Respiratory Protection Against Emerging Infectious Diseases: Face Masks, Respirators, and Tools for Choosing Between Them

The scientific literature reflects considerable debate over which types of respiratory protective devices (RPDs) are appropriate for protecting workers against exposure to infectious bioaerosols, including during outbreaks of emerging diseases. Some evidence suggests that face masks may offer similar protection to respirators, while other studies have found marked disparities in the protectiveness of these types of devices. Previous reviews have called for more information, chiefly in the form of clinical trials, to better inform decision making about RPDs. However, alternative approaches to respirator selection, including control banding tools that match groups of similar hazards to appropriate control measures, may be useful in choosing RPDs for workers with potential bioaerosol exposures on the job. These tools, while offering more streamlined approaches to RPD selection, come with challenges of their own, including questions about how to allocate different RPDs to different workers. This article reviews arguments on both sides of the face mask-respirator divide and considers the use of control banding tools in the context of preparedness for serious emerging infectious disease outbreaks.