Many healthcare organizations across long term care, home care, community health, clinical environments, and dental practices continue relying on procedure masks instead of respirators. Combined with a potential influenza vaccine mismatch and persistent respirator fit challenges, this creates widening gaps in protection for both staff and the vulnerable populations they serve.
Below is an evidence based overview of the key risk factors this season and why healthcare leadership may want to reassess respiratory protection strategies.
1. Rising Risk: Vaccine Mismatch and Seasonal Pressures
According to the Government of Canada’s Respiratory Virus Surveillance Program (updated Dec 5), influenza activity has increased and remains elevated. Older adults continue to be disproportionately affected, with 41 percent of laboratory confirmed influenza cases occurring in adults aged 65 plus.
Source: Government of Canada, Respiratory Virus Surveillance: Influenza
https://health-infobase.canada.ca/respiratory-virus-surveillance/influenza.html
Outbreak patterns further reinforce this vulnerability. Long term care facilities account for 44.7 percent of all influenza outbreaks, highlighting the elevated risk for both residents and the staff who support them.
Because real world vaccine effectiveness data is not available until later in the season, organizations are operating with uncertainty regarding protection levels, especially as influenza A viruses continue to evolve. Even mild respiratory infections can rapidly escalate in frail seniors and those with COPD, asthma, heart disease, immunocompromise, or multiple chronic conditions.
Operational impacts include:
- higher absenteeism
- staffing instability
- increased outbreak response requirements
- added strain on care continuity
These pressures extend beyond LTC into assisted living, home care, clinical settings, community health, and dental environments.
2. Procedure Masks vs Respirators in Healthcare Settings
Procedure masks do not protect the wearer
Public health agencies consistently emphasize that procedure masks are intended for source control only. They do not seal to the face, do not filter airborne particles effectively, and do not provide meaningful inward protection.
Reference:
Canadian Centre for Occupational Health and Safety (CCOHS)
https://www.ccohs.ca/oshanswers/prevention/ppe/surgical_mask.html
Where wearer protection is critical
Many daily tasks across LTC, assisted living, home care, acute and community care, and dental settings involve close proximity or aerosol exposure:
- personal care within inches of residents
- home visits in small or poorly ventilated spaces
- symptomatic assessments and respiratory therapy
- suctioning and airway related procedures
- dental aerosol generating procedures (AGPs), including drilling and ultrasonic scaling
In dental clinics, many AGPs generate high velocity aerosols containing viruses, bacteria, and blood borne particles. Procedure masks are not considered respiratory protection and do not filter these aerosols.
Reference: OSHA (citing CDC), Dentistry Worker and Employer Guidance
https://www.osha.gov/coronavirus/control-prevention/dentistry
3. Respirator Fit Challenges: A Persistent Gap in Workforce Protection
Even when respirators are provided, fit remains one of the most common and underestimated failure points in healthcare.
Why fit issues occur
Many conventional respirators come in only one or two sizes, despite Canada’s healthcare workforce including:
- a high proportion of women
- individuals with smaller or more slender facial profiles
- diverse facial anthropometries
Key workforce data:
- More than 75 percent of selected health care professionals in Canada are women (CIHI). https://www.cihi.ca/en/health-workforce-in-canada-overview
- In regulated nursing, about 90 percent of nurses are female (CNA).
https://www.cna-aiic.ca/en/nursing/regulated-nursing-in-canada/nursing-statistics - Women account for about 75 percent of all paid care workers in Canada (Statistics Canada).
https://www150.statcan.gc.ca/n1/pub/75-006-x/2022001/article/00001-eng.htm
One and two size respirators often fail to accommodate this diversity, leading to widespread fit test failures.
Peer reviewed research confirming high failure rates
- Regli et al. (Anaesthesia, 2021)
Found N95 and FFP2/3 initial fit pass rates range from 40 to 90 percent, with lower success among women and Asian healthcare workers.
https://pubmed.ncbi.nlm.nih.gov/32932556/ - Hasni et al. (PLOS ONE, 2023)
Demonstrated that gender and facial dimensions strongly influence fit, with women and smaller faced individuals experiencing significantly lower fit success. https://doi.org/10.1371/journal.pone.0288105
Operational impacts of poor respirator fit
- increased staff illness and absenteeism
- repeated failed fit tests
- inconsistent protection across shifts
- higher occupational health liability
- SKU complexity and procurement inefficiencies
- reduced confidence among staff and families
A respirator that does not seal to the wearer cannot deliver its certified level of protection, regardless of filtration performance.
4. For Leaders Reassessing Respiratory Protection Models
Many organizations are now re-evaluating respirator programs, fit strategies, and PPE expectations due to elevated influenza activity, staffing pressures, and continued fit challenges.
Canada Masq Q100: A Fit Inclusive CSA Certified CA N95
Canada Masq’s Q100 is the only CSA certified CA N95 respirator available in four sizes, aligning with CSA Z94.4 selection requirements and addressing the well documented fit issues seen with one size and two size respirators.
This size range enables a demonstrated 95 percent fit test success rate across healthcare and pharmacy staff in multi site evaluations.
The Q100 also meets or exceeds CSA’s highest rating for breathability with 100 pa airflow resistance, making it up to four times more breathable than many standard N95 models and better suited for extended use by staff or seniors with respiratory sensitivities.
CSA Certification:
https://www.csagroup.org/testing-certification/product-listing/certificate/?cert=302735-7204-03
Canada Masq Corporation is a leading Canadian manufacturer of disposable medical supplies, having delivered more than 350 million masks to government procurement agencies, national distributors, GPOs, and retailers.
Evaluation Window
A no cost one month evaluation window is available through December 23 for organizations wishing to assess fit inclusive respirators in a structured, non commercial, no commitment format.
Following December 23, inquiries may still be considered on a case by case basis.
Teams can gather internal feedback on:
- real world fit
- comfort across diverse facial profiles
- staff acceptance
- operational considerations
- inventory feasibility
-
consistency of protection across shifts
If your organization wishes to participate in a respirator fit evaluation, contact seanl@canadamasq.com.
FAQ: Respiratory Protection in Healthcare Settings
1. Are procedure masks adequate for protecting healthcare workers from airborne viruses?
No. Procedure masks do not seal to the face and do not filter airborne particles. They are intended for source control only, not wearer protection.
Reference: CCOHS.
2. Why are seniors disproportionately affected by influenza outbreaks?
Adults 65 plus represent 41 percent of lab confirmed influenza cases, and LTC facilities account for 44.7 percent of outbreaks, making seniors significantly more vulnerable to complications.
Reference: Government of Canada.
3. Why do so many healthcare workers fail N95 respirator fit tests?
Most N95 models come in one or two sizes, even though more than 75 percent of Canada’s healthcare workforce is female, and many staff have smaller or narrower facial profiles. Peer reviewed studies confirm lower fit success among these groups.
4. What makes the Q100 different from standard N95 respirators?
The Q100 is the only CSA certified CA N95 with four sizes, enabling a 95 percent fit test pass rate across diverse facial profiles. It also has industry leading breathability suitable for long wear and respiratory sensitive populations.
5. Who is eligible for the December evaluation program?
Healthcare organizations including LTC, assisted living, home care, community health, clinics, and dental teams. Requests after December 23 may be reviewed case by case.
6. How do we request participation?
Email seanl@canadamasq.com to register for a fit evaluation or request product information.