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Respiratory Protection Effect of Ear-loop-type KF94 Masks according to the Wearing Method in COVID-19 Pandemic: a Randomized, Open-label Study.
J Korean Med Sci. 2021 Jul 19; 36(28):e209.JK

Abstract

BACKGROUND

Ear-loop-type Korean Filter 94 masks (KF94 masks, equivalent to the N95 and FFP2) are broadly used in health care settings in Korea for the coronavirus disease 2019 pandemic.

METHODS

A prospective randomized open-label study was designed to identify differences in the fitting performance between mask wearing methods in three different types of KF94 mask with ear loops between January to March 2021. General-fitting involved wearing an ear-loop-type KF94 mask, and tight-fitting involved wearing a mask aided by a clip connecting the ear loops. Each of the 30 participants wore three types of masks according to a randomly assigned order in both methods and performed a total of six quantitative fit tests (QNFTs) according to the occupational safety and health administration protocol.

RESULTS

All fit factors (FFs) measured by the QNFT were significantly higher for tight-fitting method with the clip in all KF94 masks (P < 0.001). However, the total FFs were very low, with a median (interquartile range) of 6 (3-23) and 29 (9-116) for general-fitting and tight-fitting, respectively. When wearing tightly, the horizontal 3-fold type mask with adjustable ear-loop length had the highest FF, with a median of 125, and the QNFT pass rate (FF ≥ 100) increased significantly from 4 (13%) to 18 (60%).

CONCLUSION

Even with sufficient filter efficiency, ear-loop-type-KF94 masks do not provide adequate protection. However, in relatively low-risk environments, wearing a face-seal adjustable KF94 mask and tight wearing with a clip can improve respiratory protection for healthcare workers.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04794556.

Authors+Show Affiliations

Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wildhi.yoon@samsung.com.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

34282608

Citation

Yang, Hyun Jun, et al. "Respiratory Protection Effect of Ear-loop-type KF94 Masks According to the Wearing Method in COVID-19 Pandemic: a Randomized, Open-label Study." Journal of Korean Medical Science, vol. 36, no. 28, 2021, pp. e209.
Yang HJ, Yoon H, Kang SY, et al. Respiratory Protection Effect of Ear-loop-type KF94 Masks according to the Wearing Method in COVID-19 Pandemic: a Randomized, Open-label Study. J Korean Med Sci. 2021;36(28):e209.
Yang, H. J., Yoon, H., Kang, S. Y., Lee, G., Park, J. E., Kim, T., Lee, S. U., Hwang, S. Y., Cha, W. C., Shin, T. G., & Jo, I. J. (2021). Respiratory Protection Effect of Ear-loop-type KF94 Masks according to the Wearing Method in COVID-19 Pandemic: a Randomized, Open-label Study. Journal of Korean Medical Science, 36(28), e209. https://doi.org/10.3346/jkms.2021.36.e209
Yang HJ, et al. Respiratory Protection Effect of Ear-loop-type KF94 Masks According to the Wearing Method in COVID-19 Pandemic: a Randomized, Open-label Study. J Korean Med Sci. 2021 Jul 19;36(28):e209. PubMed PMID: 34282608.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Respiratory Protection Effect of Ear-loop-type KF94 Masks according to the Wearing Method in COVID-19 Pandemic: a Randomized, Open-label Study. AU - Yang,Hyun Jun, AU - Yoon,Hee, AU - Kang,Soo Yeon, AU - Lee,Guntak, AU - Park,Jong Eun, AU - Kim,Taerim, AU - Lee,Se Uk, AU - Hwang,Sung Yeon, AU - Cha,Won Chul, AU - Shin,Tae Gun, AU - Jo,Ik Joon, Y1 - 2021/07/19/ PY - 2021/05/04/received PY - 2021/07/06/accepted PY - 2021/7/20/entrez PY - 2021/7/21/pubmed PY - 2021/7/27/medline KW - COVID-19 KW - Infection Control KW - KF94 Mask KW - N95 Filtering Facepiece Respirators KW - Quantitative Fit Test KW - Respiratory Protective Devices SP - e209 EP - e209 JF - Journal of Korean medical science JO - J Korean Med Sci VL - 36 IS - 28 N2 - BACKGROUND: Ear-loop-type Korean Filter 94 masks (KF94 masks, equivalent to the N95 and FFP2) are broadly used in health care settings in Korea for the coronavirus disease 2019 pandemic. METHODS: A prospective randomized open-label study was designed to identify differences in the fitting performance between mask wearing methods in three different types of KF94 mask with ear loops between January to March 2021. General-fitting involved wearing an ear-loop-type KF94 mask, and tight-fitting involved wearing a mask aided by a clip connecting the ear loops. Each of the 30 participants wore three types of masks according to a randomly assigned order in both methods and performed a total of six quantitative fit tests (QNFTs) according to the occupational safety and health administration protocol. RESULTS: All fit factors (FFs) measured by the QNFT were significantly higher for tight-fitting method with the clip in all KF94 masks (P < 0.001). However, the total FFs were very low, with a median (interquartile range) of 6 (3-23) and 29 (9-116) for general-fitting and tight-fitting, respectively. When wearing tightly, the horizontal 3-fold type mask with adjustable ear-loop length had the highest FF, with a median of 125, and the QNFT pass rate (FF ≥ 100) increased significantly from 4 (13%) to 18 (60%). CONCLUSION: Even with sufficient filter efficiency, ear-loop-type-KF94 masks do not provide adequate protection. However, in relatively low-risk environments, wearing a face-seal adjustable KF94 mask and tight wearing with a clip can improve respiratory protection for healthcare workers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04794556. SN - 1598-6357 UR - https://www.unboundmedicine.com/medline/citation/34282608/Respiratory_Protection_Effect_of_Ear-loop-type_KF94_Masks_according_to_the_Wearing_Method_in_COVID-19_Pandemic:_a_Randomized,_Open-label_Study. L2 - https://jkms.org/DOIx.php?id=10.3346/jkms.2021.36.e209 DB - PRIME DP - Unbound Medicine ER -