scholarly journals UV decontamination of personal protective equipment with idle laboratory biosafety cabinets during the COVID-19 pandemic

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0241734
Author(s):  
Davis T. Weaver ◽  
Benjamin D. McElvany ◽  
Vishhvaan Gopalakrishnan ◽  
Kyle J. Card ◽  
Dena Crozier ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Medical Personnel ◽  
The United States ◽  
Common Element ◽  
Protective Equipment ◽  
Healthcare Organizations ◽  
Complete Inactivation ◽  
Surgical Masks ◽  
Mask Material ◽  
Uv C

Personal protective equipment (PPE) is crucially important to the safety of both patients and medical personnel, particularly in the event of an infectious pandemic. As the incidence of Coronavirus Disease 2019 (COVID-19) increases exponentially in the United States and many parts of the world, healthcare provider demand for these necessities is currently outpacing supply. In the midst of the current pandemic, there has been a concerted effort to identify viable ways to conserve PPE, including decontamination after use. In this study, we outline a procedure by which PPE may be decontaminated using ultraviolet (UV) radiation in biosafety cabinets (BSCs), a common element of many academic, public health, and hospital laboratories. According to the literature, effective decontamination of N95 respirator masks or surgical masks requires UV-C doses of greater than 1 Jcm−2, which was achieved after 4.3 hours per side when placing the N95 at the bottom of the BSCs tested in this study. We then demonstrated complete inactivation of the human coronavirus NL63 on N95 mask material after 15 minutes of UV-C exposure at 61 cm (232 μWcm−2). Our results provide support to healthcare organizations looking for methods to extend their reserves of PPE.

scholarly journals UV Sterilization of Personal Protective Equipment with Idle Laboratory Biosafety Cabinets During the COVID-19 Pandemic

2020 ◽  
Author(s):  
◽  
Kyle J. Card ◽  
Dena Crozier ◽  
Andrew Dhawan ◽  
Mina N. Dinh ◽  
...  
Keyword(s):  
Uv Radiation ◽  
Personal Protective Equipment ◽  
Cleveland Clinic ◽  
The United States ◽  
Alternative Methods ◽  
Common Element ◽  
Protective Equipment ◽  
Surgical Masks ◽  
N95 Respirators ◽  
Uv C

ABSTRACTDISCLAIMERThis article does not represent the official recommendation of the Cleveland Clinic or Case Western Reserve University School of Medicine, nor has it yet been peer reviewed. We are releasing it early, pre-peer review, to allow for quick dissemination/vetting by the scientific/clinical community given the necessity for rapid conservation of personal protective equipment (PPE) during this dire global situation. We welcome feedback from the community.Personal protective equipment (PPE), including face shields, surgical masks, and N95 respirators, is crucially important to the safety of both patients and medical personnel, particularly in the event of an infectious pandemic. As the incidence of Coronavirus Disease (COVID-19) increases exponentially in the United States and worldwide, healthcare provider demand for these necessities is currently outpacing supply. As such, strategies to extend the lifespan of the supply of medical equipment as safely as possible are critically important. In the midst of the current pandemic, there has been a concerted effort to identify viable ways to conserve PPE, including decontamination after use. Some hospitals have already begun using UV-C light to decontaminate N95 respirators and other PPE, but many lack the space or equipment to implement existing protocols. In this study, we outline a procedure by which PPE may be decontaminated using ultraviolet (UV) radiation in biosafety cabinets (BSCs), a common element of many academic, public health, and hospital laboratories, and discuss the dose ranges needed for effective decontamination of critical PPE. We further discuss obstacles to this approach including the possibility that the UV radiation levels vary within BSCs. Effective decontamination of N95 respirator masks or surgical masks requires UV-C doses of greater than 1 Jcm−2, which would take a minimum of 4.3 hours per side when placing the N95 at the bottom of the BSCs tested in this study. Elevating the N95 mask by 48 cm (so that it lies 19 cm from the top of the BSC) would enable the delivery of germicidal doses of UV-C in 62 minutes per side. Effective decontamination of face shields likely requires a much lower UV-C dose, and may be achieved by placing the face shields at the bottom of the BSC for 20 minutes per side. Our results are intended to provide support to healthcare organizations looking for alternative methods to extend their reserves of PPE. We recognize that institutions will require robust quality control processes to guarantee the efficacy of any implemented decontamination protocol. We also recognize that in certain situations such institutional resources may not be available; while we subscribe to the general principle that some degree of decontamination is preferable to re-use without decontamination, we would strongly advise that in such cases at least some degree of on-site verification of UV dose delivery be performed.

scholarly journals Modeling-based UV-C decontamination of N95 masks optimized to avoid undertreatment

2020 ◽  
Author(s):  
Adam P. Sears ◽  
Jacques Ohayon ◽  
Anton D. Shutov ◽  
Roderic I. Pettigrew
Keyword(s):  
Personal Protective Equipment ◽  
Path Length ◽  
Protective Equipment ◽  
Capital Equipment ◽  
Mask Material ◽  
The World ◽  
Uv C ◽  
Significant Data

AbstractAs the Coronavirus 2019 pandemic creates worldwide shortages of personal protective equipment, hospitals have increasingly turned to sterilization and re-use protocols, often without significant data supporting the specific methodologies. When using UV-C irradiation, previously shown to be effective for decontaminating hard surfaces, modeling shows the importance of accounting for the porosity and non-uniform curvature of the N95 masks in decontamination procedures. Data shows a standard incident dose of 1 J/cm2 delivered to both front and back surfaces is more than 500x higher than the known kill dose. However, modeling indicates this would undertreat 40% of the mask material due to the curvature, path-length attenuation and scatter. Multidirectional UV-C irradiation employing dose calibrated exposures can adjust for this loss and best decontaminate masks. Such protocols can be rapidly implemented in thousands of hospitals across the world equipped with UV-C irradiation lamps without the need for additional capital equipment purchases.

Infectious safety of nursing staff in departments (offices) functional diagnostics in the context of the COVID-19 pandemic

2020 ◽  
pp. 30-33
Author(s):  
E. V. Panina ◽  
M. V. Pugachev ◽  
A. G. Shchesiu
Keyword(s):  
Medical Care ◽  
Nursing Staff ◽  
Personal Protective Equipment ◽  
Medical Personnel ◽  
Medical Waste ◽  
Daily Activities ◽  
Protective Equipment ◽  
Functional Diagnostics ◽  
Prevention Of Infections ◽  
Epidemiological Situation

The article shows that in the daily activities of nursing staff of functional diagnostics departments (offices), it is necessary to strictly observe the requirements and rules for the prevention of infections associated with medical care, especially during the COVID-19 pandemic. The types of personal protective equipment (PPE) of medical personnel (MP), as well as current effective methods of disinfection, rules for collecting medical waste in a complex epidemiological situation are presented.

scholarly journals Ultraviolet-C as a Viable Reprocessing Method for Disposable Masks and Filtering Facepiece Respirators

Polymers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 801
Author(s):  
Talita Nicolau ◽  
Núbio Gomes Filho ◽  
Andrea Zille
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Personal Protective Equipment ◽  
State Of The Art ◽  
Protective Equipment ◽  
Multiple Methods ◽  
Ultraviolet C ◽  
Single Use ◽  
Uv C ◽  
New Strategies

In normal conditions, discarding single-use personal protective equipment after use is the rule for its users due to the possibility of being infected, particularly for masks and filtering facepiece respirators. When the demand for these protective tools is not satisfied by the companies supplying them, a scenario of shortages occurs, and new strategies must arise. One possible approach regards the disinfection of these pieces of equipment, but there are multiple methods. Analyzing these methods, Ultraviolet-C (UV-C) becomes an exciting option, given its germicidal capability. This paper aims to describe the state-of-the-art for UV-C sterilization in masks and filtering facepiece respirators. To achieve this goal, we adopted a systematic literature review in multiple databases added to a snowball method to make our sample as robust as possible and encompass a more significant number of studies. We found that UV-C’s germicidal capability is just as good as other sterilization methods. Combining this characteristic with other advantages makes UV-C sterilization desirable compared to other methods, despite its possible disadvantages.

Management of personal protective equipment during the COVID-19 pandemic in England and the state of New York: A comparative case study

2020 ◽  
Vol 18 (7) ◽  
pp. 71-89
Author(s):  
Amy Barber, BSc ◽  
Annaëlle Vinzent, BS ◽  
Imani Williams, BA
Keyword(s):  
New York ◽  
Supply Chain ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
New York State ◽  
The United States ◽  
Mitigation Strategies ◽  
Comparative Case Study ◽  
Protective Equipment

Background: The COVID-19 crisis placed extraordinary demands on the supply of personal protective equipment (PPE) at the beginning of 2020. These were coupled with shocks to the supply chain resulting from the disease. Many typically well-resourced health systems faced subsequent shortages of equipment and had to implement new strategies to manage their stocks. Stockpiles of protective equipment were held in both the United States and United Kingdom intended to prevent shortages. Method: Cross-comparative case study approach by applying Pettigrew and Whipp’s framework for change management. Setting: The health systems of England and New York state from January 2020 to the end of April 2020. Results: Both cases reacted slowly to their outbreaks and faced problems with supplying enough PPE to their health systems. Their stockpiles were not enough to prevent shortages, with many distribution problems resulting from inadequate governance mechanisms. No sustainable responses to supply disruptions were implemented during the study period in either case. Health systems planned interventions along each part of the supply chain from production and importing, to usage guidelines. Conclusion: Global supply chains are vulnerable to disruptions caused by international crises, and existing mitigation strategies have not been wholly successful. The existence of stockpiles is insufficient to preventing shortages of necessary equipment in clinical settings. Both the governance and quality of stockpiles, as well as distribution channels are important for preventing shortages. At the time of writing, it is not possible to judge the strength of strategies adopted in these cases.

scholarly journals Emergency Management Missing from the Pandemic?

2020 ◽  
Vol 18 (7) ◽  
pp. 149-150
Author(s):  
Attila J. Hertelendy, PhD ◽  
William L. Waugh, Jr., PhD
Keyword(s):  
United States ◽  
Emergency Management ◽  
Task Force ◽  
Medical Personnel ◽  
The United States ◽  
First Year ◽  
Protective Equipment ◽  
Protective Measures ◽  
White House ◽  
Pandemic Response

The change in presidential administrations in the United States promises new approaches to deal with the COVID-19 pandemic. The first year of the pandemic response in the United States has been characterized by a lack of national leadership. Moreover, the message from the White House Coronavirus Task Force has been muddled at best. There have been great inconsistencies in how the States have chosen to address spreading infections and increased stress on individual Americans who are trying to protect themselves and their families. The same pattern can be found with the distribution of vaccines and management of vaccinations. Politics has often conflicted with public health concerns. The States have been left to provide personal protective equipment (PPE) to medical personnel and first responders and to formulate their own guidance for protective measures.

Feasibility study: Proposed alternative to N95 respirator during the personal protective equipment shortage from COVID-19 pandemic

2021 ◽  
Vol 19 (7) ◽  
pp. 192-202
Author(s):  
Ahel El Haj Chehade, MD ◽  
Jesintha Stephenson, MD ◽  
Evan Floyd, PhD ◽  
Jean Keddissi, MD, FCCP ◽  
Tony Abdo, MD ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Feasibility Study ◽  
Personal Protective Equipment ◽  
Geometric Mean ◽  
Face Mask ◽  
The United States ◽  
Geometric Standard Deviation ◽  
Protective Equipment ◽  
Health Administration ◽  
Fit Testing

Introduction: Having an adequate supply of personal protective equipment during the COVID-19 pandemic has been a constant challenge for hospitals across the United States. In the event of shortages, our assembled mask might offer noninferior protection compared to an N95 respirator. Objective: To study the ability of an assembled mask to pass a quantitative fit testing.Methods: We conducted a feasibility study at the Oklahoma City Veteran Affairs Health Care System. Volunteers were fitted with an assembled mask made of either a Hans Rudolph half-face mask or a Respironics Performax full-face mask, attached to an Iso-Gard HEPA light Filter 28022 through a Performax SE elbow hinge. Quantitative fit testing was conducted using the Occupation Safety and Health Administration fit testing protocol. The primary outcome was the percentage of participants who pass the quantitative fit test. Secondary outcomes included the overall fit factor (FF), average FF for different exercises, changes in pulse oximetry and endtidal CO2 at 0 and 15 minutes, willingness to use the mask, and visibility assessment.Results: Twenty participants completed the study, and all (100 percent) passed the quantitative fit testing. The overall FF had a geometric mean of 2,317 (range: 208-16,613) and a geometric standard deviation of 3.8. The lowest FF was recorded while the subjects were talking. Between time 0 and 15 minutes, there was no clinically significant change in pulse oximetry and end-tidal CO2 levels. Most participants reported “very good” visibility and were “highly likely” to use the Hans Rudolph half-face mask in the case of shortage.Conclusion: Our assembled respirator offers noninferior protection to N95 respirators in the setting of hypothetical protective equipment shortage.

scholarly journals Utilization of an Orthopedic Hood as Personal Protective Equipment for Intubation of Coronavirus Patients: a Brief Technical Report

2020 ◽  
Vol 11 ◽  
pp. 215145932093055 ◽  
Author(s):  
Timothy T. Wills ◽  
Wilhelm A. Zuelzer ◽  
Bryant W. Tran
Keyword(s):  
Health Care ◽  
High Risk ◽  
Endotracheal Intubation ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Ventilation System ◽  
The United States ◽  
Protective Equipment ◽  
Care Workers ◽  
Technical Report

Background: The novel coronavirus disease (COVID-19) has afflicted millions of people worldwide since its first case was reported in December 2019. Personal protective equipment (PPE) has been tailored accordingly, but as of April 2020, close to 10 000 health care workers in the United States have contracted COVID-19 despite wearing recommended PPE. As such, standard guidelines for PPE may be inadequate for the health care worker performing high-risk aerosolizing procedures such as endotracheal intubation. In this brief technical report, we describe the integration of an orthopedic hood cover as an item for full barrier protection against COVID-19 transmission. Technical Description: The Coronavirus Airway Task Force at Virginia Commonwealth University Medical Center approved this initiative and went live with the full barrier suit during the last week of March 2020. The PPE described in this report includes a Stryker T4 Hood, normally used in conjunction with the Stryker Steri-Shield T4 Helmet. Instead of the helmet, the hood is secured to the head via a baseball cap and binder clip. This head covering apparatus is to be used as an accessory to other PPE items that include an N95 mask, waterproof gown, and disposable gloves. The motor ventilation system is not used in order to prevent airborne viral entry into the hood. Discussion: An advantage of the full barrier suit is an additional layer of droplet protection during intubation. The most notable disadvantage is the absence of a ventilation system within the hood covering. Conclusion: Modification of existing PPE may provide protection for health care workers during high-risk aerosolizing procedures such as endotracheal intubation. Although the integration of this medical equipment meets the immediate needs of an escalating crisis, further innovation is on the horizon. More research is needed to confirm the safety of modified PPE.

scholarly journals Patient-Worn Enhanced Protection Face Shield for Flexible Endoscopy

2020 ◽  
Vol 163 (2) ◽  
pp. 280-283 ◽  
Author(s):  
Jack B. Anon ◽  
Carter Denne ◽  
Darcy Rees
Keyword(s):  
Personal Protective Equipment ◽  
Health Care Professionals ◽  
Medical Personnel ◽  
Flexible Endoscopy ◽  
Primary Objective ◽  
Protective Equipment ◽  
Fiberoptic Endoscopy ◽  
Institutional Review ◽  
Inferior Aspect ◽  
Fluorescein Dye

Objectives The primary objective of this study was to compare the protection afforded by a standard face shield design with a new enhanced design in a controlled setting. Methods This study was exempted from review by institutional review board waiver. A flexible fiberoptic endoscopy was placed through stellate openings in the standard face shield and the enhanced face shield. A series of simulated coughs were created with bursts of fluorescein dye through an atomizer tip placed within the test participant’s mouth. Ultraviolet lighting illuminated the test area, and areas of dye splatter were noted. Results Fluorescein dye is easily aerosolized along the lateral inferior aspect of a standard shield with significant contamination of the surrounds. The enhanced face shield maintained a barrier to the aerosolized dye. Discussion Face shields, rather than face masks, should be considered a preferred alternative for the public and for health care professionals alike, as they address many of the personal protective equipment concerns especially during the COVID-19 pandemic. Otolaryngologists are at high risk from aerosol-generating procedures, such as flexible fiberoptic endoscopy, even when wearing personal protective equipment. Here we describe a uniquely designed face shield to be worn by the patient as another layer of protection for the environment and for medical personnel. Implications for Practice During the course of a flexible fiberoptic endoscopy, medical personnel are safely isolated from potential infectious particles with a newly designed face shield.

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