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Decontamination interventions for the reuse of surgical mask personal protective equipment: a systematic review.
J Hosp Infect. 2020 Oct; 106(2):283-294.JH

Abstract

BACKGROUND

The high demand for personal protective equipment during the novel coronavirus outbreak has prompted the need to develop strategies to conserve supply. Little is known regarding decontamination interventions to allow for surgical mask reuse.

AIM

To identify and synthesize data from original research evaluating interventions to decontaminate surgical masks for the purpose of reuse.

METHODS

MEDLINE, Embase, CENTRAL, Global Health, the WHO COVID-19 database, Google Scholar, DisasterLit, preprint servers, and prominent journals from inception to April 8th, 2020, were searched for prospective original research on decontamination interventions for surgical masks. Citation screening was conducted independently in duplicate. Study characteristics, interventions, and outcomes were extracted from included studies by two independent reviewers. Outcomes of interest included impact of decontamination interventions on surgical mask performance and germicidal effects.

FINDINGS

Seven studies met eligibility criteria: one evaluated the effects of heat and chemical interventions applied after mask use on mask performance, and six evaluated interventions applied prior to mask use to enhance antimicrobial properties and/or mask performance. Mask performance and germicidal effects were evaluated with heterogeneous test conditions. Safety outcomes were infrequently evaluated. Mask performance was best preserved with dry heat decontamination. Good germicidal effects were observed in salt-, N-halamine-, and nanoparticle-coated masks.

CONCLUSION

There is limited evidence on the safety or efficacy of surgical mask decontamination. Given the heterogeneous methods used in studies to date, we are unable to draw conclusions on the most efficacious and safe intervention for decontaminating surgical masks.

Authors+Show Affiliations

Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.Library Services, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.Health Sciences Library, University of Ottawa, Ottawa, Ontario, Canada.Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Department of Critical Care, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. Electronic address: choongk@mcmaster.ca.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32653432

Citation

Zorko, D J., et al. "Decontamination Interventions for the Reuse of Surgical Mask Personal Protective Equipment: a Systematic Review." The Journal of Hospital Infection, vol. 106, no. 2, 2020, pp. 283-294.
Zorko DJ, Gertsman S, O'Hearn K, et al. Decontamination interventions for the reuse of surgical mask personal protective equipment: a systematic review. J Hosp Infect. 2020;106(2):283-294.
Zorko, D. J., Gertsman, S., O'Hearn, K., Timmerman, N., Ambu-Ali, N., Dinh, T., Sampson, M., Sikora, L., McNally, J. D., & Choong, K. (2020). Decontamination interventions for the reuse of surgical mask personal protective equipment: a systematic review. The Journal of Hospital Infection, 106(2), 283-294. https://doi.org/10.1016/j.jhin.2020.07.007
Zorko DJ, et al. Decontamination Interventions for the Reuse of Surgical Mask Personal Protective Equipment: a Systematic Review. J Hosp Infect. 2020;106(2):283-294. PubMed PMID: 32653432.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decontamination interventions for the reuse of surgical mask personal protective equipment: a systematic review. AU - Zorko,D J, AU - Gertsman,S, AU - O'Hearn,K, AU - Timmerman,N, AU - Ambu-Ali,N, AU - Dinh,T, AU - Sampson,M, AU - Sikora,L, AU - McNally,J D, AU - Choong,K, Y1 - 2020/07/10/ PY - 2020/05/11/received PY - 2020/07/06/accepted PY - 2020/7/13/pubmed PY - 2020/10/21/medline PY - 2020/7/13/entrez KW - COVID-19 KW - Decontamination KW - Personal protective equipment KW - SARS-CoV-2 KW - Surgical masks KW - Systematic review SP - 283 EP - 294 JF - The Journal of hospital infection JO - J Hosp Infect VL - 106 IS - 2 N2 - BACKGROUND: The high demand for personal protective equipment during the novel coronavirus outbreak has prompted the need to develop strategies to conserve supply. Little is known regarding decontamination interventions to allow for surgical mask reuse. AIM: To identify and synthesize data from original research evaluating interventions to decontaminate surgical masks for the purpose of reuse. METHODS: MEDLINE, Embase, CENTRAL, Global Health, the WHO COVID-19 database, Google Scholar, DisasterLit, preprint servers, and prominent journals from inception to April 8th, 2020, were searched for prospective original research on decontamination interventions for surgical masks. Citation screening was conducted independently in duplicate. Study characteristics, interventions, and outcomes were extracted from included studies by two independent reviewers. Outcomes of interest included impact of decontamination interventions on surgical mask performance and germicidal effects. FINDINGS: Seven studies met eligibility criteria: one evaluated the effects of heat and chemical interventions applied after mask use on mask performance, and six evaluated interventions applied prior to mask use to enhance antimicrobial properties and/or mask performance. Mask performance and germicidal effects were evaluated with heterogeneous test conditions. Safety outcomes were infrequently evaluated. Mask performance was best preserved with dry heat decontamination. Good germicidal effects were observed in salt-, N-halamine-, and nanoparticle-coated masks. CONCLUSION: There is limited evidence on the safety or efficacy of surgical mask decontamination. Given the heterogeneous methods used in studies to date, we are unable to draw conclusions on the most efficacious and safe intervention for decontaminating surgical masks. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/32653432/Decontamination_interventions_for_the_reuse_of_surgical_mask_personal_protective_equipment:_a_systematic_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(20)30337-6 DB - PRIME DP - Unbound Medicine ER -