On April 9, 2021, the Centers for Disease Control and Prevention (CDC) updated its “Strategies for Optimizing the Supply of N95 Respirators.”  The update includes changes to respirator-provision strategies at Conventional Capacity, Contingency Capacity (periods of expected N95 shortages), and Crisis Capacity (periods of known N95 shortages).  Employers required to provide respirators as personal protective equipment (PPE) should review the updated guidance for any changes that may impact their PPE strategies.

Background

OSHA’s Respiratory Protection standard, at 29 CFR 1910.134, requires employers to provide appropriate respiratory protection, such as N95 respirators, when necessary to protect employees from a known hazard in the workplace.  Use of a respirator, in turn, requires “proper training, fit testing, availability of appropriate medical evaluations and monitoring, cleaning, and oversight by a knowledgeable staff member.”  

Last year, the CDC in coordination with the National Institute for Occupational Safety and Health (NIOSH) authorized the use of certain PPE that exceeded the manufacturer-designated shelf life in times of increased demand and decreased supply, so long as certain storage conditions were met.  It additionally released “Strategies for Optimizing the Supply of N95 Respirators” that addressed appropriate use of respirators when they are available at various “surge” capacities (i.e., conventional capacity, contingency capacity and crisis capacity).¹

Updates to N95 Strategies

The updated CDC guidance acknowledges that the availability of NIOSH-approved respirators has increased significantly in recent months.  In light of this increased supply, the updated guidance adds new strategies for Conventional Capacity and removes previously applicable strategies for Crisis Capacity respirator availability.  Major changes include:

• Non-NIOSH approved respirators developed by manufacturers that are not NIOSH-approval holders should not be used, even at Crisis Capacity.
• Decontamination of respirators for limited reuse is no longer an approved strategy, even at Crisis Capacity. 
• At Crisis Capacity, reuse of respirators should be limited to no more than five donnings per device by the same health care provider (HCP).
• At Crisis Capacity, face masks should only be used as a last resort when caring for a patient that is suspected or known to be infected with SARS-CoV-2.
• At Contingency Capacity, respirators should be prioritized for HCPs using the respirators as PPE over those using the respirators as source control.
• At Contingency Capacity, N95 respirators used for an extended time as PPE should be discarded immediately after removal.

Employers that provide respirators should review their practices for compliance with the updated CDC guidance at the appropriate capacity level.