Hydrogen Peroxide Methods for Decontaminating N95 Filtering Facepiece Respirators

Introduction: During a pandemic, when the supply of N95 filtering facepiece respirators (FFRs) is limited, FFRs may be decontaminated by methods that inactivate pathogens as long as they do not damage FFR function. Hydrogen peroxide (H2O2) is widely used for decontamination in medical settings. Objective: To review the literature on the use of H2O2 to decontaminate N95 FFRs and identify methods that inactivate virus and preserve FFR filtration efficiency and fit. Methods: The literature was searched for studies evaluating H2O2 decontamination methods on inactivating SARS-CoV-2 and other viruses and microorganisms inoculated on N95 FFRs and the effects on respirator filtration efficiency and fit. Current U.S. Federal guidelines are also presented. Results: Findings from relevant laboratory studies (N = 24) are summarized in tables. Commercially available H2O2 decontamination systems differ on how H2O2 is delivered, the temperature, the duration of treatment, and other factors that can impact N95 FFR filtration efficiency and fit. Some methods inactivate SARS-CoV-2 virus-contaminated N95 FFRs with >3 log attenuation, whereas other methods are yet to be evaluated. Discussion and Conclusion: Most of the H2O2 methods reviewed effectively decontaminate N95 FFRs without damaging FFR function. However, some methods adversely impact N95 fit or filtration efficiency, which could go undetected by the end user and compromise their protection from pathogen inhalation. When making decisions about H2O2 decontamination of respirators, it is important to understand differences in methods, effects on different FFR models, and potential hazards to workers who manage the decontamination process.

Automated summary

Hydrogen peroxide (H2O2) can effectively decontaminate N95 filtering facepiece respirators, but different decontamination systems can impact the filtration efficiency and fit of the respirators differently, emphasizing the importance of choosing appropriate methods. While some methods have been shown to effectively inactivate viruses, there are still others that require further evaluation.