key: cord-1036415-wg9t2j5x
authors: Ganesan, Anand; Parker, Jane; Chapman, Darius
title: N95 or P2 respirator fit testing policy in Australia: implementation issues to consider
date: 2021-04-09
journal: Med J Aust
DOI: 10.5694/mja2.51016
sha: 6186ff909e8a467885d44d1592e8f7acf570c0f2
doc_id: 1036415
cord_uid: wg9t2j5x

nan

To the Editor: We thank the MJA for highlighting the fit testing of N95 or P2 respirators in Australian health care workers. Regli and colleagues 1 make a compelling case that mandatory fit testing should be implemented in Australian hospitals for frontline staff, in line with South Australian guidelines. 2 We note that NSW Health has recently implemented mandatory fit testing in high risk areas. 3 We commend these efforts, but they may have important implications that would need planning and consideration in implementation.

First, it is clear that anatomical variation of the nasal and malar regions means that some health care workers will only pass the fit tests with particular N95 or P2 respirators. 4 This means that along with the implementation of a fit testing program, inventory management systems are also required to facilitate hospital tracking of stocks of particular respirator types and to ensure that sufficient stock is available in high risk areas for individual health care workers. At the Southern Adelaide Local Health Network, we have implemented such a system, which tracks stock levels of all available respirators within the hospital so that key workers who can use only specific types of N95 or P2 respirators will have access to the right type of mask when needed. Second, the coronavirus disease 2019 (COVID-19) pandemic has disrupted global supply chains, affecting the availability of N95 and P2 respirators. Moreover, fit testing is not a one-off process, but must be conducted as a rolling program to ensure that all workers have access to appropriately fitting N95 or P2 respirators. Finally, even with an efficient fit testing program, due to anatomical variations, there will always be a proportion of health care workers for whom no masks will be suitable. Along with fit testing, health departments should prioritise health care worker redeployment policies and the development of new technologies to address the needs of the proportion of the workforce with ongoing fit test failure.

0aca9 a8042 3727c c9e0e feef0 dac2a ff/C lini cal_Direc tive_Respi ratory_Prote ction_+Again st_Airbo rne_Infec tious_Disea ses_v1

Clinical Excellence Commission, NSW Health. Respiratory protection in healthcare

Evaluation of a large-scale quantitative respirator-fit testing program for healthcare workers: survey results