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Cleaning reusable PPE


Professional organisations and community groups have taken the initiative and are making reusable PPE to support medical healthcare workers. It is important that that these items are properly cleaned to maintain their fluid resistant qualities, whilst decontaminating according to medical guidelines.

How should reusable gowns and masks be cleaned?

Reference Library

Click here for a list of relevant PDFs and links we have collected together whilst doing our research.

5 Key Questions:

Breaking it down, we need answers to the following:

1. What properties make PPE reusable?

All PPE designed to be reusable, from clinical gowns through to community-made masks, must have certain elements.

A Physical Barrier — a protective barrier standing between the user’s body and the microdroplet aerosols (small droplets carried on breath), and other bodily fluids, such as mucus and blood, that pass on coronavirus and other pathogens.

Tightly Woven Construction — gowns and masks should be made from tightly woven fabrics (either synthetic or natural) with small pore size, and very low air permeability that resist penetration from particulates.

Temperature Stable Components — the fabric and components used in the construction of the masks and gowns should be able to withstand high temperature washing (for sterilisation).

Water Repellency — the fabric must be treated with water repellency to make them resistant to bodily fluids.

The combination of small fabric pore size and water repellency holds back bodily fluids and microdroplets creating effective PPE. The addition of temperature stability allows the PPE to be reusable.

 

2. What could make reusable PPE less effective?

Degradation of water repellency — both masks and gowns need to be water repellent, to stop them from becoming soaked through when in contact with bodily fluids, like mucus, blood or urine.

Conventional detergent — damages water repellency and will increase the water absorbency of a gown or mask; this can allow a fluid ‘bridge’ to form, that pathogens can cross.

Incorrect cleaning process — masks and gowns need to be cleaned in a way that ensures pathogens have been removed, without damaging the structure of the PPE.

Construction — reusable masks and gowns should be constructed from fabrics and components that resist high-temperature washing. Any change to the fabric’s shape or structure (such as shrinkage) could degrade the fit, and therefore reduce the effectiveness of the PPE.

Materials — fabrics with a looser weave are not appropriate for PPE. They have high levels of air permeability, which means low resistance to particulates.

 

3. How can we maintain the function of reusable PPE?

Clean thoroughly — bodily fluids and other water-absorbent contamination must be removed from the PPE while maintaining, or better adding, water repellency.

Sterilise — masks and gowns must be cleared of all potential pathogens, not just coronavirus particles. This requires the use of a proven sterilisation process, already adopted by the medical community – either a temperature-based or chemical-based solution (e.g. anti-microbial).

Conserve structure — the structure and physical properties of the PPE’s fabric and components must be conserved throughout the washing and sterilising processes.

Maintain water repellency — masks and gowns become dangerous if they become saturated with water, as this forms a fluid ‘bridge’ which pathogens can cross. Maintaining repellency, along with low absorbency, is key to safety.

 

4. Can existing equipment and processes be used to preserve the properties of reusable PPE?

Washing machines, along with appropriate drying facilities, can be used to clean gowns and masks, in either an industrial or domestic setting. The following elements are key:

A washing product — to effectively remove dirt and bodily fluids, while conserving water repellency.

Sterilisation — which can be achieved by using a clinically-proven methodology, that is available both in hospitals and homes. For example, washing above certain temperatures is known to destroy pathogens.

A process — within a controlled environment, where either a responsible person works to a clearly-documented process, or the process has been reliably automated.

 

5. What are the risks and benefits of maintaining reusable PPE?

Risks in cleaning gowns and masks:

  • Destruction of water repellency – use of standard detergent damages water repellency, and therefore bodily fluid resistance.
  • Coronavirus infection – risk from washed equipment can be considered very low, as soap and heat are known to easily destroy the virus.

Benefits of well-designed, reusable PPE maintained properly:

  • Correctly cleaned, good quality reusable equipment provides better protection than new, poor quality, single-use equipment, based on our laboratory testing.
  • Higher-quality, more-resistant materials are used in making it, compared to those found in disposable equipment, as suppliers can afford to invest more in materials.
  • Long-term financial benefits of reusable PPE – the cost of maintenance is significantly lower than the cost of a new single-use gown.
  • Long-term environmental benefits to reusable PPE – less single-use plastic waste, and reduction in environmentally hazardous chemicals being used (eg. per/poly-fluorinated alkyl substances).
 
QUESTION SHORT ANSWERS Standards and Processes: Masks
 
Standards: Gowns Nikwax Papers
1. How does reusable PPE work? Bodily Fluid Resistance, Water Repellency, Particulate Filtration, Microdroplet Filtration, Physical barrier to infection
 
EN 149:2001 + A1:2009 Respiratory protective devices

EN 14683:2019 Medical face mask
 
EN 13795 – Drapes and Gowns Reusable Gown Testing
2. What could make reusable PPE less effective? Raising temperature above a certain level might cause shrinkage for some fabrics and compromise fit. Conventional detergents destroys water repellency.
 
BS EN 14476:2013+A2:2019 BS EN 14476:2013+A2:2019 Reusable Masks
3. How can we maintain the function of reusable PPE? Wash Hot (60°C or above). Avoid persistent wetting agents. Wash with product that conserves or enhances water repellency. Avoid abrasion.
 
EN 149:2001 + A1:2009 Respiratory protective devices

EN 14683:2019 Medical face mask
 
EN 13795 – Drapes and Gowns As above
4. Can existing equipment and processes be used to preserve the properties of reusable PPE? Established re-waterproofing technology. Dedicated wash cycle in a domestic or industrial machine. Washing at clinically advised high temperatures, use washing products designed to conserve water repellency.
 
ISO 18184:2019 Textiles- Determination of antiviral activity of textile products ISO 18184:2019 Textiles – Determination of antiviral activity of textile products As above
5. What are the risks and benefits of maintaining reusable PPE?
 
Risks: Poor Quality Control. Inadvertent application of standard cleaning protocols

Benefits: Reusable equipment increases availability of protection. Potential cost savings. Environmental benefit.
 
Not applicable In progress As above
6. How could this knowledge be applied practically by people in the field?
 
Recommended wash cycles, recommended drying routines, recommended cleaning agents. Not applicable In progress As above

For more information about cleaning and proofing PPE please contact: ppe@nikwax.co.uk