Workshop on Respiratory Protection for Airborne Infectious Agents

NOTE: This document is provided for historical purposes only.

Breakout Session Questions and Breakout Session Presentations

PLENARY SESSION 1: Control of Airborne Infectious Agents - Basics

Workshop Questions and Breakout Session Presentations 1 & 2 (PDF)

• From an aerosol physics standpoint, is there any evidence that infectious organisms behave differently than other particles of the same size and shape?
• What differentiates control of exposure to airborne infectious agents from exposure to toxic dusts or chemical aerosols?
• What are the differences in respiratory program elements needed for protection against infectious agents as compared with toxic gases or vapors that may be used in a healthcare facility and what evidence is used to support those differences if they exist?
• Should there be a distinction between airborne, aerosol and droplet transmission?
• To what extent does mouth/nose protection protect HCWs from infectious droplets?
• How should information on distance of droplet dissemination affect recommendations for HCW protection?
• Without an exposure limit, how can one determine when respiratory protection is needed and select the appropriate respiratory protection?
• Data (historical epidemiologic data and/or historical GIS exposure reduction data)?
• “Expert opinion”?
• APFs?
• How are APFs determined?
• How are APFs used?
• How does filtration efficiency relate to APFs?
• What limitations are imposed on use of respirators (by manufacturers, CDC, users, employers, others) in healthcare settings and on what data are those limitations based?

PLENARY SESSION 2: Current state-of-science about transmission of airborne infectious agents

Workshop Questions and Breakout Session Presentations 1 & 2 (PDF)

• What did we learn from the foreign experience on SARS, particularly in Toronto and Taiwan, about respiratory protection in hospitals?
• How do we determine the following?
• Generation of infectious particles from host?
• Transmission/dissemination through environment?
• Infection of susceptible person?
• Do we need organism-specific data?

PLENARY SESSION 3: Current state-of-science about respiratory protection

Workshop Questions and Breakout Session Presentations 3 & 4 (PDF)

• What scientific or anecdotal evidence is there of the effectiveness of respirators to filter airborne infectious agents and reduce infection?
• Do respirators perform any differently with viable aerosols compared to toxic dusts and chemicals?
• Are there any different concerns on the face-to-respirator seal when dealing with infectious aerosols?
• What scientific or anecdotal evidence is there of the effectiveness of surgical masks or un-certified respirators decrease exposure to airborne infectious agents and decrease the probability of infection?

PLENARY SESSION 4: Research on Respirator Performance

Workshop Questions and Breakout Session Presentations 3 & 4 (PDF)

• What research or data are available that could guide decisions on the necessary periodicity for fit-testing?
• Under what conditions can respirators be used without requiring fit-testing?
• What is the benefit of respirator fit-testing?
• Impact on appropriate use?
• Impact on exposure prevention?
• Impact on infection prevention?
• Does it ensure proper fit during use?
• What are the design considerations/parameters to guide design of good respirators?
• Are there data that determine the effectiveness of NIOSH-certified filtering facepiece respirators?
• How well do currently NIOSH-certified (and/or CEN or other organization) respirators fit the general population?
• Is it possible to design a respirator to fit the general population without fit testing?
• Does disinfection and reuse affect the performance of respirator face-seal fit or filtration efficiency? Can respirators be safely disinfected and reused; and if so, under what circumstances (i.e., method of disinfection, organism of interest, application/procedure, etc.)? What research has been done in this area?

PLENARY SESSION 5: Regulatory Perspectives and Outlook with additional discussion on manufacturers’ and users’ perspectives.

Workshop Questions and Breakout Session Presentations 5 (PDF)

• What are the research issues with respect to implementing respiratory protection programs?
• CEN (European-certified respirators):  Can CEN-certified respirators be used in the US?  What do we do during the next N95 shortage?  What if my employees fit better with a CEN-approved respirator?
• What is the scientific basis for limiting use of N95s to one shift or less while CDC/NIOSH document (DHHS/NIOSH Pub No. 96-101) says that, other than in high (200 mg) loading situations, their service life is limited by considerations of hygiene, damage, and breathing resistance? Does this apply equally to all airborne infectious agents?
• For those who run respiratory protection programs :
• If you need to operate a respiratory protection program for non-infectious agents (e.g.., potential exposures to toxic dusts and/or chemicals) is there a difference in the programs needed for toxic dusts and chemicals compared to infectious agents?
• Is there a difference in the scope (i.e., number of employees and resources necessary) of the program? Besides complying with current OSHA regulations, what are the benefits of comprehensive respiratory protection programs?
• What is the cost and cost effectiveness of respiratory protection programs?
• How should respiratory protection programs address respiratory protection for the general public (visitors, volunteers, etc.) who may be exposed to airborne infectious agents.