[Cross-sectional study on the use of masks among occupational groups with high-risk positions for overseas import and pollution transmission].

Objective: To investigate the wearing of masks and the knowledge of masks among high-risk positions for overseas import and pollution transmission. Methods: From May 14 to 17, 2022, a convenient sampling method was used to conduct an online survey among 963 workers in high-risk positions for overseas import and pollution transmission in Beijing. The behaviors of individual use and wearing masks, the distribution and supervision of the unit, the knowledge of personal mask protection and the subjective feelings of wearing masks were analyzed. The χ(2) test and logistic regression model were used to analyze the influencing factors of the correct selection of masks. Results: The majority of the workers in high-risk positions for overseas import and pollution transmission were male (86.0%, 828/963), age concentration in 18-44 years old (68.2%, 657/963), and the majority of them had college or bachelor degrees (49.4%, 476/963). 79.4%(765/963) of the workers chose the right type of masks, female, 45-59 years old and high school education or above were the risk factors for correct selection of masks (P <0.05). Workers had good behaviors such as wearing/removing masks, but only 10.5% (101/963) could correctly rank the protective effect of different masks. 98.4% (948/963) of the workers believed that their work units had provided masks to their employees, and 99.1% (954/963) and 98.2%(946/963) of them had organized training and supervision on the use of masks, respectively. 47.4%(456/963) of the workers were uncomfortable while wearing masks. Conclusion: The overall selection and use of masks among occupational groups in high-risk positions for overseas import and pollution transmission in China need to be further standardized. It is necessary to strengthen supervision and inspection on the use of masks among occupational groups, and take improvement measures to improve the comfort of wearing masks.

Face masks influence emotion judgments of facial expressions: a drift-diffusion model.

Face masks slow the spread of SARS-CoV-2, but it has been unknown how masks might reshape social interaction. One important possibility is that masks may influence how individuals communicate emotion through facial expressions. Here, we clarify to what extent-and how-masks influence facial emotion communication, through drift-diffusion modeling (DDM). Over two independent pre-registered studies, conducted three and 6 months into the COVID-19 pandemic, online participants judged expressions of 6 emotions (anger, disgust, fear, happiness, sadness, surprise) with the lower or upper face "masked" or unmasked. Participants in Study 1 (N = 228) correctly identified expressions above chance with lower face masks. However, they were less likely-and slower-to correctly identify these expressions relative to without masks, and they accumulated evidence for emotion more slowly-via decreased drift rate in DDM. This pattern replicated and intensified 3 months later in Study 2 (N = 264). These findings highlight how effectively individuals still communicate with masks, but also explain why they can experience difficulties communicating when masked. By revealing evidence accumulation as the underlying mechanism, this work suggests that time-sensitive situations may risk miscommunication with masks. This research could inform critical interventions to promote continued mask wearing as needed.

Novel risk patterns of vasovagal reactions in NZ blood donations complicated by COVID-19 restrictions.

Introduction: Vasovagal reactions (VVRs) are common but complex donor adverse reactions (DAEs) in blood donations. VVRs have been extensively studied with a multitude of risk factors identified including young age, female gender and first-time donor status. How they may interplay remains obscure. Methods: A total of 1,984,116 blood donations and 27,952 immediate VVRs (iVVRs) and 1,365 delayed VVRs (dVVRs) reported between 2011 and 2021 in NZ were used in multivariate logistic regression analyses each concerning donations with iVVRs as cases and those free of DAEs as controls. For each analysis stepwise selection was used to identify the best model and risk factors carrying significant main effects and/or interactions. Identified interactions informed further in-depth regression analyses to dissect iVVR risk patterns. Results: Over 95% of VVRs were iVVRs that had lower female preponderance and deferrals than dVVRs. iVVRs had a school seasonal pattern in whole blood donations driven by first-time donors from schools/colleges, and interactions between gender and age group differentiating the first-time from repeat donations. Subsequent regression analyses identified the known and novel risk factors of year and mobile collection sites and their interactions. iVVR rates were roundly elevated in 2020 and 2021 probably because of COVID-19 restrictions like facemask wearing. Exclusion of the 2020 and 2021 data removed the interactions with year, but confirmed interactions of gender with mobile collection sites (p = 6.2e-07) in first-time donations only and with age group in repeat donations only (p < 2.2e-16), together indicating young female donors at the highest risk of iVVRs. Our results also revealed that donation policy changes contributed to the year effects; donors had a lower iVVR risk at mobile sites than well-medicalized donation centers probably because of under-reporting. Conclusion: Modeling statistical interactions is valuable in identifying odds and revealing novel iVVR risk patterns and insights into blood donations.

Personal Protective Equipment Protocols Lead to a Delayed Initiation of Patient Assessment in Mountain Rescue Operations.

van Veelen, Michiel J., Giulia Roveri, Ivo B. Regli, Tomas Dal Cappello, Anna Vögele, Michela Masè, Marika Falla, and Giacomo Strapazzon. Personal protective equipment protocols lead to a delayed initiation of patient assessment in mountain rescue operations. High Alt Med Biol. 24:127-131, 2023. Introduction: Mountain rescue operations can be challenging in austere environmental conditions and remote settings. Airborne infection prevention measures include donning of personal protective equipment (PPE), potentially delaying the approach to a patient. We aimed to investigate the time delay caused by these prevention measures. Methods: This randomized crossover trial consisted of 24 rescue simulation trials intended to be as realistic as possible, performed by mountain rescue teams in difficult terrain. We analyzed the time needed to perform an airborne infection prevention protocol during the approach to a patient. Time delays in scenarios involving patients already wearing versus not wearing face masks and gloves were compared using a linear mixed model Results: The airborne infection prevention measures (i.e., screening questionnaire, hand antisepsis, and donning of PPE) resulted in a time delay of 98 ± 48 (26-214) seconds on initiation of patient assessment. There was a trend to a shorter time to perform infection prevention measures if the simulated patient was already wearing PPE consisting of face mask and gloves (p = 0.052). Conclusion: Airborne infection prevention measures may delay initiation of patient assessment in mountain rescue operations and could impair clinical outcomes in time-sensitive conditions. Trial registration number 0105095-BZ Ethics Committee review board of Bolzano.

Microplastics from face masks: A potential hazard post Covid-19 pandemic.

The tremendous use of plastic products to averse the infection rate during Covid-19 pandemic has developed great pressure on the management and disposal systems of plastic waste. The compulsory use of face masks to curb the infection and prevent transmission of the virus has led to addition of millions of face masks into the terrestrial and marine environment. The current study attempts to assess and quantify the rate of infection in coherence with the annual usage of face masks in various nations across the globe. The ecological footprint of the plastic waste generated from used and discarded face masks along with their potential impacts have also been discussed. The current study has quantified the total annual face masks across thirty-six nations to be more than 1.5 million ton. The total estimated figure for annual plastic waste and microplastics in all these nations was ∼4.2 million tonnes and 9774 thousand tonnes, which emerges as a great threat to the global efforts towards reduction of plastic usage. The emergence of Covid-19 pandemic has modified the living habits with new enterprises being set up for Covid essential products, but the associated hazard of these products has been significantly ignored. Hence this study attempts to present a quantitative baseline database towards interpretation and understanding of the hazards associated with microplastics and increased dependence on plastic products.

Effect of an N95 respirator and a surgical mask-covered N95 on the cardiovascular responses of dentists treating paediatric patients: A crossover clinical trial.

BACKGROUND: The studies on cardiovascular alterations when using an N95 respirator or surgical mask-covered N95 during dental treatments are limited. AIM: To investigate and compare the cardiovascular responses of dentists treating paediatric patients while wearing an N95 respirator or a surgical mask-covered N95. DESIGN: This was a crossover clinical trial in 18 healthy dentists wearing an N95 respirator or surgical mask-covered N95 during the dental treatment of paediatric patients. Oxygen saturation (SpO2 ), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were monitored at baseline, intraoperation, and postoperation. The data were analyzed using the generalized estimating equation. RESULTS: The mean SpO2 , HR, SBP, DBP, and MAP significantly changed from baseline up to the end of the procedures after wearing an N95 by 3.1%, 19.3%, 11.5%, 17.7%, and 13.8% and after wearing a surgical mask-covered N95 by 3.0%, 20.2%, 5.3%, 13.9%, and 8.8%, respectively (p < .05). No significant differences in these values were found between groups (p > .05). CONCLUSIONS: N95 respirators and surgical mask-covered N95s significantly impact the cardiovascular responses of dentists treating paediatric patients with no differences between the two types of masks.

Respiratory protection: what SARS-CoV-2 has taught us.

PURPOSE OF REVIEW: This review summarizes the epidemiological evidence for respiratory personal protective equipment for SARA-CoV-2, a topic of considerable controversy. RECENT FINDINGS: The main findings are that the observational studies and non-coronavirus disease 2019 (COVID-19) randomized trials do not provide clear evidence that the N95 respirators offer superior protection over surgical masks. A randomized controlled trial on COVID-19 provides evidence that the absolute risk to healthcare workers over time using surgical masks is similar to N95 respirators. SUMMARY: The implications of the findings are that surgical masks and N95 respirators can be considered for respiratory protection in healthcare workers.

Masking our emotions: Emotion recognition and perceived intensity differ by race and use of medical masks.

Although medical masks have played a key role in decreasing the transmission of communicable disease, they simultaneously reduce the availability of nonverbal cues fundamental to social interaction. In the present study, we determined the collective impact of medical masks on emotional expression recognition and perceived intensity as a function of actor race. Participants completed an emotional expression recognition task involving stimuli with or without medical masks. Across six basic emotional facial expressions, medical masks were associated with significantly more emotional expression recognition errors. Overall, the effects associated with race varied depending on the emotion and appearance of masks. Whereas recognition accuracy was higher for White relative to Black actors for anger and sadness, the opposite pattern was observed for disgust. Medical mask-wearing exacerbated actor-race related recognition differences for anger and surprise, but attenuated these differences for fear. Emotional expression intensity ratings were significantly reduced for all emotions except fear, where masks were associated with increased perceived intensity. Masks further increased already higher intensity ratings for anger in Black versus White actors. In contrast, masks eliminated the tendency to give higher intensity ratings for Black versus White sad and happy facial expressions. Overall, our results suggest that the interaction between actor race and mask wearing status with respect to emotional expression judgements is complex, varying by emotion in both direction and degree. We consider the implications of these results particularly in the context of emotionally charged social contexts, such as in conflict, healthcare, and policing.

SARS-CoV-2 airborne infection probability estimated by using indoor carbon dioxide.

Airborne transmission is one of the main routes of SARS-CoV-2 spread. It is important to determine the circumstances under which the risk of airborne transmission is increased as well as the effective strategy to reduce such risk. This study aimed to develop a modified version of the Wells-Riley model with indoor CO2 to estimate the probability of airborne transmission of SARS-CoV-2 Omicron strains with a CO2 monitor and to evaluate the validity of this model in actual clinical practices. We used the model in three suspected cases of airborne transmission presented to our hospital to confirm its validity. Next, we estimated the required indoor CO2 concentration at which R0 does not exceed 1 based on the model. The estimated R0 (R0, basic reproduction number) based on the model in each case were 3.19 in three out of five infected patients in an outpatient room, 2.00 in two out of three infected patients in the ward, and 0.191 in none of the five infected patients in another outpatient room. This indicated that our model can estimate R0 with an acceptable accuracy. In a typical outpatient setting, the required indoor CO2 concentration at which R0 does not exceed 1 is below 620 ppm with no mask, 1000 ppm with a surgical mask and 16000 ppm with an N95 mask. In a typical inpatient setting, on the other hand, the required indoor CO2 concentration is below 540 ppm with no mask, 770 ppm with a surgical mask, and 8200 ppm with an N95 mask. These findings facilitate the establishment of a strategy for preventing airborne transmission in hospitals. This study is unique in that it suggests the development of an airborne transmission model with indoor CO2 and application of the model to actual clinical practice. Organizations and individuals can efficiently recognize the risk of SARS-CoV-2 airborne transmission in a room and thus take preventive measures such as maintaining good ventilation, wearing masks, or shortening the exposure time to an infected individual by simply using a CO2 monitor.

Effect of short-term use of FFP2 (N95) masks on the salivary metabolome of young healthy volunteers: a pilot study.

The use of face masks has become an integral part of public life in the post-pandemic era. However, the understanding of the effect of wearing masks on physiology remains incomplete and is required for informing public health policies. For the first time, we report the effects of wearing FFP2 masks on the metabolic composition of saliva, a proximal matrix to breath, along with cardiopulmonary parameters. Un-induced saliva was collected from young (31.2 ± 6.3 years) healthy volunteers (n = 10) before and after wearing FFP2 (N95) masks for 30 minutes and analyzed using GCMS. The results showed that such short-term mask use did not cause any significant change in heart rate, pulse rate or SpO2. Three independent data normalization approaches were used to analyze the changes in metabolomic signature. The individuality of the overall salivary metabotype was found to be unaffected by mask use. However, a trend of an increase in the salivary abundance of L-fucose, 5-aminovaleric acid, putrescine and phloretic acid was indicated irrespective of the method of data normalization. Quantitative analysis confirmed increases in concentrations of these metabolites in saliva of paired samples amid high inter-individual variability. The results showed that while there was no significant change in measured physiological parameters and individual salivary metabotypes, mask use was associated with correlated changes in these metabolites plausibly originating from altered microbial metabolic activity. These results might also explain the change in odour perception reported to be associated with mask use. Potential implications of these changes on mucosal health and immunity warrants further investigation to evolve more prudent mask use policies.

Material flow analysis-based assessment of polypropylene-fiber-containing microplastics released from disposable masks: Characterizing distribution in the environmental media.

With the upsurge in the use of disposable masks during the coronavirus disease pandemic, improper disposal of discarded masks and their negative impact on the environment have emerged as major issues. Improperly disposed of masks release various pollutants, particularly microplastic (MP) fibers, which can harm both terrestrial and aquatic ecosystems by interfering with the nutrient cycling, plant growth, and the health and reproductive success of organisms. This study assesses the environmental distribution of polypropylene (PP)-containing MPs, generated from disposable masks, using material flow analysis (MFA). The system flowchart is designed based on the processing efficiency of various compartments in the MFA model. The highest amount of MPs (99.7 %) is found in the landfill and soil compartments. A scenario analysis reveals that waste incineration significantly reduces the amount of MP transferred to landfills. Therefore, considering cogeneration and gradually increasing the incineration treatment rate are crucial to manage the processing load of waste incineration plants and minimize the negative impact of MPs on the environment. The findings provide insights into the potential environmental exposure associated with the improper disposal of waste masks and indicate strategies for sustainable mask disposal and management.

Lack of behavioral effect of surgical mask leachate on the Asian shore crab Hemigrapsus sanguineus: Implications for invasion success in polluted coastal waters.

The COVID-19 pandemic generated a new source of plastic mass pollution, i.e. surgical masks, that preferentially accumulate in intertidal environments. Made of polymers, surgical masks are likely to leach additives and impact local intertidal fauna. As typical endpoints of complex developmental and physiological functions, behavioral properties are non-invasive key variables that are particularly studied in ecotoxicological and pharmacological studies, but have, first and foremost, adaptive ecological significance. In an era of ever-growing plastic pollution, this study focused on anxiety behaviors, i.e. startle response, scototaxis (i.e. preference for dark or light areas), thigmotaxis (i.e. preference for moving toward or away from physical barriers), vigilance and level of activity, of the invasive shore crab Hemigrapsus sanguineus in response to leachate from surgical masks. We first showed that in the absence of mask leachates H. sanguineus is characterized by a short startle time, a positive scototaxis, a strong positive thigmotaxis, and an acute vigilance behavior. Specifically, a significantly higher level of activity was observed in white areas, in contrast to the lack of significant differences observed in black areas. Noticeably, the anxiety behaviors of H. sanguineus did not significantly differ after a 6-h exposure to leachate solutions of masks incubated in seawater for 6, 12, 24, 48 and 96 h. In addition, our results were consistently characterized by a high inter-individual variability. This specific feature is discussed as an adaptive behavioral trait, which - through the observed high behavioral flexibility - increases H. sanguineus resilience to contaminant exposures and ultimately contribute to its invasion success in anthropogenically-impacted environments.

Face mask is an efficient tool to fight the Covid-19 pandemic and some factors increase the probability of its adoption.

This study examines the dynamic impact of face mask use on both infected cases and fatalities at a global scale by using a rich set of panel data econometrics. An increase of 100% of the proportion of people declaring wearing a mask (multiply by two) over the studied period lead to a reduction of around 12 and 13.5% of the number of Covid-19 infected cases (per capita) after 7 and 14 days respectively. The delay of action varies from around 7 days to 28 days concerning infected cases but is more longer concerning fatalities. Our results hold when using the rigorous controlling approach. We also document the increasing adoption of mask use over time and the drivers of mask adoption. In addition, population density and pollution levels are significant determinants of heterogeneity regarding mask adoption across countries, while altruism, trust in government and demographics are not. However, individualism index is negatively correlated with mask adoption. Finally, strict government policies against Covid-19 have a strong significant effect on mask use.

High engagement in nonpharmaceutical interventions and their associations with reduced COVID-19 among US college students.

BACKGROUND: Nonpharmaceutical interventions, including face mask-wearing, physical distancing, and avoidance of crowds and poorly ventilated spaces, have been widely recommended to limit the spread of SARS-CoV-2. To date, there is little data available on engagement in nonpharmaceutical interventions and COVID-19 in college students. Using a large sample of college students, we estimate the prevalence of engagement in mask-wearing, physical distancing, and avoidance of crowds/poorly ventilated spaces and their associations with COVID-19. METHODS: A cross-sectional study was conducted (February-March 2021) using a college-wide online survey among students (n = 2,132) in California. Multiple modified poisson regression models assessed associations between mask-wearing indoors, physical distancing (both indoors or public settings/outdoors), avoidance of crowds/poorly ventilated spaces and COVID-19, controlling for potential confounders. RESULTS: Fourteen percent (14.4%) reported a previous COVID-19 illness. Most students reported wearing masks consistently indoors (58%), and 78% avoided crowds/poorly ventilated spaces. About half (50%) reported consistent physical distancing in public settings/outdoor and 45% indoors. Wearing a mask indoors was associated with 26% lower risk of COVID-19 disease (RR = 0.74; 95% CI: 0.60,0.92). Physical distancing indoors and in public settings/outdoors was associated with a 30% (RR = 0.70; 95% CI: 0.56,0.88) and 28% (RR = 0.72; 95% CI: 0.58,0.90) decrease risk of COVID-19, respectively. No association was observed with avoidance of crowds/poorly ventilated spaces. The risk of COVID-19 declined as the number of preventive behaviors a student engaged in increased. Compared to those who did not engage in any preventive behaviors (consistently), students who consistently engaged in one behavior had a 25% lower risk (RR = 0.75; 95% CI: 0.53,1.06), those who engaged in two behaviors had 26% lower risk (RR = 0.74; 95% CI: 0.53,1.03), those who engaged in three behaviors had 51% lower risk (RR = 0.49; 95% CI: 0.33,0.74), and those who consistently engaged in all four behaviors had 45% lower risk of COVID-19 (RR = 0.55; 95% CI: 0.40,0.78). CONCLUSIONS: Wearing face masks and physical distancing were both associated with a lower risk of COVID-19. Students who engaged in more nonpharmaceutical interventions were less likely to report COVID-19. Our findings support guidelines promoting mask-wearing and physical distancing to limit the spread of COVID-19 on campuses and the surrounding communities.

Who wears the face mask? Preventive measures against COVID-19 in Latin America before vaccination.

OBJECTIVES: We analyze the profile of adults who used a mask in the context of the COVID-19 pandemic in Latin America, between October and November 2020, right before the mass vaccination campaigns. STUDY DESIGN: Based on the Latinobarometer 2020 data, we assess the individual, regional, cultural and political factors of people who used a mask in the context of the COVID-19 pandemic in 18 countries of Latin America. METHODS: We applied a logistic regression to model the probability of using the mask regularly to avoid being infected with the COVID-19 virus. RESULTS: Women, older people, those with higher education, those being employed and not working in temporarily jobs, retirees, students, people with a centrist political ideology, and Catholics had a higher chance of using a face mask on a regular basis. People living in Venezuela, Chile, Costa Rica and Brazil were the most likely to use face masks. CONCLUSION: These results highlight the need to understand the social forces behind the willingness to adopt non-pharmacological preventive measures to make them more effective in health crisis emergencies.

Face mask use during the COVID-19 pandemic was associated with breathing difficulties in adolescent patients with asthma.

AIM: Face masks have been used to prevent severe acute respiratory syndrome coronavirus-2 transmission. We investigated the impact of face mask use on paediatric patients with asthma. METHODS: Between February 2021 and January 2022, we surveyed adolescents aged 10-17 attending the paediatric outpatient clinic at the Lillebaelt Hospital, Kolding, Denmark with asthma, other breathing problems or no breathing problems. RESULTS: We recruited 408 participants (53.4% girls) with a median age of 14 years: 312 in the asthma group, 37 in the other breathing problems group and 59 in the no breathing problems group. Most participants experienced mask-related breathing impairment. The relative risk (RR) of experiencing severe breathing problems, compared to no problems, was more than four times as high for adolescents with asthma (RR 4.6, 95% CI 1.3-16.8, p = 0.02) than adolescents with no breathing problems. More than a third (35.9%) of the asthma group experienced mild asthma and 3.9% had severe asthma. Girls experienced more mild (RR 1.9, 95% CI 1.2-3.1, p < 0.01) and severe (RR 6.6, 95% CI 3.1-13.8, p < 0.01) symptoms than boys. Age had no effect. Adequate asthma control minimised negative effects. CONCLUSION: Face masks caused significant breathing impairment in most adolescents, particularly in those with asthma.

Abundance, spatial distribution, and chemical characterization of face masks on the beaches of SE Kanyakumari, India.

Personal Protective Equipment (PPE) is a new world of waste during the COVID-19 pandemic. In this baseline study, the occurrence of PPE faces masks were assessed on the eleven beaches of Kanyakumari, India concerning the abundance, spatial distribution, and chemical characterization (ATR-FTIR spectroscopy). A total of 1593 items/m2 of PPE face masks and their mean density of 0.16 PPE/m2, ranging from 0.02 to 0.54 PPE/m2 were determined in the study area. Kanyakumari beach (n = 430 items/m2) has the highest concentration of masks (26.99 %), with a mean density of 0.54 m2 due to recreational, sewage disposal, and tourism activities. This is perhaps the most important study describing the scientific data that focuses on the significant effects of communal activities and accessibility on COVID-19 PPE face mask pollution. It also highlights the need for sufficient management facilities to optimize PPE disposal.