The road has not been easy, first due to the lack of initial supplies, and second, due to the great ignorance about them. What types of masks are there? Which ones should I use? How many hours? Can they be reused? How? To this day, when the use of masks has spread globally, many of these questions still do not have a clear answer, which creates confusion among the population.
The masks stay
Little by little we have been advancing in the knowledge of the behavior of SARS-CoV-2, and now we know that its transmission through aerosols is one of the main routes of contagion. The WHO recognized that “wearing a medical mask was one of the preventive measures that could limit the spread of certain respiratory viral diseases, including covid-19.” Consequently, the use of face masks by the public both in open and closed spaces was recommended and even imposed by the health authorities of different countries.
According to the WHO estimate, 89 million masks are required for medical use each month worldwide, as well as 129 billion masks for the general public.
Today, the most advanced countries in the vaccination process, such as Israel or the United States, are eliminating the obligation to wear masks in outdoor environments. In others, such as Spain, this option is also being valued. However, the use of masks does not seem to be going away completely. Just a few days ago, the Spanish Government proposed that students continue to wear a mask during the next school year 2021-2022.
In addition, the use of masks in the wake of the pandemic has led to a significant decrease in the number of flu cases. It has also been found that allergies have been less frequent this spring, very possibly thanks to the use of masks. For all these reasons, it is very likely that, once COVID-19 is over, the population will continue to use masks, not massively as now, but for specific situations.
Thus, masks will continue to be a necessary product in the long term and there are two important aspects to take into account: the environmental impact derived from the massive consumption of disposable masks and its effect on human health due to the prolonged and daily use of the masks. themselves.
Effects on human health
There are very few studies evaluating the potential risks to humans from long-term use of masks. One of the first symptoms that has been observed is the one known by the name of maskacné, which is the appearance of acne on the face due to the clogging of the pores that cause moisture and steam that are generated when breathing and speaking with the mask on.
On the other hand, on December 1, 2020, the WHO advised against the use of masks to practice intense sports, since it could cause cardiovascular damage, generating cardiac arrhythmias and spontaneous pneumothorax. And recently, a type of mask that contained graphene has been withdrawn from the Canadian and Spanish markets on suspicion that it may cause damage to the lungs by inhaling nanoparticles of said material.
We have recently published a study on the levels of plasticizers in different types of mask, as well as the degree of release of these compounds during their use. Keep in mind that face masks are produced from polymers such as polypropylene, polystyrene, polyethylene and polyester. Polymers that contain a number of chemical compounds, such as plasticizers and flame retardants.
We analyze the surgical type masks, KN95, FFP2, FFP3 and reusable cloth. In all of them we detected organophosphate plasticizers, with levels from 0.02 to 27.7 micrograms per mask. The lowest levels were for surgical masks, while the highest were for KN95s.
We also carry out inhalation tests to evaluate the proportion of these plasticizers present in the masks that come off and that, therefore, can be inhaled during use.
We were able to observe that only around 10% of the plasticizers present in each mask were inhaled during use, with the exception of reusable cloth masks. In them there was no release whatsoever, so the impact of said plasticizers in this type of mask is zero. In any case, even releasing 10% of the compounds, the amount inhaled is well below the risk threshold for these compounds.
As a result of the pandemic, there has been an increase in the production and consumption of plastic material, especially disposable.
The massive consumption of disposable masks generates a large amount of waste that cannot be recycled. Taking into account the amount of masks used worldwide, as well as their weight (between 2.5 grams for hygienic and 7 grams for cloth), we would be generating between 0.2 and 6.3 million tons of mask waste per year facials.
According to a WWF report, a total of 10 million masks are being introduced into aquatic and terrestrial ecosystems each month due to poor waste management.
Once in the middle, these masks slowly degrade into smaller particles, microplastics. On the other hand, the chemical additives are also released into the environment. In the case of organophosphate plasticizers, we would be emitting between 20 and 18,000 kg into the environment, which would add to the levels of these compounds that already affect the life of aquatic and terrestrial organisms.
The least environmental impact would occur with the use of reusable cloth masks. In addition to the fact that we would generate less waste, we would cause less dispersion in the environment of polluting compounds.
So what masks do we use?
It is clear that the use of masks is necessary to minimize the risk of contagion. The recommendations for good protection against the virus are to use FFP2-type masks in indoor environments with poor ventilation, and surgical-type masks for outdoor environments.
Based on both human health impact and environmental impact, we recommend the use of FFP2 masks indoors, ruling out the use of KN95 masks. In fact, as of January 2021, some European countries, including Spain, decided to ban the sale of this type of mask by not meeting the requirements established by the European approval. Only units in stock can continue to be marketed.
Among the different options of FFP2 masks, those that can be used for two days are preferable (such as those developed by researchers from IATA-CSIC and Bioinicia SL). These minimize the generation of waste compared to other FFP2 options whose application is restricted to a single day.
With regard to masks for outdoor environments, we recommend the use of reusable cloth masks over surgical ones. The former completely retain the plasticizers avoiding their inhalation and, as they can be reused between 20 and 50 times, they generate a lower volume of waste. They are also a cheaper option in the medium term.
However, it is important to point out that these reusable fabric masks must be approved, meeting the requirements for preparation, manufacture, marking and use specified in the UNE 0065 standard, so those homemade fabric masks would be discarded.