Elastomeric Respirators Past, Present & Future - Presented by Nicolas Smit Sept. 23rd 2021
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Elastomeric Respirators
Past, Present & Future
Presented by Nicolas Smit
Sept. 23rd 2021
• Getting both the Ontario & Canadian government to recommend
elastomeric respirators as N95 alternatives
• Getting Doug Ford’s office to launch an internal investigation into
elastomeric respirators which resulted in the purchase of 100,000
elastomeric respirators
PERSONAL • I did a presentation on elastomeric respirators last summer for
Ontario MPs in a parliamentary committee meeting on the effects of
ACCOMPLISHMENTS Covid 19 on Ontario industries. I explained how to use them to
mitigate the economic impact & business disruptions while saving
employees from infection
• I worked with union lawyers to convince unions to go to court
against the government using my resources. The government
quickly settled & HCWs got better protections
• I was interviewed along with 2 union presidents by Radio Canada
about elastomeric respirators & HCWs being actively prevented
from using them + the government refusing to distribute them
• I worked with CBC journalist Natalia Goodwin on CBC’s investigation
into the government keeping 100,000 elastomeric respirators locked
up while also keeping the public in the dark about their
recommendations to use them as N95 alternative
• Since misinformation & lack of awareness around elastomeric respirators have been a major problem, the Occupational Health Clinics for Ontario Workers asked me to do a presentation to help Canadians understand how elastomeric respirators work & to clear up the common misinformation • I worked with a small group of top Canadian experts on an open letter which got over 500 signatures from top Canadian scientists, engineers, union leaders, epidemiologists & physicians to get the government to focus more attention on airborne transmission • I helped Lloyd Armbrust create the American Mask Manufacturers Association (AMMA), an association of over 50 US PPE manufacturers that was credited for the US government officially declaring the PPE shortage over in April • I was interviewed by Dan Diamond from the Washington Post about the US government keeping the public in the dark about the CDC’s pandemic plan to put elastomeric respirators into widespread use • I did a podcast episode for Covid on Air on elastomeric respirators which was used by ZeroCovid advocacy groups to help people understand their importance
WHAT ARE ELASTOMERIC RESPIRATORS?
Tight fitting respirators made of synthetic or natural rubber material, can be repeatedly used,
disinfected, stored, and re-used
Equipped with fixed or replaceable filters
Most of them have adjustable straps that accommodate a better fit and comfort
Use N95, N99 or N100 level filters
Offer 100% protection to even the most at risk HCW
Traditionally used in construction, mining, agricultural, pharmaceutical & home renovation industries.
You might even already have an industrial one at home
https://www.theguardian.com/world/2021/jun/29/cambridge-hospitals-mask-upgrade-appears-to-eliminate-covid-19-risk-to-staff
https://www.ohcow.on.ca/edit/files/occ-covid/ohcow_nicolas_smit.pdf
Hierarchy of
Controls for
COVID -19
Prevention
https://www.ccohs.ca/bestpractice/resources/1089-COVID-19---Hierarchy-of-Controls-
(1).pdf
RESPIRATOR TYPES Disposable Half Face Full Face
DIFFERENT FILTERS AVAILABLE
While P100 filters provide the most protection against infection, there are other options available.
Minimum Filter N series – not resistant R series – somewhat
P series – oil Proof
Efficiency to oil resistant to oil
95% N95 R95 P95
99% N99 R99 P99
100% (99.997%) N100 R100 P100
https://www.cdc.gov/niosh/docs/96-101/default.html
HISTORY OF USE AMONG HEALTH CARE WORKERS
2020
2009
2003
1996 The Ontario government
Some hospitals that used recommended them as
elastomeric respirators for N95 alternatives in May &
Elastomeric respirators Health Canada
were first used by health H1N1 ended up storing
their respirators for 10 recommended them in
care workers when the They were recommended June
CDC started using them years
by the CDC during SARS CDC recommended for CDC recommended for
to protect health care COVID-19
workers from Tuberculosis H1N1
at the Texas Center for
Infectious Diseases (TCID)
https://www.kens5.com/article/news/health/san-antonio-hospital-could-have-an-answer-to-the-ppe-crisis-elastomeric-masks/273-882e7ea3-e377-4776-906c-33ce89e193cc
https://www.cdc.gov/sars/clinical/respirators.html
https://www.cdc.gov/h1n1flu/guidance/ill-hcp_qa.htm
https://www.thesudburystar.com/news/local-news/sudbury-enginee
r-raising-awareness-about-n95-mask-alternative
WHAT AGENCIES RECOMMEND ELASTOMERIC
RESPIRATORS AS A SAFE N95 ALTERNATIVE?
• Elastomeric respirators have been recommended for health care workers by the top health
agencies in Canada and the US including:
• These agencies are recommending health care workers use elastomeric respirators since these
respirators offer higher levels of protection than an N95 and can be safely reused from
months to years. These respirators are also readily available from dozens of manufactures.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/elastomeric-respirators-strategy/index.html
https://www.ontariohealth.ca/sites/ontariohealth/files/2020-
05/Ontario%20Health%20Recommendations%20on%20Optimizing%20Personal%20Protective%20Equipment%20During%20the%20COVID-
19%20pandemic_rev10May20%20PDF_v2.pdf
https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/medical-devices/personal-protective-equipment/medical-masks-
respirators/safety-performance-specifications.html
https://www.osha.gov/memos/2020-04-03/enforcement-guidance-respiratory-protection-and-n95-shortage-due-coronavirus
RECENT GOVERNMENT PPE UPDATES
July 2021
June 2021
December 21st 2020
The American Industrial Hygienist
Association sent an open letter
The US government banned the requesting the CDC update their
Ontario Health updated their PPE use of surgical masks around PPE recommendations for aerosol
guidelines to explain that suspected or confirmed patients generating medical procedures
exhalation valves on elastomeric with Covid & have recommended (AGMP) so that N95s are banned
respirators can be covered with a that only elastomeric respirators & HCWs must be upgraded to
surgical mask or N95s be used elastomeric respirators instead
https://khn.org/news/article/labor-department-osha-emergency-rules-protect-health-care-workers-from-covid/
https://aiha-assets.sfo2.digitaloceanspaces.com/AIHA/resources/AIHA-Comments-OSHA-ETS-July-2021-FINAL.pdfN95 VS ELASTOMERIC RESPIRATOR
N95 Elastomeric Respirator
Recommended length of use hours months to years
reusable, better protection, available,
Advantages disposable, common, well known can be used in more work
environments, long term cost savings
less protection, supply shortage, cost
additional training needed, not well
Disadvantages more in the long run, higher risk of
known or understood by the public
infection with reuse
Year first used by health care
1995 1996
workers
Minimum % of air filtered 95 95 - 99.997
% that pass fit-testing * 57 98
https://asapublicaccess.s3-ap-southeast-2.amazonaws.com/AustralianAnaesthetist/Feature_Fittesting.pdfWHO CAN BENEFIT FROM USING ELASTOMERIC
RESPIRATORS DURING A PANDEMIC
• Any workplace where infection could be spread
• Anywhere outbreaks occur are ideal users because widespread use of elastomeric
respirators can prevent outbreaks and the community spread that tend to follow
outbreaks. These places include but are not limited to hospitals, long term care homes,
prisons, food plants, manufacturing facilities, warehouses, schools, among migrant
workers on farms and at airports.
• Industries with would have large economic benefits from using elastomeric
respirators include mining, construction, tourism, education, entertainment,
restaurant/food, agriculture, retail, hotel, professional sports, transportation & health
care
• Anyone with a compromised immune system can use them to give themselves a
barrier of protection to viruses and bacteria that could cause them great harm or be
fatal without this added protection
• They can protect people from environmental allergens such as pollen
• Employees working in work environments that are not well ventilated
https://www.ontariohealthcoalition.ca/index.php/report-covid-19-outbreaks-in-non-healthcare-settings-data-updated-to-november-18/BENEFITS OF USING ELASTOMERIC RESPIRATORS FOR
EMPLOYERS
• Less outbreaks and infections = less employees needing to use sick days
• Can be a promotional tool to get more customers to come to their
businesses and feel safe while going there. Delta is going to keep a lot of
customers away from businesses, but this can be mitigated by providing
clients/customers a safer environment.
• Increase productivity since employees would be less distracted/scared or
needing to care for the issues they may face.
• No more worry about PPE shortages affecting their business
operations. They can also store the respirators after the pandemic is over and
take them back out and retrain employees when a future pandemic comes
around again.
• Can be used to protect people from inhaling dangerous particulates in
mining, construction, home renovations, painting and from air pollution
including wildfire smokeSECONDARY BENEFITS TO USING ELASTOMERIC
RESPIRATORS
• Places like food plants would less need to shutdown these locations to
deal with the spread or to disinfect the entire operation and this would
reduce large economic loses
• Minimize the spread and reduce the need for city wide shutdowns as
an alternative way to slow the spread
• Stabilize and prevent business disruptions and slow down
hospitalizations to a manageable amount plus stabilize the supply chain
• Reduce the spread at schools since less parents would be infecting
their children and less children would therefore be spreading it to other
students and teachers.
• Less chances of new mutations creating strains that could completely
bypass the protections vaccine provide• The UK study showing they provide 100% protection to
HCWs
https://www.researchsquare.com/article/rs-637724/v1
STUDIES ON • The American College of Surgeons study
ELASTOMERIC https://www.facs.org/media/press-releases/2020/reusable-masks-061220
RESPIRATORS
https://www.youtube.com/watch?v=RV31PWYhe-M
IN HEALTH • Reusable Elastomeric Respirators in Health Care:
Considerations for Routine and Surge Use
CARE https://www.ncbi.nlm.nih.gov/books/NBK540070/pdf/Bookshelf_NBK540070.pdf
SETTINGS • American Journal of Infection Control - Elastomeric
respirators for all healthcare workers
https://www.ajicjournal.org/action/showPdf?pii=S0196-6553%2820%2930888-9CDC • https://www.cdc.gov/niosh/npptl/pdfs/El
PRESENTATIONS astomericPAPR-Healthcare-508.pdf
ON PUTTING • https://www.aohp.org/aohp/Portals/0/Do
ELASTOMERIC cuments/Conf2019/2019A005.pdf
RESPIRATORS
• https://www.youtube.com/watch?v=8wd
INTO 5Bx2fVDI
WIDESPREAD
USE
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC191266/• https://www.cbc.ca/news/canada/ottawa/ottawa-covid-masks-
protection-1.6053953
• https://ici.radio-canada.ca/nouvelle/1756312/masques-p100-
elastomeres-syndicats-sante
• https://www.usatoday.com/story/news/nation/2020/04/03/coro
IMPORTANT navirus-national-stockpile-disposable-n-95-face-masks-
reusable-respirator/5118669002/
NEWS • https://khn.org/news/article/labor-department-osha-
ARTICLES ON
emergency-rules-protect-health-care-workers-from-covid/
• https://www.nytimes.com/2020/05/27/us/coronavirus-masks-
ELASTOMERIC elastomeric-respirators.html
RESPIRATORS
• https://www.nydailynews.com/new-york/ny-fdny-new-covid-
mask-protection-20201110-7ehwdcduwffcni3qigd2vp6dla-
story.html
• https://www.sudbury.com/local-business/sudbury-engineer-
urging-mining-industry-to-donate-respirators-2273156
• https://khn.org/news/article/year-into-pandemic-feds-design-
new-mask-guidelines-to-better-protect-more-workers/FIRST HEALTH
CANADA APPROVED
ELASTOMERIC
RESPIRATOR
WITHOUT AN
EXHALATION VALVE
Dorma 99
Respirator
https://www.cbc.ca/news/canada/new-brunswick/mask-doctor-rene-caissie-1.5870250
https://mi-integration.com/en/shop/the-revolutionary-dorma-industrial/Dorma 99 Respirator
OPTIMAL EASE OF CLARITY OF ERGONOMIC SIMPLIFIED
PROTECTION. BREATHING. SPEECH. DESIGN MULTIPLE USES
Expert in sealing, Filter surface is 3X The shape of the Designed by a Can be disinfected
we have created an larger than a shell accentuates maxillofacial up to 100X. QR
optimized design the voice and
DISTINCTIVE ADVANTAGES
standard N95 mask specialist. The code traceability
to achieve a higher and allows very facilitates biocompatible system. 100%
performance high breathing communication. thermoplastic is recyclable
grade than N95 in quality. The translucent wall more comfortable
terms of aerosol allows you to on the face.
protection. In partially see facial
addition, this expressions, which No fog in goggles
efficient filter is not the case with and visors.
blocks 99% of the N95 currently in Adjustable straps
particles. use
Reduces sick leave Allows extended Facilitates exchanges Increase worker Reduces waste and
BENEFITS
and professional use with patients (citizens) comfort and promotes the circular
fatigue and between performance economy
colleaguesMISCONCEPTIONS - AVAILABILITY
• In April 2020, the White House put elastomeric respirators on a list of banned
exports along with N95s citing low supply yet they were quickly taken off that list
when demand became very low and supply became much higher.
• A lot of new elastomeric respirator manufacturers have entered the market including:
• Several manufacturers including MI Protection can provide enough elastomeric
respirators for every health care workers in Canada to be able to have their own &
still provide more to non health care settings so there is no need to reserve them
only for HCWs
https://www.whitehouse.gov/presidential-actions/memorandum-allocating-certain-scarce-threatened-health-medical-resources-domestic-use/
https://www.fda.gov/medical-devices/letters-health-care-providers/fda-recommends-transition-use-decontaminated-disposable-respirators-letter-health-care-personnel-andMISCONCEPTIONS – COSTS ARE TOO HIGH
COMPARED TO AN N95
• Studies like the one by the American College of Surgeons performed at the Allegheny
Health Network (AHN) showed that switching to reusable elastomeric respirators vs
disposable N95s reduced long term costs by over 90% in the first month alone & the
savings continue to grow the longer elastomeric respirators are used.
COST SAVINGS CALCULATOR
https://www.facs.org/media/press-releases/2020/reusable-masks-061220 https://webapps.msasafety.com/apr-calculator/
https://www.cdc.gov/coronavirus/2019-ncov/hcp/elastomeric-respirators-strategy/index.htmlMISCONCEPTION – COMMUNICATION ISSUES
• A lot of people believe that elastomeric respirators cannot be used because the voice
could get muffled making it harder to communicate
• Like N95s, some elastomeric respirators can muffle sounds although some
manufacturers offer elastomeric respirators with speech diaphragms to improve
communication
• Manufacturers like MI Protection have also built acoustic improvements into the design
of their respirator so that communication sounds much better and clearer than an
N95 or industrial elastomeric respirator
https://www.amazon.ca/photos/share/vEVOBda964jLglAoK5ABhBPixMavfdJD
GUBFNVyN3vzARE WE JUST LEARNING ABOUT ELASTOMERIC
RESPIRATORS IN HEALTH CARE?
The CDC recommended elastomeric respirators as N95 alternatives during
SARS & for H1N1
In Canada, elastomeric respirators in health care settings have been
discussed and recommended by Canadian experts for almost 20 years.
While Ontario Health & Health Canada have created PPE guidelines
recommending their use as a safe N95 alternative in 2020, these
recommendations are not well known and are often overlooked so most
Canadians don’t know they have been a recommended option for over a
year.
https://www.cdc.gov/sars/clinical/respirators.html
https://www.cdc.gov/h1n1flu/guidance/ill-hcp_qa.htmPAST CANADIAN RECOMMENDATIONS TO USE
ELASTOMERIC RESPIRATORS FOR INFECTION CONTROL
Canadian Medical Association Region of Peel : Reducing the
Journal : SARS Respiratory Protection Risk for Front-Line Staff
https://www.cmaj.ca/content/169/6/541.3 https://www.peelregion.ca/health/infectioncontrol/pdf/ROP-2012-
Designated-Officer-Manual.pdf
2004 2013
2003 2012
OSHA for Health Care in WorkSafeBC : Assessment and Determination of
BC : Protecting the Faces Practical Considerations for Widescale Utilization of
of Health Care Workers Elastometric Half-facepiece Respirators during a
https://www.linkedin.com/feed/update/urn:li:activity:66
Pandemic or Outbreak Situation
91792157529001984/ https://www.worksafebc.com/en/resources/about-us/research/assessment-and-determination-of-practical-
considerations-for-wide-scale-utilization-of-elastometric-half-facepiece-respirators-during-a-pandemic-or-outbreak-
situation?lang=en&directBENEFIT FOR SCHOOLS
Keeping staff & students fully protected from
the virus
Closing the community transmission loop
where children infect other children who in turn
infect their parents starting a new chain of
community transmission
Helps ease anxiety among staff and kids about
being infected which allows their focus to be
on teaching and learning instead
https://www.linkedin.com/posts/nicolas-smit-b8836b5b_tom-freiden-cdc-
director-from-2009-2017-activity-6687388064760811520-MLcvBENEFIT FOR FOOD INDUSTRY Food plants can use them to prevent workplace outbreaks that then go on to create a large amount of community transmission. This will help prevent plant closures which cause food instability as well as food prices to increase Restaurants can use them to keep their employees from being infected which creates bad PR for the restaurant and could cause the restaurant to temporarily close creating large economic loses for both employees and owners https://www.cbc.ca/news/canada/calgary/cargill-high-river- outbreak-1.5904444
BENEFIT FOR TRANSPORTATION
INDUSTRY
Helps prevent the virus from spreading on buses, trains
and planes
Can keep transport drivers from being exposed
while travelling through high-risk locations and
prevents them from bringing the virus back to their
communities, families and or country
Can help stabilize the supply chain & prevent costly
disruptions
Can help prevent the spread from one part of the
province/state/country to other parts
https://www.youtube.com/watch?v=wEid0Hxt8mk&t=23sBENEFIT FOR MINING INDUSTRY When miners must go through remote communities to get to remote mine sites, wearing elastomeric respirators while travelling & entering businesses will help keep the virus from entering these communities & help keep miners protected from infection. While going underground, the cage (elevator) is often packed like sardines with miners. Wearing elastomeric respirators while riding the cage or travelling in groups will keep symptomatic & asymptomatic miners from spreading the virus throughout the mine & prevent down time due to infections which can cost some mines $100,000s - $1,000,000 of dollars in lost production per day.
BENEFITS TO TOURISM INDUSTRY Can help keep tourist areas/attractions safer for tourists and prevent the spread of the virus when tourists visit these areas Can keep the virus from spreading from large cities to smaller remote communities that rely on tourism to survive Stopping tourist areas from being covid hotspots can help keep tourists interested in visiting these areas
BENEFIT TO RETAIL
INDUSTRY
Can help keep businesses open safely while
reducing the spread
Can give businesses a PR advantage by letting
clients know employees are properly protected from
getting infected and spreading it to
clients/customers
Will reduce community transmission and keep
businesses from needing to disrupt their
operations to deal with the spread at their
workplaceBENEFIT TO HEALTH CARE INDUSTRY HCWs will no longer get infected which will help prevent the spread to vulnerable patients and residents in ltc With less infections among HCWs, there will be less mental health issues and staff shortages With less infections in hospitals, things like cancer treatments, life saving procedures and testing can return which will help reduce the surgery backlog instead of it continuing to grow Can reduce the desire for HCWs to look for jobs due to lack of protections
BENEFIT FOR GOVERNMENT No more outbreaks at postal facilities means a more stable delivery network for Canadian businesses and consumers Significantly reduces community transmission which means less need to shutdown economies as a last resort way to slow the spread Less need for social assistance or spending billions of $ to deal with the fallout of shutdowns Taxpayers can save billions of dollars while government employees get the best protection available A $25-$50 respirator prevents a $50,000 medical bill A more stable economy and workforce Employees won’t suffer as much mental health issues from being afraid of getting infected
MANUFACTURERS
*MI Protection MaskForce Trebor Rx *MSA Safety Full Support *Canopy
GVS *Precision ADM Honeywell 3M *Dentec Moldex
*Health care use https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/respsource1quest3.html• Besides being able to solve the current pandemic, putting
elastomeric respirators into widespread use now means
that whenever a future virus emerges, then governments,
workplaces and the public can just take out their
elastomeric respirators from storage to immediately
prevent the virus from spreading and turning into a
pandemic which could cause trillions of $ in damages and
THE FUTURE OF
take millions of lives like Covid has
• This could be the last pandemic the world sees thanks to
ELASTOMERIC
elastomeric respirators
• Elastomeric respirators help with things like wildfire
RESPIRATORS smoke, air pollution, pollen allergies and more so they
continue to be used after the pandemic to keep people safe
• Once the pandemic is over, hospitals can lend their supply
of elastomeric respirators to help patients with
autoimmune conditions or cancer patients going through
chemo to help keep them safe while getting treatment.
This can also help them stay safe in the community
without worrying about being exposed to a virus that
would be harmless to most but deadly to someone without
a functioning immune systemHow to Don and Doff an elastomeric respirator https://mi-integration.com/wp-content/uploads/2021/09/DonDoff-Dorma-99-Respirator_1.mp4
WAYS TO • I am not a disinfection expert and I do not know what
chemicals might interact with each respirator so I
DISINFECT cannot make any recommendations on which method
ELASTOMERIC
works best for each situation or every respirator.
Please reach out to experts like occupational
RESPIRATORS hygienists if you need help determining the
appropriate methods of disinfection or infection
control. You could also speak directly with the
manufacturer to find out what they recommend be
used with their respirator.ONTARIO HEALTH RECOMMENDATIONS
https://www.linkedin.com/feed/update/urn:li:activity:6723034660001124352/ONTARIO HEALTH RECOMMENDATIONS
https://www.linkedin.com/feed/update/urn:li:activity:6723034660001124352/
https://www.linkedin.com/feed/update/urn:li:activity:6723034660001124352/HEALTH CANADA RECOMMENDATIONS
Cleaning and disinfection
• Elastomeric respirators should be cleaned and disinfected according to the manufacturer’s
validated cleaning and disinfection instructions. Reusable respirators are to be cleaned and
disinfected after each use, according to the Occupational Health and Safety Administration
(OSHA) hospital and respiratory toolkit.
• A validation protocol should be created to provide evidence that the process chosen
adequately cleans and disinfects the reusable parts of the respirator. The microbial challenge
organism should reflect a worst-case scenario organism for the chosen technology or
method of disinfection. Also, the cleaning and disinfection procedure should demonstrate
that the most difficult areas of the respirator can handle a significant or worst-case microbial
load (for example, 6 log reduction of bacterial spores).
https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/medical-devices/personal-protective-equipment/medical-masks-respirators/safety-performance-specifications.htmlCDC RECOMMENDATIONS
Cleaning and disinfection must be done using either the procedures in OSHA’s Respiratory
Protection Standard or the procedures recommended by the respirator manufacturer,
provided they are at least as effective as OSHA’s procedures. The employer must consult with
the manufacturer for the proper disinfectants/procedures and their potential impact upon its
respirator facepiece components.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/elastomeric-respirators-strategy/index.html
https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppB2OSHA RECOMMENDATIONS
• These procedures are provided for employer use when cleaning respirators. They are general
in nature, and the employer as an alternative may use the cleaning recommendations provided
by the manufacturer of the respirators used by their employees, provided such procedures are
as effective as those listed here. Equivalent effectiveness simply means that the procedures
used must ensure that the respirator is properly cleaned and disinfected in a manner that
prevents damage to the respirator and does not cause harm to the user.
• I. Procedures for Cleaning Respirators
• A. Remove filters, cartridges, or canisters. Disassemble facepieces by removing speaking
diaphragms, demand and pressure- demand valve assemblies, hoses, or any components
recommended by the manufacturer. Discard or repair any defective parts.
• B. Wash components in warm (43 deg. C [110 deg. F] maximum) water with a mild detergent
or with a cleaner recommended by the manufacturer. A stiff bristle (not wire) brush may be
used to facilitate the removal of dirt.
• C. Rinse components thoroughly in clean, warm (43 deg. C [110 deg. F] maximum), preferably
running water. Drain.
https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppB2OSHA RECOMMENDATIONS (continued)
• D. When the cleaner used does not contain a disinfecting agent, respirator components should be
immersed for two minutes in one of the following:
• 1. Hypochlorite solution (50 ppm of chlorine) made by adding approximately one milliliter of
laundry bleach to one liter of water at 43 deg. C (110 deg. F); or,
• 2. Aqueous solution of iodine (50 ppm iodine) made by adding approximately 0.8 milliliters of
tincture of iodine (6-8 grams ammonium and/or potassium iodide/100 cc of 45% alcohol) to one
liter of water at 43 deg. C (110 deg. F); or,
• 3. Other commercially available cleansers of equivalent disinfectant quality when used as directed,
if their use is recommended or approved by the respirator manufacturer.
https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppB2OSHA RECOMMENDATIONS (continued)
• E. Rinse components thoroughly in clean, warm (43 deg. C [110 deg. F] maximum), preferably
running water. Drain. The importance of thorough rinsing cannot be overemphasized.
Detergents or disinfectants that dry on facepieces may result in dermatitis. In addition, some
disinfectants may cause deterioration of rubber or corrosion of metal parts if not completely
removed.
• F. Components should be hand-dried with a clean lint-free cloth or air-dried.
• G. Reassemble facepiece, replacing filters, cartridges, and canisters where necessary.
• H. Test the respirator to ensure that all components work properly.
https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppB2IRRST RECOMMENDATIONS
• Remove the filters and set them aside on a disposable alcohol wipe.
• Wash the respirator by immersing it in lukewarm water (maximum 43 °C) with a gentle detergent
or any cleanser recommended by the manufacturer. Rub with a soft brush for 1 minute. Do not
use cleansers containing lanolin or other oils and do not use a brush with metal bristles.
• Rinse the parts in lukewarm running water.
• The respirator must then be immersed for a minimum of 1 minute in a solution of sodium
hypochlorite (5,000 ppm) to be disinfected. Place the respirator facedown to avoid the formation
of air bubbles in the mask. Swish it around to remove any residual bubbles. The hypochlorite
solution (approximately 5,000 ppm of available chlorine) can be made by adding 100 ml of
bleach (5%) to 900 ml of lukewarm water. Since the concentration levels of commercial and
industrial bleach vary, it is advisable to use the following calculator, developed in Ontario, to
validate the necessary volumes to make your
solution : https://www.publichealthontario.ca/en/health-topics/environmental-occupational-
health/water-quality/chlorine-dilution-calculator
https://www.irsst.qc.ca/en/covid-19/irsst-notices/id/2648/disinfection-of-reusable-elastomeric-respiratory-protection-equipmentIRRST RECOMMENDATIONS (continued)
• Rinse the respirator firmly with lukewarm running water for a minimum of 2 minutes. Drain. It is
important to rinse well, since soap and disinfectant that dry on parts of the respirator can irritate
the skin and cause dermatitis. In addition, some can degrade the rubber or corrode the metal
parts.
• The RPE must be dried with a clean cloth, paper towel or simply air-dried in a clean location.
• Keep it in a clean container that is not hermetically sealed to avoid retaining moisture.
Note: Although bleach can cause premature wear of the elastics, the procedure does not recommend
removing them to facilitate its application in case of a pandemic.
https://www.irsst.qc.ca/en/covid-19/irsst-notices/id/2648/disinfection-of-reusable-elastomeric-respiratory-protection-equipment• https://www.medschool.umaryland.edu/fpi/Novel-
ADDITIONAL Coronavirus-COVID-19/Information-for-FPI-Clinical-
RESOURCES ON Practices/Personal-Protective-Equipment-
PPE/Respirators/
DISINFECTING • https://pubmed.ncbi.nlm.nih.gov/25816692/
ELASTOMERIC • https://www.sciencedirect.com/science/article/pii/S01
96655315000899
RESPIRATORS • https://med.uth.edu/orl/wp-
content/uploads/sites/68/2020/04/UTHealth-
Elastomeric-Respirator-Disinfection-SOP.pdf
• https://intjem.biomedcentral.com/articles/10.1186/s12
245-020-00296-8QUESTIONS?
You would like to ask me more questions or
would like additional resources, you can
reach me at:
smitnicolas@hotmail.com
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@PPEtoheros
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