Abstract
Background Critical shortages of personal protective equipment (PPE) especially N95 respirators, during the SARS-CoV-2 pandemic continues to be a source of great concern among health care workers (HCWs). Novel methods of N95 filtering facepiece respirator (FFR) decontamination that can be scaled-up for in-hospital use can help address this concern and keep HCWs safe.
Methods A multidisciplinary pragmatic study was conducted to evaluate the use of an ultrasonic room high-level disinfection system (HLDS) that generates aerosolized peracetic acid (PAA) and hydrogen peroxide for decontamination of large numbers of N95 respirators. A cycle duration that consistently achieved disinfection of N95 respirators (defined as ≤ 6 log10 reductions in bacteriophage MS2 and Geobacillus stearothermophilus spores inoculated onto respirators) was identified. The treated masks were then assessed for changes to their hydrophobicity, material structure, strap elasticity, and filtration efficiency (FE). Assessment of PAA off-gassing from a treated mask was also performed.
Results The PAA room HLDS was effective for disinfection of N95 respirators in a 2447 cubic feet room with deploy and dwell times of 16 and 32 minutes respectively, and a total cycle time of 1 hour and 16 minutes. After 5 treatment cycles, no adverse effects were detected on filtration efficiency, structural integrity, or strap elasticity. There was no detectable off-gassing of PAA from the treated masks.
Conclusion The PAA room disinfection system provides a rapidly scalable solution for in-hospital decontamination of large numbers of N95 respirators to meet the needs of HCWs during the SARS-CoV-2 pandemic.
Competing Interest Statement
CJD discloses research funding from Clorox, PDI and Pfizer. OA discloses stipend/ equity from CollaMedic Inc. All other authors have no conflicts of interest to disclose.
Funding Statement
No funding received
Author Declarations
All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript.
Yes
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.
Yes
Footnotes
Conflicts of interest: CJD discloses research funding from Clorox, PDI and Pfizer. OA discloses stipend/ equity from CollaMedic Inc. All other authors have no conflicts of interest to disclose.
Funding: No funding sources
Data Availability
All the available data is being made public
Abbreviations
- SARS-CoV-2
- Severe Acute Respiratory Syndrome Coronavirus
- FFR
- Filtering facepiece respirator
- PAA
- Peracetic acid
- COVID-19
- Coronavirus disease 2019
- PPE
- Personal Protective Equipment
- CDC
- Center for Disease Control
- WHO
- World Health Organization
- FE
- Filtration efficiency
- STEL
- Short-term exposure limit
- TWA
- time weighted average
- AEGL
- Acute exposure guidelines
- AGP
- Aerosol generating procedure
- PUI
- Persons under investigation
- HCW
- Healthcare worker
- HLDS
- High-level disinfection system
- EUA
- Emergency Use Authorization