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The Journal of Allergy and Clinical... Jan 2022Although masks are recommended for those with asthma in the era of COVID-19, there is limited research exploring the extent of and problems related to mask use in adults...
BACKGROUND
Although masks are recommended for those with asthma in the era of COVID-19, there is limited research exploring the extent of and problems related to mask use in adults with asthma.
OBJECTIVE
We sought to describe in adults with asthma: (1) the extent masks are worn and attitudes and beliefs about wearing masks; (2) participant characteristics associated with problems experienced while wearing a mask, and (3) participant experiences and recommendations regarding masks.
METHODS
The Mask Use in Adults with Asthma online survey was conducted with 501 adults with asthma (96.6%) primarily from the United States. A Mask Effects Scale (MES) was compiled from items addressing problems experienced wearing a mask with higher total scores indicating more problems. Open-ended questions explored factors considered when choosing a mask, problems experienced while wearing a mask, and recommendations to others with asthma. Survey data were analyzed descriptively and via multiple regression. Themes were generated from open-ended items.
RESULTS
Almost all participants (98.4%) indicated wearing a mask in public, and most (67.4%) wore a mask ≤3 hours per day. Poorer asthma control and wearing a mask longer were significantly associated with higher MES scores (P ≤ .001 and .005, respectively). Participant recommendations included "Just wear it," use a comfortable, well-fitting mask, take mask breaks, and carry your inhaler.
CONCLUSIONS
Wearing a mask in public was almost uniformly adhered to by participants, despite reporting problematic effects. Implementing recommendations, such as planned mask breaks, can support and enhance the experience of wearing a mask for adults with asthma.
Topics: Adult; Asthma; COVID-19; Humans; Masks; SARS-CoV-2; Surveys and Questionnaires; United States
PubMed: 34785392
DOI: 10.1016/j.jaip.2021.10.071 -
Folia Phoniatrica Et Logopaedica :... 2022Voice diagnostics including voice range profile (VRP) measurement and acoustic voice analysis is essential in laryngology and phoniatrics. Due to COVID-19 pandemic,...
INTRODUCTION
Voice diagnostics including voice range profile (VRP) measurement and acoustic voice analysis is essential in laryngology and phoniatrics. Due to COVID-19 pandemic, wearing of 2 or 3 filtering face piece (FFP2/3) masks is recommended when high-risk aerosol-generating procedures like singing and speaking are being performed. Goal of this study was to compare VRP parameters when performed without and with FFP2/3 masks. Further, formant analysis for sustained vowels, singer's formant, and analysis of reading standard text samples were performed without/with FFP2/3 masks.
METHODS
Twenty subjects (6 males and 14 females) were enrolled in this study with an average age of 36 ± 16 years (mean ± SD). Fourteen patients were rated as euphonic/not hoarse and 6 patients as mildly hoarse. All subjects underwent the VRP measurements, vowel, and text recordings without/with FFP2/3 mask using the software DiVAS by XION medical (Berlin, Germany). Voice range of singing voice, equivalent of voice extension measure (eVEM), fundamental frequency (F0), sound pressure level (SPL) of soft speaking and shouting were calculated and analyzed. Maximum phonation time (MPT) and jitter-% were included for Dysphonia Severity Index (DSI) measurement. Analyses of singer's formant were performed. Spectral analyses of sustained vowels /a:/, /i:/, and /u:/ (first = F1 and second = F2 formants), intensity of long-term average spectrum, and alpha-ratio were calculated using the freeware praat.
RESULTS
For all subjects, the mean values of routine voice parameters without/with mask were analyzed: no significant differences were found in results of singing voice range, eVEM, SPL, and frequency of soft speaking/shouting, except significantly lower mean SPL of shouting with FFP2/3 mask, in particular that of the female subjects (p = 0.002). Results of MPT, jitter, and DSI without/with FFP2/3 mask showed no significant differences. Further mean values analyzed without/with mask were ratio singer's formant/loud singing, with lower ratio with FFP2/3 mask (p = 0.001), and F1 and F2 of /a:/, /i:/, /u:/, with no significant differences of the results, with the exception of F2 of /i:/ with lower value with FFP2/3 mask (p = 0.005). With the exceptions mentioned, the t test revealed no significant differences for each of the routine parameters tested in the recordings without and with wearing a FFP2/3 mask.
CONCLUSION
It can be concluded that VRP measurements including DSI performed with FFP2/3 masks provide reliable data in clinical routine with respect to voice condition/constitution. Spectral analyses of sustained vowel, text, and singer's formant will be affected by wearing FFP2/3 masks.
Topics: Acoustics; Adult; COVID-19; COVID-19 Testing; Female; Humans; Male; Masks; Middle Aged; Pandemics; Phonation; Speech Acoustics; Voice; Young Adult
PubMed: 35344948
DOI: 10.1159/000524299 -
Medical Engineering & Physics Dec 2021Medical professionals have complained of extreme discomfort and fatigue from continuous wearing of N95 respirators (N95) overlaid with surgical masks (SM) and face...
Medical professionals have complained of extreme discomfort and fatigue from continuous wearing of N95 respirators (N95) overlaid with surgical masks (SM) and face shields (FS) during COVID-19 pandemic. However, there are no reports on the effect of face coverings on transdermal CO (TrCO) levels (a measure of blood CO) during moderate activity. In this study, real-time monitoring of TrCO, heart rate and skin surface temperature was conducted for six subjects aged 20-59 years with and without wearing personal protective equipment (PPE). We initially studied the effect of wearing PPE (N95+SM+FS) at rest. Then, the effect of moderate stepping/walking activity (120 steps per minute for 60 min) while wearing PPE was evaluated. In addition, we investigated the effect of exercising intensity with different masks. We observed a significant difference (p < 0.0001) in TrCO levels between without and with PPE during moderate exercise, but not while resting. TrCO levels were correlated to exercise intensity independently with masking condition and breathability of masks. For the first time, we present data showing that a properly fitting N95 worn along with SM and FS consistently leads to elevated TrCO under moderate exertion, which could contribute to fatigue over long-term use.
Topics: COVID-19; Carbon Dioxide; Humans; Masks; Pandemics; SARS-CoV-2
PubMed: 34848038
DOI: 10.1016/j.medengphy.2021.10.013 -
BMJ Open Jul 2021To compare the impact of respirator extended use and reuse strategies with regard to cost and sustainability during the COVID-19 pandemic.
OBJECTIVES
To compare the impact of respirator extended use and reuse strategies with regard to cost and sustainability during the COVID-19 pandemic.
DESIGN
Cost analysis.
SETTING
USA.
PARTICIPANTS
All healthcare workers within the USA.
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
A model was developed to estimate usage, costs and waste incurred by several respirator usage strategies over the first 6 months of the pandemic in the USA. This model assumed universal masking of all healthcare workers. Estimates were taken from the literature, government databases and commercially available data from approved vendors.
RESULTS
A new N95 respirator per patient encounter would require 7.41 billion respirators, cost $6.38 billion and generate 84.0 million kg of waste in the USA over 6 months. One respirator per day per healthcare worker would require 3.29 billion respirators, cost $2.83 billion and generate 37.22 million kg of waste. Decontamination by ultraviolet germicidal irradiation would require 1.64 billion respirators, cost $1.41 billion and accumulate 18.61 million kg of waste. HO vapour decontamination would require 1.15 billion respirators, cost $1.65 billion and produce 13.03 million kg of waste. One reusable respirator with daily disposable filters would require 18 million respirators, cost $1.24 billion and generate 15.73 million kg of waste. Pairing a reusable respirator with HO vapour-decontaminated filters would reduce cost to $831 million and generate 1.58 million kg of waste. The use of one surgical mask per healthcare worker per day would require 3.29 billion masks, cost $460 million and generate 27.92 million kg of waste.
CONCLUSIONS
Decontamination and reusable respirator-based strategies decreased the number of respirators used, costs and waste generated compared with single-use or daily extended-use of disposable respirators. Future development of low-cost,simple technologies to enable respirator and/or filter decontamination is needed to further minimise the economic and environmental costs of masks.
Topics: COVID-19; Decontamination; Humans; Hydrogen Peroxide; Masks; Pandemics; SARS-CoV-2; Ventilators, Mechanical
PubMed: 34275864
DOI: 10.1136/bmjopen-2021-048687 -
American Journal of Infection Control Oct 2014To determine the physiological and subjective effects of wearing an N95 filtering facepiece respirator (N95 FFR) in advanced stages of pregnancy.
BACKGROUND
To determine the physiological and subjective effects of wearing an N95 filtering facepiece respirator (N95 FFR) in advanced stages of pregnancy.
METHODS
Healthy pregnant women (n = 22) and nonpregnant women (n = 22) had physiological and subjective measurements taken with and without wearing an N95 FFR during exercise and postural sedentary activities over a 1-hour period.
RESULTS
There were no differences between the pregnant and nonpregnant women with respect to heart rate, respiratory rate, oxygen saturation, transcutaneous carbon dioxide level, chest wall temperature, aural temperature, and subjective perceptions of exertion and thermal comfort. No significant effect on fetal heart rate was noted.
CONCLUSIONS
Healthy pregnant women wearing an N95 FFR for 1 hour during exercise and sedentary activities did not exhibit any significant differences in measured physiological and subjective responses compared with nonpregnant women.
Topics: Adult; Exercise; Female; Healthy Volunteers; Humans; Masks; Physiological Phenomena; Pregnancy; Sedentary Behavior
PubMed: 25278401
DOI: 10.1016/j.ajic.2014.06.025 -
BMC Infectious Diseases Oct 2015There has been increasing debate surrounding mask and respirator interventions to control respiratory infection transmission in both healthcare and community settings.... (Review)
Review
BACKGROUND
There has been increasing debate surrounding mask and respirator interventions to control respiratory infection transmission in both healthcare and community settings. As decision makers are considering the recommendations they should evaluate how to provide the most efficient protection strategies with minimum costs. The aim of this review is to identify and evaluate the existing economic evaluation literature in this area and to offer advice on how future evaluations on this topic should be conducted.
METHODS
We searched the Scopus database for all literature on economic evaluation of mask or respirator use to control respiratory infection transmission. Reference lists from the identified studies were also manually searched. Seven studies met our inclusion criteria from the initial 806 studies identified by the search strategy and our manual search.
RESULTS
Five studies considered interventions for seasonal and/or pandemic influenza, with one also considering SARS (Severe Acute Respiratory Syndrome). The other two studies focussed on tuberculosis transmission control interventions. The settings and methodologies of the studies varied greatly. No low-middle income settings were identified. Only one of the reviewed studies cited clinical evidence to inform their mask/respirator intervention effectiveness parameters. Mask and respirator interventions were generally reported by the study authors to be cost saving or cost-effective when compared to no intervention or other control measures, however the evaluations had important limitations.
CONCLUSIONS
Given the large cost differential between masks and respirators, there is a need for more comprehensive economic evaluations to compare the relative costs and benefits of these interventions in situations and settings where alternative options are potentially applicable. There are at present insufficient well conducted cost-effectiveness studies to inform decision-makers on the value for money of alternative mask/respirator options.
Topics: Cost-Benefit Analysis; Humans; Influenza, Human; Masks; Pandemics; Severe Acute Respiratory Syndrome; Tuberculosis; Ventilators, Mechanical
PubMed: 26462473
DOI: 10.1186/s12879-015-1167-6 -
The Journal of Hospital Infection Aug 2020An exceptionally high demand for surgical masks and N95 filtering facepiece respirators (FFRs) during the COVID-19 pandemic has considerably exceeded their supply. These...
BACKGROUND
An exceptionally high demand for surgical masks and N95 filtering facepiece respirators (FFRs) during the COVID-19 pandemic has considerably exceeded their supply. These disposable devices are generally not approved for routine decontamination and re-use as a standard of care, while this practice has widely occurred in hospitals. The US Centers for Disease Control and Prevention allowed it "as a crisis capacity strategy". However, limited testing was conducted on the impact of specific decontamination methods on the performance of N95 FFRs and no data was presented for surgical masks.
AIM
We evaluated common surgical masks and N95 respirators with respect to the changes in their performance and integrity resulting from autoclave sterilization and a 70% ethanol treatment; these methods are frequently utilized for re-used filtering facepieces in hospitals.
METHODS
The filter collection efficiency and pressure drop were determined for unused masks and N95 FFRs, and for those subjected to the treatments in a variety of ways. The collection efficiency was measured for particles of approximately 0.037-3.2 μm to represent aerosolized single viruses, their agglomerates, bacteria and larger particle carriers.
FINDINGS
The initial collection efficiency and the filter breathability may be compromised by sterilization in an autoclave and ethanol treatment. The effect depends on a protective device, particle size, breathing flow rate, type of treatment and other factors. Additionally, physical damages were observed in N95 respirators after autoclaving.
CONCLUSION
Strategies advocating decontamination and re-use of filtering facepieces in hospitals should be re-assessed considering the data obtained in this study.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Ethanol; Guidelines as Topic; Humans; Masks; Occupational Exposure; Pandemics; Pneumonia, Viral; Respiratory Protective Devices; SARS-CoV-2; Sterilization; United States; Ventilators, Mechanical
PubMed: 32599011
DOI: 10.1016/j.jhin.2020.06.030 -
Emergency Medicine Australasia : EMA Oct 2020Concerns have been raised by healthcare organisations in New Zealand that routine mask use by healthcare workers (HCW) may increase the risk of transmission of...
OBJECTIVE
Concerns have been raised by healthcare organisations in New Zealand that routine mask use by healthcare workers (HCW) may increase the risk of transmission of SARS-CoV-2 through increased face touching. Routine mask use by frontline HCW was not recommended when seeing 'low risk' patients. The aim of this review was to determine the carriage of respiratory viruses on facemasks used by HCW.
METHODS
A systematic review was conducted with structured searches of medical and allied health databases. Two authors independently screened articles for inclusion, with substantial agreement (k = 0.66, 95% CI 0.54-0.79). Studies that at least one author recommended for full text review were reviewed in full for inclusion. Two authors independently extracted data from included studies including the setting, method of analysis and results. There was exact agreement on the proportion of virus detected on masks.
RESULTS
We retrieved 1233 titles, 47 underwent full text review and five studies reported in four articles were included. The studies were limited by small numbers and failure to test all eligible masks in some studies. The proportion in each study ranged from 0 (95% CI 0-10) to 25% (95% CI 8-54). No study reported clinical respiratory illness as a result of virus on the masks.
CONCLUSIONS
Although limited, current evidence suggests that viral carriage on the outer surface of surgical masks worn by HCW treating patients with clinical respiratory illness is low and there was not strong evidence to support the assumption that mask use may increase the risk of viral transmission.
Topics: COVID-19; Coronavirus Infections; Female; Health Personnel; Humans; Incidence; Infectious Disease Transmission, Professional-to-Patient; Male; Masks; New Zealand; Pandemics; Patient Safety; Pneumonia, Viral; Risk Assessment
PubMed: 32578915
DOI: 10.1111/1742-6723.13581 -
The Science of the Total Environment Dec 2021Providing the greater public with the current coronavirus (SARS-CoV-2) vaccines is time-consuming and research-intensive; intermediately, some essential ways to reduce... (Review)
Review
Providing the greater public with the current coronavirus (SARS-CoV-2) vaccines is time-consuming and research-intensive; intermediately, some essential ways to reduce the transmission include social distancing, personal hygiene, testing, contact tracing, and universal masking. The data suggests that universal masking, especially using multilayer surgical face masks, offers a powerful efficacy for indoor places. These layers have different functions including antiviral/antibacterial, fluid barrier, particulate and bacterial filtration, and fit and comfort. However, universal masking poses a serious environmental threat since billions of them are disposed on a daily basis; the current coronavirus disease (COVID-19) has put such demands and consequences in perspective. This review focuses on surgical face mask structures and classifications, their impact on our environment, some of their desirable functionalities, and the recent developments around their biodegradability. The authors believe that this review provides an insight into the fabrication and deployment of effective surgical face masks, and it discusses the utilization of multifunctional structures along with biodegradable materials to deal with future demands in a more eco-friendly fashion.
Topics: COVID-19; Filtration; Humans; Masks; Pandemics; SARS-CoV-2
PubMed: 34329934
DOI: 10.1016/j.scitotenv.2021.149233 -
BMC Public Health Jul 2023Indoor event locations are particularly affected by the SARS-CoV-2 pandemic. At large venues, only incomplete risk assessments exist, whereby no suitable measures can be...
Indoor event locations are particularly affected by the SARS-CoV-2 pandemic. At large venues, only incomplete risk assessments exist, whereby no suitable measures can be derived. In this study, a physical and data-driven statistical model for a comprehensive infection risk assessment has been developed. At venues displacement ventilation concepts are often implemented. Here simplified theoretical assumptions fail for the prediction of relevant airflows for airborne transmission processes. Thus, with locally resolving trace gas measurements infection risks are computed more detailed. Coupled with epidemiological data such as incidences, vaccination rates, test sensitivities, and audience characteristics such as masks and age distribution, predictions of new infections (mean), situational R-values (mean), and individual risks on- and off-seat can be achieved for the first time. Using the Stuttgart State Opera as an example, the functioning of the model and its plausibility are tested and a sensitivity analysis is performed with regard to masks and tests. Besides a reference scenario on 2022-11-29, a maximum safety scenario with an obligation of FFP2 masks and rapid antigen tests as well as a minimum safety scenario without masks and tests are investigated. For these scenarios the new infections (mean) are 10.6, 0.25 and 13.0, respectively. The situational R-values (mean) - number of new infections caused by a single infectious person in a certain situation - are 2.75, 0.32 and 3.39, respectively. Besides these results a clustered consideration divided by age, masks and whether infections occur on-seat or off-seat are presented. In conclusion this provides an instrument that can enable policymakers and operators to take appropriate measures to control pandemics despite ongoing mass gathering events.
Topics: Humans; COVID-19; SARS-CoV-2; Lung; Masks; Risk Assessment
PubMed: 37474924
DOI: 10.1186/s12889-023-16154-0