IOM gathers diverse scientific data on PPE protection for pandemic flu
Last week I was multi-tasking Wednesday and Thursday as I was trying to take in the audio presentation from the Institute of Medicine (IOM) Workshop on Personal Protective Equipment for Healthcare Workers in the Workplace Against Novel H1N1 Influenza A.
The workshop is part of the evidence that the IOM is gathering to issue a report at the request of the CDC and OSHA.
For a detailed review of the workshop and presenters, see the reports by the Center for Infectious Disease Research and Policy (CIDRAP) articles for August 12 and 13.
I can’t say that I listened to every minute of the two-day workshop, but there were some things that caught my attention.
Surgical masks and respirators in hospitals. A study by the University of New South Wales and scheduled for publication next month found that N95 respirators provided superior protection over surgical masks in preventing influenza-like illnesses among 1,936 doctors and nurses in 24 Bejing hospitals. Researchers originally wanted to do the study in Australia but couldn’t get high enough compliance with the test subjects, so China was chosen, where respiratory protections is highly valued and followed.
Hmmm… what do the Chinese know that we don’t.
Advocacy by organized labor. Representatives from the Service Employees International Union and Hospital Workers (SEIU) and the American Federation of State, County, and Municipal Employees gave impassioned presentations, in comparison to the hard science types. The SEIU presentation reiterated that H1N1 is different from seasonal flu, and failure to take adequate precautions will show this pandemic to one affecting predominantly children and workers. Also the OSHA act requires that employers must take feasible steps to reduce exposure, and with NIOSH-certified N95s costing about a $1 each, that meets the definition of feasibility.
Pregnant healthcare workers. During a Q&A session a researcher from Singapore National University Hospital noted that during the SARS outbreak pregnant healthcare workers were advised not to wear N95s because of possible fetal hypoxia. This could pose a double dilemma with pregnant healthcare workers as current CDC guidelines indicate that pregnancy increases the risk for complications from novel H1N1 flu. The attendee agreed that this issue needed further study.
But will they wear them. A presentation by the Veterans Health Administration said the key issue was not so much surgical masks vs. respirators but whether workers will consistently wear the protection provide to them. The VA found the frequency of complaints to be equal between surgical masks and respirator wearers. Respirator complaints, however, were more intense.
Be kind to your ferret. Finally I can’t let this tidbit of information go unnoticed. In comparison to mice and guinea pigs, ferrets are the gold standard for experimenting with influenza virus transmission in the laboratory.
The IOM will issue its report by September 1, 2009. Recommendations will based on scientific and empirical evidence and expert judgment. The role that economic and logistical considerations play in PPE protection from H1N1 will not be addressed in the report.
Click here to hear the audio of the workshop and view the presentation material.
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David LaHoda
David LaHoda, the managing editor of Medical Environment Update and OSHA Watch, has produced healthcare training videos and consulted for medical practices and ambulatory healthcare facilities.
David has written 196 posts.
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