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Exploring options for reprocessing of N95 Filtering Facepiece Respirators (N95-FFRs) amidst COVID-19 pandemic: A systematic review.
Paul, Diptanu; Gupta, Ayush; Maurya, Anand Kumar.
  • Paul D; Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
  • Gupta A; Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
  • Maurya AK; Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
PLoS One ; 15(11): e0242474, 2020.
Article in English | MEDLINE | ID: covidwho-937231
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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)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Protective Devices / Decontamination / Disinfection / Equipment Reuse / Masks Type of study: Experimental Studies / Qualitative research / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0242474

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Protective Devices / Decontamination / Disinfection / Equipment Reuse / Masks Type of study: Experimental Studies / Qualitative research / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0242474