Still, government health and safety organizations are standing by the more stringent standard of protection.
IOM spokeswoman Christine Stencel says that the National Institute for Occupational Safety and Health and others have provided “convincing data” on the ability of the respirators to filter out a large percentage of tiny particles.
“Based on all the available evidence and data that the committee had to look at, [it recommended] that the N95 respirator afforded the best potential protection against airborne transmission of the virus, and therefore that was the recommendation for health-care workers in terms of respiratory protection,” she says.
The Centers for Disease Control and Prevention (CDC) developed its policy independently of the IOM and the MacIntyre study, explains CDC spokesman Jeff Dimond. However, it’s similar in terms of respirator use. The CDC recommends that health-care workers in close contact with people with suspected or confirmed H1N1 influenza use a properly fitted, disposable N95 respirator, or something that offers similar or better protection.
The current recommendation is based on unique conditions associated with the current pandemic, including low levels of population immunity to 2009 H1N1, the potential for health-care personnel to be exposed to H1N1 patients, and other factors, Dimond says.
In October 2009, the Occupational Safety and Health Administration (OSHA) said it would soon issue a “compliance directive” to ensure that health-care facilities have controls in place to protect workers from occupational exposures to swine flu. OSHA said its directive would closely follow the CDC’s guidance.
In Dr. Rupp’s opinion, the respiratory protection debate has distracted from other crucial flu-fighting measures. These include:
- Quickly identifying and isolating patients with influenza-like illness.
- Preaching respiratory etiquette programs. Patients who are ill should be asked to wear a surgical mask to contain their secretions, he says, and they should use tissues and wash their hands frequently to prevent touch contamination.
- Encouraging hospital visitors to stay home if they’re sick and urging health-care workers to stay home when they’re sick.
- Getting seasonal and H1N1 vaccines. “For health-care workers, that is by far the best way to protect them,” he says.
