Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 58
Filter
2.
Disaster Med Public Health Prep ; : 1-16, 2021 Apr 30.
Article in English | MEDLINE | ID: covidwho-1700344

ABSTRACT

Objective: Bottlenecks in the personal protective equipment (PPE) supply chain have contributed to shortages of PPE during the COVID-19 pandemic, resulting in fractures in the functionality of healthcare systems. This study was conducted with the aim of determining the effectiveness of retrofitted commercial snorkel masks as an alternative respirator for healthcare workers during infectious disease outbreaks.Methods: A retrospective analysis was performed, analyzing qualitative and quantitative fit test results of the retrofitted Aria Ocean Reef® full-face snorkeling mask on healthcare workers at the McGill University Health Centre between April-June 2020. Historical fit test results, using medical-grade respirators, for healthcare workers were also analyzed.Results: During the study period, 71 participants volunteered for fit testing, 60.6% of which were nurses. The overall fit test passing rate using the snorkel mask was 83.1%. Of the participants who did not previously pass fit testing with medical-grade respirators, 80% achieved a passing fit test with the snorkel respirator.Conclusions: The results suggest that this novel respirator may be an effective and feasible alternative solution to address PPE shortages, while still providing healthcare workers with ample protection. Additional robust testing will be required to ensure that respirator fit is maintained, after numerous rounds of disinfection.

3.
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
4.
Occup Environ Med ; 78(9): 679-690, 2021 09.
Article in English | MEDLINE | ID: covidwho-1362002

ABSTRACT

OBJECTIVES: To synthesise evidence concerning the range of filtering respirators suitable for patient care and guide the selection and use of different respirator types. DESIGN: Comparative analysis of international standards for respirators and rapid review of their performance and impact in healthcare. DATA SOURCES: Websites of international standards organisations, Medline and Embase, hand-searching of references and citations. STUDY SELECTION: Studies of healthcare workers (including students) using disposable or reusable respirators with a range of designs. We examined respirator performance, clinician adherence and performance, comfort and impact, and perceptions of use. RESULTS: We included standards from eight authorities across Europe, North and South America, Asia and Australasia and 39 research studies. There were four main findings. First, international standards for respirators apply across workplace settings and are broadly comparable across jurisdictions. Second, effective and safe respirator use depends on proper fitting and fit testing. Third, all respirator types carry a burden to the user of discomfort and interference with communication which may limit their safe use over long periods; studies suggest that they have little impact on specific clinical skills in the short term but there is limited evidence on the impact of prolonged wearing. Finally, some clinical activities, particularly chest compressions, reduce the performance of filtering facepiece respirators. CONCLUSION: A wide range of respirator types and models is available for use in patient care during respiratory pandemics. Careful consideration of performance and impact of respirators is needed to maximise protection of healthcare workers and minimise disruption to care.


Subject(s)
COVID-19/epidemiology , Disposable Equipment/statistics & numerical data , Equipment Reuse/statistics & numerical data , Ventilators, Mechanical/statistics & numerical data , Disposable Equipment/standards , Equipment Reuse/standards , Health Personnel/statistics & numerical data , Humans , Pandemics/statistics & numerical data , Ventilators, Mechanical/standards
5.
Sci Rep ; 11(1): 12263, 2021 06 10.
Article in English | MEDLINE | ID: covidwho-1265973

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.

6.
BMC Anesthesiol ; 21(1): 155, 2021 05 20.
Article in English | MEDLINE | ID: covidwho-1238704

ABSTRACT

BACKGROUND: The surge of critically ill patients due to the coronavirus disease-2019 (COVID-19) overwhelmed critical care capacity in areas of northern Italy. Anesthesia machines have been used as alternatives to traditional ICU mechanical ventilators. However, the outcomes for patients with COVID-19 respiratory failure cared for with Anesthesia Machines is currently unknow. We hypothesized that COVID-19 patients receiving care with Anesthesia Machines would have worse outcomes compared to standard practice. METHODS: We designed a retrospective study of patients admitted with a confirmed COVID-19 diagnosis at a large tertiary urban hospital in northern Italy. Two care units were included: a 27-bed standard ICU and a 15-bed temporary unit emergently opened in an operating room setting. Intubated patients assigned to Anesthesia Machines (AM group) were compared to a control cohort treated with standard mechanical ventilators (ICU-VENT group). Outcomes were assessed at 60-day follow-up. A multivariable Cox regression analysis of risk factors between survivors and non-survivors was conducted to determine the adjusted risk of death for patients assigned to AM group. RESULTS: Complete daily data from 89 mechanically ventilated patients consecutively admitted to the two units were analyzed. Seventeen patients were included in the AM group, whereas 72 were in the ICU-VENT group. Disease severity and intensity of treatment were comparable between the two groups. The 60-day mortality was significantly higher in the AM group compared to the ICU-vent group (12/17 vs. 27/72, 70.6% vs. 37.5%, respectively, p = 0.016). Allocation to AM group was associated with a significantly increased risk of death after adjusting for covariates (HR 4.05, 95% CI: 1.75-9.33, p = 0.001). Several incidents and complications were reported with Anesthesia Machine care, raising safety concerns. CONCLUSIONS: Our results support the hypothesis that care associated with the use of Anesthesia Machines is inadequate to provide long-term critical care to patients with COVID-19. Added safety risks must be considered if no other option is available to treat severely ill patients during the ongoing pandemic. CLINICAL TRIAL NUMBER: Not applicable.


Subject(s)
Anesthesiology/instrumentation , COVID-19/epidemiology , COVID-19/therapy , Critical Illness/epidemiology , Critical Illness/therapy , Respiration, Artificial/instrumentation , Aged , Female , Humans , Italy/epidemiology , Male , Middle Aged , Respiration, Artificial/methods , Retrospective Studies
7.
Radiother Oncol ; 160: 125-131, 2021 07.
Article in English | MEDLINE | ID: covidwho-1209638

ABSTRACT

Novel mechanistic insights are discussed herein that link a single, nontoxic, low-dose radiotherapy (LDRT) treatment (0.5-1.0 Gy) to (1) beneficial subcellular effects mediated by the activation of nuclear factor erythroid 2-related transcription factor (Nrf2) and to (2) favorable clinical outcomes for COVID-19 pneumonia patients displaying symptoms of acute respiratory distress syndrome (ARDS). We posit that the favorable clinical outcomes following LDRT result from potent Nrf2-mediated antioxidant responses that rebalance the oxidatively skewed redox states of immunological cells, driving them toward anti-inflammatory phenotypes. Activation of Nrf2 by ionizing radiation is highly dose dependent and conforms to the features of a biphasic (hormetic) dose-response. At the cellular and subcellular levels, hormetic doses of <1.0 Gy induce polarization shifts in the predominant population of lung macrophages, from an M1 pro-inflammatory to an M2 anti-inflammatory phenotype. Together, the Nrf2-mediated antioxidant responses and the subsequent shifts to anti-inflammatory phenotypes have the capacity to suppress cytokine storms, resolve inflammation, promote tissue repair, and prevent COVID-19-related mortality. Given these mechanistic considerations-and the historical clinical success of LDRT early in the 20th century-we opine that LDRT should be regarded as safe and effective for use at almost any stage of COVID-19 infection. In theory, however, optimal life-saving potential is thought to occur when LDRT is applied prior to the cytokine storms and before the patients are placed on mechanical oxygen ventilators. The administration of LDRT either as an intervention of last resort or too early in the disease progression may be far less effective in saving the lives of ARDS patients.


Subject(s)
COVID-19 , Respiratory Distress Syndrome , Cytokine Release Syndrome , Humans , NF-E2-Related Factor 2 , SARS-CoV-2
8.
Contact Dermatitis ; 2021 Apr 04.
Article in English | MEDLINE | ID: covidwho-1207411

ABSTRACT

BACKGROUND: The coronavirus disease-2019 (COVID-19) outbreak has presented unique dermatologic challenges due to respiratory protective equipment (RPE)-related skin conditions. OBJECTIVE: To objectively evaluate the effects of RPE including medical masks and respirators on the skin barrier by measuring various physiological properties of the skin. METHODS: A cross-sectional study was designed. Twenty healthy healthcare workers were included in this study. Skin parameters including skin hydration, transepidermal water loss (TEWL), erythema, sebum secretion, pH, and skin temperature were measured in the RPE-covered and RPE-uncovered areas of the face 4 and 8 hours after wearing RPE and 14 hours after not wearing RPE. RESULTS: Skin hydration, TEWL, erythema, pH, and skin temperature increased in the RPE-covered areas after wearing RPE for 4 and 8 hours. By contrast, in the RPE-uncovered areas, skin hydration decreased and TEWL, erythema, and pH showed minimal changes over time. Based on the repeated-measure analysis, the changes in skin physiological properties over time were significantly different between RPE-covered and RPE-uncovered areas. CONCLUSION: We observed that skin physiological characteristics change with the prolonged use of RPE such as medical masks and respirators. These changes may lead to various adverse skin reactions after long-term use.

9.
Int J Occup Med Environ Health ; 34(2): 239-249, 2021 May 27.
Article in English | MEDLINE | ID: covidwho-1181806

ABSTRACT

OBJECTIVES: To evaluate the effectiveness of safety guidelines in the workplace, the authors analyzed the work-related exposure to SARS-CoV-2 and the source of COVID­19 infections among healthcare workers (HCWs), together with the use of personal protective equipment (PPE). MATERIAL AND METHODS: A cross-sectional prospective study was conducted in tertiary hospitals in the Uusimaa region, Finland, with 1072 volunteers being enrolled in the study from among the HCWs at the Helsinki University Hospital. Overall, 866 (80.8%) HCWs (including 588 nurses, 170 doctors, and 108 laboratory and medical imaging nurses) completed the questionnaire by July 15, 2020, with 52% of the participants taking care of COVID­19 patients. The participants answered a structured questionnaire regarding their use of PPE, the ability to follow safety guidelines, exposure to COVID­19, and the source of potential COVID­19 infections. The participants with COVID­19 symptoms were tested with the SARS-CoV-2 realtime polymerase chain reaction method. All infected participants were contacted, and their answers were confirmed regarding COVID­19 exposure. RESULTS: In total, 41 (4.7%) participants tested positive for SARS-CoV-2, with 22 (53.6%) of infections being confirmed or likely occupational, and 12 (29.3%) originating from colleagues. In 14 cases (63.6%), occupational infections occurred while using a surgical mask, and all infections originating from patients occurred while using a surgical mask or no mask at all. No occupational infections were found while using an FFP2/3 respirator and following aerosol precautions. The combined odds ratio for working at an intensive care unit, an emergency department, or a ward was 3.4 (95% CI: 1.2-9.2, p = 0.016). CONCLUSIONS: A high infection rate was found among HCWs despite safety guidelines. Based on these findings, the authors recommend the use of FFP2/3 respirators in all patient contacts with confirmed or suspected COVID­19, along with the use of universal masking, also in personnel rooms. Int J Occup Med Environ Health. 2021;34(2):239-49.


Subject(s)
COVID-19/epidemiology , Disease Transmission, Infectious/prevention & control , Health Personnel , Personal Protective Equipment/standards , SARS-CoV-2 , Adult , COVID-19/transmission , Cross-Sectional Studies , Female , Finland/epidemiology , Humans , Male , Prospective Studies
10.
11.
Membranes (Basel) ; 11(4)2021 Mar 30.
Article in English | MEDLINE | ID: covidwho-1159455

ABSTRACT

Wearing face masks, use of respirators, social distancing, and practicing personal hygiene are all measures to prevent the spread of the coronavirus disease (COVID-19). This pandemic has revealed the deficiency of face masks and respirators across the world. Therefore, significant efforts are needed to develop air filtration and purification technologies, as well as innovative, alternative antibacterial and antiviral treatment methods. It has become urgent-in order for humankind to have a sustainable future-to provide a feasible solution to air pollution, particularly to capture fine inhalable particulate matter in the air. In this review, we present, concisely, the air pollutants and adverse health effects correlated with long- and short-term exposure to humans; we provide information about certified face masks and respirators, their compositions, filtration mechanisms, and the variations between surgical masks and N95 respirators, in order to alleviate confusion and misinformation. Then, we summarize the electrospun nanofiber-based filters and their unique properties to improve the filtration efficiency of face masks and respirators.

12.
Int J Mol Sci ; 22(5)2021 Mar 04.
Article in English | MEDLINE | ID: covidwho-1129732

ABSTRACT

BACKGROUND: Acute lung injury (ALI) or its most advanced form, acute respiratory distress syndrome (ARDS) is a severe inflammatory pulmonary process triggered by a variety of insults including sepsis, viral or bacterial pneumonia, and mechanical ventilator-induced trauma. Currently, there are no effective therapies available for ARDS. We have recently reported that a novel small molecule AVR-25 derived from chitin molecule (a long-chain polymer of N-acetylglucosamine) showed anti-inflammatory effects in the lungs. The goal of this study was to determine the efficacy of two chitin-derived compounds, AVR-25 and AVR-48, in multiple mouse models of ALI/ARDS. We further determined the safety and pharmacokinetic (PK) profile of the lead compound AVR-48 in rats. METHODS: ALI in mice was induced by intratracheal instillation of a single dose of lipopolysaccharide (LPS; 100 µg) for 24 h or exposed to hyperoxia (100% oxygen) for 48 h or undergoing cecal ligation and puncture (CLP) procedure and observation for 10 days. RESULTS: Both chitin derivatives, AVR-25 and AVR-48, showed decreased neutrophil recruitment and reduced inflammation in the lungs of ALI mice. Further, AVR-25 and AVR-48 mediated diminished lung inflammation was associated with reduced expression of lung adhesion molecules with improvement in pulmonary endothelial barrier function, pulmonary edema, and lung injury. Consistent with these results, CLP-induced sepsis mice treated with AVR-48 showed a significant increase in survival of the mice (80%) and improved lung histopathology in the treated CLP group. AVR-48, the lead chitin derivative compound, demonstrated a good safety profile. CONCLUSION: Both AVR-25 and AVR-48 demonstrate the potential to be developed as therapeutic agents to treat ALI/ARDS.


Subject(s)
Acute Lung Injury/drug therapy , Immunologic Factors/pharmacology , Respiratory Distress Syndrome/drug therapy , Small Molecule Libraries/pharmacology , Animals , Chitin/pharmacology , Disease Models, Animal , Female , Lipopolysaccharides/pharmacology , Lung/drug effects , Male , Mice , Mice, Inbred C57BL , Pneumonia/drug therapy , Pulmonary Edema/drug therapy , Rats , Rats, Sprague-Dawley , Sepsis/drug therapy
13.
J Family Med Prim Care ; 9(12): 5850-5852, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1122403

ABSTRACT

A general term N95 Mask has been widely used by all including the health care personnel. It has been use incorrectly by all and it should be replaced with the term filtering facepiece respirator. There are two types of respirators being used in the world. One is the industrial type whereas the other one is the medical surgical one. The medical surgical masks are an intermediate product between the industrial and the triple layer medical mask. Many other equivalent products like KN95 masks are also available in the market. There is an urgent need of certification because this is the only way quality face masks can be provided to the public in these difficult times of COVID-19. This is essential because of the entry of many counterfeit and uncertified respirators have entered the market.

14.
J Hosp Infect ; 111: 125-131, 2021 May.
Article in English | MEDLINE | ID: covidwho-1084311

ABSTRACT

BACKGROUND: Clinicians around the world are experiencing skin breakdown due to the prolonged usage of masks while working long hours to treat patients with COVID-19. The skin damage is a result of the increased friction and pressure at the mask-skin barrier. Throughout the COVID-19 pandemic, clinicians have been applying various skin barriers to prevent and ameliorate skin breakdown. However, there are no studies to our knowledge that assess the safety and efficacy of using these skin barriers without compromising a sufficient mask-face seal. AIM: To conduct the largest study to date of various skin barriers and seal integrity with quantitative fit testing (QNFT). METHODS: This pilot study explored whether the placement of a silicone scar sheet (ScarAway®), Cavilon™, or Tegaderm™ affects 3M™ half-face mask respirator barrier integrity when compared to no barrier using QNFT. Data were collected from nine clinicians at an academic level 1 trauma centre in New Jersey. FINDINGS: The silicone scar sheet resulted in the lowest adequate fit, whereas Cavilon provided the highest fit factor when compared to other interventions (P < 0.05). CONCLUSION: These findings help inform clinicians considering barriers for comfort when wearing facemasks during the COVID-19 pandemic and for future pandemics.


Subject(s)
COVID-19/prevention & control , Masks/adverse effects , Occupational Exposure/prevention & control , Ointments/therapeutic use , Pandemics/prevention & control , Skin Diseases/drug therapy , Skin Diseases/etiology , Adult , Female , Health Personnel/statistics & numerical data , Humans , Male , Pilot Projects , SARS-CoV-2
15.
Can J Respir Ther ; 57: 18-21, 2021.
Article in English | MEDLINE | ID: covidwho-1083008

ABSTRACT

INTRODUCTION: The lack of mechanical ventilators for patients with COVID-19 has necessitated the use of other noninvasive ventilation (NIV) systems. One of these NIV systems is the use of an adapted snorkel mask with inspiration valves and pressure valve (PEEP). CASE AND OUTCOMES: A 48-year-old man with no previous history of lung disease was admitted to the emergency room with a diagnosis of acute respiratory failure due to SARS-COV2. The patient did not improve saturation with the use of the reservoir mask. Oxygenation was started using an adapted snorkel mask with a PEEP valve with an alveolar recruitment function and double oxygen flow. The patient presented clinical and radiological improvement after 2 days of use and was discharged 16 days later. DISCUSSION: The use of a snorkel mask is an important, viable, and simpler NIV modality for the management of patients with COVID-19 with respiratory failure who fail to use a reservoir mask, and it can be an alternative before the use of a mechanical ventilator. CONCLUSION: The use of the adapted snorkel mask with Charlotte valve and PEEP is a feasible alternative for the treatment of patients with COVID-19.

16.
Front Pediatr ; 9: 580150, 2021.
Article in English | MEDLINE | ID: covidwho-1082644

ABSTRACT

Despite the fact that the use of masks and respirators in adults has already reached a consensus in almost all countries and for situations in which they are recommended, this is not the case for the use of mask by children. This statement, regarding the usage of mask by children, has been jointly produced by the Association of Schools of Public Health in the European Region (ASPHER) and the European Academy of Paediatrics (EAP). It provides recommendations on the size of the mask, the material and ergonomics of children's masks. The authors also discuss the psychological dimension of children when they are asked to wear a mask. Moreover, they tackle the difficulties of children with disabilities.

17.
Anaesthesia ; 76(5): 617-622, 2021 05.
Article in English | MEDLINE | ID: covidwho-1066603

ABSTRACT

Disposable N95 respirator masks are the current standard for healthcare worker respiratory protection in the COVID-19 pandemic. In addition to shortages, qualitative fit testing can have low sensitivity for detecting poor fit, leading to inconsistent protection. Multiple groups have developed alternative solutions such as modified snorkel masks to overcome these limitations, but validation of these solutions has been lacking. We sought to determine if N95s and snorkel masks with attached high-efficiency filters provide consistent protection levels in healthcare workers and if the addition of positive pressure via an inexpensive powered-air purifying respirator to the snorkel mask would provide enhanced protection. Fifty-one healthcare workers who were qualitatively fitted with N95 masks underwent quantitative mask fit testing according to a simulated workplace exercise protocol. N95, snorkel masks with high-efficiency filters and snorkel masks with powered-air purifying respirators were tested. Respiratory filtration ratios were collected for each step and averaged to obtain an overall workplace protocol fit factor. Failure was defined as either an individual filtration ratio or an overall fit factor below 100. N95s and snorkel masks with high-efficiency filters failed one or more testing steps in 59% and 20% of participants, respectively, and 24% and 12% failed overall fit factors, respectively. The snorkel masks with powered-air purifying respirators had zero individual or overall failures. N95 and snorkel masks with high-efficiency filter respirators were found to provide inconsistent respiratory protection in healthcare workers.


Subject(s)
COVID-19/prevention & control , Cost-Benefit Analysis/standards , Health Personnel/standards , Masks/standards , N95 Respirators/standards , Adult , COVID-19/economics , Cohort Studies , Equipment Design/economics , Equipment Design/standards , Female , Health Personnel/economics , Humans , Male , Masks/economics , Middle Aged , N95 Respirators/economics , Occupational Exposure/economics , Occupational Exposure/prevention & control , Personal Protective Equipment/economics , Personal Protective Equipment/standards , Prospective Studies , Reproducibility of Results
18.
J Occup Environ Hyg ; 18(3): 118-127, 2021 03.
Article in English | MEDLINE | ID: covidwho-1066172

ABSTRACT

During the beginning of the SARS-CoV-2 pandemic, there was a shortage of masks and respirators for the protection of health care professionals. Masks for noninvasive ventilation (NIV) in combination with viral-proof filters, worn by healthcare workers, could serve as an alternative protection measure. We determined the simulated protection factor (SPF) of such devices in comparison to conventional surgical masks, N95, and FFP3 respirators. Masks and respirators were mounted on a ventilated mannequin head in a test-chamber. Isotonic saline containing 150 MBq 99mTC-DTPA (99mTc-diethylenetriamine pentaacetate (DTPA) was nebulized inside the box. The aerosol had a mass median aerodynamic diameter of 0.6 ± 0.4 µm. SPFs were measured using radioactive DTPA particles in the mannequin test system by calculating the ratio of unfiltered particles (Pu) and filtered particles (Pf) for each tested device (SPF = Pu/Pf). Simulated protection factors were 15.6 ± 3.6 for a ResMed AcuCare mask plus filter, 3.5 ± 0.2 for a ResMed Mirage Quattro FX mask plus filter, 9.5 ± 0.8 for a Loewenstein JOYCEclinc FF mask plus filter, 1.9 ± 0.2 for a surgical mask with a rubber band, 2.7 ± 0.7 for a surgical mask with ribbons, 2.3 ± 0.3 for an FFP3 respirator, and 3.6 ± 1.3 for an N95 respirator. The ResMed AcuCare and the Loewenstein JOYCEclinic FF mask were more effective than any other of the tested devices (p < 0.001). In conclusion, masks normally used for NIV with viral-proof filters can effectively filter respirable particles.


Subject(s)
COVID-19/prevention & control , Masks , Respiratory Protective Devices , Filtration/instrumentation , Manikins , N95 Respirators , Noninvasive Ventilation/instrumentation , Occupational Exposure/prevention & control , SARS-CoV-2 , Technetium Tc 99m Pentetate
19.
Int J Infect Dis ; 104: 320-328, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1065182

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 pandemic increased global demand for personal protective equipment (PPE) and resulted in shortages. The study evaluated the re-use of surgical masks and respirators by analysing their performance and safety before and after reprocessing using the following methods: oven, thermal drying, autoclave, and hydrogen peroxide plasma vapour. METHODS: In total, 45 surgical masks and 69 respirators were decontaminated. Visual integrity, air permeability, burst resistance, pressure differential and particulate filtration efficiency of new and decontaminated surgical masks and respirators were evaluated. In addition, 14 used respirators were analysed after work shifts before and after decontamination using reverse transcription polymerase chain reaction (RT-PCR) and viral culturing. Finally, reprocessed respirators were evaluated by users in terms of functionality and comfort. RESULTS: Oven decontamination (75 °C for 45 min) was found to be the simplest decontamination method. Physical and filtration assays indicated that all reprocessing methods were safe after one cycle. Oven decontamination maintained the characteristics of surgical masks and respirators for at least five reprocessing cycles. Viral RNA was detected by RT-PCR in two of the 14 used respirators. Four respirators submitted to viral culture were PCR-negative and culture-negative. Reprocessed respirators used in work shifts were evaluated positively by users, even after three decontamination cycles. CONCLUSION: Oven decontamination is a safe method for reprocessing surgical masks and respirators for at least five cycles, and is feasible in the hospital setting.


Subject(s)
COVID-19/prevention & control , Decontamination/methods , Masks/virology , Pandemics , Personal Protective Equipment/virology , SARS-CoV-2/isolation & purification , Ventilators, Mechanical/virology , COVID-19/epidemiology , COVID-19/virology , Equipment Reuse , Hospitals , Hot Temperature , Humans , Hydrogen Peroxide/pharmacology , SARS-CoV-2/genetics
20.
Adv Respir Med ; 88(6): 638-639, 2020.
Article in English | MEDLINE | ID: covidwho-1058966

ABSTRACT

Performing medical procedures with the use of personal protective equipment may reduce the efficiency of medical procedures performed, for example, as with the current use of respiratory protection devices, including N95 or surgical masks. Healthcare workers (HCWs) using N95 respirators or medical masks may experience discomfort associated with wearing a mask when performing medical procedures, in particular those associated with increased physical activity, causing increased respiratory effort.


Subject(s)
COVID-19/prevention & control , Infection Control/methods , N95 Respirators/standards , Occupational Exposure/prevention & control , Emergency Medical Services , Humans , Masks/standards
SELECTION OF CITATIONS
SEARCH DETAIL