Fiber-based masks and respirators: using decontamination methods and antimicrobial treatment to improve its reusability during pandemic

Abstract

Shortage of personal protective equipment (PPE) is often projected in response to public health emergencies such as infection outbreaks and pandemics. Respiratory protective devices (RPDs), namely medical face masks and respirators, are considered the last defense for the front-line healthcare workers. Cleaning, decontamination and reuse of the disposable RPDs have been accepted by local health authorities during the pandemic period. To contribute to the mitigation of RPD shortage and ensure the safe adoption of decontamination protocols, this review discusses the regulated testing standards and the most commonly studied decontamination methods in the literature. The reuse of RPDs must fulfill three criteria: remove the microbial thread, maintain original function and structural integrity (including fitting tests) and leave no harmful residuals. Decontamination methods such as ultraviolet germicidal irradiation, moist heat and vaporized hydrogen peroxide appeared to be the most promising methods in balancing the above-mentioned criteria. However, the effectiveness of decontamination methods varies depending on the RPDs’ models, materials and design. Therefore, the adoption of protocols needs to be evidence-based with full validation in the local institutes. Additionally, new technology such as antimicrobial treated PPE that can reduce the risks of fomite during donning and doffing process with an extended lifespan should be encouraged. Overall, good training and guidance for appropriate reuse of RPDs are fundamental to ensure their efficiency in protecting front-line healthcare workers.