Abstract

The rapid spread of COVID-19 and disruption of normal supply chains has resulted in severe shortages of personal protective equipment (PPE), particularly devices with few suppliers such as powered air-purifying respirators (PAPRs). A scarcity of information describing design and performance criteria for PAPRs represents a substantial barrier to mitigating shortages. We sought to apply open-source product development (OSPD) to PAPRs to enable alternative sources of supply and further innovation. We describe the design, prototyping, validation, and user testing of locally manufactured, modular, PAPR components, including filter cartridges and blower units, developed by the Greater Boston Pandemic Fabrication Team (PanFab). Two designs, one with a fully custom-made filter and blower unit housing, and the other with commercially available variants (the “Custom” and “Commercial” designs, respectively) were developed; the components in the Custom design are interchangeable with those in Commercial design, although the form factor differs. The engineering performance of the prototypes was measured and safety validated using National Institutes for Occupational Safety and Health (NIOSH)-equivalent tests on apparatus available under pandemic conditions at university laboratories. Feedback was obtained from four individuals; two clinicians working in ambulatory clinical care and two research technical staff for whom PAPR use is standard occupational PPE; these individuals were asked to compare PanFab prototypes to commercial PAPRs from the perspective of usability and suggest areas for improvement. Respondents rated the PanFab Custom PAPR a 4 to 5 on a 5 Likert-scale 1) as compared to current PPE options, 2) for the sense of security with use in a clinical setting, and 3) for comfort compared to standard, commercially available PAPRs. The three other versions of the designs (with a Commercial blower unit, filter, or both) performed favorably, with survey responses consisting of scores ranging from 3 to 5. Engineering testing and clinical feedback demonstrate that the PanFab designs represent favorable alternatives to traditional PAPRs in terms of user comfort, mobility, and sense of security. A nonrestrictive license promotes innovation in respiratory protection for current and future medical emergencies.

Highlights

  • The rapid and global spread of COVID-19 has led to dramatic increases in demand for personal protective equipment (PPE) for healthcare workers as well as significant disruption of supply chains and distribution networks for these products

  • After consulting with clinicians and infection control specialists, we focused our efforts on designing filter cartridges and blower units, the two powered air-purifying respirators (PAPRs) components most commonly in shortage

  • For the Pandemic Fabrication Team (PanFab) Commercial PAPR, we selected a commercially available high-efficiency particulate absorbing (HEPA) filter that is used in consumer vacuum cleaners and widely available; we speculated that supply of these filters is unlikely to be significantly affected by disruption of medical device supply chains caused by COVID-19 or similar pandemics

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Summary

Introduction

The rapid and global spread of COVID-19 has led to dramatic increases in demand for personal protective equipment (PPE) for healthcare workers as well as significant disruption of supply chains and distribution networks for these products. While multiple non-traditional designs for simple PPE products such as face shields have emerged (Mostaghimi et al, 2020), and multiple commercial and nontraditional technologies have been developed to decontaminate or reuse N95-type masks (N95 Decon, 2020; McAvoy et al, 2021), few alternative sources of supply exist for more complex products. This is true of powered air-purifying respirators (PAPRs) which can be worn by individuals unable to fit N95-type masks, are more comfortable in many settings, and provide a higher level of respiratory protection. Ongoing efforts to increase the supply of PAPRs have largely involved large manufacturing companies with government support (e.g., the 3M Ford Limited-Use Public Health Emergency PAPR) (CDC, 2020a; Limited-Use Public Health Emergency PAPR, 2021)

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