Journal
JOURNAL OF HOSPITAL INFECTION
Volume 105, Issue 4, Pages 608-614Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.jhin.2020.06.030
Keywords
Surgical mask; N95 respirator; Collection; COVID-19; Re-use; Disinfection
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Background: An exceptionally high demand for surgical masks and N95 filtering facepiece respirators (FFRs) during the COVID-19 pandemic has considerably exceeded their supply. These disposable devices are generally not approved for routine decontamination and reuse as a standard of care, while this practice has widely occurred in hospitals. The US Centers for Disease Control and Prevention allowed it as a crisis capacity strategy. However, limited testing was conducted on the impact of specific decontamination methods on the performance of N95 FFRs and no data was presented for surgical masks. Aim: We evaluated common surgical masks and N95 respirators with respect to the changes in their performance and integrity resulting from autoclave sterilization and a 70% ethanol treatment; these methods are frequently utilized for re-used filtering facepieces in hospitals. Methods: The filter collection efficiency and pressure drop were determined for unused masks and N95 FFRs, and for those subjected to the treatments in a variety of ways. The collection efficiency was measured for particles of approximately 0.037-3.2 mm to represent aerosolized single viruses, their agglomerates, bacteria and larger particle carriers. Findings: The initial collection efficiency and the filter breathability may be compromised by sterilization in an autoclave and ethanol treatment. The effect depends on a protective device, particle size, breathing flow rate, type of treatment and other factors. Additionally, physical damages were observed in N95 respirators after autoclaving. Conclusion: Strategies advocating decontamination and re-use of filtering facepieces in hospitals should be re-assessed considering the data obtained in this study. (C) 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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