Particulate Respirators

When Airborne Precautions are necessary (i.e., Transmission-based Precautions), a National Institute for Occupational Safety and Health (NIOSH)-certified, fit-checked particulate-filter respirator, a Class II medical device, must be worn.1-3 OSHA guidelines further require (1) medical clearance for healthcare personnel to wear a respirator, (2) education on respirator use, and (3) periodic re-evaluation of the respiratory protection program in each healthcare setting.11

Airborne Precautions require that healthcare personnel wear NIOSH-certified N95, N99, or N100 particulate-filter respirators, which have the ability to filter particles in the range of 0.1 to 1.0 micron with a filtration efficiency of 95, 99, and 99.8% respectively.11 A user seal-check (“fit-check”) must be performed by the wearer of a respirator each time a particulate respirator is donned to confirm that there is no air leakage around the facepiece.11

Currently, the CDC recommends the use of a N95 or higher level respirator by OHCP exposed to patients with suspected or confirmed tuberculosis.12 Although Airborne Precautions are recommended for preventing airborne transmission of influenza, measles, varicella-zoster, and SARS viruses, there are no data upon which to base a recommendation beyond Standard Precautions for respiratory protection of susceptible OHCP against these pathogens.