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 and hydrogen peroxide off-gassing from a treated mask was also performed.
Results The PAA room disinfection system was effective for the decontamination 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 and hydrogen peroxide from the treated masks 20 and 60 minutes after the disinfection cycle respectively.
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
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
The proposed PAA disinfection experiments were approved by an internal safety review at University Hospitals Cleveland Medical Center (UHCMC). The microbiologic analyses were approved by the Biosafety Committee at the VAMC. Institutional Review Board approval was not obtained as human subjects were not enrolled in the study.
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
Yes
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Yes
Data Availability
All the available data is being made public