Using Surgical Masks in Place of N95 Masks May Put Healthcare Workers at Greater Risk for COVID-19
The shortages of medical supplies—particularly N95 respirator face masks—due to the COVID-19 pandemic resulted in the Centers for Disease Control and Prevention (CDC) loosening its coronavirus guidance regarding facemasks. This change allows healthcare workers to wear surgical facemasks as an acceptable alternative to N95 respirator masks except when performing an intubation or any procedure on a COVID-19 patient that might release a high volume of virus particles. (https://www.washingtonpost.com/health/2020/03/10/face-mask-shortage-prompts-cdc-loosen-coronavirus-guidance/)
However, in an emailed statement, the CDC suggested that its guidance is meant to conserve scarce resources and applies primarily to shortage situations. Many health facilities—citing the CDC guidelines and scarce supply—are providing N95s in only limited medical settings.
Safety professionals and some former regulators in the field of occupational safety are expressing concern that the use of less protective surgical masks may be contributing to the growing numbers of front-line healthcare workers contracting COVID-19.
The president and executive director of the International Safety Center and a past chair of the Occupational Health and Safety section of the American Public Health Association explained the worker safety concern with this short, simple statement, “A surgical mask is not PPE (personal protective equipment.)”
The CDC loosened guidance also differs from another CDC publication, “Understanding the Difference,” which points out that a surgical mask does not protect the wearer from smaller airborne particles and is not considered respiratory protection. (https://www.cdc.gov/niosh/npptl/pdfs/UnderstandDifferenceInfographic-508.pdf)
The 3-M Company has a web publication, “Respirators and Surgical Masks: A Comparison,” demonstrating how the N95 respirator filters out at least 95% of airborne particles, including large and small particles. The 3-M article can be found at: https://multimedia.3m.com/mws/media/957730O/respirators-and-surgical-masks-contrast-technical-bulletin.pdf.
Compliance Perspective
Unnecessarily using surgical facemasks in place of N95 respirators may place staff at greater risk of contracting COVID-19 due to the fact that a surgical mask may not filter smaller airborne particles related to COVID-19 and other airborne infectious organisms.
Discussion Points:
- Review policies and procedures to determine if sufficient resources have been allocated to ensure that an adequate supply of PPE, including N95 respirators, is maintained for an infectious outbreak like COVID-19.
- Train staff on the proper use and disposal of PPE, including when an N95 respirator is necessary, and the importance of handwashing and other infection control protocols.
- Periodically audit to determine if adequate supplies of N95 respirator masks are able to be obtained, and if all necessary types of PPE are available.
