A note on extended use and re-use of respirator masks.

We receive many questions regarding re-use and length of time to wear N95 and KN95 respirator masks. In this article, we’ll summarize important information discussed in the CDC article on this topic here.

Let’s begin with definitions of extended use and re-use of respirator masks as per the CDC.

Extended use refers to the practice of wearing the same N95 respirator for repeated close contact encounters with several patients, without removing the respirator between patient encounters.

Reuse refers to the practice of using the same N95 respirator for multiple encounters with patients but removing it (‘doffing’) after each encounter. The respirator is stored in between encounters to be put on again (‘donned’) prior to the next encounter with a patient.

Extended use is favored over reuse because it is expected to involve less touching of the respirator and therefore less risk of contact transmission.

The most significant risk is of contact transmission from touching the surface of the contaminated respirator. One study found that nurses averaged 25 touches per shift to their face, eyes, or N95 respirator during extended use. Contact transmission occurs through direct contact with others as well as through indirect contact by touching and contaminating surfaces that are then touched by other people.

Healthcare facilities should develop clearly written procedures to advise staff to take the following steps to reduce contact transmission after donning:

  • Discard N95 respirators following use during aerosol generating procedures.
  • Discard N95 respirators contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients.
  • Discard N95 respirators following close contact with, or exit from, the care area of any patient co-infected with an infectious disease requiring contact precautions.
  • Consider use of a cleanable face shield (preferred) over top of an N95 respirator and/or other steps (e.g., masking patients, use of engineering controls) to reduce surface contamination.
  • Perform hand hygiene with soap and water or an alcohol-based hand sanitizer before and after touching or adjusting the respirator (if necessary for comfort or to maintain fit).

The decision to implement policies that permit extended use or limited reuse of N95 respirators should be made by the professionals who manage the institution’s respiratory protection program, in in consultation with their occupational health and infection control departments with input from the state/local public health departments. The decision to implement these practices should be made on a case by case basis taking into account respiratory pathogen characteristics (e.g., routes of transmission, prevalence of disease in the region, infection attack rate, and severity of illness) and local conditions (e.g., number of disposable N95 respirators available, current respirator usage rate, success of other respirator conservation strategies, etc.).

Read more and view sources: https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html