Evaluation of disinfection methods for personal protective equipment (PPE) items for reuse during a pandemic

The COVID-19 pandemic resulted in many supply chain issues, including crippling of essential personal protective equipment (PPE) needed for high-risk occupations such as those in healthcare. As a result of these supply chain issues, unprecedented crisis capacity strategies were implemented to divert...

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Published in:	PloS one Vol. 18; no. 7; p. e0287664
Main Authors:	Archer, John, Mikelonis, Anne, Wyrzykowska-Ceradini, Barbara, Morris, Eric, Sawyer, Jonathan, Chamberlain, Timothy, Abdel-Hady, Ahmed, Monge, Mariela, Touati, Abderrahmane
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 27.07.2023
Subjects:	Ammonium Ammonium compounds Biology and Life Sciences Bleaches Cleaning COVID-19 Decontamination Disinfection Engineering and Technology Evaluation Hydrogen peroxide Hydrogen peroxide vapor Infection control Medicine and Health Sciences Methods Pandemics Personal protective equipment Phages Physical Sciences Protective clothing Protective equipment Quaternary ammonium salts Respirators Sprays Supply chains Viruses Washing United States United States > US
ISSN:	1932-6203, 1932-6203
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Abstract	The COVID-19 pandemic resulted in many supply chain issues, including crippling of essential personal protective equipment (PPE) needed for high-risk occupations such as those in healthcare. As a result of these supply chain issues, unprecedented crisis capacity strategies were implemented to divert PPE items such as filtering facepiece respirators (FFRs, namely N95s) to those who needed them most for protection. Large-scale methods for decontamination were used throughout the world to preserve these items and provided for their extended use. The general public also adopted the use of non-specialized protective equipment such as face coverings. So, the need for cleaning, decontamination, or disinfection of these items in addition to normal clothing items became a necessary reality. Some items could be laundered, but other items were not appropriate for washing/drying. To fill research gaps in small-scale, non-commercial cleaning and disinfection, this bench-scale research was conducted using small coupons (swatches) of multiple PPE/barrier protection materials inoculated with virus (non-pathogenic bacteriophages Phi6 and MS2) and tested against a range of decontamination methods including bleach-, alcohol- and quaternary ammonium compound (QAC)-based liquid sprays, as well as low concentration hydrogen peroxide vapor (LCHPV) and bench-scale laundering. In general, non-porous items were easier to disinfect than porous items, and the enveloped virus Phi6 was overall easier to inactivate than MS2. Multiple disinfection methods were shown to be effective in reducing viral loads from PPE coupons, though only laundering and LCHPV were effective for all materials tested that were inoculated with Phi6. Applications of this and follow-on full-scale research are to provide simple effective cleaning/disinfection methods for use during the current and future pandemics.
AbstractList	The COVID-19 pandemic resulted in many supply chain issues, including crippling of essential personal protective equipment (PPE) needed for high-risk occupations such as those in healthcare. As a result of these supply chain issues, unprecedented crisis capacity strategies were implemented to divert PPE items such as filtering facepiece respirators (FFRs, namely N95s) to those who needed them most for protection. Large-scale methods for decontamination were used throughout the world to preserve these items and provided for their extended use. The general public also adopted the use of non-specialized protective equipment such as face coverings. So, the need for cleaning, decontamination, or disinfection of these items in addition to normal clothing items became a necessary reality. Some items could be laundered, but other items were not appropriate for washing/drying. To fill research gaps in small-scale, non-commercial cleaning and disinfection, this bench-scale research was conducted using small coupons (swatches) of multiple PPE/barrier protection materials inoculated with virus (non-pathogenic bacteriophages Phi6 and MS2) and tested against a range of decontamination methods including bleach-, alcohol- and quaternary ammonium compound (QAC)-based liquid sprays, as well as low concentration hydrogen peroxide vapor (LCHPV) and bench-scale laundering. In general, non-porous items were easier to disinfect than porous items, and the enveloped virus Phi6 was overall easier to inactivate than MS2. Multiple disinfection methods were shown to be effective in reducing viral loads from PPE coupons, though only laundering and LCHPV were effective for all materials tested that were inoculated with Phi6. Applications of this and follow-on full-scale research are to provide simple effective cleaning/disinfection methods for use during the current and future pandemics. The COVID-19 pandemic resulted in many supply chain issues, including crippling of essential personal protective equipment (PPE) needed for high-risk occupations such as those in healthcare. As a result of these supply chain issues, unprecedented crisis capacity strategies were implemented to divert PPE items such as filtering facepiece respirators (FFRs, namely N95s) to those who needed them most for protection. Large-scale methods for decontamination were used throughout the world to preserve these items and provided for their extended use. The general public also adopted the use of non-specialized protective equipment such as face coverings. So, the need for cleaning, decontamination, or disinfection of these items in addition to normal clothing items became a necessary reality. Some items could be laundered, but other items were not appropriate for washing/drying. To fill research gaps in small-scale, non-commercial cleaning and disinfection, this bench-scale research was conducted using small coupons (swatches) of multiple PPE/barrier protection materials inoculated with virus (non-pathogenic bacteriophages Phi6 and MS2) and tested against a range of decontamination methods including bleach-, alcohol- and quaternary ammonium compound (QAC)-based liquid sprays, as well as low concentration hydrogen peroxide vapor (LCHPV) and bench-scale laundering. In general, non-porous items were easier to disinfect than porous items, and the enveloped virus Phi6 was overall easier to inactivate than MS2. Multiple disinfection methods were shown to be effective in reducing viral loads from PPE coupons, though only laundering and LCHPV were effective for all materials tested that were inoculated with Phi6. Applications of this and follow-on full-scale research are to provide simple effective cleaning/disinfection methods for use during the current and future pandemics.The COVID-19 pandemic resulted in many supply chain issues, including crippling of essential personal protective equipment (PPE) needed for high-risk occupations such as those in healthcare. As a result of these supply chain issues, unprecedented crisis capacity strategies were implemented to divert PPE items such as filtering facepiece respirators (FFRs, namely N95s) to those who needed them most for protection. Large-scale methods for decontamination were used throughout the world to preserve these items and provided for their extended use. The general public also adopted the use of non-specialized protective equipment such as face coverings. So, the need for cleaning, decontamination, or disinfection of these items in addition to normal clothing items became a necessary reality. Some items could be laundered, but other items were not appropriate for washing/drying. To fill research gaps in small-scale, non-commercial cleaning and disinfection, this bench-scale research was conducted using small coupons (swatches) of multiple PPE/barrier protection materials inoculated with virus (non-pathogenic bacteriophages Phi6 and MS2) and tested against a range of decontamination methods including bleach-, alcohol- and quaternary ammonium compound (QAC)-based liquid sprays, as well as low concentration hydrogen peroxide vapor (LCHPV) and bench-scale laundering. In general, non-porous items were easier to disinfect than porous items, and the enveloped virus Phi6 was overall easier to inactivate than MS2. Multiple disinfection methods were shown to be effective in reducing viral loads from PPE coupons, though only laundering and LCHPV were effective for all materials tested that were inoculated with Phi6. Applications of this and follow-on full-scale research are to provide simple effective cleaning/disinfection methods for use during the current and future pandemics.
Audience	Academic
Author	Morris, Eric Abdel-Hady, Ahmed Chamberlain, Timothy Wyrzykowska-Ceradini, Barbara Touati, Abderrahmane Sawyer, Jonathan Mikelonis, Anne Archer, John Monge, Mariela
AuthorAffiliation	3 Science Systems and Applications Inc., Research Triangle Park, North Carolina, United States of America 4 CSS Inc., Research Triangle Park, North Carolina, United States of America Fiocruz Mato Grosso do Sul, BRAZIL 1 U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Homeland Security and Materials Management Division, Research Triangle Park, North Carolina, United States of America 2 Jacobs Technology Inc., Research Triangle Park, North Carolina, United States of America
AuthorAffiliation_xml	– name: 2 Jacobs Technology Inc., Research Triangle Park, North Carolina, United States of America – name: 3 Science Systems and Applications Inc., Research Triangle Park, North Carolina, United States of America – name: 4 CSS Inc., Research Triangle Park, North Carolina, United States of America – name: 1 U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Homeland Security and Materials Management Division, Research Triangle Park, North Carolina, United States of America – name: Fiocruz Mato Grosso do Sul, BRAZIL
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CitedBy_id	crossref_primary_10_1016_j_matdes_2025_114075 crossref_primary_10_1016_j_crbiot_2025_100312
Cites_doi	10.1371/journal.pone.0243965 10.3201/eid2609.201524 10.1007/978-1-60327-164-6_7 10.1080/15459624.2015.1018518 10.1186/s13099-020-00367-4 10.1016/S0195-6701(99)90066-X 10.1016/j.ajic.2020.06.194 10.1177/1535676020919932 10.1111/jam.15339 10.1111/lam.13624 10.1371/journal.pone.0241734 10.1017/ice.2021.48 10.1016/j.ajic.2021.06.012
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SubjectTerms	Ammonium Ammonium compounds Biology and Life Sciences Bleaches Cleaning COVID-19 Decontamination Disinfection Engineering and Technology Evaluation Hydrogen peroxide Hydrogen peroxide vapor Infection control Medicine and Health Sciences Methods Pandemics Personal protective equipment Phages Physical Sciences Protective clothing Protective equipment Quaternary ammonium salts Respirators Sprays Supply chains Viruses Washing
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Title	Evaluation of disinfection methods for personal protective equipment (PPE) items for reuse during a pandemic
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