HICPAC favors switch to surgical masks for H1N1
CDC director calls for IOM review before deciding
An advisory panel is recommending less stringent infection control precautions for novel H1N1, but the move is just one step in the Centers for Disease Control and Prevention examination of the issue.
The Healthcare Infection Control Practices Advisory Committee voted unanimously in July to recommend health care workers wear surgical masks when caring for patients with novel H1N1, rather than fit-tested N95 respirators, as the current guidelines state. CDC director Thomas Frieden, MD, MPH, also planned to meet with representatives of labor unions. He requested an Institute of Medicine expert panel review the scientific research and prepare a report by Sept. 1. Frieden plans to make a decision on the guidance by Oct. 1.
The HICPAC position states that "at a minimum," health care personnel should adhere to standard and droplet precautions for seven days after the onset of a patient's symptoms. An N95 respirator or higher level of respiratory protection should be used with procedures likely to produce aerosols, including bronchoscopy, cardiac pulmonary resuscitation, open airway suctioning, and sputum induction.
Yet decisions on the level of protection also should take into account factors at the hospital, such as the number of patients with novel H1N1 and any evidence of transmission of H1N1 at the facility, said David Pegues, MD, director of infectious diseases at the University of California at Los Angeles (UCLA) and head of the HICPAC working group that considered the issue. "A careful risk assessment is needed on an ongoing basis at all facilities to assess the needs of personal protection equipment," he said.
Labor reps resign in protest
Three labor union representatives resigned from the Novel Influenza A (H1N1) Infection Control Working Group, which drafted the HICPAC recommendations. The labor union representatives asserted that the working group did not want to hear from experts in respiratory protection.
"Fortunately, we have a new CDC leader who understands that their [HICPAC's] input is just one part of a much larger forum for discussion," says Bill Borwegen, MPH, health and safety director for the Service Employees International Union (SEIU).
Borwegen was pleased that an IOM panel would review the relevant research. "We think we have the science on our side [supporting the use of respirators]," he says. "Countless studies have been done that demonstrate the airborne nature of this H1N1 virus."
An advisory panel is recommending less stringent infection control precautions for novel H1N1, but the move is just one step in the Centers for Disease Control and Prevention examination of the issue.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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