Ill-fitting respirators may cause health worker skin irritation

Health-care workers with skin irritations from wearing N95 respirators for long hours during the pandemic should consider getting a new fit test and using moisturizers and washings to prevent the problems, according to NIOSH recommendations.

“Proper size and fit will ensure that users have the needed respiratory protection and that the respirator is not causing friction or putting too much pressure on the skin,” a National Institute for Occupational Safety and Health team advises in guidance issued Tuesday.

NIOSH is part of the Centers for Disease Control and Prevention and oversees approval of respirators that qualify for the N95 and higher protective ratings.

During a fit test, OSHA requires the wearer to decide whether the respirator is comfortable. A five-minute wear period is required before the fit test begins.

Wearers also should make sure the respirator’s straps are correctly placed around the head, usually on the crown of the head and behind the neck, and not resting on the ears, NIOSH says.

Nurses have complained that the shortage of N95 respirators has led to some health-care facilities taking shortcuts such as not requiring fit testing every time a new brand or model of respirators is given out.

For irritation prevention, NIOSH recommends washing skin with a soap intended for the face. Facial moisturizers should be applied well in advance of any need to use a respirator so that residue isn’t absorbed into the respirator and interferes with the seal.