Hamzavi, Iltefat H

Lim, Henry W

Ozog, David M

Torres, Angeli E

English

Henry Ford Health System Scholarly Commons

Henry Ford Health System Henry Ford Health System Scholarly Commons Dermatology Articles Dermatology 5-21-2020 Notes and Comments on "Proposed Approach for Re-using Surgical Masks in COVID-19 Pandemic" Angeli E. Torres Henry Ford Health System, atorres5@hfhs.org David M. Ozog Henry Ford Health System, dozog1@hfhs.org Iltefat H. Hamzavi Henry Ford Health System, ihamzav1@hfhs.org Henry W. Lim Henry Ford Health System, hlim1@hfhs.org Follow this and additional works at: https://scholarlycommons.henryford.com/dermatology_articles Recommended Citation Torres AE, Ozog DM, Hamzavi IH, and Lim HW. Notes and Comments on "Proposed Approach for Re-using Surgical Masks in COVID-19 Pandemic". J Am Acad Dermatol 2020. This Article is brought to you for free and open access by the Dermatology at Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Dermatology Articles by an authorized administrator of Henry Ford Health System Scholarly Commons. JAAD ONLINE: NOTES & COMMENTSComment on: ‘‘Proposed approach for reusingsurgical masks in COVID-19 pandemic’’To the Editor: The article by Liu et al1 providedvaluable recommendations regarding the use of dryheat to facilitate surgical mask reuse. Prior studiesexploring this method have largely focused on itseffect on N95 respirator integrity rather than aquantification of its virucidal activity.2 This makes itdifficult to compare its virucidal advantage overultraviolet C (UVC) and other methods.2Dry heating requires direct supervision during itsdelivery, because too high a temperature ([1008C)is known to decrease the filtering capacity ofrespirators and masks.2 In addition, the effect ofdry heating on respirator—and possibly mask—integrity varies significantly depending on theapproach used (laboratory oven, dry microwaving,or rice cooker without water)2 and the specificrespirator or mask model. For N95 respirators,failure of fit-testing after decontamination wouldhave potential catastrophic effects on health careproviders.3The authors’ statement pertaining to UVC having‘‘less penetration’’ and being ‘‘less virucidal’’ contra-dicts previous reports.2,4 Although UVC is knownforemost as a surface decontaminant, our observa-tions using a desktop UVC unit (Daavlin DesktopUVC Germicidal Lamp, Daavlin, Bryan, OH) indi-cated that when the outside-facing surface of N95respirators is irradiated at virucidal dose (1 J/cm2),410% of the dose can penetrate to the wearer-facingsurface (Kohli et al, unpublished data, 2020). Hence,it is very likely that surgical masks may yieldeven greater UVC penetration given their largerparticle penetration compared with respirators.1Furthermore, the addition of a reflective base,flipping of the masks, or the availability of unitsthat allow irradiation of both surfaces of the mask atthe same time (Orbitform Mask Sanitizer, OrbitformMedical, Jackson, MI)2 can facilitate adequate irradi-ation of all surfaces.Although testing against severe acute respiratorysyndrome coronavirus 2 (SARS-CoV-2) has notbeen done, UVC has documented activity ($3-logreduction) against SARS-CoV, Middle East respira-tory syndrome coronavirus (MERS-CoV),5 andH1N1 influenza A virus.6 This was achieved afterirradiation of N95 respirators at a dose of 1 J/cm2per side delivered in under 3 minutes.4 For surgicalmasks, being of a thinner material, it is likely thatthe required dose and irradiation time is evenlower.Angeli Eloise Torres, MD, David M. Ozog, MD,Iltefat H. Hamzavi, MD, and Henry W. Lim, MDFrom the Photomedicine and Photobiology Unit,Department of Dermatology, Henry Ford HealthSystem, Detroit, Michigan.Funding sources: None.Conflicts of interest: Dr Ozog is an investigator forBiofrontera. Dr Hamzavi is an investigator forthe LITE study, which is funded by PCORI withphototherapy units provided by Daavlin. Dr Limis an investigator for LITE study, which is fundedby PCORI with phototherapy units provided byDaavlin, and has participated as a speaker ingeneral educational session for Ra MedicalSystems. Dr Torres has no conflicts of interest todeclare.IRB approval status: Not applicable.Reprints not available from the authors.Correspondence to: Henry W. Lim, MD, Departmentof Dermatology, Henry Ford Medical Center, 3031W Grand Blvd, Ste 800, Detroit, MI 48202E-mail: hlim1@hfhs.orgREFERENCES1. Liu Y, Leachman S, Bar A. Proposed approach for reusingsurgical masks in COVID-19 pandemic. J Am Acad Dermatol.2020;83(1):e53-e54.2. Torres AE, Lyons AB, Narla S, et al. Ultraviolet-C and othermethods of decontamination of filtering facepiece N-95respirators during the COVID-19 pandemic. Photochem Photo-biol Sci. 2020;19(6):746-751.3. Ozog D, Parks-Miller A, Kohli I, et al. The importance of form fittesting in decontamination of N95 respirators: a cautionarynote. J Am Acad Dermatol. 2020;83(2):672-674.4. Hamzavi IH, Lyons AB, Kohli I, et al. Ultraviolet germicidalirradiation: possible method for respirator disinfection tofacilitate reuse during COVID-19 pandemic. J Am AcadDermatol. 2020;82(6):1511-1512.5. Bedell K, Buchaklian AH, Perlman S. Efficacy of an automatedmultiple emitter whole-room ultraviolet-C disinfection systemagainst coronaviruses MHV and MERS-CoV. Infect Control HospEpidemiol. 2016;37:598-599.6. Mills D, Harnish DA, Lawrence C, Sandoval-Powers M,Heimbuch BK. Ultraviolet germicidal irradiation ofinfluenza-contaminated N95 filtering facepiece respirators.Am J Infect Control. 2018;46:e49-e55.https://doi.org/10.1016/j.jaad.2020.05.083J AM ACAD DERMATOL n 2020 e1Downloaded for Anonymous User (n/a) at Henry Ford Hospital / Henry Ford Health System (CS North America) from ClinicalKey.com by Elsevier on August 14, 2020.For personal use only. No other uses without permission. Copyright ©2020. Elsevier Inc. All rights reserved.

Notes and Comments on  Proposed Approach for Re-using Surgical Masks in COVID-19 Pandemic

https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?article=1449&amp;context=dermatology_articles

Notes and Comments on Proposed Approach for Re-using Surgical Masks in COVID-19 Pandemic

Abstract

Similar works

Full text

Available Versions

Henry Ford Health System Scholarly Commons