Respiratory consequences of N95-type Mask usage in pregnant healthcare workers—a controlled clinical study

Tong, Pearl Shuang Ye; Kale, Anita Sugam; Ng, Kailyn; Loke, Amelia Peiwen; Choolani, Mahesh Arjandas; Lim, Chin Leong; Chan, Yiong Huak; Chong, Yap Seng; Tambyah, Paul Anantharajah; Yong, Eu-Leong

While there is a substantial negative change in TV, V E and the VO 2 and VCO 2 exchanged, there was no impact of breathing through N95 mask materials, to finger-tip oxygen saturation, maternal or fetal heart rate and no drive to increase BF in pregnancy compared to breathing ambient air at the level of exercise in our study. This study shows important descriptive findings of changes to respiratory physiology with mask use, which do not appear to have sufficient significant clinical impact based on the parameters monitored, that had been deliberately kept within the normal ranges to ensure safety of the subjects. Although harm was not demonstrated in the context of this experimental protocol, the significant changes to respiratory physiology caused by breathing through N95 mask materials raise the concern regarding prolonged use of N95-masks by pregnant healthcare workers. Our results suggest that pregnant women may experience more fatigue and require more rest breaks from mask use. Scheduled work breaks should be considered for pregnant healthcare workers working in high risk areas which require prolonged use of N95 respirators. In face of the imminent threat of pandemic airborne respiratory diseases it should be emphasized that the benefit of using N95 mask to prevent serious emerging infectious diseases should be weighed against possible respiratory consequences associated with N95 mask usage. Use of alternative protective methods such as surgical masks with lesser airway resistance, should be considered in appropriate settings [31] [32] [33] . These have been shown to be equally effective for the prevention of droplet infections such as influenza [31] , although they are insufficient for protection against airborne pathogens. Innovative interventions to improve the design of FFR, are urgently needed in the face of the imminent threat of pandemics of acute airborne respiratory infections. The key is to ensure healthcare worker protection from infectious agents without jeopardizing the wellbeing of the pregnant healthcare workers and their fetuses.