Abstract

Most respirators employed in health care settings, and often in first responder and industrial settings, are intended for single-use: the user dons the respirator, performs a work activity, and then doffs and discards the respirator. However, in the current COVID-19 pandemic, in the presence of persistent shortages of personal protective equipment, extended use and reuse of filtering facepiece respirators are routinely contemplated by many health care organizations. Further, there is considerable current effort to understand the effect of sterilization on the possibility of reuse, and some investigations of performance have been conducted. While the ability of such a respirator to continue to provide effective protection after repeated sanitization cycles is a critical component of implementing its reuse, of equal importance is an understanding of the impact that reusing the respirator multiple times in a day while performing work tasks, and even extending its wear over multiple days, has on the workplace protective performance. In this study, we subjected a stockpiled quantitatively fitted surgical style N95 filtering facepiece respirator device to extreme reuse and extended wear conditions (up to 19 uses over a duration of 5 days) and measured its protective performance at regular intervals, including simulated workplace protection factor measurements using total inward leakage. With this respirator, it was shown to be possible to maintain protection corresponding to an assigned protection factor greater than 10 under extreme usage conditions provided an individual is properly trained in the use of, and expertly fitted in, the respirator. Other factors such as hygiene and strap breakage are likely to place limits on reuse.

摘要

卫生保健环境中使用的大多数呼吸器，通常是在急救人员和工业环境中使用的，都是一次性使用的：用户戴上呼吸器，进行工作活动，然后落下并丢弃呼吸器。但是，在当前的COVID-19大流行中，在个人防护设备持续短缺的情况下，许多医疗保健组织通常会考虑广泛使用和重复使用过滤式口罩呼吸器。此外，目前有相当大的努力来了解灭菌对再利用可能性的影响，并且已经进行了一些性能研究。尽管这种呼吸器在反复消毒后仍能继续提供有效保护的能力是实现其重复使用的关键要素，同样重要的是要了解在执行工作任务时一天多次重复使用呼吸器，甚至将呼吸器的佩戴次数延长几天对工作场所防护性能的影响。在本研究中，我们对大量定量装配的手术式N95过滤式口罩呼吸器设备进行了极限重复使用和长期佩戴（在5天的时间内使用多达19次），并定期测量了其防护性能，包括模拟的工作场所防护系数使用总向内泄漏进行测量。使用这种防毒面具，可以证明，在极端使用条件下，只要对使用和佩戴防毒面具的人员进行了适当的培训，就可以维持相当于大于10的指定保护系数的保护。