Face coverings. Visors. Surgical masks. Respirators. PPE.
With so many different types of masks available, it can be difficult to know which is which and, more importantly, which option is the most effective in different situations.
So, let us walk you through each category one at a time…
Before diving into the different types of masks, it is first worth clarifying what is meant by ‘personal protective equipment’ (more commonly known simply as ‘PPE’).
PPE is typically only used in a limited number of settings, such as medical and industrial environments, to protect wearers against hazards and risks. For masks to be considered PPE, they must meet stringent regulations and have been tested for efficiency levels.
In the UK, it is mandatory to wear a face covering in most indoor public settings. According to government guidelines, a ‘face covering’ is something which safely covers the nose and mouth.
This guidance is quite misleading at first glance because, based on this definition, a face covering could cover pretty much any type of mask. However, in the context of coronavirus, the term ‘face covering’ typically refers to reusable cloth masks. The government website also states that you can use a scarf, bandana, religious garment or handmade cloth covering so long as it fits securely around the side of the face.
Nevertheless, the guidance is very clear that face coverings are not classified as PPE and are intended mainly to protect others from the spread of infection, but not the wearer. Although any material may provide a physical barrier to infection, reusable cloth masks are not tested for efficiency. It is also worth remembering that face coverings are recommended for use alongside other measures such as social distancing, hand hygiene and protective screens.
A face visor or shield is typically made of plastic and may be worn in addition to a face covering, but it should not be worn instead of one. This is because face visors or shields do not adequately cover the nose and mouth.
However, those exempt from wearing a face covering may choose to wear a visor to create at least some form of barrier between themselves and others.
Surgical (medical) masks
Surgical masks — also known as ‘Type-IIR masks’ — are loose-fitting, soft, pleated, disposable devices that create a physical barrier between the wearer’s mouth and nose and the environment.
Unlike face coverings, surgical masks are manufactured to a recognised standard and are resistant to droplets of fluids and splashes. They are designed to be worn in medical settings to limit the spread of infection and are mainly intended for healthcare professionals to wear to protect patients, for example, during surgical procedures.
Although Type-IIR masks promise 98% efficiency, this is based on ‘bacterial filtering efficiency’, but the airborne aerosol droplets that COVID-19 is transmitted in are only about one micron in size — three times smaller than the bacteria Type-IIR masks are designed to capture! They are also only rated for their exhalation filtering efficiency, meaning they are certified to prevent the user from infecting those around them but not to protect the user themselves.
In a medical environment, where the masks are used correctly and changed frequently, it is estimated that surgical masks are about 67% effective in protecting the wearer. However, in everyday use, people are unlikely to use these masks correctly. Surgical masks are, therefore, not considered PPE when worn outside of a healthcare setting.
The WHO (World Health Organization) recommends wearing an N95 or FFP2 respirator-style mask ‘when entering a room where patients are suspected or confirmed of being infected with 2019-nCoV’. This is because FFP2 respirator masks provide a better seal around the mask’s edges (less than 8% leakage). They are also tested for both inhalation and exhalation, meaning they are designed primarily to protect the user, as well as prevent them from passing the infection to those around them.
FFP2 filters are rated to stop 94% of particles at 0.3 microns (the most penetrating and, therefore, most difficult particle size to capture), whereas N95 filters are rated to stop 95% of these particles. There is little difference between the two types — FFP2 is just the European standard whilst N95 is used in the US.
Until recently, fears over supply shortages meant disposable FFP2 masks were typically reserved for frontline workers. But now that supply chains have steadied, there are calls for FFP2 masks to become compulsory. Austria and the German state of Bavaria have already made FFP2 masks mandatory in shops and on public transport, and many other countries have discussed doing the same.
However, there are some practical issues with this as disposable FFP2 masks are very expensive and create an excessive amount of waste material compared to reusable cloth or single-use Type-IIR surgical masks.
Medical silicone mask
One type of mask you may not have heard as much about is a medical silicone FFP2 mask. These reusable respirator-style masks provide a host of other benefits over disposable FFP2 masks.
For one, medical-grade silicone contains ‘silver ions’, meaning its surface is permanently antimicrobial. This is a very beneficial feature when applied to a protective face mask because it protects the user from transferring bacteria or viruses from the surfaces they touch onto their mask or face.
Medical silicone can also be sterilised in just five minutes using a microwave, oven or boiling water. Combined with replaceable FFP2 filters, which take only a few seconds to change, this presents a much safer, more convenient and more affordable alternative to the other face masks currently available.
These filters also create less than 20% of the waste material compared to a standard Type-IIR mask and 10% the waste material of your average FFP2 disposable — making them a more sustainable solution, too.
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