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With shortages of N95 face masks persisting nationwide, healthcare facilities are scrambling to find ways to clean and treat the masks for reuse to protect doctors and nurses most at risk of exposure to COVID-19.

Duke University thinks it has found a solution using vaporized hydrogen peroxide to decontaminate the masks.

The process uses specialized equipment to vaporize hydrogen peroxide, which can then infuse all the layers of the mask to kill germs (including viruses) without degrading mask material.

“This is a decontamination technology and method we’ve used for years in our biocontainment laboratory,” said Scott Alderman, associate director of the Duke Regional Biocontainment Laboratory, in a statement.

The university said it has proven effective and will begin using the technology at all three of its hospitals, according to Matthew Stiegel, the director of the Occupational and Environmental Safety Office at Duke.

Ideally, the hospitals would be able to use fresh masks and not need to try to decontaminate their masks, but these are not ideal times.

Duke’s decision to use hydrogen peroxide to decontaminate N95 masks is based on published studies conducted in 2016, but the practice wasn’t widespread, because the industry wasn’t facing shortages. Those earlier studies also didn’t include fit-testing — or the resizing of masks for individual wearers — after cleaning. Duke has now done that efficacy testing in the real world, the university said.

“The ability to reuse the crucial N95 masks will boost the hospitals’ ability to protect front-line healthcare workers during this time of critical shortages of N95 masks,” said Cameron Wolfe, MD, associate professor of medicine and infectious disease specialist.

Monte Brown, MD, vice president at Duke University Health System, said the Duke team is working to spread the word about the technique, making the protocols widely available. He said several health systems and many pharmaceutical companies already have the needed equipment, which is currently used in different ways, and could ramp up operations to come to the aid of their local hospitals.

“We could stand up in front of our staff and state with confidence that we are using a proven decontamination method,” Brown said. “It has been a proven method for years. While this alone will not solve the problem, if we and others can reuse masks even once or twice, that would be a huge benefit given the current shortages.”