{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:29:43Z","timestamp":1772166583975,"version":"3.50.1"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T00:00:00Z","timestamp":1592352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T00:00:00Z","timestamp":1592352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Antimicrob Resist Infect Control"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Transmission of SARS-CoV-2 to health care workers (HCW) poses a major burden in the current COVID-19 pandemic. Unprotected exposure to a COVID-19 patient is a key risk factor for HCWs. Transmission mainly occurs by droplet transmission, or by aerosol generating procedures. Respirators such as filtering face piece masks (FFP2), also called respirators, are required to prevent transmission during aerosol generating procedures, as part of the personal protective equipment (PPE) for HCWs. However, many HCW were infected due to lack of PPE, or failure to use them. Therefore, the worldwide shortage of respirators triggered the development of reprocessing used FFP2 respirators or N95 respirators as standard in the US. Our proposal with H\n                      <jats:sub>2<\/jats:sub>\n                      O\n                      <jats:sub>2<\/jats:sub>\n                      plasma sterilization for decontamination allows to reprocess FFP2, while they still meet the filtration efficiency required by EN 149. The protocol is simple, uses available resources in hospitals and can be rapidly implemented to decrease the shortage of respirators during this crisis. The goal of the study was the evaluate if respirators can be reprocessed and still fulfill the requirements for filtration efficiency outlined by EN 149.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Used FFP2 respirators \u2013 Model 3\u2009M Aura\u2122 1862+\u2009\u2212\u2009were sterilized using a low temperature process hydrogen peroxide (H\n                      <jats:sub>2<\/jats:sub>\n                      O\n                      <jats:sub>2<\/jats:sub>\n                      ), V-PRO\u00ae maX Low Temperature, a FDA (Food and Drug Administration) approved method to decontaminate FFP2 respirators. Decontaminated respirators were further checked for residual peroxide by a single-gas detector for H\n                      <jats:sub>2<\/jats:sub>\n                      O\n                      <jats:sub>2<\/jats:sub>\n                      . The total inward leakage of the protective respirators was quantitatively tested with 10 test persons in an atmosphere charged with paraffin aerosol according to the European Standard EN 149. The fit factor was calculated as the inverse of the total inward leakage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten new and ten decontaminated FFP2 respirators were tested for filtration efficiency. None of the respirators exceeded the maximum acceptable concentration of peroxide. More than 4000 respirators have been reprocessed so far, at cost of approximately 0.3 Euro\/piece.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FFP2 respirators can be safely reprocessed once after decontamination with plasma peroxide sterilization, whereafter they still fulfill EN 149 requirements. This allows to almost double the current number of available FFP2 respirators.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13756-020-00744-3","type":"journal-article","created":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T06:04:14Z","timestamp":1592373854000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Proposal for a EN 149 acceptable reprocessing method for FFP2 respirators in times of severe shortage"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7661-5824","authenticated-orcid":false,"given":"Andreas F.","family":"Widmer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilles","family":"Richner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"issue":"10229","key":"744_CR1","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","volume":"395","author":"F Zhou","year":"2020","unstructured":"Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054\u201362.","journal-title":"Lancet"},{"key":"744_CR2","doi-asserted-by":"publisher","first-page":"e2020013","DOI":"10.4178\/epih.e2020013","volume":"42","author":"Y Jee","year":"2020","unstructured":"Jee Y. WHO International Health Regulations Emergency Committee for the COVID-19 outbreak. Epidemiol Health. 2020;42:e2020013.","journal-title":"Epidemiol Health"},{"issue":"13","key":"744_CR3","doi-asserted-by":"publisher","first-page":"377","DOI":"10.15585\/mmwr.mm6913e1","volume":"69","author":"A Kimball","year":"2020","unstructured":"Kimball A, Hatfield KM, Arons M, James A, Taylor J, Spicer K, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(13):377\u201381. https:\/\/doi.org\/10.15585\/mmwr.mm6913e1.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"9","key":"744_CR4","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1001\/jama.2019.11645","volume":"322","author":"LJ Radonovich Jr","year":"2019","unstructured":"Radonovich LJ Jr, Simberkoff MS, Bessesen MT, Brown AC, Cummings DAT, Gaydos CA, et al. N95 respirators vs medical masks for preventing influenza among health care personnel: a randomized clinical trial. JAMA. 2019;322(9):824\u201333. https:\/\/doi.org\/10.1001\/jama.2019.11645.","journal-title":"JAMA"},{"issue":"10228","key":"744_CR5","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1016\/S0140-6736(20)30644-9","volume":"395","author":"L The","year":"2020","unstructured":"The L. COVID-19: protecting health-care workers. Lancet. 2020;395(10228):922. https:\/\/doi.org\/10.1016\/S0140-6736(20)30644-9.","journal-title":"Lancet"},{"issue":"4","key":"744_CR6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-","volume":"5","author":"CR MacIntyre","year":"2015","unstructured":"MacIntyre CR, Seale H, Dung TC, Hien NT, Nga PT, Chughtai AA, et al. A cluster randomised trial of cloth masks compared with medical masks in healthcare workers. BMJ Open. 2015;5(4):e006577. https:\/\/doi.org\/10.1136\/bmjopen-2014-.","journal-title":"BMJ Open"},{"issue":"7","key":"744_CR7","doi-asserted-by":"publisher","first-page":"2148","DOI":"10.1128\/AEM.03850-12","volume":"79","author":"AD Coulliette","year":"2013","unstructured":"Coulliette AD, Perry KA, Edwards JR, Noble-Wang JA. Persistence of the 2009 pandemic influenza a (H1N1) virus on N95 respirators. Appl Environ Microbiol. 2013;79(7):2148\u201355. https:\/\/doi.org\/10.1128\/AEM.03850-12 Epub 2013 Jan 18.","journal-title":"Appl Environ Microbiol"},{"key":"744_CR8","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.jviromet.2018.05.009","volume":"260","author":"FM Blachere","year":"2018","unstructured":"Blachere FM, Lindsley WG, McMillen CM, Beezhold DH, Fisher EM, Shaffer RE, et al. Assessment of influenza virus exposure and recovery from contaminated surgical masks and N95 respirators. J Virol Methods. 2018;260:98\u2013106. https:\/\/doi.org\/10.1016\/j.jviromet.2018.05.009 Epub Jul 17.","journal-title":"J Virol Methods"},{"issue":"8","key":"744_CR9","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1093\/annhyg\/mep070","volume":"53","author":"DJ Viscusi","year":"2009","unstructured":"Viscusi DJ, Bergman MS, Eimer BC, Shaffer RE. Evaluation of five decontamination methods for filtering facepiece respirators. Ann Occup Hyg. 2009;53(8):815\u201327. https:\/\/doi.org\/10.1093\/annhyg\/mep070 Epub 2009 Oct 4.","journal-title":"Ann Occup Hyg"},{"issue":"7","key":"744_CR10","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.1086\/433186","volume":"41","author":"MY Lai","year":"2005","unstructured":"Lai MY, Cheng PK, Lim WW. Survival of severe acute respiratory syndrome coronavirus. Clin Infect Dis. 2005;41(7):e67\u201371.","journal-title":"Clin Infect Dis"},{"issue":"4","key":"744_CR11","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.jhin.2004.10.002","volume":"59","author":"J Okpara-Hofmann","year":"2005","unstructured":"Okpara-Hofmann J, Knoll M, Durr M, Schmitt B, Borneff-Lipp M. Comparison of low-temperature hydrogen peroxide gas plasma sterilization for endoscopes using various Sterrad models. J Hosp Infect. 2005;59(4):280\u20135.","journal-title":"J Hosp Infect"},{"key":"744_CR12","first-page":"143.73","volume-title":"Manual of Clinical Microbiology","author":"A Widmer","year":"2011","unstructured":"Widmer A, Frei R. Decontamination, disinfection, sterilization. In: Versalovic J, Carroll KC, Funke G, Jorgensen CH, Landry ML, Warnock DW, editors. Manual of Clinical Microbiology, vol. 10. Washington, D.C: ASM Press; 2011. p. 143.73."},{"issue":"5","key":"744_CR13","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.ajic.2008.09.021","volume":"37","author":"DJ Viscusi","year":"2009","unstructured":"Viscusi DJ, Bergman M, Sinkule E, Shaffer RE. Evaluation of the filtration performance of 21 N95 filtering face piece respirators after prolonged storage. Am J Infect Control. 2009;37(5):381\u20136.","journal-title":"Am J Infect Control"},{"key":"744_CR14","doi-asserted-by":"publisher","unstructured":"Liao L, Xiao W, Zhao M, Yu X, Wang H, Wang Q, et al. Can N95 Respirators Be Reused after Disinfection? How Many Times? ACS Nano. 2020;5(10). https:\/\/doi.org\/10.1021\/acsnano.0c03597.","DOI":"10.1021\/acsnano.0c03597"}],"container-title":["Antimicrobial Resistance &amp; Infection Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13756-020-00744-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13756-020-00744-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13756-020-00744-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T19:34:37Z","timestamp":1623872077000},"score":1,"resource":{"primary":{"URL":"https:\/\/aricjournal.biomedcentral.com\/articles\/10.1186\/s13756-020-00744-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,17]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["744"],"URL":"https:\/\/doi.org\/10.1186\/s13756-020-00744-3","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-24935\/v1","asserted-by":"object"}]},"ISSN":["2047-2994"],"issn-type":[{"value":"2047-2994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,17]]},"assertion":[{"value":"28 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 May 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"in-vitro study, not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"88"}}