Sir, I work for the Community Dental Service (CDS), have been fit tested for, and provided with, disposable FFP3 respirators. From discussion with colleagues in general practice and reviewing manufacturers' claims, reusable respirators potentially provide some advantages which include:

  • Relatively comfortable to wear for long periods (although not all would agree!)

  • Easy to clean

  • Reusable therefore economical and reduces environmental pollution

  • Easily changeable HEPAC filters

  • Positioning of expiratory valve reduces misting of visor.

I therefore approached the Infection Prevention and Control (IPC) lead in my employing trust to seek approval for the introduction of these masks in to our CDS. I was somewhat surprised by the response which effectively actively discouraged their use. The IPC view was that 'despite claims from manufacturers, these masks have not been designed for use in healthcare. As such their ability to be easily decontaminated has not been thought out with IPC in mind. The materials or fabrics used and the complex design conflicts with decontamination'.

This response presented a dilemma. Either the reusable masks are a suitable product, in which case they should be available to all dentists and DCPs, irrespective of branch of dentistry, or the limitations should be clearly set out and their use either prohibited or restricted to very specific circumstances. I was pleased to receive the NHS Dentistry and Oral Health Update dated 25 February 2021 (NHS England) with details of a new service to deal with PPE-related complaints and enquiries (ppe.complaintsandenquiries@nhs.net). Contact with them provided a prompt response containing the following link with relevant, important information: http://www.medidex.com/research/866-reprocessing-of-respirator-masks-covid19.html, leading to the UK Decision Making Committee on PPE (DMC) interim advice paper.1 Key points (available in more detail via the link) are:

  • Reusable half mask respiratory protective devices (P3 respirators) are generally used outside of a healthcare environment, however, they may be used when healthcare workers cannot pass or complete a fit test with single use respirator face masks, but are able to pass a fit test with a reusable respirator. This is particularly true for individuals with small faces, especially women

  • Reusable respirator masks are usually intended for use in a non-clinical environment - they are intended to protect against dust and particulate matter rather than microbiological challenges

  • They are not usually intended to be decontaminated after microbiological contamination

  • There is no currently agreed standard for decontamination of such masks and therefore a UK PPE Decontamination Group is working with industry to develop guidance on appropriate methods for the decontamination of reusable respirators for routine healthcare use

  • Currently any reprocessing is likely to be independent of manufacturers' instructions for use; therefore, it is the responsibility of healthcare providers to carry out a risk assessment before purchasing and deploying reusable respirators for their staff. The HSE state that employers should contact the manufacturer for advice on the decontamination of these devices, and satisfy themselves that there is nothing further that may impact upon the risk assessment and decision made

  • For reusable PPE already in use in a healthcare setting, employers should still contact the manufacturer for advice on the decontamination of these devices and perform a risk assessment

  • The DMC interim advice paper gives details of what should be incorporated into the risk assessment.

I would strongly recommend colleagues to review the information accessible via this link and trust that the BDA will also review this situation.