Insight on the usage of mask with respect to COVID-19: a review
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International Journal of Research in Medical Sciences
Bajjad AA et al. Int J Res Med Sci. 2020 Oct;8(10):3772-3777
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20204272
Review Article
Insight on the usage of mask with respect to COVID-19: a review
Adeel A. Bajjad1, Navneet Kour2*, Anil Sharma1, Minha M. Kak3
1
Department of Orthodontics, 3Department of Oral Pathology, Kothiwal Dental College and Research Centre,
Moradabad, Uttar Pradesh, India
2
Department of Periodontology and Implantology, BRS Dental College and Hospital, Sultanpur, Panchkula, Haryana,
India
Received: 23 July 2020
Accepted: 03 September 2020
*Correspondence:
Dr. Navneet Kour,
E-mail: mehtanavneet48@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Face-masks are currently turning into a fundamental piece of our clothing standard, without a doubt. While the West
wasn't entirely ok with face-masks in the pre-COVID-19 period, East Asians were all the more inviting of them.
Controlling a respiratory contamination at source by a mask is an entrenched procedure. The utilization of masks
followed by certain precautionary measure is a piece of a thorough bundle of the avoidance and control gauges that
can restrain the spread of any respiratory viral maladies, including COVID-19. Subsequently the fundamental point of
the examination is to illuminate the mask, their utilization and guidelines to be followed during this pandemic period.
Numerous nations have suggested the utilization of fabric mask/face covers for the overall population. Right now, the
boundless utilization of mask by healthy individuals in the network setting isn't yet upheld by high calibre or direct
logical proof and there are likely advantages and damages to consider. Any mask worn for everyday assurance against
COVID-19 will be flawed, at any rate for the current pandemic time.
Keywords: COVID-19, Healthcare worker, Masks, Transmission
INTRODUCTION inoculation of section gateway such as the mouth, nose or
conjunctivae (eyes).1-4 Transmission may likewise
Information about transmission of the COVID-19 happen through fomites in the quick condition around the
infection is collecting each day. COVID-19 is basically a contaminated person.5
respiratory malady and the range of disease with this
infection can go from individuals with exceptionally The utilization of mask is a piece of a far-reaching bundle
mild, non-respiratory manifestations to serious intense of the counteraction and control quantifies that can
respiratory ailment, sepsis with organ failures and even restrict the spread of certain respiratory viral maladies,
death. A few people infected have announced no including COVID-19. Masks can be utilized either for
symptoms by any stretch of the imagination. As indicated protection of healthy persons (worn to ensure oneself
by the current proof, COVID-19 infection is when in contact with a contaminated individual) or for
fundamentally transmitted between individuals by means source control (worn by a contaminated individual to
of respiratory droplets and contact courses. Droplet forestall ahead transmission). In any case, the utilization
transmission happens when an individual is in close of a mask alone is deficient to give a satisfactory degree
contact (inside 1 meter) with an infected individual and of assurance or source control, and other individual and
presentation to conceivably infective respiratory drops network level measures ought to likewise be embraced to
happens, for instance, through coughing, wheezing or smother transmission of respiratory infections.
exceptionally close to home contact bringing about the Regardless of whether masks are utilized, consistence
International Journal of Research in Medical Sciences | October 2020 | Vol 8 | Issue 10 Page 3772Bajjad AA et al. Int J Res Med Sci. 2020 Oct;8(10):3772-3777
with hand cleanliness, physical distancing and other Non-medical masks
disease counteraction, and control (IPC) measures are
basic to forestall human-to human transmission of Non-medical masks are produced using an assortment of
COVID-19.6 An examination by a group of specialists woven and non-woven textures, for example,
drove by a Texas A&M University teacher has polypropylene. Non-medical masks might be made of
discovered that not wearing a face mask significantly various mixes of textures, layering arrangements and
builds an individual's odds of being tainted by the accessible in assorted shapes. Not many of these blends
COVID-19 infection.7 have been methodically assessed and there is no single
structure, decision of material, layering or shape among
TYPES OF MASKS AND THEIR EFFICIENCIES the non-medical masks that are accessible. The boundless
mix of textures and materials brings about factor filtration
Medical masks and breathability. A non-clinical cover is neither a
clinical gadget nor individual defensive gear. In any case,
Medical masks ought to be affirmed by global or national a non-medical masks standard has been created by the
principles to guarantee they offer unsurprising item French Standardization Association (AFNOR Group) to
execution when utilized by healthcare workers, as characterize least execution as far as filtration (least 70%
indicated by the hazard and sort of strategy acted in a strong molecule filtration or bead filtration) and
medicinal service setting. Intended for single use, a breathability (most extreme weight contrast of 0.6
medical mask underlying filtration (in any event 95% mbar/cm2 or greatest inward breath opposition of 2.4
droplet filtration), breathability and, whenever required, mbar and most extreme exhalation obstruction of
liquid opposition are credited to the sort (for example 3 mbar).9
spunbond or meltblown) and layers of produced non-
woven materials (for example polypropylene, polye The lower filtration and breathability normalized
thylene or cellulose). Clinical covers are rectangular fit in necessities, and by and large anticipated execution, show
shape and involve three or four layers. Each layer that the utilization of non-medical masks, made of woven
comprises of fine to exceptionally fine strands. These textures, for example, material, or potentially non-woven
masks are tried for their capacity to square droplets textures, should just be considered for source control
(3 micrometers in size; EN 14683 and ASTM F2100 (utilized by contaminated people) in network settings and
measures) and particles (0.1 micrometer in size; ASTM not for counteraction. They can be utilized impromptu for
F2100 standard as it was). The utilization of medical explicit exercises (e.g., while on open vehicle when
masks in the network may redirect this basic asset from physical separating can't be kept up), and their utilization
the wellbeing laborers and other people who need them ought to consistently be joined by visit hand cleanliness
the most.8 and physical removing.
Table 1: Non-medical mask filtration efficiency, pressure drop and filter quality factor.6
Filter quality
Initial filtration Initial pressure
Material Source Structure factor,
efficiency (%) drop (Pa)
Q (kPa-1)
Interfacing material, Spunbond
Polypropylene 6 1.6 16.9
purchased as-is (Nonwoven)
Cotton 1 Clothing (T-shirt) Woven 5 4.5 5.4
Cotton 2 Clothing (T-shirt) Knit 21 14.5 7.4
Cotton 3 Clothing (Sweater) Knit 26 17 7.6
Polyester Clothing (Toddler wrap) Knit 17 12.3 6.8
Cellulose Tissue paper Bonded 20 19 5.1
Cellulose Paper towel Bonded 10 11 4.3
Silk Napkin Woven 4 7.3 2.8
Cotton, gauze N/A Woven 0.7 6.5 0.47
Cotton,
N/A Woven 1.1 9.8 0.48
handkerchief
Nylon Clothing (exercise pant) woven 23 244 0.4
Disadvantages of wearing masks contamination can happen if non-clinical masks are not
changed when wet or ruined which can make good
Apart from so many advantages, mask has possible conditions for microorganism to enhance; cerebral pain
expanded the danger of self-contamination because of the as well as breathing challenges, are expected to
manipulation of mask and in this way contacting eyes contingent upon kind of mask utilized; possible
with contaminated hands, not only this potential self- developments of facial skin injuries, aggravation
International Journal of Research in Medical Sciences | October 2020 | Vol 8 | Issue 10 Page 3773Bajjad AA et al. Int J Res Med Sci. 2020 Oct;8(10):3772-3777
dermatitis or intensifying skin inflammation, when The extraordinary greater part of the GDG individuals
utilized every now and again for long hours, troubling affirmed past suggestions gave by WHO which
with clear communication; potential discomfort an incorporate that:
incorrect feeling that all is well with the world, prompting
possibly lower adherence to other basic preventive Without Aerosols Generating Procedures (AGPs), WHO
estimates, for example, physical distancing and hand suggests that healthcare workers, giving direct
cleanliness; poor consistence with wearing mask, consideration to COVID-19 patients, should wear a
specifically by small kids; waste management issues; medical mask (notwithstanding other PPE that are a part
inappropriate mask removal prompting increased litter in of droplet and contact precautionary measures), in care
open areas, danger of contamination to road cleaners and settings for COVID-19 patients where AGPs are
environmental risks; trouble imparting for hard of hearing performed (for example COVID-19 serious and semi-
people who depend on lip perusing; disservices for or concentrated consideration units), WHO suggests that
trouble wearing them, particularly for youngsters, healthcare workers should wear a respirator (N95 or
formatively challenged people, those with psychological FFP2 or FFP3 standard, or proportional).
sickness, older people with subjective impedance, those
with asthma or ceaseless respiratory or breathing issues, Targeted continuous medical mask use by health
the individuals who have had facial injury or ongoing workers in areas of known or suspected COVID-19
oral maxillofacial medical procedure, and those living in community transmission
hot and sticky situations.10-12
In zones where there is community transmission or large-
GUIDANCE ON THE USE OF MASKS IN HEALTH scale episodes of COVID-19, all universal masking has
CARE SETTINGS (BOTH LONG-TERM CARE been embraced in numerous emergency clinics to lessen
AND RESIDENTIAL FACILITIES) the capability of (asymptomatic, pre-symptomatic and
symptomatic) transmission by healthcare workers and
Use of medical masks and respirators to provide care to anybody entering the office with COVID-19 to other
suspected or confirmed COVID-19 patients healthcare workers and to patients.15 There are at present
no investigations that have assessed the viability and
Meta-analysis in orderly writing audits have announced likely antagonistic impacts of widespread or focused on
that the utilization of N95 respirators contrasted and the constant mask use by health professionals in forestalling
utilization of clinical masks isn't related with any transmission of SARS-CoV-2.
measurably noteworthy lower danger of the clinical
respiratory sickness results or research centre affirmed flu Recommendation
or viral infections.9,11 Low-certainty proof from a precise
survey of observational examinations identified with the The greater part of the WHO COVID-19 IPC GDG
betacorona viruses that cause extreme severe acute individuals underpins the act of healthcare workers and
respiratory syndrome (SARS), Middle East respiratory parental figures in clinical regions, to persistently wear a
syndrome (MERS) and COVID-19 demonstrated that the medical mask all through their work day, aside from
utilization of face protection (counting respirators and when eating and drinking or changing the mask in the
clinical masks) brings about an enormous decrease in wake of thinking about a patient requiring
danger of disease among wellbeing laborers; N95 or droplets/contact precautions for different reasons (e.g.,
comparable respirators may be related with more flu), to maintain a strategic distance from any chance of
prominent decrease in chance than clinical or 12–16 layer cross-transmission.
cotton covers), yet the examinations had significant
restrictions (recall bias, constrained data about the According to expert supposition, it is especially critical to
circumstances when respirators were utilized and about receive the consistent utilization of mask in potential
estimation of exposures) and most were led in settings in higher transmission hazard regions including triage,
which AGPs were performed.12 family doctor/GP practices, outpatient offices, crisis
rooms, COVID-19 determined units, hematological,
Recommendations malignant growth, transplant units, long haul wellbeing
and private offices.
WHO COVID-19 IPC GDG considered all accessible
proof on the COVID-19 infection methods of When utilizing medical masks all through the whole shift,
transmission and on clinical cover versus respirator use to healthcare workers should ensure that: the mask is
shield healthcare workers from disease, its degree of changed when wet, dirtied, or harmed; the mask isn't
conviction, just as the possible advantages and damages, contacted to alter it or dislodged from the face in any
for example, improvement of facial skin injuries, way, shape or form; if this occurs, the cover ought to be
aggravation dermatitis or declining skin break out, or securely evacuated and supplanted; and hand cleanliness
breathing troubles that are increasingly visit with performed; the mask (just as other individual defensive
respirators.13,14 gear) is disposed of and changed subsequent to thinking
International Journal of Research in Medical Sciences | October 2020 | Vol 8 | Issue 10 Page 3774Bajjad AA et al. Int J Res Med Sci. 2020 Oct;8(10):3772-3777
about any patient on contact/droplet precautionary damages to consider. WHO encourages leaders to apply a
measures for different pathogens; risk-based approach put together with respect to the
accompanying measures while considering or
Staff who do not work in clinical regions don't have to empowering the utilization of masks for the overall
utilize a mask during routine exercises (e.g., authoritative population:
staff); Masks ought not to be shared between workers and
ought to be fittingly discarded at whatever point expelled Reason for cover use: if the expectation is forestalling the
and not reused. infected wearer transmitting the infection to other people
(that is, source control) as well as to offer insurance to the
A particulate respirator in any event as defensive as a US solid wearer against disease (that is, prevention).
National Institute for Occupational Safety and Health-
affirmed N95, N99, US FDA careful N95, European Danger of introduction to the COVID-19 infection:
Union standard FFP2 or FFP3, or comparable, ought to because of the study of disease transmission and force of
be worn in settings for COVID-19 patients where AGPs transmission in the populace: if there is network
are performed. transmission and there is restricted or no ability to
actualize other regulation estimates, for example, contact
GUIDANCE ON THE USE OF MASKS FOR THE following, capacity to do testing and confine and care for
GENERAL PUBLIC suspected and affirmed cases contingent upon
occupation: e.g., people working in close contact with the
WHO suggests that people with any side effects general population (e.g., social laborers, individual help
reminiscent of COVID-19 laborers, clerks).
One should wear a medical mask, self-isolate, and look Vulnerability of the mask wearer/populace: for instance,
for clinical exhortation when they begin to feel unwell masks could be utilized by more seasoned individuals,
with likely side effects of COVID-19, regardless of immunocompromised patients and individuals with
whether manifestations are mild. Indications can include: comorbidities, for example, cardiovascular infection or
fever, cough, weariness, and loss of hunger, brevity of diabetes mellitus, chronic lung disease, malignant growth
breath and muscle torment. Other vague indications, like, and cerebrovascular disease.20
sore throat, nasal clog, cerebral pain, diarrhea, nausea and
retching, have additionally been accounted for. Loss of Setting in which the populace lives: settings with high
smell and taste going before the beginning of respiratory populace thickness (for example exile camps, camp-like
manifestations have likewise been reported.16,17 settings, those living in squeezed conditions) and settings
where people can't keep a physical separation of at any
Adhere to directions on the best way to put on, take off, rate 1 meter (3.3 feet) (for example open transportation).
and discard masks and perform hand hygiene.18
Plausibility: accessibility and expenses of mask, access to
Follow every one of extra measures, specifically clean water to wash non-medical masks, and capacity of
respiratory hygiene, frequent hand hygiene and keeping masks wearers to endure unfavorable impacts of wearing
up physical separation of at any rate 1 meter (3.3 feet) a masks.
from other persons.19, evade gatherings of individuals and
swarmed spaces; keep up physical separation of in any Kind of mask: medical masks versus non-medical masks.
event 1 meter (3.3 feet) from different people,
particularly from those with respiratory side effects (for GUIDANCE ON MASK MANAGEMENT6
example coughing, sniffling); perform hand cleanliness
habitually, utilizing a alcohol based hand rub if hands are For a mask, appropriate use and removal are basic to
not noticeably grimy or cleanser and water; utilize guarantee that they are as powerful as could be expected
respiratory cleanliness for example spread their nose and under the circumstances and to maintain a strategic
mouth with a bowed elbow or paper tissue when hacking distance from any expansion in transmission. WHO
or wheezing, discard the tissue following use, and offers the accompanying direction on the right utilization
perform hand cleanliness, avoid contacting their mouth, of masks, derived from best practices in healthcare
nose, and eyes. settings:
Advice to decision makers on the utilization of masks Perform hand cleanliness before putting on the masks;
for the overall population place the mask cautiously, guaranteeing it covers the
mouth and nose, change in accordance with the nose
Numerous nations have suggested the utilization of fabric extension, and tie it safely to limit any holes between the
covers/face masks for the overall population. Right now, face and the mask; abstain from contacting the mask
the broad utilization of mask by sound individuals in the while wearing it; expel the cover utilizing the suitable
network setting isn't yet bolstered by high caliber or method: don’t contacts the fronts of the mask however
direct logical proof and there are possible advantages and unfasten it from behind. after expulsion or at whatever
International Journal of Research in Medical Sciences | October 2020 | Vol 8 | Issue 10 Page 3775Bajjad AA et al. Int J Res Med Sci. 2020 Oct;8(10):3772-3777
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wearing a mask would supplement these measures by 2017;30,3:183-8.
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be of specific significance for the insurance of Beller E, Clark J, et al. Physical interventions to
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12. Matusiak L, Szepietowska M, Krajewski P,
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Conflict of interest: None declared ences due to the use of face masks during the
Ethical approval: Not required COVID-19 pandemic: a survey study of 876 young
people. Dermatol Ther. 2020.
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Cite this article as: Bajjad AA, Kour N, Sharma A,
World Health Organization. 2020. Available at:
Kak MM. Insight on the usage of mask with respect
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