Prolonged Use of Surgical Masks and Respirators Affects the Protection and Comfort for Healthcare Workers

Water-blocking Asphyxia of N95 Medical Respirator During Hot Environment Work Tasks With Whole-body Enclosed Anti-bioaerosol Suit

Background

During hot environment work tasks with whole-body enclosed anti-bioaerosol suit, the combined effect of heavy sweating and exhaled hot humid air may cause the N95 medical respirator to saturate with water/sweat (i.e., water-blocking).

Methods

32 young male subjects with different body mass indexes (BMI) in whole-body protection (N95 medical respirator + one-piece protective suit + head covering + protective face screen + gloves + shoe covers) were asked to simulate waste collecting from each isolated room in a seven-story building at 27-28°C, and the weight, inhalation resistance (Rf), and aerosol penetration of the respirator before worn and after water-blocking were analyzed.

Results

All subjects reported water-blocking asphyxia of the N95 respirators within 36-67 min of the task. When water-blocking occurred, the Rf and 10-200 nm total aerosol penetration (Pt) of the respirators reached up to 1270-1810 Pa and 17.3-23.3%, respectively, which were 10 and 8 times of that before wearing. The most penetration particle size of the respirators increased from 49-65 nm before worn to 115-154 nm under water-blocking condition, and the corresponding maximum size-dependent aerosol penetration increased from 2.5-3.5% to 20-27%. With the increase of BMI, the water-blocking occurrence time firstly increased then reduced, while the Rf, Pt, and absorbed water all increased significantly.

Conclusions

This study reveals respirator water-blocking and its serious negative impacts on respiratory protection. When performing moderate-to-high-load tasks with whole-body protection in a hot environment, it is recommended that respirator be replaced with a new one at least every hour to avoid water-blocking asphyxia.

Upscaling of Electrospinning Technology and the Application of Functionalized PVDF-HFP@TiO2 Electrospun Nanofibers for the Rapid Photocatalytic Deactivation of Bacteria on Advanced Face Masks

In recent years, Electrospinning (ES) has been revealed to be a straightforward and innovative approach to manufacture functionalized nanofiber-based membranes with high filtering performance against fine Particulate Matter (PM) and proper bioactive properties. These qualities are useful for tackling current issues from bacterial contamination on Personal Protective Equipment (PPE) surfaces to the reusability of both disposable single-use face masks and respirator filters. Despite the fact that the conventional ES process can be upscaled to promote a high-rate nanofiber production, the number of research works on the design of hybrid materials embedded in electrospun membranes for face mask application is still low and has mainly been carried out at the laboratory scale. In this work, a multi-needle ES was employed in a continuous processing for the manufacturing of both pristine Poly (Vinylidene Fluoride-co-Hexafluoropropylene) (PVDF-HFP) nanofibers and functionalized membrane ones embedded with TiO2 Nanoparticles (NPs) (PVDF-HFP@TiO2). The nanofibers were collected on Polyethylene Terephthalate (PET) nonwoven spunbond fabric and characterized by using Scanning Electron Microscopy and Energy Dispersive X-ray (SEM-EDX), Raman spectroscopy, and Atomic Force Microscopy (AFM) analysis. The photocatalytic study performed on the electrospun membranes proved that the PVDF-HFP@TiO2 nanofibers provide a significant antibacterial activity for both Staphylococcus aureus (~94%) and Pseudomonas aeruginosa (~85%), after only 5 min of exposure to a UV-A light source. In addition, the PVDF-HFP@TiO2 nanofibers exhibit high filtration efficiency against submicron particles (~99%) and a low pressure drop (~3 mbar), in accordance with the standard required for Filtering Face Piece masks (FFPs). Therefore, these results aim to provide a real perspective on producing electrospun polymer-based nanotextiles with self-sterilizing properties for the implementation of advanced face masks on a large scale.

Bacterial contamination of medical face mask wearing duration and the optimal wearing time

Introduction

Bacterial contamination is a critical parameter for how long a medical mask will be worn.

Methods

In this study, we used the pour plate method to observe the total bacteria counts in used medical face masks. The bacterial community analysis was detected using bio-Mass spectrometry technology and 16SrRNA gene sequencing technology. The wearing time of the mask from 0.5 hours to 5 hours were studied.

Results

These results shown that the total number of bacteria on the inside surface of the mask were higher than the outside. The total number of bacteria on the inner surface of masks worn for 0.5 h, 1 h 2 h, 4 h and 5 h was 69 CFU/m2,91.3 CFU/m2, 159.6 CFU/m2, 219 CFU/m2, and 879 CFU/m2, respectively. The total number of bacteria on the outside surface of masks worn for 0.5 h, 1 h 2 h, 4 h and 5 h was 60 CFU/m2, 82.7 CFU/m2, 119.8 CFU/m2, 200 CFU/m2, and 498 CFU/m2, respectively. The bacterial abundance obtained from bio-Mass spectrometry were consistent with the results of 16SrRNA sequencing. Both the methods discovered the maximum number of Neisseria followed by Corynebacterium species in mask worn 5 hours. The top 100 bacteria isolated from inside and outside surface of mask belong to 11 phyla.

Conclusions

We analyzed bacterial penetration efficiency of the bacteria that were detected both on the inside and outside surface of the masks. In the top 10 bacteria, no bacteria were detected both inside and outside the mask worn for four hours, while 6 bacteria species were detected on the inside and outside of the mask after wearing for five hours. Bacterial penetration rates ranged from 0.74% to 99.66% for masks worn continuously for five hours, and the penetration rate of four strains exceeded 10% in the top 10 colonies. We recommend timely replacement of masks worn for more than four hours.

Electrospun nanofibers for medical face mask with protection capabilities against viruses: State of the art and perspective for industrial scale-up

Face masks have proven to be a useful protection from airborne viruses and bacteria, especially in the recent years pandemic outbreak when they effectively lowered the risk of infection from Coronavirus disease (COVID-19) or Omicron variants, being recognized as one of the main protective measures adopted by the World Health Organization (WHO). The need for improving the filtering efficiency performance to prevent penetration of fine particulate matter (PM), which can be potential bacteria or virus carriers, has led the research into developing new methods and techniques for face mask fabrication. In this perspective, Electrospinning has shown to be the most efficient technique to get either synthetic or natural polymers-based fibers with size down to the nanoscale providing remarkable performance in terms of both particle filtration and breathability. The aim of this Review is to give further insight into the implementation of electrospun nanofibers for the realization of the next generation of face masks, with functionalized membranes via addiction of active material to the polymer solutions that can give optimal features about antibacterial, antiviral, self-sterilization, and electrical energy storage capabilities. Furthermore, the recent advances regarding the use of renewable materials and green solvent strategies to improve the sustainability of electrospun membranes and to fabricate eco-friendly filters are here discussed, especially in view of the large-scale nanofiber production where traditional membrane manufacturing may result in a high environmental and health risk.

A Review of Filtration Performance of Protective Masks

Masks are essential and effective small protective devices used to protect the general public against infections such as COVID-19. However, available systematic reviews and summaries on the filtration performance of masks are lacking. Therefore, in order to investigate the filtration performance of masks, filtration mechanisms, mask characteristics, and the relationships between influencing factors and protective performance were first analyzed through mask evaluations. The summary of filtration mechanisms and mask characteristics provides readers with a clear and easy-to-understand theoretical cognition. Then, a detailed analysis of influencing factors and the relationships between the influencing factors and filtration performance is presented in. The influence of the aerosol size and type on filtration performance is nonlinear and nonconstant, and filtration efficiency decreases with an increase in the gas flow rate; moreover, fitness plays a decisive role in the protective effects of masks. It is recommended that the public should wear surgical masks to prevent COVID-19 infection in low-risk and non-densely populated areas. Future research should focus on fitness tests, and the formulation of standards should also be accelerated. This paper provides a systematic review that will be helpful for the design of masks and public health in the future.