Abstract
The novel severe acute respiratory coronavirus virus 2 (SARS-CoV-2) was first reported in Wuhan, China, in December 2019 and is notable for being highly contagious and potentially lethal; and SARS-CoV-2 is mainly spread by droplet transmission. The US healthcare system's response to the COVID-19 pandemic has been challenged by a shortage of personal protective equipment (PPE), especially N95 respirators. Restricted use, reuse, and sanitation of PPE have been widely adopted to provide protection for frontline healthcare workers caring for often critically ill and highly contagious patients. Here, we describe our validated process for N95 respirator sanitation. Process development, validation, and implementation. Level 1, urban, academic, medical center. A multidisciplinary team developed a novel evidence-based process for N95 respirator reprocessing and sanitation using ultraviolet (UV) light. Dose measurement, structural integrity, moisture content, particle filtration, fit testing, and environmental testing were performed for both quality control and validation of the process. The process achieved UV light dosing for sanitation while maintaining the functional and structural integrity of the N95 respirators, with a daily potential throughput capacity of ∼12,000 masks. This process has supported our health system to provide respiratory PPE to all frontline team members. This novel method of N95 respirator sanitation can safely enable reuse of the N95 respirators essential for healthcare workers caring for patients with COVID-19. Our high-throughput process can extend local supplies of this critical PPE until the national supply is replenished.
Highlights
The large number of patients affected by COVID-19 globally induced a high demand for personal protective equipment (PPE), intensive care beds, ventilators, and disinfection supplies.[7]
As a result of N95 respirator supply shortage, regions treating a high number of COVID-19 cases early in the pandemic had to resort to subsatisfactory methods of protection of healthcare workers, including the use of self-made cloth masks or bandannas covering the mouth and nose to minimize exposure.[13,14]
Because aerosolized droplets are a primary mode of transmission for SARS-CoV-2, high-filtration respirators are an essential means of protecting healthcare workers.[6,12]
Summary
The large number of patients affected by COVID-19 globally induced a high demand for personal protective equipment (PPE), intensive care beds, ventilators, and disinfection supplies.[7] In particular, N95 respirators, an essential PPE item, have been in limited supply.[7,8,12] As a result of N95 respirator supply shortage, regions treating a high number of COVID-19 cases early in the pandemic had to resort to subsatisfactory methods of protection of healthcare workers, including the use of self-made cloth masks or bandannas covering the mouth and nose to minimize exposure.[13,14] Until the global supply chain and factory increase production to meet the demand for PPE, reuse and sanitation of N95 respirators could represent an alternative solution, provided that safety and efficacy of the device is maintained.[15] UV sanitation has been shown to be effective in eradicating a wide range of pathogens including Clostridium difficile, Mycobacterium tuberculosis, bacterial spores, and viruses (including coronaviruses).[16] A UV-C dose of 2–7 mJ/cm[2] is sufficient for killing single-stranded RNA viruses (eg, SARS-CoV, MERS-CoV) on 2-dimensional nonporous surfaces.[15] Concerns have been raised that UV sanitation of N95 respirators may result in reduced efficacy of the filter material and/or degradation of the straps or respirator structure.[17,18] Any failure mode may result in reduced protection for the user of the respirator.
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