Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity

Sven Fikenzer, T Uhe, D Lavall, U Rudolph, R Falz, M Busse, P Hepp, U Laufs, Sven Fikenzer, T Uhe, D Lavall, U Rudolph, R Falz, M Busse, P Hepp, U Laufs

Abstract

Background: Due to the SARS-CoV2 pandemic, medical face masks are widely recommended for a large number of individuals and long durations. The effect of wearing a surgical and a FFP2/N95 face mask on cardiopulmonary exercise capacity has not been systematically reported.

Methods: This prospective cross-over study quantitated the effects of wearing no mask (nm), a surgical mask (sm) and a FFP2/N95 mask (ffpm) in 12 healthy males (age 38.1 ± 6.2 years, BMI 24.5 ± 2.0 kg/m2). The 36 tests were performed in randomized order. The cardiopulmonary and metabolic responses were monitored by ergo-spirometry and impedance cardiography. Ten domains of comfort/discomfort of wearing a mask were assessed by questionnaire.

Results: The pulmonary function parameters were significantly lower with mask (forced expiratory volume: 5.6 ± 1.0 vs 5.3 ± 0.8 vs 6.1 ± 1.0 l/s with sm, ffpm and nm, respectively; p = 0.001; peak expiratory flow: 8.7 ± 1.4 vs 7.5 ± 1.1 vs 9.7 ± 1.6 l/s; p < 0.001). The maximum power was 269 ± 45, 263 ± 42 and 277 ± 46 W with sm, ffpm and nm, respectively; p = 0.002; the ventilation was significantly reduced with both face masks (131 ± 28 vs 114 ± 23 vs 99 ± 19 l/m; p < 0.001). Peak blood lactate response was reduced with mask. Cardiac output was similar with and without mask. Participants reported consistent and marked discomfort wearing the masks, especially ffpm.

Conclusion: Ventilation, cardiopulmonary exercise capacity and comfort are reduced by surgical masks and highly impaired by FFP2/N95 face masks in healthy individuals. These data are important for recommendations on wearing face masks at work or during physical exercise.

Keywords: Cardiopulmonary; Exercise capacity; FFP2/N95; Surgical masks; Ventilation.

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Fitting of mask and leakage test. Fitting of spirometry mask with sm (A1) and ffpm (B1) and the respective leakage tests with sm (A2) and ffpm (B2)
Fig. 2
Fig. 2
Effects of wearing a surgical mask (sm) and a FFP2/N95 mask (ffpm) compared to no mask on maximal power (Pmax), maximal oxygen uptake (VO2max), ventilation (VE) and overall discomfort. *p < 0.05; **p < 0.01; ***p < 0.001

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