3MTM Occupational Health and Environmental Safety Division
March 26, 2003

Summary and Comments regarding the CDC Updated Interim Infection Control Guidance in the Health Care and Community Setting for Patients with Suspected SARS and WHO Hospital Infection Control Guidance concerning Severe Acute Respiratory Syndrome (SARS).

The CDC and WHO have issued advisories containing information on personal protective equipment recommendations when caring for patients with probable SARS. Regarding respirators, the advisories state, in part:

CDC-Centers for Disease Control and Prevention

If a suspect SARS patient is admitted to the hospital, infection control personnel should be notified immediately. Infection control measures for inpatients (http://www.cdc.gov/ncidod/hip/ISOLAT/Isolat.htm) should include:

• Standard precautions (e.g., hand hygiene); in addition to routine standard precautions, health care personnel should wear eye protection for all patient contact.
• Contact precautions (e.g., use of gown and gloves for contact with the patient or their environment)
• Airborne precautions (e.g., an isolation room with negative pressure relative to the surrounding area and use of an N-95 filtering disposable respirator for persons entering the room)

The CDC also contains links to documents specific to Tuberculosis http://www.cdc.gov/ncidod/sars/res-protection.htm. These documents are presented because of their useful information on respiratory protection.

The entire CDC advisory can be found at http://www.cdc.gov/ncidod/sars/infectioncontrol.htm.

WHO-World Health Organization

• Patient movement should be avoided as much as possible. Patients being moved should wear a surgical mask to minimize dispersal of droplets. All visitors, staff, students and volunteers should wear a N95 mask on entering the room of a patient with confirmed or suspected SARS. Surgical masks are a less effective alternative to N95 masks.
• Health Care Workers (HCWs) must wear protective eyewear or face-shields during procedures where there is potential for splashing, splattering or spraying of blood or other body substances.
• HCWs are advised to wear masks whenever there is a possibility of splashing or splattering of blood or other body substances, or where airborne infection may occur. Particulate filter personal respiratory protection devises capable of filtering 0.3um particles (N95) should be worn at all times when attending patients with suspected or confirmed SARS.

The entire WHO advisory can be found at: http://www.who.int/csr/surveillance/infectioncontrol/en/

The following table lists 3M respirators that satisfy the CDC and WHO recommendations of minimum N95 for HCWs.

RESPIRATOR	ASSIGNED PROTECTION FACTOR	FILTER CLASS*	3M EXAMPLES
Half Mask	10	N95	8110S, 8210, 8511, 9210, 1860, 1860S, 1870
		R95	8240
		P95	8271, 6x00 & 750x w/2071 filters
Half Mask	10	N100	8233
		P100	8293, 6x00 & 750x w/2091 or 7093 filters

Respirators are not a guarantee that the user will not contract SARS. The following items need to be carefully read and understood.

• Respirators may help reduce exposure to airborne biological contaminants, but they don't eliminate the risk of exposure, infection, illness, or death.
• For greatest effectiveness respirators need to be worn before and during the entire exposure period.
• Respirators may help protect your lungs, however, some biological contaminants may be absorbed through the skin or eyes and other protective equipment may be required.
• Fit of the respirator to the face is very important. If it does not fit properly, airborne contaminates will penetrate (enter underneath) the facepiece seal.
• 3M respirators are not designed for children. 3M respirators are designed for occupational/professional use by adults who are properly trained in their use and limitations.
• The wearer must be clean-shaven to wear respirators that seal tightly to the face. Beard, stubble or long mustaches may cause large leaks into the respirator.
• Training on proper use and limitations, including practice putting the respirator on and wearing it is required.
• Individuals with a compromised respiratory system, such as asthma or emphysema, should consult a physician before wearing a respirator.

Each facility or individual should use the best available information to determine appropriate respiratory protection for exposures to SARS. Continue to refer to the CDC (www.cdc.gov) and WHO (www.who.int) websites for their latest recommendations.

If you have any questions please contact OH&ES Technical Service at 1-800-243-4630.

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