hepa-filter face mask performance 1261
in which it is not possible for all relevant healthcare workers to use a N95 respirator that has recently been fit tested, there are currently no established alternatives. Even multiple surgical masks do not achieve filtration factors of>13.7.8 Furthermore, it may be difficult to source appropriate respirators in an epidemic situation. Although the new generation of Totobobo masks has theoretical advantages, performance may not be superior to the old generation. Using the old generation, 16 of 22 subjects had a filtration factor ≥100.4 Totobobo masks were more comfortable (according to most
measures) than N95 respirators, which may lead to greater compliance in clinical practice, offsetting the lower filtration factor. Our study has a few weaknesses. First, Totobobo masks were
Affiliations: Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. Address correspondence to Charles Gomersall, Department of Anaesthesia
and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong (
gomersall@cuhk.edu.hk).
Received March 29, 2017; accepted April 16, 2017; electronically published
August 15, 2017 Infect Control Hosp Epidemiol 2017;38:1260–1261 © 2017 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2017/3810-0021. DOI: 10.1017/ice.2017.105
references
fitted by an expert, and the performance may be worse in real life. Second, filtration testing by the PortaCount machine is only a surrogate test; however, exposing subjects to real infectious agents would not be ethical. Third, we studied an exclusively Chinese group of predominantly female subjects. Facial characteristics may vary between racial groups, and our results may not be replicated in other groups.9 Finally, the study was unblinded; however, it was mainly based on objective parameters. In conclusion, the new Totobobo masks may be usefulwhen
regular fit testing is not possible or when a limited range of masks can be stocked, but further testing is necessary.
acknowledgments
Free Totobobo masks were supplied by the manufacturer. The inventor of the mask assisted with shaping masks to fit participants’ faces. The manufacturer and inventor had no part in gathering or preparing data, data analysis, or the preparation or writing of the manuscript. Financial support: No financial support was provided relevant to this article. Potential conflicts of interest: All authors report no conflicts of interest relevant to this article.
Constance Yung Ting Hui, MBBS; Czarina Chi Hung Leung, FHKAM; Charles David Gomersall, FCICM
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