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Topical Workshop on Respiratory Protection in Health-Care Environments

Reported by: Yousef Elmashae and Shuang Gao

On February 28, the annual Topical Workshop was held at the Procter Hall (UC College of Nursing). This year, the topic was Respiratory Protection in Health-Care Environments.This event provided an opportunity for graduate students, healthcare professionals and personnel involved in the development, testing and implementing respiratory protection strategies to observe presentations and discuss the status of respiratory protection in healthcare environments.

Three keynote speakers gave an hour of presentation each about the topic.


Keynote Lecture by Dr. Roy McKay

Dr. Roy McKay, PhD, Associate Professor of Environmental Health, University of Cincinnati, Cincinnati, OH; Chair ANSI Z88.10 Fit Testing Methods

Dr. McKay started the workshop as the Keynote Speaker presenting an interesting topic named “Fundamentals of Respiratory Protection, Importance of Respirator Fit and Non-Wear Time”.

Dr. McKay began his presentation by emphasizing the necessity of the fit testing, due to a wide variety of facial shapes and size. Then, he talked about the purpose of the fit testing and explained the qualitative fit test and quantitative fit test, respectively. Dr. McKay explained an important point, which is “Fit Test” does not measure respirator Fit.  Instead, it measures the leakage. He also talked about the respirator training and donning issues such a disconnect between respirator training, knowledge, and performance. He also showed some common mistakes of wearing respirator in workplace and common errors that may cause a poorly fitting respirator to falsely “Pass”. Other main issues he discussed in his presentation included factors affecting respirator protection, assigned protection factor, effective protection factor, reasons to remove respirator, and the effect of increasing wear-time of respirator.



Keynote Lecture by Dr. Bonnie Rogers

Bonnie Rogers, DrPH , COHN-S, LNCC, FAAN, Associate Professor of Nursing and Public Health, Director, NC OSHERC and OHN Program, The University of North Carolina at Chapel Hill, Chapel Hill, NC

Dr. Rogers gave a talk on “Respiratory Protection for Health Care workers”. Their group conducted a research that evaluated respirator usage for respiratory infection among health care workers in a sample of North Carolina acute care hospitals. Her presentation was divided into four parts including assessment of written respirator protection program policies, survey to assess knowledge and beliefs about respiratory protection among direct health care workers and managers, use of respiratory protection among health care workers, and observations of respirator use. At the end of the presentation, she gave some recommendations to the health care workers, such as keep optimizing the respiratory protection policy, conduct evaluation frequently, and consider the respiratory protection of visitors as well as patients.


 Keynote Lecture by Dr. Richard H. Koehler

Richard H. Koehler, MD, FACS, Staff Surgeon, Martha’s Vineyard Hospital, Oak Bluffs, MA & Nantucket Hospital, Nantucket, MA ; CAS, Massachusetts General Hospital, Boston, MA; CEO, Critical Fit Technologies, LLC, Tisbury, MA

Dr. Richard Koehler gave a talk on “Surgical Smoke in Operating Rooms: Considerations for Respiratory Protection”. He started his talk by presenting a picture of surgeon doctors who had very different size faces but wore the same size mask. Other surgeon doctors were wearing single elastic strap or nonfunctional lower strap. Dr. Koehler showed statistics data about the cost of surgical masks. Most hospitals pay roughly 6-11 cents per mask and a small community hospital spends about $10,000 yearly on surgical masks.


Dr. Koehler emphasized that the N95 mask provides a better seal than the surgical mask, but still does not completely contain the cough effluent. He also talked about the toxins in surgical smoke, e.g., surgical smoke has been shown to contain known carcinogens and viable biological particles. OSHA estimates that 500,000 health care workers are exposed to laser or electrosurgical smoke each year. Dr. Koehler showed many studies to support his point view about the topic. He discussed the need to develop a better face seal to accommodate the complex variables in human facial anatomy.


The presentation showed the importance of developing the surgical mask to protect health care workers from many airborne hazards. 



After the presentation of three keynote speakers, the audiences were divided into three groups for in-depth discussion with the keynote speakers. At the end of the workshop, there was a discussion panel, which was moderated by Dr. Grinshpun and included three additional members: Debra A. Novak and Kevin X. He from the National Personal Protective Technology Laboratory (NPPTL) , the National Institute for Occupational Safety and Health (NIOSH) and Pam Hunter from Cincinnati Children's Hospital Medical Center (CCHMC). In this panel discussion, members talked about the recent NIOSH research on respiratory protection, workers’ response for wearing the N95 respirators, and some other related subjects.