Comparison of different face masks on physiology and tolerability.

Murat Tuğrul Eren; Burak Pamukçu

doi:10.31067/acusaglik.1673956

Comparison of different face masks on physiology and tolerability.

Abstract

Purpose: There is insufficient data on physiological and psychological alterations that may occur among healthcare workers wearing various face masks uninterruptedly during surgeries or for air-borne infection protection. In this study, we aimed to investigate the physiological effects of various types of face masking and associated discomfort among healthcare workers. Methods: This prospective study included 33 healthy healthcare workers. Each participant was asked to wear a single surgical mask, double mask, N95 type mask, and surgical mask on N95 type mask for an uninterrupted period of 2 hours. Oxygen saturation, heart pulse, blood pressure, respiratory rate, and step counts were recorded at baseline and every 30 min of 2 hours with a total of five times for each mask type. Self-assessment of fatigue, exhaustion, and headache were also graded. Intra- and inter-group analyses were performed. Results: There was no significant difference in the oxygen saturation, diastolic blood pressure and respiratory rates among the participants including intra- and inter-groups (p>0.05). Systolic blood pressures gradually and significantly increased with a double surgical mask (p<0.05). Headache and exhaustion scores increased gradually and significantly over time at every measurement time point with every mask type (p<0.05) Fatigue scores also increased in intra-group comparison of mask types without any difference in-between. Conclusion:Type of face mask affects only subjective parameters such as headache, exhaustion and fatigue without any change in the objective physiological parameters during 2 hours of uninterrupted masking.

Keywords

References

1. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, Tamin A, Harcourt JL, Thornburg NJ, Gerber SI, Lloyd-Smith JO, de Wit E, Munster VJ. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020 Apr 16;382(16):1564-1567. doi: 10.1056/NEJMc2004973. Epub 2020 Mar 17. PMID: 32182409; PMCID: PMC7121658.
2. Leung NHL, Chu DKW, Shiu EYC, Chan KH, McDevitt JJ, Hau BJP, Yen HL, Li Y, Ip DKM, Peiris JSM, Seto WH, Leung GM, Milton DK, Cowling BJ. 3 April 2020, posting date. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nat Med 2020 May;26(5):676-680. doi: 10.1038/s41591-020-0843-2. Epub 2020 Apr 3. Erratum in: Nat Med. 2020 May 27;: PMID: 32371934.
3. Lim EC, Seet RC, Lee KH, Wilder-Smith EP, Chuah BY, Ong BK :Headaches and the N95 face-mask amongst health-care providers.:Acta Neurol Scand. 2006 Mar; 113(3):199-202.doi: 10.1111/j.1600-0404.2005.00560.x. PMID: 16441251; PMCID: PMC7159726.
4. Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, Harris JD. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018 Mar 23;2(3):e088. doi10.5435/JAAOSGlobal-D-17-00088. PMID: 30211382; PMCID: PMC6132313.
5. Seto WH, Tsang D, Yung RW, Ching TY, Ng TK, Ho M, Ho LM, Peiris JS, Advisors of Expert SARS group of Hospital Authority. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet. 2003 May 3; 361(9368):1519-20.doi: 10.1016/s0140- 6736(03)13168-6. PMID: 12737864; PMCID: PMC7112437.
6. J.L. Derrick* and C.D. Gomersall: Protecting health-care staff from severe acute respiratory syndrome: filtration capacity of multiple surgical masks:J Hosp Infect. 2005 Apr; 59(4): 365–368. doi: 10.1016/j. jhin.2004.10.013. PMID: 15749326; PMCID: PMC7114845.
7. Weber A, Willeke K, Marchioni R, Myojo T, McKay R, Donnelly J, Liebhaber F:Aerosol penetration and leakage characteristics of masks used in the health care industry.:Am J Infect Control. 1993 Aug; 21(4):167-73.doi: 10.1016/0196-6553(93)90027-2. PMID: 8239046.
8. Sinkule EJ1, Powell JB, Goss FL.:Evaluation of N95 respirator use with a surgical mask cover: effects on breathing resistance and inhaled carbon dioxide.Ann Occup Hyg. 2013 Apr;57(3):384-98. doi: 10.1093/ annhyg/mes068. Epub 2012 Oct 29. PMID: 23108786.

9. Anna Bałazy 1, Mika Toivola, Atin Adhikari, Satheesh K Sivasubramani, Tiina Reponen, Sergey A Grinshpun, Do N95 Respirators Provide 95% Protection Level Against Airborne Viruses, and How Adequate Are Surgical Masks? Am J Infect Control. 2006 Mar;34(2):51-7. doi: 10.1016/j.ajic.2005.08.018. PMID: 16490606.
10. Hashmi MF, Modi P, Sharma S. Dyspnea. [Updated 2020 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK499965/ (Accessed on December,2020)
11. Chand SP, Marwaha R. Anxiety. [Updated 2020 Nov 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470361/ (Accessed on December,2020)
12. Jensen, L.A., Onyskiw, J.E., Prasad, N.G.: Meta-analysis of arterial oxygen saturation monitoring by pulse oximetry in adults. Heart Lung 1998; 27: 387-408. 3. doi: 10.1016/s0147-9563(98)90086-3. PMID: 9835670.
13. Sinex, J.E.: Pulse oximetry: principles and limitations. Am J Emerg Med 1999; 17: 59-67.doi: 10.1016/s0735-6757(99)90019-0. PMID: 9928703.
14. Villanueva, R., Bell, C., Kain, Z.N., et al.: Effect of peripheral perfusion on accuracy of pulse oximetry in children. J Clin Anesth 1999; 11: 317-322.doi: 10.1016/s0952-8180(99)00054-9. PMID: 10470634.
15. Kagle, D.M., Alexander, C.M., Berko, R.S., et al.: Evaluation of the Ohmeda 3700 pulse oximeter: steady state and transient response characteristics. Anaesthesiology 1987; 66: 376-380.doi: 10.1097/00000542-198703000-00018. PMID: 3826695.
16. Webb, R.K., Ralston, A.C., Runciman, W.B.: Potential errors in pulse oximetry. Anaesthesia. 1991 Mar;46(3):202-6. doi: 10.1111/j.1365- 2044.1991.tb09410.x. PMID: 2014898.
17. Luciana Costa Melo, 1 Maria Alayde Mendonça da Silva, and Ana Carolina do Nascimento Calles : Obesity and lung function: a systematic review. Einstein (Sao Paulo). 2014 Jan-Mar; 12(1): 120– 125. doi: 10.1590/s1679-45082014rw2691. PMID: 24728258; PMCID: PMC4898251.
18. Beder A1, Büyükkoçak U, Sabuncuoğlu H, Keskil ZA, Keskil S.: Preliminary report on surgical mask induced deoxygenation during major surgery. Neurocirugia (Astur). 2008 Apr;19(2):121-6. doi: 10.1016/s1130-1473(08)70235-5. PMID: 18500410.
19. Bastien Presset,Balazs Laurenczy, Davide Malatesta: Accuracy of a smartphone pedometer application according to different speeds and mobile phone locations in a laboratory context. Journal of Exercise Science & Fitness Volume 16, Issue 2, August 2018, Pages 43-48.
20. Kao TW, Huang KC, Huang YL, Tsai TJ, Hsieh BS, Wu MS. The physiological impact of wearing an N95 mask during hemodialysis as a precaution against SARS in patients with end-stage renal disease. J Formos Med Assoc. 2004 Aug;103(8):624-8. PMID: 15340662.
21. Pearl Shuang Ye Tong , Anita Sugam Kale , Kailyn Ng: Respiratory Consequences of N95-type Mask Usage in Pregnant health-care Workers-A Controlled Clinical Study. Antimicrob Resist Infect Control. 2015 Nov 16;4:48. doi: 10.1186/s13756-015-0086-z. Erratum in: Antimicrob Resist Infect Control. 2016;5:26. PMID: 26579222; PMCID: PMC4647822.
22. AİLE, ÇALIŞMA VE SOSYAL HİZMETLER BAKANLIĞI Mevzuatı Listesi. İş Kanunu: 4857. Madde:68. https://kms.kaysis.gov.tr/Home/ Goster/34576 (Accessed on November, 2020)
23. Headache Classification Subcommittee of the Interna- tional Headache Society. The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004;24(Suppl. 1):1–160.
24. Ong, J.J.Y.; Bharatendu, C.; Goh, Y.; Tang, J.Z.Y.; Sooi, K.W.X.; Tan, Y.L.; Tan, B.Y.Q.; Teoh, H.; Ong, S.T.; Allen, D.M.; et al. Headaches associated with personal protective equipment—A cross-sectional study among frontline health-care workers during COVID-19. Headache. 2020 May;60(5):864-877. doi: 10.1111/head.13811. Epub 2020 Apr 12. PMID: 32232837

Details

Primary Language

English

Subjects

Health Services and Systems (Other)

Journal Section

Research Article

Authors

Murat Tuğrul Eren ^*
0000-0001-9602-3220
Türkiye

Burak Pamukçu
0000-0001-8013-1251
Türkiye

Early Pub Date

September 9, 2025

Publication Date

October 1, 2025

Submission Date

April 16, 2025

Acceptance Date

June 11, 2025

Published in Issue

Year 2025 Volume: 16 Number: 4

DOI

https://doi.org/10.31067/acusaglik.1673956

IZ

https://izlik.org/JA34BY69PA

Cite

RIS / Bibtex

EndNote

Eren MT, Pamukçu B (October 1, 2025) Comparison of different face masks on physiology and tolerability. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 16 4 567–574.