N95® Filtering Facepiece Respirator Contamination with SARS-CoV-2 Following Reuse and Extended Use

Details

• Personal Author:
  Ford, James S. ; Wang, Ralph C. ; Stephenson, Benjamin ; Degesys, Nida F. ; Fahimi, Jahan ; Fisher, Edward M. ; Harnish, Delbert ; Jones, Courtney M. C. ; Peterson, Susan ; Rosenthal, Efrat ; Rothman, Richard ; Shah, Manish N. ; Tolia, Vaishal ; Yaffee, Anna Q. ; Yoon, Katherine N. ; Raven, Maria C.
• Description:
  Objective: During the COVID-19 pandemic, the United States Centers for Disease Control and Prevention provided strategies, such as extended use and reuse, to preserve N95 filtering facepiece respirators (FFR). We aimed to assess the prevalence of N95 FFR contamination with SARS-CoV-2 among healthcare personnel (HCP) in the Emergency Department (ED). Design: Real-world, prospective, multicenter cohort study. N95 FFR contamination (primary outcome) was measured by real-time quantitative polymerase chain reaction. Multiple logistic regression was used to assess factors associated with contamination. Setting: Six academic medical centers. Participants: ED HCP who practiced N95 FFR reuse and extended use during the COVID-19 pandemic between April 2021 and July 2022. Primary exposure: Total number of COVID-19-positive patients treated. Results: Two-hundred forty-five N95 FFRs were tested. Forty-four N95 FFRs (18.0%, 95% CI 13.4, 23.3) were contaminated with SARS-CoV-2 RNA. The number of patients seen with COVID-19 was associated with N95 FFR contamination (adjusted odds ratio, 2.3 [95% CI 1.5, 3.6]). Wearing either surgical masks or face shields over FFRs was not associated with FFR contamination, and FFR contamination prevalence was high when using these adjuncts [face shields: 25% (16/64), surgical masks: 22% (23/107)]. Conclusions: Exposure to patients with known COVID-19 was independently associated with N95 FFR contamination. Face shields and overlying surgical masks were not associated with N95 FFR contamination. N95 FFR reuse and extended use should be avoided due to the increased risk of contact exposure from contaminated FFRs.
• Subjects:
  COVID-19 Occupational Health Personal Protective Equipment Safety SARS-CoV-2
• Keywords:
  N95 filtering facepiece respirators; Surgical masks; Personal protective equipment; PPE; Health care personnel; COVID-19; SARS-CoV-2; Infection control
• ISSN:
  0899-823X
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  California ; Florida ; Pennsylvania ; New York ; Maryland ; Wisconsin ; Georgia ; San Francisco Region [OSHA] ; Birmingham Region [OSHA] ; Atlanta Region [OSHA] ; New York City Region [OSHA] ; Chicago Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  NPPTL - National Personal Protective Technology Laboratory
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  6 pdf pages
• Volume:
  46
• NIOSHTIC Number:
  nn:20071095
• Citation:
  Infect Control Hosp Epidemiol 2025 Aug; 46(8):825-830
• Email:
  jaf020@health.ucsd.edu
• Federal Fiscal Year:
  2025
• Peer Reviewed:
  True
• Source Full Name:
  Infection Control and Hospital Epidemiology
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7ffd0eb43eadf6924666f9adbb01ab9ca238b6e3bbde733ecbb8dba824e4666b930d811bb14c46ee113aacd738b7d6e28ecd865862ab1b4f8789a17221092f09
• Download URL:
  https://stacks.cdc.gov/view/cdc/257871/cdc_257871_DS1.pdf
• File Type:
  [PDF - 401.53 KB ]