Vapourized hydrogen peroxide decontamination in a hospital setting inactivates SARS-CoV-2 and HCoV-229E without compromising filtration efficiency of unexpired N95 respirators

Natasha Christie-Holmes; Rachel Tyli; Patrick Budylowski; Furkan Guvenc; Amit Weiner; Betty Poon; Mary Speck; Stephenie Naugler; Allen Rainville; Ayoob Ghalami; Shannon McCaw; Steven Hayes; Samira Mubareka; Scott D Gray-Owen; Ori D Rotstein; Rita A Kandel; James A Scott

doi:10.1016/j.ajic.2021.07.012

Vapourized hydrogen peroxide decontamination in a hospital setting inactivates SARS-CoV-2 and HCoV-229E without compromising filtration efficiency of unexpired N95 respirators

Am J Infect Control. 2021 Oct;49(10):1227-1231. doi: 10.1016/j.ajic.2021.07.012. Epub 2021 Jul 25.

Authors

Natasha Christie-Holmes¹, Rachel Tyli², Patrick Budylowski³, Furkan Guvenc⁴, Amit Weiner⁴, Betty Poon¹, Mary Speck², Stephenie Naugler⁵, Allen Rainville⁵, Ayoob Ghalami⁶, Shannon McCaw⁶, Steven Hayes⁵, Samira Mubareka⁷, Scott D Gray-Owen⁴, Ori D Rotstein⁵, Rita A Kandel⁸, James A Scott⁹

Affiliations

¹ Combined Containment Level 3 Unit, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada M5S 1A8.
² Dalla Lana School of Public Health, University of Toronto, 223 College Street, Toronto, ON, Canada, M5T 1R4.
³ Combined Containment Level 3 Unit, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada M5S 1A8; Institute of Medicine, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, Canada, M5S 1A8.
⁴ Combined Containment Level 3 Unit, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada M5S 1A8; Department of Molecular Genetics, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON Canada M5S 1A8.
⁵ Unity Health Toronto, 30 Bond St, Toronto, ON Canada M5B 1W8.
⁶ Office of Environmental Health & Safety, University of Toronto, 215 Huron St, Toronto, ON Canada M5S 1A2.
⁷ Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, Toronto, ON, Canada, M5S 1A8; Sunnybrook Health Sciences Centre, 2075 Bayview Av, Toronto, ON Canada M4N 3M5.
⁸ Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, Toronto, ON, Canada, M5S 1A8.
⁹ Dalla Lana School of Public Health, University of Toronto, 223 College Street, Toronto, ON, Canada, M5T 1R4; Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, Toronto, ON, Canada, M5S 1A8. Electronic address: james.scott@utoronto.ca.

Abstract

Background: The COVID-19 pandemic highlighted the need for evidence-based approaches to decontamination and reuse of N95 filtering facepiece respirators (FFRs). We sought to determine whether vapourized hydrogen peroxide (VHP) reduced SARS-CoV-2 bioburden on FFRs without compromising filtration efficiency. We also investigated coronavirus HCoV-229E as a surrogate for decontamination validation testing.

Methods: N95 FFRs were laced with SARS-CoV-2 or HCoV-229E and treated with VHP in a hospital reprocessing facility. After sterilization, viral burden was determined using viral outgrowth in a titration assay, and filtration efficiency of FFRs was tested against ATSM F2299 and NIOSH TEB-STP-APR-0059.

Results: Viable SARS-CoV-2 virus was not detected after VHP treatment. One replicate of the HCoV-229E laced FFRs yielded virus after processing. Unexpired N95 FFRs retained full filtration efficiency after VHP processing. Expired FFRs failed to meet design-specified filtration efficiency and therefore are unsuitable for reprocessing.

Discussion: In-hospital VHP is an effective decontaminant for SARS-CoV-2 on FFRs. Further, filtration efficiency of unexpired respirators is not affected by this decontamination process.

Conclusions: VHP is effective in inactivating SARS-CoV-2 on FFRs without compromising filtration efficiency. HCoV-229E is a suitable surrogate for SARS-CoV-2 for disinfection studies.

Keywords: COVID-19; HCoV-229E; Hydrogen peroxide vapor; Mask reprocessing; N95; Respiratory protection; SARS-CoV-2.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Coronavirus 229E, Human*
Decontamination
Disinfection
Equipment Reuse
Hospitals
Humans
Hydrogen Peroxide / pharmacology
N95 Respirators
Pandemics
SARS-CoV-2

Substances

Hydrogen Peroxide