Abstract

Shortages of N95 respirators for use by medical personnel have driven consideration of novel conservation strategies, including decontamination for reuse and extended use. Decontamination methods listed as promising by the Centers for Disease Control and Prevention (CDC) (vaporous hydrogen peroxide (VHP), wet heat, ultraviolet irradiation (UVI)) and several methods considered for low resource environments (bleach, isopropyl alcohol and detergent/soap) were studied for two commonly used surgical N95 respirators (3M™ 1860 and 1870+ Aura™). Although N95 filtration performance depends on the electrostatically charged electret filtration layer, the impact of decontamination on this layer is largely unexplored. As such, respirator performance following decontamination was assessed based on the fit, filtration efficiency, and pressure drop, along with the relationship between (1) surface charge of the electret layer, and (2) elastic properties of the straps. Decontamination with VHP, wet heat, UVI, and bleach did not degrade fit and filtration performance or electret charge. Isopropyl alcohol and soap significantly degraded fit, filtration performance, and electret charge. Pressure drop across the respirators was unchanged. Modest degradation of N95 strap elasticity was observed in mechanical fatigue testing, a model for repeated donnings and doffings. CDC recommended decontamination methods including VHP, wet heat, and UV light did not degrade N95 respirator fit or filtration performance in these tests. Extended use of N95 respirators may degrade strap elasticity, but a loss of face seal integrity should be apparent during user seal checks. NIOSH recommends performing user seal checks after every donning to detect loss of appropriate fit. Decontamination methods which degrade electret charge such as alcohols or detergents should not be used on N95 respirators. The loss of N95 performance due to electret degradation would not be apparent to a respirator user or evident during a negative pressure user seal check.

Highlights

  • The 2020 global shortage of personal protective equipment (PPE) including filtering facepiece respirators (FFR) or N95 respirators has generated intense interest in methods to decontaminate respirators for reuse

  • Does electret charge correlate with changes in filtration efficiency in N95 respirators?

  • Results of testing decontamination methods for N95 respirators showed that the filtration efficiency, pressure drop, and quantitative fit were robust for several methods including vapor hydrogen peroxide, wet heat, bleach, and ultraviolet light

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Summary

Introduction

The 2020 global shortage of personal protective equipment (PPE) including filtering facepiece respirators (FFR) or N95 respirators has generated intense interest in methods to decontaminate respirators for reuse. Single use, the Centers for Disease Control and Prevention (CDC) acknowledged that decontamination and reuse may need to be considered to ensure availability for health care personnel.[2] Before utilizing a decontamination protocol, the CDC recommends that the method be evaluated for the ability to retain: (1) filtration performance, (2) fit characteristics, and (3) safety (inactivation of SARS-CoV-2).[1]. The Centers for Disease Control recommended three decontamination methods as promising: vaporous hydrogen peroxide (VHP), wet heat, and continuous ultraviolet radiation (UV, 254 nm).[2] Other methods that have been proposed include the use of ethylene oxide (EtOH), autoclaving, bleach, liquid hydrogen peroxide, plasma hydrogen peroxide, isopropanol, ethanol, dry heat, and pulsed UV.[3,4,5] Several methods including VHP, plasma hydrogen peroxide, and UV light have received Emergency Use

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