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Impact of Facial Skin Protectants on Qualitative Fit Testing of N95 Masks
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- In this study, 25 healthcare workers underwent N95 fit testing after application of each of a series of five different skin protectants. The proportion of participants passing fit testing after protectant application was as follows: 88% Cavilon film; 84% hydrocolloid bandages; 72% DuoDERM Extra Thin; 64% Mepitac Soft Silicone Tape; and 56% DuoDERM CGF. The failed stages most often included side-to-side and up-and-down head maneuvers, despite all protectants in all participants passing the seal check.
- This study suggests that skin protectants negatively impact N95 fit, particularly with movement maneuvers, even if an initial seal check was passed, potentially leading to false reassurance in users. Although skin protectants may prevent irritation, purpura, and indentation, efficacy should not be traded for comfort. If they choose to use one of these protectants, healthcare workers should be retested for fit once it is in place.
– Margaret Hammond, MD
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersThe COVID-19 pandemic has necessitated prolonged use of N95 masks, leading to superficial wounds, purpura, and indentations on healthcare workers’ faces1,2. The use of skin protectants may prevent skin irritation caused by N95 masks2 by providing a barrier and/or redistributing pressure; however, the impact on respirator fit has not been evaluated. This study assesses the impact of the use of skin protectants on N95 respirator qualitative fit-test (QLFT) results and user comfort.
Additional Info
A Pilot Study of the Impact of Facial Skin Protectants on Qualitative Fit Testing of N95 Masks
J Am Acad Dermatol 2020 Jun 24;[EPub Ahead of Print], AN Bui, Z Yu, K Lee, SJ Li, WG Tsiaras, SH Yu, NR LeBoeuf, A MostaghimiFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The current global pandemic has resulted in the increased use of personal protective equipment (PPE) by medical personnel, including N95 masks. This has resulted in heightened awareness of adverse reactions that occur when using PPE, especially for extended periods of time, including irritant and allergic contact dermatitis. Many individuals have tried various skin protectants to try to treat or prevent these problems. This study assessed the effect of skin protectants and barriers on N95 respirator fit and comfort.
The authors report that the skin protectants may interfere with respirator fit. Most of the fit test failures done with the skin protectants occurred with movement; for example, moving the head up and down and bending forward.
The researchers conclude that, although finding ways to address the skin irritation resulting from prolonged use of N95 masks is important, effectiveness of the mask fit should take precedence over comfort. They go on to state that current guidelines do not recommend skin protectants between the skin and the mask, and, if skin protectants are used, retesting the fit is needed to ensure that the fit and efficacy of the mask are not compromised.