Quantifying Respiratory Airborne Particle Dispersion Control Through Improvised Reusable Masks

Objective: To determine the effectiveness of non-medical grade washable masks or face coverings in controlling airborne dispersion from exhalation (both droplet and aerosol), and to aid in establishing public health strategies on the wearing of masks to reduce COVID-19 transmission. Design: This comparative effectiveness study using an exhalation simulator to conduct 94 experiment runs with combinations of 8 different fabrics, 5 mask designs, and airflows for both talking and coughing. Setting: Non-airtight fume hood and multiple laser scattering particle sensors. Participants: No human participants. Exposure: 10% NaCl nebulized solution delivered by an exhalation simulator through various masks and fabrics with exhalation airflows representative of "coughing" and "talking or singing." Main Outcomes and Measures: The primary outcome was reduction in aerosol dispersion velocity, quantity of particles, and change in dispersion direction. Measurements used in this study included peak expiratory flow (PEF), aerosol velocity, concentration area under curve (AUC), and two novel metrics of expiratory flow dispersion factor (EDF) and filtration efficiency indicator (FEI). Results: Three-way multivariate analysis of variance establishes that factors of fabric, mask design, and exhalation breath level have a statistically significant effect on changing direction, reducing velocity or concentration (Fabric: P = < .001, Wilks' {Lambda} = .000; Mask design: P = < .001, Wilks' {Lambda} = .000; Breath level: P = < .001, Wilks' {Lambda} = .004). There were also statistically significant interaction effects between combinations of all primary factors. Conclusions and Relevance: The application of facial coverings or masks can significantly reduce the airborne dispersion of aerosolized particles from exhalation. The results show that wearing of non-medical grade washable masks or face coverings can help increase the effectiveness of non-pharmaceutical interventions (NPI) especially where infectious contaminants may exist in shared air spaces. However, the effectiveness varies greatly between the specific fabrics and mask designs used.