Effect of Respiratory Protection Devices on Speech Intelligibility Among Healthcare Workers in a Controlled Environment Simulating the Clinical Setting.

Abstract

Background: Effective communication and collaboration among clinical and nonclinical staff are critical to the health and safety of the staff, for optimal team performance and for safe patient care. While respiratory protective equipment are routine key strategies to protect healthcare workers from exposure to select respiratory pathogens, they have been demonstrated to disrupt speech intelligibility. The COVID-19 pandemic escalated the need for and utilization of respiratory protection in all healthcare settings. The purpose of this study was to evaluate the impact of various respiratory personal protection equipment (PPE) on speech intelligibility.

Methods: Healthcare workers were invited to participate in audiology-based testing in which the audiologist read words from the Modified Rhyme Test (MRT) using two levels of background noise and rotating through six different types of respiratory PPE. Descriptive statistics and ANOVA were used for analysis.

Findings: Modified Rhyme Test (MRT) scores were significantly lower when wearing the CleanSpace Halo (-10.22 points, 95% CI [-11.28, -9.20]) and the elastomeric half mask respirator (EHMR) with or without the exhalation valve filter (-2.28 points, 95% CI [-3.33, -1.20] and -3.22 points, 95% CI [-4.40, -2.18] respectively) after adjusting for noise level, listener respiratory PPE, and correlation within each participant.Conclusions/Applications to practice:Elastomeric half mask respirator (EHMR) decreased speech intelligibility compromising clear communications. Further research on respiratory PPE design is needed to optimize speech intelligibility and communication maximally.