Approved N95, KN95, and surgical masks

Personal Protective Equipment > Approved N95, KN95, and surgical masks

It is essential for school nurses, health personnel, and school staff to have appropriate PPE available when caring for students or staff who report COVID-19 like symptoms while at school. School nurses, healthcare personnel, and school personnel who are providing care for anyone with confirmed or suspected COVID-19, need to be within 6 feet of sick school staff or a student or there is anticipated risk of splash or exposure to secretions should be provided appropriate PPE. Appropriate PPE includes an N95 or equivalent or higher-level respirator or a surgical mask if a respirator is not available.

NIOSH-Approved N95 (Medical Respirators)

A respirator is a type of face mask and an example of PPE designed to reduce your exposure to airborne contaminants.

Key Considerations:

  • Approved N95 masks (respirators) are NIOSH approved.
  • Use medical respirators for procedures that are likely to generate respiratory aerosols (e.g. tracheostomy suctioning). If not available, consider using a KN95 mask or surgical mask.
  • Approved N95 masks must be used in the context of a comprehensive respiratory protection program (fit testing program) in accordance with OSHA’s Respiratory Protection standard, (29 CFR 1910.134). An N95 mask must be individually selected to fit tight to an individual’s face and to provide a tight seal.
  • Explore the opportunity to work with the district to establish a respiratory protection program.
  • Applicable federal, state, and local laws, regulations, ordinances, and other sources of authority, including district and school policies and procedures, and applicable standards of practice.

KN95 Masks

KN95 masks are a type of filtering facepiece respirator that are commonly made in China and similar to N95 masks commonly used in the United States. The Food and Drug Administration (FDA) has issued emergency use authorization of KN95 as personal protective equipment intended for use by health care personnel in health care settings according to CDC's recommendations.

Criteria for FDA issuance of an emergency authorization:

  1. SARS-CoV-2, the virus that causes COVID-19, can cause a serious or life-threatening disease or condition, including severe respiratory illness, to humans infected by this virus;
  2. Based on the totality of scientific evidence and other information available to FDA, it is reasonable to believe that the respirator models listed in Appendix A may be effective in preventing wearer exposure to pathogenic biological airborne particulates during FFR shortages, and that the known and potential benefits of the authorized respirators, when used for such use, outweigh the known and potential risks of such products; and
  3. There is no adequate, approved, and available alternative to the emergency use of these respirator models for preventing HCP exposure to such particulates during FFR shortages to prevent disease spread during the COVID-19 emergency.

Key Considerations:

  • KN95 masks are not NIOSH-Approved.
  • KN95 masks provided for use by school nurses must meet requirements set by CDC’s National Institute for Occupational Safety and Health (NIOSH) for respirators.
  • Consider taking precautions to prevent obtaining counterfeit/fake masks. Investigate the company from which you intend to purchase (e.g. review the website, obtain and call the manufacturer’s phone number, obtain the company’s email address, speak to customer support).
  • KN95 masks, like N95 respirators, require fit testing to ensure proper fit to help prevent air (potentially with respiratory droplets containing the virus). A respiratory protection program in accordance with OSHA’s Respiratory Protection standard for fit testing is required.
  • KN95 masks will filter up to 95% of particles in the air (when they meet the right requirements and are not counterfeit/fake, and when proper fit can be achieved).

Approved Surgical Masks

A surgical mask is a type of face mask and PPE designed to help stop large particles being spread by the person wearing them. Surgical masks also keep splashes or sprays from reaching the mouth or nose of the person wearing them.

Key considerations:

  • FDA approval of surgical masks signifies they have been tested for their ability to resist splashes of blood and body fluids.
  • Only surgical facemasks that are cleared by the FDA may be legally marketed in the United States.
  • Surgical masks are not considered respirators and do not provide respiratory protection.
  • Surgical masks are not designed or certified to fit tightly against the face or to prevent the inhalation of small airborne contaminants.
  • Applicable federal, state, and local laws, regulations, ordinances, and other sources of authority, including district and school policies and procedures, and applicable standards of practice.

*Face masks, respirators, N95, and KN95 masks with valves should not be used. They provide source control, however, do not prevent potential spread from the wearer to others.

NASN Resources

Facemask Considerations for Healthcare Professionals in Schools

Guidance for Healthcare Personnel on the Use of Personal Protective Equipment (PPE) in Schools During COVID-19

CDC Resources

NIOSH- Approved N95 Particulate Filtering Facepiece Respirators (table of respirators by manufacturer)

Understand the Difference (infographic)

Required Labeling of NIOSH-Approved N95 Filtering Facepiece Respirators (infographic)

Types of Masks

Factors to Consider When Planning to Purchase Respirators from Another Country

NPPTL Respirator Assessments to Support the COVID-19 Response

Other Resources

The Difference between Respirators and Surgical Masks | U.S. Department of Labor and OSHA (video)

N95 Respirators, Surgical Masks, and Face Masks | FDA

Personal Protective Equipment | FDA

Respiratory Protection standard | OSHA

Infectious Diseases Society of America Guidelines on Infection Prevention in Patients with Suspected or Known COVID-19

The Effect on Fit of Multiple Consecutive Donning and Doffing of N95 Filtering Facepiece Respirators | NIH

FDA Letter: Imported, Non-NIOSH-Approved Disposable Filtering Facepiece Respirator | FDA

FAQs on the EUAs for Non-NIOSH Approved Respirators During the COVID-19 Pandemic | FDA

Appendix A: Authorized Imported, Non-NIOSH Approved Respirators Manufactured in China | FDA

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