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What are the Safest Surgical Masks to Use?

Certain masks are designed for higher risk environments than others. It’s important to remember, however, that a mask alone will not provide protection from COVID-19. Masks, gloves, and other PPE are needed in combination to protect the wearer, as well as basic practices such as hand washing and not touching the face. It’s also important to reserve the most protective masks for healthcare workers, who spend long periods of time in the highest risk areas for contagion.

  • N95 respirator masks (named because they filter out 95% of small particles) are designed for the highest-risk environments, such as surgery or other situations where sprays and aerosols carrying the virus are commonly emitted. N95s consequently provide the strongest protection against illness as they stop viruses and bacteria from reaching the wearer. These masks seal the area around the face completely when properly fitted, but they make breathing more of an effort. They also require the use of annual training and fit tests to ensure that the wearer is still using them safely. Untrained users may not be able to fit them properly to their faces, or may compromise the seal by adjusting it incorrectly. The U.S. Centers for Disease Control recommends N95 or P100 filters (which block 99.9% of .3 micron+ particles) for first responders potentially dealing with the disease.
  • Surgical masks are made for lower risk medical situations, and are designed to stop the spread of germs from the wearer. Because of their loose fit to the face, matter can get around the edges of the mask and still enter the nose and mouth, so they do not provide the same level of protection as an N95. Additionally, the filtering pores in the mask aren’t small enough to stop viruses. However, these masks do protect against spray, large droplets, and splashes, and they keep the wearer’s germs from spreading to other people. There is also one study by Raina MacIntyre, a professor of global biosecurity at the University of New South Wales, that shows they may have some effect against viral spread. Her study showed that people who wore these masks in the same room as a sick family member reduced their risk of infection, but only if they wore them constantly while in the same room. Additionally, a separate trial by Dr. McIntyre showed that disposable masks carry lower risks for infection.
  • Cloth masks, appropriate for lower risk environments outside of medical facilities, are recommended for consumer use by the C.D.C. These masks do not have fine enough weave to filter out viruses, but they can stop the spread of spray from coughs or sneezing. They can also be used over surgical masks or respirators to help preserve the mask underneath. Consumers are recommended to wear these masks while in places where it’s difficult to remain six feet apart, like grocery stores. However, it’s important to wash cloth masks regularly in a washing machine since the moisture from a person’s breath can breed germs in the cloth over time. It’s also important to try to fit the mask as much as possible to the face without large gaps.
  • Other masks such as painter’s or dust masks are designed to block larger particles than viruses from entering the nose and mouth, so they do not provide the same level of protection as an N95 medical respirator. However, they, like cloth masks, can help keep spray and droplets from potentially infected people contained.

It is worth noting that both masks and respirators have specific shelf lives depending on the conditions and climate in which they are stored, so it’s important to ensure the masks are stored properly and in good condition. Since respirators come in different sizes, it’s also important to ensure you have enough of them in each size, since respirators of the wrong size cannot create a proper seal and therefore will compromise their users.


Disposable Face Mask Ratings: N95, P2, BFE, CE. What does NIOSH Approved mean?

The N95 surgical face mask has been recommended by USA experts as the best protection from SARS. The mask has a >99% BFE (Bacterial Filtration Efficiency). The N95 is the USA equivalent of the European P2 and P3 masks with the P3 offering the higher protection. The N95 mask has a Particle Filtration Efficiency (PFE) of >95% @ 0.3 micron. Masks are intended for use in infection control practices.

The P1 disposable dust respirators are suitable for protection against mechanically generated particles to 1 micron, such as dust and mist. Uses include: sawing, drilling, woodworking, sanding grinding and gardening.

Standard Tie On and Earloop Face Masks are the typical disposable face mask which is latex free, hypoallergenic, fiberglass free, fluid resistant and has a three ply construction. These face masks minimize patient contamination to exhaled microorganisms. Offers a >99% Bacterial Filtration Efficiency (BFE).

So what does it mean when a respirator is “NIOSH Approved”? The Approval is issued only to a specific and complete respirator assembly after the respirator has been evaluated in the laboratory and found to comply with all the requirements of Title 42, Code of Federal Regulations, Part 84. All the components must have the NIOSH approval label. If a manufacturer’s facility has an approval number on one respirator it does not mean that all their respirators are approved just that specific model.

Recent CDC infection control guidance recommends that healthcare workers protect themselves from diseases potentially spread through The air by wearing a fit tested respirator at least as protective as a NIOSH approved N95 respirator. An N95 respirator is one of nine types of disposable particulate respirators. Particulate respirators are also known as “air purifying respirators” because they protect by filtering particles out of the air you breath. The air-purifying respirator forces contaminated air through a filtering element. Workers can wear any one of the particulate respirators for protection against these diseases. NIOSH- approved disposable respirators are marked with the manufacturer’s name, the part number (P/N), the protection provided by the filter (e.g. N95), and “NIOSH”.

TYPE DESCRIPTION- NIOSH United States Standard

  • N95 Filters at least 95% of airborne particles. Not resistant to oil
  • N99 Filters at least 99% of airborne particles. Not resistant to oil
  • N100 Filters at least 99.7% of airborne particles. Not resistant oil
  • R95 Filters at least 95% of airborne particles. Somewhat resistant
  • R99* Filters at least 99% of airborne particles. Somewhat resistant
  • R100* Filters at least 99.97%of airborne particles.Somewhat resistant
  • P95 Filters at least 95% of airborne particles. Strongly resists oil
  • P99* Filters at least 99% of airborne particles. Strongly resists oil
  • P100 Filters at least 99.97% of airborne particles. Strongly resists oil

* No NIOSH approvals are held by this type of disposable particulate Respirator

NOTE: particle size is 0.3 micron penetrating particle size (MPPS), Diffusion and interception predominate

European Standard EN 143 defines the following classes of particle filters that can be attached to a face mask:

  • CLASS FILTER PENETRATION LIMIT (ata 95L/min air flow)
  • P1 Filters at least 80% of airborne particles
  • P2 Filters at least 94% of airborne particles
  • P3 Filters at least 99.95% of airborne particles

European Standard EN 149 defines the following classes of “filtering half masks” (also called filtering face pieces) that is respirators that are entirely or substantially constructed of filtering material:

  • CLASS FILTER PENETRATION LIMIT (at 95L/min air flow)
  • FFP1 Filters at least 80% of particles <22% inward leakage
  • FFP2 Filters at least 94% of particles <8% inward leakage
  • FFP3 Filters at least 99% of particles <2% inward leakage


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