Wearing N95 masks decreases the odor discrimination ability of healthcare workers: a self-controlled before-after study.
Ontology highlight
ABSTRACT: Objective
During the coronavirus disease 2019 (COVID-19) pandemic, the N95 mask is an essential piece of protective equipment for healthcare workers. However, the N95 mask may inhibit air exchange and odor penetration. Our study aimed to determine whether the use of N95 masks affects the odor discrimination ability of healthcare workers.Methods
In our study, all the participants were asked to complete three olfactory tests. Each test involved 12 different odors. The participants completed the test while wearing an N95 mask, a surgical mask, and no mask. The score for each olfactory test was documented.Results
The olfactory test score was significantly lower when the participants wore N95 masks than when they did not wear a mask (7 vs. 10, p < 0.01). The score was also lower when the participants wore N95 masks than surgical masks (7 vs. 8, p < 0.01).Conclusion
Wearing N95 masks decreases the odor discrimination ability of healthcare workers. Therefore, we suggest that healthcare workers seek other clues when diagnosing disease with a characteristic odor.
SUBMITTER: Luo G
PROVIDER: S-EPMC10022507 | biostudies-literature | 2023
REPOSITORIES: biostudies-literature
Publications
Wearing N95 masks decreases the odor discrimination ability of healthcare workers: a self-controlled before-after study.
Luo Guanguan G Zou Xingnan X Zhou Xianlong X Gan Jiaohong J Jiang Cheng C Zhao Zhigang Z Zhao Yan Y
PeerJ 20230314
<h4>Objective</h4>During the coronavirus disease 2019 (COVID-19) pandemic, the N95 mask is an essential piece of protective equipment for healthcare workers. However, the N95 mask may inhibit air exchange and odor penetration. Our study aimed to determine whether the use of N95 masks affects the odor discrimination ability of healthcare workers.<h4>Methods</h4>In our study, all the participants were asked to complete three olfactory tests. Each test involved 12 different odors. The participants ...[more]
Similar Datasets
Project description:According to the familiar axiom, the eyes are the window to the soul. However, wearing masks to prevent the spread of viruses such as COVID-19 involves obscuring a large portion of the face. Do the eyes carry sufficient information to allow for the accurate perception of emotions in dynamic expressions obscured by masks? What about the perception of the meanings of specific smiles? We addressed these questions in two studies. In the first, participants saw dynamic expressions of happiness, disgust, anger, and surprise that were covered by N95, surgical, or cloth masks or were uncovered and rated the extent to which the expressions conveyed each of the same four emotions. Across conditions, participants perceived significantly lower levels of the expressed (target) emotion in masked faces, and this was particularly true for expressions composed of more facial action in the lower part of the face. Higher levels of other (non-target) emotions were also perceived in masked expressions. In the second study, participants rated the extent to which three categories of smiles (reward, affiliation, and dominance) conveyed positive feelings, reassurance, and superiority, respectively. Masked smiles communicated less of the target signal than unmasked smiles, but not more of other possible signals. The present work extends recent studies of the effects of masked faces on the perception of emotion in its novel use of dynamic facial expressions (as opposed to still images) and the investigation of different types of smiles.Supplementary informationThe online version contains supplementary material available at 10.1007/s42761-021-00097-z.
| S-EPMC8790014 | biostudies-literature
Project description:BackgroundRespiratory protective devices are critical in protecting against infection in healthcare workers at high risk of novel 2019 coronavirus disease (COVID-19); however, recommendations are conflicting and epidemiological data on their relative effectiveness against COVID-19 are limited.PurposeTo compare medical masks to N95 respirators in preventing laboratory-confirmed viral infection and respiratory illness including coronavirus specifically in healthcare workers.Data sourcesMEDLINE, Embase, and CENTRAL from January 1, 2014, to March 9, 2020. Update of published search conducted from January 1, 1990, to December 9, 2014.Study selectionRandomized controlled trials (RCTs) comparing the protective effect of medical masks to N95 respirators in healthcare workers.Data extractionReviewer pair independently screened, extracted data, and assessed risk of bias and the certainty of the evidence.Data synthesisFour RCTs were meta-analyzed adjusting for clustering. Compared with N95 respirators; the use of medical masks did not increase laboratory-confirmed viral (including coronaviruses) respiratory infection (OR 1.06; 95% CI 0.90-1.25; I2 = 0%; low certainty in the evidence) or clinical respiratory illness (OR 1.49; 95% CI: 0.98-2.28; I2 = 78%; very low certainty in the evidence). Only one trial evaluated coronaviruses separately and found no difference between the two groups (P = .49).LimitationsIndirectness and imprecision of available evidence.ConclusionsLow certainty evidence suggests that medical masks and N95 respirators offer similar protection against viral respiratory infection including coronavirus in healthcare workers during non-aerosol-generating care. Preservation of N95 respirators for high-risk, aerosol-generating procedures in this pandemic should be considered when in short supply.
| S-EPMC7298295 | biostudies-literature
Project description:BackgroundIt is uncertain if medical masks offer similar protection against COVID-19 compared with N95 respirators.ObjectiveTo determine whether medical masks are noninferior to N95 respirators to prevent COVID-19 in health care workers providing routine care.DesignMulticenter, randomized, noninferiority trial. (ClinicalTrials.gov: NCT04296643).Setting29 health care facilities in Canada, Israel, Pakistan, and Egypt from 4 May 2020 to 29 March 2022.Participants1009 health care workers who provided direct care to patients with suspected or confirmed COVID-19.InterventionUse of medical masks versus fit-tested N95 respirators for 10 weeks, plus universal masking, which was the policy implemented at each site.MeasurementsThe primary outcome was confirmed COVID-19 on reverse transcriptase polymerase chain reaction (RT-PCR) test.ResultsIn the intention-to-treat analysis, RT-PCR-confirmed COVID-19 occurred in 52 of 497 (10.46%) participants in the medical mask group versus 47 of 507 (9.27%) in the N95 respirator group (hazard ratio [HR], 1.14 [95% CI, 0.77 to 1.69]). An unplanned subgroup analysis by country found that in the medical mask group versus the N95 respirator group RT-PCR-confirmed COVID-19 occurred in 8 of 131 (6.11%) versus 3 of 135 (2.22%) in Canada (HR, 2.83 [CI, 0.75 to 10.72]), 6 of 17 (35.29%) versus 4 of 17 (23.53%) in Israel (HR, 1.54 [CI, 0.43 to 5.49]), 3 of 92 (3.26%) versus 2 of 94 (2.13%) in Pakistan (HR, 1.50 [CI, 0.25 to 8.98]), and 35 of 257 (13.62%) versus 38 of 261 (14.56%) in Egypt (HR, 0.95 [CI, 0.60 to 1.50]). There were 47 (10.8%) adverse events related to the intervention reported in the medical mask group and 59 (13.6%) in the N95 respirator group.LimitationPotential acquisition of SARS-CoV-2 through household and community exposure, heterogeneity between countries, uncertainty in the estimates of effect, differences in self-reported adherence, differences in baseline antibodies, and between-country differences in circulating variants and vaccination.ConclusionAmong health care workers who provided routine care to patients with COVID-19, the overall estimates rule out a doubling in hazard of RT-PCR-confirmed COVID-19 for medical masks when compared with HRs of RT-PCR-confirmed COVID-19 for N95 respirators. The subgroup results varied by country, and the overall estimates may not be applicable to individual countries because of treatment effect heterogeneity.Primary funding sourceCanadian Institutes of Health Research, World Health Organization, and Juravinski Research Institute.
| S-EPMC9707441 | biostudies-literature
Project description:ObjectiveThe aim of this study was to compare the efficacy of cloth masks to medical masks in hospital healthcare workers (HCWs). The null hypothesis is that there is no difference between medical masks and cloth masks.Setting14 secondary-level/tertiary-level hospitals in Hanoi, Vietnam.Participants1607 hospital HCWs aged ≥18 years working full-time in selected high-risk wards.InterventionHospital wards were randomised to: medical masks, cloth masks or a control group (usual practice, which included mask wearing). Participants used the mask on every shift for 4 consecutive weeks.Main outcome measureClinical respiratory illness (CRI), influenza-like illness (ILI) and laboratory-confirmed respiratory virus infection.ResultsThe rates of all infection outcomes were highest in the cloth mask arm, with the rate of ILI statistically significantly higher in the cloth mask arm (relative risk (RR)=13.00, 95% CI 1.69 to 100.07) compared with the medical mask arm. Cloth masks also had significantly higher rates of ILI compared with the control arm. An analysis by mask use showed ILI (RR=6.64, 95% CI 1.45 to 28.65) and laboratory-confirmed virus (RR=1.72, 95% CI 1.01 to 2.94) were significantly higher in the cloth masks group compared with the medical masks group. Penetration of cloth masks by particles was almost 97% and medical masks 44%.ConclusionsThis study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated.Trial registration numberAustralian New Zealand Clinical Trials Registry: ACTRN12610000887077.
| S-EPMC4420971 | biostudies-literature
Project description:Outbreaks of emerging infectious diseases have led to guidelines recommending the routine use of N95 respirators for healthcare workers, many of whom are women of childbearing age. The respiratory effects of prolonged respirator use on pregnant women are unclear although there has been no definite evidence of harm from past use.We conducted a two-phase controlled clinical study on healthy pregnant women between 27 to 32 weeks gestation. In phase I, energy expenditure corresponding to the workload of routine nursing tasks was determined. In phase II, pulmonary function of 20 subjects was measured whilst at rest and exercising to the predetermined workload while breathing ambient air first, then breathing through N95-mask materials.Exercising at 3 MET while breathing through N95-mask materials reduced mean tidal volume (TV) by 23.0 % (95 % CI -33.5 % to -10.5 %, p?<?0.001) and lowered minute ventilation (VE) by 25.8 % (95 % CI -34.2 % to -15.8 %, p?<?0.001), with no significant change in breathing frequency compared to breathing ambient air. Volumes of oxygen consumption (VO2) and carbon dioxide expired (VCO2) were also significantly reduced; VO2 by 13.8 % (95 % CI -24.2 % to -3 %, p?=?0.013) and VCO2 by 17.7 %, (95 % CI -28.1 % to -8.6 %, p?=?0.001). Although no changes in the inspired oxygen and carbon dioxide concentrations were demonstrated, breathing through N95-mask materials during low intensity work (3 MET) reduced expired oxygen concentration by 3.2 % (95 % CI: -4.1 % to -2.2 %, p?<?0.001), and increased expired carbon dioxide by 8.9 % (95 % CI: 6.9 % to 13.1 %; p <0.001) suggesting an increase in metabolism. There were however no changes in the maternal and fetal heart rates, finger-tip capillary lactate levels and oxygen saturation and rating of perceived exertion at the work intensity investigated.Breathing through N95 mask materials have been shown to impede gaseous exchange and impose an additional workload on the metabolic system of pregnant healthcare workers, and this needs to be taken into consideration in guidelines for respirator use. The benefits of using N95 mask to prevent serious emerging infectious diseases should be weighed against potential respiratory consequences associated with extended N95 respirator usage.The study was registered at clinicaltrials.gov, identifier NCT00265926.
| S-EPMC4647822 | biostudies-other
Project description:In response to the current state of the COVID-19 pandemic, healthcare providers are using common surgical masks and filtering respirators in conjunction with the presence of facial hair, which could lead to a large number of particles passing into their respiratory system. The purpose of this study was to determine the fit factor effectiveness of filtering respirators and surgical masks in bearded versus non-bearded healthcare providers. A controlled randomized clinical trial (NCT04391010) was carried out, analyzing a sample of 63 healthcare providers. The fit factors of surgical masks and FFP3 filtering respirators for healthcare providers with (n = 32) and without (n = 31) facial hair were compared. Fit factors were measured during an exercises protocol in which healthcare providers wore surgical masks and FFP3 filtering respirators. Surgical mask fit factor comparisons did not show significant differences (p > 0.05) between healthcare providers with and without facial hair. In contrast, filtering respirator fit factor comparisons showed statistically significant differences (p < 0.01) between both groups, indicating that healthcare providers with facial hair showed lower fit factor scores, which implies a worse fit factor with respect to healthcare providers without facial hair. The fit factor effectiveness of filtering respirators was reduced in healthcare providers with facial hair. The authors of this paper encourage healthcare providers to trim their beards during filtering respirator use or wear full-mask filtering facepiece respirators, especially during the COVID-19 pandemic.
| S-EPMC8533569 | biostudies-literature
Project description:This study aimed to determine whether wearing N95 masks for 4 h significantly affected physiological indicators in obese operating room staff compared to surgical masks (SMs). In this randomized crossover trial, the physiological impacts of wearing SMs and N95 masks for 4 h was analysed among 20 obese operating room staff. The data were connected to a nasal sampling tube using the Capnostream 20p monitor. The primary outcome was the change in venous carbon dioxide partial pressure (PvCO2) levels at 4-hour intervention. Secondary outcomes included venous oxygen pressure (PvO2), bicarbonate (HCO3-), pH levels, end-tidal carbon dioxide partial pressure (PetCO2), peripheral oxygen saturation (SpO2), respiratory rate (RR), pulse rate (PR) and blood pressure after mask intervention. Dyspnoea, palpitations, headache were assessed with the visual analogue scale (VAS) score. N95 masks had a statistically significant rather than clinically significant impact on PvCO2 (mean [95% CI], 1.4 [0.8, 1.9], P < 0.001) and RR (0.6 [0.1, 1.1)], P = 0.023) changes compared with SM. The three subjective VAS scores of the N95 group showed significantly increased than SM group after 2 h. In conclusion, obese operating room staff continuously wearing SM or N95 masks 4 h showed almost no difference in physiological impacts. Trial registration NCT05950256, 18/07/2023.
| S-EPMC11850626 | biostudies-literature
Project description:IntroductionCOVID-19 was declared a pandemic in March 2020. With the sudden surge in demand for personal protective equipment (PPE), significant concerns regarding the ongoing availability emerged. One solution proposed is re-sterilisation of respirator masks and this has been commenced in some parts of the world. On review of the literature, very little is documented regarding the knowledge of masks and the attitudes of healthcare workers towards using re-sterilised masks.MethodsA comprehensive questionnaire was used to assess general knowledge and attitudes around facemasks and respirators.ResultsThere were 190 respondents. There were significant gaps in knowledge and understanding of when particular face masks should be worn. One-third had significant concerns about ongoing availability. One-third had concerns about the quality of the masks as the pandemic continued. Only 10% of respondents underwent formal face-fitting. Eighty percent of respondents stated they would wear a re-sterilised mask. A further 15% would use a re-sterilised mask but required certain reassurances. Five percent of our respondents would not use a re-sterilised mask under any circumstances.DiscussionEnsuring an adequate understanding of face masks is crucial among healthcare workers (HCWs) and this study highlights a need for further education. It also demonstrates a general acceptability among HCWs towards the use of re-sterilised face masks.
| S-EPMC7870031 | biostudies-literature
Project description:ImportanceAdoption of mask wearing in response to the COVID-19 pandemic alters daily communication.ObjectiveTo assess communication barriers associated with mask wearing in patient-clinician interactions and individuals who are deaf and hard of hearing.Design, setting, and participantsThis pilot cross-sectional survey study included the general population, health care workers, and health care workers who are deaf or hard of hearing in the United States. Volunteers were sampled via an opt-in survey panel and nonrandomized convenience sampling. The general population survey was conducted between January 5 and January 8, 2021. The health care worker surveys were conducted between December 3, 2020, and January 3, 2021. Respondents viewed 2 short videos of a study author wearing both a standard and transparent N95 mask and answered questions regarding mask use, communication, preference, and fit. Surveys took 15 to 20 minutes to complete.Main outcomes and measuresParticipants' perceptions were assessed surrounding the use of both mask types related to communication and the ability to express emotions.ResultsThe national survey consisted of 1000 participants (mean [SD] age, 48.7 [18.5] years; 496 [49.6%] women) with a response rate of 92.25%. The survey of general health care workers consisted of 123 participants (mean [SD] age, 49.5 [9.0] years; 84 [68.3%] women), with a response rate of 11.14%. The survey of health care workers who are deaf or hard of hearing consisted of 45 participants (mean [SD] age, 54.5 [9.0] years; 30 [66.7%] women) with a response rate of 23.95%. After viewing a video demonstrating a study author wearing a transparent N95 mask, 781 (78.1%) in the general population, 109 general health care workers (88.6%), and 38 health care workers who are deaf or hard of hearing (84.4%) were able to identify the emotion being expressed, in contrast with 201 (20.1%), 25 (20.5%), and 11 (24.4%) for the standard opaque N95 mask. In the general population, 450 (45.0%) felt positively about interacting with a health care worker wearing a transparent mask; 76 general health care workers (61.8%) and 37 health care workers who are deaf or hard of hearing (82.2%) felt positively about wearing a transparent mask to communicate with patients.Conclusions and relevanceThe findings of this study suggest that transparent masks could help improve communication during the COVID-19 pandemic, particularly for individuals who are deaf and hard of hearing.
| S-EPMC8609412 | biostudies-literature
Project description:ObjectiveWe aimed to examine the efficacy of medical masks and respirators in protecting against respiratory infections using pooled data from two homogenous randomised control clinical trials (RCTs).MethodsThe data collected on 3591 subjects in two similar RCTs conducted in Beijing, China, which examined the same infection outcomes, were pooled. Four interventions were compared: (i) continuous N95 respirator use, (ii) targeted N95 respirator use, (iii) medical mask use and (iv) control arm. The outcomes were laboratory-confirmed viral respiratory infection, influenza A or B, laboratory-confirmed bacterial colonisation and pathogens grouped by mode of transmission.ResultsRates of all outcomes were consistently lower in the continuous N95 and/or targeted N95 arms. In adjusted analysis, rates of laboratory-confirmed bacterial colonisation (RR 0.33, 95% CI 0.21-0.51), laboratory-confirmed viral infections (RR 0.46, 95% CI 0.23-0.91) and droplet-transmitted infections (RR 0.26, 95% CI 0.16-0.42) were significantly lower in the continuous N95 arm. Laboratory-confirmed influenza was also lowest in the continuous N95 arm (RR 0.34, 95% CI 0.10-1.11), but the difference was not statistically significant. Rates of laboratory-confirmed bacterial colonisation (RR 0.54, 95% CI 0.33-0.87) and droplet-transmitted infections (RR 0.43, 95% CI 0.25-0.72) were also lower in the targeted N95 arm, but not in medical mask arm.ConclusionThe results suggest that the classification of infections into droplet versus airborne transmission is an oversimplification. Most guidelines recommend masks for infections spread by droplets. N95 respirators, as "airborne precautions," provide superior protection for droplet-transmitted infections. To ensure the occupational health and safety of healthcare worker, the superiority of respirators in preventing respiratory infections should be reflected in infection control guidelines.
| S-EPMC5705692 | biostudies-literature