Personal Protective Equipment (PPE) refers to single-use items designed to create a barrier against potential hazards, such as infectious agents, chemicals, and environmental contaminants. Disposable PPE is intended for a single wear and must be discarded immediately after use to prevent the spread of contamination. While the standard answer to reusing disposable PPE is a clear “No,” the discussion becomes more complex during periods of extreme supply chain disruption. Regulatory bodies have authorized limited, specific exceptions based on the type of equipment, but this nuanced approach is always a temporary measure to conserve supplies, not a change in routine safety standards.
The Fundamental Reasons Against Reuse
The primary reason against reusing disposable PPE is the immediate compromise to its physical and biological integrity. Disposable materials, often synthetic polymers like polypropylene, are not engineered to withstand multiple cycles of use, storage, or cleaning. Material degradation occurs as the fibers break down, which can significantly reduce the filtration efficiency of masks or the barrier strength of gowns.
For respirators and masks, repeated handling and removal (doffing) compromises the fit and seal against the wearer’s face. Even a slight loss of the proper seal allows unfiltered air to enter, negating the protective function of the mask’s filter medium. Furthermore, the unavoidable presence of biohazard contamination, from aerosol residue to direct contact, makes reuse a significant cross-contamination risk. Touching a contaminated surface during the doffing or re-donning process can transfer infectious agents directly to the hands, face, or environment.
Identifying PPE Categories and Their Reuse Potential
Reuse policies vary significantly among different types of disposable PPE, largely depending on the item’s function and material.
Gloves and Gowns (High-Contact Items)
The reuse of disposable gloves and gowns is strictly forbidden under nearly all circumstances, even during a crisis. These items are the first line of defense and are designed to be immediately saturated or soiled by blood, body fluids, and other contaminants. Reprocessing disposable gowns is generally considered impractical because it is difficult to remove contamination and maintain the material’s fluid-repellent integrity through laundering or disinfection. Disposable gloves, such as nitrile or latex, are discarded after each use, as their reuse significantly increases the risk of cross-contamination.
Surgical/Procedure Masks
Surgical and procedure masks offer protection against droplets and splashes but are not designed for filtration of airborne particles as small as those handled by respirators. These masks are meant for single use and must be discarded immediately if they become soiled, damaged, or moist. While extended use—wearing the same mask for continuous care across multiple patients without removing it—may be permitted in a resource-limited setting, any attempt at cleaning or reprocessing a surgical mask is prohibited. This is because cleaning processes destroy the static charge often responsible for capturing particles, leading to a loss of filtration capacity.
Filtering Facepiece Respirators (FFRs, e.g., N95s)
Filtering Facepiece Respirators (FFRs), such as N95 masks, represent the most complex context for reuse due to their high filtration efficiency requirements. In declared supply shortages, limited reuse may be permitted under defined protocols, which is a significant deviation from standard practice. These protocols require strict adherence to “donning and doffing” procedures and often involve placing the used respirator in a clean, breathable container, like a paper bag, between uses. Regulatory guidance sometimes suggests limiting the number of uses to no more than five wears per device, though this is not a universal standard and should be guided by manufacturer recommendations.
Emergency Protocols for Extended Use and Decontamination
When new supplies are severely depleted, authorized government agencies may permit the use of specific decontamination methods for FFRs as a last resort. These authorized reprocessing techniques are strictly controlled and must not be confused with routine cleaning.
Vaporized Hydrogen Peroxide (VHP)
One common method is Vaporized Hydrogen Peroxide (VHP) decontamination, which uses a low-temperature process to convert concentrated hydrogen peroxide into a potent sterilizing vapor. The VHP vapor breaks down the cell components of microorganisms, effectively sterilizing the item before aeration converts the vapor back into water and oxygen.
Ultraviolet Germicidal Irradiation (UVGI)
Another technique is Ultraviolet Germicidal Irradiation (UVGI), which uses UV-C light to inactivate pathogens by damaging their genetic material. The effectiveness of UVGI can be limited, as the light cannot penetrate soiled surfaces or reach areas shielded from the direct beam, such as the inner layers of a mask. Both VHP and UVGI are suitable only for FFRs and are not used for surgical masks or gowns. Repeated decontamination cycles, especially with UVGI, can cause cumulative material damage, degrading the respirator’s fit and filtration efficiency over time.