How to modify your face mask to increase protection against COVID, according to a study –

STATEN ISLAND, N.Y. — Are you getting the most protection possible from your face mask? Recent research suggests you can increase the effectiveness of wearing a mask and reduce the spread of respiratory pathogens by making several small adjustments.

The study, published last month by the American Journal of Infection Control, provides guidance toward increasing the effectiveness of face masks to reduce the spread pathogens, including the coronavirus (COVID-19). Poorly fitted masks allow respiratory aerosols to escape through face seal leaks, the study found.

It identifies specific fit modifications and face mask combinations that should be used by the public, medical patients and health-care workers to improve the performance of face masks.

Face masks are used to reduce the spread of infectious viruses such as COVID-19 that are transmitted by respiratory aerosols and droplets produced during activities such as talking, breathing and coughing.

The U.S. Centers for Disease Control and Prevention (CDC) recommends a mask that is multi-layered, covers the nose and mouth, and forms a tight seal against the face.

“The performance of face masks as devices that control infection spread depends upon both the ability of the mask material to filter aerosols and on how well the mask fits the wearer,” Francoise M. Blachere, a research biologist for the National Institute for Occupational Safety and Health (NIOSH), and the paper’s lead author, told the Association for Professionals in Infection Control and Epidemiology.

The study’s results show that layering a three-ply cloth mask over a medical mask provided the best protection against respiratory aerosols. Additionally, securing a medical mask with an elastic brace also improved its performance.

Placing the cloth mask over a medical mask blocked ≥85% of cough aerosols and ≥91% of exhaled aerosols, the study found.

Adding a brace over a medical mask blocked ≥95% of cough aerosols and ≥99% of exhaled aerosols, it reported.

Using ear loop toggles or an ear loop strap, or knotting and tucking the mask, also increased performance, as compared to medical masks without modification.

Two other mask-fit modifications tried in the study — crossing the ear loops and placing a bracket under the mask — did not increase performance.

Medical masks without modification blocked >56% of cough aerosols and >42% of exhaled aerosols, the study found.

Blachere and colleagues used human subjects and manikins to evaluate the performance of multiple mask types, combinations, and modifications. The researchers conducted experiments simulating coughs and exhalations, and then measured the efficiency of the masks at blocking respiratory aerosols.

“Since the start of the COVID-19 pandemic, there has been considerable confusion about the most effective use of face masks, especially among the general public, to reduce the spread of infection,” said Ann Marie Pettis, the APIC 2021 president. “The NIOSH study findings are important and timely because they identify specific, practical combinations of face masks and mask modifications that may improve mask seal, and thereby measurably reduce the expulsion of infectious aerosols into the environment.”

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