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NIOSH Personal Protective Technology Program Healthcare Stakeholder Meeting

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The National Institute for Occupational Safety and Health (NIOSH) Personal Protective Technology Program (PPT) and National Personal Protective Technology Laboratory (NPPTL) held our Stakeholder Meeting on Respiratory Protection for Healthcare Workers on June 18, 2013. Focusing on a theme of improving healthcare worker compliance with respiratory protection, this gathering was an opportunity to exchange knowledge and ideas between professionals, policy makers, and manufacturers involved in the field of personal protective equipment for healthcare workers.

Stakeholder feedback was sought to (1) provide input to future updates of the NIOSH PPT program research agenda and (2) assess progress toward better respirators for healthcare workers. The meeting included presentations by leading experts in the field to discuss the latest scientific data and moderated roundtable discussions on emerging topics in respiratory protection for healthcare workers.

Below you will find links to each of the presentations delivered during this meeting.

DISCLAIMER: These proceedings are intended to be used to advance the knowledge needed for improving worker safety and health. The findings, conclusions, and recommendations in these presentations and the agenda are those of the authors and do not constitute National Institute for Occupational Safety and Health (NIOSH) endorsement. Recommendations are not final statements of NIOSH policy or the author’s agencies. Mention of any company or product does not constitute endorsement by NIOSH. In addition, citations to Web sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these Web sites.

View the Speaker Biographies

Presentations

Welcome Remarks

Maryann D’Alessandro, NPPTL Director, PPT Program Manager

Maryann D’Alessandro, Director of the NIOSH National Personal Protective Technology Laboratory welcomes attendees to the 2013 Personal Protective Technology Program Healthcare Stakeholder Meeting.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Respiratory Protection, Infection Control, and Preparing for Pandemic Influenza

Stephen Redd, CDC Influenza Coordination Unit

This presentation by Dr. Stephen Redd served as the keynote address of the meeting. Dr. Redd’s presentation focused on key respiratory protection and infection control issues before, during, and after the 2009 H1N1 influenza pandemic and concluded with next steps in pandemic preparedness.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Progress Toward Updating the NIOSH PPT Program Action Plan for Healthcare Worker Personal Protective Equipment (2013-2018)

Ron Shaffer, NIOSH

Dr. Shaffer’s presentation provided an update on the current status of the NIOSH PPT program’s revised healthcare worker PPE action plan and discussed plans for obtaining stakeholder feedback.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Roundtable 1

Improving the Evidence Base to Support Guidance on the Appropriate Level of Respiratory Protection

Moderator, David Kuhar

Exposure to Influenza Aerosols during Routine Patient Care

Werner Bischoff, Wake Forest

Dr. Bischoff reported on a study that found that healthcare practitioners could be exposed to infectious dosages of influenza primarily in small particle aerosols up to 6 feet from patients.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

NIOSH Influenza Transmission Research

Bill Lindsley, NIOSH

Dr. Lindsley gave an overview of NIOSH research on how influenza is transmitted from person to person, with a particular focus on infectious aerosols.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Respiratory Protection in Healthcare Workers: Lessons from the Trenches—the ResPECT Study

Trish Perl, Johns Hopkins University

Dr. Perl gave an overview of progress to date on the Respiratory Protection Effectiveness Clinical Trial (ResPECT).

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Roundtable 2

Healthcare Worker Observational Studies of Respirator Use & New Educational Resources

Moderator - Debbie Novak, NIOSH

Adherence to Respiratory Protection Guidelines by Healthcare Workers and Hospitals: the REACH 2 Evaluation

Kristina Peterson, RTI

Dr. Peterson reported on continuing efforts related to the Respirator Evaluation in Acute Care Hospitals Study (REACH). The study found high hospital-level adherence to requirements for a respirator protection program and to fit testing standards, but also found notable gaps in knowledge and adherence among each responder group.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Development of a Hospital Respiratory Protection Program National Toolkit

Barbara Materna, California Department of Public Health

Dr. Materna described the adaptation of the California-specific Hospital Respiratory Protection Program toolkit into a national version to be released as web-based NIOSH-OSHA co-branded educational material.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Roundtable 3

Emerging Topic - Considerations for Extending Respirator Supplies During an Outbreak or Pandemic

Moderator - Lisa Koonin, CDC

Filtering Facepiece Respirators and Viable Microbial Aerosols

Brian Heimbuch, ARA

In this presentation, Mr. Heimbuch provided an overview of research done the past 6 years aimed at better understanding current filtering facepiece respirator performance and developing data that can be used for advanced development.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Transfer of Influenza from Contaminated FFRs to the Hands of Healthcare Workers

Ed Fisher, NIOSH

Mr. Fisher reported on modeling and experimental efforts that estimated that significant virus transfer from contaminated facemasks to the fingertips of healthcare workers was unlikely.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

FDA Regulatory Process for Premarket (510 k) Submission: General and Antimicrobial containing Surgical N95 Respirators

Elizabeth F. Claverie-Williams, FDA and Ramesh Kapil Panguluri, FDA

In this presentation, FDA scientists gave an overview of the FDA’s processes for clearing Surgical N95 respirators.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Roundtable 4

Standards & Test Methods for Improved Respirators for Healthcare Workers

Moderator - Lewis Radonovich, VA

Progress Toward a “B95” Respirator for Healthcare Personnel

Ron Shaffer, NIOSH

Dr. Shaffer described recent progress on the “B95” respirator concept, including draft requirements, test methods, and pass/fail criteria.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Human Correlation Fit Testing of a Static Advanced Headform

Ziqing Zhuang, NIOSH

Dr. Zhuang reported results from a study that found that a specially designed static headform with silicone polymer skin was a promising tool assessing respirator fit.

Disclaimer: The respirators used in this study were randomly selected from those commercially available. The study was not done to determine respirator performance but to determine whether the fit measured on a headform correlates with the fit obtained by a person wearing the respirator. There are other models available (including some from the same manufacturer) that were not tested. Due to the limited number of tests performed people should not generalize that any one respirator performs better than others in the same class based on the results of this study.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Measuring The Factors That Impact Respirator Comfort And Tolerability

Ray Roberge, NIOSH

Dr. Roberge reported on a series of studies done at NPPTL that found that respirator comfort and tolerability are related to a complex interplay of various factors that impact individual users differently.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Update on NIOSH Respirator Standards Affecting Healthcare

Jon Szalajda, NIOSH

Mr. Szalajda’s presentation addressed the alignment of NIOSH’s standards development efforts with consensus standards activities.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Roundtable 5

Advances Toward Improved Respirators for Healthcare Workers

Moderator - Melanie Choe, BARDA


The Grand Challenges in the Design of Respiratory Protection Devices

Sundaresan Jayaraman, Georgia Tech

Dr. Jayaraman’s presentation focused on the 3 “grand challenges” in respiratory protection and possible solutions using a judicious combination of materials, structures, and manufacturing technologies.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Design of Filtering Facepiece Respirators

Lauri Alvarez, 3M

Ms. Alvarez provided an overview of 3M's efforts on Project BREATHE with a focus on filtration media and respirator design as they relate to breathing resistance, headband materials, headband attachment methods, antimicrobial agents, and materials that contact the face.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Employing a Modular and Scalable Design for Next Generation Healthcare Respiratory Protection

Amy Quiring, Scott Safety

Ms. Quiring provided concepts for a hybrid B95 respirator to promote appropriate use and acceptance by minimizing physiological burden, minimizing training burden, and minimizing risk of interference with patient care and communication.

Slides

If the video doesn’t load, hit F5 once or twice to see if it works. If the problem persists, please call 404-639-6000 for the Service Desk.

Agenda

Time Speakers
8:00 – 8:15 Welcome Remarks – Maryann D’Alessandro, NPPTL Director, PPT Program Manager
8:15 – 9:00 Keynote Talk – Respiratory Protection, Infection Control, and Preparing for Pandemic Influenza, Stephen Redd, CDC Influenza Coordination Unit
9:00 – 9:30 Progress Toward Updating the NIOSH PPT Program Action Plan for Healthcare Worker Personal Protective Equipment (2013-2018), Ron Shaffer, NIOSH Abstract
9:30 – 10:35 Roundtable 1 – Improving the Evidence Base to Support Guidance on the Appropriate Level of Respiratory Protection
Moderator - David Kuhar, CDC
  • Exposure to Influenza Aerosols during Routine Patient Care, Werner Bischoff, Wake Forest Abstract
  • NIOSH Influenza Transmission Research, Bill Lindsley, NIOSH Abstract
  • "Respiratory Protection in Healthcare Workers: Lessons from the Trenches—the ResPECT Study," Trish Perl, Johns Hopkins University Abstract
10:35 – 10:55 Break
10:55 – 11:45 Roundtable 2 – Healthcare Worker Observational Studies of Respirator Use & New Educational Resources
Moderator - Debbie Novak, NIOSH
  • Adherence to Respiratory Protection Guidelines by Healthcare Workers and Hospitals: the REACH 2 Evaluation, Kristina Peterson, RTI Abstract
  • Development of a Hospital Respiratory Protection Program National Toolkit, Barbara Materna, California Department of Public Health Abstract
11:45 – 12:30 Lunch (on your own, but on-site)
12:30 – 2:00 Roundtable 3 – Emerging Topic - Considerations for Extending Respirator Supplies During an Outbreak or Pandemic
Moderator - Lisa Koonin, CDC
  • Filtering Facepiece Respirators and Viable Microbial Aerosols, Brian Heimbuch, ARA Abstract
  • Transfer of Influenza from Contaminated FFRs to the Hands of Healthcare Workers, Ed Fisher, NIOSH Abstract
  • FDA Regulatory Process for Premarket [510(k)] Submission: General and Antimicrobial containing Surgical N95 Respirators, Elizabeth F. Claverie-Williams, FDA and Ramesh Kapil Panguluri, FDA Abstract
2:00 – 2:20 Break
2:20 – 3:50 Roundtable 4 – Standards & Test Methods for Improved Respirators for Healthcare Workers
Moderator - Lewis Radonovich, VA
  • Progress Toward a “B95” Respirator for Healthcare Personnel, Ron Shaffer, NIOSH Abstract
  • Human Correlation Fit Testing of a Static Advanced Headform, Ziqing Zhuang, NIOSH Abstract
  • Measuring The Factors That Impact Respirator Comfort And Tolerability, Ray Roberge, NIOSH Abstract
  • Update on NIOSH Respirator Standards Affecting Healthcare, Jon Szalajda, NIOSH Abstract
3:50 – 5:00 Roundtable 5 – Advances Toward Improved Respirators for Healthcare Workers
Moderator - Melanie Choe, BARDA
  • The Grand Challenges in the Design of Respiratory Protection Devices, Sundaresan Jayaraman, Georgia Tech Abstract
  • Design of Filtering Facepiece Respirators, Lauri Alvarez, 3M Abstract
  • Employing a Modular and Scalable Design for Next Generation Healthcare Respiratory Protection, Amy Quiring, Scott Safety Abstract
5:00 – 5:15 Wrap Up – Ron Shaffer, NIOSH

For more information on the background of the meeting, please see the Federal Register Notice .

Any questions can be directed to Dr. Ronald E. Shaffer, Senior Scientist, NIOSH NPPTL Office of the Director at NPPTLEventsHealthcar@cdc.gov,
telephone (412) 386‐6111, fax (412) 386‐6617.

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