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Wild CEK, Wells H, Coetzee N, Grant CC, Sullivan TA, Derraik JGB, Anderson YC. End-user acceptability of personal protective equipment disinfection for potential reuse: a survey of health-care workers in Aotearoa New Zealand. Lancet Planet Health 2023; 7:e118-e127. [PMID: 36754468 PMCID: PMC9901938 DOI: 10.1016/s2542-5196(22)00333-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND The COVID-19 pandemic has highlighted personal protective equipment (PPE) supply, distribution, and disposal issues worldwide. Calls to conserve PPE stocks and increase supply resulted in the rapid development of potential disinfection methods, with the possibility of improvements in medical waste reduction. However, how receptive health-care workers are to PPE reuse remains unknown. We aimed to examine the views of health-care workers who used PPE during the first COVID-19 wave in Aotearoa New Zealand, in relation to acceptability of PPE disinfection and reuse. METHODS In this multi-methods survey, health-care workers in New Zealand, were invited via a multimodal recruitment strategy to complete a survey regarding use of PPE during the first COVID-19 wave. Gender question options were male, female, gender diverse, or prefer not to say. Demographic differences in self-reported PPE reuse and acceptability were examined. The survey included closed (single-response, multi-response, ranking, and Likert-scale questions) and open-text questions. Any open-text comments were analysed with thematic analysis. The survey was built and deployed using Qualtrics software. FINDINGS 1411 health-care workers completed the survey between Oct 7 and Nov 30, 2020. 1397 participants had gender data available (1140 [82%] female and 257 [18%] male) and 995 (74%) of 1347 were of New Zealand European ethnicity. PPE reuse was common and reported by 628 (45%) of the 1411 participants, with 396 (63%) of the 628 reporting reusing PPE multiple times in 1 day. Acceptability of the concept of PPE disinfection for potential reuse was high overall (1196 [85%] of 1411) but varied depending on the type of PPE. Thematic analysis confirmed that PPE reuse was already occurring and respondents recognised the potential benefits of reduced medical wastage and increased PPE supply. Important caveats for consideration included the availability of scientific evidence, level of negotiated risk, and trust in the organisation undertaking PPE disinfection, with clear communication about decontamination processes being crucial to acceptability. INTERPRETATION PPE reuse occurred frequently during the first wave of COVID-19 in New Zealand. Although support for the disinfection of PPE for reuse was high, the success of any future programmes to reuse PPE will require meaningful engagement and clear communication with health-care workers. Further research into PPE disinfection safety and logistics is warranted, alongside the development of standard operating procedures and clearly communicated policies for the end user, should this more sustainable health-care practice be planned for adoption in certain settings. FUNDING New Zealand Ministry of Business, Innovation and Employment (COVID-19 Innovation Acceleration Fund) and the Medical Assurance Society Foundation.
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Affiliation(s)
- Cervantée E K Wild
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hailey Wells
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Nicolene Coetzee
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; General Paediatrics, Starship Children's Hospital, Auckland, New Zealand
| | - Trudy A Sullivan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - José G B Derraik
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Yvonne C Anderson
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; enAble Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia; Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia; Community Health, Child and Adolescent Health Service, Perth, WA, Australia.
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Simmons SM, Page K, Davies JM, Malott RJ, Conly JM. Decontamination and reuse of personal protective masks and respirators in healthcare: Human-centered investigation and implementation considerations. HUMAN FACTORS IN HEALTHCARE 2021; 1:100003. [PMID: 35620552 PMCID: PMC8565094 DOI: 10.1016/j.hfh.2021.100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 12/04/2022]
Affiliation(s)
- Sarah M Simmons
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Ken Page
- Workplace Health and Safety Business Partnerships, Alberta Health Services, Calgary, Alberta, Canada
| | - Jan M Davies
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
- Department of Anesthesiology, Perioperative and Pain Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca J Malott
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - John M Conly
- W21C Research and Innovation Centre, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, Alberta, Canada
- Snyder Institute for Chronic Diseases, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
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3
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Standard hospital blanket warming cabinets can be utilized for complete moist heat SARS-CoV2 inactivation of contaminated N95 masks for re-use. Sci Rep 2021; 11:18316. [PMID: 34526550 PMCID: PMC8443586 DOI: 10.1038/s41598-021-97345-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/24/2021] [Indexed: 12/23/2022] Open
Abstract
Shortages of personal protective equipment for use during the SARS-CoV-2 pandemic continue to be an issue among health-care workers globally. Extended and repeated use of N95 filtering facepiece respirators without adequate decontamination is of particular concern. Although several methods to decontaminate and re-use these masks have been proposed, logistic or practical issues limit adoption of these techniques. In this study, we propose and validate the use of the application of moist heat (70 °C with humidity augmented by an open pan of water) applied by commonly available hospital (blanket) warming cabinets to decontaminate N95 masks. This report shows that a variety of N95 masks can be repeatedly decontaminated of SARS-CoV-2 over 6 h moist heat exposure without compromise of their filtering function as assessed by standard fit and sodium chloride aerosol filtration efficiency testing. This approached can easily adapted to provide point-of-care N95 mask decontamination allowing for increased practical utility of mask recycling in the health care setting.
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Grant K, Andruchow JE, Conly J, Lee DD, Mazurik L, Atkinson P, Lang E. Personal protective equipment preservation strategies in the covid-19 era: A narrative review. Infect Prev Pract 2021; 3:100146. [PMID: 34316585 PMCID: PMC8106532 DOI: 10.1016/j.infpip.2021.100146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/23/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to personal protective equipment (PPE) supply concerns on a global scale. While efforts to increase production are underway in many jurisdictions, demand may yet outstrip supply leading to PPE shortages, particularly in low resource settings. PPE is critically important for the safety of healthcare workers (HCW) and patients and to reduce viral transmission within healthcare facilities. A structured narrative review was completed to identify methods for extending the use of available PPE as well as decontamination and reuse. METHODS Database searches were conducted in MEDLINE and EMBASE for any available original research or review articles detailing guidelines for the safe extended use of PPE, and/or PPE decontamination and reuse protocols prior to September 28, 2020. Grey literature in addition to key websites from the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), Infection Prevention Association of Canada (IPAC), and the National Health Service (NHS) was also reviewed. RESULTS Extended use guidelines support co-locating patients with confirmed COVID-19 within specific areas of healthcare facilities to enable the use of PPE between multiple patients, and reduce PPE requirements outside these areas. Decontamination strategies for N95 respirators and face shields range from individual HCWs using conventional ovens and microwave steam bags at home, to large-scale centralized decontamination using autoclave machines, ultraviolet germicidal irradiation, hydrogen peroxide vapors, or peracetic acid dry fogging systems. Specific protocols for such strategies have been recommended by the US CDC and WHO and are being implemented by multiple institutions across North America. Further studies are underway testing decontamination strategies that have been reported to be effective at inactivating coronavirus and influenza, and on SARs-CoV-2 specifically. CONCLUSIONS This narrative review summarizes current extended use guidelines and decontamination protocols specific to COVID-19. Preserving PPE through the implementation of such strategies could help to mitigate shortages in PPE supply, and enable healthcare facilities in low resource settings to continue to operate safely for the remainder of the COVID-19 pandemic.
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Affiliation(s)
- Kiran Grant
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - James E. Andruchow
- Departments of Emergency Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - John Conly
- Department of Medicine, Cumming School of Medicine, Snyder Institute for Chronic Diseases and O'Brien Institute for Public Health, University of Calgary and Alberta Health Services, Calgary, AB, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Laurie Mazurik
- University of Toronto, Faculty of Medicine, Department of Medicine, Division of Emergency Medicine, Toronto, ON, Canada
| | - Paul Atkinson
- Dalhousie University, Faculty of Medicine, Department of Emergency Medicine, Saint John, NB, Canada
| | - Eddy Lang
- Departments of Emergency Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Ko PS, Lee JY. Analysis of Taiwan's Mask Collection and Plan Evasion during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4137. [PMID: 33919812 PMCID: PMC8070768 DOI: 10.3390/ijerph18084137] [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] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 01/20/2023]
Abstract
This study established a two-stage dynamic game strategy to analyze how the planned quota and price of masks were set and why mask manufacturing firms on the national mask team (NMT) in Taiwan evaded the plan. Plan evasion occurred when the NMT decided to produce less than the quota set by the government, even though they were incentivized and able to produce more. Taiwan's experience shows that through the collection of masks and the Name-Based Mask Rationing System, the people's right to procure masks can be guaranteed; however, to promote market transaction efficiency, the government should adopt a lower quota for the collection of masks and allow firms to freely sell them in the market after they complete their plans. The self-interest of the government played a key role in inducing plan evasion.
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Affiliation(s)
- Po-Sheng Ko
- Department of Public Finance and Taxation, National Kaohsiung University of Science and Technology, Kaohsiung 80778, Taiwan;
| | - Jen-Yao Lee
- Department of International Business, National Kaohsiung University of Science and Technology, Kaohsiung 80778, Taiwan
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Bentancor M, Fernández S, Viera F, Etcheverry S, Poradosú C, D'Angelo P, Montemuiño H, Mirazo S, Irigoyen Á, Sanabria A, Failache H. LUCIA: An open source device for disinfection of N95 masks using UV-C radiation. HARDWAREX 2021; 9:e00181. [PMID: 33655088 PMCID: PMC7906873 DOI: 10.1016/j.ohx.2021.e00181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/02/2021] [Accepted: 02/21/2021] [Indexed: 05/16/2023]
Abstract
Faced with a global pandemic such as the one triggered by the SARS-CoV-2 virus, the medical supply chain has been highly demanded. An item in which this manifested itself more clearly, are the N95 masks, designed to be disposable items, in many cases they have had to be reused. In these emergency conditions, it was necessary to apply an effective and safe method that can be used locally. Here a device for disinfection by ultraviolet C light was developed that allows irradiating N95 masks with a known and reproducible dose. Thus being able to apply a safe and effective disinfection method according to existing information. The use of a common model of UV-C lamps and the simple construction of the device allows it to be built at low cost and with widely available materials. The effectiveness of the device was demonstrated against an enveloped RNA virus, characteristics shared with the virus that causes COVID19, being capable of reducing the viral load by 4 orders of magnitude.
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Affiliation(s)
- Marcel Bentancor
- Laboratorio de Biología Molecular Vegetal, Instituto de Química Biológica e Instituto de Biología, Facultad de Ciencias, Universidad de la República, Iguá 4225, 11400 Montevideo, Uruguay
- Corresponding authors.
| | - Sebastián Fernández
- Instituto de Ingeniería Eléctrica, Facultad de Ingeniería, Universidad de la República, J. Herrera y Reissig 565, 11300 Montevideo, Uruguay
| | - Federico Viera
- Escuela Universitaria Centro de Diseño, Facultad de Arquitectura, Diseño y Urbanismo, Universidad de la República, Juan D. Jackson 1325, 11200 Montevideo, Uruguay
| | - Sarita Etcheverry
- Escuela Universitaria Centro de Diseño, Facultad de Arquitectura, Diseño y Urbanismo, Universidad de la República, Juan D. Jackson 1325, 11200 Montevideo, Uruguay
| | - Carolina Poradosú
- Escuela Universitaria Centro de Diseño, Facultad de Arquitectura, Diseño y Urbanismo, Universidad de la República, Juan D. Jackson 1325, 11200 Montevideo, Uruguay
| | - Pablo D'Angelo
- Escuela Universitaria Centro de Diseño, Facultad de Arquitectura, Diseño y Urbanismo, Universidad de la República, Juan D. Jackson 1325, 11200 Montevideo, Uruguay
| | - Hernán Montemuiño
- Escuela Universitaria Centro de Diseño, Facultad de Arquitectura, Diseño y Urbanismo, Universidad de la República, Juan D. Jackson 1325, 11200 Montevideo, Uruguay
| | - Santiago Mirazo
- Sección Virología, Instituto de Química Biológica, Facultad de Ciencias, Universidad de la República, Iguá 4225, 11400 Montevideo, Uruguay
| | | | - Analía Sanabria
- División Laboratorio Ambiental, Dirección Nacional de Medio Ambiente, Ministerio de Ambiente Av., Italia 6201, 11400 Montevideo, Uruguay
| | - Horacio Failache
- Instituto de Física, Facultad de Ingeniería, Universidad de la República, J. Herrera y Reissig 565, 11300 Montevideo, Uruguay
- Corresponding authors.
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Kirubarajan A, Khan S, Got T, Yau M, Bryan JM, Friedman SM. Mask shortage during epidemics and pandemics: a scoping review of interventions to overcome limited supply. BMJ Open 2020; 10:e040547. [PMID: 33247019 PMCID: PMC7703444 DOI: 10.1136/bmjopen-2020-040547] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/13/2020] [Accepted: 11/02/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To characterise published evidence regarding preclinical and clinical interventions to overcome mask shortages during epidemics and pandemics. DESIGN Systematic scoping review. SETTINGS All healthcare settings relevant to epidemics and pandemics. SEARCH STRATEGY English peer-reviewed studies published from January 1995 to June 2020 were included. Literature was identified using four databases (Medline-OVID, EMBASE, CINAHL, Cochrane Library), forwards-and-backwards searching through Scopus and an extensive grey literature search. Assessment of study eligibility, data extraction and evidence appraisal were performed in duplicate by two independent reviewers. RESULTS Of the 11 220 database citations, a total of 47 articles were included. These studies encompassed six broad categories of conservation strategies: decontamination, reusability of disposable masks and/or extended wear, layering, reusable respirators, non-traditional replacements or modifications and stockpiled masks. Promising strategies for mask conservation in the context of pandemics and epidemics include use of stockpiled masks, extended wear of disposable masks and decontamination. CONCLUSION There are promising strategies for overcoming face mask shortages during epidemics and pandemics. Further research specific to practical considerations is required before implementation during the COVID-19 pandemic.
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Affiliation(s)
- Abirami Kirubarajan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Shawn Khan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tiffany Got
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Matthew Yau
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer M Bryan
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Emergency Medicine, University Health Network, Toronto, Ontario, Canada
| | - Steven Marc Friedman
- Department of Emergency Medicine, University Health Network, Toronto, Ontario, Canada
- Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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Bergman M, Fisher EM, Heimbuch BK. A Review of Decontamination Methods for Filtering Facepiece Respirators. JOURNAL OF THE INTERNATIONAL SOCIETY FOR RESPIRATORY PROTECTION 2020; 37:71-86. [PMID: 33268915 PMCID: PMC7707143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
During the current COVID-19 infectious disease pandemic, the demand for NIOSH-approved filtering facepiece respirators (FFR) has exceeded supplies and decontamination and reuse of FFRs has been implemented by various user groups. FFR decontamination and reuse is only intended to be implemented as a crisis capacity strategy. This paper provides a review of decontamination procedures in the published literature and calls attention to their benefits and limitations. In most cases, the data are limited to a few FFR models and a limited number of decontamination cycles. Institutions planning to implement a decontamination method must understand its limitations in terms of the degree of inactivation of the intended microorganisms and the treatment's effects on the fit and filtration of the device.
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Affiliation(s)
- Mike Bergman
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, 626 Cochrans Mill Road, Pittsburgh, PA 15236
| | - Edward M. Fisher
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, 626 Cochrans Mill Road, Pittsburgh, PA 15236
| | - Brian K. Heimbuch
- Applied Research Associates, 430 W 5th St, Suite 700, Panama City, FL 32401
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Yang H, Hu J, Li P, Zhang C. Ultraviolet germicidal irradiation for filtering facepiece respirators disinfection to facilitate reuse during COVID-19 pandemic: A review. Photodiagnosis Photodyn Ther 2020; 31:101943. [PMID: 32763473 PMCID: PMC7402378 DOI: 10.1016/j.pdpdt.2020.101943] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 01/14/2023]
Abstract
UVGI is one possible method for respiratory disinfection to facilitate the reuse of dwindling supplies. Appropriate dose UVGI exposition could provide enough energy to effectively decontaminate respiratory viral agent and maintenance respirator's integrity for reuse. Further evidence concerning UVGI as a decontamination technique for SARS-COV-2 is needed.
Background To review the effect of ultraviolet germicidal irradiation (UVGI) as a disinfection method for filtering facepiece respirators (FFRs) to facilitate reuse during COVID-19 pandemic. Methods Systematic review of the research concerning UVGI for FFRs disinfection to facilitate reuse (also termed limited reuse) during respiratory infectious diseases where aerosol transmission is considered possible. Results UVGI is one possible method for respiratory disinfection to facilitate the reuse of dwindling supplies. Appropriate dose UVGI exposition could provide enough energy to effectively decontaminate respiratory viral agents and maintain respirator's integrity for reuse. There was not currently sufficient research evidence on the effect of UVGI to inactivate coronaviruses SARS-CoV-2, and the practical application of UVGI is still unclear. . Conclusion Appropriate dose UVGI exposition could provide enough energy to effectively decontaminate respiratory viral agents and maintain respirator's integrity for reuse. Further evidence concerning UVGI as a decontamination technique specifically for SARS-CoV-2 isneeded.
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Affiliation(s)
- Hua Yang
- Department of Thoracic Internal Medicine, Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Jiajia Hu
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
| | - Ping Li
- Department of Obstetrics, Xiangya Hospital, Central South University Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, Changsha,China
| | - Chengliang Zhang
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha, China.
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Polkinghorne A, Branley J. Evidence for decontamination of single-use filtering facepiece respirators. J Hosp Infect 2020; 105:663-669. [PMID: 32473179 PMCID: PMC7251398 DOI: 10.1016/j.jhin.2020.05.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022]
Abstract
Single-use filtering face respirators (FFRs) are critical pieces of personal protective equipment for healthcare workers treating patients with suspected upper respiratory tract pathogens. Experiences during pandemics in the 2000s, as well as the ongoing COVID-19 pandemic caused by the SARS-2-CoV-2, have highlighted concerns over the pressures that sustained respiratory virus pandemics may have on supplies of FFRs globally. Decontamination of FFRs has been posited as one solution to support the re-use of FFRs with a growing body of literature over the last 10+ years beginning to examine both the efficacy of disinfection of contaminated FFRs but also the impact of the decontamination process on the FFR's performance. Physical and chemical methods of decontamination have been tested for treatment of FFRs with ultraviolet germicidal irradiation, sterilization by steam, ethylene oxide and vaporous hydrogen peroxide, demonstrating the most promising results thus far. Many of these methods utilize existing equipment that may already be available in hospitals and could be re-purposed for FFR decontamination. Importantly, some methods may also be replicated on household equipment, broadening the utility of FFR decontamination across a range of healthcare settings. Utilizing techniques to experimentally contaminate FFRs with a range of microorganisms, most decontamination methods appear to reduce the risk of the mask as a source of infection to the wearer and others to negligible levels. The performance of the filter, especially the efficiency of particle penetration following treatment, varied greatly depending on the processing method as well as the model of the filter itself, however. Urgent regulatory body-supported research is required to endorse the routine decontamination of FFRs. In emergency settings, these methods should nevertheless be carefully considered as one strategy to address potential shortfalls in supplies of FFRs for healthcare workers.
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Affiliation(s)
- A Polkinghorne
- Department of Microbiology and Infectious Diseases, New South Wales Health Pathology, Nepean Blue Mountains Pathology Service, PO Box 63, Penrith, New South Wales, 2751, Australia; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, 62 Derby St, Kingswood, New South Wales, 2747, Australia
| | - J Branley
- Department of Microbiology and Infectious Diseases, New South Wales Health Pathology, Nepean Blue Mountains Pathology Service, PO Box 63, Penrith, New South Wales, 2751, Australia; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, 62 Derby St, Kingswood, New South Wales, 2747, Australia.
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