2009 H1N1 influenza PPE federal guidance for healthcare workers causes concern among prevention experts

Infectious diseases prevention experts say current guidelines are not supported by science; could have dangerous consequences for patients and health care workers

Three leading scientific organizations specializing in infectious diseases prevention issued a letter to President Obama today expressing their significant concern with current federal guidance concerning the use of personal protective equipment (PPE) by healthcare workers in treating suspected or confirmed cases of 2009 H1N1 influenza. The Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA) and the Association for Professionals in Infection Control and Epidemiology (APIC) urged the administration to modify the guidance and issue an immediate moratorium on Occupational Safety and Health Administration's (OSHA) enforcement of the current requirements.

Federal PPE guidance and requirements issued recently by the Centers for Disease Control and Prevention (CDC) and OSHA include the use of fit-tested N95 respirators by healthcare workers rather than the use of standard surgical masks. According to these organizations--representing scientists, infectious disease specialists and healthcare professionals dedicated to healthcare quality, safety and infection control--this guidance does not reflect the best available scientific evidence. Their letter to the White House cited two recent studies demonstrating that the use of N95 respirators does not offer additional protection over that provided by the use of surgical masks.

Mark Rupp, MD, president of SHEA called the current requirements "deeply flawed" and expressed his concern over the "potential for considerable untoward consequences" that could result from the guidance. Among the consequences, Rupp cited significant confusion among healthcare professionals and administrators and the potential for further limiting the availability of the already scarce respirators in situations where they are truly warranted.

"During a time of a national emergency, healthcare professionals need clear, practical and evidence-based guidance from the government," said Richard Whitley MD, president of IDSA. "The current guidance is not supported by the best-available science and only serves to create skepticism toward federal public and occupational health decision-making."

"The supply of N95 respirators is rapidly being depleted in our healthcare facilities," said APIC 2009 President Christine Nutty, RN, MSN, CIC. "We are concerned that there won't be an adequate supply to protect healthcare workers when TB patients enter the healthcare system."

The organizations have provided input to federal agencies including the CDC regarding the handling of 2009 H1N1 influenza in the past and say they stand ready to continue to lend their knowledge and expertise as the pandemic advances.