Thinking Green: Respirator Reuse Strategies to Reduce Cost and Waste

Abstract

Background: The COVID-19 pandemic has led to N95 respirator shortages worldwide. We compare several respirator extended use and reuse strategies with regard to cost and sustainability.Methods: We developed a model to estimate usage, costs, and waste incurred by several respirator usage strategies over the first 6-months of the pandemic in the United States. This model assumed universal masking of all healthcare workers. Estimates were taken from the literature, government databases, and commercially available data from approved vendors.Findings: A new N95 respirator per patient encounter would require 7∙41 billion respirators, cost $6∙38 billion, and generate 84∙0 million kg of waste in the U.S. over 6-months. One respirator per day per healthcare worker would require 3∙29 billion respirators, $2∙83 billion, and 37∙22 million kg of waste. Decontamination by ultraviolet germicidal irradiation would require 1∙64 billion respirators, $1∙41 billion, and 18∙61 million kg of waste. H2O2 vapor decontamination would require 1∙15 billion respirators, $1∙40 billion, and 13∙03 million kg of waste. One reusable respirator with daily disposable filters would require 18 million respirators, $1∙24 billion, and generate 15∙73 million kg of waste. Pairing a reusable respirator with UVGI or H2O2 vapor-decontaminatable filters would reduce cost to $581∙48 million and generate 1∙58 million kg of waste. The use of one surgical mask per day would require 3∙29 billion masks, cost $493 million, and generate 20∙86 million kg of waste.Interpretation: Reuse-based strategies decreased the number of respirators used, costs, and waste generated compared to single- or daily extended-use of disposable respirators. Future development of low-cost, low-tech technologies to enable respirator and/or filter decontamination is needed to further minimize the economic and environmental costs of masks.Funding: J.N.C: 5T32DK007191; O.G.: MIT Undergraduate Research Opportunities Program; PC: NIH K23DA044874, R44DA051106.Conflict of Interest: The authors declare the following competing financial interest(s): A.J.W., J.D.B., and G.T. have filed multiple patents surrounding the respirator and sensors. In addition, A.J.W., J.D.B. and G.T. have a financial interest in TEAL Bio, a biotechnology company focused on developing the next generation of personal protective equipment. J.N.C., P.R.C., O.G, J.C., F.D., and C.H. declare no competing interests.Ethical Approval: Ethics approval was not required for this study.