Mask: What You Need to Know Before Wearing It!

What is a Face Mask?

The surgical face mask is now considered an everyday essential; however, face masks have been used since the middle ages.

In 1897 a French Surgeon, Paul Berger, used a piece of fabric to cover his face to prevent cross-infection during surgery.

Surgical masks were invented by Dr. Wu Lien-teh's, a Chinese-Malaysian epidemiologist, which invented the precursor to the N95 masks to respond to the Manchurian Plague that affected China in 1910.

Surgical masks have been used for the very first time in the 1920s, in Germany and in the USA, especially in surgery and minor procedures.

Face masks are a Personal Protective Equipment (PPE) and have been proven to help the spread of the coronavirus (SARS-CoV-2) that causes COVID-19.

There are several types of masks available in the market nowadays; each model to be used in different settings or depending on the individual's circumstances.

Most of the masks available to buy today don't have tests for Filtration or Fluid resistance, our masks do, and they are entirely made in Britain in our warehouse in Bristol.

The Shortage of Face Masks

Covid-19

The COVID-19 virus was initially detected in Wuhan, China, in December 2019, and by the 30th of January 2020, the WHO Director-General declared that the outbreak constituted an international emergency.

This virus is transmitted through close contact and droplets; hence masks have been advised as a tool to tackle the pandemic from the early days of it.

The Need for Face Masks During the Pandemic

The use of face masks in the past year has increased drastically to avoid COVID-19 transmission, and the research behind the use and the production of them is constantly developing to make sure we are protected and safe.

The main route of transmission of COVID-19 is through air particles, and it's well known that it can be transmitted by both symptomatic or asymptomatic individuals.

To reduce the spreading of this disease, it's crucial to limit contacts through physical distancing and to use face masks to decrease the probability of transmission.

Wearing a face mask significantly reduces the transmissibility of the virus, hence why it is so widely used in clinical and public contexts today.

Compliance is essential, and many government bodies have been enforcing and encouraging the use of face masks for everyone's safety: as of today, several countries have implemented some requirements for wearing a mask in specific community settings.

Since the early days of the pandemic, wearing a face mask has become an everyday essential when we go out shopping or in busy environments.

Shortage of Masks and the WHO

In March 2020, at the early stages of the pandemic, the WHO called for a shortage of Personal Protective Equipment, causing the endangering of health care workers on a global scale.

Action was taken immediately, and they immediately called the governments and the industries for an increase in manufacturing by 40 percent to meet the increasing global demand.

The increasing shortage was caused by the rise in demand, panic buying, misuse, and hoarding. As a consequence, healthcare workers and the frontline workforce were left working in dangerously ill-equipped conditions to face COVID-19 patients.

The shortage included masks, gloves, aprons, goggles, face shields, gowns, respirators, and surgical masks.

According to the WHO, each month, 89 million medical masks are required to face the COVID-19 outbreak; therefore, guidance to the use of PPE has been published on their website at the end of February 2020.

Why Use Face Masks?

As per WHO's recommendation, face masks are crucial to prevent the spreading of the disease and to save lives.

Along with other recommendations, such as social distancing, avoiding crowded, close-contact, and closed settings, washing hands, and covering sneezes and coughs, a face mask must be implemented as part of the plan to reduce the transmission of the virus.

Who Can Use Face Masks?

Everyone can use a face mask. The type of face mask recommended depends on the settings in which the individuals find themselves.

Anyone who is feeling unwell, including people with flu-like symptoms such as fatigue and sore throat, should use a surgical mask, along with people waiting for COVID-19 test results, whoever had a positive result, and people caring for individuals that have suspected or confirmed COVID-19 infection.

Healthcare workers are also advised to wear surgical masks in clinical settings, occupational health departments, and infection prevention and control departments.

Wearing a surgical mask is also recommended to those who are more vulnerable or at higher risk of becoming seriously ill with the virus, such as people aged 60 and over and people with any underlying condition, such as asthma, cancer, respiratory diseases, cardiovascular diseases, diabetes patients, obesity, and immunocompromised patients.

Face masks should be worn in areas where the virus may be circulating, such as crowded settings, such as shopping centres, schools, and public transport, and in rooms with poor ventilation.

If you have a visitor that is not part of your household, it's advised to wear a mask (and let them wear a mask too).

In public settings where the physical distance cannot be kept, it is advised to wear a face mask, such as crowded streets and bus stops.

Healthy individuals with no underlying conditions can wear cloth masks.

The Types of Face Masks

There are several types of face masks available, and depending on the setting and the individual, according from the US government, Food and Drug Administration, they are meant to protect and reduce the spread of the virus, combined with other preventative measures.

We created a helpful list of the face masks currently available in the market to clarify the differences. We know it can be confusing trying to understand which model is the most appropriate for us to wear.

Cloth Mask
Cloth masks are classified as non medical face covering.
A cloth mask is meant to create a barrier to trap the respiratory droplets released when we talk, laugh, cough, and sneeze.
They are also meant to trap the droplets released by others.
This face covering should be made of three layers of fabric.
The outer layer should be water-resistant, the middle layer should act as a filter, and the inner layer should be water absorbent.
These can be washed at high temperatures (60 degrees at least) and reused.
Surgical Face Masks
Also called medical masks, they protect from droplets and sprays, and large particles.
In Europe, Medical face masks must comply with the European standard EN 14683:2019; surgical face masks can be Type I and Type II, depending on the level of bacterial filtration and whether or not the mask is fluid-resistant.
These masks are usually sold as non-sterile, but they can be provided as sterile if necessary.

Type I
They have a bacterial filtration efficiency (BFE) of 95%.
This type of face mask cannot be used by healthcare professionals in theatre or in similar settings.
Type II (EN14683)
These provide bacterial filtration and should be only used by patients and other people to reduce the risk of spread of the virus.
They have a bacterial filtration efficiency (BFE) of 98%.
Type IIR
This type of mask is a sub-category of Type II, and it has the same characteristics, but the "R" means that the mask is splash resistant.
They have a bacterial filtration efficiency (BFE) of 98%.

Respirators
These offer more protection compared to surgical masks, as they can filtrate small and large particles, and they are reserved for health care practitioners working in a clinical setting.
In Europe, these must meet European standard EN 149:2001.
The healthcare practitioners must be fully trained and carry a "fit test" before wearing them to ensure they can get the level of protection given by these masks.
The wearing time should be <8 hours in a single day.

FFP1
These respirators filter >80% of aerosols.
FFP2
These are the equivalent of the N95 respirator mask. These respirators filter >94% of aerosols.
FFP3
These respirators filter >99% of aerosols. These are the most efficient when it comes to filtration, and they are usually used to handle asbestos.

Antiviral Masks
Designed and developed by scientists of the Nottingham Trent University (UK), these masks are proven to kill up to 99.9% of coronaviruses within 5 minutes of contact.
These face masks are made of 5 layers, including an inner layer that incorporates nano-copper particles.
Masks with Valves
These masks (usually either medical or made of cloth) have a valve that makes breathing easier.
Unfortunately, they don't provide a filter for the air inhaled and exhaled; therefore, they are not recommended for antiviral purposes.
Tech Masks
Some tech companies worldwide are manufacturing face masks that incorporate high-tech features.
This may include LED, transparent masks with fans, filtration levels higher or comparable to an N95 respirator mask, USB charging, and smart sensors.
Prices start from 100 USD for the most simple one and go up quite significantly depending on the features offered.
Face Shields
Wearing a face shield alone without using a face mask is not recommended, as it's unclear how much protection these can provide.
These can be worn along with a face mask for added protection, especially in clinical environments.

What are the Materials for Making Masks for Coronavirus Disease?

The most common materials used to make surgical masks are:

Polypropylene (PP);
Polyethylene (PE);
Cellulose;
Polyolefin;
Felt

PP is the most common one, followed by a combination of PP and PE.

When it comes to the "texture" of the materials, the most commonly used one in surgical face masks is the "SMS" texture, which is made of Spunbond PP for the inner layer, Meltblown PP for the middle layer, and Spunbond PP for the outer layer.

Spundbond PP is strong and durable, whereas Meltblown PP is weaker but, due to its composition, works better as a barrier.

Allergies and Cautions with Face Masks

Some people may suffer from adverse events caused by allergies to some types of face masks. It's a rare occurrence, but there are a few reported cases.

Some individuals may in fact, experience contact dermatitis caused by formaldehyde and elastic components of certain masks such as textile dyes, thiuram, and carbamate, materials found in some surgical and non-surgical masks.

Formaldehyde is generally used to keep bugs and insects away during the manufacturing process, but in contact with the skin, it can cause irritation and act as an allergen.

The main symptom is a persistent rash, causing red and blotchy skin, and switching to another face mask that doesn't contain those materials is necessary, along with some prescribed medications.

Anyone experiencing this type of symptom should speak to their GP and if necessary, be referred to a dermatologist or an allergist.

People that have to wear face masks for a prolonged period of time, such as healthcare workers, are advised to use a barrier cream to protect themselves from the rubbing and chafing.

It's also advised to avoid products containing witch hazel or rubbing alcohol as they would be even more irritating, making the skin dry and sensitive.

How to Wear a Face Mask?

There are different ways to correctly wear a face mask, according the type of mask.

Following WHO official guidelines, this is how to put on and take off a cloth mask:

Before touching the mask, wash your hands with soap and water or use an alcohol-based hand rub.
Check if the mask has any holes or if it's damaged; in this case, it shouldn't be worn.
Wear the mask by covering your nose, mouth, and chin areas, and make sure there is no gap between the face and the mask.
If you touch the front of the mask, make sure you wash your hands to avoid any contamination.

To remove the cloth mask:

Wash your hands with soap and water or with an alcohol-based rub.
Without touching the front of the mask, as it may be contaminated, remove the straps from behind the head or ears.
Lean forward as you remove the mask and pull it away from your face.
Wash your hands after taking out the mask.

Cloth masks can be reused by washing them in soap and water at high temperatures (at least 60 degrees) after each day of use.

Following WHO official guidelines, this is how to put on and take off a medical mask:

Before touching the mask, wash your hands with soap and water or use an alcohol based hand rub.
Check if the mask has any holes or if it's damaged.
Don't use a mask that has been previously used.
Check which side is the front.
This is usually where the metal strip for the bridge of the nose is.
Check which side is the inside one, which is usually the white one.
Wear the mask by covering your nose, mouth, and chin areas, and make sure there is no gap between the face and the mask.
The straps should be placed behind the ears without twisting them or crossing them as this can cause gaps.
Pinch the metal strip on the nose bridge so it can moult to the shape of your nose and be more comfortable and close any gap.
If you touch the front of the mask, make sure you wash your hands to avoid any contamination.

To remove the surgical mask/respirator:

Wash your hands with soap and water or with an alcohol-based rub.
Without touching the front of the mask, as it may be contaminated, remove the straps from behind the head or ears.
Lean forward as you remove the mask and pull it away from your face.
Surgical masks are single use only, so discard them in a bin after use.
If the mask gets damp or soiled while in use, replace it with a new one.
Wash your hands after taking out the mask.
It's paramount not to share face masks.

What are the Best Face Masks?

Choosing the right mask is important, but making sure the product is genuine has become essential too.

The best masks are the ones that can actually protect you and the others around you by delivering the protection that they promise, following the local regulations, and having the right certifications.

Due to the global run of face masks, people across the globe are trying to stockpile them as much as possible.

Many people ordered them online, unable to find them on the local pharmacies, stores, or websites, relying on dodgy website shipping from the Far East.

The recent news reported that some vendors from China were selling face masks, sometimes at an overcharged price due to the rise in demand, but those masks were of very low quality, passed as N95 masks.

More than 11 million of fake masks have been seized in the USA, and many of them haven't been tested or checked for quality control.

Looking at them is difficult to spot the differences, but those masks are putting many people's health at risk.

They are not as effective at preventing the transmission of the virus, and several lawsuits are being filed against the vendors.

For this reason is essential to order locally from a trusted UK website, or from the pharmacy, to make sure the product has been thoroughly checked before being allowed in the shelves.

Signs That a Face Mask May Not Be Genuine

It's crucial to make sure we use reliable sources for our face masks to avoid being scammed into buying a counterfeit product, which could be extremely dangerous for our health.

The main signs that face masks and respirators may not be genuine are the following:

Presence of decorative fabric, such as sequins or prints, and different colours
No markings or approval (TC) number
Misspellings

Where to Buy a Surgical Face Mask

As of today, the use of face masks is mandatory in most public places.

It is, therefore, paramount to be prepared and to always carry at least one face mask so that it can be of use.

There are several ways to buy face masks.

They can be found in local stores and pharmacies or online from trusted UK companies such as Bristol Mask.

It's strongly advised not to buy them from dodgy marketplaces from abroad to prevent buying counterfeit products passed as genuine.

The face mask must fit snugly, must be secured with ear loops, include multiple layers of fabric, must allow for breathing without being restrictive, and in the case of a cloth mask, it must be washable without being damaged or changing its shape.

Conclusion

Wearing a face mask is crucial to reduce the spreading of the virus and to protect ourselves and others.

Still, it's also essential to keep practicing social distancing, hand washing, and other precautions, regardless of the type of mask that you're wearing.

Make sure you're choosing the right mask for the proper protection based on your circumstances, and feel free to rely on our guide or to send us an email for more information; we will be happy to help you choose the right product for you.

We produce only high-quality surgical face masks in UK (Bristol), and we produce more than a million masks a month! If you're close to the warehouse/ shop, you can come and collect your surgical masks directly; otherwise, you can make an order online.

Bristol Mask will donate £1 to NHS Charities Together (add link) with the sale of each box of masks.