医用防护口罩的重复使用性能评估

呼吸道飞沫和接触传播是呼吸系统疾病的主要传播途径。经验证，佩戴医用防护口罩可有效预防呼吸系统疾病。在应急及日常生活中常存在重复使用口罩的情况。基于此，该研究依据GB 19083-2010《医用防护口罩技术要求》对医用防护口罩进行模拟使用、消杀，并检测处理前后过滤效率、气流阻力性能及纤维微观结构，以评估重复使用性能。经检验，医用防护口罩经佩戴、紫外线照射和沸水浸煮前后的物理性能及内部纤维微观结构无明显变化，可重复使用。75%乙醇喷淋会导致医用防护口罩过滤效率下降，影响重复使用性能。     

医用防护口罩密合性设计的影响因素研究

针对国内医用防护口罩密合性指标不合格率偏高的现状,通过技术攻关研究,分析探讨影响口罩密合性的关键因素,对医用防护口罩的设计改进提出建议,为医护人员在呼吸道疾病大流行时正确选用和佩戴医用防护口罩提供帮助.     

医用口罩防护效果研讨

目的 探讨各类医用口罩的防护效果,确定使用范围,合理选用.方法 对各类医用口罩执行的技术标准进行分析,指导医务人员合理选用.结果 医用防护口罩有国家技术标准,颗粒过滤效率≥95％,决定其能阻挡经空气传播的直径＜5 μm的感染因子或近距离接触经飞沫传播的感染因子;医用外科口罩有行业技术标准,对气溶胶的过滤效率＞30％,细菌过滤效率＞95％;当体液以16.0 kPa(120 mm Hg)压力喷向口罩外侧面后,口罩内侧面无渗透;普通医用口罩仅对0.3 μ m直径的气溶胶达到20.0％～25.0％的防护效果.结论 医用防护口罩能阻止经空气或飞沫传播的大部分细菌、病毒等病原体,适用于呼吸科传染病区、发热门诊等科室;医用外科口罩可以阻隔大部分细菌和部分病毒,能阻隔血液、体液、分泌物等的喷溅,既能防止医务人员被感染,又能防止医务人员向外界传播病原菌,适用于临床医务人员的基本防护.     

在售医用口罩关键参数的检测与分析

目的：根据相关国家和行业标准，对已上市的一次性医用防护口罩、一次性医用外科口罩和一次性医用口罩进行相关检测分析，评价市面上口罩的整体质量，为上市后监管提供参考。方法：按照YY/T 0969-2013《一次性使用医用口罩》、YY 0469-2011《医用外科口罩》和GB 19083-2017《医用防护口罩技术要求》，对口罩关键参数如口罩带、过滤效率、气流阻力、合成血液穿透阻力和环氧乙烷残留量等进行检测。结果：随机抽取的69批产品中有9批不合格。结论：抽取的在售口罩有超过10%的产品检测不符合相应的标准。     

医用外科口罩过滤效率检测

目的分析医用外科口罩常见的不合格项——过滤效率、压力差。方法参照YY0469-2011标准中规定的方法,对不同厂家生产的医用外科口罩过滤效率及压力差进行评价。结果厂家1、2、3生产的医用外科口罩符合标准要求,其他厂家生产的口罩未达标。结论选择合适的滤料是生产合格口罩的先决条件,建议生产企业选取滤料时,不但要考虑滤料的过滤效率,还应考虑其阻力性能。     

医用口罩防护性能的监测与评价

目的了解医用口罩的防护效果。方法参照国家相关标准,利用人工发生的标准气溶胶对口罩材料、佩戴泄漏量等参数进行了监测与分析。结果国产医用无纺布口罩对于0.3μm直径的气溶胶,防护效率仅达20.0%～25.0%。结论医用口罩标准、医务人员个人防护意识有待提高,医疗环境有待改善。     

疾控专家教您如何佩戴口罩

药里五花八门的口罩该如何选择?出门是不是一定要佩戴N95口罩?为防止冬春季常见呼吸道疾病,武汉市疾病预防控制中心消毒与病媒生物防控所所长梁建生为网友、读者介绍选择与佩戴口罩的正确方式。梁建生介绍,市面上常见的口罩可以分为三类——医用外科口罩、医用防护口罩(N95口罩)和普通棉纱口罩。     

医务人员佩戴医用防护口罩行为现状及其影响因素

目的 了解医务人员佩戴医用防护口罩的行为现状, 并分析未能规范佩戴医用防护口罩的影响因素, 为改进口罩佩戴相关培训提供依据。 方法 2022年6月—2023年3月, 选取某三级甲等医院的工作人员为研究对象, 采用气溶胶凝结核计数法对市面上常见的5款医用防护口罩进行实时定量适合性测试, 通过测试仪器适合因数的变化、是否需要专业人员辅助调整综合判断医用防护口罩佩戴情况, 应用自制的一般资料调查表对参与者进行问卷调查, 借助三维(3D)激光扫描技术扫描参与者头面部, 将扫描图像导入Geomagic Studio 2013软件测量头面部尺寸。 结果 共调查222名医务人员, 完成991次实时测试, 208次3D扫描。其中221次(22.30%)测试参与者未能规范佩戴医用防护口罩, 5款医用防护口罩的不规范佩戴比率分别为30.56%、25.62%、25.87%、23.15%、7.35%。佩戴口罩不规范率: 不同医用防护口罩形状, 参与者职业、上一次医用防护口罩佩戴技能培训时间及是否有呼吸道传染病防治相关工作经验各组比较, 差异均有统计学意义(均P＜0.05);医用防护口罩品牌、尺寸, 以及参与者性别、科室等各组比较, 差异无统计学意义(均P＞0.05)。折叠状医用防护口罩佩戴规范与不规范者身体质量指数(BMI)比较, 差异均有统计学意义(均P＜0.05)。 结论 医务人员佩戴医用防护口罩不规范受诸多因素影响, 在正式的定量适合性测试之前推荐进行实时测试, 能节省时间, 提高测试效率。未来进行医用防护口罩佩戴培训时, 对不同形状的口罩应进行针对性的培训, 重点关注后勤人员、实习生、BMI高者, 以及从未接受医用防护口罩佩戴培训者及未参加过呼吸道传染病防治相关工作者。     

我国非医用口罩标准及防护性能介绍

 

新型冠状病毒肺炎（COVID-19）主要通过近距离飞沫传播和接触传播,口罩可以降低感染风险和传播概率,但因医用口罩产能有限,各地政府鼓励企业生产非医用口罩,以满足公众新冠肺炎疫情防控需要。本文介绍我国非医用口罩相关标准,对比分析其细菌过滤效率、颗粒物过滤效率等防护性能要求,提出非医用口罩防护新型冠状病毒的重要指标。同时,分析2020年1月27日-2月25日我国各省公示的102份非医用口罩企业标准,提出疫情防控非医用口罩标准化的建议,以期为相关部门、生产企业及普通人群提供帮助。

     

医用口罩材质和应用效能研究进展

传染病的传播途径众多,包括消化道、呼吸道、接触、虫媒甚至体液及血液传播。其中,阻断呼吸道传播是传染病防控过程的重点和难点,合理选择和佩戴口罩是预防呼吸道传染病的重要举措。基于国内外对医用口罩的需求方向以及研究现状,通过综述医用口罩结构与材料、种类及应用场景、医用口罩相应过滤标准、滤过性能及其检测方法等,阐述未来医用口罩材质、外形和功能检测的研究方向。     

The usefulness of masks in preventing transient carriage of epidemic methicillin-resistant Staphylococcus aureus by healthcare workers

We assessed the usefulness of wearing masks in preventing epidemic methicillin-resistant Staphylococcus aureus (EMRSA) carriage in nursing and physiotherapy staff on two dedicated EMRSA units. In the first phase of the study, members of staff were screened for EMRSA carriage immediately before and after periods of duty using nose, throat and hand swabs. During the second phase of the study, masks were worn by staff carrying out procedures associated with significant EMRSA exposure and examined for EMRSA as described for the first phase. Both phases were conducted over a period of two months. Forty-eight percent of nursing staff were colonized with EMRSA at some time during the first phase of the study. Wearing masks significantly reduced nasal, throat and hand carriage of EMRSA (P= 0.05). We conclude that the wearing of masks by healthcare workers performing certain activities for EMRSA positive patients may prevent transient colonization and hence may be a useful intervention in the control of EMRSA in the hospital environment.     

Filter penetration and breathing resistance evaluation of respirators and dust masks

The primary objective of this study was to compare the filter performance of a representative selection of uncertified dust masks relative to the filter performance of a set of NIOSH-approved N95 filtering face-piece respirators (FFRs). Five different models of commercially available dust masks were selected for this study. Filter penetration of new dust masks was evaluated against a sodium chloride aerosol. Breathing resistance (BR) of new dust masks and FFRs was then measured for 120 min while challenging the dust masks and FFRs with Arizona road dust (ARD) at 25°C and 30% relative humidity. Results demonstrated that a wide range of maximum filter penetration was observed among the dust masks tested in this study (3–75% at the most penetrating particle size (p < 0.001). The breathing resistances of the unused FFRs and dust masks did not vary greatly (8–13 mm H₂O) but were significantly different (p < 0.001). After dust loading there was a significant difference between the BR caused by the ARD dust layer on each FFR and dust mask. Microscopic analysis of the external layer of each dust mask and FFR suggests that different collection media in the external layer influences the development of the dust layer and therefore affects the increase in BR differently between the tested models. Two of the dust masks had penetration values < 5% and quality factors (0.26 and 0.33) comparable to those obtained for the two FFRs (0.23 and 0.31). However, the remaining three dust masks, those with penetration > 15%, had quality factors ranging between 0.04–0.15 primarily because their initial BR remained relatively high. These results indicate that some dust masks analysed during this research did not have an expected very low BR to compensate for their high penetration.     

Surgical face masks in the operating theatre: re-examining the evidence

In most modern hospitals, no one is allowed to enter the operating theatre without wearing a surgical face mask. The practice of wearing masks is believed to minimize the transmission of oro- and nasopharyngeal bacteria from operating theatre staff to patients' wounds, thereby decreasing the likelihood of postoperative surgical site infections. In this era of cost-restraints, shrinking hospital budgets, and evidence-based medicine, many health care professionals have begun to re-examine traditional infection control practices. Over the past decade, studies challenging the accepted dogma of surgical face mask usage have been published. Masks that function as protective barriers are another emerging issue. Due to a greater awareness of HIV and other blood-borne viruses, masks are taking on a greater role in protecting health care workers from potentially infectious blood and body fluids. The purpose of this review is to evaluate the latest evidence for and against routine use of surgical face masks in the operating theatre.     

以医用口罩为例探讨新型冠状病毒肺炎疫情中政府应急卫生资源保障对策

2019年12月,新型冠状病毒肺炎在武汉爆发,并蔓延至全国大部地区。在突如其来的疫情危机面前,民众面临着巨大恐慌,由此产生对某些疫情防护物品的需求猛增。文章以疫情发生后的医用口罩需求动态为观测点,搜集相关新闻、评论,发现该物资在疫情蔓延早期面临着价格暴涨、质量良莠不齐、保障不足与分配失衡等问题,而由此引发的民众脆弱性和政府信任危机给政府危机治理带来了巨大挑战。以医用口罩问题为依据进行分析,探讨其引发的政府危机治理和应对问题,并提出加强物品保障和协调,完善政府监管,加快推进信息公开和政务公开,加强健康宣教与规范信息科学传播等相应对策。     

The impacts and implications of the community face mask use during the Covid-19 pandemic: A qualitative narrative interview study

Introduction

A range of nonpharmaceutical public health interventions has been introduced in many countries following the rapid spread of Covid-19 since 2020, including recommendations or mandates for the use of face masks or coverings in the community. While the effectiveness of face masks in reducing Covid-19 transmission has been extensively discussed, scant attention has been paid to the lived experience of those wearing face masks.

Method

Drawing on 40 narrative interviews with a purposive sample of people in the United Kingdom, with a particular focus on marginalised and minoritized groups, our paper explores experiences of face mask use during the pandemic.

Results

We find that face masks have a range of societal, health and safety impacts, and prompted positive and negative emotional responses for users. We map our findings onto Lorenc and Oliver's framework for intervention risks. We suggest that qualitative data offer particular insights into the experiences of public health interventions, allowing the potential downsides and risks of interventions to be more fully considered and informing public health policies that might avoid inadvertent harm, particularly towards marginalised groups.

Patient or Public Contribution

The study primarily involved members of the public in the conduct of the research, namely through participation in interviews (email and telephone). The conception for the study involved extensive discussions on social media with a range of people, and we received input and ideas from presentations we delivered on the preliminary analysis.     

Public Discourse Against Masks in the COVID-19 Era: Infodemiology Study of Twitter Data

BackgroundDespite scientific evidence supporting the importance of wearing masks to curtail the spread of COVID-19, wearing masks has stirred up a significant debate particularly on social media.ObjectiveThis study aimed to investigate the topics associated with the public discourse against wearing masks in the United States. We also studied the relationship between the anti-mask discourse on social media and the number of new COVID-19 cases.MethodsWe collected a total of 51,170 English tweets between January 1, 2020, and October 27, 2020, by searching for hashtags against wearing masks. We used machine learning techniques to analyze the data collected. We investigated the relationship between the volume of tweets against mask-wearing and the daily volume of new COVID-19 cases using a Pearson correlation analysis between the two-time series.ResultsThe results and analysis showed that social media could help identify important insights related to wearing masks. The results of topic mining identified 10 categories or themes of user concerns dominated by (1) constitutional rights and freedom of choice; (2) conspiracy theory, population control, and big pharma; and (3) fake news, fake numbers, and fake pandemic. Altogether, these three categories represent almost 65% of the volume of tweets against wearing masks. The relationship between the volume of tweets against wearing masks and newly reported COVID-19 cases depicted a strong correlation wherein the rise in the volume of negative tweets led the rise in the number of new cases by 9 days.ConclusionsThese findings demonstrated the potential of mining social media for understanding the public discourse about public health issues such as wearing masks during the COVID-19 pandemic. The results emphasized the relationship between the discourse on social media and the potential impact on real events such as changing the course of the pandemic. Policy makers are advised to proactively address public perception and work on shaping this perception through raising awareness, debunking negative sentiments, and prioritizing early policy intervention toward the most prevalent topics.     

新型冠状病毒肺炎疫情期间居民使用口罩和消毒产品的影响因素

  目的  了解新型冠状病毒肺炎（corona virus disease 2019,COVID-19,简称新冠肺炎）疫情期间居民口罩和消毒产品使用情况及其影响因素,为进一步做好疫情防控提供科学依据。  方法  采用Cronbach's α系数和KMO值对问卷的信度和效度进行评价。2020年3月4日至5日,通过网络调查居民的人口学特征、口罩和消毒产品使用情况,并分析居民口罩和消毒产品使用的影响因素。  结果  共回收有效问卷1 713份,其中男性492人（28.72%）,有382人（24.12%）认为戴多层口罩会更安全,有269人（15.70%）认为口罩可以经过蒸煮后再用,有265人（15.47%）认为口罩可以经过喷酒精后再用。有1 529人（89.26%）近一个月使用消毒产品对门把手/开关/按钮（84.96%）、地面（71.88%）和马桶/便池（70.70%）进行消毒。多因素结果显示文化程度越高、年龄越大、月收入越高和企业人员更多使用口罩和消毒产品。  结论  COVID-19流行期间,居民戴口罩和使用消毒产品的比例较高,但依旧存在误区,文化程度、年龄、职业和月收入对戴口罩和使用消毒产品有影响,应进行针对性的宣传教育。     

Exploring respiratory protection practices for prominent hazards in healthcare settings

The use of respiratory protection, an important component of personal protective equipment (PPE) in healthcare, is dependent on the hazard and environmental conditions in the workplace. This requires the employer and healthcare worker (HCW) to be knowledgeable about potential exposures and their respective protective measures. However, the use of respirators is inconsistent in healthcare settings, potentially putting HCWs at risk for illness or injury. To better understand respirator use, barriers, and influences, the National Institute for Occupational Safety and Health (NIOSH) Health and Safety Practices Survey of Healthcare Workers provided an opportunity to examine self-reported use of respirators and surgical masks for targeted hazards. The hazards of interest included aerosolized medications, antineoplastic drugs, chemical sterilants, high-level disinfectants, influenza-like illness (ILI), and surgical smoke. Of the 10,383 HCWs who reported respiratory protection behaviors, 1,904 (18%) reported wearing a respirator for at least one hazard. Hazard type, job duties, site characteristics, and organizational factors played a greater role in the likelihood of respirator use than individual factors. The proportion of respirator users was highest for aerosolized medications and lowest for chemical sterilants. Most respondents reported using a surgical mask for at least one of the hazards, with highest use for surgical smoke generated by electrosurgical techniques and ILI. The high proportion of respirator non-users who used surgical masks is concerning because HCWs may be using a surgical mask in situations that require a respirator, specifically for surgical smoke. Improved guidance on hazard recognition, risk evaluation, and appropriate respirator selection could potentially help HCWs better understand how to protect themselves at work.     

Masking fears: SARS and the politics of public health in China

This paper examines shifts in attitudes to mask-wearing during and in the aftermath of the outbreak of Severe Acute Respiratory Syndrome (SARS) in the People’s Republic of China (PRC) in 2002–2003. In the PRC, as throughout East Asia, face masks were widely adopted as a practical preventative measure. However, the ubiquitous image of the masked Chinese citizen in both the Chinese and international media also acquired a political resonance. Masks were equated with the Party’s attempts to censure dissent and ‘cover up’ the epidemic. A perceived lack of government transparency, at least in the initial phase of SARS, recalled earlier public health incidents and episodes of public dissension, notably the Tiananmen Square protests of 1989. Drawing on samples of qualitative data from a broad range of Chinese and English language sources, the paper shows how debates about mask-wearing in China during SARS became intertwined with political concerns, reflecting a tension between the Party’s liberalizing policy – epitomized by the country’s admission to membership of the World Trade Organization in December 2001 – and real anxieties about the consequential ‘fall-out’ of this new openness. The paper concludes by arguing for an approach to public health which incorporates a critical capacity, particularly in relation to the ways in which political contexts may determine responses to epidemic episodes.