1
|
van der Westhuizen H, Nice JA, Tudor C, Liu Y, Ahmedov S, Kansal AR, Jensen PA, Vincent RL, Mustapha G, Vauhkonen V, Ochoa Delgado IM, van der Walt M, Volchenkov G. Embracing novel thinking to safeguard against airborne pathogens in indoor spaces. IJTLD OPEN 2024; 1:239-241. [PMID: 39021449 PMCID: PMC11249653 DOI: 10.5588/ijtldopen.24.0198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 04/28/2024] [Indexed: 07/20/2024]
Affiliation(s)
- H van der Westhuizen
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Nuffield Department of Primary Care Health Sciences, Oxford University, UK
- TB Proof, Cape Town, South Africa
| | - J-A Nice
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Independent TB IPC Built Environment Consultant, Tshwane, South Africa
- Department of Architecture & Industrial Design, Tshwane University of Technology, Tshwane, South Africa
| | - C Tudor
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Y Liu
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Clinical Center on Tuberculosis, Beijing Chest Hospital, Beijing, China
| | - S Ahmedov
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Bureau for Global Health, TB Division, United States Agency for International Development, Washington DC, USA
| | - A R Kansal
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- National Institute of TB and Respiratory Diseases, New Delhi, India
| | - P A Jensen
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Final Approach Inc, Port Orange, United States of America
| | - R L Vincent
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Icahn School of Medicine at Mount Sinai, New York City, USA
| | - G Mustapha
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - V Vauhkonen
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Independent Heating, Ventilation and Air Conditioning Consultant, Helsinki, Finland
| | | | - M van der Walt
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Tuberculosis Platform, South African Medical Research Council, Pretoria, South Africa
| | - G Volchenkov
- End TB Transmission Initiative - Powering Airborne IPC, Working Group of the Stop TB Partnership, Geneva, Switzerland
- Independent TB and Airborne IPC Consultant, Vladimir, Russia
| |
Collapse
|
2
|
Onishi K, Nojima M. Comparison of the inward leakage rate between N95 filtering facepiece respirators and modified surgical masks during the COVID-19 pandemic. Environ Health Prev Med 2024; 29:8. [PMID: 38369324 PMCID: PMC10898862 DOI: 10.1265/ehpm.23-00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/30/2023] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Owing to shortage of surgical and N95 filtering facepiece respirators (FFRs) during the COVID-2019 pandemic, various masks were developed to prevent infection. This study aimed to examine the inward leakage rate (ILR) of sealed face masks and modified surgical masks using a quantitative fit test and compared it with the ILR of unmodified N95 FFRs. METHODS We conducted paired comparisons of ILRs of bent nose-fit wire masks, double masks, and N95 FFRs from October to December 2021. To measure the protective effectiveness of masks, participants wore masks, and the number of particles outside and inside the mask were measured. The ILR was based on the percentage of particles entering the mask using a fit tester. RESULTS We enrolled 54 participants (20 men and 34 women) in this study. The median ILR for surgical masks without and with a W-shaped bend in the nose-fit wire were 96.44% and 50.82%, respectively. The nose-fit wire adjustment reduced the ILR of surgical masks by a mean of 28.57%, which was significantly lower than the ILR without adjustment (P < 0.001). For double masks, with surgical or polyurethane masks on top of the W-shaped mask, the ILR did not differ significantly from that of N95. Although the filtration performance of double surgical masks matched that of N95 masks, their ILR was notably higher, indicating that double masks do not provide equivalent protection. CONCLUSIONS Wearing N95 masks alone is effective in many cases. However, surgical mask modifications do not guarantee consistent effectiveness. Properly selected, sealed masks with a good fit overcome leakage, emphasizing their crucial role. Without evidence, mask-wearing may lead to unexpected infections. Education based on quantitative data is crucial for preventing adverse outcomes.
Collapse
Affiliation(s)
- Kazunari Onishi
- Division of Environmental Health, Graduate School of Public Health, St. Luke’s International University, 3-6-2 Tsukiji Chuo-ku, Tokyo 104-0045, Japan
| | - Masanori Nojima
- Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| |
Collapse
|
3
|
Robertson I, Kortum P. The Usability of Face Coverings Used to Prevent the Spread of COVID-19. HUMAN FACTORS 2023; 65:1702-1717. [PMID: 34905433 DOI: 10.1177/00187208211051131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To describe the perceived usability and usability problems associated with face coverings used to prevent the spread of COVID-19. BACKGROUND Since public health experts have now identified the appropriate use of facemasks as one of the critical elements in an effective COVID mitigation strategy, understanding how people use and care for them has become important. METHOD Data were collected via a survey that was shared on social media to which 2148 people responded. Participants were asked to identify the category class of the face covering they most often wear, rate its usability, answer demographic information, and questions about their mask use and hygiene, and identify issues they may suffer in relation to face cover use. RESULTS Overall, users appear to perceive their face coverings favorably from a usability and satisfaction standpoint, even though almost two-thirds of users indicated that they experienced discomfort and problems with glasses fogging with the most popular mask types. When considering demographic information, users' political party affiliation appears related to how they perceive the usability of their face covering. CONCLUSION Designers should work to improve the fit and comfort properties of protective masks; evidence suggests the System Usability Scale may be a useful tool in those efforts. APPLICATION Understanding mask design and behavioral issues related to their use can help in the development of masks and will maximize their acceptance and effectiveness in the field.
Collapse
Affiliation(s)
- Ian Robertson
- Department of Psychological Sciences, Rice University, Houston, TX, USA
| | - Philip Kortum
- Department of Psychological Sciences, Rice University, Houston, TX, USA
| |
Collapse
|
4
|
Lam SC, Odetayo A, Yu ITS, So SNY, Cheung K, Lee PH, Suen LKP. Evaluation of N95 respirators on fit rate, real-time leakage, and usability among Chinese healthcare workers: study protocol of a randomized crossover trial. Front Public Health 2023; 11:1266607. [PMID: 38045983 PMCID: PMC10691761 DOI: 10.3389/fpubh.2023.1266607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/27/2023] [Indexed: 12/05/2023] Open
Abstract
Background N95 respirators are used to limit the transmission of respiratory viruses in clinical settings. There are two to three major types of N95 available for all healthcare workers in Hong Kong. However, after the coronavirus outbreak and the consequent shortage of many commonly used respirators, several new N95 respirators were adopted temporarily in clinical settings without evaluation. Prior literature indicates that traditional N95 respirators used in hospitals in Hong Kong are not fit for Chinese people and have fit rates ranging from 50 to 60%. This study aims to investigate and compare the fit rate, real-time leakage, and mask usability of traditional and new N95 respirators among Chinese healthcare workers. Methods This study will employ two sequential phases. Phase 1 has a cross-sectional exploratory design used to investigate the fit rate and mask usability of three types of respirators. Phase 2 will examine the effectiveness of respiratory protection by comparing traditional and new N95 respirators by a randomized crossover trial. Eligible participants will be randomly allocated through a controlled crossover experiment to either a traditional or new respirator group (n = 100 in each arm) for performing standard clinical procedures. The primary outcome (real-time leakage) will be recorded at 30 s intervals during nasopharyngeal suctioning and cardiopulmonary resuscitation. The secondary outcomes are the fit rate and mask usability. After a 2 min suctioning (15 s twice) and 4 min one-person CPR, the fit rate (assessed by standard N95 fit testing) and mask usability (measured by self-reported mask usability scale) will be recorded as data of post-procedure. After 10 min rest, measurement of real-time leakage (i.e., crossover), fit test, and usability will be repeated. Discussion The result of real-time leakage will be a vital indicator of the respiratory protection of Chinese healthcare workers while performing prevalent clinical procedures, such as resuscitation. The fit rate and usability result will serve as an essential reference for consumable purchase policy in clinical settings.Trial registration: ISRCTN registry: ISRCTN40115047. Retrospectively registered on May 9, 2023. https://www.isrctn.com/ISRCTN40115047.
Collapse
Affiliation(s)
- Simon Ching Lam
- School of Nursing, Tung Wah College, Kowloon, Hong Kong SAR, China
| | - Aderonke Odetayo
- School of Nursing, Tung Wah College, Kowloon, Hong Kong SAR, China
| | - Ignatius Tak Sun Yu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | | | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Paul Hong Lee
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | | |
Collapse
|
5
|
Fakherpour A, Jahangiri M, Jansz J. A systematic review of passing fit testing of the masks and respirators used during the COVID-19 pandemic: Part 1-quantitative fit test procedures. PLoS One 2023; 18:e0293129. [PMID: 37883443 PMCID: PMC10602271 DOI: 10.1371/journal.pone.0293129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND During respiratory infection pandemics, masks and respirators are highly sought after, especially for frontline healthcare workers and patients carrying respiratory viruses. The objective of this study was to systematically review fit test pass rates and identify factors influencing the fitting characteristics. METHODS Potentially relevant studies were identified using PubMed, Scopus, Web of Science, and Science Direct during the COVID-19 pandemic from February 5, 2020, to March 21, 2023. The search strategy using the following keywords was conducted: Quantitative Fit Test, Condensation Nuclei Counter, Controlled Negative Pressure, PortaCount, Sibata, Accufit, Fit, Seal, Mask, Respirator, Respiratory Protective Device, Respiratory Protective Equipment, Protective Device, Personal Protective Equipment, COVID-19, Coronavirus, and SARS-CoV-2. The quality of the included studies was also assessed using the Newcastle-Ottawa scale. RESULTS A total of 137 articles met the eligibility criteria. Fifty articles had a quality score of less than 7 (good quality). A total of 21 studies had a fit test pass rate of less than 50%. 26 studies on disposable respirators and 11 studies on reusable respirators had an FF of less than 50 and less than 200, respectively. The most influential factors include respirator brand/model, style, gender, ethnicity, facial dimensions, facial hair, age, reuse, extensive movement, seal check, comfort and usability assessment, and training. CONCLUSION 37.36% of the disposable respirator studies and 43% of the reusable respirator studies did not report fit test results. 67.86% of the disposable respirator studies had a fit test pass rate greater than 50%, and 35.84% of these studies had an FF greater than 100. Also, 85.71% of the reusable respirator studies had a fit test pass rate greater than 50%, and 52.77% of these studies had an FF greater than 1000. Overall, the fit test pass rate was relatively acceptable. Newly developed or modified respirators must undergo reliable testing to ensure the protection of HCWs. Subject and respirator characteristics should be considered when implementing fit testing protocols. An optimal fit test panel should be developed prior to respirator design, certification, procurement decisions, and selection procedures.
Collapse
Affiliation(s)
- Anahita Fakherpour
- Student Research Committee, Department of Occupational Health and Safety Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Jahangiri
- Department of Occupational Health and Safety Engineering, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Janis Jansz
- School of Mines: Minerals, Energy and Chemical Engineering, Faculty of Science and Engineering, Curtin University, Perth, Australia
| |
Collapse
|
6
|
Goko C, Forster E, Mason M, Zimmerman PA. Effectiveness of fit testing versus fit checking for healthcare workers respiratory protective equipment: A systematic review. Int J Nurs Sci 2023; 10:568-578. [PMID: 38020846 PMCID: PMC10667321 DOI: 10.1016/j.ijnss.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 06/30/2023] [Accepted: 09/18/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Respiratory protection is critical in healthcare to minimise the risk of airborne infections for healthcare workers (HCWs). It emphasizes the use of proper fitting of particulate filter respirators and equivalent respiratory protective equipment (RPE) to ensure a good facial seal. The systematic review aimed to compare the effectiveness of fit testing and fit checking for HCWs' respiratory protective equipment. Methods A systematic review of the literature exploring RPE for HCWs to determine the effectiveness of fit-testing versus fit-checking from January 2003 to April 2022 was identified using CINAHL Complete via EBSCO Host, Cochrane Library, EMBASE, PubMed, and MEDLINE via Ovid electronic databases, and grey literature. The study protocol was registered with PROSPERO (registration number: CRD42020213968). Results Of the 561 articles identified in the search, 25 articles (22 quantitative studies and three guidelines) were included in this review. Overall, these studies suggest fit-testing as a method that is more effective, widely adopted, and reliable in assessing the effectiveness of RPE; however, a respiratory program should include both fit-testing and fit-checking to maximise effectiveness of the RPE. The COVID-19 epidemic highlighted a lack of knowledge among HCWs regarding fit-checking and fit-testing, and relevant education increased the effectiveness of respiratory equipment protection. Conclusion It is imperative that both fit-testing and fit-checking is implemented in order to ensure HCW safety. It is recommended to integrate education, fit-testing and fit-checking into a comprehensive respiratory protective program run by trained fit-testers. There is also a need for practical testing methods that incorporate the clinical environment.
Collapse
Affiliation(s)
- Charlotte Goko
- School of Nursing & Midwifery, Griffith University, Australia
| | - Elizabeth Forster
- School of Nursing & Midwifery, Griffith University, Australia
- Menzies Health Institute Queensland, Griffith University, Australia
| | - Matthew Mason
- Collaborative for the Advancement of Infection Prevention and Control, Australia
- University of the Sunshine Coast, Queensland, Australia
| | - Peta-Anne Zimmerman
- School of Nursing & Midwifery, Griffith University, Australia
- Menzies Health Institute Queensland, Griffith University, Australia
- Collaborative for the Advancement of Infection Prevention and Control, Australia
- Infection Control Department, Gold Coast Hospital and Health Services, Australia
| |
Collapse
|
7
|
Cheng P, Espano J, Harkaway A, Naclerio AE, Moehring NK, Braeuninger-Weimer P, Kidambi PR. Nanoporous Atomically Thin Graphene Filters for Nanoscale Aerosols. ACS APPLIED MATERIALS & INTERFACES 2022; 14:41328-41336. [PMID: 36036893 DOI: 10.1021/acsami.2c10827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Filtering nanoparticulate aerosols from air streams is important for a wide range of personal protection equipment (PPE), including masks used for medical research, healthcare, law enforcement, first responders, and military applications. Conventional PPEs capable of filtering nanoparticles <300 nm are typically bulky and sacrifice breathability to maximize protection from exposure to harmful nanoparticulate aerosols including viruses ∼20-300 nm from air streams. Here, we show that nanopores introduced into centimeter-scale monolayer graphene supported on polycarbonate track-etched supports via a facile oxygen plasma etch can allow for filtration of aerosolized SiO2 nanoparticles of ∼5-20 nm from air steams while maintaining air permeance of ∼2.28-7.1 × 10-5 mol m-2 s-1 Pa-1. Furthermore, a systematic increase in oxygen plasma etch time allows for a tunable size-selective filtration of aerosolized nanoparticles. We demonstrate a new route to realize ultra-compact, lightweight, and conformal form-factor filters capable of blocking sub-20 nm aerosolized nanoparticles with particular relevance for biological/viral threat mitigation.
Collapse
Affiliation(s)
- Peifu Cheng
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee 37212, United States
| | - Jeremy Espano
- Interdisciplinary Graduate Program for Material Science, Vanderbilt University, Nashville, Tennessee 37212, United States
| | - Andrew Harkaway
- Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee 37212, United States
| | - Andrew E Naclerio
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee 37212, United States
| | - Nicole K Moehring
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee 37212, United States
- Interdisciplinary Graduate Program for Material Science, Vanderbilt University, Nashville, Tennessee 37212, United States
| | | | - Piran R Kidambi
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee 37212, United States
- Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee 37212, United States
- Vanderbilt Institute of Nanoscale Sciences and Engineering, Vanderbilt University, Nashville, Tennessee 37212, United States
| |
Collapse
|
8
|
Cloet A, Griffin L, Yu M, Durfee W. Design considerations for protective mask development: A remote mask usability evaluation. APPLIED ERGONOMICS 2022; 102:103751. [PMID: 35339761 PMCID: PMC8943342 DOI: 10.1016/j.apergo.2022.103751] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
The design of N95 filtering facepiece respirators (FFRs) continues to pose usability concerns for healthcare workers, which have been exacerbated by the COVID-19 pandemic. The aim of this study was to develop a holistic model to guide mask design improvement. Dental students (n = 38) with experience wearing N95 FFRs participated in a randomized wear trial of three alternative protective masks. A mixed methods survey was used to examine usability of individual mask design components, the relationship of facial/head area to mask features, and overall mask design. Survey results indicated MNmask v1 demonstrated higher usability in seal confidence (M = 3.46), while MNmask v2 performed higher in satisfactory fit (M = 3.50). Design components of nose wire and head/neck bands were the most problematic, while conditions of skin irritation and tight/loose fit created an unfavorable wear experience. To consider healthcare workers' needs in improving the usability of protective masks, a model is presented to consider characteristics of fit, comfort, material, and design.
Collapse
Affiliation(s)
- Alison Cloet
- College of Design, University of Minnesota, 1985 Buford Ave, 240 McNeal Hall, St. Paul, MN, 55108, USA
| | - Linsey Griffin
- College of Design, University of Minnesota, 1985 Buford Ave, 240 McNeal Hall, St. Paul, MN, 55108, USA.
| | - Minji Yu
- College of Design, University of Minnesota, 1985 Buford Ave, 240 McNeal Hall, St. Paul, MN, 55108, USA
| | - William Durfee
- Department of Mechanical Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN, 55455, USA
| |
Collapse
|
9
|
Bhattacharjee S, Bahl P, Chughtai AA, Heslop D, MacIntyre CR. Face masks and respirators: Towards sustainable materials and technologies to overcome the shortcomings and challenges. NANO SELECT 2022. [DOI: 10.1002/nano.202200101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Shovon Bhattacharjee
- Biosecurity Program The Kirby Institute, Faculty of Medicine University of New South Wales Kensington Sydney Australia
- Department of Applied Chemistry and Chemical Engineering Faculty of Engineering and Technology Noakhali Science and Technology University Noakhali Bangladesh
| | - Prateek Bahl
- School of Mechanical & Manufacturing Engineering University of New South Wales Sydney Australia
| | - Abrar Ahmad Chughtai
- School of Population Health Faculty of Medicine University of New South Wales Kensington Sydney Australia
| | - David Heslop
- School of Population Health Faculty of Medicine University of New South Wales Kensington Sydney Australia
| | - C. Raina MacIntyre
- Biosecurity Program The Kirby Institute, Faculty of Medicine University of New South Wales Kensington Sydney Australia
- College of Public Service and Community Solutions and College of Health Solutions Arizona State University Tempe Arizona USA
| |
Collapse
|
10
|
Freeman C, Burch R, Strawderman L, Black C, Saucier D, Rickert J, Wilson J, Seitz H, Stull J. Do They Really Work? Quantifying Fabric Mask Effectiveness to Improve Public Health Messaging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116372. [PMID: 35681957 PMCID: PMC9180754 DOI: 10.3390/ijerph19116372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this study is to compare masks (non-medical/fabric, surgical, and N95 respirators) on filtration efficiency, differential pressure, and leakage with the goal of providing evidence to improve public health messaging. Masks were tested on an anthropometric face filtration mount, comparing both sealed and unsealed. Overall, surgical and N95 respirators provided significantly higher filtration efficiency (FE) and differential pressure (dP). Leakage comparisons are one of the most significant factors in mask efficiency. Higher weight and thicker fabric masks had significantly higher filtration efficiency. The findings of this study have important implications for communication and education regarding the use of masks to prevent the spread of COVID-19 and other respiratory illnesses, specifically the differences between sealed and unsealed masks. The type and fabric of facial masks and whether a mask is sealed or unsealed has a significant impact on the effectiveness of a mask. Findings related to differences between sealed and unsealed masks are of critical importance for health care workers. If a mask is not completely sealed around the edges of the wearer, FE for this personal protective equipment is misrepresented and may create a false sense of security. These results can inform efforts to educate health care workers and the public on the importance of proper mask fit.
Collapse
Affiliation(s)
- Charles Freeman
- School of Human Sciences, Mississippi State University, Starkville, MS 39762, USA;
- Correspondence:
| | - Reuben Burch
- Department of Industrial & Systems Engineering, Mississippi State University, Starkville, MS 39762, USA; (R.B.); (L.S.)
- Human Factors & Athlete Engineering, Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS 39759, USA;
| | - Lesley Strawderman
- Department of Industrial & Systems Engineering, Mississippi State University, Starkville, MS 39762, USA; (R.B.); (L.S.)
| | - Catherine Black
- School of Human Sciences, Mississippi State University, Starkville, MS 39762, USA;
| | - David Saucier
- Human Factors & Athlete Engineering, Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS 39759, USA;
| | - Jaime Rickert
- Institute for Clean Energy and Technology, Mississippi State University, Starkville, MS 39759, USA; (J.R.); (J.W.)
| | - John Wilson
- Institute for Clean Energy and Technology, Mississippi State University, Starkville, MS 39759, USA; (J.R.); (J.W.)
| | - Holli Seitz
- Department of Communication, Mississippi State University, Starkville, MS 39762, USA;
| | - Jeffrey Stull
- International Personal Protection, Incorporated, Austin, TX 78709, USA;
| |
Collapse
|
11
|
Nanotechnology Role Development for COVID-19 Pandemic Management. JOURNAL OF NANOTECHNOLOGY 2022. [DOI: 10.1155/2022/1872933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The global outbreak of coronavirus disease has sent an ominous message to the field of innovative and advanced technology research and development (COVID-19). To accomplish this, convectional technology and recent discoveries can be combined, or new research directions can be opened up using nanotechnology. Nanotechnology can be used to prevent, diagnose, and treat SARS-CoV-2 infection. As the pandemic spreads, a thorough examination of nanomaterials' role in pandemic response is highly desirable. According to this comprehensive review article, nanotechnology can be used to prevent, diagnose, and treat COVID-19. This research will be extremely useful during the COVID-19 outbreak in terms of developing rules for designing nanostructure materials to combat the outbreak.
Collapse
|
12
|
Knowledge Level on Infection Control among Romanian Undergraduate and Postgraduate Dental Students. Medicina (B Aires) 2022; 58:medicina58050661. [PMID: 35630077 PMCID: PMC9145850 DOI: 10.3390/medicina58050661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: Infection control practices in dentistry should be continuously evaluated. The aim of the present study was to assess the knowledge of dental students from Iași, Romania about infection control in the dental office. Materials and Methods: Dental students and resident dentists attending the “Grigore T. Popa” University of Medicine and Pharmacy in Iași were randomly selected in accordance with ethical guidelines, and a cross-sectional, questionnaire-based online study was conducted. The questionnaire included 21 items about infection control in dentistry. A descriptive statistical analysis was performed, and the chi-square test was used for data comparison, with a cutoff point of 0.05 for statistical significance. Results: The study sample included 150 subjects (75.3% female and 24.7% male) with a mean age of 25.71 ± 4.54 years. Mode of infection transmission was known by 74% of the subjects, and 76% were aware of standard precautions, with significant differences by the year of study (p = 0.012, r = 0.002). A percentage of 20% of subjects knew the means of transmission of the hepatitis B virus (HBV) (p = 0.032, r = 0.166). Most of the subjects were not vaccinated against HBV (p = 0.002, r = −0.274). Notions of high-level disinfection and sterilization were confused by 19.5% of the subjects. Only 22% of the subjects knew the correct processing of handpieces (p = 0.048, r = −0.071). The sources of information were diverse for 64.66% of the respondents, while 31.33% of them used courses and seminars only. Conclusions: There is a need for improvement in the level of knowledge on infection control for both dental students and residents.
Collapse
|
13
|
Rashid TU, Sharmeen S, Biswas S. Effectiveness of N95 Masks against SARS-CoV-2: Performance Efficiency, Concerns, and Future Directions. ACS CHEMICAL HEALTH & SAFETY 2022; 29:135-164. [PMID: 37556270 PMCID: PMC8768005 DOI: 10.1021/acs.chas.1c00016] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Indexed: 12/24/2022]
Abstract
The coronavirus disease 2019 (COVID-19) epidemic, which is caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has continued to spread around the world since December 2019. Healthcare workers and other medical first responders in particular need personal protective equipment to protect their respiratory system from airborne particulates, in addition to liquid splashes to the face. N95 respirator have become a critical component for reducing SARS-CoV-2 transmission and controlling the scale of the COVID-19 pandemic. However, a major dispute concerning the protective performance of N95 respirators has erupted, with a myriad of healthcare workers affected despite wearing N95 masks. This article reviews the most recent updates about the performance of N95 respirators in protecting against the SARS-CoV-2 virus in the present pandemic situation. A brief overview of the manufacturing methods, air filtration mechanisms, stability, and reusability of the mask is provided. A detailed performance evaluation of the mask is studied from an engineering point of view. This Review also reports on a comparative study about the protective performance of all commercially available surgical and respiratory masks used to combat the spread of COVID-19. With the aim of protecting healthcare providers more efficiently, we suggest some potential directions for the development of this respiratory mask that improve the performance efficiency of the mask.
Collapse
Affiliation(s)
- Taslim Ur Rashid
- Fiber and Polymer Science, Department of Textile
Engineering, Chemistry and Science, Wilson College of Textiles, North
Carolina State University, 1020 Main Campus Drive, Raleigh, North Carolina
27695, United States
- Department of Applied Chemistry and Chemical
Engineering, Faculty of Engineering and Technology, University of
Dhaka, Dhaka 1000, Bangladesh
| | - Sadia Sharmeen
- Department of Applied Chemistry and Chemical
Engineering, Faculty of Engineering and Technology, University of
Dhaka, Dhaka 1000, Bangladesh
- Chemistry Department, University of
Nebraska−Lincoln, Lincoln, Nebraska 68588, United
States
| | - Shanta Biswas
- Department of Applied Chemistry and Chemical
Engineering, Faculty of Engineering and Technology, University of
Dhaka, Dhaka 1000, Bangladesh
- Department of Chemistry, Louisiana State
University, Baton Rouge, Louisiana 70803, United
States
| |
Collapse
|
14
|
Damokhi A, Yousefinejad S, Fakherpour A, Jahangiri M. Improvement of performance and function in respiratory protection equipment using nanomaterials. JOURNAL OF NANOPARTICLE RESEARCH : AN INTERDISCIPLINARY FORUM FOR NANOSCALE SCIENCE AND TECHNOLOGY 2022; 24:76. [PMID: 35368829 PMCID: PMC8959790 DOI: 10.1007/s11051-022-05460-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/17/2022] [Indexed: 05/25/2023]
Abstract
Nanotechnology has become one of key areas for the current development and research. Nanotechnology focuses on matter at the nanoscale and is capable of using different approaches to produce nanomaterials, structures, devices, and systems. One of the concerns that have to be addressed is the adverse effects of exposure to pathogens and pollutants in different workplaces and environments. Respiratory protective equipment (RPE) is one of the personal protective equipment (PPE) utilized to reduce the risk of exposure to environmental or occupational respiratory hazards. Thus, various studies have been conducted for improving the functional properties of sorbents or filters in different kinds of RPE. Different categories of nanomaterials have been reported as effective agents for achieving this goal. The application of these nanomaterials in mask layers or respirators' cartridge could significantly increase the filtration efficiency, breathing comfort, and antibacterial/antiviral properties of the masks and respirators. The present study aimed to comprehensively review the nanomaterials used in different types of face RPE with emphasis on various properties of the utilized nanomaterials. The study also aimed to show an applied perspective for future research on this important subject.
Collapse
Affiliation(s)
- Arezoo Damokhi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Health Sciences, Institute of Health, Department of Occupational Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Yousefinejad
- Research Center for Health Sciences, Institute of Health, Department of Occupational Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Fakherpour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Jahangiri
- Research Center for Health Sciences, Institute of Health, Department of Occupational Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
15
|
van der Westhuizen HM, Dorward J, Roberts N, Greenhalgh T, Ehrlich R, Butler CC, Tonkin-Crine S. Health worker experiences of implementing TB infection prevention and control: A qualitative evidence synthesis to inform implementation recommendations. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000292. [PMID: 36962407 PMCID: PMC10021216 DOI: 10.1371/journal.pgph.0000292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/10/2022] [Indexed: 11/18/2022]
Abstract
Implementation of TB infection prevention and control (IPC) measures in health facilities is frequently inadequate, despite nosocomial TB transmission to patients and health workers causing harm. We aimed to review qualitative evidence of the complexity associated with implementing TB IPC, to help guide the development of TB IPC implementation plans. We undertook a qualitative evidence synthesis of studies that used qualitative methods to explore the experiences of health workers implementing TB IPC in health facilities. We searched eight databases in November 2021, complemented by citation tracking. Two reviewers screened titles and abstracts and reviewed full texts of potentially eligible papers. We used the Critical Appraisals Skills Programme checklist for quality appraisal, thematic synthesis to identify key findings and the GRADE-CERQual method to appraise the certainty of review findings. The review protocol was pre-registered on PROSPERO, ID CRD42020165314. We screened 1062 titles and abstracts and reviewed 102 full texts, with 37 studies included in the synthesis. We developed 10 key findings, five of which we had high confidence in. We describe several components of TB IPC as a complex intervention. Health workers were influenced by their personal occupational TB risk perceptions when deciding whether to implement TB IPC and neglected the contribution of TB IPC to patient safety. Health workers and researchers expressed multiple uncertainties (for example the duration of infectiousness of people with TB), assumptions and misconceptions about what constitutes effective TB IPC, including focussing TB IPC on patients known with TB on treatment who pose a small risk of transmission. Instead, TB IPC resources should target high risk areas for transmission (crowded, poorly ventilated spaces). Furthermore, TB IPC implementation plans should support health workers to translate TB IPC guidelines to local contexts, including how to navigate unintended stigma caused by IPC, and using limited IPC resources effectively.
Collapse
Affiliation(s)
| | - Jienchi Dorward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Nia Roberts
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Rodney Ehrlich
- Department of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Chris C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Sarah Tonkin-Crine
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
16
|
Patel P, Yadav BK, Patel G. State-of-the-Art and Projected Developments of Nanofiber Filter Material for Face Mask Against COVID-19. RECENT PATENTS ON NANOTECHNOLOGY 2022; 16:262-270. [PMID: 34086552 DOI: 10.2174/1872210515666210604110946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The Covid-19 epidemic was declared a pandemic by the World Health Organization in March 2020. It is difficult to foresee the future length and severity; it may extend to weeks, months, or even years to deplete the energy and resources of the health care facilities and the providers as there is marginal to no pharmacological medication available to treat the Covid-19. Unless an effective pharmacological treatment such as medicines and vaccines is developed and released publicly, wearing protective face masks and protecting personal health and hygiene is merely a choice to avoid the Covid-19 spread. This review summarizes the background knowledge on the Covid-19 disease and currently available face masks for highly infectious disease primary prevention. According to recent studies of Covid-19 prevention, diagnosis, and treatment, nanotechnologists have provided a revolutionary approach that involves both pharmacological and non-pharmacological steps, one of which is the use of nanofibers in facemasks and respirators. METHODS Various researches carried out in the field of nanomask and patented reports based on the application of nanomask were reviewed. CONCLUSION The most recent developments of nanofibers, including research publications, patents and commercial products in Covid-19 prevention, are extensively reviewed from scientific literature and appropriately represented in this study.
Collapse
Affiliation(s)
- Priya Patel
- Department of Pharmaceutics & Pharmaceutical Technology, Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology (CHARUSAT), CHARUSAT Campus, Changa 388421, India
| | - Bindu Kumari Yadav
- Department of Pharmaceutics & Pharmaceutical Technology, Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology (CHARUSAT), CHARUSAT Campus, Changa 388421, India
| | - Gayatri Patel
- Department of Pharmaceutics & Pharmaceutical Technology, Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology (CHARUSAT), CHARUSAT Campus, Changa 388421, India
| |
Collapse
|
17
|
Sinha D, Bhandary SK, Aroor R, Reddy R, Alva S. Effect of N-95 Mask on Oxygen Saturation Level in Health Care Workers and Their Experience While Using N-95 Mask. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0041-1740329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Background N-95 masks are in high demand during this COVID-19 pandemic but wearing an N-95 mask is a real challenge to the health workers during their duty hours. The present study aims to measure the effect of the N-95 mask on oxygen saturation level in the blood and the discomforts experienced while using it.
Materials and Methods Oxygen saturation was measured in 80 health care workers before and after wearing the N-95 mask continuously for more than 6 hours. The participants were asked to fill a questionnaire regarding various discomforts of N-95 mask usage, which consisted of 14 questions.
Results The most common discomfort was pain around the pinna followed by difficulty in breathing and fogging of spectacles or goggles. In addition, 71% of them had decreased oxygen saturation by 1%.
Conclusion N-95 mask can alter the oxygen saturation but it does not produce significant effects in healthy individuals. It can significantly affect patients with compromised airways.
Collapse
Affiliation(s)
- Devika Sinha
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| | - Satheesh Kumar Bhandary
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| | - Rajeshwary Aroor
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| | - Rashmitha Reddy
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| | - Shravan Alva
- Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be) University, Mangalore, Karnataka, India
| |
Collapse
|
18
|
Li R, Zhang M, Wu Y, Tang P, Sun G, Wang L, Mandal S, Wang L, Lang J, Passalacqua A, Subramaniam S, Song G. What We Are Learning from COVID-19 for Respiratory Protection: Contemporary and Emerging Issues. Polymers (Basel) 2021; 13:4165. [PMID: 34883668 PMCID: PMC8659889 DOI: 10.3390/polym13234165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 02/07/2023] Open
Abstract
Infectious respiratory diseases such as the current COVID-19 have caused public health crises and interfered with social activity. Given the complexity of these novel infectious diseases, their dynamic nature, along with rapid changes in social and occupational environments, technology, and means of interpersonal interaction, respiratory protective devices (RPDs) play a crucial role in controlling infection, particularly for viruses like SARS-CoV-2 that have a high transmission rate, strong viability, multiple infection routes and mechanisms, and emerging new variants that could reduce the efficacy of existing vaccines. Evidence of asymptomatic and pre-symptomatic transmissions further highlights the importance of a universal adoption of RPDs. RPDs have substantially improved over the past 100 years due to advances in technology, materials, and medical knowledge. However, several issues still need to be addressed such as engineering performance, comfort, testing standards, compliance monitoring, and regulations, especially considering the recent emergence of pathogens with novel transmission characteristics. In this review, we summarize existing knowledge and understanding on respiratory infectious diseases and their protection, discuss the emerging issues that influence the resulting protective and comfort performance of the RPDs, and provide insights in the identified knowledge gaps and future directions with diverse perspectives.
Collapse
Affiliation(s)
- Rui Li
- Department of Apparel, Events, and Hospitality Management, Iowa State University, Ames, IA 50010, USA; (R.L.); (M.Z.); (Y.W.); (L.W.)
| | - Mengying Zhang
- Department of Apparel, Events, and Hospitality Management, Iowa State University, Ames, IA 50010, USA; (R.L.); (M.Z.); (Y.W.); (L.W.)
| | - Yulin Wu
- Department of Apparel, Events, and Hospitality Management, Iowa State University, Ames, IA 50010, USA; (R.L.); (M.Z.); (Y.W.); (L.W.)
| | - Peixin Tang
- Department of Biological and Agricultural Engineering, University of California, Davis, CA 95616, USA; (P.T.); (G.S.)
| | - Gang Sun
- Department of Biological and Agricultural Engineering, University of California, Davis, CA 95616, USA; (P.T.); (G.S.)
| | - Liwen Wang
- Department of Apparel, Events, and Hospitality Management, Iowa State University, Ames, IA 50010, USA; (R.L.); (M.Z.); (Y.W.); (L.W.)
| | - Sumit Mandal
- Department of Design, Housing and Merchandising, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Lizhi Wang
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA 50010, USA;
| | - James Lang
- Department of Kinesiology, Iowa State University, Ames, IA 50010, USA;
| | - Alberto Passalacqua
- Department of Mechanical Engineering, Iowa State University, Ames, IA 50010, USA; (A.P.); (S.S.)
| | - Shankar Subramaniam
- Department of Mechanical Engineering, Iowa State University, Ames, IA 50010, USA; (A.P.); (S.S.)
| | - Guowen Song
- Department of Apparel, Events, and Hospitality Management, Iowa State University, Ames, IA 50010, USA; (R.L.); (M.Z.); (Y.W.); (L.W.)
| |
Collapse
|
19
|
El-Atab N, Mishra RB, Hussain MM. Toward nanotechnology-enabled face masks against SARS-CoV-2 and pandemic respiratory diseases. NANOTECHNOLOGY 2021; 33:062006. [PMID: 34727530 DOI: 10.1088/1361-6528/ac3578] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
Wearing a face mask has become a necessity following the outbreak of the coronavirus (COVID-19) disease, where its effectiveness in containing the pandemic has been confirmed. Nevertheless, the pandemic has revealed major deficiencies in the ability to manufacture and ramp up worldwide production of efficient surgical-grade face masks. As a result, many researchers have focused their efforts on the development of low cost, smart and effective face covers. In this article, following a short introduction concerning face mask requirements, the different nanotechnology-enabled techniques for achieving better protection against the SARS-CoV-2 virus are reviewed, including the development of nanoporous and nanofibrous membranes in addition to triboelectric nanogenerators based masks, which can filter the virus using various mechanisms such as straining, electrostatic attraction and electrocution. The development of nanomaterials-based mask coatings to achieve virus repellent and sterilizing capabilities, including antiviral, hydrophobic and photothermal features are also discussed. Finally, the usability of nanotechnology-enabled face masks is discussed and compared with that of current commercial-grade N95 masks. To conclude, we highlight the challenges associated with the quick transfer of nanomaterials-enabled face masks and provide an overall outlook of the importance of nanotechnology in counteracting the COVID-19 and future pandemics.
Collapse
Affiliation(s)
- Nazek El-Atab
- Smart, Advanced Memory devices and Applications (SAMA) Lab, Electrical & Computer Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Rishabh B Mishra
- Smart, Advanced Memory devices and Applications (SAMA) Lab, Electrical & Computer Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
- MMH Labs, Electrical & Computer Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Muhammad M Hussain
- MMH Labs, Electrical & Computer Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
- Electrical Engineering and Computer Sciences (EECS), University of California, Berkeley, CA 94720-1170, United States of America
| |
Collapse
|
20
|
Chopra J, Abiakam N, Kim H, Metcalf C, Worsley P, Cheong Y. The influence of gender and ethnicity on facemasks and respiratory protective equipment fit: a systematic review and meta-analysis. BMJ Glob Health 2021; 6:e005537. [PMID: 34764145 PMCID: PMC8587533 DOI: 10.1136/bmjgh-2021-005537] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 09/12/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Black, Asian and minority ethnic (BAME) people are disproportionately affected by COVID-19. Respiratory protective equipment (RPE) has conventionally been developed for a predominantly white male population that does not represent the healthcare workforce. The literature was reviewed to determine the protection offered to female and BAME users. METHODS Five databases were searched. Eligible studies related to respirator fit in the context of anthropometrics, gender and ethnicity. Meta-analysis was performed for gender-based anthropometric differences. A priori protocol registration was not performed. RESULTS 32 studies were included and anthropometric data was extracted from 15 studies. Meta-analysis revealed 14 anthropometric measurements were significantly smaller for females. Mean differences ranged from 0.37 mm to 22.05 mm. Gender-based anthropometric differences did not always translate to lower fit factor scores, with 12 studies reporting worse performance and fit for females and 10 reporting no gender effect. No studies provided disaggregate anthropometric data by ethnic group. Pass rates (PR) were low or moderate in 12 BAME or mixed-ethnicity cohorts. 14 studies reported associations between facial dimensions (FD) and respirator fit. Three comparative studies showed lower PR among selective BAME people. 18 studies reported RPE performance differed with model and design. Most studies did not prespecify inclusion/exclusion criteria. Small sample size and lack of justification or power calculations was a concern. Significant heterogeneity in study designs limited comparisons, particularly relating to respirator selection or availability and defining study outcomes relating to RPE performance. CONCLUSION The literature reports on largely Caucasian or single ethnic populations, and BAME people remain under-represented, limiting comparisons between ethnic groups. Facial anthropometrics vary between gender and likely between ethnicity, which may contribute to lower PR among females and ethnic minorities, particularly Asians. There is a need for studies including a broader spectrum of ethnicities and for consideration of female and BAME users during RPE development.
Collapse
Affiliation(s)
- Jagrati Chopra
- Scool of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nkemjika Abiakam
- School of Health Sciences, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, UK
| | - Hansung Kim
- School of Electronics and Computer Science, University of Southampton, Southampton, UK
| | - Cheryl Metcalf
- School of Health Sciences, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, UK
| | - Peter Worsley
- School of Health Sciences, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, UK
| | - Ying Cheong
- Scool of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- Complete Fertility Southampton, Princess Anne Hospital, Southampton, UK
| |
Collapse
|
21
|
Ipaki B, Merrikhpour Z, Taheri Rizi MS, Torkashvand S. A study on usability and design parameters in face mask: Concept design of UVW face mask for COVID-19 protection. HUMAN FACTORS AND ERGONOMICS IN MANUFACTURING 2021; 31:664-678. [PMID: 34898977 PMCID: PMC8653001 DOI: 10.1002/hfm.20934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 05/24/2021] [Accepted: 08/06/2021] [Indexed: 06/14/2023]
Abstract
The aim of this study is to investigate the usability of conventional masks to prevent the transmission of coronavirus 2019 (COVID-19) and subsequently design the proposed concept of the mask to reduce leakage and increase efficiency. Acute respiratory syndrome COVID-19 is spreading around the world and can be transmitted from one person with COVID-19 to another through personal contact and breathing. Improper design of current masks can lead to virus transmission. One hundred fifteen users participated in the study using a simple random sampling method in which N95-FFP2 face mask and surgery face mask usability tests were chosen as the most widely used face masks in Iranian people with an online usability questionnaire. Data were analyzed by SPSS. The results showed that the usability of the N95-FFP2 face mask with a total average of 4.46 and a surgical mask with a total average of 3.35 cannot be considered acceptable. Anthropometric and formal changes in people's faces and improper design of the face masks used make it necessary to review the mask redesign measures to increase the prevention of pathogens. In this study, new parameters for face mask design are proposed. Thirty different types of jaws have been considered with the help of CorelDRAW software, along with ideas for optimal mask design with UVW mask concept to be accessed by manufacturers around the world.
Collapse
Affiliation(s)
- Bahram Ipaki
- Faculty of DesignTabriz Islamic Art UniversityTabrizIran
| | - Zahra Merrikhpour
- Industrial Design Department, Art and Architecture FacultyBu‐Ali Sina UniversityHamadanIran
| | | | | |
Collapse
|
22
|
Gir E, Menegueti MG, Sousa LRM, Pereira-Caldeira NMV, de Carvalho MJ, Reis RK. Reusing and/or reprocessing the N95 face respirator mask or equivalent: An integrative review. Rev Lat Am Enfermagem 2021; 29:e3492. [PMID: 34730768 PMCID: PMC8570250 DOI: 10.1590/1518-8345.5135.3492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 07/04/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE to analyze the scientific evidence available on the different reprocessing methods and the necessary conditions for reuse of the N95 face respirator mask or equivalent. METHOD an integrative literature review. The PICO strategy was used to elaborate the question. The search was conducted in four databases: PubMed, SciVerse Scopus, WebofScience and EMBASE, considering any period of time. RESULTS a total of 32 studies were included from the 561 studies identified, and they were presented in two categories: "Conditions for reuse" and "Reprocessing the masks". Of the evaluated research studies, seven(21.8%) addressed the reuse of the N95 face respirator mask or equivalent and 25(78.1%) evaluated different reprocessing methods, namely: ultraviolet germicidal irradiation(14); hydrogen peroxide(8); vapor methods(14); using dry heat(5) and chemical methods(sodium hypochlorite[6], ethanol[4] and sodium chloride with sodium bicarbonate and dimethyldioxirane[1]). We emphasize that different methods were used in one same article. CONCLUSION no evidence was found to support safe reprocessing of face respirator masks. In addition, reuse is contraindicated due to the risk of self-contamination and inadequate sealing.
Collapse
Affiliation(s)
- Elucir Gir
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
| | - Mayra Gonçalves Menegueti
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
| | - Laelson Rochelle Milanês Sousa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
| | - Natália Maria Vieira Pereira-Caldeira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
| | | | - Renata Karina Reis
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
| |
Collapse
|
23
|
[Analysis of the materials for the manufacture of masks: The challenge of facing the shortage of personal protective equipment]. ENFERMERIA CLINICA 2021; 31:S73-S77. [PMID: 34629853 PMCID: PMC8022220 DOI: 10.1016/j.enfcli.2020.12.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 11/23/2022]
Abstract
The main element of personal protective equipment against the SARS-CoV-2 pandemic are masks, which protect against droplets and aerosols that can remain suspended in the air. The objective of this study is to summarize the existing evidence on the filtration of different materials for the manufacture of masks. A scoping review or exploratory review has been carried out in the PubMEd and Scopus databases, using the terms "respirator", "mask", "facemask", "material", and "tissue", combined with Boolean operators. The results show some of the materials used for the manufacture of masks, both surgical masks and medium-high filtration masks, as well as materials used for the manufacture of household masks. As a conclusion, it is necessary to know the characteristics of the different materials as well as their properties to guarantee an adequate use according to the specific needs in each context, being fundamental the application of particle filtration systems as well as support materials that comply with current recommendations.
Collapse
|
24
|
Bosque D, Forbes S, Ward EN, Delaney J, Meyers GT. Reconciliation and Disposal of Oral Medication: Creating a Safe Process for Clinical Research Personnel. Clin J Oncol Nurs 2021; 25:587-590. [PMID: 34533524 DOI: 10.1188/21.cjon.587-590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Clinical research nurses and non-licensed study coordinators observed variation in procedures for reconciliation and disposal of oral investigational medications across the institution. An academic medical center implemented a quality improvement project to standardize the process of reconciliation and disposal of oral investigational medications. An interprofessional collaborative workgroup was formed, which led to multiple interventions to standardize practice, including revision of three policies and procedures, redesign of specific work areas to establish drug-counting rooms, review of personal protective equipment requirements, revision of educational training, and regular cleaning of potentially contaminated workstations.
Collapse
|
25
|
Zhang R, Liu J, Zhang L, Lin J, Wu Q. The distorted power of medical surgical masks for changing the human thermal psychology of indoor personnel in summer. INDOOR AIR 2021; 31:1645-1656. [PMID: 33818847 PMCID: PMC8251099 DOI: 10.1111/ina.12830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/18/2021] [Indexed: 06/12/2023]
Abstract
The medical surgical mask (MSM) has been the essential protective equipment in people's daily work. The experimental purpose is to explore the effects of wearing MSM on human thermal sensation, thermal comfort, and breathing comfort in office buildings in summer. A total of 30 healthy college students were recruited for the testing. The experiment was carried out in a climate chamber, which can simulate the office buildings in summer. The experiment collects the subjects' skin temperature, microclimate in the mask, and subjective votes, including thermal sensory votes (TSV), thermal comfort votes (TCV), and respiratory comfort votes (BCV). Experimental results show that wearing MSM has no significant effect on the skin temperature of the human body. The microclimate temperature inside the MSM reaches over 34℃, and the relative humidity reaches over 70%. The high-temperature and high-humidity microclimate put human beings in an uneven thermal environment, which leads to poor human tolerance to the thermal environment and becomes the main reason for destroying human thermal comfort. Wearing MSM has a significant impact on the subjective thermal sensation, thermal comfort, and breathing comfort of the human body, and the impact becomes more significant as the environmental temperature increases. Once the mask is taken off, the human body will enter an extremely comfortable environment, resulting in an excessively high vote value. The difference in voting values before and after removing the mask becomes larger with the environmental temperature. By fitting the voting results and perform data processing, it can be found that wearing MSM will reduce the neutral temperature by 1.5°C, and the environmental temperature with the optimal thermal comfort by 1.4°C, and as the temperature increases, the respiratory discomfort will become more and more intense. Regardless of whether wearing a MSM, the subjects preferred a slight warmer environment. In conclusion, with the increase of ambient temperature, wearing MSM can cause the human worse tolerance to the thermal environment, and this disturbance will become more and more intense.
Collapse
Affiliation(s)
- Ruhang Zhang
- School of Energy and Power EngineeringUniversity of Shanghai for Science and TechnologyShanghaiChina
| | - Jianhua Liu
- School of Energy and Power EngineeringUniversity of Shanghai for Science and TechnologyShanghaiChina
- Shanghai Key Laboratory of Multiphase Flow and Heat Transfer in Power EngineeringShanghaiChina
| | - Liang Zhang
- School of Energy and Power EngineeringUniversity of Shanghai for Science and TechnologyShanghaiChina
| | - Jindi Lin
- School of Energy and Power EngineeringUniversity of Shanghai for Science and TechnologyShanghaiChina
| | - Qingqing Wu
- School of Energy and Power EngineeringUniversity of Shanghai for Science and TechnologyShanghaiChina
| |
Collapse
|
26
|
Homaeigohar S, Liu Q, Kordbacheh D. Biomedical Applications of Antiviral Nanohybrid Materials Relating to the COVID-19 Pandemic and Other Viral Crises. Polymers (Basel) 2021; 13:2833. [PMID: 34451371 PMCID: PMC8401873 DOI: 10.3390/polym13162833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/12/2021] [Accepted: 08/20/2021] [Indexed: 01/19/2023] Open
Abstract
The COVID-19 pandemic has driven a global research to uncover novel, effective therapeutical and diagnosis approaches. In addition, control of spread of infection has been targeted through development of preventive tools and measures. In this regard, nanomaterials, particularly, those combining two or even several constituting materials possessing dissimilar physicochemical (or even biological) properties, i.e., nanohybrid materials play a significant role. Nanoparticulate nanohybrids have gained a widespread reputation for prevention of viral crises, thanks to their promising antimicrobial properties as well as their potential to act as a carrier for vaccines. On the other hand, they can perform well as a photo-driven killer for viruses when they release reactive oxygen species (ROS) or photothermally damage the virus membrane. The nanofibers can also play a crucial protective role when integrated into face masks and personal protective equipment, particularly as hybridized with antiviral nanoparticles. In this draft, we review the antiviral nanohybrids that could potentially be applied to control, diagnose, and treat the consequences of COVID-19 pandemic. Considering the short age of this health problem, trivially the relevant technologies are not that many and are handful. Therefore, still progressing, older technologies with antiviral potential are also included and discussed. To conclude, nanohybrid nanomaterials with their high engineering potential and ability to inactivate pathogens including viruses will contribute decisively to the future of nanomedicine tackling the current and future pandemics.
Collapse
Affiliation(s)
- Shahin Homaeigohar
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK;
| | - Qiqi Liu
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China;
| | - Danial Kordbacheh
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK;
| |
Collapse
|
27
|
Plana D, Tian E, Cramer AK, Yang H, Carmack MM, Sinha MS, Bourgeois FT, Yu SH, Masse P, Boyer J, Kim M, Mo J, LeBoeuf NR, Li J, Sorger PK. Assessing the filtration efficiency and regulatory status of N95s and nontraditional filtering face-piece respirators available during the COVID-19 pandemic. BMC Infect Dis 2021; 21:712. [PMID: 34325673 PMCID: PMC8319695 DOI: 10.1186/s12879-021-06008-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/22/2021] [Indexed: 02/05/2023] Open
Abstract
Background The COVID-19 pandemic has severely disrupted supply chains for many types of Personal Protective Equipment (PPE), particularly surgical N95 filtering facepiece respirators (FFRs; “masks”). As a consequence, an Emergency Use Authorization (EUA) from the FDA has allowed use of industrial N95 respirators and importation of N95-type masks manufactured to international standards; these include KN95 masks from China and FFP2 masks from the European Union. Methods We conducted a survey of masks in the inventory of major academic medical centers in Boston, MA to determine provenance and manufacturer or supplier. We then assembled a testing apparatus at a university laboratory and performed a modified test of filtration performance using KCl and ambient particulate matter on masks from hospital inventories; an accompanying website shows how to build and use the testing apparatus. Results Over 100 different makes and models of traditional and nontraditional filtering facepiece respirators (N95-type masks) were in the inventory of surveyed U.S. teaching hospitals as opposed to 2–5 models under normal circumstances. A substantial number of unfamiliar masks are from unknown manufacturers. Many are not correctly labelled and do not perform to accepted standards and a subset are obviously dangerous; many of these masks are likely to be counterfeit. Due to the absence of publicly available information on mask suppliers and inconsistent labeling of KN95 masks, it is difficult to distinguish between legitimate and counterfeit products. Conclusions Many FFRs available for procurement during the COVID-19 pandemic do not provide levels of fit and filtration similar to those of N95 masks and are not acceptable for use in healthcare settings. Based on these results, and in consultation with occupational health officers, we make six recommendations to assist end users in acquiring legitimate products. Institutions should always assess masks from non-traditional supply chains by checking their markings and manufacturer information against data provided by NIOSH and the latest FDA EUA Appendix A. In the absence of verifiable information on the legitimacy of mask source, institutions should consider measuring mask fit and filtration directly. We also make suggestions for regulatory agencies regarding labeling and public disclosure aimed at increasing pandemic resilience. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06008-8.
Collapse
Affiliation(s)
- Deborah Plana
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Harvard-MIT Division of Health Sciences & Technology, Cambridge, MA, USA.,Harvard Ludwig Cancer Research Center and Department of Systems Biology, Harvard Medical School, Boston, MA, USA
| | - Enze Tian
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Department of Building Science, Tsinghua University, Beijing, China.,Department of Nuclear Science and Engineering and Department of Materials Science and Engineering, MIT, Cambridge, MA, USA
| | - Avilash K Cramer
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Harvard-MIT Division of Health Sciences & Technology, Cambridge, MA, USA
| | - Helen Yang
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA
| | - Mary M Carmack
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA
| | - Michael S Sinha
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA
| | - Florence T Bourgeois
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA
| | - Sherry H Yu
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
| | - Peter Masse
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Environmental Affairs, Brigham & Women's Hospital, Boston, MA, USA
| | - Jon Boyer
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.,Environmental Affairs, Brigham & Women's Hospital, Boston, MA, USA
| | - Minjune Kim
- Department of Nuclear Science and Engineering and Department of Materials Science and Engineering, MIT, Cambridge, MA, USA
| | - Jinhan Mo
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Department of Building Science, Tsinghua University, Beijing, China
| | - Nicole R LeBoeuf
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA. .,Department of Dermatology, Center for Cutaneous Oncology, Brigham and Women's Hospital; Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Ju Li
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA. .,Department of Nuclear Science and Engineering and Department of Materials Science and Engineering, MIT, Cambridge, MA, USA.
| | - Peter K Sorger
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA. .,Harvard Ludwig Cancer Research Center and Department of Systems Biology, Harvard Medical School, Boston, MA, USA. .,Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
28
|
Rasmi Y, Saloua KS, Nemati M, Choi JR. Recent Progress in Nanotechnology for COVID-19 Prevention, Diagnostics and Treatment. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:1788. [PMID: 34361174 PMCID: PMC8308319 DOI: 10.3390/nano11071788] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic is currently an unprecedented public health threat. The rapid spread of infections has led to calls for alternative approaches to combat the virus. Nanotechnology is taking root against SARS-CoV-2 through prevention, diagnostics and treatment of infections. In light of the escalating demand for managing the pandemic, a comprehensive review that highlights the role of nanomaterials in the response to the pandemic is highly desirable. This review article comprehensively discusses the use of nanotechnology for COVID-19 based on three main categories: prevention, diagnostics and treatment. We first highlight the use of various nanomaterials including metal nanoparticles, carbon-based nanoparticles and magnetic nanoparticles for COVID-19. We critically review the benefits of nanomaterials along with their applications in personal protective equipment, vaccine development, diagnostic device fabrication and therapeutic approaches. The remaining key challenges and future directions of nanomaterials for COVID-19 are briefly discussed. This review is very informative and helpful in providing guidance for developing nanomaterial-based products to fight against COVID-19.
Collapse
Affiliation(s)
- Yousef Rasmi
- Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia 5714783734, Iran;
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia 5714783734, Iran
| | - Kouass Sahbani Saloua
- Department of Nuclear Medicine & Radiobiology, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
| | - Mahdieh Nemati
- Department of Medical Nanotechnology, Faculty of Advanced Medical Science, Tabriz University of Medical Sciences, Tabriz 5154853431, Iran;
| | - Jane Ru Choi
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| |
Collapse
|
29
|
Bambi S, Giusti GD, Galazzi A, Mattiussi E, Comisso I, Manici M, Rosati M, Lucchini A. Pressure Injuries Due to Personal Protective Equipment in COVID-19 Critical Care Units. Am J Crit Care 2021; 30:287-293. [PMID: 33912903 DOI: 10.4037/ajcc2021178] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Caring for patients with COVID-19 requires wearing a full set of personal protective equipment (PPE) to avoid contamination. Personal discomfort has been associated with use of PPE, and anecdotal reports describe pressure injuries related to wearing PPE. OBJECTIVES To investigate the occurrence of device-related pressure injuries due to wearing PPE among Italian nurses caring for patients with COVID-19 in critical care settings. METHODS This descriptive study used an online survey investigating both the demographic characteristics of respondents and complications related to wearing PPE, including the development of pressure injuries. RESULTS A total of 266 nurses throughout Italy completed the survey; 32% of respondents were men. Nurses' median age was 36 years (range 22-59 years), and the median time spent working in their current clinical setting (an intensive care or high-dependency unit) was 3 years (range 0-32 years). Personal protective equipment was worn for a median duration of 5 hours (range 2-12 hours). While wearing PPE, 92.8% of nurses experienced pain and 77.1% developed device-related pressure injuries, mainly on the nose, ears, and forehead. Pain was more frequent among nurses with such injuries. Transparent dressings, emollient cream, and no dressing were associated with development of device-related pressure injury. CONCLUSIONS Pressure injuries related to PPE represent an important adverse effect for nurses caring for patients with COVID-19. This topic deserves study to determine adequate solutions for preventing and treating such injuries and their potential influence on nurses' work tolerance.
Collapse
Affiliation(s)
- Stefano Bambi
- Stefano Bambi is a staff nurse in the medical and surgical intensive care unit, Careggi University Hospital, Florence, Italy
| | - Gian Domenico Giusti
- Gian Domenico Giusti is a staff nurse in the intensive care unit, Perugia University Hospital, Perugia, Italy, and a nurse educator in the Department of Experimental Medicine, School of Nursing, University of Perugia, Perugia, Italy
| | - Alessandro Galazzi
- Alessandro Galazzi is a clinical nurse educator in the Healthcare Professions Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Mattiussi
- Elisa Mattiussi is a nurse educator in the Department of Medical Sciences, School of Nursing, University of Udine, Udine, Italy; and a staff nurse in the Department of Anaesthesia and Intensive Care, Azienda Sanitaria Universitaria Friuli Centrale, University Hospital of Udine, Udine, Italy
| | - Irene Comisso
- Irene Comisso is a staff nurse in the Clinica di Anestesia e Rianimazione, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Matteo Manici
- Matteo Manici is a staff nurse in the postsurgical intensive care unit, University Hospital of Parma, Parma, Italy
| | - Moris Rosati
- Moris Rosati is a staff nurse in the Anestesia e Rianimazione DEA e dei Trapianti, Azienda ospedaliero-universitaria Senese, Siena, Italy
| | - Alberto Lucchini
- Alberto Lucchini is a nurse coordinator in the general intensive care unit, ASST Monza, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| |
Collapse
|
30
|
Ahmed A, Zhong Z, Suprono M, Savignano R, Riter H, Oyoyo U, Wilson A, Reece R, Kim J, Cho EH, Handysides R, Richardson P, Caruso J, Li Y. Enhancement of peripheral seal of medical face masks using a 3-dimensional-printed custom frame. J Am Dent Assoc 2021; 152:542-550. [PMID: 34176568 PMCID: PMC8486490 DOI: 10.1016/j.adaj.2021.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/16/2021] [Accepted: 03/05/2021] [Indexed: 01/22/2023]
Abstract
Background During the COVID-19 pandemic, American Society for Testing and Materials level 3 and level 2 medical face masks (MFMs) have been used for most health care workers and even for the first responders owing to a shortage of N95 respirators. However, the MFMs lack effective peripheral seal, leading to concerns about their adequacy to block aerosol exposure for proper protection. The purpose of this study was to evaluate the peripheral seal of level 3 and level 2 MFMs with a 3-dimensional (3D-) printed custom frame. Methods Level 3 and level 2 MFMs were tested on 10 participants with and without a 3D-printed custom frame; the efficiency of mask peripheral seal was determined by means of quantitative fit testing using a PortaCount Fit Tester based on ambient aerosol condensation nuclei counter protocol. Results The 3D-printed custom frame significantly improved the peripheral seal of both level 3 and level 2 MFMs compared with the masks alone (P < .001). In addition, both level 3 and level 2 MFMs with the 3D-printed custom frame met the quantitative fit testing standard specified for N95 respirators. Practical Implications The 3D-printed custom frame over level 3 and level 2 MFMs can offer enhanced peripheral reduction of aerosols when using collapsible masks. With the shortage of N95 respirators, using the 3D-printed custom frame over a level 3 or level 2 MFM is considered a practical alternative to dental professionals.
Collapse
|
31
|
Guellich A, Tella E, Ariane M, Grodner C, Nguyen-Chi HN, Mahé E. The face mask-touching behavior during the COVID-19 pandemic: Observational study of public transportation users in the greater Paris region: The French-mask-touch study. JOURNAL OF TRANSPORT & HEALTH 2021; 21:101078. [PMID: 33968608 PMCID: PMC8092492 DOI: 10.1016/j.jth.2021.101078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 05/18/2023]
Abstract
BACKGROUND To limit the spread of the new coronavirus disease 2019 (COVID-19), the World Health Organization recommends the use of face mask as a part of the pandemic control strategy. It has published also "best practices" in which it advises to avoid touching the mask while wearing it. This might be challenging. The purpose of this study was to investigate the frequency of mask-touching behavior in public transportation. METHODS Observational study using data collected in real life. This survey was conducted in subways and local trains of the greater Paris region, France, between May 4th and 25th, 2020. Public Transportation users were covertly observed. Demographic characteristics, type of mask and the main activity were collected by the investigator. The duration of observation, the frequency of touching face mask, hair and the uncovered area of the face were also recorded. Frequency of mask-touching per hour was determined. RESULTS One hundred eighty two persons were observed. The median of estimated age [1st and 3rd interquartile] was 35 [30;45] years and 87 (48%) were women. One hundred forty three (79%) were wearing surgical mask. The median time of observation was 8 [4;12] minutes. During this period, 87 (48%) persons touched their mask 15 [7.5;30] times per hour of whom only two (8%) have used hydroalcoholic solution to disinfect their hands. CONCLUSIONS Mask touching is frequent and is rarely followed by hand disinfection. Actions regarding mask use should be taken to improve compliance.
Collapse
Affiliation(s)
- Aziz Guellich
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
- Primary Care Department, Université Paris-Est Créteil (UPEC), School of Medicine, Créteil, France
| | - Emilie Tella
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Molka Ariane
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Camille Grodner
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Hoai-Nam Nguyen-Chi
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| | - Emmanuel Mahé
- Dermatology Department, Hôpital Victor Dupouy Argenteuil, Argenteuil, France
| |
Collapse
|
32
|
Chea B, Bolt A, Agelin-Chaab M, Dincer I. Assessment of effectiveness of optimum physical distancing phenomena for COVID-19. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2021; 33:051903. [PMID: 34040335 PMCID: PMC8142834 DOI: 10.1063/5.0046429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/10/2021] [Indexed: 05/06/2023]
Abstract
Currently, COVID-19 is a global pandemic that scientists and engineers around the world are aiming to understand further through rigorous testing and observation. This paper aims to provide safe distance recommendations among individuals and minimize the spread of COVID-19, as well as examine the efficacy of face coverings as a tool to slow the spread of respiratory droplets. These studies are conducted using computational fluid dynamics analyses, where the infected person breathes, coughs, and sneezes at various distances and environmental wind conditions and while wearing a face-covering (mask or face shield). In cases where there were no wind conditions, the breathing and coughing simulations display 1-2 m physical distancing to be effective. However, when sneezing was introduced, the physical distancing recommendation of 2 m was deemed not effective; instead, a distance of 2.8 m and greater was found to be more effective in reducing the exposure to respiratory droplets. The evaluation of environmental wind conditions necessitated an increase in physical distancing measures in all cases. The case where breathing was measured with a gentle breeze resulted in a physical distancing recommendation of 1.1 m, while coughing caused a change from the previous recommendation of 2 m to a distance of 4.5 m or greater. Sneezing in the presence of a gentle breeze was deemed to be the most impactful, with a recommendation for physical distancing of 5.8 m or more. It was determined that face coverings can potentially provide protection to an uninfected person in static air conditions. However, the uninfected person's protection can be compromised even in gentle wind conditions.
Collapse
Affiliation(s)
- Branson Chea
- Faculty of Engineering and Applied Science, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario L1H 7K4, Canada
| | | | | | | |
Collapse
|
33
|
Nanofiber-Based Face Masks and Respirators as COVID-19 Protection: A Review. MEMBRANES 2021; 11:membranes11040250. [PMID: 33808380 PMCID: PMC8066241 DOI: 10.3390/membranes11040250] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 01/12/2023]
Abstract
Wearing face masks, use of respirators, social distancing, and practicing personal hygiene are all measures to prevent the spread of the coronavirus disease (COVID-19). This pandemic has revealed the deficiency of face masks and respirators across the world. Therefore, significant efforts are needed to develop air filtration and purification technologies, as well as innovative, alternative antibacterial and antiviral treatment methods. It has become urgent—in order for humankind to have a sustainable future—to provide a feasible solution to air pollution, particularly to capture fine inhalable particulate matter in the air. In this review, we present, concisely, the air pollutants and adverse health effects correlated with long- and short-term exposure to humans; we provide information about certified face masks and respirators, their compositions, filtration mechanisms, and the variations between surgical masks and N95 respirators, in order to alleviate confusion and misinformation. Then, we summarize the electrospun nanofiber-based filters and their unique properties to improve the filtration efficiency of face masks and respirators.
Collapse
|
34
|
Oliveira ACD, Lucas TC. Is it possible to decontaminate N95 masks in pandemic times? integrative literature review. ACTA ACUST UNITED AC 2021; 42:e20200146. [PMID: 33787720 DOI: 10.1590/1983-1447.2021.20200146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/09/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the protocols on decontamination/reuse of N95 masks available in the literature in times of the Covid-19 pandemic. METHOD Integrative literature review, in the period from 2010 to 2020, on the databases MEDLINE/PubMed, Science Direct, Cochrane, SAGE journals, Web of Science, Scopus, Embase and Wiley, with the descriptors Masks AND Respiratory protective devices; Mask OR N95 AND Covid-19; N95 AND Respirators; Decontamination AND N95 AND Coronavirus; Facemask OR Pandemic. RESULTS Twelve studies were included, of which 3 (30.0%) used ultraviolet germicidal irradiation and indicated mask deterioration between 2 and 10 cycles, 4 (40.0%) used hydrogen peroxide vapor, and seal loss varied from 5 to 20 cycles, 4 (33.3%) evaluated the structural integrity of the N95 mask through visual inspection and 6 (54.4%), its filtration efficiency. CONCLUSION Reuse strategies to overcome a shortage of devices in the face of the pandemic challenge the current concept for good practices in health-product processing.
Collapse
Affiliation(s)
| | - Thabata Coaglio Lucas
- Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Departamento de Enfermagem. Diamantina. Minas Gerais, Brasil
| |
Collapse
|
35
|
Xu M, Lee P, Collins D. The critical importance of mask seals on respirator performance: An analytical and simulation approach. PLoS One 2021; 16:e0246720. [PMID: 33596228 PMCID: PMC7888670 DOI: 10.1371/journal.pone.0246720] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/26/2021] [Indexed: 11/18/2022] Open
Abstract
Filtering facepiece respirators (FFRs) and medical masks are widely used to reduce the inhalation exposure of airborne particulates and biohazardous aerosols. Their protective capacity largely depends on the fraction of these that are filtered from the incoming air volume. While the performance and physics of different filter materials have been the topic of intensive study, less well understood are the effects of mask sealing. To address this, we introduce an approach to calculate the influence of face-seal leakage on filtration ratio and fit factor based on an analytical model and a finite element method (FEM) model, both of which take into account time-dependent human respiration velocities. Using these, we calculate the filtration ratio and fit factor for a range of ventilation resistance values relevant to filter materials, 500-2500 Pa∙s∙m-1, where the filtration ratio and fit factor are calculated as a function of the mask gap dimensions, with good agreement between analytical and numerical models. The results show that the filtration ratio and fit factor are decrease markedly with even small increases in gap area. We also calculate particle filtration rates for N95 FFRs with various ventilation resistances and two commercial FFRs exemplars. Taken together, this work underscores the critical importance of forming a tight seal around the face as a factor in mask performance, where our straightforward analytical model can be readily applied to obtain estimates of mask performance.
Collapse
Affiliation(s)
- Mingxin Xu
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Lee
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - David Collins
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
36
|
de Araújo Andrade T, Nascimento Junior JAC, Santos AM, Borges LP, Quintans-Júnior LJ, Walker CIB, Frank LA, Serafini MR. Technological Scenario for Masks in Patent Database During Covid-19 Pandemic. AAPS PharmSciTech 2021; 22:72. [PMID: 33575845 PMCID: PMC7877530 DOI: 10.1208/s12249-021-01918-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/28/2020] [Indexed: 01/08/2023] Open
Abstract
Since January 2020, the World Health Organization announces COVID-19 outbreak a case of public health emergency of international interest, and declaring it a pandemic on March. Due to the high transmission of this disease, rate precautions have been implemented, such as the use of masks by the population, personal protective equipment (PPE), and safety protocols, mainly to health workers. Thus, we performed a patent review to evaluate the current patents related to the protective mask. The review was carried out in the patent database in the period of May 2019 to May 2020. After the process of screening and eligibility, 563 patents were selected for our analysis according to the aim of the study which used masks such as a PPE against dust particles and pathogens, mostly when it is about airborne transmission, such as viruses and bacteria. Here, an overview of the main materials used in the mask manufacturing and their efficiency was described. The results of the review showed that most of the masks used cotton, nylon, silver fiber fabrics, among others as fabrics to develop the masks. It also makes an analysis of masks composed of nanotechnology which provide high filtration efficiency. Moreover, the review also brought possibilities of masking the population, which already have been done in countries such as China and Korea and ways of sterilization for reuse of PPE during COVID-19 outbreak. Thus, this review can further researchers in the developing of masks to decrease the spread of a pandemic disease. Graphical abstract.
Collapse
|
37
|
Barycka K, Szarpak L, Filipiak KJ, Jaguszewski M, Smereka J, Ladny JR, Turan O. Comparative effectiveness of N95 respirators and surgical/face masks in preventing airborne infections in the era of SARS-CoV2 pandemic: A meta-analysis of randomized trials. PLoS One 2020; 15:e0242901. [PMID: 33320847 PMCID: PMC7737973 DOI: 10.1371/journal.pone.0242901] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 11/11/2020] [Indexed: 11/30/2022] Open
Abstract
Background Recently, several randomized controlled trials (RCTs) have evaluated the effect of N95 respirators compared with medical masks to protect against acute respiratory infections. However, these studies are limited by modest sample sizes and inconclusive results. Therefore, the goal of the present study was to review the relevant and available published RCTs with the aid of the increased power of meta-analytic methods in order to assess the effectiveness of medical masks and N95 respirators in reducing the risk of respiratory infections. Methods This meta-analysis follows the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for conducting and reporting results. We searched PubMed, Web of Science, Embase, and Cochrane databases from inception through April 1, 2020 to identify potentially relevant studies. Two authors (LS and JS) independently searched the titles and abstracts of the potentially eligible articles. They independently retrieved required data from the eligible trials; the data were initially tabulated for statistical analysis. Two authors (JRL and LS) independently assessed the methodological quality of the included RCTs using the Cochrane Collaboration’s tool for assessing risk of bias. Results Six articles met the inclusion criteria. The pooled analysis showed that N95 respirators did not reduce the risk of infection with respiratory viruses compared with medical/surgical masks (5.7% vs. 7.9%; RR = 1.12; 95% CI: 0.88–1.41; p = 0.36); however, there was no statistically significant difference in laboratory-confirmed influenza between N95 and medical masks (RR = 0.91; 95% CI: 0.77–1.07; p = 0.26). Medical masks provided similar protection against other viruses, including coronavirus (RR = 0.74; 95% CI: 0.32–1.73; p = 0.49). Respiratory illness, as well as influenza-like illness were less frequently observed with N95 respirators. Conclusions Our meta-analysis suggests that there are insufficient data to definitively determine whether N95 respirators are superior to medical masks in protection against transmissible acute respiratory infections. Further randomized trials are necessary to compare the above methods of respiratory protection in the context of COVID-19 incidence.
Collapse
Affiliation(s)
| | - Lukasz Szarpak
- Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland
- * E-mail:
| | | | - Milosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Robert Ladny
- Clinic of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Oguz Turan
- Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| |
Collapse
|
38
|
Graczyk KM, Matyka M. Predicting porosity, permeability, and tortuosity of porous media from images by deep learning. Sci Rep 2020; 10:21488. [PMID: 33293546 PMCID: PMC7722859 DOI: 10.1038/s41598-020-78415-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/17/2020] [Indexed: 02/02/2023] Open
Abstract
Convolutional neural networks (CNN) are utilized to encode the relation between initial configurations of obstacles and three fundamental quantities in porous media: porosity ([Formula: see text]), permeability (k), and tortuosity (T). The two-dimensional systems with obstacles are considered. The fluid flow through a porous medium is simulated with the lattice Boltzmann method. The analysis has been performed for the systems with [Formula: see text] which covers five orders of magnitude a span for permeability [Formula: see text] and tortuosity [Formula: see text]. It is shown that the CNNs can be used to predict the porosity, permeability, and tortuosity with good accuracy. With the usage of the CNN models, the relation between T and [Formula: see text] has been obtained and compared with the empirical estimate.
Collapse
Affiliation(s)
- Krzysztof M Graczyk
- Institute of Theoretical Physics, Faculty of Physics and Astronomy, University of Wrocław, pl. M. Borna 9, 50-204, Wrocław, Poland.
| | - Maciej Matyka
- Institute of Theoretical Physics, Faculty of Physics and Astronomy, University of Wrocław, pl. M. Borna 9, 50-204, Wrocław, Poland
| |
Collapse
|
39
|
Quality Assurance During a Global Pandemic: An Evaluation of Improvised Filter Materials for Healthcare Workers. J Occup Environ Med 2020; 62:781-782. [PMID: 32769798 DOI: 10.1097/jom.0000000000001986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The proliferation of improvised masks during the COVID-19 pandemic has raised questions regarding filter effectiveness and safety. We sought to compare the effectiveness of commonly used improvised filter materials against N95 industry standards. METHODS Six different filter materials commonly used in the community were tested using both single- and multi-layer configurations with the TSI 8130 automated filter tester in accordance with National Institute for Occupational Safety and Health (NIOSH) standards for N95 respirators. RESULTS Only three of the tested filter material configurations met N95 parameters with regard to filtration efficiency and pressure drop across the filter material-the: True-high-efficiency particulate air (HEPA) filter, four-layer MERV 13 and 14 HVAC filters. CONCLUSIONS Many proposed filter materials for improvised masks do not meet current industry standards and may pose safety and efficacy concerns. Care should be taken when selecting materials for this critical respirator component, particularly for health care workers or others at high risk for pathogen exposure.
Collapse
|
40
|
Ansari U, Mendonca C, Danha R, Robley R, Davies T. The effects of personal protective equipment on airway management: An in-situ simulation. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2020; 34:23-27. [PMID: 38620295 PMCID: PMC7335411 DOI: 10.1016/j.tacc.2020.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 12/04/2022]
Abstract
The novel coronavirus disease (COVID-19) was declared a pandemic by the World Health Organisation on 11th March and has led to over 41,000 deaths in the UK. Public Health England guidance for aerosol generating procedures (AGP) requires the donning of personal protective equipment (PPE). We evaluated airway management skills using an in-situ emergency simulation. The scenarios were video recorded and scored by two independent assessors using a skill specific checklist. A total of 34 airway management procedures were evaluated. The checklist involved 13 steps with a maximum score of 26. The median (IQR [range]) checklist score was 25 (24-25 [20-26]). Four teams failed to intubate the trachea and proceeded to manage the airway using a supraglottic airway device. The mean (SD) intubation time was 47.9 (16.5) seconds and two anaesthetists (7%) required a second attempt. Our results show that airway management can be carried out successfully whilst donned in PPE. However, additional training in using newly introduced devices such as a McGrath® video laryngoscope is of paramount importance.
Collapse
Affiliation(s)
- Umair Ansari
- University Hospitals Coventry & Warwickshire NHS Trust, UK
| | | | - Ratidzo Danha
- University Hospitals Coventry & Warwickshire NHS Trust, UK
| | - Richard Robley
- University Hospitals Coventry & Warwickshire NHS Trust, UK
| | - Tim Davies
- University Hospitals Coventry & Warwickshire NHS Trust, UK
| |
Collapse
|
41
|
Reusable Face Masks as Alternative for Disposable Medical Masks: Factors that Affect their Wear-Comfort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186623. [PMID: 32932918 PMCID: PMC7558362 DOI: 10.3390/ijerph17186623] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/02/2020] [Accepted: 09/09/2020] [Indexed: 11/29/2022]
Abstract
The coronavirus outbreak that commenced at the end of 2019 has led to a dramatic increase in the demand for face masks. In countries that are experiencing a shortage of face masks as a result of panic buying or inadequate supply, reusable fabric masks have become a popular option, because they are often considered more cost-effective and environmentally friendly than disposable medical masks. Nevertheless, there remains a significant variation in the quality and performance of existing face masks; not all are simultaneously able to provide protection against the extremely contagious virus and be comfortable to wear. This study aims to examine the influential factors that affect the comfort of reusable face masks, but not to assess the antimicrobial or antiviral potential. Seven types of masks were selected in this study and subjected to air and water vapor permeability testing, thermal conductivity testing and a wear trial. The results indicate that washable face masks made of thin layers of knitted fabric with low density and a permeable filter are more breathable. Additionally, masks that contain sufficient highly thermally conductive materials and have good water vapor permeability are often more comfortable to wear as they can transfer heat and moisture from the body quickly, and thus do not easily dampen and deteriorate.
Collapse
|
42
|
Lam SC, Suen LKP, Cheung TCC. Global risk to the community and clinical setting: Flocking of fake masks and protective gears during the COVID-19 pandemic. Am J Infect Control 2020; 48:964-965. [PMID: 32405127 PMCID: PMC7219383 DOI: 10.1016/j.ajic.2020.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 12/02/2022]
|
43
|
O’Dowd K, Nair KM, Forouzandeh P, Mathew S, Grant J, Moran R, Bartlett J, Bird J, Pillai SC. Face Masks and Respirators in the Fight against the COVID-19 Pandemic: A Review of Current Materials, Advances and Future Perspectives. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E3363. [PMID: 32751260 PMCID: PMC7435473 DOI: 10.3390/ma13153363] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/09/2020] [Accepted: 07/25/2020] [Indexed: 12/14/2022]
Abstract
The outbreak of COVID-19 has spread rapidly across the globe, greatly affecting how humans as a whole interact, work and go about their daily life. One of the key pieces of personal protective equipment (PPE) that is being utilised to return to the norm is the face mask or respirator. In this review we aim to examine face masks and respirators, looking at the current materials in use and possible future innovations that will enhance their protection against SARS-CoV-2. Previous studies concluded that cotton, natural silk and chiffon could provide above 50% efficiency. In addition, it was found that cotton quilt with a highly tangled fibrous nature provides efficient filtration in the small particle size range. Novel designs by employing various filter materials such as nanofibres, silver nanoparticles, and nano-webs on the filter surfaces to induce antimicrobial properties are also discussed in detail. Modification of N95/N99 masks to provide additional filtration of air and to deactivate the pathogens using various technologies such as low- temperature plasma is reviewed. Legislative guidelines for selecting and wearing facial protection are also discussed. The feasibility of reusing these masks will be examined as well as a discussion on the modelling of mask use and the impact wearing them can have. The use of Artificial Intelligence (AI) models and its applications to minimise or prevent the spread of the virus using face masks and respirators is also addressed. It is concluded that a significant amount of research is required for the development of highly efficient, reusable, anti-viral and thermally regulated face masks and respirators.
Collapse
Affiliation(s)
- Kris O’Dowd
- Nanotechnology and Bio-Engineering Research Group, Department of Environmental Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (K.O.); (K.M.N.); (P.F.); (S.M.); (J.G.); (R.M.)
| | - Keerthi M. Nair
- Nanotechnology and Bio-Engineering Research Group, Department of Environmental Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (K.O.); (K.M.N.); (P.F.); (S.M.); (J.G.); (R.M.)
| | - Parnia Forouzandeh
- Nanotechnology and Bio-Engineering Research Group, Department of Environmental Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (K.O.); (K.M.N.); (P.F.); (S.M.); (J.G.); (R.M.)
| | - Snehamol Mathew
- Nanotechnology and Bio-Engineering Research Group, Department of Environmental Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (K.O.); (K.M.N.); (P.F.); (S.M.); (J.G.); (R.M.)
| | - Jamie Grant
- Nanotechnology and Bio-Engineering Research Group, Department of Environmental Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (K.O.); (K.M.N.); (P.F.); (S.M.); (J.G.); (R.M.)
| | - Ruth Moran
- Nanotechnology and Bio-Engineering Research Group, Department of Environmental Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (K.O.); (K.M.N.); (P.F.); (S.M.); (J.G.); (R.M.)
| | - John Bartlett
- Faculty of Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (J.B.); (J.B.)
| | - Jerry Bird
- Faculty of Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (J.B.); (J.B.)
| | - Suresh C. Pillai
- Nanotechnology and Bio-Engineering Research Group, Department of Environmental Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (K.O.); (K.M.N.); (P.F.); (S.M.); (J.G.); (R.M.)
- Faculty of Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (J.B.); (J.B.)
| |
Collapse
|
44
|
Luo LS, Jin YH, Cai L, Pan ZY, Zeng XT, Wang XH. COVID-19: Presumed Infection Routes and Psychological Impact on Staff in Administrative and Logistics Departments in a Designated Hospital in Wuhan, China. Front Psychol 2020; 11:1501. [PMID: 32595580 PMCID: PMC7303357 DOI: 10.3389/fpsyg.2020.01501] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/05/2020] [Indexed: 12/22/2022] Open
Abstract
Objective: Our aim was to explore the presumed infection routes and psychological impact of COVID-19 on staff in administrative and logistics departments (ALDs). Methods: We gathered data from all 18 staff members with COVID-19 in ALDs in Zhongnan Hospital of Wuhan University, China. The baseline, job before diagnosis, presumed infection environment, use of protective equipment, and psychological status before and after diagnosis were collected and analyzed. A total of 18 uninfected staff members working alongside them in the same environment and 18 random matched infected doctors and nurses formed two control groups; the psychological impact of these three groups was then compared. Results: Of the 18 members of staff, 88.89% were infected due to the working environment (hospital), and nine had face-to-face conversations with doctors and nurses in their daily work. Many staff members did not take any protective measures in their routine work. Before they were diagnosed, 12 staff members were aware of the seriousness of the epidemic, and most of the staff maintained a neutral attitude to the COVID-19 outbreak. A total of 77.78% of the staff experienced psychological stress or emotional changes after diagnosis, which were mainly caused by family health and disease related issues. Most of them managed their emotions by self-control and video calls with their families. There was no significant difference in psychological impact among the three groups, but uninfected staff members were fully aware of the seriousness of the epidemic. Conclusions: Effective protective measures should be taken for staff members in ALDs. Psychological interventions are very important to help infected staff members in ALDs cope with psychological distress.
Collapse
Affiliation(s)
- Li-Sha Luo
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, China
| | - Ying-Hui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, China
| | - Lin Cai
- Institute of Hospital Management, Wuhan University, Wuhan, China
| | - Zhen-Yu Pan
- Division of Medical Affairs, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, China
- Division of Personnel Services, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xing-Huan Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, China
- Institute of Hospital Management, Wuhan University, Wuhan, China
| |
Collapse
|
45
|
Bagnasco A, Zanini M, Hayter M, Catania G, Sasso L. COVID 19-A message from Italy to the global nursing community. J Adv Nurs 2020; 76:2212-2214. [PMID: 32352175 PMCID: PMC7267658 DOI: 10.1111/jan.14407] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genova, Italy
| | - Mark Hayter
- School of Health & Social Work, University of Hull, Hull, UK
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genova, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genova, Italy
| |
Collapse
|
46
|
Ashour HM, Elkhatib WF, Rahman MM, Elshabrawy HA. Insights into the Recent 2019 Novel Coronavirus (SARS-CoV-2) in Light of Past Human Coronavirus Outbreaks. Pathogens 2020; 9:E186. [PMID: 32143502 PMCID: PMC7157630 DOI: 10.3390/pathogens9030186] [Citation(s) in RCA: 337] [Impact Index Per Article: 84.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/23/2020] [Accepted: 03/02/2020] [Indexed: 12/15/2022] Open
Abstract
Coronaviruses (CoVs) are RNA viruses that have become a major public health concern since the Severe Acute Respiratory Syndrome-CoV (SARS-CoV) outbreak in 2002. The continuous evolution of coronaviruses was further highlighted with the emergence of the Middle East Respiratory Syndrome-CoV (MERS-CoV) outbreak in 2012. Currently, the world is concerned about the 2019 novel CoV (SARS-CoV-2) that was initially identified in the city of Wuhan, China in December 2019. Patients presented with severe viral pneumonia and respiratory illness. The number of cases has been mounting since then. As of late February 2020, tens of thousands of cases and several thousand deaths have been reported in China alone, in addition to thousands of cases in other countries. Although the fatality rate of SARS-CoV-2 is currently lower than SARS-CoV, the virus seems to be highly contagious based on the number of infected cases to date. In this review, we discuss structure, genome organization, entry of CoVs into target cells, and provide insights into past and present outbreaks. The future of human CoV outbreaks will not only depend on how the viruses will evolve, but will also depend on how we develop efficient prevention and treatment strategies to deal with this continuous threat.
Collapse
Affiliation(s)
- Hossam M. Ashour
- Department of Biological Sciences, College of Arts and Sciences, University of South Florida St. Petersburg, St. Petersburg, FL 33701, USA
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Walid F. Elkhatib
- Department of Microbiology and Immunology, School of Pharmacy & Pharmaceutical Industries, Badr University in Cairo (BUC), Entertainment Area, Badr City, Cairo 11829, Egypt;
- Microbiology and Immunology Department, Faculty of Pharmacy, Ain Shams University, African Union Organization St., Abbassia, Cairo 11566, Egypt
| | - Md. Masudur Rahman
- Department of Pathology, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet 3100, Bangladesh;
| | - Hatem A. Elshabrawy
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX 77304, USA
| |
Collapse
|