Mask Hypoxia in Subjects Using Masks to Prevent Infection Spread
Mask Hypoxia in Subjects Using Masks to Prevent Infection Spread
There is some evidence that the use of surgical masks can induce mild hypoxia with a low
 level of activity (e.g. performing surgery). There is no evidence that this decrease in
 oxygenation is clinically significant. The degree of hypoxia associated with surgical mask
 use, N-95 mask use or the combination at rest and with exertion is unclear and warrants
 further investigation, particularly given the current widespread use of both due to the
 COVID-19 pandemic. Our working hypothesis is that there is a decrement in oxygenation with
 the use of any mask that is higher with an N-95 than a surgical mask and higher still when
 wearing both and that this decrement is more pronounced with exertion than at rest.
Research has shown some evidence of hypoxia associated with the prolonged use of a surgical
 or N-95 mask. Despite this, the prolonged use of surgical and/or N-95 masks in the clinical
 setting and surgical masks in the non-clinical setting is the current standard due to the
 COVID-19 pandemic. The physiologic cost of wearing a respirator was demonstrated in healthy
 volunteers with mask use during heavy exertion associated with increased respiratory rate,
 blood pressure and heart rate. N95 use during light exercise increases CO2 intake reduces
 inspired oxygen and increases the work of breathing. The physiologic effects of N95 fit
 testing using a hood include higher CO2 levels and lower oxygen levels in the respirator. In
 patients with ESRD, N95 mask use was associated with reduced PaO2 and increased respiratory
 rate. The use of surgical masks for prolonged surgeries is associated with decreased SpO2 and
 increased heart rate, particularly in those over 35 years old. Many studies have suggested
 that there is a physiologic burden and risk of hypoxia associated with surgical and/or N95
 mask use. This pilot study aims to compare baselines with each and both masks and with no
 mask versus short-duration exertion, which has not yet been done per review of the
 literature.

 There is some evidence that the use of surgical masks can induce mild hypoxia with a low
 level of activity (e.g. performing surgery) with prolonged use. There is no evidence that
 this decrease in oxygenation is clinically significant. The degree of hypoxia associated with
 surgical mask use, N-95 mask use, or the combination at rest and with exertion is unclear and
 warrants further investigation, particularly given the current widespread use of both due to
 the COVID-19 pandemic. Our working hypothesis is that there is a decrement in oxygenation
 with the use of a mask with exertion. The general public is being advised to wear a mask,
 including those with pre-existing pulmonary disease and heart disease. If there is evidence
 of a statistically significant decrease in oxygen saturation with short duration mask use
 with exertion, then further studies on patients at risk for decompensation due to
 mask-induced hypoxia is warranted. Our working hypothesis is that there is a decrement in
 oxygenation with the use of a mask with exertion.

 This is a single-site study.
Inclusion Criteria:

 -  Subjects 18 years old and up wearing masks as personal protective equipment (measure)

 Exclusion Criteria:

 -  Subjects younger than 18 years old.

 -  Females who are pregnant or women of childbearing potential with a positive pregnancy
 test at the time of consenting. (If a pregnancy test has not been performed at the
 time of consenting, the individual will be automatically excluded since a confirmed
 negative pregnancy test is not available. We will not be able to provide the cost of
 pregnancy test and will only rely on verbal confirmation from the subject that they
 are not pregnant or have a -personally purchased standard of care- negative pregnancy
 test.)

 -  Consent cannot be obtained from the subject

 -  Prisoners will be excluded

 -  Cognitively impaired subjects will be excluded.