By Jeremy Urekew, Hazmat Specialist with the FEMA Urban Search and Rescue system
In January of 2020 it would have been hard to imagine opening a supply cabinet at a local hospital to find that there are just no more N95 masks to hand out to your staff. It would almost seem preposterous to assume that a point would come where there was just no supplier to even procure them from. Alas, March 2020 arrived and first response agencies, hospitals, other healthcare facilities found themselves in this very position.
Throughout my career I have worn a plethora of respirators to protect me from the hazards of my work. I have worn SCBAs (Self- Contained Breathing Apparatus), PAPRs (Powered Air-Purifying Respirators), APRs (Air-Purifying Respirators), and rebreathing circuits. Respiratory protection always fascinated me in that as resilient as the human body can be, we have an inherent weakness through the openings of the nose, mouth, and ocular membranes. We rely on clean air with a suitable oxygen concentration to keep our bodies alive. When the world finds a way to deprive of us this, we fight back with respiratory protection.
As the need for continuous respiratory protection arose with the uncertainty of COVID-19 transmission, we had an answer. It was the N95. The N95, though never genuinely appreciated, is a formidable opponent to the viral particles allowing workers to be in harm’s way, yet truly protected. When worn with splash glasses, face shield, and other PPE, we had a great way of keeping ourselves safe. This proved to be problematic when our supply nationwide began to dwindle.
The answer: reusable respirators. In healthcare and EMS agencies these solutions have been available yet overlooked. The problem with disposable N95 masks is that they rely on the tightness of the elastic straps to maintain a seal. This tightness can prove to be uncomfortable over extended time. In addition, the lack of comfort causes workers to adjust the mask, pull on the mask, and have a myriad of reflexive motions that almost always lead to cross contamination. Workers also complain of the fatigue from extended wearing as inspiration was difficult and the exhaling of hot air made your next breath even more unbearable. To pile on to this, continuous wearing of the N95 mask results in skin breakdown at the bridge of the nose and in prominent places around the back of the head.
As supplies were noticed to be dwindling or non-existent, workers across the nation are being asked to reuse disposable PPE. They are being asked to doff N95 masks, set them aside, and redon them as needed throughout the shift. To promote this as a practice, several methods of decontamination were designed. Hospitals and emergency services have started using UVC sterilizers, microwaving, Hydrogen Peroxide, and high heat to disinfect the N95 masks for reuse. Several independent studies were performed to validate the efficacy of these treatments, yet all were found to cause some form of breakdown to the filtering medium or worse, to alter the electrostatic charge over time.
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