Are Exhalation Valves on N95 Filtering Facepiece Respirators Beneficial at Low-Moderate Work Rates: An Overview

REFERENCES

• Baig , A. S. , Knapp , C. , Eagan , A. E. and Radonovich , L. E. Jr . 2010 . Health care workers’ views about respirator use and features that should be included in the next generation of respirators . Am. J. Infect. Control , 38 ( 1 ) : 18 – 25 .
   PubMed Web of Science ®Google Scholar
• Guo , Y. P. , Yi , L. Tokura , H. 2008 . Evaluation on masks with exhaust valves and with exhaust holes from physiological and subjective responses . J. Physiol. Anthropol. , 27 ( 2 ) : 93 – 102 .
   PubMedGoogle Scholar
• Roberge , R. J. , Coca , A. , Williams , W. J. , Powel , J. B. and Palmiero , A. J. 2010 . Physiological impact of the N95 filtering facepiece respirator on healthcare workers . Respir. Care , 55 ( 5 ) : 569 – 577 .
   PubMed Web of Science ®Google Scholar
• Herris , W. P. How Regulation and Innovation Have Shaped Respiratory Protection . Available at http://ehstoday.com/ppe/respirators/regulation_innovation_shaped/ (accessed January 26, 2012)
   Google Scholar
• Garvey , D. 2010 . When not to use FFRs . Occup. Health Safety , 79 ( 3 ) : 24 – 26 .
   PubMedGoogle Scholar
• Caretti , D. M. , Scott , W. H. and Johnson , A. T. 2001 . Work performance when breathing through different respirator exhalation resistances . Am. Ind. Hyg. Assoc. J. , 62 ( 4 ) : 411 – 415 .
   Web of Science ®Google Scholar
• Meyer , J. P. , Hery , M. Herrault , J. 1997 . Field study of subjective assessment of negative pressure half-masks. Influence of work conditions on comfort and efficiency . Appl. Ergon. , 28 ( 5–6 ) : 331 – 338 .
   PubMed Web of Science ®Google Scholar
• Harber , P. , Bansal , S. Santago , S. 2009 . Multidomain subjective response to respirator use during simulated work . J. Occup. Environ. Med. , 51 ( 1 ) : 38 – 45 .
   PubMed Web of Science ®Google Scholar
• Laird , I. S. 1995 . “ The Physiological Costs of Wearing Respiratory Protective Devices ” . New Zealand : Ph.D. diss., Massey University .
   Google Scholar
• Committee on the Development of Reusable Facemasks for Use During an Influenza Pandemic . 2006 . Reusability of Facemasks During an Influenza Pandemic: Facing the Flu , Washington , D.C. : The National Academies Press .
   Google Scholar
• Brueck , S. , Lehtimaki , M. , Krishnan , U. and Willeke , K. 1992 . Method development for measuring respirator exhalation valve leakage . Appl. Occup. Environ. Hyg. , 7 ( 3 ) : 174 – 179 .
   Google Scholar
• Laferty , E. A. and McKay , R. T. 2006 . Physiologic effects and measurement of carbon dioxide and oxygen levels during qualitative respirator fit testing . J. Chem. Health Safety. , 13 ( 5 ) : 22 – 28 .
   Google Scholar
• Delaney , L. J. , McKay , R. T. and Freeman , A. 2003 . Determination of known exhalation valve damage using a negative pressure user seal check method on full facepiece respirators . Ann. Occup. Environ. Hyg. , 18 ( 4 ) : 237 – 243 .
   PubMedGoogle Scholar
• Kuo , Y.-M. , Lai , C.-Y. and Chen , C.-C. 2005 . Evaluation of exhalation valves . Ann. Occup. Hyg. , 49 ( 7 ) : 563 – 568 .
   PubMed Web of Science ®Google Scholar
• Wetherell , A. The UK General Service Respirator . Available at http://www.dtic.mil/cgi-bin/GetTRDoc?AD = ADA452235 (accessed January 12, 2012)
   Google Scholar
• Burgess , W. A. and Anderson , D. E. 1967 . Performance of respirator expiratory valves . Am. Ind. Hyg. Assoc. J. , 28 : 216 – 223 .
   PubMed Web of Science ®Google Scholar
• Bellin , P. and Hinds , W. 1990 . Aerosol penetration through respirator exhalation valves . Am. Ind. Hyg. Assoc. , 51 ( 10 ) : 555 – 560 .
   PubMed Web of Science ®Google Scholar
• Koh , F. C. , Johnson , A. T. and Rehak , T. E. 2011 . Inward leakage in tight-fitting PAPRs . J. Environ. Public Health , 14 ( 2 ) : E19 – 26 .
   Google Scholar
• Maxwell , D. L. , Cover , D. and Hughes , J. M.B. 1985 . Effect of respiratory apparatus on timing and depth of breathing in man . Respiration Physiol. , 61 ( 2 ) : 255 – 264 .
   PubMedGoogle Scholar
• O’Kroy , J. A. , James , T. , Miller , J. M. , Torok , D. and Campbell , K. 2001 . Effects of an external nasal dilator on the work of breathing during exercise . Med. Sci. Sports. Exerc. , 33 ( 3 ) : 454 – 458 .
   PubMed Web of Science ®Google Scholar
• Harber , P. , Beck , J. and Luo , J. 1997 . Study of respirator effect on nasal-oral flow partition . Am. Ind. Hyg. Assoc. J. , 32 ( 4 ) : 408 – 412 .
   Google Scholar
• Murthy , R. and Pavlidis , I. 2006 . Noncontact measurement of breathing function . Eng. Med. Biol. Mag. , 25 ( 3 ) : 57 – 67 .
   PubMed Web of Science ®Google Scholar
• Murakami , S. 2004 . Analysis and design of micro-climate around the human body with respiration by CFD . Indoor Air , 14 ( Suppl 7 ) : 144 – 156 .
   PubMed Web of Science ®Google Scholar
• Horvath , I. , Hunt , J. and Barnes , P. J. 2005 . Exhaled breath condensate: Methodological recommendations and unresolved questions . Eur. Respir. J. , 26 ( 3 ) : 523 – 548 .
   PubMed Web of Science ®Google Scholar
• Winslow , C. -E. A. , Herrington , L. P. and Nelbach , J. H. 1942 . The influence of atmospheric temperature and humidity upon the dryness of the oral mucosa . Am. J. Hyg. , 35 : 27 – 39 .
   Google Scholar
• Hayashi , C. and Tokura , H. 2004 . The effects of two kinds of mask (with and without exhaust valve) on clothing microclimates inside the mask in participants wearing protective clothing for spraying pesticides . Int. Arch. Occup. Environ. Health , 77 ( 1 ) : 73 – 78 .
   PubMed Web of Science ®Google Scholar
• Lee , S-A. , Adhikari , A. Grinshpun , S. A. 2005 . Respiratory protection provided by N95 filtering facepiece respirators against airborne dust and microorganisms in agricultural farms . J. Occup. Environ. Hyg. , 2 : 577 – 585 .
   PubMed Web of Science ®Google Scholar
• Roberge , R. J. , Kim , J.-H. and Benson , S. M. 2012 . N95 filtering facepiece respirator deadspace temperature and humidity . J. Occup. Environ. Hyg. , 9 : 166 – 171 .
   PubMed Web of Science ®Google Scholar
• Li , Y. , Wong , T. Chung , J. 2006 . In vivo protective performance of N95 respirator and surgical facemask . Am. J. Ind. Med. , 49 ( 12 ) : 1056 – 1065 .
   PubMed Web of Science ®Google Scholar
• Roberge , R. J. , Coca , A. , Williams , W. J. , Powell , J. B. and Palmiero , A. J. 2010 . Reusable elastomeric air-purifying respirators: Physiologic impact on health care workers . Am. J. Infect. Control , 38 ( 5 ) : 381 – 386 .
   PubMed Web of Science ®Google Scholar
• Brosseau , L. M. Update on Respirators and Surgical Masks: Review of Literature (2007–2010) . Available at http://www.iom.edu/~/media/Files/Activity%20Files/PublicHealth/PPECurrentResearch/2010-JUN-3/Brosseau%20-%20Panel%202.pdf (accessed February 8, 2012)
   Google Scholar
• Vojtko , M. R. , Roberge , M. R. , Vojtko , R. J. and Roberge , R. J. 2008 . Effect on breathing resistance of a surgical mask worn over a N95 filtering facepiece respirator . J. Int. Soc. Resp. Protect. , 25 : 1 – 8 .
   Google Scholar
• McKay , R. Filtering Facepieces With Exhalation Valves: Are They Any Cooler and More Comfortable? . Available at http://www.isrp.com/americas/docs/rpn_100110.pdf (accessed February 14, 2012)
   Google Scholar
• Roberge , R. J. , Kim , J.-H. and Coca , A. 2012 . Protective facemask impact on human thermoregulation: An overview . Ann. Occup. Hyg. , 56 ( 1 ) : 102 – 112 .
   PubMed Web of Science ®Google Scholar
• Jones , J. G. 1991 . The physiological cost of wearing a disposable respirator . Am. Ind. Hyg. Assoc. J. , 52 ( 6 ) : 219 – 225 .
   PubMed Web of Science ®Google Scholar
• Li , Y. , Tokura , H. Guo , Y. P. 2005 . Effect of wearing N95 and surgical facemasks on heart rate, thermal stress and subjective sensations . Int. Arch. Occup. Environ. Health , 78 ( 6 ) : 501 – 509 .
   PubMed Web of Science ®Google Scholar
• 3M . Make a Cool Decision . Available at http://solutions.3m.com/3MContentRetrievalAPI/BlobServlet?locale = en_GB&lmd = 1297086776000&assetId = 1273676751538&assetType = MMM_ Image&blobAttribute = ImageFile (accessed February 13, 2012)
   Google Scholar
• Roberge , R. J. , Coca , A. , Williams , W. J. , Palmiero , A. J. and Powell , J. B. 2010 . Surgical mask placement over N95 filtering facepiece respirators: Physiological effects on healthcare workers . Respirology , 15 ( 3 ) : 516 – 521 .
   PubMed Web of Science ®Google Scholar
• Suzuki , K. , Ogawa , A. and Matsumura , Y. Influencing Factors of Carbon Dioxide Concentration Increase of Filtering Respirators . Available at http://www.isrp.com.au/isrpcom/journal/jp_abstracts/suzuki.htm (accessed February 13, 2012)
   Google Scholar
• Harber , P. , Beck , J. , Brown , C. and Luo , J. 1991 . Physiologic and subjective effects of respirator mask type . Am. Ind. Hyg. Assoc. J. , 52 ( 9 ) : 357 – 362 .
   PubMed Web of Science ®Google Scholar
• Sinkule , E. , Turner , N. and Hota , S. 2003 . Automated Breathing and Metabolic Simulator (ABMS) CO2 Test for Powered and Nonpowered Air-Purifying Respirators, Airline Respirators and Gas Masks . American Industrial Hygiene Conference and Expo , : 10 – 15 . Abstract no. 227. Paper presented at Dallas, Texas, May
   Google Scholar
• Roberge , R. J. , Bayer , E. , Powell , J. B. , Coca , A. , Roberge , M. J. and Benson , S. M. 2010 . Effect of exhaled moisture on breathing resistance of N95 filtering facepiece respirators . Ann. Occup. Hyg. , 54 ( 6 ) : 671 – 677 .
   PubMed Web of Science ®Google Scholar
• Martin , P. G. and Jianxian , X. 2003 . Filtering face mask that has a resilient seal surface in its exhalation valve. US Patent 7,188,622, filed Jun . 19, 2003, and issued Mar. 13, 2007
   Google Scholar
• Fisher , E. M. , Williams , J. L. and Shaffer , R. E. 2011 . Evaluation of microwave steam bags for the decontamination of filtering facepiece respirators . PLoS ONE , 6 ( 4 ) : e18585
   PubMed Web of Science ®Google Scholar
• Monaghan , W. D. , Roberge , M. R. , Rengasamy , M. and Roberge , R. J. 2009 . Thermal imaging comparison of maximum surface temperatures achieved on N95 filtering facepiece respirators with and without exhalation valves at sedentary breathing volumes . J. Int. Soc. Resp. Protect. , 26 : 12 – 19 .
   Google Scholar
• Nielsen , R. , Gwosdow , A. R. , Berglund , L. G. and DuBois , A. B. 1987 . The effect of temperature and humidity levels in a protective mask on user acceptability during exercise . Am. Ind. Hyg. Assoc. J. , 48 : 639 – 645 .
   PubMed Web of Science ®Google Scholar
• Hanson , R. D.G. 1974 . Respiratory heat loss at increased core temperature . J. Appl. Physiol. , 37 ( 1 ) : 103 – 107 .
   PubMed Web of Science ®Google Scholar
• Roberge , R. , Benson , S. and Kim , J.-H. 2012 . Thermal burden of N95 filtering facepiece respirators . Ann. Occup. Hyg. , 56 ( 7 ) : 808 – 814 .
   PubMed Web of Science ®Google Scholar
• Kim , J.-H. , Benson , S. M. and Roberge , R. J. Pulmonary and heart rate response to wearing N95 filtering facepiece respirators . Am. J. Infect. Control , [In Press]
   Google Scholar
• Radonovich , L. J. Jr. , Cheng , J. , Shenal , B. V. , Hodgson , M. and Bender , B. S. 2009 . Respirator tolerance in health care workers (Research Letter) . J. Am. Med. Assoc. , 301 ( 1 ) : 38 – 38 .
   Google Scholar
• Shenal , B. V. , Radonovich , L. J. Jr. , Cheng , J. , Hodgson , M. and Bender , B. S. 2012 . Discomfort and exertion associated with prolonged wear of respiratory protection in a health care setting . J. Occup. Environ. Hyg. , 9 : 59 – 64 .
   PubMed Web of Science ®Google Scholar
• Radonovich , L. J. Jr. , Yanke , R. , Cheng , J. and Bender , B. 2010 . Diminished speech intelligibility associated with certain types of respirators worn by healthcare workers . J. Occup. Environ. Hyg. , 7 : 63 – 70 .
   PubMed Web of Science ®Google Scholar
• Thomas , F. , Allen , C. , Butts , W. , Rhoades , C. , Brandon , C. and Handrahan , D. L. 2011 . Does wearing a surgical facemask or N95-respirator impair radio communication? . Air Med. J. , 30 ( 2 ) : 97 – 102 .
   PubMedGoogle Scholar