- 學位論文
N95口罩密合度測試及佩戴舒適度改善評估
Evaluation of Fit Test and Comfort Improvement of Wearing N95 Respirator
摘要
近年來新型流行性感冒不斷爆發，佩戴口罩以預防及阻隔生物性氣膠暴露感染之重要策略之一。第一線醫護人員常以佩戴N95口罩為主，然而一般醫護人員常缺乏佩戴N95口罩之密合度訓練；加上口罩易使佩戴者呼吸阻抗增加，且長時間使用也將使臉部的感知熱上升，造成佩戴意願降低，也使得暴露於生物性感染之風險將相對增加。 本研究分為兩部份，首先針對傳染病防治醫療網內11家應變醫院之551位醫療從業人員，進行問卷調查其口罩佩戴習慣與認知，並採用醫院庫存與採購之N95口罩以TSI Portacount Plus 8020定量密合度測試儀搭配N95模組進行口罩佩戴之密合度測試。接下來使用新研發之吐氣噴嘴，連結於N95口罩吐氣閥門上，可順利使佩戴者呼出熱氣，因此實驗選用三類型六款N95口罩，研究評估佩戴時口罩內的蓄積溫度、相對濕度、口罩密合度等變項，以作為舒適度之評估標的，之後並於各款口罩上加載新研發噴嘴吐氣閥門，並再次評估其佩戴舒適度之改善狀況。 研究結果發現：一、經由教育訓練與密合度測試，有90%以上醫療從業人員對正確佩戴口罩有信心，且對密合度訓練感受良好，並願意配合未來之測試。研究中，共使用12款N95口罩，整體密合度通過率為46.64%，其中「口罩款式」、「測試時有無調整口罩」和「工作人員觀察口罩是否適合臉型」皆與「通過密合度測試」有顯著相關。，工作人員認為不適合臉型而未通過密合度測試者佔70.34%，認為適合臉型且通過密合度測試者 有62.26%。二、未加裝新研發噴嘴吐氣閥門之所有類型口罩於佩戴後，面體內最高溫度介於37-42℃之間，佩戴一小時後溫度穩定維持於36-38℃。而在加載新研發閥門後，除出氣口溫度維持37℃外，口罩內溫度維持於26-28℃之室溫溫度，及60%之相對濕度，顯見口罩內較無熱蓄積情形，因此也間接提昇了佩戴之舒適度。
並列摘要
Since recently constant breakout of new types of influenza, wearing respirators to prevent bioaerosol infection has become emphasized. Nevertheless, N95 respirator primarily used by frontline medical personnel is liable to increase breathing resistance to the wearers, and risen sense heat from the face resulted from long-term using may decrease their willingness to wear which would increase risks in exposure to bioaerosol infection. The study was divided into two parts, the first part:,the infectious disease prevention and control of health care network of 11 response hospitals, there were 551 healthcare workers, conducted a questionnaire associated survey about their cognition of habits at N95 respirators, and quantitative fit test with TSI Porta Count Plus 8020 fit test instrument to using hospital inventory and purchasing of N95 respirators. The second part:a new exhaling nozzle connected to exhalation valve of the respirator was developed by this study, enabling the wearers to smoothly exhale the heat. Based on this, six styles of N95 disposable respirators in three types were selected for the experiment. All respirators were worn on manikin for standard domestic male labors. Various variables in wearing such as accumulated temperature, relative humidity inside respirators, and wearing fitness of respirators were then studied and assessed to identify targets for comfort evaluation. Thereafter, the invented nozzle-exhalation valves were installed to all styles of respirators, assessing again individual improvement in wearing comfort. The result showed:in the first part of study,after training and fit testing, more than 90 % of healthcare workers were confidented for correctly wearing a respirator, feel satisfied on the training of fit fest and willing to cooperate with future tests. A total of 12 models of N95 respirators in this study, the fit test overall pass rate of 46.64%, and there were significant associated in “passed fit test”with “models in respirators”, “the adjustment of respirators”, and "observation by the operator masks whether suitable for the subject's face". Staff considered unsuitable for subjects' face and fit test failed by 70.34 %,suitable of face and passed fit test by 62.26%. Second: the highest temperatures within respirator after wearing showed between 37 and 42 °C for all types of respirators without installing the invented nozzle-exhalation valves, temperatures had been constantly maintained between 36 and 38 °C after one hour of wearing. But for those installed with the invented nozzle-exhalation valves, except for 37 °C of temperature maintained in air outlet of the manikin, temperatures within all respirators maintain between 26 and 28 °C of room temperature with a relative humidity of 60 %, which significantly indicated less heat accumulation within respirators, indirectly increasing the wearing comfort.