EtCO2 Levels in Medical Students Wearing N95 Masks
Downloads
Introduction: N95 masks are very popular for daily use and can actively filter microparticles such as viruses. However, there are concerns that prolonged wearing of the mask may result in exhaled CO2 accumulation between the face and the mask, which may cause increased end-tidal carbon dioxide (EtCO2) levels and physiological changes. This study aimed to determine EtCO2 levels in students wearing the N95 mask.
Methods: This was an experimental study with a case-control design. The subjects were divided into a treatment and a control group and were subjected to five measurements in 120 minutes. The data were analyzed using the independent samples T-test (normally distributed data) and the Mann-Whitney U test (not normally distributed data).
Results: Mann-Whitney test at minute 0 showed that p = 0.010, independent sample T-test at minute 30 showed that the control group p = 0.016, while in the treatment group p = 0.019. Independent sample T-test at minute 60 for the control group p = 0.034, while the treatment group p = 0.037. Independent sample T-test at minute 90 for the control group and treatment p = 0.001, and independent sample T-test showed that at minute 120 in the control and treatment groups p = 0.000.
Conclusion: The EtCO2 measurements at each of the five time points showed a statistical difference (p < 0.05). However, medical students who wore an N95 mask did not suffer adverse effects because the EtCO2 values in the control group were higher than in the treatment group.
(WHO) WHO. Anjuran Mengenai Penggunaan Masker dalam Konteks COVID-19. Geneva, https://www.who.int/docs/default-source/searo/indonesia/covid19/anjuran-mengenai-penggunaan-masker-dalam-konteks-covid-19-june-20.pdf (2020).
(WHO) WHO. COVID-19 Weekly Epidemiological Update. Geneva, https://www.who.int/docs/default-source/coronaviruse/situation-reports/weekly_epidemiological_update_22.pdf (2021).
Nasional TKKPCVD 2019 (COVID-19) dan PE. Pemulihan Ekonomi. Jakarta, https://covid19.go.id/pemulihan-ekonomi (2021).
Maluku PP. Tanggap COVID-19 Provinsi Maluku. Ambon, https://corona.malukuprov.go.id/ (2021).
Ambon PK. Satuan Tugas COVID-19 Kota Ambon. Ambon, https://ambon.go.id/covid-19/ (2021).
Indonesia KKR. Penggunaan Alat Pelindungan Wabah COVID-19. Jakarta, 2020.
Indonesia KKR. Begini Aturan Pemakaian Masker Kain yang Benar. Jakarta, https://www.kemkes.go.id/article/view/20060900002/begini-aturan-pemakaian-masker-kain-yang-benar.html (2020).
(WHO) WHO. Advice on the Use of Masks in the Context of COVID-19. Geneva PP - Geneva: World Health Organization, https://apps.who.int/iris/handle/10665/331693 (2020).
COVID-19 GTP. Standar Alat Pelindung Diri Untuk Penanganan COVID-19 di Indonesia. Jakarta, https://covid19.go.id/storage/app/media/Protokol/2020/Agustus/standar-apd-revisi-3.pdf (2020).
(WHO) WHO. Naming the Coronavirus Disease (COVID-19) and the Virus that Causes It. Geneva, https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(COVID-2019)-and-the-virus-that-causes-it (2020).
Dattel A, O'Toole N, Lopez G, et al. Face Mask Effects of CO2, Heart Rate, Respiration Rate, and Oxygen Saturation on Instructor Pilots. Coll Aviat Rev Int; 38. Epub ahead of print 1 January 2020.
Aminiahidashti H, Shafiee S, Zamani Kiasari A, et al. Applications of End-Tidal Carbon Dioxide (ETCO2) Monitoring in Emergency Department: A Narrative Review. Emerg (Tehran, Iran) 2018; 6: e5.
Richardson M, Moulton K, Rabb D, et al. Capnography for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings: A Health Technology Assessment. Ottawa (ON), 2016.
McSwain SD, Hamel DS, Smith PB, et al. End-Tidal and Arterial Carbon Dioxide Measurements Correlate across All Levels of Physiologic Dead Space. Respir Care 2010; 55: 288–293.
Kumar J, Katto MS, Siddiqui AA, et al. Knowledge, Attitude, and Practices of Healthcare Workers Regarding the Use of Face Mask to Limit the Spread of the New Coronavirus Disease (COVID-19). Cureus 2020; 12: e7737.
Bickley L, Szilagyi PG. Bates' Guide to Physical Examination and History-Taking. 11th ed. Wolters Kluwer Health, https://books.google.co.id/books?id=g0Ao61hGAloC (2012).
Scheid JL, Lupien SP, Ford GS, et al. Commentary: Physiological and Psychological Impact of Face Mask Usage during the COVID-19 Pandemic. Int J Environ Res Public Health; 17. Epub ahead of print September 2020.
O'Kelly E, Arora A, Pirog S, et al. Comparing the Fit of N95, KN95, Surgical, and Cloth Face Masks and Assessing the Accuracy of Fit Checking. PLoS One 2021; 16: e0245688.
Luximon Y, Anne Sheen K, Luximon A. Time Dependent Infrared Thermographic Evaluation of Facemasks. Work 2016; 54: 825–835.
Shaw KA, Zello GA, Butcher SJ, et al. The Impact of Face Masks on Performance and Physiological Outcomes during Exercise: A Systematic Review and Meta-Analysis. Appl Physiol Nutr Metab 2021; 46: 693–703.
Copyright (c) 2023 Safira Eka Putri Madubun, Ony Wibriyono Angkejaya, Bertha Jean Que, Felmi de Lima, Christiana Rialine Titaley
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution Share-Alike (CC BY-SA).
4. The Creative Commons Attribution Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violation.