Use and fit of filtering facepiece respirators in a department of anaesthesiology

Abstract

Background: Reliable protection against nosocomial tuberculosis transmission in theatre depends on the appropriate use of filtering facepiece respirators (FFRs) with an N95 filter, as recommended by the Centers for Disease Control and Prevention. Aim: To describe anaesthetist compliance and comfort with the use of FFRs, followed by donning technique and fit tests outcomes. Design: Prospective, contextual, descriptive, two part study. Setting: Part 1 was done in a university affiliated department of anaesthesiology. Part 2 was a pilot study in the theatre complex of a 1200-bed tertiary-level academic hospital. Participants: Part 1 – anaesthetists in the department selected by convenience sampling (n=140). Part 2 – anaesthetists selected by stratified random sampling (10 male and 10 female). Methods: In Part 1 a self-administered questionnaire was distributed. In Part 2 the donning technique was directly observed, corrected, then followed by qualitative fit testing with the single model and size FFR available. Results: Part 1 -Compliance with the use of the FFR was inadequate with a compliance score of 14.5 (SD 5.0) out of 25. FFRs are deemed to be uncomfortable (discomfort score of 9.9 (SD 4.0) out of 21.) Part 2 - Of the 20 anaesthetists, six (30%), five males and one female, passed the fit test. Conclusions: Compliance with FFR use was poor and anaesthetists at the research institution found the FFRs uncomfortable. FFR donning technique was observed to be lacking. Research with a larger study group is required. Poor fit test results were most likely due to the availability of only one size and model of FFR.