scholarly journals Can N95 respirators be reused after disinfection? And for how many times?

Author(s):  
Lei Liao ◽  
Wang Xiao ◽  
Mervin Zhao ◽  
Xuanze Yu ◽  
Haotian Wang ◽  
...  

AbstractThe Coronavirus Disease 2019 (COVID-19) pandemic has led to a major shortage of N95 respirators, which are essential to protecting healthcare professionals and the general public who may come into contact with the virus. Thus, it is essential to determine how we can reuse respirators and other personal protection in these urgent times. We investigated multiple commonly used and easily deployable, scalable disinfection schemes on media with particle filtration efficiency of 95%. Among these, heating (≤85 °C) under various humidities (≤100% RH) was the most promising, nondestructive method for the preservation of filtration properties in meltblown fabrics as well as N95-grade respirators. Heating can be applied up to 50 cycles (85 °C, 30% RH) without observation in the degradation of meltblown filtration performance. Ultraviolet (UV) irradiation was a secondary choice which was able to withstand 10 cycles of treatment and showed small degradation by 20 cycles. However, UV can also potentially impact the material strength and fit of respirators. Finally, treatments involving liquids and vapors require caution, as steam, alcohol, and household bleach may all lead to degradation of the filtration efficiency, leaving the user vulnerable to the viral aerosols.

Author(s):  
Alan Baron ◽  
John Hassard ◽  
Fiona Cheetham ◽  
Sudi Sharifi

This chapter looks ‘outside’ the Hospice at issues of the organization’s image. The authors talked to staff, volunteers, and members of the general public, as well as to a number of key stakeholders in the local healthcare community, in order to gauge their views on the host organization. The analysis examines the problems associated with the image of hospices and discusses attempts of staff and volunteers to ‘dispel the myths’ about the nature of hospice care work—a form of labour which potentially runs the risk of being characterized as ‘dirty work’. The chapter then examines how the Hospice is seen in the eyes of other healthcare professionals and discusses the choice of palliative medicine as a career for junior medics. Finally it discusses a degree of ‘confusion’ that staff and volunteers claim exists in the minds of GPs and consultants in specialist cancer hospitals about the role of hospices.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Kamal ◽  
Mohammad Abdulwahab ◽  
Ahmed Al-Zaid

Abstract Background Oral and maxillofacial surgery specialty has grown rapidly in Kuwait in recent years. However, the general public and healthcare professionals remain unaware of its expanding scope of practice. The aim of the study is to assess public and professional (dental and medical) perception of the oral and maxillofacial surgical specialty in Kuwait. Methods This is a cross-sectional study evaluating responses of dental professionals, medical professionals, and general public in Kuwait toward the oral and maxillofacial surgical specialty using a previously validated survey instrument with 100 participants in each group. Participants were asked to choose the most appropriate specialist to treat certain procedures across 4 disciplines: reconstruction, trauma, pathology, and cosmetic. Statistical comparison was conducted between dentists and medical doctors using Fisher’s exact test with a p-value of < 0.05. Results Disparities were noted each group’s responses. Oral and maxillofacial surgery was preferred overall for most clinical scenarios in trauma (p < 0.001), pathology (p < 0.001), and reconstructive surgery (p < 0.001). Plastic surgery was preferred for cosmetic surgeries (p < 0.001). Conclusions This study indicates the need to increase awareness especially towards cosmetic surgery procedures, and conduct health campaigns regarding oral and maxillofacial surgery among healthcare professionals, especially medical doctors, and the general public.


PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258191
Author(s):  
Scott Duncan ◽  
Paul Bodurtha ◽  
Syed Naqvi

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.


Author(s):  
Elmer V. Bernstam ◽  
Funda Meric-Bernstam

This chapter discusses the problem of how to evaluate online health information. The quality and accuracy of online health information is an area of increasing concern for healthcare professionals and the general public. We define relevant concepts including quality, accuracy, utility, and popularity. Most users access online health information via general-purpose search engines, therefore we briefly review Web search-engine fundamentals. We discuss desirable characteristics for quality-assessment tools and the available evidence regarding their effectiveness and usability. We conclude with advice for healthcare consumers as they search for health information online.


Author(s):  
Martina Barchitta ◽  
Annalisa Quattrocchi ◽  
Andrea Maugeri ◽  
Maria Clara La Rosa ◽  
Claudia La Mastra ◽  
...  

The issue of antimicrobial resistance (AMR) is a focus of the World Health Organization, which proposes educational interventions targeting the public and healthcare professionals. Here, we present the first attempt at a regionwide multicomponent campaign in Sicily (Italy), called “Obiettivo Antibiotico”, which aims to raise the awareness of prudent use of antibiotics in the public and in healthcare professionals. The campaign was designed by an interdisciplinary academic team, and an interactive website was populated with different materials, including key messages, letters, slogans, posters, factsheets, leaflets, and videos. The campaign was launched in November 2018 and, as of 21 December 2018, the website had a total of 1159 unique visitors, of which 190 became champions by pledging to take simple actions to support the fight against AMR. Data from social media showed that the audience was between 18 and 54 years of age, with a high proportion of female participants (64%). Interestingly, the LinkedIn page received more than 1200 followers, and Facebook 685 followers. The number of actions taken (pledges) by the audience was 458, evenly divided between experts (53%) and the general public (47%). Additional efforts are needed to reach more people, thus future efforts should focus on further promotion within the Sicilian region to sustain the engagement with the campaign.


Author(s):  
Amrita R. John ◽  
Shine Raju ◽  
Jennifer L. Cadnum ◽  
Kipum Lee ◽  
Phillip McClellan ◽  
...  

AbstractBackgroundCritical shortages of personal protective equipment (PPE) especially N95 respirators, during the SARS-CoV-2 pandemic continues to be a source of great concern among health care workers (HCWs). Novel methods of N95 filtering facepiece respirator (FFR) decontamination that can be scaled-up for in-hospital use can help address this concern and keep HCWs safe.MethodsA multidisciplinary pragmatic study was conducted to evaluate the use of an ultrasonic room high-level disinfection system (HLDS) that generates aerosolized peracetic acid (PAA) and hydrogen peroxide for decontamination of large numbers of N95 respirators. A cycle duration that consistently achieved disinfection of N95 respirators (defined as ≤ 6 log10 reductions in bacteriophage MS2 and Geobacillus stearothermophilus spores inoculated onto respirators) was identified. The treated masks were then assessed for changes to their hydrophobicity, material structure, strap elasticity, and filtration efficiency (FE). Assessment of PAA off-gassing from a treated mask was also performed.ResultsThe PAA room HLDS was effective for disinfection of N95 respirators in a 2447 cubic feet room with deploy and dwell times of 16 and 32 minutes respectively, and a total cycle time of 1 hour and 16 minutes. After 5 treatment cycles, no adverse effects were detected on filtration efficiency, structural integrity, or strap elasticity. There was no detectable off-gassing of PAA from the treated masks.ConclusionThe PAA room disinfection system provides a rapidly scalable solution for in-hospital decontamination of large numbers of N95 respirators to meet the needs of HCWs during the SARS-CoV-2 pandemic.


2020 ◽  
Author(s):  
Albert I. Nazeeri ◽  
Isaac A. Hilburn ◽  
Daw-An Wu ◽  
Kabir A. Mohammed ◽  
D. Yovan Badal ◽  
...  

AbstractA critical shortage of respirators, masks and other personal protective equipment (PPE) exists due to the COVID-19 pandemic. Of particular need are N95 respirators, which use meltblown microfibers of charged polypropylene. An intensive search is underway to find reliable methods to lengthen the useful life of these normally disposable units.Recent experiments on respirators cleaned with ethanol solutions found drastic post-treatment drops infiltration efficiency (>40%). This has been attributed to a mechanism whereby ethanol disrupts the charges in the microfibers, reducing their ability to trap particles. The CDC/NIOSH has issued guidance directing clinicians and researchers to pursue other methods of decontamination.In our experiments, we replicated the drop in efficiency after 70% ethanol treatment, but we found that the efficiency rose again after more effective drying, which we achieved with a vacuum chamber. After drying at pressures of < ∼6 mbar (0.6 kPa), the measured filtering efficiency rose to within 2% of the pre-washing value, and we found that this was sustained for 5 cleaning-drying cycles in three models of N95 masks. We stress that our tests are not meant to certify that the respirators are safe for use, which would require further, standardized, testing under NIOSH protocols. The tests presented here are used to understand basic mechanisms by which treatments can decrease or increase filtration efficiency.The main mechanism underlying the loss and recovery of filter efficiency seems to be the deposition and removal of water molecules adsorbed on the fiber surfaces, a hypothesis which is supported by several observations: (A) the filtering efficiency increases non-linearly with the weight loss during drying. (B) filtration efficiency shows an abrupt recovery as the vacuum pressure drops from 13 to 6 mbar, the range physically attributable to the removal of adsorbed water. (C) Optical microscopy of the microfiber layer reveals surface wetting of the fibers, which is most resistant to drying in dense regions of the fiber network. These observations indicate that losses in filter efficiency may be caused by the wicking of water into the dense fiber networks, reducing the available surface area for filtration.Such a degradation mechanism has two implications: (A) Ethanol and other aqueous decontamination methods may be more viable than previously assumed. Investigations of such methods should specify drying methods in their protocols. We employ vacuum chambers in this study, but other methods of removing adsorbed water could be equivalent. (B) This mechanism presents the possibility that mask filtration performance may be subject to degradation by other sources of moisture, and that the mask would continue to be compromised even if it appears dry. Further research is needed to determine the conditions under which such risks apply, and whether drying should be a routine practice for respirators undergoing extended use.This study introduces a number of methods which could be developed and validated for use in resource-limited settings. As the pandemic continues to spread in rural areas and developing nations, these would allow for local efforts to decontaminate, restore, and test medical masks.


2020 ◽  
Vol 20 (12) ◽  
pp. 2581-2591
Author(s):  
Chenxing Pei ◽  
Qisheng Ou ◽  
Seong Chan Kim ◽  
Sheng-Chieh Chen ◽  
David Y.H. Pui

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