Source avec lien : JAMA Internal Medicine, , 8/11/2020. 10.1001/jamainternmed.2020.4221
Importance La protection respiratoire des cliniciens et autres travailleurs de la santé est devenue un défi majeur de la pandémie de coronavirus 2019 (COVID-19) et a entraîné des pratiques non standard telles que l’utilisation de respirateurs périmés et divers processus de décontamination pour prolonger la vie utile des respirateurs dans les établissements de soins de santé. En outre, des respirateurs importés, non approuvés par le NIOSH (National Institute for Occupational Safety and Health), ont été donnés ou acquis par les hôpitaux comme remplacement potentiel des quelques respirateurs N95 approuvés par le NIOSH. Objectif Évaluer les efficacités de filtration ajustée (FFE) des masques faciaux de rechange utilisés pendant la pandémie de COVID-19. Conception, mise en place et participants Pour cette étude d’amélioration de la qualité menée entre avril et juin 2020, nous avons utilisé le protocole d’essai d’ajustement quantitatif de l’Occupational Safety and Health Administration pour le filtrage des masques respiratoires dans une atmosphère de laboratoire complétée par des particules de chlorure de sodium afin d’évaluer les EFP de divers masques respiratoires portés par un homme volontaire et une femme volontaire.
Importance Procuring respiratory protection for clinicians and other health care workers has become a major challenge of the coronavirus disease 2019 (COVID-19) pandemic and has resulted in nonstandard practices such as the use of expired respirators and various decontamination processes to prolong the useful life of respirators in health care settings. In addition, imported, non–National Institute for Occupational Safety and Health (NIOSH)-approved respirators have been donated or acquired by hospitals as a potential replacement for limited NIOSH-approved N95 respirators. Objective To assess fitted filtration efficiencies (FFEs) for face mask alternatives used during the COVID-19 pandemic. Design, Setting, and Participants For this quality-improvement study conducted between April and June 2020, we used the Occupational Safety and Health Administration’s Quantitative Fit Testing Protocol for Filtering Facepiece Respirators in a laboratory atmosphere supplemented with sodium chloride particles to assess the FFEs of a variety of respirators worn by a male volunteer and female volunteer. Main Outcomes and Measures The FFEs of respirators commonly worn by clinicians and other health care workers and available respirator alternatives during the COVID-19 pandemic. Results Of the 29 different fitted face mask alternatives tested on 1 man and 1 woman, expired N95 respirators with intact elastic straps and respirators subjected to ethylene oxide and hydrogen peroxide sterilization had unchanged FFE (95%). The performance of N95 respirators in the wrong size had slightly decreased performance (90%-95% FFE). All of the respirators not listed as approved in this evaluation (n = 6) failed to achieve 95% FFE. Neither of the 2 imported respirators authorized for use by the Centers for Disease Control and Prevention that were not NIOSH-approved tested in this study achieved 95% FFE, and the more effective of the 2 functioned at approximately 80% FFE. Surgical and procedural face masks had filtering performance that was lower relative to that of N95 respirators (98.5% overall FFE), with procedural face masks secured with elastic ear loops showing the lowest efficiency (38.1% overall FFE). Conclusions and Relevance This quality-improvement study evaluating 29 face mask alternatives for use by clinicians interacting with patients during the COVID-19 pandemic found that expired N95 respirators and sterilized, used N95 respirators can be used when new N95 respirators are not available. Other alternatives may provide less effective filtration.