The Health Care Worker Protection Paradox


courtesy of creative commons user wallyg via flickr

courtesy creative commons user wallyg via flickr

From an Institute of Medicine workshop on workplace protection against novel A(H1N1) influenza, Washington, D.C.

I spent the last day and a half listening to presentations on various topics related to the transmission of the novel A(H1N1) influenza virus, the filtration properties of surgical masks, and the effectiveness of respirators in preventing the spread of the virus.

This was an information-gathering workshop, so the IOM committee can send a report to the CDC, and the CDC can use the information to decide whether to continue to advise health care workers to wear N95 respirators, which fit tighter to the face than basic surgical masks.

During a public comment period, representatives from several labor unions, a firefighters’ association, and a nurses’ association supported wearing N95 respirators for first responders and health care workers at risk of H1N1 infection.  

Yet the doctor who spoke on behalf of the Society for Healthcare Epidemiology of America and the Infectious Disease Society of America said that her organizations would revise the CDC guidance, because current evidence suggests the H1N1 is transmitted by droplets, and therefore the same precautions as seasonal flu, including use of surgical masks and good hygiene practices are what is needed.

Other than a lack of evidence that they help, why might health care workers resist respirators? Comfort is one reason. But this morning, a doctor from Canada brought up another point–empathy. Some surveys of Canadian health care workers after the SARS epidemic suggested that respirators led to a sense of isolation, and a feeling of not being able to relate to patients or colleagues.

I hadn’t thought about that, but we humans are wired to respond to faces, either positively or negatively.

Maybe that’s the difference between a firefighter who is confronting a scary wall of flame and a physician who is confronting a scared patient.

—Heidi Splete (@hsplete on Twitter)
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1 Comment

Filed under Emergency Medicine, Hospital and Critical Care Medicine, Infectious Diseases, Primary care

One response to “The Health Care Worker Protection Paradox

  1. Hey, great post, very well written. You should blog more about this. I’ll definitely be subscribing.

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