The adequacy of user seal checking for N95 respirators compared to formal fit testing: A multicentred observational study.

OBJECTIVE: The objective of this study was to evaluate the adequacy of the user seal check (USC) in predicting N95 respirator fit. DESIGN: This was a prospective, observational study conducted from May to September 2020. SETTING: The study setting included three private intensive care units (ICUs) in Victoria, Australia. PARTICIPANTS: ICU staff members in three private ICUs in Melbourne and regional Victoria participated in this study. MAIN OUTCOME MEASURES: The main outcome measure is the proportion of participants who passed a USC and subsequently failed fit testing of an N95 respirator. INTERVENTION: Three different respirators were available: two N95 respirator brands and CleanSpace HALO® powered air-purifying respirator. Participants were sequentially tested on N95 respirators followed by powered air-purifying respirators until either successful fit testing or failure of all three respirators. The first N95 tested was based on the availability on the day of testing. The primary outcome was failure rate of fit testing on the first N95 respirator type passing a USC. RESULTS: Of 189 participants, 22 failed USC on both respirators, leaving 167 available for the primary outcome. Fifty-one of 167 (30.5%, 95% confidence interval = 23.7-38.1) failed fit testing on the first respirator type used that had passed a USC. CONCLUSION: USC alone was inadequate in assessing N95 respirator fit and failed to detect inadequate fit in 30% of participants. Mandatory fit testing is essential to ensure adequate respiratory protection against COVID-19 and other airborne pathogens. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12620001193965.

A study of special care dental patient preference toward choice of mask and visor use by dental clinicians.

BACKGROUND: Do patients have a preference for the clinician's choice of face protection (visor or mask), and can this make a difference to the patient's feelings of anxiety? METHOD: In a normative sample (n = 72) of patients from Special Care Dentistry, different combinations of face protection were studied to see whether the patients clearly preferred one type over another, and whether that was related to the levels of anxiety they suffered, based on the modified dental anxiety scale. RESULTS: The majority of patients, 68% had the visor only as their first choice of face protection. This was followed by 22% having the mask only as their first choice and 10% having the visor and mask combination as their first choice. Patients with higher anxiety levels were more likely to believe that the type of face protection worn by the dentist would affect their levels of anxiety. CONCLUSION: The patients preferred the visor only option. As the level of anxiety rose, so did the percentage of patients that felt the style of protection worn by the dentist would affect their level of anxiety. The comments from patients referred to the benefit of nonverbal communication offered by the visor.