Obama letter: N95s threaten response
Obama letter: N95s threaten response
APIC, SHEA request 'immediate moratorium'
The nation's leading infection prevention groups are urging President Barack Obama to halt federal enforcement of a mandate that health care workers wear N95 respirators to treat H1N1 pandemic patients.
"You have long championed evidence-based medicine and your administration has laudably been committed to enactment of science-driven policies," a Nov. 5 letter to the White House states. ". . . Given these principles, it is not clear why the federal PPE [personal protective equipment] guidance and requirements do not reflect the best available scientific evidence, which demonstrates that N95 respirators are not superior to surgical masks in the prevention of transmission of influenza in most patient care settings."
Particulate respirators are currently mandated by the Occupational Safety and Health Admini- stration to protect health care workers from acquiring H1N1 pandemic influenza A from patients. OSHA issued the edict to enforce the Centers for Disease Control and Prevention's recently issued "Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare Personnel."
The letter asking the president to reverse the decision was submitted by the Society for Healthcare Epidemiology of America (SHEA), Infectious Diseases Society of America (IDSA), and Association of Professionals in Infection Control and Epidemiology (APIC). Specifically, the groups asked President Obama to:
- Modify the federal PPE guidance to reflect the position best supported by the available science—first-line use of surgical masks for routine H1N1 patient care.
- Institute an immediate moratorium on the enforcement of OSHA's requirement for healthcare facilities related to the use of N95 respirators in relation to H1N1 influenza.
"Permitting OSHA to continue to enforce a policy that is not grounded in science will force healthcare facilities to waste time and resources working to comply with a flawed requirement when they instead should be working to enact measures that will have a beneficial impact on patient care and worker safety during this national emergency," APIC, SHEA, and the IDSA argued. ". . . In addition to providing appropriate protection for all routine patient encounters, surgical masks have the great advantage of being far more readily available, more practical to implement, more likely to be worn, and less costly than N95 respirators."
Indeed, requiring the use of fit-tested respirators for routine evaluation and care of all suspect cases of H1N1 influenza could lead to unintended adverse consequences including the unnecessary referral of patients to already overloaded emergency departments. "In addition, because the respirators are cumbersome and make it more difficult to breathe and talk, health care workers may avoid their use or limit the time they spend with influenza patients," the letter states.
The White House had not replied to the letter as this issue went to press.
The nation's leading infection prevention groups are urging President Barack Obama to halt federal enforcement of a mandate that health care workers wear N95 respirators to treat H1N1 pandemic patients.Subscribe Now for Access
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