title: Does a cheaper mask save money? The cost of implementing a respiratory personal protective equipment program.
abstract: OBJECTIVE
  To determine the annual cost of implementing and maintaining a respiratory personal protective equipment (PPE) program at an urban hospital.
  
  
  METHODS
  St Clare's Hospital and Health Center, a 250-bed hospital in Manhattan that treats 60 to 100 cases of tuberculosis annually.
  
  
  METHODS
  Review of Purchasing Department records for all masks acquired by the hospital from 1992 to 1995, and an estimate of administrative time spent developing and implementing the guidelines recommended by various agencies during the study interval.
  
  
  RESULTS
  Respiratory isolation was provided for 6,360 to 10,883 days annually during the 4-year interval. Yearly costs for the PPE program ranged from $86,560 to $175,690. Of note, the daily cost for a respiratory isolation day decreased dramatically between 1994 and 1995 ($25/day to $13/day), when the high-efficiency particulate air-filter (HEPA) respirator was used by all staff. The decrease occurred because of lower administrative costs and a sharp decrease in the numbers of HEPA units purchased. Objective measures of worker compliance with HEPA respirators demonstrated the decrease was not due to less HEPA use but rather that employees were using each HEPA unit for several weeks, as recommended.
  
  
  CONCLUSIONS
  We found a significant decrease in cost in the second year of our HEPA program due to increasing employee familiarity with the program. Newly approved, cheaper, but less durable, N-95 masks are unlikely to withstand multiple wearings and may be discarded after a few uses. Thus, cheaper masks may result in a more expensive PPE program.
authors.affiliation: St Clare's Hospital and Health Center, New York City, USA.
authors.forename: P
authors.initials: P
authors.lastname: Rivera
authors.forename: J
authors.initials: J
authors.lastname: Louther
authors.forename: J
authors.initials: J
authors.lastname: Mohr
authors.forename: A
authors.initials: A
authors.lastname: Campbell
authors.forename: J
authors.initials: J
authors.lastname: DeHovitz
authors.forename: K A
authors.initials: KA
authors.lastname: Sepkowitz
mesh_terms: D003362:Cost-Benefit Analysis; D017743:Equipment Reuse; D006744:Hospital Bed Capacity, 100 to 299; D006786:Hospitals, Urban; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D009519:New York City; D016273:Occupational Exposure / Q000517:prevention & control*; D010356:Patient Isolation; D010564:Personnel, Hospital; D015397:Program Evaluation; D012134:Respiratory Protective Devices / Q000191:economics* / Q000592:standards; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control / Q000635:transmission