Mass. nurses union balks at reused face masks

It alleges that even after decontamination, the equipment puts health care workers at risk.

The Massachusetts Nurses Associations says N95 face masks were meant for one-time use.Justin Chin/Bloomberg

The state’s largest nurses union is protesting the reuse of respirator masks that protect against coronavirus — even when they’ve been cleaned in an elaborate decontamination process — and is arguing that nurses should be able to refuse the masks and request new ones for each shift.

Hospitals and state and federal officials have said it’s safe to reuse masks when they’ve been properly sanitized. But officials at the Massachusetts Nurses Association, which has 23,000 members, say there isn’t enough evidence to support decontamination methods.

The union alleged this week that hospitals are withholding access to protective equipment and putting nurses at risk by forcing them to reuse respirator masks. The masks, known as N95s, help protect health care workers from respiratory droplets that carry coronavirus.

“These masks have always been designed to be one-time use,” said Judith Pare, director of nursing education and practice at the nurses union. “They were never designed to be reused, because over time the materials these masks are made out of naturally break down.”

Pare said nurses want to see long-term evidence that proves decontaminated masks are safe. “If the health care workforce becomes ill because we failed to protect them, who will be left to take care of them?” she said.

Many hundreds of health care workers at major Massachusetts health systems have contracted coronavirus over the past several weeks, but hospital officials have said those infections are largely the result of community spread — not problems with protective equipment for workers on the front lines. The union disputes that health care worker infections largely have occurred through community spread.

The Massachusetts union’s position follows statements by National Nurses United, an affiliated national labor group, which in early April said nurses should not have to reuse decontaminated masks.

Another union, 1199SEIU United Healthcare Workers East, said this week that hospitals should not decontaminate and reuse N95 masks — unless there is an “extreme shortage.”

"We oppose any occupational health practices that rely on the decontamination and reuse of N95 respirator masks or other PPE as standard practice," 1199SEIU said in a statement.

Hospital officials say the ability to clean and reuse respirator masks is critical to ensuring health care workers have enough protective equipment to safely work through the pandemic. In April, Partners HealthCare and the Ohio nonprofit Battelle teamed up to open a facility in Somerville that can sterilize 80,000 respirator masks per day.

Hospitals are following federal officials’ guidance on the proper use of personal protective equipment, said Patricia Noga, vice president for clinical affairs at the Massachusetts Health & Hospital Association.

“While hospitals continue to work around the clock to identify new sources of protective equipment," she said in a statement, "these decontamination solutions have made it possible for them to respond to this unprecedented health care challenge and meet the needs of the Commonwealth’s patients.”

Dr. Paul Biddinger, medical director for emergency preparedness at Partners HealthCare, said Partners — the state’s largest health system, including Massachusetts General, Brigham and Women’s, and other hospitals — has sent more than 20,000 respirators through the decontamination system.

Partners' data validates the safety of the respirators, Biddinger said, and employees have responded well to reusing the cleaned masks.

“We’ve not just looked to make sure that bacteria and viruses are killed, which is important, but also that the respirator still filters as effectively as it needs to,” he said. “All the data that we have has been extraordinarily reassuring.”

The availability of personal protective equipment — including masks, gowns, gloves, and face shields — has been a constant concern since the start of the coronavirus pandemic. Hospitals have been buying whatever supplies they can find, and state officials have taken unusual steps to obtain equipment, even using the New England Patriots team plane to bring shipments in from China.