Respiratory Protection Equipment Requirements

Technical Characteristics

The American College of Occupational and Environmental Medicine recommends that a respiratory protection equipment should have a minimum filtration efficiency of 95% for particles with a diameter of 0.3 microns, and allow for quantitative or qualitative fit testing with a facial seal leakage of ≤10% 1, 2
The National Institute for Occupational Safety and Health (NIOSH) recommends the use of N95 respirators, which filter at least 95% of airborne particles, for workers who are at risk of exposure to airborne pathogens 1, 3
The use of P-100 respirators or powered air-purifying respirators (PAPRs) with HEPA filters, which provide a filtration efficiency of 99.97%, is recommended for high-risk procedures 4, 5
P-100 respirators allow for a maximum penetration of 0.03% compared to 5% for N95 respirators, making them more than 100 times more effective 4, 5

The Centers for Disease Control and Prevention (CDC) recommends that respirators should be certified by NIOSH and marked with the manufacturer's name, part number, level of protection (e.g. N95, P-100), and "NIOSH" 7
The use of respirators that are not certified by NIOSH is not recommended, as they may not provide adequate protection 7
International equivalents, such as FFP2/FFP3 (Europe), KN95/KN100 (China), and P2/P3 (Australia/New Zealand), are acceptable alternatives to NIOSH-certified respirators 7

The Occupational Safety and Health Administration (OSHA) recommends that the use of respirators should be administered as part of a comprehensive Respiratory Protection Program (RPP) that includes training, selection, fit testing, and maintenance 1, 3
The RPP should include components such as training on the correct use, limitations, and maintenance of respirators, as well as medical evaluation to determine if workers can safely use respirators 8, 9

Workers with pre-existing respiratory conditions should undergo medical evaluation before using respirators, and may require alternative respirators, such as PAPRs, that provide positive airflow 9
Users of glasses or contact lenses should use full-face respirators with special glasses kits designed for respirators, rather than conventional frames, to prevent breaking the facial seal 10

The use of respirators with exhalation valves can reduce the resistance to exhalation, making it easier to breathe, but should not be used by workers or patients who are infected with a respiratory pathogen 5, 6
Respirators approved by NIOSH with additional FDA clearance have been tested for bacterial filtration efficiency, flammability, and biocompatibility, and are recommended for use in medical settings 7

The use of respirators can pose physiological risks, including dehydration and heat stress, and workers should be allowed sufficient time to don and doff respirators, and to rest and rehydrate 1, 3, 9
The duration of work shifts should be limited, and workers should be allowed sufficient time to don and doff respirators, and to rest and rehydrate 1, 3

Respirators only trap airborne pathogens, but do not destroy or inactivate them, and there is currently no known safe level of exposure to biological aerosols 7
The use of respirators can provide a false sense of security, and workers should be aware of the limitations and risks associated with their use 7