Face masks: benefits and risks during the COVID-19 crisis

Christiane Matuschek; Friedrich Moll; Heiner Fangerau; Johannes C Fischer; Kurt Zänker; Martijn van Griensven; Marion Schneider; Detlef Kindgen-Milles; Wolfram Trudo Knoefel; Artur Lichtenberg; Balint Tamaskovics; Freddy Joel Djiepmo-Njanang; Wilfried Budach; Stefanie Corradini; Dieter Häussinger; Torsten Feldt; Björn Jensen; Rainer Pelka; Klaus Orth; Matthias Peiper; Olaf Grebe; Kitti Maas; Peter Arne Gerber; Alessia Pedoto; Edwin Bölke; Jan Haussmann

doi:10.1186/s40001-020-00430-5

Face masks: benefits and risks during the COVID-19 crisis

Christiane Matuschek, Friedrich Moll, Heiner Fangerau, Johannes C Fischer, Kurt Zänker, Martijn van Griensven, Marion Schneider, Detlef Kindgen-Milles, Wolfram Trudo Knoefel, Artur Lichtenberg, Balint Tamaskovics, Freddy Joel Djiepmo-Njanang, Wilfried Budach, Stefanie Corradini, Dieter Häussinger, Torsten Feldt, Björn Jensen, Rainer Pelka, Klaus Orth, Matthias PeiperOlaf Grebe, Kitti Maas, Peter Arne Gerber, Alessia Pedoto, Edwin Bölke^*, Jan Haussmann

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

BACKGROUND: The German government has made it mandatory to wear respiratory masks covering mouth and nose (MNC) as an effective strategy to fight SARS-CoV-2 infections. In many countries, this directive has been extended on shopping malls or public transportation. The aim of this paper is to critically analyze the statutory regulation to wear protective masks during the COVID-19 crisis from a medical standpoint.

METHODS: We performed an extensive query of the most recent publications addressing the prevention of viral infections including the use of face masks in the community as a method to prevent the spread of the infection. We addressed the issues of practicability, professional use, and acceptability based on the community and the environment where the user resided.

RESULTS: Upon our critical review of the available literature, we found only weak evidence for wearing a face mask as an efficient hygienic tool to prevent the spread of a viral infection. However, the use of MNC seems to be linked to relevant protection during close contact scenarios by limiting pathogen-containing aerosol and liquid droplet dissemination. Importantly, we found evidence for significant respiratory compromise in patients with severe obstructive pulmonary disease, secondary to the development of hypercapnia. This could also happen in patients with lung infections, with or without SARS-CoV-2.

CONCLUSION: Epidemiologists currently emphasize that wearing MNC will effectively interrupt airborne infections in the community. The government and the politicians have followed these recommendations and used them to both advise and, in some cases, mandate the general population to wear MNC in public locations. Overall, the results seem to suggest that there are some clinically relevant scenarios where the use of MNC necessitates more defined recommendations. Our critical evaluation of the literature both highlights the protective effects of certain types of face masks in defined risk groups, and emphasizes their potential risks.

Original language	English
Article number	32
Number of pages	8
Journal	European Journal of Medical Research
Volume	25
Issue number	1
DOIs	https://doi.org/10.1186/s40001-020-00430-5
Publication status	Published - 12 Aug 2020

Keywords

HEALTH-CARE WORKERS
N95 RESPIRATOR USE

Access to Document

10.1186/s40001-020-00430-5Licence: CC BY

Cite this

Matuschek, C., Moll, F., Fangerau, H., Fischer, J. C., Zänker, K., van Griensven, M., Schneider, M., Kindgen-Milles, D., Knoefel, W. T., Lichtenberg, A., Tamaskovics, B., Djiepmo-Njanang, F. J., Budach, W., Corradini, S., Häussinger, D., Feldt, T., Jensen, B., Pelka, R., Orth, K., ... Haussmann, J. (2020). Face masks: benefits and risks during the COVID-19 crisis. European Journal of Medical Research, 25(1), Article 32. https://doi.org/10.1186/s40001-020-00430-5

@article{eb8c21a2b37f4ff6932598a49898cd93,

title = "Face masks: benefits and risks during the COVID-19 crisis",

abstract = "BACKGROUND: The German government has made it mandatory to wear respiratory masks covering mouth and nose (MNC) as an effective strategy to fight SARS-CoV-2 infections. In many countries, this directive has been extended on shopping malls or public transportation. The aim of this paper is to critically analyze the statutory regulation to wear protective masks during the COVID-19 crisis from a medical standpoint.METHODS: We performed an extensive query of the most recent publications addressing the prevention of viral infections including the use of face masks in the community as a method to prevent the spread of the infection. We addressed the issues of practicability, professional use, and acceptability based on the community and the environment where the user resided.RESULTS: Upon our critical review of the available literature, we found only weak evidence for wearing a face mask as an efficient hygienic tool to prevent the spread of a viral infection. However, the use of MNC seems to be linked to relevant protection during close contact scenarios by limiting pathogen-containing aerosol and liquid droplet dissemination. Importantly, we found evidence for significant respiratory compromise in patients with severe obstructive pulmonary disease, secondary to the development of hypercapnia. This could also happen in patients with lung infections, with or without SARS-CoV-2.CONCLUSION: Epidemiologists currently emphasize that wearing MNC will effectively interrupt airborne infections in the community. The government and the politicians have followed these recommendations and used them to both advise and, in some cases, mandate the general population to wear MNC in public locations. Overall, the results seem to suggest that there are some clinically relevant scenarios where the use of MNC necessitates more defined recommendations. Our critical evaluation of the literature both highlights the protective effects of certain types of face masks in defined risk groups, and emphasizes their potential risks.",

keywords = "HEALTH-CARE WORKERS, N95 RESPIRATOR USE",

author = "Christiane Matuschek and Friedrich Moll and Heiner Fangerau and Fischer, {Johannes C} and Kurt Z{\"a}nker and {van Griensven}, Martijn and Marion Schneider and Detlef Kindgen-Milles and Knoefel, {Wolfram Trudo} and Artur Lichtenberg and Balint Tamaskovics and Djiepmo-Njanang, {Freddy Joel} and Wilfried Budach and Stefanie Corradini and Dieter H{\"a}ussinger and Torsten Feldt and Bj{\"o}rn Jensen and Rainer Pelka and Klaus Orth and Matthias Peiper and Olaf Grebe and Kitti Maas and Gerber, {Peter Arne} and Alessia Pedoto and Edwin B{\"o}lke and Jan Haussmann",

note = "Publisher Copyright: {\textcopyright} 2020 The Author(s).",

year = "2020",

month = aug,

day = "12",

doi = "10.1186/s40001-020-00430-5",

language = "English",

volume = "25",

journal = "European Journal of Medical Research",

issn = "0949-2321",

publisher = "BioMed Central",

number = "1",

}

Matuschek, C, Moll, F, Fangerau, H, Fischer, JC, Zänker, K, van Griensven, M, Schneider, M, Kindgen-Milles, D, Knoefel, WT, Lichtenberg, A, Tamaskovics, B, Djiepmo-Njanang, FJ, Budach, W, Corradini, S, Häussinger, D, Feldt, T, Jensen, B, Pelka, R, Orth, K, Peiper, M, Grebe, O, Maas, K, Gerber, PA, Pedoto, A, Bölke, E & Haussmann, J 2020, 'Face masks: benefits and risks during the COVID-19 crisis', European Journal of Medical Research, vol. 25, no. 1, 32. https://doi.org/10.1186/s40001-020-00430-5

TY - JOUR

T1 - Face masks: benefits and risks during the COVID-19 crisis

AU - Matuschek, Christiane

AU - Moll, Friedrich

AU - Fangerau, Heiner

AU - Fischer, Johannes C

AU - Zänker, Kurt

AU - van Griensven, Martijn

AU - Schneider, Marion

AU - Kindgen-Milles, Detlef

AU - Knoefel, Wolfram Trudo

AU - Lichtenberg, Artur

AU - Tamaskovics, Balint

AU - Djiepmo-Njanang, Freddy Joel

AU - Budach, Wilfried

AU - Corradini, Stefanie

AU - Häussinger, Dieter

AU - Feldt, Torsten

AU - Jensen, Björn

AU - Pelka, Rainer

AU - Orth, Klaus

AU - Peiper, Matthias

AU - Grebe, Olaf

AU - Maas, Kitti

AU - Gerber, Peter Arne

AU - Pedoto, Alessia

AU - Bölke, Edwin

AU - Haussmann, Jan

PY - 2020/8/12

Y1 - 2020/8/12

N2 - BACKGROUND: The German government has made it mandatory to wear respiratory masks covering mouth and nose (MNC) as an effective strategy to fight SARS-CoV-2 infections. In many countries, this directive has been extended on shopping malls or public transportation. The aim of this paper is to critically analyze the statutory regulation to wear protective masks during the COVID-19 crisis from a medical standpoint.METHODS: We performed an extensive query of the most recent publications addressing the prevention of viral infections including the use of face masks in the community as a method to prevent the spread of the infection. We addressed the issues of practicability, professional use, and acceptability based on the community and the environment where the user resided.RESULTS: Upon our critical review of the available literature, we found only weak evidence for wearing a face mask as an efficient hygienic tool to prevent the spread of a viral infection. However, the use of MNC seems to be linked to relevant protection during close contact scenarios by limiting pathogen-containing aerosol and liquid droplet dissemination. Importantly, we found evidence for significant respiratory compromise in patients with severe obstructive pulmonary disease, secondary to the development of hypercapnia. This could also happen in patients with lung infections, with or without SARS-CoV-2.CONCLUSION: Epidemiologists currently emphasize that wearing MNC will effectively interrupt airborne infections in the community. The government and the politicians have followed these recommendations and used them to both advise and, in some cases, mandate the general population to wear MNC in public locations. Overall, the results seem to suggest that there are some clinically relevant scenarios where the use of MNC necessitates more defined recommendations. Our critical evaluation of the literature both highlights the protective effects of certain types of face masks in defined risk groups, and emphasizes their potential risks.

AB - BACKGROUND: The German government has made it mandatory to wear respiratory masks covering mouth and nose (MNC) as an effective strategy to fight SARS-CoV-2 infections. In many countries, this directive has been extended on shopping malls or public transportation. The aim of this paper is to critically analyze the statutory regulation to wear protective masks during the COVID-19 crisis from a medical standpoint.METHODS: We performed an extensive query of the most recent publications addressing the prevention of viral infections including the use of face masks in the community as a method to prevent the spread of the infection. We addressed the issues of practicability, professional use, and acceptability based on the community and the environment where the user resided.RESULTS: Upon our critical review of the available literature, we found only weak evidence for wearing a face mask as an efficient hygienic tool to prevent the spread of a viral infection. However, the use of MNC seems to be linked to relevant protection during close contact scenarios by limiting pathogen-containing aerosol and liquid droplet dissemination. Importantly, we found evidence for significant respiratory compromise in patients with severe obstructive pulmonary disease, secondary to the development of hypercapnia. This could also happen in patients with lung infections, with or without SARS-CoV-2.CONCLUSION: Epidemiologists currently emphasize that wearing MNC will effectively interrupt airborne infections in the community. The government and the politicians have followed these recommendations and used them to both advise and, in some cases, mandate the general population to wear MNC in public locations. Overall, the results seem to suggest that there are some clinically relevant scenarios where the use of MNC necessitates more defined recommendations. Our critical evaluation of the literature both highlights the protective effects of certain types of face masks in defined risk groups, and emphasizes their potential risks.

KW - HEALTH-CARE WORKERS

KW - N95 RESPIRATOR USE

U2 - 10.1186/s40001-020-00430-5

DO - 10.1186/s40001-020-00430-5

M3 - (Systematic) Review article

C2 - 32787926

SN - 0949-2321

VL - 25

JO - European Journal of Medical Research

JF - European Journal of Medical Research

IS - 1

M1 - 32

ER -