Thread by @ToshiAkima

Unsolicited Review: Castle Grade N98 respirator. This gets a recommendation from me. TGA approved making it suitable for HCWs. It is comfortable and reusable. Ideal for Australian HCWs who suffer PPE burns from N95 masks, while upgrading aerosol protection castlegrade.com.au

Initial concerns included that I am not fit-tested by work, but as soon as you put it on you can tell there is reduced air leakage around the mask edges vs. a fit-tested N95. That means ZERO fogging of glasses. The tight seal pushes the air through the front of the respiratory

The acid test is whether I'd wear it working on COVID duties despite not being fit-tested. The answer is YES. There is obvious reduction in air leakage around the mask edges. It would be difficult for work to object to me wearing a TGA approved N98 respiratory instead of an N95

Reusability means environmental friendliness. It is also fairly economical to run as the filter lasts for 32 hours of direct use ie about every three days. A pack of 25 filters costs $60 (free shipping >$99). Replacing it is easy and takes seconds to do. castlegrade.com.au/products/filte…

You can see from my photo that it is small and discrete. It lacks the frightful "gas mask" appearance of many elastomeric respirators! Even non-HCWs could wear it without it turning heads, and in the long run, may be more economical to run than buying throwaway masks

The one drawback is that it muffles the speaking voice. This makes it necessary to speak more slowly and deliberately while clearly articulating words. However, the effect is modest and was not a dealbreaker for me. Models designed to retain vocal clarity do exist overseas

I did consider the transparent Canopy elastomeric N98 respirator as it doesn't muffle the voice (helpful for the hearing impaired), but it's neither NIOSH (approval pending) nor TGA approved for work use. It's expensive and international shipping is a pain onecanopy.com/products/canop…

I'm also keeping my KF94s for cycling. No peri-mask air-leaks means all the air goes through a small filter. You get a soft hissing (think Darth Vader) sound as you expire. It's not designed to move enough air for high-intensity exercise

https://twitter.com/ToshiAkima/status/1461952828092530688?s=20

Just an addit. This is a Melbourne based Australian firm. The product is approved by the Australian Therapeutic Goods Administration (TGA). No approvals for other jurisdictions are claimed eg Canada, US, Europe, UK etc if you are using this in a HCW setting

Finally, keep in mind this piece of feedback from @kate_cole_ that TGA approval on its own is not sufficient to make this suitable for the workplace. Thank you very much for your feedback, Kate. All readers of this thread please take due note

https://twitter.com/kate_cole_/status/1462166049177018374?s=20

This doesn't solve my issues. On non-COVID areas of the hospital we're not given fit-tested P2 masks and the ones that are can only be found in the COVID ward. A Sunstrom SR100 or SR200 is hardly practical for F2F clinical use. A Halo costs a grand

https://twitter.com/fifteenforty/status/1462230786719944706?s=20

A physician simply cannot do non-COVID ward rounds in this. Between a P2 which has failed fit-testing and surgical mask, I am still going to take my chances with a Castle Grade as it gives a better seal than my fit-tested P2 and doesn't fog my glasses

ADDIT: please keep in mind that this respirator does not conform to the AS/NZS 1716: 2012 standard for a P2/N95 respiratory. It is thus best reserved for non-COVID duties where a high-grade respirator is not mandated by your workplace

@kate_cole_ The more I think about this, the less I think this is a failure on behalf of clinicians sourcing their own PPE to avoid pain, ulcers, fogging glasses, impaired vocal clarity. It's a failure of #occupationalhygienists to come up with solutions to these problems

Note: Castle Grade make no claims to conforming to "N98" regulatory standards. The information they do provide is as follows. They also make no claims to "self-conforming" to the P2 AS/NZS 1716: 2012 standard. My fit-tested Trident work mask does though and it leaks like a sieve!

How do I know my work test-fitted P2/N95 leaks more than the Castle Grade? My glasses fog when worn, lenses fog when held up against sides or bottom. Doesn't happen on the CG, no matter where you hold your lenses eg bottom, sides, in front of filter ie the aerosol is filtered out