• Simeon C Daeschler, Niclas Manson, Kariym Joachim, Alex W H Chin, Katelyn Chan, Paul Z Chen, Kiana Tajdaran, Kaveh Mirmoeini, Jennifer J Zhang, Jason T Maynes, Libo Zhang, Michelle Science, Ali Darbandi, Derek Stephens, Frank Gu, PoonLeo L MLLMSickKids Research Institute (Daeschler, Chan, Tajdaran, Mirmoeini, Darbandi), The Hospital for Sick Children (SickKids); The Hospital for Sick Children (SickKids) Occupational Health and Safety (Manson); Division of Plastic and Reconstructiv, and Gregory H Borschel.
• SickKids Research Institute (Daeschler, Chan, Tajdaran, Mirmoeini, Darbandi), The Hospital for Sick Children (SickKids); The Hospital for Sick Children (SickKids) Occupational Health and Safety (Manson); Division of Plastic and Reconstructive Surgery (Joachim, J. Zhang), The Hospital for Sick Children (SickKids) and University of Toronto, Toronto, Ont.; School of Public Health, LKS Faculty of Medicine (Chin, Poon), The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Chemical Engineering & Applied Chemistry (Chen, Gu), University of Toronto; Department of Anesthesia and Pain Medicine (Maynes, L. Zhang) and Division of Infectious Disease (Science), and Child Health Evaluative Sciences (Stephens), and Institute of Biomaterials and Biomedical Engineering and Division of Plastic and Reconstructive Surgery (Borschel), The Hospital for Sick Children, Toronto, Ont.
• CMAJ. 2020 Oct 13; 192 (41): E1189E1197E1189-E1197.

BackgroundUnprecedented demand for N95 respirators during the coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of these masks. We validated a rapidly applicable, low-cost decontamination protocol in compliance with regulatory standards to enable the safe reuse of N95 respirators.MethodsWe inoculated 4 common models of N95 respirators with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and evaluated viral inactivation after disinfection for 60 minutes at 70°C and 0% relative humidity. Similarly, we evaluated thermal disinfection at 0% to 70% relative humidity for masks inoculated with Escherichia coli. We assessed masks subjected to multiple cycles of thermal disinfection for structural integrity using scanning electron microscopy and for protective functions using standards of the United States National Institute for Occupational Safety and Health for particle filtration efficiency, breathing resistance and respirator fit.ResultsA single heat treatment rendered SARS-CoV-2 undetectable in all mask samples. Compared with untreated inoculated control masks, E. coli cultures at 24 hours were virtually undetectable from masks treated at 70°C and 50% relative humidity (optical density at 600 nm wavelength, 0.02 ± 0.02 v. 2.77 ± 0.09, p < 0.001), but contamination persisted for masks treated at lower relative humidity. After 10 disinfection cycles, masks maintained fibre diameters similar to untreated masks and continued to meet standards for fit, filtration efficiency and breathing resistance.InterpretationThermal disinfection successfully decontaminated N95 respirators without impairing structural integrity or function. This process could be used in hospitals and long-term care facilities with commonly available equipment to mitigate the depletion of N95 masks.© 2020 Joule Inc. or its licensors.

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