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American Journal of Infection Control
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Major Article| Volume 48, ISSUE 2, P153-156, February 01, 2020

Sterile field contamination from powered air-purifying respirators (PAPRs) versus contamination from surgical masks

Published:September 10, 2019DOI:https://doi.org/10.1016/j.ajic.2019.08.009
Sterile field contamination from powered air-purifying respirators (PAPRs) versus contamination from surgical masks
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      Highlights

      • •
        PAPRs are excellent respiratory protection, but not recommended near sterile fields.
      • •
        Concerns are that unfiltered aerosols from PAPRs could contaminate sterile fields.
      • •
        PAPRs proved as effective at protecting sterile fields as surgical masks.
      • •
        Guidance for PAPR usage around surgeries or sterile fields should be tested further.

      Background

      Currently, powered air-purifying respirators (PAPRs) are not recommended for usage in close proximity to sterile fields owing to concerns that exhaled, unfiltered air potentially may cause contamination; however, this has not been confirmed by experimental study.

      Methods

      After establishing background levels of airborne contamination, our team placed settling plates in a sterile field and collected contamination from participants who were performing particulate-generating actions. Participants performed the actions while wearing various forms of respiratory protection, including: (1) a full facepiece PAPR, (2) a full facepiece PAPR with a shoulder-length hood, (3) a surgical mask, and (4) no facial covering (as a positive control to determine contamination-reduction effectiveness). Specimens were collected at the end of a 10-minute sampling time frame. After incubation at 36.5˚C for 72 hours, we tabulated colony forming units as a marker of contamination.

      Results

      Surgical masks and the 2 PAPR configurations all drastically reduced aerosolized droplet contamination. Surgical masks reduced contamination by 98.48%, and both PAPRs reduced contamination by 100% (compared with the usage of no facial covering). There was no statistical difference between their effectiveness (surgical mask vs both PAPRs, P value = .588 and no hood PAPR vs hood PAPR, P value >.999).

      Discussion/Conclusions

      Based on these findings, the tested PAPR configurations are effective at reducing aerosolized droplet contamination into a sterile field, and further testing is warranted to assess other PAPR configurations as well as PAPR suitability in an operating room.

      Key Words

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      References

      1. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2018-176. A guide to air-purifying respirators. Available from: https://doi.org/10.26616/NIOSHPUB2018176. Accessed February 5, 2019.

        View in Article

      2. Occupational Safety and Health Administration. Occupational safety and health standards: personal protective equipment: respiratory protection: 1910.134(d)(3)(i)(A).https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=12716&p_table=STANDARDS. Accessed February 5, 2019.

        View in Article

      3. Occupational Safety and Health Administration. OSHA technical manual, section III: chapter 4, heat stress. Heat-related illness prevention program. Available from:https://www.osha.gov/dts/osta/otm/otm_iii/otm_iii_4.html#acclimatization. Accessed February 5, 2019.

        View in Article

      4. The National Institute for Occupational Safety and Health. Eye safety: infection control. Available from:https://www.cdc.gov/niosh/topics/eye/eye-infectious.html. Accessed February 5, 2019.

        View in Article

      5. The National Personal Protective Technology Laboratory. Respirator trusted-source information. Section 3: ancillary respirator information. Available from: https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/respsource3healthcare.html. Accessed April 9, 2019.

        View in Article

      6. AORN Recommended Practices Committee. Recommended practices for surgical attire. Available from: https://doi.org/10.1016/S0001-2092(06)60424-9. Accessed April 19, 2019.

        View in Article

      7. Lindsley WG, Green BJ, Blachere FM, Martin SB, Law BF, Jensen PA, et al. NIOSH. Sampling and characterization of bioaerosols. In: NIOSH manual of analytical methods (NMAM), 5th ed; 2017.

        View in Article
        • Gralton J
        • Tovey E
        • McLaws M
        • Rawlinson W
        The role of particle size in aerosolised pathogen transmission: a review.
        J Infect. 2011; 62: 1-13
        View in Article

      9. Technical specifications 3M Versaflo Powered Air Purifying Respirator TR-600. Available from: https://multimedia.3m.com/mws/media/1000749O/3m-versaflo-tr-600-technical-specifications.pdf. Accessed October 29, 2018.

        View in Article

      10. 3M Versaflo High Durability Hood with Integrated Head Suspension S-533L product informational website. Available from:https://www.3m.com/3M/en_US/company-us/all-3m-products/∼/3M-Versaflo-High-Durability-Hood-with-Integrated-Head-Suspension-S-533L-Medium-Large-1-EA-Case/?N=5002385+3294753635&preselect=3293786499&rt=rud. Accessed July 16, 2019.

        View in Article

      11. 3M™ Versaflo™ Headcover with Integrated Head Suspension, S-133L-5 product informational website. Available from:https://www.3m.com/3M/en_US/company-us/all-3m-products/∼/3M-Versaflo-Headcover-with-Integrated-Head-Suspension-S-133L-5-White-Medium-Large-5-EA-Case/?N=5002385+3294753641&preselect=3293786499&rt=rud. Accessed July 16, 2019.

        View in Article

      12. Occupational Safety and Health Administration. Occupational safety and health standards: personal protective equipment: respiratory protection: 1910.134 App A. Available from: https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppA. Accessed October 10, 2018.

        View in Article

      13. BioTyper User Manual, Version 2.0. Bruker Maltronik GmbH; 2007.

        View in Article

      14. Occupational Safety and Health Administration. OSHA technical manual, section III: chapter 2, indoor air quality investigation, sampling instrumentation and methods. Available from:https://www.osha.gov/dts/osta/otm/otm_iii/otm_iii_2.html#4. Accessed June 24, 2019.

        View in Article

      Article Info

      Publication History

      Published online: September 10, 2019

      Footnotes

      Conflicts of interest: None to report.

      Identification

      DOI: https://doi.org/10.1016/j.ajic.2019.08.009

      Copyright

      Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.

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