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3.
Sci Rep ; 11(1): 24490, 2021 12 29.
Article in English | MEDLINE | ID: covidwho-1594104

ABSTRACT

During the first wave of Covid-19 infections in Germany in April 2020, clinics reported a shortage of filtering face masks with aerosol retention> 94% (FFP2 & 3, KN95, N95). Companies all over the world increased their production capacities, but quality control of once-certified materials and masks came up short. To help identify falsely labeled masks and ensure safe protection equipment, we tested 101 different batches of masks in 993 measurements with a self-made setup based on DIN standards. An aerosol generator provided a NaCl test aerosol which was applied to the mask. A laser aerosol spectrometer measured the aerosol concentration in a range from 90 to 500 nm to quantify the masks' retention. Of 101 tested mask batches, only 31 batches kept what their label promised. Especially in the initial phase of the pandemic in Germany, we observed fluctuating mask qualities. Many batches show very high variability in aerosol retention. In addition, by measuring with a laser aerosol spectrometer, we were able to show that not all masks filter small and large particles equally well. In this study we demonstrate how important internal and independent quality controls are, especially in times of need and shortage of personal protection equipment.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Masks/statistics & numerical data , Aerosols , Filtration/instrumentation , Germany , Humans , Masks/standards , Masks/trends , N95 Respirators/standards , N95 Respirators/statistics & numerical data , Occupational Exposure/prevention & control , Pandemics/prevention & control , Personal Protective Equipment/standards , Quality Control , Respiratory Protective Devices/standards , SARS-CoV-2/pathogenicity
4.
PLoS One ; 16(3): e0247575, 2021.
Article in English | MEDLINE | ID: covidwho-1573727

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has led to widespread shortages of N95 respirators and other personal protective equipment (PPE). An effective, reusable, locally-manufactured respirator can mitigate this problem. We describe the development, manufacture, and preliminary testing of an open-hardware-licensed device, the "simple silicone mask" (SSM). METHODS: A multidisciplinary team developed a reusable silicone half facepiece respirator over 9 prototype iterations. The manufacturing process consisted of 3D printing and silicone casting. Prototypes were assessed for comfort and breathability. Filtration was assessed by user seal checks and quantitative fit-testing according to CSA Z94.4-18. RESULTS: The respirator originally included a cartridge for holding filter material; this was modified to connect to standard heat-moisture exchange (HME) filters (N95 or greater) after the cartridge showed poor filtration performance due to flow acceleration around the filter edges, which was exacerbated by high filter resistance. All 8 HME-based iterations provided an adequate seal by user seal checks and achieved a pass rate of 87.5% (N = 8) on quantitative testing, with all failures occurring in the first iteration. The overall median fit-factor was 1662 (100 = pass). Estimated unit cost for a production run of 1000 using distributed manufacturing techniques is CAD $15 in materials and 20 minutes of labor. CONCLUSION: Small-scale manufacturing of an effective, reusable N95 respirator during a pandemic is feasible and cost-effective. Required quantities of reusables are more predictable and less vulnerable to supply chain disruption than disposables. With further evaluation, such devices may be an alternative to disposable respirators during public health emergencies. The respirator described above is an investigational device and requires further evaluation and regulatory requirements before clinical deployment. The authors and affiliates do not endorse the use of this device at present.


Subject(s)
COVID-19/prevention & control , Equipment Design/instrumentation , Filtration/instrumentation , Pandemics/prevention & control , Personal Protective Equipment , Respiratory Protective Devices , Ventilators, Mechanical , Equipment Reuse , Face , Humans , Materials Testing/instrumentation , N95 Respirators , Occupational Exposure/prevention & control , Printing, Three-Dimensional/instrumentation , SARS-CoV-2/pathogenicity
5.
J Hazard Mater ; 424(Pt B): 127429, 2022 02 15.
Article in English | MEDLINE | ID: covidwho-1445413

ABSTRACT

Transmission of pathogens through air is a critical pathway for the spread of airborne diseases, as airborne pathogenic microorganisms cause several harmful infections. This review summarizes the occurrence, transmission, and adverse impacts of airborne pathogenic microorganisms that spread over large distances via bioaerosols. Air cleaning technologies have demonstrated great potential to prevent and reduce the spread of airborne diseases. The recent advances in air cleaning technologies are summarized on the basis of their advantages, disadvantages, and adverse health effects with regard to the inactivation mechanisms. The application scope and energy consumption of different technologies are compared, and the characteristics of air cleaners in the market are discussed. The development of high-efficiency, low-cost, dynamic air cleaning technology is identified as the leading research direction of air cleaning. Furthermore, future research perspectives are discussed and further development of current air cleaning technologies is proposed.


Subject(s)
Air Microbiology , Filtration/instrumentation , Technology , Air Filters
6.
Sci Rep ; 11(1): 19910, 2021 10 07.
Article in English | MEDLINE | ID: covidwho-1462025

ABSTRACT

Face masks are a primary preventive measure against airborne pathogens. Thus, they have become one of the keys to controlling the spread of the COVID-19 virus. Common examples, including N95 masks, surgical masks, and face coverings, are passive devices that minimize the spread of suspended pathogens by inserting an aerosol-filtering barrier between the user's nasal and oral cavities and the environment. However, the filtering process does not adapt to changing pathogen levels or other environmental factors, which reduces its effectiveness in real-world scenarios. This paper addresses the limitations of passive masks by proposing ADAPT, a smart IoT-enabled "active mask". This wearable device contains a real-time closed-loop control system that senses airborne particles of different sizes near the mask by using an on-board particulate matter (PM) sensor. It then intelligently mitigates the threat by using mist spray, generated by a piezoelectric actuator, to load nearby aerosol particles such that they rapidly fall to the ground. The system is controlled by an on-board micro-controller unit that collects sensor data, analyzes it, and activates the mist generator as necessary. A custom smartphone application enables the user to remotely control the device and also receive real-time alerts related to recharging, refilling, and/or decontamination of the mask before reuse. Experimental results on a working prototype confirm that aerosol clouds rapidly fall to the ground when the mask is activated, thus significantly reducing PM counts near the user. Also, usage of the mask significantly increases local relative humidity levels.


Subject(s)
COVID-19/prevention & control , Inhalation Exposure/prevention & control , Masks , Particulate Matter/isolation & purification , Respiratory Protective Devices , SARS-CoV-2/isolation & purification , Aerosols/isolation & purification , Air Microbiology , Equipment Design , Filtration/instrumentation , Humans , Mobile Applications , Particle Size , Smart Materials/chemistry , Smartphone
7.
PLoS One ; 16(10): e0258191, 2021.
Article in English | MEDLINE | ID: covidwho-1456093

ABSTRACT

Face coverings are a key component of preventive health measure strategies to mitigate the spread of respiratory illnesses. In this study five groups of masks were investigated that are of particular relevance to the SARS-CoV-2 pandemic: re-usable, fabric two-layer and multi-layer masks, disposable procedure/surgical masks, KN95 and N95 filtering facepiece respirators. Experimental work focussed on the particle penetration through mask materials as a function of particle diameter, and the total inward leakage protection performance of the mask system. Geometric mean fabric protection factors varied from 1.78 to 144.5 for the fabric two-layer and KN95 materials, corresponding to overall filtration efficiencies of 43.8% and 99.3% using a flow rate of 17 L/min, equivalent to a breathing expiration rate for a person in a sedentary or standing position conversing with another individual. Geometric mean total inward leakage protection factors for the 2-layer, multi-layer and procedure masks were <2.3, while 6.2 was achieved for the KN95 masks. The highest values were measured for the N95 group at 165.7. Mask performance is dominated by face seal leakage. Despite the additional filtering layers added to cloth masks, and the higher filtration efficiency of the materials used in disposable procedure and KN95 masks, the total inward leakage protection factor was only marginally improved. N95 FFRs were the only mask group investigated that provided not only high filtration efficiency but high total inward leakage protection, and remain the best option to protect individuals from exposure to aerosol in high risk settings. The Mask Quality Factor and total inward leakage performance are very useful to determine the best options for masking. However, it is highly recommended that testing is undertaken on prospective products, or guidance is sought from impartial authorities, to confirm they meet any implied standards.


Subject(s)
Filtration/instrumentation , Masks/statistics & numerical data , N95 Respirators/statistics & numerical data , Textiles , Equipment Reuse , Inhalation Exposure/prevention & control
8.
Sci Rep ; 11(1): 19403, 2021 09 30.
Article in English | MEDLINE | ID: covidwho-1447324

ABSTRACT

The ongoing worldwide outbreak of COVID-19 has set personal protective equipment in the spotlight. A significant number of countries impose the use of facemasks in public spaces and encourage it in the private sphere. Even in countries where relatively high vaccination rates are achieved at present, breakthrough infections have been frequently reported and usage of facemasks in certain settings has been recommended again. Alternative solutions, including community masks fabricated using various materials, such as cotton or jersey, have emerged alongside facemasks following long-established standards (e.g., EN 149, EN 14683). In the present work, we present a computational model to calculate the ability of different types of facemasks to reduce the exposure to virus-laden respiratory particles, with a focus on the relative importance of the filtration properties and the fitting on the wearer's face. The model considers the facemask and the associated leakage, the transport of respiratory particles and their accumulation around the emitter, as well as the fraction of the inhaled particles deposited in the respiratory system. Different levels of leakages are considered to represent the diversity of fittings likely to be found among a population of non-trained users. The leakage prevails over the filtration performance of a facemask in determining the exposure level, and the ability of a face protection to limit leakages needs to be taken into account to accurately estimate the provided protection. Filtering facepieces (FFP) provide a better protection efficiency than surgical and community masks due to their higher filtration efficiency and their ability to provide a better fit and thus reduce the leakages. However, an improperly-fitted FFP mask loses a critical fraction of its protection efficiency, which may drop below the protection level provided by properly-worn surgical and community masks.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Filtration/instrumentation , Masks/standards , SARS-CoV-2 , Aerosols , Air Microbiology , COVID-19/virology , Disease Transmission, Infectious/prevention & control , Filtration/standards , Humans , Inhalation Exposure/prevention & control , Models, Theoretical , Particle Size
9.
J Aerosol Med Pulm Drug Deliv ; 34(5): 293-302, 2021 09.
Article in English | MEDLINE | ID: covidwho-1440594

ABSTRACT

Background: The precaution of airborne transmission of viruses, such as influenza, SARS, MERS, and COVID-19, is essential for reducing infection. In this study, we applied a zero-valent nanosilver/titania-chitosan (nano-Ag0/TiO2-CS) filter bed, whose broad-spectrum antimicrobial efficacy has been proven previously, for the removal of viral aerosols to minimize the risk of airborne transmission. Methods: The photochemical deposition method was used to synthesize the nano-Ag0/TiO2-CS antiviral material. The surface morphology, elemental composition, and microstructure of the nano-Ag0/TiO2-CS were analyzed by a scanning electron microscopy/energy dispersive X-ray spectroscopy and a transmission electron microscopy, respectively. The MS2 bacteriophages were used as surrogate viral aerosols. The antiviral efficacy of nano-Ag0/TiO2-CS was evaluated by the MS2 plaque reduction assay (PRA) and filtration experiments. In the filtration experiments, the MS2 aerosols passed through the nano-Ag0/TiO2-CS filter, and the MS2 aerosol removal efficiency was evaluated by an optical particle counter and culture method. Results and Conclusions: In the MS2 PRA, 3 g of nano-Ag0/TiO2-CS inactivated 97% of MS2 bacteriophages in 20 mL liquid culture (2 ± 0.5 × 1016 PFU/mL) within 2 hours. The removal efficiency of nano-Ag0/TiO2-CS filter (thickness: 6 cm) for MS2 aerosols reached up to 93%. Over 95% of MS2 bacteriophages on the surface of the nano-Ag0/TiO2-CS filter were inactivated within 20 minutes. The Wells-Riley model predicted that when the nano-Ag0/TiO2-CS filter was used in the ventilation system, airborne infection probability would reduce from 99% to 34.6%. The nano-Ag0/TiO2-CS filter could remain at 50% of its original antiviral efficiency after continuous operation for 1 week, indicating its feasibility for the control of the airborne transmission.


Subject(s)
Air Filters , Air Microbiology , Chitosan/chemistry , Filtration/instrumentation , Inhalation Exposure/prevention & control , Levivirus/isolation & purification , Metal Nanoparticles , Silver/chemistry , Titanium/chemistry , Aerosols , COVID-19/prevention & control , COVID-19/transmission , Equipment Design , Humans , Inhalation Exposure/adverse effects , Levivirus/pathogenicity , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity
12.
PLoS One ; 16(7): e0255051, 2021.
Article in English | MEDLINE | ID: covidwho-1327979

ABSTRACT

At present, people are demanding better indoor air quality during the COVID-19 pandemic. In addition to maintaining the basic functions, new air-conditioning should also add air purification functions to improve indoor air quality and reduce the possibility of virus transmission. Nowadays, there is lack of research results on the innovation of air-conditioning. The aim of this study is to present a two-stage mathematical model for identifying critical manufacturing factors in the innovation process of air conditioning. In this paper, Kano and quality function deployment (QFD) are used to analyze the critical factors affecting air-conditioning innovation. Some studies have proposed using Kano-QFD model to analyze product innovation, but the study only studies one stage, which loses the analysis of the subsequent stages of product innovation. Based on this, this paper studies the priority method of two-stage critical factors for air-conditioning innovation. Firstly, the questionnaire survey and fuzzy sets are used to collect demand information of multi-agent (customers and professional technicians). Secondly, the Kano model is used to classify and calculate satisfaction of multi-agent. Then, QFD is used to transform multi-agent demands into engineering property indexes (first stage) and technical property indexes (second stage) and calculate the weight of each index. Finally, the applicability and superiority of this method is illustrated by taking the central air-conditioning as an example.


Subject(s)
Air Conditioning , Air Microbiology , COVID-19/epidemiology , Filtration/instrumentation , Models, Theoretical , Pandemics , COVID-19/prevention & control , COVID-19/transmission , Fuzzy Logic
13.
J Occup Environ Hyg ; 18(7): 334-344, 2021 07.
Article in English | MEDLINE | ID: covidwho-1254232

ABSTRACT

Homemade cloth masks and other improvised face coverings have become widespread during the COVID-19 pandemic driven by severe shortages of personal protective equipment. In this study, various alternative (mostly common household) materials, which have not traditionally been used in respiratory protective devices, were tested for particle filtration performance and breathability. Most of these materials were found of some-but rather limited-utility in facemasks. At a breathing flow rate of 30 L min-1, 17 out of 19 tested materials demonstrated collection efficiency below 50%; at 85 L min-1, only one material featured particle collection efficiency above 50%. Pressure drop values were mostly below 4 mm w.g. (observed in 89% of cases for the two flow rates), which provides comfortable breathing. Only for one fabric material (silk) tested at 85 L min-1 did the pressure drop reach 11 mm w.g. Based on these results, a three-layer facemask prototype was designed and fabricated comprised of the best performing materials. Additional tests were conducted to examine possible particle detachment/shedding from the materials used in the newly developed facemask, but no such phenomenon was observed. The prototype was evaluated on 10 human subjects using the standard OSHA-approved quantitative fit testing protocol. The mask protection level, determined as an adopted fit factor, was found to lie between that of the two commercial surgical/medical masks tested for comparison. A 10-cycle washing of the mask prototype lowered its collection efficiency across the particle size range; however, washing did not substantially affect mask breathability. The study revealed that although homemade masks offer a certain level of protection to a wearer, one should not expect them to provide the same respiratory protection as high-end commercial surgical/medical masks or-by any means-NIOSH-certified N95 filtering facepieces.


Subject(s)
COVID-19/prevention & control , Equipment Design , Filtration/instrumentation , Masks/standards , Materials Testing , Humans , Masks/supply & distribution , Occupational Exposure/prevention & control , Particle Size , Personal Protective Equipment/standards , Personal Protective Equipment/supply & distribution , Respiration , Respiratory Protective Devices/standards , Respiratory Protective Devices/supply & distribution , SARS-CoV-2 , Textiles
14.
Indoor Air ; 31(6): 2058-2069, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1222522

ABSTRACT

Recirculating air purification technologies are employed as potential means of reducing exposure to aerosol particles and airborne viruses. Toward improved testing of recirculating air purification units, we developed and applied a medium-scale single-pass wind tunnel test to examine the size-dependent collection of particles and the collection and inactivation of viable bovine coronavirus (BCoV, a betacoronavirus), porcine respiratory coronavirus (PRCV, an alphacoronavirus), and influenza A virus (IAV), by a commercial air purification unit. The tested unit, the Molekule Air Mini, incorporates a MERV 16 filter as well as a photoelectrochemical oxidating layer. It was found to have a collection efficiency above 95.8% for all tested particle diameters and flow rates, with collection efficiencies above 99% for supermicrometer particles with the minimum collection efficiency for particles smaller than 100 nm. For all three tested viruses, the physical tracer-based log reduction was near 2.0 (99% removal). Conversely, the viable virus log reductions were found to be near 4.0 for IAV, 3.0 for BCoV, and 2.5 for PRCV, suggesting additional inactivation in a virus family- and genus-specific manner. In total, this work describes a suite of test methods which can be used to rigorously evaluate the efficacy of recirculating air purification technologies.


Subject(s)
Air Filters , Air Pollution, Indoor , Coronavirus , Orthomyxoviridae/isolation & purification , Aerosols , Air Microbiology , Air Pollution, Indoor/analysis , Coronavirus/isolation & purification , Filtration/instrumentation , Oxidative Stress , Particle Size
16.
ACS Appl Mater Interfaces ; 13(14): 16084-16096, 2021 Apr 14.
Article in English | MEDLINE | ID: covidwho-1164786

ABSTRACT

As COVID-19 exemplifies, respiratory diseases transmitted through aerosols or droplets are global threats to public health, and respiratory protection measures are essential first lines of infection prevention and control. However, common face masks are single use and can cause cross-infection due to the accumulated infectious pathogens. We developed salt-based formulations to coat membrane fibers to fabricate antimicrobial filters. Here, we report a mechanistic study on salt-induced pathogen inactivation. The salt recrystallization following aerosol exposure was characterized over time on sodium chloride (NaCl), potassium sulfate (K2SO4), and potassium chloride (KCl) powders and coatings, which revealed that NaCl and KCl start to recrystallize within 5 min and K2SO4 within 15 min. The inactivation kinetics observed for the H1N1 influenza virus and Klebsiella pneumoniae matched the salt recrystallization well, which was identified as the main destabilizing mechanism. Additionally, the salt-coated filters were prepared with different methods (with and without a vacuum process), which led to salt coatings with different morphologies for diverse applications. Finally, the salt-coated filters caused a loss of pathogen viability independent of transmission mode (aerosols or droplets), against both DI water and artificial saliva suspensions. Overall, these findings increase our understanding of the salt-recrystallization-based technology to develop highly versatile antimicrobial filters.


Subject(s)
Filtration/instrumentation , Influenza A Virus, H1N1 Subtype/drug effects , Klebsiella pneumoniae/drug effects , Masks , Potassium Chloride/chemistry , Sodium Chloride/chemistry , Sulfates/chemistry , Aerosols , Air Filters , Crystallization , Kinetics , Membranes, Artificial , Polypropylenes , Powders , Respiratory Protective Devices , Temperature , X-Ray Diffraction
17.
J Aerosol Med Pulm Drug Deliv ; 34(5): 293-302, 2021 09.
Article in English | MEDLINE | ID: covidwho-1149900

ABSTRACT

Background: The precaution of airborne transmission of viruses, such as influenza, SARS, MERS, and COVID-19, is essential for reducing infection. In this study, we applied a zero-valent nanosilver/titania-chitosan (nano-Ag0/TiO2-CS) filter bed, whose broad-spectrum antimicrobial efficacy has been proven previously, for the removal of viral aerosols to minimize the risk of airborne transmission. Methods: The photochemical deposition method was used to synthesize the nano-Ag0/TiO2-CS antiviral material. The surface morphology, elemental composition, and microstructure of the nano-Ag0/TiO2-CS were analyzed by a scanning electron microscopy/energy dispersive X-ray spectroscopy and a transmission electron microscopy, respectively. The MS2 bacteriophages were used as surrogate viral aerosols. The antiviral efficacy of nano-Ag0/TiO2-CS was evaluated by the MS2 plaque reduction assay (PRA) and filtration experiments. In the filtration experiments, the MS2 aerosols passed through the nano-Ag0/TiO2-CS filter, and the MS2 aerosol removal efficiency was evaluated by an optical particle counter and culture method. Results and Conclusions: In the MS2 PRA, 3 g of nano-Ag0/TiO2-CS inactivated 97% of MS2 bacteriophages in 20 mL liquid culture (2 ± 0.5 × 1016 PFU/mL) within 2 hours. The removal efficiency of nano-Ag0/TiO2-CS filter (thickness: 6 cm) for MS2 aerosols reached up to 93%. Over 95% of MS2 bacteriophages on the surface of the nano-Ag0/TiO2-CS filter were inactivated within 20 minutes. The Wells-Riley model predicted that when the nano-Ag0/TiO2-CS filter was used in the ventilation system, airborne infection probability would reduce from 99% to 34.6%. The nano-Ag0/TiO2-CS filter could remain at 50% of its original antiviral efficiency after continuous operation for 1 week, indicating its feasibility for the control of the airborne transmission.


Subject(s)
Air Filters , Air Microbiology , Chitosan/chemistry , Filtration/instrumentation , Inhalation Exposure/prevention & control , Levivirus/isolation & purification , Metal Nanoparticles , Silver/chemistry , Titanium/chemistry , Aerosols , COVID-19/prevention & control , COVID-19/transmission , Equipment Design , Humans , Inhalation Exposure/adverse effects , Levivirus/pathogenicity , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity
18.
Nano Lett ; 21(7): 2968-2974, 2021 04 14.
Article in English | MEDLINE | ID: covidwho-1147826

ABSTRACT

The ongoing COVID-19 pandemic highlights the severe health risks posed by deep submicrometer-sized airborne viruses and particulates in the spread of infectious diseases. There is an urgent need for the development of efficient, durable, and reusable filters for this size range. Here we report the realization of efficient particulate filters using nanowire-based low-density metal foams which combine extremely large surface areas with excellent mechanical properties. The metal foams exhibit outstanding filtration efficiencies (>96.6%) in the PM0.3 regime, with the potential for further improvement. Their mechanical stability, light weight, chemical and radiation resistance, ease of cleaning and reuse, and recyclability further make such metal foams promising filters for combating COVID-19 and other types of airborne particulates.


Subject(s)
Filtration/instrumentation , Nanowires , Particle Size , SARS-CoV-2/isolation & purification
20.
J Prev Med Public Health ; 54(1): 31-36, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1097322

ABSTRACT

OBJECTIVES: Non-traditional materials are used for mask construction to address personal protective equipment shortages during the coronavirus disease 2019 (COVID-19) pandemic. Reusable masks made from surgical sterilization wrap represent such an innovative approach with social media frequently referring to them as "N95 alternatives." This material was tested for particle filtration efficiency and breathability to clarify what role they might have in infection prevention and control. METHODS: A heavyweight, double layer sterilization wrap was tested when new and after 2, 4, 6, and 10 autoclave sterilizing cycles and compared with an approved N95 respirator and a surgical mask via testing procedures using a sodium chloride aerosol for N95 efficiency testing similar to 42 CFR 84.181. Pressure testing to indicate breathability was also conducted. RESULTS: The particle filtration efficiency for the sterilization wrap ranged between 58% to 66%, with similar performance when new and after sterilizing cycles. The N95 respirator and surgical mask performed at 95% and 68% respectively. Pressure drops for the sterilization wrap, N95 and surgical mask were 10.4 mmH2O, 5.9 mmH2O, and 5.1 mmH2O, respectively, well below the National Institute for Occupational Safety and Health limits of 35 mmH2O during initial inhalation and 25 mmH2O during initial exhalation. CONCLUSIONS: The sterilization wrap's particle filtration efficiency is much lower than a N95 respirator, but falls within the range of a surgical mask, with acceptable breathability. Performance testing of non-traditional mask materials is crucial to determine potential protection efficacy and for correcting misinterpretation propagated through popular media.


Subject(s)
Filtration/standards , Masks/standards , Filtration/instrumentation , Filtration/statistics & numerical data , Humans , Masks/microbiology , Masks/virology , Occupational Exposure/prevention & control , Pandemics/prevention & control , Personal Protective Equipment/standards , Personal Protective Equipment/statistics & numerical data , Sterilization/methods , Sterilization/standards , Sterilization/statistics & numerical data
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