Possible toxicity of chronic carbon dioxide exposure associated with face mask use, particularly in pregnant women, children and adolescents – A scoping review

Kisielinski, Kai; Wagner, Susanne; Hirsch, Oliver; Klosterhalfen, B.; Prescher, Andreas

doi:10.1016/j.heliyon.2023.e14117

Cited by 14 publications

(31 citation statements)

References 141 publications

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“…was lower (absent or even reverse) than expected ( 122 , 138 , 139 ). In former human experiments with low level 1-2% CO 2 exposure to breathing air – which corresponds to measured values during mask use ( 140 )—an increased respiratory minute volume (V E ) of >34% was detected ( 122 ). In contrast to that and according to our results under masks a significantly decreased V E by −19% on an average and up to −24% under N95 masks occurs despite face mask driven CO 2 exposure ( 140 ).…”

Section: Discussionmentioning

confidence: 75%

“…In mask users, those compensatory mechanisms however seem to differ or get disturbed (e.g., no rise in respiratory rate, heart rate and simultaneous fall in V E ). Health risks should be considered despite the mask related compensation attempts ( 140 ). During face mask use a rise in the arterial PaCO 2 is possible in the long term ( 26 , 52 , 81 , 91 , 105 ).…”

Section: Discussionmentioning

confidence: 99%

“…Short mask experiments are also unable to show long-term changes. However, immediate compensatory mechanisms can hide further adverse reactions ( 122 , 138 , 140 ). Therefore, longer observation times can lead to clearer values that are closer or above the thresholds due to the attenuation or collapse of transient physiological mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…risks should be considered despite the mask related compensation attempts (140). During face mask use a rise in the arterial PaCO 2 is possible in the long term (26,52,81,91,105).…”

Section: Compensatory Physiological Mechanismsmentioning

confidence: 99%

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RETRACTED: Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation

Kisielinski¹,

Hirsch

Wagner³

et al. 2023

Front. Public Health

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BackgroundAs face masks became mandatory in most countries during the COVID-19 pandemic, adverse effects require substantiated investigation.MethodsA systematic review of 2,168 studies on adverse medical mask effects yielded 54 publications for synthesis and 37 studies for meta-analysis (on n = 8,641, m = 2,482, f = 6,159, age = 34.8 ± 12.5). The median trial duration was only 18 min (IQR = 50) for our comprehensive evaluation of mask induced physio-metabolic and clinical outcomes.ResultsWe found significant effects in both medical surgical and N95 masks, with a greater impact of the second. These effects included decreased SpO2 (overall Standard Mean Difference, SMD = −0.24, 95% CI = −0.38 to −0.11, p < 0.001) and minute ventilation (SMD = −0.72, 95% CI = −0.99 to −0.46, p < 0.001), simultaneous increased in blood-CO2 (SMD = +0.64, 95% CI = 0.31–0.96, p < 0.001), heart rate (N95: SMD = +0.22, 95% CI = 0.03–0.41, p = 0.02), systolic blood pressure (surgical: SMD = +0.21, 95% CI = 0.03–0.39, p = 0.02), skin temperature (overall SMD = +0.80 95% CI = 0.23–1.38, p = 0.006) and humidity (SMD +2.24, 95% CI = 1.32–3.17, p < 0.001). Effects on exertion (overall SMD = +0.9, surgical = +0.63, N95 = +1.19), discomfort (SMD = +1.16), dyspnoea (SMD = +1.46), heat (SMD = +0.70), and humidity (SMD = +0.9) were significant in n = 373 with a robust relationship to mask wearing (p < 0.006 to p < 0.001). Pooled symptom prevalence (n = 8,128) was significant for: headache (62%, p < 0.001), acne (38%, p < 0.001), skin irritation (36%, p < 0.001), dyspnoea (33%, p < 0.001), heat (26%, p < 0.001), itching (26%, p < 0.001), voice disorder (23%, p < 0.03), and dizziness (5%, p = 0.01).DiscussionMasks interfered with O2-uptake and CO2-release and compromised respiratory compensation. Though evaluated wearing durations are shorter than daily/prolonged use, outcomes independently validate mask-induced exhaustion-syndrome (MIES) and down-stream physio-metabolic disfunctions. MIES can have long-term clinical consequences, especially for vulnerable groups. So far, several mask related symptoms may have been misinterpreted as long COVID-19 symptoms. In any case, the possible MIES contrasts with the WHO definition of health.ConclusionFace mask side-effects must be assessed (risk-benefit) against the available evidence of their effectiveness against viral transmissions. In the absence of strong empirical evidence of effectiveness, mask wearing should not be mandated let alone enforced by law.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256694, identifier: PROSPERO 2021 CRD42021256694.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…risks should be considered despite the mask related compensation attempts (140). During face mask use a rise in the arterial PaCO 2 is possible in the long term (26,52,81,91,105).…”

Section: Compensatory Physiological Mechanismsmentioning

confidence: 99%

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RETRACTED: Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation

Kisielinski¹,

Hirsch

Wagner³

et al. 2023

Front. Public Health

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“…With regards to issues of CO 2 release, it has been reported that mask wearing rapidly leads to children inhaling CO 2 at concentrations above the accepted safe levels [53], the long term implications of which to children's health are unknown. The effects of CO 2 toxicity as a result of mask wearing, particularly for pregnant women, children and adolescents, have been recently and comprehensively reviewed, in which a number of issues associated with adverse effects and risks related to extended mask mandates were raised, including increased risk in stillbirths and reduced overall cognitive performance in children [54]. Sukul et al have also highlighted the potential problems of rebreathing, showing that the exhaled breath profiles of several endogenous volatile compounds, i.e.…”

Section: Physical Harmsmentioning

confidence: 99%

Revisiting the rationale of mandatory masking

Beauchamp,

Mayhew

2023

J. Breath Res.

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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.

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Wearing face masks as a potential source for inhalation and oral uptake of inanimate toxins – A scoping review

Kisielinski,

Hockertz,

Hirsch

et al. 2024

Ecotoxicology and Environmental Safety

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Possible toxicity of chronic carbon dioxide exposure associated with face mask use, particularly in pregnant women, children and adolescents – A scoping review

Cited by 14 publications

References 141 publications

RETRACTED: Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation

RETRACTED: Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation

Revisiting the rationale of mandatory masking

Wearing face masks as a potential source for inhalation and oral uptake of inanimate toxins – A scoping review

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