3M has received a number of inquiries regarding the appropriate respirator recommendations for potential exposures to the Middle East respiratory syndrome coronavirus (MERS-CoV) (previously referred to as a novel coronavirus (nCoV)). Following are responses to many of the most commonly asked questions. It is important to note this FAQ is not a substitute for the guidance of the United States Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and your local health authority. Please frequently consult their websites for the most current information and infection control procedures regarding MERS-CoV.
For further information on 3M personal protective equipment please contact 3M Technical Service in the US at 1-800-243-4630 or consult the website at www.3M.com/PPESafety.
Frequently Asked Questions (FAQs)
How is the MERS-CoV virus transmitted?
According to the US Centers for Disease Control and Prevention (CDC) it is believed that MERSCoV is found in camels and possibly bats. Occasionally a person in close contact with camels or who has ingested camel milk, urine or meat has contracted MERS-CoV from this source. People can also contract MERS-CoV from other people infected with MERS-CoV. There is still much that is unknown about how coronaviruses spread between people. According to the US CDC the most likely ways that human coronaviruses spread from one infected person to another is through the air (from an infected patient coughing and sneezing) and through close personal contact such as touching an infected person. It’s possible that the virus may also be spread when someone touches a surface that is contaminated with viruses and then touching their nose, mouth or eyes. Those studying MERS-CoV transmission have not seen any ongoing spreading of MERS-CoV in the community.
Here are three links from the US CDC which provide additional information on this topic.
Who is at risk of contracting Middle East Respiratory Syndrome (MERS)?
According to the US CDC there are several groups of people at higher risk of contracting MERS. These are:
If you fall into one of these groups and are concerned you should contact your local health care provider.
This document from the US CDC provides additional details.
What respiratory protection is recommended against the MERS-CoV for the General Public?
At this time we are not aware that recommendations have been issued regarding the use of respiratory protection by the general public to help reduce exposure to the MERS-CoV.
Are there any recommendations for use of a respirator against the MERS-CoV?
The recommendations to date have been for occupational use by health care personnel who may be caring for a patient potentially infected with the MERS-CoV.
If I choose to wear one, can respirators protect you from biological agents such as bacteria or viruses?
A respirator is just one of several preventative measures that can be used to help reduce exposure to bacteria or viruses such as MERS-CoV. Respirators are designed to help reduce exposures of the wearer to airborne hazards. Biological agents, such as bacteria or viruses, are particles and can be filtered by particulate filters with the same efficiency as non-biological particles having the same physical characteristics (size, shape, etc.). However, unlike most industrial particles there are no exposure limits, such as Permissible Exposure Limit (PEL) or Threshold Limit Value (TLV), established for biological agents such as MERS-CoV. Therefore, respirators are not a guarantee that the user will not contract an infection. Respirators may help reduce exposures to airborne biological contaminants, but they do not eliminate the risk of exposure, infection, illness, or death.
Can medical facemasks be used to help reduce airborne exposures to biological agents?
Medical, surgical and patient care masks are not designed to protect the wearer from inhaling airborne hazards; therefore 3M recommends that they not be used for this purpose, or in place of an approved respirator.
What is the main difference between a government-certified respirator and a surgical mask?
Respirators are designed to help reduce the wearer’s exposure to airborne particles. The primary purpose of a surgical facemask is to help prevent biological particles from being expelled by the wearer from going into the environment. Surgical masks are also designed to be fluid resistant to splash and splatter of blood and other infectious materials. Surgical facemasks are not necessarily designed to seal tightly to the face and therefore the potential of air leakage around the edges exists. Even those masks that appear similar to respirators have not been designed to protect the wearer from airborne hazards or tested to the same level of filtration efficiency; therefore they should not be considered an equivalent substitute to government-approved respirators.
Are there any medical restrictions for wearing a respirator?
Individuals with a compromised respiratory system, such as asthma or emphysema, or people with a history of heart disease should consult a physician before wearing a respirator. When personal protective equipment, including respirators, is used in a professional environment, its use must comply with applicable workplace standards, regulations and policies. In the United States, workers must receive medical clearance to wear a respirator from a licensed health care professional prior to using the respirator.
What are the limitations of using respirators for potential exposures to MERS-CoV?
Respirators are not a guarantee that the user will not contract MERS. The following items need to be carefully read and understood.
Each facility or individual should use the best available information to determine appropriate respiratory protection for exposures to MERS-CoV.
Can children use respirators?
Respirators have not been evaluated for use by children. Respirators are designed according to government performance standards for use by healthy adults who work in an occupational/workplace setting. There are no government performance standards today which specify criteria for designing respirators for children, such as breathing resistance.
Current 3M respirators are not sized to fit the smaller face of a young child. In addition, children may have difficulty breathing through a respirator and wearing the respirator without shifting it around or lifting it off of the face. "Fidgeting" or restlessness, common to children, could cause a leak during exposure. The effectiveness of a respirator is dependent upon the wearer being able to continuously wear the respirator without breaking the seal. Infants and toddlers should not be given respirators due to the risk of chocking or suffocation.
Nevertheless, under certain special circumstances, such as with a child who is immunocompromised, government approved respirators have been used by children under the advisement and care of the child’s physician. If you are considering use of a respirator for a child, consult your personal physician regarding your specific situation.
How important is fit?
Fit is very important. If a respirator does not seal tightly to the face, airborne hazards can penetrate or enter underneath the facepiece seal and into the breathing zone. It is very important to always follow the donning instructions and do a user seal-check or fit-check before entering the contaminated environment. A good fit can only be obtained if the face is clean-shaven in the area where the respirator seals against the face. Beards, long mustaches, and stubble may cause leaks into the respirator. Many medical facemasks, not approved as respirators, do not seal tightly to the face allowing airborne hazards to enter the breathing zone. Even those medical facemasks that appear to seal tightly to the face have not been designed to protect the wearer from airborne hazards. Therefore, they should not be considered an equivalent substitute for government-approved respirators.
In U.S. workplaces, the Occupational Safety and Health Administration (OSHA) requirements for respiratory protection (29 CFR 1910.134) must be followed including medical evaluation, training, and fit testing for employees required to use respirators in the workplace. In the U.S., health care workers, and other employees that are required to wear respirators must do a fit test before wearing the respirator for the first time. This fit test must be performed before a new make or model of respirator is worn by the employee. For U.S. employees required to wear a respirator, a user seal check cannot be used as a substitute for the fit test.
In countries where the OSHA standards do not apply, health care workers and other employees required to wear a respirator should follow applicable national workplace standards, regulations and policies concerning use, fit-testing/checking and training. 3M recommends that fit testing and training always be conducted for occupational use of a respirator.
What if I have a beard or stubble and want to wear a respirator?
A tight sealing respirator, one where the sealing surface contacts the face, will not provide an adequate seal when placed over any amount of facial hair. A bearded worker will typically require a powered air-purifying respirator (PAPR) with a hood or helmet.
How do I put on the respirator and check for proper fit?
The User Instructions for a 3M respirator contain the proper procedures for putting on a 3M respirator and checking for fit and seal. It is very important to read and follow the donning instructions very carefully and to conduct a fit check or user seal check every time the respirator is put on. The user instructions are provided with the original packaging of the respirator.
Can disposable respirators be shared between people?
Disposable respirators should never be shared.
Can a valved respirator be used for protection from the virus that causes influenza?
A valved respirator is designed to allow for easy exhalation through a one-way exhalation valve. If a person is wearing a respirator to help reduce his or her exposure to airborne viruses, a respirator with an exhalation valve would be acceptable. It would not be acceptable for someone to wear a valved respirator if they have a suspected/probable/confirmed case of MERS, as they would be exhaling into the environment.
For other situations where healthcare workers are required to wear a respirator the use of a valved respirator must be in accordance with national guidelines. For example, in some regions of the world such as the U.S. and Canada, it is not acceptable for a healthcare worker to wear a valved respirator in a situation requiring a sterile environment, such as the operating room.
Respirators should not be worn by a person whose respiratory system has been compromised or who may have trouble breathing through a respirator, unless otherwise advised by your personal physician.
Can I clean or wash a disposable respirator?
Under no circumstances should an attempt be made to clean or wash a disposable respirator.
What is the risk of inhaling biological particles that have been collected by the respirator filter?
The risk of inhaling particles that have been collected by the filter is very low, particularly in very clean areas (such as a patient care setting or a home). When particles are collected on a filter they are strongly held to the filter. Breathing through a filter has not been shown to dislodge the particles collected in that filter. However, it is important to understand that proper use of respirators only reduces your exposure to particles and does not prevent the risk of some exposure.
Can particles, such as bacteria or viruses, be reaerosolized from the respirator filter?
When particles are collected on a filter they are strongly held to the filter. Proper and normal use of a respirator has not been shown to reaerosolize the particles collected in that filter. Just because particles may not reaerosolize, does not mean that a respirator can be reused. The recommendations of the local health authority and the facilities infection control practioner regarding reuse should be followed.
Do 3M disposable respirators contain natural rubber latex?
None of 3M’s National Institute for Occupational Safety and Health (NIOSH) approved N95, N100, R95, P95, or P100 disposable respirators contain components made from natural rubber latex. This is stated on each original packaging of these respirators. Many 3M respirators sold outside the U.S. do not contain components made from latex. However, there are some that contain natural rubber latex components and these respirators carry a statement on the primary packaging similar to the following: “This product contains components which contain natural rubber latex which may cause allergic reaction.” If you require information on which 3M products contain natural rubber latex components, please contact your local 3M office.
Do any of 3M’s disposable respirators contain fiberglass material?
No. All 3M disposable respirators have filter media made from polypropylene and coverings typically made from a combination of polypropylene, polyester.
For more information, visit www.3M.com/PPESafety