Editorial: The right — and wrong — way to cope with the N95 mask shortage

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If pre-pandemic Americans didn’t know what N95 masks were, they certainly do now. Like gowns, face shields and gloves, they are a key piece of personal protective equipment that safeguards health care workers in the fight against COVID-19.

In short supply, N95 masks have become a topic of debate on reuse: Can hospitals and health care facilities safely clean them to prolong their use, even for multiple shifts?

Northfield, Ill.-based Medline Industries has pitched to the White House a way to decontaminate N95 masks. That would be laudable, if it weren’t for the chemical Medline wants to use to clean the masks: ethylene oxide, a known carcinogen, the Chicago Tribune’s Michael Hawthorne reports. Researchers say the compound can damage the brain, and can raise the risk of leukemia, breast cancer and lymphomas at extremely low levels of exposure.

Medline uses ethylene oxide to sterilize medical instruments at its plant in Waukegan, Ill. That plant recently underwent an overhaul to reduce emissions of the compound into surrounding neighborhoods.

The Food and Drug Administration would have to approve use of ethylene oxide to decontaminate N95 masks. Here’s why the agency should say no: The Centers for Disease Control and Prevention, the Occupational Safety and Health Administration and 3M, a leading maker of masks, have all said it’s a bad idea. Masks cleaned with ethylene oxide could still have residual amounts of the chemical that the wearer could breathe in via off-gassing, 3M said in an April technical bulletin.

Health care workers are putting themselves at risk in hospitals, nursing homes and testing sites where sick COVID-19 patients are concentrated. They deserve the best armor we can give them.

Is there an alternative cleaning solution? Yes, and its FDA-approved methodology is already in use. In the parking lot of a medical device supplier in Waukegan, an Ohio biochemical research firm, Battelle, has been using vaporized hydrogen peroxide to clean up to 80,000 masks a day for reuse by health care personnel. The FDA backed usage of the process within the past month.

Medline is looking for the same emergency approval that the FDA gave Battelle. Yes, N95 masks are in short supply, and decontaminating masks to keep doctors, nurses and other health care workers properly equipped makes sense. But a remedy that could put them at risk is no remedy.

Richard Peltier, a health sciences professor at the University of Massachusetts Amherst, told Hawthorne, “If I were faced with a choice in wearing a mask that just came out of an (ethylene oxide) sterilizer or a surgical mask that doesn’t meet N95 standards, I’d take the surgical mask.”

It’s a fair bet that most health care workers would make the same choice. So to the FDA: Say no to Medline’s request for emergency approval. There are safer alternatives to clean and reuse N95 masks.


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