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Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic?


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This study examined homemade masks as an alternative to commercial face masks. Several household materials were evaluated for the capacity to block bacterial and viral aerosols. Twenty-one healthy volunteers made their own face masks from cotton t-shirts; the masks were then tested for fit. The number of microorganisms isolated from coughs of healthy volunteers wearing their homemade mask, a surgical mask, or no mask was compared using several air-sampling techniques. The median-fit factor of the homemade masks was one-half that of the surgical masks. Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask. Our findings suggest that a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection. (Disaster Med Public Health Preparedness. 2013;0:1-6).
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Testing the Efficacy of Homemade Masks: Would
They Protect in an Influenza Pandemic?
Anna Davies, BSc, Katy-Anne Thompson, BSc, Karthika Giri, BSc, George Kafatos, MSc,
Jimmy Walker, PhD, and Allan Bennett, MSc
Objective: This study examined homemade masks as an alternative to commercial face masks.
Methods: Several household materials were evaluated for the capacity to block bacterial and viral aerosols.
Twenty-one healthy volunteers made their own face masks from cotton t-shirts; the masks were then tested
for fit. The number of microorganisms isolated from coughs of healthy volunteers wearing their homemade
mask, a surgical mask, or no mask was compared using several air-sampling techniques.
Results: The median-fit factor of the homemade masks was one-half that of the surgical masks. Both
masks significantly reduced the number of microorganisms expelled by volunteers, although the
surgical mask was 3 times more effective in blocking transmission than the homemade mask.
Conclusion: Our findings suggest that a homemade mask should only be considered as a last resort to
prevent droplet transmission from infected individuals, but it would be better than no protection.
(Disaster Med Public Health Preparedness. 2013;0:1–6)
Key Words: homemade facemasks, respirators, airborne transmission, microbial dispersion, pandemic
Wearing a face mask in public areas may
impede the spread of an infectious disease
by preventing both the inhalation of
infectious droplets and their subsequent exhalation
and dissemination. In the event of a pandemic
involving an airborne-transmissible agent, the general
public will have limited access to the type of high-
level respiratory protection worn by health care
workers, such as N95 respirators. Images of members
of the public wearing surgical masks were often used
to illustrate the 2009 H1N1 flu pandemic. However,
the evidence of proportionate benefit from widespread
use of face masks is unclear.
A recent prospective cluster-randomized trial compar-
ing surgical masks and non-fit-tested P2 masks (filters
at least 94% of airborne particles) with no mask use in
the prevention of influenza-like illness. The findings
of the study found that adherence to mask use
significantly reduced (95% CI, 0.09-0.77; P5.015)
the risk for infection associated with influenza-like
illness, but that less than 50% of participants wore
masks most of the time.
Facemasks may prevent
contamination of the work space during the outbreak
of influenza or other droplet-spread communicable
disease by reducing aerosol transmission. They may
also be used to reduce the risk of body fluids, including
blood, secretions, and excretions, from reaching the
wearer’s mouth and nose.
To date, studies on the efficacy and reliability of face
masks have concentrated on their use by health care
workers. Although health care workers are likely to
be one of the highest risk groups in terms of exposure,
they are also more likely to be trained in the use of
masks and fit tested than the general public. Should
the supply of standard commercial face masks not
meet demand, it would be useful to know whether
improvised masks could provide any protection to
others from those who are infected.
In this study, common household materials(see
Table 1) were challenged with high concentrations
of bacterial and viral aerosols to assess their filtration
efficiencies. Surgical masks have been considered the
type of mask most likely to be used by the general
public, and these were used as a control. The pressure
drop across each of the materials was measured to
determine the comfort and fit between face and mask
that would be needed to make the material useable in
mask form. We devised a protocol for constructing a
‘‘homemade’’ mask, based on the design of a surgical
mask, and volunteers were invited to make their own
masks. These were then quantitatively fit tested. To
determine the effect of homemade and surgical masks
in preventing the dispersal of droplets and aerosol
particles produced by the wearer, the total bacterial
Disaster Medicine and Public Health Preparedness 1
Copyright &2013 Society for Disaster Medicine and Public Health, Inc. DOI: 10.1017/dmp.2013.43
count was measured when the volunteers coughed wearing
their homemade mask, a surgical mask, and no mask.
Testing the Filtration Efficiency
A range of common household materials were tested, together
with the material from a surgical mask (Mo
¨lnlycke Health Care
Barrier face mask 4239, EN14683 class I), for comparison.
Circular cutouts of the tested materials were placed without
tension in airtight casings, creating a ‘‘filter’’ in which the
material provided the only barrier to the transport of the aerosol.
A Henderson apparatus allows closed-circuit generation of
microbial aerosols from a Collison nebulizer at a controlled
relative humidity. This instrument was used to deliver the
challenge aerosol across each material at 30 L/min using
the method of Wilkes et al,
which is about 3 to 6 times per
minute the ventilation of a human at rest or doing light work,
but is less than 0.1 the flow of an average cough.
Downstream air was sampled simultaneously for 1 minute into
10 ml of phosphate buffer manucol antifoam using 2 all-glass
impingers. One impinger sampled the microorganisms that
had penetrated through the material filter, while the other
sampled the control (no filter). The collecting fluid was
removed from the impingers and assayed for microorganisms.
This test was performed 9 times for each material. The
filtration efficiency (FE) of the fabric was calculated using the
following formula (cfu indicate colony-forming units):
FE ¼Upstream cfu Downstream cfu 100
Upstream cfu
The pressure drop across the fabric was measured using a
manometer (P200UL, Digitron), with sensors placed on
either side of the filter casing, while it was challenged with a
clean aerosol at the same flow rate.
Two microorganisms were used to simulate particle challenge:
Bacillus atrophaeus is a rod-shaped spore-forming bacterium
(0.95-1.25 mm) known to survive the stresses caused by
The suspension was prepared from batches
previously prepared by the Health Protection Agency, Centre
for Emergency Preparedness and Response Production Division.
Each material was challenged with approximately 10
B atrophaeus.
Bacteriophage MS2 (MCIMB10108) is a nonenveloped
single-stranded RNA coliphage, 23 nm in diameter, known
to survive the stresses of aerosolization.
Each material was
challenged with approximately 10
plaque-forming units
(pfu) of bacteriophage MS2.
The two test organisms can be compared in size to influenza
virus, which is pleomorphic and ranges from 60 to 100 nm;
Yersinia pestis, which is 0.75 mm; Banthracis,which is 1 to
1.3 mm; Francisella tularensis, which is 0.2 mm; and Mycobacterium
tuberculosis, which is 0.2 to 0.5 mm.
Bacteriophage MS2 and
B atrophaeus were chosen as the test organisms to represent
influenza virus. This decision was made not only because of the
lower risks of associated infection but also because the work
would be technically easier to carry out using an Advisory
Committee on Dangerous Pathogens (ACDP) class 1 organism
versus an ACDP class 2 organism influenza.
Making the Face Mask
For this study, 21 healthy volunteers were recruited, 12 men
and 9 women. The participants were aged between 20 and
44 years; the majority was in the 20- to 30-year age range.
Each volunteer made a homemade face mask following a
protocol devised by the authors. All face masks were made
with 100% cotton t-shirt fabric using sewing machines to
speed construction. A surgical mask (Mo
¨lnlycke Health Care
Filtration Efficiency and Pressure Drop Across Materials Tested with Aerosols of Bacillus atrophaeus and Bacteriophage
MS2 (30 L/min)
B atrophaeus Bacteriophage MS2 Pressure Drop Across Fabric
Mean % Filtration Efficiency SD Mean % Filtration Efficiency SD Mean SD
100% cotton T-shirt 69.42 (70.66) 10.53 (6.83) 50.85 16.81 4.29 (5.13) 0.07 (0.57)
Scarf 62.30 4.44 48.87 19.77 4.36 0.19
Tea towel 83.24 (96.71) 7.81 (8.73) 72.46 22.60 7.23 (12.10) 0.96 (0.17)
Pillowcase 61.28 (62.38) 4.91 (8.73) 57.13 10.55 3.88 (5.50) 0.03 (0.26)
Antimicrobial Pillowcase 65.62 7.64 68.90 7.44 6.11 0.35
Surgical mask 96.35 0.68 89.52 2.65 5.23 0.15
Vacuum cleaner bag 94.35 0.74 85.95 1.55 10.18 0.32
Cotton mix 74.60 11.17 70.24 0.08 6.18 0.48
Linen 60.00 11.18 61.67 2.41 4.50 0.19
Silk 58.00 2.75 54.32 29.49 4.57 0.31
Numbers in parentheses refer to the results from 2 layers of fabric.
Are Homemade Masks Effective?
Disaster Medicine and Public Health Preparedness2
Barrier face mask 4239, EN14683 class I) was used as
a control. Also, all volunteers completed a questionnaire
indicating their opinions of mask wearing.
Determining the Fit Factor of the Mask
A commercial fit test system (TSI PortaCount Plus Respirator
Fit Tester and N95- Companion Module model 8095) was
used to measure respirator fit by comparing the concentration
of microscopic particles outside the respirator with the
concentration of particles that have leaked into the respirator.
The ratio of these 2 concentrations is known as the fit factor.
To conduct the fit test, the apparatus was set up and operated
according to the manufacturer’s instructions.
Volunteers were instructed to fit their surgical and homemade
face masks with no help or guidance from the operator; to
ensure that the mask was comfortable for 2 minutes; the
participants were given time to purge any particles trapped
inside the mask. The fit test was then conducted with
volunteers performing the following consecutive exercises,
each lasting 96 seconds: (1) normal breathing, (2) deep
(3) head moving side to side, (4) head moving up
and down, (5) talking aloud (reading a prepared paragraph),
(6) bending at the waist as if touching their toes, and
(7) normal breathing.
Determining the Effect of Masks in Preventing the
Dispersal of Droplets and Aerosol
An enclosed 0.5-m
mobile sampling chamber, or cough box,
which was constructed for the purpose of sampling aerosols and
droplets from healthy volunteers (PFI Systems Ltd, Milton
Keynes), was placed in a 22.5-m
high-frequency particulate
air-filtered environmental room. Four settle plates were placed
in the cough box to sample for droplets, together with a 6-stage
Andersen sampler to sample and separate small particles.
A Casella slit-air sampler
was also attached to the cough box.
Tryptose soya agar was used as the culture medium. Volunteers
wearing protective clothing (Tyvek suits) coughed twice into
the box, and the air inside was sampled for 5 minutes. Each
volunteer was sampled 3 times: wearing the homemade mask,
the surgical mask, and no mask. The air within the cough box
was high-frequency particulate air filtered for 5 minutes
between each sample to prevent cross-contamination between
samples. The plates were incubated for a minimum of 48 hours
at 378C before counting.
Statistical Analysis
To evaluate the face mask fit, the median and interquartile
range were calculated for each exercise and face mask for
the 21 individuals. Wilcoxon sign rank tests were used to
compare the masks. The same approach was used to
determine differences between the different mask types
and their efficacy in preventing dissemination of droplets
and particles
Filtration Efficacy
All the materials tested showed some capability to block
the microbial aerosol challenges. In general, the filtration
efficiency for bacteriophage MS2 was 10% lower than for
B atrophaeus (Table 1). The surgical mask had the highest
filtration efficiency when challenged with bacteriophage
MS2, followed by the vacuum cleaner bag, but the bag’s
stiffness and thickness created a high pressure drop across
the material, rendering it unsuitable for a face mask. Simi-
larly, the tea towel, which is a strong fabric with a thick
weave, showed relatively high filtration efficiency with both
B atrophaeus and bacteriophage MS2, but a high pressure
drop was also measured.
The surgical mask (control) showed the highest filtration
efficiency with B atrophaeus. Also, as expected, its measured
low pressure drop showed it to be the most suitable material
among those tested for use as a face mask. The pillowcase and
the 100% cotton t-shirt were found to be the most suitable
household materials for an improvised face mask. The slightly
stretchy quality of the t-shirt made it the more preferable
choice for a face mask as it was considered likely to provide a
better fit.
Although doubling the layers of fabric did significantly
increase the pressure drop measured across all 3 materials
(P,.01 using Wilcoxon sign rank test), only the 2 layers of
tea towel material demonstrated a significant increase in
filtration efficiency that was marginally greater than that of
the face mask.
In the questionnaire on mask use during a pandemic,
6 participants said they would wear a mask some of the time,
6 said they would never wear a mask, and 9 either did not
know or were undecided. None of the participants said that
they would wear a mask all of the time. With 1 exception, all
participants reported that their face mask was comfortable.
However, the length of time each participant kept their mask
on during testing was minimal (15 min), and with long-term
wear, comfort might decrease.
Facemask Fit Testing
A Wilcoxon sign rank test showed a significant difference
between the homemade and surgical mask for each exercise
and in total (all tests showed P,.001). The median and
interquartile range for each mask and exercise are given in
Table 2.
Prevention of Droplet and Particle Dissemination
When Coughing
Results from the cough box experiments showed that both
the surgical mask and the homemade mask reduced the total
number of microorganisms expelled when coughing (P,.001
and P5.004, respectively; see Table 3).
Are Homemade Masks Effective?
Disaster Medicine and Public Health Preparedness 3
On analyzing the effect of mask wearing in reducing the
number of microorganisms isolated from the Anderson air
sampler (Table 4), the surgical mask was found to be
generally more effective in reducing the number of micro-
organisms expelled than the homemade mask, particularly at
the lowest particle sizes. The number of microorganisms
isolated from the coughs of healthy volunteers was generally
low, although this varied according to the individual sampled
(Table 3). It is possible, therefore, that the sampling
limitations negatively affected the statistical analysis.
Pearson x
tests comparing the proportion of particles greater
than 4.7 mm in diameter and particles less than 4.7mmin
diameter found that the homemade mask did not significantly
reduce the number of particles emitted (P5.106). In contrast,
the surgical mask did have a significant effect (P,.001).
Facemasks reduce aerosol exposure by a combination of the
filtering action of the fabric and the seal between the mask
and the face. The filtration efficiency of the fabric depends
on a variety of factors: the structure and composition of the
fabric, and the size, velocity, shape, and physical properties of
the particles to which it is exposed.
Although any material
may provide a physical barrier to an infection, if as a mask it
does not fit well around the nose and mouth, or the material
freely allows infectious aerosols to pass through it, then it will
be of no benefit.
The test organisms in this study can be used to estimate
the efficacy of these masks against influenza virus because
essentially any aerosolized particle will behave predominately
in the air as a result of its physical characteristics rather than
its biological properties (ie, influenza virus particles will travel
in the air in the same manner as particles of an equivalent
size). Therefore, as we have tested a viral pathogen smaller
than influenza and a bacterial pathogen larger than influenza,
we have tested the face masks with a suitable challenge across
the size range of influenza virus particles. Furthermore, the
data from this study could also be applied to other organisms
within this size range that are potentially transmitted via the
aerosol route.
Quantitative fit testing can only estimate the combined
effects of filtration efficiency and goodness of fit. Although
sensitive to particles with diameters as small as 0.02 mm, it is
not sensitive to variations in particle size, shape, composition,
or refractive index. As a result, this method of fit testing
does not allow the distinction between true bioaerosols and
droplet contamination.
A study conducted in the Netherlands using a commercial
fit-test system (Portacount Plus Respirator Fit Tester) on
volunteers wearing both improvised masks made from tea
cloths and surgical masks over a 3-hour period found results
similar to those found in this study.
The authors
demonstrated a median protection factor of between 2.2
and 2.5 for various activities when wearing a mask with a tea
Median and Interquartile Range Results from
Respirator Fit Testing of Homemade and Surgical
Median Interquartile Range
Condition Homemade Mask Surgical Mask
Normal breathing 2.0 (2.0, 2.5) 6.0 (2.5, 9.0)
Heavy breathing 2.0 (2.0, 3.0) 7.0 (2.5, 13.5)
Head moving side to side 2.0 (1.0, 2.0) 5.0 (3.0, 7.0)
Head moving up and down 2.0 (1.5, 2.0) 5.0 (3.0, 7.0)
Bending over 1.0 (1.0, 2.0) 3.0 (2.0, 9.0)
Talking 2.0 (1.0, 2.0) 6.0 (3.0, 12.0)
Normal 2.0 (1.0, 2.0) 5.0 (2.0, 8.5)
All data 2.0 (1.0, 2.0) 5.0 (3.0, 9.0)
Median Colony-Forming Units by Sampling Method
Isolated From Volunteers Coughing When Wearing a
Surgical Mask, a Homemade Mask, and No Mask
Median Interquartile Range
Sampling Method No Mask Homemade Mask P
Air 6.0 (1.0, 26.5) 1.0 (0.5, 6.5) .007
Settle plates 1.0 (0.0, 3.0) 1.0 (0.0, 2.0) .224
Total 2.0 (0.0, 12.3) 1.0 (0.0, 3.0) .004
Median Interquartile Range
Sampling Method No Mask Surgical Mask P
Air 6.0 (1.0, 26.5) 1.0 (0.5, 3.0) .002
Settle plates 1.0 (0.0, 3.0) 0.0 (0.0, 0.0) .002
Total 2.0 (0.0, 12.3) 0.0 (0.0, 1.0) ,.001
Total Colony-Forming Units Isolated by Particle Size
From 21 Volunteers Coughing When Wearing a
Surgical Mask, Homemade Mask, and No Mask
Particle Diameter, mm No Mask Homemade Mask Surgical Mask
4.7-7 18 7 7
3.3-4.7 5 4 4
2.1-3.3 47 7 5
1.1-2.1 100 16 6
0.65-1.1 21 6 3
Total 200 43 30
Are Homemade Masks Effective?
Disaster Medicine and Public Health Preparedness4
towel filter and protection factors of between 4.1 and 5.3
for the surgical mask. It was interesting that the study also
found that median protection factors increased over the
3-hour period for those wearing the homemade masks,
decreased for those wearing filtering face piece (FFP2) masks
that lower the wearer’s exposure to airborne particles by a
factor of 10, and showed no consistent pattern for those
wearing a surgical mask.
The materials used in this published study were fresh and
previously unworn. It is likely that materials conditioned
with water vapor, to create a fabric similar to that which has
been worn for a couple of hours, would show very different
filtration efficiencies and pressure drops. In contrast, a study
of breathing system filters found a greater breakthrough of
bacteriophage MS2 on filters that had been preconditioned.
Although the droplet sizes for both virus and bacteria were
the same and affected the filter media in a similar manner, it
was suggested that the viruses, after contact with the moisture
on the filter, were released from their droplet containment,
and driven onward by the flow of gas.
The average concentration of Streptococcus organisms in
saliva has been estimated to be 6.7 310
is higher than that of influenza viruses in inoculated
Therefore, the number of oral microorganisms
isolated may well provide an indication of the concentration
of influenza being shed. Results from the cough box
demonstrated that surgical masks have a significant effect in
preventing the dispersal of large droplets and some smaller
particles when healthy volunteers coughed. The homemade
mask also prevented the release of some particles, although
not at the same level as the surgical mask. The numbers
of microorganisms isolated from the coughs of healthy
volunteers was in general very low, and it is likely that had
we used volunteers with respiratory infections, the homemade
mask may have shown a more significant effect in preventing
the release of droplets.
It was observed during this study that there was greater
variation among volunteers in their method of fitting the
surgical mask. The need to tie the straps at the back of the
head meant that the surgical mask was fit in a variety of ways.
In contrast, the face mask had looped elastic straps that were
easier for the volunteer to fit.
Comfort should be an important factor in the material used to
make a homemade mask. The pressure drop across a mask is a
useful measure both of resistance to breathing and the
potential for bypass of air around the filter seal. If respiratory
protection is not capable of accommodating the breathing
demands of the wearer, then the device will impose an extra
breathing load on the wearer, which is especially impractic-
able for people with breathing difficulties. Furthermore,
the extra breathing load may induce leakage owing to the
increased negative pressure in the face mask.
In practice, people will not wear an uncomfortable mask for
a long period; even if they do, it is unlikely that they will
wear the mask properly. During the outbreak of severe acute
respiratory syndrome, an account of a flight from Bangkok,
Thailand, to Manchester, England. described mask wearers
removing their mask to cough, sneeze, and wipe their nose
(not necessarily into a handkerchief) and to sort through the
communal bread basket.
For those who wear a mask for
necessity, such as health care workers, regular training and fit
testing must be emphasized. Whereas, for those who choose
to wear a homemade mask, the requirements of cleaning and
changing the mask should be highlighted. Most importantly,
the lower protective capabilities of a homemade mask should
be emphasized so that unnecessary risks are not taken.
A protective mask may reduce the likelihood of infection, but
it will not eliminate the risk, particularly when a disease has
more than 1 route of transmission. Thus any mask, no matter
how efficient at filtration or how good the seal, will have
minimal effect if it is not used in conjunction with other
preventative measures, such as isolation of infected cases,
immunization, good respiratory etiquette, and regular hand
hygiene. An improvised face mask should be viewed as the
last possible alternative if a supply of commercial face masks is
not available, irrespective of the disease against which it may
be required for protection. Improvised homemade face masks
may be used to help protect those who could potentially, for
example, be at occupational risk from close or frequent
contact with symptomatic patients. However, these masks
would provide the wearers little protection from microorgan-
isms from others persons who are infected with respiratory
diseases. As a result, we would not recommend the use of
homemade face masks as a method of reducing transmission
of infection from aerosols.
About the Authors
Public Health England (HPA), Porton Down Salisbury (Dr Walker, Miss Thompson,
Davies and Giri, and Mr Bennett); PHE, Colindale, London (Mr Kafatos),
United Kingdom.
Address correspondence and reprint requests to Jimmy Walker, PhD, PHE, Porton
Down, Salisbury, SP4 0JG UK (e-mail:
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Disaster Medicine and Public Health Preparedness6
... Of course, this type of mask only filters air breathed in, and does not reduce virus transmission from an infected wearer to others. Testing in laboratory settings conducted at the University of Cambridge showed that a 100% cotton t-shirt showed a mean filtration efficiency of 70.7% for Bacillus atrophaeus compared to 96.4% for a surgical mask 19 . It was concluded that homemade face coverings should not be recommended to reduce transmission of infectious aerosols unless it was a last resort. ...
... It was concluded that homemade face coverings should not be recommended to reduce transmission of infectious aerosols unless it was a last resort. It can only provide effective protection if paired with other methods of virus suppression such as isolation of the infected, social distancing, immunisation and hand hygiene 19 . Whilst materials such as cotton have been shown to offer limited protection 20 , a key reason for their popularity is the comfort, and apparent breathability afforded to the wearer 21 . ...
... Substrate materials. Cotton is commonly used as a material for face masks and coverings 17,82 due to its availability, comfort, breathability, and moderate filtration performance 19,82 . Two non-woven 4-layer swab variants of size 5 × 5 cm, made of cotton, were purchased online from JFA medical Ltd in the UK. ...
Full-text available
The novel coronavirus pandemic (COVID-19) has necessitated a global increase in the use of face masks to limit the airborne spread of the virus. The global demand for personal protective equipment has at times led to shortages of face masks for the public, therefore makeshift masks have become commonplace. The severe acute respiratory syndrome caused by coronavirus-2 (SARS-CoV-2) has a spherical particle size of ~97 nm. However, the airborne transmission of this virus requires the expulsion of droplets, typically ~0.6–500 µm in diameter (by coughing, sneezing, breathing, and talking). In this paper, we propose a face covering that has been designed to effectively capture SARS-CoV-2 whilst providing uncompromised comfort and breathability for the wearer. Herein, we describe a material approach that uses amorphous silica microspheres attached to cotton fibres to capture bioaerosols, including SARS CoV-2. This has been demonstrated for the capture of aerosolised proteins (cytochrome c, myoglobin, ubiquitin, bovine serum albumin) and aerosolised inactivated SARS CoV-2, showing average filtration efficiencies of ~93% with minimal impact on breathability.
... During pandemics caused by respiratory pathogens, especially when efficacious pharmaceutical treatments are unavailable, many experts recommend universal masking in public [11,12]. However, overwhelming demand for respiratory protection can severely strain commercial supplies [13,14], requiring some front-line workers and others to use improvised or homemade protection [15,16]. A major challenge is to develop an improvised mask that both front-line workers as well as non-experts can produce for ad-hoc respiratory protection. ...
... The effectiveness of improvised respiratory protection is largely determined by the choice of filtration material and quality of design [27]. Readily available fabrics, including various cotton fabrics, silk, chiffon, tea towels, and surgical fabric have been repurposed as respiratory filtration systems [15,16,[28][29][30][31][32][33][34]. However, even with excellent filtration capabilities, if a mask does not fit properly, virus-containing particles can penetrate through gaps between the mask and face [35,36] leading to filtration efficiency decreases of up to 60% [29]. ...
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Respiratory aerosols with diameters smaller than 100~$\mu$m have been confirmed as important vectors for the spread of diseases such as SARS-CoV-2. While disposable and cloth masks afford some protection, they are typically inefficient at filtering these aerosols and require specialized fabrication devices to produce. We describe a fabrication technique that makes use of a folding procedure (origami) to transform any filtration material into a mask. These origami masks can be fabricated by non-experts at minimal cost and effort, provide adequate filtration efficiencies, and are easily scaled to different facial sizes. Using a mannequin fit test simulator, we demonstrate that these masks can provide filtration efficiencies of over 90\% while simultaneously providing greater comfort as demonstrated by pressure drops of <~20~Pa. We also quantify mask leakage by measuring the variations in filtration efficiency and pressure drop when masks are sealed to the mannequin face compared to when the mask is unsealed but positioned to achieve the best fit. While leakage generally trended with pressure drop, some of the best performing mask media achieved <~10\% reduction in filtration efficiency due to leakage. Because this mask can provide high filtration efficiencies at low pressure drop compared to commercial alternatives, it is likely to promote greater mask wearing tolerance and acceptance.
... Face masks should provide protection against cough particles with a droplet size (5-10 µm), while the size of the saliva particles released during speech is approx. 1 (Asadi et al., 2019). Davies et al. (2013) have found that traditional fabrics filter 49% to 86% of particles in the air up to 0.02 µm, while surgical masks up to 89% of these particles. Van der Sande et al. (2008) and Rengasamy et al. (2010) claimed that textile masks filter 3%-60% of the particles in the exhaled air. ...
... Data collection via the smartphone: (a) the data set; (b) reading scheme of the data: (1) time of the measurement; (2) CO2 concentration; (3) temperature; (4) air humidity;(5) battery voltage ...
... Compelling data and experimental studies on humans and manikins demonstrate that masking is an effective tool in mitigating SARS-CoV-2 airborne and droplets transmission [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. The clinical efficacy of a face mask is determined by the filtration efficacy of the material, fit of the mask, and compliance to wearing the mask [8,14,27]. ...
... The pressurized droplets or aerosol particles are likely to escape directly from the gap between the mask and the human face due to poor fit. Inward protection, also known as wearer protection, is the capability of masks to act as a barrier to protect the uninfected wearers from respiratory droplets and aerosol particles, to penetrate through and land on exposed mucous membranes of the eye, nose, and mouth [14,17,18,24,32]. [33,34] finds that cloth masks have limited inward protection in healthcare settings where viral exposure is high compared to surgical masks and N95 respirators. ...
Masks have remained an important mitigation strategy in the fight against COVID-19 due to their ability to prevent the transmission of respiratory droplets between individuals. In this work, we provide a comprehensive quantitative analysis of the impact of mask-wearing. To this end, we propose a novel agent-based model of viral spread on networks where agents may either wear no mask or wear one of several types of masks with different properties (e.g., cloth or surgical). We derive analytical expressions for three key epidemiological quantities: The probability of emergence, the epidemic threshold, and the expected epidemic size. In particular, we show how the aforementioned quantities depend on the structure of the contact network, viral transmission dynamics, and the distribution of the different types of masks within the population. Through extensive simulations, we then investigate the impact of different allocations of masks within the population and tradeoffs between the outward efficiency and inward efficiency of the masks. Interestingly, we find that masks with high outward efficiency and low inward efficiency are most useful for controlling the spread in the early stages of an epidemic, while masks with high inward efficiency but low outward efficiency are most useful in reducing the size of an already large spread. Last, we study whether degree-based mask allocation is more effective in reducing the probability of epidemic as well as epidemic size compared to random allocation. The result echoes the previous findings that mitigation strategies should differ based on the stage of the spreading process, focusing on source control before the epidemic emerges and on self-protection after the emergence.
... Where V is the cabin volume, κ is the cabin air exchange rate. θ is the mask permeability coefficient and ranges from 0 to 1; 0 represents complete isolation of the pathogen by the mask, while the filtration efficiency of a standard surgical mask for an aerosol containing viruses is approximately 60% [28]. Considering the potential for some passengers to experience air leakage when wearing masks, θ can be set at 50% to eliminate the impact of this factor [10]. ...
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Civil aviation transport is an important source of global respiratory disease spread due to the closely-spaced environment. In order to reduce the probability of infection of passengers, an improved Wells-Riley model for cabin passenger risk assessment have been given in this work, the cabin ventilation and passenger nose and mouth orientation were considered. The model’s effectiveness has been verified with published data. Finally, how the load factor and use of an empty seat scheme are associated with the number of infected people was assessed. The results demonstrated that the number of infected people positively correlates with the passenger load factor, and the most suitable load factor can be determined by controlling the final number of infected people with the condition of the epidemic situation in the departure city. Additionally, infection risk was found to be lower among passengers in window seats than in those in aisle seats and middle seats, and keeping empty seats in the middle or aisle could reduce the cabin average probability of infection by up to 37.47%. Using the model developed here, airlines can determine the optimal load factor threshold and seating arrangement strategy to improve economic benefits and reduce the probability of passenger infection.
... (8) However, in this study, a handmade two-layered cotton tissue mask was most commonly used, despite studies indicating that it was not an effective filter for respiratory droplets. (9)(10)(11) Despite the physical barriers to free breathing, in this study, masks were not associated with any clinical manifestations. The slight decrease in PSO 2 observed in young adult men had no clinical relevance according to the volunteers, who complained only of minor ear discomfort due to short elastic bands and allergic reactions to the mask and elastic band material. ...
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Objective The World Health Organization and Centers for Disease Control and Prevention recommend the use of face masks in public. This study aimed to evaluate the effects of face masks on pulse rate and partial blood oxygen saturation in patients without cardiorespiratory disorders. Methods A total of 150 volunteers of both sexes were divided into three groups (n=50) according to age (children, young adults, and older adults). The partial blood oxygen saturation and pulse rate were measured for each volunteer using a digital oximeter while wearing a facial mask and remaining at rest. The masks were removed for two minutes, and partial blood oxygen saturation and pulse rate were remeasured. The materials and types of masks used were recorded. The t -test for paired samples was used to compare the mean values obtained before and after removing the masks. Results The most frequently used mask was a two-layered cloth (64.7%). A decrease in pulse rate was observed after removing the face mask in males, particularly in children (p=0.006) and young adults (p=0.034). Partial blood oxygen saturation levels increased in young adult males after mask removal (p=0.01). Conclusion The two-layer cotton tissue face masks are associated with a higher pulse rate and reduced arterial blood oxygen saturation without associated clinical disorders, mainly in adult men with a lower tolerance to breathing and ear discomfort. Facial masks; Heart rate; Oxygen saturation; Respiration; SARS-CoV-2; Coronavirus infections; Age factors
... was the mask efficiency, which was assumed to be 0.25, 0.56 or 1 if 100%, 50% or 0% of the occupants are wearing a mask inside (Davies, A., 2013). They were sampled from a uniform distribution by Monte Carlo method to represent the uncertainty of occupants. ...
Conference Paper
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To contain the spread of COVID-19 in buildings, the HVAC systems were required to operate with a higher outdoor air flow rate for a sufficient time, which caused a sharp increase in building energy consumption. Consequently, finding a high-energy efficiency ventilation control strategy is critical while maintaining a low infection risk. In this study, we recruited a medium size office building from Sept. 2021 to Dec. 2022 for data collection. Then an attention-based occupant number prediction algorithm was designed, which could predict the occupancy distribution interval accurately. After that, a demand ventilation rate was calculated by Wells-Riley equation and finally integrated with a stochastic model predictive control model for the building ventilation control. SMPC can maintain the indoor infection risk lower than 2% for 94.4% of cases, and up to 15.1% of HVAC energy could be reduced while decreasing the space unmet hour by 71.3%.
... whether viral transmission could elicit infection in others) or the use of unsoiled masks (most people during the SARS-CoV-2 pandemic did not replace their mask every five minutes, the latter being the maximum duration of mask use in the study in question). Another (pre-pandemic) study investigating the filtration efficiency of different types of mask, including surgical and fabric-based homemade mask varieties, concluded that the latter offered limited filtration compared to the former [18]. Despite the carefully executed experiments, and like the previously cited work, many aspects of the study are not directly translatable to real-world conditions, including not accounting for peripheral escape, prolonged mask use, or correlation with infectiousness. ...
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In this perspective, we review the evidence for the efficacy of face masks to reduce the transmission of respiratory viruses, specifically severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and consider the value of mandating universal mask wearing against the widespread negative impacts that have been associated with such measures. Before the SARS-CoV-2 pandemic, it was considered that there was little to no benefit in healthy people wearing masks as prophylaxis against becoming infected or as unwitting vectors of viral transmission. This accepted policy was hastily reversed early on in the pandemic, when districts and countries throughout the world imposed stringent masking mandates. Now, more than three years since the start of the pandemic, the amassed studies that have investigated the use of masks to reduce transmission of SARS-CoV-2 (or other pathogens) have led to conclusions that are largely inconsistent and contradictory. There is no statistically significant or unambiguous scientific evidence to justify mandatory masking for general, healthy populations with the intention of lessening the viral spread. Even if mask wearing could potentially reduce the transmission of SARS-CoV-2 in individual cases, this needs to be balanced against the physical, psychological and social harms associated with forced mask wearing, not to mention the negative impact of innumerable disposed masks entering our fragile environment. Given the lack of unequivocal scientific proof that masks have any effect on reducing transmission, together with the evident harms to people and the environment through the use of masks, it is our opinion that the mandatory use of face masks in the general population is unjustifiable and must be abandoned in future pandemic countermeasures policies.
The COVID-19 pandemic has highlighted environmental and supply issues related to single-use protective masks for both the general public and some healthcare workers. Reusable fabrics are an interesting alternative to disposable nonwovens and offer a prospect of protection in other fields such as against fine particles in urban areas. In this paper, the behavior of 22 woven fabrics regarding air permeability, simulating breathability through the material, and filtration against 3 µm diameter particles is investigated. First, basic laws are verified between the performance of a single layer of fabrics and that of a stack. A relationship is established between air permeability and filtration efficiency, allowing one to be calculated when the other is known. Second, the influence of parameters defined at various scales of the structure (fibers, yarns and fabrics) is analyzed. The most sensitive structural parameters that can be considered as predictors are then identified and used in a model allowing the calculation of air permeability. In this model two levels of porosity are taken into account: a macroscopic porosity at the scale of the woven structure and a microscopic porosity at the scale of the thread. The model proposed in this study offers a convenient method to design an effective filter from data easily measurable during manufacturing.
Conference Paper
To prevent the spread of the epidemic, a lightweight mask-wearing detection algorithm based on the modified YOLOv5 is proposed. The three categories of mask-wearing, mask-less, and non-standard mask-wearing were studied, and images of faces covered with hands and clothing were added as interference items to make the study more realistic. Using YOLOv5 as the base model, the modified deformable convolution is introduced into the CSP-Darknet53 module of the backbone network, which effectively enhances the model's ability to extract key information such as faces and masks and improves the detection accuracy of the model. In addition, image defogging based on dark channel prior is introduced to make the model adapt to detect whether pedestrians wear a mask correctly in special weather. Finally, the knowledge distillation method is used to perform light-weight compression on the model to solve the problem of slow detection speed in practical applications. Training and testing on the self-made T-Mask dataset, the mAP of the model reaches 93.6%, which is about 3% points higher than the original YOLOv5m algorithm, and the number of parameters is reduced to 1/3 of the original one, which has a higher practical value.
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Objective To measure the concentration of microbial aerosols in general dental practices and to use this information to carry out quantitative microbiological risk assessments.Methodology Microbial air sampling was carried out continuously during 12 treatment sessions in 6 general dental practices in the South West of England.Results The microbial aerosol concentration in treatment rooms was generally less than 103 colony forming units per cubic metre of air (cfu.m-3). However, in 6 out of the 12 visits, at least one peak concentration with much higher numbers of bacteria was detected. The peak concentrations were associated with increased recoveries of presumptive oral streptococci suggesting these aerosols originated from the mouths of patients. These aerosol peaks dissipated within 30 minutes and no dissemination into waiting areas was detected. The peak concentrations were associated with mechanical scaling procedures (47% of procedures giving rise to a peak) and to a lesser extent by cavity preparation (11%). No aerosolised blood was detected.Conclusions The data have been used to generate a framework for quantifying risk of exposure of staff to aerosolised microbial pathogens in general dental practice. For example, dentists and their assistants may have a slightly higher risk of exposure to Mycobacterium tuberculosis than the general public. The use of face seal masks that have been shown to protect against aerosolised micro-organisms may reduce this exposure.
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The sedimentation behavior of influenza virus in dilute solutions of electrolyte was found to be quite variable. At times the virus activity appeared to sediment at a rate comparable with that of particles about 80 to 120 mmicro in diameter, at other times at a rate comparable with that of particles about 10 mmicro in diameter, and at still other times the bulk of the activity appeared to sediment at a rate comparable with that of the larger particles and the residual activity at a rate comparable with that of the smaller particles. However, in the presence of a sucrose density gradient, the virus activity was always found to sediment with a rate comparable to that of particles about 80 to 120 mmicro in diameter; hence it appeared that the variable sedimentation behavior in dilute electrolyte solution was due to convection or mechanical disturbances during centrifugation. About 30 per cent of the high molecular weight protein present in the allantoic fluid of chick embryos infected with the F 12 strain of influenza virus was found to consist of a component having a sedimentation constant of about 30 S, and hence a probable particle diameter of about 10 mmicro. The residual protein of high molecular weight was present in the form of a component having a sedimentation constant of about 600 S, and hence a probable particle diameter of about 70 mmicro. The proportion of the 30 S component in allantoic fluid of chick embryos infected with the PR8 strain of influenza virus was found to be considerably less. The 600 S and 30 S components of F 12 allantoic fluid were purified and separated by differential centrifugation. The purified preparations of the 600 S component were found to possess a specific virus activity from 100 to over 10,000 times that of the purified preparations of the 30 S component, the difference in activity apparently depending only on the degree of fractionation of the two components. The purified 30 S component was found to sediment normally in the presence of 12 per cent sucrose, whereas the small residual virus activity of such preparations was found to sediment in the presence of a sucrose density gradient with a rate comparable to that of much heavier particles. It is concluded that influenza virus activity is not associated with material having a particle diameter of about 10 mmicro, but is associated solely with material having a sedimentation constant of about 600 S and hence a probable particle diameter of about 70 mmicro.
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Many countries are stockpiling face masks for use as a nonpharmaceutical intervention to control virus transmission during an influenza pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non–fit-tested P2 masks, and no masks in prevention of influenza-like illness (ILI) in households. Mask use adherence was self-reported. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. We found that adherence to mask use significantly reduced the risk for ILI-associated infection, but <50% of participants wore masks most of the time. We concluded that household use of face masks is associated with low adherence and is ineffective for controlling seasonal respiratory disease. However, during a severe pandemic when use of face masks might be greater, pandemic transmission in households could be reduced. Many countries are stockpiling face masks for use as nonpharmaceutical interventions to reduce viral transmission during an influenza pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non–fit-tested P2 masks, and no masks in prevention of influenza-like illness (ILI) in households. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. Intent-to-treat analysis showed no significant difference in the relative risk of ILI in the mask use groups compared with the control group; however, <50% of those in the mask use groups reported wearing masks most of the time. Adherence to mask use was associated with a significantly reduced risk of ILI-associated infection. We concluded that household use of masks is associated with low adherence and is ineffective in controlling seasonal ILI. If adherence were greater, mask use might reduce transmission during a severe influenza pandemic.
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The effect of relative humidity (RH) on the airborne stability of two small bacterial viruses, S-13 and MS-2, was studied. Poorest recovery of S-13 was obtained at 50% RH. Humidification prior to aerosol sampling significantly increased the recovery of S-13 at RH deleterious to the airborne virus. A commercial preparation of MS-2 suspended in a buffered saline solution showed a rapid loss of viability at RH above 30%, whereas a laboratory preparation containing 1.3% tryptone showed high recoveries at all RH studied. Dilution of the commercial MS-2 into tryptone broth conferred stability on the airborne virus. Humidification prior to sampling significantly reduced the viable recovery from aerosols of commercial MS-2, whereas the laboratory preparation was unaffected.
The genus Bacillus comprises a heterogeneous group of chemoorganotrophic, aerobic, rod-shaped microorganisms. These include both mesophilic and thermophilic species as well as acidophiles and alkalophiles. One of their main characteristics is their ability to produce heat-resistant endospores.
1. A slit sampler for air-borne bacteria is described, in which air is sucked through a narrow slit on to the surface of agar in an ordinary Petri dish. 2. This method has proved very rapid and simple in use, and has appeared more efficient than other methods against which it has been tested. 3. The collection efficiency for an aerosol consisting of Staph. albus , sprayed from distilled water as single cocci, is about 96%. The method thus collects the finest bacteria-carrying, particles almost as efficiently as coarser ones. 4. In contrast to this, the exposure of plain open Petri dishes appears to collect the larger particles in the air of crowded rooms at least 200 times as efficiently as it does single washed bacteria. This highly selective effect renders it advisable to use great caution in evaluating tests made in plain open dishes. 5. The methods of determining sampling efficiency, and their errors are discussed in detail.
During an epidemic of influenza B, 43 ambulatory children were prospectively followed to determine the quantitative shedding patterns of influenza B viral infection, because these have not been previously described. The spectrum of illness included 74% with a typical influenzalike illness, 7% with an afebrile infection of the upper respiratory tract, and 19% with croup. Mild myositis occurred in 21%. For the first three days of illness, ⩾93% of the children shed virus, and 74% shed on day 4. The average peak quantity of virus shed in the nasal wash was 4.0 log10 50% tissue culture infective doses/ml (range,1.5–6.0), which gradually declined over four days to 2.4 log10 50% tissue culture infective doses/ml. The quantities of virus shed correlated significantly with severity of illness and fever score, but not with sex, type of illness, or occurrence of myositis. These results suggest that the degree of clinical illness may be directly related to the cytotoxic effects of the virus and to the transmissibility of the disease.
A study was conducted at a secondary lead smelter to evaluate the workplace performance of the 3M W-344 and Racal AH3 powered air-purifying respirators equipped with helmets and high efficiency filters. The research protocol developed for the study has been described in a companion paper. The results of the study indicate that the mean lead concentrations, measured inside the facepiece of both PAPRs, were significantly less than the OSHA lead exposure limit of 50 micrograms/m3. The means of the workplace protection factor measurements on both PAPRs were significantly less than the PAPR selection guide protection factor classification of 1000. Correlation analysis of preshift quantitative fit factors and corresponding workplace protection factors indicated no linear association between these two measures of performance. This finding suggests that for PAPRs equipped with helmets and high efficiency filters quantitative fit factors as presently determined are not indicative of the workplace protection which the respirators provide. Since the PAPR protection factor classification of 1000 was originally based on quantitative fit factors, the lack of a demonstrated association between quantitative fit factors and workplace protection as found in this study may explain why their performance was significantly less than expected.
The bacterial and viral filtration performance of 12 breathing system filters was determined using test methods specified in the draft European standard for breathing system filters, BS EN 13328-1. All the filters were of two types, either pleated hydrophobic or electrostatic, and these two types differed in their filtration performance. The filtration performance is expressed in terms of the microbial penetration value, defined as the number of microbes passing through the filter per 10 million microbes in the challenge. The geometric mean (95% confidence limits) microbial penetration value was 1.0 (0.5, 3.5) and 2390 (617, 10 000) for the pleated hydrophobic and electrostatic filters, respectively, for the bacterial challenge, and 87 (48, 212) and 32 600 (10 900, 84 900), respectively, for the viral challenge. In general, there was little change in the microbial penetration values following 24 h simulated use. It is concluded that results from the tests specified in the draft standard will allow comparisons to be made between different manufacturers' products enabling an informed choice to be made.