N95 vs Half‐face Respirator Wear in Surgical Trainees: Physiologic and Psychological Effects of Prolonged Use

Abstract

Objectives As specialists of the upper airway, otolaryngologists are at high risk for COVID-19 transmission. N95 and half-face respirator (HFR) masks are commonly worn, each with advantages in functionality and comfort. In this study, physiologic and psychological parameters of prolonged N95 vs HFR wear were compared. Study Design Prospective crossover cohort study. Setting Single academic tertiary care hospital. Methods A prospective crossover cohort study was performed. Healthy otolaryngology trainees and medical students (N = 23) participated and wore N95 and HFR masks continuously for 3 hours each on separate days. Various measures were analyzed: vitals, spirometry variables, scores on the State-Trait Anxiety Inventory and HIT-6 (Headache Impact Test–6), distress, and “difficulty being understood.” Results The average age was 26.3 years (SD, 3.42). There were no significant differences in vital signs and spirometry variables between N95 and HFR wear. N95 wear was associated with decreases in oxygen saturation of approximately 1.09% more than with HFRs (95% CI, 0.105-2.077). State-Trait Anxiety Inventory scores increased more with HFR wear when compared with mean changes with N95 wear (95% CI, 1.350-8.741). There were no significant differences in HIT-6 scores or distress levels between masks. The proportions of participants reporting difficulty being understood was significantly higher with HFRs. Conclusions Oxygen saturation decreases with prolonged N95 wear, but anxiety and difficulty being understood are greater with HFR wear. Although HFRs have less resistance to gas exchange, N95 respirators may produce less anxiety and distress in clinical situations. Further studies are warranted to evaluate the clinical significance of these differences. Level of Evidence 2.

Health effects of filtering facepiece respirators: Research and clinical implications of comfort, thermal, skin, psychologic, and workplace effects

“…The adage that 10% of users have claustrophobia has limited empirical support and was disseminated when respirators were more intrusive than the typical FFR. Controlled laboratory research studies of normal volunteers and health professionals have compared FFR's to elastomeric respirators to demonstrate that anxiety in FFR's is much less frequent 72,73 …”

Side effect of using N95 mask on oxygen saturation, respiration rate and pulse rate of health workers in Jakarta

“…Masker N95 juga dapat disimpan dan digunakan kembali, asalkan tidak kotor atau tidak ada kontaminasi virus pada masker, tidak kendor, tidak berlubang, dan tidak basah [10]. Di sisi lain, untuk mencegah penyebaran infeksi, petugas kesehatan yang memakai masker N95 dihadapkan pada beberapa tantangan, yaitu: mengalami kesulitan bernapas, tidak nyaman, dehidrasi [11], penurunan konsentrasi oksigen sirkulasi, peningkatan denyut nadi, sensasi sesak napas, pusing [6], sakit kepala [12], kelelahan ekstrem, kelelahan meningkat [13] menurun saturasi oksigen [14] dan resistensi pernapasan [15].…”

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“…In addition to its function as self-protection from viruses, bacteria, and dust, masks have several side effects. Several studies have reported that the use of N95 masks can cause excessive fatigue [4], decreased oxygen saturation, anxiety [5], increased pulse rate, shortness of breath, and headaches [6]).…”

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