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Hyun C, Jensen MM, Yang K, Weaver JC, Wang X, Kudo Y, Gordon SJ, Samir AE, Karp JM. The Ultra fit community mask-Toward maximal respiratory protection via personalized face fit. PLoS One 2023; 18:e0281050. [PMID: 36920944 PMCID: PMC10016631 DOI: 10.1371/journal.pone.0281050] [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: 09/23/2022] [Accepted: 01/16/2023] [Indexed: 03/16/2023] Open
Abstract
Effective masking policies to prevent the spread of airborne infections depend on public access to masks with high filtration efficacy. However, poor face-fit is almost universally present in pleated multilayer disposable face masks, severely limiting both individual and community respiratory protection. We developed a set of simple mask modifications to mass-manufactured disposable masks, the most common type of mask used by the public, that dramatically improves both their personalized fit and performance in a low-cost and scalable manner. These modifications comprise a user-moldable full mask periphery wire, integrated earloop tension adjusters, and an inner flange to trap respiratory droplets. We demonstrate that these simple design changes improve quantitative fit factor by 320%, triples the level of protection against aerosolized droplets, and approaches the model efficacy of N95 respirators in preventing the community spread of COVID-19, for an estimated additional cost of less than 5 cents per mask with automated production.
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Affiliation(s)
- Chulho Hyun
- Katharos Labs LLC., Boston, Massachusetts, United States of America
| | - Mark M. Jensen
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Anesthesiology, Perioperative and Pain Medicine, Center for Nanomedicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Kisuk Yang
- Department of Anesthesiology, Perioperative and Pain Medicine, Center for Nanomedicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Harvard–MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, United States of America
- Proteomics Platform, Broad Institute, Cambridge, Massachusetts, United States of America
- Division of Bioengineering, Incheon National University, Incheon, Republic of Korea
- Research Center for Bio Materials & Process Development, Incheon National University, Incheon, Republic of Korea
| | - James C. Weaver
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, United States of America
| | - Xiaohong Wang
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Radiology, Center for Ultrasound Research & Translation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Yoshimasa Kudo
- Department of Anesthesiology, Perioperative and Pain Medicine, Center for Nanomedicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Steven J. Gordon
- Katharos Labs LLC., Boston, Massachusetts, United States of America
| | - Anthony E. Samir
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Radiology, Center for Ultrasound Research & Translation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jeffrey M. Karp
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Anesthesiology, Perioperative and Pain Medicine, Center for Nanomedicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Harvard–MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, United States of America
- Proteomics Platform, Broad Institute, Cambridge, Massachusetts, United States of America
- Harvard Stem Cell Institute, Cambridge, Massachusetts, United States of America
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2
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Singh T, Duba T, Muleba L, Matuka DO, Glaser D, Ratshikhopha E, Kirsten Z, van Reenen T, Masuku Z, Singo D, Ntlailane L, Nthoke T, Jones D, Ross M, du Toit P. Effectiveness of a low-cost UVGI chamber for decontaminating filtering facepiece respirators to extend reuse. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:40-53. [PMID: 36256682 DOI: 10.1080/15459624.2022.2137299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In emergencies like the COVID-19 pandemic, the reuse or reprocessing of filtering facepiece respirators (FFRs) may be required to mitigate exposure risk. Research gap: Only a few studies evaluated decontamination effectiveness against SARS-CoV-2 that are practical for low-resource settings. This study aimed to determine the effectiveness of a relatively inexpensive ultraviolet germicidal irradiation chamber to decontaminate FFRs contaminated with SARS-CoV-2. A custom-designed UVGI chamber was constructed to determine the ability to decontaminate seven FFR models including N95s, KN95, and FFP2s inoculated with SARS-CoV-2. Vflex was excluded due to design folds/pleats and UVGI shadowing inside the chamber. Structural and functional integrity tolerated by each FFR model on repeated decontamination cycles was assessed. Twenty-seven participants were fit-tested over 30 cycles for each model and passed if the fit factor was ≥100. Of the FFR models included for testing, only the KN95 model failed filtration. The 3M™ 3M 1860 and Halyard™ duckbill 46727 (formerly Kimberly Clark) models performed better on fit testing than other models for both pre-and-post decontaminations. Fewer participants (0.3 and 0.7%, respectively) passed fit testing for Makrite 9500 N95 and Greenline 5200 FFP2 and only two for the KN95 model post decontamination. Fit testing appeared to be more affected by donning & doffing, as some passed with adjustment and repeat fit testing. A ≥ 3 log reduction of SARS-CoV-2 was achieved for worn-in FFRs namely Greenline 5200 FFP2. Conclusion: The study showed that not all FFRs tested could withstand 30 cycles of UVGI decontamination without diminishing filtration efficiency or facial fit. In addition, SARS-CoV-2 log reduction varied across the FFRs, implying that the decontamination efficacy largely depends on the decontamination protocol and selection of FFRs. We demonstrated the effectiveness of a low-cost and scalable decontamination method for SARS-CoV-2 and the effect on fit testing using people instead of manikins. It is recognized that extensive experimental evidence for the reuse of decontaminated FFRs is lacking, and thus this study would be relevant and of interest in crisis-capacity settings, particularly in low-resource facilities.
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Affiliation(s)
- Tanusha Singh
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
- Department of Clinical Microbiology and Infectious Diseases, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Department of Environmental Health, University of Johannesburg, Johannesburg, South Africa
| | - Thabang Duba
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
| | - Lufuno Muleba
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
| | - Dikeledi Onnicah Matuka
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
| | - Daniel Glaser
- Mechanical Engineering, Council for Scientific and Industrial Research (CSIR), Accra, Ghana
- Department of Mechanical Engineering, Nelson Mandela University, Gqeberha, South Africa
| | - Edith Ratshikhopha
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
| | - Zubaydah Kirsten
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
| | - Tobias van Reenen
- Mechanical Engineering, Council for Scientific and Industrial Research (CSIR), Accra, Ghana
| | - Zibusiso Masuku
- Division of Biosafety & Biosecurity, National Institute for Communicable Diseases (NICD), Johannesburg, South Africa
| | - Dikeledi Singo
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
| | - Lebogang Ntlailane
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
| | - Tebogo Nthoke
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
| | - David Jones
- Division of the National Health Laboratory Service, National Institute for Occupational Health (NIOH), Johannesburg, South Africa
| | - Mary Ross
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Pieter du Toit
- National Metrology Institute of South Africa (NMISA), Pretoria, South Africa
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3
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Young CC, Byrne JD, Wentworth AJ, Collins JE, Chu JN, Traverso G. Respirators in Healthcare: Material, Design, Regulatory, Environmental, and Economic Considerations for Clinical Efficacy. GLOBAL CHALLENGES (HOBOKEN, NJ) 2022; 6:2200001. [PMID: 35601599 PMCID: PMC9110919 DOI: 10.1002/gch2.202200001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Indexed: 06/15/2023]
Abstract
Maintaining an ample supply of personal protective equipment continues to be a challenge for the healthcare industry, especially during emergency situations and times of strain on the supply chain. Most critically, healthcare workers exposed to potential airborne hazards require sufficient respiratory protection. Respirators are the only type of personal protective equipment able to provide adequate respiratory protection. However, their ability to shield hazards depends on design, material, proper fit, and environmental conditions. As a result, not all respirators may be adequate for all scenarios. Additionally, factors including user comfort, ease of use, and cost contribute to respirator effectiveness. Therefore, a careful consideration of these parameters is essential for ensuring respiratory protection for those working in the healthcare industry. Here respirator design and material characteristics are reviewed, as well as properties of airborne hazards and potential filtration mechanisms, regulatory standards of governmental agencies, respirator efficacy in the clinical setting, attitude of healthcare personnel toward respiratory protection, and environmental and economic considerations of respirator manufacturing and distribution.
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Affiliation(s)
- Cameron C. Young
- Division of GastroenterologyBrigham and Women's HospitalHarvard Medical School75 Francis StBostonMA02115USA
- Departments of Chemical Engineering and BiochemistryNortheastern University300 Huntington AveBostonMA02115USA
| | - James D. Byrne
- Division of GastroenterologyBrigham and Women's HospitalHarvard Medical School75 Francis StBostonMA02115USA
- Harvard Radiation Oncology Program55 Fruit StBostonMA02114USA
- David H. Koch Institute for Integrative Cancer ResearchMassachusetts Institute of Technology500 Main St. Building 76CambridgeMA02142USA
- Department of Mechanical EngineeringMassachusetts Institute of Technology77 Massachusetts AveCambridgeMA02139USA
- Department of Radiation OncologyDana‐Farber Cancer Institute/Brigham and Women's Hospital44 Binney StBostonMA02115USA
| | - Adam J. Wentworth
- Division of GastroenterologyBrigham and Women's HospitalHarvard Medical School75 Francis StBostonMA02115USA
- David H. Koch Institute for Integrative Cancer ResearchMassachusetts Institute of Technology500 Main St. Building 76CambridgeMA02142USA
- Department of Mechanical EngineeringMassachusetts Institute of Technology77 Massachusetts AveCambridgeMA02139USA
| | - Joy E. Collins
- David H. Koch Institute for Integrative Cancer ResearchMassachusetts Institute of Technology500 Main St. Building 76CambridgeMA02142USA
- Department of Mechanical EngineeringMassachusetts Institute of Technology77 Massachusetts AveCambridgeMA02139USA
- Division of GastroenterologyMassachusetts General Hospital55 Fruit StBostonMA02114USA
| | - Jacqueline N. Chu
- David H. Koch Institute for Integrative Cancer ResearchMassachusetts Institute of Technology500 Main St. Building 76CambridgeMA02142USA
| | - Giovanni Traverso
- Division of GastroenterologyBrigham and Women's HospitalHarvard Medical School75 Francis StBostonMA02115USA
- David H. Koch Institute for Integrative Cancer ResearchMassachusetts Institute of Technology500 Main St. Building 76CambridgeMA02142USA
- Department of Mechanical EngineeringMassachusetts Institute of Technology77 Massachusetts AveCambridgeMA02139USA
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4
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Chen W, Wang Z, Wang L, Chen X. Smart Chemical Engineering-Based Lightweight and Miniaturized Attachable Systems for Advanced Drug Delivery and Diagnostics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2106701. [PMID: 34643302 DOI: 10.1002/adma.202106701] [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: 08/25/2021] [Revised: 10/09/2021] [Indexed: 06/13/2023]
Abstract
Smart attachable systems have attracted much attention owing to their capabilities in terms of body performance evaluation, disease diagnostics, and drug delivery. Recent advances in chemical and engineering techniques provide many opportunities to improve device fabrication and applications owing to the advantages of being lightweight and easy to control as well as their battery absence and functional diversity. This review highlights the latest developments in the field of chemical engineering-based lightweight and miniaturized attachable systems, which are mainly inspired by the natural world. Their applications for real-time monitoring, point-of-care sampling, biomarker detection, and controlled release are discussed thoroughly with respect to specific products/prototypes. The perspectives of the field, including persistence guarantee, burden reduction, and personality improvement, are also discussed. It is believed that chemical engineering-based lightweight and miniaturized attachable systems have good potential in both clinical and industrial fields, indicating a large potential to improve human lives in the near future.
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Affiliation(s)
- Wei Chen
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zheng Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Lin Wang
- Research Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China
- Department of Clinical Laboratory, Union Hospital, Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Xiaoyuan Chen
- Departments of Diagnostic Radiology and Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
- Departments of Chemical and Biomolecular Engineering and Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, 117597, Singapore
- Clinical Imaging Research Centre, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
- Nanomedicine Translational Research Program, NUS Center for Nanomedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
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5
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Iitani K, Tyson J, Rao S, Ramamurthy SS, Ge X, Rao G. What do masks mask? A study on transdermal CO 2 monitoring. Med Eng Phys 2021; 98:50-56. [PMID: 34848038 PMCID: PMC8550888 DOI: 10.1016/j.medengphy.2021.10.013] [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] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/15/2021] [Accepted: 10/24/2021] [Indexed: 01/11/2023]
Abstract
Medical professionals have complained of extreme discomfort and fatigue from continuous wearing of N95 respirators (N95) overlaid with surgical masks (SM) and face shields (FS) during COVID-19 pandemic. However, there are no reports on the effect of face coverings on transdermal CO2 (TrCO2) levels (a measure of blood CO2) during moderate activity. In this study, real-time monitoring of TrCO2, heart rate and skin surface temperature was conducted for six subjects aged 20-59 years with and without wearing personal protective equipment (PPE). We initially studied the effect of wearing PPE (N95+SM+FS) at rest. Then, the effect of moderate stepping/walking activity (120 steps per minute for 60 min) while wearing PPE was evaluated. In addition, we investigated the effect of exercising intensity with different masks. We observed a significant difference (p < 0.0001) in TrCO2 levels between without and with PPE during moderate exercise, but not while resting. TrCO2 levels were correlated to exercise intensity independently with masking condition and breathability of masks. For the first time, we present data showing that a properly fitting N95 worn along with SM and FS consistently leads to elevated TrCO2 under moderate exertion, which could contribute to fatigue over long-term use.
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Affiliation(s)
- Kenta Iitani
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA; Department of Life Science and Medical Bioscience, Graduate School of Advanced Science and Engineering, Waseda University (TWIns), 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8480, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Joel Tyson
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Samyukta Rao
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Sai Sathish Ramamurthy
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA; STAR Laboratory, Department of Chemistry, Sri Sathya Sai Institute of Higher Learning, Prasanthi Nilayam, Puttaparthi, Anantapur, Andhra Pradesh 515134, India
| | - Xudong Ge
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Govind Rao
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
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6
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El-Atab N, Mishra RB, Hussain MM. Toward nanotechnology-enabled face masks against SARS-CoV-2 and pandemic respiratory diseases. NANOTECHNOLOGY 2021; 33:062006. [PMID: 34727530 DOI: 10.1088/1361-6528/ac3578] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
Wearing a face mask has become a necessity following the outbreak of the coronavirus (COVID-19) disease, where its effectiveness in containing the pandemic has been confirmed. Nevertheless, the pandemic has revealed major deficiencies in the ability to manufacture and ramp up worldwide production of efficient surgical-grade face masks. As a result, many researchers have focused their efforts on the development of low cost, smart and effective face covers. In this article, following a short introduction concerning face mask requirements, the different nanotechnology-enabled techniques for achieving better protection against the SARS-CoV-2 virus are reviewed, including the development of nanoporous and nanofibrous membranes in addition to triboelectric nanogenerators based masks, which can filter the virus using various mechanisms such as straining, electrostatic attraction and electrocution. The development of nanomaterials-based mask coatings to achieve virus repellent and sterilizing capabilities, including antiviral, hydrophobic and photothermal features are also discussed. Finally, the usability of nanotechnology-enabled face masks is discussed and compared with that of current commercial-grade N95 masks. To conclude, we highlight the challenges associated with the quick transfer of nanomaterials-enabled face masks and provide an overall outlook of the importance of nanotechnology in counteracting the COVID-19 and future pandemics.
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Affiliation(s)
- Nazek El-Atab
- Smart, Advanced Memory devices and Applications (SAMA) Lab, Electrical & Computer Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Rishabh B Mishra
- Smart, Advanced Memory devices and Applications (SAMA) Lab, Electrical & Computer Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
- MMH Labs, Electrical & Computer Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Muhammad M Hussain
- MMH Labs, Electrical & Computer Engineering, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
- Electrical Engineering and Computer Sciences (EECS), University of California, Berkeley, CA 94720-1170, United States of America
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7
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Chu J, Ghenand O, Collins J, Byrne J, Wentworth A, Chai PR, Dadabhoy F, Hur C, Traverso G. Thinking green: modelling respirator reuse strategies to reduce cost and waste. BMJ Open 2021; 11:e048687. [PMID: 34275864 PMCID: PMC8290946 DOI: 10.1136/bmjopen-2021-048687] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/01/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To compare the impact of respirator extended use and reuse strategies with regard to cost and sustainability during the COVID-19 pandemic. DESIGN Cost analysis. SETTING USA. PARTICIPANTS All healthcare workers within the USA. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES A model was developed to estimate usage, costs and waste incurred by several respirator usage strategies over the first 6 months of the pandemic in the USA. This model assumed universal masking of all healthcare workers. Estimates were taken from the literature, government databases and commercially available data from approved vendors. RESULTS A new N95 respirator per patient encounter would require 7.41 billion respirators, cost $6.38 billion and generate 84.0 million kg of waste in the USA over 6 months. One respirator per day per healthcare worker would require 3.29 billion respirators, cost $2.83 billion and generate 37.22 million kg of waste. Decontamination by ultraviolet germicidal irradiation would require 1.64 billion respirators, cost $1.41 billion and accumulate 18.61 million kg of waste. H2O2 vapour decontamination would require 1.15 billion respirators, cost $1.65 billion and produce 13.03 million kg of waste. One reusable respirator with daily disposable filters would require 18 million respirators, cost $1.24 billion and generate 15.73 million kg of waste. Pairing a reusable respirator with H2O2 vapour-decontaminated filters would reduce cost to $831 million and generate 1.58 million kg of waste. The use of one surgical mask per healthcare worker per day would require 3.29 billion masks, cost $460 million and generate 27.92 million kg of waste. CONCLUSIONS Decontamination and reusable respirator-based strategies decreased the number of respirators used, costs and waste generated compared with single-use or daily extended-use of disposable respirators. Future development of low-cost,simple technologies to enable respirator and/or filter decontamination is needed to further minimise the economic and environmental costs of masks.
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Affiliation(s)
- Jacqueline Chu
- Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Omkar Ghenand
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Joy Collins
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - James Byrne
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Harvard Radiation Oncology Program, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Adam Wentworth
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Peter R Chai
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Farah Dadabhoy
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Chin Hur
- Department of Medicine, Columbia University Medical Center, New York, New York, USA
- Department of Epidemiology, Columbia University Medical Center, New York, New York, USA
| | - Giovanni Traverso
- Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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8
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McAvoy M, Bui ATN, Hansen C, Plana D, Said JT, Yu Z, Yang H, Freake J, Van C, Krikorian D, Cramer A, Smith L, Jiang L, Lee KJ, Li SJ, Beller B, Huggins K, Short MP, Yu SH, Mostaghimi A, Sorger PK, LeBoeuf NR. 3D Printed frames to enable reuse and improve the fit of N95 and KN95 respirators. BMC Biomed Eng 2021; 3:10. [PMID: 34099062 PMCID: PMC8182357 DOI: 10.1186/s42490-021-00055-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 05/09/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND In response to supply shortages caused by the COVID-19 pandemic, N95 filtering facepiece respirators (FFRs or "masks"), which are typically single-use devices in healthcare settings, are routinely being used for prolonged periods and in some cases decontaminated under "reuse" and "extended use" policies. However, the reusability of N95 masks is limited by degradation of fit. Possible substitutes, such as KN95 masks meeting Chinese standards, frequently fail fit testing even when new. The purpose of this study was to develop an inexpensive frame for damaged and poorly fitting masks using readily available materials and 3D printing. RESULTS An iterative design process yielded a mask frame consisting of two 3D printed side pieces, malleable wire links that users press against their face, and cut lengths of elastic material that go around the head to hold the frame and mask in place. Volunteers (n = 45; average BMI = 25.4), underwent qualitative fit testing with and without mask frames wearing one or more of four different brands of FFRs conforming to US N95 or Chinese KN95 standards. Masks passed qualitative fit testing in the absence of a frame at rates varying from 48 to 94 % (depending on mask model). For individuals who underwent testing using respirators with broken or defective straps, 80-100 % (average 85 %) passed fit testing with mask frames. Among individuals who failed fit testing with a KN95, ~ 50 % passed testing by using a frame. CONCLUSIONS Our study suggests that mask frames can prolong the lifespan of N95 and KN95 masks by serving as a substitute for broken or defective bands without adversely affecting fit. Use of frames made it possible for ~ 73 % of the test population to achieve a good fit based on qualitative and quantitative testing criteria, approaching the 85-90 % success rate observed for intact N95 masks. Frames therefore represent a simple and inexpensive way of expanding access to PPE and extending their useful life. For clinicians and institutions interested in mask frames, designs and specifications are provided without restriction for use or modification. To ensure adequate performance in clinical settings, fit testing with user-specific masks and PanFab frames is required.
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Affiliation(s)
- Malia McAvoy
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Department of Neurosurgery, University of Washington, Seattle, WA USA
| | - Ai-Tram N. Bui
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - Christopher Hansen
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Harvard Graduate School of Design, Cambridge, MA USA
| | - Deborah Plana
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA USA
- Department of Systems Biology, Harvard Ludwig Cancer Research Center, Harvard Medical School, Boston, MA USA
| | - Jordan T. Said
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - Zizi Yu
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - Helen Yang
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
| | - Jacob Freake
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Fikst Product Development, Woburn, MA USA
| | - Christopher Van
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Borobot, Middleborough, MA USA
| | - David Krikorian
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Dana-Farber Cancer Institute, MA Boston, USA
| | - Avilash Cramer
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA USA
| | - Leanne Smith
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Borobot, Middleborough, MA USA
| | - Liwei Jiang
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA USA
| | - Karen J. Lee
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA USA
| | - Sara J. Li
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA USA
| | - Brandon Beller
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Engineering Science at Norwalk Community College, Norwalk, CT USA
| | | | - Michael P. Short
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA USA
| | - Sherry H. Yu
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Department of Dermatology, Yale University School of Medicine, New Haven, CT USA
| | - Arash Mostaghimi
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Harvard Medical School, Boston, MA USA
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA USA
| | - Peter K. Sorger
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Department of Systems Biology, Harvard Ludwig Cancer Research Center, Harvard Medical School, Boston, MA USA
- Harvard Program in Therapeutic Science, Harvard Medical School, Boston, MA USA
| | - Nicole R. LeBoeuf
- Greater Boston Pandemic Fabrication Team (PanFab) c/o Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA USA
- Harvard Medical School, Boston, MA USA
- Dana-Farber Cancer Institute, MA Boston, USA
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA USA
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9
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Nanofiber-Based Face Masks and Respirators as COVID-19 Protection: A Review. MEMBRANES 2021; 11:membranes11040250. [PMID: 33808380 PMCID: PMC8066241 DOI: 10.3390/membranes11040250] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 01/12/2023]
Abstract
Wearing face masks, use of respirators, social distancing, and practicing personal hygiene are all measures to prevent the spread of the coronavirus disease (COVID-19). This pandemic has revealed the deficiency of face masks and respirators across the world. Therefore, significant efforts are needed to develop air filtration and purification technologies, as well as innovative, alternative antibacterial and antiviral treatment methods. It has become urgent—in order for humankind to have a sustainable future—to provide a feasible solution to air pollution, particularly to capture fine inhalable particulate matter in the air. In this review, we present, concisely, the air pollutants and adverse health effects correlated with long- and short-term exposure to humans; we provide information about certified face masks and respirators, their compositions, filtration mechanisms, and the variations between surgical masks and N95 respirators, in order to alleviate confusion and misinformation. Then, we summarize the electrospun nanofiber-based filters and their unique properties to improve the filtration efficiency of face masks and respirators.
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10
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Cassorla L. Decontamination and Reuse of N95 Filtering Facepiece Respirators: Where Do We Stand? Anesth Analg 2021; 132:2-14. [PMID: 33002929 PMCID: PMC7571614 DOI: 10.1213/ane.0000000000005254] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 02/02/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic created an extraordinary demand for N95 and similarly rated filtering facepiece respirators (FFR) that remains unmet due to limited stock, production constraints, and logistics. Interest in decontamination and reuse of FFR, a product class designed for single use in health care settings, has undergone a parallel surge due to shortages. A worthwhile decontamination method must provide effective inactivation of the targeted pathogen(s), and preserve particle filtration, mask fit, and safety for a subsequent user. This discussion reviews the background of the current shortage, classification, structure, and functional aspects of FFR, and potentially effective decontamination methods along with reference websites for those seeking updated information and guidance. The most promising techniques utilize heat, hydrogen peroxide, microwave-generated steam, or ultraviolet light. Many require special or repurposed equipment and a detailed operational roadmap specific to each setting. While limited, research is growing. There is significant variation between models with regard to the ability to withstand decontamination yet remain protective. The number of times an individual respirator can be reused is often limited by its ability to maintain a tight fit after multiple uses rather than by the decontamination method itself. There is no single solution for all settings; each individual or institution must choose according to their need, capability, and available resources. As the current pandemic is expected to continue for months to years, and the possibility of future airborne biologic threats persists, the need for plentiful, effective respiratory protection is stimulating research and innovation.
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Affiliation(s)
- Lydia Cassorla
- From the Department of Anesthesia and Perioperative Care, University of California, San Francisco, California
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11
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Wentworth AJ, Byrne JD, Orguc S, Sands J, Maji S, Tov C, Babaee S, Huang HW, Boyce H, Chai PR, Min S, Li C, Chu JN, Som A, Becker SL, Gala M, Chandrakasan A, Traverso G. Prospective Evaluation of the Transparent, Elastomeric, Adaptable, Long-Lasting (TEAL) Respirator. ACS Pharmacol Transl Sci 2020; 3:1076-1082. [PMID: 33330837 PMCID: PMC7671102 DOI: 10.1021/acsptsci.0c00157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Indexed: 11/28/2022]
Abstract
N95 filtering facepiece respirators (FFR) and surgical masks are essential in reducing airborne disease transmission, particularly during the COVID-19 pandemic. However, currently available FFR's and masks have major limitations, including masking facial features, waste, and integrity after decontamination. In a multi-institutional trial, we evaluated a transparent, elastomeric, adaptable, long-lasting (TEAL) respirator to evaluate success of qualitative fit test with user experience and biometric evaluation of temperature, respiratory rate, and fit of respirator using a novel sensor. There was a 100% successful fit test among participants, with feedback demonstrating excellent or good fit (90% of participants), breathability (77.5%), and filter exchange (95%). Biometric testing demonstrated significant differences between exhalation and inhalation pressures among a poorly fitting respirator, well-fitting respirator, and the occlusion of one filter of the respirator. We have designed and evaluated a transparent elastomeric respirator and a novel biometric feedback system that could be implemented in the hospital setting.
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Affiliation(s)
- Adam J. Wentworth
- Division
of Gastroenterology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
- David
H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02142, United States
| | - James D. Byrne
- Division
of Gastroenterology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
- David
H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02142, United States
- Harvard
Radiation Oncology Program, Brigham and
Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02114, United States
| | - Sirma Orguc
- Microsystems
Technology Laboratories, Massachusetts Institute
of Technology, Cambridge, Massachusetts 02139, United States
| | - Joanna Sands
- Microsystems
Technology Laboratories, Massachusetts Institute
of Technology, Cambridge, Massachusetts 02139, United States
| | - Saurav Maji
- Microsystems
Technology Laboratories, Massachusetts Institute
of Technology, Cambridge, Massachusetts 02139, United States
| | - Caitlynn Tov
- Division
of Gastroenterology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Sahab Babaee
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
- David
H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02142, United States
| | - Hen-Wei Huang
- Division
of Gastroenterology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
- David
H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02142, United States
| | - Hannah Boyce
- Division
of Gastroenterology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Peter R. Chai
- David
H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02142, United States
- Division
of Medical Toxicology, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical
School, Boston, Massachusetts 02115, United States
- The
Fenway Institute, Boston, Massachusetts 02215, United States
- Department
of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston Massachusetts 02215, United States
| | - Seokkee Min
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Canchen Li
- David
H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02142, United States
| | - Jacqueline N. Chu
- Division
of Gastroenterology, Massachusetts General
Hospital, Harvard Medical School, Boston, Massachusetts 02114, United States
| | - Avik Som
- Department
of Radiology, Massachusetts General Hospital,
Harvard Medical School, Boston, Massachusetts 02114, United States
| | - Sarah L. Becker
- Division
of Gastroenterology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Manish Gala
- Division
of Gastroenterology, Massachusetts General
Hospital, Harvard Medical School, Boston, Massachusetts 02114, United States
| | - Anantha Chandrakasan
- Microsystems
Technology Laboratories, Massachusetts Institute
of Technology, Cambridge, Massachusetts 02139, United States
| | - Giovanni Traverso
- Division
of Gastroenterology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Mechanical Engineering, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
- David
H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02142, United States
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12
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COVID-19: How to Reduce Some Environmental and Social Impacts? Ann Glob Health 2020; 86:139. [PMID: 33200070 PMCID: PMC7646277 DOI: 10.5334/aogh.3104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The proposed viewpoint seems important at this time of the COVID-19 pandemic. Indeed, the COVID-19 prevention strategies implemented in the population are based on medical paradigms that generate extremely deleterious social and environmental impacts. Using the occupational health and safety perspective – taking care of myself with recyclables PPE (Personal Protective Equipment) – in place of the medical perspective – taking care of others with disposable PPE – can help to influence and support this important public health reflection.
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