Total outward leakage of half-mask respirators and surgical masks used for source control.

Both respirators and surgical masks (SM) are used as source control devices. During the COVID-19 pandemic, there was much interest in understanding the extent of particle total outward leakage (TOL) from these devices. The objective of this study was to quantify the TOL for five categories of devices: SMs, National Institute for Occupational Safety and Health (NIOSH) Approved N95 filtering facepiece respirators (FFRs) without exhalation valves, NIOSH Approved N95 FFRs with exhalation valves (N95 FFRV), NIOSH Approved elastomeric half-mask respirators (EHMRs) with exhalation valves, and NIOSH Approved EHMRs with an SM covering the exhalation valve (EHMRSM). A benchtop test system was designed to test two models of each device category. Each device was mounted on a headform at three faceseal levels (0% faceseal, 50% faceseal, and 100% faceseal). At each faceseal level, the TOL was assessed at three flow rates of minute ventilations of 17, 28, and 39 L/min. The experimental design was a split-split-plot configuration. Device type, faceseal level, flow rate, and the interaction of device type and faceseal level were found to have a significant effect (p-value < 0.05) on the TOL. This study found that the N95 FFRs without exhalation valves had the lowest mean TOL. The SMs had about three times higher TOL than the N95 FFRs without exhalation valves. The TOL of the N95 FFRV was comparable to that of the SM at 0% and 50% faceseal on average overall conditions, but the N95 FFRV had a significantly higher TOL than the SM at a 100% faceseal. The EHMRs had the highest TOL because of the exhalation valve. Using an SM to cover the exhalation valve did not improve the EHMRs' efficiency in mitigating the TOL. Caution should be exercised when using N95 FFRVs as a source control measure against respiratory activities with heavy work rates, such as performing CPR. Results of this study showed that reduced faceseal leakage for N95 FFRs and SMs improves source control.

Correlation between quantitative fit factors and workplace protection factors measured in actual workplace environments at a steel foundry.

Past studies have found little or no correlation between workplace protection factors (WPFs) and quantitative fit factors (FFs). This study investigated the effect of good- and poor-fitting half-facepiece, air-purifying respirators on protection in actual workplace environments at a steel foundry and the correlation between WPFs and FFs. Fifteen burners and welders, who wore respirators voluntarily, and chippers participated in this study. Each subject was fit-tested with two respirator models each with three sizes, for a total of six fit-tests. Models and sizes were assigned this way to provide a wide range of FFs among study participants. Each worker donned the respirator twice per day (at the beginning of the shift and following the lunch break) for 2 days. Quantitative FFs were first obtained for each donning using the PortaCount Plus trade mark in a separate room. Without redonning the respirators, workers performed normal work for 1 to 2 hours, and WPFs were measured by collecting ambient and in-facepiece samples simultaneously. A second fit-test was conducted without disturbing the respirator. FFs were obtained by averaging the results from the first and second fit-tests. The resulting FFs had a geometric mean (GM) of 400 (range=10-6010) and a geometric standard deviation (GSD) of 6.1. Of the 55 valid donnings, 43 were good fitting (FFs> or =100) and 12 were poor fitting (FFs<100). The WPFs had a GM of 920 (range=13-230,000) and a GSD of 17.8. The WPFs were found to be significantly correlated with the FFs (R(2)=.55 and p-value=.0001). Therefore, FF was shown to be a meaningful indicator of respirator performance in actual workplace environments.

Comparison of five methods for fit-testing N95 filtering-facepiece respirators.

Five fit-testing methods (Bitrex, ambient aerosol condensation nuclei counter using the TSI PortaCount Plus, saccharin, modified ambient aerosol condensation nuclei counter using the TSI PortaCount Plus with the N95-Companion, and generated aerosol using corn oil) were evaluated for their ability to identify poorly fitting N95 filtering-facepiece respirators. Eighteen models of NIOSH-certified, N95 filtering-facepiece respirators were tested by a panel of 25 subjects using each fit-testing method. The penetration of the corn oil and the ambient aerosols through the filter media of each respirator was measured in order to adjust the corresponding generated and ambient aerosol overall fit factors, reflecting only face-seal leakage. Fit-testing results were compared to 5th percentiles of simulated workplace protection factors. Beta errors (the chance of passing a fit-test in error) ranged from 3 percent to 11 percent. Alpha errors (the chance of failing a fit-test in error) ranged from 51 percent to 84 percent. The ambient aerosol using the TSI PortaCount Plus and the generated aerosol methods identified poorly fitting respirators better than the saccharin, the Companion, and Bitrex methods. These errors rates should be considered when selecting a fit-testing method for fitting N95 filtering-facepieces. When both types of errors were combined as an assignment error, the ambient aerosol method using the TSI PortaCount Plus had the lowest percentage of wearers being assigned a poor-fitting respirator.