In general, there are two types of respirators: (1) air-purifying respirators that filter out or capture harmful agents from the surrounding air, and (2) air-supplying respirators that provide a separate source of clean air for breathing.

A: No, only certain certified respirators will protect you against TB. Also, OSHA requires the use of certified respirators when respiratory protection is needed.

A: The National Institute for Occupational Safety and Health (NIOSH).

A: Certified respirators have a certification number (TC-84A-XXX) or (TC-21C-XXX) and a NIOSH or NIOSH/MSHA approval label on the filter, container, instruction sheet and sometimes on the respirator (See the following samples).

New NIOSH Approval Label

NIOSH/MSHA (HEPA) Approval Label

Types of Respirators for Protection Against TB

These respirators remove small particles from the air you breathe. There are several types of particulate respirators (HEPA, N, P or R series) that are available for use against TB. Some are made without exhalation valves, making them particularly useful in certain health-care settings.

Replaceable filter and disposable respirators

USE particulate respirators when entering TB isolation rooms or other areas of the health-care facility that your employer has determined require respiratory protection. A face shield may provide additional protection against body fluids.

DO NOT USE particulate respirators with an exhalation valve when working in a sterile field, such as an operating room. The exhalation valve allows droplets and particles exhaled by the health care worker to escape and potentially contaminate the surgical field.

• These respirators are light weight and do not restrict mobility.
• These respirators are low cost (compared to other respirators).

• This respirator is a negative-pressure device using the suction produced by inhalation to draw air through the filter. The inhalation process, under the best of circumstances, will allow some contaminated air to leak into the facepiece.
• Communication can be difficult.
• Models with a full facepiece may fog up during use.

• These respirators may be available in as many as three sizes.
• Fit check this respirator every time you put it on to ensure a proper fit. Follow the manufacturers' recommendations, which can be found in the packaging. [See "Q: Can I check the fit of my respirator?"]
• This respirator can be used for as long as it remains functional. The filter on a disposable respirator should be discarded when it or the disposable respirator is physically damaged, or soiled. Disposable respirators should also be discarded when they fail the fit check.

Fit Check: worker covering inlet and inhaling

A PAPR uses a blower to pass contaminated air through a HEPA filter, which removes the contaminant and supplies purified air to a facepiece, hood or helmet.

PAPRs should be used when disposable and reusable half-masks do not provide adequate protection. Your employer should perform a risk assessment to identify situations in your health-care facility that might require the use of this advanced level of respiratory protection. A face shield may also be used in conjunction with a half-mask PAPR for protection against body fluids. Whenever high risk procedures such as bronchoscopy or autopsy are conducted, respiratory protection exceeding the CDC standard performance criteria may be needed. Better respirators include half- and full-face negative pressure respirators, PAPRs, or positive-pressure airline half-mask respirators.

Since this type of respirator exhausts air contaminated by the user, it should not be worn during sterile procedures. Hoods, helmets, and facepiece exhalation valves allow droplets and particles to escape, potentially spreading any contagious particles to the surgical field by the health care worker.

• This type of respirator usually provides better protection than the other types already mentioned.
• The PAPR is easier to breathe through, more comfortable, and enough air is delivered to the facepiece, hood or helmet that leakage is usually outward.

• A PAPR can be bulky, noisy, depends on a battery for operation, and is not a true positive pressure device (may allow leakage into hood, helmet, or facepiece).
• Communication can be difficult.

• PAPRs utilizing half-mask and full facepieces are usually available in three sizes. Loose-fitting PAPRs (hoods, helmets, etc.) are available in one size intended to fit everyone.
• Filters should be thrown away when they become physically damaged or soiled.

Supplied-air respirators use compressed air from a stationary source delivered through a hose under pressure to a half-mask or full facepiece.

This type of respirator should be used when disposable, reusable respirators, or PAPRs do not provide adequate protection. Your employer should perform a risk assessment to identify situations in your health-care facility that might require the use of this advanced level of respiratory protection. A face shield may also be used in conjunction with a half-mask airline respirator for protection against body fluids.

Since this type of respirator exhausts air contaminated by the user it should not be worn during sterile procedures. The exhalation valve allows droplets and particles to escape through the valve, potentially spreading any contagious particles to the surgical field by the health care worker.

• The supplied-air respirator is much more protective because it provides a positive pressure in the facepiece and almost all leakage is outward.

• A source of breathing air is needed and the airline hose may limit movement.
• Communication can be difficult.

• These respirators are usually available in three sizes.

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