The President of Canada Health Net, Julia Novik recently met with Leon Matrosov, CRSP, Health & Safety Manager and an independent consultant with Workplace Safety & Wellness Solutions (www.workplacesafety-ontario.com), as well as program developer at Safe To Work (www.safetowork.ca).  We discussed the impact of COVID-19 on our daily lives and addressed questions about respiratory protection, so hopefully we can help you make a more informed decision about using a disposable respirator or mask. 

Julia Novik, President CHN:  These are certainly unprecedented times, and considering our current situation, you must be very busy. We appreciate you taking the time to speak with us today.

More so than ever, Health & Safety seems to be on the minds of everyone.  Over the past several months, in our collective effort to stop the spread of COVID-19 and help flatten the curve, we’ve all had to make tremendous sacrifices, both in our personal and professional lives. In your opinion, how do we move forward from here?

Leon Matrosov, CRSP, Health & Safety Consultant:  Absolutely, we are facing some challenging times.  The health and economic impacts of this global pandemic are unprecedented.  We are all struggling, and certainly learning to navigate this new reality with COVID-19.  That said, I am downright impressed with the solidarity of the Canadian people, and how we have all come together to support our frontline workers.  We have headed the medical advice for physical distancing and to stay home, to wash our hands often…and all of these measures appear to be working as we continue to safeguard our medical system and protect those that are most vulnerable in our communities…in our families.    However, as government directives shift, and we commence the process of a gradual return to work and school, we need to remain cautious about our personal safety and security knowing that until there is a vaccine for COVID-19, the risk of infection still exists.

Julia Novik, President CHN:  So, considering this new reality, with COVID-19, what can we do to ensure our own safety and security as we gradually increase our activities?  How do we continue to protect ourselves and others, as we return to work, or visit the grocery store or go the pharmacy?

Leon Matrosov, CRSP, Health & Safety Consultant:  Okay, first and foremost, it’s important that we continue to follow public health advice and the direction set out by the government.  However, you can see that as case numbers decline, some provinces are already preparing to lift certain restrictions while others have started to plan for an eventual reopening.  Collectively we are preparing for a return to what some have referred to as the “new normal”.  In doing so, we are looking at ways that we can continue to operate while ensuring the highest standards for workplace and personal health and safety.  Part of this discussion is looking at personal protective equipment (PPE) for both workers and the public.

In reading the news, we see that many private businesses, grocery store chains, and even schools are already considering the use of face masks for the public or are mandating that patrons wear face masks during certain interactions.  I don’t disagree with that.  We know that this virus likes entry points like our eyes, nose and mouth, and covering up to protect those areas can only help.  Wearing a face mask in public creates an additional layer of protection for others around you and is especially important when physical distancing may not be feasible, such as when using public transit or doing your grocery shopping in a busy store.

Julia Novik, President CHN:  Prior to COVID-19 most people wouldn’t even think about wearing a face mask in public but now are considering wearing one.  Some have resorted to making their own. Can you explain to us the difference between the level of protection you get from wearing a cloth mask versus wearing a medical or surgical mask, or using a disposable respirator, like an N95 or KN95?

Leon Matrosov, CRSP, Health & Safety Consultant: There is an abundance of information available online about masks and respirators, what they do and how they protect, but I would urge you to seek out reputable sources such as the Centers for Disease Control and Prevention (CDC) website or the ACGIH or NIOSH.

For example, the respiratory protection you get with a disposable respirator, such as an N95 or KN95, is superior over wearing a handmade face covering, a non-medical or even a medical or surgical mask.  According to the CDC website, an N95 respirator is one of nine types of disposable particulate respirators. I can read you the excerpt, “Particulate respirators are also known as “air-purifying respirators” because they protect by filtering particles out of the air as you breathe. These respirators protect only against particles… Since airborne biological agents such as bacteria or viruses are particles, they can be filtered by particulate respirators.” The disposable respirators, such as the N95, are tight-fitting providing a seal around your nose and mouth. When properly fitted and worn, there is minimal leakage around the edges of the respirator when the user inhales or exhales, thus reducing the wearer’s exposure to particle agents,  as in the case of COVID-19. So, essentially the N95 or KN95 respirator is meant to both protect you and those around you.

The N95 is a North American rating and has NIOSH approval; NIOSH is the U.S. National Institute for Occupational Health and Safety which works collaboratively with the CDC.  Health Canada accepts the NIOSH certification as an appropriate quality standard for N95 respirators.  The N95 respirator comes in different sizes and it is recommended that fit-testing be completed to ensure an optimal fit.

KN95 respirators fall under the Chinese approval system.  U.S. Food and Drug Agency as well as  Health Canada are accepting the KN95 respirators due to COVID-19.

However, if an N95 or KN95 respirator is not readily available, which is currently the case, we need to look at other options.

In general, wearing anything over the face such as a scarf, a non-medical or cloth mask, is better than wearing nothing at all; some barrier between you and the people around you is better than none.   A medical/surgical mask is of course a better alternative to a cloth mask for several reasons. CDC notes that while surgical masks are not designed for use as particulate respirators and do not provide as much respiratory protection as an N95 or KN95 respirator, they do provide barrier protection against droplets including large respiratory particles. Surgical masks are also affordable and are somewhat available at the current time. According to the CDC, a medical-grade surgical mask is fluid-resistant and provides the wearer protection against large droplets, splashes, or sprays of bodily or other hazardous fluids.  When you wear a surgical mask, it protects other people from your respiratory emissions.   Wearing a medical mask when you go out into the community, is a measure to protect others.   Medical masks are generally good “respiratory etiquette” to prevent you from spreading germs by talking, coughing, or sneezing.  If we all wear a surgical mask, this offers an extra level of protection for all us.  But it is important to emphasize the limitation of a surgical mask; it is not a substitute for an N95 or KN95 respirator.   A surgical mask has openings.

Julia Novik, President CHN:  There are several different grades of medical/surgical masks.  Can you clarify the difference between Level 1, 2 or 3?

Leon Matrosov, CRSP, Health & Safety Consultant:  Yes, there are 3 levels of protection with ASTM-rated medical masks, offering low, medium and high barrier protection.  ASTM refers to the American Society of Testing and Materials, which is an international standards organization that develops standards for a wide range of materials, products, systems and services – including those in healthcare.  To achieve the ASTM rating, a medical mask must meet certain requirements.  Beware of mask ratings that do not follow ASTM guidelines.  There are 1-ply, 2-ply, 3-ply and 4-ply masks, obviously the more layers the better.  Single-layer masks are very thin and typically effective at capturing larger dust particles, but not virus-sized particles.  Level 2 masks are 3-ply and are made with a form-fitting pliable nose and chin band.  Level 3 masks feature a 4-ply design with a fluid-resistant outer layer.  While some medical masks come with ties to offer a snugger fit, others have earloops for quicker donning (i.e. putting on the mask).

Julia Novik, President CHN:  Do you have any other advice for someone considering wearing a mask in a non-medical setting?

Leon Matrosov, CRSP, Health & Safety Consultant: It is prudent to note that while the KN95 has been accepted as an alternative for COVID-19 protection, through FDA and Health Canada, because of shortages of N95 respirators,  based on technical bulletins from various manufacturers, in testing criteria such as “pressure drop” and other measures, the N95 appears to perform slightly better than the KN95.  On the balance, the N95 is just a bit snugger and a bit easier to breathe in.  Therefore, anyone using the KN95 using it in a different way, other than for the purpose of COVID-19 protection, should be cautious, i.e. in construction, to protect against hazardous materials.