Protecting 18 million United States health care workers from infectious agents — known and unknown — involves a range of occupational safety and health measures that include identifying and using appropriate protective equipment. The 2009 H1N1 influenza pandemic and the 2014 Ebola virus outbreak in West Africa have called raised questions about how best to ensure appropriate and effective use of different kinds of personal protective equipment such as respirators, not only to promote occupational safety but also to reduce disease transmission.

The Use and Effectiveness of Powered Air Purifying Respirators in Health Care is the summary of a workshop convened by the Institute of Medicine Standing Committee on Personal Protective Equipment for Workplace Safety and Health to explore the current state of practices and research related to powered air purifying respirator (PAPRs) and potential updates to performance requirements. Presentations and discussions highlighted current health care practices using PAPRs and outlined the research to date on the use and effectiveness of PAPRs in health care settings with a focus on the performance requirements. The Use and Effectiveness of Powered Air Purifying Respirators in Health Care focuses on efficacy, current training, maintenance, supplies, and possible enhancements and barriers to use in inpatient, clinic, nursing home, and community (home) settings. This report also explores the strengths and weaknesses of using various approaches to health care PAPR standards.

Contents

• THE NATIONAL ACADEMIES
• PLANNING COMMITTEE
• Reviewers
• 1. Introduction
  • OPENING REMARKS
• 2. Defining PAPRs and Current Standards
  • NIOSH CERTIFICATION STANDARDS
  • REGULATORY PERSPECTIVE
  • ISO RESPIRATORY PROTECTIVE DEVICE STANDARDS
  • DISCUSSION ON STANDARDS AND REGULATION
• 3. Why, Where, and How PAPRs Are Being Used in Health Care
  • WORKER EXPERIENCE IN USING PAPRs IN HEALTH CARE SETTINGS
  • EMPLOYER EXPERIENCE IN USING PAPRs IN HEALTH CARE SETTINGS
  • PAPRs AND EMERGENCY PLANNING
• 4. Research and Design Perspectives
  • RESPIRATORY DEMANDS OF THE HEALTH CARE WORKFORCE
  • EVALUATING PHYSIOLOGICAL REQUIREMENTS WHEN USING PAPRs
  • IMPACT OF CERTIFICATION STANDARDS ON RESEARCH AND DESIGN
• 5. Priorities and Opportunities for Improving PAPRs for Use in Health Care
  • IMPROVE PAPR DESIGN AND STANDARDS: ASSESSING THE RISKS AND INCORPORATING HEALTH CARE NEEDS
  • INCREASE EDUCATION AND TRAINING
  • STRENGTHEN IMPLEMENTATION AND USE
• References
• APPENDIXES
  • A Agenda
  • B Registered Attendees

Rapporteurs: Catharyn T. Liverman, Sarah B. Domnitz, and Margaret A. McCoy.

This project was supported by Award #10002141 between the National Academy of Sciences and the United States Department of Health and Human Services Centers for Disease Control and Prevention. The views presented in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2015. The use and effectiveness of powered air purifying respirators in health care: Workshop summary. Washington, DC: The National Academies Press.

NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.