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:ObjectivesNon-traditional materials are used for mask construction to address personal protective equipment shortages during the coronavirus disease 2019 (COVID-19) pandemic. Reusable masks made from surgical sterilization wrap represent such an innovative approach with social media frequently referring to them as "N95 alternatives." This material was tested for particle filtration efficiency and breathability to clarify what role they might have in infection prevention and control.MethodsA heavyweight, double layer sterilization wrap was tested when new and after 2, 4, 6, and 10 autoclave sterilizing cycles and compared with an approved N95 respirator and a surgical mask via testing procedures using a sodium chloride aerosol for N95 efficiency testing similar to 42 CFR 84.181. Pressure testing to indicate breathability was also conducted.ResultsThe particle filtration efficiency for the sterilization wrap ranged between 58% to 66%, with similar performance when new and after sterilizing cycles. The N95 respirator and surgical mask performed at 95% and 68% respectively. Pressure drops for the sterilization wrap, N95 and surgical mask were 10.4 mmH2O, 5.9 mmH2O, and 5.1 mmH2O, respectively, well below the National Institute for Occupational Safety and Health limits of 35 mmH2O during initial inhalation and 25 mmH2O during initial exhalation.ConclusionsThe sterilization wrap's particle filtration efficiency is much lower than a N95 respirator, but falls within the range of a surgical mask, with acceptable breathability. Performance testing of non-traditional mask materials is crucial to determine potential protection efficacy and for correcting misinterpretation propagated through popular media.
| S-EPMC7939758 | biostudies-literature
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.
| S-EPMC7870031 | biostudies-literature
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.
| S-EPMC10364739 | biostudies-literature
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.
| S-EPMC7449413 | biostudies-literature
Project description:BACKGROUND:There is a worldwide shortage of medical-grade face masks. Donning masks can play an important role in curbing the spread of SARS-CoV-2. AIM:To 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. METHODS:We 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-?m particles, are hydrophobic, seal on the face, are breathable, and can be washed. FINDINGS:Fourteen of the 25 (combinations of) materials filtered at least 35% of 0.3-?m 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. CONCLUSIONS:It 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 ePM? 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.
| S-EPMC7403160 | biostudies-literature
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.
| S-EPMC8809580 | biostudies-literature
Project description:Given the current shortage of respirator masks and the resulting lack of personal protective equipment for use by clinical staff, we examined bottom-up solutions that would allow hospitals to fabricate respirator masks that: (i) meet requirements in terms of filtering capacities, (ii) are easy to produce rapidly and locally, and (iii) can be constructed using materials commonly available in hospitals worldwide. We found that Halyard H300 material used for wrapping of surgical instruments and routinely available in hospitals, met these criteria. Specifically, three layers of material achieved a filter efficiency of 94%, 99%, and 100% for 0.3 ?m, 0.5 ?m, and 3.0 ?m particles, respectively; importantly, these values are close to the efficiency provided by FFP2 and N95 masks. After re-sterilization up to 5 times, the filter's efficiency remains sufficiently high for use as an FFP1 respirator mask. Finally, using only one layer of the material satisfies the criteria for use as a 'surgical mask'. This material can therefore be used to help protect hospital staff and other healthcare professionals who require access to high quality masks but lack commercially available solutions.
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Project description:In the CoVID-19 pandemic, singing came into focus as a high-risk activity for the infection with airborne viruses and was therefore forbidden by many governmental administrations. The aim of this study is to investigate the effectiveness of surgical masks regarding the spatial and temporal dispersion of aerosol and droplets during professional singing. Ten professional singers performed a passage of the Ludwig van Beethoven's "Ode of Joy" in two experimental setups-each with and without surgical masks. First, they sang with previously inhaled vapor of e-cigarettes. The emitted cloud was recorded by three cameras to measure its dispersion dynamics. Secondly, the naturally expelled larger droplets were illuminated by a laser light sheet and recorded by a high-speed camera. The exhaled vapor aerosols were decelerated and deflected by the mask and stayed in the singer's near-field around and above their heads. In contrast, without mask, the aerosols spread widely reaching distances up to 1.3 m. The larger droplets were reduced by up to 86% with a surgical mask worn. The study shows that surgical masks display an effective tool to reduce the range of aerosol dispersion during singing. In combination with an appropriate aeration strategy for aerosol removal, choir singers could be positioned in a more compact assembly without contaminating neighboring singers all singers.
| S-EPMC8491963 | biostudies-literature
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.
| S-EPMC8805669 | biostudies-literature
Project description:There have been many studies on the microplastic pollution, influence and control mechanisms of different plastic products. The potential harm of microplastic pollution to the environment has been confirmed. With the outbreak and spread of the COVID-19 in the world, disposable surgical masks as effective and cheap protective medical equipment have been widely used by the public. Disposable masks have been a new social norm, but they must have a sense of environmental responsibilities. The random disposal of masks may result in new and greater microplastic pollution, because masks made of polymer materials would release microplastics after entering the environment. Current results showed that masks are a potential and easily overlooked source of environmental microplastics. The release amount of microplastics in the static water by one mask was 360 items, and with the increase of vibration rate, the release amount also increased. The addition of organic solvents (detergent and alcohol) in water would increase the release of microplastics from masks. When the mask became fragments, the ability to release microplastic fibers into the environment was greatly improved due to the increase of exposure area. After two months of natural weathering, the masks become very fragile pieces and microplastics. A fully weathered mask could release several billions of microplastic fibers into the aquatic environment once these fragile fragments enter the water without reservation. The rapid growth of mask production and consumption and improper disposable is worrying. It is urgent to understand the potential environmental risks and significance of masks.
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