Mask Hypoxia in Subjects Using Masks to Prevent Infection Spread

To Determine the Presence of Mask Hypoxia in Subject Wearing Masks as Personal Protective Equipment (PPE) Due to the Federal Guidelines

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.

Study Overview

• Status: Withdrawn
• Conditions: Hypoxia
• Intervention / Treatment: Other: Wearing Mask

Detailed Description

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.

• Study Type: Interventional
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Screening
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Healthy subjects wearing masks; Subjects wearing masks to prevent coronavirus infection spread in COVID19 pandemic	Other: Wearing Mask; Participants wearing masks as per federal guidelines to prevent Coronavirus spread

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hypoxia	Decrease from baseline oxygenation from 70-80% of predicted maximum	one year

Collaborators and Investigators

• Sponsor: University of New Mexico

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2020
• Primary Completion (Actual): December 1, 2020
• Study Completion (Actual): December 1, 2020

Study Registration Dates

• First Submitted: December 10, 2020
• First Submitted That Met QC Criteria: December 10, 2020
• First Posted (Actual): December 17, 2020

Study Record Updates

• Last Update Posted (Actual): February 8, 2022
• Last Update Submitted That Met QC Criteria: January 25, 2022
• Last Verified: December 1, 2020

More Information

Terms related to this study

• Keywords: hypoxia; mask
• Additional Relevant MeSH Terms: Signs and Symptoms, Respiratory; Hypoxia
• Other Study ID Numbers: 20-456

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No