In earlier blogs in this series, we examined the significant healthcare challenges faced in the early 21st century, particularly regarding personal protective equipment (PPE), preparedness, and response. These discussions focused on identifying the real needs for a standardized healthcare respirator that can effectively serve HCWs for both daily use and during epidemics or pandemics.
Over the years, various workshops, studies, projects, and regulations have aimed to address these challenges. These were delineated in our previous blog and are highlighted in Slide 1.
Slide 1: Follow-up Activities in Response to Major Healthcare Outbreaks in the First Two Decades of the 21st Century
The consolidated discussions from these initiatives show that while the N95 has served as a staple in respiratory protection, it falls short in several areas. Table 1 summarizes these shortcomings and outlines the expert recommendations for the next generation of healthcare respirators.
Project B.R.E.A.T.H.E., launched in 2008, aimed to define criteria and develop a prototype for the next-generation respirator. Unfortunately, a respirator that fully meets these criteria has yet to be commercialized from this effort. Key issues include the need to address fit testing challenges, user discomfort, and adverse effects during prolonged use
The 2014 Institute of Medicine (IOM) Workshop focused on the potential increased use of Powered Air-Purifying Respirators (PAPRs) in healthcare. The analysis compared existing conventional PAPR designs against the new standard’s criteria and found that PAPRs met many of the requirements better than the N95. However, concerns over cost, bulkiness, and ease of use have limited their wider adoption in healthcare settings.
Table 1: Summary of Specifications for the New Standard of Respiratory Protection for Healthcare Workers
The findings summarized in Table 1, reveal two critical insights. Firstly, the limitations and shortcomings of the N95 respirator, long considered the standard in many situations, are evident. Secondly, these findings reflect the expert consensus on what the next standard for respiratory and contact protection should entail.
The shortcomings of N95 and conventional PAPR technologies are rooted in the failure to adapt these technologies to the actual needs of healthcare workers. The challenge lies in creating an affordable, air-tight seal device that can withstand the demands of healthcare environments—something that current N95 and similar elastomeric respirators cannot achieve.
Moreover, significant design changes are required to transition conventionally designed powered respirators, which excel in industrial applications, for suitability in the healthcare sector. These changes are essential to ensure that healthcare workers are adequately protected during routine patient care and in the heightened demands of pandemic situations.
In our next blog, we will delve deeper into the criteria for a new gold standard for respiratory and contact protection. We will explore how this gold standard can be accessible to virtually every healthcare organization, bridging the gaps in current PPE technology to better protect our frontline workers.
