The effect of face masks on our health

The Effect of Face Masks on Our Health
Prepared By
Yousef Elshrek

• Prevention of infection with airborne pathogens and exposure to airborne
particulates and aerosols (environmental pollutants and allergens) can be
facilitated through use of disposable face masks.
• The effectiveness of such masks for excluding pathogens and pollutants is
dependent on the intrinsic ability of the masks to resist penetration by airborne
contaminants.
• The masks, with or without features intended for enhancing comfort, provide
protection against both small- and large-size pathogens.
• Importantly, the mask appears to be highly efficient for filtration of pathogens,
including influenza and rhinoviruses, as well as the fine particulates present in
aerosols that represent a greater challenge for many types of dental and
surgical masks.
Introduction

• The wearing of face masks during the COVID-19
pandemic has received varying recommendations from
different public health agencies and governments.
• The World Health Organization and other public health
organizations agree that masks can limit the spread of
respiratory viral diseases such as COVID-19.
• However, the topic has been a subject of debate, with some
public health agencies and governments disagreeing on a
protocol for wearing face masks.
Introduction

• As of early May 2020, 88% of the world's population lives in countries that
recommend or mandate the use of masks in public; more than 75 countries
have mandated the use of masks.
• Debates have emerged regarding whether masks should be worn even when
social distancing at 2 meters (6 feet), and whether they should be worn during
exercise.
• Additionally, public health agencies of some countries and territories have
changed their recommendations regarding face masks over time.
• Face masks have been a subject of shortages, and not all have been certified.
• Moreover, substandard masks were reported on the market with significantly
reduced performance.
Introduction

• The COVID-19 outbreak is placing
stress on resources available for
personal protective equipment.
• In the setting of disaster response, there
is concern over the adequate supply of
both surgical masks, N95 and N99
masks.
• Masks must be used responsibly, and
excessive use of either surgical masks
or N95 or N99 masks may create future
risks.
https://cms.qz.com/wpcontent/uploads/2020/03/RTS34V4P.jpg?quality
=75&strip=all&w=1600&h=1068
https://www.fda.gov/files/surgical-mask.jpg
N95 mask
surgical masks
Introduction

• The recommendation is that surgical masks are sufficient to
prevent the transmission of COVID-19 for medical staff
who are not in high-risk situation.
• By WHO recommendation, N95 masks are only essential for
healthcare workers who are involved in procedures of
COVID-19 patients which may generate aerosols.
• In these days' masks are needed for administrative workers
and those in public patient interactions and for all people.
Introduction

• Cloth face masks
• medical (non-surgical) masks.
• surgical masks.
• filtering facepiece respirators such as N95 masks and FFP
masks (filtering facepiece mask), also called respiratory
protection mask or simply respirator is a type of protective
mask certified by the European Union that serves to protect
against particulates such as dust particles.
• The EN 149 standard defines three classes of filter efficiency
for these masks, namely FFP1, FFP2 and FFP3).
Types of face masks include
https://upload.wikimedia.org/wikipedia/c
ommons/4/48/Atemluftfilter_Einwegmas
ke.jpg
Filtering half mask with
exhalation valve (FFP3)

• Face shields, medical goggles, and other types of personal
protective equipment are sometimes used together with face
masks.
https://images-na.ssl-images-
amazon.com/images/I/81PGlr1ZbTL._AC_SL1500_.jpg
Face shieldsMedical goggles
https://cdn.shopify.com/s/files/1/0371/6369/6261/products/1_396f7b1a-
11b9-4ea1-832b-fbef2d44b33c_480x480.jpg?v=1588034732
Filtering half mask with
exhalation valve
https://upload.wikimedia.org/wikipedia/c
ommons/4/48/Atemluftfilter_Einwegmas
ke.jpg

Source: GVS filter technology

• Cloth face coverings are an additional step to help
slow the spread of COVID-19 when combined with
every day preventive actions and social distancing
in public settings
• Who should not use cloth face coverings:
• children under age 2, or anyone who has trouble
breathing, is unconscious, incapacitated or
otherwise unable to remove the mask without
assistance.
• Cloth face coverings are NOT surgical masks or
N95 respirators.
• Currently, surgical masks and N95 respirators are
critical supplies that should be reserved for
healthcare workers and other first responders.
French cloth face masks.
https://upload.wikimedia.org/wikipedia/commons/thumb/6/68/Deu
x_masques_grand_public.jpg/1024px-
Deux_masques_grand_public.jpg
Cloth face masks

• Cloth face coverings are not surgical masks or N95
respirators.
• Currently, surgical masks and N95 or N99 respirators
are critical supplies that should be reserved for
healthcare workers and other first responders.
• Wear your Face Covering Correctly
• Wash your hands before putting on your face covering
• Put it over your nose and mouth and secure it under
your chin
• Try to fit it snugly against the sides of your face
• Make sure you can breathe easily
https://www.cdc.gov/coronavirus/2019-ncov/images/prevent-getting-
sick/fitting-cloth-facemask-small.png
Cloth face masks
How to Wear Face
Covering Correctly

https://www.cdc.gov/coronavirus/2019-ncov/images/prevent-getting-
sick/dos-donts.jpg
• Wear a face covering to help protect others
in case you’re infected but don’t have
symptoms
• Wear the covering in public settings when
around people who don’t live in your
household, especially when other social
distancing measures are difficult to maintain
• Don’t put the covering around your neck or
up on your forehead
• Don’t touch the face covering, and, if you
do, wash your hands
Use the Face Covering to Protect Others

1. Stay at least 6 feet
away from others
2. Avoid contact with people
who are sick
3. Wash your hands often,
with soap and water, for at
least 20 seconds each time
4. Use hand sanitizer if soap
and water are not available
Follow Everyday Health Habits
https://www.cdc.gov/
Stay at least 6 feet away from others

5. Take off your cloth face covering carefully, when you’re Home
untie the strings behind your head or stretch the ear loops
6. Handle only by the ear loops or ties
7. Fold outside corners together
8. Place covering in the washing machine (learn more about how
to wash cloth face coverings)
9. Be careful not to touch your eyes, nose, and mouth when
removing and wash hands immediately after removing.
Follow Everyday Health Habits

• Cloth face coverings are an additional step to help slow the
spread of COVID-19 when combined with every day
preventive actions and social distancing in public settings.
• Cloth face coverings should be washed after each use.
• It is important to always remove face coverings correctly and
wash your hands after handling or touching a used face
covering
How to Wash Cloth Face Coverings

• Washing machine
• You can include your face
covering with your regular
laundry.
• Use regular laundry detergent
and the warmest appropriate
water setting for the cloth used
to make the face covering. https://www.cdc.gov/coronavirus/2019-ncov/images/prevent-getting-sick/wash-face covering-01-
washer.png
How to clean the masks

• Prepare a bleach solution by
mixing:
o 5 tablespoons (1/3rd cup)
household bleach per gallon of
room temperature water or
o 4 teaspoons household bleach
per quart of room temperature
water
Washing by hand

• Check the label to see if your bleach is
intended for disinfection.
• Some bleach products, such as those designed for safe
use on colored clothing, may not be suitable for
disinfection.
• Ensure the bleach product is not past its expiration date.
• Never mix household bleach with ammonia or any other
cleanser.
• Soak the face covering in the bleach solution for 5
minutes.
• Rinse thoroughly with cool or room temperature water.
Washing by hand

•How to dry
• Dryer
• Use the highest heat setting and leave in
the dryer until completely dry.
• Air dry
• Lay flat and allow to completely dry.
• If possible, place the cloth face covering
in direct sunlight.
Make sure to completely dry cloth
face covering after washing.

Surgical Masks
• A surgical mask is a loose-fitting,
disposable device that creates a physical
barrier between the mouth and nose of
the wearer and potential contaminants in
the immediate environment.
• Surgical masks are regulated under 21
CFR 878.4040.
• Surgical masks are not to be shared and
may be labeled as surgical, isolation,
dental, or medical procedure masks.
https://upload.wikimedia.org/wikipedia/commons/thumb/3/34/Surgi
cal_face_mask.jpg/1024px-Surgical_face_mask.jpg
A surgical mask

Surgical Masks

https://upload.wikimedia.org/wikipedia/commons/thumb/3/34/Surgi
cal_face_mask.jpg/1024px-Surgical_face_mask.jpg
A surgical mask
• They may come with or without a face
shield.
• These are often referred to as face
masks, although not all face masks are
regulated as surgical masks.
• Surgical masks are made in different
thicknesses and with different ability to
protect you from contact with liquids.
• These properties may also affect how
easily you can breathe through the face
mask and how well the surgical mask
protects you.
https://products.halyardhealth.com/media/catalog/product/cache/1/image/3
00x/9df78eab33525d08d6e5fb8d27136e95/s/u/surgical_mask-49701-blue.jpg
Surgical Masks

https://upload.wikimedia.org/wikipedia/commons/thumb/d/db/CPMC_Sur
gery_%28412142792%29.jpg/1024px-
CPMC_Surgery_%28412142792%29.jpg
• If worn properly, a surgical mask is meant to help
block large-particle droplets, splashes, sprays, or
splatter that may contain germs (viruses and
bacteria), keeping it from reaching your mouth
and nose.
• Surgical masks may also help reduce exposure of
your saliva and respiratory secretions to others.
• While a surgical mask may be effective in
blocking splashes and large-particle droplets, a
face mask, by design, does not filter or block very
small particles in the air that may be transmitted
by coughs, sneezes, or certain medical
procedures.
Surgical Masks
Surgical masks

• Surgical masks also do not provide complete protection
from germs and other contaminants because of the
loose fit between the surface of the mask and your face.
• Surgical masks are not intended to be used more than
once.
• If your mask is damaged or soiled, or if breathing
through the mask becomes difficult, you should remove
the face mask, discard it safely, and replace it with a
new one.
• To safely discard your mask, place it in a plastic bag
and put it in the trash.
• Wash your hands after handling the used mask.
Special trash cans to collect the used
facial masks and other household
medial equipment have been set up
in a residential community in Xigu
District of Lanzhou city, Gansu.
[photo provided to
chinadaily.com.cn]
https://img2.chinadaily.com.cn/images/202002/05/5
e3a0801a3101282064f8589.jpeg
Surgical Masks

• The CDC Trusted Source recommends that the general public
use cloth face masks.
• They specify, “The cloth face coverings recommended are not
surgical masks or N-95 respirators.”
• However, the CDC emphasizes that the reason we shouldn’t be
using N95 masks isn’t health-related, but because they “must
continue to be reserved for healthcare workers and other medical
first responders.”
What to know about N95 masks?

• “Rebreathing tiny amounts of CO2 from wearing either properly
fitted N95 respirators or more loosely fitted cloth or surgical
masks is of no concern for the vast, vast majority of people,”
• Even workers, including medical providers, wearing surgical or
cloth masks for a whole shift should have no concerns about
retaining CO2 and shouldn’t worry about negative effects from
wearing a mask.
• The ‘dose’ of CO2 we might rebreathe while masking is quickly
and easily eliminated by both the respiratory and metabolic
systems in the body.
What to know about N95 masks

Source: GVS filter

• Wearer comfort can be enhanced by a
variety of modifications to the masks,
including (among others) the addition
to the face mask of features such as
the Micro Ventilator (comprising a
Smart Valve and ventilation fan)
(Figure 1).)
• The Micro Ventilator improves the
flow of exhaled gas out of the mask
(11).
Schematic representation of the N95 test mask, the features designed to enhance
wearer comfort, and the permitted airflows. (A) Airflow through the test mask during
an exhalation; (B) detail of Smart Valve (located beneath the ventilator fan) showing
the permitted air flow from inside to outside of the mask.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906272/bin/jtd-10-03-2059-f1.jpg
the N95 test mask, the features designed
to enhance wearer comfort.

• The purpose of the one-way Smart Valve is to limit the air flow
into the mask through the valve such that all the air must pass
through the filter material
• On the other hand, exhaled air may pass out of the mask
through the valve.
• The purpose of the fan is to aid in the removal of
exhaled air from the interior of the mask.
The Dettol PROTECT+ Smart Mask

• The Dettol PROTECT+ Smart
Mask Large size (hereafter
called the “test mask”)
(Figure 1) incorporates these
features that are designed for
the purpose of enhancing
wearer comfort (11.
Stay cool and comfortable. Micro Fan keeps you cool
and comfortable by removing heat, moisture and CO2.
https://www.dettolsitishield.co.in/media/1125/fan.png
https://www.dettolsitishield.co.in/media/1144/170921-air-2349_front-edit.png
The Dettol PROTECT+ Smart Mask

• Surgical and N95 masks are both intended to minimize the
spread of disease.
• Surgical masks protect users from pathogens spreading via
droplets.
• N95 masks, when fitted correctly, limit the spread of droplets
and aerosolized pathogens.
• Evidence supports that COVID19 is not aerosolized. 2
• Therefore, surgical masks are sufficient for most healthcare
workers.
What is the difference between a surgical mask
and N95 mask?

• N95 masks are designed for infectious diseases which are
aerosolized.
• Evidence supports that COVID19 is not aerosolized.
• Multiple clinical reviews have demonstrated that N95 masks do
not provide a statistically significant increase over surgical masks
when protecting from influenza, which transmits similarly to
COVID-19.
What is the difference between N95 masks and
surgical masks in preventing COVID19?

• Temperature
• The human body can maintain a constant core temperature by using
a combination of physiological mechanisms.
• Heat is produced from the body itself, principally through the
metabolism of hydrocarbons (from food) and skeletal muscle
contraction. On the other hand, heat is lost from the body by
conduction, convection, radiation and evaporation.1
• It is believed that the preoptic area of the hypothalamus is the main
thermoregulatory center of the body.
• Thus, the temperature of arterial blood perfusing this site can
reasonably be considered to represent the true core temperature.
Can wearing a mask effect on body health?

• However, routine measurement of this temperature is
obviously impractical. When measuring the body
temperature, it is an estimate of the body's core temperature
that is being sought.
• There are sites on the body where major arteries pass close
enough to the surface for a reasonable estimate to be made.
• When taking a person's temperature orally, the thermometer
should be placed firmly in the pockets on either side of the
frenulum below the tongue, which measures the temperature
of the blood in the carotid arteries.

• The accuracy of oral temperatures could be threatened by
some external factors, including ingestion of hot and cold
liquids, respiratory diseases with tachypnoea, and inability
to cooperate.
• Aural temperature devices use measured infrared radiation
emissions from the tympanic membrane to determine body
temperature.
• The instrument we used displays readings, after additional
adjustments, to represent the temperature as if at 'oral' sites.

• People may wear mask for several
hours or even a day during the
outbreak of an infectious disease, like
SARS.
• Wearing face mask may increase readi
ng in oral temperature measurement
in healthy subjects.
• He also reported that Totally 93
subjects were recruited, with 28 males
and 65 females (Table 1).
Gender Number
of
subjects
Percentag
e (%)
Male 28 30.1
Female 65 69.9
Table 1. Sex distribution
•Can Wearing A Mask Raise body Temperature?

• The age distribution is shown in Table 2.
Age
(Years)
Number of
subjects
Percentage
(%)
20-30 37 39.8
31-40 38 40.9
>40 18 19.3
Table 2. Age distribution
•Can wearing a mask raise body temperature?

• Exactly two thirds of them wore surgical mask, with the remaining
one third wore N95 mask (Table 3).
Table (3) Type of mask used
• Can wearing a mask raise body temperature?

• Oral temperature was significantly higher when a mask was
worn (p=0.002, 95% CI 0.06-0.26) (Table 4).
Temperature
ₒ
C Mean
Oral temp. no mask 36.56)
Oral temp. with mask 36.73
Ear temp. no mask 36.49
Ear temper. With mask 36.53
Table (4) Comparison of oral and aural
temperature with and without mask

• When considered separately, only those wearing N95 mask demonstrated such
significance, while such significance was not found in those wearing surgical
mask (Table 5).
• They also reported that wearing face mask may increase reading in oral
temperature measurement in healthy subjects.
• However, the difference may not be clinically significant.
Table (5) Difference in oral temperatures using
different types of mask
Mask type Mean difference
Surgical mask 0.11
N95 mask 0.27

• On the other hand, although the mean aural temperature was higher when a mask
was worn, it was not statistically significant (p=0.38, 95% CI -0.05 to 0.12)
(Table 4).
• When considered separately, no statistical significance in aural temperature
existed for individual type of masks (Table 6).
Table 6. Difference in aural temperatures
using different types of mask
Surgical mask Mask type Mean difference (°C)
Surgical mask 0.7
N95 mask 0.03

• Wearing face mask may increase reading in oral
temperature measurement in healthy subjects.
• For instance, the use of protective face masks negatively impacts
respiratory and dermal mechanisms of human thermoregulation
through impairment of convection, evaporation, and radiation
processes. However, the difference may not be clinically
significant.

• Carbon Dioxide
• The form and function of the human respiratory system
ensures an efficient gas exchange with the environment.
• During expiration, hot, humid air that is rich in carbon
dioxide (CO2) and depleted in oxygen is vented away
from the body in the form of one jet from the mouth or
two jets from the nostrils that entrains air from the
surrounding; during inspiration, air from the immediate
surroundings of the face is inhaled in a diffuse manner
from all directions in front of the mouth/nostrils.

• This combination of directed expiration and diffuse inspiration ensures that
rebreathing is kept to a minimum, because we inhale air close to our faces
and exhale far away and in a manner that dilutes the expired air.
• Respiration thus also significantly changes the airflow pattern around us.
• Now, when putting on a facepiece respirator (filtering facepiece
respirator FFR) covering our mouth and nostrils, by altering the air
exchange by not only extending the physiological dead space of the
respiratory system by the dead-space volume of the FFR itself, but also by
altering the airflow pattern during respiration.
• In this context, it is therefore perhaps not surprising that filtering facepiece
respirators (FFRs) are known to adversely affect the comfort of the wearer
in terms of, for example, lowered thermal comfort and elevated CO2 levels

• The decreased thermal comfort is mainly due to increased
humidity and temperature inside the dead space of the
filtering facepiece respirator (FFR) from respiration and
thermal regulation, which together give rise to a
significantly higher apparent temperature than the
ambient under normal conditions.
• The elevated CO2 levels originate from the CO2 -rich
expired air that is around one-hundred times higher in
CO2 concentration than that of atmospheric air

• Especially the significantly increased CO2 concentration is
potentially hazardous: increased CO2 levels have been linked to
changes in visual performance, altered exercise endurance,
headaches, shortness of breath, decreased reasoning and
alertness as well as increased irritability.
• In order to reduce the CO2 levels in the dead space to near-
ambient levels, introduce an active venting system (AVS) that
aims to mimic and thus restore the functionality of the human
respiratory system even when an FFR is covering our mouth
and nostrils.

• In order to reduce the CO2 levels in the
dead space to near-ambient levels, introduce
an active venting system (AVS) that aims to
mimic and thus restore the functionality of
the human respiratory system even when an
FFR is covering our mouth and nostrils.
• In short, the lightweight active venting
system comprises a housing for a one-way
valve, a blower and battery that can be
attached to the FFR with negligible
mechanical deformation of the filter.
• The blower illustrated in Fig 1 vents the air
out from the FFR and should thus reduce
the CO2 concentration inside the dead
space.
Fig. Illustration of FFRs and the computational
domains.
(a) a standard FFR,
(b) (b) a FFR equipped with the blower of the AVS
and
(c) (c-d) the computational domains comprising
the dead space of the FFR, the filter and the
blower; for the simulation of the standard FFR,
the blower region was treated as a filter.
https://journals.plos.org/plosone/article/figure/image?size=inline&id=info:doi/10.1
371/journal.pone.0130306.g001
Can wearing a mask effect
On body health?

• During expiration, the carbon dioxide (CO2) levels
inside the dead space of a filtering facepiece respirator
(FFR) increase significantly above the ambient
concentration.
• To reduce the CO2 concentration inside the dead space,
attach an active lightweight venting system (AVS)
comprising a one-way valve, a blower and a battery in a
housing to a FFR.

• The results suggest that the AVS can reduce the CO2 levels inside the
dead space at the end of expiration to around 0.4% as compared to a
standard FFR, for which the CO2 levels during expiration reach the
same concentration as that of the expired alveolar air at around 5%.
• During inspiration, the average CO2 volume fraction drops to near-to
ambient levels of around 0.08% with the AVS.
• Overall, the time-averaged CO2 volume fractions inside the dead space
for the standard FFR and the one with AVS are around 3% and 0.3%
respectively.
• Further, the ability of the AVS to vent the dead-space air in the form of
a jet into the ambient – similar to the jets arising from natural
expiration without a FFR – ensures that the expired air is removed and
diluted more efficiently than a standard FFR.

Carbon dioxide rebreathing in respiratory protective devices:
influence of speech and work rate in full-face masks
• influence of speech and work rate in full-face masks
• Few studies have indented the ill effects of
prolonged use of using face mask which includes a
reduced oxygen intake, increased carbon dioxide
content,, increased shortness of breath, etc.
• Carbon dioxide (CO2) rebreathing has been recognized as a
concern regarding respirator use and is related to symptoms of
discomfort, fatigue, dizziness, headache, muscular weakness and
drowsiness.

• A total of 40 workers trained in the use of respiratory protective
devices (RPDs) performed a graded exercise test on a cycle ergometer
that increased in workload every 5 min.
• During the third minute of each stage, participants read aloud a
prepared text.
• Measures of mixed expired CO2 (PECO2), mixed inspired CO2
(PICO2) and respiration were monitored.
• The results showed that phonic respiration and low work rates
contributed to significantly higher levels of CO2 rebreathing.
• They concluded that Overall, the results of the study indicate speech
and low work rates significantly increase CO2 rebreathing in RPDs.
Carbon dioxide rebreathing in respiratory protective devices: influence
of speech and work rate in full-face masks

• Overall, the results of the studies indicate speech and low work rates
significantly increase CO2 rebreathing in RPDs.
• Based on Australian respirator design standards it is evident speech
could contribute to inspired CO2 exceeding the maximal allowable
concentrations in inspired air. However, the impact of gender and
body size on CO2 levels could not be ascertained. The implication of
these findings is that high CO2 concentrations in full face RPDs may
be linked to wearer discomfort and contribute to reduced tolerability
and wear time of the device. Since many occupations require workers
to communicate while wearing RPDs these findings must be taken
into consideration. It is recommended that the findings in this study
be considered in the design and use of RPDs.

• The using mask during physical activity did not reduce the quantity
of weekly activity on individuals as compared to the instances with
no mask.
• But there was a significant reduction in life satisfaction and an
increase in dyspnoea and perceived exertion grades while performing
morning walk with mask.
• They suggest that individuals who participate in physical activities
must isolate themselves from others during the workout period so
that they can perform better without mask with avoiding the risk of
getting affected or spreading the disease.
• Individuals must also identify areas within their household premises
to reduce contact with others within their locality and to and a safe
area to perform exercises.
Carbon dioxide rebreathing in respiratory protective devices: influence
of speech and work rate in full-face masks

• Physical activity
• Forty-seven adults between 30 to 79
years of age participated in the
study
• All participants acknowledged that
they are using mask regularly as
well as during morning walk. 30 out
of 47 participants informed that
they face difficulty in physical
activity while wearing masks, with
29 people found an increased effort
in breathing with the use of mask
during morning walk (The
following Figure).
Carbon dioxide rebreathing in respiratory protective
devices: influence of speech and work rate in full-face masks
• Fig. Subjective Response to morning walk
with wearing mask

• The potential for infection with airborne pathogens and
for exposure to such airborne particulates poses a threat
to global public health which can be mitigated through
the personal use of disposable face masks.
• The effectiveness of such masks for excluding pathogens
and pollutants is a function both of wearer compliance
and comfort and the intrinsic ability of the masks to
resist penetration by airborne particulates and, infectious
agents.
What does a mask do?

• Two simple demos: First, in case of
sneezing, singing, and coughing toward an
agar culture plate with or without a mask.
Bacteria colonies show where droplets
landed.
• A mask blocks virtually all of them.
• In this demonstration presence of bacteria
(not viruses) on plates is only meant to be
proxy for microbes present in respiratory
droplets.
• Likely smaller aerosolized droplets (that
could carry viruses like SARS-CoV-2) are
also produced by sneezing, singing, talking
and coughing and that those would travel
further and stay in the air longer than larger
respiratory droplets.
Byhttps://images.foxtv.com/static.foxla.com/www.foxla.com/content/uplo
ads/2020/06/932/524/demo-1.jpg?ve=1&tl=1 Austin Williams

• The images of the experiment showed that every action
performed unmasked nearly covered each Petri dish in
bacteria, while the dishes used during the masked
demonstration were left nearly untouched.
• Sneezing and coughing left the most noticeable
difference on the plates.

• In the second demonstration,
showed how keeping one’s
distance makes a difference in
stopping the spread of respiratory
droplets.
• setting open bacteria culture
plates 2, 4 and 6 feet away and
coughing (hard) for ~15s, with
repeating this without a mask.
Byhttps://images.foxtv.com/static.foxla.com/www.foxla.com/content/uploads/2020/06/9
32/524/demo-1.jpg?ve=1&tl=1 Austin Williams

• The pictures show that
standing two feet apart with
no mask practically covered
the Petri dish with bacteria.
• Davis’ respiratory droplets
also managed to land on the
dish at four feet with no
mask with scarce amounts
still managing to get on the
dish from six feet away.
Byhttps://images.foxtv.com/static.foxla.com/www.foxla.com/contn
t/uploads/2020/06/932/524/demo-1.jpg?ve=1&tl=1 Austin Williamse

• But no matter the distance, the demonstration showed that a mask nearly completely
blocked bacteria from landing on the plates.
• Researcher also noted that besides the actions shows in his demonstration, the simple
act of breathing is also a source of spreading respiratory droplets.
• “Just breathing (exhaling) does release moisture from your lungs – think of when
you breathe out onto a pane of glass
• Also, during the act of normal breathing, you might clear your throat, laugh, or sigh.
• Would there be as many droplets, and potential microbes, spread as by coughing and
sneezing (common symptoms of respiratory tract infections)? Probably not, but it is
possible there could be some.”
• This experiment “was primarily looking at the way a mask can block droplets and
secretions from your mouth.”

• Colonies of normal bacteria from my mouth/throat show the spread of large
respiratory droplets, like the kind we think mostly spread #COVID19, and
how a mask can block them.
• The U.S. Centers for Disease Control and Prevention recommends wearing
a cloth face covering while in public to help combat the spread of COVID-
19, especially in settings where social distancing measures can be difficult
to maintain.
• Research shows that the material of your mask matters, and by using a
surgical-grade face covering in this demonstration, any type of material, a
hospital grade surgical mask, a homemade cotton mask, even a tissue paper
held in front of my mouth, would likely have had the same effect in what
these bacteria culture plates looked like.”

Where we should wear face mask
• “Wearing a mask indoors, certainly when you enter a gym facility so
you’re providing that protection to the greeter and others as you come
in,” said Dr. Etches. But no, you can’t be expected to exercise
wearing a mask, and so that can come off, just Wash your hands and
proceed with the activity, it’s important that everyone continue to
practice physical distancing as we resume activities, including
working out at the gym or visiting a bar or restaurant.
• “Wearing a mask indoors, certainly when you enter a gym facility so
you’re providing that protection to the greeter and others as you come
in,” said Dr. Etches.
• “But no, you can’t be expected to exercise wearing a mask, and so
that can come off. Wash your hands and proceed with the activity.”

Conclusion
• Prevention of infection with airborne pathogens and exposure to
airborne particulates and aerosols (environmental pollutants and
allergens) can be facilitated through use of disposable face masks.
• The effectiveness of such masks for excluding pathogens and
pollutants is dependent on the intrinsic ability of the masks to resist
penetration by airborne contaminants.
• The masks, with or without features intended for enhancing comfort,
provide protection against both small- and large-size pathogens.
• Importantly, the mask appears to be highly efficient for filtration of
pathogens, including influenza and rhinoviruses, as well as the fine
particulates present in aerosols that represent a greater challenge for
many types of dental and surgical masks.

• The use of N95 respirators compared with surgical masks is not associated
with a lower risk of laboratory-confirmed influenza. It suggests that N95
respirators should not be recommended for general public and nonhigh-
risk medical staff those are not in close contact with influenza patients or
suspected patients.
• Some studies found that wearing face mask may increase reading in oral
temperature measurement in healthy subjects. However, the difference may
not be clinically significant. Better-controlled studies are required to
delineate whether such findings could be extended to those who are febrile
or ill.
• Wearing face mask may increase reading in oral temperature measurement
in healthy subjects. However, the difference may not be clinically
significant.
Conclusion

• The masks, with or without features intended for enhancing comfort,
provide protection against both small- and large-size pathogens.
Importantly, the mask appears to be highly efficient for filtration of
pathogens, including influenza and rhinoviruses, as well as the fine
particulates present in aerosols that represent a greater challenge for many
types of dental and surgical masks. This renders this individual-use N95
respiratory mask an improvement over the former types of masks for
protection against a variety of environmental contaminants including
PM2.5 and pathogens such as influenza and rhinoviruses.
Conclusion

Conclusion

1. Brook RD, Newby DE, Rajagopalan S. The Global Threat of Outdoor Ambient Air Pollution
to Cardiovascular Health: Time for Intervention. JAMA Cardiol 2017;2:353-4.
10.1001/jamacardio.2017.0032 [PubMed] [CrossRef] [Google Scholar]
2. CDC (2020). How to Wear Cloth Face Coverings. https://www.cdc.gov/
3. CDC (2020). No, Face Masks Can’t Cause CO2 Poisoning. https://www.cdc.gov/
4. Chamberlain JM, Grandner J, Rubinoff JL, Klein BL, Waisman Y, Huey M. (1991).
Comparison of a tympanic thermometer to rectal and oral thermometers in a pediatric
emergency department. Clin Pediatr (Phila);30(4 Suppl):24-9.
5. Chamberlain JM, Terndrup TE, Alexander DT, (1995). Determination of normal ear
temperature with an infrared emission detection thermometer. Ann Emerg Med ;25(1):15-20.
References

6. CDC has advised using face masks to reduce risk of infection with the new coronavirus, particularly in
settings where social or physical distancing is difficult to maintain.
7. Chen X, Chughtai AA, MacIntyre CR. (2017). Herd protection effect of N95 respirators in healthcare
workers. J Int Med Res. 45(6):1760‐1767. - PMC – PubMed
8. CDC (2020)The Early Release - Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou,
China, Volume 26, Number 6. Emerging Infectious Diseases journal. from
https://wwwnc.cdc.gov/eid/article/26/6/20-0412_article
9. CDC (2020). How to Wear Cloth Face Coverings. https://www.cdc.gov/
10 CDC (2020). No, Face Masks Can’t Cause CO2 Poisoning. https://www.cdc.gov/
11 Centers for Disease Control and Prevention.(2020). "Recommendation Regarding the Use of Cloth
Face Coverings, Especially in Areas of Significant Community-Based Transmission.
References

12. CDC (2020). Interim guidance, Rational use of personal protective equipment for coronavirus disease (COVID-19)
https://apps.who.int/iris/handle/10665/331215
13. CDC ( 2019). Situation Summary. (2020). Coronavirus Disease 2019 (COVID-19) Retrieved from
https://www.cdc.gov/coronavirus/2019-
ncov/casesupdates/summary.html?CDC_AA_refVal=https://www.cdc.gov/coronavirus/2019- ncov/summary.html
14. Chen X, Chughtai AA, MacIntyre CR. (2017). Herd protection effect of N95 respirators in healthcare workers. J Int
Med Res. 45(6):1760‐1767. - PMC – PubMed
15. Davis Richard (2020). Doctor demonstrates how face mask blocks respiratory ...fox6now.com › -.
16. European Centre for Disease Prevention and Control. (2020). Using face masks in the community – Reducing COVID-
19 transmission from potentially asymptomatic or pre-symptomatic people through the use of face masks".
17. Erik Birgersson ,Ee Ho Tang, Wei Liang Jerome Lee, and wok Jiang Sak (2015). Reduction of Carbon Dioxide in
Filtering Facepiece Respirators with an Active-Venting System: A Computational Study
https://doi.org/10.1371/journal.pone.0130306
References

18. Erickson RS, Yount ST. (1991). Comparison of tympanic and oral temperatures in surgical patients. Nurs Res ;
40(2):90-3.
19. Flo G, Brown M. Comparing three methods of temperature taking: oral mercury-in-glass, oral Diatek, and tympanic
First Temp. Nurs Res 1995; 44(2):120-2. 5.
20. Guan WJ, Zheng XY, Chung KF, et al. Impact of air pollution on the burden of chronic respiratory diseases in China:
time for urgent action. Lancet 2016;388:1939-51. 10.1016/S0140-6736(16)31597-5 [PubMed]
21. Huang C, Wang Y, Li X, et al. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan.
China Lancet ;S0140‐6736(20):30183‐30185
22. Hoek G, Krishnan RM, Beelen R, (2013).Long-term air pollution exposure and cardio- respiratory mortality: a
review. Environ Health 2013;12:43. 10.1186/1476-069X-12-43 [PMC free article] [PubMed]
23. Ijaz MK, Zargar B, Wright KE, (2016). Generic aspects of the airborne spread of human pathogens indoors and
emerging air decontamination technologies. Am J Infect Control 2016;44:S109-20. 10.1016/j.ajic.2016.06.008 [PMC
free article] [PubMed]
References

24. Masks4All. (2020) What Countries Require Masks in Public or Recommend Masks?".
25. Parshina-Kottas, Y.; Saget, B.; Patanjali, B. (2020). "This 3-D Simulation Shows Why Social Distancing Is So
Important". The New York Times.
26. Pope CA, 3rd, Burnett RT, Thun MJ, et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine
particulate air pollution. JAMA 2002;287:1132-41. 10.1001/jama.287.9.1132 [PMC free article] [PubMed]
[CrossRef] [Google Scholar]
27. Reynolds, G. (2020). "For Runners, Is 15 Feet the New 6 Feet for Social Distancing? When we walk briskly or run, air
moves differently around us, increasing the space required to maintain a proper social distance". The New York Times
28. Roberge RJ, Kim JH, Benson S. (2012) N95 Filtering Facepiece Respirator Dead space Temperature and Humidity.
Journal of Occupational and Environmental Hygiene; 9: 166–171. pmid:22413894View Article. PubMed/NCBI
29. Rohde RA, Muller RA. Air Pollution in China: Mapping of Concentrations and Sources. PLoS One 2015;10:e0135749.
10.1371/journal.pone.0135749 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
References

30. Roberge RJ, Kim JH, Coca A. Protective facemask impact on human thermoregulation: an overview. Ann Occup
Hyg 2012;56:102-12. [PubMed] [Google Scholar]
31. Rohde RA, Muller RA. Air Pollution in China: Mapping of Concentrations and Sources. PLoS
ONE 2015;10:e0135749. 10.1371/journal.pone.0135749 [PMC free article] [PubMed]
32. Radonovich LJ; Simberkoff MS; Bessesen MT; Brown AC; Cummings DAT; Gaydos CA; Los JG; Krosche AE; Gibert
CL; Gorse GJ; Nyquist AC; Reich NG; Rodriguez-Barradas MC; Price CS; Perl TM; ; (2019). N95 Respirators vs
Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial. Retrieved from
https://pubmed.ncbi.nlm.nih.gov/31479137/
33. Setti, L.; Passarini, F.; De Gennaro, G. (2020). "Airborne Transmission Route of COVID-19: Why 2 Meters/6 Feet of
Inter-Personal Distance Could Not Be Enough". Int. J. Environ. Res. Public Health. 17(8) 2932 (8):
2932. doi:10.3390/ijerph17082932. PMC 7215485. PMID 32340347.
34. Smith CL, Whitelaw JL, Davies B. (2013). Carbon dioxide rebreathing in respiratory protective devices: influence of
speech and work rate in full-face masks. Ergonomics; 56: 781–790. pmid:23514282
References

35. Sinkule E, Powell J, Goss F. (2013). Evaluation of n95 respirator use with a surgical mask cover: Effects
on breathing resistance and inhaled carbon dioxide. Ann Occup Hyg; 57: 384–398. pmid:23108786
36. Steve Zhou S., Salimatu Lukula, Cory Chiossone, Raymond W. Nims, Donna B. Suchmann, and M.
Khalid Ijazcorresponding (2018). Assessment of a respiratory face mask for capturing air pollutants and
pathogens including human influenza and rhinoviruses J. Thorac Dis. 10(3): 2059–2069.
37. Sattar S, Bhardwaj N, Ijaz M. (2016). Airborne viruses. In: Yates M, Nakatsu C, Miller R, et al., editors.
Manual of environmental microbiology. 4th edition. Washington (DC): ASM Press :3.2.7-1-24.
38. Sheikh, K.; Gorman, J.; Chang, K. (2020). "Stay 6 Feet Apart, We're Told. But How Far Can Air Carry
Coronavirus? Most of the big droplets travel a mere six feet. The role of tiny aerosols is the "trillion-
dollar question."". The New York Times.
References

39. Tufekci, Z; Howard, J.; Greenhalgh, T. (2020). "The Real Reason to Wear a Mask. Much of the
confusion around masks stems from the conflation of two very different uses". The Atlantic.
40. Ting, Victor (2020). To mask or not to mask: WHO makes U-turn while US, Singapore abandon
pandemic advice and tell citizens to start wearing masks". South China Morning Post.
41. Watson R. (1998). Controlling body temperature in adults. Nurs Stand 1998;12(20):49-55
42. World Health Organization. (2020), Q&A: Masks and COVID-19
43. Williams WJ. (2010). Physiological response to alterations in [O2] and [CO2]: relevance to respiratory
protective devices. J Int Soc Respir Prot; 27: 27–51
44. Wikipedia (2020). Face masks during the COVID-19 pandemic
45. WL Yip , LP Leung , PF Lau , HK Tong, (2005). The effect of wearing a face mask on body
temperature. Hong Kong j. emerg. med. Vol. 12(1).
References

46. World Health Organization . Burden of disease from the joint effects of Household and Ambient Air
Pollution for 2012. WHO Technical Report. Available
online: http://www.who.int/phe/health_topics/outdoorair/databases/AP_jointeffect_BoD_results_March
2014.pdf
47. www.houstonmethodist.org › for-patients › Coronavirus. N95 Masks vs. Surgical Masks. What do I
need? - Houston ...
48. Yang G, Wang Y, Zeng Y. (2013). Rapid health transition in China, 1990-2010: findings from the Global
Burden of Disease Study 2010. Lancet 2013;381:1987-2015. 10.1016/S0140-6736(13)61097-1 [PMC
49. Zhiqing L, Yongyun C, Wenxiang C,(2018). Surgical masks as source of bacterial contamination during
operative procedures. J Orthop Translat. 14:57‐62. - PMC – PubMed
References

The effect of face masks on our health

Recommended

Recommended

More Related Content

Similar to The effect of face masks on our health

Similar to The effect of face masks on our health (20)

More from Univ. of Tripoli

More from Univ. of Tripoli (20)

Recently uploaded

Recently uploaded (20)

The effect of face masks on our health