A pilot study of the impact of facial skin protectants on qualitative fit testing of N95 masks.
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ABSTRACT:
SUBMITTER: Bui AN
PROVIDER: S-EPMC7313513 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Publications
A pilot study of the impact of facial skin protectants on qualitative fit testing of N95 masks.
Bui Ai-Tram N AN Yu Zizi Z Lee Karen K Li Sara J SJ Tsiaras William G WG Yu Sherry H SH LeBoeuf Nicole R NR Mostaghimi Arash A
Journal of the American Academy of Dermatology 20200624 2
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Project description:IntroductionThe COVID-19 pandemic has made well-fitting face masks a critical piece of protective equipment for healthcare workers and civilians. While the importance of wearing face masks has been acknowledged, there remains a lack of understanding about the role of good fit in rendering protective equipment useful. In addition, supply chain constraints have caused some organizations to abandon traditional quantitative or/and qualitative fit testing, and instead, have implemented subjective fit checking. Our study seeks to quantitatively evaluate the level of fit offered by various types of masks, and most importantly, assess the accuracy of implementing fit checks by comparing fit check results to quantitative fit testing results.MethodsSeven participants first evaluated N95 and KN95 respirators by performing a fit check. Participants then underwent quantitative fit testing wearing five N95 respirators, a KN95 respirator, a surgical mask, and fabric masks.ResultsN95 respirators offered higher degrees of protection than the other categories of masks tested; however, it should be noted that most N95 respirators failed to fit the participants adequately. Fit check responses had poor correlation with quantitative fit factor scores. KN95, surgical, and fabric masks achieved low fit factor scores, with little protective difference recorded between respiratory protection options. In addition, small facial differences were observed to have a significant impact on quantitative fit.ConclusionFit is critical to the level of protection offered by respirators. For an N95 respirator to provide the promised protection, it must fit the participant. Performing a fit check via NHS self-assessment guidelines was an unreliable way of determining fit.
| S-EPMC7822328 | biostudies-literature
Project description:This study aimed to determine whether wearing N95 masks for 4 h significantly affected physiological indicators in obese operating room staff compared to surgical masks (SMs). In this randomized crossover trial, the physiological impacts of wearing SMs and N95 masks for 4 h was analysed among 20 obese operating room staff. The data were connected to a nasal sampling tube using the Capnostream 20p monitor. The primary outcome was the change in venous carbon dioxide partial pressure (PvCO2) levels at 4-hour intervention. Secondary outcomes included venous oxygen pressure (PvO2), bicarbonate (HCO3-), pH levels, end-tidal carbon dioxide partial pressure (PetCO2), peripheral oxygen saturation (SpO2), respiratory rate (RR), pulse rate (PR) and blood pressure after mask intervention. Dyspnoea, palpitations, headache were assessed with the visual analogue scale (VAS) score. N95 masks had a statistically significant rather than clinically significant impact on PvCO2 (mean [95% CI], 1.4 [0.8, 1.9], P < 0.001) and RR (0.6 [0.1, 1.1)], P = 0.023) changes compared with SM. The three subjective VAS scores of the N95 group showed significantly increased than SM group after 2 h. In conclusion, obese operating room staff continuously wearing SM or N95 masks 4 h showed almost no difference in physiological impacts. Trial registration NCT05950256, 18/07/2023.
| S-EPMC11850626 | biostudies-literature
Project description:In times of crisis, including the current COVID-19 pandemic, the supply chain of filtering facepiece respirators, such as N95 respirators, are disrupted. To combat shortages of N95 respirators, many institutions were forced to decontaminate and reuse respirators. While several reports have evaluated the impact on filtration as a measurement of preservation of respirator function after decontamination, the equally important fact of maintaining proper fit to the users' face has been understudied. In the current study, we demonstrate the complete inactivation of SARS-CoV-2 and preservation of fit test performance of N95 respirators following treatment with dry heat. We apply scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDS), X-ray diffraction (XRD) measurements, Raman spectroscopy, and contact angle measurements to analyze filter material changes as a consequence of different decontamination treatments. We further compared the integrity of the respirator after autoclaving versus dry heat treatment via quantitative fit testing and found that autoclaving, but not dry heat, causes the fit of the respirator onto the users face to fail, thereby rendering the decontaminated respirator unusable. Our findings highlight the importance to account for both efficacy of disinfection and mask fit when reprocessing respirators to for clinical redeployment.
| S-EPMC8730429 | biostudies-literature
Project description:BackgroundIn the context of the COVID-19 pandemic, cases of adverse skin reactions related to the wearing of masks have been observed.ObjectivesTo analyze the short-term effects of N95 respirators and medical masks, respectively, on skin physiological properties and to report adverse skin reactions caused by the protective equipment.MethodsThis study used a randomized crossover design with repeated measurements. Twenty healthy Chinese volunteers were recruited. Skin parameters were measured on areas covered by the respective masks and on uncovered skin 2 and 4 hours after donning, and 0.5 and 1 hour after removing the masks, including skin hydration, transepidermal water loss (TEWL), erythema, pH, and sebum secretion. Adverse reactions were clinically assessed, and perceived discomfort and non-compliance measured.ResultsSkin hydration, TEWL, and pH increased significantly with wearing the protective equipment. Erythema values increased from baseline. Sebum secretion increased both on the covered and uncovered skin with equipment-wearing. There was no significant difference in physiological values between the two types of equipment. More adverse reactions were reported following a N95 mask use than the use of a medical mask, with a higher score of discomfort and non-compliance.ConclusionsThis study demonstrates that skin biophysical characters change as a result of wearing a mask or respirator. N95 respirators were associated with more skin reactions than medical masks.
| S-EPMC7272965 | biostudies-literature
Project description:In response to the current state of the COVID-19 pandemic, healthcare providers are using common surgical masks and filtering respirators in conjunction with the presence of facial hair, which could lead to a large number of particles passing into their respiratory system. The purpose of this study was to determine the fit factor effectiveness of filtering respirators and surgical masks in bearded versus non-bearded healthcare providers. A controlled randomized clinical trial (NCT04391010) was carried out, analyzing a sample of 63 healthcare providers. The fit factors of surgical masks and FFP3 filtering respirators for healthcare providers with (n = 32) and without (n = 31) facial hair were compared. Fit factors were measured during an exercises protocol in which healthcare providers wore surgical masks and FFP3 filtering respirators. Surgical mask fit factor comparisons did not show significant differences (p > 0.05) between healthcare providers with and without facial hair. In contrast, filtering respirator fit factor comparisons showed statistically significant differences (p < 0.01) between both groups, indicating that healthcare providers with facial hair showed lower fit factor scores, which implies a worse fit factor with respect to healthcare providers without facial hair. The fit factor effectiveness of filtering respirators was reduced in healthcare providers with facial hair. The authors of this paper encourage healthcare providers to trim their beards during filtering respirator use or wear full-mask filtering facepiece respirators, especially during the COVID-19 pandemic.
| S-EPMC8533569 | biostudies-literature
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| S-EPMC7262031 | biostudies-literature
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| S-EPMC10686483 | biostudies-literature
Project description:BackgroundDuring the coronavirus disease 2019 pandemic, wearing medical respirators and masks was essential to prevent transmission.ObjectiveTo quantify the effects of N95 mask usage by measuring facial skin biophysical characteristics and changes in the lipidome.MethodsSixty healthy volunteers wore N95 respirators for 3 or 6 h. Facial images were acquired and physiological parameters were measured in specific facial areas, before and after mask-wearing. Lipidome analysis was also performed.ResultsAfter N95 respirator usage, facial erythema was observed in both the 3 and 6 h groups. Both sebum secretion and trans-epidermal water loss increased significantly in mask-covered cheeks and chins after 6 h of mask wearing compared with before mask wearing (p < 0.05). Principal component analysis revealed significant differences in lipid composition after mask wearing compared with before. The ceramide subclass NS exhibited a positive correlation with stratum corneum hydration, whereas the AP subclass was negatively correlated with trans-epidermal water loss in the 6 h group.ConclusionProlonged wear of N95 respirators may impair facial skin function and alter lipidome composition.
| S-EPMC10941554 | biostudies-literature
Project description:IntroductionDuring the course of the COVID-19 pandemic, there have been suggestions that various techniques could be employed to improve the fit and, therefore, the effectiveness of face masks. It is well recognized that improving fit tends to improve mask effectiveness, but whether these fit modifiers are reliable remains unexplored. In this study, we assess a range of common "fit hacks" to determine their ability to improve mask performance.MethodsBetween July and September 2020, qualitative fit testing was performed in an indoor living space. We used quantitative fit testing to assess the fit of both surgical masks and KN95 masks, with and without 'fit hacks', on four participants. Seven fit hacks were evaluated to assess impact on fit. Additionally, one participant applied each fit hack multiple times to assess how reliable hacks were when reapplied. A convenience of four participants took part in the study, three females and one male with a head circumference range of 54 to 60 centimetres.Results and discussionThe use of pantyhose, tape, and rubber bands were effective for most participants. A pantyhose overlayer was observed to be the most effective hack. High degrees of variation were noted between participants. However, little variation was noted within participants, with hacks generally showing similar benefit each time they were applied on a single participant. An inspection of the fit hacks once applied showed that individual facial features may have a significant impact on fit, especially the nose bridge.ConclusionsFit hacks can be used to effectively improve the fit of surgical and KN95 masks, enhancing the protection provided to the wearer. However, many of the most effective hacks are very uncomfortable and unlikely to be tolerated for extended periods of time. The development of effective fit-improvement solutions remains a critical issue in need of further development.
| S-EPMC8809580 | biostudies-literature
Project description:ObjectiveQualitative fit testing is a popular method of ensuring the fit of sealing face masks such as N95 and FFP3 masks. Increased demand due to the coronavirus disease 2019 (COVID-19) pandemic has led to shortages in testing equipment and has forced many institutions to abandon fit testing. Three key materials are required for qualitative fit testing: the test solution, nebulizer, and testing hood. Accessible alternatives to the testing solution have been studied. This exploratory qualitative study evaluates alternatives to the nebulizer and hoods for performing qualitative fit testing.MethodsFour devices were trialed to replace the test kit nebulizer. Two enclosures were tested for their ability to replace the test hood. Three researchers evaluated promising replacements under multiple mask fit conditions to assess functionality and accuracy.ResultsThe aroma diffuser and smaller enclosures allowed participants to perform qualitative fit tests quickly and with high accuracy.ConclusionsAroma diffusers show significant promise in their ability to allow individuals to quickly, easily, and inexpensively perform qualitative fit testing. Our findings indicate that aroma diffusers and homemade testing hoods may allow for qualitative fit testing when conventional apparatus is unavailable. Additional research is needed to evaluate the safety and reliability of these devices.
| S-EPMC7642972 | biostudies-literature