With the rise in COVID-19 cases across the country and throughout the state because of the omicron variant, West Virginia University implemented several updated campus health and safety protocols ahead of the start of the spring semester.
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Among the key changes were updated mask protocols. Here, School of Public Health Public Health-General Preventive Medicine program residents &#; Margaret Karcher, DO, and Vida Falahatian, MD &#; and PH-GPM Program Director Jennifer Lultschik, MD, help answer some frequently asked questions about masks, including the KN95 mask, recommended by WVU, and N95 mask, used widely in patient-care settings.
Why is the KN95 mask the recommended mask to use right now?
A KN95 mask is made to filter at least 95% of particles of size down to 3 microns in diameter. It permits 8% or less leakage, by Chinese standards.
A medical procedure mask, or surgical mask, fits loosely and will stop large droplets and particles, but does not stop small droplets. Because the omicron variant is so transmissible, a higher level of protection is strongly recommended.
What&#;s the difference between an N95 and KN95?
KN95 masks originated in China as a counterpart to the N95 respirator and are now made in a number of countries around the world. They are intended to provide protection close to that of an N95 respirator, which is regulated by the CDC National Institute for Occupational Safety and Health (NIOSH). An N95 respirator has straps that go around the head to ensure a tight seal and ideally is fit-tested. A KN95 respirator has ear loops and does not form a tight seal; however, the leakage of air around the mask is much lower than with a surgical mask.
KN95 and N95 masks are both rated to filter out at least 95% of particles down to 3 microns. The N95 is more effective due to being able to achieve a better fit. They have similar resistance to inhalation and exhalation (which affects breathing comfort), with the N95 being slightly less resistant.
Should N95 be reserved for frontline workers or is there no longer a shortage?
Currently the US is not experiencing a shortage of N95 masks; they are widely available. They are usually more expensive than KN95 masks.
What are your recommendations if someone wants to purchase additional KN95 or N95 masks? How do you ensure that whatever you&#;re purchasing isn&#;t counterfeit?
A large proportion of KN95 masks and N95 respirators sold in the US are counterfeits, so pay attention to important details, outlined below, before purchasing. These non-approved masks have frequently been shown to be of low quality and not to meet filtration standards.
Red flags that indicate either a KN95 or N95 is counterfeit:
The FDA created a list of Personal Protective Equipment, which includes KN95 masks, for Emergency Use Authorization (EUA) for healthcare workers early in the pandemic. The EUA is no longer in use, but the FDA list of manufacturer names for KN95 masks that were tested at an accredited laboratory and found to meet filtration standards is still available online:
The CDC has an online list of counterfeit respirators, which can be found here.
Using this information will help you find a quality mask and avoid low-quality counterfeits.
Can KN95 masks be reused? Is it safe to wash to extend its use?
KN95 masks can be reused by the same wearer for several days if they are used and cared for properly. Refer to Guidance on use of KN95 masks for additional information.
KN95 masks should NOT be washed.
Do KN95s need to be fit-tested to ensure maximum protection?
No. They are not suitable for fit-testing.
Because the KN95 mask has not been certified by the National Institute for Occupational Safety and Health, the Occupational Safety and Health Administration (OSHA) does not consider it a negative-pressure respirator.
How do you properly store an already worn KN95 or N95 that can be used again?
Refer to the guidance provided by WVU for storing your KN95 mask, available in this downloadable PDF.
For N95 masks: If worn for an extended period of time, the CDC recommends that users store them in a breathable container such as a paper bag. The container must be clearly labeled (to avoid accidental use by someone else).
Are face shields acceptable? If not, how can we accommodate those who interact with people who are hearing impaired?
Wearing a face shield instead of a mask does not provide adequate protection and is not recommended. Most face shields permit small droplets to travel on air currents around the edges and bottom of the shield, increasing risks to both the wearer and those nearby.
Wearing a clear mask or a fabric mask with a clear panel may be a good idea if you&#;re going to be engaging with people who depend on lip-reading to communicate. Vinyl and other non-breathable materials are not suggested for masks but may be an exception to the rule for the sake of lip-reading. Alternatives to clear masks are textual communication, closed captioning, or lowering background noise to communicate while wearing a mask that covers your mouth.
How do I properly remove my mask?
Before touching the mask, wash your hands with soap and water or use hand sanitizer.
Depending on the type of mask, adhere to the following:
After you&#;ve removed and stored or discarded your mask, depending on its condition, hands should be disinfected with soap and water or sanitizer.
What are some tips/techniques for safely using surgical and/or cloth masks?
If you don&#;t have access to a KN95 or N95 mask, it is recommended you choose a mask with multiple layers and a nose wire that can be bent around your nose to prevent air leaks. Double-masking should also be considered. Most important: ensure your mask is tightly fitted to your face. Additional tips for putting on your mask:
Keep in mind: Significant facial hair (growth of more than three days) decreases a mask&#;s capacity to establish a tight seal around your face, reducing its effectiveness in shielding you and others against COVID-19. As a result, it is recommended that all areas of your face that come into contact with a mask, particularly a KN95 mask, should be hair-free.
For additional guidance, visit the Return to Campus website.
CONTACT: Nikky Luna, Director of Marketing and Communications
WVU School of Public Health
304.293.
In this FAQ we answer questions about reusable fabric masks (nonmedical masks), including questions about mask fabrics, nonwoven polypropylene (NWPP), and mask designs. Some of the key questions answered in this FAQ are:
Polypropylene (PP) is a lightweight synthetic material that is inexpensive, durable, breathable, water resistant, and recyclable (#5). PP is generally considered non-toxic, and safe for human contact. PP is used in a broad range of applications and is available in many forms. For example, PP is available as sheets of plastic (e.g., in yogurt containers), as woven fabrics (e.g., in clothing), and as nonwoven fabrics (e.g., in masks). The type of polypropylene used in masks in nonwoven polypropylene (NWPP).
Yes, polypropylene is nontoxic and is generally considered the safest plastic for human use. However, as with all textiles, there are different thicknesses and grades of NWPP and we cannot guarantee or vouch for the effectiveness of hand-made masks constructed from alternatively sourced materials. For more information to help guide your selection of polypropylene materials for community masks read more at: &#;The Big 4: Criteria for Community Mask Materials.&#;
Nonwoven polypropylene is used in masks because it is nontoxic, breathable, hydrophobic (water-resistant), lightweight, provides filtration, and is inexpensive.
Nonwoven polypropylene (NWPP) is the most common material used in medical grade masks. Instead of being woven like cloth, NWPP is created by spinning polypropylene fibers into threads and laying them down in a porous web that is breathable, provides filtration, and is naturally water resistant. There are two different types of NWPP that are used in masks: spunbond NWPP and meltblown NWPP.
Spunbond NWPP is washable and reusable where meltblown NWPP is considered a single-use (disposable) material. This is because of structural differences in the materials and how they are manufactured. For reusable fabric masks we recommend spunbond NWPP. For a deeper dive into the differences between spunbond and meltblown NWPP, see: &#;Mask Fabrics: Introduction to Fibers and Fabrics&#;
Spunbond NWPP is a sturdier material spun from larger diameter fibers that are thermally bonded together, which makes them more suitable for washing and reuse.
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Meltblown NWPP is constructed from smaller, more delicate fibers, resulting in a material that is not generally considered washable or reusable. Although meltblown NWPP is considered safe in commercially manufactured masks and filter inserts, the size of meltblown fibers suggests extra caution may be warranted when cutting, handling, and/or sewing these materials due to potential inhalation risks.
Yes. Spunbond NWPP is considered a good choice for fabric masks because it is lightweight, reusable, breathable, water-resistant, and helps with filtration. However, meltblown NWPP is not considered washable and should not be sewn into reusable masks. For more on how to identify and select NWPP for masks see: &#;The Big Four: Criteria for Fabric Mask Materials for COVID&#;
Is all spunbond NWPP the same?No. As with all textiles, there are different thicknesses and grades of NWPP. This is one of the reasons that we can&#;t guarantee or vouch for the effectiveness of hand-made masks constructed from alternatively sourced materials. For reusable fabric masks we recommend using spunbond NWPP because it is washable and reusable.
How do I evaluate whether my nonwoven polypropylene will work for a mask?First, check to make sure that the fabric is made from 100% polypropylene (look for a label or tag). Next, look for the dimpled texture characteristic of spunbond nonwoven fabrics. To check that it is water resistant, flick water at the fabric, you want to see the water droplets bead up and roll off, while the inside stays dry. You also want to make sure that the material is breathable.
For more on how to identify and select NWPP for masks see: &#; The Big Four: Criteria for Fabric Mask Materials for COVID
If NWPP interfacing is used, &#;sew in&#; interfacing is preferred to &#;fusible&#; (iron on) because: 1) the plastics beads used in iron-on interfacing may reduce the breathability of the material and 2) the types of adhesives and binders used in the &#;dots&#; in fusible interfacing may are not have been evaluated for potential inhalation risks associated with use in masks. For more information fusing interfacing check out the following links:
Click here for the Zhang & Kan () review of &#;Fusible Interlinings Usage in Garment Manufacture.&#;
Polymers (Basel)
. ;10(11):
Click here for an example patent for fusing interfacing describing additives used to improve melting and adhesion properties
NWPP from landscape cloth and other geotextiles may pose inhalation risk. The fibers in these materials are prone to shedding and may pose risk of mechanical irritation when inhaled. In addition, preliminary data from particle testing suggests poor filtration performance, and they are not always water resistant.
What about surgical barrier materials?Nonwovens used as barriers in other medical applications (e.g., gowns and surgical drapes) may contain coatings or chemical treatments to enhance water-resistance and water-repellence. These treatments allow materials to gain regulatory approval at higher barrier standards but may not be suitable for use in masks. Check manufacturers&#; information on materials used for possible hazards (Jones, ).
Spunbond nonwoven polypropylene can be upcycled from a number of different places, and can be found in bulk (i.e., by the yard) as sewing and/or crafting material. Specifics about where to buy NWPP vary regionally. Click here for our guide to &#;Finding and Selecting Polypropylene for Washable Masks&#;
Yes, fabric masks made from spunbond nonwoven polypropylene can be washed and reused (by the same individual). Disposable medical masks (and respirators) that contain meltblown NWPP are designed to be safely discarded after a single use, but due to ongoing shortages may be reused up to five times when safely stored (e.g., in a breathable paper bag) for at least 5 days between uses [CDC, ].
Yes, spunbond NWPP can be washed. Check for specific washing instructions from the mask and or material manufacturer. In general:
NWPP can be hand washed in warm or hot water, rinsed thoroughly, and hung to dry. Handwashing may extend the longevity of NWPP materials.
NWPP can be machine washed (warm) and tumble dried (low). We recommend putting NWPP masks in lingerie bags while washing to help them retain their shape.
Avoid using bleach or alcohol on these fabrics, because those chemicals break down the properties that make NWPP a good choice. Be sure to rinse masks thoroughly to eliminate soap residues, which may alter mask properties. Do not use fabric softener as it leaves residues that may alter the properties of the fabric.
For disinfection, spunbond NWPP masks may be boiled for 10 minutes and then hung to dry.
Yes. NWPP is recyclable (look for recycling #5). Check with local and regional recycling policies for details. In addition, the spunbond NWPP used in fabric masks can be washed and reused, which helps cut down on waste.
Best practices currently suggest that fabric masks should be constructed of three or more layers of breathable fabrics [WHO, ]. For more information about the WHO Guidance on Fabric Masks (last updated December, ) check out: &#;WHO Fabric Mask Guidance &#; December Updates&#;
In general, the materials considered best for use in reusable fabric masks are water-resistant nonwoven fabrics (e.g., NWPP) and tightly woven cotton fabrics. For general use, MakerMask typically recommends either 3 layers of NWPP (NWPP-NWPP-NWPP), or a skin-contacting layer a hydrophilic fabric (e.g., cotton) with 2 outermost layers of NWPP (cotton-NWPP-NWPP). The NWPP layers are designed to act as barriers to droplets, which help contain the users droplets and help protect the user by preventing outside droplets from penetrating the mask [Songer, ]. For more information see,
We recommend using NWPP as the outermost mask layer due to its water resistance and hydrophobic properties. If a cotton layer is included, using it as the innermost mask layer (closest to the skin) to absorb the users droplets is preferred [WHO, ]. For more information, see:
NWPP has been known to melt with some irons and could damage both the mask and your iron. For this reason, we do not recommend ironing. If you do decide to iron your masks, use precautions for sensitive/delicate fabrics such as ironing on the lowest heat setting and placing a towel or other cloth between the mask and your iron.
Both woven and nonwoven fabrics can be characterized by &#;fabric weight&#; in terms of grams per square meter (gsm) or ounces per square yard (oz/yd²). Although we use gsm throughout our discussions, depending on where you are, oz/yd² may be used. It is easy to convert from one to the other by googling it, or using an online conversion tool such as this &#;Textile and Fabric Weight Converter&#;.
We use gsm to describe fabrics because it can be used to describe both woven and nonwoven fabrics and it can be easily measured by scientists and home sewists alike. All you need is a kitchen scale and a ruler!
If the gsm (grams per square meter) of a given fabric is not provided by the manufacturer, it can be calculated at home using a digital kitchen scale, a ruler, and either a calculator following these three easy steps:
meters (or
convert to meters; e.g., 1 cm = 0.01 m, 1 inch = 0.025 m, or 1 yard = 0.9 m).
(or convert to grams; e.g., 1 ounce = 28 grams).
GSM = Fabric Weight / (Length x Width)
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