On-again, off-again N95 guidelines for H1N1

By: August 4th, 2009 Email This Post Print This Post

Here’s the latest news on whether workers need to use respirators or not for protection from novel influenza A H1N1.

The CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) has adopted the recommendations of the Influenza A (H1N1) Working Group with regards to “Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare Setting,” according to a July 23 report by the Association for Professionals in Infection Control and Epidemiology (APIC).

In general, the recommendations call for the protection of healthcare workers through standard and droplet precautions rather than airborne precautions with a respirator such as an N95. Specific items, according to APIC, include:

  • Healthcare personnel to wear a surgical mask when caring for patients with suspected or confirmed cases.
  • Reserving N95 respirators for use during select procedures that are potentially aerosol-generating (e.g. bronchoscopy, intubation, CPR, open airway suctioning, and sputum induction).
  • Healthcare personnel to adhere to standard and droplet precautions for 7 days after the onset of illness or until symptoms resolve, whichever is longer.

But hold on before you ditch your N95s and fit-testing plans.

The recommendation caused those members of the Working Group representing organized labor to quit in protest, claiming that the review was less than systematic, overlooking data favorable to respirator use, according to Inside OSHA, Aug. 3.

The CDC, which is not required to automatically accept HICPAC recommendations, has yet to change the interim guidelines. It still wants to hear from an expert panel on personal protective equipment for healthcare personnel in the workplace by the Institute of Medicine, August 11-14, 2009, says APIC.

Look for the to-don-or-not-to-don respirator wrangling to be settled by October 1, 2009, according to APIC.

Additionally, a study published this week in the Annals of Internal Medicine approaches the topic at the community level. The study found that when sick people wear surgical masks and wash their hands within the first 36 hours of symptoms, healthy family members are less likely to get seasonal flu. Researchers believe this is applicable to H1N1.

If anything, this supports the importance of providing surgical masks to patients if they have the H1N1 virus, in order to protect healthy patients and healthcare workers. (Click here to read more about the study on CNN.)

While we’re on the subject of protection, as a healthcare worker will you protect yourself by getting the H1N1 vaccine when it comes out? Let us know in this week’s polling question.


By christina Weinberg on August 5th, 2009 at 4:44 pm

Viral nucleii are aerosolized as droplets evaporate in less than a second ,spraying live virus into the air from surgical masks which were never designed to protect the wearer from those nearby. The respirator masks in the national stockpile have NEVER passed the latest total inward leakage protocols from NIOSH and basically can’t as they all leak at the faceseal. The nurses are basically sitting ducks no matter which way they go as health care workers found out during SARS in TORONTO. More than 25% of the fatalities were HCWs.We make THE ONLY respiratory protection barrier masks capable of protecting HCWs from H1N1 . See comparison demo at http://www.weinproducts.com

By Baerbel Merrill on August 7th, 2009 at 10:00 am

My concern is that H1N1 viral shedding will not be stopped by a surgical mask, this type of mask was not designed to stop viruses. What are healthcare institutions liability toward the staff when there are work related exposures, and possible fatalities? especially when data is not conclusive regarding the proper mask.

By christina Weinberg on August 7th, 2009 at 8:41 pm

August 12/09 please access IOM under the auspices of the National Academy of Sciences where we will introduce our novel Niosh Certified FDA cleared adhesion Respirators. As we all look into, possibly ,the abyss of a second wave of H1N1 in conjunction with seasonal Influenza, The US is just about the only country that does not officially endorse the wearing of respirator masks by the general public. Probably because the chances of getting a good fit per OSHA protocols is not very likely.

Wein has succeeded in achieving a one size fits all certification with adhesion technology and could result in much faster fit testing.

Christina Weinberg

By David LaHoda on August 10th, 2009 at 1:49 pm

One size fits all concept is interesting, but I don’t OSHA is the problem with acceptance in the general public category.

By Robin Akin, RN, CIC on September 14th, 2009 at 7:58 pm

For years we wore surgical masks for TB patient care – and TB mycobacteria is a lot smaller than most viruses. I was privileged to hear the delivery of a paper regarding a study done at the University of Virginia comparing TB skin test conversion rates of nurses wearing surgical masks for TB care versus those wearing N95 respirators and there was no appreciable difference! Considering the fact that I can’t breath when wearing an N95 and have severely restricted peripheral vision and hearing when wearing a PAPR, I have to ask myself if “compliance” is the issue: I’d be much more inclined to put on a surgical mask than either an N95 or PAPR!


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