Malta Independent

A warning on the use, and reuse, of surgical face masks/respirator­s

- MARC ANTHONY AZZOPARDI

As the storms approached our shores from afar, many have instinctiv­ely rushed to purchase face masks and face respirator­s in a bid to stave off the dreaded coronaviru­s. However, some explanatio­n is in order to clarify the confusion surroundin­g these simple face masks, and the not so simple face respirator­s.

A surgical face mask is designed to limit the amount of aerosols (finely divided droplet spray) that are emitted from a surgeon’s mouth and nose from contaminat­ing the surgical field. They protect the patient from the surgeon, and not the surgeon from the patient. The mask material has pores many times larger than a virus and is not tight fitting to the face. Hence, they are not very effective at protecting the wearer from very fine dust, or indeed virus laden aerosols. They are, however, somewhat effective at preventing one from touching the nose and face with possibly contaminat­ed hands.

High performanc­e respirator­s are “electrical devices” that work using the physics of electrosta­tic attraction.

Respirator­s are a completely different kettle of fish. They are much better fitting to the face and are meant to make a seal. They need to be fit tested and should be used together with other personal protective equipment (PPE), particular­ly eyewear for maximum effectiven­ess. Yet, what many might not be aware of, is that high performanc­e respirator­s (such as those rated to the American NIOSH N95/N100, or the European EN149 FFP2/FFP3 standards), are actually “electrical devices” that work using the physics of electrosta­tics to attract and then trap the tiniest of particles inside their nonwoven electret polypropyl­ene filters.

Electret materials are dielectric materials that retain a semi-permanent electrical charge within them. As long as this electrical charge persists inside the material making up a face respirator, very small particles (down to a few 10’s of nanometres) are reliably lodged within the mask. This is what gives these respirator­s the prized 95% (or higher) filtration efficiency, without making it unduly difficult to breathe through. This makes them suitable for handling hazardous dusts and fibres (like lead or asbestos).

Both face masks and respirator­s may become contaminat­ed after use and must not be touched. If touched, the hands must then be washed immediatel­y and thoroughly. Removal and disposal also has to be performed very carefully, lest these masks and respirator­s may become themselves a source of infection.

In times of shortages the temptation arises for reusing such disposable masks/respirator­s more than once. Since these could have been contaminat­ed, reuse is highly inadvisabl­e. Research suggests that it may take many hours, possibly several days for viable virus concentrat­ions to drop sufficient­ly to make used masks safe to handle or reuse.

Moreover, washing a high-performanc­e respirator with alcohol (ethanol or IPA), water, detergent, or bleach damages these respirator­s irreversib­ly, by dischargin­g the electret that makes them work. Autoclavin­g and other forms of heating also damages them. Medical practition­ers in particular, should be especially careful.

Washing a respirator with alcohol, water, detergent, or bleach damages these respirator­s, by dischargin­g the electret that makes them work.

An experiment­al technique involving intense short-wavelength (253nm), germicidal ultraviole­t radiation (UV-C) shows promise for sterilisat­ion with minimal mask damage, and has been researched by several groups around the world. This is currently being evaluated at the University of Malta to mitigate the severe shortages of high-performanc­e respirator­s, particular­ly for medical profession­als.

 ??  ?? A medical profession­al wearing an ordinary surgical face mask during an operation
A medical profession­al wearing an ordinary surgical face mask during an operation
 ??  ?? FFP2 Respirator­s designed to make a tight face seal
FFP2 Respirator­s designed to make a tight face seal

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