OBJECTIVES:
To compare the performance of four
N95 respirator types with
respect to quantitative fit test pass rate and
health care worker-rated usability and comfort. DESIGN, SETTING,
PARTICIPANTS:
Health care workers who participated in the respiratory
protection program at the Royal Melbourne
Hospital, 1 October 2020 - 31 May 2021. Participants underwent quantitative
N95 respirator fit testing (at least three of four types semi-rigid cup, flat-fold cup, duckbill, and three-panel flat-fold types), and were invited to complete an online usability and comfort assessment for
respirators for which their fit test results were passes. MAIN OUTCOME
MEASURES:
Fit test pass rate, and user-rated overall comfort and assessment ratings (five-point Likert
scales), by
N95 respirator type.
RESULTS:
A total of 2161
health care workers underwent quantitative fit testing (
women, 1586 [73.4%];
nurses, 1271 [58.8%]). The overall fit test pass rates were 65.0% for the semi-rigid cup
respirators (1029/1583 tests), 32.4% for the flat-fold
respirator (660/2035 tests), 59.2% for the duckbill
respirators (2005/3387 tests), and 96.4% for the three-panel flat-fold
respirator (1876/1946 tests). 378
health care workers completed the comfort and usability
survey. Overall comfort and assessment ratings each differed by
respirator group (P < 0.001); the median overall comfort (4; IQR, 3-4) and overall assessment values (4; IQR, 3-5) were highest for the three-panel flat-fold
respirator and lowest for the semi-rigid cup
respirators (comfort 2 [IQR, 1-3]; assessment 2 [IQR, 2-3]).
CONCLUSIONS:
The three-panel flat-fold
N95 respirator outperformed the three alternative types with regard to fit test pass rate and user-rated comfort and usability. To maximise respiratory
protection for
health care workers, these factors should be considered when making
respirator procurement decisions.