Suitability of Rose Bengal sodium salt staining for visualisation of face mask contamination by living organisms

Kisielinski, Kai; Wojtasik, Barbara

doi:10.3934/environsci.2022015

Cited by 8 publications

(9 citation statements)

References 9 publications

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“…Increased humidity and temperature can increase droplet and aerosol generation, which facilitate liquid penetration through the mask mesh. This not only increases the chance of microorganism (fungal and bacterial pathogens) growth on and in masks [127][128][129] causing increased risk for accumulation of fungal and bacterial pathogens 127,129 including mucormycosis 130 , but also leading to re-breathing of viruses that may be trapped and enriched within the moisturised mask meshwork. Therefore, these conditions within masks are favourable for pathogenic growth and are unfavourable for good/systemic microbiota i.e., individual specific.…”

Section: Physical Burden Of Masks: Humidity and Skin Temperaturementioning

confidence: 99%

WITHDRAWN: Physio-metabolic and clinical consequences of wearing face masks -Systematic review with meta-analysis and comprehensive evaluation

Kisielinski¹,

Hirsch

Wagner

et al. 2022

Preprint

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Background: As face masks are a mandatory public health intervention during the COVID-19 pandemic, adverse effects require substantiated investigation. Methods: A systematic review of 2168 studies yielded 54 publications for synthesis and 37 studies for meta-analysis (on n=8641, m=2482, f=6159, age=34.8±12.5). The median trial duration was only 18 min (IQR=50) for our comprehensive evaluation of mask induced physio-metabolic and clinical outcomes. Results: We found significant effects in both medical masks with a greater impact regarding the N95. These effects included decreased SpO2 (overall SMD=-0.24, 95%CI=-0.38 to -0.11, p=0.0004) and minute ventilation (SMD=-0.72, 95%CI=-0.99 to -0.46, p<0.00001), simultaneously increased blood-CO2 (SMD=+0.64, 95%CI=0.31–0.96, p=0.0001), heart rate (N95: SMD=+0.22, 95%CI=0.03–0.41, p=0.02), systolic blood pressure (surgical: SMD=+0.21, 95%CI=0.03–0.39, p=0.02), skin temperature (overall SMD=+0.80 95%CI 0.23–1.38, p=0.006) and humidity (SMD +2.24, 95%CI=1.32–3.17, p<0.00001). Effects on exertion (overall SMD=+0.9, surgical=+0.63, N95=+1.19), discomfort (SMD=+1.16), dyspnoea (SMD=+1.46), heat (SMD=+0.70) and humidity (SMD=+0.9) were significant in 373 cases with a robust relationship to mask wearing (p<0.006 to p<0.00001). Pooled symptom prevalence was significant in users (n=8128) for: headache (62%, p<0.00001), acne (38%, p<0.00001), skin irritation (36%, p<0.00001), dyspnoea (33%, p<0.00001), heat (26%, p<0.00001), itching (26%, p<0.00001), voice disorder (23%, p<0.03) and dizziness (5%, p=0.01). Discussion: Masks interfered with O2-uptake and CO2-release and compromised respiratory compensation. Though evaluated wearing durations do not represent daily/prolonged use, outcomes independently validate mask-induced exhaustion-syndrome (MIES). MIES can have long-term clinical consequences, especially for vulnerable groups. Conclusion: Face mask side-effects must be assessed (risk-benefit) against the available evidence of their effectiveness against viral transmissions.

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Section: Physical Burden Of Masks: Humidity and Skin Temperaturementioning

confidence: 99%

WITHDRAWN: Physio-metabolic and clinical consequences of wearing face masks -Systematic review with meta-analysis and comprehensive evaluation

Kisielinski¹,

Hirsch

Wagner

et al. 2022

Preprint

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“…In addition, plastics also absorb chemicals from their surroundings [94,104,138] including heavy metals [65] as well as microorganisms [134]. Moreover, a microorganism growth on and in masks is scientifically proven [90,139].…”

Section: Mp and Np Risksmentioning

confidence: 99%

“…We did not address the risks of the inhalable living organisms in our review, although there is also a large body of scientific evidence on this issue, describing the health risk for humans from animate toxins [139,[205][206][207][208][209].…”

Section: Limitationsmentioning

confidence: 99%

Wearing Face Masks as a Potential Source for Inhalation and Oral Uptake of Inanimate Toxins: a Scoping Review

Kisielinski¹,

Hockertz²,

Hirsch³

et al. 2023

Preprint

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From 2020 to 2023 many people around the world were forced to wear masks for large proportions of the day based on mandates and laws. We aimed to study the potential of face masks for the content and release of inanimate toxins. A scoping review of 1003 studies was performed (database search in PubMed/MEDLINE, qualitative and quantitative evaluation). Twenty-four studies were included (experimental time 17 min to 15 days) evaluating content and/or release in 631 masks (273 surgical, 228 textile and 130 N95 masks). Most studies (63%) showed alarming results with high micro- and nanoplastics (MPs and NPs) release and exceedances could also be evidenced for volatile organic compounds (VOCs), xylene, acrolein, per-/polyfluoroalkyl substances (PFAS), phthalates (including di(2-ethylhexyl)-phthalate, DEHP) and for Pb, Cd, Co, Cu, Sb and TiO2. Of course, masks filter bacteria, dirt and plastic particles and fibers from the air we breathe and have specific indications, but according to our data they also carry risks. Depending on the application, a risk-benefit analysis is necessary. However, mask mandates during the SARS-CoV-2 pandemic have been generating an additional source of potentially harmful exposition to toxins at population level with almost zero distance to the airways.

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“…Staining with Rose Bengal sodium salt was used to detect contamination of masks, as described previously [46]. Figure 1 illustrates the area of the mask analysed.…”

Section: Rose Bengal Staining and Visualisation Of Contaminationmentioning

confidence: 99%

“…A further concern, not encompassed within MIES, relates to the potential adverse microbiological consequences of wearing face masks. Owing to the creation of a warm, moist micro-environment [39][40][41][42], bacteria, fungi and even viruses may accumulate on both sides of the worn masks [43][44][45][46][47]. So far, these aspects have not been evaluated in depth.…”

Section: Introductionmentioning

confidence: 99%

The Bacterial Burden of Worn Face Masks – Observational Research and Literature Review

Kisielinski,

Wojtasik,

Zalewska

et al. 2023

Preprint

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We investigated and quantified bacterial accumulation in facemasks used by the general population, using 16S rRNA (Sanger Sequencing), culture and biochemical analysis along with Rose Bengal staining. Additionally, a systematic overview of the literature on face mask contamination was undertaken. We found an average bacterial load of 4.24 × 104 CFU recovered/mask, with a maximum load of 2.85 × 105 CFU. This maximum is 310 times higher than the limit value for contamination of ventilation system outlet surfaces specified by the German standard VDI 6022. Biochemical and molecular identification predominantly found Staphylococcus species (80%), including Staphylococcus aureus, along with endospore-forming Bacillus spp. Literature reports also indicate contamination of masks by bacterial and fungal opportunists of the genera Acinetobacter, Aspergillus, Alternaria, Bacillus, Cadosporium, Candida, Escherichia, Enterobacter, Enterococcus, Klebsiella (including K. pneumoniae), Micrococcus, Microsporum, Mucor, Pseudomonas, Staphylococcus and Streptococcus. Bacterial counts increase linearly with wearing duration, and prolonged use may affect the skin and respiratory microbiomes, promoting consequential eye, skin, oral and airway conditions. These aspects underscore the urgent need for further research and a risk-benefit analysis in respect of mask use, particularly given their unproven efficacy in disrupting the transmission of respiratory viruses and their adverse social consequences.

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Suitability of Rose Bengal sodium salt staining for visualisation of face mask contamination by living organisms

Cited by 8 publications

References 9 publications

WITHDRAWN: Physio-metabolic and clinical consequences of wearing face masks -Systematic review with meta-analysis and comprehensive evaluation

WITHDRAWN: Physio-metabolic and clinical consequences of wearing face masks -Systematic review with meta-analysis and comprehensive evaluation

Wearing Face Masks as a Potential Source for Inhalation and Oral Uptake of Inanimate Toxins: a Scoping Review

The Bacterial Burden of Worn Face Masks – Observational Research and Literature Review

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