Carbon dioxide increases with face masks but remains below short-term NIOSH limits.
Carbon dioxide increases with face masks but remains below short-term NIOSH limits.
复制标题
戴口罩后二氧化碳会增加，但仍低于短期NIOSH限值。
DOI：
10.1186/s12879-021-06056-0
复制
发表时间：
2021-04-16
影响因子：
3.7
通讯作者：
Sharma VK
中科院分区：
文献类型：
--
作者：
Rhee MSM;Lindquist CD;Silvestrini MT;Chan AC;Ong JJY;Sharma VK
COVID-19疫情导致医护人员广泛使用口罩、呼吸器及其他个人防护装备。认为归因于使用PPE的各种症状至少部分是由于二氧化碳（CO2）水平升高。我们评估了各种PPE下的CO2浓度。在一项针对健康志愿者的前瞻性观察性研究中，在正常呼吸期间测量CO2水平，同时佩戴1）无面罩，2）JustAir®动力空气净化呼吸器（PAPR），3）KN 95呼吸器和4）带阀呼吸器。对于每种PPE配置，使用鼻插管以1 Hz的频率进行连续CO2测量15分钟，以评估是否违反美国国家职业安全与健康研究所（NIOSH）的限值。该研究包括11名健康志愿者，中位年龄32岁（范围16-54）和6名（55%）男性。无面罩、JustAir® PAPR、KN 95呼吸器和阀式呼吸器的CO2值的百分比平均（SD）变化分别为0.26（0.12）、0.59（0.097）、2.6（0.14）和2.4（0.59）。使用面罩（KN 95和带阀呼吸器）导致CO2浓度显着增加，超过了8小时NIOSH暴露阈值限值加权平均值（TLV-TWA）。然而，二氧化碳浓度的增加并没有突破短期（15分钟）的限制。重要的是，这些水平大大低于在佩戴JustAir® PAPR期间的长期（8小时）NIOSH限值。除KN 95和带阀呼吸器（p = 0.25）外，所有呼吸器对之间的差异均有统计学意义（p < 0.0001）。然而，二氧化碳水平的增加是否具有临床意义仍然存在争议。尽管常规使用的口罩会导致二氧化碳浓度显著增加，但短期使用的水平仍保持在NIOSH限值范围内。因此，医疗保健提供者不应该担心它们的日常使用。长期使用口罩导致CO2水平升高的临床意义需要进一步研究。使用PAPR可预防相对高碳酸血症。然而，PAPR是否应该提倡医护人员需要PPE延长时间需要在进一步的研究进行评估。
COVID-19 pandemic led to wide-spread use of face-masks, respirators and other personal protective equipment (PPE) by healthcare workers. Various symptoms attributed to the use of PPE are believed to be, at least in part, due to elevated carbon-dioxide (CO2) levels. We evaluated concentrations of CO2 under various PPE. In a prospective observational study on healthy volunteers, CO2 levels were measured during regular breathing while donning 1) no mask, 2) JustAir® powered air purifying respirator (PAPR), 3) KN95 respirator, and 4) valved-respirator. Serial CO2 measurements were taken with a nasal canula at a frequency of 1-Hz for 15-min for each PPE configuration to evaluate whether National Institute for Occupational Safety and Health (NIOSH) limits were breached. The study included 11 healthy volunteers, median age 32 years (range 16–54) and 6 (55%) men. Percent mean (SD) changes in CO2 values for no mask, JustAir® PAPR, KN95 respirator and valve respirator were 0.26 (0.12), 0.59 (0.097), 2.6 (0.14) and 2.4 (0.59), respectively. Use of face masks (KN95 and valved-respirator) resulted in significant increases in CO2 concentrations, which exceeded the 8-h NIOSH exposure threshold limit value-weighted average (TLV-TWA). However, the increases in CO2 concentrations did not breach short-term (15-min) limits. Importantly, these levels were considerably lower than the long-term (8-h) NIOSH limits during donning JustAir® PAPR. There was a statistically significant difference between all pairs (p < 0.0001, except KN95 and valved-respirator (p = 0.25). However, whether increase in CO2 levels are clinically significant remains debatable. Although, significant increase in CO2 concentrations are noted with routinely used face-masks, the levels still remain within the NIOSH limits for short-term use. Therefore, there should not be a concern in their regular day-to-day use for healthcare providers. The clinical implications of elevated CO2 levels with long-term use of face masks needs further studies. Use of PAPR prevents relative hypercapnoea. However, whether PAPR should be advocated for healthcare workers requiring PPE for extended hours needs to evaluated in further studies.
登录
查看更多内容
影响因子：
5.3
作者：
Atangana E;Atangana A
通讯作者：
Atangana A
影响因子：
4.4
作者：
Bharatendu, Chandra;Ong, Jonathan J. Y.;Sharma, Vijay K.
通讯作者：
Sharma, Vijay K.
DOI：
10.1038/s41370-018-0055-8
发表时间：
2019-06-01
影响因子：
4.5
作者：
Allen, Joseph G.;MacNaughton, Piers;Spengler, John D.
通讯作者：
Spengler, John D.
DOI：
10.3390/ijerph17186655
发表时间：
2020-09-12
影响因子：
--
作者：
Scheid JL;Lupien SP;Ford GS;West SL
通讯作者：
West SL
影响因子：
3.5
作者：
Lim, ECH;Seet, RCS;Ong, BKC
通讯作者：
Ong, BKC