perform fit testing should take these factors into consideration when designing an effective respiratory protection programme.

G3BP1-linked mRNA partitioning supports selective protein synthesis in response to oxidative stress.

Cells limit energy-consuming mRNA translation during stress to maintain metabolic homeostasis. Sequestration of mRNAs by RNA binding proteins (RBPs) into RNA granules reduces their translation, but it remains unclear whether RBPs also function in partitioning of specific transcripts to polysomes (PSs) to guide selective translation and stress adaptation in cancer. To study transcript partitioning under cell stress, we catalogued mRNAs enriched in prostate carcinoma PC-3 cell PSs, as defined by polysome fractionation and RNA sequencing (RNAseq), and compared them to mRNAs complexed with the known SG-nucleator protein, G3BP1, as defined by spatially-restricted enzymatic tagging and RNAseq. By comparing these compartments before and after short-term arsenite-induced oxidative stress, we identified three major categories of transcripts, namely those that were G3BP1-associated and PS-depleted, G3BP1-dissociated and PS-enriched, and G3BP1-associated but also PS-enriched. Oxidative stress profoundly altered the partitioning of transcripts between these compartments. Under arsenite stress, G3BP1-associated and PS-depleted transcripts correlated with reduced expression of encoded mitochondrial proteins, PS-enriched transcripts that disassociated from G3BP1 encoded cell cycle and cytoprotective proteins whose expression increased, while transcripts that were both G3BP1-associated and PS-enriched encoded proteins involved in diverse stress response pathways. Therefore, G3BP1 guides transcript partitioning to reprogram mRNA translation and support stress adaptation.