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Harber P, Beckett WS. Health effects of filtering facepiece respirators: Research and clinical implications of comfort, thermal, skin, psychologic, and workplace effects. Am J Ind Med 2023; 66:1017-1032. [PMID: 37702368 DOI: 10.1002/ajim.23535] [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: 06/08/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023]
Abstract
Filtering facepiece respirators (FFR's) such as N95s have become widely used in appropriate settings for personal respiratory protection and are increasingly used beyond workplace settings. Concerns about possible adverse effects have appeared in many publications, particularly since the COVID-19 pandemic led to much more widespread use. This paper synthesizes known effects based upon review of publications in PubMed since 1995, addressing effects other than pulmonary and cardiovascular (reviewed elsewhere). Findings: (1) Subjective discomfort is very frequently reported; this includes general discomfort or organ-system-specific complaints such as respiratory, headache, dermatologic, and heat. Research methods are widely divergent, and we propose a taxonomy to classify such studies by methodology, study population (subjects, experimental vs. observational methodology, comparator, specificity, and timeframe) to facilitate synthesis. (2) Objective measures of increased heat and humidity within the mask are well documented. (3) Frequency and characteristics of dermatologic effects have been insufficiently evaluated. (4) Physical mask designs are varied, making generalizations challenging. (5) More studies of impact on work performance and communication are needed. (6) Studies of effect of FFR design and accompanying training materials on ease and consistency of use are needed.
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Affiliation(s)
- Philip Harber
- Environmental Health Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - William S Beckett
- Mount Auburn Hospital (Emeritus Status), Cambridge, Massachusetts, USA
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2
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Castro PASVD, Freire BR, Petroianu A. Effects of face mask on pulse rate and blood oxygenation. EINSTEIN-SAO PAULO 2023; 21:eAO0349. [PMID: 37970950 DOI: 10.31744/einstein_journal/2023ao0349] [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: 10/09/2022] [Accepted: 12/01/2022] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE The World Health Organization and Centers for Disease Control and Prevention recommend the use of face masks in public. This study aimed to evaluate the effects of face masks on pulse rate and partial blood oxygen saturation in patients without cardiorespiratory disorders. METHODS A total of 150 volunteers of both sexes were divided into three groups (n=50) according to age (children, young adults, and older adults). The partial blood oxygen saturation and pulse rate were measured for each volunteer using a digital oximeter while wearing a facial mask and remaining at rest. The masks were removed for two minutes, and partial blood oxygen saturation and pulse rate were remeasured. The materials and types of masks used were recorded. The t -test for paired samples was used to compare the mean values obtained before and after removing the masks. RESULTS The most frequently used mask was a two-layered cloth (64.7%). A decrease in pulse rate was observed after removing the face mask in males, particularly in children (p=0.006) and young adults (p=0.034). Partial blood oxygen saturation levels increased in young adult males after mask removal (p=0.01). CONCLUSION The two-layer cotton tissue face masks are associated with a higher pulse rate and reduced arterial blood oxygen saturation without associated clinical disorders, mainly in adult men with a lower tolerance to breathing and ear discomfort.
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Affiliation(s)
| | - Bruno Rodarte Freire
- Faculdade de Medicina , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil
| | - Andy Petroianu
- Faculdade de Medicina , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil
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3
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Deng S, Han A, Jin S, Wang S, Zheng J, Jalaludin BB, Hajat S, Liang W, Huang C. Effect of extreme temperatures on asthma hospital visits: Modification by event characteristics and healthy behaviors. ENVIRONMENTAL RESEARCH 2023; 226:115679. [PMID: 36913996 DOI: 10.1016/j.envres.2023.115679] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/16/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Although ambient temperature has been linked to asthma exacerbation, impacts associated with extreme temperature events remain unclear. This study aims to identify the events characteristics that elevate risk of asthma hospital visits, and to assess whether healthy behavior changes due to the COVID-19 prevention and control policy may modify the relationships. Data of asthma hospital visits from all medical facilities in Shenzhen, China during 2016-2020 were assessed in relation to extreme temperature events using a distributed lag model. Stratified analysis was conducted by gender, age and hospital department to identify susceptible populations. Through events defined by various duration days and temperature thresholds, we explored the modification by events intensity, length, occurrence time and healthy behaviors. The cumulative relative risk of asthma during heat waves compared to other days was 1.06 (95%CI: 1.00-1.13) and for cold spells was 1.17 (95%CI: 1.05-1.30), and that of males and school-aged children were generally higher than other sub-groups. There were significant effects of heat waves and cold spells on asthma hospital visits when the mean temperature was above 90th percentile (30 °C) and below 10th percentile (14 °C) respectively, and the relative risks were higher when events lasted longer, became stronger, occurred in daytime and in early summer or winter. During the healthy behaviors maintaining period, the risk of heat waves increased whilst the risk of cold spells reduced. Extreme temperatures may pose considerable impact on asthma and the health effect can be modified by the event characteristics and anti-epidemic healthy behaviors. Strategies of asthma control should consider the heightened threats of the intense and frequent extreme temperature events in the context of climate change.
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Affiliation(s)
- Shizhou Deng
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Shanghai Typhoon Institute, China Meteorological Administration & Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Azhu Han
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shuyan Jin
- Department of Prevention and Health Care, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shuang Wang
- Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Jing Zheng
- Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Bin B Jalaludin
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China.
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China.
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4
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Medical Guidance for Respiratory Protection: Who Should Wear What, Where, and When? Ann Am Thorac Soc 2023; 20:196-199. [PMID: 36315426 DOI: 10.1513/annalsats.202207-599vp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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5
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Pantazopoulos I, Kotsiou OS. Cutting-Edge Approaches in Respiratory and Critical Care Medicine. J Pers Med 2023; 13:jpm13010105. [PMID: 36675766 PMCID: PMC9867085 DOI: 10.3390/jpm13010105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 01/04/2023] Open
Abstract
The COVID-19 pandemic has affected health care across the world, with respiratory and critical care medicine being affected the most [...].
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Affiliation(s)
- Ioannis Pantazopoulos
- Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
- Correspondence: ; Tel.: +30-6945661525
| | - Ourania S. Kotsiou
- Department of Human Pathophysiology, Faculty of Nursing, University of Thessaly, 41110 Larissa, Greece
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6
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The impact of the COVID-19 pandemic on the development of anxiety disorders - a literature review. CURRENT PROBLEMS OF PSYCHIATRY 2022. [DOI: 10.2478/cpp-2021-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: The COVID-19 is a disease caused by the SARS-CoV-2 virus. A number of psychological symptoms have been identified in people living during the COVID-19 pandemic. Most of them are associated with widely understood anxiety disorders, which have always been a significant problem for mental health.
Materials and methods: The available literature was reviewed on the Pubmed platform and from other sources. The analysis included original studies, reviews, meta-analyzes and internet sources. The aim of the study was to review the literature on the relationship between the COVID-19 pandemic and the occurrence and severity of symptoms of anxiety disorders.
Results: The studies conducted so far show that the COVID-19 pandemic has had a significant impact on the mental state of people around the world, especially in the area of anxiety disorders. Many studies indicate an increase in the prevalence of symptoms of generalized anxiety disorder. Research also indicates a greater incidence of post-traumatic stress disorder and panic disorder in society. Symptoms of somatization were also quite often observed in patients. However, the state of published studies indicates that the pandemic did not significantly affect the severity of symptoms associated with social phobia. In the context of phobic disorders, a new type has been formulated: COVID-19-related phobia.
Conclusions: The conducted literature review shows that the current COVID-19 pandemic is associated with an increase in the prevalence of symptoms of anxiety disorders in the general population. The multifaceted nature of the issue of anxiety disorders in the COVID-19 pandemic clearly indicates the need to continue research in this area.
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7
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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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8
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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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9
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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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10
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Monjezi M, Jamaati H. The effects of face mask specifications on work of breathing and particle filtration efficiency. Med Eng Phys 2021; 98:36-43. [PMID: 34848036 PMCID: PMC8493656 DOI: 10.1016/j.medengphy.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
The outbreak of the ongoing coronavirus disease 2019 (COVID-19) pandemic has led to the recommended routine use of face masks to reduce exposure risk. In this study, the increase in work of breathing (WOB) imposed by face masks is theoretically studied for both normals and patients with obstructive and restrictive lung diseases at different levels of activity. The results show a significant increase in WOB due to face masks, which is more severe in higher activity levels. The added WOB is considerable during physical activity and may be intolerable for patients with preexisting lung disease and may contribute to inspiratory muscle fatigue and dyspnea. Moreover, in this study, the effects of the physical properties of a fibrous medium, including thickness, porosity, and fiber diameter, are analyzed on the particle filtration efficiency (PFE) and the added WOB. The relations between the physical properties of the fibrous medium and the added WOB and the PFE are shown on some contour plots as a quick and simple tool to select the desired physical properties for a single layer filter to ensure that the added WOB is comfortable while the PFE is sufficiently high.
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Affiliation(s)
- Mojdeh Monjezi
- Chronic Respiratory Diseases Research Center (CRDRC), Critical Care Department Shaheed Bahonar Ave., National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Darabad, Tehran 1955841452, Iran
| | - Hamidreza Jamaati
- Chronic Respiratory Diseases Research Center (CRDRC), Critical Care Department Shaheed Bahonar Ave., National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Darabad, Tehran 1955841452, Iran.
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Lansiaux E, Tchagaspanian N, Arnaud J, Durand P, Changizi M, Forget J. Side-Effects of Public Health Policies Against Covid-19: The Story of an Over-Reaction. Front Public Health 2021; 9:696818. [PMID: 34589461 PMCID: PMC8473612 DOI: 10.3389/fpubh.2021.696818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 05/24/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | - Juliette Arnaud
- Global Variations, Genève, Switzerland.,Ecole Normale Supérieure, Paris, France
| | | | | | - Joachim Forget
- Global Variations, Genève, Switzerland.,Assemblée Nationale, Paris, France
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12
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Monini S, Meliante PG, Salerno G, Filippi C, Margani V, Covelli E, Barbara M. The impact of surgical masks on the nasal function in the COVID-19 era. Acta Otolaryngol 2021; 141:941-947. [PMID: 34520301 DOI: 10.1080/00016489.2021.1974555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The Covid-19 pandemics has obliged to using different types of personal protective devices (PPD) for a prolonged time of the day, especially in the Health Centers, with preference of surgical masks (SM) during the first pandemic waves. AIMS/OBJECTIVES This study was designed to assess the eventual changes of the nasal respiratory condition during continuous SM wearing. MATERIAL AND METHODS Fourteen healthcare professionals filled a visual analogue scale (VAS) questionnaire for the detection of eventual nasal breathing impairment or symptoms. Nasal resistance and flow values were obtained via the active anterior rhinomanometry (AAR) that was performed under the basal condition, as well as immediately after wearing the surgical mask (SM) and 3 h after its continuous use. RESULTS The increase of inspiratory resistance was significantly correlated to the reduction of the maximum flux, when comparing SM parameters to the basal ones (r = -0.70, p < .05). At VAS evaluation, SM wearing showed to induce itching in 70% of the subjects, nasal dryness in 55%, nasal blockage in 50%, headache in 39%, watery nasal discharge in 20% and sneezing in 18%. CONCLUSIONS AND SIGNIFICANCE The SMs do not induce evident physiological variations of the nasal function due to a compensatory respiratory mechanism that, despite a progressive increase of nasal resistances, is not inducing significant changes of the nasal fluxes.
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Affiliation(s)
- Simonetta Monini
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | | | - Gerardo Salerno
- Laboratory Unit University Hospital, Sant’Andrea, Rome, Italy
| | - Chiara Filippi
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Valerio Margani
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Edoardo Covelli
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Maurizio Barbara
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
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13
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Johansson B. Challenges and Controversies in COVID-19: Masking the General Population may Attenuate This Pandemic's Outbreak. Front Public Health 2021; 9:643991. [PMID: 34568248 PMCID: PMC8455895 DOI: 10.3389/fpubh.2021.643991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
SARS-CoV-2, the virus that causes COVID-19, spreads i. a., by respiratory droplets. The use of masks in preventing spread is controversial; masks are considered useless by many, while being mandated in some locations. Here, the effect of masking the general population on a COVID-19-like epidemic is estimated by computer simulation using three separate types of software. The main questions are whether mask use by the general population can limit the spread of SARS-CoV-2 in a country and how to identify opportunities when mask use is cost-effective and safe. To address these questions, the protective effects of different types of masks, the side-effects of masks, and avenues for improvements of masks and masking are addressed. Main results: (i) Any type of mask, even simple home-made ones, may be of value, even if the protective effect of each mask (here dubbed "one mask-protection") is low. Strict adherence to mask use does not appear to be critical but increasing one mask-protection to >50% was found to be advantageous. (ii) Masks do seem to reduce the number of new cases even if introduced at a late stage in an epidemic, but early implementation helps reduce the cumulative and total number of cases. (iii) The simulations suggest that it might be possible to eliminate a COVID-19 outbreak by widespread mask use during a limited period. There is a brief discussion of why the reported effect size of masking varies widely, and is expected to do so, because of different filtration abilities of different masks, differences in compliance and fitting, other routes of transmission, pre-existing immunity, and because a system of interconnected, disease-prone individuals has non-linear properties. A software solution to visualize infection spread is presented. The results from these simulations are encouraging, but do not necessarily represent the real-life situation, so it is suggested that clinical trials of masks are now carried out while continuously monitoring effects and side-effects. As mask use is not without risks and costs, it is suggested that governments and scientists have an important role in advising the public about the sensible use of masks.
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Affiliation(s)
- Björn Johansson
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Fietsam AC, Deters JR, Workman CD, Rudroff T. Personal Protective Equipment Alters Leg Muscle Fatigability Independent of Transcranial Direct Current Stimulation: A Comparison with Pre-COVID-19 Pandemic Results. Brain Sci 2021; 11:brainsci11080962. [PMID: 34439581 PMCID: PMC8392507 DOI: 10.3390/brainsci11080962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/02/2021] [Accepted: 07/19/2021] [Indexed: 01/12/2023] Open
Abstract
In response to the COVID-19 pandemic, the use of personal protective equipment (PPE; e.g., face mask) has increased. Mandating subjects to wear PPE during vigorous exercise might affect the fatigue outcomes of transcranial direct current stimulation (tDCS) studies. The purpose of this study was to investigate whether the use of PPE affected the performance of a tDCS-influenced fatigue task in healthy adults. A total of 16 young and healthy subjects were recruited and wore PPE during an isokinetic fatigue task in conjunction with sham, 2 mA, and 4 mA tDCS conditions. Subjects were matched to subjects who did not wear PPE during our previous pre-pandemic study in which right knee extensor fatigability increased under these same conditions. The results show that right knee extensor fatigability, derived from torque and work (FI-T and FI-W, respectively), was higher in the PPE study compared to the No PPE study in the sham condition. Additionally, there were no differences in knee extensor fatigability or muscle activity between sham, 2 mA, and 4 mA tDCS in the present study, which contrasts with our previous results. Thus, PPE worn by subjects and researchers might have a detrimental effect on fatigue outcomes in tDCS studies irrespective of the stimulation intervention.
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Affiliation(s)
- Alexandra C. Fietsam
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA; (A.C.F.); (J.R.D.); (C.D.W.)
| | - Justin R. Deters
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA; (A.C.F.); (J.R.D.); (C.D.W.)
| | - Craig D. Workman
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA; (A.C.F.); (J.R.D.); (C.D.W.)
| | - Thorsten Rudroff
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA; (A.C.F.); (J.R.D.); (C.D.W.)
- Department of Neurology, University of Iowa Health Clinics, Iowa City, IA 52242, USA
- Correspondence: ; Tel.: +1-319-467-0363
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Sanyal A, Sinha-Ray S. Ultrafine PVDF Nanofibers for Filtration of Air-Borne Particulate Matters: A Comprehensive Review. Polymers (Basel) 2021; 13:1864. [PMID: 34205188 PMCID: PMC8199986 DOI: 10.3390/polym13111864] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/14/2022] Open
Abstract
The ongoing global pandemic has bestowed high priority uponthe separation of air-borne particulate matters (PMs), aerosols, etc. using nonwoven fibrous materials, especially for face masks as a means of personal protection. Although spunbond or meltblown nonwoven materials are amongst the forerunners for polymer microfiber-based face mask or air filter development in mass scale, relatively new process of nonwoven manufacturing such as electrospinning is gaining a lot of momentum amongst the filter membrane manufacturers for its scalability of nanofiber-based filter membrane fabrication. There are several nanofiber-based face masks developing industries, which claim a very high efficiency in filtration of particulate matters (PM0.1-10) as well as other aerosols for their products. Polyvinylidene fluoride (PVDF), which is commonly known for its use of tactile sensors and energy harvesters, due to its piezoelectric property, is slowly gaining popularity among researchers and developers as an air filter material. Electrospun PVDF nanofibers can be as fine as 50 nm in mass scale, which allows the membrane to have large surface area compared to its volume, enhancing nanofiber-PM interaction. At the same time, the breathability index can be improved through these PVDF nanofiber membranes due to their architectural uniqueness that promotes slip flow around the fibers. The conductive nature of PVDF makes it advantageous as a promising electret filter allowing better capturing of ultrafine particles. This review aims to provide a comprehensive overview of such PVDF nanofiber-based filter membranes and their roles in air filtration, especially its application in filtrate of air-borne PMs.
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Affiliation(s)
- Ayishe Sanyal
- School of Engineering, Indian Institute of Technology Mandi, Mandi 175005, HP, India;
| | - Sumit Sinha-Ray
- School of Engineering, Indian Institute of Technology Mandi, Mandi 175005, HP, India;
- Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, IL 60607-7022, USA
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Sheek-Hussein M, Abu-Zidan FM, Stip E. Disaster management of the psychological impact of the COVID-19 pandemic. Int J Emerg Med 2021; 14:19. [PMID: 33761863 PMCID: PMC7988636 DOI: 10.1186/s12245-021-00342-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/12/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has exposed a suboptimal response to this threatening global disaster, including the response to the psychological impact. Both the economic hardship and the continuous media coverage of alarming news have exacerbated this effect which also includes increased domestic violence. AIM To address this important aspect of disaster management and provide recommendations on how to mitigate these effects. METHODS This is a narrative review written by three experts in community medicine, disaster medicine and psychiatry reflecting the interdisciplinary approach in managing disasters. Selected important papers, personal published papers, PUBMED articles and media news related to the disaster management of the psychological effects of COVID-19 pandemic were collected over the last year, critically appraised and used in writing this manuscript. RESULTS The COVID-19 pandemic causes major emotional distress. Lack of effective treatments and availability of the current vaccines for this virus increases the fear of being infected and infecting others. Negative emotions are common and are related to adjustment but may progress in the long term to anxiety, depression, and post-traumatic stress syndrome. The COVID-19 pandemic has a major impact on mental health. The most common distress reactions include anxiety, insomnia, perception of insecurity, anger, fear of illness, and risky behaviors. Patients having mental disorders are vulnerable during the pandemic because of (1) somatic vulnerability, (2) cognitive and behavioral vulnerability, (3) psychosocial vulnerability, and (4) disruption to psychiatric care. Psychiatric wards, which are commonly separate from main hospitals, should be included in the disaster management plans. Acute care physicians carry the psychological and ethical impact of difficult triage decisions when ending the support of some patients to save others. A combination of fear and guilt may overcome normal human tolerance levels in vulnerable health workers. The moral injuries can be carried for a long time. CONCLUSIONS Addressing the psychological effects is an essential component of disaster management of infectious pandemics. This should be implemented through the whole spectrum of disaster management including preparedness, mitigation, response, and recovery.
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Affiliation(s)
- Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Emmanuel Stip
- Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
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Merlo EM, Sicari F, Frisone F, Costa G, Alibrandi A, Avena G, Settineri S. Uncertainty, alexithymia, suppression and vulnerability during the COVID-19 pandemic in Italy. HEALTH PSYCHOLOGY REPORT 2021; 9:169-179. [PMID: 38084287 PMCID: PMC10501415 DOI: 10.5114/hpr.2021.104078] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/19/2020] [Accepted: 01/15/2021] [Indexed: 01/20/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has expanded to reach many countries, involving healthcare systems facing high numbers of infected patients. The repercussions concern every segment of the population; therefore it is necessary to understand the extent of psychopathological variations. PARTICIPANTS AND PROCEDURE 355 subjects aged from 18 to 78 years old (M = 36.51, SD = 13.08) with a prevalence of female subjects (70.3%) were involved in completing the protocol during the early 10 days of lockdown. The module provided for the collection of personal information, such as age, gender, and years of study. The variables considered concerned the administration of the IUS-12, the TAS-20, the PVDQ-15 and the SMQ. Descriptive statistics, correlational and linear regressions analyses were performed in order to highlight significant relationships and dependences among the variables. RESULTS Several relationships emerged with reference to the included variables. In particular, uncertainty and alexithymia proved to be indices with an important predictive role in developing psychopathology. The suppression of disturbing and unknown contents represented a defense for overcoming representations, whose impact proved to be negative in terms of adaptation. The results clarified the general tendencies of the population to cope with anguish due to the lack of knowledge in the first 10 days of lockdown. CONCLUSIONS The impact of the COVID-19 pandemic on the population is evident. The decision to analyze uncertainty, alexithymia and contamination as relevant issues brought the need to analyze a dynamic of conscious suppression of disturbing contents. The results may represent key points to establish interventions.
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Corridon PR. Admissions to Medical School during the COVID-19 Era without the MCAT. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211014898. [PMID: 33997289 PMCID: PMC8107258 DOI: 10.1177/23821205211014898] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/03/2021] [Indexed: 05/04/2023]
Abstract
As medical schools cope with the consequences of the COVID-19 pandemic, a new cohort of students will be admitted in the fall. Administrators are again challenged to make unprecedented enrollment decisions without standardized exams. This challenge provides unique opportunities to re-evaluate admission processes that has been employed since 1928 and support holistic admissions. This article highlights key factors that are being considered during current medical school admission cycles, including limited opportunities to take standardized exams, heightened student anxiety, and potential exam alternatives. These factors are framed and discussed within the context of the medical college admission test (MCAT) exam.
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Affiliation(s)
- Peter R. Corridon
- College of Arts and Sciences, Khalifa
University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Immunology and Physiology,
College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu
Dhabi, United Arab Emirates
- Peter R. Corridon, Department of Immunology and
Physiology, College of Medicine and Health Sciences, Khalifa University of Science and
Technology, PO Box 127788, Abu Dhabi, United Arab Emirates.
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