Abstract

Powered air-purifying respirators (PAPRs) are worn to protect workers from hazardous respiratory exposures in a wide range of workplaces, including healthcare. However, PAPRs may diminish the ability of wearers to correctly hear words spoken by others, potentially interfering with safe performance of healthcare duties. Accordingly, the impact of PAPRs during healthcare use on speech intelligibility (SI) and consequently on user safety, usability, and patient care is not well studied. The objectives of this study were to (1) determine a listener’s ability to comprehend single-syllable words spoken by a PAPR wearer; (2) determine a PAPR wearer’s ability to intelligibly hear and identify single-syllable words spoken by a PAPR wearer; (3) to assess the variability between speakers, listeners, and PAPR models; (4) to investigate the effects of PAPR design features on SI; and (5) inform a SI requirement for certifying future PAPRs for use in healthcare. This study utilized a Modified Rhyme Test to assess SI for PAPRs. The current National Institute for Occupational Safety and Health (NIOSH) methods for assessing SI are limited to the recently introduced PAPR100 respirator class and the class of respirators claiming chemical, biological, radiological, and nuclear (CBRN) protections. Four NIOSH-approved PAPRs were evaluated using four human subjects. Four experimental conditions were examined:(1) Speaker and Listener with no PAPR; (2) Speaker and Listener both wearing PAPRs; (3) Speaker with a PAPR, Listener without a PAPR; and (4) Speaker without a PAPR, Listener with a PAPR resulted in a total of 144 experiments. Statistical analysis showed that the SI performance ratings were not significantly different among the PAPR models, but experimental conditions had significant impact on SI. The pattern of SI across the conditions of the experiment also showed a significant difference depending on PAPR model. The SI performance rating for all PAPRs could meet the current NIOSH CBRN certification requirement for speech intelligibility.

摘要

佩戴动力式空气净化呼吸器（PAPR）可以保护工人免受包括医疗保健在内的各种工作场所中有害的呼吸道伤害。但是，PAPR可能会降低佩戴者正确听到他人说出的文字的能力，从而可能会干扰医疗职责的安全执行。因此，尚未很好地研究医疗保健期间PAPR对语音清晰度（SI）以及因此对用户安全性，可用性和患者护理的影响。这项研究的目的是（1）确定听者理解P​​APR佩带者说出的单音节单词的能力；（2）确定PAPR佩戴者能够听得见并识别PAPR佩戴者说出的单音节单词的能力；（3）评估说话者，听众和PAPR模型之间的差异；（4）研究PAPR设计特征对SI的影响；（5）告知SI要求，以认证用于医疗保健的未来PAPR。这项研究利用改良的押韵测试来评估PAPR的SI。当前的国家职业安全与健康研究院（NIOSH）评估SI的方法仅限于最近推出的PAPR100呼吸器等级和要求化学，生物，放射和核（CBRN）保护的呼吸器等级。使用四个人类受试者评估了四个NIOSH批准的PAPR。研究了四个实验条件：（1）没有PAPR的演讲者和听者；（2）演讲者和听者都穿着PAPR；（3）具有PAPR的演讲者，不具有PAPR的听者；（4）没有PAPR的演讲者，具有PAPR的听众进行了144个实验。统计分析表明，PAPR模型之间的SI性能评级没有显着差异，但是实验条件对SI的影响很大。在整个实验条件下，SI的模式也显示出显着差异，具体取决于PAPR模型。所有PAPR的SI性能等级都可以满足当前NIOSH CBRN认证对语音清晰度的要求。