Cloth face mask
|Cloth face mask|
Homemade cloth face mask
A cloth face mask is a mask made of common textiles, usually cotton, worn over the mouth and nose. Although they are less effective than surgical masks or N95 masks, they are used by the general public in household and community settings as perceived protection against both infectious diseases and particulate air pollution. For these reasons, cloth face masks are generally recommended by public health agencies only for disease source control in epidemic situations, but are not considered to be personal protective equipment.
They were routinely used by healthcare workers starting from the late 19th century until the mid 20th century. In the 1960s they fell out of use in the developed world in favor of modern surgical masks, but their use has persisted in developing countries. During the COVID-19 pandemic, their use in developed countries was revived as a last resort due to shortages of surgical masks and respirators.
Prior to the COVID-19 pandemic, reusable cloth face masks were predominantly used in developing countries and especially in Asia. Cloth face masks contrast with surgical masks and respirators such as N95 masks, which are made of nonwoven fabric formed through a melt blowing process, and are regulated for their effectiveness. Like surgical masks, and unlike respirators, cloth face masks do not provide a seal around the face.
In healthcare settings, they are used on sick patients as source control to reduce disease transmission through respiratory droplets, and by healthcare workers when surgical masks and respirators are unavailable. Cloth face masks are generally recommended for use only as a last resort if supplies of surgical masks and respirators are exhausted. They are also used by the general public in household and community settings as perceived protection against both infectious diseases and particulate air pollution.
Several types of cloth face masks are available commercially, especially in Asia. Homemade masks can also be improvised using bandanas, T-shirts, handkerchiefs, scarves, or towels.
Cloth face masks can be used for source control to reduce disease transmission arising from the wearer's respiratory droplets, but are not considered personal protective equipment for the wearer as they have very low filter efficiency (generally varying between 2–38%). There are no standards or regulation for self-made cloth face masks.
As of 2015, there had been no randomized clinical trials or guidance on the use of reusable cloth face masks. Most research had been performed in the early 20th century, before disposable surgical masks became prevalent. One 2010 study found that 40–90% of particles in the 20–1000 nm range penetrated a cloth mask and other fabric materials. The performance of cloth face masks varies greatly with the shape, fit, and type of fabric, as well as the fabric fineness and number of layers. As of 2006, no cloth face masks had been cleared by the U.S. Food and Drug Administration for use as surgical masks.
An experiment carried out in 2013 by Public Health England, that country's health-protection agency, found that a commercially made surgical mask filtered 90% of virus particles from the air coughed out by participants, a vacuum cleaner bag filtered out 86%, a tea towel blocked 72% and a cotton t-shirt 51%—though fitting any diy mask properly and ensuring a good seal around the mouth and nose is crucial. The use of common fabrics in making face masks has been tested.
The primary role of masks worn by the general public is to "stop those who are already infected broadcasting the virus into the air around them." This is of particular importance with the COVID-19 epidemic, as silent transmission seems to be a key feature of its rapid spread. For example, of the people on board the Diamond Princess cruise ship, 634 people were found to be infected—52% had no symptoms at the time of testing, including 18% who never developed symptoms.
The first recorded use of a cloth face mask involved the French surgeon Paul Berger during an 1897 operation in Paris. Masks came into use to protect against infectious diseases in the early 20th century. A design by Wu Lien-teh, who worked for the Chinese Imperial Court during the 1910–11 Manchurian pneumonic plague outbreak, was the first that protected users from bacteria in empirical testing; it inspired masks used during the 1918 flu pandemic. The first study of mask use by healthcare workers took place in 1918. In the 1940s, face masks made from cheesecloth were used to protect nurses from tuberculosis.
Cloth masks were largely supplanted by modern surgical masks made of nonwoven fabric in the 1960s, although their use continued in developing countries. They were used in Asia during the 2002–2004 SARS outbreak, and in West Africa during the 2013–2016 Ebola epidemic.
During the COVID-19 pandemic, multiple countries have recommended the use of cloth masks to reduce the spread of the virus.
The U.S. Centers for Disease Control and Prevention (CDC) in March 2020 recommended that if neither respirators nor surgical masks are available, as a last resort, it may be necessary for healthcare workers to use masks that have never been evaluated or approved by NIOSH or homemade masks, though caution should be exercised when considering this option. In April 2020, CDC recommended that the general public wear cloth face coverings in public settings where other social distancing measures are difficult to maintain, such as grocery stores and pharmacies, especially in areas of significant community-based transmission, due to the significance of asymptomatic and pre-symptomatic disease transmission.
In April 2020 Germany made the wearing of cloth face masks on public transport mandatory, as well as for shopping in most German states. In Scotland, the government recommended using cloth face masks whilst shopping or using public transport, although the central United Kingdom government has not issued the same advice.
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