The impact of extreme reuse and extended wear conditions on protection provided by a surgical-style N95 filtering facepiece respirator.

Most respirators employed in health care settings, and often in first responder and industrial settings, are intended for single-use: the user dons the respirator, performs a work activity, and then doffs and discards the respirator. However, in the current COVID-19 pandemic, in the presence of persistent shortages of personal protective equipment, extended use and reuse of filtering facepiece respirators are routinely contemplated by many health care organizations. Further, there is considerable current effort to understand the effect of sterilization on the possibility of reuse, and some investigations of performance have been conducted. While the ability of such a respirator to continue to provide effective protection after repeated sanitization cycles is a critical component of implementing its reuse, of equal importance is an understanding of the impact that reusing the respirator multiple times in a day while performing work tasks, and even extending its wear over multiple days, has on the workplace protective performance. In this study, we subjected a stockpiled quantitatively fitted surgical style N95 filtering facepiece respirator device to extreme reuse and extended wear conditions (up to 19 uses over a duration of 5 days) and measured its protective performance at regular intervals, including simulated workplace protection factor measurements using total inward leakage. With this respirator, it was shown to be possible to maintain protection corresponding to an assigned protection factor greater than 10 under extreme usage conditions provided an individual is properly trained in the use of, and expertly fitted in, the respirator. Other factors such as hygiene and strap breakage are likely to place limits on reuse.

Estimates of percutaneous toxicity of sulfur mustard vapor suitable for use in protective equipment standards.

An analysis was performed of historical human chamber data for exposure to sulfur mustard vapor, in order to correlate skin exposure dosages with effects in a manner specifically suitable for use in protective clothing standards. Data were reanalyzed to take into account (1) body region variability of skin responses to a single acute exposure to sulfur mustard vapor, (2) effect of hot/humid versus cooler exposure, and (3) influence of clothing. This approach permits deriving predicted skin responses pertinent to a protective clothing wearer, for a relatively short single acute exposure to vapor (up to a few hours) under the hot/humid conditions expected within a protective ensemble. Values for permissible dermal exposure to sulfur mustard vapor are proposed for protected emergency responders or military serving in combat theaters that may be used in standards intended to be employed in conjunction with evaluation of vapor protection provided by individual protective equipment for protection against chemical warfare agents by Man-in-Simulant vapor test methods.

In vitro dermal absorption of methyl salicylate, ethyl parathion, and malathion: first responder safety.

In vitro tests with fresh dermatomed (0.3 to 0.4 mm thick) female breast skin and one leg skin specimen were conducted in Bronaugh flow-through Teflon diffusion cells with three chemicals used to simulate chemical warfare agents: 14C-radiolabeled methyl salicylate (MES), ethyl parathion (PT), and malathion (MT), at three dose levels (2, 20, and 200 mM). Tests were conducted at a skin temperature of 29 degrees C using a brief 30-min exposure to the chemical and a 6.5-h receivor collection period. Rapid absorption of all three chemicals was observed, with MES absorbed about 10-fold faster than PT and MT. For MES, PT, and MT, respectively, there was 32%, 7%, and 12% absorption into the receivor solution (Hank's HEPES buffered saline with 4% bovine serum albumin [BSA], pH 7.4) at the low dose (2 mM), 17%, 2%, and 3% at the medium dose (20 mM), and 11%, 1%, and 1% at the high dose (200 mM) levels. Including the skin depot for MES, PT, and MT, respectively, there was 40%, 41%, and 21% (low dose), 26%, 16%, and 8% (medium dose), and 13%, 19%, and 10% (high does) absorption. Efficacy of skin soap washing conducted at the 30 min exposure time ranged from 31% to 86%, varying by chemical and dose level. Skin depot levels were highest for the relatively lipophilic PT. "Pseudo" skin permeability coefficient (K(p)) data declined with dose level, suggesting skin saturation had occurred. An in-depth comparison with literature data was conducted and risk assessment of first responder exposure was briefly considered.

Determination of the in vivo pharmacokinetics of palladium-bacteriopheophorbide (WST09) in EMT6 tumour-bearing Balb/c mice using graphite furnace atomic absorption spectroscopy.

Palladium-bacteriopheophorbide (WST09), a novel bacteriochlorophyll derivative, is currently being investigated for use as a photodynamic therapy (PDT) drug due to its strong absorption in the near-infrared region and its ability to efficiently generate singlet oxygen when irradiated. In this study, we determined the pharmacokinetics and tissue distribution of WST09 in female EMT6 tumour-bearing Balb/c mice in order to determine if selective accumulation of this drug occurs in tumour tissue. A total of 41 mice were administered WST09 by bolus injection into the tail vein at a dose level of 5.0 +/- 0.8 mg kg(-1). Three to six mice were sacrificed at each of 0.08, 0.25, 0.5, 1.0, 3.0, 6.0, 9.0, 12, 24, 48, 72, and 96 h post injection, and an additional three control mice were sacrificed without having been administered WST09. Terminal blood samples as well as liver, skin, muscle, kidney and tumour samples were obtained from each mouse and analyzed for palladium content (from WST09) using graphite furnace atomic absorption spectroscopy (GFAAS). The representative concentration of WST09 in the plasma and tissues was then calculated. Biphasic kinetics were observed in the plasma, kidney, and liver with clearance from each of these tissues being relatively rapid. Skin, muscle and tumour did not show any significant accumulation at all time points investigated. No selective drug accumulation was seen in the tumour and normal tissues, relative to plasma. Thus the results of this study indicate that vascular targeting resulting from WST09 in the circulation, as opposed to selective WST09 accumulation in tumour tissues, may be responsible for PDT effects in tumours that have been observed in other WST09 studies.

A new whole-body vapor exposure chamber for protection performance research on chemical protective ensembles.

A chemical vapor exposure chamber was designed to permit the study of whole-body vapor exposure of individuals wearing full protective clothing and equipment systems. A methodology also was developed to quantify the vapor protection performance of chemical protective ensembles (CPE) under safe and validated laboratory procedures. The principal research objectives were to (1) provide a methodology to accurately assess the performance of CPE and equipment under different environmental and chemical vapor challenge conditions; (2) quantify the vapor protection on a per body region basis; (3) have a systems level tool to aid in the research and development of more effective CPE for use in chemical biological environments; and (4) have a safe and reliable means of qualifying new CPE on the basis of vapor protection. Although designed for the evaluation of military-style protective equipment, the procedures apply equally to other styles of CPE used by civilian agencies such as firefighters, police, and hazmat units. The chamber and methodology were specifically designed to examine the vapor protection performance of clothing ensembles, including the details of protection variation over the body. A variety of exposure conditions appropriate to indoor and outdoor scenarios are possible, including the effects of wind, temperature, and relative humidity. Protection performance results from a number of individuals wearing typical military-style CPE are presented. These results demonstrate that there is no such thing as a unique protection performance level obtained for a given CPE. Rather, the individual and the ensemble interact differently in each situation, resulting in a protection performance distribution for individuals, and for groups of wearers, even under a standardized set of exposure conditions.