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 Table of Contents  
LETTER TO EDITOR
Year : 2022  |  Volume : 17  |  Issue : 3  |  Page : 802-803

N95: Hurdles ahead!


Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Submission24-Jun-2020
Date of Decision01-Mar-2021
Date of Acceptance17-Dec-2021
Date of Web Publication2-Nov-2022

Correspondence Address:
Dr. Mini P Singh
Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_236_20

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How to cite this article:
Chauhan P, Gupta P, Goyal K, Sangeetha K, Singh MP. N95: Hurdles ahead!. J Datta Meghe Inst Med Sci Univ 2022;17:802-3

How to cite this URL:
Chauhan P, Gupta P, Goyal K, Sangeetha K, Singh MP. N95: Hurdles ahead!. J Datta Meghe Inst Med Sci Univ [serial online] 2022 [cited 2023 Feb 4];17:802-3. Available from: http://www.journaldmims.com/text.asp?2022/17/3/802/360197



Dear Editor,

With the ongoing coronavirus disease 2019 pandemic, the usage of N95/P2 respirators among healthcare workers has raised concerns. It has been noted that adequacy of the fit declines with increase in facial hair, with full beards rarely achieving an adequate fit.[1] Thereby, full beards are not recommended for health care workers. However, in a country like India, where people of different religions reside in harmony, shaving of hair is forbidden owing to the religious sentiments as in Sikh community, which contributes to 24 million of Indian population with 77% residing in Punjab.[2] Moreover, Sikh communities exist globally in multiple continents such as the United States, Canada, and the United Kingdom. Respecting their religious sentiments, the Hospital Administration should ensure that such healthcare workers should be excluded from dealing with respiratory pathogens where wearing N95 is mandatory or provide suitable alternative in the form of powered air-purifying respirator (PAPR).[3],[4] Further, many healthcare workers who may be required for handling potential respiratory pathogens may be keeping beard, as most of the Indian healthcare setups do not have a strict policy on keeping the type of beard as recommended by Centers of Disease Control and Prevention and National Institute of Occupational Safety and Health (NIOSH).[4] NIOSH recently presaged that any hair either growing or protruding into the area of primary sealing surface prevents a good fit.[5] Henceforth, in the absence of a proper fit (owing to beard or inappropriate size), the N95 mask may not be protective.

The ongoing pandemic of novel coronavirus (SARS-CoV 2) across the globe has led to an upsurge in the use of N95 masks among healthcare personnel as advised by the World Health Organization.[6] N95 masks are nonresistant to oil and hoard at least 95% of aerosol challenge. Proper donning of these respirators demands tight sealing to the face and gaps in the seal due to inadequate fit lead to leakage of contaminated air inside the respirator, which the respirator filters are unable to clean. As per the manufacturer's instructions for N95 mask, even a day or two growth of facial stubble can be enough to give significant leak paths for contaminants. In such a scenario, the manufacturer recommends the use of a PAPR with suitable filters or a supplied airline systems with a hood or helmet style head top, as needed.[4] The PAPRs are expensive and not readily available in resource-poor countries like India. An important part of preparedness for impending threats would be induction training for the usage of N95 mask and PAPR among the healthcare workers to prevent nosocomial infections. Hence, preparedness for the deadly pandemic is required not only in terms of stockpiling of personal protective equipment and N95 masks, but standard operating procedures should also be available and refresher training should be carried out to ensure their effective protection. It is important to have policies in place “To Beard or Not to Beard” for those dealing with aerosol-generating procedures.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sandaradura I, Goeman E, Pontivivo G, Fine E, Gray H, Kerr S, et al. A close shave? Performance of P2/N95 respirators in healthcare workers with facial hair: Results of the BEARDS (BEnchmarking Adequate Respiratory DefenceS) study. J Hosp Infect 2020;104:529-33.  Back to cited text no. 1
    
2.
Census Reference Tables, C-Series Population by Religious Communities. Available from: http://censusindia.gov.in/Census_Data_2001/Census_data_finder/C_Series/Population_by_religious_communities.htm. [Last accessed on 2020 Mar 26].  Back to cited text no. 2
    
3.
Understanding Respiratory Protection Options in Healthcare: The Overlooked Elastomeric Blogs CDC. Available from: https://blogs.cdc.gov/niosh-science-blog/2017/07/06/elastomerics/. [Last accessed on 2020 Mar 26].  Back to cited text no. 3
    
4.
To Beard or not to Beard? That's a Good Question! Blogs CDC. Available from: https://blogs.cdc.gov/niosh-science-blog/2017/11/02/noshave/. [Last accessed on 2020 Mar 02].  Back to cited text no. 4
    
5.
NIOSH Updates Position on Facial Hair, Respirator Use. American Industrial Hygiene Association. Available from: https://www.aiha.org/news/niosh-updates-position-on-facial-hair-respirator-use.[Last accessed on 2020 Mar 26].  Back to cited text no. 5
    
6.
When and How to Use Masks. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks. [Last accessed on 2020 Feb 11].  Back to cited text no. 6
    




 

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