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In this section: Articles | Clinical Evidence | Glossary of Terms
Articles
The Legacy of World Trade Center Dust
Jonathan M. Samet, M.D., Alison S. Geyh, Ph.D., and Mark J. Utell, M.D.
31 May 2007. The New England Journal of Medicine
In addition to the matter of the immediate and persistent respiratory effects on
“first responders,” occupants of the towers, cleanup workers, and neighborhood residents, concern has arisen about longer-term risks, including the risk of cancer.
9/11 Responders Twice as Likely to Have Asthma
Laura Walter, EHS Today.
4 November 2009
First responders who were exposed to caustic dust and toxic pollutants
following the 2001 World Trade Center (WTC) terrorist attacks suffer from
asthma at more than twice the rate of the general U.S. population, according to
Mount Sinai School of Medicine researchers.
Adverse skin reactions to personal protective equipment against severe acute respiratory syndrome – a descriptive study in Singapore
Chris C. I. Foo, Anthony T. J. Goon, Yung-Hian Leow, CHee-Leok Goh.
9 July 2006
The National Skin Centre, 1 Mandalay Road, Singapore, Republic of Singapore.
Correspondence to C. C. I. Foo, MRCP
Healthcare workers in affected countries were exposed to the regular use of personal protective equipment (PPE) such as the N95 mask, gloves, and gowns. Our aim was to study the prevalence of adverse skin reactions to PPE among healthcare workers in Singapore during the SARS outbreak. Healthcare staff in the National Skin Centre and Tan Tock Seng Hospital were surveyed using questionnaires.
Generation and Behavior of Airborne Particles (Aerosols)
Paul Baron.
29 March 2010
Division of Applied Technology,
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention
Particle size range; Inhalation & lung deposition; Particle behavior – Settling, impaction, electrostatic effects; Particle generation – Energy input, size, charge, humidity; Particle collection and measurement.
AFL-CIO Concerns About Total Inward Leakage
Bill Kojola. 17 December 2009
American Federation of Labor and Congress of Industrial Organizations
Comments on NIOSH's proposed rule regarding total inward leakage requirements for half-mask air-purifying particulate respirators.
Research Needs in Respiratory Protection, White Paper
American Industrial Hygiene Association, Respiratory Protection Committee.
11 September 2009.
Many current practices in respiratory protection are based on assumptions, past practices
or extrapolation from laboratory studies. Few studies have been done to evaluate the
efficacy of, or the need for, each of these practices. AIHA believes the results of research
on the practical, applied topics presented in this paper may significantly enhance the safe
and effective use of respiratory protection.
Disrupting the Transmission of Influenza A: Face Masks and Ultraviolet Light as Control Measures
Martin Meyer Weiss, MD, Peter D. Weiss, MD, Danielle E. Weiss, MD, and Joseph B. Weiss,
MD. 6 December 2006
Public Health Policy For influenza has focused on vaccination and antiviral agents
for prophylaxis and therapy. Both modalities concede viral penetration of the host. Interruption of transmission, before the virus has invaded the body, has received scant attention. We examine 2 potential modalities for the latter.
Determinants of Microbial Exposure in Grain Farming
A. S. Halstensen, K. C. Nordby, I. M. Wouters and W. Eduard.
27 September 2007
© The Author 2007. Published by Oxford University Press on behalf of the British Occupational Hygiene Society
Conclusions: Farmers were exposed to high levels of microorganisms and their components
during dusty grain work. Dust prevention and protection may reduce microbial exposure, and
may be particularly important in areas with frequent fungal forecasts, when fungal damage has been observed, during storage work or when handling barley.
Bill C-45 lives: Worker death sparks criminal negligence charges
Cheryl A. Edwards, Shane D. Todd and Jeremy Warning.
05 March 2010
In what should serve as a stark reminder for both employers and
individuals, police in Ontario recently charged a corporate employer and two individuals with criminal negligence causing death after a fatal workplace accident at a construction project.
What is Bill C-45?
Bill C-45 is federal legislation that amends the Canadian Criminal Code. Bill C-45 became
law on March 31, 2004 and is now the new Section 217.1 in the Criminal Code.
California Nurses Say CDC Swine Flu Prevention Guidelines Must Be Followed
Lori Abbott, Public News Service.
3 August 2009
A California nurse has become the first health care worker in the state to die from
swine flu.
Exposure to World Trade Center Attack Linked to New Cases
of Asthma, PTSD
Laura Walter.
20 August 2009
Large numbers of recovery and rescue workers, nearby residents and office workers
who experienced intense or prolonged exposure to the World Trade Center attack
have reported new diagnoses of asthma or post-traumatic stress 5-6 years after the
attack.
Farmers should use respiratory protection
Gary Tilghman,
Glasgow Daily Times.com.
© 1999-2006 cnhi, inc.
It is important for farmers to use respiratory protection to safeguard their lungs against dusts in the coming weeks and months as they harvest crops, clean out grain bins, open silos and strip tobacco.
Filtering Facepiece Respirator Use in Construction
Don Garvey, CIH, CSP.
Occupational Health & Safety.
1 March 2010
Construction workers are frequently exposed to hazardous airborne contaminants such
as silica and welding fume, which can cause lung damage, as well as other occupational
diseases.
Guidance for Cruise Ships during the 2009-10 Influenza Season
The Centers for Disease Control and Prevention.
29 January 2010
This document provides interim guidance for crew members and passengers of cruise
ships originating from or stopping in the United States during the 2009-10 influenza
season.
Headaches and the N95 face-mask amongst healthcare providers
E. C. H. Lim, R. C. S. Seet, K.-H. Lee, E. P. V. Wilder-Smith, B. Y. S. Chuah,
B. K. C. Ong
Correspondence to Erle Chuen-Hian Lim, Division of Neurology, Department of
Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore
Background: During the 2003 severe acute respiratory distress syndrome epidemic,
healthcare workers mandatorily wore the protective N95 face-mask.
New respirator aims for a truly universal fit
Hospital Employee Health.
March 2009
A newly approved respirator may be the closest thing yet to a "universal fit."
NIOSH to mandate better-fitting respirators, ease fit-test requirements
Hospital Employee Health.
August 2007
Newly proposed criteria will require manufacturers to prove that their N95 filtering facepiece respirators meet a minimal level of fit – right out of the box.
This doesn’t mean the end of fit-testing. But along with implementing
these criteria, the National Institute for Occupational Safety and Health
(NIOSH) is researching whether annual fit-testing could be replaced by
intervals of two or three years.
NIOSH: N95s must fit most faces
Hospital Employee Health.
January 2010
Manufacturers
will be required to make respirators that fit most people well under a rule proposed by the National Institute for Occupational Safety and Health.
IOM Recommends Respiratory Protection Guidelines for H1N1
International Association of Fire Fighters.
4 September 2009
“The IAFF is hopeful that this report will end the ridiculous debate once and for all that surgical masks provide respiratory protection," says IAFF General President Harold Schaitberger. Surgical masks were never intended to be respiratory protection, and should never be used for this purpose.”
Life as a nurse during SARS: Surviving and finding the strength to go on
The Canadian Press
Five years after the SARS coronavirus invaded Sorrenti's lungs, she can talk with her family and others about that stressful time without the anguish that used to accompany conversation about the dreaded disease.
Construction looking forward 2009-2017
Safe At Work Ontario,
Minister of Labour
In the construction sector, occupational illness and disease from workplace exposures
continue to be a significant hazard. According to WSIB statistics, there are more deaths
on average from occupational disease than injury. In 2007, the number of deaths from
occupational disease (40) exceeded the number of deaths from injuries (30). Based on
the available data for fatalities, mesothelioma and lung cancer are the top occupational
diseases, accounting for 82 per cent of all occupational disease fatalities for 1998-2007.
Officials Investigate Suspicious Office Building Fire
CityNews.ca,
CityNews.ca Staff.
3 February 2010
It was a scary end to the workday for some office workers in Mississauga who were trapped in a burning building on Wednesday evening.
Respirator Donning in Post-Hurricane New Orleans
Emerging Infectious Diseases, Vol. 13, No. 5.
May 2007
Kristin J. Cummings, Jean Cox-Ganser, Margaret A. Riggs, Nicole Edwards, Kathleen Kreiss
We evaluated correctness of N95 filtering facepiece respirator donning by the public in post-hurricane NewOrleans, where respirators were recommended for mold remediation. We randomly selected, interviewed, and observed 538 participants, using multiple logistic regression for analysis.
Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC
Endorsed by the Advisory Council for the Elimination of Tuberculosis, the National Commission on Correctional Health Care, and the American Correctional Association.
Tuberculosis (TB) control can be particularly problematic in correctional and detention
facilities, in which persons from diverse backgrounds and communities are housed in close
proximity for varying periods. This report provides a framework and general guidelines for
effective prevention and control of TB in jails, prisons, and other correctional and
detention facilities.
Protective masks often not worn properly: study
Scientific American.
4 April 2007
More than three-quarters of people given protective face masks put them on incorrectly, U.S. researchers said on Wednesday in a study showing confusion about using the breathing aids in
an emergency or pandemic.
Shortcomings of Banded Filtering Facepiece Respirators
NIOSH – National Institute of Occupational Safety and Health
National and international authoritative bodies such as the Center for Disease Control
(CDC), World Health Organization (WHO), International Labor Organization (ILO), the
International Federation of Firefighters and the AFL-CIO, have all recognized the
shortcomings of the current generation of banded half-piece filtering facepiece
particulate respirators (FFPR’s) in occupational and non-occupational settings.
Haiti Hospital’s Fight Against TB Falls to One Man
The New York Times.
5 February 2010
At a fly-infested clinic hastily erected alongside the rubble of the only tuberculosis
sanatorium in this country, Pierre-Louis Monfort is a lonely man in a crowded room.
Haiti has the highest tuberculosis rate in the Americas, and health experts say it is about to drastically increase.
Performance of an N95 Filtering Facepiece Particulate Respirator and a
Surgical Mask During Human Breathing: Two Pathways for Particle Penetration
Sergey A. Grinshpun, Hiroki Haruta, Robert M. Eninger, Tiina Reponen, Roy T. McKay, Shu-An Lee
Journal of Occupational and Environmental Hygiene.
22 September 2009
The protection level offered by filtering facepiece particulate respirators and face masks is defined by the percentage of ambient particles penetrating inside the protection device.
There are two penetration pathways: (1) through the faceseal leakage, and the (2) filtermedium. This study aimed at differentiating the contributions of these two pathways for particles in the size range of 0.03–1 — under actual breathing conditions.
Fall flu wave tested pediatric hospitals with tough choices
Lisa Schnirring Staff Writer. Center for Infectious Disease Research & Policy. 5 January 2010
In early August 2009, when the pandemic virus started tearing through southern states where schools had already started, the pandemic preparedness team at Children's Hospitals and Clinics of Minnesota felt a sense of foreboding that the virus was poised to strike the area a second time.
Clinical Evidence
Material Safety Data Sheet
Copyright Wein Products Inc. 2009.
13 November 2006
This MSDS is provided as a courtesy to customers upon request. This product is not regulated under, an MSDS is not required for this product, by the OSHA Hazard Communication Standard (29 CFR 1910.1200). When this product is used according to manufacturer’s instructions it should not represent a health or safety hazard. Inappropriate use, or use counter to manufacturer’s instructions may affect product performance causing potential health or safety hazards.
Product Clinical Data Summary
Acrylate Co-Polymer Medical Grade Adhesive
Copyright Wein Products Inc. 2009. 13 November 2006
The adhesive used on the Fitseal™ Disposable Adhesion Filtering Facepiece Particulate Respirator has been
subjected to the following safety evaluations.
Bacterial Filtration Efficiency and Differential Pressure – Final Report
Copyright Wein Products Inc. 2006. 31 July 2006
The Bacterial Filtration Efficiency (BFE) procedure is performed to determine the filtration efficiency of various materials and filtration devices using a challenge organism of Staphylococcus aureus. The Differential Pressure (Delta P) test is performed to determine the air exchange differential (breathability) of porous materials.
Flammability of Clothing Textiles – Final Report
Copyright Wein Products Inc. 2006. 31 July 2006
This test method measures the ease of ignition and the speed of flame spread of different materials.
Modified Greene and Vesley – Final Report
Copyright Wein Products Inc. 2006. 20 September 2006
This Modified Greene and Vesley (G&V) report describes an in vivo procedure for the evaluation of the efficacy of surgical face masks. The procedure involves enunciating the word "chew" 120 times in a two minute period while wearing the test mask. Microorganisms which escape capture by the masks are contained in the test chamber and are drawn by vacuum into a six-stage Andersen sampler. Filtration efficiencies are calculated by comparison to control values performed by the subject without a mask.
Performance of an N95 Filtering Facepiece Particulate Respirator and a
Surgical Mask During Human Breathing: Two Pathways for Particle Penetration
Sergey A. Grinshpun, Hiroki Haruta, Robert M. Eninger, Tiina Reponen, Roy T. McKay, Shu-An Lee
Journal of Occupational and Environmental Hygiene, 22 September 2009
The protection level offered by filtering facepiece particulate respirators and face masks is defined by the percentage of ambient particles penetrating inside the protection device.
–1 – under actual breathing conditions.
Synthetic Blood Penetration Resistance – Final Report
Copyright Nelson Laboratories Inc. 2006
25 July 2006
This report describes details for testing surgical face masks and other types of protective clothing materials designed to protect against fluid penetration. The purposes of this procedure are to simulate an arterial spray and then evaluate the effectiveness of the material in protecting the healthcare worker from possible exposure to blood and other body fluids.
Viral Filtration Efficiency – Final Report
Copyright Nelson Laboratories Inc. 2006. 7 August 2006
Glossary of Terms
Adhesion Technology — a novel one-size-fits-all respirator design that uses a medical-grade, hypoallergenic, latex-free adhesive (instead of straps/bands) that is applied to the respirator’s inner circumference, which when applied to the face, forms an effective adhesion seal to minimize face-seal leakage.
Air-Purifying Respirator (APR) — a respirator with an air-purifying filter, cartridge or canister whereby inhaled air passes through a filter which traps potentially harmful particulate contaminants such as metallic or silica dust, viruses, bacteria, and allergens.
Ambient Concentration — the concentration of a specific contaminant in a person’s breathing zone.
Assigned Protection Factor (APF) — the minimum protection provided to trained users by a fitted, undamaged, and properly functioning respirator. The APF is the level of protection that a particular type of respirator is expected to provide 95% of the time.
An APF of 10 means that a new respirator (if donned properly) can be used safely in an atmosphere that has a concentration of up to 10 times the Permissible Exposure Limit (PEL) for that particular hazard (contaminant).
APF’s and PEL’s are determined by various national standards associations such as NIOSH and ANSI. However, there are no established standard PEL’s for biological hazards (viruses, bacterial, molds, allergens).
Typically, half-face negative pressure air-purifying respirators (APR’s) have an APF =10, and full-face negative pressure APR’s have APF=50.
The customary practice is to use ten times the Fit Factor Pass Level (FFPF) for quantitative fit-testing. Therefore, FFPL’s of 100 and 500 respectively are commonly used for half-face and full-face negative pressure air-purifying respirators. FitSeal™ respirators far exceed both these levels.
Communication (speech recognition) — in certain occupations such as healthcare workers, police, and emergency responders, intelligible speech with minimal distortion is critical for proper interpersonal communications. The respirator should ideally not muffle the wearer’s speech.
Demand Respirator — a respirator in which inhalation creates a negative pressure inside the facepiece which cause the ambient air to pass through the filter. The act of breathing creates the “demand” for air to enter.
Disposable Respirators — a respirator that is designed to be used only once, and to be discarded after the end of its recommended functional lifespan, or if/when damaged before or during use.
Escape Respirators — respirators that are to be used only for the purpose of egress/escape from a hazardous situation. They are not meant to be used on a continuous, prolonged, nor repetitive basis.
Exhalation Valve — most filtering respirators of higher filtration efficiencies, N99 and N100, create significantly increased resistance to exhalation. This would require much increased effort of breathing, and therefore an exhalation valve is incorporated into the filter media in order to minimize this. The Fitseal™ respirators, even at N100 rating, do NOT require such a valve, as the pressure gradient across the filter medium is only a minimal 8-10 mm (vs. standard of 35mm).
Face-seal - is the tightness of fit or seal, between the respirator and the wearer’s facial skin. The maximal integrity of the face se™al is paramount if Total Inward Leakage(TIL) is to be minimum. Current conventional technology utilizes both a pliable (metalic or plastic) nose clip and headstraps/bands to create tension in order to have the edges of the facepiece conform to the contours of the wearer’s face. Fitseal™ respirators utilize adhesion technology to create a nearly hermetic (airtight) seal between respirator and face.
Filter Medium — the component used to remove vapor, mist, and particulates from inhaled air.
Filtering Facepiece Particulate Respirator (FFPR) — a half-piece respirator with the filter medium constituting the entire surface of the respirator.
Fit Factor (FF) — a quantitative measure of a specific facepiece’s “fit” to the wearer’s face. The better the seal the better the fit factor, the better the protection provided. Performing a fit-test, the measurement is made by an instrument during simulation of workplace activities (specified exercises). It is expressed as the ration of the challenge aerosol concentration outside the respirator divided by the concentration that
Fit-Test —the protocol used to qualitatively (QLFT) or quantitatively (QNFT) evaluate the fit of a specific respirator on an individual wearer’s face.
HEPA Filter — a High Efficiency Particulate Air filter that is at least 99.97% efficient in preventing penetration of particles of 0.3 microns in size(median aerodynamic diameter) as stipulated in 42 Code of Federal Regulation Part 84. The corresponding NIOSH designations are: N,R, or P100.
Immediate Danger to Life or Health (IDLH) — ambient conditions that pose an immediate threat, be it because of very high concentrations of toxic chemicals, or highly virulent/pathogenic bio-aerosols, or lack of oxygen.
Latex — because of historically intensive and ubiquitous usage of this otherwise useful product, many people became highly sensitized; to the point of developing severe allergic reactions and even anaphylaxis upon contact/exposure to it. Many products, such as gloves, masks, sealants, rubber, etc., that utilized this material, no longer do. Faceseal™respirators do not contain any latex.
Mist — very fine liquid particles suspended in the ambient air.
Negative Pressure Respirator —a “demand” respirator in which the pressure inside the facepiece is negative during inhalation with respect to the ambient atmospheric pressure on the outside.
Oxygen Defficient Atmosphere — an atmosphere which contains less than 19.5% volumetric oxygen <148mm Hg @STP.
Licensed Healthcare Professional — LHCP is an OSHA definition in 29CFR1910.134 for a physician or another practitioner whose legally permitted scope of practice allows him/her to provide the healthcare assessment/medical evaluation proscribed re fitness for respirator use.
Qualitative Fit Test (QLFT) — a pass/fail fit-test to assess the adequacy of respirator “fit” that relies on ’s response to the (taste)test agent being used.
Quantitative Fit Test (QNFT) — an assessment of the adequacy of respirator fit by the numeric measure (using an instrument called a Portacount) of the amount of total leakage into the respirator.
Respirator — any device designed to protect the wearer from inhaling harmful substances.
Respiratory Program Officer (RPO) — is the person within an organization who is responsible for all aspects of the respirator program, with the necessary authority to make decisions to ensure its success.
Inward Leakage — the total of all three possible routes of particle inhalation:
1) through the filter media
2) through gaps between the respirator and the wearer’s facial skin (the face seal)
3) through the exhalation valve if there is one.
Inward Leakage is measured as the ratio of the external concentrations of defined airborne particles (outside the respirator) to the concentrations of defined airborne particles within the breathing zone (inside the respirator).
User Seal Check — a breathing in-and-out action conducted by the respirator user to determine if the respirator is properly sealed to the face without any leakage between the respirator and the wearer’s facial skin.
Vapor — a gas or many gases in combination with water vapor and/or suspended particulate matter.
