Preparing for an Influenza Pandemic: Hospital Acceptance Study of Filtering Facepiece Respirator Decontamination Using Ultraviolet Germicidal Irradiation

Abstract

Objectives: Predictions estimate supplies of filtering facepiece respirators (FFRs) would be limited in the event of a severe influenza pandemic. Ultraviolet decontamination and reuse (UVDR) is a potential approach to mitigate an FFR shortage. A field study sought to understand healthcare workers' perspectives and potential logistics issues related to implementation of UVDR methods for FFRs in hospitals. Methods: Data were collected at three hospitals using a structured guide to conduct 19 individual interviews, 103 focus group interviews, and 285 individual surveys. Data were then evaluated using thematic analysis to reveal key themes. Results: Data revealed noteworthy variation in FFR use across the sample, along with preferences and requirements for the use of UVDR, unit design, and FFR reuse. Based on a scale of 1 (low) to 10 (high), the mean perception of safety in a high mortality pandemic wearing no FFR was 1.25 of 10, wearing an FFR for an extended period without decontamination was 4.20 of 10, and using UVDR was 7.72 of 10. Conclusions: In addition to technical design and development, preparation and training will be essential to successful implementation of a UVDR program. Ultraviolet decontamination and reuse program design and implementation must account for actual clinical practice, compliance with regulations, and practical financial considerations to be successfully adopted so that it can mitigate potential FFR shortages in a pandemic.

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

“…Two studies analysed the determinants related to provider uptake of decontamination. 61 62 Nemeth et al 61 evaluated user acceptance of FFR decontamination, noting that perceived safety of UV decontamination was higher in comparison to wearing an FFR for an extended period of time without decontamination. 61 Viscusi et al 62 reported that decontamination with UV, moist heat or microwave steam did not significantly change the user experience.…”

“…All studies were ranked as medium to high risk for bias. Fisher et al, 47 Fisher and Shaffer, 109 Heimbuch et al, 52 Lin et al, 54 Mills et al, 48 Nemeth et al, 61 Bergman et al, 56 Lin et al, 53 Lindsley et al, 60 Lore et al, 50 Richter et al, 51 Salter et al, 55 Viscusi et al, 55 Viscusi et al, 57 Viscusi et al, 62 Vo et al, 111 Woo et al, 110 Heimbuch et al 49 (2) Reuse of disposable masks 63-65 70-72 Reuse of disposable masks without decontamination or disinfection.…”

“…61 62 Nemeth et al 61 evaluated user acceptance of FFR decontamination, noting that perceived safety of UV decontamination was higher in comparison to wearing an FFR for an extended period of time without decontamination. 61 Viscusi et al 62 reported that decontamination with UV, moist heat or microwave steam did not significantly change the user experience. Their clinical study found that FFR users are not likely to experience clinically meaningful reduction in fit, or an increase in odour, discomfort or difficulty in donning after decontamination.…”

Ultraviolet germicidal irradiation for filtering facepiece respirators disinfection to facilitate reuse during COVID-19 pandemic: A review

“…decontamination must account for actual clinical practice, regulations, and financial considerations. so that UVGI may mitigate potential FFR shortages in a pandemic[ 26 ]…”

Analysis of Taiwan’s Mask Collection and Plan Evasion during the COVID-19 Pandemic

“…Kirubarajan et al [ 20 ] revealed numerous strategies that had been evaluated for overcoming a limited supply of personal protective equipment during pandemics or epidemics. They grouped the strategies into six main categories: (1) decontamination of disposable masks [ 21 , 22 , 23 ], (2) reuse and/or extended wear of disposable masks [ 24 , 25 , 26 , 27 ], (3) layering of masks [ 28 , 29 ], (4) introduction of reusable respirators [ 29 , 30 ], (5) use of non-traditional replacements or modifications to masks [ 31 , 32 ], and (6) use of stockpiled or expired masks [ 33 , 34 , 35 ]. However, none of the above-mentioned studies discussed the mechanism of allocating masks.…”