Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review.
Journal
Infection control and hospital epidemiology
ISSN: 1559-6834
Titre abrégé: Infect Control Hosp Epidemiol
Pays: United States
ID NLM: 8804099
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
pubmed:
9
10
2020
medline:
21
1
2021
entrez:
8
10
2020
Statut:
ppublish
Résumé
Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination. To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators. We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews. Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized. In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale. Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.
Sections du résumé
BACKGROUND
Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination.
OBJECTIVES
To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators.
DATA SOURCES
We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews.
METHODS
Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized.
RESULTS
In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale.
CONCLUSIONS
Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.
Identifiants
pubmed: 33028441
pii: S0899823X2001243X
doi: 10.1017/ice.2020.1243
pmc: PMC7588721
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
75-83Références
Occup Environ Med. 2021 Sep;78(9):679-690
pubmed: 33504624
J Hosp Infect. 2020 Nov;106(3):536-553
pubmed: 32841704
J Hosp Infect. 2020 Sep;106(1):163-175
pubmed: 32687870
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Infect Control Hosp Epidemiol. 2020 Sep;41(9):1117
pubmed: 32299519
Infect Control Hosp Epidemiol. 2020 Aug;41(8):958
pubmed: 32279694
J Hosp Infect. 2020 Nov;106(3):504-521
pubmed: 32800824
Emerg Infect Dis. 2020 Sep;26(9):
pubmed: 32491983
Cochrane Database Syst Rev. 2020 Apr 15;4:CD011621
pubmed: 32293717
JAMA. 2009 Jan 7;301(1):36-8
pubmed: 19126810
Cochrane Database Syst Rev. 2020 Apr 21;4:CD013582
pubmed: 32315451
Infect Control Hosp Epidemiol. 2020 Nov;41(11):1364-1366
pubmed: 32319884
N Engl J Med. 2020 Apr 16;382(16):1564-1567
pubmed: 32182409
Lancet Public Health. 2020 Sep;5(9):e475-e483
pubmed: 32745512
J Occup Environ Hyg. 2010 Jan;7(1):63-70
pubmed: 19904661