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PloS One 2022This study introduces a customized mask retainer to improve the fit performance of surgical masks using various advanced digital techniques. The participant's 3D face...
This study introduces a customized mask retainer to improve the fit performance of surgical masks using various advanced digital techniques. The participant's 3D face scans with and without a surgical mask were taken by using a smartphone. The mask retainer was designed using the 3D face scan data based on the facial anthropometric landmarks. The fitting was inspected and adjusted using the masked face scan data. The retainer was fabricated using a 3D printer. The effectiveness of the retainer on the augmentation of the fit of the surgical mask was tested according to the Chinese Standard (GB 19083-2010). A questionnaire was used to assess the effect of wearing surgical masks with and without retainers and N95 respirators on subjective perception of discomfort. The effectiveness test of the retainer on the augmentation of the fit performance showed a better than 25-fold increase in the overall fit factor, meeting the fit requirement for KN95 respirators in China. The subjective perception of discomfort of wearing N95 was significantly greater than surgical mask with and without retainers. The fit factor results indicated that by using the retainer, the overall fit factors and that of each exercise significantly increased compared to that of the group with the surgical mask alone. And compared with N95, the surgical mask with the retainer significant improved comfort. The surgical mask with the retainer can provide an alternative of personal protective equipment for healthcare workers.
Topics: Humans; Respiratory Protective Devices; Masks; N95 Respirators; Health Personnel; Materials Testing
PubMed: 36490277
DOI: 10.1371/journal.pone.0278889 -
Advances in Colloid and Interface... Jun 2021Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the novel coronavirus disease 2019 (COVID-19), has caused a global pandemic on a... (Review)
Review
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the novel coronavirus disease 2019 (COVID-19), has caused a global pandemic on a scale not seen for over a century. Increasing evidence suggests that respiratory droplets and aerosols are likely the most common route of transmission for SARS-CoV-2. Since the virus can be spread by presymptomatic and asymptomatic individuals, universal face masking has been recommended as a straightforward and low-cost strategy to mitigate virus transmission. Numerous governments and public health agencies around the world have advocated for or mandated the wearing of masks in public settings, especially in situations where social distancing is not possible. However, the efficacy of wearing a mask remains controversial. This interdisciplinary review summarizes the current, state-of-the-art understanding of mask usage against COVID-19. It covers three main aspects of mask usage amid the pandemic: quality standards for various face masks and their fundamental filtration mechanisms, empirical methods for quantitatively determining mask integrity and particle filtration efficiency, and decontamination methods that allow for the reuse of traditionally disposable N95 and surgical masks. The focus is given to the fundamental physicochemical and engineering sciences behind each aspect covered in this review, providing novel insights into the current understanding of mask usage to curb COVID-19 spread.
Topics: Aerosols; COVID-19; Decontamination; Humans; Masks
PubMed: 33971389
DOI: 10.1016/j.cis.2021.102435 -
Singapore Medical Journal Oct 2023Countries are mandating the use of face masks to stem the spread of coronavirus disease 2019 (COVID-19). Face mask use has been associated with discomfort due to its...
INTRODUCTION
Countries are mandating the use of face masks to stem the spread of coronavirus disease 2019 (COVID-19). Face mask use has been associated with discomfort due to its effects on thermoregulation, breathing and oxygenation. We evaluated the prevalence and severity of self-reported cardiovascular symptoms before and during face mask use.
METHODS
This was a cross-sectional study of 1,001 participants residing in Singapore, who participated in a self-administered questionnaire between 25 April 2020 and 4 May 2020. Symptom severity before and during mask use, and health-seeking behaviour information were collected. The study outcome was self-reported worsening of cardiovascular symptoms and its association with the type of mask worn, duration of mask worn per day, and intensity of physical activities during mask use.
RESULTS
The most common symptom reported during mask use was dyspnoea. Independent predictors for self-reported cardiovascular symptoms during mask use were moderate-high physical activity during mask use (odds ratio [OR] 1.634, 95% confidence interval [CI] 1.176-2.270, P = 0.003), duration of mask use for ≥3 h (OR 1.672, 95% CI 1.189-2.352, P = 0.003) and type of mask used, after adjusting for age, sex, healthcare-based worker status and presence of comorbidities. N95 mask was associated with worse symptoms when compared to surgical mask. Participants with ≥3 worsening symptoms or worsening dyspnoea, palpitations, fatigue and dizziness were more likely to seek medical help.
CONCLUSION
Face mask use has been proven to be an effective way in curbing COVID-19 transmission. However, participants in this study had concerns regarding its use and these concerns should be urgently addressed to enable mask use policies to be enacted.
Topics: Humans; COVID-19; Pandemics; Masks; Self Report; Cross-Sectional Studies; Dyspnea
PubMed: 34600453
DOI: 10.11622/smedj.2021140 -
PloS One 2020Dust masks are widely used to prevent the inhalation of particulate matter into the human respiratory organs in polluted air environments. The filter of a dust mask...
Dust masks are widely used to prevent the inhalation of particulate matter into the human respiratory organs in polluted air environments. The filter of a dust mask inherently obstructs the natural respiratory air flows, and this flow resistance is mainly responsible for the discomfort experienced when wearing a dust mask. In atmospheric conditions seriously contaminated with fine dust, it is recommended that common citizens wear a dust mask in their everyday lives, yet many people are reluctant to wear a dust mask owing to the discomfort experienced when wearing it for a long time. Understanding of physical reasons for the discomfort is thus crucial in designing a dust mask, but remains far from clear. This study presents a technique to quantify the wearing comfort of dust masks. By developing a respiration simulator to measure the pressure loss across a dust mask, we assessed the energy costs to overcome flow resistance when breathing through various types of dust masks. The energy cost for a single inhalation varies with the mask type in a range between 0 and 10 mJ. We compared the results with the survey results of 40 people about the wearing comfort of the dust masks, which revealed that the wearing comfort crucially depends on the energy cost required for air inhalation though the dust mask. Using the measured energy cost during inhalation as a parameter to quantify the wearing comfort, we present a comprehensive evaluation of the performance of dust masks in terms of not only the filtering performance but also the wearing comfort. Our study suggests some design principles for dust mask filters, auxiliary electric fans, and check valves.
Topics: Adult; Dust; Ear; Female; Filtration; Humans; Inhalation; Male; Masks; Middle Aged; Particulate Matter; Respiration; Respiratory Protective Devices
PubMed: 32817715
DOI: 10.1371/journal.pone.0237848 -
British Journal of Anaesthesia Jul 2023Difficult facemask ventilation is perilous in children whose tracheas are difficult to intubate. We hypothesised that certain physical characteristics and anaesthetic...
BACKGROUND
Difficult facemask ventilation is perilous in children whose tracheas are difficult to intubate. We hypothesised that certain physical characteristics and anaesthetic factors are associated with difficult mask ventilation in paediatric patients who also had difficult tracheal intubation.
METHODS
We queried a multicentre registry for children who experienced "difficult" or "impossible" facemask ventilation. Patient and case factors known before mask ventilation attempt were included for consideration in this regularised multivariable regression analysis. Incidence of complications, and frequency and efficacy of rescue placement of a supraglottic airway device were also tabulated. Changes in quality of mask ventilation after injection of a neuromuscular blocking agent were assessed.
RESULTS
The incidence of difficult mask ventilation was 9% (483 of 5453 patients). Infants and patients having increased weight, being less than 5th percentile in weight for age, or having Treacher-Collins syndrome, glossoptosis, or limited mouth opening were more likely to have difficult mask ventilation. Anaesthetic induction using facemask and opioids was associated with decreased risk of difficult mask ventilation. The incidence of complications was significantly higher in patients with "difficult" mask ventilation than in patients without. Rescue placement of a supraglottic airway improved ventilation in 71% (96 of 135) of cases. Administration of neuromuscular blocking agents was more frequently associated with improvement or no change in quality of ventilation than with worsening.
CONCLUSIONS
Certain abnormalities on physical examination should increase suspicion of possible difficult facemask ventilation. Rescue use of a supraglottic airway device in children with difficult or impossible mask ventilation should be strongly considered.
Topics: Infant; Humans; Child; Masks; Intubation, Intratracheal; Retrospective Studies; Respiration; Lung; Laryngeal Masks; Airway Management
PubMed: 37076335
DOI: 10.1016/j.bja.2023.02.035 -
International Journal of Nursing Studies Mar 2021Universal face mask use was recommended owing to the growing pandemic of the coronavirus disease (COVID-19). However, little is known about the public's compliance with...
BACKGROUND
Universal face mask use was recommended owing to the growing pandemic of the coronavirus disease (COVID-19). However, little is known about the public's compliance with mask-wearing behaviours.
OBJECTIVE
To evaluate the public's mask-wearing behaviours in the context of COVID-19.
DESIGN
Cross-sectional study.
SETTING
Online survey from 6 April 2020 to 5 May 2020 in China.
PARTICIPANTS
This study included 10,165 persons who lived in China, understood Chinese, and were not health care providers.
METHODS
Descriptive statistics were used to assess the public's mask-wearing behaviours. A binary logistic regression analysis was performed to identify the risk factors affecting the mask-wearing behaviours.
RESULTS
Nearly all (99%) people wore a mask during the covid-19 pandemic, with most (73.3%) demonstrating good compliance with face mask use. However, 41.8% of the participants seldom cleaned their hands before putting on a face mask, and more than half (55.3%, 62.1%) of those who touched (n=8108, 79.8%) or adjusted (n=9356, 92.0%) their mask while using it failed to consistently wash their hands afterward. When removing a used mask, 7.6% of the participants discarded it into a garbage bin without a lid and 22.5% discarded it into a garbage bin in their reach regardless of presence of a lid. Participants reported wearing disposable medical masks (93.8%), followed by N95 respirators (26.2%), and cloth face masks (8.5%). Some participants wore multiple masks simultaneously (occasionally 26.5%, often 2.1%, always 1.5%). A total of 5,981 (58.8%) participants reported reusing disposable masks, with nearly two thirds (n=3923, 65.6%) indicating they would hang the used masks in well-ventilated places. More than one-third (37.6%) of the respondents did not replace mask when it had been used for more than 8 hours. Exposure to instructions on face mask use was the strongest predictor of good compliance (odds ratio=4.13, 95% confidential interval= 3.60-4.75, p=0.000). Other factors included specific situations, location, and gender. The influence of age needs further investigation. Most participants (76.4%) accessed information mainly via social media platforms.
CONCLUSIONS
Nearly all people wore face mask and most of them used it properly during the COVID-19 pandemic. Hand hygiene before and during mask-wearing, choosing an appropriate type of face mask, reusing disposal face mask, and disposing of used face masks should be particularly emphasized in future evidence dissemination or behaviour-change interventions. Information on social media platforms for evidence dissemination and behaviour change may benefit the public the most, but this initiative requires further research to investigate its effectiveness.
Topics: Adolescent; Adult; Aged; COVID-19; China; Cross-Sectional Studies; Female; Hand Hygiene; Health Behavior; Humans; Male; Masks; Middle Aged; SARS-CoV-2; Surveys and Questionnaires; Young Adult
PubMed: 33352496
DOI: 10.1016/j.ijnurstu.2020.103853 -
Journal of Voice : Official Journal of... Nov 2022To analyze the vocal self-perception of individuals who wore face masks for essential activities and those who wore them for professional and essential activities during... (Observational Study)
Observational Study
OBJECTIVE
To analyze the vocal self-perception of individuals who wore face masks for essential activities and those who wore them for professional and essential activities during the coronavirus disease pandemic.
MATERIALS AND METHODS
This was an observational, descriptive, cross-sectional study. The study included 468 individuals who were stratified into two groups: the Working Group, comprising individuals who wore face masks for professional and essential activities during the pandemic; and the Essential Activities Group, with individuals who wore face masks only for essential activities during the pandemic. The outcome measures tested were self-perception of vocal fatigue, vocal tract discomfort, vocal effort, speech intelligibility, auditory feedback, and coordination between speech and breathing. Descriptive and inferential statistics were performed.
RESULTS
Face masks increased the perception of vocal effort, difficulty in speech intelligibility, auditory feedback, and difficulty in coordinating speech and breathing, irrespective of usage. Individuals who wore face masks for professional and essential activities had a greater perception of symptoms of vocal fatigue and discomfort, vocal effort, difficulties in speech intelligibility, and in coordinating speech and breathing.
CONCLUSION
Use of face masks increases the perception of vocal symptoms and discomfort, especially in individuals who wore it for professional and essential activities.
Topics: Humans; Masks; Cross-Sectional Studies; Pandemics; Voice Disorders; Speech Intelligibility; Self Concept
PubMed: 33011037
DOI: 10.1016/j.jvoice.2020.09.006 -
Anesthesia and Analgesia Jul 2018Manual positive pressure ventilation is an essential skill in a variety of clinical situations. The C&E technique is commonly used with standard facemasks to provide... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Manual positive pressure ventilation is an essential skill in a variety of clinical situations. The C&E technique is commonly used with standard facemasks to provide effective ventilation. The Tao mask is a novel design that allows a more ergonomic grip. A seal between the mask and face is made with downward pressure of the palm, centered on the mask, and jaw lift is achieved with 4 fingers centered under the mandible. The purpose of this study was to evaluate the safety and effectiveness of the Tao mask compared to a standard mask before and after the administration of neuromuscular blockade (NMB) using 2 previously established ventilation scales.
METHODS
One hundred fifty-two patients >18 years of age who were scheduled for general anesthesia were recruited. All care team members were shown a brief instructional video on the use of the Tao mask. After induction of general anesthesia with a standardized protocol, each patient was ventilated with both the standard (Vital Signs #082510) and Tao masks and effectiveness was measured using the Han and Warters scales. This process was repeated after NMB. The sequence of masks was determined with a random-number generator.
RESULTS
Tao mask ventilation scores were significantly better than standard mask scores on both the Han scale and the Warters scale before the administration of NMB (P < .001 for both). Tao mask scores were also significantly better than standard mask scores on the Warters scale after the administration of NMB (P < .001). However, there was no significant difference on the Han scale between the 2 mask types after NMB (P = .180). On the Warters scale, there were significantly fewer patients who were difficult to ventilate with the Tao mask than the standard mask before NMB (18 vs 40; P < .001) and after NMB (8 vs 17; P = .005). No adverse events were reported with either mask.
CONCLUSIONS
Our results indicate that the Tao mask demonstrated equivalent safety and superior effectiveness compared to a standard mask. The study design favored the standard mask because all participating practitioners had multiple years of experience with the standard mask and no prior experience with the Tao mask. Since the incidence of inadequate mask ventilation goes up significantly with inexperienced operators, the improved effectiveness of the Tao mask could be even more profound with novice operators.
Topics: Adult; Aged; Anesthesia, General; Equipment Design; Equipment Failure; Female; Humans; Male; Masks; Middle Aged; Neuromuscular Blockade; Patient Safety; Positive-Pressure Respiration; Risk Assessment; Risk Factors
PubMed: 29135589
DOI: 10.1213/ANE.0000000000002621 -
The European Physical Journal. E, Soft... Jun 2021Face masks are used to trap particles (or fluid drops) in a porous material (filter) in order to avoid or reduce the transfer of particles between the human lungs (or...
Face masks are used to trap particles (or fluid drops) in a porous material (filter) in order to avoid or reduce the transfer of particles between the human lungs (or mouth and nose) and the external environment. The air exchange between the lungs and the environment is assumed to occur through the face mask filter. However, if the resistance to air flow through the filter is high some air (and accompanied particles) will leak through the filter-skin interface. In this paper I will present a model study of the side-leakage problem.
Topics: Masks; Particle Size
PubMed: 34089395
DOI: 10.1140/epje/s10189-021-00081-2 -
Journal of Medical Radiation Sciences Dec 2018While use of a thermoplastic mask during radiotherapy (RT) treatment for head and neck cancer (HNC) is an essential component of safe patient care, there is little...
INTRODUCTION
While use of a thermoplastic mask during radiotherapy (RT) treatment for head and neck cancer (HNC) is an essential component of safe patient care, there is little understanding of the extent to which this evokes anxiety (i.e. "mask anxiety") for the person undergoing treatment.
METHODS
A mixed method, convergent design was used to examine the prevalence and experience of mask anxiety using two clinical cohorts. In phase one, a cohort of 100 patients undergoing RT for HNC were assessed for self-perceived mask anxiety using a modified distress thermometer screening tool. In phase two, a separate cohort of 20 patients who identified as having mask anxiety participated in individual interpretative descriptive interviews to explore the nature of their experience.
RESULTS
In phase one, 26% of participants self-identified as being anxious about the use of a thermoplastic mask. In phase two thematic analysis of the interviews revealed two over-arching themes relating to the person's experience of mask anxiety: contributors to the mask anxiety (vulnerability, response to experience and expectations); and how the person was going to manage the mask anxiety during treatment (strategies and mindset).
CONCLUSIONS
Mask anxiety impacted a quarter of participants undergoing radiotherapy for HNC. In line with the themes elicited from the participants, implementation of routine screening to ensure early identification, and patient education to assist preparation for wearing the mask during RT are strategies that could improve current management of mask anxiety.
Topics: Adult; Aged; Aged, 80 and over; Anxiety; Female; Head and Neck Neoplasms; Humans; Male; Masks; Middle Aged
PubMed: 30378282
DOI: 10.1002/jmrs.308