November 2010

Respirators: Function, Fit, and Comfort -- I Want It All!

These are the next hurdles to bridge, and manufacturers are doing just that as they develop next-generation respirators for an expanded base of users.

Not very long ago, respirators were just a piece of personal protective equipment that safety managers were insisting employees wear and most end users grudgingly had to accept. In the not too distant past, we experienced SARS, Avian flu, H1N1, and several other respiratory exposure risk events. These widespread events and the response of the medical community helped to raise awareness of respiratory safety and personal health within the general public.

This increased general awareness appears to have further transitioned into the workplace, where employees now seek out respiratory protection rather than awaiting initiatives from safety managers. OSHA and the National Institute for Occupational Safety and Health have spent a great deal of time, energy, and money to develop public awareness of respiratory health protection and have made tremendous progress.

Another indication of the increased general public awareness is the use of respirators in disaster situations. After the terrorist attacks of 9/11, people were seen wearing respirators; the volcano eruption in Iceland earlier this year produced many photos of people wearing respirators. As recently as August 2010, people in Moscow were shown wearing respirators in response to smoke from wildfires. Not long ago, the general public would avoid using any respiratory protection or resort to some very rudimentary (and not really functional) item, such as a scarf or cloth.

Respirator use and respiratory protection has come to the forefront and is generally accepted for health events, workplace safety, and disaster responses.

All of this put together only bridges the first hurdle, which is user awareness of the potential risks and protections available. The next hurdles to bridge are the "I want it all!" issues:

  • I want a respirator that functions properly to protect me against the risk,
  • I want a respirator that fits "me," and
  • I want a respirator that I can comfortably wear.

Developing Next-Generation Respirators
The traditional round, cupped respirators have been a widely accepted design for the past 30 years. The cupped respirator certainly has many advantages in terms of a low-cost, mass-produced, recognizable design that provides the mandated protection for specific applications. Today's users want the protection required but also want a secure fit that provides a protective seal around the edges and does not come away from the face when bending over, moving, talking, or performing workplace activities. Today's users also want a respirator they can comfortably wear for periods of time without having to remove it and thus exposing themselves to the contaminants they are trying to avoid.

The first consideration in respirator selection is choosing the right mask for the potential risk. NIOSH has established protocol standards for different filtration levels and the protections afforded a user. In Europe, the standards are set by CE. NIOSH has produced the following table, which is very important to review and understand in the respirator selection process. The table outlines the key NIOSH designations; additional information is available on CDC's website (www.cdc.gov/niosh).

Resources available from NIOSH include an online "NIOSH Pocket Guide to Chemical Hazards," which helps to identify the respirator needed for certain types of chemical exposures (http://www.cdc.gov/niosh/npg/npgsyn-a.html).

Class Description
N95: 95% efficiency level effective against particulate aerosols free from oil
N99: 99% efficiency level effective against particulate aerosols free from oil
N100: 99.97% efficiency level effective against particulate aerosols free from oil
R95: 95% efficiency level effective against all particulate aerosols; time use restrictions may apply
P95: 95% efficiency level effective against all particulate aerosols
P99: 99% efficiency level effective against all particulate aerosols
P100: 99.97% efficiency level effective against all particulate aerosols

The respirator manufacturing industry has been trying for several years to develop the next-generation respirator and has had mild success with vertical fold flat and "duck bill" or "beak" masks. Several manufacturing companies, including ours, have recently developed next-generation respirator masks for use in accordance with the NIOSH protocols. The industry continues to strive for new and creative ways to meet public demand for function, fit, and comfort.

An example of function is the recent U.S. EPA regulations and federal laws requiring contractors performing renovation, repair, and painting projects that disturb lead-based paint in homes, child care facilities, and schools built before 1978 to be certified and to follow specific work practices to prevent lead contamination exposure. The rule became effective April 22, 2010. Contractors working in these situations need certification in order to perform the work. One aspect of the contractor training and actual work environment is the use of respiratory protection. The recommended respirator for renovation, repair, and painting projects that do not employ power tools but that disturb lead-based paint is an N100 respirator, which filters 99.97 percent of non-oil airborne particles.

The next-generation respirator masks seek a secure fit for a broader spectrum of facial features and to address issues such as collapse and hard edges while still providing the required functionality for the specific exposure risk.

Responding to End Users' Preferences
It is important for any respirator user to determine the proper respirator for the risk to be addressed and that it properly functions for the identified risk. The next consideration in respirator selection process is that the respirator fits properly. To ensure a secure seal around the edges and a proper fit, it is recommended that users examine several different styles and brands of respirators.

The fit process is determining which of the respirators on the market properly fits the unique facial features of the user. Traditional cupped respirators tend to have ridged edges that do not mold easily to different facial features and can leaves gaps where contaminants can enter the breathing field. Some of the softer duck bill and vertical fold flat respirators can create smaller breathing fields, increasing breathing stress, and also encounter user reluctance to use because of the duck bill appearance.

The best way to ensure a proper fit is to undergo a fit test and confirm that the respirator selected fits you as an individual. It is recommended that each user be fit tested for at least two different brands of respirators so the individual's choice in comfort is readily available from the safety department and the employer. A single source is typically not the best choice for all users.

The final demand from the end user is that it has to be comfortable enough to actually wear. A great-functioning respirator that properly fits will not protect the user if he or she doesn't wear it because it is uncomfortable. Comfort often means a lightweight, easy-to-breathe-through respirator that is cosmetically acceptable in appearance and readily available. Some of today's respirators have added valves to ease the exhalation and heat buildup issues identified by many users. Many of the next-generation respirators will have increased surface area to lower breathing resistance and allow a user to talk through the mask without being muted. They will provide softer materials against the skin, more formable materials to improve the fit around the nose, and headbands with controlled stretch, creating an overall improvement in comfort.

The choice of valved or non-valved really is a user choice, but both are worth evaluating for an individual user. The next-generation respirator will come in several colors -- industrial users may not like the traditional white, while health professionals may like the clean appearance of white. Some manufacturers are also offering pink headbands in support of charities.

The choices continue to expand. It comes down to user choice for appearance and availability.

This article originally appeared in the November 2010 issue of Occupational Health & Safety.

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