NDLI: Evaluation of the user seal check on gross leakage detection of 3 different designs of N95 filtering facepiece respirators.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lam, Simon C. Lui, Andrew K. F. Lee, Linda Y. K. Lee, Joseph K. L. Wong, K. F. Lee, Cathy N. Y.
Description	Author Affiliation: Lam SC ( Division of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China. Electronic address: chlam@ouhk.edu.hk.); Lui AK ( Computing, School of Science and Technology, The Open University of Hong Kong, Hong Kong, China.); Lee LY ( Division of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China.); Lee JK ( Division of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China.); Wong KF ( Division of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China.); Lee CN ( Division of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China.)
Abstract	BACKGROUND: The use of N95 respirators prevents spread of respiratory infectious agents, but leakage hampers its protection. Manufacturers recommend a user seal check to identify on-site gross leakage. However, no empirical evidence is provided. Therefore, this study aims to examine validity of a user seal check on gross leakage detection in commonly used types of N95 respirators. METHODS: A convenience sample of 638 nursing students was recruited. On the wearing of 3 different designs of N95 respirators, namely 3M-1860s, 3M-1862, and Kimberly-Clark 46827, the standardized user seal check procedure was carried out to identify gross leakage. Repeated testing of leakage was followed by the use of a quantitative fit testing (QNFT) device in performing normal breathing and deep breathing exercises. Sensitivity, specificity, predictive values, and likelihood ratios were calculated accordingly. RESULTS: As indicated by QNFT, prevalence of actual gross leakage was 31.0%-39.2% with the 3M respirators and 65.4%-65.8% with the Kimberly-Clark respirator. Sensitivity and specificity of the user seal check for identifying actual gross leakage were approximately 27.7% and 75.5% for 3M-1860s, 22.1% and 80.5% for 3M-1862, and 26.9% and 80.2% for Kimberly-Clark 46827, respectively. Likelihood ratios were close to 1 (range, 0.89-1.51) for all types of respirators. CONCLUSIONS: The results did not support user seal checks in detecting any actual gross leakage in the donning of N95 respirators. However, such a check might alert health care workers that donning a tight-fitting respirator should be performed carefully.
File Format	HTM / HTML
ISSN	01966553
Issue Number	5
Journal	American Journal of Infection Control
Volume Number	44
e-ISSN	15273296
Language	English
Publisher	Elsevier
Publisher Date	2016-05-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Communicable Diseases
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Public Health, Environmental and Occupational Health Epidemiology Health Policy

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