Issues
N95 respirators are associated with diminished communication acuity, head and facial discomfort due to facial heat, pressure or pain, headache, itch and burning eyes. Some experience nausea, dizziness, difficulty concentration and issues with mechanical interference with duties.(75) J Wong et al reported 20% of their anaesthetist failed the fit-testing for the N95 respirator.(1) Eczema is a frequent complication of prolonged use, requiring medicated creams or ointments, or even adhesive bandage which may affect the fit of the mask. The irritation may increase the likelihood of inadvertent PPE protocol breach like mask touching or adjustment in an unconscious effort to relieve a source of irritation.(98) All these may impact on compliance over time, placing HCW at risk of infection.
On average, noncompliance in terms of adjusting the N95 respirator, touching the respirator or under it, face, or eye has been found to be 25.7 times per 12-hour shift.(78) Compliance is worst in those with higher BMIs.(78) Body movement when performing medical procedures by HCW may increase the risk of seal leakage.(99)