Filtering facepiece masks lead to facial injuries when worn for too long

Wearing filtering facepiece 3 (FFP3) masks for more than the recommended 1-hour duration can lead to facial injuries, a new study has found.

In the absence of advanced personal protective equipment (PPE), such as powered air flow masks, “we must provide targeted skin care support, modify shift patterns to reduce mask wear intensity, and amend fit test protocols to optimise protection against COVID-19,” the researchers said.

A total of 178 healthcare workers (median age 30 years, 84 percent women) accomplished a survey designed to assess mask-wearing behaviours, related facial injuries, and coping mechanisms. The survey included multiple choice-type items, as well as visual analogue scales and open-ended questions.

Nearly half of respondents were nurses, while 55 percent worked in intensive therapy units. Ninety-one percent of respondents said that they wore FFP3 masks at work, of whom a further 91 percent did so continuously for more than 1 hour. Of note, half of wearers said they kept their mask on for the entire length of their shift, the mean duration for which was 12 hours. The mean FFP3 wear duration was 4 hours per shift.

Majority (n=124, 79 percent) of respondents sustained grade 1 facial pressure injuries. Pain (70 percent), dry skin (50 percent), and worse acne (41 percent) were other common occupational dermatoses. The most affected sites were the cheeks and nose bridge.

To adjust, almost all (96 percent) respondents said they moisturized their faces more intensively, while 80 percent paid greater attention to hydration during the day. Nevertheless, such mask-related injuries led to five participants needing time off work, while 17 were in the process of applying for leaves or transfers. Thirteen participants had already transferred into roles that did not need FFP3 masks.