What are alternatives to N95 respirators?

The COVID-19 pandemic has lead the world to be in constant tension and fear, particularly among the health care workers. The imminent N95 respirator shortage that has been predicted multiple times over the last months is still not here, but people are already preparing for it, especially workers who are facing respiratory hazards daily. 

 

What is an N95 respirator? 

For it to be considered an N95 respirator, a disposable face mask has to be classified as such by the National Institute for Occupational Safety and Health (NIOSH). This is a federal agency of the United States responsible for preventing work-related injuries and diseases. They are a part of the CDC, and they have an active and central role in regulating personal protection equipment. 

The NIOSH air filtration rating classifies respirators based on their minimum filtration efficacy, as well as other physical properties. According to this classification, respirators are given a name based on two things:

  • N, R, or P: these letters indicate their level of resistance to oil. N95 respirators are not resistant to oil, so they can be used to filtrate particles that are not oil-based, like viruses.
  • The minimum filtration efficacy: this percentage indicates the filtration rate of the respirator. N95 masks filtrate at least 95% of all airborne particles in the air. 

These characteristics make the N95 respirator an important part of the medical, surgical, and dental PPE. The main manufacturer and supplier for these masks are 3M. Back in April, the government invoked the Defense Production Act of 1950, which authorized them to direct private companies to prioritize domestic production and supply of critical necessities, like the N95 respirator. 3M followed the instructions, and increased their production of N95 respirators in the US.

 

N95 shortages: the main problem

A shortage of N95 respirators has been creeping on us ever since the beginning of the pandemic. The goal has always been to prioritize health care workers on the frontline when it comes to N95 masks, but the general public is scared and needs alternatives.

The NIOSH certification is important to take into consideration when navigating other options. N95 respirators are approved by the NIOSH after being tested on certain characteristics, mainly the filtration efficiency, as we explained above. 

Face masks that are not verified by either NIOSH or the FDA can be used if an N95 shortage gets to a critical point somewhere in the future, but always as a last resort. Using handmade fabric masks is an accessible option for the general public, but you must keep in mind that these don’t meet the standard regulations: proper seal, fit, or filtration of airborne particles, including viruses. 

Reusing N95 respirators: is it possible?

The main problem with reusing N95 respirators is that they start losing efficacy. They are designed to be used once for 8 to 12 hours. However, certain practices have been recommended by the Centers for Disease Control and Prevention (CDC) under their strict guidelines. 

For example, ‘limited reuse’ is defined under this guide as “the practice of using the same N95 respirator for multiple encounters with patients but removing it after each encounter. The respirator is stored in between encounters to be put on again before the next encounter with a patient”. The N95 respirator is always used by the same worker and it can only be used as long as the equipment remains functional. 

The CDC recommends the practice of 'extended use' above 'limited reuse'. They define it as “the practice of wearing the same N95 respirator for repeated close contact encounters with several patients, without removing the respirator between patient encounters”. They say this is especially useful for attending several patients with the same respiratory illness. 

On the other hand, the Occupational Safety and Health Administration (OSHA) recommends to visually inspect the respirator to evaluate its integrity when reuse is considered.

What are the alternatives?

There are certain non-surgical PPE that is being considered good alternatives to N95 masks amid the imminent shortages, not only to the general public, but for workers as well.

  • Half-mask respirator

This mask covers only the nose and mouth, and it requires a previous fit test to ensure the fit to the face is correct. This is a reusable mask that can be cleaned, and when you purchase a high-quality one, it will be durable. They don't protect against gases or vapors, and leaves the eyes uncovered.

  • Full-face respirator

This one offers eye protection as well as noise and mouth protection. It covers the whole head, with better sealing around the face. The benefit of this mask is that it takes out the need to find additional goggles to protect the eyes, which are also an entry to pathogens. 

  • Powered air-purifying respirator

Also known as the PAPR for short. This unit provides protection to the whole head, not only mouth, nose, and eyes. It doesn’t require fit testing, and are easily cleaned and decontaminated for reuse.

As always, we recommend our readers to stay safe and practice social distancing. One good way to do both is protecting yourself, your family, and your kids by wearing N95 respirators, and to purchase them online. They are easy to find, and can still be found in stock on our online shops, at reasonable prices. 

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