Improvement in Fitted Filtration Efficiency of N95 Respirators With Escalating Instruction of the Wearer
Hao Chen, PhD,
Edward R. Pennington, PhD,
Martin W. Case, BS,
Haiyan Tong, MD, PhD,
Ana G. Rappold, PhD,
James M. Samet, PhD, MPH,
Steven E. Prince, PhD
Affiliations
Hao Chen, PhD
Oak Ridge Institute for Science Education, Oak Ridge, Tennessee
Edward R. Pennington, PhD
Oak Ridge Institute for Science Education, Oak Ridge, Tennessee
Martin W. Case, BS
Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina
Haiyan Tong, MD, PhD
Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina
Ana G. Rappold, PhD
Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina
James M. Samet, PhD, MPH
Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina
Steven E. Prince, PhD
Public Health and Environmental Systems Division, Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina; Address correspondence to: Steven E. Prince, PhD, Public Health & Environmental Systems Division, Center for Public Health and Environmental Assessment, Office of Research & Development, U.S. Environmental Protection Agency, 109 TW Alexander Drive, Research Triangle Park NC 27711.
Introduction: Fitted filtration performance of an N95 respirator may benefit from differing levels of instructions. Methods: Using a modified Occupational Safety and Health Administration fit test protocol, we measured fitted filtration efficiency for an N95 respirator in 21 screened, healthy participants given 4 levels of escalating instruction: (1) uninstructed (baseline), (2) written/pictorial manufacturer instructions, (3) step-by-step video demonstration, and (4) staff instruction (visual inspection of respirator fit and verbal suggestions to adjust when applicable). Results: Baseline fitted filtration efficiency was not significantly different between participants with or without previous experience of N95 use. Clear improvements in fitted filtration efficiency were observed progressing from baseline (average=86.1%) to manufacturer paper instructions (93.3%), video instructions (97.5%), and post staff intervention (98.3%). Baseline fitted filtration efficiency values were significantly lower than those after video instruction (p<0.037) and staff intervention (p<0.033) sessions. Conclusions: Beyond uninstructed wear or provision of manufacturer instructions, efforts to train and instruct users in proper respirator fit principles with visual feedback are likely to yield benefits to public health outcomes in reducing respiratory exposure during air quality emergencies such as airborne viral outbreaks and wildland fires.
