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Environmental Science and Pollution... Apr 2022A massive increase in the use and production of masks worldwide has been seen in the current COVID-19 pandemic, which has contributed to reducing the transmission of the...
A massive increase in the use and production of masks worldwide has been seen in the current COVID-19 pandemic, which has contributed to reducing the transmission of the virus globally. This paper aims to evaluate the life cycle environmental impacts of disposable medical masks to identify the life cycle stages that cause the highest impact on the environment. A further goal is to estimate the total environmental impacts at the global level in 2020. The inventory data was constructed directly from the industry. The system boundary of the study is from cradle to grave comprising raw material extraction and processing, production, packaging, distribution, use, and disposal as well as transport and waste management along the supply chain. Eleven environmental impacts have been estimated. The results suggest that the global warming potential of a disposable medical mask is 0.02 g CO-eq. for which the main contributor is the raw material supply (40.5%) followed by the packaging (30.0%) and production (15.5%). Sensitivity analysis was carried out to test the environmental impacts. In total, 52 billion disposable medical masks used worldwide consumes 22 TJ of energy in 2020. The global warming potential of disposable medical masks supplied in a year of the COVID-19 pandemic is 1.1 Mt CO eq. This paper assessed the hotspots in the medical mask. The findings of this study will be of interest to policymakers, global mask manufacturers, and users, allowing them to make more informed decisions about the medical mask industry.
Topics: Animals; COVID-19; Carbon Dioxide; Environment; Humans; Life Cycle Stages; Masks; Pandemics
PubMed: 34841484
DOI: 10.1007/s11356-021-17430-5 -
CMAJ : Canadian Medical Association... May 2016Conflicting recommendations exist related to which facial protection should be used by health care workers to prevent transmission of acute respiratory infections,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Conflicting recommendations exist related to which facial protection should be used by health care workers to prevent transmission of acute respiratory infections, including pandemic influenza. We performed a systematic review of both clinical and surrogate exposure data comparing N95 respirators and surgical masks for the prevention of transmissible acute respiratory infections.
METHODS
We searched various electronic databases and the grey literature for relevant studies published from January 1990 to December 2014. Randomized controlled trials (RCTs), cohort studies and case-control studies that included data on health care workers wearing N95 respirators and surgical masks to prevent acute respiratory infections were included in the meta-analysis. Surrogate exposure studies comparing N95 respirators and surgical masks using manikins or adult volunteers under simulated conditions were summarized separately. Outcomes from clinical studies were laboratory-confirmed respiratory infection, influenza-like illness and workplace absenteeism. Outcomes from surrogate exposure studies were filter penetration, face-seal leakage and total inward leakage.
RESULTS
We identified 6 clinical studies (3 RCTs, 1 cohort study and 2 case-control studies) and 23 surrogate exposure studies. In the meta-analysis of the clinical studies, we found no significant difference between N95 respirators and surgical masks in associated risk of (a) laboratory-confirmed respiratory infection (RCTs: odds ratio [OR] 0.89, 95% confidence interval [CI] 0.64-1.24; cohort study: OR 0.43, 95% CI 0.03-6.41; case-control studies: OR 0.91, 95% CI 0.25-3.36); (b) influenza-like illness (RCTs: OR 0.51, 95% CI 0.19-1.41); or (c) reported workplace absenteeism (RCT: OR 0.92, 95% CI 0.57-1.50). In the surrogate exposure studies, N95 respirators were associated with less filter penetration, less face-seal leakage and less total inward leakage under laboratory experimental conditions, compared with surgical masks.
INTERPRETATION
Although N95 respirators appeared to have a protective advantage over surgical masks in laboratory settings, our meta-analysis showed that there were insufficient data to determine definitively whether N95 respirators are superior to surgical masks in protecting health care workers against transmissible acute respiratory infections in clinical settings.
Topics: Cross Infection; Humans; Masks; Occupational Diseases; Occupational Exposure; Respiratory Protective Devices; Respiratory Tract Infections
PubMed: 26952529
DOI: 10.1503/cmaj.150835 -
Italian Journal of Dermatology and... Apr 2021During the recent COVID-19 outbreak, masks became mandatory and shortages frequent, therefore the prevalence of non-CE (European Conformity Mark) approved masks... (Comparative Study)
Comparative Study Observational Study
Masks use and facial dermatitis during COVID-19 outbreak: is there a difference between CE and non-CE approved masks? Multi-center, real-life data from a large Italian cohort.
BACKGROUND
During the recent COVID-19 outbreak, masks became mandatory and shortages frequent, therefore the prevalence of non-CE (European Conformity Mark) approved masks increased in the general population. We aimed to quantify the prevalence of mask-related cutaneous side effects and the differences between CE and non-CE approved masks.
METHODS
In this multicenter prospective observational study conducted from March 20, 2020 to May 12, 2020(during and after quarantine), patients attending emergency departments for a dermatological consult were clinically assessed and their masks were inspected to detect CE marks and UNI (Italian National Unification Entity) norms. Patients with history of facial dermatoses or under current treatment for facial dermatoses were excluded.
RESULTS
We enrolled 412 patients (318 during quarantine and 94 after quarantine). CE-approved masks were observed 52.8% vs. 24.5%, whilst subsets of non-CE approved masks were 9.7% vs. 14.9% (Personal protective equipment (PPE)-masks), 16.4% vs. 12.8% (surgical masks [SM]), and 21.1% vs. 47.9%(non-PPE) and (non-SM masks), respectively during and after quarantine. Remarkably, non-CE-approved masks resulted in patients displaying a statistically significant higher incidence of facial dermatoses and irritant contact dermatitis compared to CE-approved masks, and these differences were mainly driven by non-PPE non-SM masks. Comparing quarantine and after quarantine periods, no statistically significant differences were found for CE-approved masks, whilst differences were detected in non-CE-approved masks regarding incidence of facial dermatoses (P<0.0001)and irritant contact dermatitis (P=0.0041).
CONCLUSIONS
Masks are essential to prevent COVID-19 but at the same time higher awareness regarding mask specifications should be promoted in the general population. Non-PPE and non-SM masks should undergo more rigorous testing to prevent the occurrence of cutaneous side effects and future patients' lawsuit damages.
Topics: COVID-19; Dermatitis, Occupational; Disease Outbreaks; Facial Dermatoses; Humans; Italy; Masks; Personal Protective Equipment; Prospective Studies
PubMed: 33960753
DOI: 10.23736/S2784-8671.21.06895-4 -
Cell Reports Methods Sep 2023We introduce a generative data augmentation strategy to improve the accuracy of instance segmentation of microscopy data for complex tissue structures. Our pipeline uses...
We introduce a generative data augmentation strategy to improve the accuracy of instance segmentation of microscopy data for complex tissue structures. Our pipeline uses regular and conditional generative adversarial networks (GANs) for image-to-image translation to construct synthetic microscopy images along with their corresponding masks to simulate the distribution and shape of the objects and their appearance. The synthetic samples are then used for training an instance segmentation network (for example, StarDist or Cellpose). We show on two single-cell-resolution tissue datasets that our method improves the accuracy of downstream instance segmentation tasks compared with traditional training strategies using either the raw data or basic augmentations. We also compare the quality of the object masks with those generated by a traditional cell population simulation method, finding that our synthesized masks are closer to the ground truth considering Fréchet inception distances.
Topics: Computer Simulation; Masks; Microscopy
PubMed: 37725984
DOI: 10.1016/j.crmeth.2023.100592 -
The American Journal of Managed Care Jul 2021As of May 2021, the United States remains the world leader with 33 million of 165 million cases worldwide (20%) and 590,000 of 3.4 million deaths worldwide (17%) from...
As of May 2021, the United States remains the world leader with 33 million of 165 million cases worldwide (20%) and 590,000 of 3.4 million deaths worldwide (17%) from COVID-19. Achieving herd immunity by disease spread and vaccination may result in 2 million to 4 million total US deaths. The future perfect of the vaccine should not be the enemy of the present good, which is masking. Masking, especially when combined with social distancing, crowd avoidance, frequent hand and face washing, increased testing capabilities, and contact tracing, is likely to prevent at least as many premature deaths as the widespread utilization of an effective and safe vaccine. Worldwide, masking is the oldest and simplest engineered control to prevent transmission of respiratory pathogens. Masking has been a cornerstone of infection control in hospitals, operating rooms, and clinics for more than a century. Unfortunately, since the epidemic began in the United States, masking has become politicized. All countries, but especially the United States, must adopt masking as an urgent necessity and a component of coordinated public health strategies to combat the COVID-19 pandemic. Any economic advantages of pandemic politics are short-lived and shortsighted in comparison with public health strategies of proven benefit that can prevent needless and mostly avoidable premature deaths from COVID-19. During the worst epidemic in more than 100 years, most Americans (75%) trust their health care providers. As competent and compassionate health care professionals, we recommend that effective strategies, especially masking, and not pandemic politics, should inform all rational clinical and public health decision-making.
Topics: COVID-19; Contact Tracing; Humans; Infection Control; Masks; Physical Distancing; United States
PubMed: 34314121
DOI: 10.37765/ajmc.2021.88670 -
PloS One 2021Public health and social interventions are critical to mitigate the spread of the coronavirus disease 2019 (COVID-19) pandemic. Ethiopia has implemented a variety of...
Public health and social interventions are critical to mitigate the spread of the coronavirus disease 2019 (COVID-19) pandemic. Ethiopia has implemented a variety of public health and social measures to control the pandemic. This study aimed to assess social distancing and public health preventive practices of government employees in response to COVID-19. A cross-sectional study was conducted among 1,573 government employees selected from 46 public institutions located in Addis Ababa. Data were collected from 8th to 19th June 2020 using a paper-based self-administered questionnaire and analyzed using SPSS version 23.0. Descriptive statistics were used to summarize the data. Binary logistic regression analyses were used to identify factors associated with outcome variables (perceived effectiveness of facemask wearing to prevent coronavirus infection, and COVID-19 testing). Majority of the participants reported facemask wearing (96%), avoiding close contact with people including handshaking (94.8%), consistently followed government recommendations (95.6%), frequent handwashing (94.5%), practiced physical distancing (89.5%), avoided mass gatherings and crowded places (88.1%), restricting movement and travelling (71.8%), and stayed home (35.6%). More than 80% of the participants perceived that consistently wearing a facemask is highly effective in preventing coronavirus infection. Respondents from Oromia perceived less about the effectiveness of wearing facemask in preventing coronavirus infection (adjusted OR = 0.27, 95% CI:0.17-0.45). About 19% of the respondents reported that they had ever tested for COVID-19. Respondents between 40-49 years old (adjusted OR = 0.41, 95% CI:0.22-0.76) and 50-66 years (adjusted OR = 0.43, 95% CI:0.19-0.95) were less likely tested for coronavirus than the younger age groups. Similarly, respondents from Oromia were less likely to test for coronavirus (adjusted OR = 0.26, 95% CI:0.12-0.56) than those from national level. Participants who were sure about the availability of COVID-19 testing were more likely to test for coronavirus. About 57% of the respondents perceived that the policy measures in response to the pandemic were inadequate. The findings showed higher social distancing and preventive practices among the government employees in response to COVID-19. Rules and regulations imposed by the government should be enforced and people should properly apply wearing facemasks, frequent handwashing, social and physical distancing measures as a comprehensive package of COVID-19 prevention and control strategies.
Topics: Adolescent; Adult; COVID-19; COVID-19 Testing; Cross-Sectional Studies; Ethiopia; Female; Government Employees; Hand Disinfection; Humans; Male; Masks; Pandemics; Physical Distancing; Surveys and Questionnaires; Young Adult
PubMed: 34492089
DOI: 10.1371/journal.pone.0257112 -
Annals of Internal Medicine Nov 2020Guidelines differ in their guidance on the use of N95 respirators versus medical masks for frontline health care workers working with patients with COVID-19,...
Guidelines differ in their guidance on the use of N95 respirators versus medical masks for frontline health care workers working with patients with COVID-19, particularly when aerosolized procedures are not involved. This article makes the case that the existing data are inconclusive regarding the comparative effectiveness of N95 versus medical masks and could be misinterpreted. The authors suggest a reevaluation of this evidence or acknowledgement of these deficiencies in the setting of guidelines.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Masks; Pandemics; Personal Protective Equipment; Pneumonia, Viral; SARS-CoV-2
PubMed: 32598163
DOI: 10.7326/M20-2623 -
Scientific Reports Aug 2021The use of close-fitting PPE is essential to prevent exposure to dispersed airborne matter, including the COVID-19 virus. The current pandemic has increased pressure on...
The use of close-fitting PPE is essential to prevent exposure to dispersed airborne matter, including the COVID-19 virus. The current pandemic has increased pressure on healthcare systems around the world, leading to medical professionals using high-grade PPE for prolonged durations, resulting in device-induced skin injuries. This study focuses on computationally improving the interaction between skin and PPE to reduce the likelihood of discomfort and tissue damage. A finite element model is developed to simulate the movement of PPE against the face during day-to-day tasks. Due to limited available data on skin characteristics and how these vary interpersonally between sexes, races and ages, the main objective of this study was to establish the effects and trends that mask modifications have on the resulting subsurface strain energy density distribution in the skin. These modifications include the material, geometric and interfacial properties. Overall, the results show that skin injury can be reduced by using softer mask materials, whilst friction against the skin should be minimised, e.g. through use of micro-textures, humidity control and topical creams. Furthermore, the contact area between the mask and skin should be maximised, whilst the use of soft materials with incompressible behaviour (e.g. many elastomers) should be avoided.
Topics: Computer Simulation; Face; Finite Element Analysis; Friction; Humans; Masks; Skin Diseases; Skin Physiological Phenomena; User-Centered Design
PubMed: 34376802
DOI: 10.1038/s41598-021-95861-3 -
International Journal of Environmental... Dec 2021South Korea's social distancing policies on public transportation only involve mandatory wearing of masks and prohibition of food intake, similar to policies on other...
South Korea's social distancing policies on public transportation only involve mandatory wearing of masks and prohibition of food intake, similar to policies on other indoor spaces. This is not because public transportation is safe from coronavirus disease 2019 (COVID-19), but because no suitable policies based on accurate data have been implemented. To relieve fears regarding contracting COVID-19 infection through public transportation, the government should provide accurate information and take appropriate measures to lower the risk of COVID-19. This study aimed to develop a model for determining the risk of COVID-19 infection on public transportation considering exposure time, mask efficiency, ventilation rate, and distance. The risk of COVID-19 infection on public transportation was estimated, and the effectiveness of measures to reduce the risk was assessed. The correlation between the risk of infection and various factors was identified through sensitivity analysis of major factors. The analysis shows that, in addition to the general indoor space social distancing policy, ventilation system installation, passenger number reduction in a vehicle, and seat distribution strategies were effective. Based on these results, the government should provide accurate guidelines and implement appropriate policies.
Topics: COVID-19; Government; Humans; Masks; SARS-CoV-2; Transportation
PubMed: 34886516
DOI: 10.3390/ijerph182312790 -
Social Science & Medicine (1982) Jan 2021We define prediction bias as the systematic error arising from an incorrect prediction of the number of positive COVID cases x-weeks hence when presented with y-weeks of...
OBJECTIVE
We define prediction bias as the systematic error arising from an incorrect prediction of the number of positive COVID cases x-weeks hence when presented with y-weeks of prior, actual data on the same. Our objective is to investigate the importance of an exponential-growth prediction bias (EGPB) in understanding why the COVID-19 outbreak has exploded. To that end, our goal is to document EGPB in the comprehension of disease data, study how it evolves as the epidemic progresses, and connect it with compliance of personal safety guidelines such as the use of face coverings and social distancing. We also investigate whether a behavioral nudge, cost less to implement, can significantly reduce EGPB.
RATIONALE
The scientific basis for our inquiry is the received wisdom that infectious disease spread, especially in the initial stages, follows an exponential function meaning few positive cases can explode into a widespread pandemic if the disease is sufficiently transmittable. If people suffer from EGPB, they will likely make incorrect judgments about their infection risk, which in turn, may lead to reduced compliance of safety protocols.
METHOD
To collect data on prediction bias, we ran an incentivized, experiment on a global, online platform with participation from people in forty-three countries, each at different stages of progression of COVID-19. We also constructed several indices of compliance by surveying participants about their frequency of hand-washing and use of sanitizers and masks; their willingness to pay for masks; their view about the social appropriateness of others' behavior; and their like/dislike of government responses. The prediction data was used to construct several measures of EGPB. Our experimental design permits us to identify the root of under-prediction as EGPB arising from the general tendency to underestimate the speed at which exponential processes unfold.
RESULTS
Respondents make predictions about the path of the disease using a model that is substantially less convex than the actual data generating process. This creates significant EGPB, which, in turn, is significantly and negatively associated with non-compliance with safety measures. The bias is significantly higher for respondents from countries at a later stage relative to those at an early stage of disease progression. A simple behavioral nudge that shows prior data in terms of raw numbers, as opposed to a graph, causally reduces EGPB.
CONCLUSION
Behavioral biases concerning the comprehension of disease data are quantitatively important, and act as severe impediments to effective policy action against the spread of COVID-19. Clear communication of future infection risk via raw numbers could increase the accuracy of risk perception, in turn, facilitating compliance with suggested protective behaviors.
Topics: Adult; Bias; COVID-19; Female; Forecasting; Guideline Adherence; Guidelines as Topic; Hand Disinfection; Hand Sanitizers; Humans; Male; Masks; Public Health; Surveys and Questionnaires
PubMed: 33130402
DOI: 10.1016/j.socscimed.2020.113473