On the Flip Side of Mask Wearing: Increased Exposure to Volatile Organic Compounds and a Risk-Reducing Solution

Do We Need Titanium Dioxide (TiO2) Nanoparticles in Face Masks?

The use of face masks has proven to be an effective preventive measure during the COVID-19 pandemic. However, concerns have emerged regarding the safety of metal (nano)particles incorporated into face masks for antimicrobial purposes. Specifically, this review examines the risks associated with TiO2 nanoparticles (NPs), which are classified as a possible human carcinogen. The inhalation of TiO2 NPs can cause multiple adverse effects, including oxidative stress, pulmonary inflammation, histopathological changes, and (secondary) genotoxicity. Different aspects are discussed, such as the composition and filtration efficiency of face masks, the antimicrobial mode of action and effectiveness of various metals, and the hazards of TiO2 NPs to human health, including exposure limits. A conservative risk assessment was conducted using different worst-case scenarios of potential (sub)chronic TiO2 exposure, derived from published leaching experiments. Most face masks are considered safe, especially for occasional or single use. However, the nanosafety of a minority of face masks on the European market may be inadequate for prolonged and intensive use. Important uncertainties remain, including the risks of combined exposure to TiO2 NPs and silver biocides, and the lack of direct exposure measurements. Considering the potential safety issues and the limited added protective value of TiO2 NPs, it is recommended to ban all applications of TiO2 in face masks based on the precautionary principle.

Phthalates in face masks and their effects on cellular energetics in human bronchial epithelial cells

The widespread use of disposable masks has sparked concerns about potential exposure to harmful chemicals, including the already ubiquitous phthalates. It has been demonstrated that there is a causal relationship between the exposure to phthalates and the onset of respiratory diseases. Moreover, there is an increasing body of evidence, which suggests that mitochondria contribute to significant impact to the epithelial function in respiratory diseases. However, the specific effects induced by these compounds at the mitochondrial level in respiratory cells are unknown. The objective of this study was to identify phthalates in disposable face masks and to evaluate their effect on mitochondrial function in human bronchial epithelial cells (BEAS-2B). In order to identify and quantify the phthalates in face masks, an extraction method was developed and a phthalate quantification method using Gas Chromatography-Mass Spectrometry was employed. The analysis of the face masks sample revealed the presence of three major phthalates: di(2-ethylhexyl) phthalate (DEHP), dibutyl phthalate (DBP) and diisobutyl phthalate (DiBP). To evaluate the effects of these phthalates on mitochondrial function, BEAS-2B were exposed to the phthalates individually and in a mixture of the three at concentrations ranging from 0.5 to 10 mg/L for 24 hours. Then extracellular flux analysis (Seahorse analysis), adenosine levels (LC-DAD) and lactate levels (LC-MS) were evaluated. The observed effects at the mitochondrial level varied according to the specific phthalates that were tested. The major dysfunctions were identified following exposure to DEHP, which exerted inhibitory effects on the basal and maximal oxygen consumption rate of BEAS-2B cells, as well as an alteration in oxidative phosphorylation and a reduction in the ATP/ADP ratio. This was accompanied by an increase in both extracellular lactate production and extracellular acidification rate. A shift towards a glycolytic phenotype was noted. Similar, yet more pronounced effects, were observed following exposure to the mixture of the three phthalates, which suggest that DEHP may contribute to the overall effect of the mixture. This study is the first to provide knowledge on the adverse effects of a mixture of phthalates on mitochondrial function in bronchial epithelial cells, demonstrating the capacity of some phthalates to induce a shift toward a glycolytic phenotype. These results highlight the potential risks of inhaled phthalates on mitochondrial function, predisposing to the development of respiratory diseases.

Bisphenol A in Disposable Face Masks: A Novel Human Exposure Pathway and Impact on the Aquatic Environment

We identified and quantified bisphenol A (BPA), a known estrogen-like endocrine disruptor, in disposable face mask samples collected in Hong Kong. Results revealed that BPA is a common contaminant in face masks, with concentrations reaching up to 2 μg/mask. Although polypropylene, the primary material used in mask production, is generally considered to be BPA-free, the contaminant likely originates from additives, such as flame retardants, added during manufacturing. With a dermal absorption coefficient of 0.59 for BPA, the data indicate that mask-borne BPA is readily absorbed by the skin. Notably, 8 of 85 samples could cause the user to exceed the tolerable daily BPA intake set by the European Food Safety Agency (0.0002 μg/kg body weight per day). Additionally, BPA dissolves completely in landfill leachate in less than 70 days, which poses previously unrecognized health and environmental hazards. Given the extensive use of face masks during the pandemic, their role as personal protective equipment for medical practitioners, and the fact that there are currently no regulations regarding BPA contents in masks, it is imperative to investigate the need for regulations in order to safeguard face mask users and the environment.

Merger of Single-Atom Catalysis and Photothermal Catalysis for Future Chemical Production

Photothermal catalysis is an emerging field with significant potential for sustainable chemical production processes. The merger of single-atom catalysts (SACs) and photothermal catalysis has garnered widespread attention for its ability to achieve precise bond activation and superior catalytic performance. This review provides a comprehensive overview of the recent progress of SACs in photothermal catalysis, focusing on their underlying mechanisms and applications. The dynamic structural evolution of SACs during photothermal processes is highlighted, and the current advancements and future perspectives in the design, screening, and scaling up of SACs for photothermal processes are discussed. This review aims to provide insights into their continued development in this rapidly evolving field.

Scalable pilot production of highly efficient 5-ply respiratory masks enhanced by bacterial cellulose nanofibers

This study presents the pilot-scale production of highly efficient real respiratory masks enhanced by bacterial cellulose nanofibers (BCNFs). The BCNFs suspension was deposited onto tissue paper substrates using fog spray technique with three BCNFs grammage levels of 0.5, 1, and 2 g/m2, followed by freeze drying. Also, two continuous and batch welding processes have been used to construct the core structure of the masks. Field emission scanning electron microscopy (FE-SEM) confirmed the uniform distribution and size of fog-sprayed BCNFs and their pore networks. With increase in BCNFs grammage, the adsorption efficiency of masks increased in both continuous and batch production methods. The mask produced through batch processing showed the highest efficiency of 99.2 % (N99) for the particulate matter of 0.3 μm, while the maximum corresponding efficiency value in continuous processing was 95.4 % (N95). The pressure drops of the masks increased with the increase in BCNFs grammage in both methods. The maximum pressure drops of N95 and N99 masks obtained were 112 ± 10 Pa and 128 ± 8 Pa, respectively. Notably, the filtration efficacy of masks was preserved when subjected to relative humidity fluctuations ranging from 30 % to 70 %. The successful findings of this study offer significant promise for future air filtration applications.

Functionalized Face Masks as Smart Wearable Sensors for Multiple Sensing

Wearable sensors provide continuous physiological information and measure deviations from healthy baselines, resulting in the potential to personalize health management and diagnosis of diseases. With the emergence of the COVID-19 pandemic, functionalized face masks as smart wearable sensors for multimodal and/or multiplexed measurement of physical parameters and biochemical markers have become the general population for physiological health management and environmental pollution monitoring. This Review examines recent advances in applications of smart face masks based on implantation of digital technologies and electronics and focuses on respiratory monitoring applications with the advantages of autonomous flow driving, enrichment enhancement, real-time monitoring, diversified sensing, and easily accessible. In particular, the detailed introduction of diverse respiratory signals including physical, inhalational, and exhalant signals and corresponding associations of health management and environmental pollution is presented. In the end, we also provide a personal perspective on future research directions and the remaining challenges in the commercialization of smart functionalized face masks for multiple sensing.

Typical Misconceptions Pertaining to Facepiece Masks against Viral Aerosols

Since the early stages of the COVID-19 pandemic, there have been debates regarding the transmission modes of contagious viruses, including the influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), along with its variants [...].

Effects of COVID-19 on coastal and marine environments: Aggravated microplastic pollution, improved air quality, and future perspective

The COVID-19 pandemic during 2020-2023 has wrought adverse impacts on coastal and marine environments. This study conducts a comprehensive review of the collateral effects of COVID-19 on these ecosystems through literature review and bibliometric analysis. According to the output and citation analysis of these publications, researchers from the coastal countries in Asia, Europe, and America payed more attentions to this environmental issue than other continents. Specifically, India, China, and USA were the top three countries in the publications, with the proportion of 19.55%, 18.99%, and 12.01%, respectively. The COVID-19 pandemic significantly aggravated the plastic and microplastic pollution in coastal and marine environments by explosive production and unproper management of personal protective equipment (PPE). During the pandemic, the estimated mismanaged PPE waste ranged from 16.50 t/yr in Sweden to 250,371.39 t/yr in Indonesia. In addition, the PPE density ranged from 1.13 × 10-5 item/m2 to 2.79 item/m2 in the coastal regions worldwide, showing significant geographical variations. Besides, the emerging contaminants released from PPE into the coastal and marine environments cannot be neglected. The positive influence was that the COVID-19 lockdown worldwide reduced the release of air pollutants (e.g., fine particulate matter, NO2, CO, and SO2) and improved the air quality. The study also analyzed the relationships between sustainable development goals (SDGs) and the publications and revealed the dynamic changes of SDGs in different periods the COVID-19 pandemic. In conclusion, the air was cleaner due to the lockdown, but the coastal and marine contamination of plastic, microplastic, and emerging contaminants got worse during the COVID-19 pandemic. Last but not least, the study proposed four strategies to deal with the coastal and marine pollution caused by COVID-19, which were regular marine monitoring, performance of risk assessment, effective regulation of plastic wastes, and close international cooperation.

Disposable surgical/medical face masks and filtering face pieces: Source of microplastics and chemical additives in the environment

The production and consumption of disposable face masks (DFMs) increased intensely during the COVID-19 pandemic, leading to a high amount of them being found in the terrestrial and aquatic environment. The main goal of this research study is to conduct a comparative evaluation of the water-leachability of microplastics (MPs) and chemical additives from various types of disposable surgical/medical face masks (MM DFMs) and filtering face pieces (FFPs). Fourier-Transform Infrared Spectroscopy was used for MPs analysis. Liquid Chromatography/High Resolution Mass Spectrometry was used to analyse analytes presented in the water-leachates of DFMs. FFPs released 3-4 times more microplastic particles compared to MM DFMs. The release of MPs into water from all tested DFMs without mechanical stress suggests potential MP contamination originating from the DFM production process. Our study for the first time identified bisphenol B (0.25-0.42 μg/L) and 1,4-bis(2-ethylhexyl) sulfosuccinate (163.9-115.0 μg/L) as leachables from MM DFMs. MPs in the water-leachates vary in size, with predominant particles <100 μm, and the release order from DFMs is MMIIR > MMII > FFP3>FFP2>MMI. The main type of microplastics identified in the water leachates of the investigated face masks was polypropylene, accounting for 93-97% for MM DFMs and 82-83% for FFPs. Other polymers such as polyethylene, polycarbonate, polyester/polyethylene terephthalate, polyamide/Nylon, polyvinylchloride, and ethylene-propylene copolymer were also identified, but in smaller amounts. FFPs released a wider variety and a higher percentage (17-18%) of other polymers compared to MM DFMs (3-7%). Fragments and fibres were identified in all water-leachate samples, and fragments, particularly debris of polypropylene fibres, were the most common MP morphotype. The findings in this study are important in contributing additional data to develop science-based policy recommendations on the health and environmental impacts of MPs and associated chemical additives originated from DFMs.

Wearing face masks as a potential source for inhalation and oral uptake of inanimate toxins - A scoping review

BACKGROUND

From 2020 to 2023 many people around the world were forced to wear masks for large proportions of the day based on mandates and laws. We aimed to study the potential of face masks for the content and release of inanimate toxins.

METHODS

A scoping review of 1003 studies was performed (database search in PubMed/MEDLINE, qualitative and quantitative evaluation).

RESULTS

24 studies were included (experimental time 17 min to 15 days) evaluating content and/or release in 631 masks (273 surgical, 228 textile and 130 N95 masks). Most studies (63%) showed alarming results with high micro- and nanoplastics (MPs and NPs) release and exceedances could also be evidenced for volatile organic compounds (VOCs), xylene, acrolein, per-/polyfluoroalkyl substances (PFAS), phthalates (including di(2-ethylhexyl)-phthalate, DEHP) and for Pb, Cd, Co, Cu, Sb and TiO2.

DISCUSSION

Of course, masks filter larger dirt and plastic particles and fibers from the air we breathe and have specific indications, but according to our data they also carry risks. Depending on the application, a risk-benefit analysis is necessary.

CONCLUSION

Undoubtedly, mask mandates during the SARS-CoV-2 pandemic have been generating an additional source of potentially harmful exposition to toxins with health threatening and carcinogenic properties at population level with almost zero distance to the airways.

Revealing the characteristics of biofilms on different polypropylene plastic products: Comparison between disposable masks and takeaway boxes

The increasingly severe plastic pollution issue was intensified by the enormous plastic emissions into ecosystems during the Covid-19 pandemic. Plastic wastes entering the environment were swiftly exposed to microorganisms and colonized by biofilms, and the plastic-biofilm combined effects further influenced the ecosystem. However, the non-woven structure of disposable masks discarded carelessly during the COVID-19 pandemic was different from those of plastics with flat surface. To reveal the potential effects of plastic structure on colonized biofilms, white disposable surgical masks (DM) and transparent takeaway boxes (TB), both made of polyethylene, were selected for the incubation of organic conditioning films and biofilms. The results indicated that the non-woven structure of disposable mask was destroyed by the influence of water infiltration and biofilm colonization. The influence of surface structure on conditioning films led to a relatively higher proportion of tryptophan-like substances on DM than those on TB samples. Therefore, biofilms with significantly higher microbial biomass and carbon metabolic capacity were formed on DM than those on TB samples owing to the combined effects of their differences in surface structure and conditioning films. Moreover, abundant functional microorganisms associated with stress tolerance, carbon metabolism and biofilm formation were observed in biofilms on disposable mask. Combining with the results of partial least squares regression analysis, the selective colonization of functional microorganisms on disposable masks with uneven surface longitudinal fluctuation was revealed. Although the predicted functions of biofilms on disposable masks and takeaway boxes showed more similarity to each other than to those of free-living aquatic microorganisms owing to the existence of the plastisphere, biofilms on disposable masks may potentially trigger environmental risks different from those of takeaway boxes by unique carbon metabolism and abundant biomass.

Indoor Air Sources of Outdoor Air Pollution: Health Consequences, Policy, and Recommendations: An Official American Thoracic Society Workshop Report

Indoor sources of air pollution worsen indoor and outdoor air quality. Thus, identifying and reducing indoor pollutant sources would decrease both indoor and outdoor air pollution, benefit public health, and help address the climate crisis. As outdoor sources come under regulatory control, unregulated indoor sources become a rising percentage of the problem. This American Thoracic Society workshop was convened in 2022 to evaluate this increasing proportion of indoor contributions to outdoor air quality. The workshop was conducted by physicians and scientists, including atmospheric and aerosol scientists, environmental engineers, toxicologists, epidemiologists, regulatory policy experts, and pediatric and adult pulmonologists. Presentations and discussion sessions were centered on 1) the generation and migration of pollutants from indoors to outdoors, 2) the sources and circumstances representing the greatest threat, and 3) effective remedies to reduce the health burden of indoor sources of air pollution. The scope of the workshop was residential and commercial sources of indoor air pollution in the United States. Topics included wood burning, natural gas, cooking, evaporative volatile organic compounds, source apportionment, and regulatory policy. The workshop concluded that indoor sources of air pollution are significant contributors to outdoor air quality and that source control and filtration are the most effective measures to reduce indoor contributions to outdoor air. Interventions should prioritize environmental justice: Households of lower socioeconomic status have higher concentrations of indoor air pollutants from both indoor and outdoor sources. We identify research priorities, potential health benefits, and mitigation actions to consider (e.g., switching from natural gas to electric stoves and transitioning to scent-free consumer products). The workshop committee emphasizes the benefits of combustion-free homes and businesses and recommends economic, legislative, and education strategies aimed at achieving this goal.

Occurrence of phthalates in facemasks used in India and its implications for human exposure

Synthetic polymers with additives are used in the manufacturing of face masks (FMs); hence, FMs could be a potential source of exposure to phthalic acid esters (PAEs). India stands second in the world in terms of the FMs usage since the beginning of Covid-19 pandemic. However, little is known about the PAEs content of FMs used in India. Some PAEs, such as DEHP and DBP are suspected endocrine disrupting chemicals (EDCs); hence, wearing FM may increase the risk of exposure to these EDCs. In this study, we collected 91 samples of FMs from eight Indian cities and analyzed for five PAEs viz. DMP, DEP, DBP, BBP, and DEHP. The PAEs contents in FMs ranged from 101.79 to 27,948.64 ng/g. The carcinogenic risk of N 95 with filter, N-95, and cloth masks was higher than the threshold levels. The findings indicate the need to control PAEs in FMs through regulatory actions.

Correlation between use of different type protective facemasks and the oral ecosystem

BACKGROUND

Spread worldwide through droplets, the Virus Sars-Cov-19 has caused a global health emergency alarm. In order to limit its spread, the use of masks has become part of the daily life of the entire population, however, little is known about its constant use and the changes generated in the oral cavity. This work aims to investigate correlations between the continuous use of masks covering the nose and mouth for 3 h and changes in the ecological factors of the oral cavity.

METHODS

34 volunteers were divided into 2 groups: wear only the filtering facepiece code 2 (FFP2) mask (Group A) and wear the FFP2 mask covered by a surgical mask (Group B). Measurement of Volatile Organic Compounds (VOCs), saliva rehydration and consistency test, collection of basal saliva and saliva stimulated with paraffin gum and mucosal swab were collected and analyzed at two times: before using the mask(s) (T0) and 3 h after continuous use of the mask(s) (T1).

RESULTS

The results indicated a significant difference between the groups, in which the basal saliva volume and pH and the peaks of VOCs increased for group B between T0 and T1. The rehydration time decreased and the volume and pH of the stimulated saliva increased, but with no significant difference between the groups. Furthermore, group B showed a significant decrease in Candida albicans Colony Forming Units (CFUs) and Total Bacterial Count (TBC) between T0 and T1.

CONCLUSION

It is concluded that the prolonged use of the FFP2 mask covered by a surgical mask can generate oral alterations in the user.

Phthalate acid esters contribute to the cytotoxicity of mask leachate: Cell-based assay for toxicity assessment

After the COVID-19 outbreak, masks have become an essential part of people lives. Although several studies have been conducted to determine the release of hazardous substances from masks, how their co-presence poses a potential exposure risk to human health remains unexplored. In this study, we quantitatively compared the leaching of substances from six different common types of masks, including phthalate acid esters (PAEs), metals, and microplastics (MPs), and comprehensively evaluated the potential cytotoxicity of different leachates. MPs smaller than 3 µm were quantified by Py-GC-MS, and reusable masks showed greater releasing potentials up to 1504 µg/g. We also detected the prevalence of PAEs in masks, with the highest release reaching 42 μg/g, with dibutyl phthalate (DBP), diisobutyl phthalate (DiBP) and bis (2-ethylhexyl) phthalate (DEHP) being the predominant types. Moreover, the antimicrobial cloth masks released 173.0 µg of Cu or 4.5 µg of Ag, representing 2.7% and 0.04% of the original masks, respectively. Our cell-based assay results demonstrated for the first time that mask leachate induced nuclear condensation with DNA damage, and simultaneously triggered high levels of glutathione and reactive oxidative stress production, which exacerbated mitochondrial fragmentation, eventually leading to cell death. Combined with substance identification and correlation analysis, PAEs were found to be the contributors to cytotoxicity. Masks containing Cu or Ag led to acidification of lysosomes and alkalinization of cells. These results strongly suggested that the levels of PAEs in the production of regulatory masks should be strictly controlled.

Exploring the release of hazardous volatile organic compounds from face masks and their potential health risk

Hazardous chemicals released from the petroleum-derived face mask can be inhaled by wearers and cause adverse health effects. Here, we first used headspace solid-phase microextraction coupled with GC-MS to comprehensively analyze the volatile organic compounds (VOCs) released from 26 types of face masks. The results showed that total concentrations and peak numbers ranged from 3.28 to 197 μg/mask and 81 to 162, respectively, for different types of mask. Also, light exposure could affect the chemical composition of VOCs, particularly increasing the concentrations of aldehydes, ketones, organic acids and esters. Of these detected VOCs, 142 substances were matched to a reported database of chemicals associated with plastic packaging; 30 substances were identified by the International Agency for Research on Cancer (IARC) as potential carcinogenic to humans; 6 substances were classified in the European Union as persistent, bioaccumulative, and toxic, or very persistent, very bioaccumulative substance. Reactive carbonyls were ubiquitous in masks, especially after exposure to light. The potential risk of VOCs released from the face masks were then accessed by assuming the extreme scenario that all the VOC residues were released into the breathing air within 3 h. The result showed that the average total concentration of VOCs (17 μg/m3) was below the criterion for hygienic air, but seven substances, 2-ethylhexan-1-ol, benzene, isophorone, heptanal, naphthalene, benzyl chloride, and 1,2-dichloropropane exceeded the non-cancer health guidelines for lifetime exposure. This finding suggested that specific regulations should be adopted to improve the chemical safety of face masks.

Revisiting the rationale of mandatory masking

In this perspective, we review the evidence for the efficacy of face masks to reduce the transmission of respiratory viruses, specifically severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and consider the value of mandating universal mask wearing against the widespread negative impacts that have been associated with such measures. Before the SARS-CoV-2 pandemic, it was considered that there was little to no benefit in healthy people wearing masks as prophylaxis against becoming infected or as unwitting vectors of viral transmission. This accepted policy was hastily reversed early on in the pandemic, when districts and countries throughout the world imposed stringent masking mandates. Now, more than three years since the start of the pandemic, the amassed studies that have investigated the use of masks to reduce transmission of SARS-CoV-2 (or other pathogens) have led to conclusions that are largely inconsistent and contradictory. There is no statistically significant or unambiguous scientific evidence to justify mandatory masking for general, healthy populations with the intention of lessening the viral spread. Even if mask wearing could potentially reduce the transmission of SARS-CoV-2 in individual cases, this needs to be balanced against the physical, psychological and social harms associated with forced mask wearing, not to mention the negative impact of innumerable disposed masks entering our fragile environment. Given the lack of unequivocal scientific proof that masks have any effect on reducing transmission, together with the evident harms to people and the environment through the use of masks, it is our opinion that the mandatory use of face masks in the general population is unjustifiable and must be abandoned in future pandemic countermeasures policies.

Personal protective equipment and micro-nano plastics: A review of an unavoidable interrelation for a global well-being hazard

The usage and the demand for personal protective equipments (PPEs) for our day-to-day survival in this pandemic period of COVID-19 have seen a steep rise which has consequently led to improper disposal and littering. Fragmentation of these PPE units has eventually given way to micro-nano plastics (MNPs) emission in the various environmental matrices and exposure of living organisms to these MNPs has proven to be severely toxic. Numerous factors contribute to the toxicity imparted by these MNPs that mainly include their shape, size, functional groups and their chemical diversity. Even though multiple studies on the impacts of MNPs toxicity are available for other organisms, human cell line studies for various plastic polymers, other than the most common ones namely polyethylene (PE), polystyrene (PS) and polypropylene (PP), are still at their nascent stage and need to be explored more. In this article, we cover a concise review of the literature on the impact of these MNPs in biotic and human systems focusing on the constituents of the PPE units and the additives that are essentially used for their manufacturing. This review will subsequently identify the need to gather scientific evidence at the smaller level to help combat this microplastic pollution and induce a more in-depth understanding of its adverse effect on our existence.

Measuring the quantity of harmful volatile organic compounds inhaled through masks

An increase in the concentration of environmental particulate matter and the spread of the COVID-19 virus have dramatically increased our time spent wearing masks. If harmful chemicals are released from these masks, there may be harmful effects on human health. In this study, the concentration of volatile organic compounds (VOCs) emitted from some commonly used masks was assessed qualitatively and quantitatively under diverse conditions (including different mask material types, time between opening the product and wearing, and mask temperature). In KF94 masks, 1-methoxy-2-propanol (221 ± 356 µg m-3), N,N-dimethylacetamide (601 ± 450 µg m-3), n-hexane (268 ± 349 µg m-3), and 2-butanone (160 ± 244 µg m-3) were detected at concentrations 22.9-147 times higher than those found in masks made from other materials, such as cotton and other functional fabrics. In addition, in KF94 masks, the total VOC (TVOC) released amounted to 3730 ± 1331 µg m-3, about 14 times more than that released by the cotton masks (267.5 ± 51.6 µg m-3). In some KF94 masks, TVOC concentration reached over 4000 µg m-3, posing a risk to human health (based on indoor air quality guidelines established by the German Environment Agency). Notably, 30 min after KF94 masks were removed from their packaging, TVOC concentrations decreased by about 80% from their initial levels to 724 ± 5.86 µg m-3; furthermore, 6 h after removal, TVOC concentrations were found to be less than 200 µg m-3. When the temperature of the KF94 masks was raised to 40 oC, TVOC concentrations increased by 119-299%. Since the types and concentrations of VOCs that will be inhaled by mask wearers vary depending on the mask use conditions, it is necessary to comply with safe mask wearing conditions.

Mask device as a new wearable sampler for breath analysis: what can we expect in the future?

Human exhaled breath is becoming an attractive clinical source as it is foreseen to enable noninvasive diagnosis of many diseases. Because mask devices can be used for efficiently filtering exhaled substances, mask-wearing has been required in the past few years in daily life since the unprecedented COVID-19 pandemic. In recent years, there is a new development of mask devices as new wearable breath samplers for collecting exhaled substances for disease diagnosis and biomarker discovery. This paper attempts to identify new trends in mask samplers for breath analysis. The couplings of mask samplers with different (bio)analytical approaches, including mass spectrometry (MS), polymerase chain reaction (PCR), sensor, and others for breath analysis, are summarized. The developments and applications of mask samplers in disease diagnosis and human health are reviewed. The limitations and future trends of mask samplers are also discussed.

Current knowledge on the presence, biodegradation, and toxicity of discarded face masks in the environment

During the first year of the COVID-19 pandemic, facemasks became mandatory, with a great preference for disposable ones. However, the benefits of face masks for health safety are counteracted by the environmental burden related to their improper disposal. An unprecedented influx of disposable face masks entering the environment has been reported in the last two years of the pandemic, along with their implications in natural environments in terms of their biodegradability, released contaminants and ecotoxicological effects. This critical review addresses several aspects of the current literature regarding the (bio)degradation and (eco)toxicity of face masks related contaminants, identifying uncertainties and research needs that should be addressed in future studies. While it is indisputable that face mask contamination contributes to the already alarming plastic pollution, we are still far from determining its real environmental and ecotoxicological contribution to the issue. The paucity of studies on biodegradation and ecotoxicity of face masks and related contaminants, and the uncertainties and uncontrolled variables involved during experimental procedures, are compromising eventual comparison with conventional plastic debris. Studies on the abundance and composition of face mask-released contaminants (microplastics/fibres/ chemical compounds) under pre- and post-pandemic conditions should, therefore, be encouraged, along with (bio)degradation and ecotoxicity tests considering environmentally relevant settings. To achieve this, methodological strategies should be developed to overcome technical difficulties to quantify and characterise the smallest MPs and fibres, adsorbents, and leachates to increase the environmental relevancy of the experimental conditions.

Determination and risk assessment of phthalates in face masks. An Italian study

Serious human health concerns have been recently raised from daily use of face masks, due to the possible presence of hazardous compounds as the phthalic acid esters (PAEs). In this study, the content of 11 PAEs in 35 commercial masks was assessed by applying a specific and accurate method, using Gas Chromatography/Mass Spectrometry. Surgical, FFP2 and non-surgical models, for both adults and children were collected from the Italian market. Analyses showed that four of the target analytes were detected in all tested samples with median total concentrations ranging between 23.6 mg/kg and 54.3 mg/kg. Results obtained from the experimental analysis were used in the risk assessment studies carried out for both carcinogenic and non-carcinogenic effects. Doses of exposure (D_exp) of PAEs ranged from 6.43 × 10^-5 mg/kg bw/day to 1.43 × 10^-2 mg/kg bw/day. Cumulative risk assessment was performed for non-carcinogenic and carcinogenic effects. No potential risk was found for non-carcinogenic effects, yet the 20% of the mask samples showed potential carcinogenic effects for humans. A refined exposure assessment was performed showing no risk for carcinogenic effects. This paper presents a risk assessment approach for the identification of potential risks associated to the use of face masks.

Release of phthalate esters (PAEs) and microplastics (MPs) from face masks and gloves during the COVID-19 pandemic

Marine pollution with personal protective equipment (PPE) has recently gained major attention. Multiple studies reported the release of microplastics (MPs) and chemical contaminants from face masks, the most used PPE type. However, not much is known concerning the release of phthalate esters (PAEs) in aquatic media, as well as the hazard posed by other types of PPE. In the present study, we investigated the release of MPs and PAEs from face masks and gloves recovered from the environment. The results indicated that both PPEs release MPs comparable to the literature, but higher concentrations were presented by face masks. In turn, the total concentration of six PAEs was higher in gloves than in face masks. The release of these contaminants is exacerbated over time. The present study allows researchers to understand the contribution of PPE to marine pollution while accounting for gloves, a generally overlooked source of contaminants.

Face masks invading protected areas: Risks and recommendations

Among the indirect environmental impacts generated by the global COVID-19 pandemic, contamination with personal protective equipment (PPE), like face masks, may be one of the most relevant ones. PPE has been found in multiple aquatic, marine, and terrestrial environments, including places of absolute relevancy to biodiversity conservation, such as protected areas (PAs). Here, a brief report of the presence of PPE in six PAs of Peru is presented. PPE pollution in PAs consisted mainly of single-use and reusable face masks, as well as plastics associated with PAs, such as KN95 respirator wrappings. The mean PPE density was estimated as 1.32 × 10-3 PPE/m2. FTIR spectroscopy confirmed that face masks and wrappers mainly consisted of polypropylene and polyethylene, two of the most commonly available synthetic polymers. The material was poorly degraded according to their FTIR spectra, possibly suggesting that they were discarded recently. The recent ban on single-use plastic in Peruvian PAs is regarded as a great step forward toward the efforts made to preserve these invaluable places. However, these measures seemed insufficient to prevent PPE and other types of litter from contaminating areas of ecological importance. Considering the current scenario, several recommendations were proposed to be implemented in PAs in order to prevent PPE from becoming a new plastic issue to tackle. These recommendations are expected to also serve for future events where the use of single-use plastics becomes inevitable, like global pandemics.

Per- and polyfluoroalkyl substances in the atmosphere of waste management infrastructures: Uncovering secondary fluorotelomer alcohols, particle size distribution, and human inhalation exposure

Per- and polyfluoroalkyl substances (PFAS) have been applied in numerous industrial and consumer products, the majority of which flow into waste management infrastructures (WMIs) at the end of their life cycles, but little is known about atmospheric releases of PFAS from these facilities. In this study, we addressed this key issue by investigating 49 PFAS, including 23 ionic and 26 neutral and precursor PFAS, in the potential sources (n = 4; within or adjacent to WMIs) and reference sites (n = 2; coastal and natural reserve sites) in urban and rural areas of Hong Kong, China. Duplicate samples of air and size-segregated particulate matter were collected for 48 h continuously using a 11-stage Micro-Orifice Uniform Deposit Impactor (MOUDI). In general, fluorotelomer alcohols (FTOHs) and perfluoroalkane sulfonamides were the predominant PFAS classes found across sampling sites. We also demonstrated the release of several less frequently observed semivolatile intermediate products (e.g., secondary FTOHs) during waste treatment. Except for perfluorooctane sulfonate, the size-segregated distributions of particulate PFAS exhibited heterogeneity across sampling sites, particularly in the WMIs, implying combined effects of sorption affinity and emission sources. A preliminary daily air emission estimation revealed that landfill was a relatively important source of PFAS relative to the wastewater treatment plant. A simplified International Commission on Radiological Protection model was used to estimate lung depositional fluxes, and the results showed that inhaled particulate PFAS were mainly deposited in the head airway while fine and ultrafine particles carried PFAS deeper into the lung alveoli. The cumulative daily inhalation dose of gaseous and particulate PFAS ranged from 81.9 to 265 pg/kg/d. In-depth research is required to understand the health effect of airborne PFAS on workers at WMIs.

Polyurethane Foam Face Masks as a Dosimeter for Quantifying Personal Exposure to Airborne Volatile and Semi-Volatile Organic Compounds

Airborne volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs) are commonly quantitated by collecting the analytes on solid sorbent tubes or passive air samplers, followed by solvent extraction and instrumental analysis, or by grab bag/canister measurements. We report herein a user-friendly sampling method by breathing through polyurethane foam (PUF) face masks to collect airborne VOCs and SVOCs for chemical analysis. Specifically, dibasic esters, phthalate esters, polycyclic aromatic hydrocarbons, linalool, and nicotine trapped on PUF masks were quantitated by gas chromatography-mass spectrometry analysis as model VOCs and SVOCs. Results showed that the amount of these model VOCs and SVOCs trapped on PUF masks is proportional to the exposure duration. After cross-validation by parallel sampling using XAD-2 packed sorbent tubes, the method was used to quantitate VOCs and SVOCs in a variety of indoor and outdoor environments with varying air concentrations of analytes, temperature, humidity, and wind speed. Because air pollution is considered a major cause of many human diseases and premature deaths and the developed PUF mask sampling method showed high trapping efficiencies for both VOCs and SVOCs, it is believed that the developed sampling method will find wide application in assessing air pollution-associated disease risks with possible extension to more classes of VOCs and SVOCs when coupled with suitable instrumental detection methods.

Significant changes in follicular fluid phthalate metabolite levels reflect the lifestyle changes brought about by the strict COVID-19 lockdown in India

OBJECTIVE

To assess if the unprecedented changes in lifestyle because of the lockdown initiated by the COVID-19 pandemic, which altered human behavior, and influenced purchase and consumption patterns, may have had an impact on the exposure to phthalates in Indian women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). To evaluate if the effects of the strict and lengthy lockdown in India, which promoted the new norms of stay-at-home and work-from-home, closure of beauty parlors, and restriction on public gatherings, may have contributed to a decrease in the exposure to phthalates like dibutyl phthalate and diethyl phthalate. These chemicals are found in many personal care products (PCPs) which include cosmetics and fragrances. To investigate if the extensive use of flexible single-use plastic in personal protective equipment like face masks/gloves and in plastic packaging used for online purchases, food takeaways, and home deliveries of essentials and groceries during the COVID-19 pandemic, in an attempt to provide a contact-free delivery system may have inadvertently led to an increase in exposure to phthalates like di(2-ethylhexyl) phthalate, di-isononyl phthalate, and di-isodecyl phthalate which are plasticizers used in manufacturing flexible plastic.

DESIGN

A comparative study of the levels of six phthalate metabolites detected in follicular fluid (FF) of Indian women undergoing IVF/ICSI 1 year before and immediately after the lockdown initiated by the COVID-19 pandemic.

SETTING

In vitro fertilization center in a large referral hospital in India.

PATIENT(S)

A total of 176 Indian women seeking treatment for infertility and undergoing oocyte retrieval were included after obtaining consent. Each woman contributed one FF sample to the study. Group A (n = 96) women (mean age, 34.0 [±3.9] years, and mean BMI, 25.4 [±4.8]) had their FF samples collected and screened between January 2019 and mid-March 2020, 1 year before the lockdown. Group B (n = 80) women (mean age, 33.9 [±4.1] years, and mean BMI, 25.0 [±4.4]) had their FF collected and screened post the lockdown between October 2020 and June 2021. Both groups were matched by age and BMI.

INTERVENTION(S)

The cryopreserved FF samples of 176 women were processed using enzymatic deconjugation as well as the solid-phase extraction technique, and analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to detect the total levels of six phthalate metabolites.

MAIN OUTCOME MEASURE(S)

To evaluate the impact of the COVID-19 lockdown on the change in the phthalate metabolite levels in the FF of Indian women undergoing IVF/ICSI pre and post the lockdown.

RESULT(S)

The median levels of mono-n-butyl phthalate (1.64 ng/ml in group A vs. 0.93 ng/ml in group B; P<.001) and mono-ethyl phthalate (5.25 ng/ml in group A vs. 3.24 ng/ml in group B; P<.001) metabolites of dibutyl phthalate and diethyl phthalate found in PCPs including cosmetics and fragrances were significantly higher in the FF of 96 women (group A) compared with the levels seen in the FF of 80 women (group B). However, the median levels of mono-isononyl phthalate (0.11ng/ml in group A vs. 0.13 ng/ml in group B; P<.001), mono-isodecyl phthalate (0.11 ng/ml in group A vs. 0.14 ng/ml in group B; P<.001), and mono(2-ethyl-5-oxohexyl) phthalate (0.13 ng/ml in group A vs. 0.14 ng/ml in group B; P=.023) metabolites of di-isononyl phthalate, di-isodecyl phthalate, and di(2-ethylhexyl) phthalate used as plasticizers were significantly higher in the FF of women in group B compared with women in group A.

CONCLUSION(S)

The significant drop in mono-n-butyl phthalate and mono-ethyl phthalate levels, accumulated in the FF of 80 Indian women in group B reflects a decrease or absence of usage patterns of PCPs, including cosmetics and fragrances, thereby suggesting that these women may have deprioritized their use during the COVID-19 pandemic giving preference to personal hygiene and safety. Whereas the unprecedented increase in the use of flexible single-use plastic that became our first line of defense against the coronavirus during the COVID-19 pandemic might be responsible for the accumulation of significantly higher levels of mono-isononyl phthalate, mono-isodecyl phthalate, and mono(2-ethyl-5-oxohexyl) phthalate in FF of the same group.

Public face masks wearing during the COVID-19 pandemic: A comprehensive analysis is needed for potential implications

Face mask-wearing as a public health measure has been practiced since the coronavirus 2019 (COVID-19) pandemic outbreak. Extensive research has shown that face masks are an effective non-pharmaceutical measure to contain the spread of respiratory infections. However, recent studies indicate that face masks release microplastics and other contaminants that have adverse health effects on humans. This communication reviews the evidence for face mask as a potential source of contaminants capable of adversely affecting human health. The benefits of face masks in reducing the transmission of SARS-Cov-2 (severe acute respiratory syndrome coronavirus 2) and seasonal communicable diseases were addressed. In addition, the risk of inhaling microplastics and organic contaminants, as well as the associated exposure level, were discussed. Finally, the potential research gaps that need to be addressed were outlined to provide a holistic view of the problem. This communication has illustrated that face mask-wearing as a public health measure to contain the spread of COVID-19 could be a potential risk factor for human health. Very few studies have been done on microplastics, organic pollutants, and trace metal inhalation from surgical masks. However, future work providing a comprehensive understanding of the risk and exposure levels needs to be undertaken.

Electrospun Nanofibrous Membranes for Controlling Airborne Viruses: Present Status, Standardization of Aerosol Filtration Tests, and Future Development

The global COVID-19 pandemic has raised great public concern about the airborne transmission of viral pathogens. Virus-laden aerosols with small size could be suspended in the air for a long duration and remain infectious. Among a series of measures implemented to mitigate the airborne spread of infectious diseases, filtration by face masks, respirators, and air filters is a potent nonpharmacologic intervention. Compared with conventional air filtration media, nanofibrous membranes fabricated via electrospinning are promising candidates for controlling airborne viruses due to their desired characteristics, i.e., a reduced pore size (submicrometers to several micrometers), a larger specific surface area and porosity, and retained surface and volume charges. So far, a wide variety of electrospun nanofibrous membranes have been developed for aerosol filtration, and they have shown excellent filtration performance. However, current studies using electrospinning for controlling airborne viruses vary significantly in the practice of aerosol filtration tests, including setup configurations and operations. The discrepancy among various studies makes it difficult, if not impossible, to compare filtration performance. Therefore, there is a pressing need to establish a standardized protocol for evaluating the electrospun nanofibrous membranes' performance for removing viral aerosols. In this perspective, we first reviewed the properties and performance of diverse filter media, including electrospun nanofibrous membranes, for removing viral aerosols. Next, aerosol filtration protocols for electrospun nanofibrous membranes were discussed with respect to the aerosol generation, filtration, collection, and detection. Thereafter, standardizing the aerosol filtration test system for electrospun nanofibrous membranes was proposed. In the end, the future advancement of electrospun nanofibrous membranes for enhanced air filtration was discussed. This perspective provides a comprehensive understanding of status and challenges of electrospinning for air filtration, and it sheds light on future nanomaterial and protocol development for controlling airborne viruses, preventing the spread of infectious diseases, and beyond.

Photothermal Synergistic Effect of Pt1/CuO-CeO2 Single-Atom Catalysts Significantly Improving Toluene Removal

Photothermal synergistic catalytic oxidation of toluene over single-atom Pt catalysts was investigated. Compared with the conventional thermocatalytic oxidation in the dark, toluene conversion and CO₂ yield over 0.39Pt₁/CuO-CeO₂ under simulated solar irradiation (λ = 320-2500 nm, optical power density = 200 mW cm^-2) at 180 °C could be increased about 48%. An amount of CuO was added to CeO₂ to disperse single-atom Pt with a maximal Pt loading of 0.83 wt %. The synergistic effect between photo- and thermocatalysis is very important for the development of new pollutant treatment technology with high efficiency and low energy consumption. Both light and heat played an important role in the present photothermal synergistic catalytic oxidation. 0.39Pt₁/CuO-CeO₂ showed good redox performance and excellent optical properties and utilized the full-spectrum solar energy. Light illumination induced the generation of reactive oxygen species (^•OH and ^•O₂^-), which accelerated the transformation of intermediates, promoted the release of active sites on the catalyst surface, and improved the oxidation reaction.

Identifying environmental factors that influence immune response to SARS-CoV-2: Systematic evidence map protocol

BACKGROUND

Widespread environmental contamination can directly interact with human immune system functions. Environmental effects on the immune system may influence human susceptibility to respiratory infections as well as the severity of infectious diseases, such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Furthermore, the efficacy of vaccines to respiratory diseases may be impacted by environmental exposures through immune perturbations. Given the quick pace of research about COVID-19 and associated risk factors, it is critical to identify and curate the streams of evidence quickly and effectively.

OBJECTIVE

We developed this systematic evidence map protocol to identify and organize existing human and animal literature on high-priority environmental chemical classes (Per- and polyfluoroalkyl substances, pesticides, phthalates, quaternary ammonium compounds, and air pollutants) and their potential to influence three key outcomes: (1) susceptibility to respiratory infection, including SARS-CoV-2 (2) severity of the resultant disease progression, and (3) impact on vaccine efficacy. The result of this project will be an online, interactive database which will show what evidence is currently available between involuntary exposures to select environmental chemicals and immune health effects, data gaps that require further research, and data rich areas that may support further analysis.

SEARCH AND STUDY ELIGIBILITY

We will search PubMed for epidemiological or toxicological literature on select toxicants from each of the chemical classes and each of the three outcomes listed above.

STUDY APPRAISAL AND SYNTHESIS OF METHODS

For each study, two independent reviewers will conduct title and abstract screening as well as full text review for data extraction of study characteristics. Study quality will not be evaluated in this evidence mapping. The main findings from the systematic evidence map will be visualized using a publicly available and interactive database hosted on Tableau Public.

A pandemic-induced environmental dilemma of disposable masks: solutions from the perspective of the life cycle

The coronavirus disease 2019 (COVID-19) has swept the world and still afflicts humans. As an effective means of protection, wearing masks has been widely adopted by the general public. The massive use of disposable masks has raised some emerging environmental and bio-safety concerns: improper handling of used masks may transfer the attached pathogens to environmental media; disposable masks mainly consist of polypropylene (PP) fibers which may aggravate the global plastic pollution; and the risks of long-term wearing of masks are elusive. To maximize the utilization and minimize the risks, efforts have been made to improve the performance of masks (e.g., antivirus properties and filtration efficiency), extend their functions (e.g., respiration monitoring and acting as a sampling device), develop new disinfection methods, and recycle masks. Despite that, from the perspective of the life cycle (from production, usage, and discard to disposal), comprehensive solutions are urgently needed to solve the environmental dilemma of disposable masks in both technologies (e.g., efficient use of raw materials, prolonging the service life, and enabling biodegradation) and policies (e.g., stricter industry criteria and garbage sorting).

Degradation of plastics associated with the COVID-19 pandemic

The ongoing COVID-19 pandemic has resulted in an unprecedented form of plastic pollution: personal protective equipment (PPE). Numerous studies have reported the occurrence of PPE in the marine environment. However, their degradation in the environment and consequences are poorly understood. Studies have reported that face masks, the most abundant type of PPE, are significant sources of microplastics due to their fibrous microstructure. The fibrous material (mostly consisting of polypropylene) exhibits physical changes in the environment, leading to its fracture and detachment of microfibers. Most studies have evaluated PPE degradation under controlled laboratory conditions. However, in situ degradation experiments, including the colonization of PPE, are largely lacking. Although ecotoxicological studies are largely lacking, the first attempts to understand the impact of MPs released from face masks showed various types of impacts, such as fertility and reproduction deficiencies in both aquatic and terrestrial organisms.

Recent Advances in Facemask Devices for In Vivo Sampling of Human Exhaled Breath Aerosols and Inhalable Environmental Exposures

Since the COVID-19 pandemic, the unprecedented use of facemasks has been requiring for wearing in daily life. By wearing facemask, human exhaled breath aerosols and inhaled environmental exposures can be efficiently filtered and thus various filtration residues can be deposited in facemask. Therefore, facemask could be a simple, wearable, in vivo, onsite and noninvasive sampler for collecting exhaled and inhalable compositions, and gain new insights into human health and environmental exposure. In this review, the recent advances in developments and applications of in vivo facemask sampling of human exhaled bacteria, viruses, proteins, and metabolites, and inhalable facemask contaminants and air pollutants, are reviewed. New features of facemask sampling are highlighted. The perspectives and challenges on further development and potential applications of facemask devices are also discussed.