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1.
Rio de Janeiro; SES/RJ; 03/03/2023. 28 p.
Non-conventional Pt | LILACS, SES-RJ | ID: biblio-1418987

Este guia se destina a profissionais que atuam, principalmente, nas Instituições de Acolhimento destinadas à População em Situação de Rua (PSR). Entretanto, vários conceitos e informações que serão apresentados aqui podem ser usados em outros espaços de acolhimento e de oferta de cuidados a esta população, como os de grupos informais e de organizações públicas, governamentais ou não-governamentais.


Tuberculosis/transmission , Tuberculosis, Pulmonary/prevention & control , Ill-Housed Persons/classification , Tuberculosis, Multidrug-Resistant/drug therapy , Brazilian Health Surveillance Agency , Environmental Monitoring , Infection Control/standards , Personal Protective Equipment/virology
2.
Int J Mol Sci ; 23(3)2022 Jan 21.
Article En | MEDLINE | ID: mdl-35163084

International interest in metal-based antimicrobial coatings to control the spread of bacteria, fungi, and viruses via high contact human touch surfaces are growing at an exponential rate. This interest recently reached an all-time high with the outbreak of the deadly COVID-19 disease, which has already claimed the lives of more than 5 million people worldwide. This global pandemic has highlighted the major role that antimicrobial coatings can play in controlling the spread of deadly viruses such as SARS-CoV-2 and scientists and engineers are now working harder than ever to develop the next generation of antimicrobial materials. This article begins with a review of three discrete microorganism-killing phenomena of contact-killing surfaces, nanoprotrusions, and superhydrophobic surfaces. The antimicrobial properties of metals such as copper (Cu), silver (Ag), and zinc (Zn) are reviewed along with the effects of combining them with titanium dioxide (TiO2) to create a binary or ternary contact-killing surface coatings. The self-cleaning and bacterial resistance of purely structural superhydrophobic surfaces and the potential of physical surface nanoprotrusions to damage microbial cells are then considered. The article then gives a detailed discussion on recent advances in attempting to combine these individual phenomena to create super-antimicrobial metal-based coatings with binary or ternary killing potential against a broad range of microorganisms, including SARS-CoV-2, for high-touch surface applications such as hand rails, door plates, and water fittings on public transport and in healthcare, care home and leisure settings as well as personal protective equipment commonly used in hospitals and in the current COVID-19 pandemic.


Anti-Infective Agents/pharmacology , COVID-19/prevention & control , Coated Materials, Biocompatible/pharmacology , Metals/chemistry , Touch , Animals , Anti-Infective Agents/chemical synthesis , Anti-Infective Agents/chemistry , COVID-19/transmission , Coated Materials, Biocompatible/chemical synthesis , Coated Materials, Biocompatible/chemistry , Humans , Pandemics , Personal Protective Equipment/microbiology , Personal Protective Equipment/virology , SARS-CoV-2/drug effects , Surface Properties , Viruses/drug effects
3.
Acta sci., Health sci ; 44: e56401, Jan. 14, 2022.
Article En | LILACS | ID: biblio-1367453

Blood-borne viruses, includingthe human immunodeficiency virus and hepatitis B virus, have certain common epidemiological characteristics and these viruses infect millions of people worldwide. This study aimed to determine the job satisfaction and the level of knowledge and practices regarding infectious diseases of employees working as hairdressers and barbers.This descriptive and cross-sectional study comprised 1200 hairdressers and barbers. The study sample comprised 628 people who consented to participate in the study. The mean age of the participants who participated in the study was 28, 13 ± 6. 9 years. The mean job satisfaction score of the participants was 3.85 ± 0.58. The job satisfaction score was found to be higher among those with sufficient knowledge of hepatitis B (p < 0.005). Employees should be provided performance trainings to achieve job satisfaction. It is recommended that employees be encouraged to wear gloves and gowns to protect their health and prevent contamination.


Humans , Male , Female , Adult , Barbering/instrumentation , HIV , Knowledge , Beauty and Aesthetics Centers , Hepatitis B/epidemiology , Hepatitis B/virology , Hepatitis B virus , Communicable Diseases/transmission , Communicable Diseases/epidemiology , Occupational Health/ethnology , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/virology , Personal Protective Equipment/supply & distribution , Personal Protective Equipment/virology , Job Satisfaction , Occupational Groups
4.
Indoor Air ; 32(1): e12938, 2022 Jan.
Article En | MEDLINE | ID: mdl-34693567

Self-contamination during doffing of personal protective equipment (PPE) is a concern for healthcare workers (HCW) following SARS-CoV-2-positive patient care. Staff may subconsciously become contaminated through improper glove removal; so, quantifying this exposure is critical for safe working procedures. HCW surface contact sequences on a respiratory ward were modeled using a discrete-time Markov chain for: IV-drip care, blood pressure monitoring, and doctors' rounds. Accretion of viral RNA on gloves during care was modeled using a stochastic recurrence relation. In the simulation, the HCW then doffed PPE and contaminated themselves in a fraction of cases based on increasing caseload. A parametric study was conducted to analyze the effect of: (1a) increasing patient numbers on the ward, (1b) the proportion of COVID-19 cases, (2) the length of a shift, and (3) the probability of touching contaminated PPE. The driving factors for the exposure were surface contamination and the number of surface contacts. The results simulate generally low viral exposures in most of the scenarios considered including on 100% COVID-19 positive wards, although this is where the highest self-inoculated dose is likely to occur with median 0.0305 viruses (95% CI =0-0.6 viruses). Dose correlates highly with surface contamination showing that this can be a determining factor for the exposure. The infection risk resulting from the exposure is challenging to estimate, as it will be influenced by the factors such as virus variant and vaccination rates.


Air Pollution, Indoor , COVID-19 , Fomites , Occupational Exposure , Personal Protective Equipment , Fomites/virology , Gloves, Protective/virology , Hospitals , Humans , Personal Protective Equipment/virology , SARS-CoV-2
5.
Ciênc. cuid. saúde ; 21: e58841, 2022. tab, graf
Article Pt | LILACS, BDENF | ID: biblio-1384531

RESUMO Objetivo: realizar a tradução, adaptação cultural e validação da Reason of Using Face Mask Scale entre brasileiros. Métodos: estudo metodológico realizado entre abril e maio de 2020 mediante as seguintes etapas: tradução; síntese das traduções; retrotradução; comitê de juízes; pré-teste e avaliação das propriedades psicométricas. A coleta dos dados foi online a partir de mensagens enviadas por meio de mídias sociais. O questionário foi disponibilizado a partir de um link e os dados armazenados no Google Forms. Utilizou-se a Análise Fatorial Exploratória, testes de Kaiser-Meyer-Olkin e de Esfericidade de Bartlett para constatar se a amostra era adequada e passível de fatoração. Resultados: a escala foi traduzida para o português, avaliada por cinco especialistas, pré-testada com 20 adultos e aplicada em 500 pessoas da população brasileira. O índice de validade de conteúdo para a escala como um todo foi de 0,92. Os valores de Kaiser-Meyer-Olkin (0,639) e teste de esfericidade de Bartlett (p=0,000) indicaram que os itens eram fatoráveis. A variância explicada foi de 62,18%. Na validade de construto por grupos distintos, obteve-se resultado satisfatório (p<0,05). Conclusão: a Versão Brasileira da escalafoi adaptada para a cultura brasileira, sendo válida para avaliar os motivos para o uso de máscaras entre brasileiros.


RESUMEN Objetivo: realizar la traducción, adaptación cultural y validación de la Reason ofUsingFaceMaskScale entre brasileños. Métodos: estudio metodológico realizado entre abril y mayo de 2020 a través de las siguientes etapas: traducción; síntesis de las traducciones; retrotraducción; evaluación por jueces; pretest y evaluación de las propiedades psicométricas. La recolección de datos se realizó online a partir de mensajes enviados a través de redes sociales. La encuesta se hizo disponible a partir de un enlace y los datos almacenados en Google Forms. Se utilizó el Análisis Factorial Exploratorio, pruebas de Kaiser-Meyer-Olkin y de Esfericidad de Bartlett para determinar si la muestra era adecuada y susceptible a la factorización. Resultados: la escala fue traducida al portugués, evaluada por cinco especialistas, pre-testada con 20 adultos y aplicada en 500 personas de la población brasileña. El índice de validez del contenido para la escala como un todo fue de 0,92. Los valores de Kaiser-Meyer-Olkin (0,639) y test de esfericidad de Bartlett (p=0,000) indicaron que los ítems eran susceptibles a la factorización. La varianza explicada fue de 62,18%. En la validez de constructo por grupos distintos se obtuvo resultado satisfactorio (p<0,05). Conclusión: la Versión Brasileña de la escala fue adaptada para la cultura brasileña yes válida para evaluar los motivos para el uso de máscaras entre brasileños.


ABSTRACT Objective: to carry out the translation, cultural adaptation and validation of the Reason of Using Face Mask Scale among Brazilians. Methods: methodological study conducted between April and May 2020 using the following steps: translation; synthesis of translations; back-translation; committee of judges; pre-test and evaluation of psychometric properties. Data collection took place online from messages sent through social media. The questionnaire was made available from a link and the data stored in Google Forms. Exploratory Factor Analysis, Kaiser-Meyer-Olkin and Bartlett's Sphericity tests were used to check if the sample was adequate and factorable. Results: the scale was translated into Portuguese, evaluated by five experts, pre-tested with 20 adults and applied to 500 people from the Brazilian population. The content validity index for the scale as a whole was 0.92. The Kaiser-Meyer-Olkin (0.639) and Bartlett's Sphericity test (p=0.000) values indicated that the items were factorable. The explained variance was 62.18%. In the construct validity for different groups, a satisfactory result was obtained (p<0.05). Conclusion: the Brazilian Version of the scale was adapted to the Brazilian culture and is valid to evaluate the reasons for the use of masks among Brazilians.


Humans , Male , Female , Social Adjustment , Adaptation, Psychological/ethics , Validation Studies as Topic , COVID-19/transmission , Masks/virology , Psychometrics/statistics & numerical data , Translating , Brazil/epidemiology , Cultural Characteristics , Pandemics/prevention & control , Social Networking , Personal Protective Equipment/virology
6.
Sci Rep ; 11(1): 19216, 2021 09 28.
Article En | MEDLINE | ID: mdl-34584143

Global health organizations recommend the use of cloth face coverings to slow the spread of COVID-19. Seemingly overnight, companies whose primary business is in no way related to healthcare or personal protective equipment-from mattresses manufacturers to big box stores-transitioned into the "mask business." Many companies advertise antimicrobial masks containing silver, copper, or other antimicrobials. Often, the techniques used to load such antimicrobials onto mask fibers are undisclosed, and the potential for metal leaching from these masks is yet unknown. We exposed nine so-called "antimicrobial" face masks (and one 100% cotton control mask) to deionized water, laundry detergent, and artificial saliva to quantify the leachable silver and copper that may occur during mask washing and wearing. Leaching varied widely across manufacturer, metal, and leaching solution, but in some cases was as high as 100% of the metals contained in the as-received mask after 1 h of exposure.


COVID-19/prevention & control , Masks , Personal Protective Equipment , Anti-Infective Agents , Filtration , Humans , Masks/virology , Metals , Personal Protective Equipment/virology , SARS-CoV-2 , Textiles
7.
Exp Biol Med (Maywood) ; 246(22): 2381-2390, 2021 11.
Article En | MEDLINE | ID: mdl-34342550

Due to the essential role of dentists in stopping the COVID-19 pandemic, the purpose of this review is to help dentists to detect any weaknesses in their disinfection and cross-contamination prevention protocols, and to triage dental treatments to meet the needs of patients during the pandemic. We used PRISMA to identify peer-reviewed publications which supplemented guidance from the center for disease control about infection control and guidelines for dentists. Dentists must triage dental treatments to meet the needs of patients during the pandemic. The ongoing pandemic has changed the practice of dentistry forever, the changes make it more cumbersome, time-consuming, and costly due to the possible pathways of transmission and mitigation steps needed to prevent the spread of COVID-19. Dental chairside rapid tests for SARS-CoV-2 are urgently needed. Until then, dentists need to screen patients for COVID-19 even though 75% of people with COVID-19 have no symptoms. Despite the widespread anxiety and fear of the devastating health effects of COVID-19, only 61% of dentists have implemented a change to their treatment protocols. As an urgent matter of public health, all dentists must identify the additional steps they can take to prevent the spread of COVID-19. The most effective steps to stop the pandemic in dental offices are to; vaccinate all dentists, staff, and patients; triage dental treatments for patients, separate vulnerable patients, separate COVID-19 patients, prevent cross-contamination, disinfect areas touched by patients, maintain social distancing, and change personal protective equipment between patients.


COVID-19/prevention & control , COVID-19/transmission , Cross Infection/prevention & control , Pandemics/prevention & control , Dental Offices/methods , Dentists , Humans , Infection Control/methods , Personal Protective Equipment/virology , SARS-CoV-2/pathogenicity
8.
Arch Virol ; 166(9): 2487-2493, 2021 Sep.
Article En | MEDLINE | ID: mdl-34231028

The safety of personal protective equipment (PPE) is very important, and so is the choice of materials used. The ability of electrostatic charges (ESCs) generated from the friction of engineered materials to attract or repel viruses has a significant impact on their applications. This study examined the ESCs generated on the surface of PPE used by healthcare workers to enhance their potential effectiveness in protecting the wearer from viruses. This is a crucial consideration for the newly emerged severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which has a negative charge. The magnitudes and signs of generated ESCs on the surfaces of the PPE were determined experimentally using an Ultra Stable Surface DC Voltmeter. The high negative ESCs acquired by the polyethylene disposable cap and facemask are expected to repel negatively charged viruses and prevent them from adhering to the outer layer of the material. Also, the choice of polypropylene for facemasks and gowns is excellent because it is an aggressively negatively charged material in the triboelectric series. This property guarantees that facemasks and gowns can repel viruses from the wearer. However, the positive ESCs generated on latex glove surfaces are of great concern because they can attract negatively charged viruses and create a source of infection. In conclusion, it is necessary to ensure that PPE be made of materials whose surfaces develop a negative ESC to repel viruses, as well as to select polyethylene gloves.


COVID-19/prevention & control , Health Personnel/education , Personal Protective Equipment/virology , SARS-CoV-2/chemistry , COVID-19/transmission , Hair/chemistry , Health Knowledge, Attitudes, Practice , Humans , Latex/chemistry , Materials Testing , Polyethylene/chemistry , Polypropylenes/chemistry , Skin/chemistry , Static Electricity
9.
Internet resource Pt | LIS | ID: lis-48263

As máscaras se tornaram uma das maiores aliadas da população contra a transmissão do Coronavírus desde o início da pandemia. Especialistas alertam que a máscara ainda deve ser item obrigatório no vestuário, tanto para se proteger quanto para evitar a transmissão do vírus que já levou, até esta data (18 de junho de 2021), aproximadamente 496 mil brasileiros a óbito. É importante também saber diferenciar o grau de proteção das máscaras pois, dada material utilizado na fabricação possui uma trama capaz de impedir que parte das gotículas respiratórias que exalamos seja transferida para outra pessoa ou fique no ar.


COVID-19/prevention & control , Pneumonia, Viral/prevention & control , Personal Protective Equipment/virology
10.
World Neurosurg ; 153: e187-e194, 2021 09.
Article En | MEDLINE | ID: mdl-34166828

OBJECTIVE: To assess organizational and technical difficulties of neurosurgical procedures during the coronavirus disease 2019 (COVID-19) pandemic and their possible impact on survival and functional outcome and to evaluate virological exposure risk of medical personnel. METHODS: Data for all urgent surgical procedures performed in the COVID-19 operating room were prospectively collected. Preoperative and postoperative variables included demographics, pathology, Karnofsky performance status (KPS) and neurological status at admission, type and duration of surgical procedures, length of stay, postoperative KPS and functional outcome comparison, and destination at discharge. We defined 5 classes of pathologies (traumatic, oncological, vascular, infection, hydrocephalus) and 4 surgical categories (burr hole, craniotomy, cerebrospinal fluid shunting, spine surgery). Postoperative SARS-CoV-2 infection was checked in all the operators. RESULTS: We identified 11 traumatic cases (44%), 4 infections (16%), 6 vascular events (24%), 2 hydrocephalus conditions (8%), and 2 oncological cases (8%). Surgical procedures included 11 burr holes (44%), 7 craniotomies (28%), 6 cerebrospinal fluid shunts (24%), and 1 spine surgery (4%). Mean patient age was 57.8 years. The most frequent clinical presentation was coma (44 cases). Mean KPS score at admission was 20 ± 10, mean surgery duration was 85 ± 63 minutes, and mean length of stay was 27 ± 12 days. Mean KPS score at discharge was 35 ± 25. Outcome comparison showed improvement in 16 patients. Four patients died. Mean follow-up was 6 ± 3 months. None of the operators developed postoperative SARS-CoV-2 infection. CONCLUSIONS: Standardized protocols are mandatory to guarantee a high standard of care for emergency and urgent surgeries during the COVID-19 pandemic. Personal protective equipment affects maneuverability, dexterity, and duration of interventions without affecting survival and functional outcome.


COVID-19/prevention & control , COVID-19/transmission , Infection Control , Neurosurgical Procedures/mortality , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19 Testing , Emergencies , Female , Humans , Infant , Infection Control/instrumentation , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Italy/epidemiology , Length of Stay/statistics & numerical data , Male , Middle Aged , Operating Rooms/organization & administration , Pandemics , Perioperative Care , Personal Protective Equipment/adverse effects , Personal Protective Equipment/virology , Prospective Studies , SARS-CoV-2 , Survival Analysis , Treatment Outcome
11.
Antimicrob Resist Infect Control ; 10(1): 82, 2021 05 27.
Article En | MEDLINE | ID: mdl-34044893

Aerosolization may occur during reprocessing of medical devices. With the current coronavirus disease 2019 pandemic, it is important to understand the necessity of using respirators in the cleaning area of the sterile processing department. To evaluate the presence of severe acute respiratory syndrome coronavirus (SARS-CoV-2) in the air of the sterile processing department during the reprocessing of contaminated medical devices. Air and surface samples were collected from the sterile processing department of two teaching tertiary hospitals during the reprocessing of respiratory equipment used in patients diagnosed with coronavirus disease 2019 and from intensive care units during treatment of these patients. SARS-CoV-2 was detected only in 1 air sample before the beginning of decontamination process. Viable severe acute respiratory syndrome coronavirus 2 RNA was not detected in any sample collected from around symptomatic patients or in sterile processing department samples. The cleaning of respiratory equipment does not cause aerosolization of SARS-CoV-2. We believe that the use of medical masks is sufficient while reprocessing medical devices during the coronavirus disease 2019 pandemic.


Aerosols , Decontamination , Equipment Reuse , Personal Protective Equipment/virology , SARS-CoV-2/isolation & purification , Air Microbiology , Cross-Sectional Studies , Equipment and Supplies, Hospital/virology , RNA, Viral/isolation & purification , Tertiary Care Centers , Ventilators, Mechanical/virology
12.
Appl Environ Microbiol ; 87(14): e0052621, 2021 06 25.
Article En | MEDLINE | ID: mdl-33962986

The transmission of SARS-CoV-2 is likely to occur through a number of routes, including contact with contaminated surfaces. Many studies have used reverse transcription-PCR (RT-PCR) analysis to detect SARS-CoV-2 RNA on surfaces, but seldom has viable virus been detected. This paper investigates the viability over time of SARS-CoV-2 dried onto a range of materials and compares viability of the virus to RNA copies recovered and whether virus viability is concentration dependent. Viable virus persisted for the longest time on surgical mask material and stainless steel, with a 99.9% reduction in viability by 122 and 114 h, respectively. Viability of SARS-CoV-2 reduced the fastest on a polyester shirt, with a 99.9% reduction within 2.5 h. Viability on the bank note was reduced second fastest, with 99.9% reduction in 75 h. RNA on all surfaces exhibited a 1-log reduction in genome copy number recovery over 21 days. The findings show that SARS-CoV-2 is most stable on nonporous hydrophobic surfaces. RNA is highly stable when dried on surfaces, with only 1-log reduction in recovery over 3 weeks. In comparison, SARS-CoV-2 viability reduced more rapidly, but this loss in viability was found to be independent of starting concentration. Expected levels of SARS-CoV-2 viable environmental surface contamination would lead to undetectable levels within 2 days. Therefore, when RNA is detected on surfaces, it does not directly indicate the presence of viable virus, even at low cycle threshold values. IMPORTANCE This study shows the impact of material type on the viability of SARS-CoV-2 on surfaces. It demonstrates that the decay rate of viable SARS-CoV-2 is independent of starting concentration. However, RNA shows high stability on surfaces over extended periods. This has implications for interpretation of surface sampling results using RT-PCR to determine the possibility of viable virus from a surface, where RT-PCR is not an appropriate technique to determine viable virus. Unless sampled immediately after contamination, it is difficult to align RNA copy numbers to quantity of viable virus on a surface.


COVID-19 , Fomites/virology , Personal Protective Equipment/virology , RNA, Viral/isolation & purification , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Humans , Microbial Viability , Surface Properties
13.
Expert Rev Respir Med ; 15(6): 773-779, 2021 06.
Article En | MEDLINE | ID: mdl-33798401

Introduction: Bronchoscopy and related procedures have unambiguously been affected during the Corona Virus Disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS COV-2). Ordinary bronchoscopy practices and lung cancer services might have changed over this pandemic and for the years to come.Areas covered: This manuscript summarizes the utility of bronchoscopy in COVID-19 patients, and the impact of the pandemic in lung cancer diagnostic services, in view of possible viral spread during these We conducted a literature review of articles published in PubMed/Medline from inception to November 5th, 2020 using relevant terms.Expert opinion: Without doubt this pandemic has changed the way bronchoscopy and related procedures are being performed. Mandatory universal personal protective equipment, pre-bronchoscopy PCR tests, dedicated protective barriers and disposable bronchoscopes might be the safest and simpler way to perform even the most complicated procedures.


Bronchoscopy , COVID-19/epidemiology , COVID-19/therapy , Cross Infection/prevention & control , Practice Patterns, Physicians' , Bronchoscopes/microbiology , Bronchoscopes/standards , Bronchoscopes/virology , Bronchoscopy/instrumentation , Bronchoscopy/methods , Bronchoscopy/standards , COVID-19/prevention & control , COVID-19/transmission , Equipment Contamination/prevention & control , History, 21st Century , Humans , Lung Neoplasms/diagnosis , Medical Oncology/instrumentation , Medical Oncology/methods , Medical Oncology/standards , Pandemics , Personal Protective Equipment/virology , Practice Patterns, Physicians'/standards , Practice Patterns, Physicians'/trends , SARS-CoV-2/physiology
14.
Ann Otol Rhinol Laryngol ; 130(11): 1245-1253, 2021 Nov.
Article En | MEDLINE | ID: mdl-33730891

OBJECTIVES: Define aerosol and droplet risks associated with routine otolaryngology clinic procedures during the COVID-19 era. METHODS: Clinical procedures were simulated in cadaveric heads whose oral and nasal cavities were coated with fluorescent tracer (vitamin B2) and breathing was manually simulated through retrograde intubation. A cascade impactor placed adjacent to the nares collected generated particles with aerodynamic diameters ≤14.1 µm. The 3D printed models and syringes were used to simulate middle and external ear suctioning as well as open suctioning, respectively. Provider's personal protective equipment (PPE) and procedural field contamination were also recorded for all trials using vitamin B2 fluorescent tracer. RESULTS: The positive controls of nebulized vitamin B2 produced aerosol particles ≤3.30 µm and endonasal drilling of a 3D model generated particles ≤14.1 µm. As compared with positive controls, aerosols and small droplets with aerodynamic diameter ≤14.1 µm were not detected during rigid nasal endoscopy, flexible fiberoptic laryngoscopy, and rigid nasal suction of cadavers with simulated breathing. There was minimal to no field contamination in all 3 scenarios. Middle and external ear suctioning and open container suctioning did not result in any detectable droplet contamination. The clinic suction unit contained all fluorescent material without surrounding environmental contamination. CONCLUSION: While patients' coughing and sneezing may create a baseline risk for providers, this study demonstrates that nasal endoscopy, flexible laryngoscopy, and suctioning inherently do not pose an additional risk in terms of aerosol and small droplet generation. An overarching generalization cannot be made about endoscopy or suctioning being an aerosol generating procedure. LEVEL OF EVIDENCE: 3.


Aerosols/adverse effects , COVID-19 , Disease Transmission, Infectious/prevention & control , Endoscopy , Otolaryngology , Risk Adjustment/methods , Suction , COVID-19/prevention & control , COVID-19/transmission , Cadaver , Endoscopy/adverse effects , Endoscopy/instrumentation , Endoscopy/methods , Humans , Otolaryngology/methods , Otolaryngology/standards , Outcome Assessment, Health Care , Personal Protective Equipment/classification , Personal Protective Equipment/virology , Research Design , Risk Assessment/methods , SARS-CoV-2 , Suction/adverse effects , Suction/instrumentation , Suction/methods
15.
Sci Rep ; 11(1): 2051, 2021 01 21.
Article En | MEDLINE | ID: mdl-33479334

The COVID-19 pandemic has led to widespread shortages of personal protective equipment (PPE) for healthcare workers, including of N95 masks (filtering facepiece respirators; FFRs). These masks are intended for single use but their sterilization and subsequent reuse has the potential to substantially mitigate shortages. Here we investigate PPE sterilization using ionized hydrogen peroxide (iHP), generated by SteraMist equipment (TOMI; Frederick, MD), in a sealed environment chamber. The efficacy of sterilization by iHP was assessed using bacterial spores in biological indicator assemblies. After one or more iHP treatments, five models of N95 masks from three manufacturers were assessed for retention of function based on their ability to form an airtight seal (measured using a quantitative fit test) and filter aerosolized particles. Filtration testing was performed at a university lab and at a National Institute for Occupational Safety and Health (NIOSH) pre-certification laboratory. The data demonstrate that N95 masks sterilized using SteraMist iHP technology retain filtration efficiency up to ten cycles, the maximum number tested to date. A typical iHP environment chamber with a volume of ~ 80 m3 can treat ~ 7000 masks and other items (e.g. other PPE, iPADs), making this an effective approach for a busy medical center.


Hydrogen Peroxide/pharmacology , N95 Respirators/virology , Personal Protective Equipment/virology , Sterilization/methods , COVID-19/epidemiology , COVID-19/prevention & control , Equipment Reuse/statistics & numerical data , Humans , N95 Respirators/supply & distribution , Pandemics/prevention & control , Personal Protective Equipment/supply & distribution , Respiratory Protective Devices , SARS-CoV-2/isolation & purification , United States/epidemiology
16.
Int J Infect Dis ; 104: 320-328, 2021 Mar.
Article En | MEDLINE | ID: mdl-33359951

OBJECTIVES: The coronavirus disease 2019 pandemic increased global demand for personal protective equipment (PPE) and resulted in shortages. The study evaluated the re-use of surgical masks and respirators by analysing their performance and safety before and after reprocessing using the following methods: oven, thermal drying, autoclave, and hydrogen peroxide plasma vapour. METHODS: In total, 45 surgical masks and 69 respirators were decontaminated. Visual integrity, air permeability, burst resistance, pressure differential and particulate filtration efficiency of new and decontaminated surgical masks and respirators were evaluated. In addition, 14 used respirators were analysed after work shifts before and after decontamination using reverse transcription polymerase chain reaction (RT-PCR) and viral culturing. Finally, reprocessed respirators were evaluated by users in terms of functionality and comfort. RESULTS: Oven decontamination (75 °C for 45 min) was found to be the simplest decontamination method. Physical and filtration assays indicated that all reprocessing methods were safe after one cycle. Oven decontamination maintained the characteristics of surgical masks and respirators for at least five reprocessing cycles. Viral RNA was detected by RT-PCR in two of the 14 used respirators. Four respirators submitted to viral culture were PCR-negative and culture-negative. Reprocessed respirators used in work shifts were evaluated positively by users, even after three decontamination cycles. CONCLUSION: Oven decontamination is a safe method for reprocessing surgical masks and respirators for at least five cycles, and is feasible in the hospital setting.


COVID-19/prevention & control , Decontamination/methods , Masks/virology , Pandemics , Personal Protective Equipment/virology , SARS-CoV-2/isolation & purification , Ventilators, Mechanical/virology , COVID-19/epidemiology , COVID-19/virology , Equipment Reuse , Hospitals , Hot Temperature , Humans , Hydrogen Peroxide/pharmacology , SARS-CoV-2/genetics
17.
Infect Control Hosp Epidemiol ; 42(4): 381-387, 2021 04.
Article En | MEDLINE | ID: mdl-32900402

OBJECTIVE: To characterize associations between exposures within and outside the medical workplace with healthcare personnel (HCP) SARS-CoV-2 infection, including the effect of various forms of respiratory protection. DESIGN: Case-control study. SETTING: We collected data from international participants via an online survey. PARTICIPANTS: In total, 1,130 HCP (244 cases with laboratory-confirmed COVID-19, and 886 controls healthy throughout the pandemic) from 67 countries not meeting prespecified exclusion (ie, healthy but not working, missing workplace exposure data, COVID symptoms without lab confirmation) were included in this study. METHODS: Respondents were queried regarding workplace exposures, respiratory protection, and extra-occupational activities. Odds ratios for HCP infection were calculated using multivariable logistic regression and sensitivity analyses controlling for confounders and known biases. RESULTS: HCP infection was associated with non-aerosol-generating contact with COVID-19 patients (adjusted OR, 1.4; 95% CI, 1.04-1.9; P = .03) and extra-occupational exposures including gatherings of ≥10 people, patronizing restaurants or bars, and public transportation (adjusted OR range, 3.1-16.2). Respirator use during aerosol-generating procedures (AGPs) was associated with lower odds of HCP infection (adjusted OR, 0.4; 95% CI, 0.2-0.8, P = .005), as was exposure to intensive care and dedicated COVID units, negative pressure rooms, and personal protective equipment (PPE) observers (adjusted OR range, 0.4-0.7). CONCLUSIONS: COVID-19 transmission to HCP was associated with medical exposures currently considered lower-risk and multiple extra-occupational exposures, and exposures associated with proper use of appropriate PPE were protective. Closer scrutiny of infection control measures surrounding healthcare activities and medical settings considered lower risk, and continued awareness of the risks of public congregation, may reduce the incidence of HCP infection.


COVID-19/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Adult , Aged , COVID-19/prevention & control , Case-Control Studies , Female , Global Health/statistics & numerical data , Humans , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Logistic Models , Male , Middle Aged , Occupational Exposure/prevention & control , Occupational Exposure/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , Personal Protective Equipment/virology , Respiratory Protective Devices/statistics & numerical data , Respiratory Protective Devices/virology , Young Adult
18.
ACS Appl Bio Mater ; 4(7): 5485-5493, 2021 07 19.
Article En | MEDLINE | ID: mdl-35006721

Attachment of microbial bodies including the corona virus on the surface of personal protective equipment (PPE) is found to be potential threat of spreading infection. Here, we report the development of a triboelectroceutical fabric (TECF) consisting of commonly available materials, namely, nylon and silicone rubber (SR), for the fabrication of protective gloves on the nitrile platform as model wearable PPE. A small triboelectric device (2 cm × 2 cm) consisting of SR and nylon on nitrile can generate more than 20 V transient or 41 µW output power, which is capable of charging a capacitor up to 65 V in only ∼50 s. The importance of the present work relies on the TECF-led antimicrobial activity through the generation of an electric current in saline water. The fabrication of TECF-based functional prototype gloves can generate hypochlorite ions through the formation of electrolyzed water upon rubbing them with saline water. Further, computational modelling has been employed to reveal the optimum structure and mechanistic pathway of antimicrobial hypochlorite generation. Detailed antimicrobial assays have been performed to establish effectiveness of such TECF-based gloves to reduce the risk from life-threatening pathogen spreading. The present work provides the rationale to consider the studied TECF, or other materials with comparable properties, as a material of choice for the development of self-sanitizing PPE in the fight against microbial infections including COVID-19.


Anti-Infective Agents/chemistry , Electricity , Personal Protective Equipment , Anti-Infective Agents/metabolism , Anti-Infective Agents/pharmacology , Bacterial Proteins/chemistry , Bacterial Proteins/metabolism , Biomimetic Materials/chemistry , Biomimetic Materials/pharmacology , COVID-19/pathology , COVID-19/prevention & control , COVID-19/virology , Humans , Nylons/chemistry , Personal Protective Equipment/microbiology , Personal Protective Equipment/virology , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/metabolism , Recycling , SARS-CoV-2/drug effects , SARS-CoV-2/isolation & purification , SARS-CoV-2/metabolism , Silicone Elastomers/chemistry , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/metabolism
20.
Int J Health Plann Manage ; 36(2): 587-589, 2021 Mar.
Article En | MEDLINE | ID: mdl-33000518

Locally made, washable and reusable personal protective equipment (PPE), used in combination with N95 masks that were reused safely, has proven to be a viable alternative to disposable gowns and caps for hospital staff in low- and middle-income countries. Muhimbili University Hospital's children's cancer ward in Dar es Salaam, Tanzania, developed locally made PPE and created rigorous cleaning and disinfecting protocols, when the daily use of imported, disposable materials were not an option. These items continue to protect staff, children and parents. The novel PPE approach was able to prevent staff from becoming infected during the pandemic despite the fact that several parents, and subsequently their children, became infected with Covid-19 during cancer treatment at the facility.


COVID-19/prevention & control , Disinfection/methods , Masks , Personal Protective Equipment , Personnel, Hospital , Disinfection/standards , Humans , Masks/virology , Personal Protective Equipment/virology , Tanzania
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