A Complete Guide to Using Masks

In the midst of this alarming COVID-19 pandemic, the need for reliable information on protective equipment has never been so high. Many of us have never bought or even never thought that we would one day have to wear compulsory masks before heading to the grocery store. Hence, many of us don’t know which mask to buy!
This article is a complete guide that covers the types of masks, their descriptions, uses, filter capacities, advantages, and disadvantages.
Here’s everything you need to know about the different types of masks available.

What are Masks?

A mask is a protective gear mostly used by healthcare providers to protect themselves, others, and the environment from microorganisms, droplets, and other harmful particles.

Face masks exist in different shapes, sizes, colors, and filter efficiencies.  Different types of face masks are meant for different purposes.

Masks vs. Respirators: What’s the Difference?

While most people refer to respirators as masks, there’s a clear difference between the two.

• Masks act as physical barriers against splashes, spit, and droplets.
• Respirators prevent the wearer from inhaling airborne particles like smoke, paint, gases, and other harmful infectious agents such as the novel Coronavirus.  Respirators have a tight seal [1].

There are 2 types of respirators:

• • Air-purifying respirators filter out contaminated air to make it breathable. These respirators are mostly used against particulates and gases.
  • Atmosphere-supplying respirators provide an alternative source of breathable air.
    

    Valved Vs Non-valved Masks

    Face masks exist in 2 types:

    • Valved
    • Non-valved

    Valves do not increase the level of protection of a mask.  In fact, valves are primarily used to improve breathing comfort.  When you use a mask for a long time, it can become sweaty.  This can become uncomfortable in the long run.  An exhalation valve allows air to flow out of the mask without creating breathing resistance.  This helps to balance the temperature and airflow, hence creating a more comfortable wearing experience.

    Caution: Sometimes, valves can be defective. Defective valves increase the risk of exposure to harmful particles

     

Disposable vs. Reusable Masks

Surgical masks and N95 masks are disposable masks. They should not be reused. Washing them damages the filter material and decreases their efficiencies. Cloth and pitta masks are reusable.  They can be washed, dried, and worn again and again. Respirators with cartridges can be reloaded with new ones.

Credits: Photo by cottonbro from Pexels

What are Masks Standards?

Every country has its own set of guidelines to regulate masks and respirators. These are known as mask standards. In the United States, the National Institute for Occupational Safety and Health, NIOSH regulates respirators. Masks are regulated by the FDA.

What Makes a Good Mask?

The best mask should have the following features:

• Tight but Comfortable
• High Breathability
• High Filter Efficiency
• High Splash Resistance
• Two-way Protection
• Reusable
• Long-Wear Duration

It is nearly impossible to have a completely perfect mask that fits all the criteria duly, but some masks do come close to this idyllic description.

To find out more, keep reading!

Types of Masks

In this article, we will be discussing each type of mask, its uses, advantages, disadvantages, and efficiencies. There may be different variations of a specific type of mask depending on the manufacturing company.

1. Surgical Mask
2. N95
3. KN95
4. FFP
   • FFP1
   • FFP2
   • FFP3
5. Reusable Respirator with Cartridge Filters (Gas Mask)
6. Pitta Mask
7. Cloth Mask

1.   Surgical Masks

Description

Surgical masks, also known as medical masks are loose-fitting, disposable 3 ply devices designed to protect health care providers from spreading secretions and aerosols to patients.

Standards:  China, USA, Europe

How Are Surgical Masks Made? 

The production of surgical masks is carried out in several well-established steps.  Most mask factories have machines that help with stitching, transporting the masks, and sticking together the ear loops.  However, these factories still need human resources as certain steps cannot be automated.

Surgical masks are primarily made from polypropylene.  They can also be made from polycarbonate, polyethylene, or polyester.  The first step involves creating very tiny fibers using melt-blown technology.

The next step involves putting together the different layers.

Surgical masks are made up of 3 layers:

• The colored outer layer is a waterproof, non-woven layer. It repels fluids.
• The middle layer is made up of a meltdown filter that filters germs.
• The inner layer is made up of a soft, absorbent, non-woven layer that absorbs moisture.

Once assembled, these layers are welded together using ultrasonic technology.  Earloops and plastic nose strips are then attached to the masks.  Once ready, all the masks are verified by machines and sterilized before delivery.

Filter Efficiency

The efficiency of the filter is variable.  It greatly depends on the manufacturer and the manufacturing country.

Uses 

• Surgical masks loosely cover the mouth and nose to protect the wearer from splashes, spits, large droplets, or other dangerous fluids.
• Surgical masks also protect those around the wearer from the respiratory secretions of the latter. They are recommended for use by surgeons to keep the operating room sterile.

Benefits

• Surgical masks are loose. They offer good breathability.
• They are comfortable to wear.
• Surgical masks are cheap.

Disadvantages

• They are This means that they can allow leakages around the edges.
• Single-use only
• Surgical masks only provide one-way protection. The wearer is not protected. They do not protect against very small airborne particles that can be transmitted by coughing, sneezing, or talking.

Reuse

Surgical masks should not be reused, washed, or disinfected.  However, in case of shortage, the CDC recommends certain special amendments [2].

2.   N95

Description

N95 respirators are tightly fitting disposable safety devices that cover the mouth and the nose to efficiently filter out harmful airborne particles.

Photo Credits: Photo by Jonathan J. Castellon on Unsplash

Filter Efficiency

N95 respirators have a filter efficiency of at least 95 % with a flow rate of 85L/min.  This means that they can filter above 95% of particles.

Uses

• N95 respirators are designed for use by health care providers such as doctors, nurses, and other individuals in direct contact with sick patients. It can be used to protect against COVID-19, flu viruses, and bacteria.
• N95 can also be used in areas such as mining, construction, and painting.

Notice: Major health authorities like the WHO and the CDC do not recommend the general public to wear N95 respirators.  N95 respirators are essential supplies that need to be reserved for health care providers and other frontline workers.

Benefits

• N95 respirators are tight-fitting and thus, allow very minimal air leakage.
• N95 respirators provide two-way protection. They can filter at least 95% of very small particles of 0.3 microns in size [3].
• They can be worn for up to 8 hours.
• While N95 respirators have low breathability, they still provide less breathing resistance as compared to KN95.

Disadvantages 

• Less comfortable than surgical masks and are less breathable.
• More expensive than surgical masks.

Precautions 

Reuse

N95 respirators should not be reused, washed, or disinfected.  However, in the case of shortages, we find more and more people reusing their masks.  The CDC has also made amendments in its recommendations for reuse during times of scarcity [2].

3.   KN95

Description

KN95 masks are manufactured based on the Chinese standards for masks.  The KN95 masks have some differences to the N95 respirators but can still be used as an alternative.

Standards: Asia

Filter Efficiency

The filter performance of the KN95 mask is at least 95% with a flow rate of 85L/min.  However, KN95 masks are looser than N95 and allow 8% of leakage.

Uses 

The FDA has recently approved the use of the KN95 mask as an alternative to N95 masks in case of shortages [4].

Benefits

• Since KN95 masks have a good filter performance, they are good alternatives to N95 respirators during periods of shortages such as the Coronavirus pandemic.

Disadvantages

• Looser than N95 and allows some leakages around its edges.
• KN95 masks are slightly less breathable than N95 since they have less rigid manufacturing criteria to satisfy.

4.   FFP Masks

Description

The term FFP in FFP masks stands for Filtering Face Piece.  FFP masks are also known as respiratory protection masks.  These masks are certified by the European Union.  The FFP rating gives you an idea of the level of protection each type offers.  The larger the number beside the term ‘‘FFP’’, the higher the level of protection.

Standards: Europe

Photo Credits: Photo by Ashkan Forouzani on Unsplash

FFP 1

Description

FFP1 masks commonly abbreviated as P1, have a rate of 4 APF, Assigned Protection Factor.  They confer the lowest level of protection among the FFP types.  Yellow elastic bands are usually used to categorize FFP1 masks.

Filter Efficiency

The filtration performance of the FFP1 mask is of at least 80%, with a leakage rate of 22% [5].

Uses 

FFP1 masks are mainly used as dust masks to provide the wearer respiratory protection against low concentrations of dust and mists. A dusk mask can prevent a person with known dust allergy from coughing, wheezing, and bouts of allergic rhinitis.

Benefits

• FFP1 masks can filter particles of 0.3 microns by at least 80%.
• Easy breathability as compared to FFP2 and FFP3.

Disadvantages

• FFP1 masks have a high internal leak rate of 22%.

FFP2 (N95 equivalent)

Description

FFP2 masks, also known as P2 masks, are the UK/EU equivalent of the US N95 masks.  Blue elastic bands are usually used to categorize FFP2 masks.  Most FFP2 masks come as valved masks due to greater breathing resistance.

Filter Efficiency

FFP2 masks have a filter efficiency of at least 94% with a leakage rate of 8%.

Uses

• FFP2 masks are usually used by glass, agricultural, and construction industries to protect the wearer against moderate concentration of dust, mists, and powdered chemicals.
• FFP2 masks are also used during outbreaks, epidemics, and pandemics to protect healthcare providers who are in direct contact with infected individuals from being infected. They can filter viruses such as flu viruses, SARS, and Coronavirus.

Benefits

FFP2 masks can filter particles of 0.3 microns by up to 94%.

Disadvantages

• FFP2 masks do not provide a full seal around the mouth of the wearer. There is still a small percentage of leakage.
• Despite the fact that they still allow some leakages, FFP2 masks have low breathability. It can be uncomfortable and might not be the best choice for patients with respiratory, cardiovascular, or other medical conditions.

FFP3

Description

FFP3 masks, abbreviated as P3 masks confer the highest level of protection, at 20 APF.  Red elastic bands are usually used to categorize FFP3 masks.  Since the filter used in FFP3 masks make them less breathable, most FFP3 masks have a valve attached on their surface to lower the breathing resistance.

Filter Efficiency

FFP3 masks have an even higher filter efficiency of at least 99%, with a leakage rate of only 2%.

Uses

• FFP3 masks should be worn when carrying out risky procedures during which the wearer will be in direct contact with infectious particles such as bronchoscopy, endotracheal intubation, tracheostomy, and other high-risk medical procedures [6].
• FFP3 masks protect the wearer against a high concentration of fine dust particles, noxious asbestos fibers, spores, silica, and ceramic.

Benefits

• FFP3 masks have a very high filter efficiency. They can filter particles of 0.3 microns in size by up to 99%.
• FFP3 masks also have the lowest leakage rate among all the FFP masks.

Disadvantages

• The valve in the FFP3 mask may be defective, hence may unknowingly expose the wearer to harmful germs and substances while providing a fake sense of reassurance [7].

5.   Reusable Respirators with Cartridge Filters

Description

Respirators with cartridge filters are reusable devices specially designed to filter noxious substances such as asbestos, paints, wood particles, lead, vapors, and other chemicals.  There are different types of cartridges available, namely, particulate filters, gas cartridges, or a combination of both gas and particulate filters.  The cartridges are regulated by the NIOSH,   National Institute for Occupational Safety and Health [8].

Photo Credits: Photo by Daniel Lincoln on Unsplash

Filter Efficiency

The filtering efficiency varies according to the type of cartridge used and the manufacturing company. They range from 95 to 100% efficiency.

Standard: USA, European Union, and Russia

Uses 

• Respirators equipped with gas cartridges protect the wearer against gases such as ammonia, acidic gases, organic vapors, chlorine, formaldehyde, and other noxious gases.
• Respirators equipped with particulate filters protect the wearer from mists, fumes, smokes, mold, and bacteria.

Recommended for Whom

• Painters, woodworkers, workers dealing with harmful fumes, mists, and chemicals.

Benefits

• Reusable
• Tight-fitting
• Minimal Leakage

Disadvantages 

• Expensive
• Fit test required
• Seal test required
• Must be cleaned and disinfected between each patient.

Reuse

• Respirators with cartridge filters are reusable. The device is loaded in a timely manner with new cartridges depending on the frequency of use.

6.  Pitta Masks

Description

The Pitta mask is a fashion trend that has been going on for some years now in Japan.  In 2014, the Pitta mask won the Good Design Award.  It is made from polyurethane.

Photo Credits: Photo by Min An from Pexels

Standard:  Japan

Filter Efficiency

Pitta masks are designed to filter out particles ranging from 5-100 microns in size.  Some brands claim to filter up to 99% of allergy-triggering particles such as pollen and dust.

Uses

• Pitta masks are designed to filter out pollen and dust particles, thus preventing allergic reactions.
• They can also be worn as a fashion trend.

Reuse

Pitta masks can be reused after having been washed with soap and water and dried under direct sunlight.

Benefits

• The pitta mask is washable and reusable.
• The right masks can effectively filter up to 99% of allergens.

Disadvantages

• May differ in efficiency against allergens depending on the fabric used.
• Pitta masks only protect against allergens ranging from 5 -10 microns in size.

7.   Cloth Masks

  Description

Cloth masks are masks made from materials used to make clothing. Though cloth masks do not protect the wearer, it slows down the spread of the virus by acting as a physical barrier that blocks out any respiratory secretions being expelled from the mouth of the wearer.

Uses

• To protect individuals around the wearer from catching germs, thus slowing the spread of germs if worn by everyone.

On the 4^th of April, the CDC modified its recommendations with regard to face masks.  The CDC now firmly recommends that every healthy person should wear a cloth mask because there is evidence that doing so can slow down the spread of COVID-19 [2].

Benefits

• Extremely cheap
• Washable
• Readily available
• Can be made at home
• High breathability
• Very comfortable to wear

Disadvantages

• Cloth masks only provide one-way protection against germs. They do not protect the wearer against catching harmful viruses such as the novel Coronavirus.
• Cloth masks are loose-fitting. They allow air leakages around the edges.

Learn How to Make Reliable Cloth Masks 

You can visit the CDC’s official website to learn how to make a reliable cloth mask: Click here to visit CDC’s official website

The Best Face Mask against Coronavirus

To understand filter efficiency against the novel Coronavirus, it is important to know the size of the infectious particles released by the virus. This was determined by viewing the virus and its spherical viral particles which scientists like to refer to as virions.

• Size of the viral particles released by the Coronavirus:06-0.14 microns (60 -140 nm)
• Average size of the virion: 0.125 microns (125nm)

The best face mask against COVID-19 is one that filters the maximum of particles ranging from 0.06 to 0.125 microns. The perfect mask does not exist but N95 respirators, FFP2, FFP3, and N99 masks provide fair protection [9] [10].

Coronavirus Outbreak in Malaysia: An Update

The first case of Coronavirus disease 2019 (COVID-19) in Malaysia was confirmed for the first time during the month of January. Today, we have over 5,600 people in Malaysia who tested positive for the novel Coronavirus, with Selangor and Kuala Lumpur at the top of the list, having registered the majority of cases.

Coronavirus Outbreak in Singapore: An Update

Singapore, now with 11,178 confirmed cases, has recently extended the lockdown due to a second COVID-19 wave, just as everyone was about to loosen their restrictions.

Singapore identified its first COVID-19 case on the 23^rd of January, a 66-year-old coming from the city of Wuhan, where the Coronavirus had emerged for the very first time.

You can learn more about the latest COVID-19 statistics in Malaysia and Singapore by following these links:

• Click here to view an infographic by the CNA on the evolution of COVID-19 in Singapore
• Google News Live Statistics for Coronavirus in Malaysia and Singapore