This note also covers N95 respirators, since they share similar value chains, and the commercial data does not differentiate between them and surgical masks. N95 respirators and surgical masks are examples of PPE used to protect a wearer against particles or fluids contaminating their face. Barrier face coverings are no substitutes for N95 respirators and other filtering facepiece respirators (FFRs), which provide respiration protection for the wearer, nor are surgical masks, which provide protection against liquids and particles.
NIOSH recommends using these masks in the work setting, but importantly, does not recommend the masks as replacements for N95s or other respirators. If a facility is considering using surgical mask covers or cloth as a last resort in the event of a crisis strategy, it must be taken care that N95 respirators are not adversely affected by fit and function. N95 respirators with poor fit provide a range of protection, which is in some cases comparable to surgical and cloth masks.
Surgical masks also did not offer full protection against germs and other contaminants due to loose fitting between the face of the mask and the surface of the face. Surgical masks and N95 respirators are parts of the personal protective equipment (PPE) used by healthcare workers, and they are different from other types of masks used for protection against contamination or dust.1 Surgical masks are loose-fitting, designed to catch the sprays and droplets of coughing and sneezing.2 N95 respirators are tighter-fitting, and they also protect against smaller particles in the air. These products are the gold standard of masks, as, unlike fabric, surgical, and N95 alternatives, they are tested and approved by the federal agency, having shown that they can filter at least 95% of airborne particles in adverse conditions, according to CDC.
Because N95 masks are always in low supply, the CDC has said that they should be reserved for healthcare providers. Specifically, surgical N95 masks would be reserved for healthcare workers.
Health care workers will need to receive training and undergo fit testing before using N95 masks. N95 masks can filter as much as 95% of particles in the air if approved by NIOSH and proper fit is achieved.
Wearing surgical masks or cloth covers over a PFR, like N95, is not approved or recommended by NIOSH as this does not meet approval conditions, thus nullifying certification, however this is a strategy that can be used in crisis situations, as described in CDCs Strategy to Optimize N95 Respirator Supplies. Because the N95 masks approved by the National Institute of Occupational Safety and Health (NIOSH) are no longer available in shortages, the CDCs guidelines suggest individuals can opt to use a NIOSH-approved N95 mask instead of cloth covers. In this episode, two AMA members take the time to share what patients should know about wearing N95 or KN95 masks, the types of specialty filtration masks referred to by doctors and others in healthcare as respirators.