Evaluation of a point-of-use kiosk for improving the fit of N95/P2 respirators in health care settings: A randomized controlled trial.

Background: Fit of N95/P2 half-face respirators is critical. No objective ways exist to evaluate their implementation at use. Previously, we showed 26% of health care workers achieve appropriate fit at point of use.

Methods: 657 quantitative fits were conducted on 166 subjects, using 4 different respirator styles. Randomization was performed; controls employing standard "fit-check" and intervention using a infrared video kiosk. Primary outcome was passing rates of quantitative fit, with secondary outcomes of respirator type, gender, race, and previous experience.

Results: Intervention demonstrated significantly higher pass rate (50.6%) compared with controls (30.8%). Odds of passing with kiosk was 2.3 (odds ratios [OR] 2.3, 95% confidence intervals [CI] 1.8-2.9, P < .001). Duckbill style improved the greatest (OR 4.1, 95% CI 2.1-7.9, P < .001), and Tri-fold also showing substantial benefit (OR 2.66, 95% CI 1.4-5.2, P < .001). Gender and race did not influence outcomes when using the kiosk, nor did previous experience.

Conclusions: A custom point-of-use kiosk improved odds of achieving a satisfactory fit of common respirator styles, independent of participant demographics. These findings open the door to addressing a gap in respiratory protection programs by providing individual assessment and interventions that improve worker safety at the time of highest risk.