Dr Andy Davies, commercial director, Mackwell Health, explores reasons why the healthcare industry needs to change respiratory protection practice.
For nearly two years, the healthcare industry has been in an extremely challenging situation. With the NHS handling the pandemic while facing staff shortages, workers within the industry have still had to fight to maintain a high quality of service, despite a significant increase in admitted patients. Desperate to minimise the spread of COVID-19 within crowded hospitals, the pandemic created a heightened focus on the importance of personal protective equipment (PPE) - particularly respiratory protective equipment (RPE). In turn, several underlying issues came into the spotlight: safety, cost and environmental impact.
The Omicron variant of COVID-19 showed the world that regardless of how far we might have come from the initial outbreak of the pandemic in March 2020, the continued risk of further outbreaks remains. RPE continues to be one of the most important pieces of equipment for health staff in the fight against COVID-19. With ongoing concerns around staff shortages resulting from the need to self-isolate, alongside unprecedented workloads dealing with backlogs from the pandemic, there are three key concerns that the healthcare industry must address regarding RPE…
Safety
Of course, priority number one in all healthcare facilities is safety: that of both the patient and staff. In the case of the pandemic - where such a highly contagious airborne virus is active in high-risk environments - the importance of general safety has only become further emphasised.
The issue for the healthcare industry is that providing the recommended level of safety poses a significant challenge, especially in the case of RPE. While disposable face coverings have played a role in providing protection to workers in these settings, concerns remain over the effectiveness of these single-use masks. In fact, at the end of 2021 as the Omicron wave was starting to surge, a number of UK medical bodies - including The British Medical Association, Hospital Consultants and Specialists Association (HCSA) and Doctors’ Association UK - were all calling for front-line workers to be given higher grade RPE.
When it comes to RPE in the highest risk environment, the Health and Safety Executive (HSE) currently recommends the use of tight-fitting FFP3 grade respirators, which works by creating a tight seal between the user’s face and the mask to avoid transmission of airborne viruses. These are the highest level of disposable respiratory protection equipment available. However, this does not represent an optimal solution, with re-usable respirators now available that can improve protection by orders of magnitude.
Financial burden
The NHS has already dedicated a substantial amount of financial resources to single-use PPE and RPE. However, with FFP3 grade respirators being significantly more expensive than disposable face masks, making these respirators more widely available to healthcare staff would result in another considerable uplift in cost.
The issue here is the element of single-use. The NHS is continually needing to purchase more and more disposable masks to keep up with demand. However, if these respirators were reusable, a short-term rise in cost would soon be balanced out over time, and the lack of need to replace masks. Furthermore, the longer these items can be reused, the more the NHS can begin to save on replacing RPE. Over a long-term period, a significant cost efficiency can be realised.
Sustainability
A sustainable healthcare industry has long been on the agenda. Yet, recent research has discovered that the carbon footprint of PPE totalled over 100,000 tonnes CO2e in only the first six months following the COVID-19 outbreak. The greatest contributions to this came from gloves, aprons, face shields, Type IIR surgical masks and FFP3 respirators. In light of the pandemic, and the continued disposal of contaminated PPE, a sustainable approach should be a priority.
As mentioned previously, disposable PPE creates significant financial cost for the NHS, but it also creates a major environmental challenge. Disposable masks contain significant amounts of single-use non-recyclable plastic materials, all of which must be disposed of as infectious waste requiring incineration. The ability to reuse PPE would go a long way to helping the healthcare industry’s environmental impact.
Until now, the sector has been unable to effectively decontaminate items between use. Creating an environmentally friendly environment is important but keeping patients and healthcare staff safe is the number one priority.
Any solution that provides reusable equipment would require both guaranteed disinfection and complete traceability of the process. It must also be able to eliminate any level of scepticism surrounding the ability to completely disinfect items. There has always been genuine concern over the reliability to protect health workers and patients when it comes to reusable solutions.
Finding a practical solution
There are now many reusable solutions on the market, with more being launched, that are significantly more effective than disposable FFP3 respirators. The latest products can offer both inhale and exhale protection - and consistently achieve a fit factor of over 2000. That’s more than a 99.9% reduction in infectious particles, at least an order of magnitude better than FFP3. New innovations such as UV-C respirators will also be launched this year, which can offer further orders of magnitude protection for the highest risk areas and where longer wear times are required.
By investing in a reusable PPE and RPE ecosystem, the healthcare industry can address all three of these concerns. The reusable products are incredibly safe and more secure than the currently recommended disposable face masks; they provide a long-term cost-effective solution - removing the need to replace PPE so consistently; and finally, the reuse of masks limits the disposal of single-use non-recyclable plastic - which would create a significant improvement on the current negative environmental impact from healthcare.
