Protective Face Masks: Effect on the Oxygenation and Heart Rate Status of Oral Surgeons during Surgery

Abstract

Background: Safety in medical work requires eye protection, such as glasses, and protective facial masks (PFM) during clinical practice to prevent viral respiratory infections. The use of facial masks and other full personal protective equipment increases air flow resistance, facial skin temperature and physical discomfort. The aim of the present study was to measure surgeons' oxygenation status and discomfort before and after their daily routine activities of oral interventions.

Methods: 10 male voluntary dentists, specializing in oral surgery, and 10 male voluntary doctors in dentistry, participating in master's courses in oral surgery in the Department of Oral Surgery of the University of Chieti, with mean age 29 ± 6 (27-35), were enrolled. This study was undertaken to investigate the effects of wearing a PFM on oxygenation status while the oral surgeons were actively working. Disposable sterile one-way surgical paper masks (Surgical Face Mask, Euronda, Italy) and FFP2 (Surgical Face Mask, Euronda, Italy) were used and the mask position covering the nose did not vary during the procedures. The FFP2 was covered by a surgical mask during surgical treatment. A pulse oximeter was used to measure the blood oximetry saturation during the study.

Results: In all 20 surgeons wearing FFP2 covered by surgical masks, a reduction in arterial O₂ saturation from around 97.5% before surgery to 94% after surgery was recorded with increase of heart rates. A shortness of breath and light-headedness/headaches were also noted.

Conclusions: In conclusion, wearing an FFP2 covered by a surgical mask induces a reduction in circulating O₂ concentrations without clinical relevance, while an increase of heart frequency and a sensation of shortness of breath, light-headedness/headaches were recorded.

Keywords: COVID-19; FFP2 respirators; N95; SARS-CoV-2; personal protective equipment; protective face masks; severe acute respiratory syndrome-related coronavirus; surgical mask.

Figure 1

Graph chart of the surgeons O₂ saturation (%) of Group I (20 min), II (20–40 min), III (40–120 min) and IV (120–240 min) (ANOVA post hoc Tukey HSD). No differences were detected between the baseline for both of Group I, II, III and IV. A statistically significant difference was detected in all comparisons after the surgery procedure (p < 0.05).

Figure 2

Graph chart of the surgeons’ heart rate (bmp) of Group I (20 min), II (20–40 min), III (40–120 min) and IV (120–240 min) (ANOVA post hoc Tukey HSD). No differences were detected between the baseline for both of Group I, II, III and IV. A statistically significant difference was detected by group comparison after the surgery procedure (p < 0.05).

Figure 3

Graph chart of the shortness breath visual analogic score (VAS) score perception of Group I (20 min), II (20–40 min), III (40–120 min) and IV (120–240 min) (ANOVA post hoc Tukey HSD) (Top Bars between groups comparison: lower case p < 0.05; upper case: p > 0.05).

Figure 4

Graph chart of the light-headedness and headaches VAS score perception of Group I (20 min), II (20–40 min), III (40–120 min) and IV (120–240 min) (ANOVA post hoc Tukey HSD) [Top Bars between groups comparison: lower case p < 0.05; upper case: p > 0.05].