Dr. Peter Maric, chief medical officer at respiratory company O2 Canada provides insights on how to choose the best protection

Prior to the COVID-19 pandemic, personal protective equipment (PPE) was not a commonly discussed subject for the general public. It was certainly not typical for people in Canada to walk into a grocery store, restaurant, or shopping centre wearing any form of facial covering.

However, wearing masks has long been widely accepted in some regions of the world, and it is no coincidence that many of those same regions have been more successful in combating this pandemic. As a result, wearing a facial covering is increasingly becoming about as normal as wearing a hat here as well. Face coverings have now become highly sought-after items that complement our everyday attire, the use of which is becoming more widespread and normalized throughout every corner of the globe.

Although the world has become better acquainted with the concept of PPE, the words "mask" and "respirator" are still being used interchangeably, resulting in some confusion amongst the general public, and even among professionals who wear one, or both, on a regular basis. But masks and respirators are not the same thing and the question that needs to be answered is: how are they different, and which one do you need?

 

Inform yourself

Although many have become more accepting of wearing face coverings, most still remain unsure and seek to better understand what they should be wearing, and why. When shopping for protective face coverings, we need to know what to look for. Being more informed about their use and effectiveness is essential to protect yourself from becoming infected, as well as those around you.

There is a great deal of information circulating on this subject, arguably too much to consume, and some of it misleading. But a good question to start with is whether one requires a mask or a respirator. To adequately answer this question, one needs to understand the fundamental difference between the two.

 

Mask versus respirator

There are many different kinds of masks and respirators on the market and they differ significantly based on their intended use. Although this is somewhat of an oversimplification, an easy way to understand the difference between masks and respirators with regard to airborne droplets is to appreciate that masks are primarily intended to protect others from the person wearing them, whereas respirators are primarily intended to protect the person wearing the respirator itself.

For example, generally speaking procedural and surgical masks are thin, loose-fitting and disposable. The main purpose of these masks is to protect those around the person wearing the mask from large particles and droplets exhaled by the person wearing the mask. Thus, such masks are intended to primarily avoid contaminating the area immediately surrounding the wearer when operating, as well as to protect the wearer from biological fluids accidentally getting splashed into the wearer’s nose and mouth. However, these masks typically offer less protection from inhaled aerosolized particles, since they are loose-fitting, and were never designed, nor intended, for that specific purpose.

A respirator, on the other hand, is designed to protect the wearer from inhaling hazardous airborne particles, including infectious droplets containing bacteria and viruses. Respirators accomplish this in two main ways: filtration and seal. The filter is designed to remove a high percentage of particles from the air, while the seal between the respirator and face prevents leakage around that filter. This combination is designed to restrict airborne particles from entering the wearer's nose, mouth, and ultimately, their lungs. However without a proper seal, a respirator simply becomes little more than an expensive mask, no matter how efficient the filter material it is made from.

Depending on the type of respirator used, a respirator can also offer the ability to provide two-way protection, to both the wearer and others around them. Regardless, with proper use of a respirator, by offering additional protection to the wearer, that individual is less likely to become exposed to infectious particles, and therefore less likely to in turn spread them to others. If the respirator has one way exhalation valves, the droplets of the person wearing the respirator can still be spread, so capturing those exhaled droplets may be important in certain settings, including healthcare.

As an example, the O2 Curve respirator has a unique performance-oriented modular design, where the front shell optimizes protection and airflow while the ergonomic medical-grade silicone seal fits most face shapes. The O2 Curve filter media is ionically charged to improve filter performance by attracting and trapping particles too small to be filtered mechanically, which efficiently removes particles as small as 0.1 microns in size. Due to its size, the O2 Curve can also easily fit underneath a surgical mask, to provide additional protection by helping to contain exhaled droplets.

 

What the different classifications of respirators mean

You’ve probably heard the term “N95” thrown around by now, but may not appreciate what this actually means. Respirators filter out and remove airborne particles. They consist of the designations “N,” “R,” and “P,” which indicate “not resistant to oil,” “resistant to oil,” and “oil-proof," respectively. The number indicates the filtration efficiency, and thus a rating of “95” indicates filtration of at least 95 percent of particles, “99” indicates filtration of at least 99 percent of particles, and “100” indicates filtration of at least 99.97 percent of particles, at a specific flow rate. The most penetrating particle size is typically in the 0.3 micron range, which is more than three hundred times smaller than a millimetre. N95 respirators (also known as particulate filtering face-piece respirators) are classified as Class I medical devices in Canada.

 

Protect yourself

No matter how well-designed, no mask or respirator can guarantee protection against any virus or illness. Furthermore, PPE that is used incorrectly can actually lead to harm if not handled appropriately.

A good example would be how some individuals inappropriately wear disposable gloves in public, which can actually increase the risk of contamination, to both themselves and others. So therefore although respirators have the ability to provide superior protection to masks due to their ability to seal the mask to your face and filtrate smaller particles, they do require additional effort to learn to use them properly.

With the advent of the COVID-19 pandemic, there has been significant strain on the supply chain of all forms of protective equipment, and although disposable masks and respirators are convenient, they also carry significant environmental costs. One potential solution is to incorporate reusable respirators, provided that they can be disinfected properly. Because mask fit is an essential component to respirators, supply chain concerns can also be mitigated by the use of reusable respirators.

Regardless of whether you require a mask or a respirator, it is essential that you wear them properly, including learning how to remove and dispose of them afterward. Face coverings also require proper hand hygiene, which is essential for both your protection, and the protection of others around you.

The evidence demonstrates that if we embrace proper protocols and educate ourselves about their use, face coverings are an essential component to keeping our communities safer and healthier. So be sure to understand how they work, how to wear them properly, how to dispose of them correctly, and stay away from others if you are feeling unwell, but please do not avoid seeking medical attention if you become too unwell to stay home. Medical staff will be there to help you, with masks and respirators covering their faces, as well as the proper training to ensure that you are both adequately protected.