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Background The shortage of FFP2 and FFP3 respirators posed a serious threat to the operation of the healthcare system at the onset of the COVID-19 pandemic. Aim Our aim was to develop and validate a large-scale facility that uses hydrogen peroxide vapour for the decontamination of used respirators. Methods A multidisciplinary and multisectoral ad hoc group of experts representing various organisations was assembled to implement the collection and transport of used FFP2 and FFP3 respirators from hospitals covering 86% of the Finnish population. A large-scale decontamination facility using hydrogen peroxide vapour was designed and constructed. Microbiological tests were used to confirm efficacy of hydrogen peroxide vapour decontamination together with a test to assess the effect of decontamination on the filtering efficacy and fit of respirators. Bacterial and fungal growth in stored respirators was determined by standard methods. Results Large-scale hydrogen peroxide vapour decontamination of a range of FFP2 and FFP3 respirator models effectively reduced the recovery of biological indicators: Geobacillus stearothermophilus and Bacillus atrophaeus spores, as well as model virus bacteriophage MS2. The filtering efficacy and facial fit after hydrogen peroxide vapour decontamination were not affected by the process. Microbial growth in the hydrogen peroxide vapour-treated respirators indicated appropriate microbial cleanliness. Conclusions Large-scale hydrogen peroxide vapour decontamination was validated. After effective decontamination, no significant changes in the key properties of the respirators were detected. European Union regulations should incorporate a facilitated pathway to allow reuse of appropriately decontaminated respirators in a severe pandemic when unused respirators are not available.

The aim of this study was to collect and identify airborne bacteria in Norway, Sweden and Finland and to compare three different technologies for identifying collected airborne bacterial isolates: the ''gold standard'' method 16S rDNA sequencing, MALDI-TOF MS using the MALDI Biotyper 2.0 and the MIDI Sherlock Ò Microbial Identification System (MIDI MIS system). Airborne bacteria were collected during three different periods from May to October 2009 using air sampling directly on agar plates. A total of 140 isolates were collected during three sampling campaigns, and 74 % (103) of these isolates were analyzed by all three methods. The dominant genera in Norway and Finland were the gram-positive bacteria Bacillus and Staphylococcus, whereas the gram-negative bacterium Acinetobacter was the dominant genus in Sweden. Using 16S rDNA sequencing, MALDI-TOF MS and MIDI MIS analysis, 83, 79 and 75 %, respectively, of the isolates were identified and assigned to order or higher taxonomic levels. In this study, the MALDI-TOF MS combining with the MALDI Biotyper 2.0 classification tool was demonstrated to be a fast and reliable alternative for identifying the airborne bacterial isolates. These studies have increased knowledge about the airborne bacterial background in outdoor air, which can be useful for evaluating and improving the operational performance of biological detectors in various environments. To our knowledge, this is the first time that 16S rDNA sequencing, MALDI-TOF MS and MIDI MIS analysis technologies have been compared for their efficiency in identifying airborne bacteria. Keywords Airborne bacteria Á Identification Á 16S rDNA sequencing Á MALDI-TOF MS Á MIDI MIS analysis