Modified full-face snorkel masks as reusable personal protective equipment for hospital personnel.

Here we adapt and evaluate a full-face snorkel mask for use as personal protective equipment (PPE) for health care workers, who lack appropriate alternatives during the COVID-19 crisis in the spring of 2020. The design (referred to as Pneumask) consists of a custom snorkel-specific adapter that couples the snorkel-port of the mask to a rated filter (either a medical-grade ventilator inline filter or an industrial filter). This design has been tested for the sealing capability of the mask, filter performance, CO2 buildup and clinical usability. These tests found the Pneumask capable of forming a seal that exceeds the standards required for half-face respirators or N95 respirators. Filter testing indicates a range of options with varying performance depending on the quality of filter selected, but with typical filter performance exceeding or comparable to the N95 standard. CO2 buildup was found to be roughly equivalent to levels found in half-face elastomeric respirators in literature. Clinical usability tests indicate sufficient visibility and, while speaking is somewhat muffled, this can be addressed via amplification (Bluetooth voice relay to cell phone speakers through an app) in noisy environments. We present guidance on the assembly, usage (donning and doffing) and decontamination protocols. The benefit of the Pneumask as PPE is that it is reusable for longer periods than typical disposable N95 respirators, as the snorkel mask can withstand rigorous decontamination protocols (that are standard to regular elastomeric respirators). With the dire worldwide shortage of PPE for medical personnel, our conclusions on the performance and efficacy of Pneumask as an N95-alternative technology are cautiously optimistic.

Déclaration de conflit d'intérêts

Schmidt Futures, Moore Foundation, Autodesk and CZ BioHub provided financial support of the project. Authors Gerry Ayala (Wildhorn Outfitters), Quentin Allinne (Subea Decathlon), and Dave Kasper (iSnorkel Inc) have company affiliations with snorkel-mask manufacturers or distributors. They consulted on original designs of these masks, and in some cases to help with adapter design strategy. None of the scientific data included in this report, nor the conclusions of this report were written or substantially influenced by these co-authors. John Pearson has a conflict of interest as a stake holder in a for-profit entity focused on snorkel based PPE (True Health). Patrick Kolbay is volunteering his time at this company. Stellar Design and Waymo provided support in the form of salaries for authors DP and SE. We certify that none of the other authors have any affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript. None of the other authors (beyond what is listed above) have any affiliations with John Pearson's company. There are no patents, products in development or marketed products associated with this research to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.