Review of aerosolized hydrogen peroxide, vaporized hydrogen peroxide, and hydrogen peroxide gas plasma in the decontamination of filtering facepiece respirators

The Influence of the Steam Sterilization Process on Selected Properties of Polymer Samples Produced in MEX and JMT Processes

Polymeric materials are widely used in medical engineering, and with the dynamic development of additive manufacturing (AM) technology, increasing attention is being paid to research on the mechanical strength of composite polymer structures. At the same time, the impact of sterilization on, for example, surgical templates and the influence of the sterilization process on the geometry of these parts have not been sufficiently studied. In this work, the effect of steam sterilization on samples made of polymer materials for medical applications was presented. This research was carried out on samples with normative geometry made of polyetheretherketone (PEEK) polymers produced using the Material Extrusion (MEX) AM process and acrylic formulation (MED610) produced by Jetting Modeling Technology (JMT). These materials provide biocompatibility, which makes them suitable for potential medical applications. Steam sterilization was performed in an autoclave at temperatures of 121 °C and 134 °C. The three-point bending strength properties were determined according to ISO 178 standards. An INSTRON 5967 strength testing machine was used for those tests. Surface roughness analysis (according to ISO 21920) was performed and presented in 2D and 3D surface views using the Mountains Map Software (version 6.0).

Evaluation of disinfection methods for personal protective equipment (PPE) items for reuse during a pandemic

The COVID-19 pandemic resulted in many supply chain issues, including crippling of essential personal protective equipment (PPE) needed for high-risk occupations such as those in healthcare. As a result of these supply chain issues, unprecedented crisis capacity strategies were implemented to divert PPE items such as filtering facepiece respirators (FFRs, namely N95s) to those who needed them most for protection. Large-scale methods for decontamination were used throughout the world to preserve these items and provided for their extended use. The general public also adopted the use of non-specialized protective equipment such as face coverings. So, the need for cleaning, decontamination, or disinfection of these items in addition to normal clothing items became a necessary reality. Some items could be laundered, but other items were not appropriate for washing/drying. To fill research gaps in small-scale, non-commercial cleaning and disinfection, this bench-scale research was conducted using small coupons (swatches) of multiple PPE/barrier protection materials inoculated with virus (non-pathogenic bacteriophages Phi6 and MS2) and tested against a range of decontamination methods including bleach-, alcohol- and quaternary ammonium compound (QAC)-based liquid sprays, as well as low concentration hydrogen peroxide vapor (LCHPV) and bench-scale laundering. In general, non-porous items were easier to disinfect than porous items, and the enveloped virus Phi6 was overall easier to inactivate than MS2. Multiple disinfection methods were shown to be effective in reducing viral loads from PPE coupons, though only laundering and LCHPV were effective for all materials tested that were inoculated with Phi6. Applications of this and follow-on full-scale research are to provide simple effective cleaning/disinfection methods for use during the current and future pandemics.

Anthraquinone-Polyaniline-Integrated Textile Platforms for In Situ Electrochemical Production of Hydrogen Peroxide for Microbial Deactivation

Hydrogen peroxide (H₂O₂) is a versatile and effective disinfectant against common pathogenic bacteria such as Escherichia coli (E. coli). Electrochemical H₂O₂ generation has been studied in the past, but a lack of studies exists on miniaturized electrochemical platforms for the on-demand synthesis of H₂O₂ for antibacterial applications. In this article, a chemically modified cotton textile platform capable of in situ H₂O₂ production is demonstrated for E. coli deactivation. The cotton textile was modified by layer-by-layer coating with conductive carbon nanotubes/cellulose nanocrystals (CNT/CNC) and a polymer of polyaniline (PANI) decorated with anthraquinone (AQ), designated as the AQ@PANI@CNT/CNC@textile antibacterial patch. The AQ@PANI@CNT/CNC@textile antibacterial textile patch H₂O₂ production capabilities were evaluated using both electrochemical and colorimetric methods. The AQ@PANI@CNT/CNC@textile antibacterial patch electrochemically produced H₂O₂ concentrations up to 209 ± 25 µM over a 40 min period and displayed a log reduction of 3.32 for E. coli over a period of 2 h. The AQ@PANI@CNT/CNC@textile antibacterial patch offers promise for use as a self-disinfecting pathogen control platform.

Filtration efficiency of N95 filtering facepiece respirators during multi-cycles of '8-hour simulated donning + disinfection'

BACKGROUND

Aerosol-borne diseases such as COVID-19 may outbreak occasionally in various regions of the world, inevitably resulting in short-term shortage and corresponding reuse of disposable respirators.

AIM

To investigate the effective disinfection methods, reusable duration and frequency of N95 respirators.

METHODS

Based on the self-built respirator simulation test system, and under combinations of experimental conditions of three N95 respirators × 0-200 nm NaCl aerosols × three simulated breathing flow rates (15, 50 and 85 L/min) × two disinfection methods (dry heating and ultraviolet (UV) radiation), this study continuously measured the changes in filtration efficiency of all respirators during multi-cycles of '8-h simulated donning + disinfection' until the penetration reached ≥5%.

FINDINGS

Multi-cycles of dry heating and UV radiation treatments on the reused (i.e., multiple 8-h donning) N95 respirators had a minimal effect (<0.5%) on the respirator filtration efficiency, and even at 85 L/min, all tested N95 respirators were able to maintain filtration efficiencies ≥95% for at least 30 h or four reuse cycles of '8-h donning + disinfection', while a lower breathing flow rate (15 L/min) plus the exhalation valve could further extend the N95 respirator's usability duration up to 140 h or 18 reuse cycles of '8-h donning + disinfection'. As the respirator wearing time extended, aerosol penetration slowly increased in a quadratic function with a negative second-order coefficient, and the penetration increment during each cycle of 8-h donning was less than 0.9%.

CONCLUSION

Multi-cycles of N95 respirator reuse in combination with dry heating or UV irradiation disinfection are feasible.

Aerosolized Hydrogen Peroxide Decontamination of N95 Respirators, with Fit-Testing and Viral Inactivation, Demonstrates Feasibility for Reuse during the COVID-19 Pandemic

In response to the demand for N95 respirators by health care workers during the COVID-19 pandemic, we evaluated decontamination of N95 respirators using an aerosolized hydrogen peroxide (aHP) system. This system is designed to dispense a consistent atomized spray of aerosolized, 7% hydrogen peroxide (H₂O₂) solution over a treatment cycle. Multiple N95 respirator models were subjected to 10 or more cycles of respirator decontamination, with a select number periodically assessed for qualitative and quantitative fit testing. In parallel, we assessed the ability of aHP treatment to inactivate multiple viruses absorbed onto respirators, including phi6 bacteriophage, herpes simplex virus 1 (HSV-1), coxsackievirus B3 (CVB3), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For pathogens transmitted via respiratory droplets and aerosols, it is critical to address respirator safety for reuse. This study provided experimental validation of an aHP treatment process that decontaminates the respirators while maintaining N95 function. External National Institute for Occupational Safety & Health (NIOSH) certification verified respirator structural integrity and filtration efficiency after 10 rounds of aHP treatment. Virus inactivation by aHP was comparable to the decontamination of commercial spore-based biological indicators. These data demonstrate that the aHP process is effective, with successful fit-testing of respirators after multiple aHP cycles, effective decontamination of multiple virus species, including SARS-CoV-2, successful decontamination of bacterial spores, and filtration efficiency maintained at or greater than 95%. While this study did not include extended or clinical use of N95 respirators between aHP cycles, these data provide proof of concept for aHP decontamination of N95 respirators before reuse in a crisis-capacity scenario.

IMPORTANCE The COVID-19 pandemic led to unprecedented pressure on health care and research facilities to provide personal protective equipment. The respiratory nature of the SARS-CoV2 pathogen makes respirator facepieces a critical protective measure to limit inhalation of this virus. While respirator facepieces were designed for single use and disposal, the pandemic increased overall demand for N95 respirators, and corresponding manufacturing and supply chain limitations necessitated the safe reuse of respirators when necessary. In this study, we repurposed an aerosolized hydrogen peroxide (aHP) system that is regularly utilized to decontaminate materials in a biosafety level 3 (BSL3) facility, to develop a method for decontamination of N95 respirators. Results from viral inactivation, biological indicators, respirator fit testing, and filtration efficiency testing all indicated that the process was effective at rendering N95 respirators safe for reuse. This proof-of-concept study establishes baseline data for future testing of aHP in crisis-capacity respirator-reuse scenarios.