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Filter efficiency and pressure drop testing. a) Setup for measuring filter efficiency. b) Setup for measuring pressure drop across filter. c-e) Variety of filters tested, using the setup in a) and b). f) Filter efficiency and pressure drop across filters. https://doi.org/10.1371/journal.pone.0244422.g003
Source publication
Here we adapt and evaluate a full-face snorkel mask for use as personal protective equipment (PPE) for health care workers, who lack appropriate alternatives during the COVID-19 crisis in the spring of 2020. The design (referred to as Pneumask) consists of a custom snorkel-specific adapter that couples the snorkel-port of the mask to a rated filter...
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Objective
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Methods
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Citations
... Although the adapted diving mask was initially used as personal protective equipment for health professionals [10,30,31], studies have been developed using it in patients with COVID-19 [13,32], in which it was able to reverse AHRF and improve the PaO2/FiO2 ratio. ...
Non-invasive ventilation (NIV) can be used in acute hypoxemic respiratory failure (AHRF); however, verifying the best interface for its use needs to be evaluated in the COVID-19 pandemic scenario. To evaluate the behavior of the PaO2/FiO2 ratio in patients with AHRF with and without COVID-19 undergoing NIV with the conventional orofacial mask and the adapted diving mask. This is a randomized clinical trial in which patients were allocated into four groups: Group 1: COVID-19 + adapted mask (n=12); Group 2: COVID-19 + conventional orofacial mask (n=12); Group 3: non-COVID + adapted mask (n= 2); and Group 4: non-COVID + conventional orofacial mask (n=12]. The PaO2/FiO2 ratio was obtained 1, 24 and 48 h after starting NIV and the success of NIV was evaluated. This study followed the norms of the CONSORT Statement and registered in the Brazilian Registry of Clinical Trials, under registration RBR - 7xmbgsz. Both the adapted diving mask and the conventional orofacial mask increased the PaO2/FiO2 ratio. The interfaces differed in terms of the PaO2/FiO2 ratio in the first hour [309.66 (11.48) and 275.71 (11.48), respectively] (p=0.042) and 48 h [365.81 (16.85) and 308.79 (18.86), respectively] (p=0.021). NIV success was 91.7% in groups 1, 2 and 3, and 83.3% in Group 4. No adverse effects related to interfaces or NIV were observed. NIV through the conventional orofacial mask interfaces and the adapted diving mask was effective in improving the PaO2/FiO2 ratio, however, the adapted mask presented a better PaO2/FiO2 ratio during use. There was no significant difference between interfaces regarding NIV failure.
... -- [70] ( -Prospective evaluation of acceptability was conducted using a questionnaire. ...
... The second prototype was specifically designed for surgeons (Pneumask-S) because it was made with filters for exhalation and inhalation. The designed PPE included a customized adapter that was integrated with the snorkel port to a standard filter, such as an industrial filter or medical ventilator in-line filter [70]. ...
... The results showed that the designed, adjusted snorkeling mask passed the minimum requirements for elastomeric respirator and N95. Moreover, the fitting was evaluated quantitatively via using a TSI PortaCount device with the same fit factors of the elastomeric half-mask [70]. ...
Coronavirus disease (COVID-19) emerged in China in December 2019. In March 2020, the WHO declared it as a pandemic leading to worldwide lockdowns and travel restrictions. By May, it infected 4,789,205 and killed 318,789. This led to severe shortages in the medical sector besides devastating socio-economic effects. Many technologies such as artificial intelligence (AI), virtual reality (VR), microfluidics, 3D printing and 3D scanning can step in to contain the virus and hinder its extensive spread. This article aims to explore the potentials of 3D printing and microfluidic in accelerating the diagnosis and monitoring of the disease and fulfilling the shortages of personal protective equipment (PPE) and medical equipment. It highlights the main applications of 3D printers and microfluidics in providing PPE (masks, respirators, face shields, goggles, isolation chambers/hoods), supportive care (respiratory equipment) and diagnostic supplies (sampling swabs & lab-on-chip) to ease the COVID-19 pressures. Also, the cost of such technology and regulations considerations are addressed. We conclude that 3D-printing provided reusable and low cost solutions to mitigate the shortages. However, safety, sterility and compatibility with environmental protection standards need to be guaranteed through standardization and assessment by regulatory bodies. Finally, lessons learned from this pandemic can also help the world prepare for upcoming outbreaks
... This mask consists of several components, namely a snorkeling mask, a special adapter, and a filter (Kusano et al., 2020). This medical snorkel mask can protect the eyes and face and are equipped with an air filter (Kroo et al., 2020). It is hoped that this medical snorkel mask can be a promising innovation to overcome the inconvenience of the usage of widelyavailable PPE so that later it can reduce the rate of transmission of Covid-19 to health workers and reduce the morbidity and mortality of health workers due to exposure to Covid-19. ...
... These medical snorkels are full-face scuba masks with additional filters for filtration function. This breakthrough has been approved and used in several countries, including France, Belgium, and Italy in the form of Pneumask as a solution to the lack of PPE at that time (Kroo et al., 2020). ...
... This is also to ensure that the mask is securely attached to the user's face. The upper part is the main channel for air entry for breathing (Kroo et al., 2020). In the transition section between the main compartment and the top (air ducts) there are 3 baffles with 1 partition in the middle for the inhalation channel and 2 channels on the lateral side as the exhalation channel (see Figure 2). ...
Covid-19 is a new disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The increasing number of cases of Covid-19 has made it difficult for hospitals to handle it, and health workers are at a higher risk of infection by SARS-CoV-2 and urgently need Personal Protective Equipment (PPE) to protect themselves and minimize the spread of the virus. However, the usage of PPE especially face-masks often causes discomfort. Therefore, a new type of face mask has emerged, namely the medical snorkel mask. This mask is designed to cover the entire face and is made by modifying the air circulation section by adding an air filter. The filter used is PALL Ultipor 25 with a HEPA filter capable of filtering up to 0.3 microns in size and has an efficiency of 99.99%. Medical snorkel mask that is used properly are quite efficient in preventing the transmission of Covid-19, with a fitting factor of 142 from pass level 100. This mask also has passed the CO2 toxicity test. The advantages of a medical snorkel mask include protecting the entire face from infectious droplets, preventing direct hand contact with the face, being reusable, and being equipped with an effective air filter by minimizing the potential for filtrate malfunction. Some of the disadvantages of this mask include interfering with the communication process, cannot being used in conjunction with glasses, a buildup of CO2, increasing the work of breathing, and limiting vision. However, some of these weaknesses can be minimized by modifying the mask and maintaining an optimal barrier system. Given the high level of effectiveness and efficiency, medical snorkel masks can be a novel solution to overcome the discomfort of using PPE for health workers in Indonesia. Hopefully, it can reduce the morbidity and mortality of health workers due to exposure to Covid-19.
... Reusable masks can be cleaned after use, and filters are designed for prolonged durability and use over several weeks depending on the dust exposure and manufacturer. These advantages led to the use of reusable full face masks, half face masks or modified snorkelling masks during the coronavirus disease 2019 (COVID-19) pandemic [17,18]. ...
Background
The novel strain of severe acute respiratory syndrome coronavirus 2 is highly contagious; therefore, special emphasis must be given to personal protective equipment for healthcare workers. Reusable elastomeric respirators were previously used in intensive care units (ICU). These respirators include full or half masks and devices modified to accommodate a filter. Although the general comfort of masks used in the ICU has been studied, data comparing multiple types of masks during a pandemic are missing.
Methods
A prospective randomized trial was conducted in an ICU. After standardized training, participants were randomized to use one of three mask types (full, half or snorkelling mask), each fitted with a filter equivalent to a class 3 particle-filtering half mask (FFP3) during one shift. The main outcomes were characteristics of using the mask itself (donning/doffing, quality of seal, cleaning), working conditions with the mask (vision, comfort, perceived safety, communication) and a subjective comparison to single-use FFP2/3 masks.
Results
A total of 30 participants were included in the trial, randomized to 10 participants per group. The masks were worn 6.4 (4.5) times (mean SD) for a total duration of 132 (66) min per shift. The tested masks were rated 7 (2.6) (mean SD) in comparison to FFP2/3 on a Likert scale (0: worst, 10: best). Significant differences between the masks were found in respect to comfort (7/4/8), donning (8/7/9), overall rating (8/5/8) and comparison to single-use FFP2/3 masks (9/7/9; full-, half, snorkelling mask).
Conclusion
Using reusable elastomeric masks is feasible in clinical practice. Full face masks were significantly better in terms of comfort, donning, overall rating and in comparison to single-use FFP2/3 masks.
... 10 Several scalable, less expensive reusable respirators have been recently developed that can be easier to decontaminate using standard hospital equipment to try to address the respirator shortage. 10 12 The Pneumask project, for example, which repurposes snorkel masks, has already distributed more than 23 000 masks internationally. [12][13][14][15] Other types of reusable masks that aim to address barriers to communication, such as the Jelli M1 mask 16 and ClearMask, have recently been developed. ...
... 10 12 The Pneumask project, for example, which repurposes snorkel masks, has already distributed more than 23 000 masks internationally. [12][13][14][15] Other types of reusable masks that aim to address barriers to communication, such as the Jelli M1 mask 16 and ClearMask, have recently been developed. 17 Potential benefits of reusable respirators compared with disposable respirators could include reduced cost and waste. ...
... To model usage estimates for reuse of respirators enabled by daily UVGI decontamination, we used Number of respirators required per day for interactions with general ward patients 8 34 Number of respirators required per day for interactions with ICU patients 14 (12)(13)(14)(15)(16) Open access currently available data on respirator integrity and efficiency after multiple cycles of UVGI. Based on these estimates, we assumed that a respirator could be decontaminated for up to five cycles. ...
Objectives
To compare the impact of respirator extended use and reuse strategies with regard to cost and sustainability during the COVID-19 pandemic.
Design
Cost analysis.
Setting
USA.
Participants
All healthcare workers within the USA.
Interventions
Not applicable.
Main outcome measures
A model was developed to estimate usage, costs and waste incurred by several respirator usage strategies over the first 6 months of the pandemic in the USA. This model assumed universal masking of all healthcare workers. Estimates were taken from the literature, government databases and commercially available data from approved vendors.
Results
A new N95 respirator per patient encounter would require 7.41 billion respirators, cost $6.38 billion and generate 84.0 million kg of waste in the USA over 6 months. One respirator per day per healthcare worker would require 3.29 billion respirators, cost $2.83 billion and generate 37.22 million kg of waste. Decontamination by ultraviolet germicidal irradiation would require 1.64 billion respirators, cost $1.41 billion and accumulate 18.61 million kg of waste. H 2 O 2 vapour decontamination would require 1.15 billion respirators, cost $1.65 billion and produce 13.03 million kg of waste. One reusable respirator with daily disposable filters would require 18 million respirators, cost $1.24 billion and generate 15.73 million kg of waste. Pairing a reusable respirator with H 2 O 2 vapour-decontaminated filters would reduce cost to $831 million and generate 1.58 million kg of waste. The use of one surgical mask per healthcare worker per day would require 3.29 billion masks, cost $460 million and generate 27.92 million kg of waste.
Conclusions
Decontamination and reusable respirator-based strategies decreased the number of respirators used, costs and waste generated compared with single-use or daily extended-use of disposable respirators. Future development of low-cost,simple technologies to enable respirator and/or filter decontamination is needed to further minimise the economic and environmental costs of masks.
... Preliminary testing of these devices using qualitative and quantitative fit testing has proved to be as or more effective as using disposable N-95 respirators or equivalent. [8][9][10][11] Although the snorkel mask is a full-face respirator, wearers did not experience any additional discomfort or obstruction of view, even when worn for prolonged periods of time, making it a feasible option to implement. [8][9][10][11] While previous studies of snorkel mask respirators are important preliminary evaluations, we present the largest and most diverse series validating the fit of these respirator devices. ...
... [8][9][10][11] Although the snorkel mask is a full-face respirator, wearers did not experience any additional discomfort or obstruction of view, even when worn for prolonged periods of time, making it a feasible option to implement. [8][9][10][11] While previous studies of snorkel mask respirators are important preliminary evaluations, we present the largest and most diverse series validating the fit of these respirator devices. [8][9][10][11] We hypothesize that the retrofitted Aria Ocean Reef ® full-face snorkeling mask will protect healthcare workers from infectious SARS-CoV-2 droplets and aerosols and be a feasible solution to address potential PPE shortages. ...
... [8][9][10][11] While previous studies of snorkel mask respirators are important preliminary evaluations, we present the largest and most diverse series validating the fit of these respirator devices. [8][9][10][11] We hypothesize that the retrofitted Aria Ocean Reef ® full-face snorkeling mask will protect healthcare workers from infectious SARS-CoV-2 droplets and aerosols and be a feasible solution to address potential PPE shortages. ...
Objective: Bottlenecks in the personal protective equipment (PPE) supply chain have contributed to shortages of PPE during the COVID-19 pandemic, resulting in fractures in the functionality of healthcare systems. This study was conducted with the aim of determining the effectiveness of retrofitted commercial snorkel masks as an alternative respirator for healthcare workers during infectious disease outbreaks.
Methods: A retrospective analysis was performed, analyzing qualitative and quantitative fit test results of the retrofitted Aria Ocean Reef® full-face snorkeling mask on healthcare workers at the McGill University Health Centre between April-June 2020. Historical fit test results, using medical-grade respirators, for healthcare workers were also analyzed.
Results: During the study period, 71 participants volunteered for fit testing, 60.6% of which were nurses. The overall fit test passing rate using the snorkel mask was 83.1%. Of the participants who did not previously pass fit testing with medical-grade respirators, 80% achieved a passing fit test with the snorkel respirator.
Conclusions: The results suggest that this novel respirator may be an effective and feasible alternative solution to address PPE shortages, while still providing healthcare workers with ample protection. Additional robust testing will be required to ensure that respirator fit is maintained, after numerous rounds of disinfection.
... For example Kroo et al. [21] presented a similar arrangement with a variety of filter configurations attached to a snorkel mask via a 3D printed connector. They demonstrated their masks' success in qualitative and quantitative fit testing and also reported acceptable work of breathing, valve leakage and carbon dioxide build-up. ...
Introduction
During viral pandemics, filtering facepiece (FFP) masks together with eye protection form the essential components of personal protective equipment (PPE) for healthcare workers. There remain concerns regarding insufficient global supply and imperfect protection offered by currently available PPE strategies. A range of full-face snorkel masks were adapted to accept high grade medical respiratory filters using bespoke-designed 3D-printed connectors. We compared the protection offered by the snorkel to that of standard PPE using a placebo-controlled respirator filtering test as well as a fluorescent droplet deposition experiment. Out of the 56 subjects tested, 42 (75%) passed filtering testing with the snorkel mask compared to 31 (55%) with a FFP3 respirator mask (p = 0.003). Amongst the 43 subjects who were not excluded following a placebo control, 85% passed filtering testing with the snorkel versus to 68% with a FFP3 mask (p = 0.008). Following front and lateral spray of fluorescence liquid particles, the snorkel mask also provided superior protection against droplet deposition within the subject’s face, when compared to a standard PPE combination of FFP3 masks and eye protection (3.19x10 ⁸ versus 6.81x10 ⁸ fluorescence units, p<0.001). The 3D printable adaptors are available for free download online at https://www.ImperialHackspace.com/COVID-19-Snorkel-Respirator-Project/ .
Conclusion
Full-face snorkel masks adapted as particulate respirators performed better than a standard PPE combination of FFP3 mask and eye protection against aerosol inhalation and droplet deposition. This adaptation is therefore a promising PPE solution for healthcare workers during highly contagious viral outbreaks.
... Thus, the full-face snorkeling mask assembly minimizes the risk of contamination for people who share the patient's ambiance. Following these findings, Kroo et al. [38] used snorkel masks connected with 3D printed valves as personal protective equipment and found the equipment capable of exceeding the standards of half-face or N95 respirators. ...
Aim: To produce valves to be used with full-face snorkeling masks for noninvasive ventilation (NIV) proce- dure during the coronavirus disease 2019 (COVID-19) pandemic. Materials & methods: ISINNOVA’s Char- lotte valves for full-face snorkeling masks used for NIV procedures were redesigned, produced by selec- tive laser sintering additive manufacturing, and submitted to air leakage tests. Results: The final model assembly did not present air leakage during the NIV procedure on human models, minimizing risks of air contamination. Conclusion: This study shows the feasibility of using additive manufactured valves with snorkel facial masks to support health systems during COVID-19 and possible future pandemics.
The COVID-19 Numerical Claims Open Research Dataset (CONCORD) is a comprehensive, open-source dataset that extracts numerical claims from academic papers on COVID-19 research. To extract numerical claims, a weak-supervision based model is employed, leveraging its white-box, explainable nature and advantages over transformer-based models in terms of computational and manual annotation costs. Labelling functions are used to programmatically generate labels, incorporating techniques like pattern matching, external knowledge bases, phrase matching, and third-party models. An aggregator function reconciles overlapping or contradictory labels. The weak-supervision model is evaluated against established baselines and transformer based models, achieving a weighted F1-score of 0.932 and micro F1-score of 0.930 in extracting numerical claims.While the weak-supervision model showcases superior performance compared to baseline models, it is observed that transformer-based models achieve comparable results.CONCORD, comprising around 200,000 numerical claims extracted from over 57,000 COVID-19 research articles, serves as a valuable tool for knowledge discovery and understanding the chronological developments in various research areas associated with COVID-19. In conclusion, CONCORD, alongside the weak-supervision methodology, offers researchers a valuable resource, enhancing advancements in COVID-19 research while highlighting the significant potential of weak-supervision models within the broader biomedical domain.
Background
During respiratory infection pandemics, masks and respirators are highly sought after, especially for frontline healthcare workers and patients carrying respiratory viruses. The objective of this study was to systematically review fit test pass rates and identify factors influencing the fitting characteristics.
Methods
Potentially relevant studies were identified using PubMed, Scopus, Web of Science, and Science Direct during the COVID-19 pandemic from February 5, 2020, to March 21, 2023. The search strategy using the following keywords was conducted: Quantitative Fit Test, Condensation Nuclei Counter, Controlled Negative Pressure, PortaCount, Sibata, Accufit, Fit, Seal, Mask, Respirator, Respiratory Protective Device, Respiratory Protective Equipment, Protective Device, Personal Protective Equipment, COVID-19, Coronavirus, and SARS-CoV-2. The quality of the included studies was also assessed using the Newcastle-Ottawa scale.
Results
A total of 137 articles met the eligibility criteria. Fifty articles had a quality score of less than 7 (good quality). A total of 21 studies had a fit test pass rate of less than 50%. 26 studies on disposable respirators and 11 studies on reusable respirators had an FF of less than 50 and less than 200, respectively. The most influential factors include respirator brand/model, style, gender, ethnicity, facial dimensions, facial hair, age, reuse, extensive movement, seal check, comfort and usability assessment, and training.
Conclusion
37.36% of the disposable respirator studies and 43% of the reusable respirator studies did not report fit test results. 67.86% of the disposable respirator studies had a fit test pass rate greater than 50%, and 35.84% of these studies had an FF greater than 100. Also, 85.71% of the reusable respirator studies had a fit test pass rate greater than 50%, and 52.77% of these studies had an FF greater than 1000. Overall, the fit test pass rate was relatively acceptable. Newly developed or modified respirators must undergo reliable testing to ensure the protection of HCWs. Subject and respirator characteristics should be considered when implementing fit testing protocols. An optimal fit test panel should be developed prior to respirator design, certification, procurement decisions, and selection procedures.
