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      Fit Testing Retrofitted Full-Face Snorkel Masks as a Form of Novel Personal Protective Equipment During the COVID-19 Pandemic

      brief-report

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          Abstract

          Objective:

          Bottlenecks in the personal protective equipment (PPE) supply chain have contributed to shortages of PPE during the coronavirus disease 2019 (COVID-19) pandemic, resulting in fractures in the functionality of health-care systems. This study was conducted with the aim of determining the effectiveness of retrofitted commercial snorkel masks as an alternative respirator for health-care workers during infectious disease outbreaks.

          Methods:

          A retrospective analysis was performed, analyzing qualitative and quantitative fit test results of the retrofitted Aria Ocean Reef® full-face snorkeling mask on health-care workers at the McGill University Health Centre between April and June 2020. Historical fit test results, using medical-grade respirators, for health-care workers, were also analyzed.

          Results:

          During the study period, 71 participants volunteered for fit testing, 60.6% of which were nurses. The overall fit test passing rate using the snorkel mask was 83.1%. Of the participants who did not previously pass fit testing with medical-grade respirators, 80% achieved a passing fit test with the snorkel respirator.

          Conclusions:

          The results suggest that this novel respirator may be an effective and feasible alternative solution to address PPE shortages, while still providing health-care workers with ample protection. Additional robust testing will be required to ensure that respirator fit is maintained, after numerous rounds of disinfection.

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          Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers

          Mohamed Abbas, Tomás Robalo Nunes, Romain Martischang … (2021)
          Objectives To compile current published reports on nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), evaluate the role of healthcare workers (HCWs) in transmission, and evaluate outbreak management practices. Methods Narrative literature review. Short conclusion The coronavirus disease 2019 (COVID-19) pandemic has placed a large burden on hospitals and healthcare providers worldwide, which increases the risk of nosocomial transmission and outbreaks to “non-COVID” patients or residents, who represent the highest-risk population in terms of mortality, as well as HCWs. To date, there are several reports on nosocomial outbreaks of SARS-CoV-2, and although the attack rate is variable, it can be as high as 60%, with high mortality. There is currently little evidence on transmission dynamics, particularly using genomic sequencing, and the role of HCWs in initiating or amplifying nosocomial outbreaks is not elucidated. There has been a paradigm shift in management practices of viral respiratory outbreaks, that includes widespread testing of patients (or residents) and HCWs, including asymptomatic individuals. These expanded testing criteria appear to be crucial in identifying and controlling outbreaks.
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            Risk Assessment of Healthcare Workers at the Frontline against COVID-19

            Saqib Ali, Sara Noreen, Imran Farooq … (2020)
            The novel coronavirus disease 2019 (COVID-19) is a global pandemic. Healthcare workers (HCWs) are on the frontline of treating patients infected with COVID-19. However, data related to its infection rate among HCWs are limited. The aim was to present evidence associated with the number of HCWs being infected with COVID-19 from most viral affected countries (Italy, China, United States, Spain, and France). Furthermore, we looked into the reasons for HCWs COVID 19 infections and strategies to overcome this problem. Early available evidence suggested that HCWs are being increasingly infected with the novel infection ranging from 15% to 18% and in some cases up to 20% of the infected population. Major factors for infection among HCWs include lack of understanding of the disease, inadequate use and availability of Personal Protective Equipment (PPE), uncertain diagnostic criteria, unavailability of diagnostic tests and psychological stress. Therefore the protection of HCWs by authorities should be prioritized through education and training, the readiness of staff, incentives, availability of PPEs, and psychological support.
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              Comparison of qualitative and quantitative fit-testing results for three commonly used respirators in the healthcare sector.

              Chun-Yip Hon, Quinn Danyluk, Elizabeth Bryce … (2017)
              N95 filtering facepiece respirators are used by healthcare workers when there is a risk of exposure to airborne hazards during aerosol-generating procedures. Respirator fit-testing is required prior to use to ensure that the selected respirator provides an adequate face seal. Two common fit-test methods can be employed: qualitative fit-test (QLFT) or quantitative fit-test (QNFT). Respiratory protection standards deem both fit-tests to be acceptable. However, previous studies have indicated that fit-test results may differ between QLFT and QNFT and that the outcomes may also be influenced by the type of respirator model. The aim of this study was to determine if there is a difference in fit-test outcomes with our suite of respirators, 3M - 1860S, 1860, AND 1870, and whether the model impacts the fit-test results. Subjects were recruited from residential care facilities. Each participant was assigned a respirator and underwent sequential QLFT and QNFT fit-tests and the results (either pass or fail) were recorded. To ascertain the degree of agreement between the two fit-tests, a Kappa (Κ) statistic was conducted as per the American National Standards Institute (ANSI) respiratory protection standard. The pass-fail rates were stratified by respirator model and a Kappa statistic was calculated for each to determine effect of model on fit-test outcomes. We had 619 participants and the aggregate Κ statistic for all respirators was 0.63 which is below the suggested ANSI threshold of 0.70. There was no statistically significant difference in results when stratified by respirator model. QNFT and QLFT produced different fit-test outcomes for the three respirator models examined. The disagreement in outcomes between the two fit-test methods with our suite of N95 filtering facepiece respirators was approximately 12%. Our findings may benefit other healthcare organizations that use these three respirators.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Disaster Med Public Health Prep
                Journal ID (iso-abbrev): Disaster Med Public Health Prep
                Journal ID (publisher-id): DMP
                Title: Disaster Medicine and Public Health Preparedness
                Publisher: Cambridge University Press (New York, USA )
                ISSN (Print): 1935-7893
                ISSN (Electronic): 1938-744X
                Publication date (Electronic, pub): 19 April 2021
                Pages: 1-5
                Affiliations
                [ 1 ]Research Institute of the McGill University Health Center , Montréal, Canada
                [ 2 ]Department of Occupational Health and Safety, McGill University Health Center , Montréal, Canada
                [ 3 ]Department of Trauma Surgery, Montreal General Hospital , McGill University Health Center, Montréal, Canada
                [ 4 ]Divisions of Infectious Diseases and Medical Microbiology, McGill University Health Centre , Montréal, Canada
                [ 5 ]Department of Mining and Materials Engineering, McGill University , Montréal, Canada
                [ 6 ]Department of Emergency Medicine, McGill University Health Cente r, Montréal, Canada
                [ 7 ]Department of Infrastructure and Biomedical Engineering, McGill University Health Center , Montréal, Canada
                [ 8 ]Department of General Support, Administration, and Performance, McGill University Health Center , Montréal, Canada
                Author notes
                Corresponding author: Dan L. Deckelbaum, Email: dan.deckelbaum@ 123456mcgill.ca .
                Author information
                https://orcid.org/0000-0003-1616-255X
                Article
                Publisher Item ID: S1935789321001336
                DOI: 10.1017/dmp.2021.133
                PMC ID: 8209433
                PubMed ID: 33926606
                SO-VID: 7870f7e3-bb23-4596-bab5-efea23ff29b8
                Copyright © © Society for Disaster Medicine and Public Health, Inc. 2021
                License:

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 29 October 2020
                Date revision received : 26 April 2021
                Date accepted : 26 April 2021
                Page count
                Figures: 1, Tables: 1, References: 16, Pages: 5
                Categories
                Subject: Brief Report

                Keywords: personal protective equipment,fit test,covid-19,snorkel mask,respirator
                Data availability:
                Keywords: personal protective equipment, fit test, covid-19, snorkel mask, respirator

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