Prolonged facemask use in the heat worsens dyspnea without compromising motor-cognitive performance

Abstract

Background: Within the context of the COVID-19 pandemic, the WHO endorses facemask use to limit aerosol-spreading of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, concerns have been raised regarding facemask-associated dyspnea, thermal distress and self-reported impairment of cognition. Accordingly, we tested how facemask-use affects motor-cognitive performances of relevance for occupational safety. We hypothesized that mask use would affect cognitively dominated performances and thermal discomfort, but not alter whole-body thermal balance. Methods: Eight participants completed a facemask and a barefaced (control) trial, in a counterbalanced order, in 40°C and 20% humidity conditions. Motor-cognitive performance, physiological (rectal, mean skin and local facial temperatures) and perceptual (thermal comfort and dyspnea) measures were assessed at baseline and following 45 min of light work (100 W). Results: Perceived dyspnea was aggravated with prolonged facemask use (p = 0.04), resulting in 36% greater breathlessness compared to control. However, no other differences were observed in motor-cognitive performance, physiological strain, or thermal discomfort. Conclusions: Contradicting negative self-reported impacts of facemask-use, only dyspnea was aggravated in the present study, thereby reinforcing global recommendations of mask use, even in hot environments. (Funded by: European Union's Horizon 2020 research and innovation program under the grant agreement No 668786).

Effect of a Warm-Up Protocol with and without Facemask-Use against COVID-19 on Cognitive Function: A Pilot, Randomized Counterbalanced, Cross-Sectional Study

“…The findings of the present investigation, in corroborating the confutation of the hypercapnic hypoxia hypothesis, complement and add to the works of previous authors [ 15 , 29 , 30 ]. For instance, Morris et al [ 29 ] studied the effects of prolonged facemask-use during 45 min of light exercise on motor-cognitive performances, in a sample of 8 participants. The authors showed that motor-cognitive performance did not differ between prolonged facemask-use and the control condition.…”

Surgical masks do not increase the risk of heat stroke during mild exercise in hot and humid environment

“…We did not assess the influence of the time length or work intensity of exercise, which may affect physiological and psychological responses. Recently, Morris et al 39 ) showed that prolonged facemask use induced dyspnea without affecting moto-cognitive performance. Thus, the time length may be another factor affecting some psychological responses.…”

The effect of the protective face mask on cardiorespiratory response during aerobic exercise

“…The facemasks are one of the most important measures to prevent COVID‐19 transmission, along with eye protection and social distancing 4 . Despite being key to the safety of the population in general, previous studies have suggested that protective face masks (PFM) may worsen exercise tolerance 5–9 …”

“…It has been demonstrated that wearing a PFM during aerobic exercise increases breathing resistance, decreases arterial oxygen saturation, and could lead to respiratory discomfort 5,10,12–14 . Additionally, the use of the PFM also causes an increase in both air temperature and humidity inside the face mask, which affects the subjective perception of breathing difficulty 7,15 . Furthermore, recent studies showed differences in cardiovascular response wearing PFM during endurance exercise 5,13,16 .…”