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What face mask should you pick?

COVID-19 is a disease caused by the SARS-CoV-2 virus. The course of the disease itself is unpredictable and varies from asymptomatic disease to a life-threatening condition that predominantly affects the respiratory system but can significantly affect other organs. As there is no specific therapy or effective vaccine yet, the basis of the fight against COVID-19 to prevent the spread of the infection – are non-pharmacological measures.

Particles in the form of droplets in the exhaled air formed while the virus carrier is coughs, sneezes or talks are the main way of spreading the SARS-CoV-2 virus. These droplets spread through the air and fall on surfaces near the source of the disease.

Inhalation of those particles in the air or transmission from the contaminated surfaces to mucous membranes causes transmission of infection.

At a time while the virus is circulating freely among the population, and considering the relatively large number of asymptomatic carriers (up to 55%) and the high degree of the virus contagiousness (i.e. up to 80% of those infected received it from asymptomatic contact); from the epidemiological side, each individual should be, from an epidemiologists’ perspective – approached as a potential source of infection.

Basic non-pharmacological interventions are public health measures that aim to prevent transmission of the virus.

They include avoiding gathering more people indoors, maintaining physical distance, regular hand hygiene, avoiding touching the face, lips and eyes and wearing protective masks that prevent both – virus entering the respiratory system and dropping virus droplets from an infected person.

Wearing protective masks when staying indoors or outdoors when not being able to avoid contact with other people, for the last twenty years has become a common behavior of East Asian countries due to outbreaks of diseases such as SARS, MERS and bird flu.

The current pandemic of SARS-CoV-2 requires the acceptance of such behavior in our country with strict adherence to the recommendations for the prevention of the spread of the virus. Knowing the ways of SARS-CoV-2 spread, wearing a face mask is crucial in preventing virus spread caused by droplets and aerosols.

Protective mask’s choice depends on the intended effect. Available masks can be divided into home-made or factory-made textile masks, “surgical masks” and occlusive masks (“respirators”). Each one of these has a different protective role, as well as the advantages and disadvantages in certain situations, and that should be considered when choosing the best form of protection.

Textile, non standardized masks mostly provide the lowest degree of protection, depending on the chosen material and the number of layers. In general, they provide the least resistance to breathing and can be used repeatedly after washing and ironing. They are recommended for active, younger people without risk factors for the development of severe COVID-19 case and also, when staying in rooms / areas of low risk for disease transmission such as outdoor gatherings, smaller groups indoors with a suitable distance over 2 m.

“Surgical” masks are primarily designed to protect patients from the spread of infections that could be transmitted from a healthcare professional.

Therefore, they are more efficient in preventing the spread of disease from already ill/infested person (up to 80% risk reduction) than in protecting healthy individuals (about 50% risk reduction).

When roper applied, their impact on daily activities is minimal. They have the best balance of the ability to apply masks in everyday use and provided protection. They are highly recommended for people who are at increased risk of developing severe COVID-19 (age, associated diseases), and these that are in areas of low to moderate risk of spreading infections (greater outdoor gatherings, stay indoors without the possibility of spacing> 2m)).

Occlusive masks (“respirators”) are designed to protect healthy individuals in contact with highly contagious patients and are, therefore, most commonly used, among other protective equipment, in health facilities to protect staff caring for COVID-19 patients.

They represent a significant resistance to breathing and significantly reduce the endurance of effort and limit daily activities, due to their significantly higher degree of filtration.  Applied incorrectly (incomplete fit that allows circulating air between the masks and the face), their effect is even worse than the protective effect of “surgical” masks; in that case all the air enters unfiltered through the crack, canceling the filtration effect of the mask.

Regarding this, they are recommended only for health professionals and for the protection of persons that are the most at risk (persons with reduced immunity, patients with cancer, patients suffering from severe chronic diseases) while staying in high risk areas (health facilities, vehicles, enclosed spaces with more people).

It should be noted that models of occlusive masks with non-return valves, if the person that wears them is infected, do not protect those in their surrounding from the spread of the disease. Exhaled air is released directly into the environment without filtration, while only the inhaled air is filtrated, therefore, they should not be used in public places where, one of the main goals of wearing a mask is to prevent the spread of the virus from a potential asymptomatic carrier.

Masks with additional effects intend to solve some of the shortcomings of standard masks while preserving their existing, positive characteristics.

“Surgical” masks are most suitable for wide use, so usually, these improvements are performed on them by adding various chemical compounds to the original filter mask in order to improve the filtration effect or to increase their effect against bacteria, viruses and fungi while reducing the risk of secondary spread of infection due to the accumulation of pathogens in the mask filter during prolonged wear.

A number of different chemical compounds, such as polyvinyl alcohol, polyethylene oxide, polyamic acid, hydroxypropyl cellulose and nanoparticles (titanium oxide, zinc oxide, copper, gold, magnesium and silver) have been tested and, so far – have given the best results.

All of the additives mentioned above have improved the filtration effect and have shown an antimicrobial effect but, their use is limited/questionable regarding the potential toxic effect of inhalation of these particles. Therefore, the use of substances of the natural origin, with proven antimicrobial effects has become much more common recently.

Natural sea salt is one of the most popular natural antiseptics. From the first known civilizations, it has been used, due to its antimicrobial properties – for food preservation, as a corrective to fermentation, as an addition to toothpastes and as an antiseptic.

Salt crystals can inactivate microorganisms in a number of ways. The most significant are: their direct effects on growth and mechanical damage of microorganism, its dehydration, osmotic imbalance and changes in pH. Adding salt to microbiological filters can increase their antimicrobial effect.

Unlike previously mentioned substances, inhalation of sea salt micro-particles can only give positive effects on respiratory function. Due to the numerous positive effects of sea salt on the mucous membrane of the respiratory system function, inhalation of sea aerosol, since the ancient times, has been used as one of the treatments of respiratory diseases and a way of protection against respiratory infections.

SALT AND CHECKER MASK WITH ADDITION OF ADRIATIC SALT combines safety and applicability of the classic protective mask with the improvement of the protective antibacterial and protective effect of sea salt on the respiratory system.

By proper application of this protective mask in compliance with other epidemiological measures (physical distance, regular hand hygiene, avoidance of face-touching) can significantly reduce the risk (up to 80%) of SARS-CoV-2 transmission; and, in case of transmission – it can reduce viral load and risk of COVID-19 complications.

Furthermore, this mask protects against harmful chemical and physical factors (air pollution) that could lead to respiratory damage, reduces exposure to allergens and, by inhalation of sea salt micro-particles – it produces a beneficial effect on users’ respiratory system.

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