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Title: | Respiratory consequences of N95-type Mask usage in pregnant healthcare workers—a controlled clinical study | Authors: | Tong, Pearl Shuang Ye Kale, Anita Sugam Ng, Kailyn Loke, Amelia Peiwen Choolani, Mahesh Arjandas Lim, Chin Leong Chan, Yiong Huak Chong, Yap Seng Tambyah, Paul Anantharajah Yong, Eu-Leong |
Keywords: | N95 Respirators Infection Control |
Issue Date: | 2015 | Source: | Tong, P. S. Y., Kale, A. S., Ng, K., Loke, A. P., Choolani, M. A., Lim, C. L., et al. (2015). Respiratory consequences of N95-type Mask usage in pregnant healthcare workers—a controlled clinical study. Antimicrobial Resistance and Infection Control, 4(1), 48-. | Series/Report no.: | Antimicrobial Resistance and Infection Control | Abstract: | Background: Outbreaks of emerging infectious diseases have led to guidelines recommending the routine use of N95 respirators for healthcare workers, many of whom are women of childbearing age. The respiratory effects of prolonged respirator use on pregnant women are unclear although there has been no definite evidence of harm from past use. Methods: We conducted a two-phase controlled clinical study on healthy pregnant women between 27 to 32 weeks gestation. In phase I, energy expenditure corresponding to the workload of routine nursing tasks was determined. In phase II, pulmonary function of 20 subjects was measured whilst at rest and exercising to the predetermined workload while breathing ambient air first, then breathing through N95-mask materials. Results: Exercising at 3 MET while breathing through N95-mask materials reduced mean tidal volume (TV) by 23.0 % (95 % CI −33.5 % to −10.5 %, p < 0.001) and lowered minute ventilation (VE) by 25.8 % (95 % CI −34.2 % to −15.8 %, p < 0.001), with no significant change in breathing frequency compared to breathing ambient air. Volumes of oxygen consumption (VO2) and carbon dioxide expired (VCO2) were also significantly reduced; VO2 by 13.8 % (95 % CI −24.2 % to −3 %, p = 0.013) and VCO2 by 17.7 %, (95 % CI −28.1 % to −8.6 %, p = 0.001). Although no changes in the inspired oxygen and carbon dioxide concentrations were demonstrated, breathing through N95-mask materials during low intensity work (3 MET) reduced expired oxygen concentration by 3.2 % (95 % CI: −4.1 % to −2.2 %, p < 0.001), and increased expired carbon dioxide by 8.9 % (95 % CI: 6.9 % to 13.1 %; p <0.001) suggesting an increase in metabolism. There were however no changes in the maternal and fetal heart rates, finger-tip capillary lactate levels and oxygen saturation and rating of perceived exertion at the work intensity investigated. Conclusions: Breathing through N95 mask materials have been shown to impede gaseous exchange and impose an additional workload on the metabolic system of pregnant healthcare workers, and this needs to be taken into consideration in guidelines for respirator use. The benefits of using N95 mask to prevent serious emerging infectious diseases should be weighed against potential respiratory consequences associated with extended N95 respirator usage. | URI: | https://hdl.handle.net/10356/85565 http://hdl.handle.net/10220/43751 |
ISSN: | 2047-2994 | DOI: | 10.1186/s13756-015-0086-z | Schools: | Lee Kong Chian School of Medicine (LKCMedicine) | Rights: | © 2015 Tong et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | Fulltext Permission: | open | Fulltext Availability: | With Fulltext |
Appears in Collections: | LKCMedicine Journal Articles |
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Respiratory consequences of N95-type Mask usage in pregnant healthcare workers_a controlled clinical study.pdf | 1.84 MB | Adobe PDF | View/Open |
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