Aerosolized Hydrogen Peroxide Decontamination of N95 Respirators, with Fit-Testing and Virologic Confirmation of Suitability for Re-Use During the COVID-19 Pandemic

T. Hans Derr; Melissa A. James; Chad V. Kuny; Prem P. Kandel; Matthew D. Beckman; Kevin L. Hockett; Mark A. Bates; Moriah L Szpara

The current COVID-19 pandemic has created a shortage of N95 respirators, due to limitations in manufacturing of critical components and in the ability of supply chains to handle increased global demand for PPE. For this reason, we and others have sought to demonstrate the potential for decontamination and reuse of existing N95 respirators. Standardized procedures already exist for the sterilization and reuse of medical equipment and surfaces, such as autoclaving, steam heat, and chemical inactivation (e.g. bleach) (1) . Sterilization of most medical equipment is verified using spore-based biological indicators. Unlike most hospital equipment (e.g. steel, metal, plastic) or fabrics (e.g. blankets) for which standardized sterilization methods exist (1), N95 respirators were not intended for re-use (2) . Thus many of the standard sterilization approaches deform, damage, or destroy the integrity of N95 respirator fabric, nosepieces, or elastic straps (3, 4) . Aerosolized or vapor-phase hydrogen peroxide (H2O2) offers promising methods of use for decontamination for N95 respirators, with indications that these methods are non-deforming, non-damaging, and can penetrate the densely-woven fabric of respirator facepieces (3, 5) . In addition, the virucidal capability of H2O2 sterilization methods have been previously demonstrated (6) (7) (8) .