scholarly journals Assessment of N95 respirator decontamination and re-use for SARS-CoV-2

2020 ◽  
Author(s):  
Robert J. Fischer ◽  
Dylan H. Morris ◽  
Neeltje van Doremalen ◽  
Shanda Sarchette ◽  
Jeremiah Matson ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Uv Radiation ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Nosocomial Transmission ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Single Use ◽  
N95 Respirators

The unprecedented pandemic of SARS-CoV-2 has created worldwide shortages of personal protective equipment, in particular respiratory protection such as N95 respirators. SARS-CoV-2 transmission is frequently occurring in hospital settings, with numerous reported cases of nosocomial transmission highlighting the vulnerability of healthcare workers. In general, N95 respirators are designed for single use prior to disposal. Several groups have addressed the potential for re-use of N95 respirators from a mechanical or from a decontamination perspective. Here, we analyzed four different decontamination methods – UV radiation (260 – 285 nm), 70ºC heat, 70% ethanol and vaporized hydrogen peroxide (VHP) – for their ability to reduce contamination with infectious SARS-CoV-2 and their effect on N95 respirator function.

scholarly journals Assessment of N95 respirator decontamination and re-use for SARS-CoV-2

2020 ◽  
Author(s):  
Robert J. Fischer ◽  
Dylan H. Morris ◽  
Neeltje van Doremalen ◽  
Shanda Sarchette ◽  
M. Jeremiah Matson ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Nosocomial Transmission ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Single Use ◽  
N95 Respirators

The unprecedented pandemic of SARS-CoV-2 has created worldwide shortages of personal protective equipment, in particular respiratory protection such as N95 respirators. SARS-CoV-2 transmission is frequently occurring in hospital settings, with numerous reported cases of nosocomial transmission highlighting the vulnerability of healthcare workers. In general, N95 respirators are designed for single use prior to disposal. Here, we have analyzed four readily available and often used decontamination methods: UV, 70% ethanol, 70C heat and vaporized hydrogen peroxide for inactivation of SARS-CoV-2 on N95 respirators. Equally important we assessed the function of the N95 respirators after multiple wear and decontamination sessions.

scholarly journals Decontamination methods of personal protective equipment for repeated utilization in medical/surgical settings

2020 ◽  
Vol 8 (34) ◽  
pp. 27-39
Author(s):  
Abdurrahman Kharbat ◽  
Adin Mizer ◽  
Mimi Zumwalt
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Pilot Studies ◽  
Medical Supplies ◽  
Policy Statements ◽  
Repeated Use ◽  
Meta Analyses ◽  
N95 Respirators ◽  
Made In

The COVID-19 pandemic has affected citizens and healthcare workers worldwide due to a number of important factors. The transmission of the SARS CoV-2 microorganism, the pathogen that causes COVID-19 infection, occurs through droplet and aerosol spread due to coughs and sneezes from infected patients. A panicked public began hoarding medical supplies and personal protective equipment (PPE), leaving healthcare workers to care for patients without adequate protection. A literature review was conducted to better understand the options available to hospital and healthcare system administrators as they develop necessary protocols for the conservation and possible reuse of PPE. This review is based upon the peer-reviewed studies of various scientific investigators, biotechnology researchers, governmental agency health officials, including meta-analyses, preliminary/pilot studies, and policy statements. Current findings indicate that extended usage of N95 respirators is practical since there are methods available for the decontamination/repeated use of N95 respirators. In evaluating the efficacy of such methods, the safety of healthcare workers is important in deciding which method to recommend. Available evidence supports the use of the Bioquell Hydrogen Peroxide Vapor (HPV) system for decontaminating N95 respirators. Information on other PPE will also be discussed about more specific items. Informed decisions regarding the policies of hospitals and healthcare systems must be considered, and with the safety of healthcare workers in mind, both factors influenced the recommendations made in this comprehensive review.

scholarly journals COVID-19 infections among Healthcare Workers and Transmission within Households

2020 ◽  
Author(s):  
Kevin L. Schwartz ◽  
Camille Achonu ◽  
Sarah A. Buchan ◽  
Kevin A. Brown ◽  
Brenda Lee ◽  
...  
Keyword(s):  
General Population ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Population Based ◽  
Cross Sectional Study ◽  
Nosocomial Transmission ◽  
Protective Equipment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Testing Bias

AbstractImportanceProtecting healthcare workers (HCWs) from COVID-19 is a priority to maintain a safe and functioning healthcare system. The risk of transmitting COVID-19 to family members is a source of stress for many.ObjectiveTo describe and compare HCW and non-HCW COVID-19 cases in Ontario, Canada, as well as the frequency of COVID-19 among HCWs’ household members.Design, Setting, and ParticipantsUsing reportable disease data at Public Health Ontario which captures all COVID-19 cases in Ontario, Canada, we conducted a population-based cross-sectional study comparing demographic, exposure, and clinical variables between HCWs and non-HCWs with COVID-19 as of 14 May 2020. We calculated rates of infections over time and determined the frequency of within household transmissions using natural language processing based on residential address.Exposures and OutcomesWe contrasted age, gender, comorbidities, clinical presentation (including asymptomatic and presymptomatic), exposure histories including nosocomial transmission, and clinical outcomes between HCWs and non-HCWs with confirmed COVID-19.ResultsThere were 4,230 (17.5%) HCW COVID-19 cases in Ontario, of whom 20.2% were nurses, 2.3% were physicians, and the remaining 77.4% other specialties. HCWs were more likely to be between 30-60 years of age and female. HCWs were more likely to present asymptomatically (8.1% versus 7.0%, p=0.010) or with atypical symptoms (17.8% versus 10.5%, p<0.001). The mortality among HCWs was 0.2% compared to 10.5% of non-HCWs. HCWs commonly had exposures to a confirmed case or outbreak (74.1%), however only 3.1% were confirmed to be nosocomial. The rate of new infections was 5.5 times higher in HCWs than non-HCWs, but mirrored the epidemic curve. We identified 391 (9.8%) probable secondary household transmissions and 143 (3.6%) acquisitions. Children < 19 years comprised 14.6% of secondary cases compared to only 4.2% of the primary cases.Conclusions and RelevanceHCWs represent a disproportionate number of COVID-19 cases in Ontario but with low confirmed numbers of nosocomial transmission. The data support substantial testing bias and under-ascertainment of general population cases. Protecting HCWs through appropriate personal protective equipment and physical distancing from colleagues is paramount.Key PointsQuestionWhat are the differences between healthcare workers and non-healthcare workers with COVID-19?FindingsIn this population-based cross-sectional study there were 4,230 healthcare workers comprising 17.5% of COVID-19 cases. Healthcare workers were diagnosed with COVID-19 at a rate 5.5 times higher than the general population with 0.8% of all healthcare workers, compared to 0.1% of non-healthcare workers.MeaningHigh healthcare worker COVID-19 burden highlights the importance of physical distancing from colleagues, appropriate personal protective equipment, as well as likely substantial testing bias and under-ascertainment of COVID-19 in the general population.

scholarly journals Covid-19 and the N95 respirator shortage: Closing the gap

2020 ◽  
Vol 41 (8) ◽  
pp. 958-958 ◽  
Author(s):  
Daniel Nogee ◽  
Anthony J. Tomassoni
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Ultraviolet Germicidal Irradiation ◽  
Single Use ◽  
Closing The Gap

AbstractDue to extreme shortages of personal protective equipment caused by the COVID-19 pandemic, many healthcare workers will be forced to recycle protective masks intended for disposal after a single use. We propose investigating the use of ultraviolet germicidal irradiation to sterilize masks of SARS-CoV-2 for safer reuse.

scholarly journals Analysis of SteraMist ionized hydrogen peroxide technology in the sterilization of N95 respirators and other PPE: a quality improvement study

2020 ◽  
Author(s):  
Avilash K. Cramer ◽  
Deborah Plana ◽  
Helen Yang ◽  
Mary M. Carmack ◽  
Enze Tian ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Personal Protective Equipment ◽  
Occupational Safety ◽  
Medical Center ◽  
Academic Medical Center ◽  
Biological Indicator ◽  
Protective Equipment ◽  
Pre Treatment ◽  
Environment Chamber ◽  
N95 Respirators

AbstractObjectiveThe COVID-19 pandemic has led to widespread shortages of personal protective equipment (PPE) for healthcare workers, including filtering facepiece respirators (FFRs) such as N95 masks. These masks are normally intended for single use, but their sterilization and subsequent reuse could substantially mitigate a world-wide shortage.DesignQuality assurance.SettingA sealed environment chamber installed in the animal facility of an academic medical center.InterventionsOne to five sterilization cycles using ionized hydrogen peroxide (iHP), generated by SteraMist® equipment (TOMI; Frederick, MD).Main outcome measuresPersonal protective equipment, including five N95 mask models from three manufacturers, were evaluated for efficacy of sterilization following iHP treatment (measured with bacterial spores in standard biological indicator assemblies). Additionally, N95 masks were assessed for their ability to efficiently filter particles down to 0.3µm and for their ability to form an airtight seal using a quantitative fit test. Filtration efficiency was measured using ambient particulate matter at a university lab and an aerosolized NaCl challenge at a National Institute for Occupational Safety and Health (NIOSH) pre-certification laboratory.ResultsThe data demonstrate that N95 masks sterilized using SteraMist iHP technology retain function up to five cycles, the maximum number tested to date. Some but not all PPE could also be sterilized using an iHP environmental chamber, but pre-treatment with a handheld iHP generator was required for semi-enclosed surfaces such as respirator hoses.ConclusionsA typical iHP environment chamber with a volume of ~80 m3 can treat ~7000 masks per day, as well as other items of PPE, making this an effective approach for a busy medical center.

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 Determining the source of transmission of SARS-CoV-2 infection in a healthcare worker

2020 ◽  
Author(s):  
Nasia Safdar ◽  
Gage K. Moreno ◽  
Katarina M. Braun ◽  
Thomas C. Friedrich ◽  
David H. O’Connor
Keyword(s):  
Infection Control ◽  
Healthcare Worker ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Total Population ◽  
Protective Equipment ◽  
Hospital Infection Control ◽  
Risk Of Exposure ◽  
N95 Respirators ◽  
Cumulative Prevalence

BackgroundHealthcare workers (HCWs) are at the frontlines of the COVID-19 pandemic and are at risk of exposure to SARS-CoV-2 infection from their interactions with patients and in the community (1, 2). Limited availability of recommended personal protective equipment (PPE), in particular N95 respirators, has fueled concerns about whether HCWs are adequately protected from exposure while caring for patients. Understanding the source of SARS-CoV-2 infection in a HCW – the community or the healthcare system – is critical for understanding the effectiveness of hospital infection control and PPE practices. In Dane County, Wisconsin, community prevalence of SARS-CoV-2 is relatively low (cumulative prevalence of ~0.06% – positive cases / total population in Dane county as of April 17). Although SARS-CoV-2 infections in HCWs are often presumed to be acquired during the course of patient care, there are few reports unambiguously identifying the source of acquisition.ObjectiveTo determine the source of transmission of SARS-CoV-2 in a healthcare worker.

scholarly journals Sterilization and sanitizing of 3D-printed personal protective equipment using polypropylene and a Single Wall design

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Karstan Luchini ◽  
Shelly N. B. Sloan ◽  
Ryan Mauro ◽  
Aspram Sargsyan ◽  
Aundrea Newman ◽  
...  
Keyword(s):  
Bacterial Growth ◽  
Personal Protective Equipment ◽  
General Public ◽  
Healthcare Workers ◽  
Thermoplastic Polyurethane ◽  
Protective Equipment ◽  
E Coli ◽  
3D Printed ◽  
The Cost ◽  
N95 Respirators

Abstract Background The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic during the fall of 2019 and into the spring of 2020 has led to an increased demand of disposable N95 respirators and other types of personal protective equipment (PPE) as a way to prevent virus spread and help ensure the safety of healthcare workers. The sudden demand led to rapid modification, development, and dissemination of 3D printed PPE. The goal of this study was to determine the inherent sterility and re-sterilizing ability of 3D printed PPE in order to provide sterile equipment to the healthcare field and the general public. Methods Samples of polylactic acid (PLA), thermoplastic polyurethane (TPU) (infill-based designs) and polypropylene (single-wall hollow design) were 3D printed. Samples were inoculated with E. coli for 24 h and then sanitized using various chemical solutions or heat-based methods. The samples were then incubated for 24- or 72-h in sterile LB medium at 37°C, and bacterial growth was measured by optical density at 600nm. Statistical analysis was conducted using GraphPad Prism v8.2.1. Results Significant bacterial growth was observed in all PLA and TPU based samples following re-sterilization, regardless of the methods used when compared to controls (p < 0.05). The single-walled hollow polypropylene design was not only sterile following printing, but was also able to undergo re-sanitization following bacterial inoculation, with no significant bacterial growth (p > 0.05) observed regardless of sanitization method used. Conclusion The cost effectiveness, ease of sanitization, and reusability of 3D printed PPE, using our novel single-walled polypropylene design can help meet increased demands of PPE for healthcare workers and the general public that are needed to help decrease the viral transmission of the coronavirus disease of 2019 (COVID-19) pandemic. 3D printing also has the potential to lead to the creation and production of other sterile material items for the healthcare industry in the future. The ability to re-sterilize 3D printed PPE, as our design shows, would also contribute less to the increase in biomedical waste (BMW) being experienced by COVID-19.

scholarly journals Protecting healthcare workers during the COVID-19 pandemic: Australian results from the PPE-SAFE survey.

2020 ◽  
Author(s):  
Mahesh Ramanan ◽  
Alexis Tabah ◽  
Kevin Laupland
Keyword(s):  
Adverse Effect ◽  
Intensive Care ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Significant Proportion ◽  
Protective Equipment ◽  
The World ◽  
Fit Testing ◽  
Single Use ◽  
Current Practices

The COVID-19 pandemic has led to global shortages of personal protective equipment (PPE). Healthcare workers (HCW) have comprised a significant proportion of COVID-19 cases in many countries. The PPE-SAFE survey was conducted to study current practices, availability, shortages, training and confidence in PPE amongst intensive care HCWs around the world. Herein, we describe the results of the Australian respondents to the PPE-SAFE survey. 29% of respondents reported that at least one item of usually available PPE was missing, and 12% reported reuse of single-use items. Only 40% felt that the PPE available to them offered adequate protection. Fit-testing of respirators had never been performed for 47% of respondents, and 49% reported at least one adverse effect from the use of PPE.

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