Reusable masks could offset N95 mask shortage for health care workers

Use of elastomeric masks could reduces the number of N95 masks needed by nearly 95 percent in one month

A cost-effective strategy for health care systems to offset N95 mask shortages due to the COVID-19 pandemic is to switch to reusable elastomeric respirator masks, according to a new study. 

These long-lasting masks, often used in industry and construction, cost at least 10 times less per month than disinfecting and reusing N95 masks meant to be for single use, said authors of the study, published in the Journal of the American College of Surgeons.

The study evaluated the cost-effectiveness of using elastomeric masks in a health care setting during the COVID-19 pandemic, said Sricharan Chalikonda, MD, MHA, FACS, lead study author and chief medical operations officer for Pittsburgh-based Allegheny Health Network (AHN), where the study took place.

elastomeric masks offer health care workers equal or better protection from airborne infectious substances compared with N95 masks

Disposable N95 masks are the standard face covering when health care providers require high-level respiratory protection, but during the pandemic, providers experienced widespread supply chain shortages and price increases.

Elastomeric masks are made of a tight-fitting, flexible, rubber-like material that can adjust to nearly all individuals’ faces and can withstand multiple cleanings, Dr. Chalikonda said. These devices, which resemble gas masks, use a replaceable filter. 

According to the Centers for Disease Control and Prevention (CDC), elastomeric masks offer health care workers equal or better protection from airborne infectious substances compared with N95 masks.

At the end of March, AHN began a one-month trial of a half-facepiece elastomeric mask covering the nose and mouth. The mask holds a P100-rated cartridge filter, meaning it filters out almost 100 percent of airborne particles. The first to receive the new masks were respiratory therapists, anesthesia providers, and emergency department and intensive care unit (ICU) doctors and nurses. Initially, providers shared the reusable masks with workers on other shifts, and the masks underwent decontamination between shifts using vaporized hydrogen peroxide similar to the technique used to sterilize disposable N95 masks.

Although an elastomeric mask costs about $20 and the filter costs $10 compared with only $3 for an N95 mask, the research team found the elastomeric masks were “conservatively” 10 times less expensive.

Authors explained that the monthly cost is lower because they can disinfect elastomeric masks much more often, multiple caregivers can share the same mask, and, unlike N95s masks, they do not need to waste the mask after a failed fit test. It does not require any additional hospital resources to implement if the hospital already has an N95 mask reuse and resterilization program.