Protective masks during the SARS-CoV-2 pandemic: Any relationship with temporomandibular disorders and orofacial pain?

BACKGROUND

Wearing protective face masks has been one of the indispensable measures to prevent droplets and aerosol particles transmission during the SARS-CoV-2 pandemic.

OBJECTIVES

This observational cross-sectional survey investigated the different types and modalities of protective mask wearing and the possible association with referred signs of temporomandibular disorders and orofacial pain by respondents.

METHODS

An online-questionnaire was developed, calibrated and administered anonymously to subjects with an age of ≥ 18 years. It consisted of different sections: demographics, type and wearing modalities of the protective masks, pain in the preauricular area, noise at the temporomandibular joints and headache. Statistical analysis was performed using statistical software STATA v16.

RESULTS

The questionnaire received 665 replies mainly from participants aged 18-30 years (315 males, 350 females). The healthcare professionals were 37% of participants, 21.2% of them were dentists. The Filtering Facepiece 2 or 3 (FFP2/FFP3) mask was used by 334 subjects (50.3%), and 578 (87%) wore the mask with two elastics behind the ears. Pain while wearing the mask was referred by 400 participants, and 36.8% of them referred pain with a consecutive use of more than 4 hours (p = 0.042). 92.2% of participants did not report any TMJ noise. Headache associated with the FFP2/FFP3 was referred by 57.7% of subjects (p = 0.033).

CONCLUSION

This survey highlighted the increased referred the presence of discomfort in the preauricular area and headache possibly associated with a prolonged use of protective face masks for more than 4 hours during the SARS-CoV-2 pandemic.

Protective Face Masks: Effect on the Oxygenation and Heart Rate Status of Oral Surgeons during Surgery

Background: Safety in medical work requires eye protection, such as glasses, and protective facial masks (PFM) during clinical practice to prevent viral respiratory infections. The use of facial masks and other full personal protective equipment increases air flow resistance, facial skin temperature and physical discomfort. The aim of the present study was to measure surgeons’ oxygenation status and discomfort before and after their daily routine activities of oral interventions. Methods: 10 male voluntary dentists, specializing in oral surgery, and 10 male voluntary doctors in dentistry, participating in master’s courses in oral surgery in the Department of Oral Surgery of the University of Chieti, with mean age 29 ± 6 (27–35), were enrolled. This study was undertaken to investigate the effects of wearing a PFM on oxygenation status while the oral surgeons were actively working. Disposable sterile one-way surgical paper masks (Surgical Face Mask, Euronda, Italy) and FFP2 (Surgical Face Mask, Euronda, Italy) were used and the mask position covering the nose did not vary during the procedures. The FFP2 was covered by a surgical mask during surgical treatment. A pulse oximeter was used to measure the blood oximetry saturation during the study. Results: In all 20 surgeons wearing FFP2 covered by surgical masks, a reduction in arterial O₂ saturation from around 97.5% before surgery to 94% after surgery was recorded with increase of heart rates. A shortness of breath and light-headedness/headaches were also noted. Conclusions: In conclusion, wearing an FFP2 covered by a surgical mask induces a reduction in circulating O₂ concentrations without clinical relevance, while an increase of heart frequency and a sensation of shortness of breath, light-headedness/headaches were recorded.

A Rapidly Deployable Test Suite for Respiratory Protective Devices in the COVID-19 Pandemic

INTRODUCTION

The current COVID-19 pandemic has caused large shortages in personal protective equipment, leading to hospitals buying their supplies from alternative suppliers or even reusing single-use items. Equipment from these alternative sources first needs to be tested to ensure that they properly protect the clinicians that depend on them. This work demonstrates a test suite for protective face masks that can be realized rapidly and cost effectively, using mainly off-the-shelf as well as 3D printing components.

MATERIALS AND METHODS

The proposed test suite was designed and evaluated in order to assess its safety and proper functioning according to the criteria that are stated in the European standard norm EN149:2001+A1 7. These include a breathing resistance test, a CO2 build-up test, and a penetration test. Measurements were performed for a variety of commercially available protective face masks for validation.

RESULTS

The results obtained with the rapidly deployable test suite agree with conventional test methods, demonstrating that this setup can be used to assess the filtering properties of protective masks when conventional equipment is not available.

DISCUSSION

The presented test suite can serve as a starting point for the rapid deployment of more testing facilities for respiratory protective equipment. This could greatly increase the testing capacity and ultimately improve the safety of healthcare workers battling the COVID-19 pandemic.

Facial Skin Temperature and Discomfort When Wearing Protective Face Masks: Thermal Infrared Imaging Evaluation and Hands Moving the Mask

Individual respiratory protective devices and face masks represent critical tools in protecting health care workers in hospitals and clinics, and play a central role in decreasing the spread of the high-risk pandemic infection of 2019, coronavirus disease (COVID-19). The aim of the present study was to compare the facial skin temperature and the heat flow when wearing medical surgical masks to the same factors when wearing N95 respirators. A total of 20 subjects were recruited and during the evaluation, each subject was invited to wear a surgical mask or respirator for 1 h. The next day in the morning at the same hour, the same subject wore a N95 mask for 1 h with the same protocol. Infrared thermal evaluation was performed to measure the facial temperature of the perioral region and the perception ratings related to the humidity, heat, breathing difficulty, and discomfort were recorded. A significant difference in heat flow and perioral region temperature was recorded between the surgical mask and the N95 respirator (p < 0.05). A statistically significant difference in humidity, heat, breathing difficulty, and discomfort was present between the groups. The study results suggest that N95 respirators are able to induce an increased facial skin temperature, greater discomfort and lower wearing adherence when compared to the medical surgical masks.

N-Halamine-modified antimicrobial polypropylene nonwoven fabrics for use against airborne bacteria

Disinfecting, nonbleaching compound 1-chloro-2,2,5,5-tetramethyl-4-imidazolidinone (MC) was uniformly coated onto polypropylene melt-blown nonwoven fabrics having basis-weights of 22 and 50 g/m(2) in order to impart antimicrobial properties via a pad-dry technique. The antimicrobial efficacies of the tested fabrics loaded with MC compound were evaluated against bioaerosols of Staphylococcus aureus and Escherichia coli O157:H7 utilizing a colony counting method. It was determined that both types of coated fabrics exhibited superior antimicrobial efficacy upon exposure to aerosol generation for 3 h. The effect of the coating on air permeability was found to be minimal. Samples were stable for a 6 month time period when they were stored in darkness. However, when the fabrics were exposed to fluorescent light, partial chlorine loss was observed. The MC-coated fabrics exhibited great potential for use in protective face masks and air filters to combat airborne pathogens.