Thursday, July 16, 2020

Decontamination Methods for Reuse of Filtering Facepiece Respirators




In the continuing battle against Covid-19, one of the most critical components for healthcare workers is keeping themselves safe.  If there is not a way to prevent infection of front line healthcare workers that are actually dealing every day with patients that are confirmed positive with the disease, soon those workers will be infected themselves.  This creates a slippery slope problem because the those workers become patients who have the potential to infect more frontline workers.  The scary conclusion is that eventually there very well might not be any knowledgeable healthcare workers left to help others and then the entire system implodes.


That’s why it’s so critically important for healthcare workers to be protected with proper Personal Protective Equipment (PPE).  Without N-95 masks, face shields, goggles, water resistant gowns, head coverings, and possibly shoe coverings, the risk of infection is high.  This is especially true of N-95 masks.  Covid-19 is a virus that enters the host’s body principally through the nose and mouth and also potentially through the eyes.  That’s why high filtration masks are so important… but they are also in short supply.  The supply chain for these types of items is severely compromised right now and because of that many hospitals are having trouble getting an adequate supply of N-95 masks.


This has created a need for a way to decontaminate these articles which allows for them to be used more than once safely.  Here is a recent study on the subject.  For the page with the article, follow this link.  


Importance  The novel coronavirus disease 2019 (COVID-19) has proven to be highly infectious, putting health care professionals around the world at increased risk. Furthermore, there are widespread shortages of necessary personal protective equipment (PPE) for these individuals. Filtering facepiece respirators, such as the N95 respirator, intended for single use, can be reused in times of need. We explore the evidence for decontamination or sterilization of N95 respirators for health care systems seeking to conserve PPE while maintaining the health of their workforce.

Observations  The filtration properties and fit of N95 respirators must be preserved to function adequately over multiple uses. Studies have shown that chemical sterilization using soap and water, alcohols, and bleach render the respirator nonfunctional. Decontamination with microwave heat and high dry heat also result in degradation of respirator material. UV light, steam, low-dry heat, and commercial sterilization methods with ethylene oxide or vaporized hydrogen peroxide appear to be viable options for successful decontamination. Furthermore, since the surface viability of the novel coronavirus is presumed to be 72 hours, rotating N95 respirator use and allowing time decontamination of the respirators is also a reasonable option. We describe a protocol and best practice recommendations for redoffing decontaminated N95 and rotating N95 respirator use.

Conclusions and Relevance  COVID-19 presents a high risk for health care professionals, particularly otolaryngologists, owing to the nature of viral transmission, including possible airborne transmission and high viral load in the upper respiratory tract. Proper PPE is effective when used correctly, but in times of scarce resources, institutions may turn to alternative methods of preserving and reusing filtering facepiece respirators. Based on studies conducted on the decontamination of N95 respirators after prior outbreaks, there are several options for institutions to consider for both immediate and large-scale implementation.

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