The moment for masks

You are probably looking for the N95 rated respirator, but here is a primer in case you want options.

The novel corona virus that was given the name COVID-19 was discovered to be lethal, much like SARS and MERS before it. There are the conspiracy theories about its origins, but one undisputed fact has come to light: aside from isolation, a mask can be an effective way to avoid contraction. Masks have played a relatively common role in the Far East, where pollution is more severe and considered a health issue. In the United States, however, wearing masks in public is frowned upon, as if the wearer is a germophobe or a hypochondriac. But this view might be changing for the better. The time might have come when wearing a mask is a responsibility to ourselves and our community. If you want to be responsible, below is a primer that can get you started:

The Primer

There are four main types of masks: costume masks, masks to stay warm, masks for prevention of spreading disease, and masks for the prevention of contracting disease. Let us ignore the first two types. The third type, the type of mask that prevent the spread of disease, is commonly known as a surgical mask. You have seen it; your dental hygienist wears it. It protects them to some degree but it mostly protects you, the patient. And in the Far East, it is not uncommon to see people wearing these types of masks as a courtesy to others while going about their necessary business of life.

Lately, the biggest confusion has been around the type of mask that prevent the contraction of disease. Some of the confusion comes from the fact that the most common mask associated with disease is the common surgical mask, for obvious reasons. But the masks that prevent the contraction of disease are classified as Personal Protective Equipment. To be classified as a PPE, it must receive a rating. The ratings have also confused people who are just getting into masks. Not only are there multiple types of ratings but there are similar ratings from various ratings agencies around the world.

N95 rated respirator is what you are probably seeking. This is the most commonly recommended Personal Protective Equipment on this genre. There is good reason for this, and the primer will explain.

There is a difference between a mask and a respirator. A mask is really anything that provides cover over part or all of the face. A respirator is something that is designed to control the airflow, primarily in term of direction, though there are types that exist to control the amount as well. For protective reasons, a respirator is what you really want. But that does not mean masks cannot have these protective qualities, it’s just that masks are generally are not rated the same.

Also, there are masks that are rated for protection but one must be careful because the rating is just for the filtration system and not the airflow design. Simply put, the air filtration system might be N95 rated but that does not mean the wearer is receiving the full, or any, protection because the mask is not adequately designed to prevent unfiltered air from reaching the wearer’s lungs.

In the United States, N95 is a rating that is certified by NIOSH (National Institute of Occupational Safety and Health). The “N” comes from NIOSH. The CDC (Center for Disease Control and Prevention) states that the N95 respirator is certified to “filters at least 95% of airborne particles but is not resistant to oil”. That is to say, the respirator is effective as long as it has not been in contact with oil. But there are two other ratings series, the R and the P. The 95 in an R95 respirator is the same 95% but the R means the respirator is resistant to oil. The P in a P95 respirator means it is nearly oil proof. The percentage effectiveness can also be higher. there are N99 respirators. So, in terms of cost effectiveness, N95 makes the most sense to recommend. To make this certification even clearer for consumers, the CDC has a list of N95 certified products.

There are practical reasons for recommending the N95 respirator. N99 and N100 respirators are more difficult to breath through because they are certified to filter out more particulates. This means that the wearer is more likely to find ways to wear these respirators in ways that make them less effective.

Recently, there have been headlines about respirators being sold out. This is absolutely true. People are becoming creative, so, they are looking for equivalently certified respirators from other countries. The giant supplier 3M recently (Jan 2020) published a comparison of certified respirators from various countries. Maybe a journalist can look into the timing of this paper, but someone at 3M clearly realized that a less technical communication. Therefore, even more recently, 3M published Respiratory Protection FAQ: General Public, in which is a section called “What is the difference between different countries’ respirator approvals?” In the section, the company lists the following to be functionally similar:

Australia/New Zealand – P2

Brazil – FFP2

China – KN95, KP95

Europe – FFP2

Japan – DS2, DL2

India – BIS P2

Korea – 1st class

US NIOSH – N95, R95, P95

Another confusion with certification comes from the use of PM 2.5. PM 2.5 means particulate matter 2.5 micrometers in diameter or smaller. N95 is rated for airborne particles on at least 3 microns. For the sake of this discussion, micrometers and microns are the same. So, one would think that a product certified for PM 2.5 is better, but one would be wrong. There is no such things as a PM 2.5 certification. It is a term used by the EPA (Environmental Protection Agency) to set standards for things like buildings ventilation. The EPA does not certify respirators and masks.

The Future

For disease prevention, respirator is the solution. However, once this pandemic passes, there is still a great benefit to wearing masks. Masks that are designed to filter out PM 2.5 might not have the specific airflow design, but most of the air intake will still be through the filter in such masks. For many of us who live in large cities, air pollution is the nearly invisible cause of our headaches, allergies, indigestion, asthma, heart disease, and, even, immune deficiencies. We should all be using masks during our commute, especially those of us who use public transportation. And unlike the NIOSH certified respirators, masks can be fashionable. There have been several attempts to make it happens, but failed. But unlike the other times, this pandemic has put a spotlight on masks. This could be the moment masks have been waiting for.