Face Mask Cons

FACE MASK. 

Breathing provides your body with the oxygen it needs to survive. It also allows you to release carbon dioxide and waste. You have two air passageways to your lungs — the nose and the mouth.

The Covid-19 pandemic has made the whole planet far more aware of their breathing. For many, this has caused a great deal of fear and anxiety. The virus itself attacks our respiratory system making it hard to breathe – and when breathing feels limited, difficult or scary, so does everything else.  Here’s how to make your face mask your breathing friend and filter. By Dr Philippa Wheble and Dr Ela Manga

How You Breathe.

The way we breathe can affect our physical, mental, and emotional well-being, and conversely these states can also change how we experience our breath. It’s well documented that chronic stress, anxiety, our posture, and movement can all impact the mechanics and chemistry of our breathing. Conscious breathing practices support us to become aware of our breathing behaviors. Then we can shift them, empowering us to shift our mental and emotional states.

Many people are expressing concern about the impact of mask wearing on optimum breathing and thus on their physical and mental health. Mask wearing is now becoming mandatory in public spaces and in the work environment in many countries to curb the spread of the Coronavirus. This article aims to discuss these concerns and to offer a conscious approach to breathing in relation to mask wearing.

Why Should I Wear A Face Mask?

Covid-19 is spread through respiratory droplets. Breathing, speaking, singing, laughing, coughing, or sneezing can all push the virus into the air. In the air, the virus can travel around one metre. Further if you’re moving fast, coughing or sneezing, dropping or settling on anything with which it comes into contact. We know that we can get the virus on our hands by touching infected surfaces. We can also transfer the virus between surfaces by touching them with our contaminated hands. This is why we are all washing our hands and being mindful about the things that we touch.

A large percentage of people who are infected with the virus are asymptomatic and not aware that they are infectious. The rationale for wearing a mask in public is to curb the spread of the virus by preventing you from spreading it to other people. Wearing a mask also prevents you from touching your nose or mouth and infecting yourself with the virus that you may encounter while out and about.

What Is The Concern About Wearing A Face Mask?

There have been numerous reports in the media from people claiming feelings of dizziness, fatigue and headaches while wearing a mask. While this phenomenon has not been formally researched, there could be various reasons for this.

Why Might I Get Symptoms While Wearing A Face Mask?

The ideal mask will allow for the easy flow of air. In other words, be breathable,  but also prevent the spread of droplets through it (impermeable).

If your mask does not allow air to flow through it, this could have negative effects on your health and well-being.

But There Are Other Reasons Why You Might Get Symptoms While Wearing A Mask.

• Wearing any mask can trigger a feeling of not getting enough air and cause you to breathe differently.
• If you are concerned about being outside and being at risk of getting the virus, you might breathe differently.
• You may be anxious or stressed, you will breathe differently.
• In the event you HAVE the virus, you will breathe differently.

Typically, when we are worried or anxious, adrenaline causes us to take faster and shallower breaths. This leads to lower levels of carbon dioxide in the blood which in turn can cause dizziness, fatigue, headaches, chest pain, breathlessness, numbness and tingling, a feeling of disorientation or confusion, and increased emotionality.

If your mask is adequately breathable, it is more likely that symptoms experienced are related to your own breathing rather than the mask itself.

Does My Face Mask Limit The Amount Of Oxygen I Get?

Medical grade masks are specifically designed to offer high level protection (impermeability) and adequate oxygenation (breathability) while undertaking highly skilled and high-risk tasks. While the public does not require medical grade masks, manufactured and home-made masks should offer the same level of breathability and reasonable impermeability.

A recent study done in Illinois demonstrated that a mask made with double layered T-shirt material (cotton or cotton/polyester blends) balances the best breathability with a 98% impermeability to droplet spread which performs equally to medical masks.

The only difference is that household materials will retain droplets rather than repel them, so it is important to hot wash (or dispose of) them after each use.

Should I Breathe Through My Nose Or My Mouth When Wearing A Mask?

Breathing through the nose provides the benefit of the air being moistened and filtered. Nasal breathing also produces Nitric Oxide which kills viruses and bacteria.

Breathing through the nose is preferable when wearing a mask.

How Can I Optimize My Breathing While Wearing A Face Mask?

Mask wearing can be great training for conscious breathing. Take this opportunity to be mindful of your breathing, seeing the mask as an extra filter.

1. Breathe through your nose.
2. Notice how your breathing is changing in reaction to your experience and environment. Consciously take slower and deeper breaths if you feel overwhelmed.
4. Add a drop of essential oils such as peppermint or orange to keep your airways feeling open. This will also bring sensory enjoyment.
5. When you take your mask off, spend a few minutes taking some fully conscious breaths. Or you can practice the box breathing technique to bring calm energy and balance back to your system.

References:

Making A Homemade Coronavirus Mask? Doubled T-Shirt Fabric Offers 98% Droplet Blocking Protection. A Single Layer Of T-Shirt Fabric Is 40% Effective At Higher Droplet Blocking. Https://Neurosciencenews.Com/Coronavirus-Mask-Material-16333/

Discomfort And Exertion Associated With Prolonged Wear Of Respiratory Protection In A Health Care Setting  Brian V Shenal  1 , Lewis J Radonovich Jr, Jing Cheng, Michael Hodgson, Bradley S Bender Https://Pubmed.Ncbi.Nlm.Nih.Gov/22168256

What's True

Breathing in excessive carbon dioxide is dangerous for the body. Some people with preexisting respiratory illnesses may face health issues only with prolonged use of tight-fitting masks, such as respirators.

What's False

However, people wearing cloth or surgical masks are in little to no danger of breathing in unhealthy amounts of carbon dioxide.

Origin

During the COVID-19 coronavirus disease pandemic in the spring of 2020, questions arose about protective measures. Social media users shared related images, and in one case, a newspaper column claimed that continual or prolonged use of face masks resulted in breathing too much of one’s own exhaled carbon dioxide, which can lead to health concerns. 

“Dr. Dennis A Castro B” wrote in the Nigerian newspaper Vanguard, for instance, that prolonged use of face masks causes hypoxia: 

Breathing over and over exhaled air turns into carbon dioxide, which is why we feel dizzy.

This intoxicates the user and much more when he must move, carry out displacement actions. It causes discomfort, loss of reflexes and conscious thought. It generates great fatigue. In addition, oxygen deficiency causes glucose breakdown and endangered lactic acid rise.

The post does not specify what kinds of masks cause these issues (though the article image does show N95 respirator masks), nor does it indicate whether this affects people with respiratory conditions more. It should be noted that hypoxia is a condition in which the tissues of the body are starved of oxygen. 

Another post on Facebook argued that prolonged mask usage caused hypercapnia, a condition arising from too much carbon dioxide in the blood. 

Image via Facebook.

Symptoms of hypercapnia include dizziness, drowsiness, fatigue, headaches, feeling disoriented, flushing of the skin, and shortness of breath. Severe symptoms include a loss of consciousness, coma, hyperventilation, twitching muscles, and seizures, among others. Preexisting respiratory illnesses like chronic obstructive pulmonary disease (COPD) can cause both hypercapnia and hypoxia. 

But research articles and experts suggest that such extreme symptoms are unlikely to occur in most people. Dr. Abrar Ahmad Chughtai, an epidemiologist and lecturer at the School of Public Health and Community Medicine at University of New South Wales Australia, says the risk of hypoxia and hypercapnia are unlikely to take place with cloth and surgical masks, because they are not tight-fitting: 

Some people with pre-existing respiratory illnesses (like asthma, COPD), may face breathing difficulty with use of certain types of tight fitted masks, called respirators. [There is] less chance of hypoxia as they may discontinue using masks in that case. Risk is very low with cloth and surgical masks as they are not tight around [the] face.

He also argued that in the case of prolonged usage of any of these masks, “Dizziness [was] less likely, but fatigue may occur.”

The N95 respirator is an example of personal protective equipment (PPE) usually worn by health workers to protect the wearer from airborne particles and from liquid contaminating the face. The Centers for Disease Control and Prevention (CDC) does not recommend that the general public use these masks because health workers and other medical first responders need them more. 

A team of Stanford engineers is developing an N95 face mask to counteract the side effects of oxygen deficiency. In an interview, John Xu, a mechanical engineer behind the effort, said:

N95 masks are estimated to reduce oxygen intake by anywhere from 5 to 20 percent. That’s significant, even for a healthy person. It can cause dizziness and lightheadedness. If you wear a mask long enough, it can damage the lungs. For a patient in respiratory distress, it can even be life threatening.

And their focus is on getting these masks to healthcare workers first.

We are targeting this to anyone who has to wear a mask for the long term, first responders, doctors, nurses and even patients who don’t want to infect others. In the near term, we hope to get these into healthcare workers as soon as possible.

The general public is unlikely to wear masks for a prolonged period other than for short stints outside of homes, according to Reuters. A CDC representative spoke to Reuters: 

The CO2 will slowly build up in the mask over time. However, the level of CO2 likely to build up in the mask is mostly tolerable to people exposed to it. You might get a headache but you most likely [would] not suffer the symptoms observed at much higher levels of CO2. The mask can become uncomfortable for a variety of reasons including a sensitivity to CO2 and the person will be motivated to remove the mask. It is unlikely that wearing a mask will cause hypercapnia.

The CDC recommends that the general public wear cloth masks, leaving N95 respirators and surgical masks to healthcare workers. They also offer exceptions for who should be wearing them:

Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

With these recommendations comes the additional guidance that face masks should not be a substitute for social distancing. 

The CDC also responded to Snopes about the impact an N95 respirator would have on healthcare workers: 

Hypoventilation (deficient ventilation of the lungs) is a primary cause of significant discomfort while wearing an N95 filtering facepiece respirator (FFR). However, studies [indicate] that hypoventilation did not pose a significant risk to healthcare workers over the course of less than one hour of continuous N95 use. When healthcare workers are working longer hours without a break while continuously wearing an N95 FFR, CO2 may accumulate in the breathing space inside of the respirator and continuously increase past the 1-hour mark, which could have a significant physiological effect on the wearer, including headache, altered cognitive judgement, and increased breathing frequency, among other symptoms.

To fix the problem of breathing too much CO2 that has built up within the respirator facepiece, a worker can simply remove the respirator. Some facilities practice oxygen supplementation during these breaks from respirator use, but there really is no need for this as the oxygen in the environment is more than enough to relieve most of the symptoms listed above.

The Vanguard piece also says it is dangerous to use masks in cars:

Some people drive their car with the mask on, that is very dangerous, because, the stale air can make the driver lose consciousness.

Chughtai said he believed such danger was “less likely,” and that running while wearing such a mask also was “unlikely” to cause breathing issues, unless the runner had a pre-existing respiratory illness.

In all, little research has been done on the impact of masks on wearers, according to Chughtai. In some studies, participants noted breathing difficulties, but not hypoxia.

Ultimately, the impact of a mask on its wearer depends on the wearer’s health, any pre-existing respiratory illnesses, the type of mask, and the length of time the person wears it. In most instances, the effects of prolonged cloth mask usage are small. Masks, like most short-term measures to prevent the spread of COVID-19, should be worn only if the wearer has to be in close proximity to others, and be used in addition to necessary measures like social distancing, and more. As such, we rate this claim about the dangers of masks as “Mostly false.” 

• PUBLISHED 8 MAY 2020