Respiratory Protection Equipment Classification

Classification by Protection Level

The American College of Emergency Physicians recommends that respiratory protection equipment be classified into four levels (A, B, C, and D) based on the degree of protection offered, with Level A being the most protective and Level D being the least protective 1
Level A equipment, as recommended by the American College of Emergency Physicians, provides the highest level of protection available for both contact and inhalation hazards, and includes a fully encapsulated suit with a self-contained breathing apparatus (SCBA) 1
Level B equipment, as recommended by the American College of Emergency Physicians, provides a high level of protection suitable for entry into unknown environments, and includes an encapsulating or sealed-seam suit with a supplied-air respirator or SCBA 1
Level C equipment, as recommended by the American College of Emergency Physicians, provides a moderate level of protection, and includes a splash-resistant suit with an air-purifying respirator 1
Level D equipment, as recommended by the American College of Emergency Physicians, provides a low level of protection, and includes work clothing, including standard precautions for healthcare workers (gloves, splash protection) 1

The National Institute for Occupational Safety and Health (NIOSH) classifies respirators into three categories based on their resistance to oil: N (not resistant to oil), R (resistant to oil), and P (oil-proof) 2
NIOSH also classifies respirators into three categories based on their filtration efficiency: 95 (filters at least 95% of particles), 99 (filters at least 99% of particles), and 100 (filters at least 99.97% of particles) 2
P-100 respirators are more than 100 times more effective than N-95 respirators, allowing only 0.03% penetration compared to 5% for N-95 2

The Centers for Disease Control and Prevention (CDC) recommends the use of air-purifying respirators, including filtering facepiece respirators (FFR), half-face or full-face air-purifying respirators (APR), and powered air-purifying respirators (PAPR) 2, 3
The CDC also recommends the use of supplied-air respirators, including positive-pressure air-line respirators and self-contained breathing apparatus (SCBA) 3

The Spaulding system classifies medical equipment into three categories: critical, semi-critical, and non-critical, based on the risk of infection transmission 4, 5
Respiratory equipment used on patients is classified as semi-critical because it comes into contact with mucous membranes but does not penetrate body surfaces 4, 5

The Occupational Safety and Health Administration (OSHA) requires that all respiratory protection programs include medical evaluation of workers, training on the nature, extent, and specific risks, explanation of engineering controls and work practices, instruction on inspection, placement, fit testing, and correct use, fit testing to identify a respirator that fits properly, and regular inspection, cleaning, maintenance, and storage 7