ObjectivesTo compare the impact of respirator extended use and reuse strategies with regard to cost and sustainability during the COVID-19 pandemic.DesignCost analysis.SettingUSA.ParticipantsAll healthcare workers within the USA.InterventionsNot applicable.Main outcome measuresA model was developed to estimate usage, costs and waste incurred by several respirator usage strategies over the first 6 months of the pandemic in the USA. This model assumed universal masking of all healthcare workers. Estimates were taken from the literature, government databases and commercially available data from approved vendors.ResultsA new N95 respirator per patient encounter would require 7.41 billion respirators, cost $6.38 billion and generate 84.0 million kg of waste in the USA over 6 months. One respirator per day per healthcare worker would require 3.29 billion respirators, cost $2.83 billion and generate 37.22 million kg of waste. Decontamination by ultraviolet germicidal irradiation would require 1.64 billion respirators, cost $1.41 billion and accumulate 18.61 million kg of waste. H2O2 vapour decontamination would require 1.15 billion respirators, cost $1.65 billion and produce 13.03 million kg of waste. One reusable respirator with daily disposable filters would require 18 million respirators, cost $1.24 billion and generate 15.73 million kg of waste. Pairing a reusable respirator with H2O2 vapour-decontaminated filters would reduce cost to $831 million and generate 1.58 million kg of waste. The use of one surgical mask per healthcare worker per day would require 3.29 billion masks, cost $460 million and generate 27.92 million kg of waste.ConclusionsDecontamination and reusable respirator-based strategies decreased the number of respirators used, costs and waste generated compared with single-use or daily extended-use of disposable respirators. Future development of low-cost,simple technologies to enable respirator and/or filter decontamination is needed to further minimise the economic and environmental costs of masks.
Key Points Question Could transparent masks help to overcome communication barriers associated with widespread mask use among the general population, general health care workers, and health care workers who are deaf or hard of hearing in the United States? Findings In this survey study of 1000 members of the general public, 123 general health care workers, and 45 health care workers who are deaf or hard of hearing, participants perceived mask wearing as potentially impairing communication. Respondents reported an improved ability to read emotion with transparent mask use, and transparent masks were generally accepted across all 3 populations surveyed. Meaning These findings suggest that transparent masks have the potential to overcome barriers in communication brought on by universal mask wearing during the COVID-19 pandemic.
Objectives To compare the impact of respirator extended use and reuse strategies with regard to cost and sustainability during the COVID-19 pandemic. Design Cost analysis. Setting USA. Participants All healthcare workers within the USA. Interventions Not applicable. Main outcome measures A model was developed to estimate usage, costs and waste incurred by several respirator usage strategies over the first 6 months of the pandemic in the USA. This model assumed universal masking of all healthcare workers. Estimates were taken from the literature, government databases and commercially available data from approved vendors. Results A new N95 respirator per patient encounter would require 7.41 billion respirators, cost $6.38 billion and generate 84.0 million kg of waste in the USA over 6 months. One respirator per day per healthcare worker would require 3.29 billion respirators, cost $2.83 billion and generate 37.22 million kg of waste. Decontamination by ultraviolet germicidal irradiation would require 1.64 billion respirators, cost $1.41 billion and accumulate 18.61 million kg of waste. H 2 O 2 vapour decontamination would require 1.15 billion respirators, cost $1.65 billion and produce 13.03 million kg of waste. One reusable respirator with daily disposable filters would require 18 million respirators, cost $1.24 billion and generate 15.73 million kg of waste. Pairing a reusable respirator with H 2 O 2 vapour-decontaminated filters would reduce cost to $831 million and generate 1.58 million kg of waste. The use of one surgical mask per healthcare worker per day would require 3.29 billion masks, cost $460 million and generate 27.92 million kg of waste. Conclusions Decontamination and reusable respiratorbased strategies decreased the number of respirators used, costs and waste generated compared with singleuse or daily extended-use of disposable respirators. Future development of low-cost,simple technologies to enable respirator and/or filter decontamination is needed to further minimise the economic and environmental costs of masks.
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