Department of Nursing and Healthcare, Athlone Institute of Technology, Ireland; Centre for Disinfection, Sterilization and Biosecurity, Athlone Institute of Technology, Ireland; Empower Eco Sustainability Hub, Lough Boora, Co. Offaly, Ireland.
Lung Biology Group, Regenerative Medicine Institute at CURAM Centre for Medical Devices, National University of Ireland Galway, Galway, Ireland; Anaesthesia and Intensive Care Medicine, University Hospital Galway, Galway, Ireland.
Sci Total Environ. 2021 Jan 15;752:142259. doi: 10.1016/j.scitotenv.2020.142259. Epub 2020 Sep 10.
Currently, there is no effective vaccine for tackling the ongoing COVID-19 pandemic caused by SARS-CoV-2 with the occurrence of repeat waves of infection frequently stretching hospital resources beyond capacity. Disease countermeasures rely upon preventing person-to-person transmission of SARS-CoV2 so as to protect front-line healthcare workers (HCWs). COVID-19 brings enormous challenges in terms of sustaining the supply chain for single-use-plastic personal and protective equipment (PPE). Post-COVID-19, the changes in medical practice will drive high demand for PPE. Important countermeasures for preventing COVID-19 transmission include mitigating potential high risk aerosol transmission in healthcare setting using medical PPE (such as filtering facepiece respirators (FFRs)) and the appropriate use of face coverings by the general public that carries a lower transmission risk. PPE reuse is a potential short term solution during COVID-19 pandemic where there is increased evidence for effective deployment of reprocessing methods such as vaporized hydrogen peroxide (30 to 35% VH2O2) used alone or combined with ozone, ultraviolet light at 254 nm (2000 mJ/cm) and moist heat (60 °C at high humidity for 60 min). Barriers to PPE reuse include potentially trust and acceptance by HCWs. Efficacy of face coverings are influenced by the appropriate wearing to cover the nose and mouth, type of material used, number of layers, duration of wearing, and potentially superior use of ties over ear loops. Insertion of a nose clip into cloth coverings may help with maintaining fit. Use of 60 °C for 60 min (such as, use of domestic washing machine and spin dryer) has been advocated for face covering decontamination. Risk of virus infiltration in improvised face coverings is potentially increased by duration of wearing due to humidity, liquid diffusion and virus retention. Future sustained use of PPE will be influenced by the availability of recyclable PPE and by innovative biomedical waste management.
目前，尚无有效疫苗可用于应对由 SARS-CoV-2 引起的持续 COVID-19 大流行，而感染的反复浪潮经常使医院资源不堪重负。疾病对策依赖于防止 SARS-CoV2 的人际传播，从而保护一线医护人员（HCWs）。COVID-19 给一次性使用的塑料个人和个人防护设备（PPE）供应链的持续供应带来了巨大挑战。COVID-19 之后，医疗实践的变化将推动对 PPE 的高需求。预防 COVID-19 传播的重要对策包括在医疗环境中使用医疗 PPE（例如过滤式面罩呼吸器（FFR））来减轻潜在的高风险气溶胶传播，以及普通公众适当使用具有较低传播风险的面罩。在 COVID-19 大流行期间，PPE 重复使用是一种潜在的短期解决方案，越来越多的证据表明，重新处理方法（例如单独使用或与臭氧结合使用的汽化过氧化氢（30 至 35％VH2O2）、254nm 的紫外线（2000mJ/cm）和湿热（高湿度下 60°C 持续 60 分钟）可以有效部署。PPE 重复使用的障碍包括 HCWs 潜在的信任和接受度。面罩的功效受到适当遮盖口鼻、使用的材料类型、层数、佩戴时间长短的影响，并且系紧系带比戴耳带可能更有效。将鼻夹插入布罩中可能有助于保持贴合度。提倡使用 60°C 持续 60 分钟（例如，使用家用洗衣机和甩干机）对面罩进行去污。由于湿度、液体扩散和病毒保留，佩戴时间延长会增加临时面罩中病毒渗透的风险。未来 PPE 的持续使用将受到可回收 PPE 的可用性和创新的生物医学废物管理的影响。
