RESUMO
Surgical masks have become critical for protecting human health against the COVID-19 pandemic, even though their environmental burden is a matter of ongoing debate. This study aimed at shedding light on the environmental impacts of single-use (i.e., MD-Type I) versus reusable (i.e., MD-Type IIR) face masks via a comparative life cycle assessment with a cradle-to-grave system boundary. We adopted a two-level analysis using the ReCiPe (H) method, considering both midpoint and endpoint categories. The results showed that reusable face masks created fewer impacts for most midpoint categories. At the endpoint level, reusable face masks were superior to single-use masks, producing scores of 16.16 and 84.20 MPt, respectively. The main environmental impacts of single-use masks were linked to raw material consumption, energy requirements and waste disposal, while the use phase and raw material consumption made the most significant contribution for reusable type. However, our results showed that lower environmental impacts of reusable face masks strongly depend on the use phase since reusable face masks lost their superior performance when the hand wash scenario was tested. Improvement of mask eco-design emerged as another key factor such as using more sustainable raw materials and designing better waste disposal scenarios could significantly lower the environmental impacts.
Assuntos
COVID-19/prevenção & controle , Máscaras/normas , Equipamento de Proteção Individual/normas , Têxteis/normas , COVID-19/epidemiologia , COVID-19/virologia , Equipamentos Descartáveis/normas , Ecossistema , Meio Ambiente , Reutilização de Equipamento/normas , Humanos , Máscaras/classificação , Pandemias/prevenção & controle , Equipamento de Proteção Individual/classificação , Saúde Pública/métodos , SARS-CoV-2/fisiologia , Têxteis/classificaçãoRESUMO
Abstract The new coronavirus pandemic (COVID-19) is a global problem that is having severe impacts on health systems worldwide. One particular characteristic of this virus is its high transmission rate, which has led to a high demand for personal care materials such as masks, gloves, and alcohol for asepsis. Seventy percent is the ideal concentration for the ethanol used in hand sanitizers; however, this concentration can be expressed in different ways, and, consequently, the different solutions will have different antiseptic activity. In this manuscript we comment on some characteristics of alcohol-based preparations and the different ways of expressing the concentrations.
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Coronavirus , Etanol/efeitos adversos , Higienizadores de Mão/análise , COVID-19/prevenção & controle , Assepsia , Produtos para Higiene Pessoal , Pandemias , Máscaras/classificaçãoRESUMO
Management of the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has relied in part on the use of personal protective equipment (PPE). Face masks, as a representative example of PPE, have made a particularly significant contribution. However, most commonly used face masks are made of materials lacking inactivation properties against either SARS-CoV-2 or multidrug-resistant bacteria. Therefore, symptomatic and asymptomatic individuals wearing masks can still infect others due to viable microbial loads escaping from the masks. Moreover, microbial contact transmission can occur by touching the mask, and the discarded masks are an increasing source of contaminated biological waste and a serious environmental threat. For this reason, during the current pandemic, many researchers have worked to develop face masks made of advanced materials with intrinsic antimicrobial, self-cleaning, reusable, and/or biodegradable properties, thereby providing extra protection against pathogens in a sustainable manner. To overview this segment of the remarkable efforts against COVID-19, this review describes the different types of commercialized face masks, their main fabrication methods and treatments, and the progress achieved in face mask development.
Assuntos
Máscaras/tendências , Anti-Infecciosos/química , Anti-Infecciosos/farmacologia , Biodegradação Ambiental , COVID-19/prevenção & controle , COVID-19/virologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Humanos , Máscaras/classificação , Reciclagem , SARS-CoV-2/efeitos dos fármacos , SARS-CoV-2/isolamento & purificaçãoRESUMO
The use of face masks by the general population during viral outbreaks such as the COVID-19 pandemic, although at times controversial, has been effective in slowing down the spread of the virus. The extent to which face masks mitigate the transmission is highly dependent on how well the mask fits each individual. The fit of simple cloth masks on the face, as well as the resulting perimeter leakage and face mask efficacy, are expected to be highly dependent on the type of mask and facial topology. However, this effect has, to date, not been adequately examined and quantified. Here, we propose a framework to study the efficacy of different mask designs based on a quasi-static mechanical model of the deployment of face masks onto a wide range of faces. To illustrate the capabilities of the proposed framework, we explore a simple rectangular cloth mask on a large virtual population of subjects generated from a 3D morphable face model. The effect of weight, age, gender, and height on the mask fit is studied. The Centers for Disease Control and Prevention (CDC) recommended homemade cloth mask design was used as a basis for comparison and was found not to be the most effective design for all subjects. We highlight the importance of designing masks accounting for the widely varying population of faces. Metrics based on aerodynamic principles were used to determine that thin, feminine, and young faces were shown to benefit from mask sizes smaller than that recommended by the CDC. Besides mask size, side-edge tuck-in, or pleating, of the masks as a design parameter was also studied and found to have the potential to cause a larger localized gap opening.
Assuntos
COVID-19/prevenção & controle , Face/anatomia & histologia , Máscaras/normas , SARS-CoV-2/isolamento & purificação , Têxteis/normas , Adolescente , Adulto , Algoritmos , COVID-19/epidemiologia , COVID-19/virologia , Criança , Estudos de Coortes , Simulação por Computador , Feminino , Humanos , Imageamento Tridimensional , Masculino , Máscaras/classificação , Pessoa de Meia-Idade , Modelos Teóricos , Pandemias , SARS-CoV-2/fisiologia , Adulto JovemRESUMO
OBJECTIVE: To determine leakage for two neonatal continuous positive airway pressure (CPAP) interfaces and evaluate leak-corrective manoeuvres. DESIGN: The ToNIL (Trial of NCPAP Interface Leakage) study was a randomised, clinical, cross-over trial with data collection between August 2018 and October 2019. The primary outcome was blinded to the treating staff. SETTING: One secondary, 8-bed neonatal intensive care unit (NICU) and three larger (>15 beds), academic NICU referral centres. PATIENTS: Newborn infants with CPAP were screened (n=73), and those with stable spontaneous breathing, low oxygen requirement, postmenstrual age (PMA) over 28 weeks and no comorbidities were eligible. In total, 50 infants were included (median PMA 33 completed weeks). INTERVENTIONS: Leakage was measured for both prongs and nasal mask, before and after leak-corrective manoeuvres. Interface application was performed in a randomised order by a nurse, blinded to the measured leakage. MAIN OUTCOME MEASURES: 30 s average leakage, measured in litres per minute (LPM). RESULTS: Analyses showed a significantly lower leakage (mean difference 0.86 LPM, 95% CI 0.07 to 1.65) with prongs (median 2.01 LPM, IQR 1.00-2.80) than nasal mask (median 2.45 LPM, IQR 0.99-5.11). Leak-corrective manoeuvres reduced leakage significantly for both prongs (median 1.22 LPM, IQR 0.54-1.87) and nasal mask (median 2.35 LPM, IQR 0.76-4.75). CONCLUSIONS: Large leakages were common for both interfaces, less with prongs. Simple care manoeuvres reduced leakage for both interfaces. This is the first report of absolute leakage for nasal interfaces and should encourage further studies on leakage during CPAP treatment.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Falha de Equipamento/estatística & dados numéricos , Cuidado do Lactente , Máscaras , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Pressão Positiva Contínua nas Vias Aéreas/instrumentação , Pressão Positiva Contínua nas Vias Aéreas/métodos , Estudos Cross-Over , Feminino , Idade Gestacional , Humanos , Cuidado do Lactente/instrumentação , Cuidado do Lactente/métodos , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Máscaras/efeitos adversos , Máscaras/classificação , Máscaras/normas , Avaliação de Processos e Resultados em Cuidados de Saúde , Síndrome do Desconforto Respiratório do Recém-Nascido/terapiaRESUMO
Wearing face masks is recommended for the prevention of contracting or exposing others to cardiorespiratory infections, such as COVID-19. Controversy exists on whether wearing face masks during vigorous exercise affects performance. We used a randomized, counterbalanced cross-over design to evaluate the effects of wearing a surgical mask, a cloth mask, or no mask in 14 participants (7 men and 7 women; 28.2 ± 8.7 y) during a cycle ergometry test to exhaustion. Arterial oxygen saturation (pulse oximetry) and tissue oxygenation index (indicator of hemoglobin saturation/desaturation) at vastus lateralis (near-infrared spectroscopy) were assessed throughout the exercise tests. Wearing face masks had no effect on performance (time to exhaustion (mean ± SD): no mask 622 ± 141 s, surgical mask 657 ± 158 s, cloth mask 637 ± 153 s (p = 0.20); peak power: no mask 234 ± 56 W, surgical mask 241 ± 57 W, cloth mask 241 ± 51 W (p = 0.49)). When expressed relative to peak exercise performance, no differences were evident between wearing or not wearing a mask for arterial oxygen saturation, tissue oxygenation index, rating of perceived exertion, or heart rate at any time during the exercise tests. Wearing a face mask during vigorous exercise had no discernable detrimental effect on blood or muscle oxygenation, and exercise performance in young, healthy participants (ClinicalTrials.gov, NCT04557605).
Assuntos
Infecções por Coronavirus/prevenção & controle , Exercício Físico , Máscaras/classificação , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Betacoronavirus , COVID-19 , Teste de Esforço , Feminino , Humanos , Masculino , Oximetria , Consumo de Oxigênio , SARS-CoV-2 , Adulto JovemRESUMO
Guidelines from the CDC and the WHO recommend the wearing of face masks to prevent the spread of coronavirus (CoV) disease 2019 (COVID-19); however, the protective efficiency of such masks against airborne transmission of infectious severe acute respiratory syndrome CoV-2 (SARS-CoV-2) droplets/aerosols is unknown. Here, we developed an airborne transmission simulator of infectious SARS-CoV-2-containing droplets/aerosols produced by human respiration and coughs and assessed the transmissibility of the infectious droplets/aerosols and the ability of various types of face masks to block the transmission. We found that cotton masks, surgical masks, and N95 masks all have a protective effect with respect to the transmission of infective droplets/aerosols of SARS-CoV-2 and that the protective efficiency was higher when masks were worn by a virus spreader. Importantly, medical masks (surgical masks and even N95 masks) were not able to completely block the transmission of virus droplets/aerosols even when completely sealed. Our data will help medical workers understand the proper use and performance of masks and determine whether they need additional equipment to protect themselves from infected patients.IMPORTANCE Airborne simulation experiments showed that cotton masks, surgical masks, and N95 masks provide some protection from the transmission of infective SARS-CoV-2 droplets/aerosols; however, medical masks (surgical masks and even N95 masks) could not completely block the transmission of virus droplets/aerosols even when sealed.
Assuntos
Aerossóis , Microbiologia do Ar , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Máscaras/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Betacoronavirus , COVID-19 , Pessoal de Saúde/educação , Humanos , Máscaras/classificação , SARS-CoV-2RESUMO
The rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) has resulted in a global pandemic. Correct facemask wearing is valuable for infectious disease control, but the effectiveness of facemasks has been diminished, mostly due to improper wearing. However, there have not been any published reports on the automatic identification of facemask-wearing conditions. In this study, we develop a new facemask-wearing condition identification method by combining image super-resolution and classification networks (SRCNet), which quantifies a three-category classification problem based on unconstrained 2D facial images. The proposed algorithm contains four main steps: Image pre-processing, facial detection and cropping, image super-resolution, and facemask-wearing condition identification. Our method was trained and evaluated on the public dataset Medical Masks Dataset containing 3835 images with 671 images of no facemask-wearing, 134 images of incorrect facemask-wearing, and 3030 images of correct facemask-wearing. Finally, the proposed SRCNet achieved 98.70% accuracy and outperformed traditional end-to-end image classification methods using deep learning without image super-resolution by over 1.5% in kappa. Our findings indicate that the proposed SRCNet can achieve high-accuracy identification of facemask-wearing conditions, thus having potential applications in epidemic prevention involving COVID-19.
Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Máscaras , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Algoritmos , COVID-19 , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Bases de Dados Factuais , Aprendizado Profundo , Face , Humanos , Processamento de Imagem Assistida por Computador/métodos , Processamento de Imagem Assistida por Computador/estatística & dados numéricos , Máscaras/classificação , Máscaras/estatística & dados numéricos , Redes Neurais de Computação , Pneumonia Viral/epidemiologia , SARS-CoV-2RESUMO
BACKGROUND: In a previous randomised controlled trial (RCT) in hospital healthcare workers (HCWs), cloth masks resulted in a higher risk of respiratory infections compared with medical masks. This was the only published RCT of cloth masks at the time of the COVID-19 pandemic. OBJECTIVE: To do a post hoc analysis of unpublished data on mask washing and mask contamination from the original RCT to further understand poor performance of the two-layered cotton cloth mask used by HCWs in that RCT. SETTING: 14 secondary-level/tertiary-level hospitals in Hanoi, Vietnam. PARTICIPANTS: A subgroup of 607 HCWs aged ≥18 years working full time in selected high-risk wards, who used a two-layered cloth mask and were part of a randomised controlled clinical trial comparing medical masks and cloth masks. INTERVENTION: Washing method for cloth masks (self-washing or hospital laundry). A substudy of contamination of a sample of 15 cloth and medical masks was also conducted. OUTCOME MEASURE: Infection rate over 4 weeks of follow up and viral contamination of masks tested by multiplex PCR. RESULTS: Viral contamination with rhinovirus was identified on both used medical and cloth masks. Most HCW (77% of daily washing) self-washed their masks by hand. The risk of infection was more than double among HCW self-washing their masks compared with the hospital laundry (HR 2.04 (95% CI 1.03 to 4.00); p=0.04). There was no significant difference in infection between HCW who wore cloth masks washed in the hospital laundry compared with medical masks (p=0.5). CONCLUSIONS: Using self-reported method of washing, we showed double the risk of infection with seasonal respiratory viruses if masks were self-washed by hand by HCWs. The majority of HCWs in the study reported hand-washing their mask themselves. This could explain the poor performance of two layered cloth masks, if the self-washing was inadequate. Cloth masks washed in the hospital laundry were as protective as medical masks. Both cloth and medical masks were contaminated, but only cloth masks were reused in the study, reiterating the importance of daily washing of reusable cloth masks using proper method. A well-washed cloth mask can be as protective as a medical mask. TRIAL RESGISTRATION NUMBER: ACTRN12610000887077.
Assuntos
Infecções por Coronavirus , Desinfecção , Contaminação de Equipamentos , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Máscaras , Pandemias , Recursos Humanos em Hospital/estatística & dados numéricos , Pneumonia Viral , Adulto , Betacoronavirus , COVID-19 , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Desinfecção/métodos , Desinfecção/normas , Desinfecção/estatística & dados numéricos , Contaminação de Equipamentos/prevenção & controle , Contaminação de Equipamentos/estatística & dados numéricos , Feminino , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Controle de Infecções/normas , Masculino , Máscaras/classificação , Máscaras/normas , Máscaras/provisão & distribuição , Exposição Ocupacional/análise , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , SARS-CoV-2 , Vietnã/epidemiologiaRESUMO
BACKGROUND: Data on the filtration efficacies of various masks against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are limited. We thus evaluate the effectiveness of the surgical mask, the N95 respirator mask, and its equivalent (KF94 mask) in filtering SARS-CoV-2. METHODS: Patients hospitalised with SARS-CoV-2 infection were instructed to cough five times each while wearing (1) no mask, (2) surgical mask, (3) KF94 mask, and (4) N95 mask. The coughs were separated by 20-second intervals, and the patients were rested for at least 5 min between each setting. SARS-CoV-2 viral loads in patient samples (i.e. nasopharyngeal swabs and saliva), petri dishes placed in front of the patients during coughing, and swabs from the outer and inner surfaces of the masks were analysed with PCR. RESULTS: A total of 7 patients with SARS-CoV-2 infection participated in the mask test. SARS-CoV-2 was detected on the petri dishes after coughing in 3 out of 7 cases with the surgical mask or no mask. Viral particles were not found in the petri dishes after coughing while wearing the N95 mask or the KF94 mask. While viral particles were detected in both the inner and outer surfaces of the surgical masks, those were detected only in the inner surfaces of the N95 and K94 masks. CONCLUSION: Surgical masks were less effective in filtering viral particles from coughing patients with SARS-CoV-2 infection. N95 masks and its equivalents efficiently blocked SARS-CoV-2 particles from coughing patients.
Assuntos
Betacoronavirus/química , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Máscaras/normas , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Adolescente , Adulto , Idoso , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , COVID-19 , Infecções por Coronavirus/transmissão , Tosse/virologia , Feminino , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Masculino , Máscaras/classificação , Pessoa de Meia-Idade , Pneumonia Viral/transmissão , República da Coreia , SARS-CoV-2 , Carga Viral , Adulto JovemAssuntos
COVID-19 , Controle de Doenças Transmissíveis/instrumentação , Transmissão de Doença Infecciosa/prevenção & controle , Monitoramento Epidemiológico , Máscaras , Fotografação/métodos , África/epidemiologia , América/epidemiologia , Ásia/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Saúde Global/estatística & dados numéricos , Humanos , Máscaras/classificação , Máscaras/estatística & dados numéricos , SARS-CoV-2 , Medicina de Viagem/métodosRESUMO
Importance: Procuring respiratory protection for clinicians and other health care workers has become a major challenge of the coronavirus disease 2019 (COVID-19) pandemic and has resulted in nonstandard practices such as the use of expired respirators and various decontamination processes to prolong the useful life of respirators in health care settings. In addition, imported, non-National Institute for Occupational Safety and Health (NIOSH)-approved respirators have been donated or acquired by hospitals as a potential replacement for limited NIOSH-approved N95 respirators. Objective: To assess fitted filtration efficiencies (FFEs) for face mask alternatives used during the COVID-19 pandemic. Design, Setting, and Participants: For this quality-improvement study conducted between April and June 2020, we used the Occupational Safety and Health Administration's Quantitative Fit Testing Protocol for Filtering Facepiece Respirators in a laboratory atmosphere supplemented with sodium chloride particles to assess the FFEs of a variety of respirators worn by a male volunteer and female volunteer. Main Outcomes and Measures: The FFEs of respirators commonly worn by clinicians and other health care workers and available respirator alternatives during the COVID-19 pandemic. Results: Of the 29 different fitted face mask alternatives tested on 1 man and 1 woman, expired N95 respirators with intact elastic straps and respirators subjected to ethylene oxide and hydrogen peroxide sterilization had unchanged FFE (>95%). The performance of N95 respirators in the wrong size had slightly decreased performance (90%-95% FFE). All of the respirators not listed as approved in this evaluation (n = 6) failed to achieve 95% FFE. Neither of the 2 imported respirators authorized for use by the Centers for Disease Control and Prevention that were not NIOSH-approved tested in this study achieved 95% FFE, and the more effective of the 2 functioned at approximately 80% FFE. Surgical and procedural face masks had filtering performance that was lower relative to that of N95 respirators (98.5% overall FFE), with procedural face masks secured with elastic ear loops showing the lowest efficiency (38.1% overall FFE). Conclusions and Relevance: This quality-improvement study evaluating 29 face mask alternatives for use by clinicians interacting with patients during the COVID-19 pandemic found that expired N95 respirators and sterilized, used N95 respirators can be used when new N95 respirators are not available. Other alternatives may provide less effective filtration.
Assuntos
COVID-19 , Reutilização de Equipamento/normas , Filtração/normas , Controle de Infecções/instrumentação , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Máscaras , Respiradores N95 , Esterilização , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Desinfetantes , Contaminação de Equipamentos/prevenção & controle , Análise de Falha de Equipamento/métodos , Óxido de Etileno/farmacologia , Pessoal de Saúde , Humanos , Peróxido de Hidrogênio/farmacologia , Máscaras/classificação , Máscaras/normas , Máscaras/provisão & distribuição , Teste de Materiais/métodos , Respiradores N95/normas , Respiradores N95/provisão & distribuição , Melhoria de Qualidade , SARS-CoV-2 , Esterilização/métodos , Esterilização/normasRESUMO
Objective to analyze scientific evidence on the efficacy of cloth masks in preventing COVID-19 and other respiratory infections. Method integrative literature review based on the following guiding question: What is the efficacy of cloth face masks in absorbing particles that cause respiratory infection? The search was conducted in eight electronic databases, without any restriction in terms of language or period. Results low coverage cloth face masks made of 100% cotton, scarf, pillowcase, antimicrobial pillowcase, silk, linen, tea towel, or vacuum bag, present marginal/reasonable protection against particles while high coverage cloth masks provide high protection. Conclusion cloth face masks are a preventive measure with moderate efficacy in preventing the dissemination of respiratory infections caused by particles with the same size or smaller than those of SARS-CoV-2. The type of fabric used, number of layers and frequency of washings influence the efficacy of the barrier against droplets.
Assuntos
Infecções por Coronavirus/prevenção & controle , Máscaras , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções Respiratórias/prevenção & controle , Betacoronavirus , COVID-19 , Humanos , Máscaras/classificação , SARS-CoV-2RESUMO
INTRODUCTION: The health emergency caused by the spread of SARS-COV-2 virus has required the adoption of passive measures against contagion, such as social distancing. The use of filtering masks, of the different types available on the market, such as surgical and facial filtering masks (FFP1, FFP2 and FFP3), is also recommended. OBJECTIVES: The aim of this paper, within the Italian and European regulatory reference framework, is to suggest a rational application of existing methodologies that enable to know and assess the features and/or make a face mask intended to be used by the community. In addition to this, the study aims to provide a correct regulatory framework and useful information for a correct use and disposal of face masks. Another purpose is the assessment of the hygienic, sanitary and regulatory aspects related to the use and disposal of face masks. METHODS: The analysis of filtering masks is based on the review of scientific literature, the state of art of technology and the filtering means/materials available. Reference is made to filtering mechanisms and devices, the testing methods, the technical, manufacturing and performance features, and to the Italian and European regulatory reference framework. Reference is also made to the hygienic, sanitary and regulatory aspects related to the use and disposal of face masks. RESULTS: Surgical masks or, alternatively, filtering masks with a filtration efficiency between 90% and 95% for 3-µm particles, are the most practicable choice with minor contraindications. The reusable type of mask is conceptually superior compared to single-use masks, but cleaning procedures to be followed are quite complex and not always described in a clear way. CONCLUSIONS: The definition of rigorous and repeatable tests on mask filtration capacity, breathability, wearability, duration of use, regeneration, as well as safe disposal methods, are the main way to provide users with correct selection and use criteria. The results must be disclosed and disseminated quickly.
Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/prevenção & controle , Filtração/instrumentação , Higiene/normas , Máscaras/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Têxteis/normas , COVID-19 , Desenho de Equipamento , Europa (Continente) , França , Humanos , Higiene/legislação & jurisprudência , Itália , Máscaras/classificação , Eliminação de Resíduos de Serviços de Saúde/legislação & jurisprudência , Eliminação de Resíduos de Serviços de Saúde/métodos , Eliminação de Resíduos de Serviços de Saúde/normas , SARS-CoV-2RESUMO
BACKGROUND AND OBJECTIVE: In the COVID-19 pandemic, the demand of masks has been increased by health professionals and the general population. In this context, it is necessary to summarize the features and indications of the different types of masks. MATERIAL AND METHODS: To consult and to compile the different recommendations disseminated by prestigious institutions such as the World Health Organization, the European Center for Disease Prevention, the Center for Evidence-Based Medicine, or the Ministry of Health of the Government of Spain has been reviewed. RESULTS: The institutions consulted recommend reserving FFP respirators for healthcare workers, especially when carrying out aerosol-generating procedures (AGPs) (minimum FFP2 protection) and consider some reutilization systems during times of scarcity. The use of surgical masks is recommended to professionals who do not perform AGPs and to the symptomatic population but exist variations in its indications intended for the general healthy population. CONCLUSION: In the context of shortage of personal protective equipment due to the COVID-19 pandemic, a prioritization and rationalization of the use of each type of mask should be established according to the user and the activity performed.
Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Guias como Assunto , Máscaras/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dispositivos de Proteção Respiratória/normas , COVID-19 , Infecções por Coronavirus/epidemiologia , Contaminação de Equipamentos , Reutilização de Equipamento/normas , Filtração/instrumentação , Pessoal de Saúde , Humanos , Higiene/normas , Máscaras/classificação , Máscaras/provisão & distribuição , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , SARS-CoV-2 , Espanha/epidemiologiaAssuntos
Viagem Aérea/estatística & dados numéricos , COVID-19 , Transmissão de Doença Infecciosa/prevenção & controle , Máscaras/classificação , SARS-CoV-2/isolamento & purificação , Doença Relacionada a Viagens , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Feminino , Humanos , Controle de Infecções/métodos , Israel/epidemiologia , Masculino , Pessoa de Meia-IdadeRESUMO
The new SARS-CoV-2 pandemic is an example of an international public health emergency, which is associated with considerable social and economic challenges. At the healthcare level there is the risk that nosocomial outbreaks can be local amplifiers. Adequate infection control practices are of critical importance, which include proper use of personal protective equipment. This equipment must be appropriate to the pathogen transmission route that, in the case of SARS-CoV-2, occurs through droplet and contact routes. The infected individual, when talking, coughing or sneezing, spreads droplets containing the virus, directly contaminating other individuals within one to two meters of distance, as well as the surrounding environment. Airborne transmission may occur when aerosol-generating procedures are performed. Concerning respiratory protection, there is currently weak evidence that the use of respirators provides better protection than surgical masks for SARS-CoV-2 or other viruses (with the exception of aerosol-generating procedures, in which case the use of a respirator is recommended). Eye protection should be guaranteed whenever there is a risk of splashes, droplets or aerosols. The use of different, or higher than necessary, level of personal protective equipment, for the transmission route of the agent, is a form of misuse and can affect its supply for situations when it is clearly indicated. The adequate provision of protective equipment, as well as training of healthcare professionals in its correct use, is highly recommended to ensure safety of care.
A nova pandemia por SARS-CoV-2 é um exemplo de uma emergência de saúde pública de âmbito internacional, associada a consideráveis desafios sociais e económicos. A nível das unidades de saúde há o risco que surtos nosocomiais sejam amplificadores locais. Perante tal, práticas de controlo de infeção são de importância crítica no funcionamento destes serviços, de que faz parte a utilização adequada de equipamento de proteção individual. Este deve ser adequado à via de transmissão do agente que, no caso do SARS-CoV-2, é através de gotícula e contacto. O indivíduo infetado, ao falar, tossir ou espirrar, dissemina gotículas que contêm o vírus, contaminando diretamente outros indivíduos, que estão num raio de um a dois metros, assim como o ambiente. A transmissão por via aérea também poderá ocorrer, no caso de procedimentos geradores de aerossóis. A nível da proteção respiratória existe, atualmente, fraca evidência que a utilização de respiradores permita maior proteção que máscara cirúrgica para o SARS-CoV-2 ou outros vírus(com exceção dos procedimentos geradores de aerossóis, em que a utilização de um respirador é recomendada). A proteção ocular deverá ser garantida sempre que houver risco de salpicos, gotículas ou aerossóis. A utilização incorreta de equipamento de proteção individual, para a via de transmissão do agente ou superior ao necessário, é uma forma de uso indevido e pode afetar o seu suprimento para as situações em que é realmente indicado. A disponibilização deste equipamento de proteção, e formação dos profissionais de saúde na sua correta utilização, é fortemente recomendado para garantir a prestação de cuidados seguros.
Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Dispositivos de Proteção dos Olhos , Pessoal de Saúde , Controle de Infecções , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Microbiologia do Ar , Broncoscopia/efeitos adversos , COVID-19 , Infecções Comunitárias Adquiridas/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/transmissão , Face , Humanos , Higiene , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Intubação Intratraqueal/efeitos adversos , Máscaras/classificação , Máscaras/provisão & distribuição , Equipamento de Proteção Individual/provisão & distribuição , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , SARS-CoV-2 , Equipamentos Cirúrgicos/efeitos adversosRESUMO
Masks are widely discussed during the course of the ongoing COVID-19 pandemic. Most hospitals have implemented universal masking for their healthcare workers, and the Center for Disease Control currently advises even the general public to wear cloth masks when outdoors. The pertinent need for masks arises from plausible dissemination of the SARS-CoV-2 through close contacts, as well as the possibility of virus transmission from asymptomatic, pre-symptomatic, and mildly symptomatic individuals. Given current global shortages in personal protective equipment, the efficacy of various types of masks: N95 respirators, surgical masks, and cloth masks are researched. To accommodate limited supplies, techniques for extended use, reuse, and sterilization of masks are strategized. However, masks alone may not greatly slow down the COVID-19 pandemic unless they are coupled with adequate social distancing, diligent hand hygiene, and other proven preventive measures.