Sweat rate inside a full-facepiece respirator

Facemasks during aerobic exercise: Implications for cardiac rehabilitation programs during the Covid-19 pandemic

Introduction and objectives

During the COVID-19 pandemic, among the safety measures adopted, use of facemasks during exercise training sessions in cardiac rehabilitation programs raised concerns regarding possible detrimental effects on exercise capacity. Our study examined the cardiorespiratory impact of wearing two types of the most common facemasks during treadmill aerobic training.

Methods

Twelve healthy health professionals completed three trials of a symptom-limited Bruce treadmill protocol: Without a mask, with a surgical mask and with a respirator. Perceived exertion and dyspnea were evaluated with the Borg Scale of Perceived Exertion and the Borg Dyspnea Scale, respectively. Blood pressure, heart rate and arterial oxygen saturation (SpO2) were measured at each 3-minute stage.

Results

Using a surgical mask or a respirator resulted in a shorter duration of exercise testing. At peak capacity, using a respirator resulted in higher levels of dyspnea and perceived exertion compared to not wearing a facemask. A significant drop in SpO2 was present at the end of exercise testing only when using a respirator. There were no differences in either chronotropic or blood pressure responses between testing conditions.

Conclusions

Professionals involved in cardiac rehabilitation should be aware of the cardiorespiratory impact of facemasks. Future studies should assess whether exposure to these conditions may impact on the overall results of contemporary cardiac rehabilitation programs.

Facemasks during aerobic exercise: Implications for cardiac rehabilitation programs during the Covid-19 pandemic

Introduction and objectives

During the COVID-19 pandemic, among the safety measures adopted, use of facemasks during exercise training sessions in cardiac rehabilitation programs raised concerns regarding possible detrimental effects on exercise capacity. Our study examined the cardiorespiratory impact of wearing two types of the most common facemasks during treadmill aerobic training.

Methods

Twelve healthy health professionals completed three trials of a symptom-limited Bruce treadmill protocol: Without a mask, with a surgical mask and with a respirator. Perceived exertion and dyspnea were evaluated with the Borg Scale of Perceived Exertion and the Borg Dyspnea Scale, respectively. Blood pressure, heart rate and arterial oxygen saturation (SpO2) were measured at each 3-minute stage.

Results

Using a surgical mask or a respirator resulted in a shorter duration of exercise testing. At peak capacity, using a respirator resulted in higher levels of dyspnea and perceived exertion compared to not wearing a facemask. A significant drop in SpO2 was present at the end of exercise testing only when using a respirator. There were no differences in either chronotropic or blood pressure responses between testing conditions.

Conclusions

Professionals involved in cardiac rehabilitation should be aware of the cardiorespiratory impact of facemasks. Future studies should assess whether exposure to these conditions may impact on the overall results of contemporary cardiac rehabilitation programs.

Viscoelastic Polyurethane Foams for Use in Seals of Respiratory Protective Devices

A key factor in effective protection against airborne hazards, i.e., biological and nonbiological aerosols, vapors, and gases, is a good face fit of respiratory protective devices (RPDs). Equally important is the comfort of use, which may encourage or discourage users from donning RPDs. The objective of the work was to develop viscoelastic polyurethane foams for use in RPD seals. The obtained foams were characterized using scanning electron microscopy, infrared spectroscopy, thermogravimetry, and differential scanning calorimetry. Measurements also involved gel fraction, apparent density, air permeability, elastic recovery time, compression set, rebound resilience, and sweat uptake. The results were discussed in the context of modifications to the foam formulation: the isocyanate index (I_NCO) in the range of 0.6–0.9 and the blowing agent content in the range of 1.2–3.0 php. FTIR analysis revealed a higher level of urea groups with increasing water content in the formulation. Higher I_NCO and water content levels also led to lower onset temperatures of thermal degradation and higher glass-transition temperatures of the soft phase. A decrease in apparent density and an increase in mean pore sizes of the foams with increasing I_NCO and water content levels was observed. Functional parameters (air permeability, elastic recovery time, compression set, rebound resilience, and sweat uptake) were also found to be satisfactory at lower I_NCO and water content levels.

Respirator masks protect health but impact performance: a review

Respiratory protective masks are used whenever it is too costly or impractical to remove airborne contamination from the atmosphere. Respirators are used in a wide range of occupations, form the military to medicine. Respirators have been found to interfere with many physiological and psychological aspects of task performance at levels from resting to maximum exertion. Many of these limitations have been investigated in order to determine quantitatively how much performance decrement can be expected from different levels of respirator properties. The entire system, including respirator and wearer interactions, must be considered when evaluating wearer performances. This information can help respirator designers to determine trade-offs or managers to plan to compensate for reduced productivity of wearers.

Protective facemask impact on human thermoregulation: an overview

The use of protective facemasks (PFMs) negatively impacts respiratory and dermal mechanisms of human thermoregulation through impairment of convection, evaporation, and radiation processes. The relatively minor reported increases in core temperature directly attributable to the wearing of PFMs suggest that associated perceptions of increased body temperature may have a significant psychological component or that regional or global brain temperature changes are involved. Modifications in PFM structure, components, and materials might allow for improved heat dissipation and enhanced compliance with use.

Effects of Hoods and Flame-Retardant Fabrics on WBGT Clothing Adjustment Factors

Personal protective clothing (PPC) may include hoods and flame-retardant (FR) fabrics that may affect heat transfer and, thus, the critical wet bulb globe temperature (WBGT crit) to maintain thermal equilibrium. The purpose of this study was to compare the differences in WBGT crit for hooded vs. nonhooded versions of particle barrier and vapor barrier coveralls as well as for coveralls made of two flame-retardant fabrics (INDURA cotton and Nomex). Acclimated men (n = 11) and women (n = 4) walked on a treadmill in a climatic chamber at 180 W/m2 wearing four different ensembles: limited-use, particle barrier coveralls with and without a hood (Tyvek 1427), and limited-use vapor barrier coveralls with and without a hood (Tychem QC, polyethylene-coated Tyvek). Twelve of the participants wore one of two flame-retardant coveralls. All participants wore standard cotton clothing. Progressive exposure testing at 50% relative humidity (rh) was designed so that each subject established a physiological steady-state followed by a clear loss of thermal equilibrium. WBGT crit was the WBGT 5 min prior to a loss of thermal equilibrium. Hooded ensembles had a lower WBGT crit than the nonhooded ensembles. The difference suggested a clothing adjustment of 1 degrees C for hoods. There were no significant differences among the FR ensembles and cotton work cloths, and the proposed clothing adjustment for FR coveralls clothing is 0 degrees C.

Decision model for optimizing respirator protection

Respirators are widely used for protection against inhaled toxins. The emphasis of research and implementation effort has evolved through several stages: the respirator device itself, use situation, respirator program factors under employer control, individual worker factors not under employer control, and occupational health systems. For this study, a computer-simulation decision assistance model was developed to assess the impact of various factors on the number of workers receiving adequate protection. Factors include the respirator protection factor, identification of sites needing respirator protection, selection of proper device, availability when needed, frequency of ever use, regularity of use among users, and variability in personal susceptibility or other factors. This analysis demonstrates that for both moderate-risk and high-risk (i.e., IDLH, immediately dangerous to life and health) exposures under current circumstances, the actual protection afforded depends upon the optimization of program factors and detection of atypical outlier persons and worksites. Therefore, programs and research must focus on these areas. Occupational medicine specialists should help optimize these areas and, in addition, use each case of respiratory protection failure as an index case to improve the overall programs.