Brady Tyler M, Strauch Amanda L, Almaguer Claudia M, Niezgoda George, Shaffer Ronald E, Yorio Patrick L, Fisher Edward M
a National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania.
J Occup Environ Hyg. 2017 Nov;14(11):898-906. doi: 10.1080/15459624.2017.1346799.
Contact transmission of pathogens from personal protective equipment is a concern within the healthcare industry. During public health emergency outbreaks, resources become constrained and the reuse of personal protective equipment, such as N95 filtering facepiece respirators, may be needed. This study was designed to characterize the transfer of bacteriophage MS2 and fluorescein between filtering facepiece respirators and the wearer's hands during three simulated use scenarios. Filtering facepiece respirators were contaminated with MS2 and fluorescein in droplets or droplet nuclei. Thirteen test subjects performed filtering facepiece respirator use scenarios including improper doffing, proper doffing and reuse, and improper doffing and reuse. Fluorescein and MS2 contamination transfer were quantified. The average MS2 transfer from filtering facepiece respirators to the subjects' hands ranged from 7.6-15.4% and 2.2-2.7% for droplet and droplet nuclei derived contamination, respectively. Handling filtering facepiece respirators contaminated with droplets resulted in higher levels of MS2 transfer compared to droplet nuclei for all use scenarios (p = 0.007). MS2 transfer from droplet contaminated filtering facepiece respirators during improper doffing and reuse was greater than transfer during improper doffing (p = 0.008) and proper doffing and reuse (p = 0.042). Droplet contamination resulted in higher levels of fluorescein transfer compared to droplet nuclei contaminated filtering facepiece respirators for all use scenarios (p = 0.009). Fluorescein transfer was greater for improper doffing and reuse (p = 0.007) from droplet contaminated masks compared to droplet nuclei contaminated filtering facepiece respirators and for improper doffing and reuse when compared improper doffing (p = 0.017) and proper doffing and reuse (p = 0.018) for droplet contaminated filtering facepiece respirators. For droplet nuclei contaminated filtering facepiece respirators, the difference in MS2 and fluorescein transfer did not reach statistical significance when comparing any of the use scenarios. The findings suggest that the results of fluorescein and MS2 transfer were consistent and highly correlated across the conditions of study. The data supports CDC recommendations for using proper doffing techniques and discarding filtering facepiece respirators that are directly contaminated with secretions from a cough or sneeze.
病原体通过个人防护装备的接触传播是医疗行业关注的问题。在突发公共卫生事件爆发期间，资源变得紧张，可能需要重复使用个人防护装备，如N95过滤式面罩呼吸器。本研究旨在描述在三种模拟使用场景下，噬菌体MS2和荧光素在过滤式面罩呼吸器与佩戴者手部之间的转移情况。过滤式面罩呼吸器被含有MS2和荧光素的液滴或飞沫核污染。13名受试者进行了过滤式面罩呼吸器的使用场景测试，包括脱卸不当、正确脱卸和重复使用以及脱卸不当和重复使用。对荧光素和MS2的污染转移进行了量化。从过滤式面罩呼吸器转移到受试者手部的MS2平均转移率，对于源自液滴和飞沫核的污染，分别为7.6 - 15.4%和2.2 - 2.7%。在所有使用场景中，处理被液滴污染的过滤式面罩呼吸器导致的MS2转移水平高于飞沫核污染的情况（p = 0.007）。在脱卸不当和重复使用过程中，来自被液滴污染的过滤式面罩呼吸器的MS2转移量大于脱卸不当时的转移量（p = 0.008）以及正确脱卸和重复使用时的转移量（p = 0.042）。在所有使用场景中，与飞沫核污染的过滤式面罩呼吸器相比，液滴污染导致的荧光素转移水平更高（p = 0.009）。与飞沫核污染的过滤式面罩呼吸器相比，对于被液滴污染的面罩，脱卸不当和重复使用时的荧光素转移量更大（p = 0.007）；对于被液滴污染的过滤式面罩呼吸器，脱卸不当和重复使用时的荧光素转移量与脱卸不当时相比更大（p = 0.017），与正确脱卸和重复使用时相比也更大（p = 0.018）。对于飞沫核污染的过滤式面罩呼吸器，在比较任何使用场景时，MS2和荧光素转移的差异未达到统计学显著性。研究结果表明，在整个研究条件下，荧光素和MS2转移的结果是一致的且高度相关。这些数据支持美国疾病控制与预防中心关于使用正确脱卸技术以及丢弃直接被咳嗽或打喷嚏分泌物污染的过滤式面罩呼吸器的建议。
