COVID-19 and a novel initiative to improve safety by 3D printing personal protective equipment parts from computed tomography

Provenzano D, Rao YJ, Mitic K, Obaid SN, Pierce D, Huckenpahler J, et al. Rapid Prototyping of Reusable 3D-Printed N95 Equivalent Respirators at the George Washington University. Preprints. 2020. doi: https://doi.org/10.20944/preprints202003.0444.v1. Pearce J. Distributed Manufacturing of Open-Source Medical Hardware for Pandemics. Preprints. 2020. doi: https://doi.org/10.20944/preprints202004.0054.v1. Asadi S, Bouvier N, Wexler AS, Ristenpart WD. The coronavirus pandemic and aerosols: does COVID-19 transmit via expiratory particles? Aerosol Sci Technol. 2020;54(6):635–8. https://doi.org/10.1080/02786826.2020.1749229. Livingston E, Desai A, Berkwits M. Sourcing personal protective equipment during the COVID-19 pandemic. JAMA. 2020. https://doi.org/10.1001/jama.2020.5317. Paxton NC, Forrestal DP, Desselle M, Kirrane M, Sullivan C, Powell SK, et al. N95 respiratory masks for COVID-19: a review of the literature to inform local responses to global shortages. 2020. Rowan NJ, Laffey JG. Challenges and solutions for addressing critical shortage of supply chain for personal and protective equipment (PPE) arising from coronavirus disease (COVID19) pandemic–case study from the Republic of Ireland. Sci Total Environ. 2020;725:138532. https://doi.org/10.1016/j.scitotenv.2020.138532. Center for Disease Control and Prevention. Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic [Internet]. 2020 [updated 2020, April 13; cited 2020, April 24]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html. American Society of Anesthesiologists. UPDATE: The Use of Personal Protective Equipment by Anesthesia Professionals during the COVID-19 Pandemic [Internet]. 2020 [updated 2020, Mar 22; cited 2020 Apr 24]. Available from: https://www.asahq.org/about-asa/newsroom/news-releases/2020/03/update-the-use-of-personal-protective-equipment-by-anesthesia-professionals-during-the-covid-19-pandemic. Elkington P, Dickinson A, Mavrogordato M, Spencer D, Gillams R, De Grazia A, et al. A Personal Respirator Specification for Health-care Workers Treating COVID-19 (PeRSo). 2020. doi: https://doi.org/10.31224/osf.io/rvcs3. Brosseau LM. Are powered air purifying respirators a solution for protecting healthcare workers from emerging aerosol-transmissible diseases? Ann Work Expo Heal. 2020. https://doi.org/10.1093/annweh/wxaa024. Chughtai AA, Seale H, Rawlinson WD, Kunasekaran M, Macintyre CR. Selection and use of respiratory protection by healthcare workers to protect from infectious diseases in hospital settings. Ann Work Expos Heal. 2020. https://doi.org/10.1093/annweh/wxaa020. Hwang SY, Yoon H, Yoon A, Kim T, Lee G, Jung KY, et al. N95 filtering facepiece respirators do not reliably afford respiratory protection during chest compression: a simulation study. Am J of Emerg Med. 2020;38(1):12–7. https://doi.org/10.1016/j.ajem.2019.03.041. Park SH, Hwang SY, Lee G, Park JE, Kim T, Shin TG, et al. Are loose-fitting powered air-purifying respirators safe during chest compression? A simulation study. Am J Emerg Med. 2020. https://doi.org/10.1016/j.ajem.2020.03.054. Bischoff W. Evaluation of a Novel Powered Air Purifying Respirator (PAPR) vs. a N95 Respirator Mask for the Protection against Influenza in a Human Exposure Model. Age. 2017;30:31.4. doi: https://doi.org/10.1093/ofid/ofx163.298. Zamora JE, Murdoch J, Simchison B, Day AG. Contamination: a comparison of 2 personal protective systems. CMAJ. 2006;175(3):249–54. https://doi.org/10.1503/cmaj.060094. Sreeramoju PV, Cadena J. Airborne precautions and personal protective equipment: the powered air-purifying respirator-only approach. Infection Prevention: Springer; 2018. p. 285–91. https://doi.org/10.1007/978-3-319-60980-5_30. Fischer R, Morris DH, van Doremalen N, Sarchette S, Matson J, Bushmaker T, et al. Assessment of N95 respirator decontamination and re-use for SARS-CoV-2. medRxiv. 2020. https://doi.org/10.1101/2020.04.11.20062018. Brohi SN, Jhanjhi N, Brohi NN, Brohi MN. Key Applications of State-of-the-Art Technologies to Mitigate and Eliminate COVID-19. pdf. 2020. doi: https://doi.org/10.36227/techrxiv.12115596.v2. Ibrahim D, Broilo TL, Heitz C, de Oliveira MG, de Oliveira HW, Nobre SM, et al. Dimensional error of selective laser sintering, three-dimensional printing and PolyJet™ models in the reproduction of mandibular anatomy. J Cranio Maxill Surg. 2009;37(3):167–73. https://doi.org/10.1016/j.jcms.2008.10.008. George E, Liacouras P, Rybicki FJ, Mitsouras D. Measuring and establishing the accuracy and reproducibility of 3D printed medical models. Radiographics. 2017;37(5):1424–50. https://doi.org/10.1148/rg.2017160165. Fedorov A, Beichel R, Kalpathy-Cramer J, Finet J, Fillion-Robin J-C, Pujol S, et al. 3D slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging. 2012;30(9):1323–41. https://doi.org/10.1016/j.mri.2012.05.001. Friese K-I, Blanke P, Wolter F-E. YaDiV—an open platform for 3D visualization and 3D segmentation of medical data. Vis Comput. 2011;27(2):129–39. https://doi.org/10.1007/s00371-010-0539-6. Kikinis R. 3D Slicer. FASEB J. 2012;26. Liao W, Deserno TM, Spitzer K, editors. Evaluation of free non-diagnostic DICOM software tools. Medical Imaging 2008: PACS and Imaging Informatics; 2008: International Society for Optics and Photonics. doi: https://doi.org/10.1117/12.770431. Schonfeld P. PAPR hose connector 2020 Thingiverse: MakerBot; 2020 [updated 2020, mar 25; cited 2020 Apr 25]. Available from: https://www.thingiverse.com/thing:4240755. Kurenov SN, Ionita C, Sammons D, Demmy TL. Three-dimensional printing to facilitate anatomic study, device development, simulation, and planning in thoracic surgery. J Thorac Cardiovasc Surg. 2015;149(4):973–9. https://doi.org/10.1016/j.jtcvs.2014.12.059. Chang D, Tummala S, Sotero D, Tong E, Mustafa L, Mustafa M, et al. Three-dimensional printing for procedure rehearsal/simulation/planning in interventional radiology. Tech Vasc Interv Radiol. 2019;22(1):14–20. https://doi.org/10.1053/j.tvir.2018.10.004. Tack P, Victor J, Gemmel P, Annemans L. 3D-printing techniques in a medical setting: a systematic literature review. Biomed Eng Online. 2016;15(1):115. https://doi.org/10.1186/s12938-016-0236-4. Rengier F, Mehndiratta A, von Tengg-Kobligk H, Zechmann CM, Unterhinninghofen R, Kauczor HU, et al. 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg. 2010;5(4):335–41. https://doi.org/10.1007/s11548-010-0476-x. Paul GM, Rezaienia A, Wen P, Condoor S, Parkar N, King W, et al. Medical applications for 3D printing: recent developments. Mo Med. 2018;115(1):75–81. Chepelev L, Wake N, Ryan J, Althobaity W, Gupta A, Arribas E, et al. Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios. 3D Print Med. 2018;4(1):11. https://doi.org/10.1186/s41205-018-0030-y. Coté JJ, Badura-Brack AS, Walters RW, Dubay NG, Bredehoeft MR. Randomized controlled trial of the effects of 3D-printed models and 3D ultrasonography on maternal-fetal attachment. J Obstet Gynecol Neonatal Nurs. 2020;49(2):190–9. https://doi.org/10.1016/j.jogn.2020.01.003. Weckenmann A, Krämer P. Editors. Computed tomography for application in manufacturing metrology. Key Engin Mater. 2010;437:73–8. https://doi.org/10.4028/www.scientific.net/kem.437.73. Villarraga-Gómez H, Peitsch CM, Ramsey A, Smith ST, editors. The role of computed tomography in additive manufacturing. 2018 ASPE and euspen summer topical meeting: advancing precision in additive manufacturing; 2018: Lawrence Berkeley National Laboratory Berkeley, California (USA). Harris BD, Nilsson S, Poole CM. A feasibility study for using ABS plastic and a low-cost 3D printer for patient-specific brachytherapy mould design. Australas Phys Eng Sci Med. 2015;38(3):399–412. https://doi.org/10.1007/s13246-015-0356-3. Cooper JM, Malkaw B. We need to relax intillectual property rules to fight the virus. The Hill [newspaper on the Internet]. 2020 Apr 6 [cited 2020 Apr 24]; Opinion: [about 3 screens]. Available from: https://thehill.com/opinion/judiciary/490742-we-need-to-relax-intellectual-property-rules-to-fight-this-virus. Tietze F, Vimalnath P, Aristodemou L, and Molloy, J. Crisis-Critical Intellectual Property: Findings from the COVID-19 Pandemic. Centre for Technology Management Working Paper Series, No. 2, April 2020. doi.org/10.2139/ssrn.3569282. Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against COVID–19. 85 Fed Reg. 52 (Mar 17, 2020) p. 15198–15203. Henry TM, Lessler JP. Special Exemptions from Product and Patent Liability for COVID-19 Countermeasures 2020 [updated March 26, 2020; cited 2020 March 26, 2020]. Available from: https://www.blankrome.com/publications/special-exemptions-product-and-patent-liability-covid-19-countermeasures. Post K, Rizzolo M, Lebow B. INSIGHT: The PREP Act May Ward Off Coronavirus-Related Patent Infringement Claims 2020 [updated April 10, 2020; cited 2020. Available from: https://news.bloomberglaw.com/ip-law/insight-the-prep-act-may-ward-off-coronavirus-related-patent-infringement-claims. Society of Mechanical Engineers. Additive Manufacturing Glossary [cited 2020 Apr 15]. Available from: https://www.sme.org/technologies/additive-manufacturing-glossary/. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation and treatment coronavirus (COVID-19). StatPearls. Treasure Island (FL): StatPearls Publishing; 2020. Deg C. 3D printing specifications 2020 [cited 2020 Apr 15]. Available from: https://www.3dheadquarter.com/wp-content/uploads/2020/03/Copper3d-nanaohack-doc.pdf. Food and Drug Administration. Emergency Use Authorization [updated April 25, 2020; cited 2020 April 25, 2020]. Available from: https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization#covidppe. Indirect food additives:polymers. 21 C.F.R. § 177 (2020). Tappa K, Jammalamadaka U. Novel biomaterials used in medical 3D printing techniques. J Funct Biomaterials. 2018;9(1):17. https://doi.org/10.3390/jfb9010017. Oth O, Dauchot C, Orellana M, Glineur R. How to Sterilize 3D Printed Objects for Surgical Use? An Evaluation of the Volumetric Deformation of 3D-Printed Genioplasty Guide in PLA and PETG after Sterilization by Low-Temperature Hydrogen Peroxide Gas Plasma. Open Dent J. 2019;13(1). https://doi.org/10.2174/1874210601913010410. Arany P, Roka E, Mollet L, Coleman AW, Perret F, Kim B, et al. Fused deposition modeling 3D printing: test platforms for evaluating Post-fabrication chemical modifications and in-vitro biological properties. Pharmaceutics. 2019;11(6):277. https://doi.org/10.3390/pharmaceutics11060277. Otero JJ, Vijverman A, Mommaerts MY. Use of fused deposit modeling for additive manufacturing in hospital facilities: European certification directives. J Craniomaxillofac Surg. 2017;45(9):1542–6. https://doi.org/10.1016/j.jcms.2017.06.018. Yew G, Yusof AM, Ishak ZM, Ishiaku U. Water absorption and enzymatic degradation of poly (lactic acid)/rice starch composites. Polym Degrad Stabil. 2005;90(3):488–500. https://doi.org/10.1016/j.polymdegradstab.2005.04.006. Sandler N, Salmela I, Fallarero A, Rosling A, Khajeheian M, Kolakovic R, et al. Towards fabrication of 3D printed medical devices to prevent biofilm formation. Int J Pharm. 2014;459(1–2):62–4. https://doi.org/10.1016/j.ijpharm.2013.11.001. Sonseca A, Madani S, Rodríguez G, Hevilla V, Echeverría C, Fernández-García M, et al. Multifunctional PLA blends containing chitosan mediated silver nanoparticles: thermal, mechanical, antibacterial, and degradation properties. Nanomaterials. 2020;10(1):22. https://doi.org/10.3390/nano10010022. Maróti P, Kocsis B, Ferencz A, Nyitrai M, Lőrinczy D. Differential thermal analysis of the antibacterial effect of PLA-based materials planned for 3D printing. J Therm Anal Calorim. 2020;139(1):367–74. https://doi.org/10.1007/s10973-019-08377-4. Ghozali M, Fahmiati S, Triwulandari E, Restu WK, Farhan D, Wulansari M, et al. PLA/metal oxide biocomposites for antimicrobial packaging application. Polym Plast Technol Eng. 2020:1–11. https://doi.org/10.1080/25740881.2020.1738475. Jesline A, John NP, Narayanan P, Vani C, Murugan S. Antimicrobial activity of zinc and titanium dioxide nanoparticles against biofilm-producing methicillin-resistant Staphylococcus aureus. Appl Nanosci. 2015;5(2):157–62. https://doi.org/10.1007/s13204-014-0301-x. Lavaee F, Faez K, Faez K, Hadi N, Modaresi F. Antimicrobial and antibiofilm activity of silver, titanium dioxide and iron nano particles. Am J Dent. 2016;29(6):315–20. Minoshima M, Lu Y, Kimura T, Nakano R, Ishiguro H, Kubota Y, et al. Comparison of the antiviral effect of solid-state copper and silver compounds. J Hazard Mater. 2016;312:1–7. https://doi.org/10.1016/j.jhazmat.2016.03.023. Jeong M, Park JM, Lee EJ, Cho YS, Lee C, Kim JM, et al. Cytotoxicity of ultra-pure TiO 2 and ZnO nanoparticles generated by laser ablation. B Korean Chem Soc. 2013;34(11):3301–6. https://doi.org/10.5012/BKCS.2013.34.11.3301. Baranowska-Wojcik E, Szwajgier D, Oleszczuk P, Winiarska-Mieczan A. Effects of titanium dioxide nanoparticles exposure on human health-a review. Biol Trace Elem Res. 2020;193(1):118–29. https://doi.org/10.1007/s12011-019-01706-6. Kumar P, Nene AG, Sood S, Kaur G, Punia S, Kumar M, et al. Synthesis and evaluation of antibacterial activity of Zinc Oxide nanoparticles. Int J Pharm Res. 2020;12(1):878–81. https://doi.org/10.31838/ijpr/2020.12.01.087. Ghaffari H, Tavakoli A, Moradi A, Tabarraei A, Bokharaei-Salim F, Zahmatkeshan M, et al. Inhibition of H1N1 influenza virus infection by zinc oxide nanoparticles: another emerging application of nanomedicine. J Biomed Sci. 2019;26(1):70. https://doi.org/10.1186/s12929-019-0563-4. Skalny AV, Rink L, Ajsuvakova OP, Aschner M, Gritsenko VA, Alekseenko SI, et al. Zinc and respiratory tract infections: perspectives for COVID19 (review). Int J Mol Med. 2020. https://doi.org/10.3892/ijmm.2020.4575. Te Velthuis AJ, van den Worm SH, Sims AC, Baric RS, Snijder EJ, van Hemert MJ. Zn2+ inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog. 2010;6(11). https://doi.org/10.1371/journal.ppat.1001176. Monse C, Raulf M, Hagemeyer O, van Kampen V, Kendzia B, Gering V, et al. Airway inflammation after inhalation of nano-sized zinc oxide particles in human volunteers. BMC Pulm Med. 2019;19(1):266. https://doi.org/10.1186/s12890-019-1026-0. Swaroop C, Shukla M. Nano-magnesium oxide reinforced polylactic acid biofilms for food packaging applications. Int J Biol Macromol. 2018;113:729–36. https://doi.org/10.1016/j.ijbiomac.2018.02.156. Luque-Agudo V, Fernandez-Calderon MC, Pacha-Olivenza MA, Perez-Giraldo C, Gallardo-Moreno AM, Gonzalez-Martin ML. The role of magnesium in biomaterials related infections. Colloids Surf B. 2020;191:110996. https://doi.org/10.1016/j.colsurfb.2020.110996. Mazaheri N, Naghsh N, Karimi A, Salavati H. In vivo Toxicity Investigation of Magnesium Oxide Nanoparticles in Rat for Environmental and Biomedical Applications. Iran J Biotechnol. 2019;17(1):e1543. https://doi.org/10.21859/ijb.1543. Jin T, He Y. Antibacterial activities of magnesium oxide (MgO) nanoparticles against foodborne pathogens. J Nanopart Res. 2011;13(12):6877–85. https://doi.org/10.1007/s11051-011-0595-5. Vidic J, Stankic S, Haque F, Ciric D, Le Goffic R, Vidy A, et al. Selective antibacterial effects of mixed ZnMgO nanoparticles. J Nanopart Res. 2013;15(5):1595. https://doi.org/10.1007/s11051-013-1595-4. Khezerlou A, Alizadeh-Sani M, Azizi-Lalabadi M, Ehsani A. Nanoparticles and their antimicrobial properties against pathogens including bacteria, fungi, parasites and viruses. Microb Patho. 2018;123:505–26. https://doi.org/10.1016/j.micpath.2018.08.008. Rafiei S, Rezatofighi SE, Ardakani MR, Madadgar O. In vitro anti-foot-and-mouth disease virus activity of magnesium oxide nanoparticles. IET Nanobiotechnol. 2015;9(5):247–51. https://doi.org/10.1049/iet-nbt.2014.0028. Nallamuthu N, Braden M, Oxford J, Williams D, Patel M. Modification of pH conferring Virucidal activity on dental alginates. Materials. 2015;8(4):1966–75. https://doi.org/10.3390/ma8041966. Borkow G, Zhou SS, Page T, Gabbay J. A novel anti-influenza copper oxide containing respiratory face mask. PLoS One. 2010;5(6):e11295. https://doi.org/10.1371/journal.pone.0011295. Borkow G, Gabbay J. Copper as a biocidal tool. Curr Med Chem. 2005;12(18):2163–75. https://doi.org/10.2174/0929867054637617. Borkow G, Sidwell RW, Smee DF, Barnard DL, Morrey JD, Lara-Villegas HH, et al. Neutralizing viruses in suspensions by copper oxide-based filters. Antimicrob Agents Chemother. 2007;51(7):2605–7. https://doi.org/10.1128/AAC.00125-07. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382:1564–7. https://doi.org/10.1056/NEJMc2004973. Ingle AP, Duran N, Rai M. Bioactivity, mechanism of action, and cytotoxicity of copper-based nanoparticles: a review. Appl Microbiol Biotechnol. 2014;98(3):1001–9. https://doi.org/10.1007/s00253-013-5422-8. Adeyemi JA, Machado ART, Ogunjimi AT, Alberici LC, Antunes LMG, Barbosa F Jr. Cytotoxicity, mutagenicity, oxidative stress and mitochondrial impairment in human hepatoma (HepG2) cells exposed to copper oxide, copper-iron oxide and carbon nanoparticles. Ecotoxicol Environ Saf. 2020;189:109982. https://doi.org/10.1016/j.ecoenv.2019.109982. Kim Y-S, Kim K-K, Shin S-M, Park S-M, Hah S-S. Comparative toxicity studies of ultra-pure Ag, au, co, and cu nanoparticles generated by laser ablation in biocompatible aqueous solution. B Korean Chem Soc. 2012;33(10):3265–8. https://doi.org/10.5012/bkcs.2012.33.10.3265. Adeyemi OS, Shittu EO, Akpor OB, Rotimi D, Batiha GE-S. Silver nanoparticles restrict microbial growth by promoting oxidative stress and DNA damage. EXCLI J. 2020;19:492–500. https://doi.org/10.17179/excli2020-1244. Elechiguerra JL, Burt JL, Morones JR, Camacho-Bragado A, Gao X, Lara HH, et al. Interaction of silver nanoparticles with HIV-1. J Nanobiotechnol. 2005;3(1):6. https://doi.org/10.1186/1477-3155-3-6. Morris D, Ansar M, Speshock J, Ivanciuc T, Qu Y, Casola A, et al. Antiviral and Immunomodulatory activity of silver nanoparticles in experimental RSV infection. Viruses. 2019;11(8):732. https://doi.org/10.3390/v11080732. Park S, Park HH, Kim SY, Kim SJ, Woo K, Ko G. Antiviral properties of silver nanoparticles on a magnetic hybrid colloid. Appl Environ Microbiol. 2014 Apr 15;80(8):2343–50. https://doi.org/10.1128/AEM.03427-13. Ferdous Z, Nemmar A. Health impact of silver nanoparticles: a review of the biodistribution and toxicity following various routes of exposure. Int J Mol Sci. 2020;21(7):2375. https://doi.org/10.3390/ijms21072375. Fleischer JC, Diehl JC, Wauben LS, Dankelman J. The Effect of Chemical Cleaning on Mechanical Properties of Three-Dimensional Printed Polylactic Acid. J Med Devices. 2020;14(1). https://doi.org/10.1115/1.4046120. Lee H, Eom RI, Lee Y. Evaluation of the Mechanical Properties of Porous Thermoplastic Polyurethane Obtained by 3D Printing for Protective Gear. Adv Mater Sci Eng. 2019;2019. doi: https://doi.org/10.1155/2019/5838361. Bonilla-Gameros L, Chevallier P, Sarkissian A, Mantovani D. Silver-based antibacterial strategies for healthcare-associated infections: processes, challenges, and regulations. Integ Rev Nanomed. 2020;24:102142. https://doi.org/10.1016/j.nano.2019.102142.