Are surgical masks manufactured from sterilisation wrap safe?
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ABSTRACT: Background
Due to regional shortages some health services have proposed using surgical masks manufactured from sterilisation wrap. However, there has been little assessment of the safety of this practice. Therefore, we developed our own prototypes and evaluated whether they met regulatory standards.Methods
Surgical mask prototypes were manufactured from two thickness grades of commercial sterilisation wrap. Safety was assessed in the context of regulatory standards. As it was not previously reported, we developed and performed differential pressure and synthetic blood penetration resistance experiments in accordance with official methodology.Results
Bacterial filtration efficiency was comparable between sterilisation wrap and commercial surgical masks. Both prototypes met regulatory standards for synthetic blood resistance, whilst only our thinner mask fulfilled acceptable differential pressure ('breathability') thresholds.Conclusion
Acceptable barrier and breathability properties can be achieved with surgical masks produced from sterilisation wrap. Therefore, this may be a reasonable method to supplement stock if required. Unless there are shortages mandating alternatives, health-care workers should always use approved personal protective equipment.
SUBMITTER: Grigg SE
PROVIDER: S-EPMC7674969 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionCOVID-19 was declared a pandemic in March 2020. With the sudden surge in demand for personal protective equipment (PPE), significant concerns regarding the ongoing availability emerged. One solution proposed is re-sterilisation of respirator masks and this has been commenced in some parts of the world. On review of the literature, very little is documented regarding the knowledge of masks and the attitudes of healthcare workers towards using re-sterilised masks.MethodsA comprehensive questionnaire was used to assess general knowledge and attitudes around facemasks and respirators.ResultsThere were 190 respondents. There were significant gaps in knowledge and understanding of when particular face masks should be worn. One-third had significant concerns about ongoing availability. One-third had concerns about the quality of the masks as the pandemic continued. Only 10% of respondents underwent formal face-fitting. Eighty percent of respondents stated they would wear a re-sterilised mask. A further 15% would use a re-sterilised mask but required certain reassurances. Five percent of our respondents would not use a re-sterilised mask under any circumstances.DiscussionEnsuring an adequate understanding of face masks is crucial among healthcare workers (HCWs) and this study highlights a need for further education. It also demonstrates a general acceptability among HCWs towards the use of re-sterilised face masks.
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Project description:BackgroundThe aim of this study was to estimate the carbon footprint and financial cost of decontaminating (steam sterilization) and packaging reusable surgical instruments, indicating how that burden might be reduced, enabling surgeons to drive action towards net-zero-carbon surgery.MethodsCarbon footprints were estimated using activity data and prospective machine-loading audit data at a typical UK in-hospital sterilization unit, with instruments wrapped individually in flexible pouches, or prepared as sets housed in single-use tray wraps or reusable rigid containers. Modelling was used to determine the impact of alternative machine loading, opening instruments during the operation, streamlining sets, use of alternative energy sources for decontamination, and alternative waste streams.ResultsThe carbon footprint of decontaminating and packaging instruments was lowest when instruments were part of sets (66-77 g CO2e per instrument), with a two- to three-fold increase when instruments were wrapped individually (189 g CO2e per instrument). Where 10 or fewer instruments were required for the operation, obtaining individually wrapped items was preferable to opening another set. The carbon footprint was determined significantly by machine loading and the number of instruments per machine slot. Carbon and financial costs increased with streamlining sets. High-temperature incineration of waste increased the carbon footprint of single-use packaging by 33-55 per cent, whereas recycling reduced this by 6-10 per cent. The absolute carbon footprint was dependent on the energy source used, but this did not alter the optimal processes to minimize that footprint.ConclusionCarbon and financial savings can be made by preparing instruments as part of sets, integrating individually wrapped instruments into sets rather than streamlining them, efficient machine loading, and using low-carbon energy sources alongside recycling.
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Project description:Current recommendations for the elimination of canine-mediated human rabies focus on mass dog vaccination as the most feasible and cost-effective strategy. However, attempts to control rabies are often combined with canine surgical sterilisation programmes. The added value of sterilisation is widely debated. A systematic review was undertaken to compare the outcomes and impact of vaccination and sterilisation programmes with vaccination only programmes. A systematic search of three electronic databases (CAB Abstracts, Medline and Global Health) and grey literature was performed. From 8696 abstracts found, 5554 unique studies were identified, and 16 studies met the inclusion criteria. Eight described vaccination only programmes and eight described vaccination and sterilisation programmes. Indicators of impact measured were dog bites and/or doses of post-exposure prophylaxis administered; numbers of dog and/or human rabies cases; dog population demographic changes; changes in health and welfare of dogs, and indicators related to human behaviour change. The studies were contextually very diverse, programmes being implemented were complex, and there was variation in measurement and reporting of key indicators. Therefore, it was difficult to compare the two types of intervention, and impossible to make an evaluation of the role of sterilisation, using this evidence. Given the large number of vaccination and sterilisation programmes conducted globally, the lack of studies available for review highlights a gap in data collection or reporting, essential for impact assessment. There are several knowledge gaps concerning the impact of the sterilisation component alone, as well as subsequent effects on rabies transmission and control. Prospective studies comparing the outcomes and impact of the two interventions would be required in order to establish any additional contribution of sterilisation, as well as the underlying mechanisms driving any changes. In the absence of such evidence, the priority for rabies control objectives should be implementation of mass vaccination, as currently recommended by the World Health Organisation.
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Project description:BackgroundThere is a worldwide shortage of medical-grade face masks. Donning masks can play an important role in curbing the spread of SARS-CoV-2.AimTo conclude whether there is an effective mask for the population to wear in public that could easily be made during a medical face mask shortage using readily available materials.MethodsWe determined the effectiveness of readily available materials and models for making a face mask. The outcomes were compared with N95/FFP2/KN95 masks that entered the Netherlands in April-May 2020. Masks were tested to determine whether they filtered a minimum of 35% of 0.3-μm particles, are hydrophobic, seal on the face, are breathable, and can be washed.FindingsFourteen of the 25 (combinations of) materials filtered at least 35% of 0.3-μm particles. Four of the materials proved hydrophobic, all commercially manufactured filters. Two models sealed the face. Twenty-two of the 25 materials were breathable at <0.7 mbar. None of the hydrophobic materials stayed intact after washing.ConclusionsIt would be possible to reduce the reproduction rate of SARS-CoV-2 from 2.4 to below one if 39% of the population would wear a mask made from ePM₁ 85% commercially manufactured filter fabric and in a duckbill form. This mask performs better than 80% of the imported N95/FFP2/KN95 masks and provides a better fit than a surgical mask. Two layers of quilt fabric with a household paper towel as filter is also a viable choice for protecting the user and the environment.
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Project description:IntroductionDuring the course of the COVID-19 pandemic, there have been suggestions that various techniques could be employed to improve the fit and, therefore, the effectiveness of face masks. It is well recognized that improving fit tends to improve mask effectiveness, but whether these fit modifiers are reliable remains unexplored. In this study, we assess a range of common "fit hacks" to determine their ability to improve mask performance.MethodsBetween July and September 2020, qualitative fit testing was performed in an indoor living space. We used quantitative fit testing to assess the fit of both surgical masks and KN95 masks, with and without 'fit hacks', on four participants. Seven fit hacks were evaluated to assess impact on fit. Additionally, one participant applied each fit hack multiple times to assess how reliable hacks were when reapplied. A convenience of four participants took part in the study, three females and one male with a head circumference range of 54 to 60 centimetres.Results and discussionThe use of pantyhose, tape, and rubber bands were effective for most participants. A pantyhose overlayer was observed to be the most effective hack. High degrees of variation were noted between participants. However, little variation was noted within participants, with hacks generally showing similar benefit each time they were applied on a single participant. An inspection of the fit hacks once applied showed that individual facial features may have a significant impact on fit, especially the nose bridge.ConclusionsFit hacks can be used to effectively improve the fit of surgical and KN95 masks, enhancing the protection provided to the wearer. However, many of the most effective hacks are very uncomfortable and unlikely to be tolerated for extended periods of time. The development of effective fit-improvement solutions remains a critical issue in need of further development.
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Project description:AbstractThe COVID-19 pandemic outbreak has resulted in the massive fabrication of disposable surgical masks. As the accumulation of discarded face masks represents a booming threat to the environment, here we propose a solution to reuse and upcycle surgical masks according to one of the cornerstones of the circular economy. Specifically, the non-woven cellulosic layer of the masks is used as an environmentally sustainable and highly porous solid support for the controlled deposition of catalytically active metal-oxide nanoparticles. The native cellulosic fibers from the surgical masks are decorated by titanium dioxide (TiO2), iron oxide (FexOy), and cobalt oxide (CoOx) nanoparticles following a simple and scalable approach. The abundant surface -OH groups of cellulose enable the controlled deposition of metal-oxide nanoparticles that are photocatalytically active or shown enzyme-mimetic activities. Importantly, the hydrophilic highly porous character of the cellulosic non-woven offers higher accessibility of the pollutant to the catalytically active surfaces and high retention in its interior. As a result, good catalytic activities with long-term stability and reusability are achieved. Additionally, developed free-standing hybrids avoid undesired media contamination effects originating from the release of nanoscale particles. The upcycling of discarded cellulosic materials, such as the ones of masks, into high-added-value catalytic materials, results an efficient approach to lessen the waste´s hazards of plastics while enhancing their functionality. Interestingly, this procedure can be extended to the upcycling of other systems (cellulosic or not), opening the path to greener manufacturing approaches of catalytic materials.Graphical abstractA novel approach to upcycle discarded cellulosic surgical masks is proposed, providing a solution to reduce the undesired accumulation of discarded face masks originating from the COVID-19 pandemic. The non-woven cellulosic layer formed by fibers is used as solid support for the controlled deposition of catalytically active titanium dioxide (TiO2), iron oxide (FexOy), and cobalt oxide (CoOx) nanoparticles. Cellulosic porous materials are proven useful for the photocatalytic decomposition of organic dyes, while their peroxidase-like activity opens the door to advanced applications such as electrochemical sensors. The upcycling of cellulose nonwoven fabrics into value-added catalytic materials lessens the waste´s hazards of discarded materials while enhancing their functionality.Supplementary informationThe online version contains supplementary material available at 10.1007/s10570-022-04441-9.
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