November 16,2018 | Alyssa PereiraBrandon Mercer
“Wearing a mask may actually be harmful to some people with heart or lung disease because it can make the lungs work harder to breathe.”
“Children should not wear these masks – they do not fit properly and can impede breathing.”
-California’s Dept. of Public Health
Answering the obvious questions about conflicting advice from public health agencies
“You want to do the right thing, and protect your lungs, your kids, and your kids’ lungs. You also can’t head to Tahoe’s clear air for the weekend, and you have errands to run. To mask or not to mask? That is the question. This week, public health agencies released such conflicting guidance that only after two interviews, and reading five different advisories on mask usage do we feel even remotely confident we can make sense of this in a way that can inform the public. So, here goes.
1. Scarves, bandannas, tissues, and anything not marked N95 or better (N100, P99, P100, etc.) are not helpful. “Surgical masks that trap small particles are designed to filter air coming out of the wearer’s mouth and do not provide a good seal to prevent inhalation of small particles or gases in smoke. ” (CA Dept. of Public Health).
READ MORE: N95, P100, P99: What do all those mask types really mean and which one protects me?
2. People with breathing problems (ironically) are discouraged from wearing a mask without getting a doctor’s recommendation. In one statement, CA Dept. of Public Health writes, “Wearing a mask may actually be harmful to some people with heart or lung disease because it can make the lungs work harder to breathe.” A doctor will look at the patient’s condition, ability to draw in air, and guide them on how to make it fit right if recommended.
3. Small children should not wear masks. California’s Dept. of Public Health points out, “Children should not wear these masks – they do not fit properly and can impede breathing. If the air quality is poor enough that a child requires a mask, the child should remain indoors, in a safe place, and evacuation should be considered.”
4. People indoors should not wear masks. (The air isn’t as bad indoors, and the masks can restrict breathing and increase breathing carbon dioxide making you feel worse, not better).
5. People with beards shouldn’t wear masks (the air is going to come from around the edges, and not be filtered anyway, and the mask will then just make breathing hard with no real filtering). Of course, you could wear a half- or full-face mask like what’s used for asbestos removal, but this seems pretty drastic.
Here’s the background. “The Sacramento County Public Health Officer does not recommend use of N95 respirator masks for the general public,” read a confusing statement issued this week.
We talked to a doctor to parse the oddly conflicting public health statements.
“I’m recommending it for my patients, said Dr. Fred Herkowitz who specializes in treating pulmonary disease in Oakland. “For people with lung disease (the N95 mask) is still better than anything out there.”
He points out what other health workers point out, “The situation is we tell all people that we give an N95 mask to that if they have trouble breathing because the mask is tight then they shouldn’t wear it. But that’s different than saying they shouldn’t be worn.”
Sacramento County said, “N95 respirator can make it more difficult for the wearer to breathe due to carbon dioxide buildup, which reduces the intake of oxygen, increased breathing rates and heart rates.” The bottom line is, if you have lung disease, ask your doctor.
Sacramento County also argued that “Risks of N95 respirator use outside of fire zones outweigh benefits: Most people will not contact their healthcare provider before using the N95 respirator; N95 use may lead to increased heart rate, respiratory rate, work of breathing, CO2 buildup inicro-ambient air, potentially posing risk to sensitive populations; May encourage outdoor activity which could worsen exposure.”
“Every local health district can put out their own messaging, but the state as a whole has this message [quoted above],” said CA Dept. of Public Health spokesperson Corey Egel. Basically, stay indoors when air is this bad, if you have respiratory illness, check with a doctor before putting all your trust in the ole N95, and if you do wear a proper mask because you’re outdoors, make sure it fits right. And reduce activity either way. The state also recommends using a new mask each day, “if you can.”
Dr. Herkowitz says healthy people should wear N95 masks outdoors in this air, but if it becomes difficult to breathe because the mask is constricting, take if off.
After all, a little pollution is better than lack of oxygen.”
California Department of Public Health:
“Surgical masks, dust masks, bandanas or other face coverings do not offer protection from particle pollution. Inexpensive paper “comfort” or “dust” masks commonly found at hardware stores are designed to trap large particles and do not provide enough protection for your lungs.
Mask use may give the wearer a false sense of security, which might encourage too much physical activity and time spent outdoors. Also, wearing a mask may actually be harmful to some people with heart or lung disease because it can make the lungs work harder to breathe.”
“People with respiratory or heart conditions should consult with their healthcare provider prior to wearing a respirator mask. Respirator masks can be effective in reducing exposure to smoke particles. However, they should only be used after first implementing other, more effective methods of exposure reduction, including staying indoors with doors and windows closed, reducing activity, and using HEPA air cleaners indoors to reduce overall smoke exposure.”
“For adults, NIOSH N95 or P100 masks, when worn correctly, have been shown to filter particles and improve the quality of the air being inhaled. Masks can be ordered online or purchased at hardware stores.”
“Children should not wear these masks – they do not fit properly and can impede breathing. If the air quality is poor enough that a child requires a mask, the child should remain indoors, in a safe place, and evacuation should be considered.
For information on using masks for wildfire smoke, review these tips from the U.S. Environmental Protection Agency”
“Should I wear a mask during a wildfire, even if it’s not really smoky where I am?
Surgical masks, dust masks, bandanas or other face coverings do not offer protection from particle pollution. Inexpensive paper “comfort” or “dust” masks commonly found at hardware stores are designed to trap large particles and do not provide enough protection for your lungs.
Mask use may give the wearer a false sense of security, which might encourage too much physical activity and time spent outdoors. Also, wearing a mask may actually be harmful to some people with heart or lung disease because it can make the lungs work harder to breathe.”
