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1.
Int J Environ Res Public Health ; 19(11)2022 05 27.
Article in English | MEDLINE | ID: covidwho-1892857

ABSTRACT

The need to secure public health and mitigate the environmental impact associated with the massified use of respiratory protective devices (RPD) has been raising awareness for the safe reuse of decontaminated masks by individuals and organizations. Among the decontamination treatments proposed, in this work, three methods with the potential to be adopted by households and organizations of different sizes were analysed: contact with nebulized hydrogen peroxide (H2O2); immersion in commercial bleach (NaClO) (sodium hypochlorite, 0.1% p/v); and contact with steam in microwave steam-sanitizing bags (steam bag). Their decontamination effectiveness was assessed using reference microorganisms following international standards (issued by ISO and FDA). Furthermore, the impact on filtration efficiency, air permeability and several physicochemical and structural characteristics of the masks, were evaluated for untreated masks and after 1, 5 and 10 cycles of treatment. Three types of RPD were analysed: surgical, KN95, and cloth masks. Results demonstrated that the H2O2 protocol sterilized KN95 and surgical masks (reduction of >6 log10 CFUs) and disinfected cloth masks (reduction of >3 log10 CFUs). The NaClO protocol sterilized surgical masks, and disinfected KN95 and cloth masks. Steam bags sterilized KN95 and disinfected surgical and cloth masks. No relevant impact was observed on filtration efficiency.


Subject(s)
Decontamination , Respiratory Protective Devices , Decontamination/methods , Filtration , Humans , Hydrogen Peroxide , Permeability , Steam
2.
Molecules ; 27(12)2022 Jun 07.
Article in English | MEDLINE | ID: covidwho-1884289

ABSTRACT

With the outbreak of the COVID-19 pandemic, textile laundering hygiene has proved to be a fundamental measure in preventing the spread of infections. The first part of our study evaluated the decontamination efficiency of various treatments (thermal, photothermal, and microwave) for bio contaminated textiles. The effects on textile decontamination of adding saturated steam into the drum of a household textile laundering machine were investigated and evaluated in the second part of our study. The results show that the thermal treatment, conducted in a convection heating chamber, provided a slight reduction in efficiency and did not ensure the complete inactivation of Staphylococcus aureus on cotton swatches. The photothermal treatment showed higher reduction efficiency on contaminated textile samples, while the microwave treatment (at 460 W for a period of 60 s) of bio contaminated cotton swatches containing higher moisture content provided satisfactory bacterial reduction efficiency (more than 7 log steps). Additionally, the treatment of textiles in the household washing machine with the injection of saturated steam into the washing drum and a mild agitation rhythm provided at least a 7 log step reduction in S. aureus. The photothermal treatment of bio contaminated cotton textiles showed promising reduction efficiency, while the microwave treatment and the treatment with saturated steam proved to be the most effective.


Subject(s)
COVID-19 , Steam , Decontamination/methods , Humans , Microwaves , Pandemics , Staphylococcus aureus , Textiles
3.
J Assoc Physicians India ; 70(4): 11-12, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1801757

ABSTRACT

The recent second wave of COVID-19 cases in India has been marked by an unexpected increase in cases of mucormycosis reported in the context of COVID illness. Herein we aim to identify risk factors that may explain the sudden surge of cases and help develop preventive strategies. MATERIAL: We performed a case-control study comparing cases diagnosed with CAM and those who had recovered from COVID-19 without developing mucormycosis (controls). Information on comorbidities, glycemic control, and practices related to COVID-19 treatment was recorded. OBSERVATION: 100 patients of CAM (cases) and 150 patients of COVID-19 without mucormycosis (controls) were included in the study. The spectrum of involvement of CAM cases included rhino-sinus (n=98, 98%), rhino orbital (n=58, 58%), rhino-orbito-cerebral (n=29, 29%). In CAM group symptoms of mucormycosis began a mean of 13.46 days after onset of COVID-19. The mean age of the CAM study group was 51.16 years with 69 males (69%) and 31 females (31.0). The most frequent comorbidities seen in our study population was diabetes (n=113, 45.2%) and hypertension (n=54, 21.6%). Diabetes was significantly more frequent among cases than controls (89% vs 24%, p <0.001). 31% of patients in CAM case group showed a common practise of steam inhalation during covid illness. Most common symptom reported in CAM was related to the eye which included eye pain (58%), lid swelling (54%), eye swelling (47%). Sino-nasal symptoms were nasal discharge (25%), nasal stuffiness (21%), and epistaxis (4%). Other common symptoms were headache (51%) and facial pain (36%). On examination of nasal cavity, crusting and ulceration were present in 83% patients. Eye involvement was present in 60% of cases, of which 27% of cases had vision loss. For definitive diagnosis of CAM, Potassium hydroxide (KOH) mount was positive for aseptate hyphae in 31 patients (31%). Use of systemic steroids for the management of COVID-19, was more frequent in CAM case group than control group (n=70, 70%). The CAM case group showed mean Hba1c of 10.7 ± 2.45, mean Serum Iron levels was 49.01 ± 18.69, mean ferritin was 913.37, mean CRP was 131.56 and mean LDH was 428.70. CONCLUSION: Overzealous use of steroids, uncontrolled sugars and repeated steam inhalation provided a favourable environment for the growth of mucormycosis. Judicious use of steroids and stringent glycemic control are vital to preventing mucormycosis.


Subject(s)
COVID-19 , Diabetes Mellitus , Mucormycosis , COVID-19/drug therapy , COVID-19/epidemiology , Case-Control Studies , Diabetes Mellitus/epidemiology , Female , Humans , India/epidemiology , Male , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , SARS-CoV-2 , Steam
4.
J Occup Environ Hyg ; 18(12): 541-546, 2021 12.
Article in English | MEDLINE | ID: covidwho-1460030

ABSTRACT

This in vitro study was aimed to assess the efficacy of dry steam in inactivating Human Coronavirus OC43 (HCoV-OC43) as surrogate of SARS-CoV-2, Human Influenza Virus A/H1N1/WSN/33 and Echovirus 7 on stainless steel, polypropylene, and cotton. The virus models were chosen on the basis of their transmission route and environmental resistance. Tests were carried out under a laminar flow cabinet, where two panels of each material were contaminated with a viral suspension. The inocula were left to dry and then the virus on untreated panel (control) was collected by swabbing in order to determine the initial titer. The other panel was treated using a professional vacuum cleaner equipped with a dry steam generator. Dry steam is generated in a boiler where tap water is heated up to 155 °C at 5.5 bar pressure and then during the passage along the flexible hose the temperature decreases to a value between 100 °C and 110 °C at the output. The dry steam was applied for four sec with a window wiper on metal and plastic panels or a brush covered by a microfiber cap on cotton, simulating the steam application during routine cleaning. After the treatment, infectious virus possibly remained on the surface was collected following the same swabbing procedure applied for controls. HCoV-OC43 and Echovirus 7 were titrated by end-point method on HCT-8 line cells and Vero cells, respectively, while Human Influenza Virus was quantified by plaque reduction assay on MDCK cells. Dry steam resulted effective against the three viruses on all tested materials, achieving a mean Log10 reduction factor ≥4 in viral titer of treated samples compared with controls according to UNI EN 14476:2019. Thus, dry steam may be proposed as an ease to use, effective, fast, and nontoxic alternative to chemicals for surface disinfection without damaging materials. Therefore, this device could be employed not only in healthcare facilities but also in occupational, domestic, and community settings, with advantages for environment and human health.


Subject(s)
COVID-19 , Influenza A Virus, H1N1 Subtype , Influenza, Human , Animals , Chlorocebus aethiops , Disinfection , Enterovirus B, Human , Humans , SARS-CoV-2 , Steam , Vero Cells
5.
PLoS One ; 16(9): e0257468, 2021.
Article in English | MEDLINE | ID: covidwho-1406756

ABSTRACT

BACKGROUND: Face masks, also referred to as half masks, are essential to protect healthcare professionals working in close contact with patients with COVID-19-related symptoms. Because of the Corona material shortages, healthcare institutions sought an approach to reuse face masks or to purchase new, imported masks. The filter quality of these masks remained unclear. Therefore, the aim of this study was to assess the quality of sterilized and imported FFP2/KN95 face masks. METHODS: A 48-minute steam sterilization process of single-use FFP2/KN95 face masks with a 15 minute holding time at 121°C was developed, validated and implemented in the Central Sterilization Departments (CSSD) of 19 different hospitals. Masks sterilized by steam and H2O2 plasma as well as new, imported masks were tested for particle filtration efficiency (PFE) and pressure drop in a custom-made test setup. RESULTS: The results of 84 masks tested on the PFE dry particle test setup showed differences of 2.3±2% (mean±SD). Test data showed that the mean PFE values of 444 sterilized FFP2 face masks from the 19 CSSDs were 90±11% (mean±SD), and those of 474 new, imported KN95/FFP2 face masks were 83±16% (mean±SD). Differences in PFE of masks received from different sterilization departments were found. CONCLUSION: Face masks can be reprocessed with 121 °C steam or H2O2 plasma sterilization with a minimal reduction in PFE. PFE comparison between filter material of sterilized masks and new, imported masks indicates that the filter material of most reprocessed masks of high quality brands can outperform new, imported face masks of unknown brands. Although the PFE of tested face masks from different sterilization departments remained efficient, using different types of sterilization equipment, can result in different PFE outcomes.


Subject(s)
COVID-19/prevention & control , Masks , Sterilization , COVID-19/transmission , Equipment Reuse , Health Personnel , Humans , Hydrogen Peroxide , Masks/standards , SARS-CoV-2/physiology , Steam , Sterilization/standards
6.
Antimicrob Resist Infect Control ; 10(1): 109, 2021 07 23.
Article in English | MEDLINE | ID: covidwho-1365395

ABSTRACT

BACKGROUND: Laparoscopy is a minimally-invasive surgical procedure that uses long slender instruments that require much smaller incisions than conventional surgery. This leads to faster recovery times, fewer post-surgical wound infections and shorter hospital stays. For these reasons, laparoscopy could be particularly advantageous to patients in low to middle income countries (LMICs). Unfortunately, sterile processing departments in LMIC hospitals are faced with limited access to equipment and trained staff which poses an obstacle to safe surgical care. The reprocessing of laparoscopic devices requires specialised equipment and training. Therefore, when LMIC hospitals invest in laparoscopy, an update of the standard operating procedure in sterile processing is required. Currently, it is unclear whether LMIC hospitals, that already perform laparoscopy, have managed to introduce updated reprocessing methods that minimally invasive equipment requires. The aim of this study was to identify the laparoscopic sterile reprocessing procedures in rural India and to test the effectiveness of the sterilisation equipment. METHODS: We assessed laparoscopic instrument sterilisation capacity in four rural hospitals in different states in India using a mixed-methods approach. As the main form of data collection, we developed a standardised observational checklist based on reprocessing guidelines from several sources. Steam autoclave performance was measured by monitoring the autoclave cycles in two hospitals. Finally, the findings from the checklist data was supported by an interview survey with surgeons and nurses. RESULTS: The checklist data revealed the reprocessing methods the hospitals used in the reprocessing of laparoscopic instruments. It showed that the standard operating procedures had not been updated since the introduction of laparoscopy and the same reprocessing methods for regular surgical instruments were still applied. The interviews confirmed that staff had not received additional training and that they were unaware of the hazardous effects of reprocessing detergents and disinfectants. CONCLUSION: As laparoscopy is becoming more prevalent in LMICs, updated policy is needed to incorporate minimally invasive instrument reprocessing in medical practitioner and staff training programmes. While reprocessing standards improve, it is essential to develop instruments and reprocessing equipment that is more suitable for resource-constrained rural surgical environments.


Subject(s)
Equipment Contamination/prevention & control , Hospitals, Rural , Laparoscopy , Sterilization/methods , Developing Countries , India , Steam , Sterilization/instrumentation
7.
Rev Sci Instrum ; 92(7): 074101, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1338585

ABSTRACT

A fluid mechanics model of inhaled air gases, nitrogen (N2) and oxygen (O2) gases, and exhaled gas components (CO2 and water vapor particles) through a facial mask (membrane) to shield the COVID-19 virus is established. The model was developed based on several gas flux contributions that normally take place through membranes. Semiempirical solutions of the mathematical model were predicted for the N95 facial mask accounting on several parameters, such as a range of porosity size (i.e., 1-30 nm), void fraction (i.e., 10-3%-0.3%), and thickness of the membrane (i.e., 10-40 µm) in comparison to the size of the COVID-19 virus. A unitless number (Nr) was introduced for the first time to describe semiempirical solutions of O2, N2, and CO2 gases through the porous membrane. An optimum Nr of expressing the flow of the inhaled air gases, O2 and N2, through the porous membrane was determined (NO2 = NN2 = -4.4) when an N95 facial mask of specifications of a = 20 nm, l = 30 µm, and ε = 30% was used as a personal protection equipment (PPE). The concept of the optimum number Nr can be standardized not only for testing commercially available facial masks as PPEs but also for designing new masks for protecting humans from the COVID-19 virus.


Subject(s)
COVID-19/prevention & control , Masks , SARS-CoV-2 , Biomechanical Phenomena , Carbon Dioxide , Equipment Design , Exhalation , Gases , Humans , Hydrodynamics , Inhalation , Mathematical Concepts , Membranes, Artificial , Models, Theoretical , N95 Respirators , Nitrogen , Oxygen , Personal Protective Equipment , Porosity , Steam
8.
Antimicrob Resist Infect Control ; 10(1): 83, 2021 05 29.
Article in English | MEDLINE | ID: covidwho-1247602

ABSTRACT

BACKGROUND: With the current SARS-CoV-2 pandemic, many healthcare facilities are lacking a steady supply of masks worldwide. This emergency situation warrants the taking of extraordinary measures to minimize the negative health impact from an insufficient supply of masks. The decontamination, and reuse of healthcare workers' N95/FFP2 masks is a promising solution which needs to overcome several pitfalls to become a reality. AIM: The overall aim of this article is to provide the reader with a quick overview of the various methods for decontamination and the potential issues to be taken into account when deciding to reuse masks. Ultraviolet germicidal irradiation (UVGI), hydrogen peroxide, steam, ozone, ethylene oxide, dry heat and moist heat have all been methods studied in the context of the pandemic. The article first focuses on the logistical implementation of a decontamination system in its entirety, and then aims to summarize and analyze the different available methods for decontamination. METHODS: In order to have a clear understanding of the research that has already been done, we conducted a systematic literature review for the questions: what are the tested methods for decontaminating N95/FFP2 masks, and what impact do those methods have on the microbiological contamination and physical integrity of the masks? We used the results of a systematic review on the methods of microbiological decontamination of masks to make sure we covered all of the recommended methods for mask reuse. To this systematic review we added articles and studies relevant to the subject, but that were outside the limits of the systematic review. These include a number of studies that performed important fit and function tests on the masks but took their microbiological outcomes from the existing literature and were thus excluded from the systematic review, but useful for this paper. We also used additional unpublished studies and internal communication from the University of Geneva Hospitals and partner institutions. RESULTS: This paper analyzes the acceptable methods for respirator decontamination and reuse, and scores them according to a number of variables that we have defined as being crucial (including cost, risk, complexity, time, etc.) to help healthcare facilities decide which method of decontamination is right for them. CONCLUSION: We provide a resource for healthcare institutions looking at making informed decisions about respirator decontamination. This informed decision making will help to improve infection prevention and control measures, and protect healthcare workers during this crucial time. The overall take home message is that institutions should not reuse respirators unless they have to. In the case of an emergency situation, there are some safe ways to decontaminate them.


Subject(s)
COVID-19/prevention & control , Decontamination/methods , Equipment Reuse , N95 Respirators/standards , SARS-CoV-2 , Ethylene Oxide/pharmacology , Health Personnel , Humans , Hydrogen Peroxide/pharmacology , N95 Respirators/virology , SARS-CoV-2/drug effects , SARS-CoV-2/radiation effects , Steam , Ultraviolet Rays
9.
JAMA ; 325(13): 1296-1317, 2021 Apr 06.
Article in English | MEDLINE | ID: covidwho-1192043

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.


Subject(s)
Decontamination/methods , Equipment Reuse , N95 Respirators , Sterilization/methods , Ethylene Oxide , Hot Temperature , Humans , Hydrogen Peroxide , N95 Respirators/virology , Steam , Sterilization/economics , Ultraviolet Rays
10.
Food Chem Toxicol ; 148: 111966, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1163769

ABSTRACT

BACKGROUND: COVID-19, the presently prevailing global public health emergency has culminated in international instability in economy. This unprecedented pandemic outbreak pressingly necessitated the trans-disciplinary approach in developing novel/new anti-COVID-19 drugs especially, small molecule inhibitors targeting the seminal proteins of viral etiological agent, SARS-CoV-2. METHODS: Based on the traditional medicinal knowledge, we made an attempt through molecular docking analysis to explore the phytochemical constituents of three most commonly used Indian herbs in 'steam inhalation therapy' against well recognized viral receptor proteins. RESULTS: A total of 57 phytochemicals were scrutinized virtually against four structural protein targets of SARS-CoV-2 viz. 3CLpro, ACE-2, spike glycoprotein and RdRp. Providentially, two bioactives from each of the three plants i.e. apigenin-o-7-glucuronide and ellagic acid from Eucalyptus globulus; eudesmol and viridiflorene from Vitex negundo and; vasicolinone and anisotine from Justicia adhatoda were identified to be the best hit lead molecules based on interaction energies, conventional hydrogen bonding numbers and other non-covalent interactions. On comparison with the known SARS-CoV-2 protease inhibitor -lopinavir and RdRp inhibitor -remdesivir, apigenin-o-7-glucuronide was found to be a phenomenal inhibitor of both protease and polymerase, as it strongly interacts with their active sites and exhibited remarkably high binding affinity. Furthermore, in silico drug-likeness and ADMET prediction analyses clearly evidenced the usability of the identified bioactives to develop as drug against COVID-19. CONCLUSION: Overall, the data of the present study exemplifies that the phytochemicals from selected traditional herbs having significance in steam inhalation therapy would be promising in combating COVID-19.


Subject(s)
COVID-19/therapy , Phytochemicals/administration & dosage , Administration, Inhalation , COVID-19/virology , Computer Simulation , Humans , Molecular Docking Simulation , Phytochemicals/pharmacology , SARS-CoV-2/isolation & purification , Steam
11.
JAMA ; 325(13): 1296-1317, 2021 Apr 06.
Article in English | MEDLINE | ID: covidwho-1114146

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.


Subject(s)
Decontamination/methods , Equipment Reuse , N95 Respirators , Sterilization/methods , Ethylene Oxide , Hot Temperature , Humans , Hydrogen Peroxide , N95 Respirators/virology , Steam , Sterilization/economics , Ultraviolet Rays
12.
Food Chem ; 349: 129178, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1065087

ABSTRACT

Chinese steamed breads (CSB) and noodles are staple foods for many people. The production of frozen steamed products and boiled noodles has kept increasing. This is due to the increasing demand of ready-to-eat frozen food products from the market. Frozen storage significantly increases the self-life of the products and reduces the production costs. On the other hand, the freezing and frozen storage lead to quality loss of the frozen products. This review summarizes effects of freezing and frozen storage on diverse quality attributes (e.g., structural and textural properties) of frozen northern-type steamed breads and boiled noodles. Food safety of the frozen products related to the COVID-19 pandemic is discussed. To counteract the quality loss of the frozen products, suitable processing methods, selection of basic ingredients and uses of various food additives can be done. Research gaps to improve the textural, cooking and nutritional quality of frozen CSB and noodles are suggested.


Subject(s)
Bread/analysis , Flour/analysis , Food Storage , Cooking , Freezing , Humans , Nutritive Value , Steam
14.
Appl Environ Microbiol ; 87(3)2021 01 15.
Article in English | MEDLINE | ID: covidwho-1035279

ABSTRACT

Airborne disinfection of high-containment facilities before maintenance or between animal studies is crucial. Commercial spore carriers (CSC) coated with 106 spores of Geobacillus stearothermophilus are often used to assess the efficacy of disinfection. We used quantitative carrier testing (QCT) procedures to compare the sensitivity of CSC with that of surrogates for nonenveloped and enveloped viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mycobacteria, and spores, to an aerosolized mixture of peroxyacetic acid and hydrogen peroxide (aPAA-HP). We then used the QCT methodology to determine relevant process parameters to develop and validate effective disinfection protocols (≥4-log10 reduction) in various large and complex facilities. Our results demonstrate that aPAA-HP is a highly efficient procedure for airborne room disinfection. Relevant process parameters such as temperature and relative humidity can be wirelessly monitored. Furthermore, we found striking differences in inactivation efficacies against some of the tested microorganisms. Overall, we conclude that dry fogging a mixture of aPAA-HP is highly effective against a broad range of microorganisms as well as material compatible with relevant concentrations. Furthermore, CSC are artificial bioindicators with lower resistance and thus should not be used for validating airborne disinfection when microorganisms other than viruses have to be inactivated.IMPORTANCE Airborne disinfection is not only of crucial importance for the safe operation of laboratories and animal rooms where infectious agents are handled but also can be used in public health emergencies such as the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. We show that dry fogging an aerosolized mixture of peroxyacetic acid and hydrogen peroxide (aPAA-HP) is highly microbicidal, efficient, fast, robust, environmentally neutral, and a suitable airborne disinfection method. In addition, the low concentration of dispersed disinfectant, particularly for enveloped viral pathogens such as SARS-CoV-2, entails high material compatibility. For these reasons and due to the relative simplicity of the procedure, it is an ideal disinfection method for hospital wards, ambulances, public conveyances, and indoor community areas. Thus, we conclude that this method is an excellent choice for control of the current SARS-CoV-2 pandemic.


Subject(s)
COVID-19/prevention & control , Disinfectants/pharmacology , Disinfection/methods , Mycobacterium/drug effects , SARS-CoV-2/drug effects , Spores, Bacterial/drug effects , Aerosols , Cell Line , Decontamination/methods , Geobacillus stearothermophilus/drug effects , Hydrogen Peroxide , Particle Size , Peracetic Acid , Steam
16.
J Hosp Infect ; 108: 113-119, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1014625

ABSTRACT

BACKGROUND: The coronavirus disease 2019 pandemic has caused problems with respirator supplies. Re-use may minimize the impact of the shortage, but requires the availability of an efficient and safe decontamination method. AIM: To determine whether low-temperature-steam-2%-formaldehyde (LTSF) sterilization is effective, preserves the properties of filtering facepiece (FFP) respirators and allows safe re-use. METHODS: Fourteen unused FFP2, FFP3 and N95 respirator models were subjected to two cycles of decontamination cycles. After the second cycle, each model was inspected visually and accumulated residual formaldehyde levels were analysed according to EN 14180. After one and two decontamination cycles, the fit factor (FF) of each model was tested, and penetration tests with sodium chloride aerosols were performed on five models. FINDINGS: Decontamination physically altered three of the 14 models. All of the residual formaldehyde values were below the permissible threshold. Irregular decreases and increases in FF were observed after each decontamination cycle. In the sodium chloride aerosol penetration test, three models obtained equivalent or superior results to those of the FFP classification with which they were marketed, both at baseline and after one and two cycles of decontamination, and two models had lower filtering capacity. CONCLUSION: One and two decontamination cycles using LTSF did not alter the structure of most (11/14) respirators tested, and did not degrade the fit or filtration capacity of any of the analysed respirators. The residual formaldehyde levels complied with EN 14180. This reprocessing method could be used in times of shortage of personal protective equipment.


Subject(s)
Decontamination/methods , Formaldehyde/pharmacology , Respiratory Protective Devices/virology , Sterilization/methods , Adult , Aerosols/adverse effects , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/virology , Equipment Reuse , Formaldehyde/analysis , Humans , Male , Masks/trends , Masks/virology , Personal Protective Equipment/supply & distribution , Respiratory Protective Devices/supply & distribution , SARS-CoV-2/genetics , Sodium Chloride/analysis , Steam/adverse effects , Ventilators, Mechanical/supply & distribution , Ventilators, Mechanical/virology
17.
Life Sci ; 265: 118801, 2021 Jan 15.
Article in English | MEDLINE | ID: covidwho-939127

ABSTRACT

BACKGROUND: The emergence of SARS-CoV-2 pandemic has upset health systems around the world and caused immeasurable losses and costs. Until a vaccine will become available, the recommended prevention measures remain physical distancing and enhanced hygiene. METHODS AND FINDINGS: The proteic structure external to the virus is the main target that may eventually lead to reduce or block its replication in the upper airways. We developed a protocol based of repeated steam inhalation cycles aimed at reducing the risk of progression to full blown infection if performed soon after contagion. The protocol has been used in a single-center open label trial on ten infected asymptomatic or pauci-symptomatic health care professionals. CONCLUSIONS: The promising results we obtained with this easily accessible, non-invasive and inexpensive procedure should prompt controlled trials.


Subject(s)
COVID-19/therapy , Hot Temperature , SARS-CoV-2 , Steam , Administration, Inhalation , Adult , Disease Progression , Female , Humans , Male , Middle Aged , Polymerase Chain Reaction , Respiratory Mucosa/virology , Virus Shedding
18.
PLoS One ; 15(11): e0242474, 2020.
Article in English | MEDLINE | ID: covidwho-937231

ABSTRACT

BACKGROUND: There is global shortage of Personal Protective Equipment due to COVID-19 pandemic. N95 Filtering Facepiece Respirators (N95-FFRs) provide respiratory protection against respiratory pathogens including SARS-CoV-2. There is scant literature on reprocessing methods which can enable reuse of N95-FFRs. AIM: We conducted this study to evaluate research done, prior to COVID-19 pandemic, on various decontamination methods for reprocessing of N95-FFRs. METHODS: We searched 5 electronic databases (Pubmed, Google Scholar, Crossref, Ovid, ScienceDirect) and 1 Grey literature database (OpenGrey). We included original studies, published prior to year 2020, which had evaluated any decontamination method on FFRs. Studies had evaluated a reprocessing method against parameters namely physical changes, user acceptability, respirator fit, filter efficiency, microbicidal efficacy and presence of chemical residues post-reprocessing. FINDINGS AND CONCLUSIONS: Overall, we found 7887 records amongst which 17 original research articles were finally included for qualitative analysis. Overall, 21 different types of decontamination or reprocessing methods for N95-FFRs were evaluated. Most commonly evaluated method for reprocessing of FFRs was Ultraviolet (Type-C) irradiation (UVGI) which was evaluated in 13/17 (76%) studies. We found published literature was scant on this topic despite warning signs of pandemic of a respiratory illness over the years. Promising technologies requiring expeditious evaluation are UVGI, Microwave generated steam (MGS) and based on Hydrogen peroxide vapor. Global presence of technologies, which have been given Emergency use authorisation for N95-FFR reprocessing, is extremely limited. Reprocessing of N95-FFRs by MGS should be considered for emergency implementation in resource limited settings to tackle shortage of N95-FFRs. SYSTEMATIC REVIEW IDENTIFIER: PROSPERO, PROSPERO ID: CRD42020189684, (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020189684).


Subject(s)
Decontamination/methods , Disinfection/methods , Equipment Reuse , Masks , Respiratory Protective Devices , Betacoronavirus , COVID-19 , Coronavirus Infections/prevention & control , Equipment Safety , Humans , Hydrogen Peroxide , Microwaves , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Steam , Ultraviolet Rays
19.
J Med Virol ; 92(10): 1971-1974, 2020 10.
Article in English | MEDLINE | ID: covidwho-935084

ABSTRACT

The coronavirus disease 2019 pandemic caused by the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has claimed many lives worldwide. Wearing medical masks (MMs) or N95 masks ([N95Ms] namely N95 respirators) can slow the virus spread and reduce the infection risk. Reuse of these masks can minimize waste, protect the environment, and help solve the current imminent shortage of masks. Disinfection of used masks is needed for their reuse with safety, but improper decontamination can damage the blocking structure of masks. In this study, we demonstrated using the avian coronavirus of infectious bronchitis virus to mimic SARS-CoV-2 that MMs and N95Ms retained their blocking efficacy even after being steamed on boiling water for 2 hours. We also demonstrated that three brands of MMs blocked over 99% viruses in aerosols. The avian coronavirus was completely inactivated after being steamed for 5 minutes. Altogether, this study suggested that MMs are adequate for use on most social occasions and both MMs and N95Ms can be reused for a few days with steam decontamination between use.


Subject(s)
COVID-19/prevention & control , Disinfection/methods , Equipment Reuse , Masks/virology , N95 Respirators/virology , Steam , Gammacoronavirus , Humans , Pandemics , SARS-CoV-2
20.
Infect Dis Health ; 26(1): 72-80, 2021 02.
Article in English | MEDLINE | ID: covidwho-866717

ABSTRACT

BACKGROUND: Vulnerable patients being cared for in hospital-at-home settings require safe disinfection of their medical devices, including nebulisers and other respiratory equipment. The scale of patients now being cared for in hospital-at-home settings as a result of COVID19 places huge pressure on hospital central sterile services departments (CSSDs) to provide consumable items to safely support such patients' care. This places new importance on the disinfection of mundane objects, including crockery, cutlery and frequently touched objects in the home environment. This study examined temperature performance of steam disinfectors and the consequences of potential operator misuse on the survival of 62 bacteria and yeast organisms. METHODS: Thermal performance of steam disinfectors was evaluated using calibrated thermocouple probes in multiple permutations of device usage with 62 test organisms. RESULTS: Thermocouple data demonstrated disinfection A0 values of 6000 (upper layer) and 60 (lower layer). Steam disinfection of baby bottles had a thermal lethality of at least A0 = 600. Variation in disinfector temperatures were noted, depending on the geometric location of thermocouples. Additional notable temperature reductions occurred with device underfilling with suboptimal water volumes. Steam disinfection eradicated all 62 non-spore-forming Gram-positive, Gram-negative and yeast organisms tested and eradicated all organisms in the inner teat space of contaminated babies' dummies, rendering safe steam disinfection of babies' dummies. CONCLUSION: Domestic steam disinfection offers an inexpensive, simple, versatile and widely available technology for the elimination of common non-spore-forming nosocomial pathogens and safe disinfection of medical devices, fomites and other mundane objects within the hospital-at-home scenario, thereby enhancing patient safety.


Subject(s)
COVID-19 , Steam , Disinfection , Hospitals , Humans , Infant , SARS-CoV-2
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