Minimizing Aerosol Leakage from Facemasks in the COVID-19 Pandemic
Background: Aerosol therapies with vented facemasks are considered a risk for nosocomial transmission of viruses such as severe acute respiratory syndrome coronavirus 2. The transmission risk can be decreased by minimizing aerosol leakage and filtering the exhaled air. Objective: In this study, we determined which closed facemask designs show the least leakage. Methods: Smoke leakage was quantified during in- and exhalation in a closed system with expiration filter for three infant, six child, and six adult facemasks (three times each mask), using age-appropriate anatomical face models and breathing patterns. To assess leakage, smoke release was recorded and cumulative average pixel intensity (cAPI) was calculated. Results: In the adult group, aircushion edges resulted in less leakage than soft edges (cAPI: 407 ± 250 vs. 774 ± 152) (p = 0.004). The Intersurgical® Economy 5 mask (cAPI: 146 ± 87) also released less smoke than the Intersurgical® Clearlite 5 (cAPI: 748 ± 68) mask with the same size, but different geometry and edge type (p-value <0.05). Moreover, mask size had an effect, as there was a difference between Intersurgical® Economy 4 (cAPI: 708 ± 346) and 5, which have the same geometry but a different size (p-value <0.05). Finally, repositioning masks increased the standard deviations. Mask leakage was not dependent on breathing patterns within the child group. Conclusions: Mask leakage can be minimized by using a closed system with a well-fitting mask that is appropriately positioned. To decrease leakage, and therewith minimize potential viral transmission, selecting a well-fitting mask with an aircushion edge is to be recommended.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Journal of aerosol medicine and pulmonary drug delivery - 36(2023), 3 vom: 29. Juni, Seite 101-111 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Frankfort, Mylene G H [VerfasserIn] |
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| Links: |
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| Themen: |
Aerosol |
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| Anmerkungen: |
Date Completed 15.06.2023 Date Revised 15.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1089/jamp.2022.0036 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356751244 |
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| 245 | 1 | 0 | |a Minimizing Aerosol Leakage from Facemasks in the COVID-19 Pandemic |
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| 500 | |a Date Revised 15.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Background: Aerosol therapies with vented facemasks are considered a risk for nosocomial transmission of viruses such as severe acute respiratory syndrome coronavirus 2. The transmission risk can be decreased by minimizing aerosol leakage and filtering the exhaled air. Objective: In this study, we determined which closed facemask designs show the least leakage. Methods: Smoke leakage was quantified during in- and exhalation in a closed system with expiration filter for three infant, six child, and six adult facemasks (three times each mask), using age-appropriate anatomical face models and breathing patterns. To assess leakage, smoke release was recorded and cumulative average pixel intensity (cAPI) was calculated. Results: In the adult group, aircushion edges resulted in less leakage than soft edges (cAPI: 407 ± 250 vs. 774 ± 152) (p = 0.004). The Intersurgical® Economy 5 mask (cAPI: 146 ± 87) also released less smoke than the Intersurgical® Clearlite 5 (cAPI: 748 ± 68) mask with the same size, but different geometry and edge type (p-value <0.05). Moreover, mask size had an effect, as there was a difference between Intersurgical® Economy 4 (cAPI: 708 ± 346) and 5, which have the same geometry but a different size (p-value <0.05). Finally, repositioning masks increased the standard deviations. Mask leakage was not dependent on breathing patterns within the child group. Conclusions: Mask leakage can be minimized by using a closed system with a well-fitting mask that is appropriately positioned. To decrease leakage, and therewith minimize potential viral transmission, selecting a well-fitting mask with an aircushion edge is to be recommended | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a aerosol | |
| 650 | 4 | |a aerosol therapy | |
| 650 | 4 | |a facemask | |
| 650 | 4 | |a leakage | |
| 650 | 4 | |a nosocomial transmission | |
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| 700 | 1 | |a Lauwers, Iris |e verfasserin |4 aut | |
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| 700 | 1 | |a Dijkstra, Sjoerd F |e verfasserin |4 aut | |
| 700 | 1 | |a Boormans, Liza H G |e verfasserin |4 aut | |
| 700 | 1 | |a Schouten, Nicolaas A |e verfasserin |4 aut | |
| 700 | 1 | |a van Donkelaar, Corrinus C |e verfasserin |4 aut | |
| 700 | 1 | |a Janssens, Hettie M |e verfasserin |4 aut | |
| 700 | 0 | |a Team VERO |e verfasserin |4 aut | |
| 700 | 1 | |a Idema, Iris Merith E |e investigator |4 oth | |
| 700 | 1 | |a Jong, Tim de |e investigator |4 oth | |
| 700 | 1 | |a Lauwers, Romy T J |e investigator |4 oth | |
| 700 | 1 | |a Lensen, Irene S |e investigator |4 oth | |
| 700 | 1 | |a Verberne, Lex P B |e investigator |4 oth | |
| 700 | 1 | |a Diepens, J F L |e investigator |4 oth | |
| 700 | 1 | |a Rutten, M C M |e investigator |4 oth | |
| 700 | 1 | |a Blocken, B |e investigator |4 oth | |
| 700 | 1 | |a van Berkum, E E M |e investigator |4 oth | |
| 700 | 1 | |a Hagedoorn, P |e investigator |4 oth | |
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