Abstract

Here we adapt and evaluate a full-face snorkel mask for use as personal protective equipment (PPE) for health care workers, who lack appropriate alternatives during the COVID-19 crisis in the spring of 2020. The design (referred to as Pneumask) consists of a custom snorkel-specific adapter that couples the snorkel-port of the mask to a rated filter (either a medical-grade ventilator inline filter or an industrial filter). This design has been tested for the sealing capability of the mask, filter performance, CO2 buildup and clinical usability. These tests found the Pneumask capable of forming a seal that exceeds the standards required for half-face respirators or N95 respirators. Filter testing indicates a range of options with varying performance depending on the quality of filter selected, but with typical filter performance exceeding or comparable to the N95 standard. CO2 buildup was found to be roughly equivalent to levels found in half-face elastomeric respirators in literature. Clinical usability tests indicate sufficient visibility and, while speaking is somewhat muffled, this can be addressed via amplification (Bluetooth voice relay to cell phone speakers through an app) in noisy environments. We present guidance on the assembly, usage (donning and doffing) and decontamination protocols. The benefit of the Pneumask as PPE is that it is reusable for longer periods than typical disposable N95 respirators, as the snorkel mask can withstand rigorous decontamination protocols (that are standard to regular elastomeric respirators). With the dire worldwide shortage of PPE for medical personnel, our conclusions on the performance and efficacy of Pneumask as an N95-alternative technology are cautiously optimistic.

Highlights

  • During the COVID-19 crisis in the Spring of 2020, there is a global shortage of personal-protective equipment (PPE) for medical personnel [1]

  • This study aims to quantitatively compare the performance of modified snorkel-mask respiratory PPE to the standards of disposable N95 respirators (FDA) and half-face elastomeric respirators (NIOSH)

  • Fit testing was performed with a total of 6 participants (3 individuals for qualitative testing and 3 different individuals for quantitative testing).The purpose of this fit testing study is not to prove that this mask will fit everyone in the general population—but rather to evaluate if these masks are generally are capable of forming the quality of seal necessary for a PPE that is comparable to half-face elastomeric respirators

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Summary

Introduction

During the COVID-19 crisis in the Spring of 2020, there is a global shortage of personal-protective equipment (PPE) for medical personnel [1]. We present the concept of an adapted full-face snorkel mask as PPE for this user group, and evaluate its performance for use in a medical setting. This solution was designed as a reusable, stop-gap solution for healthcare workers to help address the short-term global N95 respirator shortage. The design concept is to connect the top snorkel-port of a recreational full-face snorkel mask to a medically or NIOSH-rated filter, where the snorkel is typically attached This is done through a simple custom adapter piece, which is injection molded out of a robust medicalgrade polypropylene material (but can be 3D-printed from high-resolution, biocompatible resins for small-volume production). A second, optional adapter piece allows for this port to attach to industrial quarter-turn NIOSH P100 filters, for expanded filter supply-chain access in the event that ventilator inline filters are unavailable or unsuitable for use

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