P2/N95 filtering facepiece respirators: Results of a large-scale quantitative mask fit testing program in Australian health care workers

Maxim Milosevic; Raaj Kishore Biswas; Lesley Innes; Martin Ng; Ali Mehmet Darendeliler; Alice Wong; Elizabeth Denney-Wilson

doi:10.1016/j.ajic.2021.12.016

P2/N95 filtering facepiece respirators: Results of a large-scale quantitative mask fit testing program in Australian health care workers

Am J Infect Control. 2022 May;50(5):509-515. doi: 10.1016/j.ajic.2021.12.016. Epub 2021 Dec 29.

Authors

Maxim Milosevic¹, Raaj Kishore Biswas², Lesley Innes³, Martin Ng⁴, Ali Mehmet Darendeliler⁵, Alice Wong⁵, Elizabeth Denney-Wilson⁶

Affiliations

¹ Community Oral Health Clinic, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, New South Wales, Australia; Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, New South Wales, Australia. Electronic address: maxim.milosevic@health.nsw.gov.au.
² Sydney Local Health District Clinical Research Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Transport and Road Safety (TARS) Research Centre, School of Aviation, University of New South Wales, Sydney, New South Wales, Australia.
³ Centre for Education and Workforce Development, Sydney Local Health District, Rozelle, New South Wales, Australia.
⁴ Cardiovascular Medicine and Bioengineering, National Health and Medical Research Council Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
⁵ Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, New South Wales, Australia.
⁶ Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

Abstract

Background: In response to the COVID-19 pandemic, 6,287 Australian health care workers (HCWs) were fit tested to N95 filtering facepiece respirators (FFRs). This study determined how readily HCWs were fitted to 8 FFRs and how age and sex influenced testing.

Methods: HCWs were fit tested following the quantitative OSHA protocol. After bivariate analysis, a logistic regression model assessed the effect of FFR model, HCW age and sex on fit test results.

Results: Of 4,198 female and 2,089 male HCWs tested, 93.3% were successfully fitted. Fifty-five percent passed the first FFR, 21% required 2 and 23% required testing on 3 or more models. Males were 15% less likely to pass compared to females (P < .001). Individuals aged 18-29 were significantly more likely to pass compared to colleagues aged 30-59. Cup-style 3M 1860S was the most suitable model (95% CI: 1.94, 2.54) while the duckbill BSN TN01-11 was most likely to fail (95% CI: 0.11, 0.15).

Conclusions: Current N95 FFRs exhibit suboptimal fit such that a large proportion (45%) of HCWs require testing on multiple models. Older age and male sex were associated with significantly higher fit failure rates. QNFT programs should consider HCW characteristics like sex, age, racial and facial anthropometric measurements to improve the protection of the health workforce.

Keywords: COVID-19; SARS-CoV-2; airborne; infection control; respiratory protection.

MeSH terms

Australia
COVID-19* / prevention & control
Equipment Design
Female
Health Personnel
Humans
Male
N95 Respirators
Occupational Exposure* / prevention & control
Pandemics / prevention & control
Respiratory Protective Devices*