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  • N95 or Nanomask?

    A friend who works for a hospital said N95 masks are not 100% safe against H5N1. He said I should look for nanomasks.
    Thoughts?

  • #2
    N95

    N-95 or N-100

    Comment


    • #3
      Re: N95 or Nanomask?

      I have been doing lots of research in this area, your friend is right that N95 respirators are not adequate against viruses. This is also true of N-100, FFP2 & FFP3 masks. I have seen testing that shows that they will let far more than you need for an infectious dose when worn. If you are looking at personal use these masks also become hazardous waste after exposure to biohazards, so you have to consider safe disposal.

      I have also researched Nanomasks as much as is possible and from what I have found they are not approved in the US or in Europe. In fact there is little test data available on these masks.

      Areas of concern would be that with no approvals there is little more than a trust me card (over the internet) to back up their claim. I haven't seen a distributor with a returns policy either which makes me even more dubious of the trust me card!!Another issue that lack of approval raises is how they fit and seal, there is no data available on the fit or seal of these masks.

      I have come across other masks which claim to be similar to the nanomasks in that they kill 99.99% of viruses etc. I think they are called Triosyn T-3000 respirators and if memory serves they are Approved in US and Europe. If you would like I will dig out the information on them and post a thread later.

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      • #4
        Re: N95 or Nanomask?

        N-95 would work for fine droplet containment but, it won't work if the virus is floating freely. So, does that mean if the droplet dries on the surface of the mask, it will then pass through the mask? Now there is an unhappy thought.
        Please do not ask me for medical advice, I am not a medical doctor.

        Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
        Thank you,
        Shannon Bennett

        Comment


        • #5
          Re: N95 or Nanomask?

          Remember,
          In 1918 you had to wear a mask if you went into the "public" areas. Some places may require masks. Who knows.

          Comment


          • #6
            Re: N95 or Nanomask?

            They may indeed make this a condition. Unfortunately, cloth masks are pretty much worthless. You would be far better off with social distancing and meeting in daylight hours in full sun.
            Please do not ask me for medical advice, I am not a medical doctor.

            Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
            Thank you,
            Shannon Bennett

            Comment


            • #7
              Mask or no mask... ?

              A friend wrote asking for information to help convince a co-worker that wearing a N-95 mask helps reduce infection. Here's what I wrote.

              For the person saying "There's no evidence that masks help... why should I wear one?..."

              The person is right. There is no definitive evidence that N95 or N100 masks can be guaranteed to prevent H5N1. We say that in the Pandemic Response Plan. The reason there's no evidence is we have not had an influenza pandemic recently to compare infection and mortality rates of those who wore them with rates of those who did not. (grin) A disposable N95 or N100 mask is breathable. The disposable mask is a level of protection intended to reduce the amount of contamination, not eliminate it. (You'd need a SCBA for that.)

              N-95: The N stands for Niosh approved. The number tells you filtration efficiency, about 95% in this case. N-100 has a filtration efficiency of around 98%. Neither is 100% efficient. The key is to get properly fitting masks. You should do a fit test on the mask for best results.

              In one Canadian study, Canadian nurses who wore N95 masks during the SARS outbreak became infected with SARS significantly less frequently than those who did not. (Can't find the Canadian one.)

              Here's another study originally published in The Lancet and done in Hong Kong -- Face masks are best protection against SARS: http://www.newscientist.com/article.ns?id=dn3692 "Wearing a N-95 mask can give a person dealing with SARS patients in hospital up to 13 times more protection compared with not wearing one." and "Not one of the 69 staff who used all four recommended protection measures - wearing a mask, gloves, gowns and washing their hands - contracted the virus.")

              Note also that the SARS virus is a Corona virus (not Influenza A virus), and is larger than the H5N1 virus. Both viruses can catch a ride on water droplets expelled in coughs, sneezes and in talking or breathing. But H5N1 viruses are so small they can also float freely in the air for a while. A person who is shedding H5N1 virus is contributing to viral load in the air. (see attached cough photo) You're more likely to become infected if breathing air high in viral load than low in viral load.

              When you inhale, you draw the virus in the air toward you with a degree of "pull" that helps it penetrate through a protective material. So to be effective, the mask material needs to be tightly woven enough to filter out certain size particles. That's also why labs and hospitals where dangerous organisms are present maintain negative air pressure and have a hepa filtering process.

              Masks are a big part of the protection equation. Equally important are eye barrier goggles and gloves, and something protective to cover your clothes.

              Gown or jumpsuit first... A Tyvek gown or Tyvek biohazard jumpsuit is also breathable and slightly more penetrable than the N-95 mask. In my opinion and I am not a physician, if you were without tyvek suit, you could probably also get away with wearing a cheap rain suit, shower cap and boot covers. You could decontaminate the rain suit with a bleach solution and reuse -- since the suit is protecting only your skin and reducing virus on your clothing. Flu virus on skin is not so dangerous if you wash well with soap and water. Viruses landing on either kind of protective suit usually stay on the surface, reducing contamination to your clothes or skin if you remove the suit and wash properly with soap and water. The flu virus, while not much risk for intact skin, is a big problem for eyes, nose and mouth mucosa.

              So you also need barrier goggles (swim goggles work) or faceplate.

              You should wear gloves, maybe 2 layers of gloves to reduce the chance those floating H5N1 virus particles will get on your hands that then touch some mucous membrane in enough viral load to infect you. Check the 2 attached photos of people working with H5N1 patients or patient samples to get an idea of their PPE. H5N1 is a biohazard level 3 organism (like ebola, but more infectious than ebola).

              I think if people must work and cannot distance themselves socially, they are most likely to avoid getting sick if they follow standard precautions for dealing with an infectious person:
              • wear and handle their PPE properly;
              • wash hands before and after EVERY contact;
              • remain more than 3 feet (or further) from the infectious person and only when absolutely necessary; and
              • clean all potentially contaminated surfaces regularly.
              The mask is part of reducing the viral load that can get you infected. The lower the viral load in the air you breath in or the air that otherwise touches your mucosa and conjunctiva, the better. Definitive study or no study, I plan to wear a N-95 mask or N-100 mask if/when the time comes that I need it. I'm gonna wear the other gear too and practice how to put it on and take it off safely.

              Here's what CDC says
              http://www.cdc.gov/flu/professionals...skguidance.htm

              Hope this helps... Good luck. Remember it is not your job to convince him or her. Just present the logic and science...

              Thanks for your good work on this. You will save some lives.

              Cheers,
              Mellie

              PS If those infected could wear surgical masks (without respirator in them), it would restrict the virus in the air too, which would protect others breathing the same air.

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              • #8
                Re: N95 or Nanomask?

                Thanks for the replies.. I found this article today:

                http://abcnews.go.com/Health/Flu/sto...1182529&page=1
                Beplate has not submitted his masks for CDC or NIOSH ratings because he wants to maintain intellectual privacy but he says an independent laboratory, Nelson Laboratories in Salt Lake City, has tested the product and found it is 99.99 percent effective at filtering particles as small as 0.027 microns. The laboratory is registered under the Food and Drug Administration.

                Comment


                • #9
                  Re: N95 or Nanomask?

                  N-95 or N-100

                  Until Nanomask jumps through the hoops, I won't wear one... And if someone did wear one, the mask itself must be cleaned -- more chance for contamination.

                  Comment


                  • #10
                    Re: masks

                    Mellie your post is perfect !
                    Your pic of a cough (scientific high speed pic i suppose) is similar to the one I shall upload to my blog, and this can help undesrtand why our face is exposed and why a perfect protocol of donning, wearing, putting off the gear is required ...

                    Comment


                    • #11
                      about Canadian nurses

                      Toronto nurse?s experience during SARS outbreak, after her testimony published on healthcare web maillist :



                      "Today the protocol of strict isolation is set. I have to don the now requisite gowns, gloves, masks and goggles. I negotiate the note writing, medication mixing and a multitude of other tasks with my dexterity impaired by gloves. Nothing however compares to the mask. A pounding headache, lethargy and disorientation appear a short time into each shift and last through the remaining long hours

                      From start to finish of every shift, all these precautions -- including the masks -- have to stay on at all times or our infection control barrier would be broken. I can't lift my mask to inhale a breath of fresh air, grab a sip of water, or even wipe sweat out of my eyes. A nurse in our staff did become infected because she relaxed her precautions and removed her mask. She has recovered since, hopefully.

                      Our protective clothing requirement is later increased to two layers: I become over-heated under all the layers, dizzy and light headed from the lack of air, the sweat begins to trickle down my face, my goggles fog over and my thick face mask sticks to my skin. We are all drowning in sweat under the double gowns, double gloves, goggles and double masks. We are finding doing even the standard procedures harder through double gloves and fogged-up goggles.

                      A medic was known to run a marathon or two. He's now finding running up two flights of stairs exhausting. It isn't the climb, it's the gowns, gloves and masks that make it a sweltering run. By the time he gets to patients he's often out of breath, straining for air through the mask.

                      I'm glad I'm not yet nursing, tells another nurse. So I don't have to wear the mask all the time. The mask created another problem for me - I turned out to be allergic to the safety shield !

                      Later some staffs moved to Stryker suits (hoods with N100 filters) to ensure they're protected from the virus. The Stryker suit is cumbersome and hot. It really did make it harder to work. The visibility isn't quite as good. It is hard to hear what other people are saying. Everything's kind of muffled under that hood. Still, that is the reality SARS teams are going to have to get used to.



                      Each patient has an isolation room, with no curtain or object that isn't deemed vital. Only hard surfaces, which can be easily wiped, are allowed. Inside and outside every room is a disposal system for gowns, garbage, etc. The unit entryway is a safe space for the staff between double sets of doors at the nursing station. After the second set of doors, we start preparing: putting on double gown, double gloves. We're already wearing our masks. Before entering the wing, we put on a yellow gown. Patient's doors are firmly closed at all times. A knock on the door signals the patient to put on a mask so the nurse can enter.

                      Because we should have alarmed the public by going out in masks, the hospital let our staff take taxis to and from work, but we even had to wear our masks in the cab! At home we have changed our lifestyle to vigilantly avoid contamination. We're living separate lives, having as little contact as possible, and being careful. When facing my family, I wear the mask ?

                      Staff education is an important point. "You not only have to train people how to go into this gear but how to come safely out of it," says an infection control nurse. "So it's training, training, training."

                      Comment


                      • #12
                        Re: about Canadian nurses

                        Just a thought, is there any reason why nurses don't use masks with valves?

                        There are plenty of FFP3 (99%) respirators out there, with the valves. From my research and testing breathing is very easy and comfortable through them. Although even with FFP3/ P100 masks there is still the risk of viral penetration. I would recommend taking a look at respirators which contain an antimicrobial element to kill the virus.

                        Comment


                        • #13
                          Re: N95 or Nanomask?

                          AnitaPlum

                          Thanks for the post on working in a biohazard environment - disturbing and enlightening. Hats off to those who did it and will be asked to do it again.

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                          • #14
                            Re: N95 or Nanomask?

                            Anita and birdfluwhispers, welcome. We really appreciate insights and discussion that can benefit healthcare workers and first responders. My primary experience with "bad bugs" is in a research capacity and more along the lines of "laminar flow clean air" hoods and ppe.

                            Again, welcome!

                            Comment


                            • #15
                              Re: N95 Mask availability

                              Today, I was in my local wholesale construction/industrial supply store which sells several varieties of N95/N100 respirators and masks. The 3M 8511 masks (box of 10) on the shelf and in the warehouse were completely sold out. They were available several months ago. I asked and the clerk told me "bird flu". Their suppliers said that these masks would be back ordered for at least the next six months.

                              They had the Moldex N95 masks with and without the valve in stock. I asked why these weren't sold out and he said that people have succumbed to 3M marketing that "3M produces a better mask".

                              If you have been waiting to purchase N95 masks, now is the time to make your purchases. Check local construction industrial supply stores where you can by them by the case (10 boxes) or by the box (10 masks in a box). These masks should be $2 or less a piece instead of the $4/mask at home improvement stores.
                              http://novel-infectious-diseases.blogspot.com/

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