THINK of face masks as the latest trending accessory that can save your life and the lives of your loved ones.

So, instead of going for a mask with fancy patterns, settle for one that provides good protection against the Covid-19 virus no matter what environment you are in.

Medical experts say that it is important to ensure that the masks we put on are effective against the Covid-19 virus, especially given the rise of increasingly contagious Covid-19 variants, like the latest Delta variant which can infect someone in just 15 seconds.

Associate Prof Dr Mogana Sundari Rajagopal, dean of the Faculty of Pharmaceutical Sciences at USCI University, said various types of face masks are available in the market, which include fabric masks that are reusable, and surgical or medical masks.

“Each country has its own certification standard for each mask type. For example, Europe uses the EN 14683 or ASTM F2100 standard for medical or surgical masks, whereas China uses the YY 0469 standard.

“Although the standards vary a little in each country, they are, however, broadly similar. For respirator masks, China uses the KN standard (for example, KN95) and the US uses the N standard (for example, N95),” she told Bernama.

To avoid purchasing counterfeit masks, there are certain ways to identify the quality of a medical or surgical face mask, said Dr Mogana, adding that masks carrying the American Society for Testing and Materials (ASTM) or European Standard (EN) rating meet international standards and requirements.
 
International requirements
The ASTM rating is a standard to review the quality of medical masks. There are three classifications, with level 3 being the standard applicable to manufacturers of face masks.

“However, certain mask manufacturers follow the European Standard which is EN14683 and categorise their masks as Type I, II and Type IIR,” she said.

She said consumers can look for face masks with the ASTM Level 1, 2 or 3 rating. However, not all face masks are ASTM-rated.

“It is worth the effort to find face masks that do carry the ASTM rating and to be sure you’re getting the proper level of protection,” she said.

She said people often confuse N95 masks with medical-grade face masks such as surgical face masks. The N95 or KN95 masks are categorised as respirators.

She said according to the United States Centers for Disease Control and Prevention (CDC), at least 60% of the KN95 masks evaluated by the National Institute for Occupational Safety and Health (an agency under the CDC) did not meet the requirements.

“A majority of the KN95 or N95 masks in the market, which are prioritised for healthcare workers, are fake,” she said.

She added that for adequate protection against the Covid-19 virus, which is about 0.1 micron in size, a medical or surgical face mask with the EN Type IIR or ASTM Level 3 rating with good filtration is highly recommended.
 
Counterfeit masks
To choose the right face mask with adequate protection against Covid-19, Dr Mogana recommended using masks manufactured by companies that hold a Medical Device Quality Management System ISO 13485:2016 certificate.

She said all medical or surgical face mask manufacturers in Malaysia are required to hold an ISO 13485 certification and be registered under the Medical Device Authority (MDA).

“The MDA helps to monitor the role of the medical device manufacturer and all these manufacturers have to register their establishments along with their products.

“The public must ensure the face masks are regulated under the international standard such as EN or ASTM by authorised bodies such as Sirim Berhad, SGS Malaysia and many others.

“Unfortunately, many manufacturers and distributors are not registered and are selling face masks that are not properly regulated,” she added.

Dr Mogana further said that the US NIOSH-approved respirators should have an approval marking beginning with TC - XXX- XXXX. 

“The public can also notice the signs of a counterfeit mask – there will be no NIOSH logo for the respirator, sketchy (information on the) retailer and the price is too good to be true.

“In fact, NIOSH doesn’t approve any mask for children, hence any statement claiming that the respirator is approved for children is fake,” she said.

Double masking
Lately, health experts have recommended double masking as a measure to curb the transmission of the Covid-19 virus. 
Double masking means wearing a fabric mask on top of a medical-grade mask which, according to experts, can help to filter more particles than a single mask.

Associate Prof Dr Kyu Kyu Win, a microbiology lecturer at the Faculty of Medicine and Health Sciences at USCI University, said the combination of a fabric mask and surgical mask is a better fit and is a bettter filtration mechanism against virus particles.

“Wear one disposable medical or surgical face mask underneath and a cloth mask on top to have a better fit and extra protection. The cloth mask can also be combined with a fitter or brace.

“Knot and tuck ear loops of a three-ply face mask where they join the edge of the mask, fold and tuck the unneeded material under the edges.

“However, the surgical or medical mask should not be layered with the same type of mask as this combination doesn’t improve fit, while the N95 mask is meant to be used alone,” she said, adding that surgical face masks should be changed every four hours, as per the recommendation from the World Health Organisation.

Surgical and medical masks for daily use
Meanwhile, Dr Hean Ooi, who is vice director of the International Centre at China Medical University Hospital, said that the efficacy of masks is based on their bacterial filtration efficiency (for bacteria more than three microns in size) and particle filtration efficiency (for less than 0.1-micron particles).

“Covid-19 is commonly spread by droplets and the size of the virus is about 0.1 micron,” he said, adding that surgical mask standards have higher requirements and are meant to filter out more than 98% of virus-sized (0.1 microns) particles.

“For respirators such as the N95 and KN95, use multiple layers of synthetic material to protect yourself from outside particles.

“As their names suggest, both must filter out 95% of particles that are 0.3 microns in size or larger,” he said.

Dr Ooi advised the public to look for a medical or surgical face mask that complies with the EN or ASTM standard.

“Plus, a good face mask should be constructed with three layers unlike those cheap face masks which have only one layer,” he said.

He said a respirator such as the N95 and KN95 or KF94 is not encouraged for daily use as it can cause breathing difficulties if worn for up to eight hours a day.

“For the public, the CDC and WHO recommend that they wear a medical or surgical face mask in order to protect themselves and other people.

“Thus, for daily use purpose, wearing a surgical or medical face mask is sufficient and it can protect people from the current pandemic,” he added. – Bernama, August 18, 2021.