CHAIR Updates

Posted August 1, 2025

CHAIR Supports CSA Z94.4-25: A New Respiratory Protection Standard for Healthcare

Posted August 1, 2025
 

CHAIR fully endorses Canada’s proposed National Standard CSA Z94.4-25: Selection, Use, and Care of Filtering Respirators. This long-overdue update—especially the new Chapter 9 for healthcare—recognizes airborne transmission as the primary route for many infectious diseases and establishes stronger respiratory protections across healthcare facilities.

• N95s required for common respiratory pathogens (e.g., flu, RSV, COVID-19)
• PAPRs recommended for high-mortality pathogens (e.g., Ebola)
• Risk-based exemptions allowed by qualified professionals
• Access to protection for staff, patients, and visitors
   

Read the full CHAIR Statement (PDF)

 Submit your public comment by August 19

 

Posted July 29, 2025

CHAIR Responds to Petition Opposing CSA Z94.4-25 Standard

Commentary: CHAIR Responds to the Petition Opposing CSA Z94.4-25

The standard is clear, science-based, and long overdue.

By CHAIR (Coalition for Community and Healthcare Acquired Infection Reduction)

https://chaircoalition.org

The petition opposing CSA Z94.4-25 contains serious misrepresentations. As experts familiar with both the CSA process and respiratory protection science, we offer the following clarifications to help set the record straight.

The CSA Standard Is Evidence-Based and Clear

• The CSA Z94.4-25 standard is thoroughly evidence-based, with references included throughout.
• It reflects a paradigm shift: the new default is to protect healthcare workers (HCWs) unless safety without protection can be clearly demonstrated, not the outdated default of leaving HCWs unprotected.
• Risk analysis now determines where respiratory protection can be waived, not where it must be justified.
• Modes of transmission are accurately classified, with airborne transmission recognized as the predominant mode for many pathogens, including SARS-CoV-2.

What the Standard Does Not Say

Contrary to claims in the petition:

• It does not claim that all antimicrobial resistant organisms are airborne.
• It does not require respirators for non-pathogenic organisms. In fact, it explicitly defines protection levels:
  • RG1 (non-pathogenic): No respiratory protection required
  • RG2 & RG3: N95 or equivalent
  • RG4: PAPR with APF 1000
• There is no confusion in the document - the protection logic is clear, practical, and science-based.

The CSA Process Is Transparent and Balanced

• The CSA standard committee follows a transparent and inclusive process. Committees are composed of a balanced matrix of stakeholder interests, and all author affiliations are disclosed.
• There were dozens of healthcare representatives engaged over two years. Some chose not to participate, but those who did were overwhelmingly supportive.
• Contrary to suggestions of bias, there is no commercial conflict of interest:
  • “Producer Interest” (e.g. manufacturers) is a required category, but in this case was underrepresented with only one manufacturer (3M) present on the committee.
• Disclosure - Barry Hunt, Co-Founder and Executive Director of CHAIR, is a CSA Z94.4 Committee member, former respirator producer, and provides unpaid voluntary guidance to the Canadian Association of PPE Manufacturers (CAPPEM).

Respirator Use ≠ Commercial Windfall

• There is no commercial “pot of gold” from adopting this standard.
• Major manufacturers like 3M and Medicom already have long-term contracts (up to 10 years) in place with provincial and federal governments.
• Healthcare systems in Canada are overstocked with respirators. If not used, they will be landfilled or recycled when they expire.
• Implementing this standard would prevent waste, not create it.

A Moment to Build Trust, Not Undermine It

• Adopting CSA Z94.4-25 would increase trust in healthcare, not erode it.
• The standard provides clarity, consistency, and science-aligned policy to protect workers and patients alike.

Final Thought

Opposition to increased respiratory protection in healthcare when one-third of respiratory disease in hospitals (Flu, RSV, and CoVID) is caused by the hospital itself is the antithesis of precautionary, protective, or scientific in nature.

The CSA committee has done commendable work. At this point, it’s imperative they receive support to see this standard through. We have an opportunity in Canada to move beyond outdated paradigms to align healthcare worker and patient protection with the care, concern, science, and ethics people deserve and the sustainability our healthcare system needs.

Click here to download the PDF version of this response.

Thank You, Barry and Richard, for Leading Meaningful Conversations

Earlier this month, CHAIR board members Barry Hunt and Richard Dixon led engaging Lunch and Learn sessions for the BC IPAC Community of Practice, with a focus on the Environmental Infection Prevention (EIP) framework and CSA standards.

The feedback was overwhelmingly positive — so much so that attendees came together to share their appreciation in two GroupGreeting cards. The messages reflect not just gratitude for the information shared, but for the clarity, care, and leadership both Barry and Richard consistently bring to the infection prevention space.

Here’s a look at just a few of the many kind notes received:

“Your presentations were a big success… We are honored to have partnered with you.”

“I have heard you present many times — it is always enlightening.”

“The topics were very informative and engaging.”

We’re grateful for the time, energy, and insight Barry and Richard continue to share with the CHAIR community and beyond.

CHAIR is very excited to announce CSA Z8000:24, Health care facilities, was published in December 2024 with significant new EIP related content including

1. Precautionary Principle
2. Design building to prevent disease transmission between and to occupants
3. Use latest EIP technology
4. Use expert EIP advisors on design team
5. Use automated UV in high-risk areas
6. EIP / UV Experts & Quality Managed System
   1. Qualified Operator
   2. Qualified Commissioner
   3. Qualified Installer
   4. Qualified Trainer
   5. Qualified Service Technician
   6. Quarterly monitoring
   7. Annual Preventive Maintenance
7. Cost benefit analysis of EIP vs manual disinfection including:
8. Likelihood of achieving outcome
9. Treatment costs
10. Informative Annex on UV

CHAIR is very excited to announce CSA Z317.12:25, Cleaning & Disinfecting of Health care facilities will be published in June 2025 with significant EIP content including:

1. EIP expert to inform & recommend to the IPC MDT (Multi-disciplinary team)
2. Precautionary Principle
3. Sink disinfection
4. Mobile UV, AutoUV, Upper Air UV, FarUV
5. Electrolyzed water, Plasma activated water, Ozonated water
6. Non-toxic environmentally-friendly alternative cleaners & disinfectants
7. Aerosols
8. Re-aerosolization
9. Biofilms – wet & dry
10. Respirator use during cleaning
11. Cost benefit analysis of EIP vs manual disinfection including:
    1. Likelihood of achieving outcome
    2. Treatment costs

Exciting News from CHAIR! ✨

We’re thrilled to share that two CHAIR board members recently met with Chemical Engineering Professors at the University of Waterloo to explore future collaborations! The focus? How CHAIR can contribute to their engineering program by sharing our extensive research on Engineered Infection Prevention strategies! 

Over the years, CHAIR has conducted significant research on the efficacy, specifications, and usage of innovative infection prevention products such as antimicrobial copper, ultraviolet light in the C wavelength, ozonated water, and more. 

For example, our 2.5-year research project used antimicrobial copper products from three different companies installed on transit vehicles (subway trains and buses) with Vancouver Transit and Toronto Transit Commission. This study showed very high antimicrobial and virus efficacy, with valuable lessons learned about the application, locations, wearability, and standard cleaning & disinfection practices of the facilities staff. 

Bus and subway engineers were involved in the planning, design, and testing setups, while clinical staff conducted routine planning and testing. Laboratory staff at Vancouver Coastal Health and North York Hospital handled the clinical analysis and reporting. What makes this project unique is that, unlike typical research conducted in stationary healthcare or community facilities, these sample sites were in constant motion throughout the city. And yes—antimicrobial copper makes transit ridership safer for the public.

Next, we will meet with the Engineering Entrepreneur departments at both the University of Waterloo and the University of Toronto to continue these exciting conversations. 

By bringing real-world applications and learnings to academic settings, we aim to enhance students' understanding of how these cutting-edge technologies help reduce infections and improve public health. ✨

Explore our Summer 2024 Newsletter 

CHAIR Coalition has been at the forefront of infection prevention solutions for over a decade, and our work is more crucial than ever. 

In our latest newsletter, we dive deep into:

- Innovative Solutions: From safe sink and drain designs to Reactive Oxygen Species (ROS) water technology that revolutionizes disinfection.

- Health Canada Collaboration: Simplifying UV equipment regulations to ensure safe and effective disinfection.

- CSA Standards: Leading the renewal of Canada's national standard for cleaning and disinfection in healthcare.

Summer 2024 Newsletter

CSA Comments made by Barry Hunt

Discover how Barry Hunt, a leading voice in healthcare, is shaping patient-centered standards for safer, more efficient environments. His insights are a must-read for those in healthcare design and operation. Open the PDF to explore his valuable contributions.

Barry Hunt's Contributions

Explore our Fall 2023 Newsletter 

Discover the latest updates and insights on infection reduction and community safety in our Fall Newsletter.

Fall 2023 Newsletter