Since being first reported in December 2019, coronavirus disease 2019 (COVID-19) has continued to spread worldwide with more than 164 million confirmed cases and 3.4 million related deaths as of May 20, 2021.1 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the beta coronavirus which causes COVID-19, and is able to be spread via multiple modes of transmission, including direct contact and through airborne particulates.2 As a result, the importance of methods to reduce the spread of all types of infectious disease between individuals has been emphasized. While mask wearing as a mitigation technique has been effective, it has also revealed the shortcomings of current mask technologies.
Previous studies have shown masks to be effective at blocking the release of respiratory particles into the wearer’s nearby environment, while also acting as a filter that can reduce the exposure to these infectious droplets.3,4 However, the ability of a mask to protect the wearer is reduced when it is not used properly. One of the most common faults in the use of a protective face covering is contamination. Improper handling and storage of a mask when not in use, as well as prolonged use without sanitization, and physical touching of the mask material with infected hands can all contribute to the contamination of the face covering and the exposure of the wearer to these pathogens.5
Current mask technology is limited to two broad categories of face coverings: disposable and reusable. Both types have unique advantages and disadvantages, allowing for significant room for improvement. Disposable masks are designed for single-use and can easily be thrown away and replaced when contaminated, making them useful in clinical settings. However, the United Nations reported in July 2020 that an estimated 75% of the waste from disposable masks will end up in landfills or in the oceans.6 A September 2020 study estimated that 16,659 tons of medical waste is produced daily solely in Asia.7 With the spread of the COVID-19 pandemic, the rate of production of medical waste in the United states has increased from 5 million tons/year to 30 million tons/year.8 It is estimated that 75–90% of this waste is composed of nonhazardous paper and plastic materials, which includes disposable face masks and other personal protective equipment (PPE).9 Furthermore, the World Health Organization expects the demand for disposable PPE to increase by up to 20% by 2025 as additional emphasis is placed on reducing the spread of infectious disease.10
Reusable masks significantly reduce the amount of plastic waste produced; however, the repeated use of a single face covering can lead to the accumulation of harmful viruses and bacteria on the protective material.11 In order to maintain the function of reusable face coverings, they must be constantly washed, resulting in the expenditure of large amounts of water and electricity, while also taking extended periods of time for the sanitization process to be completed, making them expensive and impractical in clinical settings.
When considering alternative methods to sanitize a face covering, few options match effectiveness with practicality. Antiseptic solutions such as bleach are primarily used to disinfect hard surfaces and require copious amounts of water when used on porous materials.12 Autoclaves are commonly used to sterilize laboratory materials; however, these machines are expensive and impractical for use in many clinical settings and by the public.13 One method that combines efficiency and functionality is the use of concentrated ultraviolet radiation to sanitize surfaces.14,15,16 Ultraviolet C (UVC) radiation has been directly tested on SARS-CoV-2, and has been shown to hinder viral replication by damaging the nucleic acid genetic material.15 It was found that 254 nm UVC at an energy dosage of 5 mJ/cm2 inactivates 99% of the virus on surfaces.15 Buonanno, et. al. showed the effectiveness of using ultraviolet C radiation at wavelength 222 nm to destroy the outer shell of coronaviruses similar to SARS-CoV-2.16 It was found that an energy dosage of 2 mJ/cm2 successfully inactivated 99.9% of the alpha coronavirus HCoV-229E and 99.99% of the beta coronavirus HCoV-OC43.16 Germicidal UV light has long been proven useful in disinfecting surfaces to reduce the spread of other pathogens such as Mycobacterium tuberculosis, H1N1 Influenza, and Escherichia coli.14,16,17
Given the importance of facial coverings in order to reduce the transmission of COVID-19 between individuals, insufficient attention is given to the improvement of current mask design function and sustainability. There is a need for a mask that is more easily sanitized and can still be easily put on and removed, while also promoting healthy mask wearing. As a result, we have developed the Auto-sanitizing Retractable Mask Optimized for Reusability (ARMOR), to further combat the spread of COVID-19 and other infectious diseases and reduce unnecessary waste.
Armor Prototype Design
The idea behind our ARMOR is simple: use ultraviolet C radiation to kill bacteria and viruses on the face covering. However, there was much to be considered in the design. First, in order to provide maximum UVC exposure to the mask and limit exposure to the wearer, the light-emitting diode (LED) lamps must be contained within a case with the face covering at the time of sterilization. To achieve this, a case was designed to be worn around the wearer’s neck, with the mask contained inside while not being used (Fig. 1a). When the user requires use of the face covering, it can easily be extracted from the case and worn for as long as necessary (Fig. 1b). If the face covering becomes contaminated, it can be retracted back into the case with a simple press of a button where it is then disinfected.
The interior of ARMOR was designed to promote ease of use and maximal UVC exposure to all parts of the face covering (Fig. 1c). In this initial prototype, a cotton cloth was used as a sample face covering. Rods were used to define the track the mask follows when inside the case, creating a zig-zag pattern that prevents the material from folding in on itself and blocking areas from the LEDs. Polycarbonate was the selected material for these rods because it is permeable to UVC, allowing the germicidal radiation to reach the areas of the mask in direct contact with the rods. Ball bearings allow the rods to rotate while the mask glides over the track. A roller mechanism was employed to retract and deploy the face covering. One side of the roller contains an anchor which attaches to the left end cap, and the other side of the roller contains a ratchet mechanism which slips when the mask is being extracted. As the mask is pulled from the case, two strings attached to the bottom of the mask cause the roller to rotate, adding tension to a spring inside the roller. Upon complete extraction, the ratchet mechanism holds the spring tension until the retractor button is pressed, causing the clutch to disengage, allowing the spring tension to be released, which pulls the mask back into the case. The guides surrounding the roller act as a spool for the incoming string.
Four strips of 7 270 nm UVC-producing LEDs (28 lamps total) (cleanUV™, Waveform Lighting, Vancouver, WA) were placed in different locations around the interior of the case to provide exposure to all surfaces of the face covering (Fig. 2). Two rechargeable 3.7V lithium-ion batteries (lithium-ion cylindrical battery, Adafruit, New York City, NY) serve as the power source for ARMOR. The LEDs require a 12V power source, and therefore two isolated step-up voltage regulators (step-up regulator, Pololu Robotics and Electronics, Las Vegas, NV) were used to generate a 12V output. The batteries are confined in a separate space from the mask in ARMOR and can easily be accessed and removed for recharging with the removal of the rear battery cover. A push-button switch (Push-button switch 1A, CW Industries, Southampton, PA) allows for the LEDs to be turned on and off. The current iteration features a micro-USB port for recharging the batteries to provide increased ease of use (micro-LiPo charger with micro-USB jack, Adafruit, New York City, NY).