The KN95 Facts You Should Know
May 13, 2020
Jeremy N. Krell, DMD, MBA
By now you may have found KN95 masks, purchased them, waited for them, and perhaps received them. So now what?
There are many things you should know about the proper use of KN95 masks to keep yourself, your staff, and your patients safe.
How to Put my Mask On and Take It Off?
As suggested by the CDC in their step-by-step guide, it makes sense that if you are trying to protect yourself from aerosolized pathogens, you should take precautions handling your mask. Consider washing your hands thoroughly before putting it on (as to avoid initial contamination) and taking it off (as the outer surfaces of your mask have been contaminated). Visually inspect your mask to ensure that it has no damage and is void of any object that could come between your face and the mask. At work, you may get an annual fit test, but this is only once per year!
Remember, the usage of a respirator is indicated when aerosolized pathogens are a hazard. Therefore, it is critical that you establish a strong seal between your face and the mask. Follow the guide’s instructions. You may not realize it, but you are forming an airtight seal, which means you should be able to fully breathe through the mask. There should not be any air leakage around the mask if you inhale or exhale.
When you are done using the mask, remove it and discard it safely. The front of the mask may be contaminated, so avoid touching it.
Is my Mask Counterfeit?
Given that safety is your primary concern, it certainly follows that you want to have a legitimate product in hand to protect yourself, staff, and patients. That said, it can be very tricky to tell if a respirator is counterfeit. As explained by the ADA, understand the different mask types.
The good news is that back in April, both China and the US increased import and export legislation to help address the problem. The bad news is that this can lead to increased lead times and is still not a perfect solution.
Every manufacturer should be registered with the FDA and each of their products should be FDA certified. Pre-purchase, the easiest way to verify FDA registration is to check the FDA website, here. You should make sure that the paperwork supplied to you, inclusive of the FDA certificate, looks legitimate: the font should be consistent, the manufacturer’s name and owner/operator number on the certificate should match with the listing online as well as the box or product that you receive, and there shouldn’t be grammatical errors. Ask if the masks are repackaged throughout the supply chain, which can cause contamination.
While KN95 masks differ in the governing body compared to N95 masks, the CDC, OSHA, and ADA do offer some good general guidelines and best practices to consider. There are normally approval markings on respirators, but not any form of decoration or customization. The US performance standard for N95 masks is NIOSH-42CFR84, while the same for China is GB2626-2006, see the similarities as compared by 3M, here. These should be spelled correctly, but may not contain the full numerical representation. There should not be any claim to protect young children, just look at the size of the mask, it is clearly too big for a young child.
Quality control has become a global hardship as a result of the extremely high demand and limited supply of masks due to the fast pace nature of the outbreak. Prices and counterfeiting have soared. While the FDA does have an emergency clearance list that with certain criteria, it changes frequently. It is key that the manufacturer is registered with the FDA and that the KN95 mask has an FDA certification. This has been the long standing best practice in this industry.
You may hear about “at-home” tests to determine the legitimacy of a respirator. Such tests include spraying an aerosol as the mask to see if it will visually pass, filling the mask with water to see if it will hold, and placing the mask in the autoclave to see if it will degrade. You should take caution here as these are not scientifically proven will not lead you to an official determination of legitimacy.
How to Clean my Mask?
Cleaning your mask is a necessary consideration when PPE supplies can be limited, expensive, and carry long lead times. That said, respirators used during the treatment of highly contagious pathogens or other dangerous conditions are meant to be disposable. The Department of Labor offers some guidance on best practices for decontamination.
Using vaporous hydrogen peroxide, UV germicidal irradiation, or moist heat (like an oven) may have protective effects. Vaporous hydrogen peroxide, commonly found in plasma sterilization, may be difficult to come by. UV radiation may be more common, but consider that your mask consists of layers, and using light can cast a shadow, thereby leading to incomplete coverage. You may be able to more easily find microwave-generated steam or liquid hydrogen peroxide and use them as suitable alternatives.
Common methods that are not considered to have the desired effects include autoclaving, dry heat, isopropyl alcohol, soap, dry microwave irradiation, chlorine bleach, disinfectant wipes, or ethylene oxide.
While none of these options is perfect, and disposing of your mask after each use is ideal, any recommended cleansing technique that you are able to conduct safely may reduce the likelihood of contamination.
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