For healthcare and infection prevention leaders in various sectors, keeping up with technological developments in respiratory protection keeps staff, residents, and patients safe—especially in places where airborne contaminants, coughing, sneezing, and heavy exhalations are common.
If you’re looking to learn more about CBRN PAPR or chemical, biological, radiological, and nuclear-powered air purifying respirators and how they differ from other types of masks, you aren’t alone. It can be difficult for new users to select the best device.
To prevent the spread of infection, users must understand the differences and similarities between devices. In this comprehensive guide, we will break them down.
Air Purifying Respirators Offer Advanced Protection
The broader APR or air purifying respirator category of PPE (personal protective equipment) includes filtering face-worn respirators and PAPRs. The most significant difference between APRs and face masks is in the level of protection offered. Regulated by the National Institute for Occupational Safety and Health, these devices typically use cartridges, canisters, or filters to eliminate airborne hazards.
Healthcare workers often use these APRs to protect themselves:
- N95 face-worn respirators
- Surgical N95s
- Powered air purifying respirators
These devices work similarly in that they remove aerosol particles, gases, vapors, and combinations of these materials from the air users breathe. Unlike conventional face masks, they protect against the smallest particles.
How Filtering Face-Worn Respirators Work in Healthcare and Other Settings
FFRs or filtering face-worn respirators are single-use devices that cover the nose and mouth, protecting users by removing airborne contaminants. NIOSH approves FFRs with filtration levels at 95% and above, with N95s being the most well-known entry in this category. Filtering respirators catch particles including:
- Dust
- Mist
- Fumes
As we learned during the earliest days of the pandemic, the supply of disposable face masks and respirators may be severely limited. While the supply chain has since recovered, facilities of all types must work to protect staff in the event of another emergency.
N95s: Not as Protective as PAPRs, But Valuable
N95 respirators are tight-fitting and filter at least 95% of airborne particles, hence their name. These face-worn respirators filter out particles down to 0.3 microns, including bacteria and viruses. Healthcare providers often use N95s when caring for those with suspected or confirmed infectious diseases. While these respirators are often used when there’s a high risk of airborne contamination, FFR selection depends on the nature of the contaminants present.
Fitment Testing for FFRs
A close fit is crucial to the performance and air filtration of an FFR. When masks are worn improperly, air may pass under the edges during inhalation. Therefore, annual fitment testing is recommended.
All respirators with close-fitting facepieces must be tested, including FFRs. These tests may seem time-consuming and tedious, but the goal is to ensure a tight seal and minimize leakage. Several testing methods exist, each with unique procedures and results.
Afterward, staff should use respirator sizes, styles, and models for which they’ve been tested. Fitment testing is a vital component of an overall respiratory protection strategy and is governed by the Occupational Safety and Health Administration. Healthcare facilities must offer adequate sizes and models of respirators, so each staff member has access to properly fitted, comfortable protective equipment.
Surgical N95s
Also known as medical respirators, surgical N95s are a subset of the PPE mentioned above. Surgical N95s protect against:
- Splashes
- Sprays
- Airborne pollutants
As the name suggests, surgical N95s are reserved for use in healthcare environments. For instance, caregivers may wear these FFRs when they need protection from airborne and fluid hazards. In the event of a shortage, medical facilities must limit the use of such devices by saving them for workers who may suffer exposure to:
- High-velocity sprays and splashes
- Splattering tissues and bodily fluids
Although face-worn filtering respirators provide adequate protection in some applications, they’re not appropriate in every setting.
Problems Associated with N95s
N95 respirators are disposable and designed for one-time use. In everyday circumstances, doctors, nurses, and others would use multiple N95s per day. Throughout the COVID-19 pandemic, however, practices changed due to supply shortages, forcing workers to sterilize and reuse these masks. Although the pandemic has slowed, supply issues persist in some areas.
Discomfort is another common problem with N95 respirators. Tests have detected decreases in air exchange, which makes respiration feel labored for wearers. N95 users often feel fatigued, which may negatively affect their quality of work and well-being. In some cases, wearers have experienced bruising, acne, and cuts from the N95’s tight seal.
Because the wearer’s mouth is covered, N95 masks limit non-verbal and verbal communication. This makes healthcare workers’ jobs more difficult and can be distressing for those receiving treatment for their illnesses.
Additionally, OSHA requires yearly face fittings for each worker using N95 respirators. When new brands are brought into facilities, which was common during the pandemic, further testing is needed at a significant expense.
In the sections below, we will explain PAPRs and how they are a viable alternative to FFRs.
PAPRs: A Reusable Option
A PAPR or powered air purifying respirator is a reusable form of personal protective equipment that plays a critical role in facilities’ approach to decontamination and disease prevention.
Unlike face-worn filtration respirators that rely on a user’s exhalations to filter air, these devices use fans or blowers to pull outside air through canisters or cartridges. The process eliminates dangerous contaminants and brings purified air into the wearer’s inhalation zone. These devices, when used properly, may help healthcare workers breathe easier. A PAPR may include components such as:
- Close-fitting face shields
- Batteries
- Motor/blower combinations
- Filter cartridges or canisters
- Loose helmets or hoods
If worn with a helmet or hood, fitment testing is not required.
How PAPRs Protect Users
At an APF or assigned protection factor between 25 and 1000, a powered air purifying respirator is significantly more efficient than an N95 mask. Some units with helmets or hoods offer additional eye and face protection from biological and chemical splashes, while those equipped with cartridges offer dependable protection from vapors, gases, and particulate matter.
How PAPRs are Used in Healthcare and Emergency Response
PAPRs are often used in environments where caregivers face exposure to airborne pathogens that cause respiratory infections. Furthermore, most parts can be removed, cleaned, sterilized, and reused, making PAPRs an indispensable asset when FFR supplies are limited. Increasingly, facilities are keeping powered air purifying respirators on hand for new workers and in times of N95 shortage.
PAPRs Offer a Reliable, Safe, Economical, and Reusable Solution
Valued for their high efficiency, powered air purifying respirators have been used for decades in industrial settings. During the pandemic, however, the Centers for Disease Control recognized their importance in healthcare and positioned them as an alternative to FFRs. Healthcare workers in the US and other countries have benefited from the respiratory protection of PAPRs along with their use with other personal protective equipment and systems.
PAPRs and loose-fitting headgear have positively affected patient recovery, as discovered by medical professionals everywhere. When a wearer’s face is unencumbered, they find it easier to communicate with patients and reduce their risk of disease contraction.
PAPRs Aren’t Just for Healthcare Workers
The events of the last few years have underscored the vulnerability of healthcare workers and first responders. Whether facing biological contaminants or coping with supply chain breakdowns, these professionals have struggled to do their jobs effectively and safely. With CBRN PAPRs and other safety equipment, medical staff, EMTs, and firefighters can care for others while protecting themselves.
During these challenging times, rising infection rates and personal protective equipment shortages have resulted in a battle to protect first responders and healthcare workers. Even now, as the supply chain gets back to normal, emergency medical service agencies across the country are coping with rising disposable PPE costs, as well as the risk of future health emergencies and their effects.
Equipment problems are just one of many stressors healthcare and emergency workers have recently faced. The last thing a professional should worry about is their equipment—and simple yet reliable PPE protects them without hindering movement or affecting response times.
Personal protective equipment doesn’t have to be expensive or bulky. With CBRN PAPRs, facilities and departments can manage PPE expenses while increasing users’ protection, range of motion, ease of use, and comfort.
The Bottom Line on PAPRs and the Protection They Provide
Whether on the scene of an accident, cleaning up chemical spills, or treating patients, healthcare workers and first responders need the safety and protection PAPRs provide. Unlike multi-piece PPE, which may include goggles, N95s, and face shields, PAPRs offer a unified solution that reduces bulk and time spent putting on and removing gear. The above benefits, among others, make PAPR equipment ideally suited to unsafe, high-stress, and fast-paced environments.
To prevent infection and lung damage, healthcare facilities, emergency medical services, and fire departments must create and implement effective, all-encompassing respiratory protection programs. When buyers and users know the differences between respirator types and protection levels, they’ll be prepared and protected during disease outbreaks and other crises.
