Airborne Pathogens: Elusive and Dangerous

Next, anyone that comes in contact with patients suspected to have a potentially contagious infection that can be spread via airborne pathogens should take airborne precautions, and many times must also take contact precautions.

The specifics of these are spelled out by the CDC (Centers for Disease Control and Prevention) but they call for a NIOSH approved respirator such as an N-95 mask or higher protection. It is important to understand that a surgical mask is not a respirator and provides no protection against airborne pathogens. A surgical mask only prevents droplets from the healthcare worker reaching the patient. A respirator prevents airborne particles from reaching the healthcare worker. It is also important to understand that an N-95 mask is a tight fitting respirator that requires annual fit testing of the healthcare worker. In years past, OSHA did not enforce this but the Wicker Amendment has expired and enforcement is now in effect.

In addition, facial hair is not allowed when wearing a tight-fitting respirator such as an N-95 mask. Furthermore, it is important to be aware that there are respirators that do not require fit testing. PAPRs when worn with loose-fitting face pieces or hoods do not require fit testing. This is because air is constantly flowing into the respirator and effectively pushing out contaminants that may try to enter through the loose seal. This type of respirator actually provides higher protection than an N-95; PAPRs carry an assigned protection factor (APF) of 25 or 1000 (depending upon the head top) while an N-95 mask only carries an APF of 10. For more about assigned protection factors go to www.osha.gov.

Finally, training must be done early and often. Too often I hear about a hospital receiving HRSA (Health Resources and Services Administration) grant money and buying respirators that get locked up in a remote storage location never to be heard from again. The danger here is that when the protective equipment is needed it will be too inaccessible and used improperly.