Pandemic reveals new concerns about facial protection products: Design may be the answer to altering behaviors, habits ushered into standard practice

The article examines what medical suppliers and providers learned about facial protection products after the Covid-19 pandemic of 2020-2022. Topics discussed include remarks from Jason Burnham, Senior Director of Facial Protection at Owens & Minor, evidence of pandemic-relaxed behaviors morphing into workflow acceptance, and statement from Gary Harris, Vice President of Sales and Marketing at Prestige Ameritech, about emergency use guidelines for personal protective equipment (PPE).

Evaluation of the effectiveness of UV-C dose for photoinactivation of SARS-CoV-2 in contaminated N95 respirator, surgical and cotton fabric masks.

As part of efforts to combat the Covid-19 pandemic and decrease the high transmissibility of the new coronavirus, SARS-CoV-2, effective inactivation strategies, such as UV-C decontamination technologies, can be reliably disseminated and well-studied. The present study investigated the susceptibility of a high viral load of SARS-CoV-2 in filtering facepiece respirators (FFR) N95, surgical mask, cotton fabric mask and N95 straps under three different doses of UV-C, applying both real-time PCR (qPCR) and plaque formation assays to quantify viral load reduction and virus infectivity, respectively. The results show that more than 95% of the amount of SARS-CoV-2 RNA could be reduced after 10 min of UV-C exposure (0.93 J cm-2 per side) in FFR N95 and surgical masks and, after 5 min of UV-C treatment (0.46 J cm-2 per side) in fabric masks. Furthermore, the analysis of viable coronaviruses after these different UV-C treatments demonstrated that the lowest applied dose is sufficient to decontaminate all masks ([Formula: see text] 3-log10 reduction of the infective viral load, > 99.9% reduction). However, for the elastic strap of N95 respirators, a UV-C dose three times greater than that used in masks (1.4 J cm-2 per side) is required. The findings suggest that the complete decontamination of masks can be performed effectively and safely in well-planned protocols for pandemic crises or as strategies to reduce the high consumption and safe disposal of these materials in the environment.

Safety in the practice of decontaminating filtering facepiece respirators: A systematic review.

BACKGROUND: Considering the new SARS-CoV-2 pandemic and the potential scarcity of material resources, the reuse of personal protective equipment such as filtering facepiece respirators (FFRs) for N95 filtering or higher is being discussed, mainly regarding the effectiveness and safety of cleaning, disinfection and sterilization processes. AIM: To analyze the available evidence in the literature on the safety in processing FFRs. METHODS: A systematic review conducted by searching for studies in the following databases: PubMed, CINAHL, LILACS, CENTRAL, EMBASE, Web of Science, and Scopus. RESULTS: Forty studies were included in this review. The disinfectant/sterilizing agents most frequently tested at different concentrations and exposure periods were ultraviolet irradiation, vaporized hydrogen peroxide and steam sterilization. Microbial reduction was assessed in 21 (52.5%) studies. The only disinfectants/sterilizers that did not caused degradation of the material-integrity were alcohol, electric cooker, ethylene oxide, and peracetic acid fogging. Exposure to ultraviolet irradiation or microwave generated-steam resulted in a nonsignificant reduction in filter performance. CONCLUSION: There is a complex relationship between the FFR raw materials and the cycle conditions of the decontamination methods, evidencing the need for validating FFRs by models and manufacturers, as well as the process. Some methods may require additional tests to demonstrate the safety of FFRs for use due to toxicity.

Mask decontamination methods (model N95) for respiratory protection: a rapid review.

BACKGROUND: N95 respiratory protection masks are used by healthcare professionals to prevent contamination from infectious microorganisms transmitted by droplets or aerosols. METHODS: We conducted a rapid review of the literature analyzing the effectiveness of decontamination methods for mask reuse. The database searches were carried out up to September 2020. The systematic review was conducted in a way which simplified the stages of a complete systematic review, due to the worldwide necessity for reliable fast evidences on this matter. RESULTS: A total of 563 articles were retrieved of which 48 laboratory-based studies were selected. Fifteen decontamination methods were included in the studies. A total of 19 laboratory studies used hydrogen peroxide, 21 studies used ultraviolet germicidal irradiation, 4 studies used ethylene oxide, 11 studies used dry heat, 9 studies used moist heat, 5 studies used ethanol, two studies used isopropanol solution, 11 studies used microwave oven, 10 studies used sodium hypochlorite, 7 studies used autoclave, 3 studies used an electric rice cooker, 1 study used cleaning wipes, 1 study used bar soap, 1 study used water, 1 study used multi-purpose high-level disinfection cabinet, and another 1 study used chlorine dioxide. Five methods that are promising are as follows: hydrogen peroxide vapor, ultraviolet irradiation, dry heat, wet heat/pasteurization, and microwave ovens. CONCLUSIONS: We have presented the best available evidence on mask decontamination; nevertheless, its applicability is limited due to few studies on the topic and the lack of studies on real environments.

[Limited Reuse and Extended Use of Filtering Facepiece Respirators]. / Reutilización limitada y uso extendido de mascarillas de media-alta filtración.

AIM: Personal protective equipment (PPE), including respirators, is essential in a pandemic like COVID-19, which has required, on many occasions, the reuse of material due to its shortage. The aim of this review is to summarize available evidence on the reuse and extended use of filtering facepiece respirator. METHOD: Scoping review. Search through natural language in PUBMED and Centers, Agencies and Organizations for Disease Control. Limited to articles published between 2010-2020 in English and Spanish. RESULTS: 83 articles were located, 14 were selected, plus 5 recommendations. The topics included in this study are classified in 7 sections: expiration, extended use and reuse of masks, handling techniques, sealing, physical-psychological effects and compliance, contamination and decontamination of respirators. CONCLUSIONS: The reuse of masks is not recommended by official organizations or manufacturers, and is only accepted in extraordinary cases, such as pandemics. The studies are characterized by having small samples, using different models of respirators adjusting their recommendation to the model.

Decontamination and reuse of N95 filtering facemask respirators: A systematic review of the literature.

INTRODUCTION: As has happened in other emerging respiratory pandemics, demand for N95 filtering facemask respirators (FFRs) has far exceeded their manufacturing production and availability in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. One of the proposed strategies for mitigating the massive demand for N95 FFRs is their reuse after a process of decontamination that allows the inactivation of any potentially infectious material on their surfaces. This article aims to summarize all of the available evidence on the different decontamination methods that might allow disposable N95 FFRs to be reused, with emphasis on decontamination from SARS-CoV-2. METHODS: We performed a systematic review of the literature in order to identify studies reporting outcomes of at least 1 decontamination method for inactivating or removing any potentially infectious material from the surface of N95 FFRs, specifically addressing issues related to reduction of the microbial threat (including SARS-CoV-2 when available), maintaining the function of N95 FFRs and a lack of residual toxicity. RESULTS: We identified a total of 15 studies reporting on the different decontamination methods that might allow disposable N95 FFRs to be reused, including small-scale energetic methods and disinfecting solutions/spray/wipes. Among these decontamination methods, ultraviolet germicidal irradiation and vaporized hydrogen peroxide seem to be the most promising decontamination methods for N95 FFRs, based on their biocidal efficacy, filtration performance, fitting characteristics, and residual chemical toxicity, as well as other practical aspects such as the equipment required for their implementation and the maximum number of decontamination cycles. CONCLUSIONS: Although all the methods for the decontamination and reuse of N95 FFRs have advantages and disadvantages, ultraviolet germicidal irradiation and vaporized hydrogen peroxide seem to be the most promising methods.