呼吸器适合性测试方法进展

Progress of fit testing of respirators

呼吸器是降低医疗保健工作者(HCW)暴露于呼吸道感染风险的重要个人防护设备,通过适合性测试筛选合适的呼吸器并正确佩戴至关重要。本文介绍了呼吸器的分类、适合性测试的目的、方法、要求以及执行适合性测试所面临的挑战等内容。包括动力呼吸器在内的、带有密合式面罩的呼吸器,均需进行适合性测试,以帮助使用者筛选适合的呼吸器。适合性测试包括定性和定量两种方案,研究表明定量测试在检测泄漏方面较定性测试更胜一筹。此外,即使经过适合性测试筛选的呼吸器,在每次使用之前也均应进行密合性检查,以确保使用者正确佩戴了呼吸器。新型冠状病毒肺炎(COVID-19)大流行期间,由于呼吸器的供应短缺导致适合性测试难以实施;随着呼吸器供应的恢复,国内外相关机构将重新重视对呼吸器适合性测试的监管。虽然开展呼吸器适合测试需要面临技术体系和各种成本挑战,但其不仅有很高的教育价值,而且能为医疗机构HCW在工作中提供充分的呼吸保护。

Respirators are important personal protective equipment to reduce the exposure of respiratory tract infections in health care workers(HCW).It is important to choose suitable respirators through fit testing and wear them correctly.This article introduced the classification of respirators and summarized the purposes,methods and requirements of fit testing,as well as the challenges when performing it.Users can choose the suitable respirators including powered air-purifying respirators and tight-fitting facepiece only when they passed fit testing.Qualitative fit testing(QLFT)and quantitative fit testing(QNFT)assays were two categories of fit testing and studies showed that the effect of QNFT in the detection of leaks was better than that of QLFT.Users should perform fit checking everytime in order to wear the respirator correctly although the respirators were screened by fit testing before.It was difficult to implement fit testing during the COVID-19 pandemic because of the shortage of respirator supply.But now,domestic and foreign institutions have re-emphasized the supervision of respirator fit testing as the supply of respirators resumes.Although the fit testing of respirators needs the support of clinical technical systems and faces various cost challenges,it not only has high education value but also provides effective protection for the HCW in medical institutions.