关于降低甲型H1N1流感传播使用口罩和呼吸器的临时性建议

Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission

关于降低甲型H1N1流感传播使用口罩和呼吸器的临时性建议

May 23, 2009 9:00 AM US Eastern Time
2009年5月23日东部时间上午9点

This document provides updated interim guidance on the use of facemasks and respirators for decreasing the exposure to  novel influenza A (H1N1) virus. This guidance replaces other CDC guidance on mask and/or respirator use that may be included in other CDC documents in regards to the outbreak of novel H1N1 virus. No change has been made to guidance on the use of facemasks and respirators for health care settings. This document includes guidance on facemask and respirator use for a wider range of settings than was included in previous documents and includes recommendations for those who are at increased risk of severe illness from infection with the novel H1N1 virus compared with those who are at lower risk of severe illness from influenza infection. For more information about human infection with novel influenza A (H1N1) virus, visit the CDC H1N1 Flu website. Other CDC novel H1N1 guidance will be updated with the information contained in this document as soon as possible.

本文件对通过使用口罩和呼吸器降低甲型H1N1流感病毒暴露的建议进行了更新。它代替CDC发布的其他有关口罩和/或呼吸器使用的，包含在CDC的其他的有关甲型H1N1流感爆发的文件中的建议。对医疗机构使用口罩和呼吸器的建议目前没有变化。本文件包括了使用口罩和呼吸器的建议，它所针对的工作场所类型比前期建议的覆盖面更广，并包括对在感染甲型H1N1流感后，相对于风险较小的人群的那些可导致严重疾病的高风险人群的建议。如需了解有关人类传染甲型H1N1流感病毒的更多信息，请访问CDC H1N1 Flu website官方网站。CDC的其他有关甲型H1N1流感的指南将会尽快按照本文件的建议作相应更新。

Detailed background information and recommendations regarding the use of facemasks and respirators in non-occupational community settings can be found on PandemicFlu.gov in the document Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemichttp://www.cdc.gov/h1n1flu/masks.htm - linkPolicyhttp://www.cdc.gov/h1n1flu/masks.htm - linkPolicy. Information on the use of facemasks and respirators in health care settings can be found at http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm.

有关非工作场所使用口罩和呼吸器的建议可以在PandemicFlu.gov官方网站的Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemic（《流感爆发期间关于非工作场所使用口罩和呼吸器的公共卫生临时性指南》）中获得http://www.cdc.gov/h1n1flu/masks.htm - linkPolicyhttp://www.cdc.gov/h1n1flu/masks.htm - linkPolicy。有关医疗机构使用口罩和呼吸器的信息可以在官方网站http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm上获得。

Information on the effectiveness of facemasks and respirators for decreasing the risk of influenza infection in community settings is extremely limited. Thus, it is difficult to assess their potential effectiveness in decreasing the risk of novel influenza A (H1N1) virus transmission in these settings. In the absence of clear scientific data, the interim recommendations below have been developed on the basis of public health judgment, the historical use of facemasks and respirators in other settings for preventing transmission of influenza and other respiratory viruses, and on current information on the spread and severity of the novel influenza A (H1N1) virus.

目前关于戴口罩和呼吸器可降低人群中流感传播的有效性的信息还非常有限，因此，对其降低甲型H1N1流感病毒传播的可能的有效性问题进行评价是一件困难的工作。在缺少明确的科学数据的情况下，下面的临时性建议是基于公共卫生的判断，并以历史上对其他类型工作场所预防流感和其他呼吸道传染病使用口罩和呼吸器的要求，和目前对甲型H1N1流感病毒的传播性和致病性的现有了解为基础。

In areas with confirmed human cases of novel influenza A (H1N1) virus infection, the risk for infection can be reduced through a combination of actions. No single action will provide complete protection, but an approach combining the following steps can help decrease the likelihood of transmission. These recommended actions are:

在有确诊甲型H1N1流感病毒传染病例的区域，采取综合预防措施，能够降低传染风险。任何单一措施都不能提供完全的保护，但按照以下步骤，采取综合措施，是能够降低传染的可能性的。建议采取的措施包括：

• Wash hands frequently with soap and water or use alcohol-based hand cleaner when soap and water are not available.
• 勤洗手，使用肥皂和水，或当没有肥皂和水的时候用含酒精的洗手液洗手。
• Cover your mouth and nose with a tissue when coughing or sneezing.
• 咳嗽和打喷嚏的时候用纸巾掩盖口鼻。
• Avoid touching your eyes, nose and mouth
• 避免触摸自己的眼睛、鼻子和嘴。
• People who are sick with an influenza-like illness should stay home and minimize contact with others, including avoiding travel, for 7 days after their symptoms begin or until they have been symptom-free for 24 hours, whichever is longer.
• 有流感样症状的人员应待在家中自行隔离，尽量避免与他人接触，包括避免旅行，隔离时间应从症状开始时计算至少满7天，并直至症状消逝24小时以后，以其中时间较长者为准。
• Avoid close contact (i.e. being within about 6 feet) with persons with influenza-like illness.
• 避免与有流感样症状的人员有近距离的接触（约2米）。

In addition, influenza antiviral medications are an important tool for the treatment and prevention of influenza, including novel H1N1. Also see Guidance on the use of antiviral medications.

此外，使用抗流感药物是治疗和预防流感，包括甲型H1N1流感的重要工具，参见《使用抗病毒药物指南》Guidance on the use of antiviral medications。

Facemasks and Respirators

口罩和呼吸器

Recommendations for the uses of facemasks and/or respirators are listed in Table 1 below for different settings where a person may be exposed to novel H1N1 virus. These recommendations also differ based on whether the person exposed to novel H1N1 is in a group at increased risk for severe illness from influenza infection. Additional recommendations for use of facemasks by people who have influenza-like illnesses that may be due to novel H1N1 infection are included in Table 2.

表1分别列出了不同类型场所中的工作人员，在存在甲型H1N1流感暴露的可能时，使用口罩和/或呼吸器的建议，并根据其是否属于因感染流感可导致严重疾病的高风险人群的判断，分别做出了不同的建议。在表2中对有流感样症状，怀疑受甲型H1N1流感传染的人员是否使用口罩也提出了额外的建议。

There are important differences between facemasks and respirators. Facemasks do not seal tightly to the face and are used to block large droplets from coming into contact with the wearer’s mouth or nose. Most respirators (e.g. N95) are designed to seal tightly to the wearer’s face and filter out very small particles that can be breathed in by the user. For both facemasks and respirators, however, limited data is available on their effectiveness in preventing transmission of H1N1 (or seasonal influenza) in various settings. However, the use of a facemask or respirator is likely to be of most benefit if used as early as possible when exposed to an ill person and when the facemask or respirator is used consistently. (Ref. 1. MacIntyre CR, et al. EID 2009;15:233-41. 2. Cowling BJ, et al. Non-pharmaceutical interventions to prevent household transmission of influenza. The 8th Asia Pacific Congress of Medical Virology, Hong Kong, 26-28 February 2009. )

口罩和呼吸器之间存在着重大的差别。口罩不与使用者脸部有紧密的贴合，用于阻挡大颗粒的飞沫与使用者口鼻的直接性接触，而绝大多数呼吸器（如N95级）的设计都是为保证与使用者脸面有紧密贴合，可过滤非常微小的颗粒物，以防止其进入呼吸道。虽然目前对口罩和呼吸器能够在各类工作中降低甲型H1N1流感（或季节性流感）传染的有效性的数据还非常有限，然而，如果在接触病人的时候能尽早使用口罩和呼吸器，并坚持使用，则可能是最好的方法（参考文献[注1] MacIntyre CR, et al. EID 2009;15:233-41. 2. Cowling BJ, et al. Non-pharmaceutical interventions to prevent household transmission of influenza. The 8th Asia Pacific Congress of Medical Virology, Hong Kong, 26-28 February 2009.）。

Facemasks:  Unless otherwise specified, the term ”facemasks” refers to disposable facemasks cleared by the U.S. Food and Drug Administration (FDA) for use as medical devices. This includes facemasks labeled as surgical, dental, medical procedure, isolation, or laser masks. Such facemasks have several designs. One type is affixed to the head with two ties, conforms to the face with the aid of a flexible adjustment for the nose bridge, and may be flat/pleated or duck-billed in shape. Another type of facemask is pre-molded, adheres to the head with a single elastic band, and has a flexible adjustment for the nose bridge. A third type is flat/pleated and affixes to the head with ear loops. Facemasks cleared by the FDA for use as medical devices have been determined to have specific levels of protection from penetration of blood and body fluids. Facemasks help stop droplets from being spread by the person wearing them. They also keep splashes or sprays from reaching the mouth and nose of the person wearing the facemask. They are not designed to protect against breathing in very small particle aerosols that may contain viruses. Facemasks should be used once and then thrown away in the trash.

口罩：除非另外说明，本文件所指“口罩”系由美国食品药品管理局(FDA)批准的随弃式医用口罩，包括标称为外科用、牙医用、治疗用、隔离用或激光手术用口罩。这类口罩有几种设计，其中一类靠两根带子固定在头部，在鼻梁处的调节可以弯曲，帮助口罩贴近脸部，形状是平面/平面打褶或鸭嘴状；另一类是模压成杯罩状的口罩，靠一根松紧带固定在头部，鼻梁处的调节也可以弯曲；第三类也是平面/平面打褶的形状，用耳带固定在头部。获得FDA批准的医用口罩都经过特殊的测试，证明对血液和体液喷溅具有一定水平的抗穿透能力，口罩还帮助阻止口罩佩戴者自己产生的飞沫在空气中散布，也能阻拦喷溅物直接接触到口罩使用者的口鼻，但口罩不是为防止佩戴者吸入空气中微小颗粒物而设计的，而空气中的微小颗粒物气溶胶中就可能含有病原微生物。口罩为一次性使用，使用后应废弃。

Respirators: Unless otherwise specified, "respirator" refers to an N95 or higher filtering face piece respirator certified by the CDC/National Institute for Occupational Safety and Health (NIOSH). A respirator is designed to protect the person wearing the respirator against breathing in very small particle aerosols that may contain viruses. A respirator that fits snugly on the face can filter out virus-containing small particle aerosols that can be generated by an infected person, but compared with a facemask it is harder to breathe through a respirator for long periods of time. Respirators are not recommended for children or  people who have facial hair.

呼吸器：除非另外说明，本文件中所指“呼吸器”是N95级别或更高级别的，得到CDC/国家职业安全健康研究所（NIOSH）认证的随弃式呼吸防护口罩。呼吸器是为保护使用者的呼吸，防止吸入空气中非常微小的颗粒物气溶胶设计的，这些气溶胶中就会包含有病原微生物。呼吸器能够和使用者脸部紧密密合，能过滤掉传染病人散发的含有病原微生的微小颗粒物。和口罩相比，长时间使用呼吸器会感觉呼吸阻力比较大。呼吸器不建议给儿童使用，面部有毛发的人也不建议使用。

Where respirators are used in a non-occupational setting, fit testing, medical evaluation and training are recommended for optimal effectiveness.  

当呼吸器在非工作场所中使用时，为获得最佳的防护效果，建议仍需要进行适合性检验（译者注：即测试具体的面罩与使用者脸之间的密合性）、医学评价（译者注：即评价使用者身体状况是否适合使用呼吸器）和使用方法培训。

When respiratory protection is required in an occupational setting, respirators must be used in the context of a comprehensive respiratory protection program as required under OSHA’s Respiratory Protection standard (29 CFR 1910.134). This includes fit testing, medical evaluation and training of the worker. When required in the occupational setting, tight-fitting respirators cannot be used by people with facial hair that interferes with the face seal.

当呼吸器是在工作场所中使用时，必须按照OSHA的《呼吸保护标准》（29CFR1910.134）的要求，把呼吸器的使用纳入到一个综合的呼吸保护计划当中，这包括适合性检验、医学评价和使用者的培训。如果工作人员的面部有毛发，由于毛发会影响面罩与脸部的密合，这类人员就不能使用密合式呼吸器面罩了。

When respirators are used on a voluntary basis in an occupational setting, requirements for voluntary use of respirators in work sites can be found on the OSHA websitehttp://www.cdc.gov/h1n1flu/masks.htm - linkPolicy.

如果工作场所中使用呼吸器是自愿的，关于自愿使用呼吸器的要求可以在OSHA官方网站上获得：http://www.cdc.gov/h1n1flu/masks.htm - linkPolicy。

Employers should continue to evaluate workplace hazards related to the novel H1N1 influenza A situation in accordance with CDC and OSHA guidance. Mandatory use of respiratory protection may be required when work activities in occupational settings confer risk that is task/function based, and risk analyses conducted by the employer could identify hazardous work activities. For example, performing activities which generate large amounts of aerosols require respiratory protection regardless of the setting in which it is performed (i.e. in a hospital, an outpatient setting, a prison).

雇主应按照CDC和OSHA的指导，继续对工作场所甲型H1N1流感的危害进行评估，当工作场所中存在的危害是由工作/作业方式决定，则必须采取呼吸防护措施，而雇主在进行风险分析时应对工作活动中存在的危害进行辨识，例如，无论在什么样的工作场所，只要会产生大量的气溶胶（如在医院、门诊诊所、监狱），就需要采取呼吸防护措施。

For additional information on facemasks and respirators, see the CDC/NIOSH website, the Food and Drug Administration websitehttp://www.cdc.gov/h1n1flu/masks.htm - linkPolicy, and the Occupational Safety and Health Administration website.

如需了解有关口罩和呼吸器的其他信息，请访问CDC/NIOSH官方网站、食品药品管理局（FDA）官方网站http://www.cdc.gov/h1n1flu/masks.htm - linkPolicy，和职业安全健康管理局的官方网站。

 

Groups at Higher Risk for Severe Illness from Novel Influenza A (H1N1) Infection

感染甲型H1N1流感后可导致严重疾病的高风险人群

Groups of people at higher risk for severe illness from novel influenza A (H1N1) infection are thought to be the same as those people at higher risk for severe illness from seasonal influenza. These groups include:

可因甲型H1N1流感而导致严重疾病的高风险人群也是易由季节性流感引发严重疾病的那部分人，包括：

• Children younger than 5 years old
• 不足5周岁的婴幼儿；
• Persons aged 65 years or older
• 65岁以上的老年人
• Children and adolescents (younger than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection
• 长期服用阿司匹林的儿童和青少年（年龄低于18周岁），这类人群在感染流感后可能产生急性脑病综合症；
• Pregnant women
• 孕妇
• Adults and children who have pulmonary, including asthma, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders such as diabetes
• 患有对肺有影响的疾病的成年人和儿童，包括患肺气肿、心血管疾病、肝炎、血液病、神经系统疾病、神经肌肉疾病，或代谢失调的疾病，如糖尿病。
• Adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV)
• 患有抑制免疫反应的疾病（包括由于药物治疗或HIV造成的抑制免疫反应）的成年人和儿童。
• Residents of nursing homes and other chronic-care facilities.
• 在疗养院和在其他慢性病治疗机构中居住的人员。

Table 1. CDC Interim Recommendations for Facemask and Respirator Use for Home, Community, and Occupational Settings for Non-Ill Persons to Prevent Infection with Novel H1N1 12 表1. CDC对健康人员在家中、居住区和工作场所预防甲型H1N1流感使用口罩和呼吸器的临时性建议
Setting 场所	Persons not at increased risk of severe illness from influenza (Non-high risk persons) 感染流感后不易导致严重疾病的低风险人员 （低风险人群）	Persons at increased risk of severe illness from influenza (High-Risk Persons) 3 感染流感后可导致严重疾病高风险人员 （高风险人群）5
Community 居住区
No novel H1N1 in community 该地区不存在甲型H1N1流感	Facemask/respirator not recommended 不建议使用口罩/呼吸器	Facemask/respirator not recommended 不建议使用口罩/呼吸器
Novel H1N1 in community: not crowded setting 该地区存在甲型H1N1流感：在非人员聚集场所	Facemask/respirator not recommended 不建议使用口罩/呼吸器	Facemask/respirator not recommended 不建议使用口罩/呼吸器
Novel H1N1 in community: crowded setting 该地区存在甲型H1N1流感：在人员聚集场所	Facemask/respirator not recommended 不建议使用口罩/呼吸器	Avoid setting. If unavoidable, consider facemask or respirator 45 避免去这类场所。 如果无法避免，考虑使用口罩或呼吸器45
Home 在家中
Caregiver to person with influenza-like illness 照顾有流感样症状的病人。	Facemask/respirator not recommended 不建议使用口罩/呼吸器	Avoid setting. If unavoidable, consider facemask or respirator 45 避免在场。 如果无法避免，考虑使用口罩或呼吸器45
Other household members in home 家中其他成员。	Facemask/respirator not recommended 不建议使用口罩/呼吸器	Facemask/respirator not recommended 不建议使用口罩/呼吸器
Occupational (non-health care) 工作场所（非医疗机构）
No novel H1N1 in community 该地区不存在甲型H1N1	Facemask/respirator not recommended 不建议使用口罩/呼吸器	Facemask/respirator not recommended 不建议使用口罩/呼吸器
Novel H1N1 in community 该地区存在甲型H1N1	Avoid setting. If unavoidable, consider facemask or respirator 45 避免去这类地区。 如果无法避免，考虑使用口罩或呼吸器。	Avoid setting. If unavoidable, consider facemask or respirator 45 避免去这类地区。 如果无法避免，考虑使用口罩或呼吸器。
Occupational (health care)6工作场所（医疗机构）
Caring 7 for persons with known, probable or suspected novel H1N1 or influenza-like illness 护理确诊、疑似或怀疑的甲型H1N1流感病人	Respirator 使用呼吸器	Consider temporary reassignment, Respirator 考虑工作临时性调换，使用呼吸器。

1 The effectiveness of respirators and facemasks in preventing transmission of novel H1N1 (or seasonal influenza) in various settings is not known. Use of a facemask or respirator is likely to be of most benefit if used correctly and consistently when exposed to an ill person.  (Ref. a) MacIntyre CR, et al.  EID 2009;15:233-41. b) Cowling BJ, et al. Non-pharmaceutical interventions to prevent household transmission of influenza. The 8th Asia Pacific Congress of Medical Virology, Hong Kong, 26-28 February 2009.)

[注1] 虽然目前对口罩和呼吸器能够在各类工作中降低甲型H1N1流感（或季节性流感）传染的有效性还未知，然而，如果能在接触病人的时候正确使用口罩和呼吸器，并坚持使用，则可能是最好方法。（参考文献：a) MacIntyre CR, et al.  EID 2009;15:233-41. b) Cowling BJ, et al. Non-pharmaceutical interventions to prevent household transmission of influenza. The 8th Asia Pacific Congress of Medical Virology, Hong Kong, 26-28 February 2009.）

2 For the purpose of this document, respirator refers to N95 or any other NIOSH-certified filtering face piece respirator.

[注2] 本文件所使用的呼吸器一词专指N95级别或其他NIOSH认证的随弃式呼吸防护口罩。

3 Persons at increased risk of severe illness from influenza (i.e. high-risk persons) include those groups at higher risk for severe illness from seasonal influenza, including:  children younger than 5 years old;  persons aged 65 years or older;  children and adolescents (younger than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection;  pregnant women;  adults and children who have pulmonary, including asthma, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders, such as diabetes; adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV); and, residents of nursing homes and other chronic-care facilities.

[注3] 可因感染甲型H1N1流感而导致严重疾病的人员（高风险人群）包括易因季节性流感引发严重疾病的那部分人群，这包括：不足5周岁的婴幼儿；达到65岁及以上的老年人；长期服用阿司匹林的儿童和青少年（年龄低于18周岁），在感染流感后有可能产生急性脑病综合症；孕妇；患有对肺有影响的疾病的成年人和儿童，这些疾病包括肺气肿、心血管疾病、肝炎、血液病、神经系统疾病、神经肌肉疾病，或代谢失调的疾病，如糖尿病；患有抑制免疫反应的疾病（包括由于药物治疗或HIV造成的抑制免疫反应）的成年人和儿童；在疗养院和在其他慢性病治疗机构中居住的人员。

4 The optimal use of respirators requires fit testing, training and medical clearance. Proper use is recommended to maximize effectiveness. The use of facemasks may be considered as an alternative to respirators, although they are not be as effective as respirators in preventing inhalation of small particles, which is one potential route of influenza transmission.  There is limited evidence available to suggest that use of a respirator without fit-testing may still provide better protection than a facemask against inhalation of small particles. Respirators are not recommended for children or persons who have facial hair (see FDA websitehttp://www.cdc.gov/h1n1flu/masks.htm - linkPolicy).

[注4]使用呼吸器的理想做法是接受适合性检验（译者注：即测试具体的面罩与使用者脸之间的密合性）、使用方法培训和医学评估（译者注：即评价使用者的身体状况是否适合使用某呼吸器）。建议正确使用呼吸器，以获得最佳的防护效果。可以考虑把口罩作为替代呼吸器的一个选择，尽管口罩不如呼吸器那样能有效地防止空气中的微小颗粒物进入呼吸道，因为这是流感传播的一个可能的途径。关于在没有经过适合性检验的前提下，戴呼吸器比戴口罩能更有效地防止吸入微小颗粒物的证据还非常有限。不建议儿童和面部有毛发的人员使用呼吸器。(参见 FDA官方网站的信息 http://www.cdc.gov/h1n1flu/masks.htm - linkPolicy)。

5 Use of N95 respirators or facemasks generally is not recommended for workers in non-healthcare. occupational settings for general work activities.  For specific work activities that involve contact with people who have influenza-like illness (ILI) (fever plus at least either cough or sore throat), such as escorting a person with ILI, interviewing a person with ILI, providing assistance to an individual with ILI, the following are recommended: a) workers should try to maintain a distance of 6 feet or more from the person with ILI; b) workers should keep their interactions with the ill person as brief as possible; c) the ill person should be asked to follow good cough etiquette and hand hygiene and to wear a facemask, if able, and one is available; d) workers at increased risk of severe illness from influenza infection (see footnote 3) should avoid people with ILI (possibly by temporary reassignment); and, e) where workers cannot avoid close contact with persons with ILI, some workers may choose to wear a facemask or N95 respirator on a voluntary basis  (See footnote 1). When respirators are used on a voluntary basis in an occupational work setting, requirements for voluntary use of respirators in work sites can be found on the OSHA websitehttp://www.cdc.gov/h1n1flu/masks.htm - linkPolicy.

[注5] 对非医疗工作场所，通常不建议从事普通工作的人员使用N95呼吸器和口罩，对某些工作中会接触有流感样症状的病人（ILI）（发烧，并持续咳嗽或有咽喉痛）的情况，如ILI的陪同人员、需要对ILI进行访谈的人员、协助ILI的人员，有如下的建议：a)工作人员应尽量与ILI人员保持至少2米的距离；b)和ILI人员的接触时间应尽量缩短；c)应要求病人遵守咳嗽礼仪、勤洗手，在能够戴和有口罩的情况下，尽量戴口罩；d)对传染流感后可导致严重疾病的高风险型工作人员（参见[注3]），应尽量避免接触ILI人员（尽可能考虑临时性调离）；e)如果工作人员无法避免与ILI人员的密切接触，一些人可以在自愿的基础上选择戴口罩或N95级别呼吸器（参见[注1]），当工作场所中呼吸器的使用为自愿性的，应遵守OSHA对工作中自愿使用呼吸器的有关规定，参见OSHA官方网站http://www.cdc.gov/h1n1flu/masks.htm - linkPolicy。

6 See case definitions of confirmed, probable, and suspected novel influenza A (H1N1). Also see infection control in the health care setting. When respiratory protection is required in an occupational setting, respirators must be used in the context of a comprehensive respiratory protection program as required under OSHA’s Respiratory Protection standard (29 CFR 1910.134). This includes fit testing, medical evaluation and training of the worker.

[注6]见《甲型H1N1确诊、疑似和怀疑病人的定义》definitions for confirmed, probable, and suspect novel influenza A (H1N1) infection，并参见《医疗机构传染控制信息》information on infection control in health care settings当工作环境要求采取呼吸防护措施的时候，必须按照OSHA《呼吸保护标准》（29CFR1910.134）的要求，把呼吸器的使用纳入综合性的呼吸保护计划之中，这包括进行适合性检验、医学评估和使用方法培训。

7“Caring” includes all activities that bring a worker into proximity to a patient with known, probable, or suspected novel H1N1 or ILI, including both providing direct medical care and support activities like delivering a meal tray or cleaning a patient’s room.

[注7]“护理”包括需要近距离接触甲型H1N1流感确诊、疑似或怀疑病人的所有活动，包括直接的医疗护理活动和辅助的活动，包括递送餐盘和打扫病人房间等。

Table 2.  CDC Interim Recommendations For Facemask Use For Persons Ill With Confirmed, Probable, Or Suspected Novel Influenza A (H1N1)1 To Prevent Transmission Of Novel H1N1 2 表2. CDC对甲型H1N1流感确诊、疑似或怀疑的患者使用口罩避免病毒传播的临时性建议
Setting场所	Recommendation 建议
Home (when sharing common spaces with other household members) 在家中（当与其他家庭成员在同一居室内居住的情况）。	Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze 如果有口罩，而且能够忍受，最好使用口罩；或者在咳嗽/喷嚏时用纸巾遮掩。
Health care settings (when outside of patient room) 医疗机构内（病房外）	Facemask, if tolerable 如果能够忍受，使用口罩。
Non-health care setting 非医疗机构	Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze 如果有口罩，而且能够忍受，最好使用口罩；或者在咳嗽/喷嚏时用纸巾遮掩。
Breastfeeding 哺乳	Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze 如果有口罩，而且能够忍受，最好使用口罩；或者在咳嗽/喷嚏时用纸巾遮掩。

1 See definitions for confirmed, probable, and suspect novel influenza A (H1N1) infection. Also see information on infection control in health care settings.

[1] 参见《甲型H1N1确诊、疑似和怀疑病人的定义》definitions for confirmed, probable, and suspect novel influenza A (H1N1) infection，并参见《医疗机构传染控制信息》information on infection control in health care settings。

2 Ill persons should be placed in well ventilated areas when possible and placed in areas where at least 6 feet distance can be maintained between the ill person and other well and ill persons.  Selected references:  a) Blumenfeld HL, et al.  J Clin Invest 1959;38:199-212.  b) Bridges CB, et al.  Clin Infect Dis 2003;37:1094-1101. c) Foster MG and Cookson AH.  Lancet 1918 (Nov. 2): 588-90. d) Gregg MB.  Ann NY Acad Sci 1980;353:45-53. e) WHO.  Infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care.  June 2007.  f) Fabian P, et al.  Plos One 2008;3:e2691.

[注2] 如果可能，应安排病人尽量呆在通风好，并和其他人能够保持至少2米左右的距离的地方。参考文献：a) Blumenfeld HL, et al.  J Clin Invest 1959;38:199-212.  b) Bridges CB, et al.  Clin Infect Dis 2003;37:1094-1101. c) Foster MG and Cookson AH.  Lancet 1918 (Nov. 2): 588-90. d) Gregg MB.  Ann NY Acad Sci 1980;353:45-53. e) WHO.  Infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care.  June 2007.  f) Fabian P, et al.  Plos One 2008;3:e2691.

资料来源：美国CDC

翻译：3M中国有限公司技术部

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