5 years ago during the SARS, it was impossible to find an effective respirator (commonly known as N95 mask) to fit the small faces of children. We saw many children wearing surgical mask or adult-size N95 respirator. Neither of these solutions was satisfactory.
Surgical mask, as the name suggested, is designed to protect nurses or surgeons from contaminated blood during an operation. In Japan or some Asian countries it is also used to reduce the risk of spreading the flu virus from the wearer if he/she is sick.
Surgical mask is never intended to protect the wearer from air-borne flu virus. There are gaps from both sides that virus can bypass the mask easily.
Respirator (e.g. N95 mask), on the other hand, is designed to protect the wearer from air borne contaminants (e.g. flu virus). However, this is only possible if the respirator is sealing the user’s face such that air must go through the filter media before entering the breathing zone. If there are gaps between the mask and the face, the result is not different from wearing a surgical mask. So don’t jump to the conclusion that you are OK as long as you are covered with an N95 mask. To ensure the effectiveness of a certain respirator, the user needs to put it on and pass a fit-test. The fit test is conducted by trained facilitator and with proper equipments. All these is simply too complicated for most people except for large institutions such as big hospitals. A study by the Prince of Wales Hospital in Hong Kong shows that, without a fit-test validation, there are 25% chances that you are not protected even you feel that you are. The problem is that the user seal check recommended by most manufacturers is just too ambiguous and unreliable.
Two hurdles for a good children mask
Perhaps there are at least two major reasons behind the non-existence of an effective respirator for children: the first is relating to regulatory stand and the second is related to business consideration of manufacturers.
1) Regulatory hurdle –N95 or related certification is issued by a regulatory agency called NIOSH, it stands for National Institute for Occupational Safety and Health. As the name suggested, its main task is to ensure the safety of workers in working environment through the proper definition and execution of standard and procedures. Here workers means nurses, doctors, firemen or army, but never children! In a way, N95 and children should be considered as mutually exclusive.
2) Business case (the lack of) – based on existing design, producing fitting respirators for children requires manufacturers a lot more sets of tools to cater for the wide range of face sizes. It is hard for a mask producer to justify such investment. Logistic is another issue, how are you going to distribute and keep stock of the right sizes at the right time? And finally, the quantity needed for children is definitely much lower than the doctors and nurses in hospitals.
All signs suggest this is likely to be a high cost, difficult and hardly profitable business, this is precisely why we are interested in it!
Posted by chuwasg 
