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Bashihab, Al-Zahrani, Al-Horaibi, Al-Nafesa, Emam, Al-Harthi, Al-Hajaj, and Harber: Subjective response to respirator use – comparison N95 respirator, surgical mask and face cover

Introduction: Health care workers are at risk of serious infectious diseases. Respiratory protective devices can reduce the risk. This project investigates how workers tolerate protective devices and if it affects activity.

Objectives: To study the effects of using respirators in combination with face cover on various activity levels among female health care workers.

Materials and methods: This study had a controlled experimental design with two factors: respirator type and activity type. Measures of effects were based upon a rating instrument (questionnaire) designed by the Saudi Arabia Medical Students team. Ratings were based on an ordinal six-point scale. The following factors were measured: breathing difficulty, clarity of speech, heat and sweating, level of concentration, vision and level of comfort. Tasks were designed to be comparable with common health care work. These included walking outdoors, climbing stairs carrying an object, reading out loud (comparable to patient interviewing) and level of concentration (comparable to attending meetings). The activities were pilot tested. Factors such as walking distance, pace, duration, temperature, voice level and object weight were standardized. Mask conditions were: N95 respirator (3M Model 1860, 3M, Saint Paul, MN, USA), basic surgical mask (Walgreens model # 023185056204, Walgreens, Deerfield, IL, USA), face cover + N95 combination and no mask.

Results: There were statistically significant effects for both respirator type and activity level [mixed linear model, SAS (Statistical Analysis System; SAS Institute Inc., Cary, NC, USA) Proc Mixed]. Wearing a respirator (N95) combined with face cover showed the highest score in interference with breathing and level of comfort with an average of 2.01 and 2.45, respectively. These differences were seen at all levels of exertion.

Conclusions: Better controlled studies are required to delineate if such findings could be extended to those who are of different age groups, of a different sex, such as bearded males, and individuals with acute or chronic diseases in the Kingdom of Saudi Arabia.

Acknowledgements: We would like to extend our gratitude to all those people who helped and supported us in completing this project and Dr Philip I Harber for supervising this project.

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