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Thapthim-On M, Chaiear N, Mitsungnern T. Which alternative well-fit masks can be used in medical procedures? J Infect Public Health 2024; 17:204-211. [PMID: 38113817 DOI: 10.1016/j.jiph.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/09/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the WHO and CDC recommended that healthcare personnel (HCPs) performing non-aerosol-generating procedures (AGPs) don a properly fitted mask. We aimed to evaluate the fit factors (FFs) of eight alternative well-fit masks (AWMs) used by Thai HCPs. METHODS This comparative descriptive study was conducted on 33 HCPs between October and November 2022, categorized into three facial sizes: small, medium, and large. Each participant wore eight types of AWMs in random order: medical mask under adjustable ear-loop (AEL)-KF94 (MK), medical mask under AEL-KN95 with a hook (MN), medical mask under fabric mask (MF), AEL- KF94 (KF94), AEL-KF94 under fabric masks (KF), AEL-KF94 with a hook (KF94H), AEL-KN95 with a hook (KN95), and AEL-KN95 with a hook under fabric mask (NF). FFs were measured using a quantitative fit test. RESULTS The respective number of HCPs wearing small, medium, and large was 12, 12, and 9, and the mean±SD of face width and length was 132.98 ± 10.49 and 114.92 ± 10.10 mm. The highest respective median of FF was KN95 = 200, NF= 200, MN= 185, and KF94H = 171, and the respective passing fit-test rate was 97%, 84.8%, 63.6%, and 60.6%. There was no difference in FFs between the N95 and KN95 (p=0.72), the N95 and NF (p=0.202), and the three face sizes. Moreover, KF94H pass rates were significantly higher for females compared to males (OR = 13.3; p = 0.001) and for small facial sizes compared to either medium or large sizes (OR = 14.7; p = 0.009). CONCLUSION The AEL-KN95 with hook and sponge at the nosepiece is an effective respirator for use by HCPs in non-AGPs, as the FF and fit test pass rates were comparable to those of N95, and there were no differences in FFs between facial sizes. However, the female who had a small face size may use a KF94H as an alternative PPE.
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Affiliation(s)
- Maturin Thapthim-On
- Department of Community, Family, and Occupational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Naesinee Chaiear
- Department of Community, Family, and Occupational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Thapanawong Mitsungnern
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
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Fu J, Liu T, Binte Touhid SS, Fu F, Liu X. Functional Textile Materials for Blocking COVID-19 Transmission. ACS NANO 2023; 17:1739-1763. [PMID: 36683285 PMCID: PMC9885531 DOI: 10.1021/acsnano.2c08894] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/17/2023] [Indexed: 06/17/2023]
Abstract
The outbreak of COVID-19 provided a warning sign for society worldwide: that is, we urgently need to explore effective strategies for combating unpredictable viral pandemics. Protective textiles such as surgery masks have played an important role in the mitigation of the COVID-19 pandemic, while revealing serious challenges in terms of supply, cross-infection risk, and environmental pollution. In this context, textiles with an antivirus functionality have attracted increasing attention, and many innovative proposals with exciting commercial possibilities have been reported over the past three years. In this review, we illustrate the progress of textile filtration for pandemics and summarize the recent development of antiviral textiles for personal protective purposes by cataloging them into three classes: metal-based, carbon-based, and polymer-based materials. We focused on the preparation routes of emerging antiviral textiles, providing a forward-looking perspective on their opportunities and challenges, to evaluate their efficacy, scale up their manufacturing processes, and expand their high-volume applications. Based on this review, we conclude that ideal antiviral textiles are characterized by a high filtration efficiency, reliable antiviral effect, long storage life, and recyclability. The expected manufacturing processes should be economically feasible, scalable, and quickly responsive.
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Affiliation(s)
- Jiajia Fu
- School of Materials Science and Engineering,
Zhejiang Sci-Tech University, Xiasha Higher Education Zone,
Hangzhou310018, People’s Republic of China
| | - Tianxing Liu
- Department of Cell and Systems Biology,
University of Toronto, Toronto, OntarioM5S1A1,
Canada
| | - S Salvia Binte Touhid
- School of Materials Science and Engineering,
Zhejiang Sci-Tech University, Xiasha Higher Education Zone,
Hangzhou310018, People’s Republic of China
| | - Feiya Fu
- School of Materials Science and Engineering,
Zhejiang Sci-Tech University, Xiasha Higher Education Zone,
Hangzhou310018, People’s Republic of China
| | - Xiangdong Liu
- School of Materials Science and Engineering,
Zhejiang Sci-Tech University, Xiasha Higher Education Zone,
Hangzhou310018, People’s Republic of China
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3
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A Novel Antipathogenic Agent for Nonwoven Fabric. BIOMEDICAL MATERIALS & DEVICES 2022. [PMCID: PMC9299416 DOI: 10.1007/s44174-022-00001-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
AbstractMedical-grade masks and N95 respirators containing non-woven fibers are designed to prevent the spread of airborne diseases. While they effectively trap respiratory droplets and aerosols, they cannot lyse entrapped pathogens. Embedded antimicrobial agents such as silver, copper, zinc, iodine, peptides, quaternary ammonium salts, or nanoparticles have been used to overcome this limitation. However, their effectiveness remains debatable because these materials can be toxins, allergens, irritants, and environmental hazards. Recently, silicon nitride (Si3N4) was found to be a potent antipathogenic compound, and it may be an ideal agent for masks. In powder or solid form, it is highly effective in inactivating bacteria, fungi, and viruses while leaving mammalian tissue unaffected. The purpose of this study was to serially assess the antiviral efficacy of Si3N4 against SARS-CoV-2 using powders, solids, and embedded nonwoven fabrics. Si3N4 powders and solids were prepared using conventional ceramic processing. The “pad-dry-cure” method was used to embed Si3N4 particles into polypropylene fibers. Fabric testing was subsequently conducted using industrial standards—ISO 18184 for antiviral effectiveness, ASTM F2299 and EN 13274-7 for filtration efficiency, EN 14683 for differential pressure drop, and ISO 18562-2 for particle shedding. A modification of ISO 18562-3 was also employed to detect ammonia release from the fabric. Antiviral effectiveness for Si3N4 powders, solids, and embedded fabrics were 99.99% at ≤ 5 min, ~ 93% in 24 h, and 87% to 92% in 120 min, respectively. Results of the standard mask tests were generally within prescribed safety limits. Further process optimization may lead to commercial Si3N4-based masks that not only “catch” but also “kill” pathogenic microbes.
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4
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Cook JD, Campbell Grant EH, Coleman JTH, Sleeman JM, Runge MC. Evaluating the risk of SARS‐CoV‐2 transmission to bats in the context of wildlife research, rehabilitation, and control. WILDLIFE SOC B 2022. [PMCID: PMC9111074 DOI: 10.1002/wsb.1262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Jonathan D. Cook
- U.S. Geological Survey Eastern Ecological Science Center at the Patuxent Research Refuge Laurel MD 20708 USA
| | - Evan H. Campbell Grant
- U.S. Geological Survey Eastern Ecological Science Center at the S.O. Conte Research Laboratory Turners Falls MA 01376 USA
| | | | | | - Michael C. Runge
- U.S. Geological Survey Eastern Ecological Science Center at the Patuxent Research Refuge Laurel MD 20708 USA
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5
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Ataei M, Shirazi FM, Nakhaee S, Abdollahi M, Mehrpour O. Assessment of cloth masks ability to limit Covid-19 particles spread: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:1645-1676. [PMID: 34689269 PMCID: PMC8541808 DOI: 10.1007/s11356-021-16847-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/28/2021] [Indexed: 05/10/2023]
Abstract
After the spread of Covid 19 worldwide, the use of cloth masks increased significantly due to a shortage of medical masks. Meanwhile, there were different opinions about the effectiveness of these masks and, so far, no study has been done to find the best fabric masks. This study reviews and summarizes all studies related to fabric masks' effectiveness and various fabrics against coronavirus. This systematic review is based on PRISMA rules. Two researchers separately examined three databases: PubMed, Scopus, and Web of Science. Laboratory and clinical studies were included. After extracting the articles, their quality was assessed with the Joanna Briggs Institute (JBI) tool. In addition to efficacy, other factors, including the penetration of masks, pressure drop, and quality factor, were examined to select the best fabrics. Of the 42 studies selected, 39 were laboratory studies, and 3 were clinical studies. Among the various fabrics examined, cotton quilt 120 thread per inch (TPI), copy paper (bonded), hybrid of cotton with chiffon/ silk, and flannel filtration were found to have over 90% effectiveness in the particle size range of Covid-19. The results and comparison of different factors (pressure drop, filtration efficacy, penetration, filtration quality, and fit factor have been evaluated) showed that among different fabrics, hybrid masks, 2-layered cotton quilt, 2-layered 100% cotton, cotton flannel, and hairy tea towel + fleece sweater had the best performance. Clinical studies have not explicitly examined cloth masks' effectiveness in Covid-19, so the effectiveness of these types of masks for Covid 19 is questionable, and more studies are needed.
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Affiliation(s)
- Mahshid Ataei
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran
- Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), and Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farshad M Shirazi
- Arizona Poison & Drug Information Center, University of Arizona, College of Pharmacy and University of Arizona College of Medicine, Tucson, AZ, USA
| | - Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), and Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Omid Mehrpour
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran.
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
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6
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El Hassan M, Assoum H, Bukharin N, Al Otaibi H, Mofijur M, Sakout A. A review on the transmission of COVID-19 based on cough/sneeze/breath flows. EUROPEAN PHYSICAL JOURNAL PLUS 2022; 137:1. [PMID: 34909366 PMCID: PMC8660964 DOI: 10.1140/epjp/s13360-021-02162-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/08/2021] [Indexed: 05/17/2023]
Abstract
COVID-19 pandemic has recently had a dramatic impact on society. The understanding of the disease transmission is of high importance to limit its spread between humans. The spread of the virus in air strongly depends on the flow dynamics of the human airflows. It is, however, known that predicting the flow dynamics of the human airflows can be challenging due to different particles sizes and the turbulent aspect of the flow regime. It is thus recommended to present a deep analysis of different human airflows based on the existing experimental investigations. A validation of the existing numerical predictions of such flows would be of high interest to further develop the existing numerical model for different flow configurations. This paper presents a literature review of the experimental and numerical studies on human airflows, including sneezing, coughing and breathing. The dynamics of these airflows for different droplet sizes is discussed. The influence of other parameters, such as the viscosity and relative humidity, on the germs transmission is also presented. Finally, the efficacy of using a facemask in limiting the transmission of COVID-19 is investigated.
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Affiliation(s)
- Mouhammad El Hassan
- Mechanical Engineering Department, Prince Mohammad Bin Fahd University, Al Khobar, Kingdom of Saudi Arabia
| | - Hassan Assoum
- Mechanical Engineering Department, Beirut Arab University, Tripoli, Lebanon
| | - Nikolay Bukharin
- School of Manufacturing and Automation, Southern Alberta Institute of Technology, Calgary, Canada
| | - Huda Al Otaibi
- Mechanical Engineering Department, Prince Mohammad Bin Fahd University, Al Khobar, Kingdom of Saudi Arabia
| | - Md Mofijur
- Mechanical Engineering Department, Prince Mohammad Bin Fahd University, Al Khobar, Kingdom of Saudi Arabia
- Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW 2007 Australia
| | - Anas Sakout
- LASIE, University of La Rochelle, La Rochelle, France
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7
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Monjezi M, Jamaati H. The effects of face mask specifications on work of breathing and particle filtration efficiency. Med Eng Phys 2021; 98:36-43. [PMID: 34848036 PMCID: PMC8493656 DOI: 10.1016/j.medengphy.2021.10.004] [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: 07/14/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
The outbreak of the ongoing coronavirus disease 2019 (COVID-19) pandemic has led to the recommended routine use of face masks to reduce exposure risk. In this study, the increase in work of breathing (WOB) imposed by face masks is theoretically studied for both normals and patients with obstructive and restrictive lung diseases at different levels of activity. The results show a significant increase in WOB due to face masks, which is more severe in higher activity levels. The added WOB is considerable during physical activity and may be intolerable for patients with preexisting lung disease and may contribute to inspiratory muscle fatigue and dyspnea. Moreover, in this study, the effects of the physical properties of a fibrous medium, including thickness, porosity, and fiber diameter, are analyzed on the particle filtration efficiency (PFE) and the added WOB. The relations between the physical properties of the fibrous medium and the added WOB and the PFE are shown on some contour plots as a quick and simple tool to select the desired physical properties for a single layer filter to ensure that the added WOB is comfortable while the PFE is sufficiently high.
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Affiliation(s)
- Mojdeh Monjezi
- Chronic Respiratory Diseases Research Center (CRDRC), Critical Care Department Shaheed Bahonar Ave., National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Darabad, Tehran 1955841452, Iran
| | - Hamidreza Jamaati
- Chronic Respiratory Diseases Research Center (CRDRC), Critical Care Department Shaheed Bahonar Ave., National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Darabad, Tehran 1955841452, Iran.
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8
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Kwak DB, Kim SC, Kuehn TH, Pui DYH. Quantitative analysis of droplet deposition produced by an electrostatic sprayer on a classroom table by using fluorescent tracer. BUILDING AND ENVIRONMENT 2021; 205:108254. [PMID: 34400851 PMCID: PMC8358112 DOI: 10.1016/j.buildenv.2021.108254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
Due to the ongoing COVID-19 pandemic situation, measures to mitigate the risk of transmission of the SARS-CoV-2 virus in an indoor setting are urgently needed. Among the various types of disinfectant methods, electrostatic spraying is often applied to decontamination in public places. For quantitatively characterizing electrostatic spraying, we developed the novel evaluation method by using a fluorescent tracer. By applying this method, we performed three different experiment cases (static test on a table, static test on a cylinder, and dynamic test on a table) to figure out its unique characteristics (Coulombic fission and wraparound effect) and measure its performance in various aspects. To be specific, bimodal distribution with peak sizes of ~10 and ~100 μm was found due to Coulombic fission. Otherwise, a unimodal distribution with a peak size of ~100 μm occurred for the uncharged droplets. As a result, the effective contact area increased by 40-80 % due to small progeny droplets. The wraparound effect was examined on two different cylinders: copper (Cu) and polyvinyl chloride (PVC) pipe. When the target surface was not charged (Cu 0 kV and PVC 0 kV), the average normalized concentrations on the backside of the cylinder (θ = 180°) increased by around 67 % for charged droplets. Meanwhile, when the target surface was highly charged (PVC -19 kV), the average normalized concentrations at θ = 180° were increased more than two times for charged droplets.
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Affiliation(s)
- Dong-Bin Kwak
- Particle Technology Laboratory, Mechanical Engineering, University of Minnesota, 111 Church St., S.E., Minneapolis, MN, 55455, USA
| | - Seong Chan Kim
- Particle Technology Laboratory, Mechanical Engineering, University of Minnesota, 111 Church St., S.E., Minneapolis, MN, 55455, USA
| | - Thomas H Kuehn
- Particle Technology Laboratory, Mechanical Engineering, University of Minnesota, 111 Church St., S.E., Minneapolis, MN, 55455, USA
| | - David Y H Pui
- Particle Technology Laboratory, Mechanical Engineering, University of Minnesota, 111 Church St., S.E., Minneapolis, MN, 55455, USA
- School of Science and Engineering, The Chinese University of Hong Kong, Shenzhen, Guangdong, 518172, China
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9
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Reutman SR, Reponen T, Yermakov M, A Grinshpun S. Homemade facemasks: particle filtration, breathability, fit, and other performance characteristics. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:334-344. [PMID: 34080950 DOI: 10.1080/15459624.2021.1925124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Homemade cloth masks and other improvised face coverings have become widespread during the COVID-19 pandemic driven by severe shortages of personal protective equipment. In this study, various alternative (mostly common household) materials, which have not traditionally been used in respiratory protective devices, were tested for particle filtration performance and breathability. Most of these materials were found of some-but rather limited-utility in facemasks. At a breathing flow rate of 30 L min-1, 17 out of 19 tested materials demonstrated collection efficiency below 50%; at 85 L min-1, only one material featured particle collection efficiency above 50%. Pressure drop values were mostly below 4 mm w.g. (observed in 89% of cases for the two flow rates), which provides comfortable breathing. Only for one fabric material (silk) tested at 85 L min-1 did the pressure drop reach 11 mm w.g. Based on these results, a three-layer facemask prototype was designed and fabricated comprised of the best performing materials. Additional tests were conducted to examine possible particle detachment/shedding from the materials used in the newly developed facemask, but no such phenomenon was observed. The prototype was evaluated on 10 human subjects using the standard OSHA-approved quantitative fit testing protocol. The mask protection level, determined as an adopted fit factor, was found to lie between that of the two commercial surgical/medical masks tested for comparison. A 10-cycle washing of the mask prototype lowered its collection efficiency across the particle size range; however, washing did not substantially affect mask breathability. The study revealed that although homemade masks offer a certain level of protection to a wearer, one should not expect them to provide the same respiratory protection as high-end commercial surgical/medical masks or-by any means-NIOSH-certified N95 filtering facepieces.
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Affiliation(s)
- Susan R Reutman
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tiina Reponen
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Michel Yermakov
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Sergey A Grinshpun
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
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10
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Ogbuoji EA, Zaky AM, Escobar IC. Advanced Research and Development of Face Masks and Respirators Pre and Post the Coronavirus Disease 2019 (COVID-19) Pandemic: A Critical Review. Polymers (Basel) 2021; 13:1998. [PMID: 34207184 PMCID: PMC8235328 DOI: 10.3390/polym13121998] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 12/05/2022] Open
Abstract
The outbreak of the COVID-19 pandemic, in 2020, has accelerated the need for personal protective equipment (PPE) masks as one of the methods to reduce and/or eliminate transmission of the coronavirus across communities. Despite the availability of different coronavirus vaccines, it is still recommended by the Center of Disease Control and Prevention (CDC), World Health Organization (WHO), and local authorities to apply public safety measures including maintaining social distancing and wearing face masks. This includes individuals who have been fully vaccinated. Remarkable increase in scientific studies, along with manufacturing-related research and development investigations, have been performed in an attempt to provide better PPE solutions during the pandemic. Recent literature has estimated the filtration efficiency (FE) of face masks and respirators shedding the light on specific targeted parameters that investigators can measure, detect, evaluate, and provide reliable data with consistent results. This review showed the variability in testing protocols and FE evaluation methods of different face mask materials and/or brands. In addition to the safety requirements needed to perform aerosol viral filtration tests, one of the main challenges researchers currently face is the inability to simulate or mimic true aerosol filtration scenarios via laboratory experiments, field tests, and in vitro/in vivo investigations. Moreover, the FE through the mask can be influenced by different filtration mechanisms, environmental parameters, filtration material properties, number of layers used, packing density, fiber charge density, fiber diameter, aerosol type and particle size, aerosol face velocity and concentration loadings, and infectious concentrations generated due to different human activities. These parameters are not fully understood and constrain the design, production, efficacy, and efficiency of face masks.
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Affiliation(s)
- Ebuka A. Ogbuoji
- Department of Chemical and Materials Engineering, University of Kentucky, Lexington, KY 40506, USA;
| | - Amr M. Zaky
- BioMicrobics Inc., 16002 West 110th Street, Lenexa, KS 66219, USA;
| | - Isabel C. Escobar
- Department of Chemical and Materials Engineering, University of Kentucky, Lexington, KY 40506, USA;
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Ramasamy S, Subbian S. Critical Determinants of Cytokine Storm and Type I Interferon Response in COVID-19 Pathogenesis. Clin Microbiol Rev 2021; 34:e00299-20. [PMID: 33980688 PMCID: PMC8142516 DOI: 10.1128/cmr.00299-20] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), a rapidly evolving pandemic worldwide with at least 68 million COVID-19-positive cases and a mortality rate of about 2.2%, as of 10 December 2020. About 20% of COVID-19 patients exhibit moderate to severe symptoms. Severe COVID-19 manifests as acute respiratory distress syndrome (ARDS) with elevated plasma proinflammatory cytokines, including interleukin 1β (IL-1β), IL-6, tumor necrosis factor α (TNF-α), C-X-C motif chemokine ligand 10 (CXCL10/IP10), macrophage inflammatory protein 1 alpha (MIP-1α), and chemokine (C-C motif) ligand 2 (CCL2), with low levels of interferon type I (IFN-I) in the early stage and elevated levels of IFN-I during the advanced stage of COVID-19. Most of the severe and critically ill COVID-19 patients have had preexisting comorbidities, including hypertension, diabetes, cardiovascular diseases, and respiratory diseases. These conditions are known to perturb the levels of cytokines, chemokines, and angiotensin-converting enzyme 2 (ACE2), an essential receptor involved in SARS-CoV-2 entry into the host cells. ACE2 downregulation during SARS-CoV-2 infection activates the angiotensin II/angiotensin receptor (AT1R)-mediated hypercytokinemia and hyperinflammatory syndrome. However, several SARS-CoV-2 proteins, including open reading frame 3b (ORF3b), ORF6, ORF7, ORF8, and the nucleocapsid (N) protein, can inhibit IFN type I and II (IFN-I and -II) production. Thus, hyperinflammation, in combination with the lack of IFN responses against SARS-CoV-2 early on during infection, makes the patients succumb rapidly to COVID-19. Therefore, therapeutic approaches involving anti-cytokine/anti-cytokine-signaling and IFN therapy would favor the disease prognosis in COVID-19. This review describes critical host and viral factors underpinning the inflammatory "cytokine storm" induction and IFN antagonism during COVID-19 pathogenesis. Therapeutic approaches to reduce hyperinflammation and their limitations are also discussed.
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Affiliation(s)
- Santhamani Ramasamy
- Public Health Research Institute (PHRI) at New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Selvakumar Subbian
- Public Health Research Institute (PHRI) at New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
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12
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Cook JD, Grant EHC, Coleman JTH, Sleeman JM, Runge MC. Risks posed by SARS-CoV-2 to North American bats during winter fieldwork. CONSERVATION SCIENCE AND PRACTICE 2021; 3:e410. [PMID: 34230913 PMCID: PMC8250205 DOI: 10.1111/csp2.410] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/15/2022] Open
Abstract
The virus that causes COVID-19 likely evolved in a mammalian host, possibly Old-World bats, before adapting to humans, raising the question of whether reverse zoonotic transmission to bats is possible. Wildlife management agencies in North America are concerned that the activities they authorize could lead to transmission of SARS-CoV-2 to bats from humans. A rapid risk assessment conducted in April 2020 suggested that there was a small but significant possibility that SARS-CoV-2 could be transmitted from humans to bats during summer fieldwork, absent precautions. Subsequent challenge studies in a laboratory setting have shed new information on these risks, as has more detailed information on human epidemiology and transmission. This inquiry focuses on the risk to bats from winter fieldwork, specifically surveys of winter roosts and handling of bats to test for white-nose syndrome or other research needs. We use an aerosol transmission model, with parameter estimates both from the literature and from formal expert judgment, to estimate the risk to three species of North American bats, as a function of several factors. We find that risks of transmission are lower than in the previous assessment and are notably affected by chamber volume and local prevalence of COVID-19. Use of facemasks with high filtration efficiency or a negative COVID-19 test before field surveys can reduce zoonotic risk by 65 to 88%.
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Affiliation(s)
- Jonathan D. Cook
- U.S. Geological SurveyPatuxent Wildlife Research CenterLaurelMarylandUSA
| | - Evan H. C. Grant
- U.S. Geological SurveyPatuxent Wildlife Research CenterTurner's FallsMassachusettsUSA
| | | | | | - Michael C. Runge
- U.S. Geological SurveyPatuxent Wildlife Research CenterLaurelMarylandUSA
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Abstract
Objectives/hypothesis To investigate the effect of FFP3 mask usage on venous blood gases (VBG) and some subjective symptoms Methods VBG analyses and subjective symptom questionary were obtained from 15 healthcare proffesionals before and after 4-h FFP3 mask usage. Results Wearing an FFP3 mask for 4 hours did not change any venous blood gas parameters between pre- and post-values, statistically. According to an 8-symptom questionary, only nausea did not show any significance. Headache, lightheadedness, visual difficulties, shortness of breath, palpitation, confusion, and difficult communication showed statistically significant difference between pre and post values. Conclusion Four-hour use of FFP3 mask did not cause any significant VBG change. Although the participants complained about some subjective symptoms, this study indicated that long-term use of FFP3 mask did not cause any significant discomforts, and it was well tolerated.
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Grigg SE, Zampiron A, Akbaridoust F, Chandran D, Holmes NE, Johnson PDR, Marusic I, Jones D. Are surgical masks manufactured from sterilisation wrap safe? Infect Dis Health 2020; 26:104-109. [PMID: 33221298 PMCID: PMC7674969 DOI: 10.1016/j.idh.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 11/20/2022]
Abstract
Background Due to regional shortages some health services have proposed using surgical masks manufactured from sterilisation wrap. However, there has been little assessment of the safety of this practice. Therefore, we developed our own prototypes and evaluated whether they met regulatory standards. Methods Surgical mask prototypes were manufactured from two thickness grades of commercial sterilisation wrap. Safety was assessed in the context of regulatory standards. As it was not previously reported, we developed and performed differential pressure and synthetic blood penetration resistance experiments in accordance with official methodology. Results Bacterial filtration efficiency was comparable between sterilisation wrap and commercial surgical masks. Both prototypes met regulatory standards for synthetic blood resistance, whilst only our thinner mask fulfilled acceptable differential pressure (‘breathability’) thresholds. Conclusion Acceptable barrier and breathability properties can be achieved with surgical masks produced from sterilisation wrap. Therefore, this may be a reasonable method to supplement stock if required. Unless there are shortages mandating alternatives, health-care workers should always use approved personal protective equipment.
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Affiliation(s)
- Sam E Grigg
- Department of Medicine, Austin Hospital, Victoria, 3084, Australia.
| | - Andrea Zampiron
- Department of Mechanical Engineering, University of Melbourne, Victoria, 3010, Australia
| | - Farzan Akbaridoust
- Department of Mechanical Engineering, University of Melbourne, Victoria, 3010, Australia; Department of Mechanical and Aerospace Engineering, Monash University, Victoria, 3800, Australia
| | - Dileep Chandran
- Department of Mechanical Engineering, University of Melbourne, Victoria, 3010, Australia
| | - Natasha E Holmes
- Department of Infectious Diseases, Austin Hospital, Victoria, 3084, Australia
| | - Paul D R Johnson
- Department of Infectious Diseases, Austin Hospital, Victoria, 3084, Australia
| | - Ivan Marusic
- Department of Mechanical Engineering, University of Melbourne, Victoria, 3010, Australia
| | - Daryl Jones
- Department of Intensive Care, Austin Hospital, Victoria, 3084, Australia
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