Wangsan Kampanat, Sapbamrer Ratana, Sirikul Wachiranun, Kiratipaisarl Wuttipat, Ongprasert Krongporn, Assavanopakun Pheerasak, Surawattanasakul Vithawat, Kitro Amornphat, Panumasvivat Jinjuta, Wongcharoen Amnart
Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Front Public Health. 2025 Apr 28;13:1561571. doi: 10.3389/fpubh.2025.1561571. eCollection 2025.
Healthcare personnel (HCP) face high risks of airborne infections, including coronavirus disease 2019 (COVID-19), tuberculosis, and measles. Filtering facepiece respirators (FFRs) are critical for protection but require an adequate fit for effectiveness. Limited studies have explored the fit performance of different FFR designs in Southeast Asian populations. This study evaluates fit factors and pass rates of flat-fold, cup-shaped, and three-panel flat-fold respirators among Thai HCP and examines the influence of facial anthropometry on fit outcomes.
A cross-sectional study was conducted with 223 HCP at a university hospital in Chiang Mai, Thailand. Quantitative fit testing of three NIOSH-certified N95 respirators-flat-fold, cup-shaped, and three-panel flat-fold-was performed using a TSI Portacount Pro+ 8,038 device. The Occupational Safety and Health Administration (OSHA) Condensation Nuclei Counter protocol, comprising bending, talking, and head movement exercises, was followed. Fit factors, calculated as the harmonic mean, required a passing threshold of ≥100. Twenty-two facial anthropometric dimensions were also measured. Statistical analyses included the Kruskal-Wallis test, Fisher's exact test, and logistic regression.
Pass rates were 5.4% for flat-fold respirators (median fit factor [FF]: 25), 51.1% for cup-shaped models (median FF: 104), and 82.5% for three-panel flat-fold designs (median FF: 191), with significant differences ( < 0.001). The three-panel flat-fold maintained FF values near 200 across exercises. Anthropometric predictors varied by FFR type: head length (Adj. OR: 1.16) and nose length (Adj. OR: 1.28) influenced flat-fold models, while nasal bridge breadth (Adj. OR: 1.11) affected cup-shaped models.
The three-panel flat-fold respirator exhibited superior adaptability, highlighting its potential as the preferred choice for Thai HCP. The low pass rate of flat-fold designs underscores the need for region-specific respirator designs. Findings emphasize the importance of localized fit testing and the development of regional fit test panels to enhance protection. Further research is needed to explore fit retention, comfort, and usability in real-world conditions.
医护人员面临着空气传播感染的高风险，包括2019冠状病毒病（COVID-19）、结核病和麻疹。过滤式面罩呼吸器（FFR）对于防护至关重要，但需要合适的佩戴才能有效。有限的研究探讨了不同FFR设计在东南亚人群中的佩戴性能。本研究评估了泰国医护人员中平面折叠式、杯形和三层平面折叠式呼吸器的适配系数和通过率，并研究了面部人体测量学对适配结果的影响。
在泰国清迈的一家大学医院对223名医护人员进行了一项横断面研究。使用TSI Portacount Pro+ 8,038设备对三种经美国国家职业安全与健康研究所（NIOSH）认证的N95呼吸器——平面折叠式、杯形和三层平面折叠式——进行了定量适配测试。遵循了美国职业安全与健康管理局（OSHA）的凝结核计数器协议，包括弯曲、说话和头部运动练习。以调和平均数计算的适配系数要求通过阈值≥100。还测量了22个面部人体测量维度。统计分析包括Kruskal-Wallis检验、Fisher精确检验和逻辑回归。
平面折叠式呼吸器的通过率为5.4%（中位适配系数[FF]：25），杯形型号为51.1%（中位FF：104），三层平面折叠式设计为82.5%（中位FF：191），差异有统计学意义（<0.001）。三层平面折叠式在各项练习中保持FF值接近200。人体测量预测因素因FFR类型而异：头长（调整后比值比：1.16）和鼻长（调整后比值比：1.28）影响平面折叠式型号，而鼻梁宽度（调整后比值比：1.11）影响杯形型号。
三层平面折叠式呼吸器表现出卓越的适应性，凸显了其作为泰国医护人员首选的潜力。平面折叠式设计的低通过率强调了针对特定地区的呼吸器设计的必要性。研究结果强调了本地化适配测试以及开发区域适配测试小组以加强防护的重要性。需要进一步研究以探索在实际环境中的佩戴保持性、舒适度和可用性。
