Surgical Masks, N95s, Cloth Masks…Oh My!

By Kathy Kent Toney, President of Kent Business Solutions

Part 3 of a 3-Part Series:
How to Keep Your Employees Safe

If you’re like me, you may be wondering this: what’s the truth about face coverings?
These questions may have crossed your mind:

• Do cloth masks really protect against being infected by COVID-19 or any other disease?
• What’s the story around N95 masks?

We’ve all heard so many different things from so many different sources. What are the facts?

Employee safety expert, Attorney Andrew "Drew" Brought, has the answers to these questions and more. I recently interviewed him for the final feature of my 3-part series on Keeping Your Employees Safe. This week’s topic is:

N95s, Surgical Masks and the Like…What Do I Need to Know?

But before we do that, here’s a funny employee safety training video, courtesy of The Office.

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Kathy: Drew, thanks for joining me! My first question is this…I was surprised to learn that an N95 is not a mask, but a respirator. What’s that about?

Drew: I would tell you that lots of people are surprised. In fact, virtually everyone that I meet is unaware that an N95 is actually a type of PPE that OSHA regulates and refers to as a respirator. And a respirator is a type of device that protects the person wearing the piece of PPE. It's designed to filter out particulate matter, other toxic chemicals, biological agents and other airborne contaminants that protects the user wearing the respirator. To the extent that an employer makes a determination that the employees in the workplace should be wearing an N95 respirator, there are a whole series of specific requirements and rules that OSHA also expects you follow. 

So, N95 respirators are in fact regulated very differently than masks…a surgical mask, or what people are referring to now as a cloth face covering. Those are not respirators…they are not designed or intended to protect, at least scientifically, the person who's wearing that type of mask. They are designed to protect those around the person wearing the mask by keeping the bodily fluids in…from either the nostrils or from the mouth. Masks do provide some layer of protection to the wearer as an added benefit, but not the same type of protection that an N95 would, which is a respirator to protect the person wearing it.

Kathy: So, you're saying that an N95 protects the person wearing it and a surgical mask protects other people around the person wearing it.

Drew: That's exactly right. That's the whole purpose of it. An N95 is a device that has been certified by the National Institute of Occupational Safety and Health (NIOSH), which is the research arm of OSHA. It's gone through very specific testing. A separate agency has performed evaluation testing to demonstrate that the N95 respirator when worn properly creates a seal around the wearer’s face that has a level of efficiency to protect the person wearing it from inhaling various pollutants, chemicals, biological agents, chemical agents and things of that nature. The “95” is a reference that the filtering aspects of the respirator filter out 95% of airborne contaminants to the person wearing the respirator.

On the flip side, a surgical mask, or a cloth face covering, does provide a layer of protection to the person wearing it. The purpose of that mask is to protect people around the individual wearing that mask, people within the vicinity…whether it's a bodily fluid, sneeze or cough.

If you look at the CDC or FDA website, they talk about the differences between a respirator, a surgical mask and a cloth face covering. Surgical masks are regulated by the FDA and they pertain to different devices. And they are a type of PPE, for the healthcare setting, that have to be worn in a hospital or healthcare setting.

Kathy: that’s interesting…you learn something new every day, right?

Drew: Yes!

Another little wrinkle is that there are a number of people wearing respirators called K95s or KN95s, and it’s not an N95. A K95 or KN95 is a respirator that purports to be equivalent to an N95, but it has not been tested or approved by NIOSH. It's a respirator that has been made in another country that purports to have the same level of protection for the person wearing that respirator, which satisfies that country’s standards as explained in this website. So, a country other than the United States might have a similar industrial hygiene standard to protect the occupant from 95% of air contaminants reaching their body…that's what “95” refers to, for both masks.

Bottom line: if you want to satisfy the respiratory protection standards in the US with a NIOSH-approved and certified respirator, you would use an N95 and not a K95 respirator.

Kathy: Thanks for that clarification.

You mentioned earlier about a “different set of regulations” for N95s. Why don’t you fill me in on those that employers must follow?

Drew: OSHA has a detailed respiratory standard for N95s. They have a very good website that talks about what that respiratory protection standard is and what are some of the obligations that an employer has.

First, there’s educating and training employees on how to properly “don” or put on the respirator to make sure that there's a proper fit. OSHA refers to this as “fit testing”. Employees that are provided respirators need to go through a proper fit testing process to ensure that there's a proper seal around the face. OSHA also wants men to have really short or thin facial hair to make sure that there is a nice tight fit, that there is not going to be air coming out through the sides. You also don’t want air coming around the top of the nose, underneath the chin and things like that. There is supposed to be a perfect seal around the mouth and nose so that all air is filtered through the fabric before entering the body.

There are also obligations regarding the disinfection and maintenance of respirators, so obviously you can't have people wearing the same unit day-after-day, for weeks and months on end without going through proper disinfection and maintenance protocols for these units.

Kathy: Makes sense.

I understand there have been some compliance issues around N95s that OSHA is following up on. Could you explain some instances or explain about that?

Drew: Here's a situation that took place in the state of Ohio where several skilled nursing facilities and rehabilitation centers were fined with the maximum OSHA penalty for a serious citation. These skilled nursing facilities provided N95 respirators to their staff very early on during the COVID crisis, really as a measure to protect the employees, thinking that they were doing the best thing possible. In fact, OSHA even acknowledged this in a national press release, detailing one of the very first enforcement cases around COVID-19. They mentioned that the employer had been trying to protect the employees by providing N95 respirators, but that the employer didn't recognize or understand that there were additional regulatory obligations they didn’t follow. Specifically, the skilled nursing facilities had not done fit testing nor training. They also didn't have documentation showing that their employees understood the way to properly use the respirators. So, OSHA actually fined these three healthcare centers, because they did not satisfy the regulations affiliated with that respiratory protection standard.

Kathy: And they were trying to do the right thing! That’s certainly a lesson for organizations that currently use them!

Drew: Right!

Kathy: Next question: what are the basic guidelines for a business to be compliant with PPE requirements, other than N95 respirators?

Drew: Respiratory protection is just one layer of protection affiliated with PPE. Typically, when individuals and workplaces think of PPE, you're going to potentially have hardhats protecting the head, safety glasses or safety goggles, steel-toed boots, gloves, and perhaps long sleeve shirts and pants. There are general PPE OSHA regulations that indicate the type of hazards employees encounter in the workforce and what that employer needs to do to make sure they provide the proper PPE to mitigate those hazards.

Kathy: Last question…what’s the landscape of requirements for wearing masks in the workplace, be it Federal, state or local government…or even OSHA?

Drew: That's a great question… you've got different government agencies mandating or requiring different obligations right now in the COVID-19 world. There are local ordinances, as well as state ordinances, that specify mandates for the use of cloth face coverings before you go into a public establishment. Those types of local and state requirements are generally not directed at specific employers, or a duty for employers, but they apply wholesale to everyone within that area. For everyone, for example, in Kansas City or in the state of Kansas…that's an obligation.

As for employers, OSHA does not have a mandate that says they must require their employees to wear cloth face coverings, masks or respirators. OSHA leaves it up to each employer to determine what is going to provide the level of protection and safety for their workplace. Now, that's not OSHA saying the employers have no obligation; rather, it's OSHA saying employers have a duty to:

1. Identify what the risk is; and
2. Figure out ways to engineer around that risk, such as work from home or work in different offices, so you don't have exposure.

Then if you identify a risk and can't implement engineering or administrative controls (which we've talked about in our first interview)…say in our current COVID-19 landscape…OSHA would say to a specific employer that a face covering or a respirator would be necessary as an obligation…not because it’s in a regulation. They would say it’s part of the general duty they have, and because of the industry they’re in, they would have to provide that protection.

Kathy: So, this falls under their general duty.

Drew: Exactly. It's called the 5(a)1 Clause. It's Section 5(a) of the Occupational Safety and Health Act, but everyone calls it either the 5(a)1 Clause or the General Duty Clause.  

Kathy: Makes sense.

Well, I think that’s a wrap, Drew! Thanks for taking time over the last couple of weeks to inform us about important safety topics businesses are facing. It’s been a pleasure!

Drew: It’s been my pleasure, too!

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Thanks for tuning into today for Part 3 of this three-part series! If you missed the other two blogs featuring Drew Brought, you can check them out here:

Part 1: Design an Employee Safety Program Using These 4 Steps
Part 2: Current Trends in OSHA Enforcement: How This Affects You
 
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