Elastomeric Half-Mask Respirators
Elastomeric half-mask respirators are a reusable alternative to the disposable half-mask filtering facepiece respirators commonly used by health care practitioners. Though they are not cleared by the FDA for fluid resistance, it has been shown that elastomeric respirators work with at least equivalent efficacy when compared to the N95 disposable half-mask. Certain brands of elastomeric half-mask respirators may even exceed the effectiveness of the N95 via the use of higher assigned protection factors, such as air-purification filters and enhanced sealing surfaces. However, as with all half-masks, the wearer’s eyes remain vulnerable to infectious or hazardous environmental elements.
In order to make the elastomeric half-mask respirator safe for reuse, one must have a ready stock of the replaceable components. For example, in order to prevent the mask from clogging or becoming leaky, replacing the filter throughout chronic use may be necessary. If the integrity of the filter has not been compromised by becoming soiled or wet, it may be expected to withstand a year of use, conservatively.[1] Additional maintenance includes frequent disinfection, particularly of the straps, inhalation and exhalation valves, and valve covers. If the mask is being shared by multiple people, disinfection and replacement of filters before each exchange is strongly encouraged by the CDC.[2] A detailed account of how to properly clean an elastomeric half-mask respirator has been compiled by Bessessen et al.[3]
It is strongly recommended by the Occupational Safety and Health Administration (OSHA) that healthcare practitioners undergo a quantitative fit testing for their elastomeric half-mask respirators before commencing use, in order to ensure there are no leaks in the face seal. However, in the case of a serious outbreak such as COVID-19, during which there may be a shortage of masks, fit-testing may be waived by the OSHA. It may also be the case that qualitative, not quantitative fit-testing becomes the minimal requirement, in order to streamline the mask allocation process.
In response to the COVID-19 pandemic, there has been an increased demand for elastomeric half-mask respirators. On September 14, 2020, the National Institute for Occupational Safety and Health requested increased information about the distribution and use of the masks in healthcare settings.[4] The CDC anticipates that increased use of elastomeric half-mask respirators will help mitigate the shortage of disposable N95 half-masks that has posed a large problem for healthcare providers throughout the COVID-19 crisis. The ultimate goal of switching to a reusable, more sustainable option will lead to a lesser need for constant mask production and help to reduce medical waste.
[1] Personal communications with University of Maryland School of Medicine, March 18, 2020.
[2] Elastomeric Respirators: Strategies During Conventional and Surge Demand Situations. (2019). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/elastomeric-respirators-strategy/index.html#ftn-18
[3] Bessesen M, Adams JC, Radonovich L, Anderson J (2015). Disinfection of Reusable Elastomeric Respirators by Health Care Workers: A Feasibility Study and Development of Standard Operating Procedures. American Journal of Infection Control 43(6):629-634.
[4] NIOSH Announces Plans for Distributing Elastomeric Half Mask Respirators. (2020). Retrieved from https://www.asahq.org/advocacy-and-asapac/fda-and-washington-alerts/washington-alerts/2020/09/niosh-announces-plans-for-distributing-elastomeric-half-mask-respirators