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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.
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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
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Bray C, Vanberkel PT. A framework for comparing N95 and elastomeric facepiece respirators on cost and function for healthcare use during a pandemic- A literature review. Health Policy 2023; 134:104857. [PMID: 37336164 DOI: 10.1016/j.healthpol.2023.104857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 05/16/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
SARS-CoV-2 has posed implications for personal protective equipment supply. In this literature review we examine if elastomeric facepiece respirators (EFRs) are effective substitutes for N95 respirators through comparing their functionality and cost. We reviewed 30 articles which researched the advantages and disadvantages of each respirator. We compiled the reported results and found, among other things, that users favour N95 respirators for comfort but prefer EFRs for protection. EFRs are more cost effective when N95s are used as designed (single use) but mixed strategies minimize costs when N95s are reused (as practiced during shortages). Future research is needed on multicriteria analyses and to incorporate SARS-CoV-2 specific data to support future pandemic planning.
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Affiliation(s)
- Ceilidh Bray
- Dalhousie University, Industrial Engineering, PO BOX 15000, Halifax, NS B3H 4R2, Canada
| | - Peter T Vanberkel
- Dalhousie University, Industrial Engineering, PO BOX 15000, Halifax, NS B3H 4R2, Canada.
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3
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Weng CH, Kao CL, Chiu PW, Huang SP, Kuo YS, Lin YY, Lin IC, Chang HC, Lu CH, Lin CH. A full-face mask for protection against respiratory infections. Biomed Eng Online 2022; 21:62. [PMID: 36064546 PMCID: PMC9442593 DOI: 10.1186/s12938-022-01027-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aerosols and droplets are the transmission routes of many respiratory infectious diseases. The COVID-19 management guidance recommends against the use of nebulized inhalation therapy directly in the emergency room or in an ambulance to prevent possible viral transmission. The three-dimensional printing method was used to develop an aerosol inhalation treatment mask that can potentially prevent aerosol dispersion. We conducted this utility validation study to understand the practicability of this new nebulizer mask system. RESULTS The fit test confirmed that the filter can efficiently remove small particles. The different locations of the mask had an excellent fit with a high pressure making a proper face seal usability. The full-face mask appeared to optimize filtration with pressure and is an example of materials that perform well for improvised respiratory protection using this design. The filtering effect test confirmed that the contamination of designated locations could be protected when using the mask with filters. As in the clinical safety test, a total of 18 participants (10 [55.6%] females; aged 33.1 ± 0.6 years) were included in the final analysis. There were no significant changes in SPO2, EtCO2, HR, SBP, DBP, and RR at the beginning, 20th, 40th, or 60th minutes of the test (all p >.05). The discomfort of wearing a mask increased slightly after time but remained within the tolerable range. The vision clarity score did not significantly change during the test. The mask also passed the breathability test. CONCLUSION The results of our study showed that this mask performed adequately in the fit test, the filtering test, and the clinical safety test. The application of a full-face mask with antiviral properties, together with the newly designed shape of a respirator that respects the natural curves of a human face, will facilitate the production of personal protective equipment with a highly efficient filtration system. METHODS We conducted three independent tests in this validation study: (1) a fit test to calculate the particle number concentration and its association with potential leakage; (2) a filtering effect test to verify the mask's ability to contain aerosol spread; and (3) a clinical safety test to examine the clinical safety, comfortableness, and visual clarity of the mask.
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Affiliation(s)
- Chen-Hsun Weng
- Medical Device Innovation Center, National Cheng Kung University, No. 138, Shengli Rd., North District, Tainan, 70403, Taiwan
| | - Chia-Lung Kao
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Wei Chiu
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shao-Peng Huang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shin Kuo
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Yuan Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I-Chen Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Chieh Chang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Hsin Lu
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hao Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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4
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Petrone P, Birocchi E, Miani C, Anzivino R, Sciancalepore PI, Di Mauro A, Dalena P, Russo C, De Ceglie V, Masciavè M, Fiorella ML. Diagnostic and surgical innovations in otolaryngology for adult and paediatric patients during the COVID-19 era. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:S46-S57. [PMID: 35763274 PMCID: PMC9137384 DOI: 10.14639/0392-100x-suppl.1-42-2022-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/17/2022] [Indexed: 01/25/2023]
Abstract
During the Coronavirus Disease 2019 (COVID-19) pandemic, otolaryngology has been shown to be a high-risk specialty due to the exposure to aerosol-generating physical examinations, procedures and surgical interventions on the head and neck area, both in adult and paediatric patients. This has prompted the issue of updating the guidelines by International Health Authorities in the Ear Nose and Throat (ENT) field and, at the same time, has stimulated engineers and healthcare professionals to develop new devices and technologies with the aim of reducing the risk of contamination for physicians, nurses and patients. Methods A review of the literature published on PubMed, Ovid/Medline and Scopus databases was performed from January 01, 2020 to December 31, 2021. Results 73 articles were eligible to be included, which were subdivided into 4 categories: ("Artificial Intelligence (AI)"; "Personal Protective Equipment (PPE)"; "Diagnostic tools"; "Surgical tools"). Conclusions All of the innovations that have been developed during the COVID-19 pandemic have laid the foundation for a radical technological change of society, not only in medicine but also from a social, political and economical points of view that will leave its mark in the coming decades.
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Affiliation(s)
| | | | - Cesare Miani
- Department of Otorhinolaryngology, Hospital of Tolmezzo, ASUFC Udine, Udine, Italy
| | - Roberta Anzivino
- Department of Otorhinolaryngology, Di Venere Hospital, ASL BA, Bari, Italy
| | | | - Antonio Di Mauro
- National Pediatric Health Care System, Margherita di Savoia, Italy
| | - Paolo Dalena
- Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany
| | - Cosimo Russo
- Department of Otorhinolaryngology, Di Venere Hospital, ASL BA, Bari, Italy
| | | | - Maurizio Masciavè
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Eassa HA, Helal NA, Amer AM, Fouad A, Bedair AF, Nagib R, Mansoor I, Hawash M, Abdul-Latif M, Mohammed KHA, Helal MA, Nounou MI. 3D-Printed Microfluidics Potential in Combating Future and Current Pandemics (COVID-19). RECENT ADVANCES IN DRUG DELIVERY AND FORMULATION 2022; 16:192-216. [PMID: 35894464 DOI: 10.2174/2667387816666220727101214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
Coronavirus disease (COVID-19) emerged in China in December 2019. In March 2020, the WHO declared it a pandemic leading to worldwide lockdowns and travel restrictions. By May, it infected 4,789,205 and killed 318,789 people. This led to severe shortages in the medical sector besides devastating socio-economic effects. Many technologies such as artificial intelligence (AI), virtual reality (VR), microfluidics, 3D printing, and 3D scanning can step into contain the virus and hinder its extensive spread. This article aims to explore the potentials of 3D printing and microfluidic in accelerating the diagnosis and monitoring of the disease and fulfilling the shortages of personal protective equipment (PPE) and medical equipment. It highlights the main applications of 3D printers and microfluidics in providing PPE (masks, respirators, face shields, goggles, and isolation chambers/hoods), supportive care (respiratory equipment) and diagnostic supplies (sampling swabs & lab-on-chip) to ease the COVID-19 pressures. Also, the cost of such technology and regulation considerations are addressed. We conclude that 3D printing provided reusable and low-cost solutions to mitigate the shortages. However, safety, sterility, and compatibility with environmental protection standards need to be guaranteed through standardization and assessment by regulatory bodies. Finally, lessons learned from this pandemic can also help the world prepare for upcoming outbreaks.
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Affiliation(s)
- Heba A Eassa
- Department of Pharmaceutical Sciences, School of Pharmacy & Physician Assistant Studies, University of Saint Joseph, Hartford, CT 06103, USA
| | - Nada A Helal
- Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, TX, 78363, USA
| | - Ahmed M Amer
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Aliaa Fouad
- Division of Pathological Sciences, Department of Pharmacology and Experimental Therapeutics, Kyoto Pharmaceutical University, Kyoto, Japan
| | - Asser F Bedair
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | | | | | - Motaz Hawash
- Dept of Food Science and Agri-Food Supply Chains, Harper Adams University, Newport, UK
| | | | - Kamilia H A Mohammed
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy (Girls), Al- Azhar University, Cairo, Egypt
| | - Mohamed A Helal
- Construction Planning Department, National Marine Dredging Company (NMDC), Abu Dhabi 11372, United Arab Emirates
| | - Mohamed Ismail Nounou
- Department of Pharmaceutical Sciences, School of Pharmacy & Physician Assistant Studies, University of Saint Joseph, Hartford, CT 06103, USA
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6
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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.
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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.)
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7
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Ballard DH, Dang AJ, Kumfer BM, Weisensee PB, Meacham JM, Scott AR, Ruppert-Stroescu M, Burke BA, Morris J, Gan C, Hu J, King B, Jammalamadaka U, Sayood S, Liang S, Choudhary S, Dhanraj D, Maranhao B, Millar C, Bertroche JT, Shomer N, Woodard PK, Biswas P, Axelbaum R, Genin G, Williams BJ, Meacham K. Protection levels of N95-level respirator substitutes proposed during the COVID-19 pandemic: safety concerns and quantitative evaluation procedures. BMJ Open 2021; 11:e045557. [PMID: 34475144 PMCID: PMC8413478 DOI: 10.1136/bmjopen-2020-045557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 08/03/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has precipitated widespread shortages of filtering facepiece respirators (FFRs) and the creation and sharing of proposed substitutes (novel designs, repurposed materials) with limited testing against regulatory standards. We aimed to categorically test the efficacy and fit of potential N95 respirator substitutes using protocols that can be replicated in university laboratories. SETTING Academic medical centre with occupational health-supervised fit testing along with laboratory studies. PARTICIPANTS Seven adult volunteers who passed quantitative fit testing for small-sized (n=2) and regular-sized (n=5) commercial N95 respirators. METHODS Five open-source potential N95 respirator substitutes were evaluated and compared with commercial National Institute for Occupational Safety and Health (NIOSH)-approved N95 respirators as controls. Fit testing using the 7-minute standardised Occupational Safety and Health Administration fit test was performed. In addition, protocols that can be performed in university laboratories for materials testing (filtration efficiency, air resistance and fluid resistance) were developed to evaluate alternate filtration materials. RESULTS Among five open-source, improvised substitutes evaluated in this study, only one (which included a commercial elastomeric mask and commercial HEPA filter) passed a standard quantitative fit test. The four alternative materials evaluated for filtration efficiency (67%-89%) failed to meet the 95% threshold at a face velocity (7.6 cm/s) equivalent to that of a NIOSH particle filtration test for the control N95 FFR. In addition, for all but one material, the small surface area of two 3D-printed substitutes resulted in air resistance that was above the maximum in the NIOSH standard. CONCLUSIONS Testing protocols such as those described here are essential to evaluate proposed improvised respiratory protection substitutes, and our testing platform could be replicated by teams with similar cross-disciplinary research capacity. Healthcare professionals should be cautious of claims associated with improvised respirators when suggested as FFR substitutes.
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Affiliation(s)
- David H Ballard
- School of Medicine Mallinckrodt Institute of Radiology, Washington University, Saint Louis, Missouri, USA
| | - Audrey J Dang
- Department of Energy, Environmental and Chemical Engineering, Washington University in St Louis, St Louis, Missouri, USA
| | - Benjamin M Kumfer
- Department of Energy, Environmental and Chemical Engineering, Washington University in St Louis, St Louis, Missouri, USA
| | - Patricia B Weisensee
- Department of Mechanical Engineering & Materials Science, Washington University in St Louis, St Louis, Missouri, USA
| | - J Mark Meacham
- Department of Mechanical Engineering & Materials Science, Washington University in St Louis, St Louis, Missouri, USA
| | - Alex R Scott
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Mary Ruppert-Stroescu
- Sam Fox School of Design and Visual Arts, Washington University in St Louis, St Louis, Missouri, USA
| | - Broc A Burke
- Department of Anesthesiology, Washington University in St Louis, St Louis, Missouri, USA
| | - Jason Morris
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Connie Gan
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Jesse Hu
- School of Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Bradley King
- Department of Environmental Health & Safety, Washington University in St Louis, St Louis, Missouri, USA
| | - Udayabhanu Jammalamadaka
- School of Medicine Mallinckrodt Institute of Radiology, Washington University, Saint Louis, Missouri, USA
| | - Sena Sayood
- Division of Infectious Diseases, Washington University in St Louis, St Louis, Missouri, USA
| | - Stephen Liang
- Division of Infectious Diseases, Washington University in St Louis, St Louis, Missouri, USA
| | - Shruti Choudhary
- Department of Energy, Environmental and Chemical Engineering, Washington University in St Louis, St Louis, Missouri, USA
| | - David Dhanraj
- Department of Energy, Environmental and Chemical Engineering, Washington University in St Louis, St Louis, Missouri, USA
| | - Bruno Maranhao
- Department of Anesthesiology, Washington University in St Louis, St Louis, Missouri, USA
| | - Christine Millar
- Department of Anesthesiology, Memorial Hospital Belleville, St Louis, Missouri, USA
| | - J Tyler Bertroche
- Department of Otolaryngology-Head & Neck Surgery, Washington University in St Louis, St Louis, Missouri, USA
| | - Nirah Shomer
- Division of Comparative Medicine, Washington University in St Louis, St Louis, Missouri, USA
| | - Pamela K Woodard
- School of Medicine Mallinckrodt Institute of Radiology, Washington University, Saint Louis, Missouri, USA
| | - Pratim Biswas
- Department of Energy, Environmental and Chemical Engineering, Washington University in St Louis, St Louis, Missouri, USA
| | - Richard Axelbaum
- Department of Energy, Environmental and Chemical Engineering, Washington University in St Louis, St Louis, Missouri, USA
| | - Guy Genin
- Department of Mechanical Engineering & Materials Science, Washington University in St Louis, St Louis, Missouri, USA
- NSF Science and Technology Center for Engineering Mechanobiology, Washington University in St. Louis, St Louis, Missouri, USA
- Bioinspired Engineering and Biomechanics Center, School of Life Sciences and Technology, Xi'an Jiaotong University, China, Xi'an, China
| | - Brent J Williams
- Department of Energy, Environmental and Chemical Engineering, Washington University in St Louis, St Louis, Missouri, USA
| | - Kathleen Meacham
- Department of Anesthesiology, Washington University in St Louis, St Louis, Missouri, USA
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8
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Protection, disinfection, and immunization for healthcare during the COVID-19 pandemic: Role of natural and synthetic macromolecules. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 776. [PMCID: PMC7895681 DOI: 10.1016/j.scitotenv.2021.145989] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The world is trying to improve public health while the outbreak of the COVID-19 is at its worst. So far, countless people have died from the COVID-19 disease and it is still a serious threat to human health. Synthetic and natural polymers are unavoidable materials in the healthcare sector. During the COVID-19 outbreak, diverse medical equipment and devices were designed and developed by using these macromolecules for the protection, disinfection, and immunization applications. Synthetic polymers such as polypropylene, polystyrene, poly(lactic acid), poly(ethylene terephthalate), and so forth have been successfully applied for the design and fabrication of diverse face masks, shields, anti-viral coatings, as well as diagnostic kits. Natural polymers having great features such as biodegradability and environmentally friendly are made from algae, plants, and animals. These polymers including sodium alginate, chitosan, cellulose, and gums have been shown a critical role in the fabrication of personal protective equipment, immunosensors, and anti-viral spray for control and fight against COVID-19. Besides, the problem of plastic waste can be solved by replacing them with natural polymers. This mini-review aims to show the application of polymer-based materials during the COVID-19 epidemic.
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9
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Luchini K, Sloan SNB, Mauro R, Sargsyan A, Newman A, Persaud P, Hawkins D, Wolff D, Staudinger J, Creamer BA. Sterilization and sanitizing of 3D-printed personal protective equipment using polypropylene and a Single Wall design. 3D Print Med 2021; 7:16. [PMID: 34115246 PMCID: PMC8193021 DOI: 10.1186/s41205-021-00106-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/30/2021] [Indexed: 12/29/2022] Open
Abstract
Background The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic during the fall of 2019 and into the spring of 2020 has led to an increased demand of disposable N95 respirators and other types of personal protective equipment (PPE) as a way to prevent virus spread and help ensure the safety of healthcare workers. The sudden demand led to rapid modification, development, and dissemination of 3D printed PPE. The goal of this study was to determine the inherent sterility and re-sterilizing ability of 3D printed PPE in order to provide sterile equipment to the healthcare field and the general public. Methods Samples of polylactic acid (PLA), thermoplastic polyurethane (TPU) (infill-based designs) and polypropylene (single-wall hollow design) were 3D printed. Samples were inoculated with E. coli for 24 h and then sanitized using various chemical solutions or heat-based methods. The samples were then incubated for 24- or 72-h in sterile LB medium at 37°C, and bacterial growth was measured by optical density at 600nm. Statistical analysis was conducted using GraphPad Prism v8.2.1. Results Significant bacterial growth was observed in all PLA and TPU based samples following re-sterilization, regardless of the methods used when compared to controls (p < 0.05). The single-walled hollow polypropylene design was not only sterile following printing, but was also able to undergo re-sanitization following bacterial inoculation, with no significant bacterial growth (p > 0.05) observed regardless of sanitization method used. Conclusion The cost effectiveness, ease of sanitization, and reusability of 3D printed PPE, using our novel single-walled polypropylene design can help meet increased demands of PPE for healthcare workers and the general public that are needed to help decrease the viral transmission of the coronavirus disease of 2019 (COVID-19) pandemic. 3D printing also has the potential to lead to the creation and production of other sterile material items for the healthcare industry in the future. The ability to re-sterilize 3D printed PPE, as our design shows, would also contribute less to the increase in biomedical waste (BMW) being experienced by COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s41205-021-00106-8.
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Affiliation(s)
- Karstan Luchini
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | - Shelly N B Sloan
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA.,Department of Biology and Environmental Health, Missouri Southern State University, Joplin, MO, USA
| | - Ryan Mauro
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | - Aspram Sargsyan
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | - Aundrea Newman
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | - Purnadeo Persaud
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | | | - Dennis Wolff
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA.,Department of Biology and Environmental Health, Missouri Southern State University, Joplin, MO, USA
| | - Jeff Staudinger
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA.,Department of Biology and Environmental Health, Missouri Southern State University, Joplin, MO, USA
| | - Bradley A Creamer
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA. .,Department of Biology and Environmental Health, Missouri Southern State University, Joplin, MO, USA.
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10
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Vakharia VN, Khan S, Marathe K, Giannis T, Webber L, Choi D. Printing in a Pandemic: 3D printing solutions for healthcare during COVID-19. A Protocol for a PRISMA systematic review. ANNALS OF 3D PRINTED MEDICINE 2021; 2:100015. [PMID: 38620763 PMCID: PMC8106194 DOI: 10.1016/j.stlm.2021.100015] [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: 04/10/2021] [Accepted: 05/03/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction The COVID-19 pandemic had an unprecedented global socioeconomic impact. Responses to pandemics include strategies to accumulate vast stockpiles of vital medical equipment. In such times of desperation, 3D-printing could be a life-saving alternative. Methods We undertook a PRISMA systematic review of 3D printing solutions in response to COVID-19 utilising the PICO methodology. The objectives were to identify the uses of 3D printing during the COVID-19 pandemic, determine the extent of preclinical testing, comparison to commercial alternatives, presence of regulatory approvals and replicability regarding the description of the printing parameters and the availability of the print file. Results Literature searches of MEDLINE (OVID interface)/ PubMed identified 601 studies. Of these, 10 studies fulfilled the inclusion and exclusion criteria. Reported uses of 3D printing included personal protective equipment (PPE), nasopharyngeal swabs and adjunctive anaesthetic equipment. Few studies undertook formal safety and efficacy testing before clinical use with only one study comparing to the commercial equivalent. Six articles made their model print files available for wider use. Conclusion We describe a protocol for a systematic review of 3D-printed healthcare solutions in response to COVID-19. This remains a viable method of producing vital healthcare equipment when supply chains are exhausted. We hope that this will serve as a summary of innovative 3D-printed solutions during the peak of the pandemic and also highlight concerns and omissions regarding safety and efficacy testing that should be addressed urgently in preparation for a subsequent resurgences and future pandemics.
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Affiliation(s)
- Vejay N Vakharia
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London, WC1N 3BG, United Kingdom
| | - Sehrish Khan
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London, WC1N 3BG, United Kingdom
| | - Kajol Marathe
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London, WC1N 3BG, United Kingdom
| | - Theofanis Giannis
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London, WC1N 3BG, United Kingdom
| | - Louise Webber
- Department of Critical Care, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London, WC1N 3BG, United Kingdom
| | - David Choi
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London, WC1N 3BG, United Kingdom
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11
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Welch JL, Xiang J, Mackin SR, Perlman S, Thorne P, O’Shaughnessy P, Strzelecki B, Aubin P, Ortiz-Hernandez M, Stapleton JT. Inactivation of Severe Acute Respiratory Coronavirus Virus 2 (SARS-CoV-2) and Diverse RNA and DNA Viruses on Three-Dimensionally Printed Surgical Mask Materials. Infect Control Hosp Epidemiol 2021; 42:253-260. [PMID: 32783787 PMCID: PMC7463154 DOI: 10.1017/ice.2020.417] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/04/2020] [Accepted: 08/08/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Personal protective equipment (PPE) is a critical need during the coronavirus disease 2019 (COVID-19) pandemic. Alternative sources of surgical masks, including 3-dimensionally (3D) printed approaches that may be reused, are urgently needed to prevent PPE shortages. Few data exist identifying decontamination strategies to inactivate viral pathogens and retain 3D-printing material integrity. OBJECTIVE To test viral disinfection methods on 3D-printing materials. METHODS The viricidal activity of common disinfectants (10% bleach, quaternary ammonium sanitizer, 3% hydrogen peroxide, or 70% isopropanol and exposure to heat (50°C, and 70°C) were tested on four 3D-printed materials used in the healthcare setting, including a surgical mask design developed by the Veterans' Health Administration. Inactivation was assessed for several clinically relevant RNA and DNA pathogenic viruses, including severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and human immunodeficiency virus 1 (HIV-1). RESULTS SARS-CoV-2 and all viruses tested were completely inactivated by a single application of bleach, ammonium quaternary compounds, or hydrogen peroxide. Similarly, exposure to dry heat (70°C) for 30 minutes completely inactivated all viruses tested. In contrast, 70% isopropanol reduced viral titers significantly less well following a single application. Inactivation did not interfere with material integrity of the 3D-printed materials. CONCLUSIONS Several standard decontamination approaches effectively disinfected 3D-printed materials. These approaches were effective in the inactivation SARS-CoV-2, its surrogates, and other clinically relevant viral pathogens. The decontamination of 3D-printed surgical mask materials may be useful during crisis situations in which surgical mask supplies are limited.
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Affiliation(s)
- Jennifer L. Welch
- Medical Service, Iowa City Veterans’ Affairs Medical Center, Iowa City, Iowa
- Department of Internal Medicine, Carver College of Medicine University of Iowa, Iowa City, Iowa
- Department of Microbiology and Immunology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Jinhua Xiang
- Medical Service, Iowa City Veterans’ Affairs Medical Center, Iowa City, Iowa
- Department of Internal Medicine, Carver College of Medicine University of Iowa, Iowa City, Iowa
- Department of Microbiology and Immunology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Samantha R. Mackin
- Department of Microbiology and Immunology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Stanley Perlman
- Department of Microbiology and Immunology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Peter Thorne
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Patrick O’Shaughnessy
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | | | - Patrick Aubin
- Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Washington
- Department of Mechanical Engineering, University of Washington, Seattle, Washington
| | - Monica Ortiz-Hernandez
- Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Washington
- Department of Mechanical Engineering, University of Washington, Seattle, Washington
| | - Jack T. Stapleton
- Medical Service, Iowa City Veterans’ Affairs Medical Center, Iowa City, Iowa
- Department of Internal Medicine, Carver College of Medicine University of Iowa, Iowa City, Iowa
- Department of Microbiology and Immunology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
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12
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Berryhill McCarty E, Soldatova L, Brant JA, Newman JG. Innovations in otorhinolaryngology in the age of COVID-19: a systematic literature review. World J Otorhinolaryngol Head Neck Surg 2021; 8:S2095-8811(21)00003-2. [PMID: 33520334 PMCID: PMC7825952 DOI: 10.1016/j.wjorl.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/31/2020] [Accepted: 01/14/2021] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID-19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPE) and preparation guidelines for surgery in the COVID-19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that need. DATA SOURCES PubMed, Ovid/Medline, and Scopus. METHODS A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All English-language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID-19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. RESULTS A total of 41 papers met inclusion criteria and were organized into 5 categories ('General Recommendations for Otolaryngologic Surgery', 'Equipment Shortage Solutions', 'Airway Procedures', 'Nasal Endoscopy and Skull Base Procedures', and 'Otologic Procedures'). Articles were summarized, highlighting the innovations created and evaluated during the COVID-19 pandemic. Creative solutions such as application of topical viricidal agents, make-shift mask filters, three-dimensional (3-D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID-19 transmission. CONCLUSIONS Persistent risk of COVID-19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID-19 positive patients present asymptomatically. This review examines and organizes creative solutions that have been proposed and utilized in the otolaryngology. These solutions have a potential to minimize the risk of viral transmission in the current clinical environment and to create safer outpatient and operating room conditions for patients and healthcare staff.
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Affiliation(s)
| | - Liuba Soldatova
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity of Pennsylvania Health System, PhiladelphiaPennsylvaniaPAUSA
| | - Jason A. Brant
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity of Pennsylvania Health System, PhiladelphiaPennsylvaniaPAUSA
| | - Jason G. Newman
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity of Pennsylvania Health System, PhiladelphiaPennsylvaniaPAUSA
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13
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Schmitt J, Jones LS, Aeby EA, Gloor C, Moser B, Wang J. Protection Level and Reusability of a Modified Full-Face Snorkel Mask as Alternative Personal Protective Equipment for Healthcare Workers during the COVID-19 Pandemic. Chem Res Toxicol 2021; 34:110-118. [PMID: 33331780 PMCID: PMC7771246 DOI: 10.1021/acs.chemrestox.0c00371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Indexed: 01/26/2023]
Abstract
The worldwide outbreak of COVID-19 has drastically increased pressure on medical resources and highlighted the need for rapidly available, large-scale, and low-cost personal protective equipment (PPE). In this work, an alternative full-face mask is adapted from a modified snorkel mask to be used as PPE with two medical-grade filters and a 3D-printed adapter. Since the mask covers the eyes, mouth, and nose, it acts as a full-face shield, providing additional protection to healthcare workers. The SARS-CoV-2 has a size between 60 nm and 140 nm, and airborne viral particles can be carried by larger droplets with sizes up to several millimeters. The minimum filtration efficiency of mechanical and electrostatic filters is usually reached between 30 nm and 300 nm. The filtration efficiency of different medical filters is measured for particles below 300 nm to cover the size of the SARS-CoV-2 and small virus-laden droplets, and determine the minimum efficiency. The filtration performance of the adapted full-face mask is characterized using NaCl particles below 500 nm and different fitting scenarios to determine the minimum protection efficiency. The mask is compared to a commercial respirator and characterized according to the EN 149 standard, demonstrating that the protection fulfills the requirements for the FFP2 level (filtering face-piece 2, stopping at least 94% of airborne particles). The device shows a good resistance to several cycles of decontamination (autoclaving and ethanol immersion), is easy to be produced locally at low cost, and helps to address the shortage in FFP2 masks and face shields by providing adequate protection to healthcare workers against particles <500 nm in size.
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Affiliation(s)
- Jean Schmitt
- Institute of Environmental Engineering, Department of
Civil, Environmental and Geomatic Engineering, ETH Zurich,
Zurich 8093, Switzerland
- Laboratory for Advanced Analytical Technologies,
EMPA, Swiss Federal Laboratories for Materials Science and
Technology, Dubendorf 8600, Switzerland
| | - Lewis S. Jones
- Institute for Chemical- and Bioengineering, Department
of Chemistry and Applied Biosciences, ETH Zurich, Zurich 8093,
Switzerland
| | - Elise A. Aeby
- Laboratory of Applied Mechanobiology, Department of
Health Sciences and Technology, ETH Zurich, Zurich 8093,
Switzerland
| | - Christian Gloor
- Spiez Laboratory Division CBRNe Protection Systems,
Federal Office of Civil Protection, Spiez 3700,
Switzerland
| | - Berthold Moser
- Department of Anesthesia and Intensive Care,
Medical University of Innsbruck, Innsbruck 6020
Austria
| | - Jing Wang
- Institute of Environmental Engineering, Department of
Civil, Environmental and Geomatic Engineering, ETH Zurich,
Zurich 8093, Switzerland
- Laboratory for Advanced Analytical Technologies,
EMPA, Swiss Federal Laboratories for Materials Science and
Technology, Dubendorf 8600, Switzerland
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14
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Tcharkhtchi A, Abbasnezhad N, Zarbini Seydani M, Zirak N, Farzaneh S, Shirinbayan M. An overview of filtration efficiency through the masks: Mechanisms of the aerosols penetration. Bioact Mater 2021; 6:106-122. [PMID: 32817918 PMCID: PMC7426537 DOI: 10.1016/j.bioactmat.2020.08.002] [Citation(s) in RCA: 155] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/01/2020] [Accepted: 08/02/2020] [Indexed: 12/12/2022] Open
Abstract
The masks have always been mentioned as an effective tool against environmental threats. They are considered as protective equipment to preserve the respiratory system against the non-desirable air droplets and aerosols such as the viral or pollution particles. The aerosols can be pollution existence in the air, or the infectious airborne viruses initiated from the sneezing, coughing of the infected people. The filtration efficiency of the different masks against these aerosols are not the same, as the particles have different sizes, shapes, and properties. Therefore, the challenge is to fabricate the filtration masks with higher efficiency to decrease the penetration percentage at the nastiest conditions. To achieve this concept, knowledge about the mechanisms of the penetration of the aerosols through the masks at different effective environmental conditions is necessary. In this paper, the literature about the different kinds of face masks and respiratory masks, common cases of their application, and the advantages and disadvantages of them in this regard have been reviewed. Moreover, the related mechanisms of the penetration of the aerosols through the masks are discussed. The environmental conditions affecting the penetration as well as the quality of the fabrication are studied. Finally, special attention was given to the numerical simulation related to the different existing mechanisms.
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Affiliation(s)
- A. Tcharkhtchi
- Arts et Metiers Institute of Technology, CNAM, PIMM, HESAM University, F-75013, Paris, France
| | - N. Abbasnezhad
- Arts et Metiers Institute of Technology, CNAM, PIMM, HESAM University, F-75013, Paris, France
- Arts et Metiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013, Paris, France
| | - M. Zarbini Seydani
- Arts et Metiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013, Paris, France
| | - N. Zirak
- Arts et Metiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013, Paris, France
| | - S. Farzaneh
- P4Tech, 23 Rue du 8 Mai 1945, 94470, Boissy Saint Leger, France
| | - M. Shirinbayan
- Arts et Metiers Institute of Technology, CNAM, PIMM, HESAM University, F-75013, Paris, France
- Arts et Metiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013, Paris, France
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15
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Zhang Z, Ji D, He H, Ramakrishna S. Electrospun ultrafine fibers for advanced face masks. MATERIALS SCIENCE & ENGINEERING. R, REPORTS : A REVIEW JOURNAL 2021; 143:100594. [PMID: 33519094 PMCID: PMC7836643 DOI: 10.1016/j.mser.2020.100594] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/30/2020] [Accepted: 10/14/2020] [Indexed: 05/07/2023]
Abstract
The outbreak of Coronavirus Disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has triggered great global public health concern. Face masks are essential tools to reduce the spread of SARS-CoV-2 from human to human. However, there are still challenges to prolong the serving life and maintain the filtering performance of the current commercial mask. Filters composed of ultrafine fibers with diameter down to tens of nanometers have the potential to physically block viruses. With adjustable composition and nanostructures, the electrospun ultrafine fiber filter is possible to achieve other necessary functions beyond virus blocking, such as antiviral, transparent, and degradable, making it an important part of fighting the epidemic. In this review, beginning with the basic information of the viruses, we summarize the knowledge of masks and respirators, including the filtering mechanism, structure, classification, and standards. We further present the fabrication method, filtering performance, and reusable potential of electrospun ultrafine fiber-based masks. In the end, we discuss the development directions of ultrafine fibers in protective devices, especially their new functional applications and possible contributions in the prevention and control of the epidemic.
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Affiliation(s)
- Zhenfang Zhang
- Faculty of Mechanical Engineering, National University of Singapore, 117574, Singapore
| | - Dongxiao Ji
- Faculty of Mechanical Engineering, National University of Singapore, 117574, Singapore
| | - Haijun He
- Department of Polymer Engineering, Faculty of Mechanical Engineering, Budapest University of Technology and Economics, Műegyetem rkp. 3-9, H-1111, Budapest, Hungary
| | - Seeram Ramakrishna
- Faculty of Mechanical Engineering, National University of Singapore, 117574, Singapore
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16
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Andrearczyk A, Konieczny B, Sokołowski J. Additively Manufactured Parts Made of a Polymer Material Used for the Experimental Verification of a Component of a High-Speed Machine with an Optimised Geometry-Preliminary Research. Polymers (Basel) 2020; 13:E137. [PMID: 33396352 PMCID: PMC7794797 DOI: 10.3390/polym13010137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/18/2020] [Accepted: 12/25/2020] [Indexed: 11/16/2022] Open
Abstract
This paper describes a novel method for the experimental validation of numerically optimised turbomachinery components. In the field of additive manufacturing, numerical models still need to be improved, especially with the experimental data. The paper presents the operational characteristics of a compressor wheel, measured during experimental research. The validation process included conducting a computational flow analysis and experimental tests of two compressor wheels: The aluminium wheel and the 3D printed wheel (made of a polymer material). The chosen manufacturing technology and the results obtained made it possible to determine the speed range in which the operation of the tested machine is stable. In addition, dynamic destructive tests were performed on the polymer disc and their results were compared with the results of the strength analysis. The tests were carried out at high rotational speeds (up to 120,000 rpm). The results of the research described above have proven the utility of this technology in the research and development of high-speed turbomachines operating at speeds up to 90,000 rpm. The research results obtained show that the technology used is suitable for multi-variant optimization of the tested machine part. This work has also contributed to the further development of numerical models.
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Affiliation(s)
- Artur Andrearczyk
- Institute of Fluid Flow Machinery, Polish Academy of Sciences, 80-231 Gdansk, Poland
| | - Bartlomiej Konieczny
- University Laboratory of Material Research, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Jerzy Sokołowski
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland;
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17
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Perna G, Cuniberti F, Daccò S, Nobile M, Caldirola D. Impact of respiratory protective devices on respiration: Implications for panic vulnerability during the COVID-19 pandemic. J Affect Disord 2020; 277:772-778. [PMID: 33065816 PMCID: PMC7476564 DOI: 10.1016/j.jad.2020.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The wearing of respiratory protective devices (RPDs) correctly and continually in situations where people are at risk of respiratory infections is crucial for infection prevention. Certain people are poorly compliant with RPDs due to RPD-related annoyance, including respiratory discomfort. We hypothesized that individuals vulnerable to panic attacks are included in this group. No published studies on this topic are available. The evidence for our hypothesis was reviewed in this study as a starting point for future research. METHODS We selected a set of experimental studies that measured the respiratory physiological burden in RPD wearers through objective and validated methods. We conducted a bibliographic search of publications in the PubMed database (January 2000-May 2020) to identify representative studies that may be of interest for panic respiratory pathophysiology. RESULTS Five studies were included. Wearing RPDs exerted significant respiratory effects, including increased breathing resistance, CO2 rebreathing due to CO2 accumulation in the RPD cavity, and decreased inhaled O2 concentration. We discussed the implications of these effects on the respiratory pathophysiology of panic. LIMITATIONS Most studies had a small sample size, with a preponderance of young participants. Different methodologies were used across the studies. Furthermore, differences in physical responses between wearing RPDs in experimental settings or daily life cannot be excluded. CONCLUSIONS This research supports the idea that panic-prone individuals may be at higher risk of respiratory discomfort when wearing RPDs, thereby reducing their tolerance for these devices. Strategies to decrease discomfort should be identified to overcome the risk of poor compliance.
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Affiliation(s)
- Giampaolo Perna
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy.
| | - Francesco Cuniberti
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Silvia Daccò
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Maria Nobile
- Scientific Institute IRCCS Eugenio Medea, Bosisio Parini 23842, Lecco, Italy
| | - Daniela Caldirola
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
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18
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Verberne JWR, Worsley PR, Bader DL. A 3D registration methodology to evaluate the goodness of fit at the individual-respiratory mask interface. Comput Methods Biomech Biomed Engin 2020; 24:1-12. [PMID: 33241703 DOI: 10.1080/10255842.2020.1849156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/16/2020] [Accepted: 11/04/2020] [Indexed: 02/08/2023]
Abstract
Respiratory masks are used to deliver non-invasive ventilation for cardiorespiratory pathologies. Masks must minimize skin tissue compression while maintaining a seal at the interface. Ill-fitting masks or those applied too tightly are implicated in pressure ulcer formation. This study aimed to analyse respiratory mask goodness of fit in a cohort of face shapes. A number of parameters were identified and analysed with a novel registration protocol. In the majority of cases, mask indentation exceeded the thickness of the interface material and significant gapping was observed. The size range was most appropriate for males, with only one size suitable for females.
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Affiliation(s)
- J W R Verberne
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - P R Worsley
- School of Health Sciences, University of Southampton, Southampton, UK
| | - D L Bader
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- School of Health Sciences, University of Southampton, Southampton, UK
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19
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Vicini C, Cammaroto G, Meccariello G, Iannella G, Fragale M, Cacco T, Sampieri C, Guastini L, Castello E, Parrinello G, De Vito A, Gulotta G, Visconti IC, Abita P, Pelucchi S, Bianchi G, Melegatti MN, Garulli G, Bosco F, Gennaiotti A, Berrettini S, Magnani M, Troncossi M, Peretti G. Overview of different modified full-face snorkelling masks for intraoperative protection. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2020; 40:317-324. [PMID: 32970047 PMCID: PMC7726642 DOI: 10.14639/0392-100x-n0841] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/23/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has caused significant impact on healthcare systems worldwide. The rate of infected healthcare workers is > 10% in Italy. Within this dramatic scenario, the development of new personal protective equipment (PPE) devices is mandatory. This study focuses on validation of modified full-face snorkel masks (MFFSM) as safe and protective equipment against SARS-CoV-2 infection during diagnostic and therapeutic procedures on the upper aerodigestive tract. METHODS Five different MFFSM were tested during otolaryngological surgery and in anaesthesia procedures. Data were collected through an online survey to assess the feedback of operators. pO2 and pCO2 monitoring values during procedures were recorded in selected cases. RESULTS All five MFFSM tested were easy to use and gave all operators a sound "feeling" of protection. All clinicians involved had common agreement regarding safety and the user-friendly format. CONCLUSIONS In the future, specific development of different type of masks for protection in the operating room, intensive care units and/or office will be possible as a joint venture between clinicians and developers. Goals for clinicians include better definition of needs and priorities, while developers can devote their expertise to produce devices that meet medical requirements.
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Affiliation(s)
- Claudio Vicini
- Department of Head-Neck Surgery, AUSL Romagna, Italy - Ear Nose Throat (ENT) Unit of Forlì and Faenza, University of Ferrara and Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Giovanni Cammaroto
- Department of Head-Neck Surgery, AUSL Romagna, Italy - Ear Nose Throat (ENT) Unit of Forlì and Faenza, University of Ferrara and Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Giuseppe Meccariello
- Department of Head-Neck Surgery, AUSL Romagna, Italy - Ear Nose Throat (ENT) Unit of Forlì and Faenza, University of Ferrara and Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Giannicola Iannella
- Department of Head-Neck Surgery, AUSL Romagna, Italy - Ear Nose Throat (ENT) Unit of Forlì and Faenza, University of Ferrara and Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Marco Fragale
- IRCCS Ospedale Policlinico San Martino, Unit of Otorhinolaryngology Head and Neck Surgery, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy
| | - Tommaso Cacco
- IRCCS Ospedale Policlinico San Martino, Unit of Otorhinolaryngology Head and Neck Surgery, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy
| | - Claudio Sampieri
- IRCCS Ospedale Policlinico San Martino, Unit of Otorhinolaryngology Head and Neck Surgery, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy
| | - Luca Guastini
- IRCCS Ospedale Policlinico San Martino, Unit of Otorhinolaryngology Head and Neck Surgery, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy
| | - Eolo Castello
- IRCCS Ospedale Policlinico San Martino, Unit of Otorhinolaryngology Head and Neck Surgery, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy
| | - Giampiero Parrinello
- IRCCS Ospedale Policlinico San Martino, Unit of Otorhinolaryngology Head and Neck Surgery, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy
| | - Andrea De Vito
- Department of Head-Neck Surgery AUSL Romagna, Italy - Ear Nose Throat (ENT) Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | | | | | - Pietro Abita
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, Unit of Otorhinolaryngology, University of Messina, Italy
| | - Stefano Pelucchi
- Otolaryngology Head and Neck Surgery, University Hospital of Ferrara, Italy
| | - Giulia Bianchi
- Otolaryngology Head and Neck Surgery, University Hospital of Ferrara, Italy
| | | | - Gianluca Garulli
- Minimally Invasive General and Thoracic Surgery Unit, AUSL Romagna, Italy - Ceccarini Hospital, Riccione, Italy
| | - Filippo Bosco
- Department of Anesthesia and Intensive Care, Cisanello Hospital, University Hospital of Pisa, Italy
| | - Alessandro Gennaiotti
- Department of Anesthesia and Intensive Care, Cisanello Hospital, University Hospital of Pisa, Italy
| | - Stefano Berrettini
- Otolaryngology Head and Neck Surgery, Cisanello Hospital, University Hospital of Pisa, Italy
| | - Massimo Magnani
- Department of Head-Neck Surgery AUSL Romagna, Italy; Ear Nose Throat (ENT) Unit, Bufalini Hospital, Cesena, Italy
| | - Marco Troncossi
- Department of Industrial Engineering, University of Bologna, Italy
| | - Giorgio Peretti
- IRCCS Ospedale Policlinico San Martino, Unit of Otorhinolaryngology Head and Neck Surgery, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy
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20
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Ong S, Lim WY, Ong J, Kam P. Anesthesia guidelines for COVID-19 patients: a narrative review and appraisal. Korean J Anesthesiol 2020; 73:486-502. [PMID: 32668835 PMCID: PMC7714635 DOI: 10.4097/kja.20354] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/14/2020] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has challenged health systems globally and prompted the publication of several guidelines. The experiences of our international colleagues should be utilized to protect patients and healthcare workers. The primary aim of this article is to appraise national guidelines for the perioperative anesthetic management of patients with COVID-19 so that they can be enhanced for the management of any resurgence of the epidemic. PubMed and EMBASE databases were systematically searched for guidelines related to SARS-CoV and SARS-CoV-2. Additionally, the World Federation Society of Anesthesiologists COVID-19 resource webpage was searched for national guidelines; the search was expanded to include countries with a high incidence of SARS-CoV. The guidelines were evaluated using the Appraisal of Guidelines for Research and Evaluation II tool. Guidelines from Australia, Canada, China, India, Italy, South Africa, South Korea, Taiwan, the United Kingdom, and the United States of America were evaluated. All the guidelines focused predominantly on intubation and infection control. The scope and purpose of guidelines from China were the most comprehensive. The UK and South Africa provided the best clarity. Editorial independence, the rigor of development, and applicability scored poorly. Heterogeneity and gaps pertaining to preoperative screening, anesthesia technique, subspecialty anesthesia, and the lack of auditing of guidelines were identified. Evidence supporting the recommendations was weak. Early guidelines for the anesthetic management of COVID-19 patients lacked quality and a robust reporting framework. As new evidence emerges, national guidelines should be updated to enhance rigor, clarity, and applicability.
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Affiliation(s)
- Sharon Ong
- Duke-NUS Medical School, Yong Loo Lin School of Medicine, Singapore.,Department of Surgical Intensive Care, Sengkang General Hospital, Singapore.,Division of Anesthesiology and Perioperative Sciences, Singapore General Hospital, Singapore
| | - Wan Yen Lim
- Division of Anesthesiology and Perioperative Sciences, Singapore General Hospital, Singapore
| | - John Ong
- Department of Engineering, University of Cambridge, Cambridge, UK.,Department of Medicine, National University of Singapore, Singapore
| | - Peter Kam
- Department of Anesthetics, Royal Prince Alfred Hospital, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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