National Institute for Occupational Health, PO Box 4788, Johannesburg 2000, South Africa.
School of Public Health, University of Witwatersrand, Private Bag 3, Wits 2050, Johannesburg, South Africa.
Ann Work Expo Health. 2017 Nov 10;61(9):1154-1162. doi: 10.1093/annweh/wxx077.
Respirators are widely used in health care settings but there is scant information on adequacy of fit and its determinants, particularly in resource-constrained settings. The aim of the study is to describe the proportion of South African diagnostic laboratory respirator users with adequate quantitative respirator fit while wearing their currently selected respirators which were generally supplied without regard to face size, and to identify determinants of fit test pass and fail.
This was a cross-sectional study with 562 participants. Quantitative respirator fit testing was conducted using a PortaCount fit testing machine. Four facial dimensions were taken using callipers and a tape measure. STATA 14 was used to perform descriptive and inferential statistics. The effect of the independent variables including face dimensions, race, smoking, respirator make and size, and age group was explored using multiple logistic regression stratified by sex.
Ninety one percent of the respirators supplied were medium-sized. Seventy eight percent of respirator users failed fit testing and were thus probably not protected by their currently supplied respirator. Multiple logistic regression analysis showed that face length in mm (odds ratio [OR] = 1.04, 95% confidence interval [CI] = 1.00-1.09), nasal root breadth in mm (OR = 1.16, 95% CI = 1.06-1.28), and respirator shape (OR = 0.56, 95% CI = 0.39-0.78) were significant predictors of overall fit for all subjects and for women alone, but these factors explained only a small percentage of fit test outcomes.
A large proportion of diagnostic laboratory employees were using poorly fitting respirators. This creates a false impression of protection. Fit testing of respirators is therefore important and recommended. The determinants evaluated described only a small portion of the variability in fit; important determinants were absent from the models.
呼吸防护器在医疗保健环境中被广泛使用，但关于其适配度及其决定因素的信息很少，尤其是在资源有限的环境中。本研究旨在描述在佩戴目前所选呼吸防护器的情况下，南非诊断实验室呼吸防护器使用者中定量适配度合格的比例，这些防护器通常不考虑脸型供应，并且确定适配测试通过和失败的决定因素。
这是一项横断面研究，共纳入 562 名参与者。使用 PortaCount 适配测试机进行定量呼吸防护器适配测试。使用卡尺和卷尺测量四个面部尺寸。使用 STATA 14 进行描述性和推断性统计。使用多元逻辑回归分析，按性别分层，探索包括面部尺寸、种族、吸烟、呼吸防护器类型和尺寸以及年龄组在内的独立变量的影响。
供应的呼吸防护器中 91%为中号。78%的呼吸防护器使用者适配测试失败，因此他们可能无法得到当前所供应的呼吸防护器的保护。多元逻辑回归分析显示，面部长度（毫米）（比值比[OR] = 1.04，95%置信区间[CI] = 1.00-1.09）、鼻根宽度（毫米）（OR = 1.16，95% CI = 1.06-1.28）和呼吸防护器形状（OR = 0.56，95% CI = 0.39-0.78）是所有受试者和女性的总体适配的显著预测因素，但这些因素仅解释了适配测试结果的一小部分。
很大一部分诊断实验室员工使用适配不佳的呼吸防护器。这会造成保护效果的假象。因此，呼吸防护器适配测试很重要且推荐进行。评估的决定因素仅描述了适配度变化的一小部分；模型中缺少重要的决定因素。
