Effects of face masks on cardiopulmonary performance in a partly double-blinded randomized cross-over study

Abstract

Background: The use of face masks in the public and at work became mandatory as a result of the SARS-CoV-2 pandemic in many countries. Wearing masks under physical work or for a prolonged time may lead to complaints of labored breathing and increased stress. The influence of three types of masks on cardiopulmonary performance was investigated in a randomized cross-over design. Method(s): Forty volunteers (20 women, 19-65 years) underwent bodyplethysmography, spiroergometric and ergometric exercise tests without mask, with a surgical mask, a community mask and a FFP2 mask. Additionally, a 4hour mask wearing period was investigated during regular work (office or laboratory). Cardiopulmonary, physical, capnometric, and blood gas-related parameters were recorded. Result(s): Breathing resistance and work of breathing were increased when wearing a mask. During physical exercise minute ventilation was lower and the breathing cycle time was extended with mask. Wearing a mask caused minimal decreases in blood oxygen partial pressure (pO2) and oxygen saturation (sO2) and an initial slight rise in blood carbon dioxide partial pressure (pCO2) during exercise. All effects were most pronounced with FFP2. Temperature, humidity, and inspiratory CO2 concentration slightly increased behind the mask. No changes in pO2, sO2, and pCO2 were observed during the 4-hour wearing period at work. Conclusion(s): Wearing face masks at rest and under workload changed the breathing pattern in the sense of physiological compensation. Wearing a mask for 4 hours during light work had no effect on blood gases and no adverse effects were observed throughout all testing.