N95 filtering face piece respirators remain effective after extensive reuse during the coronavirus disease 2019 (COVID-19) pandemic

  1. Valeria Fabre
  2. Sara E. Cosgrove
  3. Yea-Jen Hsu
  4. George F. Jones
  5. Taylor Helsel
  6. James Bukowski
  7. Mark Sobota
  8. Anna C. Sick-Samuels
  9. Aaron M. Milstone
  10. Lisa L. Maragakis
  11. Clare Rock
  12. for the Centers for Disease Control and Prevention Epicenters Program

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Abstract

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  1. Version published to 10.1017/ice.2021.76
  2. ScreenIT

    SciScore for 10.1101/2020.12.04.20244087: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Any N95 that failed the seal check or the saccharine fit-test was further evaluated with a confirmatory quantitative fit-test using the ambient aerosol condensation nuclei counter (PortaCount®) protocol6,7.
    PortaCount®
    suggested: None
    Analyses were performed using StataCorp 2019 (College Station, TX: StataCorp LLC).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has limitations. We did not perform a PortaCount on N95s that passed the seal check or the saccharine fit-test due to limited N95 supplies and we may have overestimated “passes”; however, false passes are infrequent with the saccharin method8. Although we evaluated two of the most commonly used N95 respirators in the United States 9, findings may not be generalizable to alternative models. The number of repeated N95 donnings was based on HCW recall, which may have been under- or over-estimated; however, we do not think there was bias in either direction. We did not sample the N95s to assess for pathogen contamination, a risk of N95 reuse, but our protocol of face shield to protect N95 reduces this risk by preventing droplets from landing on the respirator surface. This study was not powered to assess effectiveness of N95s to prevent SARS-COV-2 infection or other potentially airborne transmitted infections. Notably, no patient-to-HCW SARS-COV-2 transmissions have been documented for HCWs who complied with the recommended COVID-19 precautions at JHH to date (authors’ personal communication). There was missing PortaCount data from some HCWs who failed the seal check or saccharine fit-test; however, we performed a sensitivity analysis to minimize the impact of missing data on interpretation of the study results. In summary, extensive reuse of the N95 models tested in our study seems an acceptable and safe approach during critical supply shortages rather than uniform dis...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.12.04.20244087v1 on medRxiv