Alternate Respirator Options During the N95 Mask Shortage

In spite of efforts to prioritize respirator use, there’s an acute global shortage of N95 masks. Limited N95 mask availability prompts health and safety managers to adapt their strategies and consider alternative respirator solutions. Here is what you need to know about the advantages and disadvantages of Plan B.

The importance of a NIOSH certification

Handmade, do-it-yourself masks are an accessible respiratory option. However, it must be kept in mind that these handmade respiratory masks may not meet government-mandated or internationally prescribed regulations. This means the material may not be capable of ensuring a proper fit, seal or filter airborne pathogens.

N95 masks should follow tight safety requirements to ensure they adequately protect healthcare professionals and workers facing dangerous particulate hazards.

N95 masks are typically certified by the  US National Institute for Occupational Safety and Health (NIOSH). NIOSH tests and certifies respirators based on their physical and performance characteristics, including filtration efficiency. N95-rated filtering facepiece respirators block at least 95 percent of non-oily particles, based on NIOSH criteria.

Bear in mind, even NIOSH-certified respirators can be rendered inefficient, if the original fit, form or function are modified.

 “The use of either counterfeit or altered respirators can jeopardize worker health and safety because there is no way of knowing whether these products or parts meet the stringent testing and quality assurance requirements of NIOSH and will provide workers with the expected level of protection”, OSHA warns.

“Never alter a respirator. Doing so can reduce its protective quality and expose the user to the airborne hazard."

In healthcare settings, surgical N95 masks are cleared by the Food and Drug Administration or equivalent agencies, based on manufacturer data. Fluid resistance, the ability to resist penetration by high-pressure streams of liquid, is a key performance requirement.

Therefore, unverified masks should be used with caution. The CDC recommends using homemade face masks in occupational settings, as a last resort.

“In settings where N95 respirators are so limited that routinely practiced standards of care for wearing N95 respirators and equivalent or higher level of protection respirators are no longer possible, and surgical masks are not available, as a last resort, it may be necessary for HCP to use masks that have never been evaluated or approved by NIOSH or homemade masks.”

Re-using N95 masks - good or bad?

When respirators are used beyond their designated shelf-life, they may not perform as expected.

“N95 masks aren’t designed to be re-worn”, Benjamin Wyatt, Honeywell Respiratory Specialist says. “They should be discarded when they are saturated and/or breathing is restricted.”

OSHA recommends workers to visually inspect the N95 respirator to determine if the structural and functional integrity of the respirator has been compromised.

“Over time, components such as the straps, nose bridge, and nose foam material may degrade, which can affect the quality of the fit and seal”, the agency says. “If the structural and functional integrity of any part of the respirator is compromised, or if a successful user seal check cannot be performed, discard the respirator and try another respirator.”

However, limited reuse is acceptable under certain circumstances, according to the CDC. “Even when N95 respirator reuse is practiced or recommended, restrictions are in place which limit the number of times the same FFR is reused. “

The decision to extend use or allow mask re-use is made by the safety professionals managing the institution’s respiratory protection program, together with the occupational health and infection control departments, and input from the state/local public health departments, the Center for Disease Control and Prevention concludes.

What are the alternatives?

Amid the global shortage of medical masks, here are three non-surgical PPE alternatives to consider.

The Half-Mask Respirator

This is a tight-fitting, air-purifying respirator covering the nose and mouth.

“For workers in brief contact with hazards, a half-mask, with N95 or higher filters, would be the next best economical option in this situation”, Wyatt says. “It’s easy to clean, durable and can sustain exposure longer than an N95 mask”.

Half-masks need to be fit tested, unless worn in voluntary conditions. They do not protect against non-particulate hazards such as gases or vapors.

The Full-Face Respirator

The full-facepiece provides better sealing and covers the user’s eyes and face, offering additional protection against liquid splashes and vapors.

“We must also consider eye protection”, Wyatt says. “A half-mask should be paired with a full-seal goggle.  If finding goggles is also a challenge, the full-face respirator is great to protect the eyes, in addition to the nose and mouth. Both the half-mask or full-face respirator options are a durable solution, as they can be sanitized and reused for years.”

The Powered Air Purifying Respirator

PAPR units provide full head protection, low breathing resistance and a high level of protection.

There is no fit-testing required when choosing loose-fitting hoods. PAPRs can be re-used, decontaminated and are comfortable to be worn for extended periods of time.

“The PAPR is a great solution for workers exposed to hazards for extended periods of time, and who must remain mobile”, Wyatt adds.

Both masks and PAPRs can be sanitized and stored for future crisis management.

The Honeywell North Primair 700 (PA700) Powered Air Purifying Respirator (PAPR) is engineered to be ergonomic, efficient and effortless to get workers on the job faster and keep them comfortable and productive.