H1N1 Respiratory Protection: Surgical Masks vs. N95 Respirators

The Centers for Disease Control (CDC) issued updated guidelines for infection control procedures for the H1N1 influenza virus.

Included in these updated guidelines were recommendations that employees having direct exposure to H1N1 patients use respirators at least as protective as NIOSH N95 filtering facepiece respirators. In healthcare settings, however, questions can arise about whether a surgical mask or an N95 respirator should be used. Knowing the differences between a surgical mask and an N95 respirator can help answer those questions.

Surgical mask: Medical devices intended for use in preventing and treating disease are subject to regulation under the device provisions of the Federal Food, Drug, and Cosmetic Act. This includes surgical masks. As such, the certification of the manufacture of surgical masks is through the Food and Drug Administration (FDA)—not NIOSH.

A surgical mask is intended to act as a physical barrier to prevent the release of potential contaminants into the immediate environment—they serve as barriers to splash, droplets, and spit. As such, they do provide some measure of protection from bacteria and viruses in these materials, but not airborne particles. Surgical masks are not designed to fit tightly to the face (leakage occurs around the edge of the mask when the user inhales), and they do not effectively filter small particles—such as viruses—from air.

N95 respirator: An N95 is a particulate-filtering facepiece respirator. N95 respirators filter at least 95% of non-oil airborne particles. The National Institute of Occupational Safety and Health (NIOSH) has responsibility for the certification and approval of respiratory protection devices for occupational use, including N95 respirators. Only respirators that have been NIOSH-certified can be marketed as NIOSH-approved—and these respirators bear labeling or marking that indicates they are NIOSH certified.

N95 respirators provide protection from exposure to airborne particles such as biological aerosols, including viruses and bacteria, by effectively filtering large and small particles from the air. N95 respirators are designed to fit tightly to the face, preventing leakage of unfiltered air into the breathing space when the wearer inhales. Many N95 respirators cannot be worn in health care settings where a sterile environment must be maintained—for example, those with exhalation valves.

Surgical N95 respirators: For a health care center where protection from H1N1 is required and the environment must be maintained as sterile, a surgical N95 respirator is an option. Surgical N95 respirators are a type of hybrid respirator. Surgical N95 respirators are both NIOSH approved and cleared by the FDA as a surgical mask. Like a surgical mask, the surgical N95 respirator provides a physical barrier for splashes and sprays, and like an N95 respirator, it fits tightly to the face to provide protection from airborne particles.

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