Pilot Study: Comparing the Quantitative Fit Testing Results of Half-Mask Respirators with Various Skin Barriers in a Crossover Study Design

Trehan, Rajiv S.; McDonnell, Erin P.; McCoy, Jonathan V.; Ohman-Strickland, Pamela A.; Donovan, Colleen; Quinoa, Travis R.; Morrison, Daniel S.

Clinicians around the world are experiencing skin breakdown due to the prolonged usage of masks while working long hours to treat patients with COVID-19. The skin damage is a result of the increased friction and pressure at the mask-skin barrier. Throughout the COVID-19 pandemic, clinicians have been applying various skin barriers to prevent and ameliorate skin breakdown. However, there are no studies to our knowledge that assess the safety and efficacy of using these skin barriers without compromising a sufficient mask-face seal. We report the largest study to date of various skin barriers and seal integrity with quantitative fit testing (QNFT). Our pilot study explores whether the placement of a silicone scar sheet (ScarAway®), Cavilon™, or Tegaderm™ affects 3M™ half-face mask respirator barrier integrity when compared to no barrier using QNFT. We collected data from nine clinicians at an academic Level 1 trauma center in New Jersey. We found that the silicone scar sheet resulted in the lowest adequate fit while Cavilon™ provided the highest fit factor when compared to other interventions (p<0.05). Our findings help inform clinicians considering barriers for comfort when wearing facemasks during the COVID-19 pandemic and for future pandemics.