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Evidence for decontamination of single-use filtering facepiece respirators.
J Hosp Infect. 2020 Aug; 105(4):663-669.JH

Abstract

Single-use filtering face respirators (FFRs) are critical pieces of personal protective equipment for healthcare workers treating patients with suspected upper respiratory tract pathogens. Experiences during pandemics in the 2000s, as well as the ongoing COVID-19 pandemic caused by the SARS-2-CoV-2, have highlighted concerns over the pressures that sustained respiratory virus pandemics may have on supplies of FFRs globally. Decontamination of FFRs has been posited as one solution to support the re-use of FFRs with a growing body of literature over the last 10+ years beginning to examine both the efficacy of disinfection of contaminated FFRs but also the impact of the decontamination process on the FFR's performance. Physical and chemical methods of decontamination have been tested for treatment of FFRs with ultraviolet germicidal irradiation, sterilization by steam, ethylene oxide and vaporous hydrogen peroxide, demonstrating the most promising results thus far. Many of these methods utilize existing equipment that may already be available in hospitals and could be re-purposed for FFR decontamination. Importantly, some methods may also be replicated on household equipment, broadening the utility of FFR decontamination across a range of healthcare settings. Utilizing techniques to experimentally contaminate FFRs with a range of microorganisms, most decontamination methods appear to reduce the risk of the mask as a source of infection to the wearer and others to negligible levels. The performance of the filter, especially the efficiency of particle penetration following treatment, varied greatly depending on the processing method as well as the model of the filter itself, however. Urgent regulatory body-supported research is required to endorse the routine decontamination of FFRs. In emergency settings, these methods should nevertheless be carefully considered as one strategy to address potential shortfalls in supplies of FFRs for healthcare workers.

Authors+Show Affiliations

Department of Microbiology and Infectious Diseases, New South Wales Health Pathology, Nepean Blue Mountains Pathology Service, PO Box 63, Penrith, New South Wales, 2751, Australia; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, 62 Derby St, Kingswood, New South Wales, 2747, Australia.Department of Microbiology and Infectious Diseases, New South Wales Health Pathology, Nepean Blue Mountains Pathology Service, PO Box 63, Penrith, New South Wales, 2751, Australia; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, 62 Derby St, Kingswood, New South Wales, 2747, Australia. Electronic address: james.branley@health.nsw.gov.au.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32473179

Citation

Polkinghorne, A, and J Branley. "Evidence for Decontamination of Single-use Filtering Facepiece Respirators." The Journal of Hospital Infection, vol. 105, no. 4, 2020, pp. 663-669.
Polkinghorne A, Branley J. Evidence for decontamination of single-use filtering facepiece respirators. J Hosp Infect. 2020;105(4):663-669.
Polkinghorne, A., & Branley, J. (2020). Evidence for decontamination of single-use filtering facepiece respirators. The Journal of Hospital Infection, 105(4), 663-669. https://doi.org/10.1016/j.jhin.2020.05.032
Polkinghorne A, Branley J. Evidence for Decontamination of Single-use Filtering Facepiece Respirators. J Hosp Infect. 2020;105(4):663-669. PubMed PMID: 32473179.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence for decontamination of single-use filtering facepiece respirators. AU - Polkinghorne,A, AU - Branley,J, Y1 - 2020/05/27/ PY - 2020/04/26/received PY - 2020/05/20/accepted PY - 2020/5/31/pubmed PY - 2020/8/22/medline PY - 2020/5/31/entrez KW - Disinfection KW - Ethylene oxide KW - Health care workers KW - Hydrogen peroxide KW - PPE KW - Pandemics KW - Personal protective equipment KW - SARS KW - Steam KW - Sterilisation KW - Ultra-violet SP - 663 EP - 669 JF - The Journal of hospital infection JO - J. Hosp. Infect. VL - 105 IS - 4 N2 - Single-use filtering face respirators (FFRs) are critical pieces of personal protective equipment for healthcare workers treating patients with suspected upper respiratory tract pathogens. Experiences during pandemics in the 2000s, as well as the ongoing COVID-19 pandemic caused by the SARS-2-CoV-2, have highlighted concerns over the pressures that sustained respiratory virus pandemics may have on supplies of FFRs globally. Decontamination of FFRs has been posited as one solution to support the re-use of FFRs with a growing body of literature over the last 10+ years beginning to examine both the efficacy of disinfection of contaminated FFRs but also the impact of the decontamination process on the FFR's performance. Physical and chemical methods of decontamination have been tested for treatment of FFRs with ultraviolet germicidal irradiation, sterilization by steam, ethylene oxide and vaporous hydrogen peroxide, demonstrating the most promising results thus far. Many of these methods utilize existing equipment that may already be available in hospitals and could be re-purposed for FFR decontamination. Importantly, some methods may also be replicated on household equipment, broadening the utility of FFR decontamination across a range of healthcare settings. Utilizing techniques to experimentally contaminate FFRs with a range of microorganisms, most decontamination methods appear to reduce the risk of the mask as a source of infection to the wearer and others to negligible levels. The performance of the filter, especially the efficiency of particle penetration following treatment, varied greatly depending on the processing method as well as the model of the filter itself, however. Urgent regulatory body-supported research is required to endorse the routine decontamination of FFRs. In emergency settings, these methods should nevertheless be carefully considered as one strategy to address potential shortfalls in supplies of FFRs for healthcare workers. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/32473179/Evidence_for_decontamination_of_single_use_filtering_facepiece_respirators_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(20)30263-2 DB - PRIME DP - Unbound Medicine ER -