Speech intelligibility and hearing acuity assessments of N95/P2 respirator with under-mask elastic band beard cover

Objective: Using the Modified Rhyme Test in accordance with the National Institute for Occupational Safety and Health (NIOSH) protocol, we assessed the communication performance for both speech intelligibility and hearing acuity in bearded healthcare workers (HCWs) wearing a N95/P2 respirator with an under-mask elastic band beard cover. Design and setting: A prospective simulation study conducted at the respiratory fit test center of the Royal Melbourne Hospital. Participants: Bearded HCWs who required respiratory protection and could not shave for medical, cultural, or religious reasons. Results: The overall performance rating score was 91.3% and 99.8% for speech intelligibility and hearing acuity respectively. There was a reduction in the percentage of correct words perceived by a panel of trained listeners when bearded HCWs were speaking while wearing the N95/P2 respirator/elastic band combination compared to the uncovered beard condition (84.5% vs. 92.9%, p = 0.011). However, no significant difference was found in the perception of medical phrases between these two conditions. In the hearing assessment, there were no differences found in hearing correct single words or medical phrases between the two conditions. Conclusions: This study demonstrates that when bearded HCWs wore the N95/P2 respirator/elastic band combination, their speech intelligibility and hearing acuity greatly exceeded the NIOSH standard of 70% in the Modified Rhyme Test. This finding is crucial for ensuring effective communication among bearded HCWs, thereby supporting both respiratory protection and operational efficiency in healthcare settings.