A Guide to Face Masks
For those previously inexpert in the world of Personal Protective Equipment (PPE), navigating the newly-relevant face mask market is undoubtedly a confusing and frustrating journey. I see many people who lack an understanding or have some misconceptions about the purposes and designs of the various types of masks, so I wanted to offer some information and clarification on this topic.
Let’s first talk about cloth masks. I wrote another blog examining some noteworthy clinical research about cloth masks and how they performed (or rather didn’t) in a randomized controlled trial. If you haven’t checked that out, it’s a great in-depth breakdown of the facts that have formed my professional opinion on cloth masks—which is that they are not a good solution. The thing is, they just don’t perform according to the research (where they’re being used in the most rigidly proper/clean way anyone could ever aspire to).
This leads me to my main point on cloth masks…I’m willing to go out on a limb here and say that they are likely doing more harm than good to anyone. Why? Because I know virtually no one is washing them every day the way they should. So not only are the germs not effectively being blocked, but they’re just being extraneously spread around to everything (including your face) by these germ magnets that have become more of an attempt to be politically correct than a legitimate attempt at infectious disease control.
Moving on to surgical (often called 3-ply) masks, there’s a fundamental fact about this type of mask that I think a lot of people don’t know or understand: their primary purpose is self- containing germs, not keeping them out. In other words, the goal is preventing viral particles from spreading to the environment from a person carrying the virus. Surgical masks are not designed to protect the wearer from airborne particles, such as the microscopic respiratory droplets generated by coughs, sneezes, and even talking, which can contain infectious material and suspend in the air for long periods of time. These masks are called “surgical” masks because they are designed to solve the infection control problems of a surgical setting:
1.) They prevent large splashes or sprays of body fluids from entering the nose/mouth of a practitioner in the Operating Room
2.) They prevent the breath/speech particles of said practitioner from contaminating a sterile field (an entirely germ-free area, such as a table of surgical tools or an open body cavity)
Surgical masks also find a large part of their purpose in being worn by persons who are already ill, to limit the excessive spraying of germs into the environment during coughs and sneezes. Though surgical masks will provide some level of protection for a healthy person who is trying to keep germs away, they aren’t necessarily the most effective choice for this, as they allow a great amount of air leakage because they do not fit tightly around the face. Think of it this way: surgical masks are designed to provide a broad barrier between one’s face and potential fluid sprays, and to contain one’s own germs. This self-containing purpose is the main reason why the general public is being instructed to wear face masks during the Coronavirus pandemic.
But if you’re in close contact with someone who’s sick with an airborne disease (airborne means that the disease is spread through microscopic respiratory droplets that are so small they can suspend in the air for significant periods of time), such as tuberculosis or COVID-19, you turn to a respirator mask. A respirator mask is called a respirator because it forces the air you breathe through a filter—thus, as I like to think of it, it “respires” for you.
The filter layers in a respirator mask are made to block a given minimum percentage of airborne particles from penetrating the mask. For example, an N95 or KN95 will filter out at least 95% of particles when worn properly. They’re designed to cover the nose and mouth and form a seal around the face, preventing air from leaking in around the edges of the mask (as occurs with a surgical mask). It’s critical to the function of a respirator that it fits properly and forms a good seal around the face, so that airborne particles can’t find their way in through gaps between the mask and the skin. In fact, healthcare providers go through a “fit testing” process for respirator masks, as they come in many different models that can be used to find the best fit on different faces.
In summary, I’ve outlined the essential differences in use between a 3-ply surgical mask and a respirator such as an N95 or KN95, as well as the populations or settings each mask may be appropriate for:
- Surgical masks are primarily used to keep germs in, and provide a broad barrier for large cough/sneeze droplets that may come your In the midst of the Coronavirus pandemic, their functional purpose among the general public is to prevent people who may be carriers of the virus from spreading it into the environment and to others through their normal breathing and talking, or coughing and sneezing.
- Respirator masks are used to keep germs out. These are typically only necessary for those in close contact with ill persons/potential virus carriers, such as healthcare providers, dentists, or those who work in healthcare Members of the general public who are immunocompromised may also choose to wear respirators while in social/public settings, as they are much more susceptible to developing infection from things that may be floating around in the air.
I hope this article is helpful for anyone who’s found themselves in a sea of confusion or just hasn’t been able to get the right information about face masks. If you learned something here, or you have any questions or feel I’ve left a piece of important information out, please leave a comment below!
Kailey Lareau, BSN, RN
Disclaimer: This blog provides general information only. It does not provide medical advice nor is it a substitute for the advice of a physician. Persons are advised to always consult their healthcare provider for any specific information about personal health.