We all know the situation we’re living in right now is out-of-the-ordinary, and the United States, along with the rest of the world, is facing a dangerous threat. This has led to shortages of many medical supplies, but particularly of N95 respirators, also known as N95 masks. These have been a crucial part of the PPE (personal protective equipment) of healthcare workers.
But, they’re as valuable as they’re scarce, and healthcare centers struggle to obtain enough of them for their workers. An item once found easily for sale in any online store, is now very difficult to buy in bulk or wholesale. For this reason, the Centers for Disease Control and Prevention (CDC) has issued a series of recommendations to reuse these masks in healthcare settings during emergencies like the COVID-19 pandemic. In this article, we’ll discuss these recommendations, whether it’s best to reuse a N95 mask or buy a new one.
What are N95 masks?
N95 masks are also known as N95 respirators, and they’re currently the best available face mask for virus protection. They offer a great antiviral activity, which is higher than the one found in medical or surgical masks, as well as reusable cloth masks. They can filter out viral particles very effectively, which makes them a great resource for protection of healthcare providers working during the pandemic.
As the name suggests, they can filter out a minimum of 95% of the airborne particles in the air, as indicated by their percentage of minimum particulate filtration efficacy of 95%. The ‘N’ means they’re not resistant to oil, which means they can only filter out particles that don’t contain any oil in them and that have a size of 0.3 micrometers, meaning that they’re airborne. Some particles that meet these requirements include dust, smoke, and viruses like the flu or the novel coronavirus, which are all respiratory hazards.
N95 masks have been used as PPE in many work fields, and because of this, they need to be regulated by an entity that is in charge of helping workplaces in the USA prevent work-related injuries or illnesses. This entity is the National Institute for Occupational Safety and Health, or NIOSH for short. They test and certify if a respirator manufactured as an N95 mask meets their requirements for this respirator type. If an N95 mask doesn’t have their approval seal, it means it’s not safe to be used as such.
During the COVID-19 pandemic, these masks have been widely used in the healthcare field, which was never the case before. For this reason, the CDC has recommended the general public to wear reusable cloth masks and leave these respirators for the healthcare workers, since they’ve been scarce for most of the year. Other items they’ve been using include face shields and KN95 masks.
The CDC’s recommendations for N95 mask reuse
N95 respirators are designed as traditionally disposable face masks, which means they’re not manufactured to be reused, and can endure a lifespan of 8 to 12 hours of use. In ideal conditions, these masks should be used once and then discarded properly, but with the COVID-19 pandemic, healthcare providers are looking for ways to extend the half-life of these items.
The disposable nature of these masks is due to the material used in them: polypropylene, which is used to make non-woven fabric. The filter media of these respirators is made of several layers of this non-woven fabric, also known as non-woven material. This is a raw material that isn’t very durable, and if worn for too long, the antiviral properties can disappear. The scarcity of these masks also come from the fact that this material is hard to produce, and manufacturers haven’t managed to meet the global demand.
While many reusable N95 masks, as well as techniques and systems for sterilizing them, are on the making, very few of them have completely been cleared to be distributed in the market. For now, the only way to reuse N95 respirators is by following the recommendations made by the CDC regarding this practice.
According to them, the ‘limited reuse’ of an N95 respirator is defined as “the practice of using the same N95 respirator for multiple encounters with patients but removing it after each encounter. The respirator is stored in between encounters to be put on again before the next encounter with a patient”. A different practice, the ‘extended use’ of N95 masks, is defined as “the practice of wearing the same N95 respirator for repeated close contact encounters with several patients, without removing the respirator between patient encounters”. The CDC recommends extended use over limited reuse as it involves less contact with the N95 respirator, decreasing the risk of contamination.
The techniques listed by the CDC and the FDA (Food and Drug Administration) for decontamination of respirators, and the subsequent reuse, is only recommended for when FFRs are scarce, highlighting that if a new N95 mask is available it should always be the first option above reusing N95 masks. They also state that these techniques can only be implemented for respirators approved by NIOSH or the FDA, and those that don’t have exhalation valves, and that these techniques should be evaluated for each individual respirator model, following the guidance of the manufacturer or a third-party expert if needed.
We always recommend using high-quality N95 respirators from reputable brands when choosing to decontaminate and reuse N95 masks. For example, 3M is the biggest and most important PPE brand in the United States and the world, and their 3M N95 masks are some of the most reputable and high-quality ones. Some popular models include the 3M 8210 and the 3M 8511. But, it’s always important to keep in mind the recommendations published by the CDC and the FDA on their websites, and to remember that this practice should only be done in emergencies with shortages of this item.