N95 Respirators can be Safely Reprocessed to Augment Supply in Future Epidemics

A new study showed using vaporized hydrogen peroxide (VHP), a standard decontamination approach, maintained the function of N95 respirator on human subjects with up to 25 cycles of re-use.

A common type of N95 respirator can be safely reprocessed to augment supply during future epidemics, suggest study results published in the American Journal of Infection Control (AJIC).

N95 respirators are commonly used in hospitals worldwide to protect healthcare personnel from infectious pathogens.

Respiratory Diseases - Diseases of the Human Respiratory System
Respiratory diseases affect any part of the respiratory system. Some of the lung diseases like chronic obstructive pulmonary disease can lead to respiratory failure.

‘Investing in vaporized hydrogen peroxide capabilities could help to access the personal protective equipment during any future pandemic.’

During the COVID-19 pandemic, healthcare facilities experienced shortages of respirators, forcing personnel to re-use them or resort to less protective alternatives (e.g., facial masks).

It is important that we now find ways to scale and translate this capability to smaller hospitals and resource-limited healthcare settings that could benefit just as much from this type of personal protective equipment reprocessing in future disaster scenarios.

Researchers used vaporized hydrogen peroxide (VHP) to serially decontaminate seven N95 respirators. After each VHP cycle, they conducted a series of qualitative and quantitative tests to evaluate both the function and effectiveness of the respirators on human subjects as compared to baseline.

Severe Acute Respiratory Syndrome (SARS)
SARS is a viral respiratory disease caused by SARS-associated coronavirus.

These tests comprised a user seal check (performed by subjects donning and doffing the respirators), qualitative and quantitative respirator fit testing, and filtration efficiency testing, which assesses the ability of the respirator to filter out particles

Results showed that even after 25 decontamination cycles there were no alterations to respiratory integrity or filtration efficiency among the seven N95 respirators the researchers evaluated.

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One-fourth of patients hospitalized for the acute respiratory distress syndrome (ARDS) associated with severe COVID-19 infections are prone to distinct disease presentation.

All met the primary endpoints of function and effectiveness, passing 25 user seal checks and eight quantitative and four qualitative fit tests, in addition to maintaining filtration efficiencies of 95% or above throughout the study.

As compared to baseline filtration efficiencies of 99% for particles between 0.3-10 µm in diameter, filtration rates after VHP reprocessing cycles 20 and 25 for 0.3-10 diameter particles were 99.9% and 99.6%, respectively. These changes were not statistically significant.

What is the Best Treatment for Acute Respiratory Distress Syndrome?
The best treatment for Acute Respiratory Distress Syndrome (ARDS) may be lower pressure volumes of ventilation called ultra-protective mechanical ventilation, as it creates less risk for typical lung injuries such as hyperinflation and barotrauma.

Researchers noted that successful, large-scale implementation of N95 respirator reprocessing requires planning and coordination, multidisciplinary teams to ensure disinfection efficacy and end-user safety, and significant logistical support.

The findings from this study are encouraging and valuable, particularly given the N95 respirator shortage we experienced during the COVID-19 pandemic.

Source-Medindia