Assessment of half-mask elastomeric respirator and powered air-purifying respirator reprocessing for an influenza pandemic

Abstract

Background: Health care facilities are considering the use of reusable respiratory protective devices (RPDs) to mitigate a potential N95 filtering facepiece respirator shortage caused by an influenza pandemic. US regulators are also considering stockpiling reusable RPDs for pandemic preparedness, but limited data exist on the effectiveness of cleaning and disinfection of these devices. This study defines reprocessing protocols and evaluates their effectiveness against a pandemic influenza strain in a laboratory setting. Methods: Five half-mask elastomeric respirator models and 3 powered air-purifying respirator models were contaminated with influenza virus and artificial skin oil on multiple surfaces. RPDs were then manually treated with 1 of 2 methods: cleaned or cleaned and disinfected. Presence of viable influenza was determined via swab sampling and a median tissue culture infectious dose assay. Results: Across 41 RPD surfaces, a mean log reduction in viable influenza of 4.54 ±0.97 log10 median tissue culture infectious dose was achieved for all treated surfaces, which included both cleaned and cleaned and disinfected surfaces. Conclusions: The methods defined as part of this study are effective for eliminating viable influenza in the presence of artificial skin oil on most of the RPD surfaces tested. Material type and RPD design should be considered when implementing RPD reprocessing protocols.

Ultraviolet germicidal irradiation of influenza-contaminated N95 filtering facepiece respirators

“…During real-world contamination events, influenza virus could very likely be shielded by organic soiling agents like saliva or skin oil, which can inhibit the effectiveness of decontamination techniques. [27][28][29] The objective of the current study was to evaluate the UVGI decontamination efficiency of an intact FFR contaminated with both a pandemic influenza strain and a soiling agent to better simulate real-world contamination events. Fifteen N95 FFR models were contaminated with viable H1N1 influenza and either artificial saliva or artificial skin oil, then subsequently treated with UV light and evaluated for remaining viable virus.…”

COVID-19 and respiratory protection for healthcare providers

“…The major limiting factor for the utilization of RERs by healthcare institutions is related to concerns about the cleaning and disinfection of such equipment. In a laboratory setting, the reprocessing protocols were defined by Lawrence et al [30]. They evaluated the effectiveness of this equipment for an influenza pandemic.…”

“…Forty-one surfaces were contaminated with the influenza virus, following which they were cleaned and disinfected. Lawrence et al [30] concluded that the methods they explained could be effective in cleaning and disinfecting influenza viruses. Moreover, these data might overcome some concerns regarding the effectiveness of the cleaning and disinfection of reusable respiratory devices such as half-or full-facepiece elastomeric respirators and PAPRs.…”

Mask shortage during epidemics and pandemics: a scoping review of interventions to overcome limited supply

“…Derrick et al, 73 Rebmann et al, 74 Roberge et al, 75 Sinkule et al, 76 Shenal et al 69 (5) Reusable respirators [77][78][79][80][81][82][83] Fabrication or testing of reusable respirators that are meant to be decontaminated between uses.…”

“…Bessesen et al, 79 Hines et al, 81 Hines et al, 82 Hines et al, 83 Lawrence et al, 77 Pompeii et al, 80 Subhash et al 78 (6) Unconventional mask replacements or modifications 43-45 84 Assessment of cloth masks, new mask types, modifications of existing mask designs and use of non-medical equipment as masks.…”