Reprocessing of N95 – an update
The questions regarding reprocessing of N95 masks continue so here is an update.
RNAO wishes we would not need to consider this matter. Unfortunately, the reality of PPE shortages, in Ontario, requires having this alternative as a fallback option. Health Canada has developed considerations for the reprocessing of N95 masks. This is in addition to a notice Health Canada issued to industry on April 8th. Health Canada is expected to move forward this week with approval of decontamination equipment and issuing guidance on this matter.
RNAO has been asked to review a draft document from Health Canada. Although COVID-19 is a novel virus, there are studies of other coronaviruses that can be applied to assess the safety and effectiveness of reprocessing strategies. The draft document states that “Health Canada’s evidence requirements will include sterility assurance; demonstration that respirator filter and fit performance are maintained; evidence that there is no residual chemical hazard related to reprocessing; and ensuring adequate labelling that describes the validated methods and reprocessing conditions applied to the respirator." This correctly identifies the key issues to consider. The expert opinion we have gathered suggests that, properly done, decontamination is not an issue – the virus is eliminated by the methods proposed. The more concerning question is whether reprocessing affects the physical characteristics of the mask eroding proper fit. There also needs to be confirmation there is no residual chemical hazard.
The research is still ongoing (see, for example, here). Given that testing is done on specific models and brands of mask, there is no assurance that another model or brand will have different results. So guidance should be brand and model specific. RNAO asks for a careful explanation of the basis upon which the reprocessed N95s are being introduced.
RNAO insists that any documentation should address the issues mentioned above. The guidance should specify that the use of reprocessed masks be kept always as a last resort, and not as way to diminish costs. RNAO also strongly recommends the need for proper documentation and training on PPE use that is sector-specific. See my earlier updates here.