Decontamination interventions for the reuse of surgical mask personal protective equipment: A systematic review
Date
2020Author
Zorko, David J.
Gertsman, Shira
O’Hearn, Katie
Timmerman, Nicholas
Ali, Nasser Ambu
Dinh, Tri
Sampson, Margaret
Sikora, Lindsey
McNally, James Dayre
Choong, Karen
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Abstract
Background: The high demand for personal protective equipment during the novel coronavirus
outbreak has prompted the need to develop strategies to conserve supply. Little is known
regarding decontamination interventions to allow for surgical mask reuse.
Aim: Identify and synthesize data from original research evaluating interventions to
decontaminate surgical masks for the purpose of reuse.
Methods: We searched MEDLINE, Embase, CENTRAL, Global Health, the WHO COVID-19
database, Google Scholar, DisasterLit, preprint servers, and prominent journals from inception to
April 8, 2020 for prospective original research on decontamination interventions for surgical
masks. Citation screening was conducted independently in duplicate. Study characteristics,
interventions, and outcomes were extracted from included studies by two independent reviewers.
Outcomes of interest included impact of decontamination interventions on surgical mask
performance and germicidal effects.
Findings: Seven studies met eligibility criteria: one evaluated the effects of heat and chemical
interventions applied after mask use on mask performance, and six evaluated interventions
applied prior to mask use to enhance antimicrobial properties and/or mask performance. Mask
performance and germicidal effects were evaluated with heterogenous test conditions. Safety
outcomes were infrequently evaluated. Mask performance was best preserved with dry heat
decontamination. Good germicidal effects were observed in salt-, N-halamine-, and nanoparticlecoated masks. Conclusion: There is limited evidence on the safety or efficacy of surgical mask
decontamination. Given the heterogenous methods used in studies to date, we are unable to draw
conclusions on the most efficacious and safe intervention for decontaminating surgical masks.
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https://doi.org/10.1016/j.jhin.2020.07.007Collections
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