Respirators, and Masks, More to their Proper Use than Most People Know

Ohio’s State Representative Nino Vitale Shows Oxygen Levels Drop in Seconds When Wearing A Mask

Also See:

Respirators Still a Hot Item, So Should Be Knowledge of Their Use and Styles 04-08-2020

Respiratory Protection, Things You May Need to Know as a User or Employer 03-30-2020

Respirators, Things You Need to Know! 02-01-2020

Alas, what the Ohio Senator measured is the exhaled breath caught in the space, a space enlarged by the presence of the detector, essentially creating a static or dead air space that wasn’t present before the monitor was placed there. The monitor is measuring the reduced oxygen in the exhaled breath. Since by nature we don’t exhale all of our breath, there is air in the lungs, air passages, and mouth, that will contain lower oxygen, but that is diluted by incoming air much richer in oxygen.

At work, every year, we had a fit test for respirators, and a physical to determine if we could wear a respirator. The physical included a Spirometry Test, to determine volume of air breathed and other factors. One year, my Spirometry Test was reported to be below 50% of the value predicted for my age and weight. I visited my family doctor, and he order a Pulmonary Function Test with DLCO (Lung Diffusion Capacity Testing).

The Test Booth looked like this, only the door is closed. They measure lung capacity and the volume of air displace in the booth as you breathe.

Video: Pulmonary Function Test (PFT) – Springfield Clinic Pulmonary

This test determined I was breathing at 70% of expected, a relief for me.

For 23 years, and 12 of those years daily at work, some times for long periods, I had to wear a Half-Face Elastomeric Respirator, rubber or silicone, they take 2 replaceable cartridges. I also had a Full-Face Elastomeric Respirator, this protects the eyes too. The dead air, in a Full-Face Respirator exceeds the volume of dead air in Half-Face respirators possibly by a considerable volume. Yet, I noted no difficulties in performance wearing either one.

We did wear a 4 Gas Monitor, Oxygen, CO, H2S, and LEL. We had to wear it at Breathing Level and Stratification of Gases can occur, leaving one area with Sufficient Oxygen, but a few feet away it could be insufficient. It wasn’t uncommon to breathe out, with the Exhaust Valve near the 4 Gas Monitor, and have the O2 Alarm go off due to Low Oxygen, but it was caused by the exhaled air.

Our bodies don’t notice too little Oxygen, not nearly as much as too much Carbon Dioxide. CO2 causes an increased Rate and Depth of Respiration, and an Increased Heart Rate, in the absence of CO2, say in a Nitrogen Environment Displacing the Oxygen, it’s common for people to fall unconscious without realizing something is wrong.

As I looked for information, the World Health Organization was the first returned result:

“The prolonged use of medical masks* when properly worn, DOES NOT cause CO2 intoxication nor oxygen deficiency

The prolonged use of medical masks can be uncomfortable. However, it does not lead to CO2 intoxication nor oxygen deficiency. While wearing a medical mask, make sure it fits properly and that it is tight enough to allow you to breathe normally. Do not re-use a disposable mask and always change it as soon as it gets damp.

* Medical masks (also known as surgical masks) are flat or pleated; they are affixed to the head with straps or have ear loops.”

Yet in a National Institutes of Health Article from 2016, I found this:

Respirator masks protect health but impact performance: a review

Facepiece dead volume accumulates exhaled carbon dioxide in the voids between the respirator and the face and returns it to the respiratory system during the next inspiration. This carbon dioxide then acts as a respiratory stimulant. Because carbon dioxide is a psychoactive gas, dead volume may also produce discomfort and a performance decrement at low-intensity work. A typical value for full-facepiece APR respirator dead volume is 350 mL. Such a dead volume is expected to reduce performance time by 19 % at a work rate of 80 to 85 % of maximum oxygen uptake.

And this article detailed, in multiple ways, that Respirators reduce performance.

Admittedly, the WHO is addressing Masks, the Flat Surgical Mask used to help reduce pathogens escaping from a person coughing, sneezing, and sometimes just talking, and to help prevent the wearer from inadvertently touching his/her mouth or nose, and the NIH is addressing formal Respirators. But I want to return to the WHO statement of: “The prolonged use of medical masks* when properly worn, DOES NOT cause CO2 intoxication nor oxygen deficiency”. In order to wear Respirators in the Workplace, the Employer needs to Conduct Fit Tests, have a Respirator Program, and do Training.

If the WHO admits that of a Mask worn incorrectly (it’s implicit in their statement), that harm can happen, I’m wondering where wearers mandated to wear Masks received their training and had physicals to determine if they are healthy enough to wear a Mask and to assure that they are wearing them correctly?

A show I used to watch (still new shows on YouTube), Tim Tracker, a guy, occasionally his wife, more often now that they just had a later in life baby, their first. Tim has made a well deserved living doing videos on all things Disneyworld. In my opinion, he now works for Disneyworld. But he bought a Pulse Ox, a device that shows a relative oxygenation of blood by simply clamping it onto a finger tip long enough to get a reading. His device showed 98% oxygenation of the blood before, and then hours later, after videoing his activities at Disneyworld. But I’m not confident that his results are a global thing, I feel confident that they are not. And strangely, when he put it on, prior to wearing the mask, and was inside his home, not sweating profusely like he’s hot, his pulse was in the 90s, that’s very high for a resting, or near resting, pulse.

Ear and fingertip oxygen saturation measurements of healthcare workers wearing protective masks

The CDC has this to say:

“Minor, but statistically significant, differences in oxygen saturation measured by pulse oximetry were noted between N95 filtering facepiece respirators with and without an exhalation valve and one model of an elastomeric air-purifying respirator worn by healthcare workers over one hour at two low work rates.”

They misuse the term Masks above, they are denoting Filtering Facepiece Respirators

Nevertheless, there are differences, though slight, in Oxygen Saturation workers with Exhaust Valve Equipped Filtering Facepiece Respirators (you cannot use these with patients with infectious disease as the air exits the Respirator unfiltered) and ones without the Exhaust Valves, so that’s proof that concerns are worthy of addressing. WHO said that patients “Correctly Wearing” Masks will not have issues with oxygen, but no one has taught anyone to correctly wear them, and all of this is predicated on people with a certain degree of health or better, and no attempt has been made to determine if people are healthy enough to wear them.

I think the Ohio State Senator efforts are laudable, and I think it should be the foundation for discussion on the topic of Masks and Filtering Facepiece Respirators. There is more to properly wearing them than one thinks, and if you do everything correctly, and are in an infectious environment, can contract certain diseases via the Eyes, and the Tear in the Eyes that Drains into the Sinuses. So, what is the net advantage of wearing them, in what circumstances, and by who? We have no guidance, just wear them we’re told.

Author: Dr-Artaud

A Doctor that is not a Doctor, but named after a character in the movie "No Such Thing", as is the Avatar.

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