Members of the Institute of Medicine’s (IOM) committee on respiratory protection for healthcare workers against novel H1N1 Influenza A write for the mainstream in this week’s New England Journal of Medicine. The two-page article is a fast read, with their bottom line recommendation to clinicians:

 “…reach for the N95 respirator [not a standard surgical mask] when confronting patients with influenza-like illnesses, particularly in enclosed spaces.”  

Their article is a follow-up to the Committee’s full report issued on September 3, 2009.  In that report and again here, the authors acknowledge the limitations of N95 respirators including improper fit, users’ reasons for not wearing them, and inadequate supply.  They correctly expand their recommendations beyond PPE, noting:

“Personal protective equipment (PPE) should be considered just one component of a set of occupational safety and health measures designed to reduce workers’ risk of exposure through all possible pathways.  These measures include the use of negative-pressure rooms, isolation of patients, standard practices for hand hygiene, frequent air exchange with out the use of recirculated air, and ultraviolet lighting.”

Final message:  an N95 is good, but not nearly enough.