Mask vs Respirator: Key Differences Explained

It’s time to rethink and upgrade masks for you and your family.

respiratorOften incorrectly called “masks” because of their appearance, personal protective equipment is made to a particular standard and designed to prevent inhaling hazardous airborne contaminants.

In the US, respiratory standards are managed by the National Institute for Occupational Safety and Health (NIOSH), and include three things: filter efficiency, breathing resistance, and fit.

A filter that meets the N95 standard (Europe’s equivalent of FFP2) must capture at least 95 percent of the particles in the most penetrating size range at high flow rates. In Australia, a respirator must meet TGA standards.

A respirator that consists entirely of filtering material—instead of layers, say for waterproofing—is called a filtering facepiece respirator (FFR). An FFR can be worn multiple times but should eventually be thrown away.

Research shows that FFRs lose their ability to fit well after 20 wears – due to stretching of the straps or failure of the nose clip or sidewall components.

The filter material is typically a non-woven polypropylene electret, which means that the fibers carry an electric charge to increase particulate collection while ensuring low breathing resistance.

It was initially believed that SARS-CoV-2 spread through droplets (in coughs and sneezes), which caused infection when it landed on the mouth, nose or eyes.

For such particles, a cloth or surgical mask is an efficient form of source control to protect others from the virus emitted by the wearer.

It is now understood that the virus is in the air. Over time, virus-laden particles accumulate in the air due to breathing and speaking.

It depends on the type of exposure you are having and for how long you are exposed. It’s important to consider your risk based on where you are, what you’re doing, who you’ve been with, and for how long.

Safest position, especially for prolonged exposure in crowded settings, when everyone is wearing a well-fitting N95 respirator.

It is hard to show evidence to support the use of respirators in the community – but the lack of randomized controlled trials (RCTs) does not mean they are not effective.

Studying masks or respirators at the population level is complex and involves many variables.

There is strong evidence from RCTs in healthcare workers and laboratory studies showing that respirators are effective for source control and personal protection.

Maybe not. Fabric masks are not made to any particular standard, so their quality and quality vary greatly.

In general, they are poor filters of small airborne particles.

Not necessary. While some surgical masks may have better filtration efficiency than cloth masks, they were primarily designed to prevent the emission of larger droplets. Some medical-grade surgical masks may also provide protection against splashes or sprays of body fluids. However, no surgical mask will prevent the excretion or inhalation of small infectious particles.

A major drawback of surgical and cloth masks is their slackness compared to respirators.

While some older, hard-cup style respirators can be uncomfortable, newer styles are better tolerated. This may be due to their large surface area, which may contribute to the low breathing resistance.

No. When respirators are used to protect workers from airborne hazards such as dust or pollution, employers are legally required to perform a fit-test (see for example the US Occupational Safety and Health Administration fit-testing standard ). But even non-fit tested respirators will provide better protection over clothing or surgical masks.

A respirator should rest on your face without gaps, especially around the nose and chin. To create a tight seal, make a nose clip and place both straps around your head, adjusting them if necessary.

If the facepiece sags slightly when you inhale, the respirator is probably well fitted. Get in the habit of doing a “self seal-check” before each wear.

No. At the start of the pandemic, the public was discouraged from purchasing respirators due to a global shortage of personal protective equipment and the belief that healthcare workers were at high risk of catching COVID from so-called “aerosol-generating procedures” such as intubation.

We now know that everyday activities such as talking and singing are more likely to generate infectious aerosols than medical procedures.

Like vaccines, there are global equity issues and we need to expand manufacturing capacity to ensure adequate supplies for all.

Compared to cloth masks, respirators (which are not washable) cost more and have a greater environmental impact.

But disposable respirators can be used for extended periods if they are not wet or damaged, and there are reusable alternatives such as elastometric respirators. A respirator should be thrown away when it becomes dirty or if bandages, nose clips or other components lose their integrity.

Cost and environmental concerns need to be weighed against the cost and waste produced by a single COVID hospital admission. In Australia, the average daily cost of living in an intensive care unit is estimated at US$4375.

The Korean KF94 and Chinese KN95 are cheaper alternatives that offer better protection than surgical or cloth masks. Beware of counterfeits, such as those without a GN stamp to show that they meet manufacturing standards.

If you can’t get hold of a respirator, you can improve the safety of a surgical or cloth mask.

Options include “double masking” by wearing a tight-fitting cloth mask over the surgical mask. You can also “knot and tuck” the surgical mask by tying the edges and tucking the remainder in.

Lastly, a well designed cloth mask (with three layers) can perform as well as a good quality surgical mask.

It is still true that something is better than nothing.

But don’t rely on this type of mask to provide the same level of protection for the same amount of time as an N95 respirator.

The World Health Organization has stressed the importance of a “vaccine-plus” approach.

There is a strong case, when the spread of COVID is high, for governments to both provision and fund respirators for the public, as some parts of the US are doing now.

This story has been published without modification in text from a wire agency feed. Only the title has been changed.