Are N95 masks washable and reusable?
Due to the recent Coronavirus (Covid-19) outbreak there has been shortage of N95 respirators. Because of this shortage many people wants to know “Are N95 masks washable and reusable?”
Though the CDC do not recommend that everyone should use face mask as a means of protection against the COVID-19 virus, many persons are already using using them and this has further reduce the availability of these face mask for the health care workers.
Unfortunately, many workers are reusing theirs on the grounds that some protection is better than nothing, but is that the safest and most effective course of action, though?
These masks were designed to be disposed of after they’re used, so it’s worth asking in the face of a disease outbreak: Are N95 masks washable and reusable?
CDC Definition of face mask reuse
Reuse refers to the practice of using the same N95 respirator for multiple encounters with patients but removing it (‘doffing’) after each encounter. The respirator is stored in between encounters to be put on again (‘donned’) prior to the next encounter with a patient. For pathogens in which contact transmission (e.g., fomites) is not a concern, non-emergency reuse has been practiced for decades. For example, for tuberculosis prevention, CDC recommends that a respirator classified as disposable can be reused by the same worker as long as it remains functional and is used in accordance with local infection control procedures. Even when N95 respirator reuse is practiced or recommended, restrictions are in place which limit the number of times the same FFR is reused. Thus, N95 respirator reuse is often referred to as “limited reuse”. Limited reuse has been recommended and widely used as an option for conserving respirators during previous respiratory pathogen outbreaks and pandemics.
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Respirator Reuse Recommendations by CDC
There is no way of determining the maximum possible number of safe reuses for an N95 respirator as a generic number to be applied in all cases. Safe N95 reuse is affected by a number of variables that impact respirator function and contamination over time. However, manufacturers of N95 respirators may have specific guidance regarding reuse of their product.The recommendations below are designed to provide practical advice so that N95 respirators are discarded before they become a significant risk for contact transmission or their functionality is reduced.
If reuse of N95 respirators is permitted, respiratory protection program administrators should ensure adherence to administrative and engineering controls to limit potential N95 respirator surface contamination (e.g., use of barriers to prevent droplet spray contamination) and consider additional training and/or reminders (e.g., posters) for staff to reinforce the need to minimize unnecessary contact with the respirator surface, strict adherence to hand hygiene practices, and proper PPE donning and doffing technique, including physical inspection and performing a user seal check. Healthcare facilities should develop clearly written procedures to advise staff to take the following steps to reduce contact transmission:
- Discard N95 respirators following use during aerosol generating procedures.
- Discard N95 respirators contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients.
- Discard N95 respirators following close contact with any patient co-infected with an infectious disease requiring contact precautions.
- Consider use of a cleanable face shield (preferred3) over an N95 respirator and/or other steps (e.g., masking patients, use of engineering controls), when feasible to reduce surface contamination of the respirator.
- Hang used respirators in a designated storage area or keep them in a clean, breathable container such as a paper bag between uses. To minimize potential cross-contamination, store respirators so that they do not touch each other and the person using the respirator is clearly identified. Storage containers should be disposed of or cleaned regularly.
- Clean hands with soap and water or an alcohol-based hand sanitizer before and after touching or adjusting the respirator (if necessary for comfort or to maintain fit).
- Avoid touching the inside of the respirator. If inadvertent contact is made with the inside of the respirator, discard the respirator and perform hand hygiene as described above.
- Use a pair of clean (non-sterile) gloves when donning a used N95 respirator and performing a user seal check. Discard gloves after the N95 respirator is donned and any adjustments are made to ensure the respirator is sitting comfortably on your face with a good seal.
To reduce the chances of decreased protection caused by a loss of respirator functionality, respiratory protection program managers should consult with the respirator manufacturer regarding the maximum number of donnings or uses they recommend for the N95 respirator model(s) used in that facility. If no manufacturer guidance is available, preliminary data suggests limiting the number of reuses to no more than five uses per device to ensure an adequate safety margin. Management should consider additional training and/or reminders for users to reinforce the need for proper respirator donning techniques including inspection of the device for physical damage (e.g., Are the straps stretched out so much that they no longer provide enough tension for the respirator to seal to the face?, Is the nosepiece or other fit enhancements broken?, etc.). Healthcare facilities should provide staff clearly written procedures to:
- Follow the manufacturer’s user instructions, including conducting a user seal check.
- Follow the employer’s maximum number of donnings (or up to five if the manufacturer does not provide a recommendation) and recommended inspection procedures.
- Discard any respirator that is obviously damaged or becomes hard to breathe through.
- Pack or store respirators between uses so that they do not become damaged or deformed.
FDA Guidelines for Respirator Masks
The US Food and Drug Administration recommends that N95 respirators and disposable masks aren’t shared or reused. Both surgical face masks and N95 respirators are designed to block large particles from reaching the mouth. Surgical type face masks don’t filter or block very small particles in the air, nor do they seal particularly well around the face to provide complete protection. N95 respirators are designed to provide a better seal around the face and built especially to filter smaller particles—the 95 in the name comes from how, in testing, the respirator blocks 95% of 0.3 micron-sized test particles.
Neither masks nor respirators are intended to be used more than once. If they become damaged or soiled the wearer risks getting exposed to bacteria and viruses. In an ideal scenario, they should be removed and properly disposed of with careful hand-washing afterward.
However, instead of reuse, extended use is the recommended course of action for handling respiratory pathogen outbreaks. This means, healthcare personnel wear the same N95 respirator for several patients without removing it as long as those patients are infected with the same pathogen and placed together in a dedicated area. As long as the mask continues to fit securely, they can be worn for a maximum of eight hours depending on environmental conditions. It’s time to change a mask when it becomes difficult to breathe comfortably.