Tuesday, December 10, 2013

Healthcare-Related FAQs

Is a surgical mask an N95 respirator?

No. Surgical masks are not designed for use as particulate respirators and do not provide as much respiratory protection as an N95 respirator. Surgical masks provide barrier protection against droplets including large respiratory particles. Most surgical masks do not effectively filter small particles from the air and do not prevent leakage around the edge of the mask when the user inhales.2 The NIOSH Science Blog: N95 Respirators and Surgical Masks, posted 10/15/2009, provides an explanation of the science behind and the similarities/differences between NIOSH-approved particulate respirators and surgical masks.
2 Reference: Rengasamy,S., B.C.Eimer, and R.E.Shaffer. (2009) Filtration performance of FDA-Cleared surgical masks. Journal International Society Respiratory Protection 26; 54-70.
OSHA Video: The Difference Between Respirators and Surgical MasksExternal Web Site Icon (scroll down page)
The Difference Between Respirators and Surgical Masks. U.S. Department of Labor Video, (2009, December 16). This video is available in English and Spanish and is available for downloading.


What is a surgical N95 respirator?

A surgical N95 respirator is a NIOSH-approved N95 respirator that has also been cleared by the Food and Drug Administration (FDA) as a surgical mask. These products are noted in bold font on the table ofNIOSH-approved N95 respirators. For your convenience, a comprehensive table of these products appears below. If you have a product that you believe is FDA cleared that does not appear on this table, you should verify the FDA clearance by contacting the FDA at 1-800-638-2041.
The National Institute for Occupational Safety and Health (NIOSH) is the U.S. Government agency responsible for the certification and approval of respiratory protective devices for occupational use. The authority is granted to NIOSH in accordance with conditions and standards established in Title 42 of the Code of Federal Regulations (CFR), Part 84. It also addresses quality assurance requirements for the manufacturing of respiratory protective equipment. The approach to approval is that anybody can manufacture and sell any type of respiratory protective device, but only those that meet or exceed all of the requirements established in the 42 CFR 84 standards are acknowledged by NIOSH, and only those that have been NIOSH certified may be marketed as a NIOSH-approved respirator.
The Food and Drug Administration (FDA) is the U.S. Government agency that oversees most medical products, foods, and cosmetics. Within the FDA, the Center for Devices and Radiological Health (CDRH) oversees the safety and effectiveness of medical devices. Medical devices intended for use in preventing and treating disease is subject to regulation under the device provisions of the Federal Food, Drug, and Cosmetic Act. This includes surgical masks and surgical N95 respirators. The FDA has no role in the approval or clearance of N95 respirators not intended for use as a medical device.
This table of Surgical N95's is provided as a courtesy. If you have a product that you believe is FDA cleared that does not appear on this table, you should verify the FDA clearance by contacting the FDA at 1-800-638-2041.
Supplier/ManufacturerModel/
Product
Approval 
Number
User Donning Instructions
3M CompanyExternal Web Site Icon
888-3M HELPS
186084A-0006InstructionsExternal Web Site Icon
187084A-3844 Adobe PDF file [PDF - 190 KB]External Web Site Icon
180584A-5469 Adobe PDF file [PDF - 330 KB]External Web Site Icon
1805S84A-5470 Adobe PDF file [PDF - 330 KB]External Web Site Icon
Aearo CorporationExternal Web Site Icon
800-444-4774
Pleats Plus 
N951050 
1050S 
1051 
1051S 
1052 
84A-2630 Adobe PDF file [PDF - 205 KB]External Web Site Icon
N9504C 
N9504CS
84A-3715 Adobe PDF file [PDF - 14 KB]External Web Site Icon
N9514C84A-4272 Adobe PDF file [PDF - 14 KB]External Web Site Icon
Pleats Plus 
1054S 
1054
84A-4320 Adobe PDF file [PDF - 205 KB]External Web Site Icon
Alpha Pro TechExternal Web Site Icon
800-749-1363
MAS 69584A-0457 Adobe PDF file [PDF - 211 KB]External Web Site Icon
Ansell Healthcare Products LLCExternal Web Site Icon [*W]
800-821-7236
11241084A-5200112410 Adobe PDF file [PDF - 759 KB]External Web Site Icon
11241184A-5201112411 Adobe PDF file [PDF - 759 KB]External Web Site Icon
Cardinal HealthExternal Web Site Icon [*E]
800-379-9929
N95-ML84A-3323 Adobe PDF file [PDF - 842 KB]External Web Site Icon
N95-S84A-4107 Adobe PDF file [PDF - 5.6 MB]External Web Site Icon
N95A-ML84A-5411 Adobe PDF file [PDF - 538 KB]External Web Site Icon
N95A-S84A-5463 Adobe PDF file [PDF - 538 KB]External Web Site Icon
Cardinal HealthExternal Web Site Icon [*Z
866-401-8972
USA-N95-S84A-5229 Adobe PDF file [PDF - 1.8 MB]External Web Site Icon
USA-N95-R84A-5527 Adobe PDF file [PDF - 3.2 MB]External Web Site Icon
Dynarex CorporationExternal Web Site Icon [*E]
800-379-9929
229584A-3323 Adobe PDF file [PDF - 842 KB]External Web Site Icon
2296A84A-4541 Adobe PDF file [PDF - 5.5 MB]External Web Site Icon
2295A84A-5411 Adobe PDF file [PDF - 538 KB]External Web Site Icon
Emerald Medical Inc.External Web Site Icon [*E]
610-670-8571
N950084A-3323 Adobe PDF file [PDF - 2.7 MB]External Web Site Icon
Filligent (HK) Limited
852-2542-2400
Professional BF-200-3013AN84A-6252Pending NIOSH receipt from company
Foss Manufacturing Company
603-929-6000
SpectraShield 950084A-5199 Adobe PDF file [PDF - 577 KB]External Web Site Icon
Spectra Shield Protector N9584A-5670Spectra Shield Protector N95 Adobe PDF file [PDF - 577 KB]External Web Site Icon
GlaxoSmithCline Consumer HealthcareExternal Web Site Icon[*C]
800-821-7236
ActiProtect UF84A-5163 Adobe PDF file [PDF - 59 KB]External Web Site Icon
Handen Heng Yong Protective and Clean Products Company, Ltd.External Web Site Icon
86-311-8551-8218
86-311-8551-8968
HY851084A-4276 Adobe PDF file [PDF - 105 KB]External Web Site Icon
HY981084A-4521 Adobe PDF file [PDF - 114 KB]External Web Site Icon
Inovel, LLCExternal Web Site Icon [*J]
800-421-0668
1511 
1512 
1513 
1517 
Obsolete 08/2009
84A-0013InstructionsExternal Web Site Icon
Inovel, LLCExternal Web Site Icon
866-546-6835
FRN95-S 
FRN95-ML 
FRN95-A 
FRN95-XS 
Obsolete 05/2012
84A-4100InstructionsExternal Web Site Icon
FRN95-SEZ 
FRN95-MLEZ
Obsolete 05/2012
84A-4101InstructionsExternal Web Site Icon
3001N95-S 
3002N95-M 
3003N95-L 
3004N95-LP
Obsolete 05/2012
84A-4102InstructionsExternal Web Site Icon
3101N95-S 
3102N95-M/L
Obsolete 05/2012
84A-4103InstructionsExternal Web Site Icon
1510
Obsolete 05/2012
84A-4333InstructionsExternal Web Site Icon
3211N95-S 
321N95-M/L 
3217N-95-LP
Obsolete 05/2012
84A-4338InstructionsExternal Web Site Icon
Kimberly-Clark CorporationExternal Web Site Icon
800-524-3577
46827 
46867
84A-0005InstructionsExternal Web Site Icon
46727 
46767
84A-0010InstructionsExternal Web Site Icon
Livingstone International Pty, Ltd.External Web Site Icon [*E]
800-379-9929
FMN95RN84A-5411 Adobe PDF file [PDF - 538 KB]External Web Site Icon
Louis M. Gerson Company, Inc.External Web Site Icon
800-225-8623
173084A-0160 Adobe PDF file [PDF - 122 KB]External Web Site Icon
2130
2131
84A-4123 Adobe PDF file [PDF - 122 KB]External Web Site Icon
Magid Glove and Safety, LLCExternal Web Site Icon [*E]
800-379-9929
910-N9584A-3323 Adobe PDF file [PDF - 842 KB]External Web Site Icon
Makrite Industries, Inc.External Web Site Icon
800-379-9929
910-N9584A-3323 Adobe PDF file [PDF - 842 KB]External Web Site Icon
910-N95S84A-4107 Adobe PDF file [PDF - 5.6 MB]External Web Site Icon
910-N95FMX84A-4541 Adobe PDF file [PDF - 5.6 MB]External Web Site Icon
9500-N9584A-54119500-N95 Adobe PDF file [PDF - 538 KB]External Web Site Icon
9500-N95S84A-54639500-N95S Adobe PDF file [PDF - 615 KB]External Web Site Icon
Medline Industries, Inc.External Web Site Icon [*E]
800-379-9929
NON2450684A-3323 Adobe PDF file [PDF - 842 KB]External Web Site Icon 
NON2450784A-4107 Adobe PDF file [PDF - 5.6 MB]External Web Site Icon
NON24506A84A-5411NON24506A Adobe PDF file [PDF - 538 KB]External Web Site Icon
NON24507A84A-5463NON24506A Adobe PDF file [PDF - 538 KB]External Web Site Icon
Moldex-Metric, Inc.External Web Site Icon
800-421-0668
1511 
1512 
1513 
1517
84A-0013InstructionsExternal Web Site Icon
2210GN95-XS
2211GN95-S
2212GN95-M/L
2217GN95-LP
84A-4339InstructionsExternal Web Site Icon
151084A-5171InstructionsExternal Web Site Icon
3211N95-S
3212N95-ML
3217N95-LP
84A-5172InstructionsExternal Web Site Icon
171284A-5227 Adobe PDF file [PDF - 127 KB]External Web Site Icon
Nexera Medical Inc.External Web Site Icon [*AA]
603-929-6000
SpectraShield 950084A-5199SpectraShield 9500 Adobe PDF file [PDF - 577 KB]External Web Site Icon
SpectraShield Protector N9584A-5670Spectra Shield Protector N95 Adobe PDF file [PDF - 577 KB]External Web Site Icon
Precept Medical ProductsExternal Web Site Icon [*E]
800-379-9929
65-339584A-3323 Adobe PDF file [PDF - 182 KB]External Web Site Icon
65-3395S84A-4107 Adobe PDF file [PDF - 182 KB]External Web Site Icon
Prestige AmeritechExternal Web Site Icon
866-401-8972
RP8802084A-5216 Adobe PDF file [PDF - 256 KB]External Web Site Icon
USA-N95-S84A-5229 Adobe PDF file [PDF - 1.8 MB]External Web Site Icon
RP8801084A-5475 Adobe PDF file [PDF - 187 KB]External Web Site Icon
USA-N95-R84A-5527 Adobe PDF file [PDF - 3.2 MB]External Web Site Icon
priMed Medical Products CompanyExternal Web Site Icon
1-877-877-4633
PN4-7064
PN4-7074
PN4-7084
84A-5535 Adobe PDF file [PDF - 1.6 MB]External Web Site Icon
PN4-7065
PN4-7075
PN4-7085
84A-6659Pending NIOSH receipt from company
Shanghai Dasheng Health Products Manufacture Company, Ltd.External Web Site Icon
86-21-5778-3126
DTC3M-184A-4331 Adobe PDF file [PDF - 247 KB]External Web Site Icon
DTC3B84A-4336 Adobe PDF file [PDF - 247 KB]External Web Site Icon
Shanghai Gangkai Purifying Products Company, Ltd.External Web Site Icon
86-21-5777-5401
GIKO 140084A-4282 Adobe PDF file [PDF - 78 KB]External Web Site Icon
Shuenn Bao Shing CorporationExternal Web Site Icon
886-4-875-6141
AP0018 N9584A-4049 Adobe PDF file [PDF - 63 KB]External Web Site Icon
AP002884A-4175 Adobe PDF file [PDF - 65 KB]External Web Site Icon
Sperian Respiratory Protection USA, LLCExternal Web Site Icon
800-821-7236 
800-343-3411
1930
Obsolete 04/2010
84A-0301 Adobe PDF file [PDF - 33 KB]External Web Site Icon
1940
Obsolete 04/2010
84A-0301 Adobe PDF file [PDF - 594 KB]External Web Site Icon
HC-NB09584A-4357 Adobe PDF file [PDF - 33 KB]External Web Site Icon
HC-NB295F84A-4371 Adobe PDF file [PDF - 33 KB]External Web Site Icon
HC-NB095F84A-4372 Adobe PDF file [PDF - 33 KB]External Web Site Icon
HC-NB295FP84A-5667Pending
SteelProExternal Web Site Icon [*A]
800-225-8623
173084A-01601730 Adobe PDF file [PDF - 122 KB]External Web Site Icon
TrioMed Innovations CorporationExternal Web Site Icon
858-794-3200
B13084A-5200 Adobe PDF file [PDF - 759 KB]External Web Site Icon
B15084A-5201 Adobe PDF file [PDF - 759 KB]External Web Site Icon
A - Private label of Louis M. Gerson Company, Inc.External Web Site Icon (800-225-8623)
AA - Private label of Foss Manufacturing CompanyExternal Web Site Icon(603-929-6000)
C - Private label of SperianExternal Web Site Icon (800-821-7236)
E - Private label of Makrite Industries, Inc.External Web Site Icon (800-749-1363)
J - Private label of Moldex-Metric, Inc.External Web Site Icon (800-421-0668)
W - Private Label of TrioMed Innovations CorporationExternal Web Site Icon (800-821-7236)
Z - Private Label of Prestige AmeritechExternal Web Site Icon (866-401-8972)


Can the products with an exhalation valve be used in healthcare?

Respirators with exhalation valves can be used in a healthcare setting when it is not important to maintain a sterile field (an example of an acceptable practice would be when taking the temperature or blood pressure of a patient). Respirators with exhalation valves should not be used in situations where a sterile field is required (e.g. during an invasive procedure in an operating or procedure room) because the exhalation valve allows unfiltered exhaled air to escape into the sterile field.


Do N95 respirators come in different sizes?

Yes. The sizing differs with each respirator model. Some of the sizing options include small, small/medium, medium, medium/large, and large. Particulate filtering facepiece respirators, including those commonly referred to as N95s, are available in multiple size configurations that are variable and not standardized across models.


How do I know what size I need?

Fit testing is needed to determine if a particular size and model of respirator provides you with an acceptable fit. Fit testing is model specific. Before you wear a respirator in an occupational setting, youmust be fit tested in each respirator model you will wear.


Do N95 respirators come in different styles?

Yes. Filtering facepiece respirators are available in a wide range of colors, shapes, and styles. Some styles will fit individuals better than others and certain styles may be more comfortable and have better fitting characteristics. As long as the N95 is NIOSH-approved, has been fit tested, and is being used in accordance with the requirements of an OSHA-compliant respirator program, including appropriately donned by the user, then the wearer should receive the expected protection factor regardless of color, shape, or style.

Below are some of the styles available:
Example of respirator
Example of respirator
Example of Respirator
Example of respirator
Example of respirator
Example of respirator
Example of respirator
Example of respirator
Example of respirator

Example of respirator
Photos courtesy of 3M, Kimberly-Clark, and Moldex.


Why do some N95 respirators have an exhalation valve on the front?

The use of an exhalation valve reduces exhalation resistance, which makes it easier to breathe (exhale). Some users feel that a respirator with an exhalation valve keeps the face cooler and reduces moisture build up inside the facepiece.


Does moisture build up in respirators?

The wearer’s respiratory secretions and moist exhaled breath can lead to moisture build-up in a respirator. While it is possible for moisture to build up in a respirator with or without an exhalation valve, preliminary research shows that this is unlikely.


What are the differences among these products?

Surgical, Medical, or Procedure MaskN95 RespiratorSurgical N95 Respirator
Standard Earloop Mask
Standard Earloop Mask
Photo courtesy of Newton Safety/Sanax
Molded Cup Style N95 respirator
Molded Cup Style N95 respirator
Photo courtesy of Sperian
Molded Cup Style Surgical N95 respirator
Molded Cup Style Surgical N95 respirator
Photo courtesy of Sperian
Standard Tie On Surgical Mask
Standard Tie On Surgical Mask
Photo courtesy of Newton Safety/Sanax
Pleated style N95 respirator
Pleated style N95 respirator
Photo courtesy of Alpha TechPro
Duck bill style Surgical N95
Duck bill style Surgical N95
Photo courtesy of Kimberly Clark
Duckbill surgical mask
Duckbill surgical mask
Flexwing style, one strap N95 respirator
Flexwing style, one strap N95 respirator
Photo courtesy of Moldex
Flexwing style, one strap, Duramesh cover Surgical N95 respirator
Flexwing style, one strap, Duramesh cover Surgical N95 respirator
Photo courtesy of Moldex
Molded Cone Surgical Mask
Molded Cone Surgical Mask
Photo courtesy of 3M
Cup Style N95 Respirators
Photo courtesy of 3M
Cup Style N95 Respirator
Cup Style and Flat Fold N95 Respirators
Photo courtesy of Newton Safety/Sanax
Cup Style Surgical N95 respirator (interior and exterior view)
Cup Style Surgical N95 respirator (interior and exterior view)
Photo courtesy of Louis Gerson

Surgical, Medical, or Procedure MaskN95 RespiratorSurgical N95 Respirator
Evaluation, Testing and Certification
Filter efficiency, breathing resistance, fluid resistance and flammability data are reviewed by the FDA. Must demonstrate filtration efficiency no less than another surgical mask already cleared by the FDA. (the minimum filtration level is unspecified).Evaluated, tested and certified by NIOSH as per the minimum performance requirements like filter efficiency and breathing resistance.

NIOSH approves 9 filter classes of which N95 is the lowest.
Evaluated, tested and certified by NIOSH as per the minimum performance requirements as an N95 filtering facepiece respirator.

FDA accepts filter efficiency and breathing resistance based on NIOSH test results from the NIOSH approval evaluation, and reviews fluid resistance and flammability data submitted by the manufacturer for clearance of the N95 respirator as a medical device for use in a surgical setting.
Intended Use
A surgical mask is intended to prevent the release of potential contaminants from the user into their immediate environment. It is also used to protect the wearer from large droplets, sprays and splashes of body fluids.Occupational (including medical) use. Reduces wearer’s exposure to particles including small particle aerosols and large droplets (all non-oil aerosols).Can be used in any occupational setting where an N95 respirator is appropriate. Medical use where a sterile field needs to be maintained. Reduces wearer’s exposure to certain airborne particles (all non-oil aerosols) and provides a barrier to splashes and sprays.
Purpose
Barrier to splash, droplets, spit.Protects from exposure to airborne particles. In a healthcare setting, protects from exposure to biological aerosols including viruses and bacteria.Protects from exposure to airborne particles and barrier to splashes, droplets, and sprays. In a healthcare setting, protects from exposure to biohazards including viruses and bacteria.
Face Seal Fit
Not designed to fit tight to face.Designed to fit tight to face creating a seal around the perimeter of the respirator to improve protection.Designed to fit tight to face creating a seal around the perimeter of the respirator to improve protection.
User Seal Check Requirement
Not designed for seal check.Required each time a respirator is donned.Required each time a respirator is donned.
Filtration
Does not effectively filter small particles from air.Effectively filters large and small particles from air.Effectively filters large and small particles from air.
Leakage
Leakage occurs around the edge of the mask when the user inhales.When properly fitted and donned, minimal leakage around edges of the respirator when the user inhales.When properly fitted and donned, minimal leakage around edges of the respirator when the user inhales.
Use Limitations
One time use (one patient encounter).Single use. Should be discarded when it becomes damaged or deformed; no longer forms an effective seal to the face; becomes wet or visibly dirty; breathing through it becomes more difficult; or if it becomes contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients.Single use. Should be discarded when it becomes damaged or deformed; no longer forms an effective seal to the face; becomes wet or visibly dirty; breathing through it becomes more difficult; or if it becomes contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients.
Available sizes
Generally only one size.Available in multiple size configurations. However, sizing is not standardized among approved models. Some of the sizing options include small, small/medium, medium, medium/large, and large.Available in multiple size configurations. However, sizing is not standardized among approved models. Some of the sizing options include small, small/medium, medium, medium/large, and large.


How long can you wear the same N95 respirator?

The current NIOSH service-time-limit recommendations for non-powered particulate filter respirators are that filter elements should be replaced at the following frequencies:
  • The service life of all filters on NIOSH-approved respirators is limited by considerations of hygiene, damage, and breathing resistance. All filters should be replaced whenever they are damaged, soiled, or causing noticeably increased breathing resistance.
  • N-series filters generally should be used and reused subject only to considerations of hygiene, damage, and increased breathing resistance. However, for dirty workplaces that could result in high filter loading (i.e., 200 mg), service time for N-series filters should only be extended beyond 8 hours of use (continuous or intermittent) by performing an evaluation in specific workplace settings that demonstrates: (a) that extended use will not degrade the filter efficiency below the efficiency level specified in 42 CFR 84, or (b) that the total mass loading of the filter(s) is less than 200 mg. These determinations would need to be repeated whenever conditions change or modifications are made to processes that could change the type of particulate generated in the user's facility.
  • For healthcare applications where use is for protection against confirmed or suspected 2009 H1N1 influenza, please refer to: Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare Personnel.


Can a N95 respirator be used from Operating Room (OR) case to OR case or from patient to patient?

Used respirators are considered contaminated and ideally should be discarded after each patient encounter. Disposable N95 respirators worn during aerosol-generating procedures should be discarded after the procedure.
Healthcare facilities can extend the use of disposable N95 respirators by training personnel to wear them during serial patient encounters without removing or re-donning between encounters. There is the risk of respirator contamination and contact transmission with this practice where extended use of disposable N95 respirators could entail a risk of contact transmission by touching a contaminated surface of the respirator and subsequently touching the mucous membranes of the face or a hypothetical risk of re-aerosolization of virus from a used respirator. The risk will be minimized if HCWs perform hand hygiene every time before and after touching the respirator.
For healthcare applications where use is for protection against confirmed or suspected 2009 H1N1, please refer to Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare Personnel and Questions & Answers Regarding Respiratory Protection for Infection Control Measures for 2009 H1N1 Influenza among Healthcare Personnel for recommendations for the duration of wear for protection against the 2009 H1N1 exposure hazards.


Is cross contamination a concern if I wear the same N95 from patient room to patient room?

Yes, especially if the respirator was worn in a room with any type of aerosol generating procedure, or if the patient is suspected of or confirmed with having the 2009 H1N1 virus. Although this practice has the potential benefit of providing respiratory protection with limited supplies of respirators, there is the risk of respirator contamination and contact transmission. Extended use (i.e. use without removing or re-donning between encounters) of disposable N95 respirators could entail a risk of contact transmission by touching a contaminated surface of the respirator and subsequently touching the mucous membranes of the face or a hypothetical risk of re-aerosolization of virus from a used respirator. The precise balance between risk of contact transmission and benefit of extended use is unknown, although the risk will be minimized if HCWs perform hand hygiene every time before and after touching the respirator. In general, wearing an N95 respirator over multiple encounters (while minimizing touching, removing, or re-donning between encounters) would be favored over re-use, as this strategy is expected to involve less touching of the respirator and therefore less risk of contact transmission. For healthcare applications where use is for protection against confirmed or suspected 2009 H1N1, please refer toInterim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare Personnel and Questions & Answers Regarding Respiratory Protection for Infection Control Measures for 2009 H1N1 Influenza among Healthcare Personnel for recommendations for the duration of wear for protection against the 2009 H1N1 exposure hazards.


Can I take a N95 respirator off in between patients or Operating Room cases?

Used respirators are considered contaminated and ideally should be discarded after each patient encounter. A user should never touch the contaminated front of the respirator with his or her bare hands. Hands should always be washed after donning and doffing the respirator. Healthcare facilities implementing steps to extend the existing supply of disposable N95 respirators by training personnel to re-use them (i.e. removing and re-donning between patient encounters) refer to Questions & Answers Regarding Respiratory Protection for Infection Control Measures for 2009 H1N1 Influenza among Healthcare Personnel for recommendations for the possible re-use of respirators between patient encounters when used for protection against the 2009 H1N1 exposure hazards.


How should I store my N95 in between patient encounters, in a healthcare setting?

The manufacturers provide instructions for cleaning, sanitizing, repairing, inspecting, and storing their respirators. The respirators should be packed or stored so that the respirators do not become damaged or deformed. Never store disposable respirators in pockets, plastic bags, or other confined areas. Infectious material deposited on personal protective equipment may cause it to become a vehicle for direct or indirect transmission. In those situations, care is needed when removing and storing personal protective equipment to avoid contaminating skin, clothing, and mucous membranes. Remove the respirator and either hang it in a designated area or place it in a bag. (Consider labeling respirators with a user’s name before use to prevent reuse by another individual.) In healthcare settings where the patients have confirmed or suspected 2009 H1N1 influenza, please refer to Questions & Answers Regarding Respiratory Protection for Infection Control Measures for 2009 H1N1 Influenza among Healthcare Personnel for recommendations for the possible storage of respirators between patient encounters when used for protection against the 2009 H1N1 exposure hazards.


Can I infect myself from the droplets that accumulate on the outside of the respirator?

Respirators protect by capturing particles with the filter of the N95 respirator. Some aerosols can pose a contact hazard for infection. The accumulation of particles on the external surface of the respirator may be an exposure hazard from contact with the filter, including becoming a fomite for infectious agents. Users should be cautious and follow appropriate procedures to avoid self-inoculation from contact with these surfaces. Hand hygiene and infection control practices should be followed before and after touching the outside of the respirator when it is used in the presence of infectious agents.


Do I need special training to wear an N95 or do I put it on and wear it like a surgical mask?

The NIOSH certification requires respirators to be put on, used and maintained in accordance with the manufacturer instructions and a respiratory protection program that meets the requirements of the OSHA respiratory protection standard (29 CFR 1910.134External Web Site Icon). Training for all users is a mandatory part of OSHA’s respirator program requirements. Training is usually done at the same time that fit testing takes place. The OSHA standard contains required training elements. The manufacturer instructions for donning and doffing for each brand and model may be model-specific and must be followed. These instructions are located in the User Instructions provided, on the box or individual package of the respirators. The manufacturer’s instruction for putting on (donning) the respirator is also included in the information provided in the NIOSH listing for approved disposable respirators.


Can we use an N95 that has not been cleared by the FDA in a patient setting?

NIOSH-certified N95 respirators that have not been cleared by the FDA can be used for respiratory protection to reduce the exposures of healthcare personnel in a patient setting to hazardous particulates. These respirators have not been evaluated by FDA to determine whether they meet the fluid and flammability resistance as required for FDA clearance as medical devices. For this reason, they are not intended for use in exposure settings where the performance of a surgical mask to maintain a sterile field is required.


What does it mean if a respirator is approved by NIOSH and cleared by the FDA?

N95 respirators that are both certified by NIOSH and cleared by FDA as medical devices for use by healthcare personnel are called “surgical N95 respirators.” As with all NIOSH-certified N95 respirators, these products have been evaluated by NIOSH certification process and have demonstrated that they can filter out a minimum of 95% of airborne particles under worse case test conditions. These products have also been evaluated by the FDA to have demonstrated an acceptable level of fluid and flame resistance, which may be important in healthcare occupational settings, such as surgical suites. The FDA clearance process also requires that these products have labeling that is relevant to healthcare personnel, such as information about the presence of natural rubber latex.

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