Surgical masks and filtering facepiece class 2 respirators (FFP2) have no major physiological effects at rest and during moderate exercise at 3000-m altitude: a randomised controlled trial.

COVID-19 Personal protective equipment arterial blood gas cognition high altitude hypobaric chamber

Journal

Journal of travel medicine
ISSN: 1708-8305
Titre abrégé: J Travel Med
Pays: England
ID NLM: 9434456

Informations de publication

Date de publication:
05 09 2023
Historique:
received: 23 12 2022
revised: 21 02 2023
accepted: 24 02 2023
medline: 7 9 2023
pubmed: 8 3 2023
entrez: 7 3 2023
Statut: ppublish

Résumé

During the COVID-19 pandemic, the use of face masks has been recommended or enforced in several situations; however, their effects on physiological parameters and cognitive performance at high altitude are unknown. Eight healthy participants (four females) rested and exercised (cycling, 1 W/kg) while wearing no mask, a surgical mask or a filtering facepiece class 2 respirator (FFP2), both in normoxia and hypobaric hypoxia corresponding to an altitude of 3000 m. Arterialised oxygen saturation (SaO2), partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), heart and respiratory rate, pulse oximetry (SpO2), cerebral oxygenation, visual analogue scales for dyspnoea and mask's discomfort were systematically investigated. Resting cognitive performance and exercising tympanic temperature were also assessed. Mask use had a significant effect on PaCO2 (overall +1.2 ± 1.7 mmHg). There was no effect of mask use on all other investigated parameters except for dyspnoea and discomfort, which were highest with FFP2. Both masks were associated with a similar non-significant decrease in SaO2 during exercise in normoxia (-0.5 ± 0.4%) and, especially, in hypobaric hypoxia (-1.8 ± 1.5%), with similar trends for PaO2 and SpO2. Although mask use was associated with higher rates of dyspnoea, it had no clinically relevant impact on gas exchange at 3000 m at rest and during moderate exercise, and no detectable effect on resting cognitive performance. Wearing a surgical mask or an FFP2 can be considered safe for healthy people living, working or spending their leisure time in mountains, high-altitude cities or other hypobaric environments (e.g. aircrafts) up to an altitude of 3000 m.

Sections du résumé

BACKGROUND
During the COVID-19 pandemic, the use of face masks has been recommended or enforced in several situations; however, their effects on physiological parameters and cognitive performance at high altitude are unknown.
METHODS
Eight healthy participants (four females) rested and exercised (cycling, 1 W/kg) while wearing no mask, a surgical mask or a filtering facepiece class 2 respirator (FFP2), both in normoxia and hypobaric hypoxia corresponding to an altitude of 3000 m. Arterialised oxygen saturation (SaO2), partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), heart and respiratory rate, pulse oximetry (SpO2), cerebral oxygenation, visual analogue scales for dyspnoea and mask's discomfort were systematically investigated. Resting cognitive performance and exercising tympanic temperature were also assessed.
RESULTS
Mask use had a significant effect on PaCO2 (overall +1.2 ± 1.7 mmHg). There was no effect of mask use on all other investigated parameters except for dyspnoea and discomfort, which were highest with FFP2. Both masks were associated with a similar non-significant decrease in SaO2 during exercise in normoxia (-0.5 ± 0.4%) and, especially, in hypobaric hypoxia (-1.8 ± 1.5%), with similar trends for PaO2 and SpO2.
CONCLUSIONS
Although mask use was associated with higher rates of dyspnoea, it had no clinically relevant impact on gas exchange at 3000 m at rest and during moderate exercise, and no detectable effect on resting cognitive performance. Wearing a surgical mask or an FFP2 can be considered safe for healthy people living, working or spending their leisure time in mountains, high-altitude cities or other hypobaric environments (e.g. aircrafts) up to an altitude of 3000 m.

Identifiants

pubmed: 36881665
pii: 7070565
doi: 10.1093/jtm/taad031
pmc: PMC10481409
pii:
doi:

Substances chimiques

Oxygen S88TT14065

Types de publication

Randomized Controlled Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Fondazione Cassa di Risparmio di Bolzano in collaboration with NOI Techpark, Südtiroler Wirtschaftsring and Rete Economia Alto Adige

Informations de copyright

© International Society of Travel Medicine 2023. Published by Oxford University Press.

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Auteurs

Giovanni Vinetti (G)

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.

Alessandro Micarelli (A)

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.

Marika Falla (M)

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.
Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto (TN), Italy.
Department of Neurology, General Hospital of Bolzano, Bolzano, Italy.

Anna Randi (A)

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.
Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto (TN), Italy.

Tomas Dal Cappello (T)

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.

Hannes Gatterer (H)

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.
Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT TIROL-Private University for Health Sciences and Health Technology, Hall in Tirol, Austria.

Hermann Brugger (H)

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.

Giacomo Strapazzon (G)

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.

Simon Rauch (S)

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.
Department of Anaesthesiology and Intensive Care Medicine, Hospital of Merano (SABES-ASDAA), Merano (BZ), Italy; Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität.

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