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      • Record: found
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      Prospective comprehensive evaluation of an elastic-band beard cover for filtering facepiece respirators in healthcare workers

      research-article
      Author(s): , MBBS, FANZCA, MBA, CPI, FAPCR 1 , 2 , , MBBS, FANZCA 1 , , GCert (Health, WHS) 3 , , BAppSc (OT), GDip (Ergonomics) 3 , , BA(Hons) 3 , , MBBS, FANZCA, MClinRes, GCert (CritCareEcho) 1 , 2 ,
      Publication date (Electronic, pub):
      Journal: Infection Control and Hospital Epidemiology
      Publisher: Cambridge University Press

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          Abstract

          Objective:

          To undertake a healthcare-based multimodal evaluation of the combination of filtering facepiece respirator (FFR) with the elastic-band beard cover technique, including quantitative fit test (QNFT) results, skills assessment, and usability assessment.

          Design and setting:

          We conducted a prospective study through the Respiratory Protection Program at the Royal Melbourne Hospital from May 2022 to January 2023.

          Participants:

          Healthcare workers who required respiratory protection and could not shave for religious, cultural, or medical reasons.

          Intervention:

          Online education and personal face-to-face training on the use of FFR with the elastic-band beard cover technique.

          Results:

          Among 87 participants (median beard length 38 mm; interquartile range [IQR], 20–80), 86 (99%) passed 3 QNFTs consecutively with the elastic-band beard cover under a Trident P2 respirator and 68 (78%) passed 3 QNFTs consecutively with a 3M 1870+ Aura respirator. The first QNFT pass rate and the overall fit factors were significantly higher when using the technique than without the elastic-band beard cover. Most participants displayed a high skill level in their donning, doffing, and user seal-check techniques. Of 87 participants, 83 (95%) completed the usability assessment. The overall ease of use, comfort, and overall assessment were rated highly.

          Conclusions:

          The elastic-band beard cover technique can provide safe and effective respiratory protection for bearded healthcare workers. The technique was easily taught, comfortable, well tolerated and accepted by healthcare workers, potentially allowing them full participation in the workforce during pandemics with airborne transmission. We recommend further research and evaluation of this technique in a broader health workforce.

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          Most cited references11

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          Investigating the Psychological Impact of COVID-19 among Healthcare Workers: A Meta-Analysis

          Kavita Batra, Tejinder Singh, Manoj Sharma … (2020)
          Previous meta-analyses were conducted during the initial phases of the COVID-19 pandemic, which utilized a smaller pool of data. The current meta-analysis aims to provide additional (and updated) evidence related to the psychological impact among healthcare workers. The search strategy was developed by a medical librarian and bibliographical databases, including Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for studies examining the impact of the COVID-19 pandemic on the psychological health of healthcare workers. Articles were screened by three reviewers. Heterogeneity among studies was assessed by I2 statistic. The random-effects model was utilized to obtain the pooled prevalence. A subgroup analysis by region, gender, quality of study, assessment methods, healthcare profession, and exposure was performed. Publication bias was assessed by Funnel plot and Egger linear regression test. Sixty-five studies met the inclusion criteria and the total sample constituted 79,437 participants. The pooled prevalence of anxiety, depression, stress, post-traumatic stress syndrome, insomnia, psychological distress, and burnout was 34.4%, 31.8%, 40.3%, 11.4%, 27.8%, 46.1%, and 37.4% respectively. The subgroup analysis indicated higher anxiety and depression prevalence among females, nurses, and frontline responders than males, doctors, and second-line healthcare workers. This study highlights the need for designing a targeted intervention to improve resilience and foster post-traumatic growth among frontline responders.
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            A close shave? Performance of P2/N95 respirators in health care workers with facial hair: results of the BEARDS (Adequate Respiratory DefenceS) study

            Indy Sandaradura, Emma Goeman, Giulietta Pontivivo … (2020)
            P2/N95 filtering face piece respirators (FFRs) protect healthcare workers (HCWs) from airborne infections. This study assessed the impact of facial hair on quantitative respirator fit in 105 male HCWs, of whom 38 were clean shaven, and assessed the prevalence of male facial hair at the study facility. Only 34 (32%) male HCWs overall achieved an adequate FFR fit, including 47% of clean-shaven men. No full-bearded HCWs achieved a fit. Adequate respirator fit decreased significantly with increasing facial hair (P<0.01 for trend). Facial hair was present on 49% of male employees. This study supports quantitative fit testing prior to P2/N95 respirator use.
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              Assessing the effect of beard hair lengths on face masks used as personal protective equipment during the COVID-19 pandemic

              Steven Prince, Hao Chen, Haiyan Tong … (2021)
              Background Globally, a large percentage of men keep a beard at least occasionally. Workplace regulations prohibit beards with N95 respirators, but there is little information on the effect of beards with face masks worn by the public for protection against SARS-CoV-2. Methods and findings We examined the fitted filtration efficiency (FFE) of five commonly worn protective face masks as a function of beard length following the US Occupational Safety and Health Administration Quantitative Fit Test: N95 (respirator), KF94 and KN95, surgical/procedure, and cloth masks. A comparison using N95 respirators was carried out in shaven and bearded men. A detailed examination was conducted for beard lengths between 0 and 10 mm (0.5 mm increments). The effect of an exercise band covering the beard on FFE was also tested. Although N95 respirators showed considerable variability among bearded men, they had the highest FFE for beard lengths up to 10 mm. KF94 and KN95 masks lost up to 40% of their FFE. Procedure and cotton masks had poor performance even on bare skin (10–30% FFE) that did not change appreciably with beard length. Marked performance improvements were observed with an exercise band worn over the beard. Conclusions Though variable, N95 respirators offer the best respiratory protection for bearded men. While KF94 and KN95 FFE is compromised considerably by increasing beard length, they proved better options than procedure and cotton face masks. A simple exercise band improves FFE for face masks commonly used by bearded men during the COVID-19 pandemic.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Infect Control Hosp Epidemiol
                Journal ID (iso-abbrev): Infect Control Hosp Epidemiol
                Journal ID (publisher-id): ICE
                Title: Infection Control and Hospital Epidemiology
                Publisher: Cambridge University Press (New York, USA )
                ISSN (Print): 0899-823X
                ISSN (Electronic): 1559-6834
                Publication date (Print, pub): January 2024
                Publication date (Electronic, pub): 12 July 2023
                Volume: 45
                Issue: 1
                Pages: 89-95
                Affiliations
                [1 ]Department of Anaesthesia and Pain Management, Royal Melbourne Hospital , Parkville, Victoria, Australia
                [2 ]University of Melbourne , Parkville, Victoria, Australia
                [3 ]Respiratory Protection Program, Royal Melbourne Hospital , Parkville, Victoria, Australia
                Author notes
                Corresponding author: Irene Ng; Email: Irene.Ng@ 123456mh.org.au
                Author information
                https://orcid.org/0000-0002-6987-5804
                https://orcid.org/0000-0002-9499-1831
                https://orcid.org/0000-0002-6533-7646
                https://orcid.org/0000-0001-5456-7852
                https://orcid.org/0000-0002-8425-6227
                https://orcid.org/0000-0002-6632-5604
                Article
                Publisher ID: S0899823X23001411
                DOI: 10.1017/ice.2023.141
                PMC ID: 10782203
                PubMed ID: 37435792
                SO-VID: eb4d4d9c-d33c-4dc8-a646-a7c3f049f4f9
                Copyright © © The Author(s) 2023
                License:

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

                History
                Date received : 25 March 2023
                Date revision received : 21 May 2023
                Date accepted : 23 May 2023
                Page count
                Figures: 3, Tables: 4, References: 21, Pages: 7
                Categories
                Subject: Original Article

                Data availability:

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