The adverse dermatological effects of N95 masks amongst Australian healthcare workers -A cross sectional study.

Abstract

N95 masks are worn daily by healthcare workers and have become a part of mandatory PPE in many hospitals during the COVID-19 pandemic. It is well established that adverse skin reactions (ie. dermatitis, acne, pressure sores, cheilitis etc) are associated with N95 mask wear. There is, however, little information as to which N95 masks are more closely associated with these adverse reactions. Aim(s): This cross-sectional study analyses the association between different N95 masks available in Australia with the rate and type of skin reactions reported, and the involvement of general practitioners and dermatologists in their management. Method(s): Healthcare workers (ie. doctors, nurses, allied health professionals) at a metropolitan health care network were sent a digital survey questionnaire. The questionnaire contained questions regarding the type of N95 mask worn (ie. 3M Aura, Industree Trident, BYD, BSN, Halyard, and 3M1860), as well as frequency and duration of wear time. Participants were also asked about the frequency, severity and type of adverse skin reactions experienced; use of any preventative measures; and whether management was initiated by a general practitioner or dermatologist. Result(s): Healthcare workers wore N95 masks for an average of 64 h per fortnight. Over 80% of responders reported adverse skin reactions associated with their fit tested N95 mask, with the highest number of reactions relating to 3M Aura Respirator mask use. Conclusion(s): Different manufactures of N95 masks produced different rates and types of adverse skin reactions. Until now, fit testing for the best seal to prevent airborne and aerosol disease spread has been the primary basis for selecting N95 mask types. The results of our survey on the type, rate and severity of adverse skin reactions may provide a secondary consideration when selecting N95 mask brands, as well as help predict and guide prevention or management strategies for adverse skin reactions.