Long-life for respirator masks: a new perspective good for the planet

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Long-life for respirator masks: the reuse of FFP3/FFP2/N95, and other devices can be a new perspective good for the planet

Respirator masks: types of masks

There are many types of respirator masks with facial filters, categorized according to different classification systems all over the world, but very similar to each other. Respirators are a key element of PPE (Personal Protective Equipment) for healthcare professionals and doctors. They are masks with a filtering power in the inspiratory phase. They prevent the spread of infecting particles into the surrounding environment, thanks to 5 filtering layers. They usually fit very close to the face.

The most commonly used respirator masks, N95 and FFP2, are equivalent for filtering non-oil-based particles, like bioaerosols, i.e. viruses as Covid-19. The letter before the number isn’t relevant to the level of protection. The number is instead really important: the higher the number, the better the filtration efficiency. So an N100 mask will be more effective at stopping micro particles than an N95.

The following are the most common respirators for medical health staff in the main areas of the world:

• N95, R95, P95, N99, N100, P100 (United States NIOSH-42CFR84)¹. These respirator masks come in three different letter variations, N, R, and P. The word NIOSH and N95 are printed on the front to guarantee their efficiency.  The N95 respirators’ protection is confirmed to be at least 95%.
• FFP2, FFP3 (Europe EN 149-2001)². FFP2 is rated at 94% and acts very similarly to an N95 mask. FFP3 is rated at 99% of protection and performs similarly to an N99 mask.  European EN rated masks perform similarly to their NIOSH equivalents. To comply with current legislation (Regulation (EU) 425/2016), devices must have a CE marking affixed legibly.
• KN95, KN100, KP100 (China GB2626-2006): KN and KP masks are both available in 90%, 95% and 100% varieties.

• Korea 1st class (Korea KMOEL – 2017-64): The KF system is based on the European FFP rating system and as such, it performs almost identically.
• P2, P3  (Australia/New Zealand AS/NZA 1716:2012) A P2 mask will perform similarly to an N95 mask, so it’s recommended for COVID-19 patients.
• DS/DL2, DS/DL3 (Japan JMHLW-2000): the Japanese rating system follows the FFP system used by the European Union.
• PFF2, PFF3 (Brazil ABNT / NBR 13698:2011).
• N100, P100, R100, N99, P99, R99, N95, P95, R95 (Mexico NOM-116-2009 ) NOM-116.

THE LIFETIME OF RESPIRATOR MASKS

The Therapeutic Goods Administration (TGA) recommends not using face masks that are past their shelf life³.  However, in emergency times it happens very often.  In this context we are talking about non-disposable respirators, therefore exclude surgical masks.

The Italian association of health hygienists has drawn up a scientific contribution on the correct use of respirators for doctors, nurses and health personnel in general.⁴
It says “extended use is better than re-use”, as it implies less need to touch the PPE and consequently less risk of contact infection from viruses and bacteria. A fundamental requirement for extensive use is that the PPE must maintain its characteristics and functionality unchanged. It is strongly recommended to dispose of PPE after operations with a high risk of contamination, such as certain diagnoses of Coronavirus or other virulent diseases. The PPE cannot in any case be used by physicians or nurses more than 5 times and 8 consecutive hours. Respirator masks like N95 or FFP2 can’t be traditionally washed, but they need special treatments not to lose their protective texture.

THE MULTIPLE ADVANTAGES OF INTELLIGENT REUSE

It is really essential to invest in sterilization and decontamination methods for certified respirators for many reasons. First of all, to avoid having to face other emergencies without the availability of the necessary PPE, as it happened with Sars-Cov-2. Second, to significantly reduce health costs, as highlighted in the graph in this article. Last but not least, to protect the environment.

Hospital and medical centers’ waste has increased significantly due to the coronavirus emergency. Most of the waste is made up of PPE. The problem of the sterilization of waste and its disposal is obvious, also considering that it is added to all domestic garbage.

In addition to the increase in the volume of medical waste, there is also a further pollution problem, because potentially infected waste must first be disinfected, then stored in special packaging and finally incinerated.

To reduce the environmental impact, decontamination systems such as DeconBox^TM have been developed to safely allow extending the life of the respirators and caring for the environment.

The use of these purifying machines can become a good practice and an essential resource used daily in hospitals and private clinics all over the world. Sars-Cov-2, despite its drama, has confronted many countries around the world with the same problems at the same historical moment. Good practices in the defense of the planet and sustainable medicine can become a common thread that unites many scientific communities in the various countries of the world.

¹⁾ Centers for Disease Control and Prevention.

²⁾ Europe EN 149-2001.

³⁾ Advice on surgical masks and gowns during COVID-19.

⁴⁾ The Italian association: a scientific contribution to the correct use of respirators.