Well, it’s finally happened. After five years of intense preparations for an Avian Influenza A (H5N1) pandemic ("bird flu"), we have a swine-origin Influenza A (H1N1) pandemic instead. Fortunately, our preparedness efforts will work in either scenario. There are several authoritative references to consult to stay up-to-date on what is happening throughout the
This web site is devoted entirely to one aspect of an influenza pandemic response - the use of facemasks and respirators. Many people have probably seen video clips or still photos in magazines of people in Mexican and other parts of the world wearing facemasks to help slow the spread of this novel H1N1 Influenza A strain. Although there are many different types of facemasks and respirators, they all basically function in the same way.
Unfortunately, many people use the word "mask" loosely to mean either a facemask or a respirator. However, this is an essential distinction, because there are a number of significant differences between facemasks and respirators. Moreover, few people outside of health care have any knowledge of, or experience with, using facemasks or respirators for infection control or public health purposes. Buying some facemasks or respirators at your local pharmacy or hardware store isn’t enough. You must also learn how to use them properly.
Influenza is spread by several modes of transmission. Wearing facemasks or respirators doesn’t address all of them. Moreover, wearing facemasks or respirators may give people a false sense of security, encouraging them to engage in riskier behavior than they would otherwise.
Just how effective are facemasks and respirators? Used correctly, facemasks and respirators may reduce, but not eliminate, the risk of contracting or spreading influenza. Therefore, the use of facemasks and respirators is only one component in a system of personal, household, community and healthcare measures to reduce risk or contracting influenza and slow the spread of influenza during an influenza pandemic.
The most important thing to understand about facemasks and respirators is that they don’t offer anything approaching complete “protection.” When used properly, facemasks and respirators can help reduce, but not eliminate, the risk of contracting or spreading pandemic influenza. Proper training in how to use a facemask or respirator is crucial to achieving the performance it was designed to achieve. It is especially important when dealing with influenza to properly remove a facemask or respirator without contaminating your hands or face, then to immediately wash your hands and face. Otherwise, you may touch infectious material deposited on the outside of the facemask or respirator, and then inoculate your mouth, nose or eyes by inadvertently touching them.
There are many questions surrounding the use of facemasks and respirators during an influenza pandemic such as:
Facemasks and respirators may be of particular importance during the first 3-6 months of an influenza pandemic. This is because it will take time to develop, distribute and administer a vaccine, which is widely regarded as the best hope for protecting people in the long run. In the interim, it may also be necessary to implement “social distancing” measures such as selective school and daycare closings, and cancellation of mass public gatherings such as concerts, parades and sporting events. Finally, during the initial phase, there will be many uncertainties about the new pandemic flu virus including the relative contribution of the different modes of transmission. Therefore, the conservative approach is to include the use of facemasks and respirators in addition to these other strategies.
This web site is hosted by a hospital safety officer who manages the health care respiratory protection program for a regional health care delivery system in the Northeast. He is available for speaking engagements in the Greater Boston, Massachusetts and
Disclaimer
The information in this website is of an introductory nature, and is intended to increase awareness of this important topic. The author has used reasonable diligence in compiling this information from authoritative sources. However, the author makes no warranty, express or implied, as to the suitability of this information for any specific person or situation. Moreover, because the author cannot control how you choose to use or not use this information, he expressly disclaims any legal liability arising from the detrimental reliance thereon. This web site is not intended to diagnose or treat any disease. Only a licensed health care professional can do that. If you have specific health questions, please seek the guidance of a licensed health care provider, or local, state or federal public health officials.
Please feel free to submit questions or constructive comments about this website to mailto:info@podflu.com. The author regrets that he may not be able to reply to each question or comment individually. Instead, he will respond to topics of general interest via this website. However, he will not identify the source of the question or comment without your express written consent to do so.
The information in this website will help prepare you to pursue additional reading in the resources below.
General Information
U.S. Government’s Clearinghouse for Swine, Avian and Pandemic Influenza:
http://www/pandemicflu.gov
CDC: H1N1 Flu (Swine Flu):
http://www.cdc.gov/h1n1flu/
Facemasks and Respirators for H1N1 Influenza A (Swine Flu)
PandemicFlu.gov Masks/Respirators:
http://www.pandemicflu.gov/vaccine/mask.html
CDC: Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission
http://www.cdc.gov/h1n1/flu/masks
The Food and Drug Administration (FDA) and Personal Protection Equipment for the 2009 H1N1 Flu Virus Questions and Answers link (this includes another good discussion about the differences between facemasks and N95 respirators):
http://www.fda.gov/oc/opacom/hottopics/H1N1Flu/ppe_faq.html
CDC Pandemic Influenza Links
For health care institutions:
Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic, October, 2006
http://www.pandemicflu.gov/plan/healthcare/maskguidancehc.html
For members of the general public:
Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemic, May, 2007.
http://www.pandemicflu.gov/plan/community/maskguidancecommunity.html
FDA Links:
Personal Protective Equipment and Influenza Outbreaks, including Bird Flu (Avian Influenza)
http://www.fda.gov/cdrh/ppe/fluoutbreaks.html
Masks and N95 Respirators
http://www.fda.gov/cdrh/ppe/masksrespirators.html
Respirators for Public Health Emergencies
http://www.fda.gov/consumer/updates/respirators061107.html
Search for all FDA-cleared surgical masks:
http://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm?st=fxx+or+(surgical+mask)
Search for all FDA-cleared surgical N95 respirators:
http://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm?st=msh+or+(N95)
National Academies News, Reuse of Disposable Medical Masks During Flu Pandemic Not Recommended; Reusing Respirators Is Complicated, April 27, 2006
http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=11637
Reusability of Facemasks During an Influenza Pandemic: Facing the Flu, April, 2004, The National Academies Press
http://www.nap.edu/catalog.php?record_id=11637
National Institute of Occupational Safety and Health (NIOSH)
NIOSH-Approved Disposable Particulate Respirators (Filtering Facepieces)
http://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/
OSHA Pandemic Flu Links (although this pertains to employers and employees,
much of this guidance can be extrapolated to non-work environments):
Guidance on Preparing Workplaces for an Influenza Pandemic, 2007,
OSHA/DOL Publication No. 3327-02N.
Pandemic Influenza Preparedness and Response Guidance for
Healthcare Workers and Healthcare Employers, 2007, OSHA Publication No. 3328-05.
Updated 6/13/09
