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Autoclave sterilization and ethanol treatment of re-used surgical masks and N95 respirators during COVID-19: impact on their performance and integrity.
J Hosp Infect. 2020 Aug; 105(4):608-614.JH

Abstract

BACKGROUND

An exceptionally high demand for surgical masks and N95 filtering facepiece respirators (FFRs) during the COVID-19 pandemic has considerably exceeded their supply. These disposable devices are generally not approved for routine decontamination and re-use as a standard of care, while this practice has widely occurred in hospitals. The US Centers for Disease Control and Prevention allowed it "as a crisis capacity strategy". However, limited testing was conducted on the impact of specific decontamination methods on the performance of N95 FFRs and no data was presented for surgical masks.

AIM

We evaluated common surgical masks and N95 respirators with respect to the changes in their performance and integrity resulting from autoclave sterilization and a 70% ethanol treatment; these methods are frequently utilized for re-used filtering facepieces in hospitals.

METHODS

The filter collection efficiency and pressure drop were determined for unused masks and N95 FFRs, and for those subjected to the treatments in a variety of ways. The collection efficiency was measured for particles of approximately 0.037-3.2 μm to represent aerosolized single viruses, their agglomerates, bacteria and larger particle carriers.

FINDINGS

The initial collection efficiency and the filter breathability may be compromised by sterilization in an autoclave and ethanol treatment. The effect depends on a protective device, particle size, breathing flow rate, type of treatment and other factors. Additionally, physical damages were observed in N95 respirators after autoclaving.

CONCLUSION

Strategies advocating decontamination and re-use of filtering facepieces in hospitals should be re-assessed considering the data obtained in this study.

Authors+Show Affiliations

Center for Health-Related Aerosol Studies, Department of Environmental and Public Health Sciences, University of Cincinnati, PO Box 670056, Cincinnati, OH, 45267-0056, USA. Electronic address: sergey.grinshpun@uc.edu.Center for Health-Related Aerosol Studies, Department of Environmental and Public Health Sciences, University of Cincinnati, PO Box 670056, Cincinnati, OH, 45267-0056, USA.Department of Internal Medicine, Division of Allergy, Immunology, and Rheumatology, University of Cincinnati, PO Box 670563, Cincinnati, OH, 45267-0563, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32599011

Citation

Grinshpun, S A., et al. "Autoclave Sterilization and Ethanol Treatment of Re-used Surgical Masks and N95 Respirators During COVID-19: Impact On Their Performance and Integrity." The Journal of Hospital Infection, vol. 105, no. 4, 2020, pp. 608-614.
Grinshpun SA, Yermakov M, Khodoun M. Autoclave sterilization and ethanol treatment of re-used surgical masks and N95 respirators during COVID-19: impact on their performance and integrity. J Hosp Infect. 2020;105(4):608-614.
Grinshpun, S. A., Yermakov, M., & Khodoun, M. (2020). Autoclave sterilization and ethanol treatment of re-used surgical masks and N95 respirators during COVID-19: impact on their performance and integrity. The Journal of Hospital Infection, 105(4), 608-614. https://doi.org/10.1016/j.jhin.2020.06.030
Grinshpun SA, Yermakov M, Khodoun M. Autoclave Sterilization and Ethanol Treatment of Re-used Surgical Masks and N95 Respirators During COVID-19: Impact On Their Performance and Integrity. J Hosp Infect. 2020;105(4):608-614. PubMed PMID: 32599011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Autoclave sterilization and ethanol treatment of re-used surgical masks and N95 respirators during COVID-19: impact on their performance and integrity. AU - Grinshpun,S A, AU - Yermakov,M, AU - Khodoun,M, Y1 - 2020/06/27/ PY - 2020/05/10/received PY - 2020/06/22/accepted PY - 2020/7/1/pubmed PY - 2020/8/22/medline PY - 2020/6/30/entrez KW - COVID-19 KW - Collection KW - Disinfection KW - N95 respirator KW - Re-use KW - Surgical mask SP - 608 EP - 614 JF - The Journal of hospital infection JO - J Hosp Infect VL - 105 IS - 4 N2 - BACKGROUND: An exceptionally high demand for surgical masks and N95 filtering facepiece respirators (FFRs) during the COVID-19 pandemic has considerably exceeded their supply. These disposable devices are generally not approved for routine decontamination and re-use as a standard of care, while this practice has widely occurred in hospitals. The US Centers for Disease Control and Prevention allowed it "as a crisis capacity strategy". However, limited testing was conducted on the impact of specific decontamination methods on the performance of N95 FFRs and no data was presented for surgical masks. AIM: We evaluated common surgical masks and N95 respirators with respect to the changes in their performance and integrity resulting from autoclave sterilization and a 70% ethanol treatment; these methods are frequently utilized for re-used filtering facepieces in hospitals. METHODS: The filter collection efficiency and pressure drop were determined for unused masks and N95 FFRs, and for those subjected to the treatments in a variety of ways. The collection efficiency was measured for particles of approximately 0.037-3.2 μm to represent aerosolized single viruses, their agglomerates, bacteria and larger particle carriers. FINDINGS: The initial collection efficiency and the filter breathability may be compromised by sterilization in an autoclave and ethanol treatment. The effect depends on a protective device, particle size, breathing flow rate, type of treatment and other factors. Additionally, physical damages were observed in N95 respirators after autoclaving. CONCLUSION: Strategies advocating decontamination and re-use of filtering facepieces in hospitals should be re-assessed considering the data obtained in this study. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/32599011/Autoclave_sterilization_and_ethanol_treatment_of_re_used_surgical_masks_and_N95_respirators_during_COVID_19:_impact_on_their_performance_and_integrity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(20)30315-7 DB - PRIME DP - Unbound Medicine ER -