Masks are Mandatory – User comfort is the challenge.
The 2020-2022 pandemic of the human-to-human transmission of another or multiple “airborne” viruses or diseases and requirements of personal and occupational Personal Protection Equipment (PPE) face masks to contribute to slowing or preventing the transmission and infection rates has transformed into a billowing conversation with proposed mandates or mandatory use. The human factors and “User Comfort” or the “User-Product” interface of wearing a temporary respirator mask is welcomed by some but long term use can only be tolerated by others. The Industrial Design problem statement is the game has changed to full time or extended use and better Human Factor product design PPE solutions are now even more important.
Airborne transmitters. Occupational and Public Safety environments have long addressed dealing with the microbe size aerosolized respiratory infections of flu virus or TB. The transmitters are the virus bacilli ranging in size from less than 1 millionth of a meter or 0.5 to 0.4 microns. The very, very small viral droplets can become aerosolized bacilli of the virus are breathed, spoken, sneezed or coughed or projected and blown into the air up to 10-15 feet or 3-5 meters. The tiny droplets also attach to airborne particulate dust floating in the air carrying the virus through the room or building heat and air conditioning ventilation systems. The infected cloud remaining airborne or landing on any surface blown with the room air currents. One infected person only needs to speak, sneeze, or cough and the transmitter floats through the building to the next host.
The global event has evolved into far reaching safety and human protection practices including the general public (schools, malls, restaurants, large building complexes) and healthcare environments from the evolving mutations of viruses with the distinction of microscopic airborne or floating in the air transmission. Our Industrial Designer response to the transmission of Tuberculosis (TB) and COVID-19 (CV-19) and other airborne pathogens and the evolving drug therapy resistant viral mutations is now even more important. The real challenges are managing the personal human factor and health effects of stress with the extended use of respirator masks.
These include the short term and long term effects on personal physical and mental health and the larger social public health and the needed healthcare facilities and service providers. These problems of access to healthcare available hospital patient beds and the precautionary prevention or protection practices of social distancing, mandatory masks and vaccines for a global population 7+ billion or just the United States at an estimated 325 million and or overcrowded emergency wards or long lines of running gasoline engines or standing in cold or hot climate to get a vaccine injection are just a few.
The big picture, in the U.S. personal and worker occupational safety laws with approved protection equipment and containment efforts are headed by the Department of Health and Human Services with the Department of Labor, leading OSHA (Occupational Safety and Health Administration) and the CDC (Centers for Disease Control) and the Insurance industry. OSHA is the government agency in charge of enforcing occupational (business, public and building access laws and safety protocols set by NIOSH (National Institute of Occupational Safety and Health). Associated with the direction of the CDC and the FDA (Food and Drug Administration), the public standards are set by the government then interpreted and laws enforced by your local county and state jurisdiction governments and law enforcement of each state. General public safety recommendations include use of a NIOSH (National Institute of Occupational Safety and Health) N-95 certified PPE and sanitation practices combined with social distancing. The design issue is nationally, state to state, county or district recommendations and mandatory cover your face laws or safety practices and PPE protocol is different leading to confusion or worse. Human Factors considerations need to consider the direct and indirect benefits and physical and psychological side effects of daily and or long term use.
The government medical response has been billions invested into providing masks and ventilators with private company drug research and focus of development into vaccine immunization and therapies and providing essential medical equipment including ventilators and PPE from a hidden to the eye treat of infected air and or contact surfaces. Now more controlled, a wide range of product respiratory protection options has risen. The design issue is state to state, county or district recommendations and mandatory cover your face laws or safety practices and PPE protocol is different leading to confusion or worse. The market response are devices which may not provide adequate airborne transmission protection.
The government is challenged to react as a whole to isolate and or protect the greater health status of its citizens driven by collected data of thousands of hospital patients. Management changes may benefit most but continue to isolate patients and healthcare workers with closed off filtered, air controlled enclosed glass window environments with the health care providers. Offering limited protection from the already infected or human transmitters and the unknown, uncontrolled infected population or rest of the world. The ramifications of the rise in emotional coping skills and social interaction in children and teenagers and the surprising rise in suicide rates are just few measures of the and human factors ramifications of the continued or long term use of personal respirator masks.
Hospitals harbor a list of stressful occupational hazards including psycho/physiological exposure to needle stick, pharmaceutical drugs, chemicals and biohazards including bloodborne pathogens and airborne hazards such as CV-19. Stress is often associated with the responsibility of delivering patient care including exposure to the virus with the gravely ill, the dying and sometimes suicidal patients. Patient isolation and the requirement to wear a mask, depending on the type of respiratory protection device, there are a range of disadvantages to be considered which may add to the obvious stress factors associated with the risk of contracting an airborne disease.
Hospitals harbor a list of stressful occupational hazards including psycho/physiological exposure to needle stick, pharmaceutical drugs, chemicals and biohazards including bloodborne pathogens and airborne hazards such as CV-19. Stress is often associated with the responsibility of delivering patient care including exposure to the virus with the gravely ill, the dying and sometimes suicidal patients. Patient isolation and the requirement to wear a mask, depending on the type of respiratory protection device, there are a range of disadvantages to be considered which may add to the obvious stress factors associated with the risk of contracting an airborne disease.
With OSHA enforced, hospitals are generally required to provide government approved (NIOSH) approved PPE masks with HEPA (High Efficiency Particulate Air) filters. Negative pressure, loose fitting mask versus tight fitting sealed masks offer distinct contrasting levels of protection and comfort. Breathing resistance and increased rebreathing carbon dioxide are major comfort factors. The use of a government approved or simple half face fabric covering is adding limitations of the human to human communication channels or learning including the major sensory perception intake of vision, covering of the mouth, lips – cheeks, facial movement or gestures, and auditory with voice muffling. The emotion stress of mandatory masks is becoming more evident especially among children.
To address the HEPA filter breathing resistance the addition of a passive intake valve or battery powered motor and blower drawing in filtered air or air purifying, loose fitting or tight fitting sealed masks are the next level up on protection. The human factors challenges are the ramifications and infections rates of healthcare patient care provides who use of a respirator over an extended period of time (8-10 hours work shift) and breathing resistance and voluntarily or involuntarily touching the face mask or virus exposed surfaces and level of comfort is evitable as part of any PPE choice.
The market response are approved PPE half-face tight fitting (elastic strap) negative pressure (no power) N-95 devices provide adequate protection excluding paper or textile or fabric loose fitting masks. The medical industry is using waist – belt mounted, battery powered blowers, positive pressure, half or full face mask. Positive pressure meaning the filtered blower air in coming into the mask via a hose so no outside air enters the breathing zone. Negative pressure have issues of internal mask breathing of recirculated air oxygen intake reduction. Sensory factors of the tight elastic band, face contact skin irritation, increased sweating and normal stress factors add on the problem. The short and long term physical and psychological side effects are just coming to light.
Wearing a temporary mask while shopping is one thing but working in a powered motor blower with wind noise and vibration reducing auditory quality based on the full face mask covering with a sealed body suit increasing body temperature and sweat responses. The powered air supply brings in many human condition stressors or factors that make the wearing the PPE or mask overall uncomfortable leading to normal human psychobiological reactions that may lead to reduced ability to perform the job and unknown exposure.
Research is hinting the personal and social isolation and sensitivity of covering the face with the psychologic impact of cutting a significant sensory portion of human to human communication of reading the facial and lip movements is affecting short and long communication and memory capabilities with learning and job performance. The unseen human factors of contributing to feeling of personal isolation including the reduced spoken “muffled ” language auditory recognition has risen as a major problem for children. The physical effects of increased air inhalation pressure meaning the lungs have to work harder and increased exhaled CO2 with reduced a oxygen air intake versus open breathing is producing negative heath results. The design problem is covering the face with harder to breath reduced air oxygen intake and the long term health or medical physical and psychological side effects or personal development ramifications may not out weight the short term airborne transmission protection benefits. With recent improvements in drug therapies and the reduced rates of death have given insights that short and long term human factors of the face mask needs another look.
As Designers we must focus on the best solutions possible with due consideration of personal and dense population areas that requirements of compelling adults and children to wear a respirator mask and the life long development challenges need to be considered into the government and local PPE or mask policies. The government agencies working together have the responsibility to protect the mass population with personal protection is the major challenge. We have learned one size does not fit all. The human factors of long term use of a mask considering “User comfort” considering comfort defined as the physiological and psychological needs inherent in the human to human with a respirator interface and need for more better product design solutions for children, inventors. Industrial Designers sensitive to better PPE are needed more than ever.
Mask’s off!