Storage and Availability of Elastomeric Respirators in Health Care

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Health Secur. 2019 Sep/Oct;17(5):384-392. doi: 10.1089/hs.2019.0039. Storage and Availability of Elastomeric Respirators in Health Care.

Hines SE¹, Brown C², Oliver M¹, Gucer P¹, Frisch M³, Hogan R³, Roth T¹, Chang J³, McDiarmid M¹.
Author information

1 Stella E. Hines, MD, MSPH, is Assistant Professor; Marc Oliver, RN, MPH, MBA, is a Research Nurse; Patricia Gucer, PhD, is Assistant Professor; Tracy Roth, RN, is a Research Nurse; and Melissa McDiarmid, MD, MPH, DABT, is Director; all in the Division of Occupational and Environmental Medicine, Department of Medicine, School of Medicine, University of Maryland-Baltimore, Baltimore, MD. 2 Clayton Brown, PhD, is Professor, Department of Epidemiology and Public Health, Division of Biostatistics and Bioinformatics, School of Medicine, University of Maryland-Baltimore. 3 Melissa Frisch, MD, MPH, is an Occupational and Environmental Medicine physician; Regina Hogan, RN, MS, is Manager, Employee Health Services; and James Chang, CIH, is Safety Officer; all at the University of Maryland Medical Center, Baltimore, MD.

Abstract

Use of reusable respirators, such as elastomeric half-face respirators (EHFRs), may serve as one solution to combating the problem of N95 respirator shortages experienced during infectious disease emergencies. To clarify whether logistical issues like respirator storage and availability are barriers to implementation of healthcare respiratory protection strategies that include EHFRs, this study aimed to evaluate the availability, storage, and respirator and filter replacement practices of EHFRs used in healthcare settings under routine use. Healthcare workers using EHFRs were surveyed about their use practices. To explore whether issues related to storage and availability of EHFRs affected compliance with assigned respirator use, responses were compared between concordant users and EHFR users who were assigned to use EHFRs but currently use different respirators ("discordant users"). Most concordant EHFR users reported that their respirator was always available when needed (63.8%). Almost two-thirds of concordant but only half of discordant users reported storing their EHFRs conveniently in the patient care area (p = <0.001). Among mobile workers, discordant users had higher odds (aOR = 3.2, 95% CI [1.4,7.5]) of reporting that their respirator was not stored in the patient care area, suggesting that storage location has a significant impact on compliance with expected practice, particularly in this group. Storage and access are barriers to optimal elastomeric respirator use in healthcare. Strategies to assure ready availability and storage of respirators will permit EHFR inclusion in pandemic and routine respiratory protection programs.


KEYWORDS:

Hospital preparedness/response; Influenza; Personal protective equipment

PMID: 31593514 DOI: 10.1089/hs.2019.0039