Does Prolonged FFP2 Mask Use Cause Changes in Nasal Cytology? A Pilot Observational Study on Healthcare Workers.

TheCOVID-19 pandemic has rapidly spread worldwide. Individual prevention approaches include FFP2/N95 mask use. Healthcare (HC) workers wear face masks for a long time during their work shifts and often complain of nasal symptoms. Current data on mask-associated symptoms or upper airway epithelium transformations are limited. Nasal cytology (NC) is a useful, non-invasive diagnostic method to assess cellular alterations. The aim of this study is to compare NC in HC workers before and after the continuous wearing of FFP2 face masks. We conducted a pilot observational study on 10 volunteer HC workers, who continuously used FFP2 masks during the work shift. All subjects underwent NC at the beginning (T0) and at the end of their workshift (T1) and the cytological findings were compared. Moreover, nasal symptoms were collected. Rare inflammatory cells were detected at T0 and, comparing cytological data about T0 and T1, no significant differences were observed. The most reported nasal symptoms were itching (70%) and a dry nose (60%). Difficulty of breathing and nasal blockage were not relevant. These preliminary data seem to suggest that wearing an FFP2 mask does not determine observable alterations in NC in daily work. However, further studies on a larger population for a longer period are needed.

Clothes Make the Man-What Impact Does the Dress of Interprofessional Teams Have on Patients?

Physicians' attire seems to play an important role in the success of patient treatment. The classic doctor's white coat initiates a strong signal to the patient and can have a determining effect on a successful doctor-patient relationship. In a quantitative online questionnaire study comprising 52 questions, participants were shown four photos of an interprofessional German family medicine team in varying attire. One important study feature relating to the ongoing coronavirus pandemic was that the team was portrayed wearing FFP2 masks in one photo. We measured core values regarding the team's perception in terms of sympathy, competence, trust, choosing the practice as a personal health care provider, and wanting to participate in the team. The questionnaire was posted online between March and May 2021. It was accessed 1435 times and 906 sheets were qualified for statistical analysis. For the first time in this field of research, a practice team's attire was investigated. We found a significant influence of different clothing on the perception of sympathy, competence, trust, elective practice, and team participation. Wearing an FFP2 mask promotes feelings of security and competence. The study shows that in times of fast social changes due to rapid digitalization and an ongoing pandemic, we should present ourselves in different ways as a medical team depending on the patient groups we are targeting and the feelings we want to evoke.

Impact of wearing a FFP2 mask on cardiopulmonary fitness in school-aged children

Background and Aim: Wearing face masks to detain the COVID 19 pandemic in schools has become an integral part of fighting the virus. The most effective mask is the FFP2 mask. There is a lot of public concern, especially regarding wearing a face mask at school and especially during school sports. It is therefore important to determine whether wearing a FFP2-mask during physical activ-ity leads to changes measurable in cardiopulmonary exercise test-ing in children. Method(s): Cardiopulmonary exercise testing was performed two times by children aged 8-10 years as an incremental step test on a treadmill with and without a FFP2 within an interval of 2 weeks. A general questionnaire included medical history and sports par-ticipation since childhood. Result(s): We included 10 children (mean age 8.4 +/- 0.7 years, 6 males, 4 females). The mean parameters measured at peak exercise were comparable between both examinations (mean Peak VO2 = 39.3 +/- 3.4 vs 45.6 +/- 13.9 ml/min/kg;mean Peak HR 192/min +/- 9 vs 188/min +/- 12, mean O2pulse 6 +/- 1.4 ml/min vs. 7 +/- 1.8, mean VE 43.2 +/- 12.9 ml/min vs. 41.5 +/- 12.7 ml/min). Neither did the respiratory gases (O2 and CO2) measured 1 min into each step differ significantly (s. figure). This study is cur-rently ongoing. Conclusion(s): Since there were no significant differences with respect to peak parameters as well as with respect to the respiratory param-eters measured during each step, there is no indication to withhold physical activity even at peak capacity from children during a pan-demic which makes wearing face masks mandatory.

Evaluation of the effects on SpO2 of N95 mask (FFP2) on dental health care providers: a cross-sectional observational study.

OBJECTIVE: The purpose of this cross-sectional observational study was to evaluate the effects of SpO2 in a sample of dental health care providers who wear a N95 mask or Filtering Face Piece (FFP2) for four consecutive hours, measured by a pulse oximeter before donning the mask and again after four hours of work and to offer some strategies to minimize discomfort and improve communication with their patients while wearing the mask. MATERIALS AND METHODS: A 17-item questionnaire was sent via Google Drive to various practitioners in Italy and the USA. A sample of 162 questionnaires were returned from dentists, orthodontists, dental hygienists and dental assistants who committed to wearing a FFP2 for 4 consecutive hours during a work day and then measuring the oxygen saturation by way of a pulse oximeter before and after the 4 working hours. The final analysis was performer on 147 viable questionnaires returned. The sample was composed of 62 males and 85 females with an average age of 42.9 ± 12.0 years. RESULTS: For the entire sample population, the baseline saturation was 98.6 ± 1.2 and, after four hours of mask wearing, there was a significant decrease in oxygen saturation to 97.0 ± 2.9 (p < 0.01). No statistical differences in SpO2 were found across specialties or across types of procedures performed during the 4 h. Heart rates were not significantly different before and after the 4 h in all categories. The 3 most frequent reported complaints were: fatigue (64%), headache (36%) and external ear pain (31%). The most common additional personal protective equipment (PPE) was a mask shield (78%) and those who wore the mask continuously reported more communication difficulty with patients, compared with those who took the mask off more often, in fact, 64% of the subjects reported that using the mask influenced their communication with their patients. Based on the results of the questionnaire, a list of breathing and vocal folds health strategies was devised and proposed, along with strategies to augment communication with patients. CONCLUSIONS: This study highlights a significant decrease in oxygen saturation after only 4 h of work (except for smokers) while wearing a FFP2, and confirms the widespread symptoms of fatigue, headache and pain behind the ears that dental professionals experience. But it also highlighted how mask wearing impaired communication with patients and wearing additional masks and a facial shield may add to those communications difficulties. This aspect and the need for better communication can lead the operators to remove the mask to improve breathing and communication, thus putting themselves at a risk of infection. Of all the aspects explored in this study, the most interesting was indeed the impact on fatigue and communication and the strategies proposed in this article can easily be implemented to reduce headache and fatigue by improving breathing efficiency and by aiding communication while donning a mask by improving voice quality and by using augmentative communication tools.

Adherence to personal protective equipment use among healthcare workers caring for confirmed COVID-19 and alleged non-COVID-19 patients.

Adherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100% in COVID-19 wards.

A new form of irritant rhinitis to filtering facepiece particle (FFP) masks (FFP2/N95/KN95 respirators) during COVID-19 pandemic.

Filtering facepiece particle (FFP) masks are important items of personal protective equipment in fighting COVID-19 pandemic. They shall protect the wearer of the mask from particles, droplets, and aerosols, but they also can prevent the spread of aerosol-transmitted viruses if the wearer becomes infected. Most often, FFP respirators consist of multiple layers of non-woven fabric made from polypropylene. Worldwide, FFP respirators are subject to various regulatory standards that specify physical properties and performance characteristics. During the SARS-CoV-2 pandemic, health authorities have temporarily repealed standards for respirators. We report on 46 patients that presented with rhinitis-like symptoms strongly associated to the use of FFP masks. Some of them were obliged to use FFP masks in their work environment. Nasal endoscopy showed edemata of the nasal mucosa that significantly decreased after a period of non-use of FFP masks. Subjectively reported symptom levels decreased after cessation of FFP use for 3 or more days. The presence of polypropylene fibres isolated from nasal rinsing solution was significantly associated with the use of FFP masks in our patients. Material safety and performance deregulation of FFP masks can pose a health risk. Thus, especially health care professionals and other individuals with occupational need for FFP masks should be aware of possible hazards that come with COVID-19 pandemic protection measures.