In a recent study published in Environmental Research, researchers investigated whether surgical and N95 face masks cause respiratory distress in children. 

Study: Respiratory function in children wearing face masks. Image Credit: BearFotos/Shutterstock

Background

In a recent article published by Walach et al., they stated that the usage of face masks in children raised the carbon dioxide (CO2) amount in inhaled air so quickly to a high level that even in resting conditions it could carry serious health risks. The authors of the present work identified several methodological limitations of the Walach et al. study in order that the parents may not consider masking harmful and dangerous for his or her children.

Walach et al. considered 2000 parts per million (ppm) CO2 levels because the cut-off value of CO2 toxicity. This value applies to indoor air quality, whereas the environment created between the face and mask isn’t comparable to an enclosed environment. Also, as per america Centers for Disease Control and Prevention (CDC) website, exposure to about 50,000 ppm CO2 for half-hour causes the primary symptoms related to respiratory distress. Walach et al. reported CO2 levels between 13,120 and 13,910 ppm, that are well below the brink for CO2 toxicity.

Second, Walach et al. study couldn’t prove the alleged link to hypercapnia because they did not measure blood CO2 levels. The primary physiological compensation mechanism for hypercapnia is increased respiratory and heart rates. The study subjects showed no such symptoms, and so they didn’t show decreased oxygen saturation (SaO2). Lastly, the measuring device utilized by Walach et al. of their study couldn’t adapt to the speed of CO2 changes, hence, yielded unreliable results.

Concerning the study

In the current study, researchers assessed respiratory distress in children using multiple parameters, including partial pressure of end-tidal carbon dioxide (PETCO2), heart rate, respiratory rate, and clinical signs. They monitored the changes in respiratory parameters in all of the study subjects every quarter-hour. For the primary half-hour, these children weren’t wearing a face mask, but they were asked to wear a face mask later. The masked sessions consisted of a 12-minutes walking test in a 40-m long corridor.

Results and conclusion

During rest and physical activity, the usage of a surgical mask didn’t cause any significant changes within the respiratory parameters of the youngsters. Using the N95 mask, particularly during physical activity, increased PETCO2, however it remained in the traditional range. Overall, none of the youngsters evaluated in the present study showed any clinical signs of respiratory distress throughout the duration. In support of those findings, one other recent study in adults with severe lung impairment showed that surgical masks didn’t influence their gas exchange capabilities.

Furthermore, several studies have shown the effectiveness and accuracy of methods involving the evaluation of PETCO2 to point out changes in respiratory distress parameters, including venous pCO2 and arterial pCO2. The implications of mask use in pediatric age require careful consideration since it is the one non-pharmaceutical intervention measure that might reduce the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Furthermore, it could help contain many common pediatric diseases, which, in turn, could reduce healthcare system expenses.

Most significantly, there may be enough clinical evidence supporting the protection of masks within the pediatric age. Thus, parents shouldn’t doubt that mask use is hazardous for his or her children or increases carbon dioxide within the inhaled air. In truth, it prevents the spread of multiple pathogenic infections, including SARS-CoV-2, for the nice of public health.