Introduction. This study describes the legal recreational cannabis market across Canada over the 2 years following legalisation. We compared changes in access to the legal cannabis retail market for all provinces and territories (jurisdictions) in Canada and explored differences between jurisdictions. Methods. We collected data for all legal cannabis stores in Canada over five time periods following legalisation in October 2018. We examined the following measures by jurisdiction and retail model (public vs. private operation): absolute and per capita store numbers, hours of operation and store access across neighbourhoods. Results. Two years following legalisation, there were a total of 1183 legal cannabis stores open across Canada (3.7 stores per 100 000 individuals aged 15+). There was wide variation between jurisdictions in access to retail stores, with the lowest stores per capita in Quebec and Ontario (0.6 and 1.6 per 100 000), and the highest in Alberta and Yukon (14.3 per 100 000 in both). Jurisdictions with private retail models had more stores (4.8 vs. 1.0 per 100 000), held greater median weekly hours (80 vs. 69) and experienced greater store growth over time compared to public models. After adjusting for confounders, there were 1.96 times (95% confidence intervals: 1.84, 2.09) more cannabis stores within 1000 m of the lowest-compared to the highest-income quintile neighbourhoods. Discussion and Conclusions. While access to the recreational cannabis retail market has increased following legalisation, there is substantial variation in access between jurisdictions and evidence of concentration in lower-income neighbourhoods. These differences may contribute to disparities in cannabis use and harms.

Summary Inadequate supply of filtering facepiece respirators (FFRs) for healthcare workers during a pandemic such as the novel coronavirus outbreak (SARS-CoV-2) is a serious public health issue. The aim of this study was to synthesize existing data on the effectiveness of ultraviolet germicidal irradiation (UVGI) for N95 FFR decontamination. A systematic review (PROSPERO CRD42020176156) was conducted on UVGI in N95 FFRs using Embase, Medline, Global Health, Google Scholar, WHO feed, and MedRxiv. Two reviewers independently determined eligibility and extracted predefined variables. Original research reporting on function, decontamination, or mask fit following UVGI were included. Thirteen studies were identified, comprising 54 UVGI intervention arms and 58 N95 models. FFRs consistently maintained certification standards following UVGI. Aerosol penetration averaged 1.19% (0.70–2.48%) and 1.14% (0.57–2.63%) for control and UVGI arms, respectively. Airflow resistance for the control arms averaged 9.79 mm H 2 O (7.97–11.70 mm H 2 O) vs 9.85 mm H 2 O (8.33–11.44 mm H 2 O) for UVGI arms. UVGI protocols employing a cumulative dose >20,000 J/m 2 resulted in a 2-log reduction in viral load. A >3-log reduction was observed in seven UVGI arms using >40,000 J/m 2 . Impact of UVGI on fit was evaluated in two studies (16,200; 32,400 J/m 2 ) and no evidence of compromise was found. Our findings suggest that further work in this area (or translation to a clinical setting) should use a cumulative UV-C dose of 40,000 J/m 2 or greater, and confirm appropriate mask fit following decontamination.

Background In pandemics such as COVID-19, shortages of personal protective equipment are common. One solution may be to decontaminate equipment such as facemasks for reuse. Aim To collect and synthesize existing information on decontamination of N95 filtering facepiece respirators (FFRs) using microwave and heat-based treatments, with special attention to impact on mask function (aerosol penetration, airflow resistance), fit, and physical traits. Methods A systematic review (PROSPERO CRD42020177036) of literature available from Medline, Embase, Global Health, and other sources was conducted. Records were screened independently by two reviewers, and data was extracted from studies that reported on effects of microwave- or heat-based decontamination on N95 FFR performance, fit, physical traits, and/or reductions in microbial load. Findings Thirteen studies were included that used dry/moist microwave irradiation, heat, or autoclaving. All treatment types reduced pathogen load by a log10 reduction factor of at least three when applied for sufficient duration (>30s microwave, >60 min dry heat), with most studies assessing viral pathogens. Mask function (aerosol penetration <5% and airflow resistance <25mmH 2 O) was preserved after all treatments except autoclaving. Fit was maintained for most N95 models, though all treatment types caused observable physical damage to at least one model. Conclusions Microwave irradiation and heat may be safe and effective viral decontamination options for N95 FFR reuse during critical shortages. The evidence does not support autoclaving or high-heat (>90 o C) approaches. Physical degradation may be an issue for certain mask models, and more real-world evidence on fit is needed.

Background: Inadequate supply of filtering facepiece respirators (FFR) for healthcare workers during a global pandemic such as the novel coronavirus outbreak (SARS-CoV-2) is a serious public health issue. Aim: The objective of this review was to synthesize existing data on the effectiveness of ultraviolet germicidal irradiation (UVGI) on N95 FFR decontamination. Methods: We conducted a systematic review on UVGI in N95 FFRs by using Embase, Medline, Global Health, Google Scholar, WHO feed, and MedRxiv. Two reviewers independently determined study eligibility and extracted and verified predefined data fields. Original research reporting on N95 FFR function, decontamination, or mask fit following UVGI were included. Findings and Conclusions: Twelve studies were identified, comprising of 53 different UVGI intervention arms and 43 N95 FFR models. In all cases, FFRs maintained National Institute for Occupational Safety and Health (NIOSH) certification standards following UVGI. Aerosol penetration averaged 1.19% (0.70-2.48%) and 1.14% (0.57-2.63%) for control and UVGI arms respectively. Airflow resistance for the control arms averaged 9.79 mm H2O (7.97-11.70 mm H2O) vs 9.85 mm H2O (8.33-11.44 mm H2O) for UVGI treatment arms. All UVGI protocols employing a cumulative dose &gt;20,000 J/m2 resulted in a 2 log reduction in viral load. A &gt;3 log reduction was observed in 7 UVIG arms using a dose &gt;40,000 J/m2. Impact of UVIG on fit was evaluated in two studies (16,200; 32,400 J/m2) and did not find evidence of compromise. Altogether, our findings suggest that further work in this area should use a cumulative UV-C dose of 40,000 J/m2 or greater, and confirm appropriate mask fit following decontamination.

Background: In pandemic situations such as COVID-19, shortages of proper protective equipment are common. One solution may be to decontaminate equipment such as facemasks for reuse.Aim: The aim of this review was to collect and synthesize existing information on decontamination of N95 filtering facepiece respirators (FFRs) using microwave and heat-based treatments, with special attention to impact on mask function (aerosol penetration, airflow resistance) and fit.Methods: A systematic review (PROSPERO ID pending) of literature available on Medline, Embase, Global Health, JISRP and JEFF was conducted. Records were screened independently by two reviewers, and data was extracted and analyzed from studies that reported on the effects of microwave- or heat-based decontamination on N95 FFR performance and/or microbial load. Results: All interventions successfully destroyed viral/bacterial contaminants. Other than autoclaving, which significantly increased aerosol penetration, moist and dry microwave and heat conditions did not significantly impact functional parameters or fit. However, several conditions caused physical damage to at least one N95 model. Conclusions: Microwave irradiation and heat provides safe and effective decontamination options for N95 FFR reuse during critical shortages. However, autoclaving masks is not recommended by the evidence in this review. Any mask disinfected using these methods should be inspected for physical degradation before reuse.NOTE: The experiments summarized in this manuscript are performed under specialized laboratory conditions. Household appliances should not be used for any purposes that are not indicated in their manufacturer-supplied guidelines, including mask decontamination. Doing so may lead to damage or injury.