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Kuglics L, Géczy A, Dusek K, Busek D, Illés B. Personal Air-Quality Monitoring with Sensor-Based Wireless Internet-of-Things Electronics Embedded in Protective Face Masks. SENSORS (BASEL, SWITZERLAND) 2024; 24:2601. [PMID: 38676218 PMCID: PMC11054044 DOI: 10.3390/s24082601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
In this paper, the design and research of a sensor-based personal air-quality monitoring device are presented, which is retrofitted into different personal protective face masks. Due to its small size and low power consumption, the device can be integrated into and applied in practical urban usage. We present our research and the development of the sensor node based on a BME680-type environmental sensor cluster with a wireless IoT (Internet of Things)-capable central unit and overall low power consumption. The integration of the sensor node was investigated with traditional medical masks and a professional FFP2-type mask. The filtering efficiency after embedding was validated with a head model and a particle counter. We found that the professional mask withstood the embedding without losing the protective filtering aspect. We compared the inner and outer sensor data and investigated the temperature, pressure, humidity, and AQI (Air Quality Index) relations with possible sensor data-fusion options. The novelty is increased with the dual-sensor layout (inward and outward). It was found that efficient respiration monitoring is achievable with the device. With the analysis of the recorded data, characteristic signals were identified in an urban environment, enabling urban altimetry and urban zone detection. The results promote smart city concepts and help in endeavors related to SDGs (Sustainable Development Goals) 3 and 11.
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Affiliation(s)
- Lajos Kuglics
- Department of Electronics Technology, Faculty of Electronic Engineering and Informatics, Budapest University of Technology and Economics, H-1111 Budapest, Hungary
| | - Attila Géczy
- Department of Electronics Technology, Faculty of Electronic Engineering and Informatics, Budapest University of Technology and Economics, H-1111 Budapest, Hungary
- Department of Electrotechnology, Faculty of Electrical Engineering, Czech Technical University, 166 27 Prague, Czech Republic
| | - Karel Dusek
- Department of Electrotechnology, Faculty of Electrical Engineering, Czech Technical University, 166 27 Prague, Czech Republic
| | - David Busek
- Department of Electrotechnology, Faculty of Electrical Engineering, Czech Technical University, 166 27 Prague, Czech Republic
| | - Balázs Illés
- Department of Electronics Technology, Faculty of Electronic Engineering and Informatics, Budapest University of Technology and Economics, H-1111 Budapest, Hungary
- Łukasiewicz Research Network-Institute of Microelectronics and Photonics, LTCC Research Group, 02-255 Kraków, Poland
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Choi ME, Lee WJ, Ko JY, Kim KJ, Kim JE, Kim HS, Park KY, Park MY, Suh DH, Shin K, Shin MK, Ahn HH, Lee WJ, Lee JB, Lee HJ, Jang MS, Cheong SH, Cho S, Choi YS, Choi YW, Choi H, Lee MW. Facial Dermatoses Associated With Mask-Wearing in the COVID-19 Era: A Nationwide, Cross-Sectional, Multicenter, Questionnaire-based Study. Ann Dermatol 2024; 36:81-90. [PMID: 38576246 PMCID: PMC10995613 DOI: 10.5021/ad.23.061] [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: 08/02/2023] [Revised: 10/10/2023] [Accepted: 11/08/2023] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Daily usage of facial masks during coronavirus disease 2019 pandemic influenced on facial dermatoses. OBJECTIVE This study investigated the impact of mask-wearing habits on facial dermatoses. METHODS A nationwide, observational, questionnaire-based survey was conducted from July through August 2021, involving 20 hospitals in Korea. RESULTS Among 1,958 facial dermatoses, 75.9% of patients experienced aggravation or development of new-onset facial dermatoses after wearing masks. In aggravated or newly developed acne patients (543 out of 743), associated factors were healthcare provider, female gender, and a long duration of mask-wearing. Irritating symptoms, xerosis, and hyperpigmentation were more frequently observed in this group. Aggravated or newly developed rosacea patients (515 out of 660) were likely to be female, young, and have a long duration of mask-wearing per day. Seborrheic dermatitis patients who experienced aggravation or de novo development (132 out of 184) were younger, and they more frequently involved the chin and jaw in addition to the nasolabial folds and both cheeks. Contact dermatitis patients (132 out of 147) with aggravation or de novo development tended to be female, involve both cheeks, and complain of pruritus. Aggravated or newly developed atopic dermatitis patients (165 out of 224) were more likely to be female, and had a higher baseline investigator global assessment score before mask-wearing. CONCLUSION Clinical features and factors related to aggravation were different according to the types of facial dermatoses.
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Affiliation(s)
- Myoung Eun Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Kwang Joong Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jung Eun Kim
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Kui Young Park
- Departments of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mi Youn Park
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Dae Hun Suh
- Department of Dermatology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kihyuk Shin
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Min Kyung Shin
- Department of Dermatology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hyo Hyun Ahn
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Weon Ju Lee
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jee Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Jung Lee
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Min Soo Jang
- Department of Dermatology, Kosin University College of Medicine, Busan, Korea
| | - Seung Hyun Cheong
- Department of Dermatology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Soyun Cho
- Department of Dermatology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Yu Sung Choi
- Department of Dermatology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - You Won Choi
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hoon Choi
- Department of Dermatology, Chosun University College of Medicine, Gwangju, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Ngo H, Spaeth J, Schumann S. Effective volume of rebreathed air during breathing with facepieces increases with protection class and decreases with ambient airflow. PLoS One 2024; 19:e0299919. [PMID: 38512836 PMCID: PMC10956828 DOI: 10.1371/journal.pone.0299919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/18/2024] [Indexed: 03/23/2024] Open
Abstract
Wearing facepieces is discussed in the context of increasing the volume of rebreathed air. We hypothesized that rebreathed air volume increases with increasing filtering facepiece (FFP) class and that persons breathing via facepieces compensate for the additional dead-space. We have determined the effective amount of rebreathed air for a surgical masks and FFP2 and FFP3 respirators in a physical model and determined tidal volumes, breathing frequency, blood oxygen saturation, and transcutaneously measured blood carbon dioxide partial pressure (PCO2) in lung-healthy subjects breathing without and with facepieces at rest and during exercising on a recumbent ergometer. Rebreathed air volume increased with the facepieces' protection class and with increasing inspiration volume by 45 ± 2 ml to 247 ± 1 ml. Ambient airflow reduced rebreathed air volume by 17% up to 100% (all p < 0.001). When wearing facepieces, subjects increased tidal volume (p < 0.001) but not breathing frequency. Oxygen saturation was not influenced by facepieces. With FFP3 respirators PCO2 increased by up to 3.2 mmHg (p < 0.001) at rest but only up to 1.4 mmHg (p < 0.001) when exercising. Discomfort of breathing increased with increasing protection class of the facepiece but was consistently perceived as tolerable. We conclude that the amount of rebreathed air increases with increasing protection class of facepieces. Healthy adults were capable to compensate the facepieces' dead-space by adapting tidal volume at rest and during physical activity; thereby they tolerated moderate increases in PCO2. Ambient airflow may considerably reduce the amount of facepiece related rebreathed air.
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Affiliation(s)
- Helen Ngo
- Faculty of Medicine, Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Johannes Spaeth
- Faculty of Medicine, Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Stefan Schumann
- Faculty of Medicine, Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
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Koprubasi S, Basar F, Senel Kukner A. The impact of prolonged face mask use on ocular surface health during COVID-19 pandemic: a clinical, and conjunctiva impression cytology study. Int Ophthalmol 2024; 44:59. [PMID: 38345673 DOI: 10.1007/s10792-024-02990-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 10/19/2023] [Indexed: 02/15/2024]
Abstract
PURPOSE To investigate the relationship between prolonged face mask use and ocular surface health utilizing conjunctival impression cytology, the Schirmer test, the tear break-up time (TBUT) test, and the ocular surface disease index (OSDI) questionnaire. METHODS In this cross-sectional prospective study, individuals who used face masks for at least eight hours per day for at least six months were compared to healthy volunteers who used face masks for no more than one hour per day. Each participant completed an OSDI questionnaire. The Schirmer test (under anesthesia), the TBUT test, and conjunctiva impression cytology analysis according to the Nelson classification method were performed on each participant. RESULTS This study included 102 (49 male, 53 female) face mask users with an average age of 33.29 ± 7.71 years and 110 (60 male, 50 female) healthy controls with an average age of 32.96 ± 7.10 years (p = 0.746). The total OSDI score was significantly higher in face mask users than the control group (25.18 ± 3.54 vs 9.46 ± 2.13, p < 0.001). The mean Schirmer test value and TBUT were significantly lower in the study group than the control group (p < 0.001, p < 0.001). There was a statistically significant difference between the two groups in total score and stage of the Nelson classification system (p < 0.001, and p = 0.024, respectively). All conjunctiva impression cytology assessments, including cellularity, cell-cell contact, nucleus/cytoplasma ratio, goblet cell amount, and metaplasia, revealed statistically significant deterioration in the study group compared to the control group (p < 0.001, p = 0.025, p < 0.001, p < 0.001, and p < 0.001, respectively). CONCLUSION The prolonged use of face masks leads to dry eyes. The findings of conjunctiva impression cytology indicate the role of inflammation in the pathogenesis of mask associated dry eye.
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Affiliation(s)
- Sumeyra Koprubasi
- Department of Ophthalmology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Emek Mah. Namık Kemal Cad. No:54, 34785, Sancaktepe, Istanbul, Turkey.
| | - Feyza Basar
- Department of Pathology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Amber Senel Kukner
- Department of Ophthalmology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Emek Mah. Namık Kemal Cad. No:54, 34785, Sancaktepe, Istanbul, Turkey
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Feng L, Liu Y, Wang Y, Zhou H, Wu M, Li T. An ultra-small integrated CO 2 infrared gas sensor for wearable end-tidal CO 2 monitoring. iScience 2023; 26:108293. [PMID: 38026213 PMCID: PMC10660086 DOI: 10.1016/j.isci.2023.108293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/03/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Human physiological metabolic status can be obtained by monitoring exhaled CO2 concentration, but current CO2 sensors have disadvantages such as large size, high power consumption, and slow response time, which limit their application in wearable devices and portable instruments. In this article, we report a small size, good performance, and large range CO2 infrared gas sensor that integrates a high emissivity MEMS emitter chip, a high detectivity thermopile chip, and a high coupling efficiency optical chamber to achieve high efficiency optical-thermal-electrical conversion. Compared with typical commercial sensors, the size of the sensor can be reduced by approximately 80% to only 10 mm × 10 mm × 6.5 mm, with the advantages of low power consumption and fast response speed. Further, a monitoring system for end-tidal CO2 concentration installed on a mask was developed using this sensor, and good results were achieved.
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Affiliation(s)
- Liyang Feng
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
- University of Chinese Academy of Sciences (UCAS), Beijing 100049, China
| | - Yanxiang Liu
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - Yi Wang
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - Hong Zhou
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - Ming Wu
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - Tie Li
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
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D'Ercole S, Parisi P, D'Arcangelo S, Lorusso F, Cellini L, Dotta TC, Di Carmine M, Petrini M, Scarano A, Tripodi D. Correlation between use of different type protective facemasks and the oral ecosystem. BMC Public Health 2023; 23:1992. [PMID: 37828542 PMCID: PMC10571399 DOI: 10.1186/s12889-023-16936-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023] Open
Abstract
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.
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Affiliation(s)
- Simonetta D'Ercole
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy.
| | - Paolo Parisi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Sara D'Arcangelo
- Department of Pharmacy, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University "Gd'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Luigina Cellini
- Department of Pharmacy, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Tatiane Cristina Dotta
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, 14040-904, Brazil
| | - Maristella Di Carmine
- Department of Innovative Technologies in Medicine and Dentistry, University "Gd'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University "Gd'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Domenico Tripodi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
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Chen E, Rueff E, Nguyen AL. Impact of Mask-Associated Dry Eye on Symptom Score. Eye Contact Lens 2023; 49:433-437. [PMID: 37363998 DOI: 10.1097/icl.0000000000001009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES Owing to widespread mask use during the COVID-19 pandemic and clinical reports tying mask use with dryness, this study endeavors to determine if mask use is linked to symptoms of dry eye. METHODS A prospective, cross-sectional survey study was performed. The survey used a modified Standard Patient Evaluation of Eye Dryness Questionnaire (SPEED, TearScience, Morrisville, NC) within 15 min of the beginning and discontinuation of mask wear. The survey also asked about mask wear time, mask style, visual correction, age, and gender. RESULTS The change in SPEED scores was statistically significant ( P =0.03) between participants with mild SPEED score at baseline (0-9) versus severe SPEED score at baseline (10-28) (n=77: 59 female, 16 male, 1 nonbinary, and 1 declined to answer; range 22-55 years old). Participants in the severe group used masks with nose wire more than the mild group ( P =0.03). CONCLUSIONS In this sample, dry eye symptoms were most exacerbated with mask wear in those that had mild initial symptom scores compared with those with severe symptom scores at baseline. The use of nose wire masks may be protective, as the severe group used this type more and had significantly less exacerbation of symptoms postmask wear.
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Affiliation(s)
- Elaine Chen
- SCCO at MBKU (E.C., E.R., A.L.N.), Fullerton, CA; and California State University (A.L.N.), Fullerton, CA
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Recio-Garcia JA, Diaz-Agudo B, Acuaviva A. Becalm: Intelligent Monitoring of Respiratory Patients. IEEE J Biomed Health Inform 2023; 27:3806-3817. [PMID: 37192034 DOI: 10.1109/jbhi.2023.3276638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The Becalm project is an open and low-cost solution for the remote monitoring of respiratory support therapies like the ones used in COVID-19 patients. Becalm combines a decision-making system based on Case-Based Reasoning with a low-cost, non-invasive mask that enables the remote monitoring, detection, and explanation of risk situations for respiratory patients. This paper first describes the mask and the sensors that allow remote monitoring. Then, it describes the intelligent decision-making system that detects anomalies and raises early warnings. This detection is based on the comparison of cases that represent patients using a set of static variables plus the dynamic vector of the patient time series from sensors. Finally, personalized visual reports are created to explain the causes of the warning, data patterns, and patient context to the healthcare professional. To evaluate the case-based early-warning system, we use a synthetic data generator that simulates patients' clinical evolution from the physiological features and factors described in healthcare literature. This generation process has been verified with a real dataset and allows the validation of the reasoning system with noisy and incomplete data, threshold values, and life/death situations. The evaluation demonstrates promising results and good accuracy (0.91) for the proposed low-cost solution to monitor respiratory patients.
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Yang SC, Lee CW. Physiological effects of N95 respirators on rescuers during cardiopulmonary resuscitation. Heliyon 2023; 9:e18970. [PMID: 37600379 PMCID: PMC10432712 DOI: 10.1016/j.heliyon.2023.e18970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 07/14/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023] Open
Abstract
Objectives There is a lack of evidence in the medical literature reporting the physiological stress imposed by the wearing of N95 respirators during cardiopulmonary resuscitation (CPR) in healthcare providers. The aim of this study is to monitor the changes in hemodynamics and blood gas profiles in rescuers during the performance of CPR while wearing N95 respirators. Methods Thirty-two healthy healthcare workers performed standard CPR on manikins, each participant conducted 2 min of chest compression followed by 2 min of rest for 3 cycles. A non-invasive blood gas measuring device via a fingertip detector was used to collect arterial blood gas and hemodynamic data. Student t-test was used for comparison of various physiologic parameters before and after each session of chest compression. Results There were no significant differences in arterial blood gas profiles including partial pressure of arterial carbon dioxide and partial pressure of arterial oxygen before and after each session of chest compression (p > 0.05 for all). Heart rate and cardiac output were significantly higher after CPR (p < 0.05 for all), but no significant changes were found on blood pressure. Conclusions Our data suggest that healthcare providers wearing N95 respirators during provision of CPR in a short period of time does not cause any significant abnormalities in blood gas profiles and blood pressure. This may provide evidence to reassure the safe use of N95 respirator during performance of CPR.
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Affiliation(s)
- Shih-Chia Yang
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Wei Lee
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
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Penbe A, Oklar M, Kanar HS, Bayrak MZ, Ersarı B, Talan M, Gün RD, Orçun A, Şimşek Ş. The effects of facial mask use on ocular surface parameters and tear film cytokine profile in prolonged use. Int Ophthalmol 2023; 43:2623-2632. [PMID: 36856985 PMCID: PMC9975438 DOI: 10.1007/s10792-023-02661-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/19/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To compare tear fluid levels of matrix metalloproteinase 9 (MMP-9) and IL-1ß cytokines between healthcare workers wearing facial masks and controls with correlations in clinical findings. METHODS In a prospective, controlled clinical trial tear fluid was analyzed for MMP-9 and IL-1ß levels using a commercially available test (Invitrogen; Thermo Fisher Scientific Inc. Waltham, Massachusetts, USA). Symptoms and signs of dry eye disease (DED) were evaluated using the ocular surface disease index (OSDI), noninvasive tear break-up time (NIBUT), tear meniscus height (TMH), Oxford corneal staining, meibomiography, and clinical findings of meibomian gland dysfunction (MGD). RESULTS In the 38 eyes of healthcare workers and 30 eyes of controls, there was no statistically significant difference between the groups in terms of age and sex (p > 0.05). The mean OSDI score, daily mask wear time, meibomiography degree, and rate of positive clinical findings of MGD were higher in group 1 than in group 2, and the mean NIBUT was higher in group 2. (p > 0.05). The mean values of IL-1ß and MMP-9 were higher in group 1 (p = 0.036 and p = 0.001, respectively). The TMH and Oxford score percentages were similar between the two groups (p > 0.05). CONCLUSIONS Elevated levels of IL-1ß and MMP-9 in the basal tear fluid reveal increased ocular inflammation in healthcare professionals. Lower NIBUT values with higher OSDI and meibomian gland loss scores support ocular surface disturbance depending on regular mask use.
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Affiliation(s)
- Aysegul Penbe
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Murat Oklar
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Hatice Selen Kanar
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Müberra Zülal Bayrak
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Başak Ersarı
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Mustafa Talan
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Raziye Dönmez Gün
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Asuman Orçun
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
| | - Şaban Şimşek
- Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Semsi Denizer Caddesi, E-5, 34890 Kartal Istanbul, Turkey
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Roeder G, Bilir A, Graf A, Baron DM. Capillary carbon dioxide tension increases in hospital staff wearing filtering facepiece masks: a prospective crossover study. ERJ Open Res 2023; 9:00186-2023. [PMID: 37404843 PMCID: PMC10316034 DOI: 10.1183/23120541.00186-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/06/2023] [Indexed: 07/06/2023] Open
Abstract
Background The COVID-19 pandemic has changed worldwide hygiene practices. In particular, the use of filtering face piece (FFP) masks markedly increased. Concerns have been raised regarding possible negative respiratory effects of wearing FFP masks. The aim of this study was to investigate gas exchange and subjective breathing effort in hospital personnel wearing FFP2 or FFP3 masks. Methods In this prospective, single-centre, crossover study, 200 hospital workers were assigned to alternately wear FFP2 or FFP3 masks for 1 h during routine activities. Capillary blood gas analysis was performed to evaluate gas exchange while wearing the FFP masks. The primary end-point was the change in capillary partial pressure of carbon dioxide (PcCO2). In addition, capillary partial pressure of oxygen (PcO2), respiratory rate and subjective breathing effort were assessed at the end of each hour. Changes between time points and study groups were estimated using univariate and multivariate models. Results PcCO2 increased from 36.8±3.5 to 37.2±3.3 mmHg (p=0.047) and 37.4±3.2 mmHg (p=0.003) in individuals wearing FFP2 or FFP3 masks, respectively. Age (p=0.021) and male sex (p<0.001) were significantly associated with increased PcCO2. Similarly, the PcO2 increased from 70.7±8.4 to 73.4±8.8 mmHg (p<0.001) and 72.8±8.5 mmHg (p=0.004) in individuals wearing FFP2 or FFP3 masks, respectively. Respiratory rate and subjective breathing effort increased significantly while wearing FFP2 and FFP3 masks (p<0.001 for all analyses). The order of wearing FFP2 or FFP3 masks did not significantly affect the results. Conclusions An hour of wearing FFP2 or FFP3 masks increased PcCO2 values, respiratory rate and subjective breathing effort in healthcare personnel performing routine activities.
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Affiliation(s)
- Georg Roeder
- Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria
| | - Aylin Bilir
- Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria
| | - Alexandra Graf
- Center for Medical Data Science, Institute of Medical Statistics, Medical University Vienna, Vienna, Austria
| | - David M. Baron
- Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria
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12
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Kisielinski K, Wagner S, Hirsch O, Klosterhalfen B, Prescher A. Possible toxicity of chronic carbon dioxide exposure associated with face mask use, particularly in pregnant women, children and adolescents - A scoping review. Heliyon 2023; 9:e14117. [PMID: 37057051 PMCID: PMC9981272 DOI: 10.1016/j.heliyon.2023.e14117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction During the SARS-CoV-2-pandemic, face masks have become one of the most important ubiquitous factors affecting human breathing. It increases the resistance and dead space volume leading to a re-breathing of CO2. So far, this phenomenon and possible implications on early life has not been evaluated in depth. Method As part of a scoping review, literature was systematically reviewed regarding CO2 exposure and facemask use. Results Fresh air has around 0.04% CO2, while wearing masks more than 5 min bears a possible chronic exposure to carbon dioxide of 1.41% to 3.2% of the inhaled air. Although the buildup is usually within the short-term exposure limits, long-term exceedances and consequences must be considered due to experimental data. US Navy toxicity experts set the exposure limits for submarines carrying a female crew to 0.8% CO2 based on animal studies which indicated an increased risk for stillbirths. Additionally, mammals who were chronically exposed to 0.3% CO2 the experimental data demonstrate a teratogenicity with irreversible neuron damage in the offspring, reduced spatial learning caused by brainstem neuron apoptosis and reduced circulating levels of the insulin-like growth factor-1. With significant impact on three readout parameters (morphological, functional, marker) this chronic 0.3% CO2 exposure has to be defined as being toxic. Additional data exists on the exposure of chronic 0.3% CO2 in adolescent mammals causing neuron destruction, which includes less activity, increased anxiety and impaired learning and memory. There is also data indicating testicular toxicity in adolescents at CO2 inhalation concentrations above 0.5%. Discussion There is a possible negative impact risk by imposing extended mask mandates especially for vulnerable subgroups. Circumstantial evidence exists that extended mask use may be related to current observations of stillbirths and to reduced verbal motor and overall cognitive performance in children born during the pandemic. A need exists to reconsider mask mandates.
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Affiliation(s)
- Kai Kisielinski
- Independent Researcher, Surgeon, Private Practice, 40212 Düsseldorf, Germany
| | - Susanne Wagner
- Non Clinical Expert, Veterinarian, Wagner MSL Management, 15831 Mahlow, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, 57078 Siegen, Germany
| | | | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy (MOCA), 52074 Aachen, Germany
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13
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Metin KM, Semercioğlu CS, Hatipoğlu ÇA, Esmer H, Kayretli H, İnan LE, Kınıklı S, Yoldaş TK. Headache caused by the use of personal protective equipment in healthcare workers during the COVID-19 pandemic period. Heliyon 2023; 9:e14493. [PMID: 36942249 PMCID: PMC10008808 DOI: 10.1016/j.heliyon.2023.e14493] [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: 11/15/2022] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
Objective Coronavirus 2019 disease (COVID-19), the cause of the ongoing pandemic, is an acute respiratory tract infection, which has made it necessary for healthcare personnel to use protective equipment such as N95 masks, protective goggles and visors. External compression headaches caused by the compression of the pericranial soft tissues by wearing hats, helmets, or goggles (worn during swimming or diving) have been previously described. In our study, we aimed to evaluate the presence and characteristics of personal protective equipment-associated headaches in healthcare workers during the COVID-19 pandemic period and to determine the effects of such headaches. Materials and methods A face-to-face questionnaire was delivered to 300 male and female healthcare personnel between the ages of 18-56 working in healthcare units where COVID-19 patients were evaluated and treated. The data from 296 completed questionnaires was evaluated. Results We included 296 participants (166 females and 130 males) in our study; the mean age was 33.98 ± 8.52 years (range 18-56). One hundred ninety-six (66.22%) participants indicated that they had new onset personal protective equipment-associated headaches. Percentages of those with newly emergent headaches because of protective equipment were higher in the following participant groups: females (p = 0.045), those with COVID-19 disease history (p < 0.001), and those diagnosed with headaches before the pandemic (p = 0.001). Conclusion Our study showed the presence of new-onset headaches associated with personal protective equipment in healthcare workers during the COVID-19 pandemic. Personal protective equipment-related headaches were associated with the following factors: female sex, a history of COVID-19 disease, and the presence of primary headaches diagnosed before the pandemic.
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Affiliation(s)
- Kübra Mehel Metin
- Ministry of Health Ankara Training and Research Hospital, Neurology Clinic, Ankara, Turkey
| | | | - Çiğdem Ataman Hatipoğlu
- Ministry of Health Ankara Training and Research Hospital, İnfectious Diseases Clinic, Ankara, Turkey
| | - Hüseyin Esmer
- Ministry of Health Ankara Training and Research Hospital, İnfectious Diseases Clinic, Ankara, Turkey
| | - Hatice Kayretli
- Ministry of Health Ankara Training and Research Hospital, İnfectious Diseases Clinic, Ankara, Turkey
| | - Levent Ertuğrul İnan
- Ministry of Health Ankara Training and Research Hospital, Neurology Clinic, Ankara, Turkey
| | - Sami Kınıklı
- Ministry of Health Ankara Training and Research Hospital, İnfectious Diseases Clinic, Ankara, Turkey
| | - Tahir Kurtuluş Yoldaş
- Ministry of Health Ankara Training and Research Hospital, Neurology Clinic, Ankara, Turkey
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14
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Islam SR, Prusty D, Maiti S, Dutta R, Chattopadhyay P, Manna SK. Effect of short-term use of FFP2 (N95) masks on the salivary metabolome of young healthy volunteers: a pilot study. Mol Omics 2023. [PMID: 36846883 DOI: 10.1039/d2mo00232a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The use of face masks has become an integral part of public life in the post-pandemic era. However, the understanding of the effect of wearing masks on physiology remains incomplete and is required for informing public health policies. For the first time, we report the effects of wearing FFP2 masks on the metabolic composition of saliva, a proximal matrix to breath, along with cardiopulmonary parameters. Un-induced saliva was collected from young (31.2 ± 6.3 years) healthy volunteers (n = 10) before and after wearing FFP2 (N95) masks for 30 minutes and analyzed using GCMS. The results showed that such short-term mask use did not cause any significant change in heart rate, pulse rate or SpO2. Three independent data normalization approaches were used to analyze the changes in metabolomic signature. The individuality of the overall salivary metabotype was found to be unaffected by mask use. However, a trend of an increase in the salivary abundance of L-fucose, 5-aminovaleric acid, putrescine and phloretic acid was indicated irrespective of the method of data normalization. Quantitative analysis confirmed increases in concentrations of these metabolites in saliva of paired samples amid high inter-individual variability. The results showed that while there was no significant change in measured physiological parameters and individual salivary metabotypes, mask use was associated with correlated changes in these metabolites plausibly originating from altered microbial metabolic activity. These results might also explain the change in odour perception reported to be associated with mask use. Potential implications of these changes on mucosal health and immunity warrants further investigation to evolve more prudent mask use policies.
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Affiliation(s)
- Sk Ramiz Islam
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, Sector 1, AF Block, Bidhan Nagar, Kolkata, West Bengal 700064, India. .,Homi Bhabha National Institute, Mumbai 400094, India
| | - Debasish Prusty
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, Sector 1, AF Block, Bidhan Nagar, Kolkata, West Bengal 700064, India. .,Homi Bhabha National Institute, Mumbai 400094, India
| | - Subhadip Maiti
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, Sector 1, AF Block, Bidhan Nagar, Kolkata, West Bengal 700064, India. .,Homi Bhabha National Institute, Mumbai 400094, India
| | - Raju Dutta
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, Sector 1, AF Block, Bidhan Nagar, Kolkata, West Bengal 700064, India. .,Homi Bhabha National Institute, Mumbai 400094, India
| | - Partha Chattopadhyay
- Department of Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata, India
| | - Soumen Kanti Manna
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, Sector 1, AF Block, Bidhan Nagar, Kolkata, West Bengal 700064, India. .,Homi Bhabha National Institute, Mumbai 400094, India
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15
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Reeder EL, O'Connell CJ, Collins SM, Traubert OD, Norman SV, Cáceres RA, Sah R, Smith DW, Robson MJ. Increased Carbon Dioxide Respiration Prevents the Effects of Acceleration/Deceleration Elicited Mild Traumatic Brain Injury. Neuroscience 2023; 509:20-35. [PMID: 36332692 DOI: 10.1016/j.neuroscience.2022.10.016] [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: 08/12/2022] [Revised: 09/30/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022]
Abstract
Acceleration/deceleration forces are a common component of various causes of mild traumatic brain injury (mTBI) and result in strain and shear forces on brain tissue. A small quantifiable volume dubbed the compensatory reserve volume (CRV) permits energy transmission to brain tissue during acceleration/deceleration events. The CRV is principally regulated by cerebral blood flow (CBF) and CBF is primarily determined by the concentration of inspired carbon dioxide (CO2). We hypothesized that experimental hypercapnia (i.e. increased inspired concentration of CO2) may act to prevent and mitigate the actions of acceleration/deceleration-induced TBI. To determine these effects C57Bl/6 mice underwent experimental hypercapnia whereby they were exposed to medical-grade atmospheric air or 5% CO2 immediately prior to an acceleration/deceleration-induced mTBI paradigm. mTBI results in significant increases in righting reflex time (RRT), reductions in core body temperature, and reductions in general locomotor activity-three hours post injury (hpi). Experimental hypercapnia immediately preceding mTBI was found to prevent mTBI-induced increases in RRT and reductions in core body temperature and general locomotor activity. Ribonucleic acid (RNA) sequencing conducted four hpi revealed that CO2 exposure prevented mTBI-induced transcriptional alterations of several targets related to oxidative stress, immune, and inflammatory signaling. Quantitative real-time PCR analysis confirmed the prevention of mTBI-induced increases in mitogen-activated protein kinase kinase kinase 6 and metallothionein-2. These initial proof of concept studies reveal that increases in inspired CO2 mitigate the detrimental contributions of acceleration/deceleration events in mTBI and may feasibly be translated in the future to humans using a medical device seeking to prevent mTBI among high-risk groups.
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Affiliation(s)
- Evan L Reeder
- University of Cincinnati James L. Winkle College of Pharmacy, Division of Pharmaceutical Sciences, Cincinnati, OH 45267, USA
| | - Christopher J O'Connell
- University of Cincinnati James L. Winkle College of Pharmacy, Division of Pharmaceutical Sciences, Cincinnati, OH 45267, USA
| | - Sean M Collins
- University of Cincinnati James L. Winkle College of Pharmacy, Division of Pharmaceutical Sciences, Cincinnati, OH 45267, USA
| | - Owen D Traubert
- University of Cincinnati College of Arts and Sciences, Department of Biological Sciences, Cincinnati, OH 45221, USA
| | - Sophia V Norman
- University of Cincinnati College of Arts and Sciences, Department of Biological Sciences, Cincinnati, OH 45221, USA
| | - Román A Cáceres
- University of Cincinnati College of Medicine, Department of Cancer and Cell Biology Cincinnati, OH 45267, USA
| | - Renu Sah
- University of Cincinnati College of Medicine, Department of Pharmacology and Systems Physiology, Cincinnati, OH 45267, USA
| | | | - Matthew J Robson
- University of Cincinnati James L. Winkle College of Pharmacy, Division of Pharmaceutical Sciences, Cincinnati, OH 45267, USA.
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16
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Harber P, Beckett WS. Health effects of filtering facepiece respirators: Systematic review of pulmonary and cardiovascular effects. Am J Ind Med 2023; 66:181-198. [PMID: 36464991 PMCID: PMC9878161 DOI: 10.1002/ajim.23450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/11/2022]
Abstract
Filtering facepiece respirators (FFRs) were introduced to protect the wearer by removing small particles from inspired air. FFRs are now also used to reduce the spread of transmissible agents from the wearer and are worn outside traditional healthcare and other workplaces. The COVID-19 pandemic increased concerns about potential adverse effects on wearers. A PUBMED query retrieved articles through June 2022. Abstracts and selected full-text articles were systematically reviewed by the authors. This article focuses upon cardiopulmonary physiologic effects (e.g., ventilation, CO2 elimination, oxygen uptake, and respiratory control) with emphasis upon current and potential research methods as well as summarizing results. 1985 records were identified, of which only 26% were published before 2020. FFR effects on CO2 elimination appear more likely to be significant than effects on oxygenation or cardiovascular function. While FFRs appear well tolerated by healthy persons, more research is needed for those with pulmonary or cardiac disorders, and for children. Many traditional pulmonary exercise study methods require special care when applied to filtering facepiece respirators. Studying additional parameters may explain the paradox of many subjective discomfort reports despite very limited physiologic effects.
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Affiliation(s)
- Philip Harber
- University of Arizona‐Mel and Enid Zuckerman College of Public HealthTucsonArizonaUSA
| | - William S. Beckett
- Harvard Medical School and Mount Auburn HospitalCambridgeMassachusettsUSA
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17
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Burgos-Blasco B, Arriola-Villalobos P, Fernandez-Vigo JI, Oribio-Quinto C, Ariño-Gutierrez M, Diaz-Valle D, Benitez-del-Castillo JM. Face mask use and effects on the ocular surface health: A comprehensive review. Ocul Surf 2023; 27:56-66. [PMID: 36577463 PMCID: PMC9789923 DOI: 10.1016/j.jtos.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 12/26/2022]
Abstract
In the COVID-19 period, face masks increased exponentially. Several studies suggest that the rise in ocular discomfort symptoms during the pandemic is mostly part of dry eye disease and that these are due to the effect of face masks, resulting in the newly described term MADE, for "mask-associated dry eye". The most commonly proposed mechanism states that wearing a face mask creates an unnatural upward airflow towards the ocular surface during expiration, although the increased temperature, humidity and levels of carbon dioxide of the exhaled air, stress, increased use of video display terminals, as well as changes in the ocular microbiota may contribute. Evidence supports that the use of face masks causes an increase in dry eye disease symptoms, a decreased tear break-up time, corneal epithelial trauma, periocular temperature changes and inflammatory markers secretion. Given that the use of masks may be frequent in some settings in the near future, it is important to establish its effects and consequences on the ocular surface.
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Affiliation(s)
- Barbara Burgos-Blasco
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain.
| | - Pedro Arriola-Villalobos
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain,Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid; Madrid, Spain
| | - Jose Ignacio Fernandez-Vigo
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain
| | - Carlos Oribio-Quinto
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain
| | - Mayte Ariño-Gutierrez
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain
| | - David Diaz-Valle
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain,Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid; Madrid, Spain
| | - Jose Manuel Benitez-del-Castillo
- Ophthalmology Department, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC). Hospital Clinico San Carlos. Madrid. Spain,Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid; Madrid, Spain
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18
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Hussain SY, Khanuja S, Panjiar P, Jain D, Batt KM. Effect of N95 Filtering Facepiece Respirator on Venous Blood Carbon Dioxide Levels and Hemodynamic Changes in Health Care Workers. Indian J Occup Environ Med 2023; 27:38-41. [PMID: 37303993 PMCID: PMC10257234 DOI: 10.4103/ijoem.ijoem_170_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/18/2022] [Accepted: 09/02/2022] [Indexed: 06/13/2023] Open
Abstract
Background N95 filtering facepiece respirators (FFR) are used by health care workers for prevention of airborne infection, and its use has increased manifolds during COVID-19 pandemic. Prolonged use may result in carbon dioxide (CO2) accumulation, affect hemodynamics, and blood gas values. Although arterial blood gas values accurately measure the blood CO2 levels, venous blood gas values also show acceptable correlation. Aim To evaluate the physiological impact of N95 FFRs on health care workers, including hemodynamic changes and venous blood levels of CO2 during a period of 6 h. Settings and Design Prospective observational study in a tertiary care hospital. Methods The study was conducted on 30 health care workers who performed routine duties while wearing N95 FFR. Venous blood gas values (CO2, pH, and bicarbonate) and vitals (respiratory rate, heart rate, blood pressure, and saturation) were noted at baseline, 2 (T2), and 6 h (T6) after wearing the mask. Discomfort level was also measured on a Visual Analogue Scale (VAS) of 1-10. Statistical Analysis Repeated measures analysis was done using repeated measures ANOVA or Friedman's test. Group comparisons for continuously distributed data were made using independent sample "t" test or Wilcoxon test. Results and Conclusion Hemodynamic and blood gas values did not change over time. The VAS for discomfort because of respirator use was 1.33 (1.42) at T2 and 2.77 (1.91) at T6. This was a significant increase in discomfort over time (P = 0.001). About 80% of participants experienced discomfort during this period. N95 FFR did not lead to significant alteration in hemodynamics or change in blood gas values after 6 h of continuous usage. However, discomfort significantly increased over time.
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Affiliation(s)
- Sana Yasmin Hussain
- Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Samiksha Khanuja
- Department of Anesthesiology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Pratibha Panjiar
- Department of Anesthesiology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Dhruv Jain
- Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Kharat Mohammad Batt
- Department of Anesthesiology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
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19
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Faghy M, Arena R, Hills AP, Yates J, Vermeesch AL, Franklin BA, Popovic D, Strieter L, Lavie CJ, Smith A. The response to the COVID-19 pandemic: With hindsight what lessons can we learn? Prog Cardiovasc Dis 2023; 76:76-83. [PMID: 36481211 PMCID: PMC9722239 DOI: 10.1016/j.pcad.2022.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
The purpose of this paper is to put forward some evidence-based lessons that can be learned from how to respond to a Pandemic that relate to healthy living behaviours (HLB). A 4-step methodology was followed to conduct a narrative review of the literature and to present a professional practice vignette. The narrative review identified 8 lessons: 1) peer review; 2) historical perspectives; 3) investing in resilience and protection; 4) unintended consequences; 5) protecting physical activity; 6) school closures; 7) mental health; and 8) obesity. As in all probability there will be another Pandemic, it is important that the lessons learned over the last three years in relation to HLB are acted upon. Whilst there will not always be a consensus on what to emphasise, it is important that many evidence-based positions are presented. The authors of this paper recognise that this work is a starting point and that the lessons presented here will need to be revisited as new evidence becomes available.
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Affiliation(s)
- Mark Faghy
- School of Human Sciences, University of Derby, Derby, UK; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Ross Arena
- School of Human Sciences, University of Derby, Derby, UK; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Andrew P Hills
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; School of Health Sciences, University of Tasmania, Tasmania, Australia
| | - James Yates
- School of Human Sciences, University of Derby, Derby, UK; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Amber L Vermeesch
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Family and Community Nursing, School of Nursing, University of North, Carolina Greensboro, Greensboro, NC, USA
| | - Barry A Franklin
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Preventive Cardiology and Cardiac Rehabilitation, Beaumont Health, Royal Oak, MI, USA
| | - Dejana Popovic
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia; Mayo Clinic, Rochester, MN, USA
| | - Lindsey Strieter
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Carl J Lavie
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA, USA
| | - Andy Smith
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
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20
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Hong J, Byun J, Choi JO, Shim D, Rha DW. The Effects of Wearing Facemasks during Vigorous Exercise in the Aspect of Cardiopulmonary Response, In-Mask Environment, and Subject Discomfort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114106. [PMID: 36360983 PMCID: PMC9656209 DOI: 10.3390/ijerph192114106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 06/01/2023]
Abstract
Non-pharmaceutical intervention such as wearing a mask during the pandemic of SARS-CoV-2 is one of the most important ways to prevent the spread of the virus. However, despite high effectiveness and easy to access, the biggest problem is 'discomfort'. The purpose of this study was to measure the changes of cardiopulmonary response and related factors affecting breathing discomfort when wearing a mask during vigorous exercise. Fifteen healthy male adults participated in this study. The experimental protocol consisted of three conditions: no mask; KF-94 mask; and sports mask. Each condition consisted of three stages: stage I, 2 m/s on even level; stage II, 2 m/s with 5° inclination; and stage III, 3 m/s on even level. Oxygen saturation (SaO2) and heart rate (HR), partial pressure of carbon dioxide (pCO2), energy expenditure index (EEI), in-mask temperature, humidity, and a five-point scale questionnaire to evaluate subjective discomfort were measured. The results show that there was a significantly higher discomfort score in mask conditions compared with no mask (p < 0.05) and only pCO2 change significantly related to subjective discomfort during exercise (p < 0.05). Moreover, the pCO2 washout was significantly disturbed when wearing a sports mask in stages 2 and 3, which was related to wearer subjective discomfort.
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21
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Walach H, Traindl H, Prentice J, Weikl R, Diemer A, Kappes A, Hockertz S. Carbon dioxide rises beyond acceptable safety levels in children under nose and mouth covering: Results of an experimental measurement study in healthy children. ENVIRONMENTAL RESEARCH 2022; 212:113564. [PMID: 35636467 PMCID: PMC9142210 DOI: 10.1016/j.envres.2022.113564] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/17/2022] [Accepted: 05/21/2022] [Indexed: 05/09/2023]
Abstract
Nose and mouth covering (NMC) has been made compulsory for children in many countries during the Covid-19 pandemic. We wanted to determine the average CO2 levels in inhaled air with NMC in children between age 6 and 17. We used short term measurements under surgical masks and FFP2 masks according to European norm EN 149, compared to baseline in an experimental, intra-individually controlled study over 25 min. CO2 content was measured every 15 s using an automated dual-wavelength infrared CO2 measurement device (G100, Geotech, Leamington Spa, UK) over 25 min in a short-term experimental setting, with children seated. After baseline measurement children were provided with two types of commonly worn NMC: surgical masks and FFP2--masks in randomized sequence for 3 min each. We kept ambient CO2-levels below 1000 parts per million (ppm) through frequent ventilation. We measured breathing frequency and pulse as potential physiological moderator variables. Forty-five children, 25 boys, 20 girls, with a mean age of 10.7 years (standard deviation 2.6) were measured. We measured 13,100 ppm (SD 380) under surgical mask and 13,900 ppm (SD 370) under FFP2 mask in inhaled air. A linear model with age as a covariate showed a highly significant effect of the condition (p < 1*10-9). We measured 2,700 ppm (SD 100) CO2 at pre-baseline and 2,800 ppm (SD 100) at post-baseline, a non-significant small difference. Appropriate contrasts revealed that the change was due to the masks only and the difference between the two types of masks was small and not significant. Wearing of NMC (surgical masks or FFP2- -masks) raises CO2 content in inhaled air quickly to a very high level in healthy children in a seated resting position that might be hazardous to children's health.
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Affiliation(s)
| | | | | | - Ronald Weikl
- Obstetric, Gynecological and General Practice, Passau, Germany.
| | | | - Anna Kappes
- Anna Kappes, Psychotherapeutic Practice for Children and Youths, Müllheim, Germany.
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22
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Boi C, Borsetti F, Brugo T, Cappelletti M, De Angelis M, Fedi S, Di Giacomo S, Fabiani T, Foli G, Garelli A, Genchi U, Ghezzi D, Gualandi C, Lalli E, Magnani M, Maurizzi A, Mazzi F, Mehrabi N, Minelli M, Montalbano R, Morelli L, Nici S, Onesti R, Paglianti A, Papchenko K, Pappalardo S, Parisi N, Rapino S, Reggio M, Roselli M, Ruggeri E, Sabatini L, Saracino E, Scarponi G, Serra L, Signorini V, Storione A, Torsello M, Tugnoli E, Vargiu C, Vidali G, Violante F. One year of surgical mask testing at the University of Bologna labs: Lessons learned from data analysis. Sep Purif Technol 2022; 294:121180. [PMID: 35573908 PMCID: PMC9075986 DOI: 10.1016/j.seppur.2022.121180] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/15/2022] [Accepted: 04/25/2022] [Indexed: 01/25/2023]
Abstract
The outbreak of SARS-CoV-2 pandemic highlighted the worldwide lack of surgical masks and personal protective equipment, which represent the main defense available against respiratory diseases as COVID-19. At the time, masks shortage was dramatic in Italy, the first European country seriously hit by the pandemic: aiming to address the emergency and to support the Italian industrial reconversion to the production of surgical masks, a multidisciplinary team of the University of Bologna organized a laboratory to test surgical masks according to European regulations. The group, driven by the expertise of chemical engineers, microbiologists, and occupational physicians, set-up the test lines to perform all the functional tests required. The laboratory started its activity on late March 2020, and as of the end of December of the same year 435 surgical mask prototypes were tested, with only 42 masks compliant to the European standard. From the analysis of the materials used, as well as of the production methods, it was found that a compliant surgical mask is most likely composed of three layers, a central meltblown filtration layer and two external spunbond comfort layers. An increase in the material thickness (grammage), or in the number of layers, does not improve the filtration efficiency, but leads to poor breathability, indicating that filtration depends not only on pure size exclusion, but other mechanisms are taking place (driven by electrostatic charge). The study critically reviewed the European standard procedures, identifying the weak aspects; among the others, the control of aerosol droplet size during the bacterial filtration test results to be crucial, since it can change the classification of a mask when its performance lies near to the limiting values of 95 or 98%.
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Affiliation(s)
- C. Boi
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy,Interdepartmental Centre for Industrial Research in Health Sciences and Technologies (CIRI-SDV), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy,Corresponding authors at: Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy (C.Boi). School of Engineering, University of Edinburgh, Sanderson Building, Robert Stevenson Road, EH9 3FB, UK (M.G. De Angelis)
| | - F. Borsetti
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy
| | - T.M. Brugo
- Department of Industrial Engineering (DIN), Alma Mater Studiorum -University of Bologna, Italy
| | - M. Cappelletti
- Interdepartmental Centre for Industrial Research in Health Sciences and Technologies (CIRI-SDV), Alma Mater Studiorum - University of Bologna, Italy,Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy
| | - M.G. De Angelis
- School of Engineering, University of Edinburgh, Sanderson Building, Robert Stevenson Road, EH9 3FB, UK,Corresponding authors at: Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy (C.Boi). School of Engineering, University of Edinburgh, Sanderson Building, Robert Stevenson Road, EH9 3FB, UK (M.G. De Angelis)
| | - S. Fedi
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy
| | - S. Di Giacomo
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - T. Fabiani
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - G. Foli
- General Hospital Sant’Orsola Foundation, Bologna, Italy,Institute of Organic Synthesis and Photoreactivity (ISOF) – National Research Council (CNR), Bologna, Italy
| | - A. Garelli
- Department of Chemistry “Giacomo Ciamician”, Alma Mater Studiorum - University of Bologna, Italy
| | - U. Genchi
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - D. Ghezzi
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,Laboratory of NanoBiotechnology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - C. Gualandi
- Department of Chemistry “Giacomo Ciamician”, Alma Mater Studiorum - University of Bologna, Italy
| | - E. Lalli
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - M. Magnani
- General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - A. Maurizzi
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - F. Mazzi
- General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - N. Mehrabi
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Occupational Medicine Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - M. Minelli
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy
| | - R. Montalbano
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - L. Morelli
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - S. Nici
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - R. Onesti
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - A. Paglianti
- Department of Industrial Chemistry “Toso Montanari” (CHIMIND), Alma Mater Studiorum - University of Bologna, Italy
| | - K. Papchenko
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy
| | - S. Pappalardo
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - N.F. Parisi
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Occupational Medicine Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - S. Rapino
- Department of Chemistry “Giacomo Ciamician”, Alma Mater Studiorum - University of Bologna, Italy
| | - M. Reggio
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - M. Roselli
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy,Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Occupational Medicine Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - E. Ruggeri
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - L. Sabatini
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Occupational Medicine Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - E. Saracino
- General Hospital Sant’Orsola Foundation, Bologna, Italy,Institute of Organic Synthesis and Photoreactivity (ISOF) – National Research Council (CNR), Bologna, Italy
| | - G.E. Scarponi
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy
| | - L. Serra
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - V. Signorini
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy
| | - A. Storione
- Department of Civil, Chemical, Environmental and Materials Engineering (DICAM), Alma Mater Studiorum - University of Bologna, Italy
| | - M. Torsello
- General Hospital Sant’Orsola Foundation, Bologna, Italy,Department of Chemistry “Giacomo Ciamician”, Alma Mater Studiorum - University of Bologna, Italy
| | - E. Tugnoli
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Occupational Medicine Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - C.M. Vargiu
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - G. Vidali
- Department of Pharmacy and Biotechnology (FaBit), Alma Mater Studiorum - University of Bologna, Italy,General Hospital Sant’Orsola Foundation, Bologna, Italy
| | - F.S. Violante
- Interdepartmental Centre for Industrial Research in Health Sciences and Technologies (CIRI-SDV), Alma Mater Studiorum - University of Bologna, Italy,Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Occupational Medicine Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Italy
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23
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Zhao M, Zhao J, Yan J, Gao X. The Evaluation of Physiological Index Changes and Safety Work of Female Medical Staff With Different Medical Protection Standards in the Ward of COVID-19. Front Med (Lausanne) 2022; 9:906140. [PMID: 35814785 PMCID: PMC9256920 DOI: 10.3389/fmed.2022.906140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Effective personal protective equipment (PPE) contribute to the prevention of COVID-19 infection. However, it is necessary to evaluate the potential risk of different medical protections in the isolation ward of COVID-19. Objectives We aimed to explore the dynamics in physiological indexes of medical staff under primary and secondary PPE in the isolation ward of COVID-19 and provide the scientific basis for determining the safe work strategy. Materials and Methods In this study, 30 female nurses were selected to simulate medical work under the primary or secondary PPE, respectively. The oral temperature, axillary temperature, heart rate, respiratory rate, blood oxygen saturation, and blood pressure were measured and recorded every 20 min. The subjective adverse symptoms were recorded every 30 min. The blood glucose and weight of the individuals were measured and recorded before and after the trial. Results The results indicated that the median trial persistence time in the participants with moderate-intensity work wearing the secondary PPE (70.0 min) was much lower than that with moderate-intensity work wearing the primary PPE (180 min) and with light-intensity work wearing the primary PPE (110 min; p < 0.05). Importantly, the heart rate, oral/axillary temperature, and respiratory rate of physiological indexes of the participants under moderate-intensity work wearing the secondary PPE increased significantly faster than the primary PPE (p < 0.001), while blood oxygen saturation decreased significantly faster than the primary PPE (p < 0.001). In addition, the proportions of subjective adverse symptoms (such as dry mouth, dizziness, palpitations, and anhelation) were much higher than primary PPE (p < 0.001). The average sweat volume and blood glucose consumption of participants under moderate-intensity work wearing primary PPE were higher than secondary PPE (p < 0.001). Conclusion The combination of an exacerbated workload and secondary PPE worn by COVID-19 healthcare workers increases the change in physiological indicators, and in some cases the adverse symptoms, which can affect and even suspend their medical work. For any medical institution, there is room for improvement in terms of bioethics of a "Job Well Done" to reduce the risks of medical activities under secondary PPE.
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Affiliation(s)
- Min Zhao
- Department of Internal Medicine, Fuzhou Pulmonary Hospital of Fujian, Fuzhou, China
| | - Jianhui Zhao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Junbing Yan
- Department of Internal Medicine, Fuzhou Pulmonary Hospital of Fujian, Fuzhou, China
| | - Xiaoye Gao
- Department of Internal Medicine, Fuzhou Pulmonary Hospital of Fujian, Fuzhou, China
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24
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Effect of Wearing Surgical Face Masks on Gas Detection from Respiration Using Photoacoustic Spectroscopy. Molecules 2022; 27:molecules27113618. [PMID: 35684554 PMCID: PMC9182023 DOI: 10.3390/molecules27113618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
Wearing surgical face masks is among the measures taken to mitigate coronavirus disease (COVID-19) transmission and deaths. Lately, concern was expressed about the possibility that gases from respiration could build up in the mask over time, causing medical issues related to the respiratory system. In this research study, the carbon dioxide concentration and ethylene in the breathing zone were measured before and immediately after wearing surgical face masks using the photoacoustic spectroscopy method. From the determinations of this study, the C2H4 was established to be increased by 1.5% after one hour of wearing the surgical face mask, while CO2 was established to be at a higher concentration of 1.2% after one hour of wearing the surgical face mask, when the values were correlated with the baseline (control).
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25
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Altered Ocular Surface Health Status and Tear Film Immune Profile Due to Prolonged Daily Mask Wear in Health Care Workers. Biomedicines 2022; 10:biomedicines10051160. [PMID: 35625896 PMCID: PMC9139140 DOI: 10.3390/biomedicines10051160] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/11/2022] [Accepted: 05/09/2022] [Indexed: 02/06/2023] Open
Abstract
Prolonged daily face mask wearing over several months might affect health of the ocular surface and is reported to be associated with complaints of discomfort and dry-eye-like symptoms. We studied the ocular surface clinical parameters, tear soluble factors and immune cell proportions in ophthalmologists practicing within similar environmental conditions (n = 17) at two time points: pre-face-mask period (Pre-FM; end of 2019) and post-face-mask-wearing period (Post-FM; during 2020 COVID-19 pandemic), with continuous (~8 h/day) mask wear. A significant increase in ocular surface disease index (OSDI) scores without changes in tear breakup time (TBUT), Schirmer’s test 1 (ST1) and objective scatter index (OSI) was observed Post-FM. Tear soluble factors (increased—IL-1β, IL-33, IFNβ, NGF, BDNF, LIF and TSLP; decreased—IL-12, IL-13, HGF and VEGF-A) and mucins (MUC5AC) were significantly altered Post-FM. Ex vivo, human donor and corneoscleral explant cultures under elevated CO2 stress revealed that the molecular profile, particularly mucin expression, was similar to the Post-FM tear molecular profile, suggesting hypercapnia is a potential contributor to ocular surface discomfort. Among the immune cell subsets determined from ocular surface wash samples, significantly higher proportions of leukocytes and natural killer T cells were observed in Post-FM compared to Pre-FM. Therefore, it is important to note that the clinical parameters, tear film quality, tear molecular factors and immune cells profile observed in prolonged mask-wear-associated ocular surface discomfort were distinct from dry eye disease or other common ocular surface conditions. These observations are important for differential diagnosis as well as selection of appropriate ocular surface treatment in such subjects.
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26
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Sukul P, Bartels J, Fuchs P, Trefz P, Remy R, Rührmund L, Kamysek S, Schubert JK, Miekisch W. Effects of COVID-19 protective face-masks and wearing durations onto respiratory-haemodynamic physiology and exhaled breath constituents. Eur Respir J 2022; 60:13993003.00009-2022. [PMID: 35169028 PMCID: PMC9492982 DOI: 10.1183/13993003.00009-2022] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/03/2022] [Indexed: 11/28/2022]
Abstract
Background While assumed to protect against coronavirus transmission, face masks may have effects on respiratory–haemodynamic parameters. Within this pilot study, we investigated immediate and progressive effects of FFP2 and surgical masks on exhaled breath constituents and physiological attributes in 30 adults at rest. Methods We continuously monitored exhaled breath profiles within mask space in older (age 60–80 years) and young to middle-aged (age 20–59 years) adults over the period of 15 and 30 min by high-resolution real-time mass-spectrometry. Peripheral oxygen saturation (SpO2) and respiratory and haemodynamic parameters were measured (noninvasively) simultaneously. Results Profound, consistent and significant (p≤0.001) changes in SpO2 (≥60_FFP2-15 min: 5.8±1.3%↓, ≥60_surgical-15 min: 3.6±0.9%↓, <60_FFP2-30 min: 1.9±1.0%↓, <60_surgical-30 min: 0.9±0.6%↓) and end-tidal carbon dioxide tension (PETCO2) (≥60_FFP2-15 min: 19.1±8.0%↑, ≥60_surgical-15 min: 11.6±7.6%↑, <60_FFP2- 30 min: 12.1±4.5%↑, <60_surgical- 30 min: 9.3±4.1%↑) indicate ascending deoxygenation and hypercarbia. Secondary changes (p≤0.005) to haemodynamic parameters (e.g. mean arterial pressure (MAP) ≥60_FFP2-15 min: 9.8±10.4%↑) were found. Exhalation of bloodborne volatile metabolites, e.g. aldehydes, hemiterpene, organosulfur, short-chain fatty acids, alcohols, ketone, aromatics, nitrile and monoterpene mirrored behaviour of cardiac output, MAP, SpO2, respiratory rate and PETCO2. Exhaled humidity (e.g. ≥60_FFP2-15 min: 7.1±5.8%↑) and exhaled oxygen (e.g. ≥60_FFP2-15 min: 6.1±10.0%↓) changed significantly (p≤0.005) over time. Conclusions Breathomics allows unique physiometabolic insights into immediate and transient effects of face mask wearing. Physiological parameters and breath profiles of endogenous and/or exogenous volatile metabolites indicated putative cross-talk between transient hypoxaemia, oxidative stress, hypercarbia, vasoconstriction, altered systemic microbial activity, energy homeostasis, compartmental storage and washout. FFP2 masks had a more pronounced effect than surgical masks. Older adults were more vulnerable to FFP2 mask-induced hypercarbia, arterial oxygen decline, blood pressure fluctuations and concomitant physiological and metabolic effects. While assumed to protect against SARS-CoV-2 transmission, face masks cause various physiometabolic side-effects and changes in exhaled VOC profiles. Effects are more pronounced in FFP2 masks and are profound at age ≥60 years.https://bit.ly/33fzOMA
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Affiliation(s)
- Pritam Sukul
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Julia Bartels
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Patricia Fuchs
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Phillip Trefz
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Rasmus Remy
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Leo Rührmund
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Svend Kamysek
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Jochen K Schubert
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Wolfram Miekisch
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
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27
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Escobedo P, Fernández-Ramos MD, López-Ruiz N, Moyano-Rodríguez O, Martínez-Olmos A, Pérez de Vargas-Sansalvador IM, Carvajal MA, Capitán-Vallvey LF, Palma AJ. Smart facemask for wireless CO 2 monitoring. Nat Commun 2022; 13:72. [PMID: 35013232 PMCID: PMC8748626 DOI: 10.1038/s41467-021-27733-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/03/2021] [Indexed: 11/09/2022] Open
Abstract
The use of facemasks by the general population is recommended worldwide to prevent the spread of SARS-CoV-2. Despite the evidence in favour of facemasks to reduce community transmission, there is also agreement on the potential adverse effects of their prolonged usage, mainly caused by CO2 rebreathing. Herein we report the development of a sensing platform for gaseous CO2 real-time determination inside FFP2 facemasks. The system consists of an opto-chemical sensor combined with a flexible, battery-less, near-field-enabled tag with resolution and limit of detection of 103 and 140 ppm respectively, and sensor lifetime of 8 h, which is comparable with recommended FFP2 facemask usage times. We include a custom smartphone application for wireless powering, data processing, alert management, results displaying and sharing. Through performance tests during daily activity and exercise monitoring, we demonstrate its utility for non-invasive, wearable health assessment and its potential applicability for preclinical research and diagnostics.
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Grants
- B-FQM-243-UGR18 Consejería de Economía, Innovación, Ciencia y Empleo, Junta de Andalucía (Ministry of Economy, Innovation, Science and Employment, Government of Andalucia)
- P18-RT-2961 Consejería de Economía, Innovación, Ciencia y Empleo, Junta de Andalucía (Ministry of Economy, Innovation, Science and Employment, Government of Andalucia)
- DOC_00520 Consejería de Economía, Innovación, Ciencia y Empleo, Junta de Andalucía (Ministry of Economy, Innovation, Science and Employment, Government of Andalucia)
- EC | European Regional Development Fund (Europski Fond za Regionalni Razvoj)
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Affiliation(s)
- P Escobedo
- ECsens, CITIC-UGR, Department of Electronics and Computer Technology, University of Granada, Granada, Spain
- Unit of Excellence in Chemistry Applied to Biomedicine and the Environment of the University of Granada, Granada, Spain
| | - M D Fernández-Ramos
- Unit of Excellence in Chemistry Applied to Biomedicine and the Environment of the University of Granada, Granada, Spain
- ECsens, Department of Analytical Chemistry, University of Granada, 18071, Granada, Spain
| | - N López-Ruiz
- ECsens, CITIC-UGR, Department of Electronics and Computer Technology, University of Granada, Granada, Spain
- Unit of Excellence in Chemistry Applied to Biomedicine and the Environment of the University of Granada, Granada, Spain
| | - O Moyano-Rodríguez
- ECsens, Department of Analytical Chemistry, University of Granada, 18071, Granada, Spain
| | - A Martínez-Olmos
- ECsens, CITIC-UGR, Department of Electronics and Computer Technology, University of Granada, Granada, Spain
- Unit of Excellence in Chemistry Applied to Biomedicine and the Environment of the University of Granada, Granada, Spain
| | - I M Pérez de Vargas-Sansalvador
- Unit of Excellence in Chemistry Applied to Biomedicine and the Environment of the University of Granada, Granada, Spain
- ECsens, Department of Analytical Chemistry, University of Granada, 18071, Granada, Spain
| | - M A Carvajal
- ECsens, CITIC-UGR, Department of Electronics and Computer Technology, University of Granada, Granada, Spain
- Unit of Excellence in Chemistry Applied to Biomedicine and the Environment of the University of Granada, Granada, Spain
- Sport and Health University Research Institute (iMUDS), University of Granada, 18071, Granada, Spain
| | - L F Capitán-Vallvey
- Unit of Excellence in Chemistry Applied to Biomedicine and the Environment of the University of Granada, Granada, Spain
- ECsens, Department of Analytical Chemistry, University of Granada, 18071, Granada, Spain
| | - A J Palma
- ECsens, CITIC-UGR, Department of Electronics and Computer Technology, University of Granada, Granada, Spain.
- Unit of Excellence in Chemistry Applied to Biomedicine and the Environment of the University of Granada, Granada, Spain.
- Sport and Health University Research Institute (iMUDS), University of Granada, 18071, Granada, Spain.
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Acuti Martellucci C, Flacco ME, Martellucci M, Violante FS, Manzoli L. Inhaled CO 2 Concentration While Wearing Face Masks: A Pilot Study Using Capnography. ENVIRONMENTAL HEALTH INSIGHTS 2022. [PMID: 36133777 DOI: 10.1101/2022.05.10.22274813] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Face masks are recommended based on the assumption that they protect against SARS-CoV-2 transmission, however studies on their potential side effects are still lacking. We aimed to evaluate the inhaled air carbon dioxide (CO2) concentration, when wearing masks. METHODS We measured end-tidal CO2 using professional side-stream capnography, with water-removing tubing, (1) without masks, (2) wearing a surgical mask, and (3) wearing a FFP2 respirator (for 5 minutes each while seated after 10 minutes of rest), in 146 healthy volunteers aged 10 to 90 years, from the general population of Ferrara, Italy. The inhaled air CO2 concentration was computed as: ([mask volume × end-tidal CO2] + [tidal volume - mask volume] × ambient air CO2)/tidal volume. RESULTS With surgical masks, the mean CO2 concentration was 7091 ± 2491 ppm in children, 4835 ± 869 in adults, and 4379 ± 978 in the elderly. With FFP2 respirators, this concentration was 13 665 ± 3655 in children, 8502 ± 1859 in adults, and 9027 ± 1882 in the elderly. The proportion showing a CO2 concentration higher than the 5000 ppm (8-hour average) acceptable threshold for workers was 41.1% with surgical masks, and 99.3% with FFP2 respirators. Adjusting for age, gender, BMI, and smoking, the inhaled air CO2 concentration significantly increased with increasing respiratory rate (mean 10 837 ±3712 ppm among participants ⩾18 breaths/minute, with FFP2 respirators), and among the minors. CONCLUSION If these results are confirmed, the current guidelines on mask-wearing should be reevaluated.
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Affiliation(s)
| | - Maria Elena Flacco
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Mosè Martellucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Francesco Saverio Violante
- Occupational Health Unit, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Lamberto Manzoli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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29
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Koroteeva E, Shagiyanova A. Infrared-based visualization of exhalation flows while wearing protective face masks. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2022; 34:011705. [PMID: 35340681 PMCID: PMC8939526 DOI: 10.1063/5.0076230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/27/2021] [Indexed: 05/15/2023]
Abstract
Since the onset of the COVID-19 pandemic, a large number of flow visualization procedures have been proposed to assess the effect of personal protective equipment on respiratory flows. This study suggests infrared thermography as a beneficial visualization technique because it is completely noninvasive and safe and, thus, can be used on live individuals rather than mannequins or lung simulators. Here, we examine the effect of wearing either of three popular face coverings (a surgical mask, a cloth mask, or an N95 respirator with an exhalation valve) on thermal signatures of exhaled airflows near a human face while coughing, talking, or breathing. The flow visualization using a mid-wave infrared camera captures the dynamics of thermal inhomogeneities induced by increased concentrations of carbon dioxide in the exhaled air. Thermal images demonstrate that both surgical and cloth face masks allow air leakage through the edges and the fabric itself, but they decrease the initial forward velocity of a cough jet by a factor of four. The N95 respirator, on the other hand, reduces the infrared emission of carbon dioxide near the person's face almost completely. This confirms that the N95-type mask may indeed lead to excessive inhalation of carbon dioxide as suggested by some recent studies.
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Affiliation(s)
- E. Koroteeva
- Author to whom correspondence should be addressed:
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30
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Acuti Martellucci C, Flacco ME, Martellucci M, Violante FS, Manzoli L. Inhaled CO 2 Concentration While Wearing Face Masks: A Pilot Study Using Capnography. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221123573. [PMID: 36133777 PMCID: PMC9483963 DOI: 10.1177/11786302221123573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/10/2022] [Indexed: 05/21/2023]
Abstract
BACKGROUND Face masks are recommended based on the assumption that they protect against SARS-CoV-2 transmission, however studies on their potential side effects are still lacking. We aimed to evaluate the inhaled air carbon dioxide (CO2) concentration, when wearing masks. METHODS We measured end-tidal CO2 using professional side-stream capnography, with water-removing tubing, (1) without masks, (2) wearing a surgical mask, and (3) wearing a FFP2 respirator (for 5 minutes each while seated after 10 minutes of rest), in 146 healthy volunteers aged 10 to 90 years, from the general population of Ferrara, Italy. The inhaled air CO2 concentration was computed as: ([mask volume × end-tidal CO2] + [tidal volume - mask volume] × ambient air CO2)/tidal volume. RESULTS With surgical masks, the mean CO2 concentration was 7091 ± 2491 ppm in children, 4835 ± 869 in adults, and 4379 ± 978 in the elderly. With FFP2 respirators, this concentration was 13 665 ± 3655 in children, 8502 ± 1859 in adults, and 9027 ± 1882 in the elderly. The proportion showing a CO2 concentration higher than the 5000 ppm (8-hour average) acceptable threshold for workers was 41.1% with surgical masks, and 99.3% with FFP2 respirators. Adjusting for age, gender, BMI, and smoking, the inhaled air CO2 concentration significantly increased with increasing respiratory rate (mean 10 837 ±3712 ppm among participants ⩾18 breaths/minute, with FFP2 respirators), and among the minors. CONCLUSION If these results are confirmed, the current guidelines on mask-wearing should be reevaluated.
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Affiliation(s)
- Cecilia Acuti Martellucci
- Department of Environmental and
Prevention Sciences, University of Ferrara, Ferrara, Italy
- Cecilia Acuti Martellucci, Department of
Environmental and Prevention Sciences, University of Ferrara, Via Fossato di
Mortara 64/B, Ferrara 44121, Italy.
| | - Maria Elena Flacco
- Department of Environmental and
Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Mosè Martellucci
- Department of Medicine and Surgery,
University of Perugia, Perugia, Italy
| | - Francesco Saverio Violante
- Occupational Health Unit, Sant’Orsola
Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Lamberto Manzoli
- Department of Medical and Surgical
Sciences, University of Bologna, Bologna, Italy
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31
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Abstract
Unhealthy levels of air pollution are breathed by billions of people worldwide, and air pollution is the leading environmental cause of death and disability globally. Efforts to reduce air pollution at its many sources have had limited success, and in many areas of the world, poor air quality continues to worsen. Personal interventions to reduce exposure to air pollution include avoiding sources, staying indoors, filtering indoor air, using face masks, and limiting physical activity when and where air pollution levels are elevated. The effectiveness of these interventions varies widely with circumstances and conditions of use. Compared with upstream reduction or control of emissions, personal interventions place burdens and risk of adverse unintended consequences on individuals. We review evidence regarding the balance of benefits and potential harms of personal interventions for reducing exposure to outdoor air pollution, which merit careful consideration before making public health recommendations with regard to who should use personal interventions and where, when, and how they should be used. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Robert J Laumbach
- Rutgers School of Public Health, and Environmental and Occupational Health Sciences Institute, Piscataway, New Jersey, USA;
| | - Kevin R Cromar
- Marron Institute of Urban Management, New York University, New York, NY, USA.,Departments of Environmental Medicine and Population Health, Grossman School of Medicine, New York University, New York, NY, USA;
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32
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Comparison of Effects of N95 Respirators and Surgical Masks to Physiological and Psychological Health among Healthcare Workers: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413308. [PMID: 34948915 PMCID: PMC8705067 DOI: 10.3390/ijerph182413308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 12/15/2022]
Abstract
Since the onset of the coronavirus disease 2019 pandemic, wearing facemasks has become more important for healthcare workers. This study aimed to investigate and compare the influence of wearing N95 respirators and surgical masks for 8 h on physiological and psychological health. Sixty-eight healthcare workers were randomly assigned to the N95 respirator or surgical mask groups. Physiological parameters of participants were measured by Tensor Tip MTX at baseline and at the 2nd, 4th, 6th and 8th h of wearing the facemasks. The symptoms after wearing facemasks were also determined via the questionnaire. There were no significant changes in physiological parameters at most time checkpoints in both groups. Significant differences were observed in terms of heart rate at the 8th h, time trends (adjusted difference of least squares means were −8.53 and −2.01), and interaction of time and mask type between the two groups (p-value for interaction was 0.0146). The values of these physiological parameters were within normal ranges. The N95 respirator group had significantly higher incidences of shortness of breath, headache, dizziness, difficulty talking and fatigue that spontaneously resolved. In conclusion, healthcare workers who wore either N95 respirators or surgical masks during an 8 h shift had no obvious harmful effects on physiological and psychological health. Additionally, the N95 respirator group did not show a higher risk than the surgical mask group.
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33
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Iitani K, Tyson J, Rao S, Ramamurthy SS, Ge X, Rao G. What do masks mask? A study on transdermal CO 2 monitoring. Med Eng Phys 2021; 98:50-56. [PMID: 34848038 PMCID: PMC8550888 DOI: 10.1016/j.medengphy.2021.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/15/2021] [Accepted: 10/24/2021] [Indexed: 01/11/2023]
Abstract
Medical professionals have complained of extreme discomfort and fatigue from continuous wearing of N95 respirators (N95) overlaid with surgical masks (SM) and face shields (FS) during COVID-19 pandemic. However, there are no reports on the effect of face coverings on transdermal CO2 (TrCO2) levels (a measure of blood CO2) during moderate activity. In this study, real-time monitoring of TrCO2, heart rate and skin surface temperature was conducted for six subjects aged 20-59 years with and without wearing personal protective equipment (PPE). We initially studied the effect of wearing PPE (N95+SM+FS) at rest. Then, the effect of moderate stepping/walking activity (120 steps per minute for 60 min) while wearing PPE was evaluated. In addition, we investigated the effect of exercising intensity with different masks. We observed a significant difference (p < 0.0001) in TrCO2 levels between without and with PPE during moderate exercise, but not while resting. TrCO2 levels were correlated to exercise intensity independently with masking condition and breathability of masks. For the first time, we present data showing that a properly fitting N95 worn along with SM and FS consistently leads to elevated TrCO2 under moderate exertion, which could contribute to fatigue over long-term use.
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Affiliation(s)
- Kenta Iitani
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA; Department of Life Science and Medical Bioscience, Graduate School of Advanced Science and Engineering, Waseda University (TWIns), 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8480, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Joel Tyson
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Samyukta Rao
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Sai Sathish Ramamurthy
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA; STAR Laboratory, Department of Chemistry, Sri Sathya Sai Institute of Higher Learning, Prasanthi Nilayam, Puttaparthi, Anantapur, Andhra Pradesh 515134, India
| | - Xudong Ge
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
| | - Govind Rao
- Center for Advanced Sensor Technology, Department of Chemical, Biochemical and Environmental Engineering, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
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Ong JJY, Chan ACY, Bharatendu C, Teoh HL, Chan YC, Sharma VK. Headache Related to PPE Use during the COVID-19 Pandemic. Curr Pain Headache Rep 2021; 25:53. [PMID: 34129112 PMCID: PMC8203491 DOI: 10.1007/s11916-021-00968-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW Personal protection equipment (PPE)-associated headache is an unusual secondary headache disorder that predominantly occurs in healthcare workers as a consequence of the donning of protective respirators, face masks and/or eyewear. The appreciation of this entity is important given the significant ramifications upon the occupational health of healthcare workers and could additionally have an impact on persons living with pre-existing headache disorder(s). RECENT FINDINGS There has been a renewed interest and recognition of PPE-associated headaches amongst healthcare professionals, largely brought about by the ongoing COVID-19 pandemic which has besieged healthcare systems worldwide. De novo PPE-associated headaches may present with migrainous or tension-type features and can be viewed as a subtype of external compression headache. The prognosis of the disorder is generally favourable, given that most headaches are short-lived without long-term sequalae. Several aetiologies have been postulated to account for the development of these headaches. Notably, these headaches can affect the occupational health and work performance of healthcare workers. In this review, we discuss the epidemiology, clinical characteristics, probable etiopathogenesis, management and prognosis of PPE-associated headaches in the context of the COVID-19 pandemic. Future directions for research and PPE development are proposed.
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Affiliation(s)
- Jonathan J Y Ong
- Division of Neurology, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore.
| | - Amanda C Y Chan
- Division of Neurology, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Chandra Bharatendu
- Division of Neurology, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Stead Family Department of Pediatrics, Division of Medical Genetics and Genomics, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Hock Luen Teoh
- Division of Neurology, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Yee Cheun Chan
- Division of Neurology, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Vijay K Sharma
- Division of Neurology, National University Hospital and Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore
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35
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Au SCL. The model of N95 face mask used and hypercapnia proof upon choroidal thickness measurement. Photodiagnosis Photodyn Ther 2021; 35:102399. [PMID: 34126242 DOI: 10.1016/j.pdpdt.2021.102399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Sunny Chi Lik Au
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong.
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