Reprocessing filtering facepiece respirators in primary care using medical autoclave: prospective, bench-to-bedside, single-centre study

Objective There are widespread shortages of personal protective equipment as a result of the COVID-19 pandemic. Reprocessing filtering facepiece particle (FFP)-type respirators may provide an alternative solution in keeping healthcare professionals safe.Design Prospective, bench-to-bedside.Setting A...

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Main Authors: Ralf E Harskamp, Bart van Straten, Jonathan Bouman, Bernadette van Maltha-van Santvoort, John J van den Dobbelsteen, Joost RM van der Sijp, Tim Horeman
Format: Article
Language:English
Published: BMJ Publishing Group 2020-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/8/e039454.full
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author Ralf E Harskamp
Bart van Straten
Jonathan Bouman
Bernadette van Maltha-van Santvoort
John J van den Dobbelsteen
Joost RM van der Sijp
Tim Horeman
author_facet Ralf E Harskamp
Bart van Straten
Jonathan Bouman
Bernadette van Maltha-van Santvoort
John J van den Dobbelsteen
Joost RM van der Sijp
Tim Horeman
author_sort Ralf E Harskamp
collection DOAJ
description Objective There are widespread shortages of personal protective equipment as a result of the COVID-19 pandemic. Reprocessing filtering facepiece particle (FFP)-type respirators may provide an alternative solution in keeping healthcare professionals safe.Design Prospective, bench-to-bedside.Setting A primary care-based study using FFP-2 respirators without exhalation valve (3M Aura 1862+ (20 samples), Maco Pharma ZZM002 (14 samples)), FFP-2 respirators with valve (3M Aura 9322+ (six samples) and San Huei 2920V (16 samples)) and valved FFP type 3 respirators (Safe Worker 1016 (10 samples)).Interventions All masks were reprocessed using a medical autoclave (17 min at 121°C with 34 min total cycle time) and subsequently tested up to three times whether these respirators retained their integrity (seal check and pressure drop) and ability to filter small particles (0.3–5.0 µm) in the laboratory using a particle penetration test.Results We tested 33 respirators and 66 samples for filter capacity. All FFP-2 respirators retained their shape, whereas half of the decontaminated FFP-3 respirators showed deformities and failed the seal check. The filtering capacity of the 3M Aura 1862 was best retained after one, two and three decontamination cycles (0.3 µm: 99.3%±0.3% (new) vs 97.0±1.3, 94.2±1.3% or 94.4±1.6; p<0.001). Of the other FFP-2 respirators, the San Huei 2920 V had 95.5%±0.7% at baseline vs 92.3%±1.7% vs 90.0±0.7 after one-time and two-time decontaminations, respectively (p<0.001). The tested FFP-3 respirator (Safe Worker 1016) had a filter capacity of 96.5%±0.7% at baseline and 60.3%±5.7% after one-time decontamination (p<0.001). Breathing and pressure resistance tests indicated no relevant pressure changes between respirators that were used once, twice or thrice.Conclusion This small single-centre study shows that selected FFP-2 respirators may be reprocessed for use in primary care, as the tested masks retain their shape, ability to retain particles and breathing comfort after decontamination using a medical autoclave.
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spelling doaj-art-4d818797e1364625b30a572fc4362d1f2024-12-02T08:05:11ZengBMJ Publishing GroupBMJ Open2044-60552020-08-0110810.1136/bmjopen-2020-039454Reprocessing filtering facepiece respirators in primary care using medical autoclave: prospective, bench-to-bedside, single-centre studyRalf E Harskamp0Bart van Straten1Jonathan Bouman2Bernadette van Maltha-van Santvoort3John J van den Dobbelsteen4Joost RM van der Sijp5Tim Horeman6Amsterdam Public Health, Personalized Medicine, Amsterdam, Netherlands2 Department of BioMedical Engineering, Faculty of Engineering, Delft University of Technology, Delft, The Netherlands1 Department of General Practice, Amsterdam UMC, Locatie AMC, Amsterdam, The Netherlands4 Holendrecht Medical Center, Amsterdam, The Netherlands2 Technical Department of BioMechanical Engineering, Technical University of Delft, Delft, The Netherlands5 Medical Centre Haaglanden, Den Haag, Zuid-Holland, The Netherlands2 Department of BioMedical Engineering, Faculty of Engineering, Delft University of Technology, Delft, The NetherlandsObjective There are widespread shortages of personal protective equipment as a result of the COVID-19 pandemic. Reprocessing filtering facepiece particle (FFP)-type respirators may provide an alternative solution in keeping healthcare professionals safe.Design Prospective, bench-to-bedside.Setting A primary care-based study using FFP-2 respirators without exhalation valve (3M Aura 1862+ (20 samples), Maco Pharma ZZM002 (14 samples)), FFP-2 respirators with valve (3M Aura 9322+ (six samples) and San Huei 2920V (16 samples)) and valved FFP type 3 respirators (Safe Worker 1016 (10 samples)).Interventions All masks were reprocessed using a medical autoclave (17 min at 121°C with 34 min total cycle time) and subsequently tested up to three times whether these respirators retained their integrity (seal check and pressure drop) and ability to filter small particles (0.3–5.0 µm) in the laboratory using a particle penetration test.Results We tested 33 respirators and 66 samples for filter capacity. All FFP-2 respirators retained their shape, whereas half of the decontaminated FFP-3 respirators showed deformities and failed the seal check. The filtering capacity of the 3M Aura 1862 was best retained after one, two and three decontamination cycles (0.3 µm: 99.3%±0.3% (new) vs 97.0±1.3, 94.2±1.3% or 94.4±1.6; p<0.001). Of the other FFP-2 respirators, the San Huei 2920 V had 95.5%±0.7% at baseline vs 92.3%±1.7% vs 90.0±0.7 after one-time and two-time decontaminations, respectively (p<0.001). The tested FFP-3 respirator (Safe Worker 1016) had a filter capacity of 96.5%±0.7% at baseline and 60.3%±5.7% after one-time decontamination (p<0.001). Breathing and pressure resistance tests indicated no relevant pressure changes between respirators that were used once, twice or thrice.Conclusion This small single-centre study shows that selected FFP-2 respirators may be reprocessed for use in primary care, as the tested masks retain their shape, ability to retain particles and breathing comfort after decontamination using a medical autoclave.https://bmjopen.bmj.com/content/10/8/e039454.full
spellingShingle Ralf E Harskamp
Bart van Straten
Jonathan Bouman
Bernadette van Maltha-van Santvoort
John J van den Dobbelsteen
Joost RM van der Sijp
Tim Horeman
Reprocessing filtering facepiece respirators in primary care using medical autoclave: prospective, bench-to-bedside, single-centre study
BMJ Open
title Reprocessing filtering facepiece respirators in primary care using medical autoclave: prospective, bench-to-bedside, single-centre study
title_full Reprocessing filtering facepiece respirators in primary care using medical autoclave: prospective, bench-to-bedside, single-centre study
title_fullStr Reprocessing filtering facepiece respirators in primary care using medical autoclave: prospective, bench-to-bedside, single-centre study
title_full_unstemmed Reprocessing filtering facepiece respirators in primary care using medical autoclave: prospective, bench-to-bedside, single-centre study
title_short Reprocessing filtering facepiece respirators in primary care using medical autoclave: prospective, bench-to-bedside, single-centre study
title_sort reprocessing filtering facepiece respirators in primary care using medical autoclave prospective bench to bedside single centre study
url https://bmjopen.bmj.com/content/10/8/e039454.full
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