The American Industrial Hygiene Association (AIHA) has issued a position statement on H1N1 pandemic influenza A that endorses and reiterates the key findings of an Institute of Medicine panel that recommended N95 respirators for health care workers. Key points stressed by AIHA include:
Industrial hygiene group says N95s the right call
Industrial hygiene group says N95s the right call
One component of an effective program
The American Industrial Hygiene Association (AIHA) has issued a position statement on H1N1 pandemic influenza A that endorses and reiterates the key findings of an Institute of Medicine panel that recommended N95 respirators for health care workers. Key points stressed by AIHA include:
- H1N1 and seasonal influenza are spread by the airborne route and not limited to "droplet" or contact spread.
- A current H1N1 infectious dose has not been established. This could vary for every organism, disease, and microbial strain; therefore, it is not effective to stratify protective measures.
- Health care workers are at increased risk of H1N1 infections. Health care organizations and workers need consistent and clear H1N1 guidelines that can be implemented across all healthcare facilities. In addition, employers must devote significant effort to assessing risk in their organizations and to fully implement those guidelines so needed practices are widely adopted. This should include ongoing education and training of health care workers.
- Respiratory protection is one component of an effective aerosolized transmissible disease program. Other components include appropriate administrative and engineering controls (i.e., triage, cohorting of patients, prompt identification, isolation, signage, patient masking in public or semi-public areas, covering cough and sneezes, hygienic practices, education, ventilation).
- Health care workers (including those in non-hospital settings) who are in close contact with individuals with H1N1 influenza or influenza-like illnesses should be provided with fit-tested N95 respirators or other respirators that are demonstrably more effective. This is one measure in the continuum of safety and infection control efforts to reduce the risk of infection. Employers should ensure the use and fit testing of N95 respirators be conducted in accordance with OSHA regulations, and health care workers should use the equipment as required by regulations and employer policies. An effective respiratory protection program must include medical surveillance, fit testing, and training as described in the NIOSH and OSHA documents and standards.
- Adequate respiratory protection is not provided by "surgical masks," including most devices approved by the Food and Drug Administration. In fact, surgical masks provide very little protection for the patient or health care provider and provide a false sense of security for those who believe they may be receiving adequate respiratory protection.
- Certain aerosolizing procedures may necessitate a higher level of respiratory protection than the N95 respirator. Potential risks of higher doses of organism are being studied by NIOSH and a higher level of respiratory protection may be feasible. This may include elastomeric facepieces with P100 designations or a powered air-purifying respirator (PAPR) with P100 filter media.
- The supply of N95 respirators may be limited during a pandemic episode. Because of this, the use of additional types of NIOSH-certified respirators may be required; however, additional research to expand the capabilities of those respirators should be considered.
- NIOSH provides the entire work force with critical research and resources of immense benefit. NIOSH's research, quality of work, technical and educational materials tend to be comprehensive, scientific, and without political bias. Additional research should be funded and undertaken to resolve the unanswered questions regarding the relative contribution of various routes of influenza transmission, fully explore the effectiveness of personal respiratory protection technologies in a variety of clinical settings through randomized clinical trials, and design and develop the next generation of personal respiratory protection technologies for health care workers to enhance safety, comfort, and ability to perform work-related tasks.
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