Fluid-repellent surgical mask (FRSM) fit - one size does not fit all

Fluid-repellent surgical masks (FRSMs) are recommended by the UK government for healthcare workers as personal protective equipment (PPE) against SARS-COV-2. UK Infection Prevention and Control (IPC) national guidelines states that 'masks must be well-fitting and fit for purpose, fully covering the mouth and nose'.

To review the fit of the FRSM supplied to the NHS front line workers against the national IPC guidelines and, through re-audit, assess for improvements in fit with FRSM worn with a plastic strap (intervention A) and FFP3 mask (intervention B).

A three-part closed-loop audit was carried out comprising controlled observation, observation in the clinical area and questionnaire. Re-audit was carried out following interventions A and B.

FRSMs slipped below the nose in 43% and below the mouth of 10% of participants during the controlled observation and below the nose (above or below the mouth) in 30% of staff in the clinical area. No masks slipped below the nose or mouth with intervention A or B. 86% of participants reported touching the FRSM to keep it in the correct position and 66% reported touching the FFP3.

The current supply of FRSMs are poorly fitting for many users and do not meet the UK IPC guideline standard. These issues were not evident when worn with a plastic strap or with FFP3 masks.