Aerosolized Hydrogen Peroxide Decontamination of N95 Respirators, with Fit-Testing and Viral Inactivation, Demonstrates Feasibility for Reuse during the COVID-19 Pandemic

Derr, T. Hans; James, Melissa; Kuny, Chad V.; Patel, Dolly; Kandel, Prem P.; Field, Cassandra J.; Beckman, Matthew D.; Hockett, Kevin L.; Bates, Mark A.; Sutton, Troy; Szpara, Moriah L.

doi:10.1128/msphere.00303-22

Cited by 11 publications

(1 citation statement)

References 45 publications

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“…Once the microorganisms were trapped in the fi lter, approximately 1% of the inoculated bacteria were recovered in the buff er solution, and the exact decontamination capacity of each method was unclear. However, other in-vitro studies have demonstrated that many methods tested in this study have effi cient decontamination capacity against viruses and bacteria, including M. tuberculosis [12,[17][18][19]. However, the microorganism trapping capacity of the N95 respirator is high and may not release the captured microorganisms from the fi bre fi ltration system.…”

Section: Discussionmentioning

confidence: 83%

Comparative Evaluation of Microorganism Disinfection Methods for N95 Respirators

Mitarai*,

Noda,

Gondaira

et al. 2024

J Biomed Res Environ Sci

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Background: An excessive demand for N95 respirators occurred during the SARS-CoV-2 pandemic. Therefore, health care workers were obligated to reuse N95 respirators, which were intended to be disposable. Aim: The primary objective of this study was to establish a standard procedure for safe disinfection or sterilization that does not affect the performance of an N95 respirator. Methods: As disinfection or sterilization methods, immersion in 70% ethanol, 0.1% hypochlorous acid, 0.3% peracetic acid, 0.2% alkyldiaminoethylglycine hydrochloride aqueous solution, hypochlorous acid water, or plant mineral-activated water, autoclaving, pasteurization and hydrogen peroxide plasma sterilization were used. After sterilization/disinfection, the filtration capacity of each N95 respirator was examined. Findings: The performance changes in the N95 respirator caused by each sterilization/disinfection method differed for each manufacturer’s product. Seventy percent ethanol, 0.1% sodium hypochlorite aqueous solution, 0.3% peracetic acid aqueous solution, autoclaving, hypochlorous acid water, and plant mineral-activated water significantly deteriorated the performance of N95 respirators. Performance degradation (increased permeability) was observed in 0.2% alkyldiaminoethylglycine hydrochloride aqueous solution and hydrogen peroxide plasma sterilization, and the permeation performance significantly deteriorated by 50–70% in all N95 respirators tested. Only pasteurization resulted in no deterioration in performance, even after five repeated sterilizations. Conclusion: Verification of sterilization/disinfection methods for the reuse of N95 respirators has shown that the currently recommended hydrogen peroxide plasma sterilization is inadequate as it increases permeability by more than 50% with a single treatment. In this study, pasteurization was found to be the optimal sterilization method.

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Section: Discussionmentioning

confidence: 83%

Comparative Evaluation of Microorganism Disinfection Methods for N95 Respirators

Mitarai*,

Noda,

Gondaira

et al. 2024

J Biomed Res Environ Sci

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A fast and reliable microplate reader assay to assess the antiviral efficacy of cold plasma devices

Bekeschus,

Skowski,

Hahn

et al. 2024

Plasma Processes & Polymers

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Spurred by global COVID‐19, work in recent years has demonstrated that various devices based on technology generating cold plasma are capable of reducing the infectivity of virus particles. There is great potential in this approach, which is, however, hampered by the ability of most cold plasma science laboratories to test for antiviral effects of their individual plasma sources in sophisticated mammalian cell test systems. To this end, we developed a quick, simple, and fast assay system based on bacteriophages and their ability to lyse bacterial hosts, which can be monitored in readily available microplate readers. We successfully demonstrated the principal ability of this approach using two types of plasma jets, different microplate readers, and two different bacteriophage strains.

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Review of aerosolized hydrogen peroxide, vaporized hydrogen peroxide, and hydrogen peroxide gas plasma in the decontamination of filtering facepiece respirators

Berger

Gundermann

Sinha

et al. 2022

American Journal of Infection Control

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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to over 170 million cases worldwide with over 33.2 million cases and 594,000 deaths in the US alone as of May 31st, 2021.The pandemic has also created severe shortages of PPE, particularly of filtering facepiece respirators (FFRs). The Centers for Disease Control and Prevention (CDC) has issued recommendations to help conserve FFRs, as well as crisis standards, including four criteria required for decontamination of the traditionally single use respirators. This review is designed to provide an overview of the current literature on vaporized hydrogen peroxide (vHP), hydrogen peroxide gas plasma (HPGP), and aerosolized hydrogen peroxide (aHP) with respect to each of the four CDC decontamination criteria. Searches of PubMed and Medrxiv yielded 195 papers, of which, 79 were found to be relevant. Of those, 23 papers presented unique findings and 8 additional articles and technical papers were added to provide a comprehensive review. Overall, while there are potential concerns for all three decontamination methods, we found that vHP has the most evidence supporting its use in FFR decontamination consistent with CDC recommendation. Future research is recommended to evaluate biological inactivation and real world fit failures after FFR reuse.

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Aerosolized Hydrogen Peroxide Decontamination of N95 Respirators, with Fit-Testing and Viral Inactivation, Demonstrates Feasibility for Reuse during the COVID-19 Pandemic

Abstract: The COVID-19 pandemic led to unprecedented pressure on health care and research facilities to provide personal protective equipment. The respiratory nature of the SARS-CoV2 pathogen makes respirator facepieces a critical protective measure to limit inhalation of this virus.

Cited by 11 publications

References 45 publications

Comparative Evaluation of Microorganism Disinfection Methods for N95 Respirators

Comparative Evaluation of Microorganism Disinfection Methods for N95 Respirators

A fast and reliable microplate reader assay to assess the antiviral efficacy of cold plasma devices

Review of aerosolized hydrogen peroxide, vaporized hydrogen peroxide, and hydrogen peroxide gas plasma in the decontamination of filtering facepiece respirators

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