Abstract

BackgroundAs the SARS-CoV-2 pandemic accelerates, the supply of personal protective equipment remains under strain. To combat shortages, re-use of surgical masks and filtering facepiece respirators has been recommended. Prior decontamination is paramount to the re-use of these typically single-use only items and, without compromising their integrity, must guarantee inactivation of SARS-CoV-2 and other contaminating pathogens.AimWe provide information on the effect of time-dependent passive decontamination (infectivity loss over time during room temperature storage in a breathable bag) and evaluate inactivation of a SARS-CoV-2 surrogate and a non-enveloped model virus as well as mask and respirator integrity following active multiple-cycle vaporised hydrogen peroxide (VHP), ultraviolet germicidal irradiation (UVGI), and dry heat (DH) decontamination.MethodsMasks and respirators, inoculated with infectious porcine respiratory coronavirus or murine norovirus, were submitted to passive decontamination or single or multiple active decontamination cycles; viruses were recovered from sample materials and viral titres were measured via TCID50 assay. In parallel, filtration efficiency tests and breathability tests were performed according to EN standard 14683 and NIOSH regulations.Results and discussionInfectious porcine respiratory coronavirus and murine norovirus remained detectable on masks and respirators up to five and seven days of passive decontamination. Single and multiple cycles of VHP-, UVGI-, and DH were shown to not adversely affect bacterial filtration efficiency of masks. Single- and multiple UVGI did not adversely affect respirator filtration efficiency, while VHP and DH induced a decrease in filtration efficiency after one or three decontamination cycles. Multiple cycles of VHP-, UVGI-, and DH slightly decreased airflow resistance of masks but did not adversely affect respirator breathability. VHP and UVGI efficiently inactivated both viruses after five, DH after three, decontamination cycles, permitting demonstration of a loss of infectivity by more than three orders of magnitude. This multi-disciplinal approach provides important information on how often a given PPE item may be safely reused.

Highlights

  • As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic accelerates, the supply of personal protective equipment (PPE) remains under severe strain

  • Infectious porcine respiratory coronavirus and murine norovirus remained detectable on masks and respirators up to five and seven days of passive decontamination

  • We showed that porcine respiratory coronavirus (PRCV) and murine norovirus (MuNoV) remain detectable on surgical mask (SM) and filtering facepiece respirator (FFR) for up to five and seven days of passive decontamination at room temperature, necessitating either longer decontamination periods than currently recommended by the CDC or active decontamination techniques that can decontaminate PPE within a matter of hours

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Summary

Introduction

As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic accelerates, the supply of personal protective equipment (PPE) remains under severe strain. Prior decontamination is paramount to safe PPE re-use; SM and FFR reprocessing techniques must guarantee the complete inactivation of SARS-CoV-2 and other contaminating respiratory or oral human pathogens (the US Food and Drug Administration recommends a robust proof of infectious bioburden reduction of three orders of magnitude for viral pathogens [9]), but must do so without compromising the integrity of the items themselves. Prior decontamination is paramount to the re-use of these typically single-use only items and, without compromising their integrity, must guarantee inactivation of SARS-CoV-2 and other contaminating pathogens

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