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S S Schneider D, de Magalhães AMM, de Oliveira JLC, Costanzi AP, Nora CRD, Trevilato DD. Integrity and filtration efficiency of decontaminated N95/PFF2 masks to protect health care professionals against COVID-19: A systematic literature review and meta-analysis. Am J Infect Control 2024; 52:751-758. [PMID: 38342344 DOI: 10.1016/j.ajic.2024.01.020] [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: 07/12/2023] [Revised: 01/27/2024] [Accepted: 01/31/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND To evaluate the evidence related to maintaining the integrity and filtration efficiency of N95 and/or PFF2 respirators after decontamination in health care professionals' protection against COVID-19. METHODS Systematic review, developed based on the guidelines from Joanna Briggs Institute for syntheses focusing on effectiveness evidence. The protocol was registered on the International Prospective Register of Ongoing Systematic Reviews platform, under the number CRD42022354256. This study report was developed in accordance with the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Publications between January 2020 and August 2022 were selected of Embase, Medline, CINAHL, Web of Science, Cochrane, SciELO and Virtual Health Library databases. Joanna Briggs critical appraisal tool for nonrandomized experimental tests was used to evaluate the evidence quality. RESULTS Seven articles were included in the data extraction and critical evaluation, and 3 in the meta-analysis. Four studies evaluated the integrity by visual inspection and 2 by electron microscopy. There was no association between the number of cycles increase and the reduction in filtration in up to 10 cycles. None study was considered of high methodological quality. CONCLUSIONS There is some evidence that integrity and filtration capacity were maintained after decontamination of N95/PFF2 respirators to prevent COVID-19.
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Affiliation(s)
- Daniela S S Schneider
- PhD in Nursing at the Federal University of Rio Grande do Sul (UFRGS), Master in Genetics and Toxicology, Specialist in Operations Management for Health, Nursing Manager of the Central sterile services department (CSSD) of the Hospital de Clínicas de Porto Alegre (HCPA), Member of the Center for Nursing Management Studies (NEGE), Porto Alegre, Rio Grande do Sul, Brazil; PhD student in Nursing at the Federal University of Rio Grande do Sul (UFRGS), Master in Health Teaching, Nurse Assistant of the Surgical Center department of the Hospital Moinhos de Vento (RS), Assistant Professor of the Undergraduate Nursing Course of the Moinhos de Vento Health Sciences College, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Ana M M de Magalhães
- Director of the School of Nursing of the Federal University of Rio Grande do Sul (UFRGS), Associate Professor of the Department of Assistance and Professional Orientation, DAOP, Permanent Professor of the Postgraduate Program in Nursing (PPGENF-UFRGS), Coordinator of the Center for Nursing Management Studies (NEGE), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Joao L C de Oliveira
- Adjunct Professor, Department of Assistance and Professional Guidance, DAOP of the School of Nursing, Federal University of Rio Grande do Sul (UFRGS), Assistant Professor of the Service of Clinical Nursing of the Nursing Department of the Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | | | - Carlise R D Nora
- Adjunct Professor, Department of Assistance and Professional Guidance, DAOP, School of Nursing, Federal University of Rio Grande do Sul (UFRGS), Advisory Professor at the Nursing Service in Surgical Center (SECC) of the Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Denilse D Trevilato
- PhD student in Nursing at the Federal University of Rio Grande do Sul (UFRGS), Master in Health Teaching, Nurse Assistant of the Surgical Center department of the Hospital Moinhos de Vento (RS), Assistant Professor of the Undergraduate Nursing Course of the Moinhos de Vento Health Sciences College, Porto Alegre, Rio Grande do Sul, Brazil.
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2
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Costa DG, Margatho AS, Ciol MA, Hoffman JM, Ferreira EB, do Monte AFG, Silveira RCDCP. Comparison of 2 methods for sterilization of filtering facepiece respirators worn for extended periods during the COVID-19 pandemic: An experimental laboratory study. Am J Infect Control 2024:S0196-6553(24)00552-2. [PMID: 38885789 DOI: 10.1016/j.ajic.2024.06.006] [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: 02/20/2024] [Revised: 06/03/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, there was a shortage of filtering facepiece respirators (FFR), leading to prolonged use and reuse of FFRs. METHODS FFRs were collected in 3 hospitals after extended use (up to 15 or 30days). We assessed the physical characteristics and filtration levels of worn FFRs, before sterilization. Respirators that achieved at least 94% filtration of aerosol particles, nasal clip still attached, had no tears, had preserved elastic bands, and had no dirt were randomized to receive or not receive cleaning before being submitted to hydrogen peroxide plasma gas sterilization. RESULTS A total of 1,055 FFRs were collected. Over 85% of them exhibited secured nose clips, preserved strap elasticity, and no tears. However, more than 78% of samples contained dirt, leaving only 101 (19.6%) eligible to undergo sterilization. After sterilization, none of the FFRs in either group achieved minimum filtration, although 72% without cleaning and 80% with cleaning had filtration between 90.0% and 93.9%. DISCUSSION A large proportion of FFRs were ineligible for sterilization due to factors unrelated to health care (eg, dirt from makeup). CONCLUSIONS Prolonged reuse of FFRs significantly reduced aerosol filtration efficiency. Eligible FFRs did not maintain 94% filtration after sterilization with or without cleaning.
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Affiliation(s)
- Daniela Galdino Costa
- University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Amanda Salles Margatho
- University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Marcia A Ciol
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - Jeanne Marie Hoffman
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - Elaine Barros Ferreira
- University of Brasília, School of Health Sciences, Nursing Department, Brasília, Federal District, Brazil
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Mohsin AS, Jamiruddin MR, Peyal MMK, Sharmin S, Ahmed A, Puspita AH, Sharfuddin A, Malik A, Hasib A, Suchona SA, Chowdhury AM, Kabir ER. Design optimization and validation of UV-C illumination chamber for filtering facepiece respirators. Heliyon 2024; 10:e26348. [PMID: 38439842 PMCID: PMC10909644 DOI: 10.1016/j.heliyon.2024.e26348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/10/2023] [Accepted: 02/12/2024] [Indexed: 03/06/2024] Open
Abstract
In this study, we constructed an UV-C illumination chamber using commercially available germicidal lamps and other locally available low-cost components for general-purpose biological decontamination purposes. The illumination chamber provides uniform illumination of around 1 J/cm2 in under 5 min across the chamber. The control mechanism was developed to automate the on/off process and make it more secure minimizing health and other electrical safety. To validate the decontamination efficacy of the UV-C Illumination Chamber we performed the Geobacillus spore strip culture assay. Additionally, we performed the viral load measurement by identifying the COVID-19-specific N-gene and ORF1 gene on surgical masks. The gold standard RT-qPCR measurement was performed to detect and quantify the COVID-19-specific gene on the mask sample. The biochemical assay was conducted on the control and test group to identify the presence of different types of bacteria, and fungi before and after exposure under the illumination chamber. The findings of our study revealed satisfactory decontamination efficacy test results. Therefore, it could be an excellent device in healthcare settings as a disinfection tool for biological decontamination such as SAR-CoV-2 virus, personal protection equipment (PPE), (including n95, k95 respirators, and surgical masks), and other common pathogens.
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Affiliation(s)
- Abu S.M. Mohsin
- Department of Electrical and Electronics Engineering, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Mohd. Raeed Jamiruddin
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
- Gonoshasthaya-RNA Molecular Diagnostic and Research Center, Dhaka, Bangladesh
| | - Md Mahmudul Kabir Peyal
- Department of Electrical and Electronics Engineering, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Shahana Sharmin
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Ashfaq Ahmed
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Afrin Hossain Puspita
- Department of Electrical and Electronics Engineering, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - A.A.M. Sharfuddin
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Afrida Malik
- Department of Electrical and Electronics Engineering, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Al Hasib
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | | | - Arshad M. Chowdhury
- Department of Electrical and Electronics Engineering, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Eva Rahman Kabir
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
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4
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Wong HM, Mun CH, Loke WK, Lim WQ, Chee GWY, Tan SL, Teo JY, Yang YY, Tanoto H, Loh XJ, Lee CE, Tiang C, Wan WY, Cheong C, How KB, Ling ML, Tan BH. Moist heat as a promising method to decontaminate N95 masks: A large scale clinical study comparing four decontamination modalities-moist heat, steam, ultraviolet-C irradiation, and hydrogen peroxide plasma. Int J Infect Dis 2023; 136:151-157. [PMID: 37758170 DOI: 10.1016/j.ijid.2023.09.016] [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: 05/12/2023] [Revised: 08/28/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Early in the COVID-19 pandemic, there was a global shortage of masks. Although mask reprocessing was practiced, no clinical study has assessed systematically the impact of repeated cycles of wear and decontamination on the integrity of N95 filtering facepiece respirators (FFRs). METHODS We evaluated mask fit assessed by qualitative respirator fit test (QRFT) after each cycle of wear and decontamination, as well as four measures of mask integrity-bacterial filtration efficacy, particle filtration efficacy, differential pressure, and splash resistance through five cycles of wear and decontamination using one of the four modalities (moist heat, steam, ultraviolet-C irradiation, and hydrogen peroxide plasma). RESULTS A total of 60.6% (hydrogen peroxide plasma) to 77.5% (moist heat) of the FFRs passed five cycles of wear and decontamination, as assessed by the wearers passing QRFT all five times. Moist heat-decontaminated FFRs retained all technical measures of integrity through all five cycles. CONCLUSIONS This is the first large-scale study to assess systematically the impact (clinically and quantitatively) on N95 FFR integrity of repeated cycles of wearing followed by decontamination. Our results suggest that moist heat is a promising method for decontaminating N95 FFRs. Performing QRFT after every cycle of wear and decontamination ensures wearer safety. Although there is currently no mask shortage, reprocessing may reduce medical waste and improve sustainability.
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Affiliation(s)
- Hei Man Wong
- Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention & Epidemiology, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore.
| | | | | | | | | | | | - Jye Yng Teo
- Institute of Bioengineering and Bioimaging, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Yi Yan Yang
- Institute of Bioengineering and Bioimaging, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Hendrix Tanoto
- Institute of Materials Research and Engineering, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Xian Jun Loh
- Institute of Materials Research and Engineering, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Chen Ee Lee
- Singapore Health Services Pte Ltd, Singapore
| | | | - Wei Yee Wan
- Duke-NUS Medical School, Singapore; Department of Microbiology, Singapore General Hospital, Singapore
| | - Charlene Cheong
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Kue Bien How
- Department of Infection Prevention & Epidemiology, Singapore General Hospital, Singapore
| | - Moi Lin Ling
- Department of Infection Prevention & Epidemiology, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Ban Hock Tan
- Department of Infectious Diseases, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore
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5
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Nowak R, Wityk P, Wierzbicka-Woś A, Gos W, Kostrzewa-Nowak D. The novel sterilization device: the prototype testing. Sci Rep 2023; 13:17431. [PMID: 37833295 PMCID: PMC10575896 DOI: 10.1038/s41598-023-44483-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 10/09/2023] [Indexed: 10/15/2023] Open
Abstract
Currently, there are numerous methods that can be used to neutralize pathogens (i.e., devices, tools, or protective clothing), but the sterilizing agent must be selected so that it does not damage or change the properties of the material to which it is applied. Dry sterilization with hydrogen peroxide gas (VHP) in combination with UV-C radiation is well described and effective method of sterilization. This paper presents the design, construction, and analysis of a novel model of sterilization device. Verification of the sterilization process was performed, using classical microbiological methods and flow cytometry, on samples containing Geobacillus stearothermophilus spores, Bacillus subtilis spores, Escherichia coli, and Candida albicans. Flow cytometry results were in line with the standardized microbiological tests and confirmed the effectiveness of the sterilization process. It was also determined that mobile sterilization stations represent a valuable solution when dedicated to public institutions and businesses in the tourism sector, sports & fitness industry, or other types of services, e.g., cosmetic services. A key feature of this solution is the ability to adapt the device within specific constraints to the user's needs.
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Affiliation(s)
- Robert Nowak
- Institute of Physical Culture Sciences, University of Szczecin, 17C Narutowicza St., 70-240, Szczecin, Poland
- Department of Pathology, Pomeranian Medical University in Szczecin, 1 Unii Lubelskiej St., 71-242, Szczecin, Poland
| | - Paweł Wityk
- Faculty of Chemistry, Gdańsk University of Technology, 11/12 Narutowicza St., 80-233, Gdańsk, Poland
- Department of Biopharmaceutics and Pharmacodynamics, Faculty of Pharmacy, Medical University of Gdańsk, 107 Hallera St., 80-416, Gdańsk, Poland
| | - Anna Wierzbicka-Woś
- The Centre for Molecular Biology and Biotechnology, University of Szczecin, 13 Wąska St., 71-415, Szczecin, Poland
- Research and Development Centre, Sanprobi Sp. z o. o. Sp. k., 5/c Kurza stopka St., 70-535, Szczecin, Poland
| | - Waldemar Gos
- Institute of Economics and Finance, University of Szczecin, 64 Mickiewicza St., 71-101, Szczecin, Poland
| | - Dorota Kostrzewa-Nowak
- Faculty of Chemistry, Gdańsk University of Technology, 11/12 Narutowicza St., 80-233, Gdańsk, Poland.
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, 72 Powstańców Wlkp. Al., 70-111, Szczecin, Poland.
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6
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Bell M, Ye K, Yap TF, Rajappan A, Liu Z, Tao YJ, Preston DJ. Rapid In Situ Thermal Decontamination of Wearable Composite Textile Materials. ACS APPLIED MATERIALS & INTERFACES 2023; 15:44521-44532. [PMID: 37695080 PMCID: PMC10521748 DOI: 10.1021/acsami.3c09063] [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] [Received: 06/23/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
Pandemics stress supply lines and generate shortages of personal protective equipment (PPE), in part because most PPE is single-use and disposable, resulting in a need for constant replenishment to cope with high-volume usage. To better prepare for the next pandemic and to reduce waste associated with disposable PPE, we present a composite textile material capable of thermally decontaminating its surface via Joule heating. This material can achieve high surface temperatures (>100 °C) and inactivate viruses quickly (<5 s of heating), as evidenced experimentally with the surrogate virus HCoV-OC43 and in agreement with analytical modeling for both HCoV-OC43 and SARS-CoV-2. Furthermore, it does not require doffing because it remains relatively cool near the skin (<40 °C). The material can be easily integrated into clothing and provides a rapid, reusable, in situ decontamination method capable of reducing PPE waste and mitigating the risk of supply line disruptions in times of need.
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Affiliation(s)
- Marquise
D. Bell
- Department
of Mechanical Engineering, George R. Brown School of Engineering, Rice University, 6100 Main Street, Houston, Texas 77005, United States
| | - Kai Ye
- Department
of Biosciences, Wiess School of Natural Sciences, Rice University, 6100
Main Street, Houston, Texas 77005, United States
| | - Te Faye Yap
- Department
of Mechanical Engineering, George R. Brown School of Engineering, Rice University, 6100 Main Street, Houston, Texas 77005, United States
| | - Anoop Rajappan
- Department
of Mechanical Engineering, George R. Brown School of Engineering, Rice University, 6100 Main Street, Houston, Texas 77005, United States
| | - Zhen Liu
- Department
of Mechanical Engineering, George R. Brown School of Engineering, Rice University, 6100 Main Street, Houston, Texas 77005, United States
| | - Yizhi Jane Tao
- Department
of Biosciences, Wiess School of Natural Sciences, Rice University, 6100
Main Street, Houston, Texas 77005, United States
| | - Daniel J. Preston
- Department
of Mechanical Engineering, George R. Brown School of Engineering, Rice University, 6100 Main Street, Houston, Texas 77005, United States
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Archer J, Mikelonis A, Wyrzykowska-Ceradini B, Morris E, Sawyer J, Chamberlain T, Abdel-Hady A, Monge M, Touati A. Evaluation of disinfection methods for personal protective equipment (PPE) items for reuse during a pandemic. PLoS One 2023; 18:e0287664. [PMID: 37498861 PMCID: PMC10374148 DOI: 10.1371/journal.pone.0287664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 06/10/2023] [Indexed: 07/29/2023] Open
Abstract
The COVID-19 pandemic resulted in many supply chain issues, including crippling of essential personal protective equipment (PPE) needed for high-risk occupations such as those in healthcare. As a result of these supply chain issues, unprecedented crisis capacity strategies were implemented to divert PPE items such as filtering facepiece respirators (FFRs, namely N95s) to those who needed them most for protection. Large-scale methods for decontamination were used throughout the world to preserve these items and provided for their extended use. The general public also adopted the use of non-specialized protective equipment such as face coverings. So, the need for cleaning, decontamination, or disinfection of these items in addition to normal clothing items became a necessary reality. Some items could be laundered, but other items were not appropriate for washing/drying. To fill research gaps in small-scale, non-commercial cleaning and disinfection, this bench-scale research was conducted using small coupons (swatches) of multiple PPE/barrier protection materials inoculated with virus (non-pathogenic bacteriophages Phi6 and MS2) and tested against a range of decontamination methods including bleach-, alcohol- and quaternary ammonium compound (QAC)-based liquid sprays, as well as low concentration hydrogen peroxide vapor (LCHPV) and bench-scale laundering. In general, non-porous items were easier to disinfect than porous items, and the enveloped virus Phi6 was overall easier to inactivate than MS2. Multiple disinfection methods were shown to be effective in reducing viral loads from PPE coupons, though only laundering and LCHPV were effective for all materials tested that were inoculated with Phi6. Applications of this and follow-on full-scale research are to provide simple effective cleaning/disinfection methods for use during the current and future pandemics.
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Affiliation(s)
- John Archer
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Homeland Security and Materials Management Division, Research Triangle Park, North Carolina, United States of America
| | - Anne Mikelonis
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Homeland Security and Materials Management Division, Research Triangle Park, North Carolina, United States of America
| | | | - Eric Morris
- Science Systems and Applications Inc., Research Triangle Park, North Carolina, United States of America
| | - Jonathan Sawyer
- Jacobs Technology Inc., Research Triangle Park, North Carolina, United States of America
| | - Timothy Chamberlain
- Jacobs Technology Inc., Research Triangle Park, North Carolina, United States of America
| | - Ahmed Abdel-Hady
- Jacobs Technology Inc., Research Triangle Park, North Carolina, United States of America
| | - Mariela Monge
- CSS Inc., Research Triangle Park, North Carolina, United States of America
| | - Abderrahmane Touati
- Jacobs Technology Inc., Research Triangle Park, North Carolina, United States of America
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8
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Blacksell SD, Dhawan S, Kusumoto M, Le KK, Summermatter K, O'Keefe J, Kozlovac J, Almuhairi SS, Sendow I, Scheel CM, Ahumibe A, Masuku ZM, Kojima K, Harper DR, Hamilton K. The Biosafety Research Road Map: The Search for Evidence to Support Practices in the Laboratory-SARS-CoV-2. APPLIED BIOSAFETY 2023; 28:87-95. [PMID: 37342515 PMCID: PMC10278019 DOI: 10.1089/apb.2022.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Introduction The SARS-CoV-2 virus emerged as a novel virus and is the causative agent of the COVID-19 pandemic. It spreads readily human-to-human through droplets and aerosols. The Biosafety Research Roadmap aims to support the application of laboratory biological risk management by providing an evidence base for biosafety measures. This involves assessing the current biorisk management evidence base, identifying research and capability gaps, and providing recommendations on how an evidence-based approach can support biosafety and biosecurity, including in low-resource settings. Methods A literature search was conducted to identify potential gaps in biosafety and focused on five main sections, including the route of inoculation/modes of transmission, infectious dose, laboratory-acquired infections, containment releases, and disinfection and decontamination strategies. Results There are many knowledge gaps related to biosafety and biosecurity due to the SARS-CoV-2 virus's novelty, including infectious dose between variants, personal protective equipment for personnel handling samples while performing rapid diagnostic tests, and laboratory-acquired infections. Detecting vulnerabilities in the biorisk assessment for each agent is essential to contribute to the improvement and development of laboratory biosafety in local and national systems.
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Affiliation(s)
- Stuart D. Blacksell
- Mahidol-Oxford Tropical Research Medicine Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, United Kingdom
| | - Sandhya Dhawan
- Mahidol-Oxford Tropical Research Medicine Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Marina Kusumoto
- Mahidol-Oxford Tropical Research Medicine Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kim Khanh Le
- Mahidol-Oxford Tropical Research Medicine Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Joseph O'Keefe
- Ministry for Primary Industries, Wellington, New Zealand
| | - Joseph Kozlovac
- U.S. Department of Agriculture, Agricultural Research Service, Beltsville, Maryland, USA
| | | | - Indrawati Sendow
- Research Center for Veterinary Science, National Research and Innovation Agency, Indonesia
| | - Christina M. Scheel
- WHO Collaborating Center for Biosafety and Biosecurity, Office of the Associate Director for Laboratory Science, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anthony Ahumibe
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Zibusiso M. Masuku
- National Institute for Communicable Diseases of the National Health Laboratory Services, Sandringham, South Africa
| | - Kazunobu Kojima
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | - David R. Harper
- The Royal Institute of International Affairs, London, United Kingdom
| | - Keith Hamilton
- World Organisation for Animal Health (OIE), Paris, France
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9
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Huang M, Hasan MK, Pillai SD, Pharr M, Staack D. Electron beam technology for Re-processing of personal protective equipment. Radiat Phys Chem Oxf Engl 1993 2023; 202:110557. [PMID: 36189446 PMCID: PMC9516357 DOI: 10.1016/j.radphyschem.2022.110557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/01/2022] [Accepted: 09/18/2022] [Indexed: 11/26/2022]
Abstract
Beginning with the outbreak of COVID-19 at the dawn of 2020, the continuing spread of the pandemic has challenged the healthcare market and the supply chain of Personal Protective Equipment (PPE) around the world. Moreover, the emergence of the variants of COVID-19 occurring in waves threatens the sufficient supply of PPE. Among the various types of PPE, N95 Respirators, surgical masks, and medical gowns are the most consumed and thus have a high potential for a serious shortage during such emergencies. Considering the unanticipated demand for PPE during a pandemic, re-processing of used PPE is one approach to continue to protect the health of first responders and healthcare personnel. This paper evaluates the viability and efficacy of using FDA-approved electron beam (eBeam) sterilization technology (ISO 11137) to re-process used PPE. PPEs including 3M N95 Respirators, Proxima Sirus gowns, and face shields were eBeam irradiated in different media (air, argon) over a dose range of 0-200 kGy. Several tests were then performed to examine surface properties, mechanical properties, functionality performance, discoloration phenomenon, and liquid barrier performance. The results show a reduction of filtration efficiency to about 63.6% in the N95 Respirator; however, charge regeneration may improve the re-processed efficiency. Additionally, mechanical degradation was observed in Proxima Sirus gown with increasing dose up to 100 kGy. However, no mechanical degradation was observed in the face shields after 10 times donning and doffing. Apart from the face shield, N95 Respirators and Proxima Sirus gown both show significant mechanical degradation with ebeam dose over sterilization doses (>25 kGy), indicating that eBeam technology is not appropriate for the re-processing these PPEs.
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Affiliation(s)
- Min Huang
- Department of Mechanical Engineering, Texas A&M University, 3123 Spence St, College Station, TX, 77840, USA
| | - Md Kamrul Hasan
- Department of Mechanical Engineering, Texas A&M University, 3123 Spence St, College Station, TX, 77840, USA
| | - Suresh D Pillai
- National Center for Electron Beam Research, Texas A&M University, College Station, TX, 77840, USA
| | - Matt Pharr
- Department of Mechanical Engineering, Texas A&M University, 3123 Spence St, College Station, TX, 77840, USA
| | - David Staack
- Department of Mechanical Engineering, Texas A&M University, 3123 Spence St, College Station, TX, 77840, USA
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10
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Aerosolized Hydrogen Peroxide Decontamination of N95 Respirators, with Fit-Testing and Viral Inactivation, Demonstrates Feasibility for Reuse during the COVID-19 Pandemic. mSphere 2022; 7:e0030322. [PMID: 36040048 PMCID: PMC9599425 DOI: 10.1128/msphere.00303-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
In response to the demand for N95 respirators by health care workers during the COVID-19 pandemic, we evaluated decontamination of N95 respirators using an aerosolized hydrogen peroxide (aHP) system. This system is designed to dispense a consistent atomized spray of aerosolized, 7% hydrogen peroxide (H2O2) solution over a treatment cycle. Multiple N95 respirator models were subjected to 10 or more cycles of respirator decontamination, with a select number periodically assessed for qualitative and quantitative fit testing. In parallel, we assessed the ability of aHP treatment to inactivate multiple viruses absorbed onto respirators, including phi6 bacteriophage, herpes simplex virus 1 (HSV-1), coxsackievirus B3 (CVB3), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For pathogens transmitted via respiratory droplets and aerosols, it is critical to address respirator safety for reuse. This study provided experimental validation of an aHP treatment process that decontaminates the respirators while maintaining N95 function. External National Institute for Occupational Safety & Health (NIOSH) certification verified respirator structural integrity and filtration efficiency after 10 rounds of aHP treatment. Virus inactivation by aHP was comparable to the decontamination of commercial spore-based biological indicators. These data demonstrate that the aHP process is effective, with successful fit-testing of respirators after multiple aHP cycles, effective decontamination of multiple virus species, including SARS-CoV-2, successful decontamination of bacterial spores, and filtration efficiency maintained at or greater than 95%. While this study did not include extended or clinical use of N95 respirators between aHP cycles, these data provide proof of concept for aHP decontamination of N95 respirators before reuse in a crisis-capacity scenario. IMPORTANCE The COVID-19 pandemic led to unprecedented pressure on health care and research facilities to provide personal protective equipment. The respiratory nature of the SARS-CoV2 pathogen makes respirator facepieces a critical protective measure to limit inhalation of this virus. While respirator facepieces were designed for single use and disposal, the pandemic increased overall demand for N95 respirators, and corresponding manufacturing and supply chain limitations necessitated the safe reuse of respirators when necessary. In this study, we repurposed an aerosolized hydrogen peroxide (aHP) system that is regularly utilized to decontaminate materials in a biosafety level 3 (BSL3) facility, to develop a method for decontamination of N95 respirators. Results from viral inactivation, biological indicators, respirator fit testing, and filtration efficiency testing all indicated that the process was effective at rendering N95 respirators safe for reuse. This proof-of-concept study establishes baseline data for future testing of aHP in crisis-capacity respirator-reuse scenarios.
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Jin Z, Sun C, Wu W, Yang X. Dry Heat as a Potential Decontamination Method on the Filtration Efficiency of Filtering Facepiece Respirators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7167. [PMID: 35742417 PMCID: PMC9223160 DOI: 10.3390/ijerph19127167] [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] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 02/01/2023]
Abstract
Filtering facepiece respirators have been widely used in the fields of occupational health and public hygiene, especially during the COVID-19 pandemic. In particular, disposable respirators have been in high demand, and the waste generated from these disposable products poses a problem for the environment. Here, we aimed to test a practical decontamination method to allow for the reuse of KN95 respirators. In this study, three types of KN95 respirators were heated at 80 °C and 90 °C for different durations (15 min, 30 min, 45 min, 1 h, 2 h, 3 h, 4 h, 6 h, 8 h, 10 h, and 24 h). The filtration efficiencies of the tested KN95 respirators before and after heating were measured, and the changes in microstructure were imaged with a scanning electron microscope (SEM). In addition, a neural network model based on the nonlinear autoregressive with external input (NARX) to predict the filtration efficiency of the KN95 respirator was established. The results show that the temperature and time of dry heating affected particle prevention. The higher the temperature and the longer the heating time, the more obvious the decline in the filtration efficiency of the respirators. When the heating temperature reached 100 °C, the respirator may be no longer suitable for reuse. These results show that a dry heat temperature between 70 °C and 90 °C, and a heating time between 30 min and 2 h is assumed to be a suitable and effective decontamination method for respirators.
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Affiliation(s)
- Zhixu Jin
- School of Engineering and Technology, China University of Geosciences (Beijing), Beijing 100083, China; (Z.J.); (W.W.)
| | - Chenchen Sun
- School of Engineering and Technology, China University of Geosciences (Beijing), Beijing 100083, China; (Z.J.); (W.W.)
| | - Wending Wu
- School of Engineering and Technology, China University of Geosciences (Beijing), Beijing 100083, China; (Z.J.); (W.W.)
| | - Xiaobing Yang
- State Key Laboratory of NBC Protection for Civilian, Beijing 100191, China
- Beijing Key Laboratory of Ambient Particles Health Effects and Prevention Techniques, Beijing 100191, China
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12
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Ibáñez-Cervantes G, Lugo-Zamudio GE, Cruz-Cruz C, Durán-Manuel EM, Bravata-Alcántara JC, García-Moncada E, Mata-Rocha M, Delgado-Balbuena L, Cureño-Díaz MA, Ramírez-Cortina CR, León-Ávila G, Nogueda-Torres B, Hernández-Hernández JM, Rodil SE, Bello-López JM. Ozone as an alternative decontamination process for N95 facemask and biosafety gowns. MATERIALS LETTERS 2022; 311:131554. [PMID: 34963705 PMCID: PMC8697480 DOI: 10.1016/j.matlet.2021.131554] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 10/30/2021] [Accepted: 12/18/2021] [Indexed: 05/12/2023]
Abstract
COVID-19 pandemic created a global shortage of medical protective equipment. Here, we considered ozone (O3) a disinfectant alternative due to its potent oxidative activity against biological macromolecules. The O3 decontamination assays were done using SARS-CoV-2 obtained from patients to produce artificial contamination of N95 masks and biosecurity gowns. The quantification of SARS-CoV-2 was performed before and after exposing the samples to different ozone gas concentrations for times between 5 and 30 min. Viral loads as a function of the O3 exposure time were estimated from the data obtained by the RT-PCR technique. The genetic material of the virus was no longer detected for any tested concentrations after 15 min of O3 exposure, which means a disinfection Concentration-Time above 144 ppm min. Vibrational spectroscopies were used to follow the modifications of the polymeric fibers after the O3 treatment. The results indicate that the N95 masks could be safely reused after decontamination with treatments of 15 min at the established O3 doses for a maximum of 6 cycles.
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Affiliation(s)
- G Ibáñez-Cervantes
- Hospital Juárez de México, Ciudad de México, Mexico
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, Mexico
| | | | - C Cruz-Cruz
- Hospital Juárez de México, Ciudad de México, Mexico
| | | | | | | | - M Mata-Rocha
- Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | | | | | - C R Ramírez-Cortina
- Departamento de Energía, Universidad Autónoma Metropolitana, Ciudad de México, Mexico
| | - G León-Ávila
- Departamento de Zoología, Escuela Nacional de Ciencias Biológicas, IPN, Ciudad de México, Mexico
| | - B Nogueda-Torres
- Departamento de Parasitología. Escuela Nacional de Ciencias Biológicas, IPN, Ciudad de México, Mexico
| | - J M Hernández-Hernández
- Departamento de Biología Celular, Centro de Investigación y Estudios Avanzados del IPN, Ciudad de México, Mexico
| | - S E Rodil
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
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Unfolding the effects of decontamination treatments on the structural and functional integrity of N95 respirators via numerical simulations. Sci Rep 2022; 12:4191. [PMID: 35264706 PMCID: PMC8906365 DOI: 10.1038/s41598-022-08150-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/03/2022] [Indexed: 11/21/2022] Open
Abstract
Filtering facepiece respirators (FFRs) provide effective protection against diseases spread through airborne infectious droplets and particles. The widespread use of FFRs during the COVID-19 pandemic has not only led to supply shortages, but the disposal of single-use facemasks also threatens the environment with a new kind of plastic pollution. While limited reuse of filtering facepiece respirators has been permitted as a crisis capacity strategy, there are currently no standard test methods available for decontamination before their repeated use. The decontamination of respirators can compromise the structural and functional integrity by reducing the filtration efficiency and breathability. Digital segmentation of X-ray microcomputed tomography (microCT) scans of the meltblown nonwoven layers of a specific N95 respirator model (Venus-4400) after treatment with one and five cycles of liquid hydrogen peroxide, ultraviolet radiation, moist heat, and aqueous soap solution enabled us to perform filtration simulations of decontaminated respirators. The computed filtration efficiencies for 0.3 µm particles agreed well with experimental measurements, and the distribution of particle penetration depths was correlated with the structural changes resulting from decontamination. The combination of X-ray microCT imaging with numerical simulations thus provides a strategy for quantitative evaluation of the effectiveness of decontamination treatments for a specific respirator model.
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Kruszewska E, Czupryna P, Pancewicz S, Martonik D, Bukłaha A, Moniuszko-Malinowska A. Is Peracetic Acid Fumigation Effective in Public Transportation? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052526. [PMID: 35270221 PMCID: PMC8909421 DOI: 10.3390/ijerph19052526] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/16/2022] [Accepted: 02/19/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic made more people aware of the danger of viruses and bacteria, which is why disinfection began to be used more and more often. Epidemiological safety must be ensured not only in gathering places, but also in home and work environments. It is especially challenging in public transportation, which is a perfect environment for the spread of infectious disease. Therefore, the aim of the study was the identification of bacteria in crowded places and the evaluation of the effect of fumigation with peracetic acid (PAA) in public transportation. Inactivation of microorganisms in buses and long-distance coaches was carried out using an automatic commercial fogging device filled with a solution of peracetic acid stabilized with acetic acid (AA) and hydrogen peroxide (H2O2). Before and after disinfection, samples were taken for microbiological tests. The most prevalent bacteria were Micrococcus luteus and Bacillus licheniformis.Staphylococcus epidermidis was only present in buses, whereas Staphylococcus hominis and Exiguobacterium acetylicum were only present in coaches. Statistical analysis showed a significant reduction in the number of microorganisms in samples taken from different surfaces after disinfection in vehicles. The overall effectiveness of disinfection was 81.7% in buses and 66.5% in coaches. Dry fog fumigation with peracetic acid is an effective method of disinfecting public transport vehicles.
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Affiliation(s)
- Ewelina Kruszewska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Żurawia 14, 15-540 Białystok, Poland; (P.C.); (S.P.); (A.M.-M.)
- Correspondence:
| | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Żurawia 14, 15-540 Białystok, Poland; (P.C.); (S.P.); (A.M.-M.)
| | - Sławomir Pancewicz
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Żurawia 14, 15-540 Białystok, Poland; (P.C.); (S.P.); (A.M.-M.)
| | - Diana Martonik
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Żurawia 14, 15-540 Białystok, Poland;
| | - Anna Bukłaha
- Department of Microbiological Diagnostics and Infectious Immunology, Medical University of Białystok, Waszyngtona 15A, 15-269 Białystok, Poland;
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Żurawia 14, 15-540 Białystok, Poland; (P.C.); (S.P.); (A.M.-M.)
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Harfoot R, Yung DBY, Anderson WA, Wild CEK, Coetzee N, Hernández LC, Lawley B, Pletzer D, Derraik JGB, Anderson YC, Quiñones-Mateu ME. Ultraviolet-C Irradiation, Heat, and Storage as Potential Methods of Inactivating SARS-CoV-2 and Bacterial Pathogens on Filtering Facepiece Respirators. Pathogens 2022; 11:83. [PMID: 35056031 PMCID: PMC8780977 DOI: 10.3390/pathogens11010083] [Citation(s) in RCA: 3] [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: 12/19/2021] [Revised: 01/06/2022] [Accepted: 01/08/2022] [Indexed: 02/01/2023] Open
Abstract
The arrival of SARS-CoV-2 to Aotearoa/New Zealand in February 2020 triggered a massive response at multiple levels. Procurement and sustainability of medical supplies to hospitals and clinics during the then upcoming COVID-19 pandemic was one of the top priorities. Continuing access to new personal protective equipment (PPE) was not guaranteed; thus, disinfecting and reusing PPE was considered as a potential alternative. Here, we describe part of a local program intended to test and implement a system to disinfect PPE for potential reuse in New Zealand. We used filtering facepiece respirator (FFR) coupons inoculated with SARS-CoV-2 or clinically relevant multidrug-resistant pathogens (Acinetobacter baumannii Ab5075, methicillin-resistant Staphylococcus aureus USA300 LAC and cystic-fibrosis isolate Pseudomonas aeruginosa LESB58), to evaluate the potential use of ultraviolet-C germicidal irradiation (UV-C) or dry heat treatment to disinfect PPE. An applied UV-C dose of 1000 mJ/cm2 was sufficient to completely inactivate high doses of SARS-CoV-2; however, irregularities in the FFR coupons hindered the efficacy of UV-C to fully inactivate the virus, even at higher UV-C doses (2000 mJ/cm2). Conversely, incubating contaminated FFR coupons at 65 °C for 30 min or 70 °C for 15 min, was sufficient to block SARS-CoV-2 replication, even in the presence of mucin or a soil load (mimicking salivary or respiratory secretions, respectively). Dry heat (90 min at 75 °C to 80 °C) effectively killed 106 planktonic bacteria; however, even extending the incubation time up to two hours at 80 °C did not completely kill bacteria when grown in colony biofilms. Importantly, we also showed that FFR material can harbor replication-competent SARS-CoV-2 for up to 35 days at room temperature in the presence of a soil load. We are currently using these findings to optimize and establish a robust process for decontaminating, reusing, and reducing wastage of PPE in New Zealand.
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Affiliation(s)
- Rhodri Harfoot
- Department of Microbiology & Immunology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand; (R.H.); (D.B.Y.Y.); (L.C.H.); (B.L.); (D.P.)
| | - Deborah B. Y. Yung
- Department of Microbiology & Immunology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand; (R.H.); (D.B.Y.Y.); (L.C.H.); (B.L.); (D.P.)
| | - William A. Anderson
- Department of Chemical Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Cervantée E. K. Wild
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland 1010, New Zealand; (C.E.K.W.); (N.C.); (J.G.B.D.)
| | - Nicolene Coetzee
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland 1010, New Zealand; (C.E.K.W.); (N.C.); (J.G.B.D.)
| | - Leonor C. Hernández
- Department of Microbiology & Immunology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand; (R.H.); (D.B.Y.Y.); (L.C.H.); (B.L.); (D.P.)
| | - Blair Lawley
- Department of Microbiology & Immunology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand; (R.H.); (D.B.Y.Y.); (L.C.H.); (B.L.); (D.P.)
| | - Daniel Pletzer
- Department of Microbiology & Immunology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand; (R.H.); (D.B.Y.Y.); (L.C.H.); (B.L.); (D.P.)
| | - José G. B. Derraik
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland 1010, New Zealand; (C.E.K.W.); (N.C.); (J.G.B.D.)
| | - Yvonne C. Anderson
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland 1010, New Zealand; (C.E.K.W.); (N.C.); (J.G.B.D.)
| | - Miguel E. Quiñones-Mateu
- Department of Microbiology & Immunology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand; (R.H.); (D.B.Y.Y.); (L.C.H.); (B.L.); (D.P.)
- Webster Centre for Infectious Diseases, University of Otago, Dunedin 9016, New Zealand
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Yuen JG, Marshilok AC, Benziger PT, Yan S, Cello J, Stackhouse CA, Kisslinger K, Bock DC, Takeuchi ES, Takeuchi KJ, Wang L, Babu S, Itzkowitz G, Thanassi D, Knopf DA, Shroyer KR. Dry heat sterilization as a method to recycle N95 respirator masks: The importance of fit. PLoS One 2022; 17:e0257963. [PMID: 34986162 PMCID: PMC8730429 DOI: 10.1371/journal.pone.0257963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/14/2021] [Indexed: 12/30/2022] Open
Abstract
In times of crisis, including the current COVID-19 pandemic, the supply chain of filtering facepiece respirators, such as N95 respirators, are disrupted. To combat shortages of N95 respirators, many institutions were forced to decontaminate and reuse respirators. While several reports have evaluated the impact on filtration as a measurement of preservation of respirator function after decontamination, the equally important fact of maintaining proper fit to the users' face has been understudied. In the current study, we demonstrate the complete inactivation of SARS-CoV-2 and preservation of fit test performance of N95 respirators following treatment with dry heat. We apply scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDS), X-ray diffraction (XRD) measurements, Raman spectroscopy, and contact angle measurements to analyze filter material changes as a consequence of different decontamination treatments. We further compared the integrity of the respirator after autoclaving versus dry heat treatment via quantitative fit testing and found that autoclaving, but not dry heat, causes the fit of the respirator onto the users face to fail, thereby rendering the decontaminated respirator unusable. Our findings highlight the importance to account for both efficacy of disinfection and mask fit when reprocessing respirators to for clinical redeployment.
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Affiliation(s)
- John G. Yuen
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Amy C. Marshilok
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York, United States of America
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York, United States of America
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, New York, United States of America
| | - Peter Todd Benziger
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York, United States of America
- Center for Infectious Diseases, Stony Brook University, Stony Brook, New York, United States of America
| | - Shan Yan
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York, United States of America
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York, United States of America
| | - Jeronimo Cello
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York, United States of America
- Center for Infectious Diseases, Stony Brook University, Stony Brook, New York, United States of America
| | - Chavis A. Stackhouse
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York, United States of America
- Department of Chemistry, Stony Brook University, Stony Brook, New York, United States of America
| | - Kim Kisslinger
- Center for Functional Nanomaterials, Brookhaven National Laboratory, Upton, New York, United States of America
| | - David C. Bock
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York, United States of America
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York, United States of America
| | - Esther S. Takeuchi
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York, United States of America
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York, United States of America
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, New York, United States of America
| | - Kenneth J. Takeuchi
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York, United States of America
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York, United States of America
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, New York, United States of America
| | - Lei Wang
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York, United States of America
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York, United States of America
| | - Sruthi Babu
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Glen Itzkowitz
- Office of the Dean, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - David Thanassi
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York, United States of America
- Center for Infectious Diseases, Stony Brook University, Stony Brook, New York, United States of America
| | - Daniel A. Knopf
- School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, New York, United States of America
| | - Kenneth R. Shroyer
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
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“Re-engineering of a food oven for thermal sanitization of Personal Protective Equipment against Sars-CoV-2 virus”. SUSTAINABLE FUTURES 2022; 4:100093. [PMID: 37522104 PMCID: PMC9373476 DOI: 10.1016/j.sftr.2022.100093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/08/2022] [Accepted: 08/09/2022] [Indexed: 06/02/2023]
Abstract
One of the main issues addressed by the recent COVID-19 pandemic which affected the whole world is the availability of Personal Protective Equipment (PPE) (e.g., face masks, white coats, or disposable gloves). This issue impacts on sustainability from different perspectives, such as more generated waste or environmental pollution, both for manufacturing and disposal, or more inequalities deriving from who can afford and access PPE and who cannot, since many shortages were recorded during the pandemic as well as fluctuating unit prices. Moreover, quite often PPE intended for single use are improperly used more times, thus generating a biological risk of infection. In an attempt to propose an innovative solution to face this problem, in this paper the re-design of an oven originally intended for food purposes is presented, with the aim of operating a thermal sanitization of PPE. The machinery and its components are detailed, together with physical and microbiological tests performed on non-woven PPE to assess the effect of treatment on mechanical properties and viral load. The pilot machinery turned out to be effective in destroying a bovine coronavirus at 95 °C and thus reducing contaminating risk in one hour without compromising the main properties of PPE, opening perspectives for the commercialization of the solution in the near future.
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Martelly E, Li C, Shimada K. Moldable Mask: A Reusable, Hot Water Moldable, Additively Manufactured Mask to Be Used as an N95 Alternative. MATERIALS (BASEL, SWITZERLAND) 2021; 14:7082. [PMID: 34832483 PMCID: PMC8624460 DOI: 10.3390/ma14227082] [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: 09/30/2021] [Revised: 11/01/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022]
Abstract
There has been high demand for personal protective equipment (PPE) during the COVID-19 pandemic, especially N95 respirators. Unfortunately, at the early stage of the pandemic, the supply could not meet the demand for N95 respirators, leading to a shortage and unsafe reuse of this form of PPE. We developed the Moldable Mask to ease the demand for N95 respirators by creating a 3D-printed mask that uses a piece of N95 material as a filter. A sheet of N95 material could be used or one N95 respirator to be turned into two masks. The main feature of the mask is the ability to easily mold it in hot water to create a custom fit for each user. It can also be easily assembled at home with affordable materials. The final mask design was qualitatively fit tested on 13 subjects, with all subjects showing an improvement in fit with the hot water molding technique and 10 (77%) subjects passing the fit test. This shows that the Moldable Mask is a viable option for a safe, affordable N95 alternative when N95 mask supply is strained.
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Affiliation(s)
- Erica Martelly
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA; (C.L.); (K.S.)
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19
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Geldert A, Su A, Roberts AW, Golovkine G, Grist SM, Stanley SA, Herr AE. Mapping of UV-C dose and SARS-CoV-2 viral inactivation across N95 respirators during decontamination. Sci Rep 2021; 11:20341. [PMID: 34645859 PMCID: PMC8514565 DOI: 10.1038/s41598-021-98121-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/03/2021] [Indexed: 11/24/2022] Open
Abstract
During public health crises like the COVID-19 pandemic, ultraviolet-C (UV-C) decontamination of N95 respirators for emergency reuse has been implemented to mitigate shortages. Pathogen photoinactivation efficacy depends critically on UV-C dose, which is distance- and angle-dependent and thus varies substantially across N95 surfaces within a decontamination system. Due to nonuniform and system-dependent UV-C dose distributions, characterizing UV-C dose and resulting pathogen inactivation with sufficient spatial resolution on-N95 is key to designing and validating UV-C decontamination protocols. However, robust quantification of UV-C dose across N95 facepieces presents challenges, as few UV-C measurement tools have sufficient (1) small, flexible form factor, and (2) angular response. To address this gap, we combine optical modeling and quantitative photochromic indicator (PCI) dosimetry with viral inactivation assays to generate high-resolution maps of "on-N95" UV-C dose and concomitant SARS-CoV-2 viral inactivation across N95 facepieces within a commercial decontamination chamber. Using modeling to rapidly identify on-N95 locations of interest, in-situ measurements report a 17.4 ± 5.0-fold dose difference across N95 facepieces in the chamber, yielding 2.9 ± 0.2-log variation in SARS-CoV-2 inactivation. UV-C dose at several on-N95 locations was lower than the lowest-dose locations on the chamber floor, highlighting the importance of on-N95 dose validation. Overall, we integrate optical simulation with in-situ PCI dosimetry to relate UV-C dose and viral inactivation at specific on-N95 locations, establishing a versatile approach to characterize UV-C photoinactivation of pathogens contaminating complex substrates such as N95s.
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Affiliation(s)
- Alisha Geldert
- The UC Berkeley - UCSF Graduate Program in Bioengineering, University of California Berkeley, 308B Stanley Hall, Mailcode 1762, Berkeley, CA, 94720, USA
| | - Alison Su
- The UC Berkeley - UCSF Graduate Program in Bioengineering, University of California Berkeley, 308B Stanley Hall, Mailcode 1762, Berkeley, CA, 94720, USA
| | - Allison W Roberts
- Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, CA, 94720, USA
| | - Guillaume Golovkine
- Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, CA, 94720, USA
| | - Samantha M Grist
- Department of Bioengineering, University of California Berkeley, Berkeley, CA, 94720, USA
| | - Sarah A Stanley
- Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, CA, 94720, USA
- School of Public Health, University of California Berkeley, Berkeley, CA, 94720, USA
| | - Amy E Herr
- The UC Berkeley - UCSF Graduate Program in Bioengineering, University of California Berkeley, 308B Stanley Hall, Mailcode 1762, Berkeley, CA, 94720, USA.
- Department of Bioengineering, University of California Berkeley, Berkeley, CA, 94720, USA.
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20
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Golovkine GR, Roberts AW, Cooper C, Riano S, DiCiccio AM, Worthington DL, Clarkson JP, Krames M, Zhang J, Gao Y, Zhou L, Biering SB, Stanley SA. Practical considerations for Ultraviolet-C radiation mediated decontamination of N95 respirator against SARS-CoV-2 virus. PLoS One 2021; 16:e0258336. [PMID: 34637475 PMCID: PMC8509861 DOI: 10.1371/journal.pone.0258336] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/23/2021] [Indexed: 11/19/2022] Open
Abstract
Decontaminating N95 respirators for reuse could mitigate shortages during the COVID-19 pandemic. Although the United States Center for Disease Control has identified Ultraviolet-C irradiation as one of the most promising methods for N95 decontamination, very few studies have evaluated the efficacy of Ultraviolet-C for SARS-CoV-2 inactivation. In addition, most decontamination studies are performed using mask coupons that do not recapitulate the complexity of whole masks. We sought to directly evaluate the efficacy of Ultraviolet-C mediated inactivation of SARS-CoV-2 on N95 respirators. To that end we created a portable UV-C light-emitting diode disinfection chamber and tested decontamination of SARS-CoV-2 at different sites on two models of N95 respirator. We found that decontamination efficacy depends on mask model, material and location of the contamination on the mask. Our results emphasize the need for caution when interpreting efficacy data of UV-C decontamination methods.
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Affiliation(s)
- Guillaume R. Golovkine
- Department of Molecular and Cell Biology, University of California, Berkeley, California, United States of America
| | - Allison W. Roberts
- Department of Molecular and Cell Biology, University of California, Berkeley, California, United States of America
| | - Chase Cooper
- Verily Life Sciences, South San Francisco, California, United States of America
| | - Sebastian Riano
- Verily Life Sciences, South San Francisco, California, United States of America
| | - Angela M. DiCiccio
- Verily Life Sciences, South San Francisco, California, United States of America
| | | | - Jeffrey P. Clarkson
- Verily Life Sciences, South San Francisco, California, United States of America
| | - Michael Krames
- Arkesso, LLC, Palo Alto, California, United States of America
| | - Jianping Zhang
- Bolb Inc, Livermore, California, United States of America
| | - Ying Gao
- Bolb Inc, Livermore, California, United States of America
| | - Ling Zhou
- Bolb Inc, Livermore, California, United States of America
| | - Scott B. Biering
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Sarah A. Stanley
- Department of Molecular and Cell Biology, University of California, Berkeley, California, United States of America
- School of Public Health, University of California, Berkeley, California, United States of America
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21
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Chu C, Baxamusa S, Witherel C. Impact of COVID-19 on materials science research innovation and related pandemic response. MRS BULLETIN 2021; 46:807-812. [PMID: 34658504 PMCID: PMC8508403 DOI: 10.1557/s43577-021-00186-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 06/13/2023]
Abstract
ABSTRACT The scope of impact that the coronavirus SARS-CoV-2 has had and continues to have on life, society, and the world as we know it will be debated for years to come. One thing is for certain, scientists, engineers, clinicians, and researchers around the globe rallied to heed the call for innovation, particularly in the field of materials science. In this special issue of MRS Bulletin, we feature six articles, two of which showcase primary consumable materials research and development, along with four review articles highlighting materials innovation over the last 18 months in diagnostics, prevention, and treatment of SARS-CoV-2 infection. GRAPHIC ABSTRACT
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Affiliation(s)
- Crystal Chu
- Department of Chemistry, Lehigh University, Bethlehem, USA
| | | | - Claire Witherel
- Department of Bioengineering, University of Pennsylvania, Philadelphia, USA
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22
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Yan S, Stackhouse CA, Waluyo I, Hunt A, Kisslinger K, Head AR, Bock DC, Takeuchi ES, Takeuchi KJ, Wang L, Marschilok AC. Reusing Face Covering Masks: Probing the Impact of Heat Treatment. ACS SUSTAINABLE CHEMISTRY & ENGINEERING 2021; 9:13545-13558. [PMID: 35855909 DOI: 10.1021/acssuschemeng.1c04530/suppl_file/sc1c04530_si_001.pdf] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The COVID-19 pandemic resulted in imminent shortages of personal protective equipment such as face masks. To address the shortage, new sterilization or decontamination procedures for masks are quickly being developed and employed. Dry heat and steam sterilization processes are easily scalable and allow treatment of large sample sizes, thus potentially presenting fast and efficient decontamination routes, which could significantly ease the rapidly increasing need for protective masks globally during a pandemic like COVID-19. In this study, a suite of structural and chemical characterization techniques, including scanning electron microscopy (SEM), contact angle, X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and Raman were utilized to probe the heat treatment impact on commercially available 3M 8210 N95 Particulate Respirator and VWR Advanced Protection surgical mask. Unique to this study is the use of the synchrotron-based In situ and Operando Soft X-ray Spectroscopy (IOS) beamline (23-ID-2) housed at the National Synchrotron Light Source II at Brookhaven National Laboratory for near-edge X-ray absorption spectroscopy (NEXAFS).
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Affiliation(s)
- Shan Yan
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York 11794, United States
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York 11973, United States
| | - Chavis A Stackhouse
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York 11794, United States
- Department of Chemistry, Stony Brook University, Stony Brook, New York 11794, United States
| | - Iradwikanari Waluyo
- National Synchrotron Light Source II, Brookhaven National Laboratory, Upton, New York 11973, United States
| | - Adrian Hunt
- National Synchrotron Light Source II, Brookhaven National Laboratory, Upton, New York 11973, United States
| | - Kim Kisslinger
- Center for Functional Nanomaterials, Brookhaven National Laboratory, Upton, New York 11973, United States
| | - Ashley R Head
- Center for Functional Nanomaterials, Brookhaven National Laboratory, Upton, New York 11973, United States
| | - David C Bock
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York 11794, United States
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York 11973, United States
| | - Esther S Takeuchi
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York 11794, United States
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York 11973, United States
- Department of Chemistry, Stony Brook University, Stony Brook, New York 11794, United States
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
| | - Kenneth J Takeuchi
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York 11794, United States
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York 11973, United States
- Department of Chemistry, Stony Brook University, Stony Brook, New York 11794, United States
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
| | - Lei Wang
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York 11794, United States
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York 11973, United States
| | - Amy C Marschilok
- Institute for Electrochemically Stored Energy, Stony Brook University, Stony Brook, New York 11794, United States
- Interdisciplinary Science Department, Brookhaven National Laboratory, Upton, New York 11973, United States
- Department of Chemistry, Stony Brook University, Stony Brook, New York 11794, United States
- Department of Materials Science and Chemical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
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23
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Yan S, Stackhouse CA, Waluyo I, Hunt A, Kisslinger K, Head AR, Bock DC, Takeuchi ES, Takeuchi KJ, Wang L, Marschilok AC. Reusing Face Covering Masks: Probing the Impact of Heat Treatment. ACS SUSTAINABLE CHEMISTRY & ENGINEERING 2021; 9:13545-13558. [PMID: 35855909 PMCID: PMC9284677 DOI: 10.1021/acssuschemeng.1c04530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The COVID-19 pandemic resulted in imminent shortages of personal protective equipment such as face masks. To address the shortage, new sterilization or decontamination procedures for masks are quickly being developed and employed. Dry heat and steam sterilization processes are easily scalable and allow treatment of large sample sizes, thus potentially presenting fast and efficient decontamination routes, which could significantly ease the rapidly increasing need for protective masks globally during a pandemic like COVID-19. In this study, a suite of structural and chemical characterization techniques, including scanning electron microscopy (SEM), contact angle, X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and Raman were utilized to probe the heat treatment impact on commercially available 3M 8210 N95 Particulate Respirator and VWR Advanced Protection surgical mask. Unique to this study is the use of the synchrotron-based In situ and Operando Soft X-ray Spectroscopy (IOS) beamline (23-ID-2) housed at the National Synchrotron Light Source II at Brookhaven National Laboratory for near-edge X-ray absorption spectroscopy (NEXAFS).
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Affiliation(s)
- Shan Yan
- Institute
for Electrochemically Stored Energy, Stony
Brook University, Stony
Brook, New York 11794, United States
- Interdisciplinary
Science Department, Brookhaven National
Laboratory, Upton, New York 11973, United States
| | - Chavis A. Stackhouse
- Institute
for Electrochemically Stored Energy, Stony
Brook University, Stony
Brook, New York 11794, United States
- Department
of Chemistry, Stony Brook University, Stony Brook, New York 11794, United States
| | - Iradwikanari Waluyo
- National
Synchrotron Light Source II, Brookhaven
National Laboratory, Upton, New York 11973, United States
| | - Adrian Hunt
- National
Synchrotron Light Source II, Brookhaven
National Laboratory, Upton, New York 11973, United States
| | - Kim Kisslinger
- Center
for Functional Nanomaterials, Brookhaven
National Laboratory, Upton, New York 11973, United States
| | - Ashley R. Head
- Center
for Functional Nanomaterials, Brookhaven
National Laboratory, Upton, New York 11973, United States
| | - David C. Bock
- Institute
for Electrochemically Stored Energy, Stony
Brook University, Stony
Brook, New York 11794, United States
- Interdisciplinary
Science Department, Brookhaven National
Laboratory, Upton, New York 11973, United States
| | - Esther S. Takeuchi
- Institute
for Electrochemically Stored Energy, Stony
Brook University, Stony
Brook, New York 11794, United States
- Interdisciplinary
Science Department, Brookhaven National
Laboratory, Upton, New York 11973, United States
- Department
of Chemistry, Stony Brook University, Stony Brook, New York 11794, United States
- Department
of Materials Science and Chemical Engineering, Stony Brook University, Stony
Brook, New York 11794, United States
| | - Kenneth J. Takeuchi
- Institute
for Electrochemically Stored Energy, Stony
Brook University, Stony
Brook, New York 11794, United States
- Interdisciplinary
Science Department, Brookhaven National
Laboratory, Upton, New York 11973, United States
- Department
of Chemistry, Stony Brook University, Stony Brook, New York 11794, United States
- Department
of Materials Science and Chemical Engineering, Stony Brook University, Stony
Brook, New York 11794, United States
| | - Lei Wang
- Institute
for Electrochemically Stored Energy, Stony
Brook University, Stony
Brook, New York 11794, United States
- Interdisciplinary
Science Department, Brookhaven National
Laboratory, Upton, New York 11973, United States
| | - Amy C. Marschilok
- Institute
for Electrochemically Stored Energy, Stony
Brook University, Stony
Brook, New York 11794, United States
- Interdisciplinary
Science Department, Brookhaven National
Laboratory, Upton, New York 11973, United States
- Department
of Chemistry, Stony Brook University, Stony Brook, New York 11794, United States
- Department
of Materials Science and Chemical Engineering, Stony Brook University, Stony
Brook, New York 11794, United States
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24
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Chen TX, Pinharanda A, Steinemann NA, Yasuma-Mitobe K, Lee E, Hahn J, Wu L, Fanourakis S, Peterka DS, Hillman EMC. Evaluation of at-home methods for N95 filtering facepiece respirator decontamination. Sci Rep 2021; 11:19750. [PMID: 34611228 PMCID: PMC8492771 DOI: 10.1038/s41598-021-99129-8] [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: 01/17/2021] [Accepted: 09/14/2021] [Indexed: 11/17/2022] Open
Abstract
N95 filtering facepiece respirators (FFRs) are essential for the protection of healthcare professionals and other high-risk groups against Coronavirus Disease of 2019 (COVID-19). In response to shortages in FFRs during the ongoing COVID-19 pandemic, the Food and Drug Administration issued an Emergency Use Authorization permitting FFR decontamination and reuse. However, although industrial decontamination services are available at some large institutions, FFR decontamination is not widely accessible. To be effective, FFR decontamination must (1) inactivate the virus; (2) preserve FFR integrity, specifically fit and filtering capability; and (3) be non-toxic and safe. Here we identify and test at-home heat-based methods for FFR decontamination that meet these requirements using common household appliances. Our results identify potential protocols for simple and accessible FFR decontamination, while also highlighting unsuitable methods that may jeopardize FFR integrity.
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Affiliation(s)
- T X Chen
- Mortimer B. Zuckerman Mind Brain Behavior Institute, New York, NY, 10027, USA
| | - A Pinharanda
- Department of Biological Sciences, Columbia University, New York, NY, 10027, USA
| | - N A Steinemann
- Mortimer B. Zuckerman Mind Brain Behavior Institute, New York, NY, 10027, USA
| | - K Yasuma-Mitobe
- Department of Microbiology and Immunology, Columbia University, New York, NY, 10032, USA
| | - E Lee
- Columbia College, Columbia University, New York, NY, 10032, USA
| | - J Hahn
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA
| | - L Wu
- Columbia College, Columbia University, New York, NY, 10032, USA
| | - S Fanourakis
- Environmental Health and Safety, Columbia University, New York, NY, 10032, USA
| | - D S Peterka
- Mortimer B. Zuckerman Mind Brain Behavior Institute, New York, NY, 10027, USA.
| | - E M C Hillman
- Mortimer B. Zuckerman Mind Brain Behavior Institute, New York, NY, 10027, USA.
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA.
- Department of Radiology, Columbia University, New York, NY, 10027, USA.
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25
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Vapourized hydrogen peroxide decontamination in a hospital setting inactivates SARS-CoV-2 and HCoV-229E without compromising filtration efficiency of unexpired N95 respirators. Am J Infect Control 2021; 49:1227-1231. [PMID: 34320409 PMCID: PMC8310574 DOI: 10.1016/j.ajic.2021.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/31/2022]
Abstract
Background The COVID-19 pandemic highlighted the need for evidence-based approaches to decontamination and reuse of N95 filtering facepiece respirators (FFRs). We sought to determine whether vapourized hydrogen peroxide (VHP) reduced SARS-CoV-2 bioburden on FFRs without compromising filtration efficiency. We also investigated coronavirus HCoV-229E as a surrogate for decontamination validation testing. Methods N95 FFRs were laced with SARS-CoV-2 or HCoV-229E and treated with VHP in a hospital reprocessing facility. After sterilization, viral burden was determined using viral outgrowth in a titration assay, and filtration efficiency of FFRs was tested against ATSM F2299 and NIOSH TEB-STP-APR-0059. Results Viable SARS-CoV-2 virus was not detected after VHP treatment. One replicate of the HCoV-229E laced FFRs yielded virus after processing. Unexpired N95 FFRs retained full filtration efficiency after VHP processing. Expired FFRs failed to meet design-specified filtration efficiency and therefore are unsuitable for reprocessing. Discussion In-hospital VHP is an effective decontaminant for SARS-CoV-2 on FFRs. Further, filtration efficiency of unexpired respirators is not affected by this decontamination process. Conclusions VHP is effective in inactivating SARS-CoV-2 on FFRs without compromising filtration efficiency. HCoV-229E is a suitable surrogate for SARS-CoV-2 for disinfection studies.
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26
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Sellera FP, Sabino CP, Cabral FV, Ribeiro MS. A systematic scoping review of ultraviolet C (UVC) light systems for SARS-CoV-2 inactivation. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2021; 8:100068. [PMID: 34549200 PMCID: PMC8444477 DOI: 10.1016/j.jpap.2021.100068] [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: 06/19/2021] [Revised: 08/16/2021] [Accepted: 09/14/2021] [Indexed: 12/30/2022] Open
Abstract
A significant amount of epidemiological evidence has underlined that human-to-human transmission due to close contacts is considered the main pathway of transmission, however since the SARS-CoV-2 can also survive in aerosols, water, and surfaces, the development and implementation of effective decontamination strategies are urgently required. In this regard, ultraviolet germicidal irradiation (UVGI) using ultraviolet C (UVC) has been proposed to disinfect different environments and surfaces contaminated by SARS-CoV-2. Herein, we performed a systematic scoping review strictly focused on peer-reviewed studies published in English that reported experimental results of UVC-based technologies against the SARS-CoV-2 virus. Studies were retrieved from PubMed and the Web of Science database. After our criterious screening, we identified 13 eligible articles that used UVC-based systems to inactivate SARS-CoV-2. We noticed the use of different UVC wavelengths, technologies, and light doses. The initial viral titer was also heterogeneous among studies. Most studies reported virus inactivation in well plates, even though virus persistence on N95 respirators and different surfaces were also evaluated. SARS-CoV-2 inactivation reached from 90% to 100% depending on experimental conditions. We concluded that there is sufficient evidence to support the use of UVC-based technologies against SARS-CoV-2. However, appropriate implementation is required to guarantee the efficacy and safety of UVC strategies to control the COVID-19 pandemic.
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Affiliation(s)
- Fábio P Sellera
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil
- School of Veterinary Medicine, Metropolitan University of Santos, Santos, SP, Brazil
| | | | - Fernanda V Cabral
- Center for Lasers and Applications, IPEN-CNEN, São Paulo, SP, Brazil
| | - Martha S Ribeiro
- Center for Lasers and Applications, IPEN-CNEN, São Paulo, SP, Brazil
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27
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Standard hospital blanket warming cabinets can be utilized for complete moist heat SARS-CoV2 inactivation of contaminated N95 masks for re-use. Sci Rep 2021; 11:18316. [PMID: 34526550 PMCID: PMC8443586 DOI: 10.1038/s41598-021-97345-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/24/2021] [Indexed: 12/23/2022] Open
Abstract
Shortages of personal protective equipment for use during the SARS-CoV-2 pandemic continue to be an issue among health-care workers globally. Extended and repeated use of N95 filtering facepiece respirators without adequate decontamination is of particular concern. Although several methods to decontaminate and re-use these masks have been proposed, logistic or practical issues limit adoption of these techniques. In this study, we propose and validate the use of the application of moist heat (70 °C with humidity augmented by an open pan of water) applied by commonly available hospital (blanket) warming cabinets to decontaminate N95 masks. This report shows that a variety of N95 masks can be repeatedly decontaminated of SARS-CoV-2 over 6 h moist heat exposure without compromise of their filtering function as assessed by standard fit and sodium chloride aerosol filtration efficiency testing. This approached can easily adapted to provide point-of-care N95 mask decontamination allowing for increased practical utility of mask recycling in the health care setting.
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28
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Wang PL, Roschli A, Paranthaman MP, Theodore M, Cramer CL, Zangmeister C, Zhang Y, Urban JJ, Love L. Recent developments in filtration media and respirator technology in response to COVID-19. MRS BULLETIN 2021; 46:822-831. [PMID: 34539059 PMCID: PMC8442655 DOI: 10.1557/s43577-021-00173-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 05/03/2023]
Abstract
Abstract The COVID-19 pandemic triggered a surge in demand for N95 or equivalent respirators that the global supply chain was unable to satisfy. This shortage in critical equipment has inspired research that addresses the immediate problems and has accelerated the development of the next-generation filtration media and respirators. This article provides a brief review of the most recent work with regard to face respirators and filtration media. We discuss filtration efficiency of the widely utilized cloth masks. Next, the sterilization of and reuse of existing N95 respirators to extend the existing stockpile is discussed. To expand near-term supplies, optimization of current manufacturing methods, such as melt-blown processes and electrospinning, has been explored. Future manufacturing methods have been investigated to address long-term supply shortages. Novel materials with antiviral and sterilizable properties with the ability for multiple reuses have been developed and will contribute to the development of the next generation of longer lasting multi-use N95 respirators. Finally, additively manufactured respirators are reviewed, which enable a rapidly deployable source of reusable respirators that can use any filtration fabric. Graphic abstract
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Affiliation(s)
| | - Alex Roschli
- Oak Ridge National Laboratory, Oak Ridge, TN USA
| | | | | | | | | | | | | | - Lonnie Love
- Oak Ridge National Laboratory, Oak Ridge, TN USA
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29
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Wang CG, Li Z, Liu S, Ng CT, Marzuki M, Jeslyn Wong PS, Tan B, Lee A, Hui Lim CF, Bifani P, Fang Z, Ching Wong JC, Setoh YX, Yang YY, Mun CH, Fiona Phua SZ, Lim WQ, Lin L, Cook AR, Tanoto H, Ng LC, Singhal A, Leong YW, Loh XJ. N95 respirator decontamination: a study in reusability. MATERIALS TODAY. ADVANCES 2021; 11:100148. [PMID: 34179746 PMCID: PMC8220445 DOI: 10.1016/j.mtadv.2021.100148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 05/23/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic had caused a severe depletion of the worldwide supply of N95 respirators. The development of methods to effectively decontaminate N95 respirators while maintaining their integrity is crucial for respirator regeneration and reuse. In this study, we systematically evaluated five respirator decontamination methods using vaporized hydrogen peroxide (VHP) or ultraviolet (254 nm wavelength, UVC) radiation. Through testing the bioburden, filtration, fluid resistance, and fit (shape) of the decontaminated respirators, we found that the decontamination methods using BioQuell VHP, custom VHP container, Steris VHP, and Sterrad VHP effectively inactivated Cardiovirus (3-log10 reduction) and bacteria (6-log10 reduction) without compromising the respirator integrity after 2-15 cycles. Hope UVC system was capable of inactivating Cardiovirus (3-log10 reduction) but exhibited relatively poorer bactericidal activity. These methods are capable of decontaminating 10-1000 respirators per batch with varied decontamination times (10-200 min). Our findings show that N95 respirators treated by the previously mentioned decontamination methods are safe and effective for reuse by industry, laboratories, and hospitals.
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Affiliation(s)
- C-G Wang
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A∗STAR), 2 Fusionopolis Way, Innovis, No. 08-03, 138634, Singapore
| | - Z Li
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A∗STAR), 2 Fusionopolis Way, Innovis, No. 08-03, 138634, Singapore
| | - S Liu
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A∗STAR), 2 Fusionopolis Way, Innovis, No. 08-03, 138634, Singapore
| | - C T Ng
- Environmental Health Institute, National Environment Agency (NEA), 11 Biopolis Way No.06-05/08 Helios Block, 138667, Singapore
| | - M Marzuki
- A∗STAR Infectious Diseases Labs, Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
| | - P S Jeslyn Wong
- Environmental Health Institute, National Environment Agency (NEA), 11 Biopolis Way No.06-05/08 Helios Block, 138667, Singapore
| | - B Tan
- A∗STAR Infectious Diseases Labs, Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
| | - A Lee
- A∗STAR Infectious Diseases Labs, Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
| | - C F Hui Lim
- A∗STAR Infectious Diseases Labs, Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
| | - P Bifani
- A∗STAR Infectious Diseases Labs, Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
| | - Z Fang
- Environmental Health Institute, National Environment Agency (NEA), 11 Biopolis Way No.06-05/08 Helios Block, 138667, Singapore
| | - J C Ching Wong
- Environmental Health Institute, National Environment Agency (NEA), 11 Biopolis Way No.06-05/08 Helios Block, 138667, Singapore
| | - Y X Setoh
- Environmental Health Institute, National Environment Agency (NEA), 11 Biopolis Way No.06-05/08 Helios Block, 138667, Singapore
| | - Y Y Yang
- Institute of Bioengineering and Bioimaging, Agency for Science, Technology and Research (A∗STAR), 31 Biopolis Way, Nanos, 138669, Singapore
| | - C H Mun
- DSO National Laboratories, 12 Science Park Dr, 118225, Singapore
| | - S Z Fiona Phua
- DSO National Laboratories, 12 Science Park Dr, 118225, Singapore
| | - W Q Lim
- DSO National Laboratories, 12 Science Park Dr, 118225, Singapore
| | - L Lin
- ST Engineering Aerospace Engines Pte Ltd, 501 Airport Rd, 539931, Singapore
| | - A R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549, Singapore
| | - H Tanoto
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A∗STAR), 2 Fusionopolis Way, Innovis, No. 08-03, 138634, Singapore
| | - L-C Ng
- Environmental Health Institute, National Environment Agency (NEA), 11 Biopolis Way No.06-05/08 Helios Block, 138667, Singapore
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, 637551, Singapore
| | - A Singhal
- A∗STAR Infectious Diseases Labs, Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A∗STAR), 8A Biomedical Grove, 138648, Singapore
| | - Y W Leong
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A∗STAR), 2 Fusionopolis Way, Innovis, No. 08-03, 138634, Singapore
| | - X J Loh
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A∗STAR), 2 Fusionopolis Way, Innovis, No. 08-03, 138634, Singapore
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Healthcare Workers' Experiences and Views of Using Surgical Masks and Respirators, and Their Attitudes on the Sustainability: A Semi-Structured Survey Study during COVID-19. NURSING REPORTS 2021; 11:615-628. [PMID: 34968337 PMCID: PMC8608101 DOI: 10.3390/nursrep11030059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 02/05/2023] Open
Abstract
A universal mask use was instituted in healthcare during COVID-19 pandemic in 2020. The extensive growth in the consumption of surgical masks and respirators brought new challenges. Healthcare workers had to get accustomed to wearing the facemasks continuously, raising concerns on the patient, occupational, and environmental safety. The aim of this study is to describe frontline healthcare workers and other authorities’ views and experiences on continuous use of surgical masks and respirators (facemasks) and their attitudes towards environmental and sustainability issues. A cross-sectional web-based survey was conducted in Finland during the COVID-19 pandemic in autumn 2020. The respondents(N = 120) were recruited via social media, and the data were collected using a purpose-designed questionnaire. Descriptive statistics and inductive content analysis were used to analyze the quantitative data and qualitative data, respectively. The healthcare workers perceived their own and patient safety, and comfortability of facemasks as important, but according to their experiences, these properties were not evident with the current facemasks. They considered protection properties more important than environmental values. However, biodegradability and biobased material were seen as desired properties in facemasks. Based on the results, the current facemasks do not meet users’ expectations well enough. Especially the design, breathability, and sustainability issues should be taken more into account.
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Cheng FS, Yen YF, Lin SY, Weng SH, Chou YC, Chu D, Chen CC, Hu HY. Prevalence and Factors Associated with the Reuse of Mask during the COVID-19 Pandemic: A Nationwide Survey in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158065. [PMID: 34360358 PMCID: PMC8345646 DOI: 10.3390/ijerph18158065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/20/2021] [Accepted: 07/28/2021] [Indexed: 12/17/2022]
Abstract
Mask usage is an effective measure to prevent severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection; however, mask reuse is not recommended. Studies examining the factors associated with mask reuse during the coronavirus disease (COVID-19) pandemic are limited. This nationwide survey aimed to determine the prevalence and factors associated with mask reuse among Taiwanese citizens during the pandemic. From 18 May through 31 May 2020, a computer-assisted telephone interview system was used to randomly select Taiwanese citizens for interview regarding COVID-19-preventive behaviors and knowledge on mask usage. For a total of 1075 participants, the overall mean age was 57.4 years, and 82.2% of participants reported mask reuse during the COVID-19 pandemic. After controlling for other covariates, participants who had a greater knowledge of mask usage or had a high supply of masks were less likely to reuse masks during the pandemic. Moreover, generalized estimating equations (GEE) analysis showed that, compared with the participants' mask-wearing behaviors before the COVID-19 pandemic, they were more likely to reuse masks during the pandemic. Thus, it is imperative to educate people on the correct usage of masks. Furthermore, the government should provide sufficient masks to the general population to reduce mask reuse.
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Affiliation(s)
- Feng-Shiang Cheng
- Department of Education and Research, Taipei City Hospital, Taipei 106, Taiwan; (F.-S.C.); (Y.-F.Y.); (S.-Y.L.); (S.-H.W.); (Y.-C.C.)
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Yung-Feng Yen
- Department of Education and Research, Taipei City Hospital, Taipei 106, Taiwan; (F.-S.C.); (Y.-F.Y.); (S.-Y.L.); (S.-H.W.); (Y.-C.C.)
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Section of Infectious Diseases, Taipei City Hospital, Yangming Branch, Taipei 111, Taiwan
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
- Department of Psychology and Counseling, University of Taipei, Taipei 100, Taiwan
| | - Shu-Yi Lin
- Department of Education and Research, Taipei City Hospital, Taipei 106, Taiwan; (F.-S.C.); (Y.-F.Y.); (S.-Y.L.); (S.-H.W.); (Y.-C.C.)
| | - Shih-Han Weng
- Department of Education and Research, Taipei City Hospital, Taipei 106, Taiwan; (F.-S.C.); (Y.-F.Y.); (S.-Y.L.); (S.-H.W.); (Y.-C.C.)
| | - Yi-Chang Chou
- Department of Education and Research, Taipei City Hospital, Taipei 106, Taiwan; (F.-S.C.); (Y.-F.Y.); (S.-Y.L.); (S.-H.W.); (Y.-C.C.)
| | - Dachen Chu
- Department of Health and Welfare, University of Taipei, Taipei 100, Taiwan;
- Department of Neurosurgery, Taipei City Hospital, Taipei 103, Taiwan
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
| | - Hsiao-Yun Hu
- Department of Education and Research, Taipei City Hospital, Taipei 106, Taiwan; (F.-S.C.); (Y.-F.Y.); (S.-Y.L.); (S.-H.W.); (Y.-C.C.)
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Health and Welfare, University of Taipei, Taipei 100, Taiwan;
- Correspondence:
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Efficient facemask decontamination via forced ozone convection. Sci Rep 2021; 11:12263. [PMID: 34112900 PMCID: PMC8192912 DOI: 10.1038/s41598-021-91735-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/31/2021] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 crisis has taken a significant toll on human life and the global economy since its start in early 2020. Healthcare professionals have been particularly vulnerable because of the unprecedented shortage of Facepiece Respirators (FPRs), which act as fundamental tools to protect the medical staff treating the coronavirus patients. In addition, many FPRs are designed to be disposable single-use devices, creating an issue related to the generation of large quantities of non-biodegradable waste. In this contribution, we describe a plasma-based decontamination technique designed to circumvent the shortages of FPRs and alleviate the environmental problems posed by waste generation. The system utilizes a Dielectric Barrier Discharge (DBD) to generate ozone and feed it through the fibers of the FPRs. The flow-through configuration is different than canonical ozone-based sterilization methods, in which the equipment is placed in a sealed ozone-containing enclosure without any flow through the mask polymer fibers. We demonstrate the rapid decontamination of surgical masks using Escherichia coli (E. coli) and Vesicular Stomatitis Virus (VSV) as model pathogens, with the flow-through configuration providing a drastic reduction in sterilization time compared to the canonical approach. We also demonstrate that there is no deterioration in mask structure or filtration efficiency resulting from sterilization. Finally, we show that this decontamination approach can be implemented using readily available tools, such as a plastic box, a glass tube, few 3D printed components, and the high-voltage power supply from a plasma globe toy. The prototype assembled for this study is portable and affordable, with effectiveness comparable to that of larger and more expensive equipment.
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Ju JTJ, Boisvert LN, Zuo YY. Face masks against COVID-19: Standards, efficacy, testing and decontamination methods. Adv Colloid Interface Sci 2021; 292:102435. [PMID: 33971389 PMCID: PMC8084286 DOI: 10.1016/j.cis.2021.102435] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the novel coronavirus disease 2019 (COVID-19), has caused a global pandemic on a scale not seen for over a century. Increasing evidence suggests that respiratory droplets and aerosols are likely the most common route of transmission for SARS-CoV-2. Since the virus can be spread by presymptomatic and asymptomatic individuals, universal face masking has been recommended as a straightforward and low-cost strategy to mitigate virus transmission. Numerous governments and public health agencies around the world have advocated for or mandated the wearing of masks in public settings, especially in situations where social distancing is not possible. However, the efficacy of wearing a mask remains controversial. This interdisciplinary review summarizes the current, state-of-the-art understanding of mask usage against COVID-19. It covers three main aspects of mask usage amid the pandemic: quality standards for various face masks and their fundamental filtration mechanisms, empirical methods for quantitatively determining mask integrity and particle filtration efficiency, and decontamination methods that allow for the reuse of traditionally disposable N95 and surgical masks. The focus is given to the fundamental physicochemical and engineering sciences behind each aspect covered in this review, providing novel insights into the current understanding of mask usage to curb COVID-19 spread.
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Affiliation(s)
- Jerry T J Ju
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, HI 96822, United States
| | - Leah N Boisvert
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96826, United States
| | - Yi Y Zuo
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, HI 96822, United States; Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96826, United States.
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Schumm MA, Hadaya JE, Mody N, Myers BA, Maggard-Gibbons M. Filtering Facepiece Respirator (N95 Respirator) Reprocessing: A Systematic Review. JAMA 2021; 325:1296-1317. [PMID: 33656543 DOI: 10.1001/jama.2021.2531] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE The COVID-19 pandemic has resulted in a persistent shortage of personal protective equipment; therefore, a need exists for hospitals to reprocess filtering facepiece respirators (FFRs), such as N95 respirators. OBJECTIVE To perform a systematic review to evaluate the evidence on effectiveness and feasibility of different processes used for decontaminating N95 respirators. EVIDENCE REVIEW A search of PubMed and EMBASE (through January 31, 2021) was completed for 5 types of respirator-decontaminating processes including UV irradiation, vaporized hydrogen peroxide, moist-heat incubation, microwave-generated steam, and ethylene oxide. Data were abstracted on process method, pathogen removal, mask filtration efficiency, facial fit, user safety, and processing capability. FINDINGS Forty-two studies were included that examined 65 total types of masks. All were laboratory studies (no clinical trials), and 2 evaluated respirator performance and fit with actual clinical use of N95 respirators. Twenty-seven evaluated UV germicidal irradiation, 19 vaporized hydrogen peroxide, 9 moist-heat incubation, 10 microwave-generated steam, and 7 ethylene oxide. Forty-three types of N95 respirators were treated with UV irradiation. Doses of 1 to 2 J/cm2 effectively sterilized most pathogens on N95 respirators (>103 reduction in influenza virus [4 studies], MS2 bacteriophage [3 studies], Bacillus spores [2 studies], Escherichia virus MS2 [1 study], vesicular stomatitis virus [1 study], and Middle East respiratory syndrome virus/SARS-CoV-1 [1 study]) without degrading respirator components. Doses higher than 1.5 to 2 J/cm2 may be needed based on 2 studies demonstrating greater than 103 reduction in SARS-CoV-2. Vaporized hydrogen peroxide eradicated the pathogen in all 7 efficacy studies (>104 reduction in SARS-CoV-2 [3 studies] and >106 reduction of Bacillus and Geobacillus stearothermophilus spores [4 studies]). Pressurized chamber systems with higher concentrations of hydrogen peroxide caused FFR damage (6 studies), while open-room systems did not degrade respirator components. Moist heat effectively reduced SARS-CoV-2 (2 studies), influenza virus by greater than 104 (2 studies), vesicular stomatitis virus (1 study), and Escherichia coli (1 study) and preserved filtration efficiency and facial fit for 11 N95 respirators using preheated containers/chambers at 60 °C to 85 °C (5 studies); however, diminished filtration performance was seen for the Caron incubator. Microwave-generated steam (1100-W to 1800-W devices; 40 seconds to 3 minutes) effectively reduced pathogens by greater than 103 (influenza virus [2 studies], MS2 bacteriophage [3 studies], and Staphylococcus aureus [1 study]) and maintained filtration performance in 10 N95 respirators; however, damage was noted in least 1 respirator type in 4 studies. In 6 studies, ethylene oxide preserved respirator components in 16 N95 respirator types but left residual carcinogenic by-product (1 study). CONCLUSIONS AND RELEVANCE Ultraviolet germicidal irradiation, vaporized hydrogen peroxide, moist heat, and microwave-generated steam processing effectively sterilized N95 respirators and retained filtration performance. Ultraviolet irradiation and vaporized hydrogen peroxide damaged respirators the least. More research is needed on decontamination effectiveness for SARS-CoV-2 because few studies specifically examined this pathogen.
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Affiliation(s)
- Max A Schumm
- Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Joseph E Hadaya
- Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Nisha Mody
- Louise M. Darling Biomedical Library, UCLA Library, University of California, Los Angeles
| | - Bethany A Myers
- Louise M. Darling Biomedical Library, UCLA Library, University of California, Los Angeles
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Fahme SA, Walsh KF, Rouzier V, Chebrolu P, Jaka H, Kingery JR, Fouad FM, Mathad JS, Downs JA, McNairy M. Practical recommendations for the prevention and management of COVID-19 in low-income and middle-income settings: adapting clinical experience from the field. Fam Med Community Health 2021; 9:e000930. [PMID: 33811089 PMCID: PMC8023753 DOI: 10.1136/fmch-2021-000930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 12/15/2022] Open
Affiliation(s)
- Sasha Abdallah Fahme
- Center for Global Health Research, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Kathleen F Walsh
- Center for Global Health Research, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
- GHESKIO, Port-au-Prince, Ouest, Haiti
| | - Vanessa Rouzier
- Center for Global Health Research, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
- GHESKIO, Port-au-Prince, Ouest, Haiti
| | - Puja Chebrolu
- Center for Global Health Research, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
| | - Hyasinta Jaka
- Catholic University of Health and Allied Sciences, Mwanza, Mwanza, Tanzania
| | - Justin Roy Kingery
- Center for Global Health Research, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
- Catholic University of Health and Allied Sciences, Mwanza, Mwanza, Tanzania
| | - Fouad M Fouad
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Jyoti S Mathad
- Center for Global Health Research, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
| | - Jennifer A Downs
- Center for Global Health Research, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
- Catholic University of Health and Allied Sciences, Mwanza, Mwanza, Tanzania
| | - Margaret McNairy
- Center for Global Health Research, Cornell University Joan and Sanford I Weill Medical College, New York, New York, USA
- GHESKIO, Port-au-Prince, Ouest, Haiti
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Nicolau T, Filho NG, Zille A. Ultraviolet-C as a Viable Reprocessing Method for Disposable Masks and Filtering Facepiece Respirators. Polymers (Basel) 2021; 13:801. [PMID: 33807909 PMCID: PMC7961913 DOI: 10.3390/polym13050801] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 01/02/2023] Open
Abstract
In normal conditions, discarding single-use personal protective equipment after use is the rule for its users due to the possibility of being infected, particularly for masks and filtering facepiece respirators. When the demand for these protective tools is not satisfied by the companies supplying them, a scenario of shortages occurs, and new strategies must arise. One possible approach regards the disinfection of these pieces of equipment, but there are multiple methods. Analyzing these methods, Ultraviolet-C (UV-C) becomes an exciting option, given its germicidal capability. This paper aims to describe the state-of-the-art for UV-C sterilization in masks and filtering facepiece respirators. To achieve this goal, we adopted a systematic literature review in multiple databases added to a snowball method to make our sample as robust as possible and encompass a more significant number of studies. We found that UV-C's germicidal capability is just as good as other sterilization methods. Combining this characteristic with other advantages makes UV-C sterilization desirable compared to other methods, despite its possible disadvantages.
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Affiliation(s)
- Talita Nicolau
- 2C2T—Centre for Textile Science and Technology, University of Minho, 4800-058 Guimarães, Portugal;
| | - Núbio Gomes Filho
- School of Economics and Management, University of Minho, 4710-57 Braga, Portugal;
| | - Andrea Zille
- 2C2T—Centre for Textile Science and Technology, University of Minho, 4800-058 Guimarães, Portugal;
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37
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Tonkins M, Miles J, O'Keeffe C, Forero SJ, Goodacre S. Emergency Medicine Journal COVID-19 monthly top five. Emerg Med J 2021; 38:240-242. [PMID: 33579695 DOI: 10.1136/emermed-2021-211203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Michael Tonkins
- School of Health and Related Research, The University of Sheffield, Sheffield, UK .,Emergency Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jamie Miles
- School of Health and Related Research, The University of Sheffield, Sheffield, UK.,Research and Development, Yorkshire Ambulance Service NHS Trust, Wakefield, UK
| | - Colin O'Keeffe
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Sonia Jimenez Forero
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Steve Goodacre
- School of Health and Related Research, The University of Sheffield, Sheffield, UK.,Emergency Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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38
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Stability of SARS-CoV-2 on critical personal protective equipment. Sci Rep 2021; 11:984. [PMID: 33441775 PMCID: PMC7806900 DOI: 10.1038/s41598-020-80098-3] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/10/2020] [Indexed: 01/16/2023] Open
Abstract
The spread of COVID-19 in healthcare settings is concerning, with healthcare workers representing a disproportionately high percentage of confirmed cases. Although SARS-CoV-2 virus has been found to persist on surfaces for a number of days, the extent and duration of fomites as a mode of transmission, particularly in healthcare settings, has not been fully characterized. To shed light on this critical matter, the present study provides the first comprehensive assessment of SARS-CoV-2 stability on experimentally contaminated personal protective equipment (PPE) widely used by healthcare workers and the general public. Persistence of viable virus was monitored over 21 days on eight different materials, including nitrile medical examination gloves, reinforced chemical resistant gloves, N-95 and N-100 particulate respirator masks, Tyvek, plastic, cotton, and stainless steel. Unlike previous reports, viable SARS-CoV-2 in the presence of a soil load persisted for up to 21 days on experimentally inoculated PPE, including materials from filtering facepiece respirators (N-95 and N-100 masks) and a plastic visor. Conversely, when applied to 100% cotton fabric, the virus underwent rapid degradation and became undetectable by TCID50 assay within 24 h. These findings underline the importance of appropriate handling of contaminated PPE during and following use in high-risk settings and provide interesting insight into the potential utility of cotton in limiting COVID-19 transmission.
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39
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Kasloff SB, Leung A, Strong JE, Funk D, Cutts T. Stability of SARS-CoV-2 on critical personal protective equipment. Sci Rep 2021; 11:984. [PMID: 33441775 DOI: 10.1101/2020.06.11.20128884] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/10/2020] [Indexed: 05/17/2023] Open
Abstract
The spread of COVID-19 in healthcare settings is concerning, with healthcare workers representing a disproportionately high percentage of confirmed cases. Although SARS-CoV-2 virus has been found to persist on surfaces for a number of days, the extent and duration of fomites as a mode of transmission, particularly in healthcare settings, has not been fully characterized. To shed light on this critical matter, the present study provides the first comprehensive assessment of SARS-CoV-2 stability on experimentally contaminated personal protective equipment (PPE) widely used by healthcare workers and the general public. Persistence of viable virus was monitored over 21 days on eight different materials, including nitrile medical examination gloves, reinforced chemical resistant gloves, N-95 and N-100 particulate respirator masks, Tyvek, plastic, cotton, and stainless steel. Unlike previous reports, viable SARS-CoV-2 in the presence of a soil load persisted for up to 21 days on experimentally inoculated PPE, including materials from filtering facepiece respirators (N-95 and N-100 masks) and a plastic visor. Conversely, when applied to 100% cotton fabric, the virus underwent rapid degradation and became undetectable by TCID50 assay within 24 h. These findings underline the importance of appropriate handling of contaminated PPE during and following use in high-risk settings and provide interesting insight into the potential utility of cotton in limiting COVID-19 transmission.
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Affiliation(s)
- Samantha B Kasloff
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, R3E 3R2, Canada
| | - Anders Leung
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, R3E 3R2, Canada
| | - James E Strong
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, R3E 3R2, Canada
- Department of Pediatrics and Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Duane Funk
- Department of Anaesthesia and Medicine, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Todd Cutts
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, R3E 3R2, Canada.
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40
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Kasloff SB, Leung A, Strong JE, Funk D, Cutts T. Stability of SARS-CoV-2 on critical personal protective equipment. Sci Rep 2021; 11:984. [PMID: 33441775 DOI: 10.1101/2020.06.20128884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/10/2020] [Indexed: 05/24/2023] Open
Abstract
The spread of COVID-19 in healthcare settings is concerning, with healthcare workers representing a disproportionately high percentage of confirmed cases. Although SARS-CoV-2 virus has been found to persist on surfaces for a number of days, the extent and duration of fomites as a mode of transmission, particularly in healthcare settings, has not been fully characterized. To shed light on this critical matter, the present study provides the first comprehensive assessment of SARS-CoV-2 stability on experimentally contaminated personal protective equipment (PPE) widely used by healthcare workers and the general public. Persistence of viable virus was monitored over 21 days on eight different materials, including nitrile medical examination gloves, reinforced chemical resistant gloves, N-95 and N-100 particulate respirator masks, Tyvek, plastic, cotton, and stainless steel. Unlike previous reports, viable SARS-CoV-2 in the presence of a soil load persisted for up to 21 days on experimentally inoculated PPE, including materials from filtering facepiece respirators (N-95 and N-100 masks) and a plastic visor. Conversely, when applied to 100% cotton fabric, the virus underwent rapid degradation and became undetectable by TCID50 assay within 24 h. These findings underline the importance of appropriate handling of contaminated PPE during and following use in high-risk settings and provide interesting insight into the potential utility of cotton in limiting COVID-19 transmission.
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Affiliation(s)
- Samantha B Kasloff
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, R3E 3R2, Canada
| | - Anders Leung
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, R3E 3R2, Canada
| | - James E Strong
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, R3E 3R2, Canada
- Department of Pediatrics and Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Infectious Diseases and Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Duane Funk
- Department of Anaesthesia and Medicine, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Todd Cutts
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, R3E 3R2, Canada.
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Comparative evaluation of four hydrogen peroxide-based systems to decontaminate N95 respirators. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY 2021; 1:e21. [PMID: 36168470 PMCID: PMC9495415 DOI: 10.1017/ash.2021.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022]
Abstract
Objective: Protocols designed to facilitate N95 filtering facepiece respirator (FFR) decontamination by commercial sterilization devices do not recommend that operators verify the device’s performance against pathogens deposited on FFRs. Here, we compared the treatment efficacy of 4 hydrogen peroxide-based systems that were authorized for N95 decontamination during the COVID-19 pandemic. Methods: Suspensions prepared from S. aureus ATCC 29213 and 44300, B. subtilis ATCC 6633, a vancomycin-resistant E. faecium isolate (VRE), E. coli ATCC 25922, and P. aeruginosa ATCC 27853 colonies were inoculated onto nine 1-cm2 areas on a 3M 1805, 1860, 1860S, 1870+, 8210, 8110S, or 9105S FFR. Contaminated respirators were treated according to protocols recommended by the STERRAD 100NX, Bioquell Z-2, Sterizone VP4, or Clēan Works Mini systems. Decontamination efficacy was determined by comparing colony counts cultured from excised segments of treated and untreated FFR. Results: All devices achieved a 6-log reduction in bacterial burden and met FDA sterilization criteria. The Bioquell Z-2 device demonstrated 100% efficacy against both gram-positive and gram-negative organisms with all FFRs tested. Colonies of S. aureus ATCC 29213 and 44300 and VRE were cultivable from up to 9 (100%) of 9 STERRAD 100NX– and Sterizone VP4–treated segments. Viable B. subtilis ATCC 6633 organisms were recovered from 76.0% of STERRAD 100NX–treated FFR segments. Conclusions: Variability in decontamination efficacy was noted across devices and FFR types. gram-positive organisms were more difficult to completely eliminate than were gram-negative organisms. Prior to initiating FFR decontamination practices, institutions should verify the effectiveness of their devices and the safety of treated FFR.
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