{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T11:14:13Z","timestamp":1775646853806,"version":"3.50.1"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Face masks, also referred to as half masks, are essential to protect healthcare professionals working in close contact with patients with COVID-19-related symptoms. Because of the Corona material shortages, healthcare institutions sought an approach to reuse face masks or to purchase new, imported masks. The filter quality of these masks remained unclear. Therefore, the aim of this study was to assess the quality of sterilized and imported FFP2\/KN95 face masks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A 48-minute steam sterilization process of single-use FFP2\/KN95 face masks with a 15 minute holding time at 121\u00b0C was developed, validated and implemented in the Central Sterilization Departments (CSSD) of 19 different hospitals. Masks sterilized by steam and H\n                      <jats:sub>2<\/jats:sub>\n                      O\n                      <jats:sub>2<\/jats:sub>\n                      plasma as well as new, imported masks were tested for particle filtration efficiency (PFE) and pressure drop in a custom-made test setup.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results of 84 masks tested on the PFE dry particle test setup showed differences of 2.3\u00b12% (mean\u00b1SD). Test data showed that the mean PFE values of 444 sterilized FFP2 face masks from the 19 CSSDs were 90\u00b111% (mean\u00b1SD), and those of 474 new, imported KN95\/FFP2 face masks were 83\u00b116% (mean\u00b1SD). Differences in PFE of masks received from different sterilization departments were found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Face masks can be reprocessed with 121 \u00b0C steam or H\n                      <jats:sub>2<\/jats:sub>\n                      O\n                      <jats:sub>2<\/jats:sub>\n                      plasma sterilization with a minimal reduction in PFE. PFE comparison between filter material of sterilized masks and new, imported masks indicates that the filter material of most reprocessed masks of high quality brands can outperform new, imported face masks of unknown brands. Although the PFE of tested face masks from different sterilization departments remained efficient, using different types of sterilization equipment, can result in different PFE outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0257468","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T13:23:44Z","timestamp":1631625824000},"page":"e0257468","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Can sterilization of disposable face masks be an alternative for imported face masks? A nationwide field study including 19 sterilization departments and 471 imported brand types during COVID-19 shortages"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0269-6593","authenticated-orcid":true,"given":"B.","family":"van Straten","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3373-5113","authenticated-orcid":true,"given":"P. D.","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Oussoren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Pereira Espindola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Ghanbari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Dankelman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Picken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Horeman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"key":"pone.0257468.ref001","article-title":"SnapShot: COVID-19","author":"B Oberfeld","year":"2020","journal-title":"Cell"},{"issue":"2","key":"pone.0257468.ref002","doi-asserted-by":"crossref","first-page":"183","DOI":"10.3390\/vaccines8020183","article-title":"What does plant-based vaccine technology offer to the fight against COVID-19?","volume":"8","author":"Sergio ROSALES-MENDOZA","year":"2020","journal-title":"Vaccines"},{"issue":"3","key":"pone.0257468.ref003","article-title":"Easybreath Decathlon Mask: An Efficient Personal Protective Equipment (PPE) against COVID-19 in Africa","volume":"11","author":"Rachid Ait ADDI","year":"2020","journal-title":"Journal of Clinical & Experimental Investigations\/Klinik ve Deneysel Arastirmalar Dergisi"},{"key":"pone.0257468.ref004","unstructured":"Van Den Dobbelsteen J. J., Van Straten B. J., Horeman T. A Comparison of Particle Filter Efficiency Measurements for Protective Masks using Particle Counters with Different Flow Rates. 2020. https:\/\/repository.tudelft.nl\/islandora\/object\/uuid%3A604ed9c2-c218-45e8-8c62-7d669865056c (accessed on 28 November 2020)."},{"key":"pone.0257468.ref005","unstructured":"European Committee for Standardization. CEN\/TC 79\u2014Respiratory protective devices. 2009;https:\/\/standards.cen.eu\/dyn\/www\/f?p=204:110:0::::FSP_PROJECT,FSP_ORG_ID:32928,6062&cs=1FC98AD34A5EE26A0CB5A6155ED4D6E5E"},{"key":"pone.0257468.ref006","article-title":"Particle Size-Selective Assessment of Protection of European Standard FFP Respirators and Surgical Masks against Particles-Tested with Human Subjects","author":"SA Lee","year":"2016","journal-title":"J Healthc Eng"},{"key":"pone.0257468.ref007","unstructured":"CDC. The National Institute for Occupational Safety and Health (NIOSH) 2014 https:\/\/www.cdc.gov\/niosh\/docs\/96-101\/default.html"},{"key":"pone.0257468.ref008","unstructured":"Code of China. Chinese Standard GB 2626\u20132006. Respiratory protective equipment\u2013China Safety 2006. https:\/\/www.codeofchina.com\/standard\/GB2626-2006.html. 2006."},{"issue":"2","key":"pone.0257468.ref009","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.jhin.2020.04.001","article-title":"Sterilization of disposable face masks by means of standardized dry and steam sterilization processes: an alternative in the fight against mask shortages due to COVID-19","volume":"105","author":"P. de Man","year":"2020","journal-title":"Journal of Hospital Infection"},{"key":"pone.0257468.ref010","unstructured":"Sch\u00f6pe H. J., & Klopotek M. Strategies for the re-use of FFP3 respiratory masks during the COVID-19 pandemic 2020. arXiv preprint arXiv:2004.00769."},{"key":"pone.0257468.ref011","first-page":"815","article-title":"Evaluation of Five Decontamination Methods for Filtering Facepiece Respirators","volume":"53","author":"Dennis J. Viscusi","year":"2009","journal-title":"Annals of Occupational Hygiene"},{"key":"pone.0257468.ref012","first-page":"33","article-title":"Evaluation of Multiple (3-Cycle) Decontamination Processing for Filtering Facepiece Respirators","volume":"5","author":"Michael S. Bergman","year":"2010","journal-title":"Journal of Engineered Fibers and Fabrics"},{"key":"pone.0257468.ref013","doi-asserted-by":"crossref","unstructured":"Kumar A, Kasloff S. B, Leung A, Cutts T, Strong J.E., Hills K, et al. N95 mask decontamination using standard hospital sterilization technologies. medRxiv. 2020.","DOI":"10.1101\/2020.04.05.20049346"},{"key":"pone.0257468.ref014","first-page":"1","article-title":"Coronavirus disinfection in histopathology","author":"T Henwood","year":"2020","journal-title":"Journal of Histotechnology"},{"key":"pone.0257468.ref015","doi-asserted-by":"crossref","unstructured":"Zhang, Qinxin & Zhao, Qingshun. Inactivating porcine coronavirus before nucleic acid isolation at temperatures higher than 56 \u00b0C seriously damages its genome integrity. 2020.","DOI":"10.1101\/2020.02.20.958785"},{"issue":"8","key":"pone.0257468.ref016","doi-asserted-by":"crossref","first-page":"e039454","DOI":"10.1136\/bmjopen-2020-039454","article-title":"Reprocessing filtering facepiece respirators in primary care using medical autoclave: prospective, bench-to-bedside, single-centre study","volume":"10","author":"R. E Harskamp","year":"2020","journal-title":"BMJ open"},{"issue":"2","key":"pone.0257468.ref017","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.jhin.2020.07.024","article-title":"Is there an adequate alternative to commercially manufactured face masks? A comparison of various materials and forms","volume":"106","author":"G.R. Teesing","year":"2020","journal-title":"Journal of Hospital Infection"},{"key":"pone.0257468.ref018","unstructured":"European Committee for Standardization. NEN-EN 149+A1 (en): Respiratory protective devices\u2014Filtering half masks to protect against particles\u2014Requirements, testing, marking. 2009."},{"key":"pone.0257468.ref019","unstructured":"National Institute for Public Health and the Environment, RIVM. Reprocessing FFP-type masks. 2020; data https:\/\/www.rivm.nl\/coronavirus-covid-19\/professionals\/binnen-ziekenhuis\/mondmaskers"},{"key":"pone.0257468.ref020","unstructured":"3M. Decontamination of 3M Filtering Facepiece Respirators: Global Considerations, technical Bulletin, revision 3. 2020; https:\/\/multimedia.3m.com\/mws\/media\/1851918O\/decontamination-of-3m-filtering-facepiece-respirators-global-considerations.pdf"},{"key":"pone.0257468.ref021","unstructured":"Markus A, Contingency Reprocessing of Single-Use Personal Protective Equipment (PPE), Issue 2 White paper. 2020. https:\/\/www.belimed.com\/en-us\/success-stories\/case-studies."},{"key":"pone.0257468.ref022","unstructured":"Van Straten B, Van den Dobbelsteen J, Horeman T. Steam sterilization of used disposable face masks with respect to COVID-19 shortages 2020; http:\/\/resolver.tudelft.nl\/uuid:078a3733-84d6-4d4a-81e6-74210c7fed78"},{"key":"pone.0257468.ref023","doi-asserted-by":"crossref","first-page":"858","DOI":"10.3855\/jidc.11433","article-title":"Effectiveness of autoclaving in sterilizing reusable medical devices in healthcare facilities","volume":"13","author":"Gopal Panta","year":"2019","journal-title":"The Journal of Infection in Developing Countries"},{"key":"pone.0257468.ref024","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.spc.2020.10.030","article-title":"A Circular Healthcare Economy; a feasibility study to reduce surgical stainless steel waste","volume":"27","author":"B. van Straten","year":"2020","journal-title":"Sustainable Production and Consumption"},{"key":"pone.0257468.ref025","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/0196-6553(87)90095-2","article-title":"Reuse of disposable medical devices in Canadian hospitals","volume":"15","author":"B.A. Campbell","year":"1987","journal-title":"American journal of infection control"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0257468","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T13:24:27Z","timestamp":1631625867000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0257468"}},"subtitle":[],"editor":[{"given":"Mahendra Singh","family":"Dhaka","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,9,14]]},"references-count":25,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9,14]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0257468","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.01.15.21249843","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,14]]}}}