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AUTOMATED BREATHING AND METABOLIC SIMULATOR (ABMS) EVALUATION OF N95 RESPIRATOR USE WITH SURGICAL MASKS

Sinkule, Edward (2013) AUTOMATED BREATHING AND METABOLIC SIMULATOR (ABMS) EVALUATION OF N95 RESPIRATOR USE WITH SURGICAL MASKS. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Objective: To reduce the threat of exhausting N95 filtering face piece respirator (FFR) supplies during pandemic influenza outbreaks, the Institute of Medicine has recommended using surgical mask covers (SM) over FFR among healthcare workers as one strategy to avoid surface contamination of the FFR. The objective of this investigation was to measure and evaluate breathing air quality (average inhaled CO2 and O2 concentrations), peak inhalation (InPr) and exhalation (ExPr) breathing pressures, and average inhaled dry-bulb (Tdb) and wet-bulb (Twb) temperatures when using FFR with FDA-cleared SM and without SM.
Methods: Thirty NIOSH-approved FFR models with and without SM were evaluated using the NIOSH Automated Breathing and Metabolic Simulator (ABMS). The ABMS protocol consisted of the following levels of O2 consumption, CO2 production, and minute ventilation performed consecutively for minimum of five min each (units in STPD): 0.5, 0.4, and 9.8 L∙min-1; 1.0, 0.8, and 25.3 L∙min-1; 1.5, 1.3, and 38 L∙min-1; 2.0, 1.9, and 62 L∙min-1; 2.5, 2.5, and 70 L∙min-1; and 3.0, 3.15, and 80 L∙min-1, respectively.
Results: The mean across all FFR without SM (FFR-alone) for average inhaled CO2 and O2 ranged from 2.7% and 17.1%, respectively, for the lowest metabolic rate to 1.7% and 19.2%, respectively, for the greatest metabolic rate. The mean across all FFR with SM (FFR+SM) for average inhaled CO2 and O2 ranged from 3.0% and 16.7%, respectively, for the lowest metabolic rate to 1.9% and 18.9%, respectively, for the greatest metabolic rate. The mean across all FFR-alone for InPr and ExPr ranged from -5 and 7 mmH2O, respectively, for the lowest metabolic rate to -41 and 24 mmH2O, respectively, for the greatest metabolic rate. The mean across all FFR+SM for InPr and ExPr ranged from -7 and 8 mmH2O, respectively, for the lowest metabolic rate to -51 and 30 mmH2O, respectively, for the greatest metabolic rate. The mean across all FFR-alone for Tdb and Twb ranged from 29 to 27°C, respectively, for the lowest metabolic rate to 32 and 28°C for the greatest metabolic rate. The mean across all FFR+SM for Tdb and Twb ranged from 29 to 27°C, respectively, for the lowest metabolic rate to 33 and 30°C for the greatest metabolic rate.
When grouped by respirator type and compared to FFR-alone, average inhaled CO2 concentration was significantly higher for cup FFR+SM and significantly lower for horizontal flat-fold FFR+SM. Reciprocal significant changes were observed for average inhaled O2 concentrations. ExPr was significantly higher for cup FFR+SM at V.O2 >1.0 L∙min-1. InPr was significantly higher for cup FFR+SM at all levels of energy expenditure, and higher for other flat-fold FFR+SM at V.O2 >1.5 L∙min-1. Tdb and Twb was significantly higher for cup FFR+SM at V.O2 >0.5 L∙min-1.
Conclusions: The orientation of the SM on the FFR may have a significant effect on the inhaled breathing quality at lower levels of energy expenditure and breathing pressures at higher levels of energy expenditure. The measureable InPr and ExPr caused by SM on FFR for healthcare users likely will be imperceptible at lower activity levels. While statistically significant, the changes in Tdb and Twb for FFR+SM compared to FFR-alone were small.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Sinkule, Edwardejs33@pitt.eduEJS33
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairGoss, Fredricgoss@pitt.eduGOSS
Committee MemberNagle, Elizabeth Fnagle@pitt.eduNAGLE
Committee MemberHostler, Davidhostdp@upmc.edu
Committee MemberTurner, Ninanxt2@cdc.gov
Date: 13 May 2013
Date Type: Publication
Defense Date: 7 February 2013
Approval Date: 13 May 2013
Submission Date: 22 April 2013
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 67
Institution: University of Pittsburgh
Schools and Programs: School of Education > Health and Physical Activity
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: breathing resistance; effects from using N95 respirators; extending N95 respirators during influenza outbreak; inhaled carbon dioxide; inhaled oxygen; metabolic simulator; N95 respirator; respiratory protection; surgical mask; using N95 respirators with surgical or procedure masks
Date Deposited: 13 May 2013 17:55
Last Modified: 15 Nov 2016 14:12
URI: http://d-scholarship.pitt.edu/id/eprint/18565

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