The Difference Between Surgical Masks and N95s

With the entrance of PPE in the public’s everyday vocabulary, it is important to note differences in masks and respirators.

• By Jeffrey Birkner, Chris Arey
• Feb 01, 2021

It’s a question that has grown in popularity this year and with good reason: What is the difference between a surgical mask and a N95 respirator?

While both may be referred to as “masks,” these two protective devices are actually used for different functions. From how they fit the user’s face to the intended uses, surgical masks and N95 respirators are very different kinds of masks. Below is a breakdown of what separates surgical masks from N95s and the levels of protection that they provide.

Surgical Masks

The FDA says “a surgical mask is a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment.” By design, a surgical mask is intended to prevent physical liquids such as splashes or sprays from blood or sputum from entering the environment. The FDA adds that a surgical mask may be effective in blocking splashes and large-particle droplets, but it does not filter or block very small particles in the air that may be transmitted by coughs, sneezes or certain medical procedures.

Surgical masks are designed to cover the mouth and nose loosely and are not sized for individual fit. One of the major differences between a surgical mask and a N95 filtering face piece respirator is that surgical masks are not intended to provide respiratory protection to the wearer since they do not effectively filter smaller airborne particles.

In addition, surgical masks have not met all the standards that a N95 or higher-level respirator has. They are not approved by the National Institute for Occupation Safety and Health (NIOSH), but instead are cleared by the FDA. Surgical masks also are not intended to provide a tight-fitting seal on users’ faces. Generally speaking, surgical masks are not intended for the wearer’s protection from small particles, but rather to protect the surgical field from contamination by the wearer.

It should be noted that surgical masks are not to be confused with cloth face coverings. Cloth face coverings have increased in popularity as a result of the COVID-19 pandemic and have been advised by the CDC for general public use. However, cloth face coverings are not the same as surgical masks. Cloth face coverings do not require FDA approval, nor do they provide the same type of protection.

N95 Respirators

N95 respirators are respiratory protective devices designed to provide efficient filtration of airborne particles. This is due in part to the very close facial fit they provide. N95s are designed to seal to a wearer’s face in order to achieve the intended effectiveness of filtering 95 percent of particles with a mass median diameter of 0.3 micrometers. Under Respiratory Protection Standard 29 CFR 1910.134, OSHA requires the wearer of a respirator to be fit tested before they can use the respirator in a contaminated environment and a refit at least once annually.

OSHA also requires users to perform seal checks on respirators before each use, as well as comply with the other elements of a comprehensive respiratory protection program in accordance with 29 CFR 1910.134. If the wearer is unable to obtain a proper fit, they must not enter a contaminated work area.

A properly fit tested N95 respirator will greatly reduce the number of small particles that will enter the wearer’s respiratory system, as compared to a surgical mask that is not NIOSH approved. The extent of that reduction is a function of the fit of the mask, its filtration efficiency level (with respirators available from 95 percent to 99.97 percent filter efficiency), the size of the hazardous particles and the wearer’s proper donning and wearing of the respirator according to the training the employer provides as required by OSHA regulations. While N95s can reduce a wearer’s exposure to hazardous particles, they cannot guarantee that the wearer will not be exposed.

Not every N95 is the same. There are two main types of N95s—surgical and industrial. Both surgical N95 respirators and industrial N95 respirators provide different types of protection suited for distinctly different applications.

Surgical N95 Respirators. Surgical N95 respirators are intended for use in healthcare settings and are designed to not only reduce the wearer’s exposure to airborne biological contaminants, but also add some protection from liquid splash such as blood or body fluids. Surgical N95s form a tight seal over the mouth and nose. In order to be most effective, surgical N95s must be fit tested regularly and be adjusted to the wearer’s face.

There are two main distinctions to be made between surgical N95s and industrial N95s. The first is that surgical N95s must be approved by the FDA. The second is that surgical N95s are tested for fluid resistance and biocompatibility to ensure that they do not cause any skin irritation or allergies.

Industrial N95 Respirators. Industrial N95 respirators are designed for use in industrial settings, such as metalworking, construction and mining. Industrial N95s are designed to reduce exposure against certain airborne particles and aerosols free of oil. These types of respirators do not require FDA approval, but do require it from NIOSH. Like surgical N95 respirators, industrial N95s must form a tight seal over the wearer’s mouth and nose in order to be most effective. Workers of industrial settings must have their N95s regularly fit tested as well, in accordance with the OSHA Respiratory Protection Standard.

While surgical N95 respirators and industrial N95 respirators are similar in nature, their applications vary. During a crisis situation, such as COVID-19 the use of industrial N95 respirators have been approved for use in non-surgical healthcare settings.

Conclusion

Identifying the differences between N95s and surgical masks can be difficult, but once you understand the fundamental features of each, it becomes clear when each should be used.

In this article, we’ve only scratched the surface of the various types of filtering facepiece respirators. With various protection levels above 95 and masks that provide different levels of resistance to oil, respirator selection can get tricky.

This article originally appeared in the January/February 2021 issue of Occupational Health & Safety.