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Evaluation of Minnesota and Illinois hospital respiratory protection programs and health care worker respirator use.

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Title

Evaluation of Minnesota and Illinois hospital respiratory protection programs and health care worker respirator use.

Description

The objective of this study was to assess respiratory protection programs for aerosol-transmissible diseases in acute care hospitals for conformance with regulatory requirements and public health guidelines.

Date

2015

Citation

Brosseau, Lisa M., Lorraine M. Conroy, Margaret Sietsema, Kari Cline, and Kara Durski. 2015. "Evaluation of Minnesota and Illinois Hospital Respiratory Protection Programs and Health Care Worker Respirator Use." Journal of Occupational and Environmental Hygiene 12 (1):1-15.

Abstract

The objective of this study was to assess respiratory protection programs for aerosol-transmissible diseases in acute care hospitals for conformance with regulatory requirements and public health guidelines. Twenty-eight representative hospitals were selected by size, location, and ownership in Minnesota and Illinois. Interviews were conducted with 363 health care workers and 171 managers from high-risk departments. Written programs from each hospital were reviewed for required elements. Seventy-seven health care workers were observed donning and doffing a FFR. The most serious deficiency in many written programs was failure to identify a program administrator. Most written programs lacked adequate details about medical evaluation, fit-testing, and training and did not include a comprehensive risk assessment for aerosol transmissible diseases; tuberculosis was often the only pathogen addressed. Employees with the highest probability of tuberculosis exposure were most likely to pick a respirator for close contact, but higher levels of respiratory protection were rarely selected for aerosol-generating procedures. Surgical masks were most commonly selected for close contact with droplet disease- or influenza-infected patients; better protection (e.g., respirator) was rarely selected for higher-risk exposures. Most of the observed health care workers had access to a NIOSH-certified N95 FFR, properly positioned the facepiece, and formed the nose clip. The most frequent deficiencies were failure to correctly place straps, perform a user seal check, and remove the respirator using straps.

Keywords: aerosol transmissible diseasehealth carerespiratory protection

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