N95 vs. Surgical Mask for TB PPE

Apparently the IC specialists at my hospital have decided that surgical masks are an appropriate form of PPE for dealing with pts who have TB. However all of the research I have done the CDC and WHO all say N95 is a minimum requirement needed for precautions. Does anyone else work for a hospital with a similar policy? What would you do: get your own n95, wear 2 surgical masks at once?? I just want to adequately protect myself and I don't think a surgical mask would cut it.
I have NEVER heard of such a thing....all recommendations are for a N95.

Quote from ilovemicrobiologyApparently the IC specialists at my hospital have decided that surgical masks are an appropriate form of PPE for dealing with pts who have TB. However all of the research I have done the CDC and WHO all say N95 is a minimum requirement needed for precautions. Does anyone else work for a hospital with a similar policy? What would you do: get your own n95, wear 2 surgical masks at once?? I just want to adequately protect myself and I don't think a surgical mask would cut it.

Your IC specialists are absolutely wrong. With the increased risk of multidrug resistant TB, an appropriate respirator is mandatory (N95, even N100 for deadly forms in USA, FPP2 pr FPP3 in EEC - same masks). 2 surgical masks will not be an efficient filter. Please folow the CDC recommandations. Nurses with unappropriate surgical masks have been infected. Plesae do wear N95 only,and check the recommandation with your specialists. Regards Anita

I can't remember what the micron size of a TB is off the top of my head, but there's no way in hell a "surgical mask" filters them.OP, are you sure you have your "IC Specialists" recommendations right? If so, what is their rationale? Inquiring minds need to know...(And what Infnurse said... MDRTB is a BFD.)

Talk to your CNO and/or Infection Control nurse, and present the documentation you have from CDC. Be proactive

Quote from GuttercatI can't remember what the micron size of a TB is off the top of my head, but there's no way in hell a "surgical mask" filters them.)

TuberculosisMycobacterium tuberculosis is a fairly large rod-shaped bacterium. The rods are 2-4 microns in length and 0.2-0.5 microns in width. TB is spread from person to person through the air. When a person with infectious TB coughs or sneezes, tiny particles containing Mycobacterium tuberculosis are expelled into the air. These particles, called droplet nuclei, are about 1 to 5 microns in diameter. Droplet nuclei can remain suspended in the air for several hours, depending on the environment. The most effective droplet nuclei tend to have a diameter of 5 micron. Droplet nuclei are generated during talking, coughing and sneezing. One cough can generate 3000 droplet nuclei. Talking for 5 minutes can generate 3000 droplet nuclei and singing can generate 3000 droplet nuclei in one minute. Sneezing generates the most droplet nuclei by far (tens of thousands), which can spread to individuals up to 10 feet away.See also http://198.246.124.22/niosh/nas/RDRP...ter6/a6-30.pdfThese efficiencies are also compared with the efficiency of a typical noncertified surgical mask, originallydesigned to protect patients from 4 �m or larger droplets expelledby health care workers.(4)As incidences of Mycobacterium tubercu-losis (TB) infection began to rise in health care facilities, surgicalmasks were used, but were insufficient to protect the workers frominfected patients. In 1993 the Centers for Disease Control andPrevention (CDC) issued guidelines requiring that respirators usedfor the prevention of infection from TB have a minimum of 95%efficiency for 1 �m particles when tested at 50 L/min through therespirators.(5)Since all filter materials are more efficient at 1 �mthan at the most penetrating particle size, the new 42 CFR Part 84regulations permit all certified respirators to be used in health careindustries against TB exposure. Therefore, the performance ofN95 respirators was studied not only with solid particles, but alsowith bacteria having size and shape similar to TB. In this studyN95 respirator filters were tested with bacteria, NaCl, and poly-styrene latex (PSL) particles, and procedures similar to those usedpreviously were applied.(6–9)The N95 respirators were also testedat a flow rate lower than the certification flow rate of 85 L/min toexamine their performance at a breathing rate that is typical forhealth care workers.(10Results (diagrams) are significative. If you wear your surgical mask doing some activity inside the TBpatient's room, filtration rate is 71%. No comment. For particle sizes above 0.75 �m, the filtration efficiencies of all tested respirators are 99.5% or higher.It should be noted that theseefficiencies do not consider face seal leakage. The pressure dropacross the filter material encourages external air to bypass the filterand enter the respirator wearer’s breathing space through any faceseal leak that may be present. Appropriate face seal fit is measuredby quantitative fit-testing.So wear your right tight fitting N95 mask.