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Evaluating N95 respirator designs: A mixed-methods pilot and feasibility study.
Fatima Sheikh1, Myrna Dolovich2,3, Lisa Schwartz1
1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Plos One
|December 3, 2025
Summary
N95 respirator fit varies significantly by gender and ethnicity, with non-White females experiencing the poorest fit. Equitable respirator designs are crucial for healthcare worker safety during pandemics.
Area of Science:
- Public Health
- Occupational Health
- Medical Anthropology
Background:
- The COVID-19 pandemic highlighted the critical role of personal protective equipment (PPE), specifically N95 respirators, in preventing airborne infections.
- Existing N95 respirator designs may not adequately fit all healthcare workers (HCWs), particularly those who do not fit the average White male facial profile, increasing their risk.
Purpose of the Study:
- To assess the feasibility of a mixed-method study on N95 respirator fit among diverse HCWs.
- To generate quantitative data on N95 fit using objective measures and participant feedback.
- To explore the impact of the pandemic and PPE use on HCW well-being.
Main Methods:
- A prospective, mixed-method pilot and feasibility study was conducted.
- Quantitative N95 respirator fit was assessed using TSI PortaCount and anthropometric measurements (bizygomatic breadth, Menton-Sellion length).
- A survey collected sociodemographic data, HCW perceptions of fit and comfort, and well-being impacts.
Main Results:
- Recruitment was limited by pandemic restrictions, with 37 HCWs participating.
- Non-White females exhibited the lowest mean N95 fit factors compared to other groups.
- Observed differences in facial anthropometry (bizygomatic breadth, Menton-Sellion length) between genders and ethnicities.
- Most participants reported physical discomfort and negative psychological well-being effects due to PPE challenges.
Conclusions:
- Gender and ethnicity are significant factors influencing N95 respirator fit.
- Anthropometric variations across gender and ethnicity necessitate consideration in the design of respirators.
- Equitable N95 respirator design is essential for protecting all healthcare workers.
