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Medical/Surgical, Cloth and FFP/(K)N95 Masks: Unmasking Preference, SARS-CoV-2 Transmissibility and Respiratory Side Effects

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  • Medical/Surgical, Cloth and FFP/(K)N95 Masks: Unmasking Preference, SARS-CoV-2 Transmissibility and Respiratory Side Effects


    https://www.mdpi.com/2075-4426/12/3/325/htm
    Mouliou DS, Pantazopoulos I, Gourgoulianis KI. Medical/Surgical, Cloth and FFP/(K)N95 Masks: Unmasking Preference, SARS-CoV-2 Transmissibility and Respiratory Side Effects. Journal of Personalized Medicine. 2022; 12(3):325. https://doi.org/10.3390/jpm12030325

    Abstract

    Background: Social distancing and mask-wearing were recommended and mandatory for people during the COVID-19 pandemic. Methods: A web-based questionnaire was disseminated through social media assessing mask type preference and COVID-19 history amongst tertiary sector services and the rates of the triad of respiratory symptoms in each mask type, along with other respiratory-related parameters. Results: Amongst 4107 participants, 63.4% of the responders, mainly women, preferred medical/surgical masks; 20.5%, mainly men, preferred cotton cloth masks; and 13.8% preferred FFP/(K)N95 masks. COVID-19 history was less common in FFP/(K)N95 compared to medical/surgical (9.2% vs. 15.6%, p < 0.001) or cloth masks (9.2% vs. 14.4%, p = 0.006). Compared to the control group (rare mask-wearing, nonsmokers and without lung conditions), those wearing one medical mask were more likely to report frequent sputum production (4.4% vs. 1.9%, p = 0.026) and frequent cough (4.4% vs. 1.6%, p = 0.013), and those wearing FFP/(K)N95 masks were more likely to report frequent cough (4.1% vs. 1.6%, p = 0.048). Compared to the control group, those preferring cotton cloth masks were more likely to report a frequent cough (7.3% vs. 1.6%, p = 0.0002), sputum production (6.3% vs. 1.9%, p = 0.003) and dyspnea (8% vs. 1.3%, p = 0.00001). Conclusions: Safe mask-wearing should be in parallel with a more personalized and social interaction approach. View Full-Text
    Keywords: SARS-CoV-2; transmission; masks; medical masks; FFP masks; N95 masks; cloth masks; respiratory side effects; cough; dyspnea; sputum
    This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    ...
    Cotton cloth mask-wearing showed the highest rates in the triad of respiratory symptoms in our population-based sample. However, no further nonrespiratory symptoms were evaluated in this study, and another study revealed adverse skin reactions due to medical masks compared to cloth masks [21]. More targeted studies, in the future, should analyze the possibility of the prolonged wearing of cotton cloth masks leading to early byssinosis signs, since it is an evident lung condition among cotton workers due to fiber inhalation [22]. Nevertheless, cotton cloth masks not only were not such effective in preventing SARS-CoV-2 transmission, but also had the highest levels of respiratory side effects; additionally, daily FFP/(K)N95 mask-wearing responders were less likely to have COVID-19 history and also had lower levels of respiratory side effects. Frequent dyspnea and sputum production were not significantly seen in FFP/(K)N95 mask-wearing, and cough rates (only women reported cough) were not much different from those seen in medical/surgical mask-wearing, yet significantly different compared to the control group. Even if cough was the only respiratory symptom seen in this mask type, a study studying healthcare professionals showed that prolonged use of medical and N95 masks had caused headaches, rash, acne, skin breakdown and impaired cognition in most of those surveyed [23]. The authors suggest frequent breaks, improved hydration and rest and skin care for healthcare professionals with prolonged mask-wearing [23]. We also highlight the need for FFP/(K)N95 masks to be thoroughly studied for other potential adverse effects since, in this study, we have assessed only some basic respiratory issues.
    ...

    5. Conclusions


    FFP/(K)N95 mask-wearing responders were less likely to have a COVID-19 history and were less likely to report respiratory symptoms, compared to the other mask types. Cotton cloth masks not only did not prevent SARS-CoV-2 transmission but also were more likely to cause frequent cough, dyspnea and sputum production. Public health strategies may have overreacted during the pandemic; mask-wearing but with safe mask-types should follow a more personalized and social interaction approach, and safe mask-wearing should also be recommended in future epidemics or environmental issues.
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    Ask Congress to Investigate COVID Origins and Government Response to Pandemic H.R. 834

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