New technology cleans scarce N95 masks, but some question safety

New technology to disinfect N95 masks worn by health care workers is now in Nevada, but a major nurses union is questioning the effectiveness of the process.

The Battelle Critical Care Decontamination System has been used to clean more than 1,700 of the N95 masks since early May. It uses vaporized hydrogen peroxide to kill the novel coronavirus, which causes the respiratory disease COVID-19.

With mask shortages still being seen across the U.S., local hospital doctors and nurses began wearing masks longer than their recommended single use not long after the nation’s outbreak began. The new sanitization process is intended to make that equipment last even longer if necessary.

Southern Nevada’s decontamination system is operating out of the Nevada National Guard’s armory in Henderson. The masks are cleaned inside four identical shipping containers.

Masks are placed on metal racks inside the containers. Vaporized hydrogen peroxide is released into the back of the container, and mixing fans circulate it until the air inside the chamber reaches 101 percent humidity. The process takes about eight hours once the masks are loaded, Battelle spokeswoman Katy Delaney said.

Battelle says the system can clean a mask for up to 20 reuses, but National Nurses United, the country’s largest union of registered nurses, has repeatedly called for the process to be halted immediately.

Union president Zenei Cortez wrote in a statement that union members reported their decontaminated masks came back deformed and their straps had lost elasticity. The masks’ ability to filter out dangerous particles depends on their snug facial fit.

“We nurses know from real-life experience that N95 respirators cannot be safely reused or ‘decontaminated,’ ” Cortez wrote. “There’s no way a reprocessed mask will perform like a new one.”

Similar concerns were also raised by a local hospital worker and member of the Nevada chapter of Service Employees International Union.

“I’ve noticed the integrity of the mask begins to deteriorate in just one 12-hour shift,” said Tima Prieto, a radiology technologist at St. Rose Dominican’s Siena campus in Henderson. “It doesn’t seem like the integrity of the mask would still be there.”

Prieto said she also worried about whether each health care worker will receive the same mask back they send in for decontamination. The hospital system’s Siena campus is not using the decontamination technology, but its San Martin campus in Las Vegas is, according to state officials.

Delaney said Battelle has a tracking system that ensures each box of decontaminated masks returns to the hospital that it came from. However, hospitals are responsible for getting each employee’s mask back to him or her.

She said Battelle stands by the efficacy of its decontamination systems, but she added that it will take a “behavioral and cultural change from the nursing community” before the technology is fully accepted.

“We know this is a proven and safe technology, and we have the science behind it,” she said. “This is a short-term solution to an urgent problem.”

Battelle’s system is based on a two-year contracted project that the Ohio-based nonprofit research institute undertook for the U.S. Food and Drug Administration in 2014, investigating the feasibility of using vaporized hydrogen peroxide to decontaminate N95 masks during a public health emergency.

The Department of Defense awarded the Battelle a $415 million contract this April to deploy 60 of the systems across the U.S. Delaney said about 50 are currently in the field, and 10 remain in reserve.

The system stationed in Henderson comes at no cost to state and local governments, and health care facilities do not have to pay to use it.

It is far from reaching its capacity of cleaning 80,000 masks in a 24-hour period, Delaney said.

“The use is not as high as we would like,” Delaney said. “The capacity is there, but the demand is not quite there yet in Nevada.”

The coronavirus pandemic has driven up demand for N95 masks, causing global shortages and leading hospital workers in Las Vegas and elsewhere to commonly wear the same masks for entire shifts, and sometimes for days. In the early days of the state’s outbreak in March, some nurses said they were asked to keep their masks in paper bags between shifts.

Prieto said she is still wearing N95 masks to treat multiple patients and sometimes across multiple days.

To prevent the transmission of COVID-19 during the mask-cleaning process, workers at the Henderson armory are following strict precautions.

Masks are sealed inside two bags before they are shipped to the armory. Workers unloading masks and placing them into the decontamination system wear protective face shields, gloves and knee-length protective gowns. They are required to shower immediately after loading the system.

“We are very aware that if we go down, the process stops,” said Abe Morrison, who is leading the local operation for Battelle.

Contact Michael Scott Davidson at sdavidson@reviewjournal.com or 702-477-3861. Follow @DavidsonLVRJ on Twitter.