Major article
Effectiveness of facemasks for pediatric populations against submicron-sized aerosols

https://doi.org/10.1016/j.ajic.2015.03.032Get rights and content

Highlights

  • First study to determine the effectiveness of facemasks meant for pediatric population.

  • Variability amongst different brands is large.

  • Limited choices available for children.

  • Effectiveness can be improved by use of electret layers.

Background

In the event of a public-health threat involving bioaerosols, such as a terrorist attack or pandemic, options for devices to protect the pediatric population are limited. One strategy involves deployment of facemasks meant for the pediatric population, although protection against bioaerosols was not an intended use of such masks and little is known about their effectiveness.

Methods

We chose 3 brands of facemasks for pediatric use for characterizing penetration. To validate our experimental technique, 2 N95 respirator brands were also tested. All barriers were subjected to neutralized polydispersed sodium chloride aerosols, and their intrinsic penetration was evaluated in the submicron size range at different flow rates.

Results

As expected, the N95 brands had low penetration (5% or less) at the highest flow rates. However, for the facemasks for pediatric use, penetration varied significantly amongst brands at the highest flow rates (∼15%->50%). Studies with isopropanol-dipped respirators and facemasks demonstrated that not all brands of facemasks for pediatric use have electret layers.

Conclusions

Our bench tests suggest that the intrinsic penetration through facemasks for pediatric use can be high in the submicron size range. These data can be used in risk-assessment models to determine the extent to which facemasks for pediatric use reduce the likelihood of infection in emergency situations.

Section snippets

PPE selection

In the absence of any studies covering existing brands of facemasks for pediatric use, a literature search was undertaken. Using the key words children's face masks, kids face mask, and pediatric face masks, at least 6 facemasks brands marketed for pediatric populations were identified based on the number of references appearing in the search. Three of these could be conveniently ordered and were selected for the study. These facemasks are subsequently referred to as P1, P2, and P3.

To validate

Results

Figure 3 shows the penetration of the different brands as a function of particle size. In Figure 3, the average values and the upper end of the standard deviation for 3 samples are shown. Because the penetration was found to vary by several orders of magnitude for different brands, different logarithmic scale limits are used for each brand in Figure 3.

Beginning with the validation experiments involving adult respirators, the average (for the 3 samples tested) maximum penetration of A1 at

Discussion

Although low penetration is important, facemasks also need to be designed keeping subject comfort in mind. This is particularly true in children to ensure compliance. Fibers that capture aerosols also resist the flow, resulting in a pressure drop across the PPE. In our studies, for any single PPE, pressure drop increased with the flow rate (Table 1). Student t test revealed no significant difference in pressure drop across A1 and A2 (P > .05). Performing a 1-way analysis of variance analysis on

References (38)

  • C.J. Roy et al.

    Impact of Inhalation exposure Modality and particle size on the respiratory Deposition of ricin in BALB/c Mice

    Inhal Toxicol

    (2003)
  • P. Fabian et al.

    Influenza virus in human exhaled Breath: an Observational study

    PLoS One

    (2008)
  • W.G. Lindsley et al.

    Measurements of airborne influenza virus in aerosol particles from human coughs

    PLoS One

    (2010)
  • Stephens, B. HVAC filtration and the Wells-Riley approach to assessing risks of infectious airborne...
  • R. Tellier

    Review of aerosol transmission of influenza a virus

    Emerg Infect Dis

    (2006)
  • W. Yang et al.

    Concentrations and size distributions of airborne influenza A viruses measured indoors at a health centre, a day-care centre and on aeroplanes

    J R Soc Interface

    (2011)
  • C.C. Coffey et al.

    Fitting characteristics of Eighteen N95 filtering-facepiece respirators

    J Occup Environ Hyg

    (2004)
  • National Institute for Occupational Safety and Health. NIOSH Guide to the Selection and Use of Particulate Respirators....
  • C.D. Fryar et al.

    Anthropometric reference data for children and adults: United States, 2007–2010

    (2012)
  • Cited by (0)

    This study was funded by 2 Medical Countermeasures Initiative projects (MCM2DXXXXX205 and MCM2JXXXXX270HT) from the Office of Counterterrorism and Emerging Threats of the US Food and Drug Administration, Silver Spring, Md. Dr. Guha is a research participant in the Food and Drug Administration via Oak Ridge Associated Universities. The contents of this article do not necessarily represent policy of the US Food and Drug Administration or the Department of Health and Human Services.

    Conflicts of interest: None to report.

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