PANDEMIC AND REUSE OF N95 FILTERED FACE MASKS

Year 2020, , 115 - 125, 28.09.2020

Belgin Oral , Gülden Sarı , Ayşe Coşkun Beyan , Zeynep Doğrul

https://doi.org/10.35232/estudamhsd.762061

Cited By: 2

Abstract

Respiratory tract infections diseases form an important place in terms of public health due to their ability to
be transmitted to many people in a short time. In the historical process, mankind has struggled with many
challenging pandemics that caused serious losses. Today, the whole world is struggling with the COVID-19
pandemic which is also transmitted through respiration. In this process, the use of personal protective
equipment and especially masks is essential for breaking the infection chain in order to protect healthcare
workers as well as the entire society from infectious diseases. During the pandemic period the need for use
of masks especially among protective equipment increases in healthcare professionals. It is necessary to
use filter face masks with high protection, especially during close contact with patients such as diagnosis,
treatment, and interventional procedures. Countries can provide an appropriate and a sufficient number of
protective equipment for healthcare professionals in line with their decisions in health policies. However, in
some cases, long-term or re-use of filter face masks may be required. Re-use can be considered as a
solution in certain procedures if it is done within the framework of certain rules when there are problems
in the supply process of filter face masks.

Keywords

Pandemic, N95 masks, reuse

PANDEMİ VE N95 FİLTRELİ YÜZ MASKELERİNİN YENİDEN KULLANIMI

Abstract

Enfeksiyon hastalıkları içinde solunum yolu ile bulaşan hastalıklar kısa sürede pek çok insana bulaşabilme özelliği nedeniyle toplum sağlığı açısından önemli bir yer oluşturmaktadır. Tarihsel süreçte insanoğlu zorlu pek çok pandemi mücadele etmiş ve ciddi kayıplar vermiştir. Günümüzde yine solunum yoluyla bulaşan COVID-19 pandemisiyle tüm Dünya mücadele etmektedir. Koruyucu ve tedavi edici hizmetlerin birlikte yürütülmesi, sektörler arası işbirliğinin gerekliliği pandemi yönetimi açısından oldukça hassas bir konudur. Bu süreçte tüm toplumun olduğu kadar sağlık çalışanlarının da bulaşıcı hastalıklardan korunmaları adına kişisel koruyucu ekipman ve özellikle maske kullanımı enfeksiyon zincirini kırmak için gerekli bir uygulamadır. Sağlık çalışanlarının pandemi döneminde koruyucu ekipmanlar içerisinde özellikle maske kullanım ihtiyacı da artmaktadır. Ülkelerin sağlık politikalarında almış olduğu kararlar doğrultusunda sağlık çalışanlarının uygun ve yeterli sayıda koruyucu ekipman sağlayabilmeleri muhtemeldir. Ancak bazı durumlarda filtreli yüz maskelerinin uzun süreli veya yeniden kullanımı gerekebilir. Yeniden kullanım belirli proserdürlerde, belli kurallar çerçevesince yapıldığı takdirde, filtreli yüz maskelerinin yeterli sayıda tedarik sürecinde sorun yaşandığında bir çözüm yolu olarak düşünülebilir.

Keywords

Pandemi, N95 maskeler, yeniden kullanım

References

• 1. Forum of International Respiratory Societies. The Global Impact of Respiratory Disease – Second Edition. Sheffield, European Respiratory Society, 2017. [cited 2020 Jan 22]; Available from: https://www.who.int/gard/publications/The_Global_Impact_of_Respiratory_Disease.pdf.
• 2. UNICEF/WHO. Pneumonia: the Forgotten Killer of Children. World Health Organization, New York;2006:4-5. [cited 2020 Jan 22]; Available from: https://www.who.int/publications/i/item/pneumonia-the-forgottenkiller-of-children.
• 3. Aslan R. Tarihten günümüze epidemiler, pandemiler ve COVID-19, Göller Bölgesi Aylık Ekonomi ve Kültür Dergisi 2020 Nisan;8(85):36-41.
• 4. Nickol ME, Kindrachuk J. A year of terror and a century of reflection: perspectives on the great influenza pandemic of 1918–1919. BMC Infect Dis. 2019;19(1):117:1-10.
• 5. Nguyen-Van-Tam JS, Hampson AW. The epidemiology and clinical impact of pandemic influenza. Vaccine. 2003 May 1;21(16):1762-8.
• 6. Viboud C, Simonsen L, Fuentes R, Flores J, Miller MA, Chowell G. Global mortality ımpact of the 1957–1959 ınfluenza pandemic. J Infect Dis 2016 March 1;213(5):738-45.
• 7. Kain T, Fowler R. Preparing intensive care for the next pandemic influenza. Crit Care 2019;23(1):337:1-9.
• 8. Lycett SJ, Duchatel F, Digard P. A brief history of bird flu. Philos Trans R Soc B Biol Sci 2019;374(1775):20180257:1-15.
• 9. Kilbourne ED. Influenza Pandemics of the 20th Century. Emerg Infect Dis. 2006;12(1):9-14.
• 10. Smith GJD, Vijaykrishna D, Bahl J, Lycett SJ, Worobey M, Pybus OG, et al. Origins and evolutionary genomics of the 2009 swine-origin H1N1 influenza A epidemic. Nature. 2009 Jun 25;459(7250):1122-5.
• 11. World Health Organization. Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [cited 2020 June 11]; Available from: https://www.who.int/dg/speeches/detail/whodirector- general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
• 12. Adhikari SP, Meng S, Wu Y-J, Mao Y-P, YeR-X, Wang Q-Z, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty. 2020;9(1):29:1-12.
• 13. World Health Organization. Coronavirus disease (COVID-19) Weekly Epidemiological Update. [cited 2020 September 09]; Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200907-weekly-epi-update-4.pdf?sfvrsn=f5f607ee_2.
• 14. Iannone P, Castellini G, Coclite D, Napoletano A, Fauci AJ, Iacorossi L, et al. The need of health policy perspective to protect Healthcare Workers during COVID-19 pandemic. A Grade rapid review on the N95 respirators effectiveness, PLoS One 2020 Jun 3;15(6):1-13.
• 15. Bartoszko JJ, Farooqi MAM, Alhazzani W, Loeb M. Medical masks vs N95 respirators for preventing COVID-19 in healthcare workers: A systematic review and meta-analysis of randomized trials, Influenza Other Respi Viruses. 2020 Jul;14(4):365-73.
• 16. Schwartz A, Stiegel M, Greeson N, Vogel A, Thomann W, Brown M, vd. Decontamination and reuse of N95 respirators with hydrogen peroxide vapor to address worldwide personal protective equipment shortages during the SARS-CoV-2 (COVID-19) pandemic. Applied Biosafety 2020;25(2):67-70.
• 17. CDC - NIOSH - NPPTL Respirator Trusted-Source. NIOSH-Approved Respirators, How are NIOSH Approved Particulate Filtering Respirators Classified? [cited 2020 June 01]; Available from: https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/respsource1quest2.html.
• 18. Suen LKP, Guo YP, Ho SSK, Au-Yeung CH, Lam SC. Comparing mask fit and usability of traditional and nanofibre N95 filtering facepiece respirators before and after nursing procedures. J Hosp Infect. 2020 Mar;104(3):336-43.
• 19. Coulliette AD, Perry KA, Edwards JR, Noble-Wang JA. Persistence of the 2009 pandemic influenza A (H1N1) virus on N95 respirators. Appl Environ Microbiol. 2013;79(7):2148-55.
• 20. Bałazy A, Toivola M, Adhikari A, Sivasubramani SK, Reponen T, Grinshpun SA. Do N95 respirators provide 95% protection level against airborne viruses, and how adequate are surgical masks? Am J Infect Control. 2006 Mar;34(2):51-7.
• 21. Chughtai AA, MacIntyre CR, Zheng Y, Wang Q, Toor ZI, Dung TC, et al. Examining the policies and guidelines around the use of masks and respirators by healthcare workers in China, Pakistan and Vietnam. J Infect Prev. 2015 Mar;16(2):68-74.
• 22. CDC - Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings - NIOSH Workplace Safety and Health Topic. [cited 2020 May 29] Available from: https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html.
• 23. Fisher EM, Shaffer RE. Considerations for recommending extended use and limited reuse of filtering facepiece respirators in health care settings. J Occup Environ Hyg. 2014;11(8):115-28.
• 24. Vıscusı DJ, Bergman MS, Eımer BC, Shaffer RE. Evaluation of five decontamination methods for filtering facepiece respirators. Ann Occup Hyg. 2009;53(8):815-27.
• 25. Vo E, Rengasamy S, Shaffer R. Development of a test system to evaluate procedures for decontamination of respirators containing viral droplets. Appl Environ Microbiol. 2009;75(23):7303-9.
• 26. Heimbuch BK, Wallace WH, Kinney K, Lumley AE, Wu C-Y, Woo M-H, et al. A pandemic influenza preparedness study: Use of energetic methods to decontaminate filtering facepiece respirators contaminated with H1N1 aerosols and droplets. Am J Infect Control. 2011 Feb;39(1):e1-9.
• 27. Salter WB, Kinney K, Wallace WH, Lumley AE, Heimbuch BK, Wander JD. Analysis of residual chemicals on filtering facepiece respirators after decontamination. J Occup Environ Hyg. 2010;7(8), s:437-45.
• 28. Bergman MS, Viscusi DJ, Heimbuch BK, Wander DJD, Sambol AR, Shaffer RE. Evaluation of multiple (3-cycle) decontamination processing for filtering facepiece respirators. Journal of Engineered Fibers and Fabrics. 2010,5(4):33-41.
• 29. Kenney P, Chan BK, Kortright K, et al. Hydrogen Peroxide Vapor sterilization of N95 respirators for reuse. doi:10.1101/2020.03.24.20041087. PPR:PPR129743.
• 30. Cheng VCC, Wong S-C, Kwan GSW, Hui W-T, Yuen K-Y. Disinfection of N95 respirators by ionized hydrogen peroxide during pandemic coronavirus disease 2019 (COVID-19) due to SARS-CoV-2. J Hosp Infect. 2020 Jun;105(2):358-9.
• 31. Mackenzie D. Reuse of N95 Masks. Engineering (Beijing). 2020;6(6):593-6.
• 32. Lore MB, Heimbuch BK, Brown TL, Wander JD, Hinrichs SH. Effectiveness of three decontamination treatments against influenza virus applied to filtering facepiece respirators. Ann Occup Hyg. 2012 Jan;56(1):92-101.
• 33. Fisher E, Rengasamy S, Viscusi D, Vo E, Shaffer R. Development of a test system to apply virus-containing particles to filtering facepiece respirators for the evaluation of decontamination procedures. Appl Environ Microbiol, 2009;75(6):1500-7.
• 34. Gertsman S, Agarwal A, O’Hearn K, Webster RJ, Tsampalieros A, Barrowman N, et al. Microwave- and heat-based decontamination of N95 filtering facepiece respirators (FFR): a systematic review. J Hosp Infect. 2020;S0195-6701(20)30403-5.
• 35. Massey T, Borucki M, Paik S, Fuhrer K, Bora M, Kane S, et al. Quantitative form and fit of N95 filtering facepiece respirators are retained and coronavirus surrogate is inactivated after heat treatments. doi:10.1101/2020.04.15.20065755. PPR:PPR152525.
• 36. Carrillo I, Floyd A, Valverde C, Tingle T, Zabaneh F. Immediate use steam sterilization (ıuss) sterilizes N95 masks without mask damage. Infect Control Hosp Epidemiol. 2020 Sep;41(9):1104-5.
• 37. Lowe JJ, Paladino KD, Farke JD, Boulter K, Cawcutt K, Emodi M, et al. N95 filtering facepiece respirator ultraviolet germicidal irradiation (UVGI) process for decontamination and reuse. [cited 2020 May 29] Available from: https://www.nebraskamed.com/sites/default/files/documents/COVID-19/n-95-decon-process.pdf.
• 38. Lindsley WG, Martin SB, Thewlis RE, Sarkisian K, Nwoko JO, Mead KR, et al. Effects of ultraviolet germicidal ırradiation (UVGI) on N95 respirator filtration performance and structural ıntegrity. J Occup Environ Hyg. 2015;12(8):509-17.
• 39. Casanova L, Alfano-Sobsey E, Rutala WA, Weber DJ, Sobsey M. Virus transfer from personal protective equipment to healthcare employees’ skin and clothing. Emerg Infect Dis. 2008 August;14(8):1291-3.
• 40. North Dakota. Procedure guıdance for N95 and facemask reuse. [cited 2020 June 06] Available from:https://www.health.nd.gov/sites/www/files/documents/Files/MSS/coronavirus/Facemask_And_N95_Reuse_Guide.pdf.
• 41. Nebraska Medicine COVID-19 PPE guidance extended use and reuse of facemasks, respirators and protective eyewear for healthcare personnel. [cited 2020 June 01] Available from: https://www.nebraskamed.com/sites/default/files/documents/COVID-19/COVID-Extended-Use-Reuseof-PPE-and-N95.pdf?date03212020.
• 42. CDC. Coronavirus disease 2019 (COVID-19) decontamination and reuse of filtering facepiece respirators. [cited 2020 May 15] Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuse-respirators.html.