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<div>In a pandemic, most people will move around, and many will want to use some kind of mask, anything that makes them feel they’re doing the best they can to protect themselves and their loved ones and their communities. If there are not enough high-tech masks (which will be the rule all over the World), then what is the best practical thing?
== Influenza H1N1 (Swine Flu), Avian Flu, and flu pandemic ==
Public health officials have been concerned about the risk of another pandemic influenza.
Recent concerns about the spread of H1N1 have increased interest in making facemasks available to large numbers of the general population. Face masks can reduce the spread of airborne disease but may not be readily available to everyone in the event of an outbreak or pandemic. The World Health Organization (WHO) has advised that people handling birds during a bird flu epidemic should cover their mouths with a cloth if a facemask is not available. <ref>[http://www.wpro.who.int/NR/rdonlyres/04FA6993-8CD1-4B72-ACB9-EB0EBD3D0CB1/0/Advice10022004rev08112004.pdf  Advice for people living in areas affected by bird flu or avian
influenza] 8 November 2004</ref>


It boils down to (self)education: the mask not as a prevent-all but as one more element in the slow-down strategy, together with hand-hygiene, social distance, asynchronous transfer, etc. A handful of memes, possibly in an educational package.
== Home-made Mask Studies ==
Studies have evaluated the effectiveness of different homemade masks. While'' none of these are as effective as a commercially designed face mask'', they all offer some protection when other options are not available.


If, say, 50% of people in a community contribute to slowing down transmission, we would be better off. The value of the slow-down strategy is easily explained: at any one time there would be more healthy people taking care of less ill. This would be useful whatever the CFR may be.
==="Home-Made Mask" (Tea cloth)===
Evaluation of effectiveness of three masks; a home-made mask made from a tea cloth, a surgical mask, and Filter Facepiece Against Particles (FFP2). Subjects performed a variety of different physical actions.  Study included both adults and children. <ref>[http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2440799&blobtype=pdf  Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population
Marianne van der Sande1, Peter Teunis1, Rob Sabel] </ref>


Quite possibly, having something ''sensible'' you ''can'' do is also valuable.
'''Effectiveness'''
*FFP2 provided 50 times as much protection as home-made mask.
*Surgical mask provided 25 times as much protection as home-made mask.


== Resource Articles ==
'''Limitations'''
[http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2440799&blobtype=pdf Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population]
*"Masks worn by patients may not offer as great a degree of protection against aerosol transmission."
Marianne van der Sande1, Peter Teunis1, Rob Sabel] “Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence, personal respirators providing most protection. Masks worn by patients may not offer as great a degree of protection against aerosol transmission.
*Children were less protected.
*Better at "inward protection"


[http://www.cdc.gov/ncidod/dvrd/spb/mnpages/vhfmanual/section4.htm "Infection Control for Viral Haemorrhagic Fevers In the African Health Care Setting"]
==="Simple Respiratory Mask" (8 layer t-shirt)===
A home-made mask using eight layers of 2-ply t-shirt was tested for effectiveness and fit against a N95 mask.  <ref>[http://www.cdc.gov/ncidod/EID/vol12no06/05-1468.htm Dato VM, Hostler D, Hahn ME. Simple respiratory mask.] Emerg Infect Dis,  2006 Jun</ref>


[http://www.cdc.gov/ncidod/EID/vol12no06/05-1468.htm  Dato VM, Hostler D, Hahn ME. Simple respiratory mask. Emerg Infect Dis,  2006 Jun] ‘We showed that a hand-fashioned mask can provide a good fit and a measurable level of protection from a challenge aerosol. Problems remain. When made by naive users, this mask may be less effective because of variations in material, assembly, facial structure, cultural practices, and handling. No easy, definitive, and affordable test can demonstrate effectiveness before each use. Wearers may find the mask uncomfortable.”
'''Effectiveness'''
*N95 masks requires fit factor of 100, this mask had a fit factor of 67
*"offered substantial protection from the challenge aerosol and showed good fit with minimal leakage."


'''Limitations'''
*May be less effective when made by naïve users
*May be uncomfortable
* "No easy, definitive, and affordable test can demonstrate effectiveness before each use.”


There’s [http://www.cdc.gov/ncidod/EID/vol12no06/05-1468.htm http://www.cdc.gov/ncidod/EID/vol12no06/05-1468.htm] which gave birth to this page. How can we improve on this?
===1 or 2 layer T-shirt or cravat===
Animals exposed to the bioterrorism agents Ricin and Saxitoxin were more likely than control animals to survive when protected with one or two layer t-shirt or cravat. <ref>[http://www.regionsem.org/~trjoing/papers/123456/clr/Slides%20with%20Notes/Biological%20Warfare%20&%20Bioterrorism.pdf Biological Warfare and Terrorism: Recognition, Protection, and Treatment.] Darling RG, See pages 47-48.</ref>


We can focus on:
== Other studies and links ==
[http://www.cdc.gov/ncidod/dvrd/spb/mnpages/vhfmanual/section4.htm Infection Control for Viral Haemorrhagic Fevers In the African Health Care Setting] "If surgical masks are not available, use cotton masks made from four or five layers of cotton cloth sewn together. Use a different colour for each side of the mask. This will help health care workers quickly identify which side should be worn inside."
[http://www.nih.go.jp/JJID/59/179. Masks for Influenza Patients: Measurement of Airflow from the Mouth INOUYE SAKAE et. al. Jpn J Infect Dis 59, 3, 179-181 (2006)] A study of the effectiveness of three simple commercially available (in Japan) face masks to reduce air speed of coughing and blowing. All masks, including a 16-ply, 10.7 g weight cotton mask reduced air speed of cough to less than 1/10.


* information about usefulness: such as [http://www.nih.go.jp/JJID/59/179.pdf this].
== References ==
* design
<references/>


** better filters
== Fluwiki Links ==
** better fit
* [http://www.fluwikie.com/pmwiki.php?n=Consequences.PersonalHygiene#masks Masks on fluwikie]
** ways to messure performance
* [http://www.fluwikie2.com/pmwiki.php?n=Forum.CooperativeThinkingSimpleMasks Fluwikie forum thread to discuss this issue]
 
* [http://members.optusnet.com.au/charles57/Creative/index2.html Tools to get creative!]
* acceptability issues
* [http://www.instructables.org how to make them] and [http://www.instructables.com/ex/i/2F8D43D27C881028A786001143E7E506/ more specific instructables]
* [http://www.instructables.org/ how to use them]
* distribution of masks themselves, the know-how, and the whole ''handful of memes''
* …


== Comments ==
== Comments ==
I once saw a recommendation for a “home-made” mask made out of Indian saree silk. That is silk which is very thin, extremely tightly woven and easy flowing. You can probably get hold of a few yards at the nearest Indian tailor or cloth shop. The description, if I remember correctly, was to fold it until you have 8 layers, then shape in a form that covers mouth and nose. It is nowhere near the quality of an N95 mask, but it is washable and cheap.
I once saw a recommendation for a “home-made” mask made out of Indian saree silk. That is silk which is very thin, extremely tightly woven and easy flowing. You can probably get hold of a few yards at the nearest Indian tailor or cloth shop. The description, if I remember correctly, was to fold it until you have 8 layers, then shape in a form that covers mouth and nose. It is nowhere near the quality of an N95 mask, but it is washable and cheap.
== Links ==
* [http://www.fluwikie.com/pmwiki.php?n=Consequences.PersonalHygiene#masks Masks on fluwikie]
* [http://www.fluwikie2.com/pmwiki.php?n=Forum.CooperativeThinkingSimpleMasks Fluwikie forum thread to discuss this issue]
* [http://members.optusnet.com.au/charles57/Creative/index2.html Tools to get creative!]</div>
:''This page was taken from [http://www.fluwikie.com/pmwiki.php?n=Brainstorming.SimpleMasks Simple Masks] on the Flu Wiki.''


[[Category:Flu pandemic]]
[[Category:Flu pandemic]]
[[Category:Hygiene]]
[[Category:Hygiene]]

Revision as of 17:20, 2 May 2009

Influenza H1N1 (Swine Flu), Avian Flu, and flu pandemic

Public health officials have been concerned about the risk of another pandemic influenza. Recent concerns about the spread of H1N1 have increased interest in making facemasks available to large numbers of the general population. Face masks can reduce the spread of airborne disease but may not be readily available to everyone in the event of an outbreak or pandemic. The World Health Organization (WHO) has advised that people handling birds during a bird flu epidemic should cover their mouths with a cloth if a facemask is not available. [1]

Home-made Mask Studies

Studies have evaluated the effectiveness of different homemade masks. While none of these are as effective as a commercially designed face mask, they all offer some protection when other options are not available.

"Home-Made Mask" (Tea cloth)

Evaluation of effectiveness of three masks; a home-made mask made from a tea cloth, a surgical mask, and Filter Facepiece Against Particles (FFP2). Subjects performed a variety of different physical actions. Study included both adults and children. [2]

Effectiveness

  • FFP2 provided 50 times as much protection as home-made mask.
  • Surgical mask provided 25 times as much protection as home-made mask.

Limitations

  • "Masks worn by patients may not offer as great a degree of protection against aerosol transmission."
  • Children were less protected.
  • Better at "inward protection"

"Simple Respiratory Mask" (8 layer t-shirt)

A home-made mask using eight layers of 2-ply t-shirt was tested for effectiveness and fit against a N95 mask. [3]

Effectiveness

  • N95 masks requires fit factor of 100, this mask had a fit factor of 67
  • "offered substantial protection from the challenge aerosol and showed good fit with minimal leakage."

Limitations

  • May be less effective when made by naïve users
  • May be uncomfortable
  • "No easy, definitive, and affordable test can demonstrate effectiveness before each use.”

1 or 2 layer T-shirt or cravat

Animals exposed to the bioterrorism agents Ricin and Saxitoxin were more likely than control animals to survive when protected with one or two layer t-shirt or cravat. [4]

Other studies and links

Infection Control for Viral Haemorrhagic Fevers In the African Health Care Setting "If surgical masks are not available, use cotton masks made from four or five layers of cotton cloth sewn together. Use a different colour for each side of the mask. This will help health care workers quickly identify which side should be worn inside."

Masks for Influenza Patients: Measurement of Airflow from the Mouth INOUYE SAKAE et. al. Jpn J Infect Dis 59, 3, 179-181 (2006) A study of the effectiveness of three simple commercially available (in Japan) face masks to reduce air speed of coughing and blowing. All masks, including a 16-ply, 10.7 g weight cotton mask reduced air speed of cough to less than 1/10.

References

  1. [http://www.wpro.who.int/NR/rdonlyres/04FA6993-8CD1-4B72-ACB9-EB0EBD3D0CB1/0/Advice10022004rev08112004.pdf Advice for people living in areas affected by bird flu or avian influenza] 8 November 2004
  2. [http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2440799&blobtype=pdf Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population Marianne van der Sande1, Peter Teunis1, Rob Sabel]
  3. Dato VM, Hostler D, Hahn ME. Simple respiratory mask. Emerg Infect Dis, 2006 Jun
  4. Biological Warfare and Terrorism: Recognition, Protection, and Treatment. Darling RG, See pages 47-48.

Fluwiki Links

Comments

I once saw a recommendation for a “home-made” mask made out of Indian saree silk. That is silk which is very thin, extremely tightly woven and easy flowing. You can probably get hold of a few yards at the nearest Indian tailor or cloth shop. The description, if I remember correctly, was to fold it until you have 8 layers, then shape in a form that covers mouth and nose. It is nowhere near the quality of an N95 mask, but it is washable and cheap.

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