Reusability of Facemasks During an Influenza Pandemic Facing the Flu (2006) / Chapter Skim
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This report addresses the reuse of respirators and medical masks as a means of preventing or slowing influenza transmission during a pandemic should there be an insufficient supply of new respirators and masks available to those who need them. Medical masks are unfitted devices worn by an infected person, healthcare worker, or member of the public to reduce transfer of potentially infectious body fluids between individuals.
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The committee was also asked to assess whether there are any cost-effective alternatives to N95 filtering facepiece respirators and medical masks that could provide adequate levels of protection and could be used against the influenza virus during a pandemic. In the short time available, the committee reviewed the published literature on respirator and mask effectiveness, infectious disease control, and occupational health and industrial hygiene and communicated with representatives of industry, the public health community, government agencies, regulators, and the international community.
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Recognizing the methodological and data limitations regarding the efficacy of medical masks as a form of respiratory protection against avian influenza, and in the absence of data to the contrary, masks are likely to provide less protection against aerosols than an N95 filtering facepiece, but may offer better protection than cotton masks, homemade alternatives such as handkerchiefs and scarves, or no protection at all. No device is fail-safe, and its effectiveness depends on fit, level of exposures, and appropriate use.
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If an individual user needs to reuse his or her own disposable N95 respirator, the committee recommends that it be done in the fol lowing manner: · Protect the respirator from external surface contamination when there is a high risk of exposure to influenza (i.e., by placing a medical mask or cleanable faceshield over the respirator so as to prevent surface contamination but not compromise the devices' fit)
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FDA informed the committee that it has not cleared any medical mask/ N95 filtering facepiece respirator or medical mask as a reusable device. The agency also indicated that if such a device became available it would perform an expedited review of the premarket submission to meet the public health need.
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The committee also reviewed the limited data available about the effectiveness of cotton masks or alternative materials for respiratory protection. Regulatory standards require that a medical mask not permit blood or other potentially infectious fluids to pass through to or reach the wearers' skin, mouth, or other mucous membranes under normal conditions of use and for the duration of time that the protective equipment will be used.
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RESEARCH AGENDA The committee was hampered in its work by the lack of reliable data in many areas of concern, in particular on the routes and modes of influenza transmission. Consistent with its broader charge, the committee makes recommendations to DHHS on a research agenda ranging from the most fundamental aspects of infectious disease to more focused research opportunities in two major areas: (1)
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d. DHHS should sponsor and/or conduct research on issues related to public education on and compliance with respiratory protection guide lines, including the importance of proper fit and need for hand hy giene after handling respiratory protection.
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The public is likely to forgive lack of knowledge but will not be willing to trust public health officials in the next instance if they have in any way been misinformed or misled.
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