Lessons learned in establishing and sustaining elastomeric half mask respirator-based respiratory protection programs: An impact evaluation

Developing and overseeing Respiratory Protection Programs (RPPs) is crucial for ensuring effective respirator use among employees. To date, a gap exists in research that focuses on elastomeric half mask respirators (EHMRs) as the primary respirator in health delivery settings which would necessitate additional considerations in RPPs beyond the more common N95 filtering facepiece respirators. This paper presents lessons learned during a one-year impact evaluation with healthcare and first responder settings that received EHMRs from the Strategic National Stockpile in 2021 and 2022. The study explored the advantages and disadvantages associated with EHMRs and the challenges related to establishing, implementing, maintaining, and sustaining EHMR-based RPPs. Data was received from 42 organizations that participated in EHMR demonstration projects to address (1) the most important, perceived, elements and practices of an EHMR-based RPP to support a long-term program; and (2) differences in perceptions of the most important elements and practices based on organizational and company size (i.e., small, medium, and large). Sustaining an EHMR program was considered the most important area to focus future efforts (<i>M</i> = 2.94; SD = 1.12 on a 4-point scale), followed by daily maintenance of the program (<i>M</i> = 2.72; SD = 0.974), development and implementation of the program (<i>M</i> = 2.42; SD = 1.05), and access to EHMRs (<i>M</i> = 1.91; SD = 1.11), respectively. Findings also revealed statistically significant differences in perceptions based on organization size, particularly in access to EHMR models/designs. Results underscored the significance of user accountability, organizational support, and culture in EHMR-based RPPs to support emergency preparedness efforts.