By R Rammohana, Viju Varadarajanb and Khitish Mohantyc

  • a: Specialist Trainee, Trauma & Orthopaedics, University Hospital of Wales, Heath Park, Cardiff, UK   
  • b: Consultant Anaesthetist, Princess of Wales Hospital, Bridgend, UK
  • c: Consultant Trauma & Orthopaedic Surgeon, University Hospital of Wales, Heath Park, Cardiff, UK

Corresponding author email: [email protected]


Purpose: Frontline healthcare professionals using protective face masks during the COVID-19 pandemic have reported symptoms such as facial bruising and skin damage over social media. This snapshot survey was aimed at evaluating the extent and severity of such adverse physical effects experienced by users of disposable FFP3 masks (Filtering Face Piece mask class 3).

Methodology: All healthcare staff using disposable FFP3 masks were invited to answer an online questionnaire. Data on duration of mask usage, tolerance time, extent of pain or discomfort, general and facial symptoms experienced were collected.

Results: We received 209 responses of which 47.4% (n=99) reported moderate-to-severe pain or discomfort after wearing FFP3 masks. Pressure marks over the face and nose (83.7%, n=175) and ‘thirst’ (66.1%, n=138) were the most common facial and general symptoms experienced respectively. The average duration of FFP3 mask usage was two hours or more in 83% (n=175) but only 66.5% (n=139) could tolerate it for 60 minutes or less. There was a statistically significant association between duration of usage and severity of pain or discomfort experienced (Kruskal-Wallis test, p=0.0007).

Conclusion: A high proportion of health care professionals experienced adverse physical symptoms following the use of disposable FFP3 masks, which is dependent on the duration of usage. Professionals working in intensive care units and theatre settings were more likely to experience severe symptoms. Safer alternatives such as full-face masks or powered respirators with hoods may need to be considered for the safety and well-being of healthcare staff during COVID-19 pandemic.

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