Face Masks for Patients May Leak, Spread Germs

Health-care workers should take precautions, especially given H1N1 pandemic, experts say

By Steven Reinberg
HealthDay Reporter

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FRIDAY, Oct. 9 (HealthDay News) -- Health-care workers, take note: Hospital patients using positive pressure ventilation masks to help them breathe may be spreading germs every time they exhale, a new study finds.

The masks can leak exhaled air up to one meter from patients receiving treatments, spreading contagious respiratory illness within a hospital, researchers say. This may be of particular concern if the patient has the highly contagious H1N1 swine flu.

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"Health-care workers should take adequate respiratory precautions -- wearing N95 masks and personal protective equipment -- when providing noninvasive ventilatory support to patients with pneumonia of unknown etiology complicated by respiratory failure, including patients with pandemic H1N1 influenza," said lead researcher Dr. David S. Hui, from the department of medicine and therapeutics at the Chinese University of Hong Kong.

The report is published in the October issue of Chest.

For the study, Hui's team measured air leakage from two commonly used positive pressure ventilation masks, the Respironics ComfortFull 2 mask and the Image3 mask. The test was done on a patient simulator, which mimicked a patient with lung injury.

These masks fit over the patient's nose and mouth and provide a continuous flow of air at a steady pressure to help the patient breathe. They are used for patients with heart failure, chronic obstructive pulmonary disease (COPD), asthma and sleep apnea in addition to pneumonia.

With both models and using negative pressure, the researchers found substantial exposure to exhaled air occurs within one meter of patients receiving non-invasive ventilation in an isolation room. But far more leakage and room contamination occurred from the Image 3 mask, especially at higher pressures, Hui said.

Hui said the study results argue for avoiding the use of high pressure, which will lead to more exhaled air dispersion, and "exhalation devices, which will lead to widespread exhaled air dispersion."

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