Moist heat as a promising method to decontaminate N95 masks: A large scale clinical study comparing four decontamination modalities—moist heat, steam, ultraviolet-C irradiation, and hydrogen peroxide plasma

•The largest study to incorporate mask-wearing into a mask decontamination study.•The study design simulates clinical scenarios of repeated donning and doffing of masks.•Direct comparison of four most commonly used decontamination methods.•Assessment using four different physical tests of mask integ...

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Bibliographic Details
Published in:	International journal of infectious diseases Vol. 136; pp. 151 - 157
Main Authors:	Wong, Hei Man, Mun, Cheok Hong, Loke, Weng Keong, Lim, Wei Qi, Chee, Geraldine Wei Yen, Tan, Sook Lan, Teo, Jye Yng, Yang, Yi Yan, Tanoto, Hendrix, Loh, Xian Jun, Lee, Chen Ee, Tiang, Chuanwen, Wan, Wei Yee, Cheong, Charlene, How, Kue Bien, Ling, Moi Lin, Tan, Ban Hock
Format:	Journal Article
Language:	English
Published:	Elsevier Ltd 01-11-2023 Elsevier
Subjects:	Mask decontamination Mask fit Mask integrity Mask integrity Mask fit Mask decontamination
Online Access:	Get full text
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Summary:	•The largest study to incorporate mask-wearing into a mask decontamination study.•The study design simulates clinical scenarios of repeated donning and doffing of masks.•Direct comparison of four most commonly used decontamination methods.•Assessment using four different physical tests of mask integrity and mask fitting.•Moist heat was the best-performing decontamination method. Early in the COVID-19 pandemic, there was a global shortage of masks. Although mask reprocessing was practiced, no clinical study has assessed systematically the impact of repeated cycles of wear and decontamination on the integrity of N95 filtering facepiece respirators (FFRs). We evaluated mask fit assessed by qualitative respirator fit test (QRFT) after each cycle of wear and decontamination, as well as four measures of mask integrity—bacterial filtration efficacy, particle filtration efficacy, differential pressure, and splash resistance through five cycles of wear and decontamination using one of the four modalities (moist heat, steam, ultraviolet-C irradiation, and hydrogen peroxide plasma). A total of 60.6% (hydrogen peroxide plasma) to 77.5% (moist heat) of the FFRs passed five cycles of wear and decontamination, as assessed by the wearers passing QRFT all five times. Moist heat-decontaminated FFRs retained all technical measures of integrity through all five cycles. This is the first large-scale study to assess systematically the impact (clinically and quantitatively) on N95 FFR integrity of repeated cycles of wearing followed by decontamination. Our results suggest that moist heat is a promising method for decontaminating N95 FFRs. Performing QRFT after every cycle of wear and decontamination ensures wearer safety. Although there is currently no mask shortage, reprocessing may reduce medical waste and improve sustainability.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1201-9712 1878-3511
DOI:	10.1016/j.ijid.2023.09.016