Is N95 face mask linked to dizziness and headache?

Area of Science:

• Occupational Health
• Respiratory Physiology
• Infectious Disease Control

Background:

• Personal Protective Equipment (PPE), specifically N95 filtering facepiece respirators (FFR), are crucial for healthcare workers during pandemics like COVID-19.
• Reported side effects of N95 FFR use include headaches and dizziness, necessitating investigation into their underlying causes.

Purpose of the Study:

• To determine the physiological basis for adverse symptoms experienced by healthcare workers using N95 masks.
• To investigate the association between N95 mask usage and physiological changes, specifically respiratory alkalosis and hypocapnia.

Main Methods:

• A comparative study involving 34 healthcare workers over 18 years of age.
• Participants wore surgical masks for 1-4 hours on one day and N95 masks for a similar duration on another day.
• Post-usage, capillary blood gas analysis and a questionnaire were administered to assess physiological changes and symptoms.

Main Results:

• N95 mask use was associated with significant changes in blood gas analysis, including increased pH (7.48 vs 7.43) and decreased pCO2 (28.46 vs 37.33 mmHg), indicating respiratory alkalosis and hypocapnia.
• Participants reported significantly higher incidence of headaches, attention deficits, and difficulty concentrating after wearing N95 masks compared to surgical masks.
• A statistically significant decrease in Base Excess (BE) was observed after N95 mask use (p=0.039).

Conclusions:

• N95 respirator use in healthcare settings can lead to clinically significant respiratory alkalosis and hypocapnia.
• The physiological changes of respiratory alkalosis and hypocapnia are quantitatively demonstrated to be the cause of symptoms such as headache and cognitive impairment.
• Findings underscore the physiological impact of prolonged N95 mask use and suggest a need for strategies to mitigate these effects in healthcare professionals.