Bituminous Insurance Companies

N95 Respirators Recommended for Influenza

Release Date: September 4, 2009

The National Academy of Sciences was created by the federal government to be an adviser on scientific and technological matters. The Institute of Medicine (IOM), as part of the Academy, does not receive direct federal appropriations for their work. At the request of the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA), the IOM was asked to provide recommendations regarding the necessary respiratory protection for healthcare workers in their workplace against novel H1N1 (nH1N1) influenza A.

The IOM recommended N95 respirators over medical masks because research results on the filtration and fit of medical masks showed wide variation in penetration of aerosol particles and inadequate fit suggesting that the use of medical masks is unlikely to be effective against airborne transmission. Additionally, studies on influenza transmission show that airborne (inhalation) transmission is one of the potential routes of transmission. However, the N95 respirators are documented to filter out 95 to 99 percent of relevant particles and have maximum effectiveness when properly fitted to the face of users. Based on their study, the IOM recommended:

IOM Recommendation to Use Fit-Tested N95 Respirators

Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators or respirators that are demonstrably more effective as one measure in the continuum of safety and infection control efforts to reduce the risk of infection.

The committee endorses the current CDC guidelines and recommends that these guidelines should be continued until or unless further evidence can be provided to the effect that other forms of protection or other guidelines are equally or more effective.

Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance with OSHA regulations, and healthcare workers should use the equipment as required by regulations and employer policies.

The committee did not intend that all healthcare workers use N95 respirators; instead, the use of respirators should be for those in initial contact with individuals presenting with unidentified febrile respiratory illnesses and those healthcare workers in close contact with individuals with confirmed or suspected nH1N1.The committee based its recommendations on the available current state of scientific and empirical evidence about nH1N1 virus, as well as its expert judgment. Economic and logistical considerations regarding PPE equipment were not addressed in this letter report.

In determining the appropriate respiratory protection for the U.S. healthcare workforce, attention was given to the current PPE guidance documents offered by the CDC and by the World Health Organization for novel H1N1 influenza and for seasonal influenza. The committee, after eight weeks of work, generated the above recommendation addressing the use of N95 respirators.

For background on this issue, see the IOM letter at http://www.iom.edu/.

The information contained in this publication was obtained from sources believed to be reliable. ISO Services Properties, Inc., its companies and employees make no guarantee of results and assume no liability in connection with either the information herein contained or the safety suggestions herein made. Moreover, it cannot be assumed that every acceptable safety procedure is contained herein or that abnormal or unusual circumstances may not warrant or require further or additional procedure.