… Manufacturers told the committee that currently marketed disposable medical masks are made of materials that are likely to deteriorate with standard levels of disinfection (e.g., chemicals, heat, radiation). Because medical masks are intended for disposal, and are submitted to FDA with that labeling, manufacturers have no reason or incentive to develop methods for decontamination. However, they noted that it is physically possible for a device to be used repeatedly by the same wearer until it becomes damaged, interferes with breathing, or is visibly soiled (Jensen, 2006; D. Parks, letter to the Institute of Medicine, February 27, 2006). In addition, manufacturers expressed concern that they would incur increased liability if devices designed and intended for disposal were recommended for reuse.
In the context of SARS, the National Institute for Occupational Safety and Health (NIOSH) recommends that workers wear any NIOSH-approved particulate respirator for protection if it has been properly fit-tested and maintained. The agency warns that once worn in the presence of a SARS patient, the respirator should be considered potentially contaminated with infectious material and touching the outside of the device should be avoided. Upon leaving the patient’s room, the disposable respirator should be removed and discarded, followed by hand hygiene.
If a sufficient supply of respirators is not available, NIOSH and CDC recommend that healthcare facilities may consider reuse as long as the device has not been obviously soiled or damaged (e.g., creased or torn). Reuse may increase the potential for contamination; however, this risk must be balanced against the need to provide full respiratory protection to healthcare personnel. The agency recommends that if disposable N95 respirators are reused for contact with SARS patients, institutions should implement a procedure for safer reuse to prevent contamination through contact with infectious droplets on the outside of the respirator (see Box 3-1). Data on reuse of respirators for SARS are not available.
Also in the context of SARS, WHO recommends that disposable equipment should be used wherever possible in the treatment and care of patients with SARS (WHO, 2003). When the situation dictates the use of nondisposable equipment, the equipment should be sterilized in accordance with the manufacturer’s instructions. Surfaces should be cleaned with broad-spectrum (bactericidal, fungicidal, and virucidal) disinfectants of proven efficacy.
