Decontamination of respirators in the covid-19 pandemic

Letters Guidance to reuse PPE
Decontamination of respirators in the covid-19 pandemic
BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1986 (Published 18 May 2020)
Cite this as: BMJ 2020;369:m1986
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Miranda Loh, head of environment and public health, John W Cherrie, principal scientist, Robert J Aitken, chief executive
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We are in a public health crisis, with frontline healthcare workers at increased risk of acquiring covid-19, partly due to shortages in respiratory protection. The respirators normally used to protect healthcare workers should be disposed of frequently, preferably after each patient, but this is currently not possible.

Medical personnel have expressed concern over Public Health England’s new guidance recommending that personal protective equipment (PPE) be stretched across a shift or even reused.12 Decontamination of respirators could be one way of increasing the safety of reuse and is being actively pursued by various groups.

Some methods require more specialised equipment (such as hydrogen peroxide vapour or ultraviolet light) and might not be as easily accessible in all settings. We have undertaken pilot work with a group of engineers using heat (about 70°C for around one hour) to decontaminate respirators while retaining their effectiveness.3 This might be a simple method that allows limited reuse of respirators in healthcare settings for the short term, although further tests of the decontamination method are required.

This pandemic has shown that we need to change the way we approach PPE. Widespread use of disposable kit has led to the current shortage and is not sustainable in the long run. We also need effective PPE that comfortably fits a wider range of body and face types.