Chau, Destiny F.;O'Shaughnessy, Patrick;Schmitz, Michael L.
Journal of Preventive Medicine and Public Health
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제54권1호
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pp.31-36
/
2021
Objectives: Non-traditional materials are used for mask construction to address personal protective equipment shortages during the coronavirus disease 2019 (COVID-19) pandemic. Reusable masks made from surgical sterilization wrap represent such an innovative approach with social media frequently referring to them as "N95 alternatives." This material was tested for particle filtration efficiency and breathability to clarify what role they might have in infection prevention and control. Methods: A heavyweight, double layer sterilization wrap was tested when new and after 2, 4, 6, and 10 autoclave sterilizing cycles and compared with an approved N95 respirator and a surgical mask via testing procedures using a sodium chloride aerosol for N95 efficiency testing similar to 42 CFR 84.181. Pressure testing to indicate breathability was also conducted. Results: The particle filtration efficiency for the sterilization wrap ranged between 58% to 66%, with similar performance when new and after sterilizing cycles. The N95 respirator and surgical mask performed at 95% and 68% respectively. Pressure drops for the sterilization wrap, N95 and surgical mask were 10.4 mmH2O, 5.9 mmH2O, and 5.1 mmH2O, respectively, well below the National Institute for Occupational Safety and Health limits of 35 mmH2O during initial inhalation and 25 mmH2O during initial exhalation. Conclusions: The sterilization wrap's particle filtration efficiency is much lower than a N95 respirator, but falls within the range of a surgical mask, with acceptable breathability. Performance testing of non-traditional mask materials is crucial to determine potential protection efficacy and for correcting misinterpretation propagated through popular media.
Objectives: Mask fit is a crucial factor in preventing respiratory infections among healthcare workers. The current coronavirus(COVID-19) pandemic calls for the replacement of imported N95 medical masks with domestic N95 versions. In this study, we aimed to determine whether these masks provide proper protection. Methods: Thirty-five participants from three healthcare institutions donned four types of masks and Quantitative Fit Tests(Portacount, USA) were performed. The order of fit test for the four types of masks was randomized, and a three-minute washout period was applied between test times(2 min 29 sec) to reduce potential error stemming from physical exhaustion. Results: There were no significant differences in the Fit Factor for the four types of masks, and there were no gender differences. However, the Fit Factor significantly differed across the three healthcare institutions (p=0.007). With eight of the 35 participants passing, the pass rate with the criteria of 100 or higher was 21%. Conclusions: The mask used in this study was a new domestic N95 medical mask, and the participants were unfamiliar with how to wear it. They reported difficulties with mask fitting. In light of a previous finding that mask fit improved with frequently used masks, wearer preferred masks, or when masks that are regularly worn are used during fit training, the fact that participants were unfamiliar with the mask used in this study is a limitation that should not be overlooked.
Objectives: A number of medical institutions have been conducting fit tests to perform seal checks on masks. This study aimed to compare the differences fit factor before and after domestic N95 mask-wearing training through a fit-test. Methods: A survey of 59 healthcare workers was conducted regarding whether they had undergone a fit test or received training on mask-wearing. Further, the fit of two types of domestic N95 masks was measured before and after the training using a QNFT(Quantitative Fit test). The average fit factors before and after training were compared using a paired t-test. Additionally the differences in the fit test pass rate were analyzed using a McNemar test. Results: A statistically significant difference was seen between the fit factors in the fit tests conducted before and after the training (p=0.0015), as well as in the fit of the two types of masks tested (p<0.01). Thus, an improvement in mask fitting was seen after the training, even with differently fitted masks. Conclusions: Upon using a QNFT, a significant increase in the fit factors for N95 masks was observed after training compared with masks that were fitted as usual. This highlights the importance of training in mask-wearing, with the conclusion that training healthcare providers will improve the fit of masks.
This study explores the effects of facemasks on respiratory, thermoregulatory, cardiovascular responses during exercise on a treadmill and at rest. Five male subjects (25.8 ± 0.8 y, 171.8 ± 9.2 cm in height, 79.8 ± 28.1 kg in weight) participated in the following five experimental conditions: no mask, KF80, KF94, KF99, and N95. Inhalation resistance was ranked as KF80 < KF94 < N95 < KF99 and dead space inside a mask was ranked as KF80 = KF94 < N95 < KF99. The surface area covered by a mask was on average 1.1% of the total body surface area. The results showed no significant differences in body core temperature, oxygen consumption (VO2), carbon dioxide production (VCO2), heart rate or subjective perception among the five experimental conditions; however, cheek temperature, respiratory ventilation and blood pressure were greater for KF80 or KF94 conditions when compared to KF99 or N95 conditions (p<0.05). The differences among mask conditions are attributed to the dead space or specific designs (cup type vs pleats type) rather than the filtration level. In addition, the results suggest that improving mask design can help mitigate respiratory resistance from increased filtration.
Respiratory face masks are protective facepieces that are designed to filter inhaled air. They are easy-to-use devices that can protect the wearer against various hazardous particles in the air. Respiratory face masks also prevent the spread of viruses and bacteria-containing droplets that are released from the coughing or sneezing of the infected people. During the COVID-19 pandemic, various types of face masks have circulated on the market. Their ability to filter sub-micron particles, which are the sizes of harmful particulate matter and airborne viruses, needs to be investigated. Their breathability, the easiness of breath through the mask, also needs to be considered. In this study, wwe evaluated the performance of filters used for different types of face masks certified by different standards including Korean (KF94, KF80, KF-AD), USA (N95), and Chinese (KN95) standards. We also tested the filters of nanofiber masks and surgical masks for which there are no standards for filtration test. The N95 mask filters showed the highest quality factor for capturing virus-sized particles. The other types of mask filters have acceptable performance except for nanofiber mask filters whose performance is very low.
Objectives: Wearing medical masks has been recommended since the declaration of coronavirus disease-19 (COVID-19) as a pandemic disease. Certified medical masks are evaluated according to filtration efficiency and facial inhalation resistance. However, some people use non-certified common masks. This study aimed to evaluate various non-certified commercial masks based on the certification criteria for medical masks. Methods: Twenty mask products (three anti-droplet, three disposable dental, eight fashion, three cotton, and three children's masks) were selected. For performance evaluation, filtration efficiency and facial inhalation resistance tests were conducted. The evaluation method followed the certification method for KF-certified masks of the Ministry of Food and Drug Safety (MFDS) and the N95 respirator of the National Institute for Occupational Safety and Health (NIOSH). Results: None of the 20 masks met the KF94 certification standard set by the MFDS. Four and three masks respectively met the KF80 certification standard and the N95 standard of NIOSH. Filtration efficiency was significantly higher in three-layer masks than in single layer masks. Pleated-type masks had higher filtration efficiency than cone-type masks. There was no correlation between the structure of masks and facial inhalation resistance. Conclusion: While no masks complied with the KF94 certification standard, a few masks met the KF80 and the N95 certification standards of NIOSH. Although some people wear non-certified commercial masks, protection from aerosols is not guaranteed by such masks. Evaluation of the protection efficiency of non-certified mask against microbiological infection is needed for the prevention of infectious disease.
Objectives: Microbial contamination of face masks used by healthcare professionals can vary depending on the degree of exposure to bioaerosols in various healthcare environments. However, research on this topic is limited. Therefore, we analyzed microbial contamination of N95 respirators used in hospital offices, wards, and outpatient settings. Methods: Samples isolated from N95 respirators worn for 2, 4, and 6 hours were incubated at a temperature of 35-37℃ or 25-28℃ for 24 hours or for 3-7 days, and colony-forming units were counted in chocolate agar, tryptic soy agar, and Sabouraud dextrose agar plates. Total indoor airborne bacteria were also measured in the healthcare environments. Finally, microbial species were identified using Gram staining with a microscopic speculum. Results: The three types of environments did not deviate from the maintenance of standard indoor air quality. There was no difference between the microbial species identified in the healthcare environment and mask contamination. However, the number of bacteria in the masks worn in each environment differed, and the degree of contamination increased with mask-wearing time (p<0.05). Conclusions: Therefore, care must be taken to avoid recontamination of masks due to improper use and exposure to biological hazards in healthcare environments. In conclusion, scientific evidence is necessary for safe mask-wearing times. Based on the results of this study, we hope to conduct further research to establish guidelines for the safe use of face masks during respiratory disease epidemics.
This study evaluated the consistency between two quantitative fit test devices with different methods of ambient aerosol counting. Three types of respirators (N95, half mask, and full facepiece) were worn by 50 participants (male, n = 25; female, n = 25), PortaCount (Pro+ 8038) and MT (05U) were connected to one probe to one mask, and fit factors (FFs) were measured simultaneously with the original and modified protocols. As a result of comparing MT FFs with PortaCount FFs as references and by applying for the pass/fail criteria (FF = 100), the consistency between the two devices for half masks and full facepieces was very high. N95 was somewhat weaker than the two type of respirators in the consistency; however, the correlation between the two devices was very strong (p < 0.0001). The results showed that an FF of 100 as measured by PortaCount was likely to be measured as 75 by the MT. Therefore, when performing the fit test for N95 using the MT and pass level of FF 100, a certain level of adjustment is necessary, whether end-user or putting a scaling factor by manufacturer.
This study aimed to evaluate the inhalation resistance(IR) and fiber structure of disposable masks when exposed to repeated heating and ultraviolet(UV) sterilization. The experiments consisted of a lab-scale and a field test. For the lab-scale test, KF94 and N95 masks were selected and a trial was composed of three repetitions of an 80-min sterilization. For the field test, a subject participated over four days, of which a KF94 was worn without sterilization, and the same trial was conducted during the next four days with daily sterilization. The results showed that the IR of the KF94 mask(9.5 Pa) gradually increased according to the sterilization up to the second repetition(15.6 Pa) but decreased at the third treatment(9.7 Pa). However, the N95 mask did not showany tendency of IR during the repetitions. Microscope photos showed several warped or blackened fibers in the stiffener layer after the repeated sterilization. After wearing a KF94 mask for four consecutive days, its IR decreased until the three days but increased the fourth day, whereas another KF94 mask with sterilization showed an increase in IR for the four days. In the microscope-photos after the consecutive four days, outside fibers and stiffener layers were warped or became less dense. In summary, the IR of the KF94 mask slightly increased through the three~four rounds of heating and UV sterilizations, but the fiber structures were not significantly deformed by the repeated sterilization. To reduce discarded mask waste, the repeated sterilization of masks can be recommended.
Objectives: This study compares the differences of fit factors before and after training on the N95 mask. The results will be utilized to suggest the need of providing effective training on respirator use. Methods: A total of 49 study subjects were tested, comprised of nurses from a general hospital and undergraduate nursing students from a medical school. Anthropometric measurements of face length and face width were compared with the NIOSH(National Institute for Occupational Safety and Health) panel. Fit factors(FF) were measured with TSI Portacount Pro+8038 before and after on-site training regarding the proper use of respirators. The FF pass/fail criterion was set at 100. Results: Two subjects(4.1 %) passed the fit test before training on use of the N95. However, 36(73.5%) of the 49 passed the test after training. Overall the FF(GM(GSD)) was 13.4(3.2) before training, but improved to 106.6(2.1) after training, which was statistically significant. These findings suggest the efficacy of educational intervention, and the performance of the direct on-site training proved to be better than that of the traditional educational methods. Conclusions: This study showed the effect of on-site training of the N95 respirator among health care workers(HCW). Therefore, providing effective training on the use of N95 for HCWs before their work assignments will greatly reduce exposure to harmful agents. It is recommended that fit testing be mandated to check for adequate protection being provided by the given respirators.
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