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N95 reprocessing by low temperature sterilization with 59% vaporized hydrogen peroxide during the 2020 COVID-19 pandemic.
Am J Infect Control. 2021 01; 49(1):8-14.AJ

Abstract

BACKGROUND

Response to the COVID-19 pandemic by hospital systems has been strained by severe shortages in personal protective equipment (PPE), particularly N95 respirators. Recently, the Centers for Disease Control and Prevention endorsed decontamination strategies to prolong the lifespan of single use respirators. Battelle and Duke University have validated hospital protocols to decontaminate respirators using vaporized hydrogen peroxide (VHP) at 30%-35% concentrations. To prolong our supply of respirators, we evaluated and implemented VHP decontamination at 59% hydrogen peroxide concentration while detailing the effects of this process on the filtration efficiency and quantitative fit of single-use respirators. This study may help other health systems develop local solutions to their N95 mask shortage during this COVID-19 pandemic.

METHODS

N95 respirators (3M 8211 FF and 9210 FF) that were treated with 5 and 10 cycles of VHP by the V-PRO maX Low Temperature Sterilization System were evaluated quantitatively for filtration efficiency as well as with quantitative fit testing per Occupational Safety and Health Administration standards. A decontamination protocol was concurrently implemented at our institution. This process involved depositing used masks, reprocessing, and re-distributing treated masks efficiently back to frontline providers. Furthermore, we implemented patient safety officers on COVID-19/person under investigation units to ensure optimized donning/doffing of respirators through frontline provider education.

RESULTS

There were no statistically significant changes in mean filtration efficiency between the control and VHP-treated respirators. Furthermore, both treated and untreated respirators demonstrated fit factors above the minimum pass requirement.

CONCLUSIONS

We have successfully demonstrated that N95 respirator decontamination with VHP at 59% hydrogen peroxide can be safely utilized to decontaminate single-use N95 respirators without significant effects on filtration efficiency or quantitative fit testing. With the COVID-19 pandemic and N95 respirator shortage, health systems without access to commercial decontamination processes should investigate the viability of such a process in their facilities.

Authors+Show Affiliations

Carilion Clinic Roanoke Memorial Hospital, Roanoke, VA; Carilion Clinic Infection Prevention, Roanoke, VA.Carilion Clinic Roanoke Memorial Hospital, Roanoke, VA; Carilion Clinic Infection Prevention, Roanoke, VA.Virginia Tech Carilion School of Medicine, Roanoke, VA.Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA.Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA.Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA.Carilion Clinic Roanoke Memorial Hospital, Roanoke, VA; Carilion Clinic Infection Prevention, Roanoke, VA; Virginia Tech Carilion School of Medicine, Roanoke, VA. Electronic address: abaffoe6@vt.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32599102

Citation

Jatta, Maimuna, et al. "N95 Reprocessing By Low Temperature Sterilization With 59% Vaporized Hydrogen Peroxide During the 2020 COVID-19 Pandemic." American Journal of Infection Control, vol. 49, no. 1, 2021, pp. 8-14.
Jatta M, Kiefer C, Patolia H, et al. N95 reprocessing by low temperature sterilization with 59% vaporized hydrogen peroxide during the 2020 COVID-19 pandemic. Am J Infect Control. 2021;49(1):8-14.
Jatta, M., Kiefer, C., Patolia, H., Pan, J., Harb, C., Marr, L. C., & Baffoe-Bonnie, A. (2021). N95 reprocessing by low temperature sterilization with 59% vaporized hydrogen peroxide during the 2020 COVID-19 pandemic. American Journal of Infection Control, 49(1), 8-14. https://doi.org/10.1016/j.ajic.2020.06.194
Jatta M, et al. N95 Reprocessing By Low Temperature Sterilization With 59% Vaporized Hydrogen Peroxide During the 2020 COVID-19 Pandemic. Am J Infect Control. 2021;49(1):8-14. PubMed PMID: 32599102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - N95 reprocessing by low temperature sterilization with 59% vaporized hydrogen peroxide during the 2020 COVID-19 pandemic. AU - Jatta,Maimuna, AU - Kiefer,Carolyn, AU - Patolia,Harsh, AU - Pan,Jin, AU - Harb,Charbel, AU - Marr,Linsey C, AU - Baffoe-Bonnie,Anthony, Y1 - 2020/06/26/ PY - 2020/04/16/received PY - 2020/06/21/revised PY - 2020/06/22/accepted PY - 2020/7/1/pubmed PY - 2021/1/9/medline PY - 2020/6/30/entrez KW - Decontamination KW - N95 filtering facemask SP - 8 EP - 14 JF - American journal of infection control JO - Am J Infect Control VL - 49 IS - 1 N2 - BACKGROUND: Response to the COVID-19 pandemic by hospital systems has been strained by severe shortages in personal protective equipment (PPE), particularly N95 respirators. Recently, the Centers for Disease Control and Prevention endorsed decontamination strategies to prolong the lifespan of single use respirators. Battelle and Duke University have validated hospital protocols to decontaminate respirators using vaporized hydrogen peroxide (VHP) at 30%-35% concentrations. To prolong our supply of respirators, we evaluated and implemented VHP decontamination at 59% hydrogen peroxide concentration while detailing the effects of this process on the filtration efficiency and quantitative fit of single-use respirators. This study may help other health systems develop local solutions to their N95 mask shortage during this COVID-19 pandemic. METHODS: N95 respirators (3M 8211 FF and 9210 FF) that were treated with 5 and 10 cycles of VHP by the V-PRO maX Low Temperature Sterilization System were evaluated quantitatively for filtration efficiency as well as with quantitative fit testing per Occupational Safety and Health Administration standards. A decontamination protocol was concurrently implemented at our institution. This process involved depositing used masks, reprocessing, and re-distributing treated masks efficiently back to frontline providers. Furthermore, we implemented patient safety officers on COVID-19/person under investigation units to ensure optimized donning/doffing of respirators through frontline provider education. RESULTS: There were no statistically significant changes in mean filtration efficiency between the control and VHP-treated respirators. Furthermore, both treated and untreated respirators demonstrated fit factors above the minimum pass requirement. CONCLUSIONS: We have successfully demonstrated that N95 respirator decontamination with VHP at 59% hydrogen peroxide can be safely utilized to decontaminate single-use N95 respirators without significant effects on filtration efficiency or quantitative fit testing. With the COVID-19 pandemic and N95 respirator shortage, health systems without access to commercial decontamination processes should investigate the viability of such a process in their facilities. SN - 1527-3296 UR - https://www.unboundmedicine.com/medline/citation/32599102/N95_reprocessing_by_low_temperature_sterilization_with_59_vaporized_hydrogen_peroxide_during_the_2020_COVID_19_pandemic_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-6553(20)30576-9 DB - PRIME DP - Unbound Medicine ER -