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Size-specific filtration efficiency and pressure drop of school-aged children's woven and nonwoven masks at varying face velocities. Am J Infect Control 2023:S0196-6553(23)00051-2. [PMID: 36736383 DOI: 10.1016/j.ajic.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Differences in physiology and breathing patterns between children and adults lead to disparate responses to aerosols of varying sizes. No standardized method exists for measuring the filtration efficiency (FE) of children's masks to reflect such differences. METHODS Using an adult N95 mask as a control and two different face velocities (vf) (9.3 cm/s representing adults and 4.0 cm/s representing school-aged children), we tested the pressure drop (ΔP) through children's nonwoven masks (surgical and KN95) and children's woven masks (100% cotton and partially-cotton-based masks), as well as their size-specific FE between aerodynamic particle diameters of 0.02 and 2.01 μm. RESULTS All three types of mask showed a 1 to 9% absolute increase in minimum FE at the lower vf and a significant decrease in ΔP. For children's surgical masks the increase in FE was significant for most of the examined particle sizes, but for children's woven masks the increase was limited to particles smaller than 0.04 μm. CONCLUSIONS Lower vf for children is likely to lead to a higher FE, lower ΔP, and consequently higher filter qualities in children's masks. For woven masks, the FE for particles larger than 0.04 μm was low (typically <50%) for both vf's studied.
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Maged A, Ahmed A, Haridy S, Baker AW, Xie M. SEIR Model to address the impact of face masks amid COVID-19 pandemic. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:129-143. [PMID: 35704273 PMCID: PMC9349537 DOI: 10.1111/risa.13958] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Early in the pandemic of coronavirus disease 2019 (COVID-19), face masks were used extensively by the general public in several Asian countries. The lower transmission rate of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Asian countries compared with Western countries suggested that the wider community use of face masks has the potential to decrease transmission of SARS-CoV-2. A risk assessment model named Susceptible, Exposed, Infectious, Recovered (SEIR) model is used to quantitatively evaluate the potential impact of community face masks on SARS-CoV-2 reproduction number (R0 ) and peak number of infectious persons. For a simulated population of one million, the model showed a reduction in R0 of 49% and 50% when 60% and 80% of the population wore masks, respectively. Moreover, we present a modified model that considers the effect of mask-wearing after community vaccination. Interestingly mask-wearing still provided a considerable benefit in lowering the number of infectious individuals. The results of this research are expected to help public health officials in making prompt decisions involving resource allocation and crafting legislation.
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Affiliation(s)
- Ahmed Maged
- Department of Advanced Design and Systems EngineeringCity University of Hong KongHong Kong
- Department of Mechanical EngineeringBenha UniversityBanhaEgypt
| | - Abdullah Ahmed
- Department of Mechanical EngineeringBenha UniversityBanhaEgypt
- Department of Systems Innovation, Graduate School of Engineering ScienceOsaka UniversitySuitaJapan
| | - Salah Haridy
- Department of Mechanical EngineeringBenha UniversityBanhaEgypt
- Department of Industrial Engineering and Engineering ManagementUniversity of SharjahSharjahUnited Arab Emirates
| | - Arthur W. Baker
- Duke University School of Medicine, Division of Infectious DiseasesDurhamNorth CarolinaUSA
- Duke Center for Antimicrobial Stewardship and Infection PreventionDurhamNorth CarolinaUSA
| | - Min Xie
- Department of Advanced Design and Systems EngineeringCity University of Hong KongHong Kong
- Center for Intelligent Multidimensional Data Analysis, Hong Kong Science ParkShatinHong Kong
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Rashid TU, Sharmeen S, Biswas S. Effectiveness of N95 Masks against SARS-CoV-2: Performance Efficiency, Concerns, and Future Directions. ACS CHEMICAL HEALTH & SAFETY 2022; 29:135-164. [PMID: 37556270 PMCID: PMC8768005 DOI: 10.1021/acs.chas.1c00016] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Indexed: 12/24/2022]
Abstract
The coronavirus disease 2019 (COVID-19) epidemic, which is caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has continued to spread around the world since December 2019. Healthcare workers and other medical first responders in particular need personal protective equipment to protect their respiratory system from airborne particulates, in addition to liquid splashes to the face. N95 respirator have become a critical component for reducing SARS-CoV-2 transmission and controlling the scale of the COVID-19 pandemic. However, a major dispute concerning the protective performance of N95 respirators has erupted, with a myriad of healthcare workers affected despite wearing N95 masks. This article reviews the most recent updates about the performance of N95 respirators in protecting against the SARS-CoV-2 virus in the present pandemic situation. A brief overview of the manufacturing methods, air filtration mechanisms, stability, and reusability of the mask is provided. A detailed performance evaluation of the mask is studied from an engineering point of view. This Review also reports on a comparative study about the protective performance of all commercially available surgical and respiratory masks used to combat the spread of COVID-19. With the aim of protecting healthcare providers more efficiently, we suggest some potential directions for the development of this respiratory mask that improve the performance efficiency of the mask.
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Affiliation(s)
- Taslim Ur Rashid
- Fiber and Polymer Science, Department of Textile
Engineering, Chemistry and Science, Wilson College of Textiles, North
Carolina State University, 1020 Main Campus Drive, Raleigh, North Carolina
27695, United States
- Department of Applied Chemistry and Chemical
Engineering, Faculty of Engineering and Technology, University of
Dhaka, Dhaka 1000, Bangladesh
| | - Sadia Sharmeen
- Department of Applied Chemistry and Chemical
Engineering, Faculty of Engineering and Technology, University of
Dhaka, Dhaka 1000, Bangladesh
- Chemistry Department, University of
Nebraska−Lincoln, Lincoln, Nebraska 68588, United
States
| | - Shanta Biswas
- Department of Applied Chemistry and Chemical
Engineering, Faculty of Engineering and Technology, University of
Dhaka, Dhaka 1000, Bangladesh
- Department of Chemistry, Louisiana State
University, Baton Rouge, Louisiana 70803, United
States
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Hariharan P, Sharma N, Guha S, Banerjee RK, D'Souza G, Myers MR. A computational model for predicting changes in infection dynamics due to leakage through N95 respirators. Sci Rep 2021; 11:10690. [PMID: 34021181 PMCID: PMC8140115 DOI: 10.1038/s41598-021-89604-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/26/2021] [Indexed: 12/02/2022] Open
Abstract
In the absence of fit-testing, leakage of aerosolized pathogens through the gaps between the face and N95 respirators could compromise the effectiveness of the device and increase the risk of infection for the exposed population. To address this issue, we have developed a model to estimate the increase in risk of infection resulting from aerosols leaking through gaps between the face and N95 respirators. The gaps between anthropometric face-geometry and N95 respirators were scanned using computed tomography. The gap profiles were subsequently input into CFD models. The amount of aerosol leakage was predicted by the CFD simulations. Leakage levels were validated using experimental data obtained using manikins. The computed amounts of aerosol transmitted to the respiratory system, with and without leaks, were then linked to a risk-assessment model to predict the infection risk for a sample population. An influenza outbreak in which 50% of the population deployed respirators was considered for risk assessment. Our results showed that the leakage predicted by the CFD model matched the experimental data within about 13%. Depending upon the fit between the headform and the respirator, the inward leakage for the aerosols ranged between 30 and 95%. In addition, the non-fit-tested respirator lowered the infection rate from 97% (for no protection) to between 42 and 80%, but not to the same level as the fit-tested respirators (12%). The CFD-based leakage model, combined with the risk-assessment model, can be useful in optimizing protection strategies for a given population exposed to a pathogenic aerosol.
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Affiliation(s)
- Prasanna Hariharan
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, USA.
| | - Neha Sharma
- University of Cincinnati, 2600 Clifton Ave., Cincinnati, OH, 45221, USA
| | - Suvajyoti Guha
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, USA
| | - Rupak K Banerjee
- University of Cincinnati, 2600 Clifton Ave., Cincinnati, OH, 45221, USA
| | - Gavin D'Souza
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, USA
| | - Matthew R Myers
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, USA
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Guha S, Herman A, Carr IA, Porter D, Natu R, Berman S, Myers MR. Comprehensive characterization of protective face coverings made from household fabrics. PLoS One 2021; 16:e0244626. [PMID: 33439878 PMCID: PMC7806137 DOI: 10.1371/journal.pone.0244626] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/15/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Face coverings constitute an important strategy for containing pandemics, such as COVID-19. Infection from airborne respiratory viruses including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) can occur in at least three modes; tiny and/or dried aerosols (typically < 1.0 μm) generated through multiple mechanisms including talking, breathing, singing, large droplets (> 0.5 μm) generated during coughing and sneezing, and macro drops transmitted via fomites. While there is a growing number of studies looking at the performance of household materials against some of these situations, to date, there has not been any systematic characterization of household materials against all three modes. METHODS A three-step methodology was developed and used to characterize the performance of 21 different household materials with various material compositions (e.g. cotton, polyester, polypropylene, cellulose and blends) using submicron sodium chloride aerosols, water droplets, and mucous mimicking macro droplets over an aerosol-droplet size range of ~ 20 nm to 0.6 cm. RESULTS Except for one thousand-thread-count cotton, most single-layered materials had filtration efficiencies < 20% for sub-micron solid aerosols. However, several of these materials stopped > 80% of larger droplets, even at sneeze-velocities of up to 1700 cm/s. Three or four layers of the same material, or combination materials, would be required to stop macro droplets from permeating out or into the face covering. Such materials can also be boiled for reuse. CONCLUSION Four layers of loosely knit or woven fabrics independent of the composition (e.g. cotton, polyester, nylon or blends) are likely to be effective source controls. One layer of tightly woven fabrics combined with multiple layers of loosely knit or woven fabrics in addition to being source controls can have sub-micron filtration efficiencies > 40% and may offer some protection to the wearer. However, the pressure drop across such fabrics can be high (> 100 Pa).
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Affiliation(s)
- Suvajyoti Guha
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States of America
| | - Alexander Herman
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States of America
| | - Ian A. Carr
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States of America
| | - Daniel Porter
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States of America
| | - Rucha Natu
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States of America
| | - Shayna Berman
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States of America
| | - Matthew R. Myers
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States of America
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Coclite D, Napoletano A, Gianola S, del Monaco A, D'Angelo D, Fauci A, Iacorossi L, Latina R, Torre GL, Mastroianni CM, Renzi C, Castellini G, Iannone P. Face Mask Use in the Community for Reducing the Spread of COVID-19: A Systematic Review. Front Med (Lausanne) 2021; 7:594269. [PMID: 33511141 PMCID: PMC7835129 DOI: 10.3389/fmed.2020.594269] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/09/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Evidence is needed on the effectiveness of wearing face masks in the community to prevent SARS-CoV-2 transmission. Methods: Systematic review and meta-analysis to investigate the efficacy and effectiveness of face mask use in a community setting and to predict the effectiveness of wearing a mask. We searched MEDLINE, EMBASE, SCISEARCH, The Cochrane Library, and pre-prints from inception to 22 April 2020 without restriction by language. We rated the certainty of evidence according to Cochrane and GRADE approach. Findings: Our search identified 35 studies, including three randomized controlled trials (RCTs) (4,017 patients), 10 comparative studies (18,984 patients), 13 predictive models, nine laboratory experimental studies. For reducing infection rates, the estimates of cluster-RCTs were in favor of wearing face masks vs. no mask, but not at statistically significant levels (adjusted OR 0.90, 95% CI 0.78-1.05). Similar findings were reported in observational studies. Mathematical models indicated an important decrease in mortality when the population mask coverage is near-universal, regardless of mask efficacy. In the best-case scenario, when the mask efficacy is at 95%, the R0 can fall to 0.99 from an initial value of 16.90. Levels of mask filtration efficiency were heterogeneous, depending on the materials used (surgical mask: 45-97%). One laboratory study suggested a viral load reduction of 0.25 (95% CI 0.09-0.67) in favor of mask vs. no mask. Interpretation: The findings of this systematic review and meta-analysis support the use of face masks in a community setting. Robust randomized trials on face mask effectiveness are needed to inform evidence-based policies. PROSPERO registration: CRD42020184963.
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Affiliation(s)
- Daniela Coclite
- Centro Eccellenza Clinica, Qualità e Sicurezza delle Cure, Istituto Superiore di Sanità, Rome, Italy
| | - Antonello Napoletano
- Centro Eccellenza Clinica, Qualità e Sicurezza delle Cure, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Andrea del Monaco
- Directorate General for Economics, Statistics and Research, Bank of Italy, Rome, Italy
| | - Daniela D'Angelo
- Centro Eccellenza Clinica, Qualità e Sicurezza delle Cure, Istituto Superiore di Sanità, Rome, Italy
| | - Alice Fauci
- Centro Eccellenza Clinica, Qualità e Sicurezza delle Cure, Istituto Superiore di Sanità, Rome, Italy
| | - Laura Iacorossi
- Centro Eccellenza Clinica, Qualità e Sicurezza delle Cure, Istituto Superiore di Sanità, Rome, Italy
| | - Roberto Latina
- Centro Eccellenza Clinica, Qualità e Sicurezza delle Cure, Istituto Superiore di Sanità, Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Claudio M. Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Cristina Renzi
- Institute of Epidemiology & Health Care, University College London-UCL, London, United Kingdom
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Primiano Iannone
- Centro Eccellenza Clinica, Qualità e Sicurezza delle Cure, Istituto Superiore di Sanità, Rome, Italy
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Samuels-Reid JH, Cope JU. Medical devices and the pediatric population - a head-to-toe approach. Expert Rev Med Devices 2019; 16:647-652. [PMID: 31195845 DOI: 10.1080/17434440.2019.1629285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: This review uses a head-to-toe approach, a standardized approach similar to the format used by clinicians during the physical examination, to highlight important differences between children, adolescents and adults. The assessment of a pediatric patient is significantly different from an adult and the heterogeneity of the pediatric population requires knowledge of the inter- and intra-subpopulation differences in growth and development for all organ systems. Areas covered: A search of the English medical literature (PubMed and EMBASE) resulted in identification and review of articles that reported medical device use in the pediatric population based on specific organ systems. The review highlights unique considerations for the pediatric population with respect to growth and development as well as important physiologic and maturational differences between children and adults pertaining to the use of medical devices. Expert opinion: Children have unique medical device needs; adult devices are often adapted or configured to address these unmet needs. It is important that clinicians, and those who manufacture and design medical devices for the pediatric population, have a heightened awareness of the varied pediatric subpopulations (neonates to adolescents) with respect to growth and development, and the adjustments needed to ensure safe and effective use of devices for their unique needs.
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Affiliation(s)
- Joy H Samuels-Reid
- a Division of Anesthesiology, General Hospital, Respiratory, Infection Control and Dental Devices, Office of Device Evaluation, Center for Devices & Radiological Health, Food and Drug Administration , Silver Spring , MD , USA
| | - Judith U Cope
- b Department of Health and Human Services, Office of Pediatric Therapeutics, Office of Special Medical Programs, Office of the Commissioner, Food and Drug Administration , Silver Spring , MD , USA
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Guha S, McCaffrey B, Hariharan P, Myers MR. Quantification of leakage of sub-micron aerosols through surgical masks and facemasks for pediatric use. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2017; 14:214-223. [PMID: 27754781 DOI: 10.1080/15459624.2016.1237029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Surgical respirators, surgical masks (SMs), and facemasks for pediatric use (FPUs) are routinely used in the U.S. healthcare industry as personal protective equipment (PPE) against infectious diseases. While N95s including surgical respirators have been routinely studied, SMs and FPUs have not received as much attention, particularly in the context of aerosolized threats. This is because SMs and PFUs are not designed to protect against sub-micron aerosols. However, with the possibility of new or re-emerging airborne diseases or bio-aerosol weapons lingering, combined with the limited availability of respirators and logistical issues associated with fit-testing millions, the general adult and pediatric populations may elect to wear SMs and FPUs, respectively, in the case of a pandemic or a bio-terrorist attack. When a person dons a PPE, gaps are created between the wearer's face and the PPE, and aerosols leaking through these gaps can be an important contributor to the risk of infection compared to filtered aerosols. To understand and quantify the contribution of leakage of aerosols through gaps, with particular emphasis on SMs and FPUs, this study investigated leakage of charge-neutralized, polydispersed, dried sodium-chloride aerosols across different brands of PPE. Different breathing rates, aerosol particle sizes, and gap sizes were considered. A few major findings of this study were: (a) leakage, is not a strong function of sub-micron aerosol size; (b) for the same gap size, leakage of aerosols through surgical respirators can often be higher than in SMs and FPUs; and (c) as the gap size increases, the increase in leakage through surgical respirators is higher compared for SMs and FPUs, implying that some SMs and FPUs that possess electret layers may be preferable to N95s that have not been fit-tested. The results obtained can also be used to explain conflicting findings from clinical studies on the effectiveness of SMs when compared to N95s and can be input into risk-assessment models to determine the increase in infection rate resulting from deployment of PPE under less-than-ideal conditions.
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Affiliation(s)
- Suvajyoti Guha
- a Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health , U.S. Food and Drug Administration , Silver Spring , Maryland
| | - Brady McCaffrey
- b Fischell Department of Bioengineering , University of Maryland , College Park , Maryland
| | - Prasanna Hariharan
- a Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health , U.S. Food and Drug Administration , Silver Spring , Maryland
| | - Matthew R Myers
- a Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health , U.S. Food and Drug Administration , Silver Spring , Maryland
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