better protection than cotton masks, homemade alternatives such as handkerchiefs and scarves, or no protection at all. No device is fail-safe, and its effectiveness depends on fit, level of exposures, and appropriate use. Finally, none of these devices protects against contact transmission, and appropriate hand hygiene is necessary when using and after removing these devices.

In this final chapter, the committee provides findings and recommendations about reuse of N95 filtering facepiece respirators and medical masks and recommends a research agenda that could help the nation prepare for near- and long-term pandemic threats.

RESPIRATORS

A properly fitted N95 filtering facepiece respirator is likely to be both the least expensive and the most widely available NIOSH-certified respirator for protecting healthcare workers and the public against airborne infection. However, without manufacturing modifications, current disposable N95 respirators cannot be effectively cleaned and should therefore be discarded after a single use. Moreover, manufacturers are concerned that should extended use or reuse after cleaning and disinfection of disposal devices be recommended, they will incur higher liability without federal policies to protect them. In addition, the need for fit-testing respirators is critical and must be an integral part of any program that promotes their use.

Finding 1: The committee could not identify or find any simple modifications to the manufacturing process that would permit disposable N95 respirators to be reused without increasing the likelihood of infection.


Finding 2: Any method of decontaminating a disposable N95 filtering facepiece respirator must remove the viral threat, be harmless to the user, and not compromise the integrity of the various elements of the respirator. The committee found no method of decontamination that met all three criteria.


Finding 3: The committee found no simple modifications to currently existing N95 filtering facepiece respirators that would obviate the need for fit-testing.



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