A practical guide to the use of masks

Correct use of surgical masks

This new situation posed by the COVID-19 pandemic has led us to question ourselves about the correct use of masks. Surely, we never imagined that this sanitary element would be essential on a day-to-day basis and many doubts have arisen; we even had to make several mistakes before learning how to wear this protection product.

It is common to see how some people place the mask under their nose; some raise them too much to practically obstruct the visual field; Others have a great variety of masks that you do not understand whether or not they are effective against this type of virus, and many more situations can lead you to have dozens of unknowns, myths and uncertainties about which is the correct use.

So far, it may be that the most concrete on the subject is that the use of the mask is an effective part of the biosafety protocol and mandatory within the country to be able to circulate in public spaces, means of transport, the operation of companies in all sectors and, in all cases, to protect ourselves from being infected or from infecting others.

And it is that, at this moment, we could all be suspected of carrying the virus. As stated by the WHO, confirmed asymptomatic cases are within 6-41%. 

https://www.youtube.com/watch?v=baHXul0mO1I

The figure could be higher considering that there are carriers that have not been detected, precisely because they are detected through the COVID-19 test, which, mainly (in some cases, exclusively), is applied to patients who already have any symptoms.

This is how asymptomatic cases may be living and circulating with the virus while carrying a false health security and infecting around them unconsciously. The good news is that this imminent risk of the asymptomatic so particular of this type of virus can be drastically reduced with the proper use of masks.

Why with so-called surgical masks? Because its composition and design are specially developed as a barrier to contain the microdroplets that carry the virus that the carrier emits when speaking, coughing, sneezing and even breathing.

These masks have a minimum bacterial filtration efficiency (BFE) of 95% and, depending on their type, could be higher than 98%. This high capacity to block the passage of the virus transport droplets prevents both carriers and those around them from increasing the number of infected.

This evidence of its effectiveness is such that doctors from Madrid hospitals have openly declared the need for the entire population to wear masks to prevent infection by COVID-19.

Therefore, to help you deal with this virus effectively with the use of the correct masks, we make this content in which we collect all the scientific and specialized information that you need to have to protect yourself and others. 

We can obtain an effectiveness of bacterial protection against COVID-19 of more than 98% with the correct use of masks. #EsteVirusLoParamosUnidos.

Know the correct use of masks

The urgency of using masks is clearer, these being the special ones to contain the spread of this type of virus, particularly due to its ease of spread and asymptomatic cases.

Now we can address everything related to the correct use of masks, this being essential to achieve all that effectiveness that specialists confirm.

How to place them?

correct-use-of-surgical-masks-according-to-WHO

The first thing to clarify is how to place the masks, since many mistakes have been made that automatically lower the effectiveness rate that they are capable of and, contrary to what is wanted, increase the transmission of the virus.

Placing them correctly implies from hygiene practices to a simple but vital technique to put them on your face:

Hygiene practice when putting on the mask

  • Wash your hands with soap and water for about 20-30 seconds. Make sure to rub very well between each nail and each space between your fingers and wrists.
  • If you cannot wash with soap and water at the moment, use antibacterial gel to disinfect your hands.

Mask placement technique

  • Take the mask from the rubbers and check against the light that it has no holes or tears.
  • After checking the good condition of the mask, proceed to fix the rubber bands on the ears, taking care that the part of the molding wire is on top.
  • Make sure the nose, mouth, and chin are covered with it and that no gaps form between the fabric and the facial skin.
  • Adjust the mask to the shape of the bridge of your nose by pressing on the wire.
  • Avoid touching the mask with your hands or any surface to avoid contamination.
  • If you touch the mask during use, disinfect your hands with antiseptic alcohol or, if possible, wash them with soap and water.
  • If you have glasses, you must remove them before putting on the mask.
  • Make sure the goggles are over the mask.
  • To prevent the glasses from fogging up, you need to make sure to adhere the wire part to the bridge of the nose very well.
  • In case of not being able to avoid the vapor of your breath in the glasses, you could go to special products for this purpose.

How often should I change it?

It is noteworthy that the correct use of masks also depends on having clarity and discipline about when they should be changed.

As they are not reusable, they must be changed from time to time and in the following cases:

  • Every 4-8 hours maximum.
  • Before the recommended 6-8 hours if they show deterioration, dirt or humidity.
  • After removing it to eat or drink.

These mask change times are established considering that the mask may already be contaminated by the transmitting microdroplets in this average period of time, which potentially increases the risk of contagion by contact. In addition, with constant breathing, the mask becomes wet and, with it, the effectiveness of the filter is lost.

The effectiveness of masks of this type is lost after the recommended 4-8 hours of use, so they should be changed in this period of time or sooner if they get wet, damaged or dirty.

Now, it is worth clarifying that non-reusable masks are for single use and personal (they should not be shared).

These should not be washed to be used again, because the humidity of the breath or the environment deteriorates its filter which works as a protective barrier and, with it, all its effectiveness; hence they should be changed immediately when wet.

particular-recommendations-on-use-of-surgical-masks

On the other hand, when you work in clinical or medical settings, if you are in places where there is community transmission or presumption of this or more intense outbreaks, the change of the mask should be done in the above general situations and in other additional ones:

  • After having cared for a patient.
  • After touching the mask.
  • Every four hours maximum.

How should I remove it?

Just as important is to remove the masks with the recommended care. To do it as it should be necessary:

  • Take them from the rubbers and pull them forward. 
  • Avoid touching the fabric on either side.
  • Dispose of it in the trash immediately, being careful not to touch any object or surface while you throw it away. 
  • Avoid touching your eyes, your nose and your mouth or any surface with your hands.
  • Disinfect or wash your hands very well.

So far there is no widely proven or studied method for disinfecting reusable masks, so in this case, the best option continues to be the use of masks, noted for being single-use.

About known as surgical masks

It is convenient to delve into the concept of masks and all the characteristics that you should know to make sure you recognize them.

This type of mask is part of the so-called sanitary equipment and are regulated by the UNE-EN 14683: 2019 AC standard. It establishes the requirements that these must meet in order to be marketed throughout the European Union for quality and effectiveness reasons.

This is another essential aspect for the correct use of masks of this class. Therefore, it is important that you recognize the items that they must meet:

Construction or manufacturing. The method must ensure that the union of the layers that compose it and the different parts of the masks is indicated, ensuring the effectiveness of bacterial filtration. This method should be a seal that does not cause punctures in the mask.

Design. They must be ergonomic and ensure that they conform to facial morphology. In addition, they must ensure that there are no gaps between the skin and the mask.

Performance requirements and test methods. These must go through tests and trials that show that they are within the required thresholds of:

  • BFE or bacterial filtration efficiency.
  • Breathability or differential pressure.
  • Splash resistance pressure (for Type IIR).
  • Microbial cleaning or bioburden.

The minimum or maximum threshold that masks must meet varies according to their type and is explained in the following table, published by the Valencian Institute of Microbiology, which is an extract from the UNE-EN 14683: 2019 AC standard:

the-regulation-that-guarantees-the-effectiveness-in-use-of-surgical-masks

You can check that these quality requirements are met by checking that the masks mention on their packaging that they are certified by the standard in question.

In addition to verifying that the masks have the certification required by the EU, you can identify the following visible characteristics:

  • They are rectangular in shape with pleats.
  • They have lateral support rubbers, that is, for the ears.
  • They have a moldable wire for adjusting the bridge of the nose. 
  • They have no seams.
  • They should have a seal between the layers.
  • They usually have three layers, of which the center is the one that acts as a bacterial filter.
  • They generally have a 20 gram white filter.
  • Its material is non-woven fabric.
  • These should not have perforations or holes. 

At present, you find masks that have improved characteristics and are even more adjusted to the demands of prevention of this pandemic.  

It's about our Béjar masks, a product that was born as a solution to the shortage in the supply of masks in our country and due to the need to adapt our final product to the needs of the entire Spanish population. Among the superior characteristics that we integrate in its elaboration are:

Use of Béjar quality surgical masks

  • 53 gram TNT filter: this is higher than that found in average masks, in which the filter is 20 grams.
  • Bacterial Filtration Efficiency (BFE) greater than 99,7%: the standard requires 98%, which equates to our masks exceeding the standards and providing optimized protection against germs, viruses and dust.
  • Anti-fluid property: this makes it a type IIR, which are of maximum protection against the virus transmitting droplets.
  • Ultrasonic welding: with this an optimal union of the three layers that compose it, its rubbers and its parts is ensured.
  • Plastic lined wire: for greater comfort, hygiene and safety in use. 
  • Cotton and lycra rubber bands: for greater comfort in prolonged use and high precision in adjustment.
  • Very resistant to humidity caused by breathing: therefore its use can be extended to 6-8 hours. 
  • Safer and more hygienic textiles: those used in the mask are free of toxins, such as fiberglass and latex, and do not emit particles.
  • Certified by the EU: UNE-EN 14683: 2019 AC certification and by Aitex (Textile Technological Institute).
  • National product: manufactured in the community of Béjar, thereby promoting employment and the local economy and achieving a more convenient price for consumers in Spain.

Finally, these are customizable according to the product and the packaging. You find different presentations according to the amount needed in business use and in medical or family settings:

It is important to clarify that the masks are not sold by units, since the unit sale is only authorized to pharmacies, so that the protection of the product against the contamination that may be caused before its use can be ensured.

You can also customize the the packaging for your company, organization or social group.

Are they reusable?

Although the WHO mentions that the conditions of reusable In some designs of masks, those that are widely found in the market and on which there are tests and studies of effectiveness are the non-reusable type.

This, especially, because no effective disinfection methods have been found for this type of mask, and there are even no effective methods for EPI-type masks (FFP2, FFP3, N95…).

Therefore, the effectiveness and scientific evidence of contagion prevention applies especially to the use of non-reusable masks.

Now, if there are reusable masks, they should go through the obstruction test which is a parameter established in the UNE-EN 149: 2001 + A1: 2010 standard and they should specify on their packaging that they are of this type with the letter R and clarify the number of uses that can be given.

Do they expire?

This is another condition that you should pay attention to before using masks. The common idea may be that masks do not expire. However, as it is a sanitary element, it does have an expiration date, and this must be indicated on its packaging, along with the batch number and the date of manufacture.

One of the reasons these have an expiration date is because their gums and fibers can deteriorate over time. This prevents them from having the precise fit and meeting the conditions of your bacterial filter.

However, the masks have a medium to long-term shelf life. Our Béjar masks expire three years after the date of manufacture. 

How should I store the masks?

The storage of the masks must guarantee the integrity of the product throughout its useful life. For this purpose, they must be stored as follows:

  • In spaces at room temperature.
  • They should not be exposed to extreme hot or cold temperatures.
  • The place of its storage must be dry and free of humidity.
  • They should be kept away from direct contact with the sun's rays.
  • They should be kept in clean places and away from chemicals.
  • Pressure should be avoided on these.

After using masks, how should they be disposed of?

In any case, whether in a clinical setting, in a company in another sector or as a common citizen, the mask should be disposed of in the trash after use and hands washed or disinfected afterwards.

This is because the risk of contagion by contact at this point is imminent, considering that the mask has already been exposed during the hours or period of use.

At this point, the mask becomes a source of infection for both you and others, so ideally they should be disposed of in a closed garbage container, where they will not be exposed to other people. 

Likewise, it is important to take into account that the use of masks can cause fatigue and, in the case of irritable skin or acne, it can aggravate the condition. Therefore, it is important that after use you apply products such as creams and others that help to generate a better protective barrier on the skin.

In case you notice an obvious intolerance to the mask, you could consult your doctor about alternative solutions. Some conditions that could reveal this intolerance are:

  • Obvious and unsustainable shortness of breath.
  • Dizziness and headache
  • Rash or skin irritation.
  • Itching and discomfort in the mucous membranes.
  • When you already suffer a respiratory disease that is aggravated with its use.

Remember that many of these incompatibilities can be avoided when you use masks like ours, since our materials do not release particles or contain toxic compounds, which are the cause of many of these annoyances. In addition, they ensure breathability with maximum protection against bacteria.

Finally, remember that the mask is one of the essential elements in the battle against the spread of COVID-19.

Such as explains Professor Kim Woo-joo from the Guro University Hospital in Korea, the mistake that was made in Europe and the United States was not to promote the use of the mask in the entire population since the beginning of the pandemic to reduce the speed of contagion that we have experienced.

In addition, it is essential that we do not forget that the correct use of the mask must be accompanied by the other points of the prevention protocol declared for the entire population by the WHO:

  • Distance of 1-2 meters from person to person.
  • Avoid touching the eyes, nose and mouth.
  • Wash your hands every two hours or sooner, if necessary.
  • Disinfect surfaces and objects periodically.

Taking into account all the recommendations in this guide on the use of masks, you can be more calm and sure that you are doing what is necessary to fight against this invisible enemy.

Conclusions

The use of masks is recommended by the public health experts in the world. Therefore, it is essential to know their particularities and the conditions of their use so that they achieve the high effectiveness that has already been proven.

Among what you could find in this guide are the technical characteristics and the requirements they must have to make sure you use the correct ones, the reason for their effectiveness in this pandemic, how to place, remove and dispose of them, when they should not be used and what is essential which is to accompany them with the other elements and measures of the biosafety protocol. 

Sources:

https://apps.who.int/iris/bitstream/handle/10665/332657/WHO-2019-nCov-IPC_Masks-2020.4-spa.pdf

https://www.who.int/es/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks