Advertisement

Assessing changes to N95 respirator filtration efficiency, qualitative and quantitative fit, and seal check with repeated vaporized hydrogen peroxide (VHP) decontamination

  • Author Footnotes
    # Asterix denotes both authors had equal contributions in the development and writing of this project
    Christina F. Yen
    Correspondence
    Address correspondence to Christina F. Yen, MD, 330 Brookline Avenue, Slosberg-Landay #435, Boston, MA 02215.
    Footnotes
    # Asterix denotes both authors had equal contributions in the development and writing of this project
    Affiliations
    Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, MA

    Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA
    Search for articles by this author
  • Author Footnotes
    # Asterix denotes both authors had equal contributions in the development and writing of this project
    Robert Seeley
    Footnotes
    # Asterix denotes both authors had equal contributions in the development and writing of this project
    Affiliations
    Department of Environmental Health and Safety, Beth Israel Deaconess Medical Center, Boston, MA
    Search for articles by this author
  • Patrick Gordon
    Affiliations
    Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, MA
    Search for articles by this author
  • Lalitha Parameswaran
    Affiliations
    Massachusetts Institute of Technology, Lincoln Laboratory, Lexington, MA
    Search for articles by this author
  • Sharon B Wright
    Affiliations
    Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, MA

    Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA
    Search for articles by this author
  • Dana E Pepe
    Affiliations
    Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, MA

    Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA
    Search for articles by this author
  • Preeti Mehrotra
    Affiliations
    Division of Infection Control/Hospital Epidemiology, Silverman Institute of Health Care Quality & Safety, Beth Israel Deaconess Medical Center, Boston, MA

    Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA
    Search for articles by this author
  • Author Footnotes
    # Asterix denotes both authors had equal contributions in the development and writing of this project
Published:January 05, 2022DOI:https://doi.org/10.1016/j.ajic.2021.11.005

      Highlights

      • N95 respirators were decontaminated with vaporous hydrogen peroxide 25 times.
      • No alterations to respiratory integrity or filtration efficiency seen by 25 cycles.
      • Vaporous hydrogen peroxide does not appear to impact fit or filtration efficiency using this defined process.
      • However, implementation requires significant interdisciplinary coordination.
      N95 respirators were reprocessed using vaporized hydrogen peroxide to supplement limited supplies during the COVID-19 pandemic. In this study, we found no statistically significant differences in qualitative and quantitative fit or filtration efficiency with reprocessing. Filtration efficiency remained above 95% even at 25 cycles of reprocessing without statistically significant change from cycle 20-25 compared to cycle 0 (P = .10, P = .05, respectively). Vaporous hydrogen peroxide is an effective option to augment N95 respirator supplies.
      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Centers for Disease Control and Prevention. Implementing filtering facepiece respirator (FFR) reuse, including reuse after decontamination, when there are known shortages of N95 respirators. Updated October 19, 2020. Accessed May 2, 2021. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuse-respirators.htmlOccupational Safety and Health Administration. OSHA.gov. Enforcement Memos: Enforcement Guidance for Respiratory Protection and the N95 Shortage Due to the Coronavirus Disease 2019 (COVID-19) Pandemic. Updated April 3, 2020. Accessed May 2, 2021. https://www.osha.gov/memos/2020-04-03/enforcement-guidance-respiratory-protection-and-n95-shortage-due-coronavirus

      2. FDA.gov. Battelle Memorial Institute Emergency Use Authorization. Updated January 21, 2021. Accessed June 10, 2020. https://www.fda.gov/media/136529/download

        • Kenney PA
        • Chan BK
        • Kortright K
        • et al.
        Hydrogen Peroxide Vapor sterilization of N95 respirators for reuse [e-pub ahead of print].
        Infect Control Hosp Epi. 2021; https://doi.org/10.1017/ice.2021.48, accessed December 3, 2021
        • May K.R.
        The collison nebulizer: description, performance and application.
        J Aerosol Sci. 1973; 4 (3): 235-243
      3. National Institute for Occupational Safety and Health. Cdc.gov/niosh. Procedure No. TEB-APR-STP-0059-508. Determination particulate filter efficiency level for N95 series filters against solid particulates for non-powered, air-purifying respirators standard testing procedure (STP).

      4. Occupational Safety and Health Administration. OSHA.gov. 1910.134-Respiratory Protection. Revised June 8, 2011. Accessed June 10, 2020. https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134

      5. Richter W, Hofacre K, Willenberg Z. Final report for the bioquell hydrogen peroxide vapor (HPV) decontamination for reuse of n95 respirators. Contract No. HHSF223201400098C Study Number 3245 FDA Contracting Officer's Representative. Prepared July 22, 2016. Accessed November 19, 2020. https://www.fda.gov/media/136386/download

        • Schwartz A
        • Stiegel M
        • Greeson N
        • Vogel A
        • Thomann W
        • Brown M
        • et al.
        Decontamination and reuse of N95 respirators with hydrogen peroxide vapor to address worldwide personal protective equipment shortages during the SARS-CoV-2 (COVID-19) pandemic.
        J of Applied Biosafety. 2020; 25: 67-70
        • TSI Incorporated
        TSI; 2013. PORTACOUNT PRO 8030 and PORTACOUNT PRO + 8038 Respirator Fit Testers—Operation and Service Manual.
        Accessed. May 30, 2021; (Institute for Occupational Safety and Health. Cdc.gov/niosh. Procedure No. TEB-APR-STP-0007-508. Determination of exhalation resistance test, air-purifying respirators standard testing procedure (STP))