If there's a pandemic type emergency where face masks are necessary, a supply of disposable masks could be quickly depleted. I know that N95 or better would be preferred, but may not be necessary for all situations.

From what I've gleaned, masks are actually more helpful for those who are sick to prevent the spread of disease, but there is some protection for those not sick. And it would be better than a simple handkerchief.

Years ago, fabric masks were used in the medical world. My thinking is that a white mask with several layers of fabric which provides pretty good protection could be washed in bleach to allow reuse. In a long term situation, reuse of supplies is critical.

Does anyone have a pattern, web link, or some pictures of these old style masks from which to fashion a mask? Any recommendations for the type of fabric(s) which could/should be used?

Thanks.

Tirec

I would think that sewing a mask would be pretty simple. Pretty self explanatory. A rectangular face piece with or without darts for fitting and four tails of either sewn straps or woven cotton tape. The thickness or number of layers of the face piece could be varied according to the material used, degree of filtration desired and an acceptable level of resistance to the breath. Antibacterial treated cloth may be an option.

Plugging the terms: "sewing pattern surgical mask" into Google got me a few useful results. The most promising of these:

http://www.bevscountrycottage.com/hospital.html

http://www.lds.org/ldsfoundation/multimedia/files/pdf/51241_surgicalmask_pdf.pdf

I'm sure that a crucial point with any mask is the fit. If the harmful stuff can still be inhaled/ingested due to poor fit, the mask's material is irrelevant.

Correct, fit is essential, otherwise the germs come in with whatever you breath. I'll admit to being at the extreme, but a $110 3M Series 6000 whole facemask / respirator makes some sense for me in the event of a pandemic.

- one, my dad is in assisted living, a very high risk population. I can visit and hope to remain unexposed, assist with his care if necessary, as long as I take precautions.
- two, same for community volunteers who opt to help with care and body disposal as the pandemic works its way through the population. I am not certain that I will volunteer for this (assuming I'm not struck down by the flu right off), I haven't made up my mind. Under normal circumstances my city might give a volunteer a facemask respirator, or have me share one with another worker, while we're working. Or, they might be under-prepared and ask us to wear a half-mask, or N95, which may not provide adequate protection.
- three, going in to work puts me in an environment with lots of recirculated air, no way would I stay there any longer than is necessary. I can work remotely.
- four, in the event a family member gets sick I can work with a whole facemask and minimize my exposure still.

I'm seriously thinking of additional masks for my wife and immediate family - 'just in case.' My wife thinks I'm nuts, my brother in law the doctor thinks its not a bad idea. We agree though, I'm just as likely to come down with the flu early in any pandemic as not, someone else might use my mask - but the precautions and barriers you have if you are not infected will make a big difference. Odds are good our kids will get sick and get us sick. Life's a crapshoot.

$110 or so for a facemask, another $30 for enough N95 particulate filters to last through a pandemic (estimated at 2 12 week episodes), plus a heavy supply of alcohol based wipes to clean the mask between uses (also essential). I think $10 for the attachment for my prescription lenses. When I costed out an equivalent number of disposable N95 masks, the facemask was only a little bit more expensive for the duration of an expected pandemic. I think OSHA did a study of this as well.

But make sure it fits, try it on with the help of someone who knows what they're doing, and wear the mask around during expected work for a while to ensure a proper fit and the fact you can tolerate it for the expected timeframe.

Being able to actually use a mask is something that many don't consider beforehand, so I wholeheartedly agree that it should be tried out to make sure that it will be tolerable. Restricted breathing, restricted field of view and perspiration/fogging are potential problems when wearing full face masks.

I spent a lot of time working with patients who had hideously transmissible diseases or were at risk of getting hideously transmissible diseases, so I spent a lot of time in various types of personal protective equipment. Surgical masks are designed to keep stuff from flying out of your facial orifices and falling into the incision. Fabric or fiber masks seem to work fine for this application, and are also the usual choice for reverse isolation in non-surgical settings. Avoiding exposure to incoming infectious material requires more technology; N95 masks keep 95% of particulates out of your respiratory passages without being real tough to inspire through. tho I can't wear one if I am doing any active stuff, cause they don't let the air in and out fast enough. The best portable solution I have used was a tyvek hood with a battery powered hepa filtered fan (PAPR (powered air purifying respirator) that pushed filtered air into the hood-no fit issues, less claustrophobia, and plenty of air exchange. Spendy, though. But any of the lung-powered filtration units will place significant restriction on air movement, and will tire the user out pretty fast. The other issue is eye protection-the hood solves the problem, as doe the full face mask-but, since the eyes are not moving air in amd out like the respiratory bits, goggles provide significant protection, too. And all of it, and the wearer, need to be decontaminated before removal of the protective equipment.

Roger on that - the PAPR hoods are pretty spendy, outside my reach. I've spent some drill time during S&R, moving heavy stuff to simulate digging in rubble, the N95 mask with an exhalation valve helps alot over an N95 without one, but it really does wear you down to breath exclusively through them. And I found that eventually the N95 tends to collapse on the sides, allowing air to infiltrate (this was when I tested masks while chainsawing, after 2 hours the N95 was pretty collapsed, and so was I). I also have a half-face mask and combine that with closed goggles when I paint or sand, my glasses steam so bad though its not very conducive to working very much, only the cheaper type of goggles that look like glasses themselves and fit over the top of my glasses really work. I'll take my chances with the full face mask, and try to keep my exertions down, and stay within my limitations.

They are pretty much a must have in much of Asia for cultural reasons during flu season. ESPECIALLY in Japan. If you look at a crowd scene in any of their major cities in the winter and spring and you'll see a couple people using them.

But I don't know if their rate of transmission is any better than ours.

I think your drifting into all-or-nothing thinking. No filter system is absolutely perfect, ever. And attaching any filter onto a human only makes things worse. It is pretty well understood full-face gas masks and hoods have a certain percentage failure because the wearer fails to get it on correctly. And even when all procedures are followed human skin isn't an ideal material to seal to. As the person moves small leaks are pretty much inevitable.

What gets lost is that in most cases absolute perfection, while desirable, is not necessary. We are often surrounded by toxins and infectious agents. But the body is not entirely defenseless. A single bacteria has little chance of survival on its own. It is pretty much a sure thing that everyone has some exposure to infectious agents if they are present at all. Only a few of those exposed, those who get exposed to large populations, typically millions in a droplet that can give the infective agent a localized quorum within the body, suffer. As with anything else dose is critical.

The same is true of chemical agents. Protective equipment doesn't entirely eliminate the agent. It just keep the exposure to an acceptable minimum. In this even a simple filter mask shifts the percentages in your favor.

Don't think that just because you can't obtain some idealized protective system that it does no good to use a simpler system. A simple cloth mask has an effect. Don't fail to take advantage of what you have on hand and what you can get now because it isn't as good as what you would like to have.

Thanks for the links, replies and comments.

It sounds like for most situations, anything which restricts bad particles from reaching the respiratory system is certainly better than nothing, and the better the fit, the more that's inhibited. It's critical for the sick to at least try to prevent the spread of disease from the mouth & nose by wearing a mask.

I think I'll try adding a wire of band of some type to the top of the pad to get a better fit over the bridge of the nose, similar to many of the partial face masks with the tab over the nose.

THANKS!

Tirec.

Below is an article from the healthcare industry http://findarticles.com/p/articles/mi_m0FSL/is_1_74/ai_76653447
on cloth face masks, for your information. Personally, I would think that something cloth would be better than nothing, but...

Sue



Question: Some people ore starting to wear homemade cloth masks in the OR. The same masks are worn all day. Is this acceptable? What argument can be made against this practice?

Answer: Homemade cloth masks are unacceptable. Although early masks were made of muslin or linen, they only redirected exhaled air away from the surgical wound. Cloth surgical masks were replaced in the early 1960s with synthetic materials that also provide bacterial filtration.(3)

Wearing masks is recommended for two reasons. First, they contain and filter microorganism droplets that are expelled from the mouth and nasopharynx during talking, sneezing, and coughing. Second, they protect the wearer from exposure to infectious materials and other respiratory hazards, such as electrosurgical and laser smoke.(4) Fluid-resistant surgical masks are considered personal protective equipment (PPE), and the Occupational Safety and Health Administration requires health care workers exposed to blood and other body fluids to wear them. To be considered appropriate, PPE must

not permit blood or other potentially infectious materials to pass through
to or reach the employee's work clothes, street clothes, undergarments,
skin, eyes, mouth, or other mucous membranes under normal conditions of use
and for the duration of time which the protective equipment will be
used.(5)

Surgical masks should filter at least 0.3 [Mu] of bacteria for regular use and 0.1 [Mu] for laser use, or they should provide 90% to 95% bacterial filtration efficiency.(6) Masks must be changed between uses and whenever they become moist. Masks should not be reused throughout the day or saved by hanging them around the neck or tucking them into a pocket for future use.(7) The filter portion of the mask harbors bacteria collected from the nasopharyngeal airway, and care must be taken when removing the mask to avoid contamination of the hands.

It is extremely unlikely that an individual would have an adequate supply of freshly laundered--not home laundered--reusable masks to be able to change as frequently as recommended. Although there may be reusable materials that could meet fluid resistance and filtration criteria, it is extremely unlikely that a suitable reusable cloth material could be found, tested by an individual according to US Food and Drug Administration (FDA) guidelines, and manufactured on a home sewing machine according to industry specifications. Surgical masks are an FDA class II medical device that require special controls and are subject to premarket notification procedures (ie, 510k guidelines).(8)

Thank you, Susan. I wouldn't intend to use this for surgical situations. Looking for something reusable to add a degree of protection for the wearer from the contagious, and to reduce the spread of disease by the contagious.


I found a few more interesting links.
http://answers.google.com/answers/threadview?id=438480
one suggestion is to use anti-microbial t-shirt fabric, such as Microban.


Now this is interesting from the CDC
http://www.cdc.gov/ncidod/dvrd/spb/mnpages/vhfmanual/section4.htm

Mask: Masks protect the health care worker's face from contact with blood or droplets of infectious body fluids. Use masks that cover the mouth and nose. Use a HEPA-filter or other biosafety mask, a surgical mask, or a cotton mask made locally.

HEPA-filter or biosafety mask:A HEPA-filter mask filters the air to prevent breathing in small particles and harmful microorganisms. It provides protection from airborne transmission of microorganisms.

A HEPA-filter or biosafety mask is lightweight and easy to use. It can be reused by the same health care worker as long as it continues to fit comfortably and the mask does not become contaminated, crushed, or splattered with body fluids.

Do not touch the mask after it has been put on. The mask may become contaminated once it is touched. To avoid the necessity for touching the mask, make sure it fits comfortably before entering the patient's room.

When handling a reused mask, hold it by the strings. Be careful that the outside surface does not touch the health care worker's face.

Surgical mask:
If HEPA-filter or
other biosafety masks are not available, use surgical masks. Surgical masks will not filter out small particles, but they will protect the health care worker from droplets or splashing of body fluids.

A surgical mask can be reused by the same health care worker as long as it is not contaminated and not obviously dirty and torn.

Cotton mask: If surgical masks are not available, use cotton masks made from four or five layers of cotton cloth sewn together.

Use a different colour for each side of the mask. This will help health care workers quickly identify which side should be worn inside.

The mask should have ties that are long enough to reach behind the head.


Cotton masks will not provide protection from breathing in particles, but they will provide protection against splashes and other droplet contact with infectious body fluids. A cotton mask can be reused by the same health care worker as long as it is not contaminated and not obviously dirty and torn.

I wouldn't try too hard. Any homemade mask is not going to be very good at filtration. Making the edges as tight as possible will probably have negligible benefit.

Most likely, a pandemic disease will be transmitted in the usual person-to-person method or by droplet spray due to coughing/sneezing. In either case, you don't need a super high filtration to provide some benefit. As long as it helps keep you from touching your mouth/nose with contaminated hands or if it can trap those "big" droplets from sneezes/coughs, a homemade mask can help.

But, there are still likely going to be a small percentage of cases where the virus was truly aerosolized and airborne, in which case, no homemade mask will be efficient enough to trap such tiny particles. And if the next pandemic illness is primarily airborne, no homemade mask will protect a healthy person very well because the virus will pass through the fabric.

Of course, I'm talking about Joe Average here regarding the use of homemade masks. I'm NOT talking about the healthcare setting, where there are lots of protocols and PPE requirements already spelled out, plus a much higher exposure to acutely sick patients than out in the general population.

Here is a photo of a typical mask: http://www.lakewoodconferences.com/catal...isposables.html

You'll notice that there are two pleats on each side. They are about 6.75" square (with hems -- they probably start out about 7.75" square), and end up being about 6.75" x 3.5" with the pleats.

A tightly-woven plain cotton muslin would probably do, but remember to pre-shrink the fabric in a hot soapy wash before you cut the pieces to size. Muslin usually comes in two basic colors, beige and white; if you made each mask of at least two layers, making the inside (to the face) white would clearly designate which is which.

The ties could be just lengths of bias tape, stitched along the open edge, made long enough so you can tie a bow.

Sue

I can think of one benefit that a mask, ANY mask, would have in a pandemic situation: It would help remind you not to touch your mouth and nose with your hands. Add a pair of glasses (safety, prescription or sun) and you've improved your chances significantly.

I agree with you on that one.